2011-05-16T09:34:49-05:00 2010-06-30 PARENTEBEARD LLC 400 MARKET STREET WILLIAMSPORT PA 17701 990 2009-07-01 251865142 HOLY SPIRIT HEALTH SYSTEM HOLY 7177632130 503 NORTH 21ST STREET CAMP HILL PA 17011 SR ROMAINE NIEMEYER 7177632130 2011-05-11 1 5703236023 2009 2016-02-24 21:20:13Z Manuel J Evans 503 NORTH 21ST STREET CAMP HILL PA 17011 9596515 0 X www.hsh.org X 1999 PA TO PROVIDE RESOURCES FOR THE RESTORATION AND MAINTENANCE OF HEALTH AND THE PREVENTION OF DISEASE. 12 12 8 0 0 0 5157486 5456339 0 -216178 295238 641043 719388 5582351 6470965 4346106 4930171 0 432340 477309 146990 171014 171014 328775 409472 5254211 5987966 328140 482999 9714177 10473639 73094 108798 9641083 10364841 HOLY SPIRIT HEALTH SYSTEM IS A COMMUNITY CATHOLIC HEALTH SYSTEM SPONSORED BY THE SISTERS OF CHRISTIAN CHARITY TO CARRY OUT THE HEALING MINISTRY OF JESUS CHRIST TO ALL IN NEED. WE PROVIDE HIGH QUALITY, COST-EFFECTIVE HEALTH SERVICES IN A CARING, PATIENT-FOCUSED ENVIRONMENT TO DEVELOP HEALTHY COMMUNITIES IN THE GREATER HARRISBURG AREA AND SOUTH CENTRAL PENNSYLVANIA. 0 0 5692938 4930171 SUPPORTED AND CARRIED OUT THE MISSION OF, AND IDENTIFIED WITH THE ETHICAL PRINCIPLES OF, THE ROMAN CATHOLIC CHURCH TO PROVIDE RESOURCES FOR THE RESTORATION AND MAINTENANCE OF HEALTH AND THE PREVENTION OF DISEASE.HOLY SPIRIT HEALTH SYSTEM PROVIDES FINANCIAL SUPPORT TO ITS' CONTROLLED ENTITIES TO ALLOW THESE ENTITIES TO CARRY ON WITH THEIR EXEMPT PURPOSES OF PROVIDING AFFORDABLE HEALTHCARE AND MEDICAL SERVICES TO RESIDENTS OF CAMP HILL PENNSYLVANIA AND SURROUNDING COMMUNITIES. 5692938 1 1 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 9 0 1 8 1 0 0 0 0 0 1 1 0 0 0 12 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X Sister Romaine Niemeyer SCC 7177632130 503 NORTH 21ST STREET CAMP HILL PA 17011 X NILES BENN ESQ 1.00 X X 0 0 0 BRUCE J BROWN 1.00 X X 0 0 0 JAMES GIBSON 1.00 X X 0 0 0 SR ROMAINE NIEMEYER SCC 1.00 X X 0 0 0 ROBERT DIETZ 1.00 X 0 0 0 SR MARIA ASSUMPTA SHURER SCC 1.00 X 0 0 0 SR JOSEPH SPRING SCC 1.00 X 0 0 0 SR JOAN DANIEL HEALY SCC 1.00 X 0 0 0 ELIZABETH BERGEY MD 1.00 X 0 0 0 DR MADLYN HANES PHD 1.00 X 0 0 0 MARK JACOBSON MD 1.00 X 0 0 0 LEON FEINERMAN 1.00 X 0 0 0 0 0 0 0 0 0 0 Holy Spirit Hospital North 21st Street Camp Hill PA 17011 Benefits, Supplies, Salaries 203011 STEVENS & LEE PO BOX 679 READING PA 19603 PROFESSIONAL SERVICES 163514 PARENTEBEARD LLC 46 PUBLIC SQUARE STE 400 WILKESBARRE PA 18701 AUDITING & Tax Prep 133255 3 63116 4635445 236161 521617 7608 5456339 157429 157429 3217888 3080079 137809 137809 137809 58897 63116 45471 13426 13426 resource development 900099 392764 392764 CORPORATE COMPLIANCE R 900099 310558 310558 Miscellaneous 900099 2640 2640 705962 6470965 0 0 1014626 4925171 4925171 5000 5000 408735 408735 11371 11371 54617 54617 2586 2586 47419 47419 7802 950 6852 80574 80574 171014 171014 14783 14783 21805 21805 110070 110070 35846 35846 165 165 4087 4087 2570 2570 656 656 ANNUAL REPORT 52645 52645 DUES AND SUBSCRIPTIONS 20835 20835 OtHER MISCELLANEOUS 7213 7213 Market Research 2750 2750 Donor Recognition 252 252 5987966 5692938 124014 171014 500 500 632831 948522 12960 36741 19343 6586 10326 12757 5924690 5988645 2862285 3092536 270585 393938 9714177 10473639 28274 50848 44820 57950 73094 108798 X 9641083 10364841 9641083 10364841 9714177 10473639 X 0 1 1 X 0 X X 0 0 0 SISTERS OF CHRISTIAN CHARITY HEALTH CARE CORPORATION 232322926 1 1 1 0 HOLY SPIRIT HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY 231512747 3 1 1 1 652901 SPIRIT PHYSICIAN SERVICES INC 251766971 9 1 1 1 4272270 WEST SHORE ADVANCED LIFE SUPPORT SERVICES INC 232463002 7 1 1 0 COMFORT CARE OF HOLY SPIRIT INC 232465952 9 1 1 0 5 4925171 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2121932 9370 118956 23602 2226656 2526208 1218 -387499 17995 2121932 1.00000 0 1 1 7709 6424 1285 11634 162 11472 12757 PA COMMUNITY HOSPITAL ASSOCIATES INVESTMENT 3092536 C 3092536 Part V, Line 4: Description of Intended Use of Endowment Funds: INTEREST EARNED IS UNRESTRICTED AND TRANSFERRED TO THE OPERATING ACCOUNT TO BE USED FOR OPERATIONAL EXPENSES. Part X: Description of Uncertain Tax Positions Under FIN 48: The System accounts for uncertainty in income taxes using a recognition threshold of more-likely-than-not to be sustained upon examination by the appropriate taxing authority. Measurement of the tax uncertainty occurs if the recognition threshold is met. Management has determined that there were no tax uncertainties that met the recognition threshold in 2010 or 2009. The System's federal Exempt Organization Business Income Tax Returns for 2009, 2008, and 2007 remain subject to examination by the IRS. X X X X X X 1 STEVENS & LEE FEDERAL AND STATE GRANTS 0 183550 163514 20036 PROCOPIO FOUNDATION GRANTS 0 58479 7500 50979 242029 171014 71015 PA GOLF OUTING 122013 63116 58897 7608 22891 9111 5861 122013 63116 58897 7608 22891 9111 5861 45471 13426 0 SPIRIT PHYSICIAN SERVICES INC 503 NORTH 21ST STREET CAMP HILL PA 17011 251766971 501(C)(3) 4272270 0 CASH N/A PROVIDE FINANCIAL SUPPORT FOR OPERATIONS. HOLY SPIRIT HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY 503 NORTH 21ST STREET CAMP HILL PA 17011 231512747 501(C)(3) 652901 0 CASH N/A PROVIDE FINANCIAL SUPPORT FOR OPERATIONS. 2 0 Donation - Personal Gift 1 5000 0 cash n/a Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: ASSISTANCE IS PROVIDED TO RELATED ENTITIES FOR FINANCIAL SUPPORT. MANAGEMENT OF THE HEALTH SYSTEM OVERSEES THE USE OF FUNDS AT THE AFFILIATED ENTITIES. Form 990, Part VI, Section A, line 6 The Sisters of Christian Charity Health Care Corporation, a Pennsylvania non-profit corporation, is the sole member of Holy Spirit Health System. Form 990, Part VI, Section A, line 7a The Chairperson of the Board of Trustees, Sisters of Christian Charity Health Care Corporation (Parent), has the power to appoint or remove the President and/or Chief Executive Officer of this corporation. The Parent also has the power to elect the Directors of the corporation and to approve nominees for elected officers. Form 990, Part VI, Section A, line 7b The governance structure of Holy Spirit Health System provides reserved powers in favor of Sisters of Christian Charity Health Care Corporation (Parent) and Holy Spirit Health System (the corporate member of all subsidiary corporations). The reserved powers pertain to (i) capital debt or modification of existing capital debt, (ii) sale or transfer of any land or building, (iii) acquisition or purchase of any land or building, (iv) leasing outside of the ordinary course of business, (v) approval of any guarantee of any debt, (vi) approval of any merger, consolidation, organization or reorganization, joint venture or any other modification of corporation structure or affiliation, (vii) dissolution or termination of any existing corporation, (viii) appointment of the external fiscal auditor and (ix) appointment of general counsel. Form 990, Part VI, Section B, line 11 In accordance with the Bylaws of Holy Spirit Health System (the Parent), the Form 990 was presented to the Health System's Finance and Audit Committee by the external tax preparers and management. Following review and approval by the Finance and Audit Committee, the Form 990 was distributed to the board of directors of each corporation before the Form 990 was filed. Form 990, Part VI, Section B, line 12c The Holy Spirit Hospital Bylaws have a conflict of interest provision, specifically Article XII. Article XII is applicable to "any Director, officer or Committee member (to include any member of his or her immediate family)" and describes the nature of a conflict of interest. In addition, there is a provision in Article XII (Section 12.2.1) which sets forth the methodology to determine whether a Director, officer or Committee member has a conflict of interest and the requirements pertaining to removal of the Director, officer or Committee member with the conflict of interest from the meeting, impact on the quorum and voting. Section 12.2 requires that if a Director, officer or Committee member is determined to have a conflict of interest that the individual cannot be present at the meeting when the matter is discussed or voted upon. Article XII also requires the Board of Directors of Holy Spirit Health System to adopt a conflict of interest policy requiring periodic statements (at least annually) from Directors, officers and Committee members to disclose existing and potential conflicts of interest. In addition, the Board is required to take corrective and disciplinary action with respect to transgressions of the conflict of interest policy. Each subsidiary corporation has a comparable provision in its current Bylaws. All Directors, officers and Committee members are required to complete an annual statement disclosing existing or potential conflicts of interest. This annual disclosure requirement has been in effect for all corporations for several years. The Health System Board of Directors adopted a separate Conflict of Interest Policy on March 23, 2010. That Conflict of Interest Policy is applicable to all Directors, officers, key employees and Committee members for Holy Spirit Health System and all subsidiary corporations. That Conflict of Interest Policy also has expanded the annual disclosure statement. In addition, the Corporate Compliance Program for Holy Spirit Health System provides a conflict of interest policy which is substantially the same as the one described above, except that policy is applicable to all employees of Holy Spirit Health System and all subsidiary corporations. It is not applicable to Directors, officers or Committee members of Holy Spirit Health System or any subsidiary corporation. Form 990, Part VI, Section B, line 15 HOLY SPIRIT HEALTH SYSTEM RETAINED A CONSULTING FIRM TO REVIEW THE EXECUTIVE COMPENSATION PROGRAM IN APRIL 2008 AND TO UPDATE THE ANALYSIS IN MAY 2009. THE FIRM COLLECTED MARKET DATA FROM VARIOUS SOURCES. THE FIRM COMPARED HOLY SPIRIT HEALTH SYSTEM TO HOSPITALS SIMILAR IN SCOPE AND SCALE AND TRENDED THE DATA BASED ON THE FIRM'S US COMPENSATION PLANNING SURVEY. THE RESULTS AND RECOMMENDATIONS WERE PRESENTED TO THE BOARD. THE FOLLOWING POSITIONS THAT ARE ANALYZED ARE PRESIDENT, SENIOR VP MEDICAL AFFAIRS, SENIOR VP FINANCE, SENIOR VP AND CHIEF OPERATING OFFICER, SENIOR VP CORPORATE AFFAIRS, SENIOR VP OF HUMAN SERVICES, VP PATIENT CARE SERVICES, CHIEF INFORMATION OFFICER, VP RISK MANAGMENT AND SUPPORT SERVICES, VP/COO SPIRIT PHYSICIAN SERVICES, VP/COO WEST SHORE ADVANCED LIFE SUPPORT, PRESIDENT/CEO OF COMFORT CARE. Form 990, Part VI, Section C, line 19 THE ORGANZIATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. comfort care of holy spirit inc 503 N 21st Street Camp Hill PA 17011 232465952 Healthcare PA 501(c)(3) 9 N/A Holy Spirit Hospital 503 N 21st Street Camp Hill PA 17011 231512747 Healthcare PA 501(c)(3) 3 N/A Holy Spirit Corporation 503 N 21st Street Camp Hill PA 17011 232214540 REAL ESTATE PA 501(c)(2) N/A Spirit Physicians Services Inc 503 N 21st Street Camp Hill PA 17011 251766971 Healthcare PA 501(c)(3) 9 N/A West Shore Advanced Life Support Services Inc 503 N 21st Street Camp Hill PA 17011 232463002 Healthcare PA 501(c)(3) 7 N/A Holy Spirit Ventures Inc North 21st Street Camp Hill PA 17011 232407709 Medical SErvices PA N/A C 0 1 1 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 HOLY SPIRIT HOSPITAL B 652901 HOLY SPIRIT HOSPITAL Q 55800 HOLY SPIRIT HOSPITAL C 4635445 SPIRIT PHYSICIAN SERVICES B 4272270