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Nonprofiteer
← HAZLETON SURGICAL ALLIANCE

Form 990 for tax year 2023

Filed by HAZLETON SURGICAL ALLIANCE.

Totals

Total revenue
$1,654,967
Total expenses
$1,633,504
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$1,654,967
Investment income
$0
Other revenue
$0
Total assets, end of year
$0
Total liabilities, end of year
$0
Net assets or fund balances, end of year
$0
Program services expenses (Part IX)
$1,335,764
Management and general expenses
$297,740
Fundraising expenses
$0
Program service expenses (Part III)
$1,335,764

Program services were 81.8% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 2a · Program service revenue: OUTPATIENT REVENUE

    total $1,654,933 · related or exempt $1,654,933

  • 2b · Program service revenue: HHS COVID REVENUE

    total $34 · related or exempt $34

Functional expenses

Part IX, the statement of functional expenses.

  • 7 · Other salaries and wages

    total $453,580 · program services $358,736 · management and general $94,844

  • 9 · Other employee benefits

    total $75,305 · program services $59,559 · management and general $15,746

  • 10 · Payroll taxes

    total $33,077 · program services $26,161 · management and general $6,916

  • 11g · Fees: other

    total $230,373 · program services $225,594 · management and general $4,779

  • 12 · Advertising and promotion

    total $941 · program services $744 · management and general $197

  • 13 · Office expenses

    total $7,515 · program services $5,944 · management and general $1,571

  • 16 · Occupancy

    total $417,652 · program services $330,321 · management and general $87,331

  • 22 · Depreciation, depletion and amortization

    total $2,319 · program services $1,834 · management and general $485

  • 23 · Insurance

    total $13,646 · program services $10,793 · management and general $2,853

  • 24a · Other expenses: MEDICAL SUPPLIES

    total $224,004 · program services $177,165 · management and general $46,839

  • 24b · Other expenses: OTHER PURCHASED SERVICE

    total $111,275 · program services $88,007 · management and general $23,268

  • 24c · Other expenses: BAD DEBT EXPENSE

    total $42,898 · program services $33,928 · management and general $8,970

  • 24d · Other expenses: GENERAL SERVICES

    total $2,076 · program services $2,076

  • 24e · All other expenses

    total $18,843 · program services $14,902 · management and general $3,941

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $250 · end of year $0

  • 2 · Savings and temporary cash investments

    beginning of year $415,092 · end of year $0

  • 3 · Pledges and grants receivable

    end of year $0

  • 4 · Accounts receivable

    beginning of year $283,774 · end of year $0

  • 5 · Loans and receivables from officers and key people

    end of year $0

  • 6 · Loans and receivables from disqualified persons

    end of year $0

  • 7 · Other notes and loans receivable

    end of year $0

  • 8 · Inventories for sale or use

    beginning of year $96,639 · end of year $0

  • 9 · Prepaid expenses and deferred charges

    end of year $0

  • 10a · Land, buildings and equipment: cost or other basis

    $0

  • 10b · Land, buildings and equipment: accumulated depreciation

    $0

  • 10c · Land, buildings and equipment, net

    beginning of year $0 · end of year $0

  • 11 · Investments: publicly traded securities

    end of year $0

  • 12 · Investments: other securities

    end of year $0

  • 13 · Investments: program-related

    end of year $0

  • 14 · Intangible assets

    beginning of year $1,752,644 · end of year $0

  • 15 · Other assets

    beginning of year $4,924 · end of year $0

  • 17 · Accounts payable and accrued expenses

    beginning of year $195,582 · end of year $0

  • 25 · Other liabilities

    beginning of year $1,816,370 · end of year $0

  • 27 · Net assets without donor restrictions

    beginning of year $373,546 · end of year $0

  • 28 · Net assets with donor restrictions

    beginning of year $167,825 · end of year $0

Mission and programs · 2023

Mission

HAZLETON SURGICAL ALLIANCE (HSA) DEVELOPED A FREESTANDING AMBULATORY SURGERY CENTER IN THE HAZLETON AREA. IT PROMOTES HEALTH BY PROVIDING MEDICALLY-NECESSARY CARE TO PATIENTS IN THE COMMUNITIES SERVED BY HSA AND BY EXPANDING COMMUNITY ACCESS TO QUALITY COST-EFFECTIVE SURGICAL SERVICES, REGARDLESS OF ABILITY TO PAY.

Activities or mission (Part I)

HAZLETON SURGICAL ALLIANCE (HSA) DEVELOPED A FREESTANDING AMBULATORY SURGERY CENTER (ASC) IN THE HAZLETON AREA. IT PROMOTES HEALTH BY PROVIDING MEDICALLY-NECESSARY CARE TO PATIENTS IN THE COMMUNITIES WE SERVE.

  • HAZLETON SURGICAL ALLIANCE (HSA) DEVELOPED A FREESTANDING AMBULATORY SURGERY CENTER IN THE HAZLETON AREA. IT PROMOTES HEALTH BY PROVIDING MEDICALLY-NECESSARY CARE TO PATIENTS IN THE COMMUNITIES SERVED BY HSA AND BY EXPANDING COMMUNITY ACCESS TO QUALITY COST-EFFECTIVE SURGICAL SERVICES, REGARDLESS OF ABILITY TO PAY.IT PROMOTES HEALTH BY PROVIDING MEDICALLY-NECESSARY AMBULATORY SURGERY CARE TO PATIENTS IN THE COMMUNITIES SERVED BY HSA AND BY EXPANDING COMMUNITY ACCESS TO QUALITY COST-EFFECTIVE SURGICAL SERVICES, REGARDLESS OF ABILITY TO PAY.HSA MERGED INTO ITS SOLE CORPORATE MEMBER, LEHIGH VALLEY HOSPITAL - HAZLETON, EFFECTIVE 12/31/2023.

    Expenses $1,335,764 · Revenue $1,654,967

As filed on the 2023 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • JOHN R FLETCHER

    FORMER PRESIDENT/TRUSTEE

    Total calculated
    $49,680
    From this org
    $0
    From related orgs
    $49,680
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0
    Other
    $0 + $49,680 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $49,680 related

  • MARK J LOBITZ DO

    CHAIRPERSON

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • TERRENCE J PURCELL MBA

    TRUSTEE

    Total calculated
    $499,465
    From this org
    $0
    From related orgs
    $481,673
    Other
    $17,792
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $419,321 related
    Bonus
    $0 + $62,570 related
    Other
    $0 + -$218 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $17,792 related
    Filer's total
    $0 + $499,465 related

  • TAMMY TORRES DNP

    PRESIDENT/TRUSTEE

    Total calculated
    $247,346
    From this org
    $0
    From related orgs
    $247,005
    Other
    $341
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $230,769 related
    Bonus
    $0 + $9,000 related
    Other
    $0 + $7,236 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $341 related
    Filer's total
    $0 + $247,346 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4a · Severance or change-of-control payment

Answered no

  • 4b · Supplemental nonqualified retirement plan
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 4A
THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE PAYMENT FROM LEHIGH VALLEY HOSPITAL - HAZLETON, A RELATED ORGANIZATION, IN CALENDAR YEAR 2023: JOHN R. FLETCHER, FORMER PRESIDENT/TRUSTEE - $49,680

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

Assets distributed on this return

Schedule N, as filed: what the organization did with its assets when it liquidated or dissolved, or disposed of more than a quarter of them, and who received them. A recipient with an EIN is usually a successor organization; filers also list expenses such as legal fees here.

Provenance

Return type
form_990
Tax year
2023
Filed
14 November 2024
IRS schema version
2023v5.1
Source object
202433199349313518

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