FURP.ORG / PUBLIC DATA EXPLORER

WILLIAMSPORT HOME: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
WILLIAMSPORT HOME (EIN 24-0795507)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-11-08
IRS object ID
201833129349302368
Schema version
2017v2.3
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)
Return2018-11-08T13:17:42-06:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390859910PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BAKER TILLY VIRCHOW KRAUSE LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11650 MARKET STREET SUITE 4500AddressLine1Txt
CityPHILADELPHIACityNm
State AbbreviationPAStateAbbreviationCd
ZIP191037341ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN240795507EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE WILLIAMSPORT HOMEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlWILLBusinessNameControlTxt
Phone5703238781PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11900 RAVINE ROADAddressLine1Txt
CityWILLIAMSPORTCityNm
State AbbreviationPAStateAbbreviationCd
ZIP17701ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDONALD S POTEPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone5703238781PhoneNum
Signature2018-10-26SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJULIUS C GREEN CPAPreparerPersonNm
PTINP00350393PTIN
Phone2159720701PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address96.89.178.154IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-10-26IPDt
IP Tm10:06:14IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device Id9D0D8DD59390B7764A3ECE0F40BBFE3618018605AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2018-06-14 16:35:46ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDONALD S POTEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11900 RAVINE ROADAddressLine1Txt
CityWILLIAMSPORTCityNm
State AbbreviationPAStateAbbreviationCd
ZIP17701ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$17,814,699GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressTHEWILLIAMSPORTHOME.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1873FormationYr
Legal Domicile StatePALegalDomicileStateCd
Activity Or MissionPROVIDE NURSING SERVICES IN A 129 BED SKILLED NURSING FACILITY AND HOUSING FOR THE ELDERLY.ActivityOrMissionDesc
Voting Members Governing Body16VotingMembersGoverningBodyCnt
Voting Members Independent16VotingMembersIndependentCnt
Total Employee312TotalEmployeeCnt
Total Volunteers90TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$216,960PYContributionsGrantsAmt
CY Contributions Grants$126,428CYContributionsGrantsAmt
PY Program Service Revenue$16,208,845PYProgramServiceRevenueAmt
CY Program Service Revenue$16,598,908CYProgramServiceRevenueAmt
PY Investment Income$589,897PYInvestmentIncomeAmt
CY Investment Income$259,866CYInvestmentIncomeAmt
PY Other Revenue$610,357PYOtherRevenueAmt
CY Other Revenue$612,684CYOtherRevenueAmt
PY Total Revenue$17,626,059PYTotalRevenueAmt
CY Total Revenue$17,597,886CYTotalRevenueAmt
PY Grants And Similar Paid$2,183PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$2,636CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$8,748,981PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$9,105,542CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$7,914,939PYOtherExpensesAmt
CY Other Expenses$8,120,737CYOtherExpensesAmt
PY Total Expenses$16,666,103PYTotalExpensesAmt
CY Total Expenses$17,228,915CYTotalExpensesAmt
PY Revenues Less Expenses$959,956PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$368,971CYRevenuesLessExpensesAmt
Total Assets BOY$19,749,171TotalAssetsBOYAmt
Total Assets EOY$20,235,494TotalAssetsEOYAmt
Total Liabilities BOY$4,890,382TotalLiabilitiesBOYAmt
