1889-CHS FOUNDATION INC: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- 1889-CHS FOUNDATION INC (EIN 23-2801799)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-02-10
- IRS object ID
- 201110419349300916
- 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 | 2011-02-10T11:22:32-06:00 | 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 | Carbis Walker LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5700 Corporate Drive Ste 650 | AddressLine1 |
| City | Pittsburgh | City |
| State | PA | State |
| ZIP Code | 15237 | 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 | 232801799 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CONEMAUGH HEALTH SYSTEM INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CONE | NameControl |
| Phone | 8144108271 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1086 FRANKLIN STREET | AddressLine1 |
| City | JOHNSTOWN | City |
| State | PA | State |
| ZIP Code | 15905 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | EDWARD DEPASQUALE | Name |
| Title | CHIEF FINANCIAL OFFICER | Title |
| Phone | 8144105271 | Phone |
| Date Signed | 2011-02-08 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Jeffrey J Petrell CPA | Name |
| Phone | 4126356270 | 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 | Scott Becker | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1086 FRANKLIN STREET | AddressLine1 |
| City | JOHNSTOWN | City |
| State | PA | State |
| ZIP Code | 15905 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 6973114 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.conemaugh.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1994 | YearFormation |
| State Legal Domicile | PA | StateLegalDomicile |
| Activity Or Mission Description | TO SUPPORT MEMBER HOSPITALS WITHIN THE CONEMAUGH HEALTH SYSTEM AND PROVIDE COMMUNITY BENEFIT | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 16 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 9 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 6743809 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 6971063 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 3431 | InvestmentIncomePriorYear |
| Investment Income Current Year | 602 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 589899 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1449 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 7337139 | TotalRevenuePriorYear |
| Total Revenue Current Year | 6973114 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 5184477 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 5111026 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 2152662 | OtherExpensePriorYear |
| Other Expenses Current Year | 1862088 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 7337139 | TotalExpensesPriorYear |
| Total Expenses Current Year | 6973114 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 0 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 0 | RevenuesLessExpensesCY |
| Total Assets BOY | 4776566 | TotalAssetsBOY |
| Total Assets EOY | 5195610 | TotalAssetsEOY |
| Total Liabilities BOY | 2808118 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 3149851 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 1968448 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 2045759 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO SUPPORT MEMBER HOSPITALS WITHIN THE CONEMAUGH HEALTH SYSTEM AND PROVIDE COMMUNITY BENEFIT SERVICES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 5724693 | Expense |
| Revenue | 6971063 | Revenue |
| Description | Conemaugh Health System (CHS) serves a seven county region and supports five healthcare entities that provide medical care to protect the health and welfare of all patients. This includes providing opportunities to restore, reclaim or aid persons experiencing physical, cognitive, mental or emotional disabilities. CHS is committed to providing community health education and public awareness to the communities it serves. CHS sponsors free health screenings and free health education seminars. A monthly calendar is published in newspapers throughout the region inviting the community to attend free informational and support sessions catering to all age and demographic groups. CHS offers more than 15 support groups to provide education, networking and open forums on numerous topics including diabetes, epilepsy, stroke and suicide. Conemaugh Health System sponsored the following free screenings throughout fiscal year 2010: various healthy heart and weight management screenings as well as prostate and osteoporosis screenings. CHS also had community health fairs as follows: a heart month community health fair was held that included free screenings, speakers and health related information; a brain injury awareness health fair; a Cribs for Kids awareness program; and a free car seat check. In addition to these specific community events, contributions and event sponsorships for not for profit organizations and community groups occurred throughout the year.Memorial Medical Center, in Johnstown, Cambria County, is