GOOD SHEPHERD SPECIALTY HOSPITAL: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- GOOD SHEPHERD SPECIALTY HOSPITAL (EIN 23-3009874)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-05-12
- IRS object ID
- 201111329349302981
- 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 | 2011-05-12T14:35:29-05:00 | 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 | 1650 Market Street Suite 4500 | AddressLine1 |
| City | Philadelphia | City |
| State | PA | State |
| ZIP Code | 19103 | 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 | 233009874 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ALLENTOWN SPECIALTY HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | ALLE | NameControl |
| Phone | 6107763303 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | GOOD SHEPHERD PLAZA 850 S 5TH ST | AddressLine1 |
| City | ALLENTOWN | City |
| State | PA | State |
| ZIP Code | 181033295 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Daniel C Confalone | Name |
| Title | SVP FINANCE/CFO | Title |
| Phone | 6107763303 | Phone |
| Date Signed | 2011-05-12 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Julius Green CPA | Name |
| Phone | 2159720701 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOOD SHEPHERD SPECIALTY HOSPITAL - A | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DANIEL C CONFALONE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | GOOD SHEPHERD PLAZA 850 S 5TH ST | AddressLine1 |
| City | ALLENTOWN | City |
| State | PA | State |
| ZIP Code | 181033295 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 17100691 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.GOODSHEPHERDREHAB.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1999 | YearFormation |
| State Legal Domicile | PA | StateLegalDomicile |
| Activity Or Mission Description | To enhance lives, maximize function, inspire hope, and promote dignity and well-being. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 1 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 2 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 2657 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 3587 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 16761447 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 17095117 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 224 | InvestmentIncomePriorYear |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 7621 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1987 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 16771949 | TotalRevenuePriorYear |
| Total Revenue Current Year | 17100691 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 6700685 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 6641489 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 8622945 | OtherExpensePriorYear |
| Other Expenses Current Year | 8435416 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 15323630 | TotalExpensesPriorYear |
| Total Expenses Current Year | 15076905 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1448319 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2023786 | RevenuesLessExpensesCY |
| Total Assets BOY | 8060190 | TotalAssetsBOY |
| Total Assets EOY | 10421625 | TotalAssetsEOY |
| Total Liabilities BOY | 754618 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1092267 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 7305572 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 9329358 | NetAssetsOrFundBalancesEOY |
| Mission Description | Good Shepherd's mission is: "Motivated by the divine Good Shepherd and the physical and cognitive rehabilitation needs of our communities, our mission is to enhance lives, maximize function, inspire hope, and promote dignity and well-being with expertise and compassion." | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 12480742 | Expense |
| Revenue | 17095117 | Revenue |
| Description | THE Good Shepherd Specialty Hospital - Allentown ("GSSH") is a 32-bed facility providing acute care for medically stable but complex patients who require long periods of hospitalization. GSSH was the first long-term acute care hospital in the Lehigh Valley region and was one of the first in the country to offer patient monitoring by tele-intensivists through state-of-the-art technology. GSSH's patients require extensive nursing care and are otherwise too ill to be discharged to home, a nursing facility, or an acute rehabilitation hospital. GSSH's major programs of service are the Complex Medical Program, Transitional Rehabilitation Program and the Pulmonary Ventilator Program, which typically exceeds national vent weaning averages by a large margin. In fiscal year 2010, GSSH discharged a total of 394 inpatients and had 10,460 total patient days. | Description |
| Total Program Service Expense | 12480742 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | 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 | 1 | 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 | 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 | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 1 | 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 | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | 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 |
| States Where Copy Of Return Is Filed | FL | StatesWhereCopyOfReturnIsFiled |
| States Where Copy Of Return Is Filed | MN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DANIEL C CONFALONE SVP FINANCECFO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6107763303 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | GOOD SHEPHERD PLAZA 850 SOUTH 5TH | AddressLine1 |
| City | ALLENTOWN | City |
| State | PA | State |
| ZIP Code | 181033295 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (9 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| SARA T GAMMON | ||||||||
| CHAIR/PRESIDENT/CEO | 8.00 | X | X | 0 | 528036 | 77250 | ||
| DANIEL C CONFALONE | ||||||||
| SEC./TREAS./SVP FINANCE/CFO | 15.00 | X | X | 0 | 292027 | 51448 | ||
| PHILLIP R BRYANT | ||||||||
| CMO | 1.50 | X | 0 | 357696 | 65619 | X | ||
| SAMUEL A MIRANDA JR | ||||||||
| VICE CHAIR/CNO | 5.00 | X | 0 | 201924 | 58275 | X | ||
| clinton C Holumzer | ||||||||
| Trustee/Medical Director | 1.00 | X | 0 | 18812 | 0 | |||
| SUSAN L LAWRENCE | ||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |||
| Lisa Marsilio | ||||||||
| Administrator | 40.00 | X | 99911 | 0 | 20484 | |||
| Anthony R Bongiovanni | ||||||||
