CLARION HOSPITAL: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- CLARION HOSPITAL (EIN 25-1010039)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-04
- IRS object ID
- 201721249349301602
- Schema version
- 2015v3.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-04T13:30:56-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E ST LOUIS 200/PO BOX 1190 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 658062523 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 251010039 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLARION HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % VINCENT LAMORELLA | InCareOfNm |
| Business Name Control | CLAR | BusinessNameControlTxt |
| Phone | 8142261301 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE HOSPITAL DRIVE | AddressLine1Txt |
| City | CLARION | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16214 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | VINCENT LAMORELLA | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Signature | 2017-01-31 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Brian D Todd | PreparerPersonNm |
| PTIN | P00422601 | PTIN |
| Phone | 4178658701 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | VINCENT LAMORELLA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE HOSPITAL DRIVE | AddressLine1Txt |
| City | CLARION | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16214 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $55,794,978 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CLARIONHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1951 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | CLARION HOSPITAL IS THE COMMUNITY'S DYNAMIC RESOURCE FOR QUALITY HEALTHCARE, CONTINUOUS EDUCATION, AND THE PROMOTION OF WELLNESS. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 592 | TotalEmployeeCnt |
| Total Volunteers | 48 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $21,728 | PYContributionsGrantsAmt |
| CY Contributions Grants | $23,625 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $55,426,321 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $53,642,315 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,011,848 | PYInvestmentIncomeAmt |
| CY Investment Income | $269,697 | CYInvestmentIncomeAmt |
| PY Other Revenue | $477,043 | PYOtherRevenueAmt |
| CY Other Revenue | $471,707 | CYOtherRevenueAmt |
| PY Total Revenue | $56,936,940 | PYTotalRevenueAmt |
| CY Total Revenue | $54,407,344 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $24,330,499 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $24,678,000 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $29,945,478 | PYOtherExpensesAmt |
| CY Other Expenses | $29,329,194 | CYOtherExpensesAmt |
| PY Total Expenses | $54,275,977 | PYTotalExpensesAmt |
| CY Total Expenses | $54,007,194 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,660,963 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $400,150 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $35,825,666 | TotalAssetsBOYAmt |
| Total Assets EOY | $32,991,312 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $12,025,049 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $11,023,956 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $23,800,617 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $21,967,356 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | CLARION HOSPITAL IS THE COMMUNITY'S DYNAMIC RESOURCE FOR QUALITY HEALTHCARE, CONTINUOUS EDUCATION, AND THE PROMOTION OF WELLNESS. | MissionDesc |
| Significant New Program Srvc | Yes (true) | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $33,805,666 | ExpenseAmt |
| Revenue | $40,515,009 | RevenueAmt |
| Desc | CLARION HOSPITAL PROVIDED SERVICES TO 121,587 OUTPATIENTS AS WELL A 17,022 EMERGENCY ROOM VISITS. SERVICES INCLUDE, BUT ARE NOT LIMITED TO, RADIOLOGY SERVICES WHICH INCLUDE MRI, ULTRASOUND, CT, NUCLEAR MEDICINE AND X-RAY SERVICES, LABORATORY SERVICES, EKG AND PHYSICAL THERAPY SERVICES. THE ORGANIZATION ALSO OFFERS SAME-DAY SURGERY, GENETIC COUNSELING, DRUG AND ALCOHOL TESTING, AND OUTPATIENT PHYSICAL THERAPY AND REHABILITATION SERVICES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $8,972,258 | ExpenseAmt |
| Revenue | $10,747,438 | RevenueAmt |
| Desc | CLARION HOSPITAL PROVIDED SERVICES TO 1,710 INPATIENTS FOR MEDICAL AND SURGICAL SERVICES AS WELL AS INTENSIVE CARE SERVICES. CLARION HOSPITAL ALSO PROVIDED OBSTETRIC CARE FOR 117 NEW MOTHERS AND BABIES. THE ORGANIZATION ALSO OFFERS AN INPATIENT REHABILITATION CENTER WHERE PATIENTS WHO HAVE SUFFERED MAJOR INJURIES OR TRAUMA CAN HAVE 24-HOUR NURSING CARE, ALONGSIDE INTENSIVE PHYSICAL, OCCUPATIONAL, AND/OR SPEECH THERAPY. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,055,996 | ExpenseAmt |
| Revenue | $2,379,868 | RevenueAmt |
| Desc | CLARION HOSPITAL PROVIDED 74 EDUCATION AND SCREENING OPPORTUNITIES FOR THE COMMUNITY ATTENDED BY 6,865 MEMBERS OF THE COMMUNITY. CLASSES ARE AVAILABLE FOR EXPECTANT MOTHERS, PEOPLE WITH DIABETES, AND WORKERS LOOKING FOR SAFER ENVIRONMENTS AS WELL AS SENIOR SERVICES. THE ORGANIZATION ALSO OFFERS CPR AND EMT TRAINING COURSES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $43,833,920 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (true) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | Yes (true) | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 58 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 592 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (true) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | PA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | VINCENT LAMORELLA | PersonNm |
| Phone | 8142269500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE HOSPITAL DRIVE | AddressLine1Txt |
| City | CLARION | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16214 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| VICTOR EWY | ||||||||
| CHAIRPERSON | 3.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| FRED PORT | ||||||||
| VICE CHAIRPERSON | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | 1.0 | |
| ARTHUR DORTORT | ||||||||
| TREASURER | 2.0 | Yes (X) | Yes (X) | $0 | $70,931 | $792 | 17.0 | |
| DAVID BROOKER | ||||||||
| MED STAFF REP BEGINNING 09/15 | 1.0 | Yes (X) | $5,650 | $0 | $0 | |||
| THOMAS FREENOCK | ||||||||
| DIRECTOR | 1.0 | Yes (X) | $0 | $366,640 | $3,442 | 40.0 | ||
| ERIC FUNK | ||||||||
| SECRETARY BEGINNING 09/15 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JAMES CARROLL | ||||||||
| DIRECTOR | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| JANICE SEMEYN DO | ||||||||
| PRESIDENT MEDICAL STAFF | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| MINDY GATESMAN | ||||||||
| DIRECTOR | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| ALBERT BARRETT | ||||||||
| MEDICAL STAFF REP ENDING 09/15 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| BRUCE MCCLEARY | ||||||||
| SECRETARY ENDING 09/15 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | 1.0 | |
| JOSEPH GRUNENWALD | ||||||||
| DIRECTOR ENDING 09/15 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| VINCENT LAMORELLA | ||||||||
| CFO | 40.0 | Yes (X) | $0 | $0 | $0 | 5.0 | ||
| BYRON QUINTON | ||||||||
| CEO | 40.0 | Yes (X) | $0 | $0 | $0 | 2.0 | ||
| CHARLES BARTLEY | ||||||||
| CRNA | 40.0 | $136,616 | $0 | $14,879 | Yes (X) | |||
| CHRISTIE CONRAD | ||||||||
| PHARMACIST | 40.0 | $117,226 | $0 | $21,957 | Yes (X) | |||
| TOM MORGO | ||||||||
| CRNA | 40.0 | $165,882 | $0 | $26,852 | Yes (X) | |||
| WENDY STIVANSON | ||||||||
| CRNA | 40.0 | $165,702 | $0 | $26,843 | Yes (X) | |||
| WILL SIMPSON | ||||||||
| DIRECTOR OF PHARMACY | 40.0 | $137,463 | $0 | $25,431 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $728,539 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $437,571 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $120,196 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CLARION REHABILITATION SERVICES | |||||
| 118 SUMMER DRIVE | BLUFFTON | SC | 16346 | PHYSICAL THERAPY | $2,166,718 |
| DJD ANESTHESIA ASSOCIATES | |||||
| 216 SYCAMORE DR | SHIPPENVILLE | PA | 16544 | PHYSICIAN | $449,815 |
| SENECA PATHOLOGY ASSOC | |||||
| PO BOX 310 | SENECA | PA | 16346 | PHYSICIAN | $242,068 |
| VANTAGE MOBILE SERVICE | |||||
| 1305 SOUTH MAIN ST | MEADVILLE | PA | 16335 | MEDICAL COMPANY | $134,215 |
| BKD | |||||
| PO BOX 1190 | SPRINGFIELD | MO | 65801 | AUDIT/TAX/CONSULTING | $110,645 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $16,179 | GovernmentGrantsAmt |
| All Other Contributions | $7,446 | AllOtherContributionsAmt |
| Total Contributions | $23,625 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT REVENUE | 900099 | $52,610,645 | $52,610,645 |
| AMBULANCE | 621910 | $218,221 | $218,221 |
| EHR INCENTIVE | 900099 | $213,330 | $213,330 |
| CAFETERIA | 722210 | $411,735 | $411,735 |
| DAYCARE | 624410 | $161,255 | $161,255 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $27,129 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $27,129 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $53,642,315 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $258,438 | TotalRevenueColumnAmt |
| Exclusion | $258,438 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $96,405 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $68,531 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $27,874 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $27,874 | TotalRevenueColumnAmt |
| Exclusion | $27,874 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,304,226 | SecuritiesAmt |
| Other | $26,136 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,319,103 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$14,877 | SecuritiesAmt |
| Other | $26,136 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,259 | TotalRevenueColumnAmt |
| Exclusion | $11,259 | ExclusionAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | GAIN ON EQUITY INVESTEE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $443,833 | TotalRevenueColumnAmt |
| Exclusion | $443,833 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $443,833 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $54,407,344 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $53,642,315 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $741,404 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,200 | TotalAmt |
| Management And General | $78,200 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,690,821 | TotalAmt |
| Program Services | $16,147,008 | ProgramServicesAmt |
| Management And General | $2,543,813 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $791,500 | TotalAmt |
| Program Services | $681,622 | ProgramServicesAmt |
| Management And General | $109,878 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,722,245 | TotalAmt |
| Program Services | $3,221,952 | ProgramServicesAmt |
| Management And General | $500,293 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,395,234 | TotalAmt |
| Program Services | $1,201,543 | ProgramServicesAmt |
| Management And General | $193,691 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $821,737 | TotalAmt |
| Management And General | $821,737 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,604 | TotalAmt |
| Management And General | $57,604 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,603 | TotalAmt |
| Management And General | $105,603 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,277 | TotalAmt |
| Management And General | $56,277 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,409,819 | TotalAmt |
| Program Services | $5,755,265 | ProgramServicesAmt |
| Management And General | $1,654,554 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $224,960 | TotalAmt |
| Program Services | $567 | ProgramServicesAmt |
| Management And General | $224,393 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,639,540 | TotalAmt |
| Program Services | $1,590,831 | ProgramServicesAmt |
| Management And General | $1,048,709 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $668,278 | TotalAmt |
| Management And General | $668,278 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,379,009 | TotalAmt |
| Program Services | $603,575 | ProgramServicesAmt |
| Management And General | $775,434 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,169 | TotalAmt |
| Program Services | $61,529 | ProgramServicesAmt |
| Management And General | $7,640 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,981 | TotalAmt |
| Program Services | $67,660 | ProgramServicesAmt |
| Management And General | $12,321 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $236,751 | TotalAmt |
| Program Services | $190,352 | ProgramServicesAmt |
| Management And General | $46,399 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,193,571 | TotalAmt |
| Program Services | $1,763,673 | ProgramServicesAmt |
| Management And General | $429,898 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $584,911 | TotalAmt |
| Program Services | $393,752 | ProgramServicesAmt |
| Management And General | $191,159 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUGS | $10,585,829 | $10,585,829 | |
| BAD DEBT | $1,348,196 | $1,348,196 | |
| RECRUITING & RETENTION | $517,028 | $517,028 | |
| MISCELLANEOUS | $220,045 | $142,031 | $78,014 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $130,886 | TotalAmt |
| Program Services | $78,535 | ProgramServicesAmt |
| Management And General | $52,351 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,007,194 | TotalAmt |
| Program Services | $43,833,920 | ProgramServicesAmt |
| Management And General | $10,173,274 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $705,939 | BOYAmt |
| EOY | $7,838 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,896,122 | BOYAmt |
| EOY | $1,950,230 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,303,057 | BOYAmt |
| EOY | $4,863,281 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,178,854 | BOYAmt |
| EOY | $1,025,927 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $842,068 | BOYAmt |
| EOY | $841,879 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $63,407,836 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $52,073,947 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,578,694 | BOYAmt |
| EOY | $11,333,889 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,740,562 | BOYAmt |
| EOY | $8,656,336 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,553,149 | BOYAmt |
| EOY | $1,797,284 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,315,164 | BOYAmt |
| EOY | $2,024,736 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $712,057 | BOYAmt |
| EOY | $489,912 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,825,666 | BOYAmt |
| EOY | $32,991,312 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,272,512 | BOYAmt |
| EOY | $5,107,898 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,783,710 | BOYAmt |
| EOY | $5,038,305 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $968,827 | BOYAmt |
| EOY | $877,753 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,025,049 | BOYAmt |
| EOY | $11,023,956 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,974,223 | BOYAmt |
| EOY | $21,330,166 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $641,051 | BOYAmt |
| EOY | $461,627 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $185,343 | BOYAmt |
| EOY | $175,563 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,800,617 | BOYAmt |
| EOY | $21,967,356 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,825,666 | BOYAmt |
| EOY | $32,991,312 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $400,150 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$172,551 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$2,060,860 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (true) | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $7,521 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $7,521 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE C, PART II-B, LINE 1 (G) | DIRECT CONTACT: MANAGEMENT OCCASIONALLY HAS DIRECT CONTACT WITH LEGISLATORS AT CHAMBER FUNCTIONS AND OTHER LOCAL EVENTS, AS WELL AS BREAKFAST WITH A CONGRESSMAN'S STAFFER. THE AMOUNT OF TIME SPENT IS INSIGNIFICANT AND ANY DOLLAR AMOUNT ALLOCATED TO THIS ACTIVITY IS NEGLIGIBLE. |
| SCHEDULE C, PART II-B, LINE 1 (I) | OTHER LOBBYING ACTIVITIES: A PORTION OF DUES PAID IN FISCAL YEAR 2016 TO THE AHA, HAP, AND HCWP WERE ATTRIBUTABLE TO LOBBYING, TOTALING $7,521. |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $473,420 | OtherCostOrOtherBasisAmt |
| Book Value | $473,420 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $26,598,910 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,722,071 | DepreciationAmt |
| Book Value | $5,876,839 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $602,163 | OtherCostOrOtherBasisAmt |
| Depreciation | $391,918 | DepreciationAmt |
| Book Value | $210,245 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $33,667,074 | OtherCostOrOtherBasisAmt |
| Depreciation | $28,989,041 | DepreciationAmt |
| Book Value | $4,678,033 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,066,269 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,970,917 | DepreciationAmt |
| Book Value | $95,352 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $11,333,889 | TotalBookValueLandBuildingsAmt |
| Financial Derivatives | FinancialDerivativesGrp | |
| Closely Held Equity Interests | CloselyHeldEquityInterestsGrp |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVEST INT IN CHART | Desc |
| Book Value | $1,797,284 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $1,797,284 | TotalBookValueSecuritiesAmt |
| Total Book Value Program Rltd | $0 | TotalBookValueProgramRltdAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | EST AMT DUE TO THIRD PRTY | Desc |
| Amt | $877,753 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $877,753 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $51,083,472 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$172,551 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$3,219,852 | OtherRevenueAmt |
| Revenue Not Reported | -$3,392,403 | RevenueNotReportedAmt |
| Revenue Subtotal | $54,475,875 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$68,531 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$68,531 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $54,407,344 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $52,727,529 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $68,531 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $68,531 | ExpensesNotReportedAmt |
| Expenses Subtotal | $52,658,998 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $1,348,196 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $1,348,196 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $54,007,194 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART X, LINE 2 | UNCERTAIN TAX POSITIONS: 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 2D | OTHER REVENUE ON LINE 1, BUT NOT FORM 990, PART VIII, LINE 12: $(2,010,652) TRANSFER TO AFFILIATES 138,996 CHANGE IN INT IN NET ASSETS OF CLARION HOSPITAL FDN (1,348,196) PROVISION FOR UNCOLLECTIBLE ACCOUNTS ------------- $(3,219,852) TOTAL |
| SCHEDULE D, PART XI, LINE 4B | OTHER REVENUE ON FORM 990, PART VIII, LINE 12 BUT NOT LINE 1: $ (68,531) RENTAL EXPENSES |
| SCHEDULE D, PART XII, LINE 2D | OTHER EXPENSES ON LINE 1, BUT NOT FORM 990, PART IX, LINE 25: $ 68,531 RENTAL EXPENSES |
| SCHEDULE D, PART XII, LINE 4B | OTHER EXPENSES ON FORM 990, PART IX, LINE 25, BUT NOT LINE 1: $ 1,348,196 PROVISION FOR UNCOLLECTIBLE ACCOUNTS |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | false | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $163,344 | TotalCommunityBenefitExpnsAmt |
| Total Expense | 0.00310 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,599,221 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,826,323 | DirectOffsettingRevenueAmt |
| Total Expense | 0.07160 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,762,565 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,826,323 | DirectOffsettingRevenueAmt |
| Total Expense | 0.07470 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,307 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $11,307 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,029,258 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $758,809 | DirectOffsettingRevenueAmt |
| Total Expense | 0.00510 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,743,654 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,026,753 | DirectOffsettingRevenueAmt |
| Total Expense | 0.03260 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,784,219 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,785,562 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,307 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03790 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,546,784 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,611,885 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,307 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11260 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,348,196 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $234,586 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $17,543,333 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $16,563,311 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $980,022 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLARION HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE HOSPITAL DRIVE | AddressLine1Txt |
| City | CLARION | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16214 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.CLARIONHOSPITAL.ORG | WebsiteAddressTxt |
| State License | 297801 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLARION HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 250. | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| No Emergency Care Policy | Yes (X) | NoEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 5 | COMMUNITY INPUT: TO GUIDE THIS ASSESSMENT, THE HOSPITAL LEADERSHIP TEAM FORMED A STEERING COMMITTEE IN THEIR LOCAL SERVICE AREA THAT CONSISTED OF HOSPITAL AND COMMUNITY LEADERS WHO REPRESENTED THE BROAD INTERESTS OF THEIR LOCAL REGION. THESE INCLUDED REPRESENTATIVES WHO UNDERSTOOD THE NEEDS AND ISSUES RELATED TO VARIOUS UNDERREPRESENTED GROUPS INCLUDING MEDICALLY UNDERSERVED POPULATIONS, LOW-INCOME PERSONS, MINORITY GROUPS, AND THOSE WITH CHRONIC DISEASE NEEDS, INDIVIDUALS WITH EXPERTISE IN PUBLIC HEALTH, AND INTERNAL PROGRAM MANAGERS. THIS OUTSIDE INDIVIDUALS INCLUDED A REPRESENTATIVES FROM THE PA STATE HEALTH DEPARTMENT, CLARION COUNTY BEHAVIORAL HEALTH, YMCA, STATE SENATORS OFFICE, PA 5TH CONGRESSIONAL DISTRICT, A SCHOOL SUPERINTENDENT, AND OTHERS. THE CLARION HOSPITAL STEERING COMMITTEE MET THREE TIMES BETWEEN APRIL 2015 AND MAY 2015 TO PROVIDE GUIDANCE ON THE VARIOUS COMPONENTS OF THE CHNA. |
| SCHEDULE H, PART V, SECTION B, LINE 6A | OTHER HOSPITAL FACILITIES: - INDIANA REGIONAL MEDICAL CENTER - PUNXSUTAWNEY AREA HOSPITAL |
| SCHEDULE H, PART V, SECTION B, LINE 6B | OTHER ORGANIZATIONS: - CLARION AREA SCHOOL DESTRICT SUPERINTENDIENT - CHILDREN AND YOUTH SERVICES/HUMAN SERVICES, CLARION COUNTY - PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE - SERVICE AND ACCESS MANAGEMENT, CLARION COUNTY - CLARION COUNTY PRISON - OFFICE OF VETERANS AFFIARS, CLARION COUNTY - CLARION MINISTERIUM |
| SCHEDULE H, PART V, SECTION B, LINES 7A & 10 | CHNA AND IMPEMENTATION STRATEGY WEBSITE: HTTP://WWW.CLARIONHOSPITAL.ORG/COMMUNITY_EDUCATION/COMMUNITY_HEALTH _NEEDS_ASSESSMENT.ASPX |
| SCHEDULE H, PART V, SECTION B, LINE 11 | ADDRESSING SIGNIFICANT NEEDS: INDIVIDUALS WITH EXPERTISE IN THE FOLLOWING DISCIPLINES AND/OR ORGANIZATIONAL AFFILIATIONS: - CLARION AREA SCHOOL DISTRICT SUPERINTENDENT - CHILDREN AND YOUTH SERVICES/HUMAN SERVICES, CLARION COUNTY - PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE - SERVICE AND ACCESS MANAGEMENT, CLARION COUNTY - CLARION COUNTY PRISON - OFFICE OF VETERANS AFFAIRS, CLARION COUNTY - CLARION MINISTERIUM IN MARCH 2015, CLARION HOSPITAL CONDUCTED A 2-YEAR EVALUATION OF ITS CHNA IMPLEMENTATION STRATEGIES FROM THE 2013 ASSESSMENT. CLARION HOSPITAL IS CONDUCTING ITS CHNA A YEAR EARLY, IN ORDER TO WORK COLLABORATIVELY WITH THE OTHER PMCN HOSPITALS AND CONDUCT THEIR ASSESSMENT ON THE SAME SCHEDULE. THE 2013 CLARION CHNA IDENTIFIED 3 GOALS THAT INCLUDED IMPLEMENTING A WORKPLACE WELLNESS PROGRAM, REDUCING CHILDHOOD OBESITY AND IMPACTING THE DIABETES EPIDEMIC. WITHIN THE SHORT TIME FRAME, IT IS IMPOSSIBLE TO DETERMINE IF THE IMPLEMENTATION STRATEGIES IMPACTED ANY OF THE COUNTY-WIDE INDICATORS, AS MOST OF THE OUTCOMES MEASURES FOR THE FIRST TWO YEARS WERE PROCESS MEASURES, ALTHOUGH THE HOSPITAL HAS MADE PROGRESS TOWARD ACCOMPLISHING ITS FIRST TWO GOALS. THE THIRD GOAL, IMPACTING DIABETES, WAS NOT SCHEDULED FOR IMPLEMENTATION UNTIL THIS UPCOMING YEAR AND WILL BE A FOCUS AREA IN THE UPDATED IMPLEMENTATION STRATEGY. THE CHNA IMPLEMENTATION STRATEGY/ACTION PLAN GOT OFF TO A SLOW START AND DID NOT MEET THE INITIAL MILESTONE/DEADLINES OUTLINED IN IMPLEMENTATION STRATEGY. IN THE ORIGINAL ACTION PLAN, A COORDINATOR WAS DESIGNATED TO BE APPOINTED BY SEPTEMBER 2013. BRIDGET THORNTON WAS APPOINTED AS CHNA COORDINATOR IN JUNE 2014. WHILE THIS DELAYED THE ACCOMPLISHMENTS OF THE MILESTONES IN THE PLAN, BRIDGET MADE GREAT PROGRESS SINCE COMING ON BOARD AND BEGAN IMPLEMENTATION OF THE EMPLOYEE WELLNESS PROGRAM IN JANUARY 2015, ONLY FOUR MONTHS BEHIND THE ORIGINAL SCHEDULE. DURING HER SHORT TENURE, BRIDGET BENCHMARKED BEST PRACTICES IN EMPLOYEE WELLNESS PROGRAMS, IDENTIFIED AND OUTREACHED TO INTERNAL RESOURCES AND PROFESSIONALS WHO SHOULD BE INVOLVED IN THE PROGRAM, CONDUCTED AN EMPLOYEE SURVEY THAT ACHIEVED OVER 200 RESPONSES, CONDUCTED SITE VISITS WITH TWO OTHER EMPLOYEE WELLNESS PROGRAMS TO UNDERSTAND HOW THOSE PROGRAMS WORK, AND DEVELOPED A LOGIC MODEL WITH OUTCOMES AND IMPACT MEASUREMENTS FOR THE EMPLOYEE WELLNESS PROGRAM, AS WELL AS THE OVERALL IMPLEMENTATION STRATEGY. THE INITIAL IMPLEMENTATION STRATEGY/ACTION PLAN INCLUDED ONLY PROCESS MEASURES AND LACKED TRUE OUTCOMES AND IMPACT MEASUREMENTS. THE CHNA IMPLEMENTATION STRATEGY WAS REVISED TO INCLUDE ASSISTANCE FROM THE INFORMATION SYSTEMS DEPARTMENT TO DEVELOP METHODS TO TRACK PATIENTS AS WELL AS REPORT THE RESULTS (PRE AND POST WHERE POSSIBLE AND OVER TIME) FOR THOSE WHO PARTICIPATE IN THE EMPLOYEE WELLNESS PROGRAM AS WELL AS IN VARIOUS SCREENING AND INTERVENTION ACTIVITIES. BECAUSE THE HOSPITAL AND PHYSICIAN PRACTICES HAVE EMRS, THIS IS POSSIBLE, BUT WILL TAKE SOME TIME TO DEVELOP THE REPORTING SYSTEMS. REGARDING CLARION'S GOAL OF REDUCING CHILDHOOD OBESITY, THE HOSPITAL HAS MET WITH THE CLARION COUNTY YMCA TO FORM A PARTNERSHIP THAT WOULD EXPAND THEIR CURRENT "FUN N' FIT CLUB" CURRICULUM, ADDRESS THE ISSUE OF TRANSPORTATION TO ENSURE THAT CHILDREN CAN ATTEND THE "FUN 'N FIT CLUB." IN ADDITION, MEETINGS WERE HELD WITH VARIOUS LEADERS IN THE BUSINESS/INDUSTRY SECTOR OF THE COMMUNITY. WORK-SITE WELLNESS PROGRAMS WERE INTRODUCED WITH THE EXPECTATION OF THE HOSPITAL INITIATING THESE IN THE COMMUNITY IN 2017. DURING THE EVALUATION PROCESS, THE TEAM ALSO RECOGNIZED THAT THE HOSPITAL CURRENTLY CONDUCTS A NUMBER OF COMMUNITY BENEFIT EDUCATION AND SCREENING PROGRAMS THAT ARE DESIGNED TO IMPROVE COMMUNITY HEALTH, BUT THAT WERE NOT INCLUDED IN THE ORIGINAL IMPLEMENTATION STRATEGY. THE IMPLEMENTATION STRATEGY WAS REVISED TO INCLUDE THESE ACTIVITIES AS WELL AS THEIR ACCOMPANYING OUTCOMES AND IMPACTS. SHORT TERM OUTCOMES FROM THE INTERVENTION ACTIVITIES CONDUCTED TO DATE INCLUDE: - TEDDY BEAR CLINIC - SENIOR WELLNESS EXPO |
| SCHEDULE H, PART V, SECTION B, LINES 16 A, 16B, & 16C | FAP, PLS, AND APPLICATION WEBSITE: HTTP://WWW.CLARIONHOSPITAL.ORG/BILL_PAY/FINANCIAL_ASSISTANCE.ASPX |
| SCHEDULE H, PART V, SECTION B, LINE 22D | MAXIMUM AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: PATIENTS AND FAMILIES WILL NOT BE CHARGED MORE FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE THAN AMOUNTS GENERALLY BILLED (AGB) TO THOSE PATIENTS WHO HAVE INSURANCE. CLARION HOSPITAL CALCULATED AGB USING THE LOOK-BACK METHOD WITH THE AVERAGE OF MEDICARE AND PRIVATE INSURANCE. |
| SCHEDULE H, PART V | 501(R) FAILURE DISCLOSURE: IN APRIL 2017, DURING PREPARATION OF THE FORM 990, THE ORGANIZATION DISCOVERED THAT THE FINANCIAL ASSISTANCE POLICY DID NOT CONTAIN ALL REQUIRED INFORMATION UNDER IRS 501(R) REGULATIONS. SPECIFICALLY, IT DID NOT CONTAIN METHODS FOR CALCULATING AMOUNTS GENERALLY BILLED (AGB). THE PLAIN LANGUAGE SUMMARY DID PROVIDE REFERENCE TO AGB AND STATED THAT FAP-ELIGIBLE PATIENTS WOULD NOT BE CHARGED MORE THAN AGB. THE ORGANIZATION IMMEDIATELY TOOK ACTIONS TO DISCUSS AND IMPLEMENT CHANGES TO THE FINANCIAL ASSISTANCE POLICY TO ADDRESS THE METHOD USED TO CALCULATE AGB. MANAGEMENT IS REVIEWING THE DISCOUNTS PROVIDED TO ENSURE THAT NO FAP-ELIGIBLE INDIVIDUALS WERE CHARGED MORE THAN AGB. |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 7, COLUMN F | PERCENT 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 WAS REDUCED BY BAD DEBT EXPENSE OF $1,348,196. |
| SCHEDULE H, PART I, LINE 7 | COST TO CHARD RATIO: THE COST TO CHARGE RATIO COMPUTED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATIONS ON IRS WORKSHEETS 1 & 3. WORKSHEET 6 USED COST ACCOUNTING DATA. |
| SCHEDULE H, PART III, SECTION A, LINE 2 | BAD DEBT EXPENSE: BAD DEBT EXPENSE ON LINE 2 WAS CALCULATED USING THE AMOUNT OF BAD DEBT REPORTED ON THE AUDITED FINANCIAL STATEMENTS. |
| SCHEDULE H, PART III, SECTION A, LINE 3 | BAD DEBT ATTRIBUTABLE TO CHARITY CARE: 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. USING 2011-2015 DATA, 17.4 PERCENT OF CLARION COUNTY WAS CONSIDERED TO LIVE IN POVERTY. |
| SCHEDULE H, PART III, SECTION A, LINE 4 | BAD 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: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. |
| SCHEDULE H, PART III, SECTION B, LINE 8 | COMMUNITY BENEFIT: SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. |
| SCHEDULE H, PART III, SECTION C, LINE 9B | COLLECTION POLICY: THE NEED FOR CHARITY CARE IS ADDRESSED AS SOON AS A PATIENT INDICATES A FINANCIAL HARDSHIP. GENERALLY, THIS OCCURS AT THE TIME OF SERVICE OR UPON THE INITIAL BILLING. A PATIENT WILL HAVE 90 DAYS FROM THE DATE OF FIRST STATEMENT TO APPLY FOR FINANCIAL ASSISTANCE UNDER THE CHARITY CARE POLICY. ACCOUNTS CURRENTLY IN COLLECTION WILL NOT BE APPROVED UNDER THE CHARITY CARE PROGRAM. |
| SCHEDULE H, PART VI, LINE 2 | NEEDS ASSESSMENT: CLARION HOSPITAL IS GOVERNED BY A BOARD OF VOLUNTEER DIRECTORS WHO REPRESENT THE COMMUNITY WE SERVE. THROUGH THEIR INPUT AND OCCASIONAL COMMUNITY SURVEYS, CLARION HOSPITAL ASSESSES THE HEALTH CARE NEEDS OF ITS SERVICE AREA. |
| SCHEDULE H, PART VI, LINE 3 | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: MEDICAID APPLICATIONS ARE GIVEN TO SELF PAY PATIENTS IN EMERGENCY ROOM AND INPATIENT. THE HOSPITAL FINANCIAL POLICY AND BUSINESS OFFICE CONTACT INFORMATION ARE AVAILABLE AT REGISTRATION DESKS. FREE CARE GUIDELINES ARE PRINTED ON REVERSE SIDE OF PATIENT STATEMENTS. |
| SCHEDULE H, PART VI, LINE 4 | COMMUNITY INFORMATION: CLARION HOSPITAL SERVES CLARION COUNTY AND PARTS OF THE SURROUNDING COUNTIES, INCLUDING VENANGO, FOREST, JEFFERSON, AND ARMSTRONG. OUR SERVICE AREA IS IN A RURAL PART OF WESTERN PENNSYLVANIA, WITH MANY LIVING BELOW OR WELL BELOW THE NATIONAL AND STATE INCOME AVERAGE. ACCORDING TO US CENSUS BUREAU DATA, THE MEDIAN HOUSEHOLD INCOME FOR THE AREA IS APPROXIMATELY $41,500. THE ESTIMATED POPULATION OF CLARION COUNTY WAS 39,479. AS OF THE CENSUS OF 2000, THERE WERE 6,185 PEOPLE, 2,000 HOUSEHOLDS, AND 718 FAMILIES RESIDING IN THE BOROUGH ALONE. |
| SCHEDULE H, PART VI, LINE 5 | PROMOTION OF COMMUNITY HEALTH: THE AMERICAN DIABETES ASSOCIATION ESTIMATES THAT NEARLY 26 MILLION ADULTS AND CHILDREN HAVE DIABETES. AT LEAST 7 MILLION PEOPLE DON'T KNOW THIS YET. EDUCATION IS THE BEST WAY TO PREVENT PRE-DIABETES, ADVANCEMENT TO DIABETES, AS WELL AS HELPING THOSE DIAGNOSED WITH DIABETES TO MANAGE THEIR DISEASE AND PREVENT COMPLICATIONS. THE DIABETIC EDUCATION PROGRAM AT CLARION HOSPITAL IS DEDICATED TO EDUCATION OF INDIVIDUALS WHO HAVE DIABETES. WE SEE PEOPLE WHO ARE NEWLY DIAGNOSED, OR WHO HAVE BEEN MANAGING THEIR DIABETES FOR SOME TIME. WE SPECIALIZE IN EDUCATION RELATED TO TYPE I (INSULIN-DEPENDENT), TYPE II (THOSE WHO CAN MANAGE WITH MEDICATIONS), AND PRE-DIABETES, WHOSE BLOOD SUGARS ARE HIGH AND WHO ARE AT RISK. OUR PROGRAM TEACHES DIABETICS AND THEIR LOVED ONES ABOUT THE DISEASE PROCESS, GLUCOSE MONITORING, MEDICATION MANAGEMENT, LIFESTYLE CHANGES, EXERCISE, NUTRITIONAL MANAGEMENT, AND SICK DAY GUIDELINES. WE CAN MEET WITH PATIENTS INDIVIDUALLY OR IN A CLASSROOM ENVIRONMENT. CLARION HOSPITAL ALSO PROVIDES CLASSES ON CPR AND AED, WITH OR WITHOUT FIRST AID. THESE COURSES ARE OFFERED SEVERAL TIMES A YEAR AND ARE TAUGHT BY CLARION HOSPITAL PARAMEDICS. ADDITIONALLY, THE CLARION HOSPITAL FOUNDATION AWARDS SCHOLARSHIPS TO CLARION COUNTY STUDENTS PURSUING CAREERS IN HEALTH CARE. |
| SCHEDULE H, PART VI, LINE 6 | AFFILIATED HEALTH CARE SYSTEM: CLARION HOSPITAL IS AN AFFILIATE OF CLARION HEALTHCARE SYSTEM, INC. CLARION HEALTHCARE SYSTEM, INC. EXISTS TO SUPPORT THE HOSPITAL MISSION AND TO PROVIDE A VITAL LINK BETWEEN THE HOSPITAL SYSTEM AND THE SURROUNDING COMMUNITY. THROUGH THE PROCESSES OF STRATEGIC AND FINANCIAL DEVELOPMENT, THE HEALTH SYSTEM WILL ENHANCE THE PUBLIC'S AWARENESS OF HEALTH CARE AND THE HOSPITAL'S SERVICES; SECURE CHARITABLE GIFTS; INCREASE ITS CURRENT PERMANENTLY RESTRICTED FUNDS TO GENERATE A PERMANENT SOURCE OF INVESTMENT INCOME; AND REGULARLY DISTRIBUTE FINANCIAL ASSISTANCE TO THE SURROUNDING COMMUNITY AND THE HOSPITAL TO ENHANCE HEALTH CARE EDUCATION, TECHNICAL RESOURCES AND QUALITY PATIENT CARE. BY THESE ACTIVITIES, THE SYSTEM WILL SERVE TO LEAD THE WAY FOR THE SURROUNDING COMMUNITY'S HEALTH CARE STABILITY AND GROWTH IN THE TWENTY-FIRST CENTURY. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| THOMAS FREENOCK | ||||||||||||||
| DIRECTOR | $0 | $365,200 | $0 | $0 | $0 | $1,440 | $0 | $2,650 | $0 | $792 | $0 | $370,082 | $0 | $0 |
| CHARLES BARTLEY | ||||||||||||||
| CRNA | $136,405 | $0 | $0 | $0 | $211 | $0 | $6,831 | $0 | $8,048 | $0 | $151,495 | $0 | $0 | $0 |
| TOM MORGO | ||||||||||||||
| CRNA | $165,461 | $0 | $0 | $0 | $421 | $0 | $8,294 | $0 | $18,558 | $0 | $192,734 | $0 | $0 | $0 |
| WENDY STIVANSON | ||||||||||||||
| CRNA | $165,281 | $0 | $0 | $0 | $421 | $0 | $8,285 | $18,558 | $0 | $192,545 | $0 | $0 | $0 | |
| WILL SIMPSON | ||||||||||||||
| DIRECTOR OF PHARMACY | $137,042 | $0 | $0 | $0 | $421 | $0 | $6,873 | $0 | $18,558 | $0 | $162,894 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | COMPENSATION OF ORGANIZATION'S CEO: CLARION HOSPITAL CONTRACTED WITH QUORUM HEALTH RESOURCES, AN UNRELATED MANAGEMENT COMPANY, FOR THE SERVICES OF BYRON QUINTON, CEO, AND VINCENT LAMORELLA, CFO. AMOUNTS PAID TO QUORUM HEALTH RESOURCES ARE REPORTED IN FORM 990, PART VII, SECTION B, AND ARE FOR SERVICES PROVIDED BY THE COMPANY. NO COMPENSATION WAS REPORTED FOR EITHER INDIVIDUAL ON FORM 990, PART VII OR SCHEDULE J, PART II. IN ESTABLISHING THE COMPENSATION OF THE CEO, QUORUM HEALTH RESOURCES USED A COMPENSATION COMMITTEE, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARLA MCCLEARY | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | SPOUSE OF BRUCE | RelationshipDescriptionTxt |
| Transaction | $78,200 | TransactionAmt |
| Transaction | COMPENSATION | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 1 | ORGANIZATION'S MISSION: CLARION HOSPITAL, AS THE COMMUNITY'S RESOURCE FOR THE DELIVERY OF QUALITY-BASED HEALTHCARE, IS COMMITTED TO PROVIDE EMERGENT, ACUTE, TRANSITIONAL, AND LONG-TERM MEDICAL SERVICES FOR THE RESIDENTS OF CLARION COUNTY AND ITS SURROUNDING COMMUNITIES. PURPOSE: CLARION HOSPITAL EXISTS TO PROVIDE COMPREHENSIVE, QUALITY HEALTH CARE, APPROPRIATE TO THE NEEDS OF OUR COMMUNITY, IN A COMPASSIONATE AND EMPATHETIC MANNER. THE HOSPITAL ACKNOWLEDGES THE IMPORTANCE OF PREVENTIVE MEDICINE AND FOCUSES ON THE PROMOTION OF A HEALTHY LIFESTYLE FOR ALL. EVERY DEPARTMENT WITHIN CLARION HOSPITAL CONTRIBUTES AN INVALUABLE SERVICE TOWARD THE PROVISION OF QUALITY HEALTH CARE FROM THE ORGANIZATION AS A WHOLE. EACH DEPARTMENT EXISTS FOR A SPECIFIC PURPOSE, YET NO DEPARTMENT EXISTS SOLELY ON ITS OWN. WE ARE ALL INTER-DEPENDENT UPON EACH OTHER. VALUES: *WE BELIEVE IN BEING CUSTOMER FOCUSED. *WE BELIEVE IN COMPETENCY. *WE BELIEVE IN HONESTY. *WE BELIEVE IN CARING. *WE BELIEVE IN COMMITMENT. *WE BELIEVE IN BEING TEAM PLAYERS. *WE BELIEVE IN DEMONSTRATING PROFESSIONALISM. *WE BELIEVE IN THE PRESERVATION OF DIGNITY FOR THOSE WE SERVE. *WE BELIEVE IN MAINTAINING CONFIDENTIALITY. *WE BELIEVE IN EDUCATION AND CONTINUAL LEARNING. *WE BELIEVE IN CONTINUAL IMPROVEMENT. *WE BELIEVE IN DEMONSTRATING MUTUAL RESPECT FOR OUR CO-WORKERS. VISION: CLARION HOSPITAL ENDEAVORS TO EXCEED THE COMMUNITY'S HEALTHCARE EXPECTATIONS THROUGH THE IMPLEMENTATION OF CONTINUOUS QUALITY IMPROVEMENTS, BY REASSESSING THE COMMUNITY'S EVOLVING NEEDS, BY DEVELOPING INNOVATIVE FAMILY-ORIENTED HEALTHCARE SERVICES, AND BY PROVIDING EDUCATIONAL PROGRAMS FOR OUR FUTURE HEALTHCARE PROVIDERS. |
| FORM 990, PART I, LINE 6 | NUMBER OF VOLUNTEERS: VOLUNTEER SERVICES OF CLARION HOSPITAL CONSISTS OF APPROXIMATELY 36 VOLUNTEERS WHO WORK WITHIN 25 VARIOUS DEPARTMENTS ASSISTING EMPLOYEES, PATIENTS, AND STAFF TO DELIVER QUALITY BASED HEALTHCARE. IN ADDITION, THE MEMBERS OF THE BOARD OF DIRECTORS WHO SERVED DURING THE YEAR ARE CONSIDERED VOLUNTEERS, FOR A TOTAL OF 48. |
| FORM 990, PART VI, SECTION A, LINE 3 | MANAGEMENT DUTIES: CLARION HOSPITAL HAS A MANAGEMENT CONTRACT WITH QUORUM HEALTH RESOURCES TO PROVIDE MANAGEMENT SERVICES. IN ADDITION, QUORUM HEALTH RESOURCES PROVIDES COMPENSATION FOR THE HOSPITAL'S CEO AND CFO. THE HOSPITAL REIMBURSES QUORUM HEALTH RESOURCES WITH MONTHLY MANAGEMENT FEES FOR THE COMPENSATION PAID AND OTHER SERVICES PROVIDED. |
| FORM 990, PART VI, SECTION A, LINE 4 | SIGNIFICANT CHANGES TO BYLAWS: THE BYLAWS WERE AMENDED AS A RESULT OF THE SYSTEM'S AFFILIATION AGREEMENT WITH PENNSYLVANIA MOUNTAIN CARE NETWORK. THE BYLAWS STATE THAT PMCN HAS CERTAIN RESERVED POWERS OVER CLARION HEALTHCARE SYSTEM AND ITS SUBSIDIARIES, CLARION HOSPITAL AND HEALTH SERVICES OF CLARION. THESE POWERS INCLUDE APPROVAL OVER THE SELECTION AND APPOINTMENT OF THE PRESIDENT & CEO AS WELL AS APPROVAL OF ANY AMENDMENT TO THE BYLAWS. |
| FORM 990, PART VI, SECTION A, LINE 6, 7A, & 7B | MEMBERS OF THE ORGANIZATION: THE BOARD OF CLARION HOSPITAL SHALL CONSIST OF NINE (9) MEMBERS AND SHALL BE APPOINTED BY THE BOARD OF DIRECTORS OF CLARION HEALTHCARE SYSTEM, INC. IN ACCORDANCE WITH HOSPITAL BYLAWS. THE BOARD MEMBERS SHALL BE THE SAME PERSONS WHO SERVE AS THE EXECUTIVE COMMITTEE OF CLARION HEALTHCARE SYSTEM, INC. WHICH INCLUDE THE CHAIRPERSON, VICE CHAIRPERSON, SECRETARY, TREASURER, FORMER CHAIRPERSON (IF APPLICABLE), PRESIDENT AND CEO (NON-VOTING), CHIEF OF STAFF (WITH VOTING RIGHTS), ONE MEDICAL STAFF REPRESENTATIVE, AND ANY OTHER DIRECTORS SELECTED BY THE CHAIRPERSON. BYLAWS MAY ONLY BE AMENDED OR REPEALED AND NEW BYLAWS ADOPTED BY THE BOARD OF DIRECTORS OF CLARION HEALTHCARE SYSTEM, INC., SUBJECT TO APPROVAL OF PMCN AS SET FORTH IN THE BYLAWS OF CLARION HEALTHCARE SYSTEM, INC. AS A RESULT OF THE SYSTEM'S AFFILIATION AGREEMENT WITH PENNSYLVANIA MOUNTAIN CARE NETWORK (PMCN), PMCN HAS CERTAIN RESERVED POWERS OVER CLARION HEALTHCARE SYSTEM AND ITS SUBSIDIARIES, CLARION HOSPITAL AND HEALTH SERVICES OF CLARION. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 REVIEW PROCESS: 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. PRIOR TO FILING, A DRAFT OF THE RETURN IS REVIEWED BY THE CFO IN DETAIL. A FINAL DRAFT IS THEN PRESENTED TO THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS AND THE FULL BOARD FOR REVIEW. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST POLICY: CLARION HOSPITAL, INC. BOARD MEMBERS ARE ASKED TO COMPLETE A CONFLICT OF INTEREST FORM ON AN ANNUAL BASIS. IF A CONFLICT ARISES, THE BOARD MEMBER WITH A CONFLICT ABSTAINS FROM VOTING ON ANY MATTER RELATED TO THE CONFLICT. POLICY: MEMBERS OF THE GOVERNING BODY SHALL NOT MAINTAIN SUBSTANTIAL PERSONAL OR BUSINESS INTERESTS WHICH CONFLICT WITH THOSE OF THE HOSPITAL. PROCEDURES: ALL GOVERNING BODY MEMBERS SHALL EXECUTE A CONFLICT OF INTEREST STATEMENT. MEMBERS OF THE GOVERNING BODY SHALL NOT ENGAGE IN THE FOLLOWING FORMS OF SELF DEALINGS: A) THE SALE, EXCHANGE, OR LEASING OF PROPERTY OR SERVICES BETWEEN THE HOSPITAL AND A GOVERNING BOARD MEMBER, HIS EMPLOYER, OR AN ORGANIZATION SUBSTANTIALLY CONTROLLED BY HIM ON A BASIS LESS FAVORABLE TO THE HOSPITAL THAN THAT ON WHICH SUCH PROPERTY OR SERVICE IS MADE AVAILABLE TO THE GENERAL PUBLIC. B) FURNISHING OF GOODS, SERVICES, OR FACILITIES BY THE HOSPITAL TO A GOVERNING BOARD MEMBER, UNLESS SUCH FURNISHING IS MADE ON A BASIS NOT MORE FAVORABLE THAN THAT ON WHICH SUCH GOODS, SERVICES, OR FACILITIES ARE MADE AVAILABLE TO THE GENERAL PUBLIC OR EMPLOYEES OF THE HOSPITAL. C) ANY TRANSFER TO OR USE BY OR FOR THE BENEFIT OF A GOVERNING BOARD MEMBER OF THE INCOME OR ASSETS OF THE HOSPITAL EXCEPT BY PURCHASE FOR FAIR MARKET VALUE. ANY DIRECTOR, OFFICER, EMPLOYEE, OR COMMITTEE MEMBER HAVING AN INTEREST IN A CONTRACT OR OTHER TRANSACTION PRESENTED TO THE BOARD OF DIRECTORS OR A COMMITTEE THEREOF FOR AUTHORIZATION, APPROVAL OR RATIFICATION SHALL GIVE PROMPT, FULL AND FRANK DISCLOSURE OF HIS INTEREST TO THE BOARD OR COMMITTEE PRIOR TO ITS ACTING ON SUCH CONTRACT OR TRANSACTION. THE BODY TO WHICH SUCH DISCLOSURE IS MADE SHALL THEREUPON DETERMINE, BY MAJORITY VOTE, WHETHER THE DISCLOSURE SHOWS THAT A CONFLICT OF INTEREST EXISTS OR CAN REASONABLY BE CONSTRUED TO EXIST. IF A CONFLICT IS DEEMED TO EXIST, SUCH PERSON SHALL NOT VOTE ON, NOR USE HIS PERSONAL INFLUENCE ON, NOR PARTICIPATE (OTHER THAN TO PRESENT FACTS) IN THE DISCUSSIONS OR DELIBERATIONS WITH RESPECT TO SUCH CONTRACT OR TRANSACTION. SUCH PERSON MAY NOT BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM AT ANY MEETING WHERE THE CONTRACT OR TRANSACTION IS UNDER DISCUSSION OR IS BEING VOTED UPON. THE MINUTES OF THE MEETING SHALL REFLECT THE DISCLOSURE MADE, THE VOTE THEREON AND, WHERE APPLICABLE, THE ABSTENTION FROM VOTING AND PARTICIPATING, AND WHETHER A QUORUM WAS PRESENT. |
| FORM 990, PART VI, SECTION B, LINE 15A & 15B | COMPENSATION REVIEW POLICY: CLARION HOSPITAL CONTRACTED WITH QUORUM HEALTH RESOURCES, AN UNRELATED MANAGEMENT COMPANY, FOR THE SERVICES OF BYRON QUINTON, CEO, AND VINCENT LAMORELLA, CFO. AMOUNTS PAID TO QUORUM HEALTH RESOURCES ARE REPORTED IN FORM 990, PART VII, SECTION B, AND ARE FOR SERVICES PROVIDED BY THE INDIVIDUALS AS WELL AS OTHER SERVICES PROVIDED BY THE COMPANY. NO COMPENSATION WAS REPORTED FOR EITHER INDIVIDUAL ON FORM 990, PART VII OR SCHEDULE J, PART II. ALTHOUGH THE ORGANIZATION DID NOT DIRECTLY PAY THE COMPENSATION OF THE CEO OR CFO DURING THE YEAR, THE ORGANIZATION DOES HAVE A COMPENSATION REVIEW POLICY IN PLACE. IT SHALL BE THE POLICY OF THE BOARD OF DIRECTORS TO ESTABLISH AND MAINTAIN AN EXECUTIVE COMPENSATION PROGRAM FOR THE PRESIDENT/CEO AND CHIEF FINANCIAL OFFICER WHICH: (1) ENABLES THE BOARD TO ATTRACT AND RETAIN THE EXECUTIVES NEEDED TO EFFECTIVELY CARRY OUT THE MISSION OF THE ORGANIZATION AND THE POLICIES OF THE BOARD. (2) RESPONDS TO MARKET TRENDS. (3) REFLECTS THE VALUE OF THE FUNCTIONAL DEMANDS OF EXECUTIVE WORK. (4) REWARDS PERFORMANCE RESULTS. (5) IS BASED ON FACTORS THAT PROVIDE FOR JUST AND REASONABLE COMPENSATION. COMPENSATION ACTIONS APPROVED BY THE BOARD OF DIRECTORS MUST BE DOCUMENTED, AND SUCH DOCUMENTATION SHALL INCLUDE THE BASES OF EACH COMMITTEE'S ACTIONS AND THE NAMES OF THE COMMITTEE MEMBERS INVOLVED IN THE ACTIONS. THE DOCUMENTED PROCESS FOR DETERMINING EXECUTIVE COMPENSATION SHALL INCLUDE: (1) TERMS OF THE COMPENSATION ARRANGEMENTS. (2) APPROVAL DATE. (3) NAMES OF BOARD MEMBERS WHO APPROVED THE COMPENSATION DECISIONS. (4) DATA USED IN THE COMPENSATION DECISION. (5) DISCLOSURES OF CONFLICT OF INTEREST, IF ANY. (6) ANNUAL REVIEW OF COMPENSATION RECORDS. THE BOARD OF DIRECTORS AUTHORIZES THE HUMAN RESOURCE COMMITTEE TO REVIEW AND RECOMMEND COMPENSATION DECISIONS FOR THE PRESIDENT/CEO. THE BOARD OF DIRECTORS AUTHORIZES THE FINANCE COMMITTEE TO REVIEW AND RECOMMEND COMPENSATION DECISIONS FOR THE CHIEF FINANCIAL OFFICER. SUCH RECOMMENDATIONS ARE REPORTED TO AND ACTED UPON BY THE FULL BOARD OF DIRECTORS. GUIDELINES FOR DETERMINING PROPOSED COMPENSATION FOR THE PRESIDENT/CEO AND THE CHIEF FINANCIAL OFFICER: (A) A REVIEW AND APPROVAL OF THE OFFICER'S COMPENSATION SHALL OCCUR INITIALLY UPON HIRE OF THE OFFICER AND WHENEVER THE OFFICER'S COMPENSATION IS MODIFIED. (B) ANNUALLY, THE HUMAN RESOURCE COMMITTEE OF THE BOARD OF DIRECTORS SHALL ESTABLISH PERFORMANCE STANDARDS FOR THE PRESIDENT/CEO WHICH SHALL BE USED IN DETERMINING COMPENSATION ACTIONS. THE HUMAN RESOURCE COMMITTEE SHALL HAVE THE AUTHORITY TO REVIEW THE PERFORMANCE OF THE PRESIDENT/CEO AND RECOMMEND A COMPENSATION ADJUSTMENT, IF WARRANTED IN THE JUDGMENT OF THE COMMITTEE. (C) ANNUALLY, THE PRESIDENT/CEO SHALL ESTABLISH PERFORMANCE STANDARDS FOR THE CHIEF FINANCIAL OFFICER WHICH SHALL BE USED IN DETERMINING COMPENSATION ACTIONS. THE PRESIDENT/CEO SHALL HAVE THE AUTHORITY TO REVIEW THE PERFORMANCE OF THE CHIEF FINANCIAL OFFICER AND PROPOSE A COMPENSATION ADJUSTMENT, IF WARRANTED IN THE JUDGMENT OF THE PRESIDENT/CEO, TO THE FINANCE COMMITTEE. (D) INFORMATION GATHERED AND USED IN COMPENSATION ACTIONS SHALL INCLUDE: 1. COMPENSATION PAID BY SIMILAR ORGANIZATIONS. 2. QHR WILL PROVIDE COMPENSATION COMPARABILITY DATA FOR THE POSITION COMPILED BY INDEPENDENT ORGANIZATIONS. THE DATA MAY BE BASED ON INDUSTRY SURVEYS, EXPERT COMPENSATION STUDIES, OR OTHER COMPARABLE DATA. 3. REFERENCE TO FUNCTIONALLY COMPARABLE POSITIONS. 4. THE AVAILABILITY OF SIMILAR SERVICES IN THE GEOGRAPHIC SERVICE AREA. COMPENSATION WAS LAST REVIEWED, USING THE ABOVE METHOD, IN FEBRUARY 2011. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENT DISCLOSURE: GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE BY WRITTEN REQUEST FOR A LEGITIMATE BUSINESS PURPOSE, AS DETERMINED BY TOP MANAGEMENT. REQUESTED DOCUMENTS WILL BE MAILED TO THE REQUESTOR. |
| FORM 990, PART VII, SECTION A | COMPENSATION OF BOARD MEMBERS: ARTHUR DORTORT, TREASURER, AND THOMAS FREENOCK, DIRECTOR, ARE COMPENSATED BY HEALTH SERVICES OF CLARION, A RELATED ORGANIZATION, FOR SERVICES AS EMPLOYEES OF THAT ORGANIZATION. NEITHER INDIVIDUAL RECEIVED ANY COMPENSATION FOR SERVICES AS A MEMBER OF THE BOARD OF DIRECTORS OF CLARION HOSPITAL. |
| FORM 990, PART IX, LINE 11G | OTHER FEES FOR SERVICES: $2,507,286 MEDICAL PURCHASED SERVICES 2,183,371 REHAB PURCHASED SERVICES 1,977,196 OTHER PURCHASED SERVICES 523,304 PHYSICIAN FEES 218,662 COLLECTION AGENCY FEES ----------- $7,409,819 |
| FORM 990, PART XI, LINE 9 | OTHER CHANGES IN NET ASSETS: $(2,010,652) TRANSFER TO AFFILIATES (40,428) CHANGE IN INT IN NET ASSETS OF CLARION HOSPITAL FDN (9,780) CHANGE IN INT IN TRUST ------------- $(2,060,860) |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| HEALTH SERVICES OF CLARION | ||||||||||
| ONE HOSPITAL DRIVE | CLARION | PA | 16214 | 753126134 | PHYSICIAN GRP | PA | 501(C)(3) | 3 | CLARION HS | false |
| CLARION HEALTHCARE SYSTEM INC | ||||||||||
| ONE HOSPITAL DRIVE | CLARION | PA | 16214 | 251534023 | HOLDING CO | PA | 501(C)(3) | 11A I | NA | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLARION DEVELOPMENT CORPORATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 24 DOCTORS LANE | AddressLine1Txt |
| City | CLARION | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16214 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 251516298 | EIN |
| Primary Activities | PHARMACY | PrimaryActivitiesTxt |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Entity Type | C CORP | EntityTypeTxt |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (true) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |