2024-05-13T09:42:58-05:00 2023-06-30 FORVIS LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2022-07-01 264750523 GLADE RUN MEDICAL ASSOCIATES INC % MATTHEW KOCIOLA GLAD 7245438618 ONE NOLTE DRIVE KITTANNING PA 16201 NICHOLE D GERACI PRESIDENT AND CEO 7245438618 2024-02-22 true NICOLE D GERACI 999009999 Brian D Todd P00422601 4178658701 2024-04-01 2 2022 2023-04-26 12:10:37Z NICHOLE D GERACI ONE NOLTE DRIVE KITTANNING PA 16201 6673954 false X WWW.ACMH.ORG X 2009 PA GLADE RUN MEDICAL ASSOCIATES, INC. OPERATES SEVERAL SPECIALTY PHYSICIAN CLINICS. 2 1 88 1 0 0 444387 0 8387764 6673954 0 0 0 0 8832151 6673954 0 0 0 0 5628864 5233521 0 0 0 9679770 9274232 15308634 14507753 -6476483 -7833799 1414389 1513561 626039 919918 788350 593643 X TO ENGAGE IN ACTIVITIES RELATED TO THE PROMOTION OF HEALTH OF PERSONS IN THE CORPORATION'S SERVICE AREA BY EMPLOYING THE SUPPORT STAFF AND BY OPERATING MEDICAL PRACTICES IN SUPPORT OF THE MISSION OF ARMSTRONG CENTER FOR MEDICINE AND HEALTH, INC. false true 10481298 6673954 GLADE RUN MEDICAL ASSOCIATES, INC. OPERATES SEVERAL SPECIALTY PHYSICIAN CLINICS INCLUDING NEUROSURGERY, OB/GYN, GENERAL SURGERY, RHEUMATOLOGY, ORTHOPEDICS, UROLOGY, GI AND ENT TO THE RESIDENTS OF ARMSTRONG COUNTY. THESE CLINICS PROVIDE THE COMMUNITY ACCESS TO ADVANCED MEDICAL CARE CLOSE TO HOME. TOTAL VISITS FOR ALL OF THE SPECIALTY CLINICS FOR THE FISCAL YEAR TOTALED 58,935. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. 10481298 true false false false false false false false false false false false false true true false false true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true X 8 0 true 88 true false false false false false false false false false false false false X 2 1 true false false false true true true true true false false true true true true true true false false false PA X MATTHEW KOCIOLA 7245438618 ONE NOLTE DRIVE KITTANNING PA 16201 X BERT HEPNER PHYSICIAN 39.0 1.0 X 776820 0 41549 JATINDER KUMAR PHYSICIAN 39.0 1.0 X 583313 0 27200 CURT CONRY PHYSICIAN 39.0 1.0 X 525994 0 13862 JOHN I LEWIS PRESIDENT / CEO 1.0 39.0 X X 0 475702 60947 NATHAN FORMAINI PHYSICIAN 39.0 1.0 X 511375 0 17295 MUHAMMAD UMAR ALAM PHYSICIAN 39.0 1.0 X 402083 0 27200 JAMES BACKSTROM CHIEF MEDICAL OFFICER 1.0 39.0 X 0 371834 55514 MATTHEW KOCIOLA CHIEF FINANCIAL OFFICER 1.0 39.0 X 0 265921 58717 VOLKER ZAUN SECRETARY / TREASURER 1.0 3.0 X X 0 0 0 2799585 1113457 302284 13 false true false HEALTHCARE SUPPORT TECHNOLOGIES 315 NINTH STREET NEW BRIGHTON PA 15066 PHYSICIAN BILLING 781193 ALLEGHENY CLINIC PO BOX 951742 CLEVELAND OH 44193 PHYSICIAN SERVICES 601307 ENDOW PROPERTIES 149 WOAKHANNE VILLAGE DR FORD CITY PA 16226 RENT 246074 MUSHTAQ SYED MD 203 SKYLINE DRIVE INDIANA PA 15701 PHYSICIAN SERVICES 111055 4 0 PATIENT SERVICE REVENUE 621110 6581416 6581416 OTHER REVENUE 624100 92538 92538 6673954 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6673954 6673954 0 0 X 0 0 0 0 0 0 3990579 2577536 1413043 27592 17822 9770 767240 495564 271676 448110 289437 158673 0 0 0 0 0 0 7236148 5407801 1828347 0 190067 142043 48024 1452 1085 367 0 429223 320772 108451 6311 4716 1595 0 11546 8629 2917 0 0 0 702595 525071 177524 MEDICAL SUPPLIES & DRUGS 672875 672875 LICENSES, DUES, SUBSCRIPTIONS 17829 13324 4505 MISCELLANEOUS EXPENSE 6186 4623 1563 14507753 10481298 4026455 0 1300 1200 251729 355482 0 0 1161360 800874 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 356005 1414389 1513561 606537 555589 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19502 364329 626039 919918 X 788350 593643 0 0 788350 593643 1414389 1513561 X -7833799 7639092 X false true X true false X X X 1 ACMH 204648477 10 true 0 0 1 0 0 true false false false false false false false false false false false false false false true false SCHEDULE A, PART I, LINE 12G, COLUMN (I) SUPPORTED ORGANIZATION: THE FULL NAME OF THE SUPPORTED ORGANIZATION IS ARMSTRONG CENTER FOR MEDICINE & HEALTH, INC. ROU ASSET 356005 356005 0 EST DUE TO THIRD PARTY 1124 OPERATING LEASE LIABILITY 363205 364329 SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. false true false false false false false true false JAMES BACKSTROM CHIEF MEDICAL OFFICER 0 371596 0 0 0 238 0 30111 0 25403 0 427348 0 0 JOHN I LEWIS PRESIDENT / CEO 0 412745 0 0 0 62957 0 34125 0 26822 0 536649 0 55000 MATTHEW KOCIOLA CHIEF FINANCIAL OFFICER 0 265766 0 0 0 155 0 57183 0 1534 0 324638 0 0 BERT HEPNER PHYSICIAN 569592 0 207228 0 0 0 1875 0 39674 0 818369 0 0 0 CURT CONRY PHYSICIAN 523094 0 2900 0 0 0 1875 0 11987 0 539856 0 0 0 JATINDER KUMAR PHYSICIAN 471493 0 111820 0 0 0 0 0 27200 0 610513 0 0 0 MUHAMMAD UMAR ALAM PHYSICIAN 402083 0 0 0 0 0 0 0 27200 0 429283 0 0 0 NATHAN FORMAINI PHYSICIAN 241857 0 165451 0 104067 0 1875 0 15420 0 528670 0 0 0 SCHEDULE J, PART I, LINE 3 COMPENSATION: ARMSTRONG COUNTY MEMORIAL HOSPITAL, A RELATED ORGANIZATION, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE TOP MANAGEMENT OFFICIAL: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) NONQUALIFIED RETIREMENT PLAN AND RECEIVED THE FOLLOWING 457(F) CONTRIBUTIONS OR DISTRIBUTIONS: $ 55,000 JOHN I. LEWIS - DISTRIBUTIONS $ 29,954.34 MATTHEW KOCIOLA - CONTRIBUTIONS THE 457(F) PLAN THAT ARMSTRONG COUNTY MEMORIAL HOSPITAL ESTABLISHED FOR A SELECT GROUP OF MANAGEMENT INCLUDES THE FOLLOWING TERMS: A PARTICIPANT SHALL BECOME