Total Liabilities EOY$4,647,564TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$14,858,789NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$15,587,930NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE WILLIAMSPORT HOME HAS AS ITS MISSION TO PROVIDE ITS RESIDENTS WITH THE HIGHEST QUALITY OF CARE HONORING THEIR INDEPENDENCE AND DIGNITY. CONTINUED ON SCHEDULE "O".WE WILL REMAIN THE CAMPUS OF CHOICE IN OUR COMMUNITY COMPRISED OF DEDICATED STAFF WHO STRIVE TO PROVIDE QUALITY, COMPASSIONATE CARE, AND SERVICES TO OUR RESIDENTS. THE WILLIAMSPORT HOME VALUES ITS TRADITION OF CARING. OUR HIGHLY TRAINED STAFF ARE EMPOWERED TO SERVE RESIDENTS AND FAMILIES WITH PROFESSIONAL SERVICES, DELIVERED ON A CONTINUUM OF CARE CAMPUS WHILE MAINTAINING RESIDENT AND FAMILY SATISFACTION.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$15,550,699ExpenseAmt
Grant$2,636GrantAmt
Revenue$17,110,361RevenueAmt
DescPROVIDED 45,989 DAYS OF NURSING SERVICES TO RESIDENTS; 64,503 DAYS OF HOUSING TO RESIDENTS IN INDEPENDENT APARTMENTS; AND 11,260 DAYS IN OUR DHS LICENSED PERSONAL CARE PROGRAMS. APPROXIMATELY 53.4% OF OUR RESIDENTS ARE LOW INCOME RESIDENTS AND ARE PROVIDED SERVICES AT A REDUCED REIMBURSEMENT RATE THROUGH MEDICAID. OUR PROGRAMS ARE DESIGNED TO HELP MAINTAIN OUR RESIDENT'S HEALTH, SECURITY AND INDEPENDENCE. THE WILLIAMSPORT HOME ("TWH") PROVIDED BENEVOLENT CARE FOR ONE (1) APARTMENT RESIDENTS AND THREE (3) INDEPENDENT LIVING RESIDENTS IN OUR DHS LICENSED PERSONAL CARE PROGRAMS TOTALING APPROXIMATELY $64,189. CONTINUED ON SCHEDULE "O"RESIDENTS RECEIVED 24,552 MEDICAL ASSISTANCE DAYS OF SERVICE IN THE SKILLED NURSING AND REHABILITATION CENTER DURING 2017.VOLUNTEERING:75 INDIVIDUALS VOLUNTEERED MORE THAN 6,000 HOURS OF SERVICE TO THE WILLIAMSPORT HOME DURING 2017.TWH SKILLIED NURSING CENTER PROVIDED VOLUNTEER OPPORTUNITIES TO GROUPS FROM UNITED CHURCHES, 4H, THERAPY DOGS, SPCA, MEMBERS OF THE KIWANIS CIRCLE K AND KEY CLUBS, WHO PROVIDED 120.50 HOURS OF MUSICAL ENTERTAINMENT AND PROGRAMMING SUPPORT TO SKILLED NURSING RESIDENTS.18 JUNIOR AND ADULT VOLUNTEERS PROVIDED 2519.50 HOURS TO RESIDENTS IN THE SKILLED NURSING CENTER BY ASSISTING WITH DELIVER OF RESIDENT MAIL, NEWPAPERS, READING OR WRITING LETTERS, READING BOOKS, SPENDING 1 ON 1 TIME WITH RESIDENT AND TRANSFERRING RESIDENTS WHO ARE IN WHEELCHAIRS TO THE LOBBY, HOBBY ROOM AND BEAUTY SHOP.42 APARTMENT RESIDENTS VOLUNTEERED 2994 HOURS TO ASSIST WITH SETTING AND CLEARING THE APARTMENT DINING ROOM TABLES EACH DAY AND ASSIST IN OPERATING THE APARTMENT STORES IN EACH APARTMENT BUILDING.DURING 2017, TWH SERVED AS S HOST SITE FOR TWO EXPERIENCE WORKS WORKERS. THE EXPERIENCE WORKS PROGRAM IS DESIGNED TO GIVE INCOME QUALIFIED INDIVIDUALS OVER THE AGE OF 60 AN OPPORTUNITY TO BE PLACED IN A WORK SETTING FOR UP TO 20 HOURS A WEEK OF ON THE JOB TRAINING THAT MAY LEAD TO FULL TIME EMPLOYEMENT. DURING 2017 WE PROVIDED 1608 HOURS AS A HOST SITE.THE WILLIAMSPORT HOME WAS GOVERNED BY A 15 MEMBER ALL VOLUNTEER BOARD DURING 2017 WHO PROVIDED 494.75 HOURS OF SERVICE TO THE WILLIAMSPORT HOME ATTENDING, BOARD MEETINGS, BOARD SUBCOMMITTEE MEETINGS, SPECIAL EVENTS FOR CAMPUS RESIDENTS, FAMILIES, DONORS AND FORMER BOARD MEMBERS.COMMUNITY SUPPORT:THE WILLIAMSPORT HOME SERVED AS A HOST SITE FOR ONE INTERN FROMLOCK HAVEN UNIVERSITY, TOTALING 300 HOURS.IN ADDITION, THE WILLIAMSPORT HOME SERVED AS A CLINICAL SITE FOR 12 LPNS FROM PENN COLLEGE OF TECHNOLOGY PROVIDING ON SITE CLINICAL EXPERINCE OF 30 HOURS PER STUDENT.TWH DONATED SPACE DURING 2017 TO SPONSOR A MONTHLY ALZHEIMER'S SUPPORT GROUP MEETING FACILITATED BY BOB MEACHAM,CONSULTANT PHYCHOLOGIST TO HELP FAMILY MEMBERS COPE WITH UNDERSTANDING AND CARING FOR PERSONS WITH DEMENTIA RELATED DIAGNOSIS.DURING 2017 THE WILLIAMSPORT HOME HELD SEVERAL BASKET RAFFLES TO BENEFIT NON-PROFIT ORGANIZATIONS SUCH AS THE SPCA, SALVATION ARMY AND ALZHEIMER'S ASSOICATION.Desc
Total Program Service Expenses$15,550,699TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document15IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee312EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members16GoverningBodyVotingMembersCnt
Independent Voting Member16IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldPAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonKENNETH ANGSTADT DIRECTOR OF FINANPersonNm
