Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2011
Open to Public Inspection
A For the calendar year, or tax year beginning 07-01-2011 and ending 06-30-2012
BCheck if applicable:
CName of organization
DOYLESTOWN HEALTH FOUNDATION
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
595 WEST STATE STREET
 
Room/suite
City or town, state or country, and ZIP + 4
DOYLESTOWN, PA18901
D Employer identification number

23-2368196
E Telephone number

G Gross receipts $ 4,423,229
F Name and address of principal officer:
JIM BREXLER FACHE
595 WEST STATE STREET
DOYLESTOWN,PA18901
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.DH.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1986
M State of legal domicile: PA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO SUPPORT THE CHARITABLE TAX-EXEMPT PURPOSES, PROGRAMS AND SERVICES OF DOYLESTOWN HOSPITAL; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a)..... 3 20
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 17
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ... 5 0
6 Total number of volunteers (estimate if necessary) .... 6 10
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 2,397,183 2,978,802
9 Program service revenue (Part VIII, line 2g) ......... 16,839 17,415
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,354,798 1,290,056
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 15,397 4,800
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 3,784,217 4,291,073
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 1,902,515 1,749,082
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 0 0
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet206,877    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 1,259,031 1,231,412
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 3,161,546 2,980,494
19 Revenue less expenses. Subtract line 18 from line 12....... 622,671 1,310,579
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 34,391,765 34,734,649
21 Total liabilities (Part X, line 26)............. 3,374,729 3,506,222
22 Net assets or fund balances. Subtract line 21 from line 20..... 31,017,036 31,228,427
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid preparer use only
Print/type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name Right pointing arrowhead image

Firm's EIN Right pointing arrowhead image
Firm's address Right pointing arrowhead image



Phone no.
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2011)
Form 990 (2011)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III .........
1
Briefly describe the organization’s mission: TO SUPPORT THE CHARITABLE TAX-EXEMPT PURPOSES, PROGRAMS AND SERVICES OF DOYLESTOWN HOSPITAL; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION, WHICH PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 2,700,949 including grants of $ 1,749,082 ) (Revenue $ 17,415 )
EXPENSES INCURRED IN SUPPORT OF THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF DOYLESTOWN HOSPITAL; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION, WHICH PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 2,700,949
Form 990 (2011)
Form 990 (2011)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II.........................
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part IClick to see attachment....................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
Yes
 
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part IClick to see attachment
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II.......... Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III................... Click to see attachment
19
Yes
 
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H.....
20a
 
No
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statement to this return? Note. All Form 990 filers that operated one or more hospitals must attach audited financial statements.
20b
 
 
Form 990 (2011)
Form 990 (2011)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
Yes
 
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I......
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II.........................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV...................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV..
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2011)
Form 990 (2011)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V .........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
8
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
0
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
 
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2011)
Form 990 (2011)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI .........
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
If the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
1a
20
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
17
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? .................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ............
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ..........
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? ....
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done ....................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes," to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
PA
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
DANIEL L UPTON
595 WEST STATE STREET
DOYLESTOWN,PA18901
(215) 345-2242
Form 990 (2011)
Form 990 (2011)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII .........
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) CAROLYN DELLA RODOLFA
CHAIR - DIRECTOR
 20.0 X   X       0 0 0
(2) JEAN LEISTER
VICE CHAIR - DIRECTOR
 1.0 X   X       0 0 0
(3) PHYLLIS GAGNER
SECRETARY - DIRECTOR
 1.0 X   X       0 0 0
(4) JOYCE HANSON
TREASURER - DIRECTOR
 1.0 X   X       0 0 0
(5) KAREN SIMON
ASST. SEC/ASST TREASURER - DIR
 1.0 X   X       0 0 0
(6) MARIANNE CHABOT
DIRECTOR
 20.0 X           0 0 0
(7) PATRICK COUNIHAN
DIRECTOR
 1.0 X           0 0 0
(8) LOUIS DELLA PENNA
DIRECTOR
 1.0 X           0 0 0
(9) ROBERT HALE MD
DIRECTOR
 1.0 X           0 0 0
(10) STEPHEN HIRT
DIRECTOR
 1.0 X           0 0 0
(11) KATHRYN LAMBERT
DIRECTOR
 1.0 X           0 0 0
(12) LINDA MCILHINNEY
DIRECTOR
 10.0 X           0 0 0
(13) LINDA A PLANK
DIRECTOR - VP DEVELOPMENT
 55.0 X   X       0 184,193 13,184
(14) RICHARD A REIF
DIRECTOR - PRESIDENT/CEO
 55.0 X   X       0 627,420 22,629
(15) FRED SCHEA CPA CMA
DIRECTOR
 1.0 X           0 0 0
(16) ELIZABETH SIGETY
DIRECTOR
 1.0 X           0 0 0
(17) DL SMITH MD
DIRECTOR
 1.0 X           0 0 0
Form 990 (2011)
Form 990 (2011)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) JOHN SOFFRONOFF
DIRECTOR
 1.0 X           0 0 0
(19) MARY ELLEN STANTON
DIRECTOR
 3.0 X           0 0 0
(20) DANIEL L UPTON
DIRECTOR - CFO
 55.0 X   X       0 311,870 194,103




















1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 0 1,123,483 229,916
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet0
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
DAVID HENRY AGENCY
10 PROSPECT STREET 2ND FLOOR
WESTFIELD,NJ07090 		ADVERTISING 232,289
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet1
Form 990 (2011)
Form 990 (2011)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c 56,379
d Related organizations...1d 697,832
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		2,224,591
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 2,978,802
Program Service Revenue Business Code
2a OTHER PROGRAM RELATED REVENUE 900,099 17,415 17,415    
b
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 17,415
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 1,060,706     1,060,706
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties............MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 229,350  
b Less: cost or other basis and sales expenses    
c Gain or (loss) 229,350  
d Net gain or (loss)..........MediumBullet 229,350     229,350
8a Gross income from fundraising events (not including
$ 56,379
of contributions reported on line 1c). See Part IV, line 18 ...
a 100,356
b Less: direct expenses ...b 100,356
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a 36,600
b Less: direct expenses ...b 31,800
c Net income or (loss) from gaming activities...MediumBullet 4,800     4,800
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 0
12 Total revenue. See Instructions....MediumBullet 4,291,073 17,415 0 1,294,856
Form 990 (2011)
Form 990 (2011)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Check if Schedule O contains a response to any question in this Part IX. .........
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21 1,729,832 1,729,832
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 19,250 19,250
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 0      
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 0      
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 0      
9 Other employee benefits ....... 0      
10 Payroll taxes ........... 0      
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 0      
c Accounting ........... 2,400   2,400  
d Lobbying ........... 0      
e Professional fundraising. See Part IV, line 17.. 0  
f Investment management fees ...... 0      
g Other .......... 0      
12 Advertising and promotion .... 291,257 291,257    
13 Office expenses ....... 64,648 47,840 646 16,162
14 Information technology ...... 0      
15 Royalties .. 0      
16 Occupancy ........... 0      
17 Travel ............ 0      
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 6,566 4,793   1,773
20 Interest ........... 1,042 1,042    
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 22,896 16,256 916 5,724
23 Insurance .............. 0      
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a ALLOCATION OF PERSONNEL COSTS 763,408 511,483 68,707 183,218
b OTHER EXPENSES 79,195 79,195    
c
d
e
f All other expenses        
25 Total functional expenses. Add lines 1 through 24f 2,980,494 2,700,948 72,669 206,877
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2011)
Form 990 (2011)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 278,093 1 1,076,539
2 Savings and temporary cash investments ....... 0 2 0
3 Pledges and grants receivable, net ......... 1,775,177 3 992,943
4 Accounts receivable, net ......... 0 4 0
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L .......... 0 5 0
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L .......... 0 6 0
7 Notes and loans receivable, net ............. 0 7 0
8 Inventories for sale or use .............. 0 8 0
9 Prepaid expenses and deferred charges ............ 20,906 9 0
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 303,185
b Less: accumulated depreciation. ..... 10b 291,545 27,008 10c 11,640
11 Investments—publicly traded securities .......... 0 11 0
12 Investments—other securities. See Part IV, line 11 ...... 0 12 0
13 Investments—program-related. See Part IV, line 11 .. 32,170,312 13 32,442,134
14 Intangible assets ......... 0 14 0
15 Other assets. See Part IV, line 11 ........... 120,269 15 211,393
16 Total assets. Add lines 1 through 15 (must equal line 34)... 34,391,765 16 34,734,649
Liabilities 17 Accounts payable and accrued expenses . 114,358 17 129,716
18 Grants payable .......... 0 18 0
19 Deferred revenue .......... 0 19 0
20 Tax-exempt bond liabilities .......... 0 20 0
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 27,120 23 13,294
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D..... 3,233,251 25 3,363,212
26 Total liabilities. Add lines 17 through 25..... 3,374,729 26 3,506,222
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 17,583,390 27 17,492,197
28 Temporarily restricted net assets ..... 2,566,654 28 3,512,835
29 Permanently restricted net assets ..... 10,866,992 29 10,223,395
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 31,017,036 33 31,228,427
34 Total liabilities and net assets/fund balances ..... 34,391,765 34 34,734,649
Form 990 (2011)
Form 990 (2011)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI .........
1
Total revenue (must equal Part VIII, column (A), line 12) ...
1
4,291,073
2
Total expenses (must equal Part IX, column (A), line 25) ....
2
2,980,494
3
Revenue less expenses. Subtract line 2 from line 1 ...
3
1,310,579
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
31,017,036
5
Other changes in net assets or fund balances (explain in Schedule O) ...
5
-1,099,188
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) ....
6
31,228,427
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII .........
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?....
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant? If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O. ...........................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2011)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
DOYLESTOWN HEALTH FOUNDATION
 
Employer identification number

23-2368196
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... 6,968,356 2,481,366 5,956,086 1,565,318 2,978,802 19,949,928
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3.. 6,968,356 2,481,366 5,956,086 1,565,318 2,978,802 19,949,928
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..           587,718
6 Public Support. Subtract line 5 from line 4.           19,362,210
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
7 Amounts from line 4.. 6,968,356 2,481,366 5,956,086 1,565,318 2,978,802 19,949,928
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. 2,421,973 1,049,858 1,030,425 1,125,826 1,060,706 6,688,788
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).           26,638,716
12
12
439,405
13
Section C. Computation of Public Support Percentage
14
14
72.684 %
15
15
67.427 %
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2011
Name of organization
DOYLESTOWN HEALTH FOUNDATION
 
Employer identification number

23-2368196
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on Part I, line 2, of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 2
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
DOYLESTOWN HEALTH FOUNDATION
  		Employer identification number

23-2368196
Part I
Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
DOYLESTOWN HEALTH FOUNDATION
  		Employer identification number

23-2368196
Part II
Noncash Property (see Instructions). Use duplicate copies of Part II if additional space is needed.
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 4
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
DOYLESTOWN HEALTH FOUNDATION
  		Employer identification number

23-2368196
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
Use duplicate copies of Part III if additional space is needed
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
DOYLESTOWN HEALTH FOUNDATION
 
Employer identification number

23-2368196
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958), relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance .... 10,866,992 9,410,017 9,481,668 11,960,062
b Contributions ........        
c Net investment earnings, gains, and losses ... -643,597 1,456,975 -71,651 -1,899,628
d Grants or scholarships .....        
e Other expenditures for facilities
and programs ........ 		      459,456
f Administrative expenses ....       119,310
g End of year balance ...... 10,223,395 10,866,992 9,410,017 9,481,668
2
Provide the estimated percentage of the year end balance (line 1g) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet100.000 %
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................      
b Buildings ................        
c Leasehold improvements ............        
d Equipment ................   303,185 291,545 11,640
e Other .................        
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 11,640
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) EQUITY MUTUAL FUNDS 18,615,599 F
(2) PARTNERS 225,000 F
(3) PERPETUAL TRUSTS 10,223,395 F
(4) INVESTMENTS 230,946 F
(5) USE 2,497,251 F
(6) CASH & CASH EQUIV; LIMITED USE 649,943 F



Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet 32,442,134
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Book value
Federal Income Taxes 0
DUE TO AFFILIATED ENTITIES, NE 3,265,998
OTHER LIABILITIES 97,214







Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 3,363,212
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1 4,291,073
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 2,980,494
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 1,310,579
4 Net unrealized gains (losses) on investments .......................... 4 -455,591
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV.) ................................. 8 -643,597
9 Total adjustments (net). Add lines 4 through 8 ......................... 9 -1,099,188
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 211,391
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 3,384,947
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a -455,591
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV.) ............ 2d 132,156
e Add lines 2a through 2d ..................... 2e -323,435
3 Subtract line 2e from line 1..................... 3 3,708,382
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV.) ........... 4b 582,691
c Add lines 4a and 4b....................... 4c 582,691
5 Total Revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 4,291,073
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 2,550,121
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV.) ............ 2d 132,156
e Add lines 2a through 2d...................... 2e 132,156
3 Subtract line 2e from line 1..................... 3 2,417,965
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV.) ............ 4b 562,529
c Add lines 4a and 4b....................... 4c 562,529
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 2,980,494
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
ENDOWMENT FUNDS SCHEDULE D, PART V; QUESTION 4 ENDOWMENT FUNDS ARE MADE UP OF FOURTEEN TRUST ACCOUNTS AT VARIOUS FINANCIAL INSTITUTIONS. IT IS INTENDED THAT INCOME RECEIVED FROM ELEVEN OF THESE ACCOUNTS WILL BE USED AS UNRESTRICTED INCOME TO SUPPORT THE MISSION OF THE ORGANIZATION, AND INCOME FROM THREE OF THESE ACCOUNTS WILL BE USED FOR DONOR-DESIGNATED PROGRAMS.
TEXT OF FIN 48 AUDITED FINANCIAL STATEMENT FOOTNOTE SCHEDULE D, PART X THIS ORGANIZATION IS AN AFFILIATE OF VILLAGE IMPROVEMENT ASSOCIATION OF DOYLESTOWN AND CONTROLLED ENTITIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. AN INDEPENDENT CPA FIRM AUDITED THE FINANCIAL STATEMENTS OF DOYLESTOWN HOSPITAL FOR THE YEARS ENDED JUNE 30, 2011 AND JUNE 30, 2012; RESPECTIVELY. THE FOLLOWING IS THE TEXT OF THE FOOTNOTE INCLUDED IN THE ORGANIZATION'S YEAR ENDED JUNE 30, 2012 AUDITED FINANCIAL STATEMENTS THAT REPORTS THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48: A TAX POSITION IS RECOGNIZED OR DERECOGNIZED BY THE CORPORATION BASED ON A "MORE LIKELY THAN NOT" THRESHOLD. THIS APPLIES TO POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE CORPORATION DOES NOT BELIEVE ITS CONSOLIDATED FINANCIAL STATEMENTS INCLUDE MATERIAL UNCERTAIN TAX POSITIONS.
RECONCILIATION OF CHANGE IN NET ASSETS TO AUDITED FINANCIAL STATEMENTS SCHEDULE D, PART XI; LINE 8 OTHER CHANGES IN NET ASSETS INCLUDE: - INCREASE IN BENEFICIAL INTEREST IN PERPETUAL TRUSTS; ($643,597).
RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS SCHEDULE D, PART XII; LINE 2D OTHER RECONCILIATION ITEMS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART VIII, LINE 12 INCLUDE: - SPECIAL EVENT EXPENSES - $132,156
RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS SCHEDULE D, PART XII; LINE 4B OTHER RECONCILIATION ITEMS INCLUDED ON FORM 990, PART VIII, LINE 12 BUT NOT ON LINE 1 INCLUDE: - CHANGE IN FAIR VALUE OF ASSETS HELD IN TRUST - $3,182 AND - NET ASSETS RELEASED FROM RESTRICTIONS FOR OPERATIONS - $579,109.
RECONCILIATION OF EXPENSES PER AUDITED FINANCIAL STATEMENTS SCHEDULE D, PART XIII, LINE 4D OTHER RECONCILIATION ITEMS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART IX, LINE 25 INCLUDE: - SPECIAL EVENT EXPENSES - $132,156
RECONCILIATION OF EXPENSES PER AUDITED FINANCIAL STATEMENTS SCHEDULE D, PART XIII; LINE 4B OTHER RECONCILIATION ITEMS INCLUDED ON FORM 990, PART IX, LINE 25 BUT NOT ON LINE 1 INCLUDES: - NET ASSETS RELEASED FROM RESTRICTIONS FOR OPERATIONS - $562,529
Schedule D (Form 990) 2011

Additional Data


Software ID:  
Software Version:  




SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,or if the organization entered more than $15,000 on Form 990-EZ, line 6a.right arrowAttach to Form 990 or Form 990-EZ. right arrowSee separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
DOYLESTOWN HEALTH FOUNDATION
 
Employer identification number

23-2368196
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2011
Schedule G (Form 990 or 990-EZ) 2011
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.
(a) Event #1

CIRCLE OF LIFE
(event type) 		(b) Event #2

GOLF OUTING
(event type) 		(c) Other Events

0
(total number) 		(d) Total Events
(Add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 97,535 59,200 0 156,735
2 Less: Charitable
contributions . . . 		5,179 51,200 0 56,379
3 Gross income (line 1
minus line 2) . . . 		92,356 8,000 0 100,356
VerticalDirectExpenses 4 Cash prizes . . .        
5 Non-cash prizes . .        
6 Rent/facility costs . . 10,424 8,000   18,424
7 Food and beverages . .        
8 Entertainment . . .        
9 Other direct expenses . 81,932   0 81,932
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 100,356
11 Net income summary. Combine lines 3 and 10 in column (d)............ right arrow  
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (Add col. (a) through col. (c))
1 Gross revenue . . . .     36,600 36,600
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .     27,000 27,000
4 Rent/facility costs . . .        
5 Other direct expenses . .     4,800 4,800
6 Volunteer labor . . .
 
 
 
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow 31,800
8 Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow 4,800
9
Enter the state(s) in which the organization operates gaming activities: PA
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," Explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," Explain:
 
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ..........................
Schedule G (Form 990 or 990-EZ) 2011
Schedule G (Form 990 or 990-EZ) 2011
Page 3
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
 
b
An outside facility ........................
13b
100.000 %
14
Provide the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
WILLIAM KRAUSE
Address right arrow
595 WEST STATE STREET
DOYLESTOWN,PA18901
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
LISA REPKO
Gaming manager compensation right arrow $ 500
Description of services provided right arrow
MANAGES DAY TO DAY ACTIVITY OF RAFFLE
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)
Identifier ReturnReference Explanation
Schedule G (Form 990 or 990-EZ) 2011
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
DOYLESTOWN HEALTH FOUNDATION
 
Employer identification number
23-2368196
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) DOYLESTOWN HOSPITAL595 W ST STREET
DOYLESTOWN,PA18901 		23-1352174 501(C)(3) 1,284,559       PROGRAM SUPPORT
(2) ANN SILVERMAN COMMUNITY HEALTH CLINIC595 W ST STREET
DOYLESTOWN,PA189012554 		23-2892823 501(C)(3) 40,000       FREE CLINIC ASSIST
(3) BUCKS COUNTY HEALTH IMPROVEMENT PROJECT595 W ST STREET
DOYLESTOWN,PA189012554 		23-2862339 501(C)(3) 20,000       CNTY WIDE HLTH NEEDS
(4) GILDA CLUB200 KIRK ROAD
WARMINSTER,PA18974 		22-3617106 501(C)(3) 15,000       PROGRAM SUPPORT
(5) DOYLESTOWN HOSPITAL595 w state street
doylestown,PA18901 		23-1352174 501(c)(3) 169,848       program support
(6) DOYLESTOWN HOSPITAL595 W STATE STREET
DOYLESTOWN,PA18901 		23-1352174 501(c)(3) 200,425       PROGRAM SUPPORT












2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
4
3
Enter total number of other organizations listed in the line 1 table ......................... . Bullet Image
 
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2011

Schedule I (Form 990) 2011
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance
(1) EDUCATIONAL SCHOLARSHIPS 19 19,250      













Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
GRANT FUND MONITORING SCHEDULE I, PART I, QUESTION 2 GRANTS ARE MONITORED BY THE ORGANIZATION'S FINANCE PERSONNEL THROUGH THE UTILIZATION OF COST CENTERS AND OTHER INFORMATION; INCLUDING WRITTEN DOCUMENTATION AND RECEIPTS. THE SCHOLARSHIP COORDINATING COMMITTEE AT DOYLESTOWN HOSPITAL; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION, AWARDS SCHOLARSHIP OPPORTUNITIES. APPLICANTS ARE INVITED TO APPLY FOR ANY SCHOLARSHIPS FOR WHICH THEY QUALIFY.
Schedule I (Form 990) 2011


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
DOYLESTOWN HEALTH FOUNDATION
 
Employer identification number

23-2368196
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
 
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2011

Schedule J (Form 990) 2011
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and column (E) for that individual.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) LINDA A PLANK (i)
(ii)		 0
183,165 		0
0 		0
1,028 		0
5,343 		0
7,841 		0
197,377 		0
0
(2) RICHARD A REIF (i)
(ii)		 0
617,671 		0
0 		0
9,749 		0
7,350 		0
15,279 		0
650,049 		0
0
(3) DANIEL L UPTON (i)
(ii)		 0
310,555 		0
0 		0
1,315 		0
176,398 		0
17,705 		0
505,973 		0
0













Schedule J (Form 990) 2011

Schedule J (Form 990) 2011
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
COMPENSATION INFORMATION PART VII AND SCHEDULE J TAXABLE COMPENSATION REPORTED HEREIN IS DERIVED FROM EACH INDIVIDUAL'S 2011 FORMS W-2.
COMPENSATION INFORMATION SCHEDULE J, PART 1; QUESTION 4B THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE FOLLOWING INDIVIDUAL INCLUDES UNVESTED BENEFITS IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") BECAUSE THE AMOUNT IS SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THE INDIVIDUAL MAY NEVER ACTUALLY RECEIVE THIS UNVESTED BENEFIT AMOUNT. THE AMOUNT OUTLINED HEREIN WAS NOT INCLUDED IN HIS 2011 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: DANIEL L. UPTON, $152,548.
Schedule J (Form 990) 2011

Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
DOYLESTOWN HEALTH FOUNDATION
 