| CPO | 15.00 | 0 | 245295 | 58166 | X | |||
| Tamatha J Urffer | ||||||||
| registered nurse | 40.00 | 114733 | 0 | 18396 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 214644 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1643790 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 349638 | 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 (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| LEHIGH VALLEY HOSPITAL | |||||
| CEDAR CREST I-78 | ALLENTOWN | PA | 18103 | MEDICAL SERVICES | 1317421 |
| HEALTH NETWORK LABS | |||||
| 2024 LEHIGH STREET | ALLENTOWN | PA | 18103 | LABORATORY SERVICES | 354438 |
| SODEXHO OPERATIONS LLC | |||||
| 4880 PAYSPHERE CIRCLE | CHICAGO | IL | 60674 | DIETARY/FOOD SERVICES | 261452 |
| CROTHALL HEALTHCARE INC | |||||
| 1200 SOUTH CEDAR CREST BLVD | ALLENTOWN | PA | 18103 | HOUSEKEEPING SERVICES | 150115 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| Related Organizations | 3587 | RelatedOrganizations |
| Total Contributions | 3587 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SVC REV | Description |
| Business Code | 623000 | BusinessCode |
| Total Revenue Column | 17095117 | TotalRevenueColumn |
| Related Or Exempt Function Income | 17095117 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 17095117 | TotalProgramServiceRevenue |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MEDICAL RCRDS ABSTRACT | Description |
| Business Code | 561439 | BusinessCode |
| Total Revenue Column | 1987 | TotalRevenueColumn |
| Exclusion | $1,987 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1987 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 17100691 | TotalRevenueColumn |
| Related Or Exempt Function Income | 17095117 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $1,987 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 120395 | Total |
| Management And General | 120395 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5120718 | Total |
| Program Services | 4636370 | ProgramServices |
| Management And General | 484348 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 340933 | Total |
| Program Services | 302778 | ProgramServices |
| Management And General | 38155 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 676553 | Total |
| Program Services | 617518 | ProgramServices |
| Management And General | 59035 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 382890 | Total |
| Program Services | 339601 | ProgramServices |
| Management And General | 43289 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1388790 | Total |
| Program Services | 1388723 | ProgramServices |
| Management And General | 67 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1825278 | Total |
| Program Services | 1803409 | ProgramServices |
| Management And General | 21869 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 686429 | Total |
| Management And General | 686429 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13732 | Total |
| Program Services | 267 | ProgramServices |
| Management And General | 13465 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 207194 | Total |
| Program Services | 207194 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| CORPORATE ALLOCATION | 3882880 | 2795674 | 1087206 |
| Bad debt expense | 224528 | 224528 | |
| FOOD | 156637 | 154805 | 1832 |
| REPAIRS & MAINTENANCE | 21968 | 4619 | 17349 |
| INSPECTIONS & LICENSES | 14563 | 3600 | 10963 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13417 | Total |
| Program Services | 1656 | ProgramServices |
| Management And General | 11761 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15076905 | Total |
| Program Services | 12480742 | ProgramServices |
| Management And General | 2596163 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2541413 | BOY |
| EOY | 2954558 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 90596 | BOY |
| EOY | 76507 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 2074636 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1172541 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 903398 | BOY |
| EOY | 902095 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4524783 | BOY |
| EOY | 6488465 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8060190 | BOY |
| EOY | 10421625 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 368133 | BOY |
| EOY | 454511 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 386485 | BOY |
| EOY | 637756 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 754618 | BOY |
| EOY | 1092267 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7305572 | BOY |
| EOY | 9329358 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7305572 | BOY |
| EOY | 9329358 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8060190 | BOY |
| EOY | 10421625 | 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) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $514 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 514 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part II-B, Line 1i: | Identifier |
| Return Reference | Explanation of Other Lobbying Activities: | ReturnReference |
| Explanation | The Allentown Specialty Hospital, Inc. had lobbying expenditures through a certain percentage of membership fees paid to the National Association of Long Term Hospitals (NALTH) during the fiscal year ending June 30, 2010. $514 was the portion of the membership fees that were deemed to be used towards lobbying. | Explanation |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 190277 | OtherCostOrOtherBasis |
| Depreciation | 113504 | Depreciation |
| Book Value | 76773 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1884359 | OtherCostOrOtherBasis |
| Depreciation | 1059037 | Depreciation |
| Book Value | 825322 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 902095 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | AMOUNTS DUE FROM AFFILIATES | Description |
| Book Value | 6488465 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 6488465 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | Description |
| Amount | $637,756 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 637756 | TotalOfAmounts |
| Total Revenue | 17100691 | TotalRevenue |
| Total Expenses | 15076905 | TotalExpenses |
| Excess Or Deficit For Year | 2023786 | ExcessOrDeficitForYear |
| Total Adjustments | 0 | TotalAdjustments |