Phone5703238781PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11900 RAVINE ROADAddressLine1Txt
CityWILLIAMSPORTCityNm
State AbbreviationPAStateAbbreviationCd
ZIP17701ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
LAURIE BURKHOLDER
PRESIDENT1.00Yes (X)Yes (X)$0$0$0
MAUREEN CAREY
VICE-PRESIDENT1.00Yes (X)Yes (X)$0$0$0
KATHRYN NASSBERG
TREASURER1.00Yes (X)Yes (X)$0$0$0
BRETTE CONFAIR
SECRETARY1.00Yes (X)Yes (X)$0$0$0
SHARON ATHERHOLT
DIRECTOR1.00Yes (X)$0$0$0
VERA ANDERSON
DIRECTOR1.00Yes (X)$0$0$0
CANDY DEWAR
DIRECTOR1.00Yes (X)$0$0$0
WINNIE KREMSER
DIRECTOR1.00Yes (X)$0$0$0
DAWN LINN
DIRECTOR1.00Yes (X)$0$0$0
JUDY SARETT
DIRECTOR1.00Yes (X)$0$0$0
TRICIA SHIPMAN
DIRECTOR1.00Yes (X)$0$0$0
BETH STUBLER
DIRECTOR1.00Yes (X)$0$0$0
LAURIE BARCLAY
DIRECTOR1.00Yes (X)$0$0$0
HALLE NIKLAUS
DIRECTOR1.00Yes (X)$0$0$0
TERRY KREZMER
DIRECTOR1.00Yes (X)$0$0$0
CATHY PICCOLO
DIRECTOR1.00Yes (X)$0$0$0
DONALD S POTE
EXECUTIVE DIRECTOR40.00Yes (X)$0$0$0
JENNIFER CISNEROS
ASST. EXECUTIVE DIRECTOR40.00Yes (X)$0$0$0
TAMMY COLEMAN
DIRECTOR OF NURSING40.00Yes (X)$0$0$0
KENNETH ANGSTADT
DIRECTOR OF FINANCE40.00Yes (X)$69,864$0$2,256
SUSAN R HOOKER
REGISTERED NURSE67.80$158,515$0$22,788Yes (X)
SUSAN GETZ
REGISTERED NURSE65.30$158,437$0$24,819Yes (X)
CONNIE S FULLER
REGISTERED NURSE44.30$100,770$0$29,813Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$487,586TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$79,676TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K3IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
FUNCTIONAL PATHWAYS OF TENNESSEE
PO BOX 102426ATLANTAGA303682426THERAPY SERVICES$1,262,194
SODEXHO INC & AFFILIATES
4880 PAYSHERE CIRCLECHICAGOIL60674FOOD SERVICE DIETARY$888,041
AFFINITY HEALTH SERVICES INC
942 PHILADELPHIA STINDIANAPA15701MANAGEMENT SERVICES$739,968
DIXON AC & R
3983 WEST FOURTH STWILLIAMSPORTPA17701CONTRACTOR$238,965
TURNKEY CONSTRUCTION INC
2440 LYCOMING CREEK RDWILLIAMSPORTPA17701CONTRACTOR$172,638
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K7CntrctRcvdGreaterThan100KCnt
All Other Contributions$126,428AllOtherContributionsAmt
Total Contributions$126,428TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENUE623000$12,964,588$12,964,588
APARTMENT REVENUE623000$3,634,320$3,634,320
FieldValueIRS element (for citing)
Total Program Service Revenue$16,598,908TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$155,135TotalRevenueColumnAmt
Exclusion$155,135ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$321,544SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$216,813SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$104,731SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$104,731TotalRevenueColumnAmt
Exclusion$104,731ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
PA NURSING HOME ASSESSMENT900099$511,453$511,453
CABLE TV SERVICES FOR RESIDENTS517000$51,870$51,870
BEAUTY/BARBER SHOP REVENUE812900$33,230$33,230

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$16,131TotalRevenueColumnAmt
Exclusion$16,131ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$612,684OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$17,597,886TotalRevenueColumnAmt
Related Or Exempt Func Income$17,110,361RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$361,097ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$2,636TotalAmt
Program Services$2,636ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$72,121TotalAmt
Program Services$68,333ProgramServicesAmt
Management And General$3,788ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$7,234,232TotalAmt
Program Services$6,854,269ProgramServicesAmt
Management And General$379,963ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$39,794TotalAmt
Program Services$36,901ProgramServicesAmt
Management And General$2,893ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,200,562TotalAmt
Program Services$1,141,644ProgramServicesAmt