the flagship hospital of the Conemaugh Health System. Memorial is a regional referral hospital known for clinical excellence and offers the only Level One Regional Resource Trauma Center between Pittsburgh and Harrisburg. In addition, Memorial houses a Level III (highest level) neo-natal intensive care unit and nationally ranked programs in orthopedics, maternity, vascular, critical care, pulmonary care, neurosurgery and cardiac care. Memorial Medical Center's Lee Campus serves as a hub for outpatient care including the Lee Ambulatory Surgery Center, the Conemaugh Diabetes Institute, and numerous diagnostic and treatment options. Miners Medical Center is a 30-bed, state-of-the-art community hospital serving families across rural northern Cambria County. Meyersdale Medical Center, serving a rural area in Somerset County, is a state-designated Critical Care Access Hospital specializing in family and primary care. Good Samaritan Medical Center provides the region with a nursing care center. CHS also includes the 110+ physicians of Conemaugh Physician Group with practice office locations in Cambria, Somerset, Bedford, Indiana and Westmorland Counties.The Conemaugh Health System is an active member of the community and an advocate for the health, well being and economic strength of the region. CHS administrators have teamed up with the United Way of the Laurel Highlands over the past few years to work to identify and prioritize programs and services that can best impact the most significant needs of the community (Cambria and Somerset County). CHS and the United Way are now collecting data for a 2011 Community Needs analysis, which will be presented and distributed broadly. CHS and the United Way have also committed to monitoring the impact of programming in priority areas and reallocating resources to drive results. | Description |
| Total Program Service Expense | 5724693 | 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 | 1 | 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 | 1 | 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 | 0 | NumberOfEmployees |
| 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 | 16 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | 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 | 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 | 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 | EDWARD DEPASQUALE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8144108271 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1086 FRANKLIN STREET | AddressLine1 |
| City | JOHNSTOWN | City |
| State | PA | State |
| ZIP Code | 15905 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (22 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 |
|---|---|---|---|---|---|---|---|
| Judge Norman Krumenacker | |||||||
| Chairman | 2.00 | X | X | 0 | 0 | 0 | |
| James Hargreaves | |||||||
| Vice Chairman | 2.00 | X | X | 0 | 0 | 0 | |
| Samuel McClure | |||||||
| Treasurer | 2.00 | X | X | 0 | 0 | 0 | |
| Ron Vickroy | |||||||
| Secretary | 2.00 | X | X | 0 | 0 | 0 | |
| Kristin Brant md | |||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | ||
| James Cascio | |||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | ||
| Kim Craig | |||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | ||
| Robert A Gleason JR | |||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | ||
| aDIB kHOUZAMI MD | |||||||
| TRUstee | 2.00 | X | 0 | 1054875 | 33133 | ||
| BRIAN LIEB DO | |||||||
| TRUStee | 2.00 | X | 0 | 168170 | 28155 | ||
| Tom Marino | |||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | ||
| Roberta Ream | |||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | ||
| Sally sargent | |||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | ||
| jOHN sARACENA cpa | |||||||
| TRUStee | 2.00 | X | 0 | 0 | 0 | ||
| mICHAEL sMITH | |||||||
| tRUSTee | 2.00 | X | 0 | 0 | 0 | ||
| sCOTT bECKER | |||||||
| CHIEF EXECUTIVE OFFICER | 50.00 | X | X | 729874 | 0 | 121059 | |
| dAVID CARLSON dO | |||||||
| CHIEF MEDICAL OFFICER | 50.00 | X | 461690 | 0 | 84037 | ||
| EDWARD DEPASQUALE | |||||||
| CHIEF FINANCIAL OFFICER | 50.00 | X | 360649 | 0 | 72054 | ||
| JOSEPH DADO | |||||||
| CHIEF INFORMATION OFFICE | 50.00 | X | 287371 | 0 | 58390 | ||
| maRY YORK | |||||||
| chief learning OFFICER | 50.00 | X | 198954 | 0 | 34198 | ||
| John Moryken | |||||||
| VP Marketing/Communicati | 40.00 | X | 232208 | 0 | 47905 | ||
| Louis Sciullo | |||||||
| VP Special projects | 40.00 | 150890 | 0 | 21335 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2421636 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1223045 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 500266 | TotalOtherCompensation |
| Number Individuals GT100 K | 8 | 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 |
|---|---|---|---|---|---|
| BKD LLP | |||||
| PO Box 1178 | louisville | KY | 40201 | Accounting Services | 313820 |
| Numerof & Associates | |||||
| Four City Place Drive Suite 430 | st louis | MO | 63141 | consulting services | 146753 |
| yaffe & co inc | |||||
