2017-03-09T16:12:38-06:00 2016-06-30 550486667 ARNETT CARBIS TOOTHMAN LLP 5700 CORPORATE DRIVE STE 650 PITTSBURGH PA 15237 990 2015-07-01 232801799 1889 - CHS FOUNDATION INC FKA CONEMAUGH HEALTH SYSTEM INC 1889 8145320100 4 VALLEY PIKE JOHNSTOWN PA 15905 SUSAN MANN PRESIDENT 8145320100 2017-03-01 1 JEFFREY J PETRELL CPA P00138808 4126356270 2017-03-01 2015 2021-01-29 14:40:06Z SUSAN MANN 4 VALLEY PIKE JOHNSTOWN PA 15905 6025548 0 X N/A X 1994 PA TO SUPPORT INNOVATIVE PROGRAMS AND INITIATIVES THAT IMRPOVE AND TRANSFORM THE OVERALL HEALTH OF OUR REGION. 16 16 0 16 0 0 0 0 2374764 1747675 -3178101 1308796 1120708 2273380 317371 5329851 500000 0 0 0 1287142 0 0 0 0 6780373 11033164 8567515 11033164 -8250144 -5703313 153375496 149861604 32710700 35701660 120664796 114159944 TO SUPPORT INNOVATIVE PROGRAMS AND INITIATIVES THAT IMPROVE AND TRANSFORM THE OVERALL HEALTH AND WELLNESS OF OUR REGION. 0 0 9463324 4021055 TO SUPPORT THE MISSION OF THE 1889 FOUNDATION, INC. WHICH IS TO SUPPORT INNOVATIVE PROGRAMS AND INITIATIVES THAT IMPROVE AND TRANSFORM THE OVERALL HEALTH AND WELLNESS OF OUR REGION. 9463324 1 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 8 0 0 0 0 0 0 0 0 0 0 0 0 X 16 16 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X WENDY REITNAUER 8145320100 4 VALLEY PIKE JOHNSTOWN PA 15905 JAMES HARGREAVES CHAIRMAN 0.50 0.50 X X 0 0 0 JAMES CASCIO VICE CHAIRMAN 0.50 0.50 X X 0 0 0 KIM CRAIG TREASURER 0.50 0.50 X X 0 0 0 AMANDA ARTIM SECRETARY 0.50 0.50 X X 0 0 0 NANCY ABRAHAMS TRUSTEE 0.50 0.50 X 0 0 0 MICHAEL BARLETTA TRUSTEE 0.50 0.50 X 0 0 0 KRISTIN BRANT MD TRUSTEE 0.50 0.50 X 0 0 0 BRUCE DUKE III MD TRUSTEE 0.50 0.50 X 0 0 0 NATHAN KAUFMAN TRUSTEE 0.50 0.50 X 0 0 0 BRIAN LIEB DO TRUSTEE 0.50 0.50 X 0 0 0 FRANK QUITONI TRUSTEE 0.50 0.50 X 0 0 0 DONALD RATCHFORD MD TRUSTEE 0.50 0.50 X 0 0 0 MICHAEL SMITH TRUSTEE 0.50 0.50 X 0 0 0 ROWLAND H TIBBOTT JR TRUSTEE 0.50 0.50 X 0 0 0 RONALD VICKROY TRUSTEE 0.50 0.50 X 0 0 0 SCOTT BECKER TRUSTEE 0.50 0.50 X 0 0 0 WENDY REITNAUER DIRECTOR OF FINANCE 20.00 20.00 X 0 92623 3780 SUSAN MANN PRESIDENT/CEO 16.00 24.00 X 0 167460 6094 0 260083 9874 0 0 1 0 BKD LLP P O BOX 1178 LOUISVILLE KY 40201 ACCOUNTING SERVICES 110575 1 NET PATIENT SERVICE REVENUE LEGAC 900099 1747675 1747675 1747675 2004493 2004493 695697 -695697 -695697 -695697 OTHER INCOME 900099 2241428 2241428 FUNDED DEPRECIATION REVENUE 900099 31952 31952 2273380 5329851 4021055 0 1308796 500041 500041 32153 32153 35371 35371 320227 272193 48034 8638 7342 1296 DEFINED BENEFIT PENSION 10115164 8597889 1517275 MISCELLANEOUS EXPENSE 18764 15950 2814 MAINTENANCE 1631 1386 245 PURCHASED SERVICES 1175 999 176 11033164 9463324 1569840 0 15269844 6807380 4141 13699777 7623498 154630 97794 102606 56836 90081217 105933492 34217911 29440398 153375496 149861604 860469 136452 31850231 35565208 32710700 35701660 X 120664796 114159944 120664796 114159944 153375496 149861604 X -5703313 -5637075 4835536 X X 0 1 X 1 0 X X 1 1889 FOUNDATION INC 251719695 7 1 2520000 0 1 2520000 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 154630 97794 56836 56836 SECURITIES AND INVESTMENTS 105933492 C 105933492 INVESTMENT IN RRG 494750 1086 FRANKLIN - MMC, INC. MALPRACTICE RECOVERABLE 3420514 LIFEPOINT WARRANTS 6841605 PENSION ESCROW FUNDS 13347760 DEFERRED COMP - CSV 1086 FRANKLIN - MMC, INC. 1323518 RRG DEDUCTIBLE FUND 1086 FRANKLIN - MMC, INC. 1993085 INVESTMENT IN UPMC JV CANCER CENTER 1207799 INVESTMENT IN CANCER CENTER JV 811367 29440398 DUE TO 1889 FOUNDATION 64250 DEFERRED COMPENSATION 1323518 ASSET RETIREMENT OBLIGATION 354121 ACCRUED PENSION/RETIREMENT BENEFITS 13993240 ACCRUED MALPRACTICE INSURANCE LIABILITY 11030079 SELF REPORTING LIABILITY 8800000 35565208 1 X X X X 0 0 0 0 0 0 0 0 0 SUSAN MANN PRESIDENT/CEO 0 142460 0 25000 0 0 0 4874 0 1220 0 173554 0 0 FORM 990, PART VI, SECTION A, LINE 6 1889 FOUNDATION, INC. IS THE SOLE MEMBER OF 1889 - CHS FOUNDATION, INC. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER OF 1889 -CHS FOUNDATION, INC., 1889 FOUNDATION, INC., HAS THE POWER TO APPROVE OR DISAPPROVE THE ELECTION OF OR REMOVAL OF MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B ALL DECISIONS OF THE GOVERNING BODY OF 1889 - CHS FOUNDATION, INC. ARE SUBJECT TO APPROVAL BY ITS SOLE MEMBER, 1889 FOUNDATION, INC. THE FOLLOWING POWERS SHALL BE RESERVED EXCLUSIVELY TO THE SOLE MEMBER: (A) TO APPROVE OR DISAPPROVE ANY AMENDMENTS TO THE SUBSIDIARY CORPORATION'S ARTICLES OF INCORPORATION AND BYLAWS BEFORE THEY BECOME EFFECTIVE; (B) THE POWER TO DIRECT THE AMENDMENT OF THE SUBSIDIARY CORPORATION'S BYLAWS AND/OR ARTICLES OF INCORPORATION, PROVIDED SUCH ACTION IS APPROVED BY AT LEAST TWO-THIRDS (2/3) OF THE SITTING DIRECTORS OF THE CORPORATION AFTER AT LEAST FIFTEEN (15) DAYS PRIOR WRITTEN NOTICE TO THE MEMBER, SETTING FORTH THE TIME, DATE AND PLACE OF THE MEETING, THAT SUCH ACTION WILL BE CONSIDERED AT THE NEXT MEETING OF THE CORPORATION'S BOARD. (C) TO APPROVE OR DISAPPROVE THE ELECTION OR REMOVAL OF MEMBERS OF THE BOARD OF DIRECTORS OF THE CORPORATION AND THE BOARD OF DIRECTORS OF ANY SUBSIDIARY; (D) TO APPROVE OR DISAPPROVE ALL OPERATING AND CAPITAL BUDGETS; (E) TO APPROVE OR DISAPPROVE THE ADOPTION OF OR THE AMENDMENT OF ANY SUBSIDIARY CORPORATION'S MISSION STATEMENT; (F) TO APPROVE OR DISAPPROVE DEBT OF THE SUBSIDIARY CORPORATION NOT ALREADY IN AN APPROVED BUDGET; (G) TO APPROVE THE PURCHASE, SALE, LEASE, OR MORTGAGE OF REAL PROPERTY BY THE SUBSIDIARY CORPORATION; (H) TO APPROVE THE DISTRIBUTION, DISBURSEMENT, LOAN, OR DONATION OF FUNDS OR ASSETS OF THE SUBSIDIARY CORPORATION; (I) TO APPROVE OR DISAPPROVE THE SUBSIDIARY CORPORATION'S STRATEGIC PLANNING PROCESS AND PLAN, AS WELL AS AMENDMENTS THERETO, INCLUDING BUT NOT LIMITED TO THE SUBSIDIARY CORPORATION'S PROGRAMMING DECISIONS; (J) TO APPROVE OR DISAPPROVE ANY MERGER, CONSOLIDATION, DIVISION, LIQUIDATION, DISSOLUTION OR WINDING UP, OR SALE OF ALL OR SUBSTANTIALLY ALL THE ASSETS OF THE SUBSIDIARY CORPORATION; AND (K) TO APPROVE GIFTS AND GRANTS OVER $5,000 PER YEAR. FORM 990, PART VI, SECTION B, LINE 11 1889 - CHS FOUNDATION, INC. HAS A CPA FIRM PREPARE ITS FORM 990. THE RETURN IS COMPLETED IN DRAFT FORM AND REVIEWED BY MANANGEMENT OF THE ORGANIZATION. THE FORM 990 IS THEN PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C 1889 - CHS FOUNDATION, INC. ANNUALLY REQUIRES ITS BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES TO FILL OUT A CONFLICT OF INTEREST FORM. DURING BOARD MEETINGS, IF AN INTERESTED PARTY HAS A CONFLICT, HE OR SHE RECUSES THEMSELVES FROM VOTING. FORM 990, PART VI, SECTION B, LINE 15 1889 - CHS FOUNDATION, INC.'S BOARD OF DIRECTORS ANNUALLY REVIEWS AND APPROVES THE COMPENSATION OF THEIR ORGANIZATION'S TOP MANAGEMENT. FORM 990, PART VI, SECTION C, LINE 18 1889 - CHS FOUNDATION, INC. MAKES ITS FORM 990 AND FORM 1023 AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 AT THIS TIME, 1889 - CHS FOUNDATION, INC. DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC. FORM 990, PART XI, LINE 9: TRANSFERS TO AFFILIATES -2,520,000. CHANGE IN ADDITIONAL PENSION LIABILIITY 7,355,536. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS A FINANCE COMMITTEE THAT IS RESPONSIBLE FOR OVERSEEING THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEAR. 1086 FRANKLIN - MMC INC 4 VALLEY PIKE JOHNSTOWN PA 15905 250965307 HEALTHCARE SERVICES PA 501C(3) 3 1889 - CHS FOUNDATION INC 1 290 HAIDA- MIMC INC 4 VALLEY PIKE JOHNSTOWN PA 15905 250977902 HEALTHCARE SERVICES PA 501C(3) 3 1889 - CHS FOUNDATION INC 1 200 HOSPITAL - MYMC INC 4 VALLEY PIKE JOHNSTOWN PA 15905 251002946 HEALTHCARE SERVICES PA 501C(3) 3 1889 - CHS FOUNDATION INC 1 1889 FOUNDATION INC 4 VALLEY PIKE JOHNSTOWN PA 15905 251719695 TO SUPPORT THE HEALTHCARE NEEDS OF THE COMMUNITY PA 501C(3) 7 N/A 0 UPMC-CONEMAUGH CANCER CENTER 600 GRANT STREET PITTSBURGH PA 15219 202671883 HEALTHCARE SERVICES PA 501C(3) 3 1086 FRANKLIN - MMC INC 0 GREATER JOHNSTOWN TECH PARK 4 VALLEY PIKE JOHNSTOWN PA 15905 260389121 OPERATES MULTI-TENANT COMMERCE OFFICE PARK PA N/A 1086 FRANKLIN - CPG INC 4 VALLEY PIKE JOHNSTOWN PA 15905 251658283 PHYSICIAN SERVICES PA 1889 - CHS FOUNDATION INC C 1.00000 1 1086 FRANKLIN - CEI INC 4 VALLEY PIKE JOHNSTOWN PA 15905 202998473 ECONOMIC DEVELOPMENT PA N/A C 0 1086 REAL ESTATE 4 VALLEY PIKE JOHNSTOWN PA 15905 251489704 REAL ESTATE PA N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0