Civic Intelligence

Guthrie Same Day Surgery Center Inc

EIN 02-0551081 • 501(c)3 • Sayre, PA

990-N Coverage
1 Guthrie SquareSuiteSayre, PA 18840

www.guthrie.org

Siviq Scores

Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.

Liabilities / Assets

Score unavailable

No value available

Liabilities-to-assets requires both liabilities and assets on the latest valid filing.

Source year 2014

Liabilities / Revenue

35th percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

501(c)3 • $500k-$1M nonprofits • Source year 2014

Net Margin

75th percentile

22%

Higher net margin than 75% of similar nonprofits.

501(c)3 • $500k-$1M nonprofits • Source year 2014

Top Officer Pay

99th percentile

$628,349

Higher top officer pay than 99% of similar nonprofits.

Top officer pay equals 416.5% of source-year revenue.

501(c)3 • $500k-$1M nonprofits • Source year 2014

Asset Growth

2nd percentile

-100%

Faster asset growth than 2% of similar nonprofits.

501(c)3 • $500k-$1M nonprofits • Annualized from 2013 to 2014

Revenue Growth

1st percentile

-88%

Faster revenue growth than 1% of similar nonprofits.

501(c)3 • $500k-$1M nonprofits • Annualized from 2013 to 2014

Assets

Down

$0

Down $1,609,191 (-100%) from 2013

Liabilities

Down

$0

Down $4,126,627 (-100%) from 2013

Net Assets

Up

$0

Up $2,517,436 (+100%) from 2013

Revenue

Down

$150,870

Down $1,078,910 (-88%) from 2013

Expenses

Down

$118,000

Down $1,279,345 (-92%) from 2013

Net Income

Up

$32,870

Up $200,435 (+120%) from 2013

Trend Graphs

Balance Sheet Trend

Grouped bars show assets, liabilities, and net assets across loaded filings.

$6.0M$4.0M$2.0M$0-$2.0M-$4.0MAssets 2011: $1,988,836Liabilities 2011: $4,119,248Net Assets 2011: -$2,130,4122011Assets 2012: $1,908,556Liabilities 2012: $4,263,236Net Assets 2012: -$2,354,6802012Assets 2013: $1,609,191Liabilities 2013: $4,126,627Net Assets 2013: -$2,517,4362013Assets 2014: $0Liabilities 2014: $0Net Assets 2014: $02014

Highlighted filing

2014

Assets$0
Liabilities$0
Net Assets$0

Operations Trend

Revenue, expenses, and net income by year, with the latest filing highlighted.

$3.0M$2.0M$1.0M$0-$1.0MRevenue 2011: $2,043,503Expenses 2011: $2,263,170Net Income 2011: -$219,6672011Revenue 2012: $2,309,583Expenses 2012: $2,524,746Net Income 2012: -$215,1632012Revenue 2013: $1,229,780Expenses 2013: $1,397,345Net Income 2013: -$167,5652013Revenue 2014: $150,870Expenses 2014: $118,000Net Income 2014: $32,8702014

Highlighted filing

2014

Revenue$150,870
Expenses$118,000
Net Income$32,870

Filings

Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Jul 1, 2013 to Jun 30, 2014
Signed
May 8, 2015
Return Version
2013v4.0
Gross Receipts
$595,676
Mission and Program Overview

Mission

See Schedule O

Balance Sheet Detail
LineBeginningEndChange
Assets
Land, Buildings, and Equipment, Net$1,617,557--
Cash and Non-Interest-Bearing Accounts$21,724$0▼ $21,724
Accounts Receivable$4,361$0▼ $4,361
Prepaid Expenses and Deferred Charges$1,254$0▼ $1,254
Savings and Temporary Cash Investments$0$0→ $0
Other Notes and Loans Receivable, Net$0$0→ $0
Pledges and Grants Receivable$0$0→ $0
Receivable From Disqualified Prsn$0$0→ $0
Receivables From Officers Etc$0$0→ $0
Investments Other Securities$0$0→ $0
Investments Program Related$0$0→ $0
Investments in Publicly Traded Securities$0$0→ $0
Intangible Assets$0$0→ $0
Inventories for Sale or Use$0$0→ $0
Loans From Officers Directors$0$0→ $0
Total Assets$1,609,191$0▼ $1,609,191
Other Assets Total$324,285$0▼ $324,285
Liabilities
Mortgage Notes Payable Secured by Investment Property$3,225,808$0▼ $3,225,808
Other Liabilities$720,829$0▼ $720,829
Accounts Payable and Accrued Expenses$179,990$0▼ $179,990
Grants Payable$0$0→ $0
Unsecured Notes Loans Payable$0$0→ $0
Deferred Revenue$0$0→ $0
Escrow Account Liability$0$0→ $0
Tax Exempt Bond Liabilities$0$0→ $0
Total Liabilities$4,126,627$0▼ $4,126,627
Net Assets / Fund Balance
Temporarily Rstr Net Assets$1,667$0▼ $1,667
Permanently Rstr Net Assets$0$0→ $0
Unrestricted Net Assets$-2,519,103$0▲ $2,519,103
Total Net Assets Fund Balance$-2,517,436$0▲ $2,517,436
Total Liabilities and Net Assets / Fund Balance$1,609,191$0▼ $1,609,191
Compensation and Service Providers

Employees

NameTitleOtherTotal
Lois AllenMember - BOD$4,379$4,379

Board Members and Trustees

NameTitle
Thomas J McDonald JrMDPresident & Chairman - BOD
Minh DangCFO
David E IoccoMember - BOD
Edward L Jones MDMember - BOD
John W VanZantenMember - BOD
Marie DroegeMember - BOD
Paul ChaconaMember - BOD
David LR GibbsSecretary/Treasurer - BOD
Revenue and Support

Revenue Composition

Contributions and Grants
$120
Program Service Revenue
$-20,799
Investment Income
$4,022
Other Revenue
$167,527
All Other Contributions
$120
Change in Net Assets
$32,870
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$118,000
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Salaries, Compensation, and Employee Benefits$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Depreciation Depletion$134,650--$134,650
Interest-$117,590-$117,590
Fees for Services Other$4,938--$4,938
Fees for Services Legal-$1,726-$1,726
Office Expenses$391--$391
Other Expenses$-13,095--$-13,095
Insurance$-128,200--$-128,200
Total Functional Expenses$-1,316$119,316$0$118,000
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Insider Transactions and Loans

Loans and Receivables

Line ItemBeginningEndChange
Loans from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Receivables from Disqualified Persons$0$0→ $0
Receivables from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Backup withholding compliance
Yes
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
Yes
Compensation from other sources disclosed
No
CEO compensation reviewed
Yes
Other officer compensation reviewed
Yes
Conflict-of-interest policy
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
Yes
Management duties delegated
No

Governance Explanations

Form 990 Part VI Line 6

The Guthrie Clinic is the sole member of Guthrie Same Day Surgery Center Inc.

Form 990 Part VI Line 7A

As the sole member of Guthrie Same Say Surgery Center Inc., The Guthrie Clinic appoints the organization's Board of Directors.

Form 990 Part VI Line 7B

As the sole member of Guthrie Same Day Surgery Center Inc., The Guthrie Clinic has approval rights of certain board decisions.

Form 990 Part VI Lines 11A & 11B

The Form 990 of the organization is provided to the Board of Directors for review and is also reviewed by the organization's finance personnel and an independent accounting firm prior to filing with the IRS.

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 The Guthrie Clinic (TGC) , 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 TGC. All Members of any TGC Board/ Committee and TGH 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 TGC Administration office. TGC 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 TGC Board Chairman will be advised. Any individual having a conflict of interest or possible conflict of interest on any matter 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 Lines 15A & 15B

Executive compensation is generally established within a written employment agreement. Compensation is determined based on market studies, presented to The Guthrie Clinic Compensation Committee, and susequently 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 VI Line 19

The organization does not make its governing documents, conflict of interest poicy, and financial statements available to the public.

Filing and Contact Details

Filer

EIN
02-0551081
In Care Of
% MICHELE Y SISTO
Phone
5708874625

Signing Officer

Name
Marie Droege
Title
President/Chairman
Phone
5708874625
Signed
2015-05-08
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Thomas J McDonald Jr MD
Formed
2002
Legal Domicile
Ny
Voting Board Members
8
Independent Board Members
3
Employees
0
Volunteers
3

Preparer

Preparer
Matthew D Petroski
Phone
5708874625
Supplemental Narrative

Additional Explanations

Form 990 Part I Line 1

Guthrie Same Day Surgery, Inc. promotes the general health of the community it serves by operating a medical facility for ambulatory surgical procedures to the general public.

Form 990 Part III

Statement of Program Service Accomplishments The Guthrie Clinic is a nonprofit health care organization incorporated for the purpose of conducting exclusively charitable,scientific and educational activities. The Guthrie Clinic (TGC) acts as the parent of an integrated Section 501(c)(3) health care delivery system, consisting of the corporation and other directly and indirectly controlled entities (See Form 990, Schedule R, for a listing of the affiliates of TGC) including but not limited to Guthrie Medical Group, P.C.(GMG) and Robert Packer Hospital (RPH). Through the activities of GMG, RPH and its other affiliates (collectively referred to as "Guthrie"), The Guthrie Clinic 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, and hospice care. The Guthrie Research Institute and Guthrie Clinical Research functions of the Donald Guthrie Foundation, a subsidiary of TGC, furthers these charitable activities through providing patient access to the region's largest panel of clinical trials. The facilities and provider offices of Guthrie are located in 23 communities throughout the northern tier of Pennsylvania and southern tier of New York, with the greatest concentration of services provided principally in Bradford County, Pennsylvania and Chemung and Steuben Counties, New York. The vision of Guthrie is to help shape the delivery of health care in the region through working collaboratively with physicians and other providers, and by distributing its services throughout the region based on community needs. Guthrie seeks to be the provider of choice for patients in the Twin Tier region, and to be recognized for its superior quality and service. It also strives to advance the practice of medicine through its commitment to teaching and research. In keeping with this vision, the core values of The Guthrie Clinic are as follows: patient-centeredness, excellence, and teamwork. Guthrie providers and facilities provide care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Because it does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenue on the financial statements of Guthrie entities. Costs for services and supplies furnished under Guthrie's charity care policy amounted to approximately $2.6 million in 2014 and $3.2 million in 2013 when measured at the appropriate entity's estimated cost. As part of its charitable mission, Guthrie provides care through its hospital emergency departments. It ensures that an emergency-based treatment or hospital admission is not delayed or denied pending determination of coverage or a requirement for prepayment or deposit. As a result of this policy, Guthrie experienced approximately $3.74 million and $3.71 million in bad debts for 2014 and 2013, respectively. In addition to the charity care program and the emergency department bad debts discussed above, Guthrie supports numerous other charitable community activities. Examples of these activities include medical education for physicians and nurses, the trauma program, and medical research. The estimated cost, net of reimbursement, for these programs was $16.1 million and $16.4 million in 2014 and 2013, respectively. Guthrie also provides services to patients who participate in the Medicaid programs. Revenues generated from patients who participate in the Medicaid program are subject to substantial discounts that result in reimbursement for services rendered below the cost of providing such services. In order for patients to meet the guidelines for the Medicaid program, various income-based criteria must

Form 990 Part III Continued

RPH strives to enhance the quality of life in the communities it serves by providing superior health care services and by leading continuous improvement of community health. It achieves this mission by organizing services and directing resources toward meeting community health needs through collaboration with community agencies and by compassionate, effective, and affordable means. RPH works closely with the GMG to ensure that the skills and knowledge of the medical staff produce the maximum community health benefit. As a member of Guthrie, RPH integrates its programs and activities with those of the long-term care and education and research divisions, so that continuity and synergy result. As part of TGC, the vision of RPH is to play a leadership role in the development and provision of tertiary-level acute care services. Evidence that RPH is successfully fulfilling this role can be seen in its continued accomplishments. Highlights of those achievements include continued accreditation by the Pennsylvania Trauma Systems Foundation Board as a Level II Trauma Center and receipt of full Chest Pain Center accreditation with PCI (percutaneous coronary intervention) from the Society of Cardiovascular Patient Care. Guthrie Weight Loss Center has been accredited as a Level 1 facility under the Bariatric Surgery Center Network (BSCN) Accreditation Program of the American College of Surgeons (ACS). As part of a fully-integrated health delivery system that organizes its services on a regional basis and is accountable for improving the health of the population it serves, RPH accepts responsibility for meeting the health care needs of the community and is able to document the cost effectiveness and quality of services provided. Corning Hospital Breast Care Center was awarded a full three-year accreditation in Stereotactic Breast Biopsy by the American College of Radiology (ACR) and received the American Heart Association/American Stoke Associations Get with the Guidelines Stroke Gold Plus Achievement Award. The GMG is a multi-specialty physician group practice that includes nearly 350 specialist and primary care physicians and mid-level providers, headquartered in a facility adjacent to RPH. Physicians within the GMG provide comprehensive medical care using advanced technologies and methodologies for both diagnosis and treatment. Further, the GMG provides a broad range of educational opportunities for physicians and other health care providers. It also works closely with the Research Institute, where research contributes to recruiting and retaining physician specialists to serve the region and sustaining proficient medical practices. The GMG is committed to the advancement of medical knowledge and skills, and every effort is made to provide personal, compassionate medical care. The GMG operates a regional office network in 23 communities in Pennsylvania and New York, encompassing all of the major population centers in the Twin Tiers area. The Guthrie Clinic has developed certain guiding principles for the provision of patient care, which include a commitment the following: * Practice of clinical excellence, * Utilization of the synergy of a multi-specialty medical group practice, * Development of an integrated system that provides a continuum of care, * Provision of local access to care through support of a regional medical office network, * Provision of services to a distinct geographic region, and * Proactive operations. The GMG, through the provision of primary care services with ease of access to specialty and sub-specialty care, focuses on making an integrated system of health care easily accessible to patients. With its primary concern the diagnosis and treatment of disease and illness, it also seeks to actively improve the health of the community it serves through prevention, health screenings, and education. The GMG welcomes any patient seeking care.

Form 990 Part III Line 3

The organization transferred all assets to Corning Hospital for net book value as part of an overall restructuring of The Guthrie Clinic, formerly Guthrie Health. Form 990 Part IV Line 12B The organization's financial statements were audited on a consolidated basis with The Guthrie Clinic and Affiliates. Form 990 Part VI Line 4 In November 2013, a restructure plan was approved to merge Guthrie Healthcare System into Guthrie Health, with Guthrie Health, renamed The Guthrie Clinic, the survivor. As a result, The Guthrie Clinic became the sole member of the organization.

Form 990 Part XI Line 9

Equity Transfer to the Parent GHS.

Form 990 Part XII Line 2B

The organizations financial statements were auditied on a consolidated basis with The Guthrie Clinic & Affiliates.

Financial Statement Notes

Part X Line 2

The Corporation has analyzed the tax positions taken by the organization and has concluded that as of June 30, 2014 there are no uncertain tax positions taken or expected to be taken that would require recognition of a liability (or asset) or disclosure in the financial statements.

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IRS990/Form990PartVIISectionAGrp/TitleTxt0President & Chairman - BOD
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IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt0The Corporation has analyzed the tax positions taken by the organization and has concluded that as of June 30, 2014 there are no uncertain tax positions taken or expected to be taken that would require recognition of a liability (or asset) or disclosure in the financial statements.
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