| 49 washington ave suite 700 | towson | MD | 21204 | consulting services | 116740 |
| buck consultants | |||||
| dept ch4061 | palatine | IL | 60053 | consulting services | 107000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Management Fees | Description |
| Business Code | 561000 | BusinessCode |
| Total Revenue Column | 6971063 | TotalRevenueColumn |
| Related Or Exempt Function Income | 6971063 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 6971063 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 602 | TotalRevenueColumn |
| Exclusion | $602 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | INTEREST-OFFICER LOAN | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 1449 | TotalRevenueColumn |
| Exclusion | $1,449 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1449 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6973114 | TotalRevenueColumn |
| Related Or Exempt Function Income | 6971063 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $2,051 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2954277 | Total |
| Program Services | 2836106 | ProgramServices |
| Management And General | 118171 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1133866 | Total |
| Program Services | 433687 | ProgramServices |
| Management And General | 700179 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28975 | Total |
| Program Services | 11287 | ProgramServices |
| Management And General | 17688 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 993908 | Total |
| Program Services | 794886 | ProgramServices |
| Management And General | 199022 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 355394 | Total |
| Program Services | 355394 | ProgramServices |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 433037 | Total |
| Program Services | 433037 | ProgramServices |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 405204 | Total |
| Program Services | 349469 | ProgramServices |
| Management And General | 55735 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 196209 | Total |
| Program Services | 196209 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 63409 | Total |
| Program Services | 36594 | ProgramServices |
| Management And General | 26815 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 107488 | Total |
| Program Services | 55337 | ProgramServices |
| Management And General | 52151 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34021 | Total |
| Program Services | 33435 | ProgramServices |
| Management And General | 586 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 59650 | Total |
| Program Services | 45996 | ProgramServices |
| Management And General | 13654 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10707 | Total |
| Program Services | 6825 | ProgramServices |
| Management And General | 3882 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Dues & Subscriptions | 97157 | 40893 | 56264 |
| Miscellaneous | 58913 | 58643 | 270 |
| Purchased Services | 40899 | 36895 | 4004 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6973114 | Total |
| Program Services | 5724693 | ProgramServices |
| Management And General | 1248421 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5139 | BOY |
| EOY | 118448 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1258400 | BOY |
| EOY | 1052489 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23897 | BOY |
| EOY | 13771 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 214731 | BOY |
| EOY | 192740 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 181152 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 163121 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28738 | BOY |
| EOY | 18031 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3245661 | BOY |
| EOY | 3800131 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4776566 | BOY |
| EOY | 5195610 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1599860 | BOY |
| EOY | 1521895 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 503229 | BOY |
| EOY | 508623 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 705029 | BOY |
| EOY | 1119333 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2808118 | BOY |
| EOY | 3149851 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1968448 | BOY |
| EOY | 2045759 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1968448 | BOY |
| EOY | 2045759 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4776566 | BOY |
| EOY | 5195610 | 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) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Written IRS Determination | X | WrittenIRSDetermination |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation (5 entries)
| EINEIN | Type Of OrganizationTypeOfOrganization | Listed In Governing DocListedInGoverningDoc | Supported Organization NotifiedSupportedOrganizationNotified | Organized In USOrganizedInUS | AmountAmount |
|---|---|---|---|---|---|
| Meyersdale Medical Center | |||||
| 251002946 | 3 | 0 | 1 | 1 | $13,800 |
| Conemaugh Valley Memorial Hospital | |||||
| 250965307 | 3 | 0 | 0 | 1 | $0 |