| Excess Or Deficit Per FS | 2023786 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 17100691 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 17100691 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 17100691 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 15076905 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 15076905 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 15076905 | 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 | GOOD SHEPHERD PRESCRIBES A ROCOGNITION 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 UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. GOOD SHEPHERD'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN OPERATING EXPENSES. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13800 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 13800 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13800 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 13800 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 65814 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 65814 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00440 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 65814 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 65814 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00440 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 79614 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 79614 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00530 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $13,150 | BadDebtExpenseAmount |
| Amount Attributable To | 1315 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 8288583 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 9562781 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -1274198 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ALLENTOWN SPECIALTY HOSPITAL INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 850 South 5th Street | AddressLine1 |
| City | Allentown | City |
| State | PA | State |
| ZIP Code | 181033295 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| Other | LONG-TERM ACUTE CARE Hospital | Other |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Income Based Criteria | Part I, Line 3c: Good Shepherd Long-Term Acute Services, Inc., d/b/a Good Shepherd Specialty Hospital (the Specialty Hospital) has a written charity care policy. All patients are notified of Good Shepherd's charity care availability prior to the start of their care. Generally, patients automatically qualify under the Specialty Hospital's charity care policy if their income is less than 200% of the current Federal Poverty Guidelines. However, other factors are also used to determine eligibility including:-Sources of income-Living expenses-Other personal assets and liabilities-Demographic information-Ongoing healthcare needsQualification under the Specialty Hospital's charity care policy entitles patients to completely free care. The Specialty Hospital does not offer a program of discounted care. The Specialty Hospital's policy also provides for charity care for certain patients under unique circumstances. These circumstances include patients who may experience significant financial hardship or personal financial loss regardless of their income, including patients who may be classified as "medically indigent". These unique circumstances are reviewed by Administration, pursuant to policy. The Good Shepherd audited financial statements provide the following disclosures with respect to charity care:"Good Shepherd provides a significant amount of charity care to patients who meet certain criteria regardless of their ability to pay. The criteria for charity considers family size, sources of income, living expenses, net worth, ongoing healthcare needs, as well as other pertinent information. Because Good Shepherd does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenues. The amount of charity care provided to patients for the years ended June 30, 2010 and 2009, measured at charges, was $1,696,000 and $2,026,000, respectively.""These amounts do not include doubtful accounts. In August 2010, the FASB issued Accounting Standards Update No. 2010-23, Health Care Entities: Measuring Charity Care for Disclosure ("ASU 2010-23"). ASU 2010-23 requires that direct and indirect costs be used as the measurement for charity care disclosure purposes. The guidance was also amended to require disclosure of the method used to identify or determine such costs. ASC 2010-23 is effective for fiscal years beginning December 15, 2010. Adoption of ASC 2010-23 will result in revised disclosures in the notes to Good Shepherd's consolidated financial statements but will not impact amounts reported in the consolidated financial statements." | IncomeBasedCriteria |
| Annual Community Benefit Expln | Part I, Line 6a: The Specialty Hospital's community benefit activities are included within and reported as part of an annual Report to the Community, published on a consolidated basis by Good Shepherd Rehabilitation Network (GSRN). This report includes the community benefit activities provided by GSRN, as well as by its controlled entities (including the Specialty Hospital). This report is distributed and made available to the public in several manners, including being available on the GSRN website. A community benefit report is not required to be filed with the Commonwealth of Pennsylvania and, accordingly, GSRN has not filed one.In order to better understand the organizational, financial and operational complexities of the organizations contained within GSRN, the following information is provided:The Specialty Hospital's financial results are reported as a component of the consolidated audited financial statements of Good Shepherd Rehabilitation Network and Controlled Entities (Good Shepherd). Separate audited financial statements are not prepared for the Specialty Hospital. The consolidated audited financial statements of Good Shepherd include the following corporations:-Good Shepherd Rehabilitation Network (GSRN), the controlling parent corporation, formerly Good Shepherd Home-Good Shepherd Rehabilitation Hospital (the Hospital)-Good Shepherd Home Long-Term Care Facility, Inc. (LTC)-Good Shepherd Workshop/Vocational Services, Inc. (Work Services)-Good Shepherd Long-Term Acute Services, Inc., d/b/a Good Shepherd Specialty Hospital (the Specialty Hospital)-Good Shepherd Housing Development Corporation (SuppIL)-Good Shepherd Reciprocal Risk Retention