2011-11-11T10:26:41-06:00 2011-06-30 NANTICOKE HEALTH SERVICES 801 MIDDLEFORD RD SEAFORD DE 199733636 990 2010-07-01 510069243 NANTICOKE MEMORIAL HOSPITAL INC NANT 3026296611 801 MIDDLEFORD ROAD SEAFORD DE 19973 DEAN A SWINGLE 3026296611 2011-11-07 2011-11-11 2010 2016-03-07 17:11:31Z STEVEN ROSE 801 MIDDLEFORD ROAD SEAFORD DE 19973 114753445 false X WWW.NANTICOKE.ORG X 1945 DE NANTICOKE MEMORIAL HOSPITAL OPERATES IN A MANNER CONSISTENT WITH THE REQUIREMENTS OF REVENUE RULING 69-545, THROUGH ITS PROVISION OF HEALTH CARE SERVICES TO THE COMMUNITY, REGARDLESS OF ABILITY TO PAY. 16 13 977 235 0 0 103075460 110222611 1311419 622793 2082200 1895372 106469079 112740776 155000 38899 0 54440096 56204048 0 0 51449388 54207757 106044484 110450704 424595 2290072 93198476 91535165 65401218 60977575 27797258 30557590 X NANTICOKE MEMORIAL HOSPITAL OPERATES IN A MANNER CONSISTENT WITH THE REQUIREMENTS OF REVENUE RULING 69-545, THROUGH ITS PROVISION OF HEALTH CARE SERVICES TO THE COMMUNITY, REGARDLESS OF ABILITY TO PAY. false false 91130694 38899 SEE ATTACHED STATEMENT 91130694 true false false true false false false false false false true false false true true false false true false false false false false false false false true true true false true false false false false false false false false false false false false false true false false false false true 168 0 false 977 true false false false false false false false false false false false false X 16 13 true false false false true false false true true false false true true true true true true true true false DE X X ACCOUNTING DEPT 3026296611 801 MIDDLEFORD RD SEAFORD DE 19973 STEVEN ROSE 40.00 X X 416154 0 110833 DARR HALL 40.00 X 227470 0 51540 THERESA DRYE 40.00 X 196297 0 12133 THOMAS BROWN 40.00 X 189468 0 43278 DON TRICARICO 40.00 X 149846 0 24767 PENNY SHORT 40.00 X 145237 0 46845 ROBERT FERBER MD 40.00 X 230779 0 29442 ABIMBOLA OLOWO MD 40.00 X 222951 0 29394 MAUSHUMI BAROOAH MD 40.00 X 192689 0 12426 IMRAN JANJUA MD 40.00 X 186375 0 15493 MEREDITH ARTHUR 40.00 X 182952 0 8236 2340218 384387 23 false true false CERNER CORPORATION 2800 ROCKCREEK PARKWAY KANSAS CITY MO 64141 TECHNOLOGY 2701065 DELPHI HEALTHCARE 170 SOUTHPORT DRIVE MORRISVILLE NC 27560 ORTHOPEDICS 1574613 ANESTHESIA SERVICES PA 2 READS WAY NEW CASTLE DE 19720 ANESTHESIA 1337499 ARAMARK 25271 NETWORK PLACE CHICAGO IL 60673 FOOD SERVICE 1138560 MASTERPLAN 21540 PLUMMER STREET CHATSWORTH CA 91311 BIO-MEDICAL 842391 26 NET PATIENT REVENUE 110222611 110222611 110222611 634962 634962 2000000 500 2012669 -12669 500 -12169 -12169 MISCELLANEOUS REVENUE 1186894 1186894 CAFETERIA REVENUE 520403 520403 GIFT SHOP REVENUE 142661 142661 45414 45414 1895372 112740776 111397336 1343440 38899 38899 1324472 1158833 165639 40215775 36636571 3579204 2377720 2166103 211617 9528163 8680156 848007 2757918 2512463 245455 232257 232257 136589 136589 714591 493068 221523 3602718 2485875 1116843 293599 202583 91016 2426549 2426549 6569639 6569639 1396585 963644 432941 SUPPLIES 17231888 11890003 5341885 PURCH SRVCS-TECHNOLOGY 3393481 2341502 1051979 MEDICARE REIMB CONSULTANT 2016748 1391556 625192 EQUIPMENT RENTAL 1671777 1153526 518251 PURCH SRVCS-ORTHOPEDICS 1485188 1024780 460408 13036148 8994944 4041204 110450704 91130694 19320010 0 3264557 130836 11987861 11341985 5247792 4775584 1542740 1624950 706708 907311 92694669 55069750 39457868 37624919 24686378 28775634 6304572 6353946 93198476 91535165 9796005 9342958 40795575 39752910 6109000 6284685 8700638 5597022 65401218 60977575 X 27797258 30557590 27797258 30557590 93198476 91535165 2290072 470260 X false true true X false X false false false false false false false false false true 14061 true false false 14061 false false false false false SCHEDULE C, PART II-B, LINE 1I NANTICOKE MEMORIAL HOSPITAL PAYS DUES TO AHA AND DEHA: THE AMERICAN HOSPITAL ASSOCIATION AND THE DELAWARE HEALTHCARE ASSOCIATION. FOR 2010 THE AMOUNT OF DUES RELATING TO LOBBYING ACTIVITES WAS 14,061. NANTICOKE MEMORIAL HOSPITAL'S MANAGEMENT ALSO CORRESPONDS WITH OUR STATE AND FEDERAL LEGISLATORS REGARDING PENDING LEGISLATION AND REGULATIONS THAT MAY FINANCIALLY IMPACT THE HOSPITAL AND ITS ABILITY TO PROVIDE QUALITY HEALTHCARE TO THE COMMUNITY. false false false false false false false false false false 92694669 55069750 37624919 37624919 DEBT SERVICE FUND 4042926 DEFERRED FINANCING COSTS, NET 1069265 PENSION PLAN 698124 PRIN & INT SINKING FUND 543631 6353946 ACC POST-RETIRE LIABILITY 5237834 INTEREST PAYABLE 359188 5597022 true true true X 1.75000 true X true true true false true true 2004 2775950 2775950 0.02510 36918 27330399 19908903 7421496 0.06720 38922 30106349 19908903 10197446 0.09230 320 24887 794334 794334 0.00720 350 4000 167860 167860 0.00150 670 28887 962194 962194 0.00870 670 67809 31068543 19908903 11159640 0.10100 150 150 421797 421797 0.00380 150 150 421797 421797 0.00380 true 4352830 35130549 38716400 -3585851 X true true 1 1 NANTICOKE MEMORIAL HOSPITAL

801 MIDDLEFORD ROAD SEAFORD DE 19973

X X X NANTICOKE MEMORIAL HOSPITAL 1 COMMUNITY BUILDING ACTIVITIES PART II THE COMMUNITY BENEFIT COMMITTEE CBC OF THE BOARD CONTINUES TO TARGET COMMUNITY EDUCATION FOR STROKE CANCER AND DIGITAL MAMMOGRAPHY THESE TOPICS HAVE BEEN IDENTIFIED AS NEEDS WITHIN THE COMMUNITY THAT ALIGN WITH CURRENT NHS INITIATIVES IN ADDITION THE CBC USING THE DATA COMPLIED FOR THE OCTOBER 2010 CHA HAS DEVELOPED OUTREACH INITIATIVES SPECIFICALLY TARGETING DIABETES AND OBESITY THE CBC HAS ALSO FORMED A LATINO OUTREACH COMMITTEE CHARGED TO DEVELOP HEALTH EDUCATION AND OUTREACH FOR THE AREAS GROWING HISPANIC POPULATION BAD DEBT EXPENSE EXPLANATION PART III LINE 4 THE ORGANIZATION PROVIDES CARE WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY BECAUSE THE ORGANIZATION DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE THOSE AMOUNTS ARE NOT REPORTED AS REVENUES FOR THOSE PATIENTS WHO DID NOT MEET THE CHARITY CARE POLICY THE ORGANIZATION MUST EVALUATE THEIR ABILITY TO COLLECT AMOUNTS DUE FROM PATIENTS THAT ARE PAST DUE A PROVISION FOR BAD DEBTS IS RECORDED FOR AMOUNTS NOT YET WRITTEN OFF WHICH ARE EXPECTED TO BECOME UNCOLLECTIBLE THE HOSPITALS POLICY IS TO HAVE A MINIMUM OF 2 3 STATMENTS AND A FINAL NOTICE BEFORE SENDING PATIENT ACCOUNTS TO COLLECTIONS ADDITIONALLY ACCOUNTS GREATER THAN 500 ARE ATTEMPTED TO BE REACHED BY TELEPHONE MEDICARE EXPLANATION PART III LINE 8 THE ENTIRE SHORTFALL RELATED TO MEDICARE REPORTED ON LINE 7 PART III SHOULD BE CONSIDERED A COMMUNITY BENEFIT NANTICOKE MEMORIAL HOSPITAL IS BEARING THE BURDEN OF PROVIDING CARE IN EXCESS OF OUR COSTS TO THESE MEDICARE PATIENTS NEEDS ASSESSMENT PART VI NANTICOKE HEALTH SERVICES CURRENTLY USES AVAILABLE STATE DATA ON COMMUNITY HEALTH NEEDS THE STATE OF DELAWARE CURRENTLY CONDUCTS STATEWIDE REPORTS ON HEALTH DISPARITIES FOR THOSE WITHOUT INSURANCE THIS REPORT IS PRODUCED ABOUT EVERY FIVE YEARS ADDITIONALLY THE STATE OF DELAWARE PUBLISHED RACIAL AND ETHNIC DISPARITIES HEALTH STATUS REPORT CARD IN 2008 THIS REPORT INCLUDES COUNTY LEVEL DETAIL THE STATE OF DELAWARE ALSO PRODUCES HEALTH NEED DATA ON DIABETES CANCER WOMENS AND CHILDRENS HEALTH AND PROVIDER ACCESS IN ADDITION TO STATE DATA HOSPITAL DATA IS USED NANTICOKE MEMORIAL HOSPITAL TREATS A LARGE NUMBER OF MEDICAID PATIENTS IN ADDITION IN OCTOBER 2010 NANTICOKE CONDUCTED A COMMUNITY NEEDS ASSESSMENT SURVEY SURVEYS WERE COLLECTED FROM PHYSICIANS HIGH SCHOOL WELLNESS PROGRAM COORDINATORS CLERGY AND THE COMMUNITY AT LARGE RESULTS WERE COMBINED WITH THE ABOVE MENTIONED STATE DATA FOR THE PURPOSES OF PLANNING FOR COMMUNITY HEALTH OUTREACH NEEDS COMMUNITY SURVEYS ARE CONDUCTED ON AN ONGOING BASIS PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI NANTICOKE MEMORIAL HOSPITAL PROVIDES INFORMATION IN THEIR PATIENT INFORMATION AND VISITORS GUIDE UNDER THE FINANCIAL ARRANGEMENTINSURANCE SECTION CONCERNING THE AVAILABILITY OF FINANCIAL COUNSELORS TO DISCUSS PAYMENT ARRANGEMENTS AT THIS TIME PATIENTS ARE INFORMED ABOUT ALL THE PROGRAMS AVAILABLE TO THEM BOTH VERBALLY AND IN WRITTEN FORMAT IN PATIENTS WITHOUT ANY HEALTH INSURANCE ARE INFORMED AND SCREENED FOR POSSIBLE ELIGIBILITY FOR DELAWARE MEDICAID ASSISTANCE THE FOLLOWING DEPARTMENTS OFFER THIS TYPE OF ASSISTANCE TO OUR PATIENTS BUSINESS OFFICE REGISTRATION CASE MANAGEMENT CHAPS COORDINATOR CANCER CARE COORDINATOR CANCER NURSE NAVIGATOR SCREENING OUTREACH AND PRESCRIPTION ASSISTANCE PROGRAM COMMUNITY INFORMATION PART VI SEE ATTACHED STATEMENT false AMERICAN CANCER SOCIETY P O BOX 163 SALISBURY MD 21803 580659875 3 7000 CANCER RESEARCH X true true X X X X X false true false false false false false false false STEVEN ROSE 371154 45000 42500 68333 526987 DARR HALL 205514 21956 16500 35040 279010 THERESA DRYE 196297 2683 9450 208430 THOMAS BROWN 176207 13261 16500 26778 232746 DON TRICARICO 136511 13335 5604 19163 174613 PENNY SHORT 142232 3005 16500 30345 192082 ROBERT FERBER MD 230779 29442 260221 ABIMBOLA OLOWO MD 222951 29394 252345 MAUSHUMI BAROOAH MD 192689 12426 205115 IMRAN JANJUA MD 186375 15493 201868 MEREDITH ARTHUR 182952 8236 191188 ORGANIZATION'S MISSION FORM 990 - ORGANIZATION'S MISSION NANTICOKE MEMORIAL HOSPITAL OPERATES IN A MANNER CONSISTENT WITH THE REQUIREMENTS OF REVENUE RULING 69-545, THROUGH ITS PROVISION OF HEALTH CARE SERVICES TO THE COMMUNITY, REGARDLESS OF ABILITY TO PAY. ADDITIONAL INFORMATION FORM 990 NANTICOKE MEMORIAL HOSPITAL PAID PENCO CORPORATION 37,783 FOR PLUMBING SUPPLIES, DURING 2010, IN THE ORDINARY COURSE OF BUSINESS. KENT PETERSON IS A BOARD MEMBER OF NANTICOKE MEMORIAL HOSPITAL AND A SHAREHOLDER OF PENCO CORPORATION. RELATED PARTY INFORMATION AMONG OFFICERS FORM 990, PAGE 6, PART VI, LINE 2 PENNY SHORT DANNY SHORT CNO DIRECTOR IN-LAWS CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PAGE 6, PART VI, LINE 6 NANTICOKE HEALTH SERVICES, INC IS THE SOLE SHAREHOLDER. ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B A COPY OF THE FORM 990 IS PROVIDED TO EACH MEMBER OF THE BOARD OF DIRECTORS BEFORE BEING FILED. ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C ANNUAL DISCLOSURES ARE REVIEWED BY THE FINANCE DEPARTMENT. COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A ON AN ANNUAL BASIS, THE BOARD OF DIRECTORS' CHAIRMAN AND CHAIRMAN-ELECT REVIEW THE EXECUTIVE COMPENSATION OF THE CEO, SENIOR VP'S AND VP'S. AS PART OF THAT PROCESS, THE FACILITY'S OPERATIONS AND PERFORMANCE ARE TAKEN INTO CONSIDERATION, WHICH INCLUDE REVIEW OF HOSPITAL QUALITY INDICATORS, FINANCIAL PERFOMANCE, EMPLOYEE SATISFACTION SCORES AND PHYSICIAN SATISFACTION SCORES. THE PROCESS INCLUDES A REVIEW OF ACCOMPLISHMENTS OF EACH OF THE EXECUTIVES AND THEIR IMPORTANCE TO THE OVERALL ORGANIZATION. IN DETERMINING THE REASONABLENESS OF THE COMPENSATION, OTHER AREA HOSPITAL FORM 990'S ARE REVIEWED FOR THEIR EXECUTIVE COMPENSATION AS WELL AS PUBLISHED NATIONAL SALARY SURVEY DATA. AFTER THE REVIEW AND RECOMMENDATION OF THE CHAIRMAN AND VICE-CHAIRMAN, IT IS THEN PRESENTED TO THE FULL BOARD OF DIRECTORS, WHO REVIEW THE ANNUAL COMPENSATION REQUESTS AND EITHER APPROVE OR RECOMMEND APPROPRIATE CHANGES FOR IMPLEMENTATION. COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B SEE QUESTION 15A, ABOVE. GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC VIA ANOTHER'S WEB-SITE AND UPON REQUEST. OTHER EXPENSES FORM 990, PART IX, LINE 24F PURCH SRVCS-ANESTHESIA 1,362,495 MGMT FEES-PHARMACY 991,481 PURCH SRVCS-CANCER CARE 873,131 PURCH SRVCS-BIO-MEDICAL 806,701 LAB EXPENSE 700,856 PURCH SRVCS-MED RECORDS 634,397 PURCH SRVCS-PRINT SHOP 588,679 PURCH SRVCS-RADIOLOGY 568,075 MISCELLANEOUS 526,210 EMER &TRAUMA EXPENSE 518,299 PURCH SRVCS-WOUND CARE 431,363 PURCH SRVCS-HOUSEKEEPING 429,900 RECRUITMENT 421,797 COLLECTION/BANK FEES 370,352 PURCH SRVCS-OTHER HEALTHC 331,397 TELEPHONE 306,716 POSTAGE 263,213 PURCH SRVCS-LINEN 262,889 PURCH SRVCS-FACILITIES 259,193 PURCH SRVCS-DIALYSIS 233,824 PURCH SRVCS- HUMAN RES 220,952 PURCH SRVCS-FOOD SRVC 198,377 CASH MANAGEMENT FEES 156,088 PURCH SRVCS-HOSPITALISTS 151,764 PROF FEES-CANCER CARE 150,000 MGMT FEES-FACILITIES 145,005 PURCH SRVCS-BUS OFFICE 142,000 PROF FEES-HUMAN RESOURCES 137,703 PURCH SRVCS-COMP MGMT 135,183 OTHER PHYSICIAN FEES 132,128 PROF FEES-ADMIN 127,866 PURCH SRVCS-MATL MGMT 122,529 TRASH REMOVAL 90,245 PURCH SRVCS-ACCOUNTING 74,770 BOARD EXPENSE 66,080 PURCH SRVCS-PT EXPERIENCE 39,074 OTHER PROFESSIONAL FEES 38,027 PURCH SRVCS-OCCUP HLTH 27,389 NANTICOKE HEALTH SERVICES INC 801 MIDDLEFORD ROAD SEAFORD DE 19973 510293888 HEALTH SER DE 501C3 11B NANTICOKE HEALTH SERVICES false NANTICOKE ALTERNATIVE CARE INC 801 MIDDLEFORD ROAD SEAFORD DE 19973 510328654 HEALTH SER DE 501C3 9 NANTICOKE HEALTH SERVICES true MID-SUSSEX MEDICAL CENTER INC 801 MIDDLEFORD ROAD SEAFORD DE 19973 510224470 HEALTH SER DE 501C3 9 NANTICOKE HEALTH SERVICES true DUAL DEVELOPMENT CORP 801 MIDDLEFORD ROAD SEAFORD DE 19973 510293892 PROPERTY DE 501C3 11B NANTICOKE HEALTH SERVICES true NANTICOKE INSURANCE CO PO BOX 1109 GT GEORGE TOWN CJ 980446259 INSURANCE CJ NANTICOKE HEALTH SERVICES true PROPRIETARY ENTERPRISES INC 801 MIDDLEFORD ROAD SEAFORD DE 19973 510293887 INACTIVE DE N/A false false false false false false false false true true true true true true true true false false DUAL DEVELOPMENT J 933453 CASH NANTICOKE INSURANCE CO L 1433030 CASH