FURP.ORG / PUBLIC DATA EXPLORER

TITUSVILLE AREA HOSPITAL: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
TITUSVILLE AREA HOSPITAL (EIN 25-0965579)
Tax period
2019-07-01 to 2020-06-30
Filed
2021-05-17
IRS object ID
202131379349305468
Schema version
2019v5.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2021-05-17T13:16:06-05:00ReturnTs
Tax Period End2020-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1910 E ST LOUIS 200/PO BOX 1190AddressLine1Txt
CitySPRINGFIELDCityNm
State AbbreviationMOStateAbbreviationCd
ZIP658062523ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN250965579EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1TITUSVILLE AREA HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% JILL NEELYInCareOfNm
Business Name ControlTITUBusinessNameControlTxt
Phone8148271851PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1406 WEST OAK STREETAddressLine1Txt
CityTITUSVILLECityNm
State AbbreviationPAStateAbbreviationCd
ZIP16354ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLEE CLINTONPersonNm
Person TitleCEOPersonTitleTxt
Signature2021-05-08SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBrian D ToddPreparerPersonNm
PTINP00422601PTIN
Phone4178658701PhoneNum
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerLEE M CLINTONPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1406 WEST OAK STREETAddressLine1Txt
CityTITUSVILLECityNm
State AbbreviationPAStateAbbreviationCd
ZIP16354ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$44,150,752GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.TITUSVILLEHOSPITAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1900FormationYr
Legal Domicile StatePALegalDomicileStateCd
Activity Or MissionTAH IS A COMMUNITY BASED, ACUTE CARE, CRITICAL ACCESS HOSPITAL PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY SERVICES TO MORE THAN 30,000 PEOPLE IN 4 COUNTIES IN PA.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee262TotalEmployeeCnt
Total Volunteers75TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$144,980PYContributionsGrantsAmt
CY Contributions Grants$2,038,140CYContributionsGrantsAmt
PY Program Service Revenue$34,320,732PYProgramServiceRevenueAmt
CY Program Service Revenue$41,379,840CYProgramServiceRevenueAmt
PY Investment Income-$51,553PYInvestmentIncomeAmt
CY Investment Income-$180,338CYInvestmentIncomeAmt
PY Other Revenue$640,583PYOtherRevenueAmt
CY Other Revenue$629,682CYOtherRevenueAmt
PY Total Revenue$35,054,742PYTotalRevenueAmt
CY Total Revenue$43,867,324CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$15,647,216PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$24,573,387CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$17,937,303PYOtherExpensesAmt
CY Other Expenses$20,775,030CYOtherExpensesAmt
PY Total Expenses$33,584,519PYTotalExpensesAmt
CY Total Expenses$45,348,417CYTotalExpensesAmt
PY Revenues Less Expenses$1,470,223PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,481,093CYRevenuesLessExpensesAmt
Total Assets BOY$27,810,176TotalAssetsBOYAmt
Total Assets EOY$30,410,868TotalAssetsEOYAmt
Total Liabilities BOY$24,225,937TotalLiabilitiesBOYAmt
Total Liabilities EOY$27,412,683TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$3,584,239NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,998,185NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTITUSVILLE AREA HOSPITAL IS COMMITTED TO PROVIDING QUALITY HEALTHCARE SERVICES WITH AN EMPHASIS ON PERSONAL ATTENTION, COMPASSION AND RESPECT.MissionDesc
Significant New Program SrvcYes (true)SignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$38,546,826ExpenseAmt
Revenue$41,379,840RevenueAmt
DescTITUSVILLE AREA HOSPITAL IS AN ACUTE CARE, CRITICAL ACCESS RURAL HOSPITAL WITH 661 ADMISSIONS, 3,512 PATIENT DAYS AND 54,018 OUTPATIENT VISITS.Desc
Total Program Service Expenses$38,546,826TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee262EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldPAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJILL NEELYPersonNm
Phone8148271851PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1406 WEST OAK STREETAddressLine1Txt
CityTITUSVILLECityNm
State AbbreviationPAStateAbbreviationCd
ZIP16354ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtHighest Compensated EmployeeHighestCompensatedEmployeeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
MICHAEL DVORKIN
PHYSICIAN40.00.0Yes (X)$620,340$0$21,383
DWAIN ROGERS
PHYSICIAN40.00.0Yes (X)$452,852$0$23,222
LEE M CLINTON
CEO/PRESIDENT35.05.0$277,606$0$36,902Yes (X)
MARIA MUNOZ
PHYSICIAN40.00.0Yes (X)$241,302$0$12,993
JAMES WILKENS
PHYSICIAN40.00.0Yes (X)$215,823$0$22,282
MARY GIDOR
PHYSICIAN END 12/1940.00.0Yes (X)$167,871$0$18,511
JILL NEELY
CFO/TREASURER35.05.0$146,904$0$26,346Yes (X)
JASON REAGLE
CHAIRMAN1.01.0$0$0$0Yes (X)Yes (X)
RICHARD CARR
DIRECTOR1.01.0$0$0$0Yes (X)
STEPHEN COLEMAN
SECRETARY1.01.0$0$0$0Yes (X)Yes (X)
SCOTT MCALLISTER MD
DIRECTOR1.01.0$0$0$0Yes (X)
LARRY FLEDDERMAN
VICE CHAIRMAN1.02.0$0$0$0Yes (X)Yes (X)
PATRICIA WALKER
DIRECTOR1.01.0$0$0$0Yes (X)
JOSEPH CARTER
DIRECTOR1.01.0$0$0$0Yes (X)
MICHAEL R THOMSON
DIRECTOR1.01.0$0$0$0Yes (X)
MARK MEHLENBACHER
DIRECTOR1.01.0$0$0$0Yes (X)
KENNETH WINGER
DIRECTOR1.02.0$0$0$0Yes (X)
BRIAN NAGEOTTE
DIRECTOR BEG 3/191.01.0$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,122,698TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$161,639TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K8IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
OIL VALLEY INTERNAL MEDICINE ASSOCI
339 W SPRING STTITUSVILLEPA16354MEDICAL PURCH SVCS$1,756,305
OIL VALLEY PHYSICAL THERAPY
228 E CENTRAL AVETITUSVILLEPA16354PHYSICAL THERAPY$1,048,532
EMCARE
7032 COLLECTION CENTER DRCHICAGOIL60693ER PHYSICIANS$892,869
OIL VALLEY HOSPITALISTS
339 W SPRING STTITUSVILLEPA16354HOSPITALIST$534,745
CPS LLC
6409 N QUAIL HOLLOW RDMEMPHISTN38120PHARMACY ADMIN SVCS$495,048
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K11CntrctRcvdGreaterThan100KCnt
Related Organizations$25,744RelatedOrganizationsAmt