Group (the RRG)-Good Shepherd Group, LLC (GS Group)Good Shepherd's primary operations are conducted within the Hospital, which provides comprehensive inpatient rehabilitation services and outpatient rehabilitation services at numerous locations. The LTC operates two skilled nursing facilities which service the needs of severely disabled adults. Work Services specializes in employment and development programs for persons with physical, emotional and intellectual disabilities, hearing and sight impairments and industrial injuries by providing subcontracting services. The Specialty Hospital provides services that represent the first step in the post acute care process of recovery. The RRG is a self insurance company that provides primary liability insurance and risk management services. SuppIL provides supportive independent housing to persons with disabilities under section 811 of the Department of Housing and Urban Development. GS Group was established to develop a wheelchair device to assist rehabilitation patients.In addition to the organizations described above, in January 2007, GSRN entered into a joint venture agreement with the Trustees of the University of Pennsylvania (the University) to create Philadelphia Post Acute Partners, LLC d/b/a Good Shepherd Penn Partners (GSPP). GSPP was created to establish and operate a new long-term acute care hospital, to assume the ownership of and continue to operate all of the outpatient operations of the University, to carry out the day-to-day operations of the Hospital of the University of Pennsylvania's (HUP's) inpatient rehabilitation unit, and to provide the University and its affiliates with certain clinical and/or staffing services relating to rehabilitation. GSRN is a 70% owner of GSPP; however, the operations of GSPP are not consolidated within the consolidated financial statements of Good Shepherd as GSRN is not deemed to have control over GSPP. As a result, GSRN records their investment in GSPP under the equity method of accounting within the GSRN consolidated financial statements. | AnnualCommunityBenefitExpln |
| Costing Method Used | Part I, Line 7: The Specialty Hospital used a cost-to-charge ratio in determining the figures reported in this table. This cost-to-charge ratio was derived from Worksheet 2 Ratio of Patient Care Cost-to Charges. | CostingMethodUsed |
| Percent Of Total Expense Expln | Part I, Line 7f: The amount of bad debt expense included on Form 990, Part IX, line 25, but subtracted for purposes of calculating the percentage in this column is $224,528. | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | Part III, Line 4: The following is the text of the footnote to Good Shepherd's audited financial statements (which contain the accounts of the Specialty Hospital) that describes bad debt expense:"Accounts receivable, patients are reported at net realizable value. Accounts are written-off when they are determined to be uncollectible based upon management's assessments of individual accounts. The allowance for doubtful collections is estimated based upon a periodic review of the accounts receivable aging, payor classifications, and application of historical write-off percentages."Bad debt expense is reported in the audited financial statement and is accounted for in accordance with Healthcare Financial Management Association Statement Number 15. In this connection, the amount recorded as bad debt expense is comprised of a combination of actual bad debt write-offs and recoveries, as well as an amount derived by applying estimated historical bad debt write-off percentages against aged accounts receivable balances. For purposes of Part III, Section A, line 2, total bad debt expense (at cost) was determined by applying the cost-to-charge ratio, derived from Worksheet 2 Ratio of Patient Care Cost-to Charges to total the net of actual bad debt write-off's and recoveries processed during the 2010 fiscal year. For purposes of Part III, Section A, line 3, the following process was used to estimate the amount of the Specialty Hospital's bad debt expense (at cost) attributable to patients eligible under the Specialty Hospital's charity care policy:Total bad debt expense (at cost), per Part III, Section A, line 2, was used as a starting point. Then, the estimated poverty percentage (10%), of the Specialty Hospital's 5-County primary service area, was determined based upon the examination of Commonwealth of Pennsylvania reports, generated from the most recently-published US Census data. | BadDebtFootnote |
| Shortfall As Community Benefit | Part III, Line 8: The costing methodology utilized in the determination of the Medicare allowable costs reported in the Specialty Hospital's Cost Report is quite comprehensive. Directly allocated costs are used as a starting point and other costs are stepped-down to the Specialty Hospital based upon industry-acceptable allocation methodologies. The Specialty Hospital has not reported a Medicare shortfall in Part III, Section B (Medicare), Line 7. Had there been a shortfall, it should be considered as a component of community benefit because the Specialty Hospital treats all medically necessary patients, regardless of their ability to pay and regardless of whether the expected reimbursement is adequate to cover all related and necessary expenses. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | Part III, Line 9b: The Specialty Hospital has a written Billing and Collection policy and such policy covers the procedures necessary to bill and collect for the medical services provided to patients. Patients known to qualify for financial assistance under the Specialty Hospital's charity care policy are not subject to the collection provisions of this policy. | DebtCollectionPolicy |
| General Explanation | Part II: While minimal community building activities are provided directly within the Specialty Hospital, GSRN, the Specialty Hospital's parent company, provided $35,238 of such activities during the 2010 fiscal year. These activities took the form of Executive and Government and Community Relations Board Memberships, participation in the Partnership for a Disability Friendly Community, AMRPA Board and United Way Board Memberships as well as various workforce development activities.The value of the community building activities provided during the 2010 fiscal year was determined based upon actual reported hours valued at the average salary and benefit rate per hour of all Good Shepherd employees. Conservatively, no application of indirect or overhead costs was applied to these direct costs.All GSRN costs, inclusive of the costs associated with community building activities, are allocated to GSRN's subsidiary corporations based upon a comprehensive allocation methodology which considers departmental resource utilization and relative net patient service revenue, among other factors. | GeneralExplanation |