FULLY VESTED IN HIS DEFERRED COMPENSATION ACCOUNT AND INCOME, GAINS AND LOSSES ATTRIBUTABLE THERETO, IF HE REMAINS IN SERVICE WITH THE EMPLOYER UNTIL THE FIRST OF THE FOLLOWING EVENTS OCCUR: (A) THE DEATH OF THE PARTICIPANT; (B) THE DISABILITY OF THE PARTICIPANT; (C) THE DATE THE PARTICIPANT ATTAINS AGE 65; OR (D) THE DATE A PARTICIPANT IS TERMINATED FROM EMPLOYMENT WITH THE EMPLOYER DUE TO A CHANGE OF CONTROL EVENT. (E) THE PARTICIPANT WILL BE VESTED AT 5 YEARS, AT WHICH TIME PAYMENTS WILL BEGIN. UPON VESTING, THE DEFERRED COMPENSATION ACCOUNT WILL BE INCLUDIBLE IN THE GROSS INCOME OF THE PARTICIPANT PURSUANT TO CODE SECTION 457(F). SCHEDULE J, PART II, COLUMN B(II) BONUS PAYMENTS: MANAGEMENT USES MGMA PUBLISHED STANDARDS TO ESTABLISH A BASE SALARY FOR PROVIDERS. IN ADDITION TO THE BASE SALARY, PROVIDERS HAVE THE ABILITY TO EARN INCENTIVES BASED UPON THEIR PRODUCTIVITY AS REFLECTED IN WORK RVU MEASURES. IN ADDITION, THE CEO PRESENTS GOALS TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS OF WHAT THE ORGANIZATION HOPES TO ACHIEVE DURING EACH FISCAL YEAR. THESE GOALS ARE BASED ON REVENUES NET EARNINGS AND OTHER MEASURES. DEPENDING ON THE RESULTS, THE EXECUTIVE COMMITTEE OF THE BOARD, WITH INPUT FROM THE CEO, DETERMINES WHAT AMOUNT OF BONUSES (IF ANY) WILL BE PAID. IF APPROVED, BONUSES ARE PAID BY ARMSTRONG COUNTY MEMORIAL HOSPITAL. FORM 990, PART III, LINE 3 SIGNIFICANT CHANGES TO PROGRAM SERVICES: GLADE RUN MEDICAL ASSOCIATES, INC. CLOSED THE NEUROLOGY OFFICE. FORM 990, PART III, LINE 4A PROGRAM SERVICE ACCOMPLISHMENTS: PURSUANT TO THE GLADE RUN MEDICAL ASSOCIATES, INC. CHARITY CARE POLICY, CHARGES ARE FULLY OR PARTIALLY WRITTEN OFF FOR PATIENTS MEETING THE CRITERIA SPECIFIED IN THE POLICY. CHARGES EXCLUDED UNDER THE ORGANIZATION'S CHARITY CARE POLICY FOR THE SPECIALTY CLINICS WERE APPROXIMATELY $6,686.59 FOR THE FISCAL YEAR. FORM 990 PART V, LINE 2A AND PART IX, LINES 7, 9, & 10 W-2'S FILED AND COMPENSATION: GLADE RUN MEDICAL ASSOCIATES, INC. DIRECTLY COMPENSATES A PORTION OF ITS EMPLOYEES, AND FILE FOR THESE EMPLOYEES. THE OTHER PORTION OF GLADE RUN'S EMPLOYEES ARE COMPENSATED THROUGH ARMSTRONG COUNTY MEMORIAL HOSPITAL, A RELATED ORGANIZATION. THE SALARY AND RELATED BENEFIT EXPENSES FOR THE EMPLOYEES PAID BY THE HOSPITAL ARE ALLOCATED FROM THE HOSPITAL TO GLADE RUN ON A MONTHLY BASIS. THE W-2S RELATED TO THIS SALARY EXPENSE ARE FILED BY THE HOSPITAL AND ARE INCLUDED IN THE NUMBER ON FORM 990, PART V, LINE 2A. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIP: JAMES BACKSTROM, MD, JOHN LEWIS AND MATTHEW KOCIOLA SHARE A BUSINESS RELATIONSHIP AS THEY ARE EMPLOYED BY A RELATED TAX-EXEMPT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 6, 7A, & 7B MEMBERS/STOCKHOLDERS: THE SOLE MEMBER OF GLADE RUN MEDICAL ASSOCIATES, INC. IS ARMSTRONG CENTER FOR MEDICINE AND HEALTH (ACMH), THE PARENT CORPORATION. ACMH HAS THE FOLLOWING AUTHORITY OVER GLADE RUN MEDICAL ASSOCIATES, INC.: 1) THE BOARD SHALL CONSIST OF NO LESS THAN FOUR, NO MORE THAN SIX DIRECTORS, INCLUDING THE PRESIDENT OF THE CORPORATION WHO SHALL BE AN EX OFFICIO DIRECTOR, WITH VOTE. THE EXACT NUMBER OF DIRECTORS SHALL BE THE NUMBER FIXED FROM TIME TO TIME BY RESOLUTION. 2) ACMH SHALL APPOINT THE DIRECTORS OF THE CORPORATION (ARTICLE III, SECTION 3). 3) THE BOARD SHALL OBTAIN THE APPROVAL OF ACMH BEFORE ACTION ON ANY OF THE FOLLOWING MATTERS BECOMES FINAL AND EFFECTIVE: I) AMENDMENT OF THE ARTICLES OF INCORPORATION OF THIS CORPORATION OR OF THE BYLAWS, II) THE SALE, LEASE OR EXCHANGE OF ALL OR SUBSTANTIALLY ALL THE PROPERTY OR ASSETS OF THIS CORPORATION, III) MERGER OR CONSOLIDATION WITH ANY OTHER CORPORATION, IV) DISSOLUTION OF THIS CORPORATION AND DISTRIBUTION OF ASSETS PURSUANT THERETO, V) APPROVAL OF THE ANNUAL BUDGET AND LONG-RANGE PLAN FOR THIS CORPORATION, VI) ANY TRANSFER OF FUNDS BY GRANT, GIFT OR LOAN FROM THIS CORPORATION, VII) ANY OTHER MATTER THAT BY LAW REQUIRES THE APPROVAL OF THE OTHER BODY OF A NON-PROFIT CORPORATION (ARTICLE III, SECTION 1). FORM 990, PART VI, SECTION B, LINE 11B REVIEW OF FORM 990: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. PRIOR TO FILING, A TENTATIVE DRAFT OF THE 990 IS REVIEWED BY THE DIRECTOR OF FINANCE, THE VICE PRESIDENT OF FINANCE, AND THE PRESIDENT/CEO BEFORE BEING PRESENTED TO THE BOARD OF DIRECTORS. THE 990 IS REVIEWED AND APPROVED AT THE BOARD MEETING AND FINAL REPORTS ARE PLACED ON THE BOARD OF DIRECTORS PORTAL ONCE OFFICIALLY FILED. FORM 990 PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY: THE ORGANIZATION MONITORS COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY BY REQUESTING ON AN ANNUAL BASIS THAT MEMBERS OF THE BOARD OF DIRECTORS, ALL CORPORATE OFFICERS, AND ALL KEY EMPLOYEES COMPLETE A QUESTIONNAIRE LISTING ALL ORGANIZATIONS WITH WHICH THEY HAVE AN AFFILIATION. THE POLICY OF THE ORGANIZATION DESCRIBES HOW ANY CONFLICTS OF INTEREST ARE TO BE ADDRESSED. THE CHAIRMAN OF THE BOARD SHALL BECOME FAMILIAR WITH ALL SUCH DISCLOSURE STATEMENTS IN CASE A CONFLICT ARISES. THE VICE-CHAIRMAN OF THE BOARD SHALL BE FAMILIAR WITH THE STATEMENT FILED BY THE CHAIRMAN. IF A CONFLICT OF INTEREST SHOULD ARISE, THE MEMBERS ABSTAIN FROM THE VOTE RELATING TO THAT MATTER AND THE BOARD REVIEWS WHETHER THE MEMBER SHOULD BE REMOVED FROM THE BOARD OF DIRECTORS. FORM 990 PART VI, SECTION B, LINES 15A & 15B