| Miners Medical Center | |||||
| 250977902 | 3 | 0 | 0 | 1 | $0 |
| Good Samaritan Medical Center | |||||
| 250965428 | 3 | 0 | 0 | 1 | $0 |
| Conemaugh Health Foundation | |||||
| 251719695 | 11 | 0 | 0 | 1 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 5 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 13800 | SumOfAmounts |
Schedule D IRS990ScheduleD
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 181152 | OtherCostOrOtherBasis |
| Depreciation | 163121 | Depreciation |
| Book Value | 18031 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 18031 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (4 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Henry M Jackson Post Polio Grant Account | 508621 |
| Investment in PHHP | 7500 |
| Investment in RRG | 2164677 |
| 457(f) deferred compensation contribution | 1119333 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 3800131 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | 457(f) Deferred Compensation contribution | Description |
| Amount | $1,119,333 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1119333 | TotalOfAmounts |
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 | FASB issued ASC Topic 740 clarifies the accounting for uncertainty in income taxes recognized in an entity's financial statements and prescribes a recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken, or expected to be taken in a tax return. Topic 740 also provides guidance on description, classification, interest and penalties, accounting in interim periods, disclosure and transition. Conemaugh Health System does not have any uncertain tax positions recognized for 2010 OR 2009. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 0 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| 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 | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | 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 | 1 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 1 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| aDIB kHOUZAMI MD | |||||||||||||
| 0 | 616808 | 0 | 401927 | 0 | 36140 | 0 | 21842 | 0 | 11291 | 0 | 1088008 | 0 | 0 |
| BRIAN LIEB DO | |||||||||||||
| 0 | 166886 | 0 | 624 | 0 | 660 | 0 | 15232 | 0 | 12923 | 0 | 196325 | 0 | 0 |
| sCOTT bECKER | |||||||||||||
| 543403 | 0 | 162478 | 0 | 23993 | 0 | 106507 | 0 | 14552 | 0 | 850933 | 0 | 0 | 0 |
| dAVID CARLSON dO | |||||||||||||
| 376835 | 0 | 76111 | 0 | 8744 | 0 | 69053 | 0 | 14984 | 0 | 545727 | 0 | 0 | 0 |
| EDWARD DEPASQUALE | |||||||||||||
| 280659 | 0 | 58583 | 0 | 21407 | 0 | 60840 | 0 | 11214 | 0 | 432703 | 0 | 0 | 0 |
| JOSEPH DADO | |||||||||||||
| 236268 | 0 | 47518 | 0 | 3585 | 0 | 48680 | 0 | 9710 | 0 | 345761 | 0 | 0 | 0 |
| maRY YORK | |||||||||||||
| 164715 | 0 | 32794 | 0 | 1445 | 0 | 24750 | 0 | 9448 | 0 | 233152 | 0 | 0 | 0 |
| John Moryken | |||||||||||||
| 190740 | 0 | 28921 | 0 | 12547 | 0 | 36054 | 0 | 11851 | 0 | 280113 | 0 | 0 | 0 |
| Louis Sciullo | |||||||||||||
| 135000 | 0 | 13416 | 0 | 2474 | 0 | 18972 | 0 | 2363 | 0 | 172225 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| Part I, Line 1a | Social club dues are paid for the organization's CEO. Under the oversight of the executive compensation committee, it has always been the organization's practice to pay these dues for the CEO as the social club is primarily used to benefit the organization. |
| Part I, Line 4a | Part I, Line 4B: The following individuals participated in supplemental nonqualified retirement plans. Amounts related to these plans, which are included in the deferred compensation shown, are: Scott Becker $92,650; David Carlson, DO $57,443; Edward DePasquale $44,214; John Moryken $21,342; Joseph Dado $35,863; Mary York $24,750; Louis Sciullo $11,184; and Brian Lieb, DO $1,667. |
| Part I, Line 6 | Executive bonuses are calculated as a percentage of base salary. The percentage is contingent on various financial and non-financial incentive criteria governed by the executive compensation committee of the board. Part I, Line 6B: ADIB Khouzami, MD and BRIAN Lieb, DO received bonuses from Conemaugh Health Initiatives, a related organization. Physician bonuses are calculated on a cash basis; taking total cash collections less all office operating, physician and overhead expenses. Any remaining amount is then distributed to the physician based on a contractual percentage and cap. Total physician compensation is annually checked for reasonableness against IRS guidelines. |
Schedule L IRS990ScheduleL
Loan Table LoanTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | David Carlson DO | NamePerson |
| Purpose Of Loan | Housing loan | PurposeOfLoan |
| Loan From Organization | X | LoanFromOrganization |
| Original Principal | $31,010 | OriginalPrincipalAmount |
| Balance Due | 13771 | BalanceDue |
| Default | 0 | Default |
| Approved By Board | 1 | ApprovedByBoard |