| Needs Assessment | Part VI, Line 2: Good Shepherd periodically assesses the needs of the communities it serves in different ways. The most recent comprehensive assessment was prepared in the form of a research project commissioned and funded by Good Shepherd and conducted by the Lehigh Valley Research Consortium (LVRC), an affiliate of the Lehigh Valley Association of Independent Colleges and Universities (LVAIC). This research project was conducted over the 18-month period ended October 2009 and culminated in the preparation of a 139-page report, entitled The Lehigh Valley Disability Community: A Survey of Needs and Opportunities, and published as of December 3, 2009. This report will hereinafter be referred to as "the Research Project." The Research Project was conducted as a service to the communities Good Shepherd serves and in the interest of gathering information that can assist the Lehigh Valley in becoming more accessible and inclusive of people with disabilities. For purposes of the Research Project, "Lehigh Valley" was defined as Lehigh County and Northampton County. This definition was a bit narrower in scope than the Specialty Hospital's Primary Service Area as defined in Part VI (Supplemental Information), Line 4.Good Shepherd's aim in supporting the study was to provide a foundation for long-term efforts to build a more Disability Friendly Community in partnership with community organizations, civic and business leaders, and citizens. The goals of the Research Project included empowering people with disabilities and their advocates to recognize the Lehigh Valley's rich resources and achievements, while advancing positive change for our communities. Specifically, the Research Project addressed the following three questions:1. What are the greatest unmet needs to living fully and freely in the Lehigh Valley for persons with disabilities today?2. What are the greatest concerns among community organizations and leaders who serve, work with, and advocate for persons with disabilities and their caregivers?3. What are the well-established best practices that may be used as potential solutions to address unmet needs of persons with disabilities living in the Lehigh Valley?On December 3, 2009, a public forum was held at Northampton Community College to share the findings from the Research Project on the unmet needs of persons with disabilities who live in Lehigh and Northampton Counties. At the forum, attendees were provided with printed copies of the Executive Summary, contained within the Research Project as well as a link to the LVRC's website, where the complete report is available. The complete report is still available on the LVRC's website. Information regarding the Research Project appears on Good Shepherd's website and has also been described and discussed through various television spots and print media.Good Shepherd is currently planning the manner in which Good Shepherd will undertake their next health needs assessment. Specifically, for the past five months, Good Shepherd's Vice President for Government and Community Relations, has been meeting with representatives from Lehigh Valley Health Network, St. Luke's Hospital and Sacred Heart Hospital to develop a joint strategy for collaborating on conducting a community health needs assessment and for complying with the requirements of Section 9007 of the Patient Protection and Affordable Care Act of 2010 (the PP&AC Act of 2010). The executive staff from the Dorothy Rider Pool Health Care Trust have helped guide the process. The group, which is calling itself the Lehigh Valley Health Council (the Council), was formed to measure and use the findings from that measurement to improve clinical decision-making and community health improvement efforts in the Lehigh Valley with an emphasis toward preventing illness and injury and reducing health disparities. The Council has agreed, in principal, to gather a series of primary and secondary qualitative and quantitative data sets and share health system-specific data to form the foundation for the health needs assessment. No collective or individual costs for doing this have yet been determined. The Council expects to gather data over the next two to four months and plans to invite representatives from government, school districts, human and social service agencies, business, civic and religious sectors and higher education to eventually join the Council, even though they are not subject to any requirements in the PP&AC Act of 2010. Their participation and receptivity, however, will be necessary to successfully develop and fully implement any community health programs the founding members of the Council individually or collectively create. | NeedsAssessment |
| Patient Education Assistance | Part VI, Line 3: 1. Good Shepherd's Mission is as follows:"Motivated by the divine Good Shepherd and the physical and cognitive rehabilitation needs of our communities, our mission is to enhance lives, maximize function, inspire hope and promote dignity and well-being with expertise and compassion."Good Shepherd vigorously pursues their mission regardless of a patient's ability to pay.2. In each inpatient room, Good Shepherd provides a reference binder of important information to all inpatients. This binder supplements the patient's admissions package and includes a Notice of Financial Aid which includes the following wording:"If you have little or no health insurance to pay for the services you receive from Good Shepherd and worry that you may not be able to pay for part or all of your care, we may be able to help. Good Shepherd provides charity care to patients based on their income, assets and financial needs. In addition, if you do not meet the criteria to be eligible for charity care, we will help you arrange for an interest-free payment plan to resolve any balances you owe."3. Charity care information is available on the Good Shepherd website. In particular, patients may access a copy