ROBERT PACKER HOSPITAL: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
ROBERT PACKER HOSPITAL (EIN 24-0795463)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-13
IRS object ID
201141339349304729
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

FieldValueIRS element (for citing)
Timestamp2011-05-13T15:18:45-04:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PricewaterhouseCoopers LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12001 MARKET ST SUITE 1700AddressLine1
CityPHILADELPHIACity
StatePAState
ZIP Code19103ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN240795463EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ROBERT PACKER HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlROBENameControl
Phone5708874625Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE GUTHRIE SQUAREAddressLine1
CitySAYRECity
StatePAState
ZIP Code18840ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARIE DROEGEName
TitlePRESIDENT & COOTitle
Date Signed2011-05-11DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone2673303000Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMARIE DROEGENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1GUTHRIE SQUAREAddressLine1
CitySAYRECity
StatePAState
ZIP Code18840ZIPCode
FieldValueIRS element (for citing)
Gross Receipts398170367GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.GUTHRIE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1885YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionROBERT PACKER HOSPITAL PROVIDES HEALTHCARE SERVICES TO RESIDENTS OF THE SURROUNDING COMMUNITY ON AN IN-PATIENT AND OUT-PATIENT BASIS. APPROXIMATELY 14,167 PATIENTS WERE ADMITTED TO RPH IN FYE 6/30/10.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees1731TotalNbrEmployees
Total Nbr Volunteers248TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2000736ContributionsGrantsPriorYear
Contributions Grants Current Year1824613ContributionsGrantsCurrentYear
Program Service Revenue Prior Year224253237ProgramServiceRevenuePriorYear
Program Service Revenue CY240099269ProgramServiceRevenueCY
Investment Income Prior Year-16017598InvestmentIncomePriorYear
Investment Income Current Year15375473InvestmentIncomeCurrentYear
Other Revenue Prior Year24773331OtherRevenuePriorYear
Other Revenue Current Year-2477988OtherRevenueCurrentYear
Total Revenue Prior Year235009706TotalRevenuePriorYear
Total Revenue Current Year254821367TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year16250GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY15925GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year70134526SalariesEtcPriorYear
Salaries Etc Current Year74736374SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year132201946OtherExpensePriorYear
Other Expenses Current Year133967056OtherExpensesCurrentYear
Total Expenses Prior Year202352722TotalExpensesPriorYear
Total Expenses Current Year208719355TotalExpensesCurrentYear
Revenues Less Expenses Prior Year32656984RevenuesLessExpensesPriorYear
Revenues Less Expenses CY46102012RevenuesLessExpensesCY
Total Assets BOY250785059TotalAssetsBOY
Total Assets EOY290767514TotalAssetsEOY
Total Liabilities BOY173153910TotalLiabilitiesBOY
Total Liabilities EOY176817165TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY77631149NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY113950349NetAssetsOrFundBalancesEOY
Mission DescriptionROBERT PACKER HOSPITAL IS AN AFFILIATE OF GUTHRIE HEALTH. GUTHRIE HEALTH IS A NONPROFIT HEALTH CARE ORGANIZATION THAT SERVES TO COORDINATE THE ACTIVITY OF GUTHRIE CLINIC (CLINIC) AND THE AFFILIATES WITHIN GUTHRIE HEALTHCARE SYSTEM (GHS; SEE FORM 990, SCHEDULE R, FOR A LISTING OF AFFILIATES OF GHS, INCLUDING ROBERT PACKER HOSPITAL (RPH)). THROUGH THE ACTIVITIES OF THE CLINIC, GHS, RPH, AND ITS OTHER AFFILIATES (COLLECTIVELY REFERRED TO AS "GUTHRIE"), GUTHRIE HEALTH PROVIDES CHARITABLE COMMUNITY-BASED HEALTH CARE SERVICES AND PROGRAMS TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE AND COMMUNITIES SERVED BY ITS FACILITIES AND PROVIDERS. THESE CHARITABLE ACTIVITIES INCLUDE PROVIDING PRIMARY CARE AND SPECIALTY PHYSICIAN SERVICES, AS WELL AS OPERATING A TERTIARY CARE TEACHING HOSPITAL, COMMUNITY HOSPITALS, A RESEARCH INSTITUTE, HOME CARE, HOSPICE CARE AND A LONG-TERM CARE FACILITY. THE GUTHRIE RESEARCH INSTITUTE AND GUTHRIE CLINICAL RESEARCH FUNCTIONS OF THE GUTHRIE FOUNDATION FOR MEDICAMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense148572784Expense
Grants0Grants
Revenue239840567Revenue
DescriptionROBERT PACKER HOSPITAL PROVIDES HEALTHCARE SERVICES TO RESIDENTS OF THE SURROUNDING COMMUNITY ON AN IN-PATIENT AND OUT-PATIENT BASIS. APPROXIMATELY 14,167 PATIENTS WERE ADMITTED TO THE HOSPITAL IN FYE 6/30/2010. PATIENT DAYS TOTALED 59,381.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense8997236Expense
Grants15925Grants
Revenue258702Revenue
DescriptionROBERT PACKER HOSPITAL PROVIDES EDUCATION SERVICES TO ITS EMPLOYEES AND MEMBERS OF THE COMMUNITY. THE FOLLOWING EDUCATIONAL SERVICES ARE PROVIDED: 1) X-RAY TECHNOLOGY; 2) RESPIRATORY THERAPY; 3) MEDICAL RESIDENTS & STUDENTS; 4) LABORATORY TECHNOLOGY; AND 5) ROBERT PACKER SCHOOL OF NURSING (AN AFFILIATE).Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense157570020TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPtrueLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArttrueDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10961NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1731NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
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 VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledPAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMICHELE Y SISTONamePerson
Telephone Number5708874625TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1ONE GUTHRIE SQUAREAddressLine1
CitySAYRECity
StatePAState
ZIP Code18840ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (27 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
MARIE DROEGE
PRESIDENT & COO40.0XX34097609172
DAVID LR GIBBS
CHAIRMAN BOD1.0X000
RICHARD T RYNONE
VICE CHAIR BOD1.0X000
JOSEPH R JOYCE
SECRETARY/TREASURER BOD1.0X000
DANIEL J BROWN MD
MEMBER BOD1.0X046425743062
MARK A DIXON
MEMBER BOD1.0X000
MARVIN L FIRSHER II
MEMBER BOD1.0X000
KATHRYN B HASSEE
MEMBER BOD1.0X000
DEAN HOSTERMAN
MEMBER BOD1.0X000
RHONDA G MOSS-TATICH
MEMBER BOD1.0X000
SURYA NARAYANAN MD
MEMBER BOD1.0X034640538770
SEAN NICHOLSON
MEMBER BOD1.0X000
BURDETT R PORTER MD
MEMBER BOD1.0X038290343062
DOUGLAS G RICH
MEMBER BOD1.0X000
DANIEL SPORN MD
MEMBER BOD1.0X073110243062
JOHN NESPOLI
MEMBER BOD1.0X0259104132077
LAWRENCE SAMPSON MD
MEMBER BOD1.0X042283443062
MINH DANG
CFO39.0X021062427350
BONNIE ONOFRE
CHIEF NURSING OFFICER38.020539908684X
GEORGE ELLIS MD
EMERGENCY MEDICINE CHAIRMAN40.0315386034881X
ANOTHONY OLIVA DO CMO
CHIEF MEDICAL OFFICER32.0444498019762X
BARBARA PENNYPACKER
VP SURGICAL SERVICES27.0147396024549X
CHARLES MCGURK MD
PHYSICIAN40.0277732013976X
JAY SHAH MD
PHYSICIAN40.0274354024812X
RUSSELL BURKETT MD
PHYSICIAN40.0261279024812X
MARC HARRIS MD
PHYSICIAN40.0254555016239X
JAMES RAFTIS MD
PHYSICIAN40.0251530024812X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2773105TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2817229TotalReportableCompFrmRltdOrgs
Total Other Compensation572144TotalOtherCompensation
Number Individuals GT100 K32NumberIndividualsGT100K
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
WELLIVER MCGUIRE INC
250 NORTH GENESEE STMONTOUR FALLSNY14865CONTRACTOR SERVICES1985755
MORGAN LEWIS BOCKIUS
2000 ONE LOGAN SQUAREPHILADELPHIAPA19103LEGAL SERVICES878237
EXECUTIVE HEALTH RESOURCES
PO BOX 822688PHILADELPHIAPA19182HEALTH PROF SERVICES803021
PARIS COMPANIES
67 HOOVER AVEDUBOISPA15801LAUNDRY SERVICES626046
DIVERSIFIED CLINICAL SERVICES
4500 SALISBURY ROAD SUITE 300JACKSONVILLEFL32216HEALTHCARE SERVICES609907
FieldValueIRS element (for citing)
Number Of Contractors GT100 K16NumberOfContractorsGT100K
Federated Campaigns0FederatedCampaigns
Membership Dues0MembershipDues
Fundraising Events0FundraisingEvents
Related Organizations18500RelatedOrganizations
Government Grants436634GovernmentGrants
All Other Contributions1369479AllOtherContributions
Noncash Contributions6542NoncashContributions
Total Contributions1824613TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE REVENUE621990127667130127667130
EDUCATIONAL SERVICES611600258702258702
MEDICARE AND MEDICAID PAYMENTS621990112173437112173437
FieldValueIRS element (for citing)
Total Program Service Revenue240099269TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column5039374TotalRevenueColumn
Exclusion$5,039,374ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities153650489Securities
Other34610Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities143320845Securities
Other28155Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities10329644Securities
Other6455Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column10336099TotalRevenueColumn
Exclusion$10,336,099ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events0GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events0CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses0FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Income Gaming0GrossIncomeGaming
Gaming Direct Expenses0GamingDirectExpenses

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Cost Of Goods Sold0CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CHANGE IN DVIATIVE INSTRUMENT900099-9701792-$9,701,792
ALL OTHER REVENUE72238047223804
FieldValueIRS element (for citing)
Total Other Revenue-2477988TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column254821367TotalRevenueColumn
Related Or Exempt Function Income247323073RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$5,673,681ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total15925Total
Program Services15925ProgramServices

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)
Total1703566Total
Program Services522214ProgramServices
Management And General1181352ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total57159085Total
Program Services47484325ProgramServices
Management And General9674760ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total3266761Total
Program Services2666158ProgramServices
Management And General600603ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total8164329Total
Program Services6401405ProgramServices
Management And General1762924ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4442633Total
Program Services3625843ProgramServices
Management And General816790ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total6691645Total
Program Services239592ProgramServices
Management And General6452053ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total459751Total
Program Services3935ProgramServices
Management And General455817ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total1874540Total
Program Services0ProgramServices
Management And General1874540ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total21828Total
Management And General21828ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total28942317Total
Program Services24352842ProgramServices
Management And General4589475ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total66075Total
Program Services49439ProgramServices
Management And General16635ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total56628116Total
Program Services54604699ProgramServices
Management And General2023417ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total4648301Total
Program Services623604ProgramServices
Management And General4024697ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total4033476Total
Program Services465116ProgramServices
Management And General3568360ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total341260Total
Program Services304354ProgramServices
Management And General36906ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total153997Total
Program Services129555ProgramServices
Management And General24442ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2803602Total
Program Services0ProgramServices
Management And General2803602ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total11232712Total
Program Services34540ProgramServices
Management And General11198172ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total-86942Total
Program Services793473ProgramServices
Management And General-880415ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT1466749914667499
CAFETERIA/CATERING33710326605671047
ACCRETION EXPENSES1706720170672
ALL OTHER EXPENSES981104319446661658

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total208719355Total
Program Services157570020ProgramServices
Management And General51149335ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY4898499BOY
EOY2578326EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY105895BOY
EOY781EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY29065874BOY
EOY27816844EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY120000BOY
EOY90000EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY4871979BOY
EOY5411981EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3149381BOY
EOY3498390EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis214817326LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec141447309LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY73418368BOY
EOY73370017EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY132187063BOY
EOY174570063EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2968000BOY
EOY3431112EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY250785059BOY
EOY290767514EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY33593065BOY
EOY32284215EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY2953075BOY
EOY1683754EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY136607770BOY
EOY142849196EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY173153910BOY
EOY176817165EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY73377799BOY
EOY110089583EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY4216450BOY
EOY3812814EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY36900BOY
EOY47952EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY77631149BOY
EOY113950349EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY250785059BOY
EOY290767514EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Total0Total

Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Total0Total

Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Total0Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Total0Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total0AmountsSubstContributorsTotal
Public Support Total1700PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Total0Total

Net UBI NetUBI

FieldValueIRS element (for citing)
Total0Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Total0Total
FieldValueIRS element (for citing)
Total Support0TotalSupport
Gross Receipts From Admissions Etc0GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.00000PublicSupportPertcentage170
Public Support Pertcent Prior Year0.00000PublicSupportPertcentPriorYear

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Total0Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Total0Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Total0Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Total0Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total0Total
FieldValueIRS element (for citing)
Public Support Total5090PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Total0Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Total0Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total0Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Total0Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total0Total
FieldValueIRS element (for citing)
Public Support Percentage5090.00000PublicSupportPercentage509
Prior Year Support Percentage0.00000PriorYearSupportPercentage
Investment Income Percentage0.00000InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00000PriorYrInvestIncomePercentage

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

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$21,828OtherActivitiesAmount
Total Lobbying Expenditures IIB21828TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierSCHEDULE C, PART 11-B, LINE 1IIdentifier
Return ReferenceOTHER LOBBYING ACTIVITIESReturnReference
ExplanationMEMBERSHIPS IN AMERICAN HOSPITAL (AHA) AND THE HOSPITAL & HEALTHSYSTEM ASSOCIATION OF PENNSYLVANIA (HAP)Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Included On FSfalseIncludedOnFS

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis677915OtherCostOrOtherBasis
Book Value677915BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis121916333OtherCostOrOtherBasis
Depreciation75054061Depreciation
Book Value46862272BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis4365700OtherCostOrOtherBasis
Depreciation1873931Depreciation
Book Value2491769BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis82645120OtherCostOrOtherBasis
Depreciation62085299Depreciation
Book Value20559821BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis5212258OtherCostOrOtherBasis
Depreciation2434018Depreciation
Book Value2778240BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings73370017TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (8 entries)

DescriptionDescriptionAmountAmount
ESTIMATED THIRD PARTY PAYABLE$7,037,723
RPH AUXILLARY INVESTMENTS$63,800
ASSET RETIREMENT OBLIGATION$3,569,623
SWAP CONTRACT PAYABLE 2007$343,798
SWAP CONTRACT PAY FMV 2007$17,989,584
DUE TO AFFILIATES$12,678,239
LOAN PAY-GH TAX EXEMPT BONDS$101,166,429
RELATED PARTY PAYABLE$0
FieldValueIRS element (for citing)
Total Of Amounts142849196TotalOfAmounts

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReportfalseAnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense688309TotalCommunityBenefitExpense
Direct Offsetting Revenue267318DirectOffsettingRevenue
Net Community Benefit Expense420991NetCommunityBenefitExpense
Percent Of Total Expense0.00200PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense17141095TotalCommunityBenefitExpense
Direct Offsetting Revenue13700110DirectOffsettingRevenue
Net Community Benefit Expense3173667NetCommunityBenefitExpense
Percent Of Total Expense0.01650PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Persons Served0PersonsServed
Total Community Benefit Expense17829404TotalCommunityBenefitExpense
Direct Offsetting Revenue13967428DirectOffsettingRevenue
Net Community Benefit Expense3594658NetCommunityBenefitExpense
Percent Of Total Expense0.01850PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense705817TotalCommunityBenefitExpense
Direct Offsetting Revenue334072DirectOffsettingRevenue
Net Community Benefit Expense371745NetCommunityBenefitExpense
Percent Of Total Expense0.00180PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense7811996TotalCommunityBenefitExpense
Direct Offsetting Revenue2840793DirectOffsettingRevenue
Net Community Benefit Expense4971203NetCommunityBenefitExpense
Percent Of Total Expense0.02380PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense8316721TotalCommunityBenefitExpense
Direct Offsetting Revenue7169710DirectOffsettingRevenue
Net Community Benefit Expense1131481NetCommunityBenefitExpense
Percent Of Total Expense0.00540PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense16834534TotalCommunityBenefitExpense
Direct Offsetting Revenue10344575DirectOffsettingRevenue
Net Community Benefit Expense6474429NetCommunityBenefitExpense
Percent Of Total Expense0.03100PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Persons Served0PersonsServed
Total Community Benefit Expense34663938TotalCommunityBenefitExpense
Direct Offsetting Revenue24312003DirectOffsettingRevenue
Net Community Benefit Expense10069087NetCommunityBenefitExpense
Percent Of Total Expense0.04950PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$4,542,524BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare72802840AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare64652235CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall8150605MedicareSurplusOrShortfall
Costing Methodology UsedCostingMethodologyUsed
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV

Name Name

FieldValueIRS element (for citing)
Business Name Line1ROBERT PACKER HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1ONE GUTHRIE SQUAREAddressLine1
CitySAYRECity
StatePAState
ZIP Code18840ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Teaching HospitalXTeachingHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Costing Method UsedSchedule H, Part I, Line 7a - Cost to charge ratio was derived from Worksheet #2. Schedule H, Part I, Line 7b - Cost to charge ratio was derived from Worksheet #2. Schedule H, Part I, Line 7e - The cost methodology used was actual expenditures. Schedule H, Part I, Line 7f - The cost was taken from the Medicare Cost Report. Schedule H, Part I, Line 7g - A cost accounting system was used. Within the cost accounting system, some patient segments were based on a ratio of cost to charge - total departmental expense plus allocated overhead spread based on charges.CostingMethodUsed
Subsidized Health Services ExplnA cost accounting system was used. Within the cost accounting system some patient segments were based on a ratio of cost to charge - total departmental expense plus allocated overhead spread based on charges.SubsidizedHealthServicesExpln
Bad Debt FootnoteCost to charge was derived from worksheet #2. This was applied to gross bad debt expense from the financial statements.BadDebtFootnote
Debt Collection PolicyOnce a patient is approved for charity care or an installment plan, their account is transferred to either the Budget or Charity Care financial class. Accounts in these financial classes are not placed with collection.DebtCollectionPolicy
Needs AssessmentTHE ORGANIZATION HAS NOT DONE A HEALTH ASSESSMENT OF THE COMMUNITIES IT SERVES. THERE ARE PLANS TO COMPLETE AN ASSESSMENT DURING THE ORGANIZATION'S 2012 FISCAL YEAR.NeedsAssessment
Patient Education AssistanceCHARITY CARE AVAILABILITY AND CONTACT INFORMATION ARE POSTED IN ALL REGISTRATION AREAS AND IN THE HOSPITAL'S BUSINESS OFFICE. THE CHARITY CARE POLICY, APPLICATION, AND CONTACT INFORMATION ARE POSTED ON THE HOSPITAL'S WEBSITE. SELF PAY PATIENTS ARE REFERRED TO THE HOSPITAL'S FINANCIAL COUNSELOR FROM PHYSICIAN OFFICES, SOCIAL WORKERS, OR SELF REFERRED. THE FINANCIAL COUNSELOR AS WELL AS THE BUSINESS OFFICE STAFF FOLLOW UP WITH SELF PAY PATIENTS TO ASSESS THEIR NEED AND ASSIST IN DETERMINING THEIR ELIGIBILITY FOR SECURING A PAYMENT SOURCE (I.E. COBRA COVERAGE, SPECIAL NEEDS PROGRAM, MEDICAID, OTHER FEDERAL/ STATE PROGRAMS, OR CHARITY CARE). STAFF ALSO ASSIST WITH THE APPLICATION PROCESS AS REQUESTED BY SELF PAY PATIENTS. THE HOSPITAL'S BILLING STATEMENTS ALSO HAVE INFORMATION REGARDING WHOM TO CONTACT IN CASE A PATIENT NEEDS ASSISTANCE MEETING ITS FINANCIAL OBLIGATIONS.PatientEducationAssistance
Community InformationROBERT PACKER HOSPITAL IS A 238-BED TERTIARY CARE TEACHING HOSPITAL LOCATED IN SAYRE, PA. THE HOSPITAL OFFERS A FULL COMPLEMENT OF MEDICAL AND SURGICAL SERVICES AS WELL AS SPECIALIZED PROGRAMS. THE HOSPITAL'S PRIMARY SERVICE LIES IN BRADFORD COUNTY IN PA AND STEUBEN AND TIOGA COUNTIES IN NEW YORK. THE SECONDARY SERVICE AREA INCLUDES CONTIGUOUS COUNTIES IN BOTH PA AND NY. THE POPULATION FOR THE TOTAL SERVICE AREA IS APPROXIMATELY 630,000 WITH 50% OF THE HOUSEHOLD INCOMES GENERALLY FALLING IN TWO CATEGORIES: $25,000 - $50,000 AND $50,000 - $75,000.CommunityInformation
Community Building ActivitiesN/ACommunityBuildingActivities
Other InformationSEE THE ATTACHED STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS ATTACHED TO THE FORM 990 AS TO HOW THE HOSPITAL FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY.OtherInformation
Affiliated Health Care SystemSEE THE ATTACHED STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS ATTACHED TO THE FORM 990.AffiliatedHealthCareSystem

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantEducational Aid - Undergraduate StudentsTypeOfGrant
Number Of Recipients50NumberOfRecipients
Amount Of Cash Grant15925AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierSCHEDULE I, PART I LINE 2 AND PART IIIIdentifier
Return ReferenceGRANTS TO INDIVIDUALS IN THE UNITED STATESReturnReference
ExplanationHealth Profession Scholarships - Seniors must plan to enter an accredited college, university, hospital based nursing or allied health program with careers in health professions, including hospital administration or a planned career in medical research. Guthrie Employee Scholarships - These scholarships are offered to children of full-time employees of Guthrie. Seniors must plan to enter an accredited college or university. Any career interest is allowed.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Housing Allowance Or ResidenceXHousingAllowanceOrResidence
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
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 (17 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
MARIE DROEGE
2931650478110000091720350148000
DANIEL J BROWN MD
04173320469250000043062050731900
SURYA NARAYANAN MD
0346405000000038770038517500
BURDETT R PORTER MD
03589570239460000043062042596500
DANIEL SPORN MD
055715701739450000043062077416400
JOHN NESPOLI
018855906869201853011498801708903911810114988
LAWRENCE SAMPSON MD
04089570138770000043062046589600
MINH DANG
01797920308320000027350023797400
BONNIE ONOFRE
1764360289630000086840214083000
GEORGE ELLIS MD
3111590422700000348810350267000
ANOTHONY OLIVA DO CMO
346646056452041400000197620464260000
BARBARA PENNYPACKER
1445130288300000245490171945000
CHARLES MCGURK MD
2700790765300000139760291708000
JAY SHAH MD
2743540000000248120299166000
RUSSELL BURKETT MD
2612790000000248120286091000
MARC HARRIS MD
2545550000000162390270794000
JAMES RAFTIS MD
2515300000000248120276342000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
PART I, LINE 1AQUESTIONS REGARDING COMPENSATIONGROSS-UP PAYMENTS ARE PERIODICALLY PROVIDED TO EMPLOYEES. ALL PAYMENTS ARE MADE PURSUANT TO WRITTEN ORGANIZATIONAL POLICIES.
PART I, LINE 3QUESTIONS REGARDING COMPENSATIONEXECUTIVE COMPENSATION IS GENERALLY ESTABLISHED WITHIN A WRITTEN EMPLOYMENT AGREEMENT. COMPENSATION IS DETERMINED BASED ON MARKET STUDIES PRESENTED TO THE EXECUTIVE COMPENSATION COMMITTEE and subsequently approved by the board of directors.
PART I, LINE 4JOHN NESPOLI $114,988.

Schedule L IRS990ScheduleL

Loan Table LoanTable

FieldValueIRS element (for citing)
Name PersonANTHONY F OLIVANamePerson
Purpose Of LoanRECRUITMENT PERSONALPurposeOfLoan
Loan From OrganizationXLoanFromOrganization
Original Principal$150,000OriginalPrincipalAmount
Balance Due90000BalanceDue
DefaultfalseDefault
Approved By BoardtrueApprovedByBoard
Written AgreementtrueWrittenAgreement
FieldValueIRS element (for citing)
Total Balance Due90000TotalBalanceDue

Schedule M IRS990ScheduleM

Works Of Art WorksOfArt

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions2NumberOfContributions
Noncash Contribs Rptd F9906542NoncashContribsRptdF990
Method Of Determining RevenuesCOSTMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Art Historical TreasuresArtHistoricalTreasures
Art Fractional InterestArtFractionalInterest
Books And PublicationsBooksAndPublications
Clothing And Household GoodsClothingAndHouseholdGoods
Cars And Other VehiclesCarsAndOtherVehicles
Boats And PlanesBoatsAndPlanes
Intellectual PropertyIntellectualProperty
Securities Publicly TradedSecuritiesPubliclyTraded
Securities Closely Held StockSecuritiesCloselyHeldStock
Securities Prtnrshp Trust IntrstsSecuritiesPrtnrshpTrustIntrsts
Securities MiscellaneousSecuritiesMiscellaneous
Qualified Contrib Hist StructQualifiedContribHistStruct
Qualified Contrib OtherQualifiedContribOther
Real Estate ResidentialRealEstateResidential
Real Estate CommercialRealEstateCommercial
Real Estate OtherRealEstateOther
CollectiblesCollectibles
Food InventoryFoodInventory
Drugs And Medical SuppliesDrugsAndMedicalSupplies
TaxidermyTaxidermy
Historical ArtifactsHistoricalArtifacts
Scientific SpecimensScientificSpecimens
Archaeological ArtifactsArchaeologicalArtifacts
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftstrueReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation

FieldValueIRS element (for citing)
IdentifierFORM 990 SCHEDULE O DISCLOSURESIdentifier
ExplanationForm 990 Part IV Line 12 - The organization's financial statements were audited on a consolidated basis with Guthrie Health and Affiliates. Form 990 Part VI Line 6 - Guthrie Healthcare System is the sole member of Robert Packer Hospital. Form 990 Part VI Line 7a - As the sole member of Robert Packer Hospital, Guthrie Healthcare System appoints the organization's Board of Directors. Form 990 Part VI Line 7b - As the sole member of Robert Packer Hospital, Guthrie Healthcare System has approval rights of certain board decisions. Form 990 Part VI Line 11 - The organization's Form 990 is presented to the Board of Directors for review and is also reviewed by an independent accounting firm. Form 990 Part VI Line 12c - The Conflict of Interest Disclosure Policy sets forth that all persons, including employees, agents and Board/Committee members, particularly those involved in decision-making for Guthrie Health (GH) act in an appropriate manner and will not participate in any actions that might create a personal or professional conflict of interest and/or not be in the best interest of GH. All members of any GH Board/Committee and GH senior management must make full disclosure of any possible conflict of interest through the use of the Conflict of Interest Disclosure Form and refrain from voting or participating in decision-making involving any possible conflict of interest. The form is distributed to all Board/Committee members, and employees (when applicable) annually by the GH Administration office. GH Board/Committee members or employees must complete the Conflict of Interest Disclosure Form. This form should be completed when there is any situation where a possible conflict of interest exists, and/or on an annual basis and/or at the time of appointment or election of new Board/Committee members. If the form is not completed within 13 months of the last signing, the GH Board Chairman will be advised. Any individual having a conflict of interest or possible conflict of interest on any manner should excuse themselves from the portion of the meeting or meetings where the matter is discussed and not vote or use his or her personal influence on the matter. The minutes of the meeting or meetings should reflect the disclosure, the abstention from voting, and any action taken to determine whether a conflict of interest existed. Form 990 Part VI Line 15a - Executive compensation is generally established within a written employment agreement. Compensation is determined based on market studies, presented to the Executive Compensation Committee and subsequently approved by the Board of Directors. Form 990 Part VI Line 15b - Executive compensation is generally established within a written employment agreement. Compensation is determined based on market studies, presented to the Executive Compensation Committee and subsequently approved by the Board of Directors. Form 990 Part VI Line 18 - The organization's Form 1023, 990, and 990-T are available for public inspection upon request. Form 990 Part VII Line 19 - The organization does not make its governing documents, conflict of interest policy and financial statements available to the public. Form 990 Part VII Section A - Average hours per week devoted to related organizations - Daniel J. Brown, MD Member BOD 40 hours per week. Surya Narayanan, MD Member BOD 40 hours per week. Burdett R. Porter, MD Member BOD 40 hours per week. Daniel Sporn, MD Member BOD 40 hours per week. John Nespoli, Member BOD 40 hours per week. Lawrence Sampson, MD Member BOD 40 hours per week. Minh Dang, CFO 1 hour per week. Bonnie Onofre, Chief Nursing Officer 2 hours per week. Anthony Oliva, DO, Chief Medical Officer 8 hours per week. Barbara Pennypacker, VP Surgical Services 13 hours per week. Joseph Sawyer, VP Imaging & Ancillary Testing 14 hours per week. Form 990 Part XI Line 2b - The organization's financial statements were audited on a consolidated basis with Guthrie Health and Affiliates. Form 990 Schedule D, Part X Due To Affiliates - Robert Packer Hospital has been allocated certain proceeds of tax-exempt bonds that were issued to Guthrie Health (EIN: 23-3055017). As such, all of the tax-exempt bond reporting for Guthrie Health and its affiliates has been made on Guthrie Health's Form 990.Explanation

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (16 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStatePublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
GUTHRIE HEALTHCARE SYSTEM
ONE GUTHRIE SQUARESAYREPA18840232200910SUPPORTINGPA11C - IIINA
SAYRE HOUSE OF HOPE
ONE GUTHRIE SQUARESAYREPA18840203979472HEALTH CAREPA7NA
DONALD GUTHRIE FOUNDATION
200 SOUTH WILBUR AVENUESAYREPA18840246022957MED RESEARCHPA4NA
ROBERT PACKER HOSPITAL SCHOOL OF NURSING
200 SOUTH WILBUR AVENUESAYREPA18840236408773EDUCATIONPA2NA
TROY COMMUNITY HOSPITAL INC
101 Elmira StreetTROYPA16947240800337HEALTH CAREPA3NA
TIOGA HEALTHCARE FACILITY
ONE GUTHRIE SQUARESAYREPA18840150532257HEALTH CAREPA3NA
SAYRE HOUSE INC
1001 NORTH ELMER AVENUESAYREPA18840231643404NURSING FACPA9NA
GUTHRIE HOME CARE
421 Tomahawk RoadTOWANDAPA18848232394345HOME HEALTHPA9NA
GUTHRIE CORNING DEVELOPMENT COMPANY INC
176 DENISON PARKWAY ECORNINGNY14830161594628SUPPORTINGNY11B TYPE IINA
GUTHRIE SAME DAY SURGERY CENTER INC
ONE GUTHRIE SQUARESAYREPA18840020551081AMBULATORYNY9NA
GUTHRIE RISK RETENTION GROUP
151 MEETING STREETCHARLESTONSC29401201090801SUPPORTINGSC11A TYPE 1NA
TIOGA NURSING FACILITY
ONE GUTHRIE SQUARESAYREPA18840222979677NURSING FACNY3NA
GUTHRIE CLINIC LTD
ONE GUTHRIE SQUARESAYREPA18840250815795HEALTH CAREPA3NA
DARWAY NURSING HOME INC
ONE GUTHRIE SQUARESAYREPA18840231733967NURSING FACPA9NA
CORNING HOSPITAL
176 DENISON PARKWAY ECORNINGNY14830160393490HEALTH CARENY3NA
GUTHRIE HEALTH
ONE GUTHRIE SQUARESAYREPA18840233055017SUPPORTINGPA11B TYPE IINA

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1TWIN TIER MANAGEMENT CORP INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 310AddressLine1
CitySAYRECity
StatePAState
ZIP Code18840ZIPCode
FieldValueIRS element (for citing)
EIN232209439EIN
Primary ActivityMANAGEMENTPrimaryActivity
Legal Domicile StatePALegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityC CORPTypeOfEntity
Share Of Total Income4870914ShareOfTotalIncome
Share Of EOY Assets5551101ShareOfEOYAssets
Percentage Ownership1.00000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgtrueSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgtruePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

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