2023-11-15T17:39:32-06:00 2022-12-31 341884125 CBIZ MHM LLC 4722 N 24TH ST STE 300 PHOENIX AZ 85016 990 2022-01-01 231945075 ELK HAVEN NURSING HOME ASSOCIATION ELKH 8148342618 785 JOHNSONBURG ROAD ST MARYS PA 15857 CHARLETTE GERG VICE PRESIDENT 8148342618 2023-11-15 1 CHARLETTE GERG 999009999 1 AMY A O'LOUGHLIN P00869687 6022646835 2023-11-15 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z JUNE SORG 785 JOHNSONBURG ROAD ST MARYS PA 15857 12919229 0 X WWW.ELKHAVENNURSINGHOME.COM X 1967 PA PROVIDING LONG TERM NURSING CARE THROUGH A SKILLED NURSING FACILITY AND PERSONAL CARE UNIT. 5 5 216 46 0 0 2698564 3720438 8768648 9006474 99959 102910 59041 89275 11626212 12919097 0 0 0 0 7178969 6824301 0 0 0 3655181 4736643 10834150 11560944 792062 1358153 11975645 13340646 988946 1313058 10986699 12027588 X OUR MISSION IS TO BE THE LEADING PROVIDER OF SPECIALIZED HEALTH CARE PROGRAMS, PRODUCTS AND SERVICES IN THE AREA. WE ARE COMMITTED TO QUALITY, DIGNITY, RESPECT AND HOSPITALITY IN OUR CUSTOMER SERVICE AND ACTIVE PARTICIPATION IN THE COMMUNITIES WE SERVE. EMPOWERED EMPLOYEES DRIVE OUR CUSTOMER RELATIONS AND CREATE AN ATMOSPHERE WHICH ENHANCES PERSONAL GROWTH, EXPANDS RESPONSIBILITY, MAXIMIZES CREATIVITY AND INSTILLS TRUST. WE BELIEVE IN CREATING VALUE FOR OUR CUSTOMERS. MEETING THEIR INDIVIDUAL AND COLLECTIVE NEEDS IS A SHARED RESPONSIBILITY AND THE STANDARD OF CONDUCT BY WHICH EACH OF US IS MEASURED. 0 0 10371774 9006474 ASSOCIATION OPERATES A 120-BED NURSING FACILITY AND A 40-UNIT PERSONAL CARE CENTER, PROVIDING HOUSING, HEALTH CARE AND OTHER RELATED SERVICES FOR THE RESIDENTS OF ELK COUNTY, PENNSYLVANIA. IN PROVIDING SERVICES, CERTAIN INDIVIDUALS ARE NOT DENIED SERVICES IN EXCESS OF THEIR MEANS. THE ESTIMATED COST OF PROVIDING CHARITY CARE IS APPROXIMATELY $1,504,950 FOR THE YEAR ENDED DECEMBER 31, 2022. 10371774 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 40 0 1 216 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 PA X X COMPLETE HEALTHCARE RESOURCES-EASTERN INC 2153285723 200 DRYDEN ROAD SUITE 2000 DRESHER PA 19025 ROBERT SCHRIEBER SECRETARY/TREASURER 2.00 2.00 X X 0 0 0 JUNE SORG PRESIDENT 2.00 2.00 X X 0 0 0 FRANK BEIMEL BOARD MEMBER 2.00 2.00 X 0 0 0 CHARLETTE GERG VICE PRESIDENT 2.00 2.00 X X 0 0 0 LOU RADKOWSKI BOARD MEMBER 2.00 2.00 X 0 0 0 MARK JACOB SOLICITOR 2.00 2.00 X 0 0 0 ARLENE ANDERSON ADMINISTRATOR 38.00 2.00 X 132076 0 0 BONITA STEELE RN 40.00 X 106619 0 0 238695 0 0 2 0 0 0 CHR CONSULTING SERVICE INC 200 DRYDEN ROAD SUITE 3100 DRESHER PA 19025 MANAGEMENT SERVICES 528670 AMERICAN HEALTH STAFFING GROUP PO BOX 670529 DALLAS TX 75267 AGENCY NURSING 455135 SELECT REHABILITATION PO BOX 71985 CHICAGO IL 60694 THERAPY SERVICES 401428 ADVANTAGE CARE REHABILITATION 5035 CLAIRTON BOULEVARD PITTSBURGH PA 15236 THERAPY SERVICES 272562 COMPLETE HEALTHCARE RESOURCES 200 DRYDEN ROAD SUITE 3100 DRESHER PA 19025 MANAGEMENT SERVICES 112261 5 353350 3367088 3720438 RESIDENT SERVICE REVEN 623000 9006474 9006474 9006474 103042 103042 132 -132 -132 -132 OTHER REVENUE 900099 49420 49420 FOOD REVENUE 900099 39855 39855 89275 12919097 9006474 0 192185 X 5159822 5024179 135643 1263228 1241156 22072 401251 387422 13829 349454 349454 106766 106766 57451 57451 1352662 1065896 286766 10010 10010 68121 68121 341101 341101 10892 9012 1880 156887 153933 2954 451464 400299 51165 169686 169686 OTHER NURSING SERVICES 538377 538377 MEALS 437410 437062 348 SUPPLIES 370429 354516 15913 PHARMACY EXPENSES 141422 141422 174511 107713 66798 11560944 10371774 1189170 0 2812543 2275130 153049 287059 1544338 609569 679501 122123 132501 15610305 11139234 4745294 4471071 3312862 3929243 220205 21803 11975645 13340646 618459 1005059 6911 9035 363576 298964 988946 1313058 X 10986699 12027588 10986699 12027588 11975645 13340646 1358153 -316045 -1219 0 X 0 1 X 1 1 1 X 18208 12906 1516171 2698564 3720438 7966287 10464934 10981274 9661954 8768648 9006474 48883284 10483142 10994180 11178125 11467212 12726912 56849571 0 0 0 56849571 632287 435037 512985 89375 103042 1772726 632287 435037 512985 89375 103042 1772726 51574 69774 54110 59041 89275 323774 11167003 11498991 11745220 11615628 12919229 58946071 0.96440 0.95770 0.03010 0.03740 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER REVENUE - 2018 AMOUNT: $ 15,904. 2019 AMOUNT: $ 35,527. 2020 AMOUNT: $ 10,323. 2021 AMOUNT: $ 10,771. 2022 AMOUNT: $ 49,420. FOOD REVENUE - 2018 AMOUNT: $ 35,670. 2019 AMOUNT: $ 34,247. 2020 AMOUNT: $ 43,787. 2021 AMOUNT: $ 48,270. 2022 AMOUNT: $ 39,855. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 44000 44000 11857170 8012591 3844579 263911 254060 9851 3137028 2607325 529703 308196 265258 42938 4471071 THIRD PARTY SETTLEMENTS 298964 298964 X 12546983 -316045 -316045 12863028 12386 43683 56069 12919097 11506094 0 11506094 11167 43683 54850 11560944 PART X, LINE 2: THE ORGANIZATION IS A NOT-FOR-PROFIT ORGANIZATION AND IS RECOGNIZED AS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE CODE AND THE COMMONWEALTH ACT OF MAY 5, 1933, KNOWN AS THE NONPROFIT ORGANIZATION LAW AND, ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED. THE ORGANIZATION ACCOUNTS FOR THE EFFECT OF ANY UNCERTAIN TAX POSITIONS BASED ON A "MORE LIKELY THAN NOT" THRESHOLD APPLIED TO THE RECOGNITION OF THE TAX POSITIONS BEING SUSTAINED BASED ON THE TECHNICAL MERITS OF THE POSITION UNDER SCRUTINY BY THE APPLICABLE TAXING AUTHORITY. IF A TAX POSITION OR POSITIONS ARE DEEMED TO RESULT IN UNCERTAINTIES OF THOSE POSITIONS, THE UNRECOGNIZED TAX BENEFIT IS ESTIMATED BASED ON A "CUMULATIVE PROBABILITY ASSESSMENT" THAT AGGREGATES THE ESTIMATED TAX LIABILITY FOR ALL UNCERTAIN TAX POSITIONS. INTEREST AND PENALTIES ASSESSED, IF ANY, ARE ACCRUED AS INCOME TAX EXPENSE. THE ORGANIZATION HAS IDENTIFIED ITS TAX STATUS AS A TAX-EXEMPT ENTITY AS A TAX POSITION; HOWEVER, THE ORGANIZATION HAS DETERMINED THAT SUCH TAX POSITION DOES NOT RESULT IN AN UNCERTAINTY REQUIRING RECOGNITION. THE ORGANIZATION BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO DECEMBER 31, 2018. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 43,683. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 43,683. FORM 990, PART VI, SECTION A, LINE 3 ELK HAVEN ENTERED INTO A MANAGEMENT AGREEMENT WITH CHR CONSULTING SERVICES, INC. TO PROVIDE FINANCIAL AND ACCOUNTING SERVICES AND SUPERVISE THE DAY-TO-DAY OPERATIONS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS SENT TO THE BOARD MEMBERS FOR REVIEW AND SIGNATURE PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE ANNUALLY. THE DISCLOSURES ARE REVIEWED ANNUALLY BY THE BOARD AND AS NEW CONFLICTS ARISE. FORM 990, PART VI, SECTION B, LINE 15A MARKET STUDIES ARE PERFORMED IN THE REGION TO DETERMINE THE APPROPRIATE LEVEL OF COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS WILL BE MADE AVAILABLE TO THE PUBLIC BASED UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 24,206. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 24,206. CONTRACT SERVICE FEES: PROGRAM SERVICE EXPENSES 1,065,896. MANAGEMENT AND GENERAL EXPENSES 262,560. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,328,456. ELK HAVEN FOUNDATION 785 JOHNSONBURG ROAD ST MARYS PA 16127 841788081 SUPPORTING ORGANIZATION PA 501(C)(3) LINE 12B, II N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0