of the Notice of Financial Aid and a Charity Care Application.4. Good Shepherd publishes and distributes a Notice of Payment Responsibility to all patients. The first paragraph of this form states the following:"Good Shepherd is a non-profit charitable organization that provides healthcare services to all medically appropriate patients who seek care regardless of their funds to pay for services. This includes the uninsured and the under insured."The notice goes on to state:"It has been brought to our attention that you potentially lack the financial resources to pay for your medical care. Your admission to Good Shepherd is contingent upon your assistance in helping us secure payment of your medical bill for the care being provided to you. To address the payment of your bill, we are requesting that you apply for Medical Assistance benefits through the Pennsylvania Medicaid Program and apply for Good Shepherd's Charity Care Program."5. Each patient bill or statement includes the following statement:"Good Shepherd Specialty Hospital is a non-profit Organization and offers charity care to those who qualify. If you do not have the funds to pay, please contact us." 6. Translation services are available to any non-English-speaking patient. These services also include assistance with charity care eligibility and other financial matters. 7. As part of internal departmental orientation and training, admissions, care management and patient accounting personnel are trained in Good Shepherd's charity care policies and procedures. | PatientEducationAssistance |
| Community Information | Part VI, Line 4: Based upon Health Care Cost Containment Council data for the 2010 fiscal year, the Specialty Hospital's primary service area is comprised of the following five Pennsylvania Counties. In addition, the Specialty Hospital's market share percentage is indicated for each County within its primary service area.-Carbon County 43%-Lehigh County 80%-Northampton County 57%-Monroe County 37%-Berks County 43%Lehigh, Northampton and Berks Counties are a mix of urban, suburban and rural communities while Carbon and Monroe Counties are primarily rural. The following hospitals are located within each of these Counties:Carbon County-Two (2) Not-For-Profit Acute Care HospitalsLehigh County-Seven (7) Acute Care Hospitals - Six (6) Not-For-Profit, One (1) For-Profit-One (1) Not-For-Profit Inpatient Rehabilitation Hospital (the Hospital)-One (1) Not-For-Profit Long-Term Acute Care Hospital (the Specialty Hospital)Northampton County -One (1) For-Profit Acute Care Hospital-One (1) For-Profit Long-Term Acute Care HospitalMonroe County-One (1) Not-For-Profit Acute Care HospitalBerks County-Two (2) Not-For-Profit Acute Care Hospitals-One (1) For-Profit Inpatient Rehabilitation HospitalThese Counties have the following demographics and characteristics:1. Average Income Level and Poverty Rates (Median 2008 Household Incomes and Population Percentage Below the Poverty Level)Carbon County $47,425 and 11.0%Lehigh County $53,894 and 10.2% Northampton County $59,771 and 8.7%Monroe County $56,854 and 10.1%Berks County $54,492 and 11.3%2. Rates of Uninsured or Underinsured PersonsCarbon County 5,996 Individuals or 9.6% of the County PopulationLehigh County 31,905 Individuals or 9.5% of County PopulationNorthampton County 20,079 Individuals or 6.9% of the County PopulationMonroe County 17,690 Individuals or 10.7% of the County PopulationBerks County 31,198 Individuals or 8.0% of the County Population3. Percent of Families Who are on Medicaid or Other Assistance Carbon County July 2009 Percentage Enrolled in Medicaid - 14.5%Lehigh County July 2009 Percentage Enrolled in Medicaid - 6.6%Northampton County July 2009 Percentage Enrolled in Medicaid - 12.0%Monroe County July 2009 Percentage Enrolled in Medicaid - 15.6%Berks County July 2009 Percentage Enrolled in Medicaid - 16.6%4. Population Age Breakdown (Pennsylvania Population > Age 65 is 15.4%)Carbon County Population > Age 65 - 17.3%Lehigh County Population > Age 65 - 15.3%Northampton County Population > Age 65 - 15.1%Monroe County Population > Age 65 - 12.5%Berks County Population > Age 65 - 14.4%5. Percentages of Non-English-Speaking PopulationsCarbon County 511 Individuals or 0.9% Not Proficient in EnglishLehigh County 22,436 Individuals or 7.1% Not Proficient in EnglishNorthampton County 10,574 Individuals or 3.8% Not Proficient in EnglishMonroe County 6,140 Individuals or 4.0% Not Proficient in EnglishBerks County 21,637 Individuals or 5.8% Not Proficient in English6. Areas Designated as Federally Medically Underserved Areas or PopulationsCarbon County: Coaldale and the Boroughs of: Lansford, Nesquehoning and Summit HillLehigh County: Allentown Service Area - CT 0004.00 and CT 0005.00Northampton County: Easton Service Area - CT: 143-147 and South Bethlehem Service Area - CT: 109-113Monroe County: Low Income Stroudsburg Borough - MCD (74888) Berks County: City of Reading Service Areas - CT: 1, 2, 10, 11, 13, 14, 17, 19, 21, 22, 23 and 257. Special Populations Within the Area Served, Including Ethnic and Cultural GroupsCarbon County Population with a Disability (5+) - 19.52% vs.16.75% in PALehigh County Hispanic or Latino Population - 16.9% vs. 5.1% in PANorthampton County Hispanic or Latino Population - 9.9% vs. 5.1% in PAMonroe County Hispanic or Latino Population - 12.7% vs. 5.1% in PABerks County Hispanic or Latino Population - 14.9% vs. 5.1% in PA | CommunityInformation |
| Community Building Activities | Part VI, Line 5: While minimal community building activities are provided directly within the Specialty Hospital corporation, GSRN, the Specialty Hospital's parent company, provided $35,238 of such activities during the 2010 fiscal year. These activities took the form of Executive and Government and Community Relations Board Memberships, participation in the Partnership for a Disability Friendly Community, AMRPA Board and United Way Board Memberships as well as various workforce development activities. These activities were not provided for purposes of marketing, to increase referrals of patients with third-party insurance coverage, in fulfillment of regulatory requirements or current standards of care, or to benefit persons affiliated with GSRN. Rather, the primary purpose of these community building activities is to benefit the community and should be considered as a component of community benefit. For example, participation in the Partnership for a Disability Friendly Community directly benefits the disability community. Specifically, the Partnership educates and empowers individuals with disabilities and their caregivers to better care for themselves and to identify and utilize resources that are already available to them within the Community. Without such education and empowerment, there is a risk that those individuals with disabilities either do not receive the care or assistance they require, or they over-rely on the services of the medical community for even the most basic of needs. | CommunityBuildingActivities |
| Other Information | Part VI, Line 6: With respect to how the Specialty Hospital furthers its exempt purpose by promoting the health of the community, the following information is provided:-The GSRN Board of Trustees governs all of the entities described in Part I, Line 6a (including the Specialty Hospital). The GSRN Board of Trustee Members (Board Members) all live in the Specialty Hospital's Primary Service Area as defined in Part VI (Supplemental Information), Line 4. The vast majority of the Board Members are not employees or contractors of the Specialty Hospital. None of the Board Members are family members.-The Specialty Hospital also maintains a separate Board of Trustees. All of the members of this separate Board live in the Specialty Hospital's Primary Service and most are management employees of the Specialty Hospital.-The Specialty Hospital extends medical staff privileges to all qualified physicians in its Primary Service Area. All applicants are approved by the Specialty Hospital's Medical Executive Committee. -The Specialty Hospital participates in the Medicare, CHAMPUS, Tricare and other government sponsored healthcare programs.-The Commonwealth of Pennsylvania DPW does not recognize the Long-Term Acute Care Hospital level of service. Accordingly, the Specialty Hospital can not participate in the Pennsylvania Medicaid program. However, patients that qualify for the Pennsylvania Medicaid program would also meet Good Shepherd's charity care criteria. Finally, the Specialty Hospital will accept Medicaid patients from other states if that state recognizes the Long-Term Acute Care Hospital level of service.-The Specialty Hospital operates in a Primary Service Area, which includes only one other free-standing Long-Term Acute Care Hospital (a for-profit facility).-To the extent the Specialty Hospital generates surplus operating margins and/or free cash flow, the amounts are completely reinvested within the Specialty Hospital and/or the other affiliated corporations under the control of Good Shepherd Rehabilitation Network (GSRN). Such reinvestment can take the form of infrastructure improvements, investments in medical equipment and technology, or other investments intended to enhance patient satisfaction, improve the quality of care, conform with safety codes or regulations, etc.-The Specialty Hospital and other affiliated corporations under the control of Good Shepherd Rehabilitation Network (GSRN), are involved in health professions education, particularly for nursing and therapy. | OtherInformation |
| Affiliated Health Care System | Part VI, Line 7: Within the Good Shepherd Rehabilitation Network and Controlled Entities, the Good Shepherd Rehabilitation Hospital (the Hospital) provides "Charity Care and Certain Other Community Benefits at Cost" as reported on their Schedule H to Form 990. These amounts aggregate $7,142,692, approximately 10% of the Hospital's expenses. Through its Good Shepherd Workshop/Vocational Services, Inc. (Work Services) subsidiary, Good Shepherd Rehabilitation Network and Controlled Entities (Good Shepherd), provides employment and development programs for persons with physical, emotional and intellectual disabilities, hearing and sight impairments and industrial injuries by providing subcontracting services. These programs are operated at a loss, which totaled $658,214 for the fiscal year ended June 30, 2010, and which was funded by Good Shepherd. The loss was determined by reducing revenues generated by the Work Services programs by directly assigned expenses and allocated corporate overhead costs (which were allocated on the basis of relative operating unit revenue).Through its Good Shepherd Housing Development Corporation (SuppIL) subsidiary, Good Shepherd Rehabilitation Network and Controlled Entities (Good Shepherd), provides supportive independent housing to persons with disabilities under section 811 of the Department of Housing and Urban Development. These services are operated at a loss, which totaled $211,688 for the fiscal year ended June 30, 2010, and which was funded by Good Shepherd. The loss was determined after reducing SuppIL rental revenue and other income by the directly assigned expenses incurred to operate the program. | AffiliatedHealthCareSystem |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | 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 | 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 (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SARA T GAMMON | |||||||||||||
| 0 | 528036 | 0 | 0 | 0 | 0 | 0 | 31014 | 0 | 46236 | 0 | 605286 | 0 | 0 |
| DANIEL C CONFALONE | |||||||||||||
| 0 | 292027 | 0 | 0 | 0 | 0 | 0 | 17152 | 0 | 34296 | 0 | 343475 | 0 | 0 |
| PHILLIP R BRYANT | |||||||||||||
| 0 | 357696 | 0 | 0 | 0 | 0 | 0 | 21009 | 0 | 44610 | 0 | 423315 | 0 | 0 |
| SAMUEL A MIRANDA JR | |||||||||||||
| 0 | 201924 | 0 | 0 | 0 | 0 | 0 | 11860 | 0 | 46415 | 0 | 260199 | 0 | 0 |
| Anthony R Bongiovanni | |||||||||||||
| 0 | 245295 | 0 | 0 | 0 | 0 | 0 | 14407 | 0 | 43759 | 0 | 303461 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Part I, Line 1a | Good Shepherd does not pay any dues on behalf of CEO, Sara Gammon, directly to a social club. Good Shepherd reimburses the CEO for certain social club dues relevant in pursuing the overall mission of Good Shepherd. These expenses are accounted for under an accountable reimbursement plan. The amount of this reimbursement is included in Ms. Gammon's taxable compensation. | |
| Part III | PART I, LINE 3: SARA T. GAMMON WAS PAID BY THE GOOD SHEPHERD REHABILITATION NETWORK ("GSRN"), AN AFFILIATED TAX-EXEMPT ORGANIZATION. THE ALLENTOWN SPECIALTY HOSPITAL RELIED ON GSRN'S USE OF THE DESCRIBED METHODS TO ESTABLISH MS. GAMMON'S COMPENSATION. | Supplemental Information |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| FORM 990, PART V, LINE 1: | ACCOUNTS PAYABLE PAYMENTS ARE CONSOLIDATED UNDER A COMMON PAYMASTER REPORTING SYSTEM. SINCE TOTALS FOR EACH VENDOR MAY CONTAIN TRANSACTIONS FROM MULTIPLE CORPORATIONS, THE NUMBER OF 1099'S FILED ON BEHALF OF THE ALLENTOWN SPECIALTY HOSPITAL, INC. BY THE COMMON PAYMASTER CANNOT BE SEPARATELY IDENTIFIED AND DETERMINED. |
| FORM 990, PART V, LINE 2: | THE SALARY AND BENEFIT EXPENSES REPORTED ON FORM 990, PART IX, AND THE EMPLOYEE INFORMATION REPORTED ON FORM 990, PART VII, ARE THE ALLENTOWN SPECIALTY HOSPITAL, INC. d/b/a GOOD SHEPHERD SPECIALTY HOSPITAL - ALLENTOWN'S ("GSSH") ALLOCATED PAYROLL COSTS BASED ON TIME SPENT. ALL INDIVIDUALS WORKING AT GSSH ARE EMPLOYEES OF THE GOOD SHEPHERD REHABILITATION HOSPITAL ("GSRH") AND ARE REPORTED ON ITS FORM W-3 UNDER EIN: 23-1371947. GSRH IS AN AFFILIATED TAX-EXEMPT ORGANIZATION. |
| Form 990, Part VI, Section A, line 7a | The sole corporate member of the organization is the Good Shepherd Long Term Acute Care Services, Inc. ("LTACS"). The sole corporate member of LTACS is the Good Shepherd Rehabilitation Network ("GSRN"), a related tax-exempt entity. The Governing Board of the organization shall be appointed by the Board of GSRN. In addition, any amendments to the organization's bylaws must be approved by the board of LTACS. |
| Form 990, Part VI, Section A, line 7b | See explanation for Form 990, Part VI, Section A, line 7a. |
| Form 990, Part VI, Section B, line 11 | The IRS 990 is prepared using information solicited from officers, directors, trustees, board committee members, and management. This group of individuals are provided a draft return before the final return is filed. Questions, comments, and additional information provided by this group are incorporated into the final return. The final return is reviewed at a committee level of the board prior to it being filed. |
| Form 990, Part VI, Section B, line 12c | THERE IS A SYSTEMATIC PROCESS COORDINATED THROUGH THE GOVERNANCE COMMITTEE WHERE THE CONFLICT OF INTEREST STATEMENT FOR EVERYONE IS REVIEWED BY THE GOVERNANCE COMMITTEE. WHENEVER THE COMMITTEE FEELS THE CONFLICT STATEMENT IS EITHER INCOMPLETE OR FEELS SOMETHING MAY BE MISSING, THE COMMITTEE WILL ASK MANAGEMENT TO PURSUE FURTHER DUE DILIGENCE. WHEN A BOARD MEMBER DOES HAVE AN INHERENT CONFLICT, THE TRUSTEE IS ASKED TO EITHER ABSTAIN FROM VOTING OR EXCUSE HIMSELF FROM THE ROOM DURING THE DISCUSSION AND VOTING. |
| Form 990, Part VI, Section B, line 15 | The Good Shepherd Rehabilitation Network Board delegates responsibility for following all legal and regulatory requirements affecting executive compensation to the Human Resources/Executive Compensation Committee of the Board. This Committee is charged with administration of compensation practices for officers and key employees of the organization. This Committee selected and uses an independent consulting firm specializing in healthcare executive compensation matters and uses comparable competitive market data in their analysis. The services of the independent compensation consultant were most recently used during fiscal year 2010. Committee meetings are held on an ongoing basis and are documented in detail. |
| Form 990, Part VI, Section C, line 19 | Financial statements are published to the organization's website at least annually. The governing documents and policies are available upon request. |
| FORM 990, PART VII, SECTION A: | SARA T. GAMMON, DANIEL C. CONFALONE, PHILLIP R. BRYANT, ANTHONY R. BONGIOVANNI, AND SAMUEL A. MIRANDA, JR. ARE OFFICERS/KEY EMPLOYEES FOR ALL 7 ENTITIES WITHIN THE GOOD SHEPHERD REHABILITATION NETWORK. THEY EACH DEVOTE APPROXIMATELY 60 HOURS PER WEEK TO THE ENTIRE GROUP OF ENTITIES. THE AVERAGE HOURS LISTED IN COLUMN (B) FOR EACH INDIVIDUAL REPRESENTS THE APPROXIMATE PORTION OF 60 HOURS DEVOTED TO THE ALLENTOWN SPECIALTY HOSPITAL, INC. d/b/a GOOD SHEPHERD SPECIALTY HOSPITAL - ALLENTOWN PER WEEK. THE COMPENSATION AND BENEFIT INFORMATION REPORTED IN COLUMNS (E) AND (F) REPRESENTS WHAT EACH INDIVIDUAL EARNS FOR THEIR TIME SPENT ON THE ENTIRE GROUP OF 7 ENTITIES. |
| Form 990, PART XI, LINE 2C: | THE PROCESSES USED BY THE COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT HAVE NOT CHANGED FROM THE PRIOR YEAR. |
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 |
|---|---|---|---|---|---|---|---|---|---|
| GOOD SHEPHERD HOME LONG-TERM CARE FACILITY INC | |||||||||
| GOOD SHEPHERD PLAZA 850 SOUTH 5TH S | ALLENTOWN | PA | 18103 | 232215800 | OPERATES TWO SKILLED NURSING FACILITIES FOR THE SEVERELY DISABLED | PA | 501(c)(3) | Line 3 | N/A |
| GOOD SHEPHERD HOUSING DEVELOPMENT CORPORATION | |||||||||
| GOOD SHEPHERD PLAZA 850 SOUTH 5TH S | ALLENTOWN | PA | 18103 | 233073390 | PROVIDES INDEPENDENT LIVING APARTMENTS FOR DISABLED, LOW-INCOME ADULTS | PA | 501(c)(3) | Line 7 | N/A |
| GOOD SHEPHERD REHABILITATION HOSPITAL | |||||||||
| GOOD SHEPHERD PLAZA 850 SOUTH 5TH S | ALLENTOWN | PA | 18103 | 231371947 | PROVIDES COMPREHENSIVE INPATIENT AND OUTPATIENT REHABILITATION SERVICES | PA | 501(c)(3) | Line 3 | N/A |
| GOOD SHEPHERD REHABILITATION NETWORK | |||||||||
| GOOD SHEPHERD PLAZA 850 SOUTH 5TH S | ALLENTOWN | PA | 18103 | 232216041 | PROVIDES MANAGEMENT SERVICES IN SUPPORT OF ITS TAX-EXEMPT AFFILIATES | PA | 501(c)(3) | Line 7 | N/A |
| GOOD SHEPHERD WORKSHOPVOCATIONAL SERVICES INC | |||||||||
| 1901 LEHIGH STREET | ALLENTOWN | PA | 18103 | 232215801 | PROVIDES EMPLOYMENT DEVELOPMENT PROGRAMS AND VOCATIONAL EVALUATIONS | PA | 501(c)(3) | Line 11a, I | N/A |
| PHILADELPHIA POST-ACUTE PARTNERS LLC | |||||||||
| 1800 LOMBARD STREET | PHILADELPHIA | PA | 19146 | 208283421 | OPERATES AN INPATIENT REHAB HOSP, ACUTE CARE HOSP & 8 OUTPATIENT FACILITIES | PA | 501(c)(3) | Line 3 | N/A |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Good Shepherd Reciprocal Risk Rentention Group | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7301 Rivers Avenue Suite 230 | AddressLine1 |
| City | North Charleston | City |
| State | SC | State |
| ZIP Code | 29406 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 204065112 | EIN |
| Primary Activity | Risk Retention Group | PrimaryActivity |
| Legal Domicile State | SC | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| 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 | 1 | 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 | 1 | 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 | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |