2022-05-10T10:47:11-05:00 2021-06-30 390859910 BAKER TILLY US LLP 1570 FRUITVILLE PIKE SUITE 400 LANCASTER PA 17601 990 2020-07-01 460871813 CENTRE COUNTY CHILDREN'S ADVOCACY CENTER CENT 8142317000 1800 EAST PARK AVENUE STATE COLLEGE PA 16801 BRYAN ROACH EXECUTIVE VP & CFO 8142317000 2022-05-05 1 BRYAN ROACH 999009999 KERRI N BOGDA CPA P00760402 7177404863 X 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z KATHLEEN RHINE 1800 EAST PARK AVENUE STATE COLLEGE PA 16801 414572 0 X WWW.MOUNTNITTANY.ORG/CHILDADVOCACYCENTER X 2012 PA MEET THE NEEDS OF THE CHILDREN AND FAMILIES IN OUR COMMUNITY BY PROVIDING A COMMUNITY-BASED, CHILD-FOCUSED CENTER THAT FACILITATES A COMPASSIONATE, MULTI-DISCIPLINARY APPROACH TO THE PREVENTION, IDENTIFICATION, INTERVENTION, AND TREATMENT OF CHILD ABUSE. 9 7 4 7 0 0 112240 234965 182121 179607 0 0 0 0 294361 414572 0 0 0 0 209245 211727 0 0 0 147572 154583 356817 366310 -62456 48262 243427 451827 51899 30267 191528 421560 X CENTRE COUNTY CHILDREN'S ADVOCACY CENTER ("CAC") IS A CHILD-FOCUSED, FACILITY-BASED PROGRAM IN WHICH REPRESENTATIVES FROM MANY DISCIPLINES WORK TOGETHER TO CONDUCT INTERVIEWS OF CHILDREN AND MAKE TEAM DECISIONS ABOUT INVESTIGATION, TREATMENT, MANAGEMENT, AND PROSECUTION OF CHILD ABUSE CASES. 0 0 269586 0 179607 CHILDREN'S ADVOCACY CENTER IS AN AFFILIATE OF MOUNT NITTANY HEALTH SYSTEM (HEALTH SYSTEM) WHICH INCLUDES AN ACUTE CARE HOSPITAL (MOUNT NITTANY MEDICAL CENTER), MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES, INC., CENTRE COUNTY CHILDREN'S ADVOCACY CENTER, AND THE FOUNDATION FOR MOUNT NITTANY MEDICAL CENTER INC.AT THE CHILDREN'S ADVOCACY CENTER, OUR PRIMARY FOCUS IS ON THE WELL-BEING OF THE CHILD. OUR TEAM WORKS TOGETHER TO MAKE EACH CHILD FEEL SAFE AND SECURE, AND TO ENSURE THAT EACH CHILD IS GIVEN THE OPPORTUNITY TO SHARE THEIR ACCOUNT OF REPORTED ABUSE, NEGLECT, OR OTHER CRIMES THEY MAY HAVE BEEN VICTIM OR WITNESS TO.CONTINUED ON SCHEDULE O.DURING A VISIT TO THE CHILDREN'S ADVOCACY CENTER, CHILDREN SHARE THEIR ACCOUNT AS PART OF AN INVESTIGATION AND BEGIN THEIR JOURNEY TO HEALING. THE CHILDREN'S ADVOCACY CENTER BECAME FULLY OPERATIONAL ON FEBRUARY 21, 2014.SERVICES PROVIDED BY CAC INCLUDE THE FOLLOWING:- COORDINATION OF THE COUNTY'S MULTIDISCIPLINARY INVESTIGATIVE TEAM RESPONSE- CHILD AND FAMILY FRIENDLY FACILITIES- FORENSIC INTERVIEWING SERVICES- VICTIM ADVOCACY SUPPORT AND REFERRAL- SPECIALIZED FORENSIC MEDICAL EVALUATION AND TREATMENT- REFERRAL TO SPECIALIZED MENTAL HEALTH SERVICES- TRAINING, EDUCATION AND SUPPORT FOR CHILD ABUSE PROFESSIONALS- COMMUNITY EDUCATION AND OUTREACHFOR THE PERIOD FROM JULY 1, 2020 TO JUNE 30, 2021, CAC RECEIVED 263 REFERRALS FOR SERVICES. DURING THIS TIME PERIOD, THE CAC CONDUCTED 213 FORENSIC INTERVIEWS - 152 OF THESE INTERVIEWS WERE COVERED THROUGH GOVERNMENT REIMBURSEMENTS THROUGH CRIME VICTIMS COMPENSATION OR COUNTY GOVERNMENT. 269586 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 0 0 4 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 7 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X BRYAN ROACH EXECUTIVE VP CFO 8142317000 1800 EAST PARK AVENUE STATE COLLEGE PA 16801 JACK INFIELD CHAIR 2.00 X X 0 0 0 KATHLEEN RHINE SECRETARY/TREASURER/CEO 2.00 40.00 X X 0 1461294 156446 PATRICIA BEST DED DIRECTOR 2.00 2.00 X 0 0 0 CHARLENE FRIEDMAN DIRECTOR 2.00 X 0 0 0 JUDY GRAHAM DIRECTOR 2.00 X 0 0 0 TOM KING DIRECTOR 2.00 X 0 0 0 KIMBERLY NEELY MS DIRECTOR 2.00 X 0 0 0 RACHEL SCHWAB MD DIRECTOR 2.00 40.00 X 0 242146 1735 GINA WOSKOB DIRECTOR 2.00 X 0 0 0 MEREDITH THOMPSON EXECUTIVE DIRECTOR 40.00 X 70606 0 24992 BRYAN ROACH EXECUTIVE VP & CFO 1.00 39.00 X 0 523447 49764 LANCE ROSE FORMER CEO 0.00 0.00 X 0 14721 0 RANDY TEWKSBURY FORMER CFO 0.00 0.00 X 0 110498 0 70606 2352106 232937 0 1 1 0 0 234965 234965 CLIENT SERVICE REVENUE 624100 129462 129462 CPIP REVENUE 624100 50145 50145 179607 414572 179607 0 0 X 91477 57743 33734 90567 57169 33398 18486 8121 10365 11197 6158 5039 9610 9610 78132 78132 1035 107 928 43214 43214 939 939 3169 3169 GRANT EXPENSES 12283 12283 DUES AND SUBSCRIPTIONS 3275 3275 SPECIAL EVENTS 1669 1669 COURIER SERVICES 957 957 300 215 85 366310 269586 96724 0 65454 101368 70523 66391 419343 394727 2045 24616 105405 259452 243427 451827 51899 26873 0 3394 51899 30267 X 113846 162108 77682 259452 191528 421560 243427 451827 X 48262 181770 X 0 1 X 1 0 X 138324 224279 266298 112240 234965 976106 138324 224279 266298 112240 234965 976106 976106 894 894 977000 860774 0.99910 0.99830 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2016 AMOUNT: $ 894. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 325448 325448 0 93895 69279 24616 24616 INTEREST IN NET ASSETS OF AFFILIATE 259452 259452 DUE TO AFFILIATES 3394 3394 596342 181770 181770 414572 0 414572 366310 0 366310 0 366310 PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN INTEREST IN NET ASSETS OF THE FOUNDATION 181,770. 1 1 0 0 0 0 0 1 0 KATHLEEN RHINE SECRETARY/TREASURER/CEO 0 785208 0 259214 0 416872 0 139914 0 16532 0 1617740 0 397338 BRYAN ROACH EXECUTIVE VP & CFO 0 470771 0 52135 0 541 0 19884 0 29880 0 573211 0 0 RACHEL SCHWAB MD DIRECTOR 0 196364 0 25818 0 19964 0 0 0 1735 0 243881 0 0 RANDY TEWKSBURY FORMER CFO 0 0 0 0 0 110498 0 0 0 0 0 110498 0 0 LANCE ROSE FORMER CEO 0 0 0 0 0 14721 0 0 0 0 0 14721 0 0 PART I, LINE 3 THE CEO IS AN EMPLOYEE OF MOUNT NITTANY MEDICAL CENTER ("MNMC"). MNMC USES ALL OF THE METHODS UNDER LINE 3 OTHER THAN REVIEWING 990S OF OTHER ORGANIZATIONS TO ESTABLISH HIS COMPENSATION. PART I, LINES 4A-B SEVERANCE PAYMENTS WERE MADE TO FORMER SVP OF FINANCE/CFO, RANDY TEWKSBURY. THE FORMER CEO, LANCE ROSE, RECEIVED A NONQUALIFIED RETIREMENT PLAN PAYMENT OF $14,721 DURING THE CALENDAR YEAR. THE CHIEF EXECUTIVE OFFICER, KATHLEEN RHINE, PARTICIPATES IN 457(F) NON-QUALIFIED RETIREMENT PLAN. CONTRIBUTIONS MADE DURING THE CALENDAR YEAR WERE $120,030. SHE ALSO RECEIVED A DISTRIBUTION IN 2020 OF $397,338. PART I, LINE 7 THE EXECUTIVE TEAM MEMBERS OF MOUNT NITTANY MEDICAL CENTER AND THE MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES' (D/B/A MOUNT NITTANY PHYSICIAN GROUP) EXECUTIVE DIRECTOR RECEIVED A PORTION OF THEIR ANNUAL VARIABLE-PAY BASED UPON THE CONSOLIDATED OPERATING MARGIN, MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES' (D/B/A MOUNT NITTANY PHYSICIAN GROUP) OPERATING MARGIN, CONTRIBUTIONS, AND OTHER CORPORATE GOALS. THE CORPORATE GOALS FOCUSED ON (1) PROVIDING LOCALIZED CARE, INTEGRATED CARE, EFFICIENT CARE, AND ALIGNED CARE; (2) FINANCE; (3) QUALITY/PATIENT SAFETY; AND (4) THE WORK ENVIRONMENT. FORM 990, PART V, LINE 2: SALARIES AND BENEFITS REPORTED ON PART IX ARE ALLOCATED EXPENSES FOR TIME THAT INDIVIDUALS WORK ON CHILDREN'S ADVOCACY CENTER ("CAC"). ALL EMPLOYEES ARE EMPLOYEES OF MOUNT NITTANY MEDICAL CENTER ("MNMC"), A RELATED ORGANIZATION. MNMC FILES ALL REQUIRED EMPLOYMENT TAX RETURNS UNDER ITS EIN 24-0795682. FORM 990, PART VI, SECTION A, LINE 7A AS THE PARENT ENTITY, MOUNT NITTANY HEALTH SYSTEM (MNHS) HAS THE POWER TO APPOINT AND REMOVE, OR APPROVE THE REMOVAL OF, ANY AND ALL TRUSTEES OF THE CORPORATION, WITH THE EXCEPTION OF EX-OFFICIO TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B MNHS HAS THE FOLLOWING POWERS: (A) TO APPOINT AND REMOVE, OR APPROVE THE REMOVAL OF, ANY AND ALL DIRECTORS OF THE CORPORATION, WITH THE EXCEPTION OF EX-OFFICIO DIRECTORS; (B) TO APPROVE THE ELECTION OF AND TO REMOVE ANY AND ALL OFFICERS OF THE CORPORATION; (C) TO DEVELOP AND APPROVE ALL ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION (INCLUDING ALL AMENDMENTS THERETO); (D) TO APPROVE THE INCURRENCE, RE-FINANCING, OR PREPAYMENT OF ANY INDEBTEDNESS OF THE CORPORATION; (E) TO APPROVE THE SECURING OF ANY MORTGAGE, DEED OF TRUST, PLEDGE, SECURITY INTEREST, OR OTHER ENCUMBRANCE OF THE CORPORATION OTHER THAN A PURCHASE MONEY SECURITY INTEREST IN ACQUIRED EQUIPMENT; (F) TO APPROVE ANY TRANSFER OF FUNDS FROM THE CORPORATION BY GRANT, GIFT, OR LOAN; (G) TO APPROVE ALL UNBUDGETED EXPENDITURES IN EXCESS OF 1% OF EACH SUCH BUDGET; (H) TO APPROVE ALL STRATEGIC PLANS OF THE CORPORATION; (I) TO SELECT THE INDEPENDENT AUDITORS AND LEGAL COUNSEL OF THE CORPORATION; (J) TO AMEND OR TO APPROVE AMENDMENTS, ALTERATIONS AND MODIFICATIONS TO OR REPEALS OF THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION IN ACCORDANCE WITH SECTION 11.1; (K) TO APPROVE ALL MERGERS, CONSOLIDATIONS, DIVISIONS, SALES OF SUBSTANTIALLY ALL ASSETS, LIQUIDATION OR DISSOLUTION OF THE CORPORATION, AND ALL OTHER FUNDAMENTAL CHANGE TRANSACTIONS, AS WELL AS ALL TRANSACTIONS OUTSIDE THE ORDINARY COURSE OF BUSINESS; (L) TO ESTABLISH, TERMINATE, OR WITHDRAW FROM ANY SUBSIDIARY, JOINT VENTURE, OR OTHER PARTNERSHIP OR SHARED GOVERNANCE AGREEMENT; AND (M) TO TAKE ANY OTHER ACTION THAT IS RESERVED TO THE PARENT FROM TIME TO TIME BY THE CORPORATION'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PROVIDED BY MANAGEMENT TO ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, THE CONFLICT OF INTEREST POLICY IS DISTRIBUTED TO KEY MEMBERS OF THE ORGANIZATION INCLUDING BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES. EACH PERSON MUST REPORT ANY POTENTIAL CONFLICTS OF INTEREST. REPORTED CONFLICTS ARE THEN REVIEWED BY THE CORPORATE COMPLIANCE OFFICER AND THE HEALTH SYSTEM'S AUDIT COMMITTEE. THE CONFLICT OF INTEREST REPORT IS THEN SUBMITTED TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMPENSATION COMMITTEE FROM THE MOUNT NITTANY MEDICAL CENTER'S BOARD OF TRUSTEES REVIEWS COMPENSATION PAID TO THE EXECUTIVE MANAGEMENT TEAM IN CONJUNCTION WITH AN INDEPENDENT THIRD PARTY CONSULTING FIRM TO ENSURE COMPENSATION IS REASONABLE AND APPROPRIATE FOR DUTIES AND RESPONSIBILITES ASSIGNED. REVIEW AND APPROVAL OF COMPENSATION IS DOCUMENTED VIA MINUTES OF COMMITTEE MEETINGS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 47,502. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 47,502. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 30,630. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 30,630. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN NET ASSETS OF THE FOUNDATION 181,770. MOUNT NITTANY HEALTH SYSTEM 1800 EAST PARK AVENUE STATE COLLEGE PA 16803 800663092 PROVIDE MANAGEMENT AND ADMINISTRATIVE SUPPORT TO MNMC & SUBSIDIARIES PA 501(C)(3) LINE 12A, I N/A 0 MOUNT NITTANY MEDICAL CENTER 1800 EAST PARK AVENUE STATE COLLEGE PA 16803 240795682 HEALTHCARE PA 501(C)(3) LINE 3 MOUNT NITTANY HEALTH SYSTEM 0 THE FOUNDATION FOR MOUNT NITTANY MEDICAL CENTER 1800 EAST PARK AVENUE STATE COLLEGE PA 16803 571138956 FUNDRAISING AND SUPPORT FOR MOUNT NITTANY MEDICAL CENTER PA 501(C)(3) LINE 12A, I MOUNT NITTANY MEDICAL CENTER 0 MOUNT NITTANY MEDICAL CENTER WORKMEN'S COMPENSATION SELF INSURANCE TRUST 1800 EAST PARK AVENUE STATE COLLEGE PA 16803 256440788 PROVIDE WORKMEN'S COMPENSATION BENEFITS TO EMPLOYEES OF AFFILIATE PA 501(C)(3) LINE 12A, I MOUNT NITTANY MEDICAL CENTER 0 MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES INC 1800 EAST PARK AVENUE STATE COLLEGE PA 16803 510426500 PROFESSIONAL SERVICES TO SUPPORT MNMC PA 501(C)(3) LINE 10 MOUNT NITTANY HEALTH SYSTEM 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0