Government Grants$1,786,851GovernmentGrantsAmt
All Other Contributions$225,545AllOtherContributionsAmt
Total Contributions$2,038,140TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE621990$40,435,489$40,435,489
PHARMACY REVENUE446110$433,749$433,749
RHC REVENUE621498$254,226$254,226
CAFETERIA REVENUE811000$106,290$106,290
OTHER REVENUE900099$150,086$150,086
FieldValueIRS element (for citing)
Total Program Service Revenue$41,379,840TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$109,750RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$41,636RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$68,114RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$68,114TotalRevenueColumnAmt
Exclusion$68,114ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$61,454OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$241,792OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$180,338OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$180,338TotalRevenueColumnAmt
Exclusion-$180,338ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescINCOME FROM EQUITY INVESTEEDesc
Business900099BusinessCd
Total Revenue Column$561,568TotalRevenueColumnAmt
Exclusion$561,568ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$561,568OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$43,867,324TotalRevenueColumnAmt
Related Or Exempt Func Income$41,379,840RelatedOrExemptFuncIncomeAmt
Exclusion$449,344ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$487,758TotalAmt
Management And General$487,758ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$18,338,766TotalAmt
Program Services$15,572,331ProgramServicesAmt
Management And General$2,766,435ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$414,897TotalAmt
Program Services$218,520ProgramServicesAmt
Management And General$196,377ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,012,844TotalAmt
Program Services$3,338,664ProgramServicesAmt
Management And General$674,180ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,319,122TotalAmt
Program Services$1,048,853ProgramServicesAmt
Management And General$270,269ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$690,984TotalAmt
Management And General$690,984ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$37,010TotalAmt
Management And General$37,010ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$126,094TotalAmt
Management And General$126,094ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$7,736,348TotalAmt
Program Services$7,199,965ProgramServicesAmt
Management And General$536,383ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$82,703TotalAmt
Program Services$82,703ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$646,076TotalAmt
Program Services$458,270ProgramServicesAmt
Management And General$187,806ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,907,234TotalAmt
Program Services$1,907,234ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$57,564TotalAmt
Program Services$50,317ProgramServicesAmt
Management And General$7,247ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$18,086TotalAmt
Program Services$15,755ProgramServicesAmt
Management And General$2,331ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,054TotalAmt
Program Services$2,054ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,205,821TotalAmt
Program Services$964,657ProgramServicesAmt
Management And General$241,164ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,410,583TotalAmt
Program Services$1,363,557ProgramServicesAmt
Management And General$47,026ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES & DRUGS$6,335,248$6,103,667$231,581
MISCELLANEOUS EXPENSE$373,211$156,843$216,368
LICENSES, DUES, SUBSCRIPTIONS$146,014$63,436$82,578

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$45,348,417TotalAmt
Program Services$38,546,826ProgramServicesAmt
Management And General$6,801,591ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,970,405BOYAmt
EOY$2,176,930EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$238,291BOYAmt
EOY$24,630EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$5,640,861BOYAmt
EOY$6,960,455EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,067,261BOYAmt
EOY$1,007,137EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$281,702BOYAmt
EOY$442,257EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$41,202,800LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$29,458,859LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$9,772,483BOYAmt
EOY$11,743,941EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$4,423,234BOYAmt
EOY$4,651,699EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$2,749,978BOYAmt
EOY$2,910,779EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$120,000BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$545,961BOYAmt
EOY$493,040EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$27,810,176BOYAmt
EOY$30,410,868EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,854,910BOYAmt
EOY$2,895,324EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$3,223,113EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$603,446BOYAmt
EOY$36,994EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$20,767,581BOYAmt
EOY$21,257,252EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$24,225,937BOYAmt
EOY$27,412,683EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$57,352BOYAmt
EOY-$573,007EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,641,591BOYAmt
EOY$3,571,192EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,584,239BOYAmt
EOY$2,998,185EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$27,810,176BOYAmt
EOY$30,410,868EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$1,481,093ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$4,492NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$899,531OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$8,744OtherActivitiesAmt
Total Lobbying Expenditures$8,744TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-B, LINE IFormAndLineReferenceDesc
ExplanationOTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAYS DUES TO THE AMERICAN HOSPITAL ASSOCIATION, OF WHICH $8,744 IS ATTRIBUTABLE TO LOBBYING.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$667,995OtherCostOrOtherBasisAmt
Book Value$667,995BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$13,730,247OtherCostOrOtherBasisAmt
Depreciation$11,069,921DepreciationAmt
Book Value$2,660,326BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$173,486OtherCostOrOtherBasisAmt
Depreciation$46,837DepreciationAmt
Book Value$126,649BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$23,533,109OtherCostOrOtherBasisAmt
Depreciation$16,639,652DepreciationAmt
Book Value$6,893,457BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,097,963OtherCostOrOtherBasisAmt
Depreciation$1,702,449DepreciationAmt
Book Value$1,395,514BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$11,743,941TotalBookValueLandBuildingsAmt
Financial DerivativesFinancialDerivativesGrp
Closely Held Equity InterestsCloselyHeldEquityInterestsGrp

Other Securities OtherSecuritiesGrp (2 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
INVESTMENT - VANTAGE$94,432F
INVESTMENT - CHART$2,816,347C
FieldValueIRS element (for citing)
Total Book Value Securities$2,910,779TotalBookValueSecuritiesAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
DUE TO AFFILIATES$14,583,274
EST AMOUNTS TO 3RD PARTY$2,457,095
CONTRACT LIABILITIES$4,216,883
FieldValueIRS element (for citing)
Total Liability$21,257,252TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$44,014,407TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$4,492NetUnrealizedGainsInvstAmt
Other Revenue-$70,399OtherRevenueAmt
Revenue Not Reported-$74,891RevenueNotReportedAmt
Revenue Subtotal$44,089,298RevenueSubtotalAmt
Other Revenues Not Included-$221,974OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$221,974RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$43,867,324TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$45,570,391TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$221,974OtherExpensesIncludedAmt
Expenses Not Reported$221,974ExpensesNotReportedAmt
Expenses Subtotal$45,348,417ExpensesSubtotalAmt
Total Expenses Per Form990$45,348,417TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART X, LINE 2UNCERTAIN TAX POSITION: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
SCHEDULE D, PART XI, LINE 2DOTHER REVENUE ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12: $ (70,399) CHANGE IN BENEFICIAL INTEREST
SCHEDULE D, PART XI, LINE 4BOTHER REVENUE ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ (180,338) LOSS ON DISPOSAL OF ASSETS (41,636) RENTAL EXPENSES ------------- $ (221,974)
SCHEDULE D, PART XII, LINE 2DOTHER EXPENSES ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25: $ 180,338 LOSS ON DISPOSAL OF ASSETS 41,636 RENTAL EXPENSES ------------ $ 221,974

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$163,891TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$163,891NetCommunityBenefitExpnsAmt
Total Expense0.00360TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,407,518TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,310,326DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,097,192NetCommunityBenefitExpnsAmt
Total Expense0.04620TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,571,409TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,310,326DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,261,083NetCommunityBenefitExpnsAmt
Total Expense0.04980TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,200TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,200NetCommunityBenefitExpnsAmt

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,255TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,255NetCommunityBenefitExpnsAmt

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,455TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,455NetCommunityBenefitExpnsAmt

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,573,864TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,310,326DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,263,538NetCommunityBenefitExpnsAmt
Total Expense0.04980TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$3,104,685BadDebtExpenseAmt
Bad Debt Expense Attributable$750,812BadDebtExpenseAttributableAmt
Reimbursed By Medicare$9,683,971ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$9,425,691CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$258,280MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnfalseFinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1TITUSVILLE AREA HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1406 WEST OAK STREETAddressLine1Txt
CityTITUSVILLECityNm
State AbbreviationPAStateAbbreviationCd
ZIP16354ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.TITUSVILLEHOSPITAL.ORGWebsiteAddressTxt
State License200901StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1TITUSVILLE AREA HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART V, SECTION COwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLSEE PART V, SECTION COtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt18ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSEE PART V, SECTION CStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART V, SECTION CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART V, SECTION CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART V, SECTION CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 5COMMUNITY INPUT: THE RESEARCH PROCESS INCLUDED A WIDE BASED SURVEY OF THE POPULATION. THE SURVEY INCLUDED INPUT FROM UNDERREPRESENTED GROUPS IN PUBLIC HOUSING. BOTH ELECTRONIC SURVEYS AND FACE TO FACE PAPER SURVEYS WERE COMPLETED. A GOOD DIVERSITY OF RESPONSE WAS REALIZED.
SCHEDULE H, PART V, SECTION B, LINE 6AOTHER HOSPITAL FACILITIES: THE CHNA REPORT WAS CONDUCTED WITH MEADVILLE MEDICAL CENTER, AN AFFILIATED ENTITY.
SCHEDULE H, PART V, SECTION B, LINE 6BOTHER ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES: THE CHNA REPORT WAS CONDUCTED WITH CRAWFORD HEALTH IMPROVEMENT COALITION AND ALLEGHENY COLLEGE.
