2011-05-16T10:31:21-05:00 2010-06-30 ParenteBeard LLC 1650 Market Street Suite 4500 Philadelphia PA 19103 990 2009-07-01 232215800 THE GOOD SHEPHERD HOME LONG-TERM CARE FACILITY INC GOOD 6107763303 GOOD SHEPHERD PLAZA 850 S 5TH ST ALLENTOWN PA 181033295 Daniel C Confalone 6107763303 2011-05-16 1 Julius Green CPA 2159720701 2009 2016-02-24 21:20:13Z DANIEL C CONFALONE GOOD SHEPHERD PLAZA 850 S 5TH ST ALLENTOWN PA 181033295 22182657 0 X WWW.GOODSHEPHERDREHAB.ORG X 1982 PA To enhance lives, maximize function, inspire hope, and promote dignity and well-being. 18 13 0 98 0 0 608349 432603 22169093 21740179 0 40 9875 22777482 22182657 0 0 10976951 11185006 0 0 9991659 9165507 20968610 20350513 1808872 1832144 38126761 39976957 613017 631069 37513744 39345888 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." 0 0 18269971 21740179 The Raker Center and Bethlehem Home are residences where persons with physical disabilities requiring nursing facility care can come to live and realize their fullest potential. Services provided include nursing and medical services, occupational therapy, communication services, pastoral care, social work services, therapeutic recreation, physical therapy, adaptive wheelchair, mobility and seating program. Many of the residents utilize Good Shepherd's assistive technology program to help with their mobility, communication and everyday living needs. In fiscal year 2010, the Raker Center operated at 99.80% occupancy, with 35,956 patient days, while the Bethlehem Home operated at 99.74% occupancy, with 21,777 patient days. There is a waiting list for both homes. 18269971 1 1 0 0 0 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 18 13 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X DANIEL C CONFALONE SVP FinanceCFO 6107763303 GOOD SHEPHERD PLAZA 850 SOUTH 5TH ALLENTOWN PA 18103 X SCOTT A BAKER 0.30 X 0 0 0 SANDRA L BODNYK 0.40 X X 0 0 0 PATRICK J BRENNAN MD 0.30 X 0 0 0 ADDIE J BUTLER EDD 0.30 X 0 0 0 JAMES J DALEY MD 0.30 X 0 163074 33094 DAVID G DECAMPLI 0.30 X X 0 0 0 RICHARD E DROBNICKI 0.70 X X 0 0 0 ROBERT E GADOMSKI 0.30 X 0 0 0 MICHAEL GOLDNER DO 0.20 X 0 0 0 ELSBETH G HAYMON 0.30 X 0 0 0 KATHERINE E HILGERT 0.20 X 0 0 0 SANDRA JARVA WEISS 0.20 X 0 0 0 GERALD A NAU 0.20 X 0 0 0 EDITH D RITTER 0.20 X 0 0 0 GARY R SCHMIDT 0.30 X 0 0 0 THE REV DAVID R STROBEL 0.20 X 0 0 0 DANIEL J WILSON PHD 0.30 X 0 0 0 SARA T GAMMON 6.00 X X 0 528036 77250 DANIEL C CONFALONE 4.00 X 0 292027 51448 PHILLIP R BRYANT 0.00 X 0 357696 65619 ANTHONY R BONGIOVANNI 4.00 X 0 245295 58166 SAMUEL A MIRANDA JR 5.00 X 0 201924 58275 THOMAS BURD 40.00 X 125747 0 26592 INGRID M BARUCH LANDE 40.00 X 100798 0 20420 226545 1788052 390864 2 0 1 0 SODEXHO OPERATIONS LLC 4880 PAYSPHERE CIRCLE CHICAGO IL 60674 DIETARY/FOOD SERVICES 501489 CAMBRIDGE MEDICAL STAFFING INC 4155 INDEPENDENCE DRIVE SCHNECKSVILLE PA 18078 TEMPORARY STAFFING SERVICES 198075 2 432603 432603 NET PATIENT SVC REV 623000 21740179 21740179 21740179 bad debt recovery 900099 9875 9875 9875 22182657 21740179 0 9875 8817803 8607652 210151 568925 555366 13559 1160331 1132676 27655 637947 624224 13723 440854 398590 42264 848792 840733 8059 79965 79965 1592 1182 410 1090971 1090971 CORPORATE ALLOCATION 6284651 4524949 1759702 FOOD 173855 171926 1929 REPAIRS & MAINTENANCE 126393 123553 2840 DRUGS 105001 105001 GUEST SERVICES 7091 7091 6342 6092 250 20350513 18269971 2080542 0 1400 1398 1796290 612913 4050 20734105 12935106 11312692 7798999 25016379 31559597 38126761 39976957 434477 470462 178540 160607 613017 631069 X 37513744 39345888 37513744 39345888 38126761 39976957 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 56370 56370 9899977 5413207 4486770 10241402 7296235 2945167 536356 225664 310692 7798999 RESIDENT FUNDS 160607 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 201883 AMOUNTS DUE FROM AFFILIATES 31197107 31559597 22182657 20350513 1832144 0 1832144 22172782 0 22172782 9875 9875 22182657 20340638 -9875 -9875 20350513 0 20350513 Part IV, Line 2b: Good Shepherd Home Long Term Care Facility, Inc. holds the personal funds of its long term care residents in a segregated bank account in order to collect personal deposits and process payments for their personal bills. Part X: Description of Uncertain Tax Positions Under FIN 48: GOOD SHEPHERD PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY IN RECORDING TAX LIABILITIES IN THE FINANCIAL STATEMENTS. MEASUREMENT AND RECOGNITION OF THE TAX 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. Part XII, Line 4b - Other Adjustments: Bad Debt Recovery Included in Expenses on Financial Statements: 9875. Part XIII, Line 2d - Other Adjustments: Bad Debt Recovery Included in Expenses on Financial Statements: -9875. X 1 1 X X X X X 0 0 0 0 0 0 0 0 0 JAMES J DALEY MD 0 163074 0 0 0 0 0 9578 0 23516 0 196168 0 0 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 ANTHONY R BONGIOVANNI 0 245295 0 0 0 0 0 14407 0 43759 0 303461 0 0 SAMUEL A MIRANDA JR 0 201924 0 0 0 0 0 11860 0 46415 0 260199 0 0 THOMAS BURD 125747 0 0 0 0 0 7384 0 19208 0 152339 0 0 0 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. Supplemental Information Part III PART I, LINE 3: SARA T. GAMMON WAS PAID BY THE GOOD SHEPHERD REHABILITATION NETWORK ("GSRN"), AN AFFILIATED TAX-EXEMPT ORGANIZATION. THE GOOD SHEPHERD HOME LONG-TERM CARE FACILITY, INC. RELIED ON GSRN'S USE OF THE DESCRIBED METHODS TO ESTABLISH MS. GAMMON'S COMPENSATION. 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 GOOD SHEPHERD HOME LONG-TERM CARE FACILITY, INC. ("LTC") 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 GOOD SHEPHERD HOME LONG-TERM CARE FACILITY, INC.'S ("LTC") ALLOCATED PAYROLL COSTS BASED ON TIME SPENT. ALL INDIVIDUALS WORKING AT LTC 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 Rehabilitation Network ("GSRN"), a related tax-exempt entity. GSRN has the ultimate authority and responsibility for the following activities with respect to The Good Shepherd Home Long-Term Care Facility, Inc.: amendment, approval or revocation of bylaws; institutional development; corporate and strategic planning; financial planning and budgeting; audit and fiscal matters; resource allocation; public relations; appointment of trustees and officers; compensation and human resource policies; medical staff and general policy matters. 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 GOOD SHEPHERD HOME LONG-TERM CARE FACILITY, INC. 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. 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 THE ALLENTOWN SPECIALTY HOSPITAL INC GOOD SHEPHERD PLAZA 850 SOUTH 5TH S ALLENTOWN PA 18103 233009874 PROVIDES INPATIENT SERVICES THROUGH OPERATION OF A LONG-TERM ACUTE CARE HOSP PA 501(c)(3) Line 3 N/A Good Shepherd Reciprocal Risk Rentention Group 7301 Rivers Avenue Suite 230 North Charleston SC 29406 204065112 Risk Retention Group SC N/A C 0 0 1 0 0 0 0 1 0 0 0 1 0 1 1 1 0 1