| Written Agreement | 1 | WrittenAgreement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 13771 | TotalBalanceDue |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Form 990, Part VI, Section B, line 11 | The Form 990 is provided to the organization's board of directors before it is filed. Once the form is complete, board members are given the opportunity to review the contents of the form and submit any comments or questions. In addition, the form is reviewed by the health system's manager, tax & compliance; director, financial operations; vice president, financial operations; chief financial officer; and the audit and compliance committee. An external CPA firm is engaged to review and electronically file the return. |
| Form 990, Part VI, Section B, line 12c | The organization and all subsidiaries is governed by a conflict of interest policy. Under this policy, every board member is given a copy of the policy as well as a form that must be completed on an annual basis. No board member is approved or re-appointed until he or she has completed and signed the conflict of interest form. Once the form is returned, it is reviewed by the CHS compliance officer and CEO. If any conflicts are disclosed, the details are forwarded to the board chair to be addressed. Depending on the conflict, the board member could be given certain restrictions, such as being prohibited from participating in certain board decisions. The CHS audit and compliance committee has the final decision-making regarding all conflicts of interest. Throughout the fiscal year, board members must notify the board chair, compliance officer, and/or ceo if a new conflict has developed. |
| Form 990, Part VI, Section B, line 15 | CHS manages the determination of compensation for its executives as well as the executives of all its subsidiares. The process is outlined in its by-laws. Two outside consulting firms are utilitized to ensure that executive compensation packages are fair and comparable with similar organizations. CHS has also established an executive compensation committee to review and recommend the compensation decisions made. This committee reports directly to the board. |
| Form 990, Part VI, Section C, line 19 | All requests for this information are handled by the CHS Marketing/Public Relations department. |
| Part XI, Line 2: The organization's financial statements for the fiscal year ending June 30, 2010 were audited as part of the audit of the consolidated financial statements of the Conemaugh health System, Inc. and subsidiaries. The health system's audit and compliance committee assumes responsibility for the oversight of the audit and the selection of the independent accountant. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|
| Good Samaritan Medical Center | ||||||||||
| 1020 Franklin Street | Johnstown | PA | 15905 | 250965428 | Health Care Services | PA | 501C(3) | 3 | N/A | |
| Conemaugh Valley Memorial Hospital DBA Memorial Medical Center | ||||||||||
| 1086 FRANKLIN STREET | JOHNSTOWN | PA | 15905 | 250965307 | HEALTH CARe Services | PA | 501C(3) | 3 | N/A | |
| MINERS HOSPITAL DBA MINERS MEDICAL CENTER | ||||||||||
| 290 HAIDA AVENUE | HASTINGS | PA | 16646 | 250977902 | Health Care Services | PA | 501C(3) | 3 | N/A | |
| meyersdale community hospital dba meyersdale medical center | ||||||||||
| 200 hospital drive | meyersdale | PA | 15552 | 251002946 | health Care Services | PA | 501C(3) | 3 | N/A | |
| conemaugh health foundation | ||||||||||
| 1086 franklin street | johnstown | PA | 15905 | 251719695 | supports conemaugh health system | PA | 501C(3) | 11b | N/A | |
| conemaugh housing inc | ||||||||||
| 1086 FRANKLIN STREET | johnstown | PA | 15905 | 251606936 | provides senior housing facilities | PA | 501C(3) | 9 | conemaugh valley memorial hospital | |
Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|---|---|---|---|---|---|---|
| laurel highlands advanced imaging | ||||||||||
| 1450 scalp avenue | johnstown | PA | 15904 | 251864587 | diagnostic services | PA | conemaugh valley memorial hospital | related | 0 | 0 |
| greater johnstown tech park | ||||||||||
| 1086 franklin street | johnstown | PA | 15905 | 260389121 | operates multi-tenant commerce office park | PA | conemaugh enterprises inc | unrelated | 0 | 0 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| conemaugh health initiatives | |||||||||
| 1086 franklin street | johnstown | PA | 15905 | 251658283 | physician services | PA | N/A | C | |
| conemaugh enterprises inc | |||||||||
| 1086 franklin street | johnstown | PA | 15905 | 202998473 | economic development | PA | C | Conemaugh Valley Memorial Hospital | |
| 1086 real estate | |||||||||
| 1086 franklin street | johnstown | PA | 15905 | 251489704 | real estate | PA | C | conemaugh health initiatives | |
| sindo inc | |||||||||
| 1086 franklin street | Johnstown | PA | 15905 | 251144116 | COMMUNITY RENTALS | PA | C | CONEMAUGH HEALTH FOUNDATION | |
| 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 | 1 | 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 | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CONEMAUGH HEALTH INITIATIVES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | P | TransactionType |
| Amount Involved | 807338 | AmountInvolved |