Employer identification number

23-2368196
Identifier Return Reference Explanation
COMMUNITY BENEFIT STATEMENT CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS V.I.A. HEALTH SYSTEM BACKGROUND =============================== THE VILLAGE IMPROVEMENT ASSOCIATION ("V.I.A.") WAS FOUNDED IN 1895 WITH THE HEALTH, WELFARE AND BEAUTY OF THE COMMUNITY OF DOYLESTOWN AS ITS PRIMARY CONCERNS. In response to community needs, the V.I.A. established the Visiting Nurse service in 1916; it continues to operate today. The original 14-bed hospital facility, designed for emergency and maternity cases, was dedicated in 1923. To reflect a broadening community constituency, a new 25-bed hospital facility was dedicated in 1939 and was subsequently expanded three times to reach a capacity of 129 beds. The Hospital outgrew its original locations and, in 1975, moved to its present location at the intersection of Routes 202 and 611 in Doylestown, Bucks County, Pennsylvania, approximately 39 miles north of the center of Philadelphia. After several expansions of the Hospital's facilities, the most recent of which was in 2010, the Hospital currently occupies approximately 62 acres of land, 611,000 square feet of building space, has 1,889 parking spaces and is licensed for 238 beds. In 2001, the Health & Wellness Center of Doylestown Hospital was opened in Warrington, about five miles south of the Hospital, offering outpatient laboratory and testing services, same-day surgery and access to community physician practices. In 1986, a corporate restructuring created the V.I.A. Health System, the Doylestown Health Foundation and the V.I.A. Affiliates. Restructuring enabled the V.I.A. and Doylestown Hospital to operate more efficiently and with greater diversification. Throughout its history, the VIA continued to be forward looking, while maintaining the original goals of the Association which are to promote "every proper means of improving and beautifying Bucks County... improving the health and welfare of the residents," and "supporting a community hospital and other healthcare facilities for the benefit of all persons." IN ITS 117TH YEAR, THE V.I.A. OVERSEES THE OPERATIONS OF THE SYSTEM OF AFFILIATED HEALTH CORPORATIONS. THE PURPOSES OF THE V.I.A. HAVE BEEN CONSISTENT THROUGHOUT ITS HISTORY: - TO ENCOURAGE AND PROMOTE PUBLIC HEALTH WORK IN GENERAL - TO IMPROVE THE HEALTH AND WELFARE OF THE RESIDENTS OF DOYLESTOWN AND GREATER CENTRAL BUCKS COUNTY - TO PROVIDE FOOD, CLOTHING, SHELTER, MEDICAL AND SURGICAL CARE AND NURSING TO THE INDIGENT OF THE COMMUNITY WITHOUT CHARGE, INSOFAR AS HOSPITAL RESOURCES WILL PERMIT - TO OWN, MANAGE, SUPPORT, AND MAINTAIN A VISITING NURSE SERVICE AND COMMUNITY HOSPITAL FOR THE BENEFIT OF ALL PERSONS - TO RAISE FUNDS FOR AND TO RECEIVE AND HOLD ALL PROPERTY THAT MAY BE GIVEN TO THE ASSOCIATION TO ACCOMPLISH ITS MISSION. FOR THE FISCAL YEAR ENDING 6/30/12 THE V.I.A. HEALTH SYSTEM ACCOUNTS FOR THREE TAX-EXEMPT AFFILIATES IN THIS NARRATIVE: DOYLESTOWN HEALTH FOUNDATION, DOYLESTOWN HOSPITAL, AND THE V.I.A. AFFILIATES. DESCRIBED BELOW ARE THE CHARITABLE MISSIONS OF THESE ENTITIES. V.I.A. HEALTH SYSTEM MISSIONS ============================= DOYLESTOWN HEALTH FOUNDATION ---------------------------- The mission of the Foundation has four main points: assessment of community needs, communication of those needs and the System's response to them, solicitation of funds to support the response, and the accountability to the community for both the management of the funds and the response to the needs. DOYLESTOWN HOSPITAL ------------------- Doylestown Hospital is a comprehensive 238-bed medical center serving families throughout Bucks and Montgomery Counties and Western New Jersey. The Medical Staff includes more than 420 physicians in more than 40 specialty areas. Doylestown Hospital is one of the 100 best hospitals in the U.S., according to the Thomson Reuters 100 Top Hospitals study released in 2012. The Heart Institute of Doylestown Hospital is a regional center of excellence for cardiology and cardiac surgery and was named one of the 50 Top Cardiovascular Hospitals in the nation (Thomson Reuters 2012). Areas of clinical emphasis also include emergency medicine, oncology, maternal-child health, orthopedics, interventional radiology, gastroenterology, urology, general surgery and robotic surgery. Doylestown Hospital's mission is to "provide a responsive, healing environment for our patients and their families and to improve the quality of life for all members of our community." These community members include the vulnerable, the disenfranchised, those in need of health education, and those uninsured or underinsured persons who depend on us for care. DOYLESTOWN HOSPITAL IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. MOREOVER, DOYLESTOWN HOSPITAL OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. IT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF-PAY, MEDICARE AND MEDICAID PATIENTS; 2. IT OPERATES AN ACTIVE EMERGENCY ROOM FOR ALL PERSONS; WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3. IT MAINTAINS AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL RESTS WITH ITS BOARD OF TRUSTEES AND THE BOARD OF TRUSTEES OF THE SYSTEM. BOTH BOARDS ARE COMPRISED OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY; AND 5. SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE; PROGRAMS AND ACTIVITIES. As a values-based organization, Doylestown Hospital has made a public commitment to five core values: Service, Enthusiasm, Respect, Value and Excellence. The hospital holds Board members, Medical Staff, and paid and unpaid staff accountable for incorporating these values into policies, behaviors, clinical practices and management decisions. The five core values guide Doylestown Hospital's response to community needs: 1. SERVICE - ANTICIPATE THE HEALTHCARE NEEDS OF THE COMMUNITY, EITHER BY ADDING PROGRAMS OR SERVICES, OR OFFER OPPORTUNITIES FOR HEALTH EDUCATION OR SCREENING, AND ASSURE THAT THE HOSPITAL RESPONDS TO THOSE NEEDS IN A TIMELY FASHION. THESE NEEDS ARE DETERMINED THROUGH THE HOSPITAL'S STRATEGIC PLANNING EFFORTS, WHICH ARE IN TURN GUIDED BY THE HOSPITAL'S MISSION STATEMENT. 2. ENTHUSIASM - DOYLESTOWN HOSPITAL STRIVES TO SUSTAIN WITHIN ITS STAFF THE INSPIRATION THAT FIRST COMPELLED THEM TO HEALTHCARE-RELATED WORK AND A COMMITMENT TO THE JOB OF SERVING OUR PATIENTS. 3. RESPECT - DOYLESTOWN HOSPITAL WELCOMES AND PROVIDES CARE TO ALL MEMBERS OF THE COMMUNITY, WITHOUT REGARD FOR RACE, RELIGION, SEX, SEXUAL ORIENTATION, COLOR, NATIONAL ORIGIN, OR ABILITY TO PAY. ALL THE MEDICAL, SURGICAL, AND PROGRAM SERVICES LISTED ON ADDENDUM A ARE PROVIDED TO EVERYONE WHO COMES TO DOYLESTOWN HOSPITAL FOR CARE, INCLUDING THOSE UNABLE TO PAY FOR THESE SERVICES. 4. VALUE - AS A RESULT OF ITS COMMITMENT TO KEEP COST AND QUALITY IN PROPER PERSPECTIVE, DOYLESTOWN HOSPITAL PROVIDES MANY PROGRAMS AND SERVICES AT NO CHARGE, BECAUSE THE COMMUNITY EXPECTS, NEEDS, AND DESERVES THIS CONTRIBUTION OF HEALTHCARE RESOURCES TO ITS OVERALL GOOD HEALTH. IN THE FISCAL YEAR ENDING 6/30/12, OVER 27,500 COMMUNITY MEMBERS TOOK ADVANTAGE OF COMMUNITY BENEFIT ACTIVITIES, INCLUDING FREE HEALTH PROMOTION EVENTS, SCREENINGS, HEALTH EDUCATION PROGRAMS, AND OTHER OUTREACH EFFORTS. 5. EXCELLENCE - DOYLESTOWN HOSPITAL PROMISES THE COMMUNITY IT WILL STRIVE FOR THE BEST POSSIBLE CUSTOMER SERVICE, PATIENT CARE, AND TECHNOLOGY THAT MEET OR EXCEED THE COMMUNITY'S EXPECTATIONS. IT ALSO PROMISES FAITHFULNESS TO ITS HERITAGE AND ASSURES THAT EVERY DECISION REFLECTS A COMMITMENT TO THE VALUES. PINE RUN COMMUNITY ------------------ In 1992 Doylestown Hospital enhanced its commitment to the older adult population in the Central Bucks County area by acquiring the Pine Run Community. Pine Run operates as a division of Doylestown Hospital with the following mission: "Pine Run Community is committed to and passionate about seniors, and we are dedicated to being an exceptional retirement community. By focusing on a spectrum of wellness for everyone in our continuum, we will enhance the quality of life throughout the region." Pine Run serves the surrounding community as a non-profit continuing care retirement community by offering a continuum of services at its facilities which include 300 apartments (the Village), a 167-bed health care building providing 2 floors of nursing care and 1 floor of personal care Alzheimer's and related care (the Health Center), and a 107-bed personal care facility which includes a 13-bed dementia care unit (Lakeview).
COMMUNITY BENEFIT STATEMENT CONTINUED CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS PINE RUN STRIVES TO BE A PROGRESSIVE, RESIDENT-FOCUSED COMMUNITY, FULL OF VITALITY AND ENTHUSIASM, PROMOTING INDEPENDENCE AND WELLNESS. THROUGH A CULTURE OF WELLNESS, PINE RUN IS DEDICATED TO THE PROMOTION OF HOLISTIC CARE AND SERVICES FOR VILLAGERS AND RESIDENTS. THE VILLAGE, LOCATED APPROXIMATELY 3 MILES FROM THE HOSPITAL, CONSISTS OF GARDEN COTTAGES SET IN CLUSTERS AND A MULTI-UNIT APARTMENT BUILDING, AS WELL AS A COMMUNITY CENTER, DINING ROOM, STORE, LIBRARY, AND OTHER AMENITIES. MAINTENANCE, SECURITY, HOUSEKEEPING, UTILITIES, DINING, RECREATIONAL, CULTURAL, TRANSPORTATION AND FITNESS SERVICES ARE PROVIDED FOR THE VILLAGERS. THE HEALTH CENTER, LOCATED ON THE SAME CAMPUS AS THE VILLAGE, PROVIDES TRANSITIONAL CARE FOR SHORT-STAY NURSING AND REHABILITATION RESIDENTS, WITH SKILLED NURSING CARE AND COMPREHENSIVE THERAPY PROGRAMS; A PERSONAL CARE ALZHEIMER'S/DEMENTIA PROGRAM FOR THOSE WITH IMPAIRED MEMORY; LONG-TERM CARE FOR RESIDENTS REQUIRING ON-GOING CUSTODIAL CARE; SHORT-TERM RESPITE CARE TO ALLOW HOME-BASED CARE GIVERS TO TAKE A VACATION OR TRIP; AND HOSPICE CARE FOR END OF LIFE CARE. LAKEVIEW, A PERSONAL CARE FACILITY, WAS PURCHASED BY DOYLESTOWN HOSPITAL IN 1998 AND ADDED TO THE PINE RUN FAMILY OF FACILITIES. IT OFFERS PERSONAL CARE ACCOMMODATIONS IN PRIVATE SUITES AND COMPANION SUITES, WITH SUPPORTIVE SERVICES AND ENHANCED PROGRAMMING FOR THOSE WITH MEMORY IMPAIRMENT. THIS PERSONAL CARE RESIDENCE IS 3.5 MILES FROM PINE RUN VILLAGE, AND TWO BLOCKS FROM THE HOSPITAL. V.I.A. AFFILIATES ----------------- The V.I.A. Affiliates grew significantly in recent years in an effort to more closely integrate care, especially for the inpatient population. The physician practices of the V.I.A. Affiliates include: Hospitalists - Nine physicians certified in internal medicine are supported by three nurse practitioners/physician assistants. Together they manage the day-to-day care of most Hospital inpatients. General Surgeons - Two physician practices, combining a total of seven board-certified surgeons, are among the V.I.A. Affiliates and perform a wide array of surgical services, including laparoscopic and robotic procedures. Cardiothoracic Surgeons - The surgeons of VIAA Cardiothoracic Surgery work exclusively in the Richard A. Reif Heart Institute's closed Cardiovascular Intensive Care Unit with a dedicated nursing staff, cardiovascular anesthesiologists and 24/7 coverage by cardiovascular physician assistants. Neurology - A neurologist, supported by a nurse practitioner, works with community neurologists to manage stroke care in the Hospital setting. The goal of the V.I.A. Affiliates is to bring community-based services to the residents of the Central Bucks community that might not otherwise be available or included in the mission of other system entities. V.I.A. Affiliates exists to support the SERVE core value of Doylestown Hospital. HIGH QUALITY, LOW COST ---------------------- The Hospital has positioned itself as the high-quality, low-cost provider for medical services providing convenient and responsive access to all community members. The hospital has maintained a strong focus on clinical integration, beginning with the creation of the Bucks County Physician Hospital Association (BCPHA). The BCPHA was formed by the Hospital and Doylestown Independent Practice Association in 1989 to help coordinate medical management and risk contracting activities. The BCPHA is now engaged in a federal Bundled Payment initiative to improve the quality and efficiency of care for Medicare patients. Partnerships with several academic healthcare institutions have enabled the Hospital to offer certain state-of-the-art services in the Doylestown community as it continues to solidify its position as a quality, cost and access leader in the marketplace. The Hospital has an established and robust program of continuous performance improvement, incorporating concurrent statistical measurement, process redesign and standardization. The quality of the results is evident in data publically reported by the Centers for Medicare and Medicaid Services (CMS). CMS identified Doylestown Hospital as number two in the nation for lowest mortality rate for heart attack patients in 2011. The Hospital was named one of the 50 Top Cardiovascular Hospitals and among the 100 Top Hospitals in the U.S. by Thomson Reuters in 2012. Early in 2013, the Hospital was named among Becker's Hospital News "100 Hospitals with a Great Heart Program." The Hospital continues to make significant investments in information technology. The Hospital was among the first to convert to Meditech Client/Server and was named among the "Most Wired Hospitals" of 2010. The Hospital achieved 100 percent adoption of computerized provider order entry (CPOE) in June 2012, creating a fully electronic medical record. The Hospital has already received $2.5 million in federal "meaningful use" funds for its IT investment, and meets criteria to receive additional funds in the future. A parallel effort to create a community health information exchange was taking place at the same time the inpatient electronic medical record was in development. Community physicians currently share critical patient information such as allergies, lab results, problem lists and medications via the Doylestown Clinical Network with the hospital and other practices. Community physicians also have a portal to access their patients' hospital record, including images. The transition to an electronic medical record subsequently provides real-time data to further enhance quality improvement activities at Doylestown Hospital. The Hospital continues to seek opportunities to improve clinical integration and the patient experience. A major addition to the Hospital completed in 2010 expanded the Emergency Department from 17 to 49 beds. A second floor atop the addition provides 40 private patient rooms. An expanded and accredited Cancer Institute at Doylestown Hospital opened in 2011 and offers radiation therapy on the campus for the first time. The Hospital is accredited by The Joint Commission in for care of Stroke, Heart Failure and Joint Replacements. There is an accredited Chest Pain Center on campus. The Hospital has also received "Blue Distinction" status from Blue Cross/Blue Shield for joint replacements. PATIENT SAFETY AND SATISFACTION ------------------------------- PRESS GANEY AWARD FOR PATIENT SATISFACTION Doylestown Hospital earned a 2012 Summit Award for Patient Satisfaction - Emergency Department by Press Ganey Associates, Inc. The Summit Award recognizes top-performing facilities that sustain the highest levels of patient satisfaction performance for three consecutive years. The Press Ganey Summit Award is one of the healthcare industry's most coveted symbols of achievement. Doylestown Hospital is one of only 100 organizations to receive this prestigious honor for patient satisfaction in 2012, and one of only 24 Emergency Departments be recognized. Press Ganey partners with more than 10,000 healthcare facilities, including more than half of all U.S. hospitals, to measure and improve the patient experience. Doylestown Hospital's new, 55,756-square foot Emergency Department (ED) opened with 41 beds in April 2010. A collaborative team of physicians, nurses, hospital administrators and patients, aided by experts in emergency department design, designed an ED that focuses on how care should be delivered, not how it is traditionally delivered. Various efficiencies promote faster movement through the system, reducing the time that patients spend in the ED. In working to improve systems, the main area of focus was the impact of wait time on patient care and satisfaction. Several protocols were initiated to move the Emergency Department visitor out of the "waiting room" as soon as possible and into a treatment room. These included: instituting standing order sets for the treatment of most common ED complaints to expedite the delivery of care, and empowering nursing staff to initiate the order sets within their scope of practice before the patient is seen by a physician. Finally, all physicians in the ED adopted the same standards for patient communication and visibility. Electronic medical records consolidate and coordinate charting. A "tracker board" is plainly visible to staff to monitor who is next to be seen, the amount of wait time and the acuity of the patient. To improve communication, staff members carry cell phones with speed-dial connectivity.
COMMUNITY BENEFIT STATEMENT CONTINUED CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS "Our model of care is completely patient-centered," said Lawrence Brilliant, MD, Medical Director, Emergency Department. "With support from the staff, physicians and Administration, we have been able to create an environment from the ground up that focuses on patient experience and the way care should be delivered to ensure the best and safest possible experience for each patient." "We are proud to partner with Doylestown Hospital," said Patrick T. Ryan, CEO of Press Ganey. "Achieving this level of excellence in patient satisfaction reflects the organization's commitment to delivering outstanding service and quality. Doylestown Hospital's efforts benefit patients in the community and will lead to improved patient experience." WOMEN'S CHOICE AWARD AS ONE OF THE 2012 AMERICA'S BEST HOSPITALS FOR PATIENT EXPERIENCE ------------------------------------------------------------------------ The award is based on robust criteria that consider female patient satisfaction and what women say they want from a hospital including quality physician communications, responsiveness of nurses and support staff, cleanliness and trusted referrals from other women. The award is presented by WomenCertified, representing the collective voice of female consumers. It is a trusted referral source for top businesses and brands identified as meeting the needs and preference of women. "We are honored to receive the Women's Choice Award recognizing Doylestown Hospital as one of the Top 100 hospitals for Patient Experience," says Doylestown Hospital President & CEO Richard A. Reif. "We especially appreciate the fact that our female patients have selected us for this award. Doylestown Hospital has the unique distinction of being founded and still run by a women's civic organization, the Village Improvement Association. Being selected for this award by women affirms our commitment to providing the best experience possible as they rely on us for quality health services for themselves and their families." Women make or influence more than 90 percent of healthcare decisions for themselves and their families, according to a study published by the American Academy of Family Physicians. The Women's Choice Award signals that a hospital meets high standards regarding a woman's preferences, and the distinction allows women to make an informed decision about where to go for care for themselves or their family. "Doylestown Hospital's selection by WomenCertified as one of America's Best 100 Hospitals for Patient Experience differentiates it from other choices in the area," explains Delia Passi, CEO and founder of WomenCertified, and former publisher of Working Woman and Working Mother magazines. "Women have many choices when it comes to healthcare and they set the standard for customer service. Women's Choice Award recipients have demonstrated extraordinary service in meeting the needs of women and their families, and represent the smart choice for women." Hospitals qualify for this highly selective annual list based on an in-depth proprietary scoring process. The scoring incorporates a national, standardized survey of patients' perspectives of hospital care reported by the U.S. Department of Health and Human Services (Hospital Consumer Assessment of Healthcare Providers and Systems) and an analysis that weighs criteria identified as the most important to women for patient satisfaction. Additionally, the scoring incorporates WomenCertified's in-depth research on customer satisfaction among women, including a joint study on customer satisfaction by gender conducted with the Wharton School of the University of Pennsylvania. The 100 best scores in four hospital size categories determine the Award winners. WomenCertified accepts absolutely no payment in exchange for placement on the list. "Recognizing the best hospitals nationwide that are women-friendly and align with women's identified preferences is important to our mission at WomenCertified, where women help other women with tough, consumer decisions," Passi concludes. "Most importantly, when a woman sees the Women's Choice Award at her local hospital, she'll know the hospital values her experience as a critical component of her and her loved one's care." RECENT ACHIEVEMENTS DOYLESTOWN HOSPITAL IS 2ND IN THE NATION AND BEST IN PENNSYLVANIA FOR HEART ATTCK SURVIVAL ------------------------------------------------------------------------- The 30-day mortality rate for heart attack patients is 10.4% at Doylestown Hospital; the national average is 15.5%, according to CMS. The mortality rate takes into account not only the life-saving care provided before and during emergency angioplasty, but also the superior care a patient receives after the event and even after they return home. This ranking affirms the hospital's designation as a 50 Top Cardiovascular Hospital for 2012 by Thomson Reuters. That study examined the performance of more than 1,000 hospitals by analyzing outcomes for patients with heart failure and heart attacks and for those who received coronary bypass surgery and percutaneous coronary interventions such as angioplasties. "Doylestown Hospital has a team approach to the care of heart attack patients," says Steven Guidera, MD, cardiologist with The Heart Institute of Doylestown Hospital. "Our team consists of physicians, nurses, cardiovascular specialists, therapists and administrators. Each member of the team has a clearly defined role and makes meaningful contributions to the care of our heart attack patients. We constantly evaluate our processes and make refinements with the goal of continuous quality improvement. This recognition acknowledges the hard work of men and women from throughout our hospital family." DOYLESTOWN HOSPITAL RECEIVES STROKE GOLD PLUS QUALITY ACHIEVEMENT AWARD ------------------------------------------------------------------------- Doylestown Hospital received the Get With The Guidelines - Stroke Gold Plus Quality Achievement Award from the American Heart Association in 2012. The award recognizes Doylestown Hospital's commitment and success in implementing a higher standard of care by ensuring that stroke patients receive treatment according to nationally accepted guidelines. Get With The Guidelines - Stroke helps Doylestown Hospital's staff develop and implement acute and secondary prevention guideline processes to improve patient care and outcomes. The program provides hospitals with a web-based patient management tool, best practice discharge protocols and standing orders, along with a robust registry and real-time benchmarking capabilities to track performance. The quick and efficient use of guideline procedures can improve the quality of care for stroke patients and may reduce disability and save lives. Doylestown Hospital is a certified Primary Stroke Center that offers the highest quality care to its stroke patients. Doylestown Hospital has developed a comprehensive system for rapid diagnosis and treatment of stroke patients admitted to the emergency department. This includes always being equipped to provide brain imaging scans, having neurologists available to conduct patient evaluations and using clot-busting medications when appropriate. "This achievement represents a tremendous amount of teamwork that begins as soon as a stroke alert is issued," said Doylestown Hospital neurologist Abraham Ashkenazi, M.D. "The quality of the care spans the continuum from the assessment of the doctors and nurses in the ER all the way to the clinicians in rehab. Our goal is to provide the best diagnosis, treatment and follow-up care to ensure the stroke patient has the best quality of life possible." "Recent studies show that patients treated in hospitals participating in the American Heart Association's Get With The Guidelines-Stroke program receive a higher quality of care and may experience better outcomes," said Lee H. Schwamm, M.D., chair of the Get With The Guidelines National Steering Committee and director of the TeleStroke and Acute Stroke Services at Massachusetts General Hospital in Boston, Mass. "The Doylestown Hospital team is to be commended for their commitment to improving the care of their patients." Following Get With The Guidelines - Stroke treatment guidelines, patients are started on aggressive risk-reduction therapies including the use of medications such as tPA, antithrombotics and anticoagulation therapy, along with cholesterol-reducing drugs and smoking cessation counseling. These are all aimed at reducing death and disability and improving the lives of stroke patients. Hospitals must adhere to these measures at a set level for a designated period of time to be eligible for the achievement awards.
COMMUNITY BENEFIT STATEMENT CONTINUED CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS "Doylestown Hospital is dedicated to making our care for stroke patients among the best in the country. The American Heart Association's Get With The Guidelines - Stroke program helps us to accomplish this goal," said Doylestown Hospital's Stroke Program Coordinator, Brooke Kearins, CRNP. "This recognition demonstrates that we are on the right track and we're very proud of our team." According to the American Heart Association/American Stroke Association, stroke is one of the leading causes of death and serious, long-term disability in the United States. On average, someone suffers a stroke every 40 seconds; someone dies of a stroke every four minutes; and 795,000 people suffer a new or recurrent stroke each year. SERVICE ENHANCEMENTS DOYLESTOWN RANKED AMONG 100 TOP HOSPITALS ----------------------------------------- Doylestown Hospital is one of the best 100 hospitals in the U.S. according to the Thomson Reuters 100 Top Hospitals study released April 16. The annual study evaluates hospitals based on their overall organizational performance. "The Thomson Reuters 100 Top Hospital rating is a wonderful affirmation of the quality of care we consistently deliver and the culture of patient safety that we all have worked so hard to achieve," said Richard A. Reif, President and CEO of the hospital. "I could not be more proud of, or excited for, every Associate, member of our Medical Staff and hospital Volunteer." To conduct the 100 Top Hospitals study, Thomson Reuters researchers evaluated 2,886 short-term, acute-care, non-federal hospitals. They used public information - Medicare cost reports, Medicare Provider Analysis and Review (MedPAR) data, and core measures and patient satisfaction data from the Centers for Medicare and Medicaid Services (CMS) HospitalCompare website. Hospitals do not apply, and winners do not pay to market this honor. There are 10 areas of study: - Mortality - Medical complications - Patient safety - Average patient stay - Expenses - Profitability - Patient satisfaction - Adherence to clinical standards of care - Post-discharge mortality - Readmission rates for heart attack, heart failure and pneumonia In November 2011, Thomson Reuters named Doylestown Hospital among the Top 50 Cardiovascular Hospitals in the U.S. for 2012. That recognition came on the heels of another national honor: DH's 30-day mortality rate for heart attack was tied for fourth best in the nation according to data on the CMS HospitalCompare web site (August 2011). V.I.A. MATERNITY CENTER RENOVATIONS ----------------------------------- The birth experience at Doylestown Hospital is family-centered, and our caring staff makes every "birthday" as special as possible. Our state-of-the-art facilities and neonatal affiliation with Children's Hospital of Philadelphia place the very finest maternity and pediatric care right in the heart of our community. Approximately 1,300 babies are born every year at Doylestown Hospital, rated among the best in the region for maternity care by HealthGrades(tm). We provide services from pregnancy through birth for mothers and newborns, for the most common deliveries to neonatal intensive care services. We are equipped and ready to care for families with higher than normal risk related to multiple births, maternal age and medical risk factors. Doylestown Hospital is pleased to meet the needs of new moms by offering all private rooms in our Maternity Center. The V.I.A. Maternity Center features a 32-bed maternity unit that includes 10 Labor, Delivery & Recovery rooms; 22 private post-partum rooms (with private bathrooms), and a Jacuzzi room for mothers in labor. Our maternity team will work with you to personalize your birth experience and provide the finest care for you and your baby. NATIONAL STUDY PLACES DOYLESTOWN HOSPITAL'S CARDIAC SERVICES BEST IN BUCKS COUNTY -------------------------------------------------------------------------- Doylestown Hospital is the top rated hospital in Bucks County for overall cardiac care, according to a comprehensive annual study released today by HealthGrades, the leading independent healthcare ratings organization. The HealthGrades study analyzes tens of millions of patients' outcomes - specifically, mortality and complication rates - at the nation's 5,000 hospitals. Patients highly value independent information on hospital quality performance. And in light of recent health reform measures, demand for this information is only likely to increase. In a recent survey of visitors to HealthGrades.com related to hospital quality, 94% ranked quality outcomes and ratings as very important compared to reputation (89%), volume (78%), and location (58%). Doylestown Hospital stands committed to a culture of quality and transparency and is proud of the results that its cardiac program has achieved. Doylestown Hospital received HealthGrades highest rating - 5-stars - for both coronary interventional procedures as well as treatment of heart attacks. This is not the first year the hospital scored high; in fact it has sustained the top ratings for four consecutive years. In this year's HealthGrades study, no other hospital in Bucks County received the 5-star rating for treatment of heart attacks. "Our goal is to provide care of the highest quality with the best possible outcomes for our patients," says Chief Medical Officer Scott Levy, M.D. "Acknowledgement of our achievements by HealthGrades certainly helps validate the work we do." According to the Thirteenth Annual HealthGrades Hospital Quality in America study top-rated hospitals had a 53% lower mortality rate than the U.S. national average for 17 procedures and diagnoses ranging from bypass surgery to treatment for heart attack. When the top-rated hospitals were compared to the poorest performers, there was an even greater quality gap: a 72% lower risk of mortality. Doylestown Hospital is an accredited Chest Pain Center with protocols in place to offer the highest level of care for cardiac symptoms. The Heart Institute of Doylestown Hospital is a leader in primary (emergency) angioplasty, the treatment of choice to open blocked coronary arteries during a heart attack. At 62.5 minutes, Doylestown Hospital's Door-to-Balloon time (the time from patient arrival to when the artery is opened) is consistently superior to national averages, and well below the suggested benchmark of 90 minutes. "The key to our success is a multidisciplinary approach to the treatment of heart attack," says Executive Director of Cardiovascular Services John Mitchell. "This involves close collaboration between the Emergency Department, Cath Lab, physicians and nurses. Every member of the team has the same goal of providing successful, patient-centered care." HealthGrades' hospital ratings and awards reflect the track record of patient outcomes at hospitals in the form of mortality and complication rates. HealthGrades rates hospitals independently based on data that hospitals submit to the federal government. No hospital can opt in or out of being rated, and no hospital pays to be rated. For 26 procedures and treatments, HealthGrades issues star ratings that reflect the mortality and complication rates for each category of care. Hospitals receiving a 5-star rating have mortality or complication rates that are better than anticipated, to a statistically significant degree. A 3-star rating means the hospital performs as expected. One-star ratings indicate the hospital's mortality or complication rates in that procedure or treatment are statistically higher than average. Because the risk profiles of patient populations at hospitals are not alike, HealthGrades risk-adjusts the data to allow for equal comparisons. DOYLESTOWN RECOGNIZED FOR INNOVATIVE USE OF TECHNOLOGY FOR SAFER PATIENT CARE -------------------------------------------------------------------------- Doylestown Hospital has received two prestigious awards for its use of technology. Doylestown is among an elite group of 85 hospitals across the nation to be recognized with the Healthcare Information and Management Systems Society (HIMSS) EMR Stage 6 Award. Doylestown Hospital is the only Philadelphia-area hospital to receive this award. EMR Stage 6 marks significant progress toward achieving a full EMR (Electronic Medical Record. As a Stage 6 hospital, Doylestown does full electronic medication management; is well on its way with CPOE (Computerized Physician Order Entry) with about 32% of inpatient orders are currently generated through CPOE; has full PACS (digital radiology images) and online clinical decision support.
COMMUNITY BENEFIT STATEMENT CONTINUED CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS The next, and highest, stage according is HIMSS EMR Stage 7; Doylestown is expected to reach this level in the near future. Doylestown Hospital has also received a Microsoft Health Users Group (MS-HUG) Innovation Award in the area of HIE (Health Information Exchange) and Interoperability for its work on the Doylestown Clinical Network. This network ties together the EMR systems of the hospital and community physicians. The hospital has 185 physicians on the NextGen network, which automatically transfers a patient's EMR to specialists and the hospital. Of those, more than 50 are active EMR users. There are about 400,000 patients in our community enrolled in this network. The ultimate goal is to safely and efficiently share a patient's health information throughout the healthcare continuum. V.I.A. HEALTH SYSTEM COMMUNITY BENEFIT ACTIVITIES ================================================= THE V.I.A. HEALTH SYSTEM IS DEVOTED TO THE COMMUNITY IT SERVES, AND IT SPONSORS AND COORDINATES MANY CHARITABLE ACTIVITIES, WHICH, DESCRIBED IN THE NARRATIVE BELOW, IDENTIFIES WHAT IS DONE DAILY BY THE HEALTH SYSTEM'S ASSOCIATES AND VOLUNTEERS. COMMUNITY OUTREACH & BENEFIT ACTIVITIES --------------------------------------- AMERICAN RED CROSS DONATION The Hospital provides space on a weekly basis for a blood donation program conducted by the American Red Cross that benefits patients and the community. Hospital space is valued at $15,000. BUCKS COUNTY HEALTH IMPROVEMENT PARTNERSHIP The Bucks County Health Improvement Partnership (BCHIP) is a collaborative effort among Doylestown Hospital and the other five hospitals in the county, also including the Bucks County Medical Society and The Bucks County Department of Health. BCHIP addresses: maternal and child health issues, mental health concerns, coordination of health promotion and prevention (notably tobacco and cardiovascular risk reduction), supports CHIP enrollment, domestic violence prevention and provides adult health and dental clinics for underserved populations. The Foundation contributed $20,000 to a common fund, from which these projects were supported. CB CARES Both the Doylestown Hospital and the Doylestown Health Foundation support the Team with Board members who provide leadership, fundraising and human resource skills. The value of space, utilities, phone, computer and cleaning services were donated for FY2012 for a total of $20,098. CHILDREN'S VILLAGE DAY CARE SUBSIDIES Children's Village, on-site day care, welcomes children from low-income families in the area and also children with special needs that are eligible for child-care subsidies. $8,141 was written off for this. ANN SILVERMAN COMMUNITY HEALTH CLINIC The mission of the Clinic is to provide free medical care, dental care and social services to any eligible person who seeks its help. The target population is low income, underinsured or uninsured people in the greater Central Bucks County area. The hospital provided the Clinic with offices and exam rooms at a nominal charge. The Foundation assisted in some of the health needs of the patients that go beyond the resources of the Clinic with a contribution of $40,000. Other donations included pharmaceuticals and medical testing, as well as senior management's time contributing to the Clinic's Board. During FY11-12 there were 2,189 visits to the medical program for 813 individual adults and children. There were 826 treatment visits for the dental program for 249 adults and children. There were 87 visits provided through the Social Service Program including 453 eligibility appointments and 159 medical insurance applications. There were 418 prescriptions filled from donated samples and 390 applications completed or Prescription Assistance Programs. COMMUNITY EDUCATION CALENDAR Doylestown Hospital published a quarterly calendar which is distributed to 187,500 households. This calendar lists communications related to health education programs and classes. The approximate cost of this publication is $195,140. Advertisements are in local newspapers which inform the community members about upcoming health education classes, physician lectures, support groups and other health education activities. In addition, Doylestown Hospital publishes three disease specific newsletters which offer wellness and prevention information to patients who have been diagnosed with or are concerned about heart disease (Cardiac Connection), osteoporosis, breast cancer, menopause and other women's health issues (Her Health) and cancer (Concierge). More than 175,000 people receive this information through a mailing to their homes. An additional 2,500 e-newsletters are also sent. The cost to produce and distribute these newsletters was $160,480. MEDICAID APPLICATION PREPARATION FOR ALL UNINSURED PA RESIDENTS Doylestown Hospital offers all uninsured PA residents the option of filing a Medicaid application. HRSI is the Hospital's vendor and they help our patients through the process. The Hospital is charged $475/application, if the applicant obtains eligibility. HRIS has successfully obtained eligibility for 189 uninsured patients. For this process, the Hospital paid HRSI $89,775, staff time cost incurred of $31,571. Cost of Connecticut Medical Assistance application fee of $680 and Trans Union Monthly fees totally $73,733 for the fiscal year. LENAPE VALLEY HEALTH FOUNDATION This organization provides psychiatric coverage and clinical supervision for Unit Patients and psychiatric consultation services in the Hospital's Emergency Department. This is a cost to the hospital of $45,000. FOUNDATION FUND RAISING PROGRAM The Foundation's fund raising program requested unrestricted gifts for this fiscal year that would enable Doylestown Hospital to continue its mission of a responsive, healing environment for patients and their families. Gifts benefited many departments of the hospital, especially the Heart Institute, Hospice and the Cancer Center. Special events included a silent auction to benefit the Cancer and Hospice programs, a Heart Brunch, and a golf outing. The Planned Giving program was successful, including the growth of the charitable gift annuity program. HOSPICE PROGRAM SUPPORT The Hospice Program provided caregivers for respite care in the homes of terminally ill patients, and contacted bereaved people over the phone throughout the year after the death of a loved one. Value: $4,516. BEREAVEMENT SUPPORT The Bereavement Support Program provided support for bereaved and hospice families. There are various types of bereavement support groups that take place monthly in order to meet the needs of all types of losses. These programs are offered all year round and have a Chaplain and other professional staff in attendance. The Hospital served 180 community members, at a value of $24,437. "HOW TO COPE" PROGRAMS There were events held at various churches and organizations to discuss topics of coping with the loss of a loved one at the Holidays, "Who am I now" and having conversations before the crisis. Value: $13,321. PULSE LINE A phone line that is dedicated for community information, registration and referral. Hospital staff screened applicants and referred patients with primary care and specialist physicians. They also referred eligible patients to the Free Clinic of Doylestown. Estimated staff time was 1,040 hours (20 hours/week for 2 operators) valued at $20,280. DOYLESTOWN CLINICAL NETWORK (DCN) The DCN facilitates seamless transfer of clinical information provider-to-provider to improve the quality of care for members of the Doylestown Community. There is an estimated 12,372 hours of paid Associate time. An estimated cost of $230,000 for phone lines, maintenance, depreciation, etc. and an estimated cost of $19,200 for Administration. An estimate of direct offsetting revenue of $50,000. The outcome for the community is the serving of approximately 450,000 persons. Collaboration occurred between Doylestown Hospital and the Bucks County Physician Hospital Alliance (BCPHA). SCHOLARSHIP ASSISTANCE 17 scholarships are supported by the Foundation through restricted gifts. These scholarships, totaling $17,200 are awarded to men and women pursuing nursing, allied health, paramedic, and other training. BEN WILSON SENIOR CENTER NEWSLETTER Four times a year a staff member from Community relations assists with the preparation of a newsletter for the Ben Wilson Senior Center in Warrington by supplying health and wellness information and editorial oversight. We then print 1,500 copies at a value of $215. Staff time of 12 hours/issue valued at a total of $278, for the four issues.
COMMUNITY BENEFIT STATEMENT CONTINUED CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS COMMUNITY BUSINESS SPONSORSHIPS Throughout the year, Doylestown Hospital has made cash donations to assist local businesses, non-profits and cultural organizations provide programs and activities that improve and/or enhance the overall qualify of life for the greater Central Bucks Community. We believe that one way to keep community members safe, health and vibrant is by supporting the numerous community and business groups that are the fabric of our community and by participating in special programs and events that benefit a broad spectrum of community residents. The total amount donated for sponsorships is $ 35,800. VISITING NURSE PROGRAM FREE SUPPORT The Visiting Nurses made visits to families without insurance. Clinics were held at the Center Square Towers, Yorktowne Manor and Buckingham Springs, which are all senior living complexes. 45 hours were donated at a cost of $4,615. HOSPICE PROGRAMS Mailings and telephone contact to other community service organizations, such as Beelong Adult Day Services, Bayada Nurses in Hatboro & Bucks County Office, The Manor at Yorktown, to name a few, as well as healthcare organizations to offer information and education regarding "End of Life" and Hospice Programs. 50 paid hours and 10 donated hours at a cost of $4,441 plus refreshments and handouts at a cost of $75. LIBRARY SERVICES AT DOYLESTOWN HOSPITAL The Hospital has an extensive library that is open to users from the community, other than Medical Staff, Associates and Volunteers of the Hospital. Physicians that have privileges at the Hospital as well as Honorary/Emeritus Medical Staff make up the largest group of users. At a cost to the Hospital of $83,274. HEALTHY E-COOKING SHOW The Hospital has an ongoing program that has an online database of over 600 healthy recipes and nutritional information along with videos. These are accessible through Doylestown Hospital's website. This access to the community helps with information on obesity, diabetes, cardiovascular disease and all dietary links. This information is available to help promote healthy eating habits. At a cost to the Hospital of 48 paid professional hours at a cost of $2,074 and an annual license fee of $14,400. ADAM HEALTH ENCYCLOPEDIA Health information is the 3rd most popular search on the internet. The Hospital has an extensive health library on its website with over 4,000 health and wellness articles and covers over 1,500 medical topics. The site has reference index and interactive tools. At a cost to the Hospital of 20 paid professional hours at a cost of $ 864 and an annual license fee of $17,500. FOOD SHELTER DONATION Doylestown Hospital donated 50 cartons of food to New Britain Baptist Church to be distributed to local families in need. The cost to the Hospital was $24,000. EDUCATIONAL PROGRAMS -------------------- CANCER SURVIVOR DAY This event was held by Doylestown Hospital for all cancer survivors and their family and friends. It was intended to provide psychological support and a networking experience with other survivors and connect survivors with community resources. Over 100 people attended the event. Volunteer hours included physicians, nursing, clerical staff attending for a total of $1,223. LIFESTYLE LECTURES This was a series of informal educational lectures offered to the community by members of the medical staff. The hospital coordinated the program, which helped 354 community members. $2,500 in physician time was donated. DRIVER SAFETY PROGRAM This was a cooperative program with AARP that follows their rules for participation. We provide room for 214 participants and 11 classes, which amounted to $1,250 in hospital donated costs. COMMUNITY LECTURES The Hospital provided speakers for various community groups and organizations. Presenters for events utilized both staff and physicians. The donated staff time was $500 and the session helped 155 community individuals. These programs improved the community's health and quality of life through education. BREAST CANCER SUPPORT GROUP Provided opportunities for educational and emotional support for breast cancer survivors and their families. The Hospital provided education to 25 persons per month at a cost of $1,497. Additional programs sponsored by the Hospital for cancer support were four cancer educational programs (Psychological Support Program, Breast Cancer and Emotional Support Program, Nutrition Program and "Basket Bingo". Costs incurred for these events were $5,162. MAN TO MAN PROSTATE CANCER SUPPORT GROUP EDUCATION This monthly program addresses issues and the struggles that face prostate cancer survivors and their families. Volunteer time was 27 hours valued at $2,133. LOOK GOOD, FEEL BETTER This program provided support and resources for cancer patients undergoing chemotherapy. 26 individuals attended and $388 was the value of staff and volunteer time and resources. NUTRITION PRESENTATIONS Programs were held throughout the year to provide education on nutrition to promote optimal health and Diabetes Awareness. Locations included: several churches, senior communities, two High Schools and various women's' and men's' groups, menu evaluation for Yorktown Manor, health fair displays for YMCA and many local elementary schools. Over 1,500 were educated with these programs. 95 hours of staff time spent at a cost of $4,335 to the hospital. CANCER ROADMAP - Q&A FOR THE NEWLY DIAGNOSED PATIENT This program describes the process to the newly cancer diagnosed. There is a one-on-one with an oncology nurse, social worker and volunteer survivor to discuss a treatment plan, expectations and available resources for positive coping. There were 4 individuals who attended, and a cost of $135. I CAN COPE This program was an educational series that addressed topics such as cancer and treatment, managing side effect, emotional concerns, fatigue and energy conservation and proper nutrition. 20 persons were served at a cost of $640. STUDENT INTERNSHIP SUMMER PROGRAM This program with Students of the Gwynedd Mercy Cardiovascular Technology Program and Bucks County Community College Nursing Program. The students spend 2 weeks observing procedures in Cardiac Services, Echo and the Cath Lab to help them decide where they would like to focus their educational/career and education. The value of this program is $182,475 for support staff, physicians and professional staff time. STUDENT INTERNSHIP RADIOLOGY PROGRAM SIX students from Abington Memorial Hospital School of Radiologic Technology attend the Hospital's Department of Radiology on a rotation basis. Students learn clinical skills that are important to their educational process. Radiographers at the Hospital serve as clinical instructors for the students on a one to one ratio. Doylestown Hospital does not receive a financial reward for this agreement. The cost of this program to the Hospital is $136,648. There is also an intern program for ONE student with the Ultrasound Department. The cost of this program is $22,525. ALLIED HEALTH RCIS COLLEGE INTERN PROGRAM Students work with a Doylestown Hospital Cardiac Rehab Associate, developing their skills such as reading physician reports, collecting information for first visit patients, assessing skills, documenting meds, exercise evaluations, evaluating outcomes and discharging patients. For the student college training, this is a mandatory clinical experience program. The cost of this program to the hospital is $341,015. SMOKING CESSATION PROGRAM Programs were held using CDC Resources "Cleaning the Air". 54 individuals were given help in quitting the habit smoking. The hospital's overall contribution is valued at $1,000. AMERICAN FAMILY FESTIVAL & COUNTRY FAIR A Program was held at Pine Run for the community, at a value of $185 for time and refreshments. Staff and handout materials were valued at $1,500.
COMMUNITY BENEFIT STATEMENT CONTINUED CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS MATERNITY AND PARENTING ACTIVITIES ---------------------------------- BABY WELL This program educated 232 parents on how to care for their newborn. $5,648 in staff time was devoted towards 23 community programs. HEALTHY BEGINNINGS PROGRAM This is a program to bring prenatal health to the underserved in the Community. This is mostly the ones without the ability to pay or those who have not yet enrolled or who are enrolled in Medicaid. Much of our program deals with high risk patients and those with substance abuse problems. There is a Physician, a social worker and a dietician, as well as two nurses who run the program. The cost of this program was $454,017. BREASTFEEDING EDUCATION This program provides an increased understanding of the benefits of breastfeeding, which leads to improved nutrition/health of infants. 154 individuals attended the 24 lectures that were held throughout the year. The cost to the hospital is about $6,130. CHILDBIRTH CLASSES A program teaching the how-to's of childbirth served 600 people at a cost of $46,468 to the hospital through 25 courses series every day of the week except Friday. Tours of the Birthing Center were also given at a cost to the hospital of $1,102. TEEN PARENTING EDUCATION This is a cooperative program with Child, Home and Community, Inc. The hospital provided room for the educational course. 52 individuals were given free Childbirth instruction and 52 attended a support group called Building the Family. $4,600 is the value of the meeting space. CHILD DEVELOPMENT This program was in cooperation with the Central Bucks School District. High school students toured the LDRP Unit. They viewed and discussed family's admission from birthing room to postpartum room to the nursery. Discussions were held on newborns and basic development, including ICN & types of infants admitted at Doylestown Hospital. The program was presented on two dates, with 105 participants, including 1 teacher at a value of $1,080. Grand parenting Classes This program prepared grandparents-to-be on how to be support their children as they start their own family. 99 individuals attended the course, with a cost to the Hospital of $2,859 for the 6 classes. Prenatal Refresher Classes This program refreshed nearly 16 parents-to-be, who already have delivered other children, on the childbirth experience. $2,369 in staff time was devoted to this for 6 classes during the year. SIBLING EDUCATION CLASSES A program designed to lessen a child's feelings of anxiety and jealousy. There were 34 participants in 9 classes during the year at a cost to the Hospital of $2,006. SCHOOL AGE ACTIVITIES --------------------- PARENTING AND BABYSITTING EDUCATION This is a cooperative program with Child, Home and Community, Inc. The hospital provided room for the educational course. 92 individuals were given babysitting instruction at a cost of $300 to the Hospital. SERVICE LEARNING & CAREER ACADEMY The Service Learning Career Academy is a joint project between the VIA Health System and the three High Schools in the Central Bucks School District. In collaboration with the Consumer and Family Sciences course, the hospital's day care center provides students with hands-on experience to enhance learning of child development theory. In addition, hospital professional staff and CB faculty jointly designed a curriculum for Advanced Placement Biology Students, Advanced Health Students and Anatomy Physiology Students, who spend class time on-site at the hospital to obtain the practical application of class content. Over 200 students participated in this program where $22,000 in hospital staffs time and other costs. TEDDY BEAR CLINICS Children in the community were exposed to the Emergency Department and ambulance in a fun environment. The experience taught them to not be frightened in the event they may need emergency services. Over 200 children came through the Teddy Bear Clinic at the hospital. Donated materials and staff time is valued at $2,840. GIRL SCOUTS The hospital provided meeting space for 2 Girl Scout Troops. Meeting space was valued at $5,400. BUCKS COUNTY DOWN'S SYNDROME Space was provided for monthly meetings at Children's Village for the Bucks County Downs Syndrome group. Meeting space was valued at $750. FOCUS ON MOTHERHOOD Family Home and Community Childbirth classes for Teen Parents meet at C.V. every Monday evening to prepare for childbirth. Instruction is also provided for infant care, health & nutritional and life skills. Meeting space is valued at $2,400 annually. BEREAVEMENT GROUP MEETINGS Space is provided monthly for these meetings at C.V. and is valued at $5,400. LEADERSHIP ACTIVITIES --------------------- The Hospital President/CEO devoted $21,000 worth of his time to community benefit activities including, but not limited to, the Bucks County Health Improvement Partnership, Ann Silverman Community Health Clinic, Health Quality Partners, Delaware Valley Healthcare Council and Gilda's Club. The Vice-President of Development was also involved in contributing time to activities that benefit the community including: Ann Silverman Community Health Clinic, CB Cares, The American Red Cross, the Central Bucks Chamber of Commerce and the Doylestown Business and Community Alliance. Doylestown Hospital's managers also contribute their leadership and expertise to a variety of community boards, agencies, and projects. During 2011-2012, a value of $105,000 in manager's time was given, often during work time, to help some of the following community organizations: ADVOCACY SPEECHES AMERICAN CANCER SOCIETY AMERICAN HERITAGE FCU AMERICAN RED CROSS BLOOD DRIVE BUCKS CO. HOSPITAL DECON TASK FORCE BUCKS CO. QUALITY CHILD CARE COALITION BUCKS CO. MH/MR ADVISORY BOARD BOYS SCOUTS OF AMERICA BUCKS COUNTY HOUSING GROUP BUCKS CO. HEALTH IMPROVEMENT PARTNERSHIP CB CHAMBER OF COMMERCE CENTRAL BUCKS MINISTERIUM CB CHRISTIAN WOMEN'S CLUB CHILD, HOME AND COMMUNITY, INC CENTRAL BUCKS FAMILY YMCA CB CARES COMMUNITY OUTREACH CENTER DELAWARE VALLEY COLLEGE SENIOR EDUCATION DOYLESTOWN ATHLETIC ASSOCIATION DOYLESTOWN BUSINESS & COMMUNITY ALLIANCE DVHC BOARD AND COMMITTEES FAMILY CAREGIVERS OF SENIORS ANN SILVERMAN COMMUNITY HEALTH CLINIC FRIENDS OF PEACE VALLEY NATURE CENTER GILDA'S CLUB GWYNEDD MERCY ADVISORY COMMITTEE HEALTH AND HOUSING TASK FORCE HERITAGE CONSERVANCY LENAPE VALLEY SHRINER'S CLUB LITERACY ACADEMY OF BC IU MARCH OF DIMES MIDDLE BUCKS INSTITUTE OF TECH. ADVISORY PROFESSIONALS WORKING WITH SENIORS SPRINGFIELD TOWNSHIP (SUPERVISOR/PLANNING) TEACHING PROGRAMS ----------------- Doylestown Hospital supports medical, nursing, allied health, and hospital management programs. The following is a list of schools that sent students to the hospital for practicums, clinical rotations, and/or preceptorships: ABINGTON HOSPITAL SCHOOL OF RADIOLOGY ARCADIA UNIVERSITY BUCKS COUNTY COMMUNITY COLLEGE DREXEL UNIVERSITY/HAHNEMANN COLLEGE EASTERN UNIVERSITY GWYNEDD MERCY COLLEGE IMMACULATA UNIVERSITY LASALLE UNIVERSITY MONTGOMERY COUNTY COMMUNITY COLLEGE NAZARETH HOSPITAL PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE SALUS UNIVERSITY SANFORD BROWN INSTITUTE TEMPLE UNIVERSITY UNIVERSITY OF PENNSYLVANIA UPPER BUCKS TECHNICAL INSTITUTE WEST CHESTER UNIVERSITY Doylestown Hospital served as a clinical rotation site for medicine, physician assistant, entry and advanced nursing levels, pharmacy, radiologic technology, cardiac services and exercise physiology. All patient care areas were utilized in the education of these students. The costs of teaching the 399 students were at least $317,500. PRE-MED VOLUNTEER PROGRAM This program has been developed by the Hospital Medical Staff and Volunteer Department. It is a ten-week program starting in late May. It is supervised by the Hospital's Director of Volunteer Services and is coordinated with a special seminar program conducted by the Doylestown Hospital's Medical Staff to introduce the students to selected phases of a medical career. Students participating in the program are expected to give the Hospital a minimum of 100 hours of volunteer time in various patient related services during the course. The aim of the program is to give pre-medical students first-hand hospital experience to acquaint them with a total community hospital picture. This program brings into focus the work and responsibility of the physician in a modern hospital complex. We had 13 students in this program. Time of six physicians, four nurse educators, volunteer services and materials cost the hospital $48,706.
COMMUNITY BENEFIT STATEMENT CONTINUED CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS OUTSIDE GROUP ROOM USAGE ------------------------ The hospital provides free space for meetings to the following outside groups with a charitable mission. There were 137 individuals benefitted at a cost of $5,000: Ann Silverman Family Health Community Clinic Bucks County Autism Support Coalition Bucks County Intermediate Unit Bucks County Health Improvement Partnership Bucks County Medical Society Lenape Valley Foundation National Alliance for the Mentally Ill HEALTH SCREENINGS & IMMUNIZATIONS --------------------------------- THE HOSPITAL CONDUCTS HEALTH SCREENS AND SUPPORTED IMMUNIZATIONS FOR VARIOUS COMMUNITY MEMBERS. HEALTH SCREENINGS During the year, 176 individuals benefited from health screens. Staff time donated to this effort is estimated at $6,819. Activity improves the health of the community in general, specific groups of people, helps contain healthcare costs and/or improves the quality of life for all members of our community. The following is a list of health screening and immunization activities: SKIN CANCER SCREENING This program screened 111 Patients with volunteer medical, nursing and clerical staff totaling $3,191. PROSTATE CANCER SCREENINGS This program screened 36 patients with volunteer medical, nursing and clerical staff totaling $3,628. INFLUENZA IMMUNIZATIONS Doylestown Hospital provided a community flu shot clinic in the fall of 2011. The value of this time to serve 232 individuals was $1,000. Vaccines were provided by the Bucks County Health Department. SUPPORT GROUT & SELF-HELP PROGRAMS --------------------------------- Support groups are offered at no charge to the community, and a member of the hospital staff leads many. 833 conference room hours and 162 professional hours of support were provided to more than 3,200 community members. This amounted to $41,650 donated in space and professional staff time and hospital materials. The following is a list of the groups that held regular meetings at the hospital: - Alcoholics Anonymous - Alateen - Better Breathers Club - CADUCEUS - EATING DISORDERS ANONYMOUS - FIBROMYALGIA - AUTISM - INSULIN PUMP - LYMPHEDEMA - NURSING MOTHERS - PARKINSON'S DISEASE - PROSTATE CANCER - STROKE - PULMONARY HYPERTENSION - ALZHEIMER'S DISEASE - AUGUSTINE FELLOWSHIP - BREAST CANCER - DOWN'S