COMPENSATION REVIEW: THE ORGANIZATION'S CEO, EXECUTIVE DIRECTOR OR TOP MANAGEMENT OFFICIAL IS PAID BY ARMSTRONG COUNTY MEMORIAL HOSPITAL (ACMH HOSPITAL). THE PROCESS ACMH HOSPITAL USES TO DETERMINE IF THE OFFICERS OF THE ORGANIZATION ARE TO RECEIVE A WAGE ADJUSTMENT IS AS FOLLOWS: 1) A SALARY COMPARISON PREPARED BY SURVEY DATA OBTAINED FROM YAFF WATSON WYATT AND SULLIVAN COTTON; 2) THE INFORMATION IS COMPILED BY THE VP OF HUMAN RESOURCES AND GIVEN TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS FOR THEIR CONSIDERATION AND INPUT; 3) CHANGES TO EXECUTIVE COMPENSATION REQUIRE A SIGNED DOCUMENT FROM THE CHAIR OF THE HOSPITAL BOARD OF DIRECTORS. EXECUTIVE COMPENSATION IS REVIEWED AS DESCRIBED ABOVE, ON AN AS NEEDED BASIS AND WAS LAST COMPLETED IN MARCH 2021. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: THE ORGANIZATION TAKES THE FOLLOWING ACTIONS RELEASING INFORMATION REGARDING ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS: IF A REQUEST IS MADE TO REVIEW THE UNAUDITED FINANCIAL STATEMENTS, IT IS DISCUSSED AND DETERMINED ON A CASE BY CASE BASIS AS TO WHETHER THE INFORMATION WILL BE RELEASED. THE AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE ORGANIZATIONS THAT REQUEST THEM. A CODE OF CONDUCT FOR THE ORGANIZATION IS AVAILABLE TO THE PUBLIC ON ITS WEBSITE AT WWW.ACMH.ORG. THE CORPORATION'S GOVERNING DOCUMENTS ARE KEPT IN THE ADMINISTRATIVE DEPARTMENT OF THE HOSPITAL. THESE DOCUMENTS CAN BE VIEWED UPON REQUEST, BUT THEY ARE NOT ALLOWED TO BE TAKEN FROM THEIR DESIGNATED AREA OR HAVE COPIES MADE WITHOUT PERMISSION. FORM 990, PART VII, SECTION A BOARD MEMBER COMPENSATION: NO BOARD MEMBERS RECEIVE ANY COMPENSATION FOR THEIR DIRECTOR DUTIES. JOHN I. LEWIS IS COMPENSATED BY ARMSTRONG COUNTY MEMORIAL HOSPITAL (ACMH HOSPITAL), A RELATED TAX-EXEMPT ORGANIZATION, AS PRESIDENT/CEO. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: $ 7,639,092 TRANSFER FROM AFFILIATES FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN SERVICES TOTAL FEES:6180097 FORM 990 PART IX LINE 11G DESCRIPTION:OUTSIDE SERVICES TOTAL FEES:1056051 ARMSTRONG HEALTH & EDUCATION FOUNDATION ONE NOLTE DRIVE KITTANNING PA 16201 251655867 FOUNDATION PA 501(C) (3) 12A I ACMH false ARMSTRONG CENTER FOR MEDICINE & HEALTH ONE NOLTE DRIVE KITTANNING PA 16201 204648477 PARENT CORP PA 501(C) (3) 10 NA false ARMSTRONG COUNTY MEMORIAL HOSPITAL ONE NOLTE DRIVE KITTANNING PA 16201 250965237 HOSPITAL PA 501(C) (3) 3 ACMH false ACMH PHYSICIAN SERVICES ONE NOLTE DRIVE KITTANNING PA 16201 204648195 PRIMARY CARE PA 501(C) (3) 3 ACMH false false false false false false false false false false true true true false true true true true true true