LEHIGH VALLEY HOSPITAL-HAZLETON: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
LEHIGH VALLEY HOSPITAL-HAZLETON (EIN 23-2421970)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-11
IRS object ID
201133159349300648
Schema version
2010v3.4
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

FieldValueIRS element (for citing)
Timestamp2011-11-11T11:00:15-00:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN232421970EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1NORTHEASTERN PENNSYLVANIA HEALTH CORPORATIONBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% MOLLY P STETTLERInCareOfName
Name ControlNORTNameControl
Phone5705014000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1700 E BROAD STREETAddressLine1
CityHAZLETONCity
StatePAState
ZIP Code18201ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameWILLIAM C BAUERName
TitleCHIEF FINANCIAL OFFICERTitle
Phone5705016292Phone
Date Signed2011-11-08DateSigned
Authorize Third PartyfalseAuthorizeThirdParty
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1HAZLETON GENERAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonJames D EdwardsNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1700 E Broad StAddressLine1
CityHazletonCity
StatePAState
ZIP Code18201ZIPCode
FieldValueIRS element (for citing)
Gross Receipts120280542GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.ghha.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1985YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionHGH provides inpatient, emergency, diagnostic, maternity, rehabilitative, outpatient & therapeutic medical services; conducts community education programs/services; delivers these programs & serv with compassion & approp standards of quality, without discrimination or abiliy to pay HGH provides inpatient, emergency, diagnostic, maternity, rehabilitative, outpatient therapeutic medical services conducts community education programs/services delivers these programs serv with compassion approp standards of quality, without discrimination or abiliy to payActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees736TotalNbrEmployees
Total Nbr Volunteers13TotalNbrVolunteers
Total Gross UBI294484TotalGrossUBI
Net Unrelated Business Txbl Income-80094NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year444740ContributionsGrantsPriorYear
Contributions Grants Current Year679023ContributionsGrantsCurrentYear
Program Service Revenue Prior Year95885513ProgramServiceRevenuePriorYear
Program Service Revenue CY103823236ProgramServiceRevenueCY
Investment Income Prior Year417102InvestmentIncomePriorYear
Investment Income Current Year1374899InvestmentIncomeCurrentYear
Other Revenue Prior Year1106191OtherRevenuePriorYear
Other Revenue Current Year1294718OtherRevenueCurrentYear
Total Revenue Prior Year97853546TotalRevenuePriorYear
Total Revenue Current Year107171876TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year47966240SalariesEtcPriorYear
Salaries Etc Current Year47511705SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY25680TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year63778TotalFundrsngExpCurrentYear
Other Expense Prior Year44519256OtherExpensePriorYear
Other Expenses Current Year44932923OtherExpensesCurrentYear
Total Expenses Prior Year92485496TotalExpensesPriorYear
Total Expenses Current Year92470308TotalExpensesCurrentYear
Revenues Less Expenses Prior Year5368050RevenuesLessExpensesPriorYear
Revenues Less Expenses CY14701568RevenuesLessExpensesCY
Total Assets BOY86531882TotalAssetsBOY
Total Assets EOY100364723TotalAssetsEOY
Total Liabilities BOY66315348TotalLiabilitiesBOY
Total Liabilities EOY65346402TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY20216534NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY35018321NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionHGH commits to service health needs in the Hazleton area, through its inpatient, emergency, diagnostic, maternity, rehabilitative, outpatient therapeutic medical services by providing community education and delivering programs services with compassion appropriate standards of quality without discrimination.MissionDescription
Significant New Program ServicestrueSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense77762347Expense
Revenue104872389Revenue
DescriptionHazleton General Hospital provides hospital inpatient, outpatient, rehabilitation care, maternity care and emergency room services to the residents of Greater Hazleton regardless of race, religion or economic status. The hospital provides a full range of medical care to inpatients and outpatients, including therapeutic, diagnostic, imaging and rehabilitation services See Schedule O for new projects in 2009 done to enhance the quality efficiency of our mission. View our community report at www.ghha.orgDescription
Total Program Service Expense77762347TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingtrueProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedfalseFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondstrueInvestTaxExemptBonds
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPtrueLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgtrueTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109687NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees736NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionstrueNonDeductibleContributions
Non Deductible DisclosuretrueNonDeductibleDisclosure
Quid Pro Quo ContributionstrueQuidProQuoContributions
Quid Pro Quo DisclosuretrueQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledPAStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonFINANCE DEPARTMENTNamePerson
Telephone Number5705014989TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1700 E BROAD STAddressLine1
CityHAZLETONCity
StatePAState
ZIP Code18201ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (26 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
J EDWARDS
CEO040.00XX048016330509
W BAUER
CFO040.00X023731130166
J FLETCHER
COO040.00X016002518247
M GOLDEN
CNO040.00X018853428468
A VALENTE
VP MED AFFAIRS030.00X022554529776
E PERRONG
VP HR040.00X014609919306
L MILLER
CAO-HWC040.00X018852523295
J DANISH
ASST SECRETARY OF BOARD / DIR ADM SVC040.00X010198425598
T KENNEDY ESQ
BOARD CHAIR001.00X000
A SRINIVASAN MD
BOARD VICE CHAIR001.00X000
J MADDON PhD
BOARD SECRETARY001.00X000
J OSIECKI
BOARD TREASURER001.00X000
SISTER MARY MARGARET OSF
BOARD MEMBER001.00X000
A ARIAS
BOARD MEMBER001.00X000
M LEIB
BOARD MEMBER001.00X000
J SNYDER DO
BOARD MEMBER001.00X000
P BENYO MD
BOARD MEMBER001.00X000
A VEGLIA MD
BOARD MEMBER001.00X000
M LOBITZ DO
BOARD MEMBER001.00X000
M WASHINSKY DO
BOARD MEMBER001.00X000
A CUSATIS
BOARD MEMBER001.00X000
D PALERMO
BOARD MEMBER001.00X000
J AMENTLER
OCC HLTH MED DIRECTOR040.0018873108506X
D POGAR
PHARMACIST040.00101305025783X
C FERKO
PHARMACIST040.00104194025657X
J MCCUNE
PHARMACIST040.00103167025623X
FieldValueIRS element (for citing)
Total Reportable Comp From Org497397TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1728186TotalReportableCompFrmRltdOrgs
Total Other Compensation290934TotalOtherCompensation
Number Individuals GT100 K12NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
HAZLETON ANESTHESIA SERVICES PC
10 COMMERCE DRNEW ROCHELLENY10801ANESTHESIA SERVICES1278999
LABORATORY CORP OF AMERICA
PO BOX 12140BURLINGTONNC27216LABORATORY SERVICES875496
MORRISON MANAGEMENT SPECIALISTS
PO BOX 102289ATLANTAGA30368DIETARY MANAGEMENT668587
THE ADVISORY BOARD COMPANY
2445 M ST NWWASHINGTONDC20037CONSULTING SERVICES606400
WELLSPRING PARTNERS
P O BOX 12140BURLINGTONNC27216CONSULTING SERVICES444375
FieldValueIRS element (for citing)
Number Of Contractors GT100 K21NumberOfContractorsGT100K
Government Grants506906GovernmentGrants
All Other Contributions172117AllOtherContributions
Total Contributions679023TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Net patient service revenue900099103747809103453325294484
Pharmacy sales90009923810$23,810
Cafeteria sales62420051617$51,617
FieldValueIRS element (for citing)
Total Program Service Revenue103823236TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column991257TotalRevenueColumn
Exclusion$991,257ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real129379Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real129379Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column129379TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities13449008Securities
Other27195Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities13003170Securities
Other89391Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities445838Securities
Other-62196Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column383642TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Income Fundraising Events56864GrossIncomeFundraisingEvents
Fundraising Direct Expenses16105FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column40759TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Equity in affiliates900003673004673004
MSA revenue - HWC541610286722286722
Group rebates9000998390383903

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column80951TotalRevenueColumn
Related Or Exempt Function Income80951RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue1124580TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column107171876TotalRevenueColumn
Related Or Exempt Function Income104577905RelatedOrExemptFunctionIncome
Unrelated Business Revenue294484UnrelatedBusinessRevenue
Exclusion$1,066,684ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total36068763Total
Program Services29633784ProgramServices
Management And General6409081ManagementAndGeneral
Fundraising25898Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total8829066Total
Program Services8236436ProgramServices
Management And General582411ManagementAndGeneral
Fundraising10219Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2613876Total
Program Services2200755ProgramServices
Management And General411140ManagementAndGeneral
Fundraising1981Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total187116Total
Program Services30101ProgramServices
Management And General157015ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total80493Total
Management And General80493ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total185428Total
Management And General185428ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total25680Total
Fundraising25680Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total383159Total
Program Services27136ProgramServices
Management And General356023ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total12368657Total
Program Services11630730ProgramServices
Management And General737927ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3201553Total
Program Services2749366ProgramServices
Management And General452187ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total150923Total
Program Services141728ProgramServices
Management And General9195ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total63609Total
Program Services20444ProgramServices
Management And General43165ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2046333Total
Management And General2046333ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total6574898Total
Program Services6574898ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total1029906Total
Program Services1029906ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
CONTRACT LABOR599144599144
PURCHASED SERVICES465929828732491786049
PHYSICIAN FEES2289944219196997975
PROVISION FOR DOUBTFUL COLLECTIONS72978157297815
EQUIPMENT RENTAL AND MAINTENANCE23380291592187745842

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1476618Total
Program Services932699ProgramServices
Management And General543919ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total92470308Total
Program Services77762347ProgramServices
Management And General14644183ManagementAndGeneral
Fundraising63778Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY750BOY
EOY750EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY7446202BOY
EOY7984833EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY8859298BOY
EOY9972520EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY239196BOY
EOY182687EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY677174BOY
EOY774073EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY574727BOY
EOY803335EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis95896102LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec66871747LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY32859422BOY
EOY29024355EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY27137675BOY
EOY43815734EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY8737438BOY
EOY7806436EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY86531882BOY
EOY100364723EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY8343222BOY
EOY8406242EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY34691774BOY
EOY33731677EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY23280352BOY
EOY23208483EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY66315348BOY
EOY65346402EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY19421805BOY
EOY34380164EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY794729BOY
EOY638157EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY20216534BOY
EOY35018321EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY86531882BOY
EOY100364723EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses14701568ReconcilationRevenueExpenses
Reconcilation Other Changes100219ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii
Public Support Pertcentage1700.00000PublicSupportPertcentage170
Public Support Percentage5090.00000PublicSupportPercentage509
Investment Income Percentage0.00000InvestmentIncomePercentage

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

Total Direct Lobbying TotalDirectLobbying

FieldValueIRS element (for citing)
Filing Organizations Totals224478FilingOrganizationsTotals

Total Lobbying Expenditures TotalLobbyingExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals224478FilingOrganizationsTotals

Other Exempt Purpose Expenditures OtherExemptPurposeExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals92230954FilingOrganizationsTotals

Total Exempt Purpose Expenditures TotalExemptPurposeExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals92455432FilingOrganizationsTotals

Lobbying Nontaxable LobbyingNontaxableAmount

FieldValueIRS element (for citing)
Filing Organizations Totals1000000FilingOrganizationsTotals

Grassroots Nontaxable GrassrootsNontaxableAmount

FieldValueIRS element (for citing)
Filing Organizations Totals250000FilingOrganizationsTotals

Lobbying Nontaxable Amount2 LobbyingNontaxableAmount2

FieldValueIRS element (for citing)
Current Year Minus2254738CurrentYearMinus2
Current Year Minus1269218CurrentYearMinus1
Current Year224478CurrentYear
Total748434Total
FieldValueIRS element (for citing)
Lobbying Ceiling$1,122,651LobbyingCeilingAmount

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Included On FSfalseIncludedOnFS

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1139734OtherCostOrOtherBasis
Book Value1139734BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis66782945OtherCostOrOtherBasis
Depreciation50377398Depreciation
Book Value16405547BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis24516198OtherCostOrOtherBasis
Depreciation14908483Depreciation
Book Value9607715BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3457225OtherCostOrOtherBasis
Depreciation1585866Depreciation
Book Value1871359BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings29024355TotalOfBookValueLandBuildings

Other Assets OtherAssets (9 entries)

DescriptionDescriptionBook ValueBookValue
Due from Affiliates2414972
Investment in Hazleton Surgical Alliance1165608
Investment in Beltway Health LP1160322
Investment in Hazleton Health Wellness Center885221
Deferred Financing Expense760539
Assets Under Trust Indenture - Current610877
Other Current Assets442229
Investment in Hazleton St Joseph Medical Office Building190000
Other Long Term Assets176668
FieldValueIRS element (for citing)
Total Book Value Other Assets7806436TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (7 entries)

DescriptionDescriptionAmountAmount
Accrued Pension Costs$14,003,230
Third Party Settlements$6,057,238
Pension Payable$1,084,849
Capitalized Leases$1,083,099
Malpractice Insurance Liability$711,984
Other Liabilities$268,083
Commonwealth of Pennsylvania Payable
FieldValueIRS element (for citing)
Total Of Amounts23208483TotalOfAmounts
Total Revenue107171876TotalRevenue
Total Expenses92470308TotalExpenses
Excess Or Deficit For Year14701568ExcessOrDeficitForYear
Net Unrealized GL On Investments1001635NetUnrealizedGLOnInvestments
Other-$744,844OtherAmount
Total Adjustments256791TotalAdjustments
Excess Or Deficit Per FS14958359ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt108234899TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments1001635NetUnrealizedGainsInvestments
Revenue Not Rptd F9901001635RevenueNotRptdF990
Revenue Subtotal107233264RevenueSubtotal
Other Revenues Not Included-61388OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-61388RevenueNotRptdOnFinStmt
Total Revenue Per Form990107171876TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt92522800TotExpensesEtcAuditedFinclStmt
Expenses Subtotal92522800ExpensesSubtotal
Other Expenses Not Included-52492OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt-52492ExpensesNotRptdOnFinStmt
Total Expenses Per Form99092470308TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
XI8Minimum Pension Liability Adjustment 417,566
XI8Write down of intercompany receivable 1,827,278
XI8Long-term debt forgiveness 1,500,000
XII4bNet revenue from Hazleton St Joseph Medical Office Building, a related entity 61,388
XIII4bOperating expense from Hazleton St Joseph Medical Office Building, a related entity 52,491

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Solicitation Of Non Govt GrantsXSolicitationOfNonGovtGrants
Solicitation Of Govt GrantsXSolicitationOfGovtGrants
Special Fundraising EventsXSpecialFundraisingEvents
Agreement Ref FundraisingtrueAgreementRefFundraising

Fundraiser Activity Information FundraiserActivityInformation

Name Of Organization NameOfOrganization

FieldValueIRS element (for citing)
Business Name Line1A F TROMBINO & ASSOC LTDBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11040 LAFAYETTE STAddressLine1
CityCAPE MAYCity
StateNJState
ZIP Code08204ZIPCode
FieldValueIRS element (for citing)
ActivityGRANT CONSULTING SERVICESActivity
Fundraiser Control Of FundsfalseFundraiserControlOfFunds
Amount Retained By Contractor25202AmountRetainedByContractor
FieldValueIRS element (for citing)
Total Retained By Contractors25202TotalRetainedByContractors
Licensed StatesPALicensedStates

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Golf TournamentNameOfEvent1
Gross Receipts Event156864GrossReceiptsEvent1
Gross Revenue Event156864GrossRevenueEvent1
Non Cash Prizes Event13302NonCashPrizesEvent1
Rent Facility Costs Event19036RentFacilityCostsEvent1
Food And Beverage Event11971FoodAndBeverageEvent1
Other Direct Expenses Event11796OtherDirectExpensesEvent1
Gross Receipts Total56864GrossReceiptsTotal
Gross Revenue Total Events56864GrossRevenueTotalEvents
Non Cash Prizes Total Events3302NonCashPrizesTotalEvents
Rent Facility Costs Total Events9036RentFacilityCostsTotalEvents
Food And Beverage Total Events1971FoodAndBeverageTotalEvents
Other Direct Expenses Total Events1796OtherDirectExpensesTotalEvents
Direct Expense Summary Events16105DirectExpenseSummaryEvents
Net Income Summary40759NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense2150932TotalCommunityBenefitExpense
Net Community Benefit Expense2150932NetCommunityBenefitExpense
Percent Of Total Expense0.02330PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense11782004TotalCommunityBenefitExpense
Direct Offsetting Revenue8682888DirectOffsettingRevenue
Net Community Benefit Expense3099116NetCommunityBenefitExpense
Percent Of Total Expense0.03350PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense13932936TotalCommunityBenefitExpense
Direct Offsetting Revenue8682888DirectOffsettingRevenue
Net Community Benefit Expense5250048NetCommunityBenefitExpense
Percent Of Total Expense0.05680PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense353784TotalCommunityBenefitExpense
Direct Offsetting Revenue85486DirectOffsettingRevenue
Net Community Benefit Expense268298NetCommunityBenefitExpense
Percent Of Total Expense0.00290PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense103853TotalCommunityBenefitExpense
Direct Offsetting Revenue9388DirectOffsettingRevenue
Net Community Benefit Expense94465NetCommunityBenefitExpense
Percent Of Total Expense0.00100PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense249444TotalCommunityBenefitExpense
Net Community Benefit Expense249444NetCommunityBenefitExpense
Percent Of Total Expense0.00270PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense161522TotalCommunityBenefitExpense
Net Community Benefit Expense161522NetCommunityBenefitExpense
Percent Of Total Expense0.00170PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense868603TotalCommunityBenefitExpense
Direct Offsetting Revenue94874DirectOffsettingRevenue
Net Community Benefit Expense773729NetCommunityBenefitExpense
Percent Of Total Expense0.00830PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense14801539TotalCommunityBenefitExpense
Direct Offsetting Revenue8777762DirectOffsettingRevenue
Net Community Benefit Expense6023777NetCommunityBenefitExpense
Percent Of Total Expense0.06510PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense195098TotalCommunityBuildingExpense
Net Community Building Expense195098NetCommunityBuildingExpense
Percent Of Total Expense0.00210PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense26442TotalCommunityBuildingExpense
Net Community Building Expense26442NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense19555TotalCommunityBuildingExpense
Net Community Building Expense19555NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense137627TotalCommunityBuildingExpense
Net Community Building Expense137627NetCommunityBuildingExpense
Percent Of Total Expense0.00150PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense378722TotalCommunityBuildingExpense
Net Community Building Expense378722NetCommunityBuildingExpense
Percent Of Total Expense0.00410PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$1,566,841BadDebtExpenseAmount
Amount Attributable To983663AmountAttributableTo
Amount Reimbursed By Medicare36793715AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare36177646CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall616069MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line1Beltway Health LPBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivityMedical Office Space RentalDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.43780OrganizationProfitOrOwnership
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Northeastern Pennsylvania Health Corporation dba Hazleton General HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1700 E Broad StAddressLine1
CityHazletonCity
StatePAState
ZIP Code18201ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

IdentifierIdentifierExplanationExplanation
Part I line 3cN/A - Hazleton General Hospital uses the FPG to determine eligibility for providing free and discounted care. Uninsured patients will have their accounts adjusted in the amount of 60 as an Uninsured Discount to afford them the opportunity to avail themselves to similar arrangements offered to insured individuals and lessen their financial burden
Part I line 6aHazleton General Hospital community report activities are included with the Greater Hazleton Health Alliance annual community report, which is available by request or on our website at www.ghha.org
Part I line 7gThe subsidized health services are Hospitalist services.
Part I line 7 column fThe total expenses used in the calculation Percent of Total Expense ties back to the amount in Part IX, line 25, column A of 92,470,308.
Part I line 7Amounts used in the calculation of Charity Care and Other Community Benefits at Cost were calculated utilizing the optional supplemental worksheets provided by the IRS instructions to Schedule H.
Part III line 4The footnote to our financial statements that describes the bad debt expense is as follows Accounts receivable, patients are reported at net realizable value. Accounts are written off when they are determined to be uncollectible based on managements assessment of individual accounts. The allowance for doubtful collections is estimated based upon a periodic review of the accounts receivable aging, payor classification, and application of historical write-off percentages.
Part III line 4Bad debt expense is calculated using the worksheet provided by IRS instructions. The bad debt expense attributable to patients eligible under our charity care policy, was estimated using a sampling of accounts transferred to bad debts that were written off. We ran the patient information that we had through a 3rd-party software package to determine estimated eligibility for charity care had the patient provided the information necessary to complete the charity care application.
Part III line 8For 2010, there is no Medicare shortfall using only allowable costs however, if all costs are considered, a shortfall would exist of 2.1 million.
Part III line 9bPatient inquiries will be referred to a financial counselor who will assist the patient with the application process, as well as application for available government insurance programs. Once the application is completed, appropriate discounts will be determined.
Part III line 9bA 100 Charity Care discount will be provided to patients with incomes up to 100 of the Department of Health Human Services poverty level published on an annual basis. For patients with incomes between 100 and 300 of the poverty level, a percentage discount between 60 and 100 applies. A 60 Uninsured Patient Discount applies for patients with incomes greater than 300 of the poverty level.
Part VNortheastern Pennsylvania Health Corporation, dba Hazleton General Hospital, is a licensed general medical surgery community hospital who provides 24-hour emergency room care.
Part VSignage is posted in registration waiting areas notifying patients of the availability for Charity Care and other financial assistance. Correspondence and/or billing statements will also inform patients to contact a financial counselor if they are having difficulty in payment for services. In the patient handbook, it is posted that, in keeping with our mission, we offer Charity Care at free reduced rates. Patients need to contact a financial counselor to see if they are eligible.
Part VAll uninsured individuals received a 60 discount in 2010. The hospital monitors the overall collection rates experienced from commercial carriers as well as that of Medicare and uses the average of the two to gauge the discount applied to the bills of uninsured individuals. The uninsured discount is a higher percentage discount than the average of our top 3 insurance carriers.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgsBase Compensation Filing OrgBaseCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgComp Report Prior990 Filing OrgCompReportPrior990FilingOrg
J EDWARDS
380163100000735023159510672515795
W BAUER
18981147500714423022267477257735
J FLETCHER
14002520000479413453178272245689
M GOLDEN
15103437500564522822217001159867
A VALENTE
18054545000675023026255321249732
E PERRONG
12509921000173117575165405
L MILLER
15102537500562817668211821209181
J AMENTLER
18873156382868197237197970

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuer
Health Services Authority of Hazleton
232710214422025BJ42006-12-2810000000Expansion projectsfalsefalse
Health Services Authority of Hazleton
232710214422025BM72007-01-304000000Expansion projectsfalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds10000000TotalProceeds
Amount In Reserve Fund488231AmountInReserveFund
Issuance Costs From Proceeds200000IssuanceCostsFromProceeds
Capital Expenditures10000000CapitalExpenditures
Year Of Subst Completion2008YearOfSubstCompletion
Current RefundingfalseCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
falsefalsefalsefalsetruetrue
falsefalsefalsefalsetruetrue
true
true

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
falsetruefalsefalsefalsefalse
falsetruefalsefalsetruetrue

Schedule L IRS990ScheduleL

Loan Table LoanTable

FieldValueIRS element (for citing)
Name PersonEugene Gorski MDNamePerson
Purpose Of LoanRefinancing of debtPurposeOfLoan
Loan From OrganizationXLoanFromOrganization
Original Principal$250,000OriginalPrincipalAmount
Balance Due182687BalanceDue
DefaultfalseDefault
Approved By BoardtrueApprovedByBoard
Written AgreementtrueWrittenAgreement
FieldValueIRS element (for citing)
Total Balance Due182687TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
Marval Medical
Business of VP of Medical Affairs249444Hospitalist Servicestrue
Anthony Valente MD
VP of Medical Affairs12494Rental of Office Spacetrue

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (13 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990 Part III2New programs services at HGH include new emergency services such as hypothermia treatments for cardiac arrest patients and a Fast Track program in the Emergency Dept for urgent, but not emergent, conditions 24-hour pharmacy coverage, a clinical pharmacist program, and bedside medication verification a Catheter-Associated Urinary Tract Infection CAUTI program a second Health Beginnings Plus site 8-week osteoporosis therapy program Travel Health clinic Microvolt T-Wave Alternans MTWA cardiology testing laparoscopic sleeve gastrectomy and implantable cardioverter-defibrillator surgical services, and continued implementation of the Electronic Health Record EHR.
Form 990 Part VI6Greater Hazleton Health Alliance, a PA non-profit corporation is Northeastern Pennsylvania Health Corporations sole member. There are no stockholders.
Form 990 Part VI7aGreater Hazleton Health Alliance, the sole member, appoints the directors.
Form 990 Part VI7bGreater Hazleton Health Alliance, the sole member, makes and ratifies the decisions as specified in Northeastern Pennsylvania Health Corporations bylaws.
Form 990 Part VI11aIRS Form 990s for GHHA entities i.e. GHHA, HGH, HWC, HPS are prepared by the Finance Department and then reviewed by the CFO. A detailed summary of the 990s is presented to the Finance Committee and, subsequently, in accordance with the Finance Committees wishes, a brief summary is presented to the Board. Board members have the option to review each of the five 990s in detail. Upon approval, the 990s are then submitted to the IRS.
Form 990 Part VI12cYearly, all board members and executive staff receive the conflict of interest policy and are asked to complete a statement sheet reporting any possible business or personal conflicts. All statements are reviewed by the Compliance Officer. If any Board member has a conflict with a specific discussion at a Board meeting, he / she either removes himself / herself from the discussion or is included in the discussion, but is not allowed to vote on the matter at hand.
Form 990 Part VI15Compensation surveys are used to make a recommendation on the CEO payrate, for approval by the compensation committee. Compensation surveys are also used to make recommendations to the CEO on payrates for the other officers and the compensation committee reviews and approves those rates as well.
Form 990 Part VI19Greater Hazleton Health Alliance and affiliated entities makes the governing documents, conflicts of interest policy, tax return and financial statements available upon request. Also, Form 990 is available on www.guidestar.com.
Form 990 Part XI5Minimum Pension Liability Adjustment of 417,566
Form 990 Part XI5Write down of intercompany receivables of 1,827,278
Form 990 Part XI5Long-term debt forgiveness 1,500,000
Form 990 Part XI5Net unrealized gain on investments of 1,001,635
Form 990 Part XI5Increase in temporarily restricted net assets of 156,572

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Greater Hazleton Health Alliance
700 E Broad StHazletonPA18201232831830Management ServicesPA501c311N/Afalse
Hazleton Health & Wellness Center
700 E Broad StHazletonPA18201232580968Staffing ServicesPA501c33falseNortheastern Pennsylvania Health Corp DBA Hazleton General Hospital
Hazleton Professional Services
700 E Broad StHazletonPA18201205880364Physician ServicesPA501c33falseGreater Hazleton Health Alliance
Hazleton Surgical Alliance
700 E Broad StHazletonPA18201202038456Surgical ServicesPA501c33falseNortheastern Pennsylvania Health Corp DBA Hazleton General Hospital

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Hazleton Surgery Center LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line117480 Dallas Parkway Ste 210AddressLine1
CityDallasCity
StateTXState
ZIP Code75287ZIPCode
FieldValueIRS element (for citing)
EIN201232531EIN
Primary ActivitySurgical ServicesPrimaryActivity
Legal Domicile StateTXLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Hazleton Surgical AllianceBusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeRelatedPredominantIncomeType
Disproportionate AllocationsfalseDisproportionateAllocations
General Or Managing PartnertrueGeneralOrManagingPartner
Percentage Ownership0.63500PercentageOwnership

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Hazleton Saint Joseph Medical Office Building IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1700 E Broad StAddressLine1
CityHazletonCity
StatePAState
ZIP Code18201ZIPCode
FieldValueIRS element (for citing)
EIN232500981EIN
Primary ActivityMedical Office RentalPrimaryActivity
Legal Domicile StatePALegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Northeastern Pennsylvania Health Corp DBA Hazleton General HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityC CorpTypeOfEntity
Percentage Ownership1.00000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (14 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Hazleton Professional Services
i201244Actual Rent Expense
Hazleton Professional Services
k277155Management Fee
Greater Hazleton Health Alliance
l8372817Management Fee Expense
Hazleton Health & Wellness Center
n3216162Allocated Labor Costs
Greater Hazleton Health Alliance
o5155113Actual Expenses
Saint Joseph Medical Office Building
o24190Actual Expenses
Hazleton Professional Services
p731006Actual Expenses
Saint Joseph Medical Office Building
p51282Actual Expenses
Greater Hazleton Health Alliance
q8294887Cash Transfers Over Expenses
Hazleton Professional Services
q400000Cash Transfers
Hazleton Health & Wellness Center
q3575000Cash Transfers
Intercompany write down - HPS
q
Intercompany write down - HWC
q
Dividend distribution from HSA to HGH
r

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