Management And General$58,918ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$558,833TotalAmt
Program Services$528,995ProgramServicesAmt
Management And General$29,838ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$400,970TotalAmt
Program Services$27,922ProgramServicesAmt
Management And General$373,048ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$4,471TotalAmt
Management And General$4,471ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$46,804TotalAmt
Program Services$851ProgramServicesAmt
Management And General$45,953ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,277,177TotalAmt
Program Services$1,998,649ProgramServicesAmt
Management And General$278,528ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$43,971TotalAmt
Program Services$43,837ProgramServicesAmt
Management And General$134ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,749,573TotalAmt
Program Services$1,582,897ProgramServicesAmt
Management And General$166,676ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$652,522TotalAmt
Program Services$652,522ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$76,112TotalAmt
Program Services$63,862ProgramServicesAmt
Management And General$12,250ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$101,305TotalAmt
Program Services$101,305ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,302,462TotalAmt
Program Services$1,302,462ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$359,619TotalAmt
Program Services$182,647ProgramServicesAmt
Management And General$176,972ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
NURSING HOME ASSESSMENT$276,810$276,810
REPAIRS & MAINTENANCE$264,182$193,707$70,475
MEDICAL SUPPLIES$160,357$160,357
BAD DEBT EXPENSE$87,502$87,502

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$316,900TotalAmt
Program Services$242,591ProgramServicesAmt
Management And General$74,309ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$17,228,915TotalAmt
Program Services$15,550,699ProgramServicesAmt
Management And General$1,678,216ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$500BOYAmt
EOY$500EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,096,753BOYAmt
EOY$1,143,785EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,968,895BOYAmt
EOY$1,998,807EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$39,469BOYAmt
EOY$35,840EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$107,366BOYAmt
EOY$152,648EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$31,973,670LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$20,548,718LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$11,224,475BOYAmt
EOY$11,424,952EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$5,035,996BOYAmt
EOY$5,184,553EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$37,907BOYAmt
EOY$35,720EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$237,810BOYAmt
EOY$258,689EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$19,749,171BOYAmt
EOY$20,235,494EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,458,732BOYAmt
EOY$1,379,275EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$4,653BOYAmt
EOY$34,382EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,426,997BOYAmt
EOY$3,233,907EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,890,382BOYAmt
EOY$4,647,564EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$14,684,286BOYAmt
EOY$15,413,427EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$99,951BOYAmt
EOY$99,951EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$74,552BOYAmt
EOY$74,552EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$14,858,789BOYAmt
EOY$15,587,930EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$19,749,171BOYAmt
EOY$20,235,494EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$368,971ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$360,170NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$86,782CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$198,970CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$272,754CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$216,960CurrentTaxYearMinus1YearAmt
Current Tax Year$126,428CurrentTaxYearAmt
Total$901,894TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$14,268,808CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$14,712,482CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$15,876,408CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$16,710,739CurrentTaxYearMinus1YearAmt
Current Tax Year$17,110,361CurrentTaxYearAmt
Total$78,678,798TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$14,355,590CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$14,911,452CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$16,149,162CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$16,927,699CurrentTaxYearMinus1YearAmt
Current Tax Year$17,236,789CurrentTaxYearAmt
Total$79,580,692TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$79,580,692PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$107,514CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$106,543CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$115,670CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$121,077CurrentTaxYearMinus1YearAmt
Current Tax Year$155,135CurrentTaxYearAmt
Total$605,939TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$107,514CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$106,543CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$115,670CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$121,077CurrentTaxYearMinus1YearAmt
Current Tax Year$155,135CurrentTaxYearAmt
Total$605,939TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$108,336CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$161,478CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$111,213CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$108,463CurrentTaxYearMinus1YearAmt
Current Tax Year$101,231CurrentTaxYearAmt
Total$590,721TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$14,571,440CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$15,179,473CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$16,376,045CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$17,157,239CurrentTaxYearMinus1YearAmt
Current Tax Year$17,493,155CurrentTaxYearAmt
Total$80,777,352TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.98520PublicSupportCY509Pct
Public Support PY5090.98520PublicSupportPY509Pct
Investment Income CY0.00750InvestmentIncomeCYPct
Investment Income PY0.00710InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:FormAndLineReferenceDesc
ExplanationOTHER INCOME - 2013 AMOUNT: $ 108,336. 2014 AMOUNT: $ 161,478. 2015 AMOUNT: $ 111,213. 2016 AMOUNT: $ 108,463. 2017 AMOUNT: $ 101,231.ExplanationTxt

Schedule B IRS990ScheduleB

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$796,206OtherCostOrOtherBasisAmt
Book Value$796,206BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$23,570,878OtherCostOrOtherBasisAmt
Depreciation$14,882,551DepreciationAmt
Book Value$8,688,327BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,833,436OtherCostOrOtherBasisAmt
Depreciation$4,507,370DepreciationAmt
Book Value$1,326,066BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,773,150OtherCostOrOtherBasisAmt
Depreciation$1,158,797DepreciationAmt
Book Value$614,353BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$11,424,952TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt$17,958,056TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$360,170NetUnrealizedGainsInvstAmt
Revenue Not Reported$360,170RevenueNotReportedAmt
Revenue Subtotal$17,597,886RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$17,597,886TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$17,228,915TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$17,228,915ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$17,228,915TotalExpensesPerForm990Amt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 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
SUSAN R HOOKER
REGISTERED NURSE$158,515$0$0$0$0$0$2,275$0$20,513$0$181,303$0$0$0
SUSAN GETZ
REGISTERED NURSE$158,437$0$0$0$0$0$758$0$24,061$0$183,256$0$0$0

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1LYCOMING COUNTY AUTHORITY HEALTHCARE REVENUE NOTE SERIES A OF 2013BusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN236760375BondIssuerEIN
Bond Issued2013-04-12BondIssuedDt
Issue Price$4,400,000IssuePriceAmt
PurposeSEE PART VIPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$1,166,093RetiredAmt
Total Proceeds$4,400,000TotalProceedsAmt
Issuance Costs From Proceeds$43,739IssuanceCostsFromProceedsAmt
Capital Expenditures$4,356,261CapitalExpendituresAmt
Substantial Completion2015SubstantialCompletionYr
Current Refunding0CurrentRefundingInd
Advance Refunding0AdvanceRefundingInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropYes (1)MgmtContractBondFincdPropInd
Engage Bond Counsel ContractsYes (1)EngageBondCounselContractsInd
Any Research Agreements0AnyResearchAgreementsInd
Private Bus Use By Others0.00000PrivateBusUseByOthersPct
Private Bus Concerning UBI0.00000PrivateBusConcerningUBIPct
Total Private Business Use0.00000TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To RebateYes (1)ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE K, PART I, BOND ISSUES:FormAndLineReferenceDesc
Explanation(A) ISSUER NAME: LYCOMING COUNTY AUTHORITY HEALTHCARE REVENUE NOTE SERIES A OF 2013 (F) DESCRIPTION OF PURPOSE: DESIGN, CONSTRUCTION, AND EQUIPPING OF REHABILITATION UNITExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3THE HOME UTILIZES THE MANAGEMENT SERVICES OF AFFINITY HEALTHCARE SERVICES. AFFINITY EMPLOYS DONALD POTE, EXECUTIVE DIRECTOR ($106,963) AND JENNIFER CISNEROS, ASST. EXECUTIVE DIRECTOR ($102,711).
FORM 990, PART VI, SECTION B, LINE 11BTHE FINANCE COMMITEE OF THE WILLIAMSPORT HOME BOARD OF MANAGERS REVIEWED THE 990 IN DETAIL DURING A REGULARLY SCHEDULED FINANCE MEETING. THE 990 WAS ALSO REVIEWED AND OPENED FOR QUESTION/DISCUSSION AT THE GENERAL BOARD MEETING PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CON AN ANNUAL BASIS, THE BOARD OF DIRECTORS AND MEMBERS OF MANAGEMENT MUST COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE. ALL QUESTIONNAIRES ARE REVIEWED BY THE EXECUTIVE DIRECTOR AND MAINTAINED ON FILE. BOARD DIRECTORS WITH POTENTIAL CONFLICTS ARE REQUIRED TO ABSTAIN FROM VOTING ON MATTERS RELATED TO THE CONFLICT AND COULD BE REMOVED FROM THE BOARD IF THE CONFLICT IS SIGNIFICANT.
FORM 990, PART VI, SECTION B, LINE 15COMPENSATION FOR THE EXECUTIVE DIRECTOR AND ALL EMPLOYEES IS CALCULATED BY MANAGEMENT AND THE MANAGEMENT COMPANY, AFFINITY HEALTH SERVICES. MANAGEMENT AND AFFINITY USE DATA FROM LEADING AGE PA AND WAGE/SALARY SURVEYS FROM THE REGION TO COMPARE ORGANIZATIONAL WAGES TO LOCAL AND REGIONAL COMPETITION AS WELL AS OTHER LOCAL MARKETS. THE BOARD OF MANAGERS APPROVES ALL STAFF COMPENSATION (INCLUDING THE EXECUTIVE DIRECTOR AND MANAGEMENT) AT THE TIME THE OPRATING BUDGET IS APROVED. MANAGEMENT DESCRIBES IN DETAIL THE SALARY INCREASES FOR ALL STAFF DURING THE OPERATING BUDGET REVIEW WITH THE BOARD AND THE BOARD APPROVES THE BUDGET AND INCLUDED INCREASES. THE REVIEW AND APPROVAL IS DOCUMENTED VIA BOARD MINUTES.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST.
FORM 990, PART IX, LINE 11GTHERAPY AND ANCILLARY SERVICES: PROGRAM SERVICE EXPENSES 1,325,746. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,325,746. NURSING: PROGRAM SERVICE EXPENSES 351,501. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 351,501. OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 292,485. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 292,485. CONSULTANTS: PROGRAM SERVICE EXPENSES 28,817. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 28,817. TRUSTEE FEES: PROGRAM SERVICE EXPENSES 100. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 100. CONTRACTORS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 278,528. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 278,528.