SCHEDULE H, PART V, SECTION B, LINE 7AHOSPITAL FACILITY'S WEBSITE: HTTPS://WWW.TITUSVILLEHOSPITAL.ORG/PATIENT-VISITORS/COMMUNITY-HEALTH-NEEDS -ASSESSMENT.ASPX
SCHEDULE H, PART V, SECTION B, LINE 7BOTHER WEBSITE: HTTP://WWW.MMCHS.ORG/PATIENT-VISITORS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.AS PX
SCHEDULE H, PART V, SECTION B, LINE 10IMPLEMENATION STRATEGY WEBSITE: HTTPS://WWW.TITUSVILLEHOSPITAL.ORG/PATIENT-VISITORS/COMMUNITY-HEALTH-NEEDS -ASSESSMENT.ASPX
SCHEDULE H, PART V, SECTION B, LINE 11ADDRESSING IDENTIFIED NEEDS: IN RESPONSE TO THE RESULTS OF TITUSVILLE AREA HOSPITAL'S MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT, THE ORGANIZATION ADOPTED AN IMPLEMENTATION STRATEGY. THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) CONDUCTED IN COLLABORATION BETWEEN MEADVILLE MEDICAL CENTER, TITUSVILLE AREA HOSPITAL AND ALLEGHENY COLLEGE LOOKED AT DATA COLLECTED FROM MORE THAN 1,100 ADULT PARTICIPANTS FROM ACROSS CRAWFORD COUNTY. ONLINE AND IN PERSON SURVEYS FOCUSED ON CANCER PREVENTION, WHICH SHOWED TO BE THE PRIMARY HEALTHCARE ISSUE IN THE 2015 CHNA. THE 2019 CHNA SHOWED THAT THE RATE OF CANCER INCIDENCE IN CRAWFORD COUNTY WAS HIGHER THAN BOTH THE COMMONWEALTH OF PENNSYLVANIA AND THE UNITED STATES, AT RATES OF 494.4 IN CRAWFORD COUNTY, 481.7 IN PENNSYLVANIA AND 441.2 NATIONWIDE PER 100,000 PEOPLE. LUNG CANCER IS 48% HIGHER THAN THE NATIONAL RATE, COLON CANCER IS 28% HIGHER, AND CERVICAL CANCER IS 20% HIGHER. THE MORTALITY RATE FROM CANCER IS ALSO HIGHER IN CRAWFORD COUNTY AT 183.5 PER 100,000, AS COMPARED TO PENNSYLVANIA WHICH IS 171.6 PER 100,000 AND NATIONWIDE AT 163.5 PER 100,000. THE LEADING RISK FACTORS FOR THE INCREASED RATE OF CANCER IN THE COUNTY IS A RESULT OF SMOKING, UNDERSTANDING HUMAN PAPILLOMAVIRUS (HPV) AND PREVENTATIVE SCREENINGS. 35% OF ALL RESPONDENTS REPORTED BEING A CURRENT OR FORMER SMOKER, WITH 70% OF THEM BEING BETWEEN THE AGES OF 18-54. TYPICALLY, THESE RESPONDENTS WERE ASSOCIATED WITH A LOWER LEVEL OF EDUCATION, LOWER RATES OF SCREENING AND/OR DID NOT HAVE A PRIMARY CARE PHYSICIAN. BETWEEN 2015 AND 2018 THE CHNA RESULTS SHOWED A 14% DECREASE IN THE NUMBER OF RESIDENTS REPORTING THEY HAVE A PRIMARY CARE PHYSICIAN. TITUSVILLE AREA HOSPITAL IS COMMITTED TO DECREASING THE RATE OF CANCER AMONG THE RESIDENTS OF CRAWFORD COUNTY BY INCREASING SMOKING CESSATION EDUCATION, INCREASING HPV VACCINATIONS AND CONNECTING RESIDENTS WITH PRIMARY CARE PHYSICIANS.
SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, & 16CFAP, FAP APPLICATION, AND PLS WEBSITE: https://www.titusvillehospital.org/Patient-Visitors/Billing-Insurance/Fina ncial-Assistance.aspx
FieldValueIRS element (for citing)
Facility7FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
CONNEAUT VALLEY HEALTH CENTER
906 WASHINGTON STCONNEAUTVILLEPA16406FAMILY MEDICINE
CAMBRIDGE SPRINGS HEALTH CENTER
118 RAILROAD STCAMBRIDGEPA16403FAMILY MEDICINE
CONNEAUT LAKE HEALTH CENTER
10926 PA-18CONNEAUT LAKEPA16316FAMILY MEDICINE
MEADVILLE COMMUNITY HEALTH
747 TERRACE STMEADVILLEPA16335FAMILY MEDICINE
SAEGERTOWN MEDICAL ASSOCIATES
707 ERIE STSAEGERTOWNPA16443FAMILY MEDICINE
VALLEY DENTAL CENTER
906 WASHINGTON STREETCONNEAUTVILLEPA16406DENTAL SERVICES
ALDEN PRIMARY CARE
640 ALDEN STMEADVILLEPA16335FAMILY MEDICINE

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART I, LINE 7, COLUMN FPERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25 OF THE FORM 990.
SCHEDULE H, PART I, LINE 7COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1, 3 AND 6.
SCHEDULE H, PART III, SECTION A, LINE 2BAD DEBT EXPENSE: THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HEALTH SYSTEM DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HEALTH SYSTEM'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2020. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2.
SCHEDULE H, PART III, SECTION A, LINE 3BAD DEBT EXPENSE ATTRIBUTABLE TO FAP-ELIGIBLE PATIENTS: BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING POVERTY LIMIT DEMOGRAPHIC INFORMATION OBTAINED THROUGH THE US CENSUS BUREAU. THIS AMOUNT EXPENSED BY THE ORGANIZATION IS ATTRIBUTABLE TO LOW INCOME INDIVIDUALS IN THEIR TARGET COMMUNITY AND IS CONSIDERED A COMMUNITY BENEFIT.
SCHEDULE H, PART III, SECTION A, LINE 4BAD DEBT EXPENSE FOOTNOTE: THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE, THAT NOTE CAN BE FOUND ON PAGE 13 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.