SYNDROME INTEREST - BUILDING THE FAMILY - LOW VISION - GAMBLERS ANONYMOUS - ICD (IMPLANTABLE DEFIBRILLATOR) - LYME DISEASE - MULTIPLE SCLEROSIS - OVEREATERS ANONYMOUS - PREGNANCY LOSS - SCLERODERMA - BLINDNESS - DIABETES VOLUNTEER PROGRAMS ------------------ Doylestown Hospital enjoys the generous contribution of time and talent from community volunteers, starting at the minimum age of 14. Volunteer opportunities benefit the community by providing, for many community members, a place to go or a way to feel needed, thus preventing a variety of social problems. The Volunteer program allows some members of the community to help others, not through their dollars but through their donated time. In addition, the hospital is a place for community members to reach out to help friends and neighbors or to fulfill court-mandated community service obligations as volunteers. Throughout the year, 904 volunteers contributed 125,664 hours of service to their community through opportunities in every hospital department. Volunteers significantly enhance patient and family support in the following service categories: Addressing, Collating, Book cart, Dietary Menu, Emergency Department, Gift Shop/Cart, Hospitality Cart, Information Desks, Mail or Messenger, PRN/Floaters, Pastoral Care, Animal Assisted Therapy, Snack Bar, Surgery Waiting area, Patient Transport, Service Learning, LDRP (Labor & Delivery) and our "No One Dies Alone" program. In total, $121,260 worth of meals was given to our volunteers free of charge. Because the hospital wants to provide exceptional opportunities for community members to offer time and talent to support the V.I.A.'s mission to excellent local healthcare, $245,288 in salaries was budgeted for recruitment, orientation, management, retention and recognition of volunteers in patient transport, the gift ship, and throughout the patient services areas. CHARITY CARE TO COMMUNITY MEMBERS ================================== Doylestown Hospital and The Pine Run Community provides free medical care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Unreimbursed charges from Medical Assistance programs on behalf of patients that meet the hospital's charity care criteria are also considered charity care. The Fiscal Year 2012 total for charity care is $7,917,588. SUMMARY OF TOTAL COMMUNITY BENEFIT CONTRIBUTION ----------------------------------------------- COMMUNITY OUTREACH AND BENEFIT ACTIVITIES $ 1,266,108 EDUCATIONAL PROGRAMS $ 705,111 MATERNITY AND PARENTING ACTIVITIES $ 526,279 SCHOOL AGE ACTIVITIES $ 39,090 LEADERSHIP ACTIVITIES $ 126,000 TEACHING PROGRAMS $ 366,206 OUTSIDE GROUP ROOM USAGE $ 5,000 HEALTH SCREENINGS AND IMMUNIZATIONS $ 14,638 SUPPORT AND SELF-HELP PROGRAMS $ 41,650 VOLUNTEER PROGRAMS $ 366,548 CHARITY CARE TO COMMUNITY MEMBERS $ 7,917,588 COMMUNITY SUPPORT: $10,908,042 - PROGRAMS AND SERVICES THAT WERE COORDINATED AND SPONSORED BY EITHER THE HOSPITAL AND/OR FOUNDATION AND WERE DIRECTLY PAID FOR OR CAME AT A COST TO THE EITHER HOSPITAL AND/OR FOUNDATION. $446,176 - PROGRAMS AND SERVICES THAT WERE COORDINATED AND SPONSORED BY EITHER THE HOSPITAL AND/OR FOUNDATION BUT DID NOT INCUR ADDITIONAL EXPENSES TO THE HOSPITAL AND/OR FOUNDATION. TOTAL: $11,374,218
COMMUNITY BENEFIT STATEMENT CONTINUED CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS ADDENDUM: A DOYLESTOWN HOSPITAL STATEMENT OF PROGRAM AND SERVICES FISCAL YEAR 2011-2012 ================================================================== - ASSOCIATE HEALTH SERVICES - BEHAVIORAL HEALTH SERVICES - EAP - CRISIS SERVICES - CARDIAC AND NEUROLOGICAL SERVICES - DIAGNOSTIC CARDIAC CATHETERIZATION - NON-INVASIVE DIAGNOSTIC TESTING SERVICES - INTERVENTIONAL CARDIOLOGY PROCEDURES - EPS STUDIES (PACEMAKERS, DEVICE IMPLANTATION, ABLATION) - CARDIOVASCULAR SURGERY - CABG - VALVE REPLACEMENTS/REPAIRS - CRITICAL CARE UNITS - MED/SURG CRITICAL CARE - CARDIOVASCULAR CRITICAL CARE - DIABETES EDUCATION (INPATIENT AND OUTPATIENT) - NUTRITION EDUCATION AND COUNSELING - EMERGENCY SERVICES - CRISIS INTERVENTION - OBSERVATION/HOLDING UNIT - SANE (SEXUAL ASSAULT NURSE EXAMINER) PROGRAM - DOMESTIC VIOLENCE - ENDOSCOPY - GASTROENTEROLOGY - PULMONOLOGY - ENTEROSTOMAL THERAPY (INPATIENT AND OUTPATIENT) - NURSING HOME CONSULTATION - WOUND MANAGEMENT - CONTINENCE CARE - FOOD AND NUTRITION SERVICES - WEIGHT MANAGEMENT CLASSES (ADULTS AND CHILDREN) - NUTRITIONAL ASSESSMENT AND COUNSELING - PATIENT MEAL SERVICES - GENERAL MEDICINE - ALLERGIC DISEASES - CARDIOLOGY - DERMATOLOGY - ENDOCRINOLOGY - FAMILY MEDICINE - GASTROENTEROLOGY - INFECTIOUS DISEASE - INTERNAL MEDICINE - HEMATOLOGY - OBSTETRICS & GYNECOLOGY - NEPHROLOGY - NEUROLOGY - ONCOLOGY - PATHOLOGY - PEDIATRICS - PHYSICAL MEDICINE/REHABILITATION - PSYCHIATRY - PULMONARY - RHEUMATOLOGY - HEMODIALYSIS - INFECTION CONTROL - IV THERAPY - PICC (PERIPHERALLY INSERTED CENTRAL CATHETER) - LABORATORY SERVICES - AUTODONATION - BLOOD BANK - CHEMISTRY - CYTOLOGY - HEMATOLOGY - HISTOLOGY/PATHOLOGY - MICROBIOLOGY - URINALYSIS - MAGNETIC RESONANCE IMAGING (MRI) - MATERNITY SERVICES - ANTENATAL TESTING - BABY BRACELETS (MATERNAL/INFANT VISITING NURSE) - LABOR AND DELIVERY - MATERNAL/CHILD CARE - NEONATOLOGY - PRENATAL TESTING - POST-PARTUM CARE - PREPARED CHILDBIRTH EDUCATION - SPECIAL CARE NURSERY (LEVEL II) - WELL BABY NURSERY - MEDICAL RESEARCH - CLINICAL TRIALS - ONCOLOGY (INPATIENT AND OUTPATIENT) - OUTPATIENT INFUSION SERVICES - PASTORAL CARE SERVICES - LAY CHAPLAIN - PHARMACY - RADIOLOGY SERVICES - CT SCANNER - PET/CT SCANNER - DIAGNOSTIC RADIOLOGY - INVASIVE AND SPECIAL PROCEDURES - NUCLEAR MEDICINE - ULTRASOUND - REHABILITATION SERVICES (INPATIENT AND OUTPATIENT) - BRAIN INJURY - CARDIAC REHABILITATION - COGNITIVE REMEDIATION - ELECTROMYOGRAPHY - LYMPHEDEMA THERAPY - HAND THERAPY - NERVE CONDUCTION STUDIES - OCCUPATIONAL THERAPY - PHYSICAL THERAPY - PSYCHOLOGY - SPEECH THERAPY - SWALLOWING TEST - RESPIRATORY SERVICES - PULMONARY FUNCTION TESTING - PULMONARY REHAB - CASE MANAGEMENT/SOCIAL SERVICES - PSYCHOSOCIAL ASSESSMENTS - COUNSELING - COMPLEX DISCHARGE PLANNING - CRISIS INTERVENTION - FINANCIAL COUNSELING - ADOPTION OPTIONS COUNSELING - PATIENT AND FAMILY EDUCATION - INFORMATION AND REFERRAL - SURGICAL SERVICES (INPATIENT AND OUTPATIENT) - ACUPUNCTURE - COSMETIC - DENTISTRY - GENERAL - NERVE BLOCKS - SURGICAL SERVICES CONTINUED - OB/GYN - OPHTHALMOLOGY - ORAL/MAXILLOFACIAL - ORTHOPEDICS - OTOLARYNGOLOGY - PEDIATRIC DENTISTRY - PLASTIC SURGERY - POST-ANESTHESIA CARE UNIT - PRE-ADMISSION TESTING - SAME DAY SURGERY (NERVE BLOCKS) - UROLOGY - VASCULAR - TELEMETRY / PROGRESSIVE CARE - VISITING NURSE/ HOME CARE - ADULT AND INFANTS (UP TO 1 YEAR) SKILLED HOME HEALTH SERVICES - NURSING - PHYSICAL THERAPY - OCCUPATIONAL THERAPY - SPEECH THERAPY - SOCIAL SERVICES - HOME HEALTH AIDES - BABY BRACELETS (MATERNAL/INFANT VISITING NURSE) - COMPREHENSIVE HOSPICE PROGRAM - WOMEN'S DIAGNOSTIC CENTER - BONE DENSITOMETRY - MAMMOGRAPHY - STEREOTACTIC BREAST BIOPSY
DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 VILLAGE IMPROVEMENT ASSOCIATION OF DOYLESTOWN ("VIAD") IS THE SOLE MEMBER OF THIS ORGANIZATION. VIAD HAS THE RIGHT TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF DIRECTORS AND HAS CERTAIN RESERVED POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS.
DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION A; QUESTION 11B THE ORGANIZATION IS AN AFFILIATE IN THE VILLAGE IMPROVEMENT ASSOCIATION OF DOYLESTOWN AND CONTROLLED ENTITIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF ITS'S GOVERNING BODY, ITS BOARD OF DIRECTORS, FOR REVIEW PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. THE ORGANIZATION'S FINANCE COMMITTEE HAS THE RESPONSIBILITY TO OVERSEE, REVIEW AND APPROVE OF THE FEDERAL FORM 990, INCLUDING THE PREPARATION, REVIEW AND FILING PROCESS. AS PART OF THE TAX RETURN PREPARATION PROCESS THE ORGANIZATION HIRED A PROFESSIONAL CPA FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE PERSONNEL AND VARIOUS OTHER INDIVIDUALS OF THE ORGANIZATION AND THE SYSTEM TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S FINANCE PERSONNEL AND OTHER INDIVIDUALS FOR THEIR REVIEW. THE ORGANIZATION'S FINANCE PERSONNEL AND OTHER INDIVIDUALS REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S FINANCE PERSONNEL AND VARIOUS OTHER INDIVIDUALS FOR FINAL REVIEW AND APPROVAL PRIOR TO PROVIDING A COPY TO EACH MEMBER OF DOYLESTOWN HOSPITAL'S GOVERNING BODY, ITS BOARD OF DIRECTORS.
DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION B; QUESTION 12 THE ORGANIZATION REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. ANNUALLY, ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS AND SENIOR MANAGEMENT PERSONNEL ARE REQUIRED TO REVIEW THE EXISTING CONFLICT OF INTEREST POLICY AND COMPLETE A QUESTIONNAIRE. THE COMPLETED QUESTIONNAIRES ARE RETURNED TO THE EXECUTIVE ASSISTANT TO THE CHIEF EXECUTIVE OFFICER OF DOYLESTOWN HOSPITAL, WHO GATHERS, INVENTORIES AND FILES THE COMPLETED QUESTIONNAIRES. THEREAFTER A SUMMARY OF THE COMPLETED QUESTIONNAIRES WHICH CONTAINS INFORMATION DISCLOSED ON AN INDIVIDUAL BY INDIVIDUAL BASIS IS PREPARED AND REVIEWED BY THE DOYLETOWN HOSPITAL'S CHIEF ACCOUNTING OFFICER AND CHIEF EXECUTIVE OFFICER. THIS SUMMARY IS THEN PRESENTED TO THE ORGANIZATION'S BOARD OF DIRECTORS WHO REVIEWS AND MAKES DECISIONS ON HOW TO HANDLE CONFLICTS OF INTEREST AND ASSOCIATED MITIGATING BEHAVIOR TO BE TAKEN BY THE ORGANIZATION IF NECESSARY.
DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION B; QUESTION 15 THE ORGANIZATION IS AN AFFILIATE IN A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM") WHICH INCLUDES DOYLESTOWN HOSPITAL. THIS FILING ORGANIZATION ITSELF HAS NO PAID SENIOR MANAGEMENT PERSONNEL RECEIVING COMPENSATION DIRECTLY FROM THIS ORGANIZATION. RATHER, CERTAIN PERSONNEL ARE EMPLOYED BY DOYLESTOWN HOSPITAL, INCLUDING TTHE PRESIDENT/CHIEF EXECUTIVE OFFICER, CHIEF OPERATING OFFICER AND CHIEF FINANCIAL OFFICER. THE COMPENSATION AND BENEFITS OF THESE INDIVIDUALS ARE SHOWN ON THIS TAX RETURN BECAUSE THEY ARE ALSO EITHER OFFICERS OR BOARD MEMBERS OF THIS ORGANIZATION. THE DOYLESTOWN HOSPITAL BOARD OF DIRECTORS HAS AN EXECUTIVE COMPENSATION COMMITTEE ("COMMITTEE"). THE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES OF THE COMPENSATION AND BENEFITS OF THE ORGANIZATION'S SENIOR MANAGEMENT, INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER, CHIEF OPERATING OFFICER AND CHIEF FINANCIAL OFFICER. THE COMMITTEE REVIEWS THE "TOTAL COMPENSATION" OF THE INDIVIDUALS WHICH IS INTENDED TO INCLUDE BOTH CURRENT AND DEFERRED COMPENSATION AND ALL EMPLOYEE BENEFITS, BOTH QUALIFIED AND NON-QUALIFIED. THE COMMITTEE'S REVIEW IS DONE ON AT LEAST AN ANNUAL BASIS AND ENSURES THAT THE "TOTAL COMPENSATION" OF SENIOR MANAGEMENT OF THE ORGANIZATION IS REASONABLE. THE ACTIONS TAKEN BY THE COMMITTEE ENABLE THE ORGANIZATION TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF CERTAIN MEMBERS OF THE SENIOR MANAGEMENT TEAM, INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER, CHIEF OPERATING OFFICER AND CHIEF FINANCIAL OFFICER. THE THREE FACTORS WHICH MUST BE SATISFIED IN ORDER TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS ARE THE FOLLOWING: 1. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY AN "AUTHORIZED BODY" OF THE APPLICABLE TAX-EXEMPT ORGANIZATION WHICH IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A "CONFLICT OF INTEREST" WITH RESPECT TO THE COMPENSATION ARRANGEMENT; 2. THE AUTHORIZED BODY OBTAINED AND RELIED UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION; AND 3. THE AUTHORIZED BODY "ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION" CONCURRENTLY WITH MAKING THAT DETERMINATION. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF DIRECTORS EACH OF WHO ARE INDEPENDENT AND ARE FREE FROM ANY CONFLICTS OF INTEREST. THE COMMITTEE RELIED UPON APPROPRIATE COMPARABLE DATA; SPECIFICALLY THE COMMITTEE OBTAINED A WRITTEN COMPENSATION STUDY FROM AN INDEPENDENT FIRM WHICH SPECIALIZES IN THE REVIEWING OF HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS STUDY USED COMPARABLE GEOGRAPHIC AND DEMOGRAPHIC MARKET DATA INCLUDING BUT NOT LIMITED TO SIMILAR SIZED HOSPITALS, # OF LICENSED BEDS AND NET PATIENT SERVICE REVENUE. THE COMMITTEE ADEQUATELY DOCUMENTED ITS BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF THE COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WAS REVIEWED AND SUBSEQUENTLY APPROVED. THE ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMMITTEE AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS ONLY APPLIES TO CERTAIN SENIOR MANAGEMENT PERSONNEL, INCLUDING BUT NOT LIMITED TO THE THE PRESIDENT/CHIEF EXECUTIVE OFFICER, CHIEF OPERATING OFFICER AND CHIEF FINANCIAL OFFICER. THE COMPENSATION AND BENEFITS OF CERTAIN OTHER INDIVIDUALS CONTAINED IN THIS FORM 990 ARE REVIEWED ANNUALLY BY THE PRESIDENT/CHIEF EXECUTIVE OFFICER WITH ASSISTANCE FROM THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT IN CONJUNCTION WITH THE INDIVIDUAL'S JOB PERFORMANCE DURING THE YEAR AND IS BASED UPON OTHER OBJECTIVE FACTORS DESIGNED TO ENSURE THAT REASONABLE AND FAIR MARKET VALUE COMPENSATION IS PAID BY THE ORGANIZATION. OTHER OBJECTIVE FACTORS INCLUDE MARKET SURVEY DATA FOR COMPARABLE POSITIONS, INDIVIDUAL GOALS AND OBJECTIVES, PERSONNEL REVIEWS, EVALUATIONS, SELF-EVALUATIONS AND PERFORMANCE FEEDBACK MEETINGS.
DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION C; QUESTION 19 THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE COMMONWEALTH OF PENNSYLVANIA.
COMPENSATION INFORMATION DISCLOSURE CORE FORM, PART VII AND SCHEDULE J PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM A RELATED ORGANIZATION. PLEASE NOT THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF THE RELATED ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THIS ORGANIZATION'S BOARD OF DIRECTORS.
RELATED HOURS DISCLOSURE CORE FORM, PART VII, SECTION A, COLUMN B THE ORGANIZATION IS AN AFFILIATE IN THE VILLAGE IMPROVEMENT ASSOCIATION OF DOYLESTOWN AND CONTROLLED ENTITIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM INCLUDES BOTH FOR-PROFIT AND NOT FOR-PROFIT ORGANIZATIONS. CERTAIN BOARD OF DIRECTOR MEMBERS, OFFICERS AND/OR DIRECTORS LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM, 990 FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENT THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF DIRECTORS OF OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY the same as reflected on this form 990. THE HOURS REFLECTED ON PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS AND KEY EMPLOYEES, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF THE VILLAGE IMPROVEMENT ASSOCIATION OF DOYLESTOWN AND CONTROLLED ENTITIES; NOT SOLELY THIS ORGANIZATION.
OTHER CHANGES IN NET ASSETS CORE FORM, PART XI; QUESTION 5 OTHER CHANGES IN NET ASSETS OR FUND BALANCES INCLUDE: - UNREALIZED GAINS ON INVESTMENTS; ($455,591) AND - INCREASE IN BENEFICIAL INTEREST IN PERPETUAL TRUST; ($643,597).
AUDITED FINANCIAL STATEMENTS CORE FORM, PART XI; QUESTION 2 THE ORGANIZATION IS AN AFFILIATE WITHIN THE VILLAGE IMPROVEMENT ASSOCIATION OF DOYLESTOWN AND CONTROLLED ENTITIES ("SYSTEM") WHICH INCLUDES DOYLESTOWN HOSPITAL. AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF THE TAXPAYER AND ALL AFFILIATES FOR THE FISCAL YEARS ENDED JUNE 30, 2012 AND JUNE 30, 2011; RESPECTIVELY AND ISSUED A CONSOLIDATED FINANCIAL STATEMENT WITH CONSOLIDATING SCHEDULES BY ENTITY. AN UNQUALIFIED OPINION WAS ISSUED EACH YEAR BY THE INDEPENDENT CPA FIRM. DOYLESTOWN HOSPITAL'S FINANCE COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
DOYLESTOWN HEALTH FOUNDATION
 
Employer identification number

23-2368196
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity

















Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) DOYLESTOWN HOSPITAL

595 WEST STATE STREET

DOYLESTOWN,PA18901
23-1352174 		HEALTHCARE PA 501(c)(3) HOSPITAL VIAD
 
 
No
(2) VILLAGE IMPROVEMENT ASSN OF DOYLESTOWN

595 WEST STATE STREET

DOYLESTOWN,PA18901
23-2368200 		HEALTHCARE PA 501(c)(3) 509(A)(1) N/A
 
No
(3) VIA AFFILIATES

595 WEST STATE STREET

DOYLESTOWN,PA18901
23-2368197 		SUPPORT PA 501(c)(3) 509(A)(3) DHF
 
Yes
 








For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) DOYLESTOWN SURGICAL CENTER LLC

595 WEST STATE STREET
DOYLESTOWN,PA189012554
23-1352174 		MEDICAL SVCS PA  
        No     No  
(2) DOYLESTOWN RADIOLOGY GROUP LP

1240 OLD YORK ROAD
WARMINSTER,PA18974
23-1352174 		MEDICAL SVCS PA  
        No     No  










Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) DOYLESTOWN HOSPITAL HLTH & WELLNESS CTR
595 WEST STATE STREET
DOYLESTOWN,PA189012554
23-3022645 		FITNESS CNTR PA DHF
  		C CORP. 793,656 0 100.000 %












Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1)
(2)
(3)
(4)
(5)
(6)
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(e)
Are all
partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


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