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Nonprofiteer
← POCONO AMBULATORY SERVICES INC

Form 990 for tax year 2023

Filed by POCONO AMBULATORY SERVICES INC.

Totals

Total revenue
$1,235
Total expenses
$169,040
Contributions and grants received
$0
Grants paid
$0
Program services expenses (Part IX)
$169,040
Management and general expenses
$0
Fundraising expenses
$0
Program service expenses (Part III)
$169,040

Program services were 100.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • CORNELIO R CATENA

    CHAIRPERSON

    Total calculated
    $731,760
    From this org
    $0
    From related orgs
    $714,900
    Other
    $16,860
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $622,278 related
    Bonus
    $0 + $89,734 related
    Other
    $0 + $2,888 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $16,860 related
    Filer's total
    $0 + $731,760 related

  • ALICE J WILSON

    VICE CHAIRPERSON

    Total calculated
    $226,255
    From this org
    $0
    From related orgs
    $210,076
    Other
    $16,179
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $192,284 related
    Bonus
    $0 + $20,532 related
    Other
    $0 + -$2,740 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $16,179 related
    Filer's total
    $0 + $226,255 related

  • STEVEN T CLARK

    TREASURER

    Total calculated
    $232,840
    From this org
    $0
    From related orgs
    $207,920
    Other
    $24,920
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $197,055 related
    Bonus
    $0 + $17,789 related
    Other
    $0 + -$6,924 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $24,920 related
    Filer's total
    $0 + $232,840 related

  • JOHN J CROCKETT

    DIRECTOR

    Total calculated
    $340,095
    From this org
    $0
    From related orgs
    $318,432
    Other
    $21,663
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $168,658 related
    Bonus
    $0 + $17,099 related
    Other
    $0 + $132,675 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $21,663 related
    Filer's total
    $0 + $340,095 related

  • JAMES C MILLER

    DIRECTOR

    Total calculated
    $661,510
    From this org
    $0
    From related orgs
    $636,051
    Other
    $25,459
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $554,419 related
    Bonus
    $0 + $88,760 related
    Other
    $0 + -$7,128 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $25,459 related
    Filer's total
    $0 + $661,510 related

  • AMY H NYBERG

    DIRECTOR

    Total calculated
    $679,171
    From this org
    $0
    From related orgs
    $652,317
    Other
    $26,854
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $437,980 related
    Bonus
    $0 + $64,723 related
    Other
    $0 + $149,614 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $26,854 related
    Filer's total
    $0 + $679,171 related

  • ROBERT A BEGLIOMINI PHARMD MBA

    FORMER DIRECTOR

    Total calculated
    $854,994
    From this org
    $0
    From related orgs
    $828,521
    Other
    $26,473
    Hours/week
    0 + 60 related

    Schedule J breakdown matched by us

    Base
    $0 + $651,504 related
    Bonus
    $0 + $103,320 related
    Other
    $0 + $73,697 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $26,473 related
    Filer's total
    $0 + $854,994 related

  • WILLIAM K CORS MD

    FORMER SECRETARY

    Total calculated
    $44,569
    From this org
    $0
    From related orgs
    $40,691
    Other
    $3,878
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $27,000 related
    Bonus
    $0 + $14,850 related
    Other
    $0 + -$1,159 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $3,878 related
    Filer's total
    $0 + $44,569 related

  • JONATHAN A GOLDNER DO

    FORMER SECRETARY

    Total calculated
    $454,937
    From this org
    $0
    From related orgs
    $438,513
    Other
    $16,424
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $397,172 related
    Bonus
    $0 + $25,210 related
    Other
    $0 + $16,131 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $16,424 related
    Filer's total
    $0 + $454,937 related

  • CHRISTINE A HAYES

    FORMER TREASURER / DIRECTOR

    Total calculated
    $115,074
    From this org
    $0
    From related orgs
    $88,786
    Other
    $26,288
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $97,016 related
    Bonus
    $0 + $500 related
    Other
    $0 + -$8,730 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $26,288 related
    Filer's total
    $0 + $115,074 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 — 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
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 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, LINES 4A-B
THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE PAYMENT FROM LEHIGH VALLEY HOSPITAL, A RELATED ORGANIZATION, IN CALENDAR YEAR 2023: JOHN J. CROCKETT, DIRECTOR - $139,953 THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE 457(F) SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN OF LEHIGH VALLEY HOSPITAL, A RELATED ORGANIZATION, IN CALENDAR YEAR 2023: AMY H. NYBERG, DIRECTOR - $156,667 ROBERT A. BEGLIOMINI, PHARMD, MBA, FORMER DIRECTOR - $75,482

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.

Provenance

Return type
form_990
Tax year
2023
Filed
14 November 2024
IRS schema version
2023v5.1
Source object
202403199349313520

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