SCHEDULE H, PART III, SECTION B, LINE 8COSTING SOURCE: MEDICARE DATA COMPUTED USING THE MEDICARE COST REPORT FILED WITH CMS WAS UTILIZED FOR THE COMPUTATIONS IN PART III, SECTION B.
SCHEDULE H, PART VI, LINE 2NEEDS ASSESSMENT: TITUSVILLE AREA HOSPITAL DOES NOT CURRENTLY HAVE A FORMALIZED METHOD TO ASSESS THE COMMUNITY FOR ITS HEALTH NEEDS. IN THE NEXT COUPLE YEARS, THE ORGANIZATION PLANS TO LAUNCH A MORE FORMALIZED PROCESS TO ASSESS COMMUNITY NEEDS. TAH IS PARTNERING WITH MEADVILLE MEDICAL CENTER AND WILL INCORPORATE THEIR FORMALIZED METHOD TO ASSESS COMMUNITY NEEDS.
SCHEDULE H, PART VI, LINE 3PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: THE CHARITY CARE POLICY IS POSTED IN ADMISSIONS AND EMERGENCY ROOM AREAS. COPIES OF THE CHARITY CARE POLICY ARE AVAILABLE IN ADMISSIONS AREA AND EMERGENCY ROOM AREAS. IF A PERSON IS ADMITTED WITH NO INSURANCE THEY ARE VISITED BY A FINANCIAL AID COUNSELOR AND MADE AWARE OF THEIR OPTIONS.
SCHEDULE H, PART VI, LINE 4COMMUNITY INFORMATION: TITUSVILLE AREA HOSPITAL SERVES RESIDENTS OF CRAWFORD, FOREST, AND VENANGO COUNTIES IN PENNSYLVANIA. THE MAIN SERVICE AREA IS CRAWFORD COUNTY. CRAWFORD COUNTY IS A RURAL AREA WITH A POPULATION OF APPROXIMATELY 88,524. THE 2009 ESTIMATED MEDIAN HOUSEHOLD INCOME WAS $38,192 WHICH IS WELL BELOW THE PENNSYLVANIA ESTIMATED HOUSEHOLD INCOME OF $49,520. APPROXIMATELY 14.9% OF RESIDENTS LIVE IN POVERTY.
SCHEDULE H, PART VI, LINE 5PROMOTION OF COMMUNITY HEALTH: OUR STAFF IS COMMITTED TO THE CARE AND IMPROVEMENT OF LIFE. IN RECOGNITION OF THIS COMMITMENT, WE STRIVE TO DELIVER HIGH-QUALITY AND COST-EFFECTIVE HEALTHCARE WITH AN EMPHASIS ON COMPASSION, PERSONAL ATTENTION AND RESPECT. WE BELIEVE IN THE FOLLOWING VALUES: -WE WILL MEET OR EXCEED COMMUNITY STANDARDS FOR CARE EXPECTATIONS OF PATIENTS AND FAMILIES. -WE WILL MAINTAIN A POSITIVE AND FULFILLING WORKING ATMOSPHERE THAT BOTH MOTIVATES AND ALLOWS CAREGIVERS AND SUPPORT STAFF TO GIVE THEIR BEST. -WE WILL ENSURE THAT THE ORGANIZATION IS ADEQUATELY COMPENSATED FOR SERVICES PROVIDED, THEREBY MAINTAINING VIABILITY AS A CRITICAL REGIONAL HEALTHCARE AND ECONOMIC ASSET. -OUR VISION IS TO PROVIDE ACCESS TO HIGH QUALITY HEALTHCARE SERVICES ENHANCED BY HIGH TECHNOLOGY APPROPRIATE TO COMMUNITY NEED. -WE WILL MAINTAIN A HIGHLY QUALIFIED MEDICAL AND SUPPORT STAFF IN A POSITIVE WORKING ENVIRONMENT FOCUSED ON EXCELLENCE. A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS RESIDING IN PRIMARY SERVICE AREA AND ARE NOT EMPLOYEES OR CONTRACTORS OF THE ORGANIZATION OR FAMILY MEMBERS. THE ORGANIZATION USES SURPLUS FUNDS TO PROVIDE THE LATEST IN TECHNOLOGY TO IMPROVE PATIENT CARE.
SCHEDULE H, PART VI, LINE 6AFFILIATED HEALTH CARE SYSTEM: MEADVILLE MEDICAL CENTER (MMC) IS A CORPORATE MEMBER ALONG WITH TITUSVILLE AREA HEALTH CENTER. AS OF THE DATE OF ACQUISITION, MMC HAS DIRECT AUTHORITY OVER THE STRATEGIC, FINANCIAL, AND OPERATIONAL DIRECTION OF TITUSVILLE AREA HEALTH CENTER, INC. AND AFFILIATES. TITUSVILLE AREA HEALTH CENTER, INC. AND AFFILIATES (HEALTH CENTER) CONSISTS OF TITUSVILLE AREA HEALTH CENTER, INC. (PARENT), TITUSVILLE AREA HOSPITAL (HOSPITAL), THE TITUSVILLE AREA HEALTH CENTER FOUNDATION (FOUNDATION) AND TITUSVILLE AREA HEALTH SERVICES, INC. (HEALTH SERVICES). THE HOSPITAL PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES TO PATIENTS IN TITUSVILLE, PENNSYLVANIA, AND THE SURROUNDING AREA. THE FOUNDATION WAS ESTABLISHED TO RECEIVE, ADMINISTER AND DISTRIBUTE FUNDS AND PROPERTY FOR THE BENEFIT AND SUPPORT OF THE HEALTH CENTER AND AFFILIATES. HEALTH SERVICES OPERATES SEPARATELY FROM THE HOSPITAL OFFERING MULTISPECIALTY FAMILY MEDICINE PEDIATRICS TO PATIENTS IN TITUSVILLE, PENNSYLVANIA, AND THE SURROUNDING AREA.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (true)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JILL NEELY
CFO/TREASURER$137,147$0$9,344$0$413$0$3,250$0$23,096$0$173,250$0$0$0
LEE M CLINTON
CEO/PRESIDENT$236,469$0$40,912$0$225$0$9,300$0$27,602$0$314,508$0$0$0
JAMES WILKENS
PHYSICIAN$213,346$0$497$0$1,980$0$5,434$0$16,848$0$238,105$0$0$0
DWAIN ROGERS
PHYSICIAN$428,519$0$23,043$0$1,290$0$0$0$23,222$0$476,074$0$0$0
MARIA MUNOZ
PHYSICIAN$185,783$0$53,539$0$1,980$0$4,305$0$8,688$0$254,295$0$0$0
MARY GIDOR
PHYSICIAN END 12/19$158,268$0$8,913$0$690$0$3,077$0$15,434$0$186,382$0$0$0
MICHAEL DVORKIN
PHYSICIAN$618,360$0$0$0$1,980$0$1,154$0$20,229$0$641,723$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I, LINE 6ACONTINGENT COMPENSATION: THE ORGANIZATION PAYS AN INCENTIVE TO ITS OFFICERS, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES THAT ARE CONTINGENT ON A POSITIVE TOTAL MARGIN OF THE ORGANIZATION.
SCHEDULE J, PART I, LINE 7NON-FIXED PAYMENTS: PHYSICIANS RECEIVE A BONUS BASED ON RVU (RELATED VALUE UNITS), WHICH IS A MEASUREMENT SET BY MEDICARE.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (17 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 2SIGNIFICANT PROGRAM SERVICES ACQUIRED: ON JUNE 1, 2020, TIONESTA HEALTH CENTER TRANSITIONED FROM TITUSVILLE HEALTH SERVICES INC TO TITUSVILLE AREA HOSPITAL UNDER RURAL HEALTH STATUS.
FORM 990, PART V, LINE 1ACOMMON PAYMASTER: MEADVILLE MEDICAL CENTER, AN AFFILIATED ORGANIZATION, FILED ALL U.S. INFORMATIONAL RETURNS IN 2019 ON BEHALF OF TITUSVILLE AREA HOSPITAL. THEREFORE, PART V, LINE 1A IS REPORTED AS ZERO AND ALL 1099S APPLICABLE TO TITUSVILLE AREA HOSPITAL ARE INCLUDED IN THE NUMBER REPORTED ON THE MEADVILLE MEDICAL CENTER FORM 990.
FORM 990, PART VI, SECTION A, LINE 2FAMILY/BUSINESS RELATIONSHIPS: STEPHEN COLEMAN HAS A BUSINESS RELATIONSHIP WITH RICHARD CARR AND JASON REAGLE.
FORM 990, PART VI, SECTION A, LINE 6CLASSES OF MEMBERS OR STOCKHOLDERS: TITUSVILLE AREA HOSPITAL HAS TWO CLASSES OF MEMBERSHIP. CORPORATE MEMBERSHIP CONSISTS OF ONE MEMBER, TITUSVILLE AREA HEALTH CENTER. COMMUNITY MEMBERSHIP SHALL CONSIST OF FORMER HOLDERS OF SHARES OF THE CORPORATION WHO ELECT TO CONTINUE AS SUCH MEMBERS AND OTHER PERSONS WHO ELECT TO BECOME SUCH MEMBERS OF THE CORPORATION. COMMUNITY MEMBERS SHALL NOT BE ENTITLED TO VOTE ON ANY MATTERS RESPECTING THE ACTIONS OR GOVERNANCE OF THE CORPORATION, SUCH ENTITLEMENT HAVING BEEN RESERVED SOLELY UNTO THE CORPORATION'S CORPORATE MEMBER, AND SHALL HAVE NO INTEREST IN THE PROPERTY, ASSETS OR BUSINESS OF THE CORPORATION. MEADVILLE MEDICAL CENTER IS A CORPORATE MEMBER ALONG WITH TITUSVILLE AREA HEALTH CENTER.
FORM 990, PART VI, SECTION A, LINE 7APOWER TO ELECT MEMBERS OR STOCKHOLDERS: A MAJORITY OF THE DIRECTORS SHALL BE APPOINTED BY THE BOARD OF DIRECTORS OF THE CORPORATE MEMBER (TITUSVILLE AREA HEALTH CENTER, INC). MEADVILLE MEDICAL CENTER (MMC) SHALL APPOINT THE MMC BOARD APPOINTEE TO SERVE ON THE BOARD.
FORM 990, PART VI, SECTION A, LINE 7BDECISIONS OF GOVERNING BODY SUBJECT TO APPROVAL BY MEMBERS OR STOCKHOLDERS: THE FOLLOWING POWERS ARE RESERVED UNTO MEADVILLE MEDICAL CENTER (MMC): A) NOMINATE AND ELECT THE MMC BOARD APPOINTEE, AND REMOVE SAID APPOINTEE AT ANY TIME, WITH OR WITHOUT CAUSE; B) APPROVE OR DISAPPROVE IN WHOLE OR IN PART THE CORPORATION'S BUDGET AND AMENDMENTS THERETO; C) APPROVE OR DISAPPROVE PROJECTS OR EXPENDITURES WHICH ARE NOT IN THE BUDGET OR WHICH ARE VARIANCES THERETO INCLUDING THE AUTHORITY TO ESTABLISH A DOLLAR THRESHOLD BELOW WHICH THE CORPORATION WILL NOT NEED TO OBTAIN APPROVAL FROM MMC; D) APPROVE OR DISAPPROVE ALL LONG RANGE PLANS OF THE CORPORATION; E) APPROVE OR DISAPPROVE ALL AFFILIATIONS, MERGERS AND OTHER TRANSACTIONS BY THE CORPORATION NOT IN THE ORDINARY COURSE OF BUSINESS; F) APPROVE OR DISAPPROVE ALL AMENDMENTS TO THE CORPORATION'S ARTICLES OF INCORPORATION AND BYLAWS; G) DIRECT THE CORPORATION TO MAKE CHANGES IN ITS ARTICLES OF INCORPORATION OR BYLAWS AND IN THE ABSENCE OF SUCH ACTION BY THE CORPORATION, OR A RECOMMENDATION BY TITUSVILLE AREA HEALTH CENTER, INC. (TAHC), TO DIRECTLY AMEND ITS ARTICLES OF INCORPORATION AND/OR BYLAWS ON ITS OWN MOTION; H) APPROVE OR DISAPPROVE ALL FINANCINGS OF INDEBTEDNESS BY THE CORPORATION FOR WHICH THE OBLIGATION TO REPAY EXCEEDS (I) A TERM OF TWELVE MONTHS OR (II) AN AGGREGATE DOLLAR THRESHOLD SET BY THE BOARD OF DIRECTORS OF MMC FROM TIME TO TIME, AND; I) EXERCISE SUCH OTHER POWERS OR PERFORM SUCH OTHER TASKS AS ARE RESERVED TO OR REQUIRED OF MMC. THE FOLLOWING POWERS ARE RESERVED UNTO TITUSVILLE AREA HEALTH CENTER, INC. (TAHC): A) NOMINATE AND ELECT THE REMAINING APPOINTEES TO THE BOARD OF DIRECTORS OF THE CORPORATION AND THE OFFICERS OF THE CORPORATION AND REMOVE SUCH DIRECTORS AND OFFICERS AT ANY TIME, WITH OR WITHOUT CAUSE; B) APPROVE OR DISAPPROVE ANY CHANGE IN THE NUMBER OF DIRECTORS; C) RECOMMEND TO MMC THE APPROVAL OR DISAPPROVAL IN WHOLE OR IN PART OF THE CORPORATION'S BUDGET AND AMENDMENTS THERETO; D) RECOMMEND TO MMC THE APPROVAL OR DISAPPROVAL OF PROJECTS OR EXPENDITURES WHICH ARE NOT IN THE BUDGET OR WHICH ARE VARIANCES THERETO INCLUDING RECOMMENDATION OF A DOLLAR THRESHOLD BELOW WHICH THE CORPORATION WILL NOT NEED TO OBTAIN APPROVAL FROM MMC; E) RECOMMEND TO MMC THE APPROVAL OR DISAPPROVAL OF ALL LONG RANGE PLANS OF THE CORPORATION; F) RECOMMEND TO MMC THE APPROVAL OR DISAPPROVAL OF ALL AFFILIATIONS, MERGERS, AND OTHER TRANSACTIONS BY THE CORPORATION NOT IN THE ORDINARY COURSE OF BUSINESS; G) RECOMMEND TO MMC THE APPROVAL OR DISAPPROVAL OF ALL AMENDMENTS TO THE CORPORATION'S ARTICLES OF INCORPORATION AND BYLAWS; H) RECOMMEND TO MMC THE APPROVAL OR DISAPPROVAL OF ALL FINANCINGS OR INDEBTEDNESS BY THE CORPORATION FOR WHICH THE OBLIGATION TO REPAY EXCEEDS (I) A TERM OF TWELVE MONTHS OR (II) AN AGGREGATE DOLLAR THRESHOLD SET BY THE BOARD OF DIRECTORS OF MMC FROM TIME TO TIME, AND; I) EXERCISE SUCH OTHER POWERS OR PERFORM SUCH OTHER TASKS AS ARE RESERVED TO OR REQUIRED OF TAHC.
FORM 990, PART VI, SECTION B, LINE 11B990 REVIEW PROCEDURES: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE RETURN IS COMPLETED IN DRAFT FORM AND REVIEWED BY MANAGEMENT OF THE ORGANIZATION. THE COMPLETED 990 IS MADE AVAILABLE TO BOARD MEMBERS FOR REVIEW AND QUESTIONS PRIOR TO SUBMISSION.
FORM 990, PART VI, SECTION B, LINE 12CPROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: TITUSVILLE AREA HOSPITAL ANNUALLY REQUIRES ITS BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES TO FILL OUT A CONFLICTS OF INTEREST FORM DURING BOARD MEETINGS. ANY CONFLICT OF INTEREST IS REVIEWED BY THE BOARD OF DIRECTORS. IF AN INTERESTED PARTY HAS A CONFLICT, HE OR SHE RECUSES THEMSELVES FROM VOTING.
FORM 990, PART VI, SECTION B, LINE 15A & BREVIEW OF CEO AND OTHER OFFICER COMPENSATION: AN INDEPENDENT CONSULTING FIRM, MERCER, PERFORMED THE MOST RECENT COMPENSATION REVIEW IN JUNE 2020. THEY COMPILED THE SALARY ADMINISTRATION AND PERFORMANCE MANAGEMENT GUIDELINES WHICH THE HOSPITAL UTILIZES ANY TIME A NEW POSITION IS CREATED OR AN EXISTING POSITION'S DESCRIPTION CHANGES. A JOB FACTOR WORKSHEET IS COMPLETED WHICH EVALUATES 6 AREAS BASED ON A POINT SYSTEM. THE SIX AREAS ARE LISTED BELOW: 1.) EDUCATION 2.) EXPERIENCE 3.) CONTACTS 4.) GUIDELINES 5.) BUDGET ACCOUNTABILITY 6.) SUPERVISORY/ACCOUNTABILITY THE TOTAL POINTS ARE USED TO ARRIVE AT A PAY GRADE ON THE SALARY ADMINISTRATION POLICY MANAGEMENT PAY SCALE. THE MANAGEMENT PAY SCALE IS REVIEWED ANNUALLY, AND UPDATED IF NECESSARY, BASED ON THE HOSPITAL COUNCIL OF WESTERN PENNSYLVANIA SURVEYS, WHICH PROVIDES COMPARABLE DATA OF OTHER HOSPITALS IN THE AREA. THE DELIBERATIONS AND DECISIONS OF THE COMPENSATION COMMITTEE ARE DOCUMENTED IN THE COMMITTEE MINUTES.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS: TITUSVILLE AREA HOSPITAL MAKES ITS FORM 990 AND FORM 1023 AVAILABLE TO THE PUBLIC UPON REQUEST. AT THIS TIME, TITUSVILLE AREA HOSPITAL DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC.
FORM 990, SECTION XI, LINE 9OTHER CHANGES IN NET ASSETS: $ (70,399) CHANGE IN BENEFICIAL INTEREST 969,930 TRANSFER FROM SUBSIDIARIES --------- $ 899,531
FORM 990 PART IX LINE 11GDESCRIPTION:PURCHASED SERVICES - MEDICAL TOTAL FEES:5190644
FORM 990 PART IX LINE 11GDESCRIPTION:PURCHASED SERVICES - NON MED TOTAL FEES:1509183
FORM 990 PART IX LINE 11GDESCRIPTION:PHYSICIAN FEES TOTAL FEES:780741
FORM 990 PART IX LINE 11GDESCRIPTION:ASSOCIATED CLINICAL LABS TOTAL FEES:175819
FORM 990 PART IX LINE 11GDESCRIPTION:LAB - OTHER TOTAL FEES:62405
FORM 990 PART IX LINE 11GDESCRIPTION:COLLECTION SERVICES TOTAL FEES:17556

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (11 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
TITUSVILLE AREA HEALTH CENTER INC
406 WEST OAK STREETTITUSVILLEPA16354251517855HOLDING COPA501(C)(3)7MMCfalse
TITUSVILLE HEALTH SERVICES INC
406 WEST OAK STREETTITUSVILLEPA16354251517865COMM HLT CLNCPA501(C)(3)3TAHCfalse
TITUSVILLE AREA HEALTH CENTER FOUNDATION
406 WEST OAK STREETTITUSVILLEPA16354251517854SUPPORTPA501(C)(3)12 A ITAHCfalse
MEADVILLE MEDICAL CENTER
1034 GROVE STREETMEADVILLEPA16335251512436HOSPITALPA501(C)(3)3NAfalse
MEADVILLE MEDICAL CENTER FOUNDATION
1034 GROVE STREETMEADVILLEPA16335251681342SUPPORTPA501(C)(3)7MMCfalse
HOSPICE OF CRAWFORD COUNTY INC
1034 GROVE STREETMEADVILLEPA16335251480565HOSPICEPA501(C)(3)7MMCfalse
CONNEAUT VALLEY HEALTH CENTER
1034 GROVE STREETMEADVILLEPA16335251490887HEALTH CENTERPA501(C)(3)3MMCfalse
MEADVILLE PHYSICIANS SERVICES
751 LIBERTY STREETMEADVILLEPA16335251602133PHYS. OFFICESPA501(C)(3)10MMCfalse
COMMUNITY HEALTH SERVICES INC
1034 GROVE STREETMEADVILLEPA16335251490886PHYS. OFFICESPA501(C)(3)10MMCfalse
MEADVILLE MEDICAL CENTER AUXILIARY
751 LIBERTY STREETMEADVILLEPA16335251512834SUPPORTPA501(C)(3)12A IMMCfalse
FRENCH CREEK INTERNAL MEDICINE
751 LIBERTY STREETMEADVILLEPA16335471870077PHYS. OFFICESPA501(C)(3)10MPSfalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)

Primary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationIndAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEIN
PERPETUAL TRUST
TRUSTPATAHTRUST$2,736$70,2281.00000Yes (true)
PERPETUAL TRUST
TRUSTPATAHTRUST$10,855$278,6281.00000Yes (true)
PERPETUAL TRUST
TRUSTPATAHTRUST$1,124$28,8441.00000Yes (true)
HOME CARE CONNECTIONS INC
HOLDING COMPANYPAMMCC CORPfalse751 LIBERTY STREETMEADVILLEPA16335251605314
MEADVILLE HOUSING CORPORATION
HOUSINGPAMMCC CORPfalse934 B STREETMEADVILLEPA16335250657800
CHARITABLE TRUST
TRUSTPAMMCTRUSTfalse256196092
CHARITABLE TRUST
TRUSTPAMMCTRUSTfalse066031521
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd