2016-11-14T08:49:58-06:00 2015-12-31 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 1000 COMMERCE PARK DRIVE SUITE 430 WILLIAMSPORT PA 17701 990 2015-01-01 463243949 CENTRE CARE INC CENT 8143556777 502 E HOWARD STREET BELLEFONTE PA 16823 CARL RAUP TREASURER 8143556777 2016-11-11 1 RICK BAIR P00062995 5703236023 2016-11-10 2015 2017-02-10 21:41:12Z CENTRE CREST BETSY BOYER 502 E HOWARD STREET BELLEFONTE PA 16823 21331790 0 X WWW.CENTRECREST.ORG X 2013 PA OPERATION OF A SKILLED NURSING FACILITY 9 7 394 100 0 0 195683 143912 18025168 19457137 2219 25165 1282036 1705576 19505106 21331790 0 2771 0 0 11440486 12011017 0 0 0 10869701 9209649 22310187 21223437 -2805081 108353 21108783 20348973 3218960 2381339 17889823 17967634 PROVIDING FOR THE LONG-TERM CARE NEEDS OF THE RESIDENTS OF CENTRE COUNTY, PENNSYLVANIA 0 0 19376604 2771 21092795 OPERATION OF SKILLED NURSING FACILITY, FOCUSING ON LOWER-INCOME RESIDENTS FUNDED BY MEDICAID PROGRAMS OR PROVIDING CHARITY CARE TO FINANCIALLY INDIGENT RESIDENTS OF CENTRE COUNTY, PENNSYLVANIA REQUIRING LONG-TERM CARE SERVICES. CENTRE CREST HAD A TOTAL CENSUS FOR LOW INCOME MEDICAID RESIDENTS OF 61,038 DAYS IN 2015 (73% OF TOTAL RESIDENTS SERVED). THE REIMBURSEMENT FOR THESE RESIDENTS WAS AN AVERAGE OF $192.52 PER DAY, WHILE THE COST OF PROVIDING SERVICE TO THESE RESIDENTS WAS APPROXIMATELY $199.09 PER DAY. REIMBURSEMENT WAS APPROXIMATELY $401,000 LESS THAN THE COST TO PROVIDE SERVICES TO THESE LOW INCOME MEDICAID ELIGIBLE RESIDENTS - THIS SHORTFALL CONSTITUTES "CHARITY CARE" PROVIDED BY CENTRE CREST. 19376604 1 1 0 0 0 0 0 0 1 0 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 37 0 1 394 1 0 0 0 0 0 0 0 0 0 0 X 9 7 1 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X X LORI JAMISON 8143556777 502 E HOWARD STREET BELLEFONTE PA 16823 X BETSY BOYER PRESIDENT 1.00 X X 0 0 0 LARRY BICKFORD VICE PRESIDENT 1.00 X X 0 0 0 CARL RAUP SECRETARY/TREASURER 1.00 X X 0 0 0 STEVEN BROWN DIRECTOR 1.00 X 0 0 0 RICH WISNIEWSKI DIRECTOR 1.00 X 0 0 0 ALFRED JONES JR DIRECTOR 1.00 X 0 0 0 WILLIAM H ROCKEY DIRECTOR 1.00 X 0 0 0 SALLY WALKER DIRECTOR 1.00 X 0 0 0 CONTSTANCE CORL DIRECTOR 1.00 X 0 0 0 LORI JAMISON ADMINISTRATOR 40.00 X 0 0 0 0 0 0 0 0 0 0 APEX REHAB SOLUTIONS 209 SIGMA DR PITTSBURGH PA 15238 NURSING AGENY STAFFING 1715419 COMPLETE HEALTH CARE RESOURCES EASTERN 200 DRYDEN RD DRESHER PA 19025 MANAGEMENT SERVICES 740560 MOUNT NITTANY MEDICAL CENTER PO BOX 1259 STATE COLLEGE PA 16804 MEDICAL DIRECTOR FEES & SERVICES 109879 3 143912 6828 143912 ROOM & BOARD 623000 18261242 18261242 ANCILLARY SERVICES 623000 1195895 1195895 19457137 11460 11460 13705 0 13705 13705 13705 PA NURSING HOME ASSESSMENT 623000 1635658 1635658 FOOD 900099 63872 63872 VENDING 900099 5982 5982 64 64 1705576 21331790 21092795 0 95083 X 2771 2771 8993744 8218746 774998 110341 110341 2248190 2219312 28878 658742 603390 55352 496872 496872 98784 98784 34710 34710 2385606 2368448 17158 44538 44538 281738 172365 109373 58992 58992 1781599 1325940 455659 5954 1434 4520 101913 101913 378422 378422 PA NURSING HOME ASSESSM 1330856 1330856 MEDICAL SUPPLIES 847011 847011 DIETARY SUPPLIES 744222 744222 MAINTENANCE & SUPPLIES 272677 226719 45958 345755 293645 52110 21223437 19376604 1846833 0 1600 1600 2751860 2437222 2276418 2461828 167390 138071 262805 84885 780531 203284 448905 577247 739528 4800000 4800000 10399805 9108592 21108783 20348973 2426917 2139535 200367 241804 591676 0 3218960 2381339 X 7845361 9183875 10044462 8783759 17889823 17967634 21108783 20348973 108353 -30542 0 X 0 1 X 1 0 X 21892963 195683 143912 22232558 21892963 195683 143912 22232558 22232558 280 2219 11460 13959 7531 52754 69918 130203 22376720 41763470 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: FOOD - 2013 AMOUNT: $ 6,133. 2014 AMOUNT: $ 47,978. 2015 AMOUNT: $ 63,872. VENDING - 2013 AMOUNT: $ 359. 2014 AMOUNT: $ 4,664. 2015 AMOUNT: $ 5,982. MISCELLANEOUS - 2013 AMOUNT: $ 1,039. 2014 AMOUNT: $ 112. 2015 AMOUNT: $ 64. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 61011 5011 56000 719520 198273 521247 577247 RESIDENT TRUST FUNDS 241804 CONTRIBUTED RENT 8768873 DEPOSITS 26760 THIRD PARTY PAYOR SETTLEMENTS 71155 9108592 X 21301248 -30542 -30542 21331790 0 21331790 21223437 0 21223437 0 21223437 PART IV, LINE 2B: ESCROW ACCOUNTS ARE PATIENT FUNDS HELD IN TRUST FOR THEIR PERSONAL EXPENDITURES IN ACCORDANCE WITH DEPARTMENT OF HEALTH REGULATIONS. PART X, LINE 2: THE ORGANIZATION FOLLOWS THE PROVISIONS OF ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES WHICH PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. THE PROVISION ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, AND DISCLOSURES. MANAGEMENT HAS DETERMINED THAT THESE PROVISIONS DO NOT HAVE A MATERIAL IMPACT ON THE FINANCIAL STATEMENTS. THE ORGANIZATION'S FEDERAL INCOME TAX RETURNS SINCE ITS INCEPTION IN 2013 REMAIN SUBJECT TO EXAMINATION BY FEDERAL TAXING AUTHORITIES. STEVEN BROWN AND RICHARD WISNIEWSKI BOARD MEMBERS 109879 STEVEN BROWN AND RICHARD WISNIEWSKI ARE OFFICERS OF MOUNT NITTANY MEDICAL CENTER (MNMC). MNMC PROVIDES MEDICAL DIRECTOR SERVICES TO CENTRE CARE, INC. 0 FORM 990, PART VI, SECTION A, LINE 2 STEVE BROWN AND RICHARD WISNIEWSKI HAVE A BUSINESS RELATIONSHIP - BOTH ARE OFFICERS OF MOUNT NITTANY HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 3 CENTRE CARE HAS ENGAGED THIRD PARTY MANAGEMENT COMPANY (COMPLETE HEALTHCARE RESOURCES-EASTERN, INC. (CHRE) TO OVERSEE DAY-TO-DAY OPERATIONS. LORI JAMISON, ADMINISTRATOR OF THE FACILITY IS AN EMPLOYEE OF CHRE - HER COMPENSATION FOR 2015 FOR HER WORK AT CENTRE CARE WAS $155,460. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED IN DETAIL BY THE MANAGEMENT COMPANY AND CARL RAUP, SECRETARY/TREASURER OF THE BOARD. MANAGEMENT COMPANY HAS PROVIDED A "SHAREPOINT" SYSTEM ACCESS TO ALL FINANCIAL STATEMENTS, TAX RETURNS, OPERATING REPORTS, AND OTHER RELEVANT REPORTS THAT ALL MEMBERS OF THE BOARD HAVE ACCESS TO IN ORDER TO REVIEW OR DOWNLOAD SUCH REPORTS OR DOCUMENTS. THE FORM 990 WILL BE POSTED AND MEMBERS NOTIFIED OF ITS AVAILABILITY PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C CODE OF CONDUCT AND CONFLICT OF INTEREST POLICIES TAKEN INTO CONSIDERATION IN EVALUATING AND AWARDING CONTRACTS; BOARD HAS ENGAGED THIRD PARTY MANAGEMENT COMPANY (COMPLETE HEALTHCARE RESOURCES, "CHR") TO OVERSEE DAY-TO-DAY OPERATIONS, INCLUDING BIDS FOR CONTRACTS AND MANAGEMENT COMPANY PROVIDES RECOMMENDATIONS TO BOARD FOR FINAL APPROVAL. CHR PROVIDES ANNUAL TRAINING TO THE BOARD ON CORPORATE COMPLIANCE. THE COO OF CHR AND/OR RVP OF CHR, ALONG WITH ADMINISTRATOR ARE RESPONSIBLE FOR THE REVIEW AND MONITORING OF COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. DIRECTORS AND OFFICERS ARE REQUIRED TO SIGN OFF ON THE CODE OF CONDUCT AND CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION B, LINE 15 NO BOARD MEMBER OR OFFICER RECEIVES COMPENSATION FOR THEIR SERVICES. ADMINISTRATOR OF THE FACILITY IS AN EMPLOYEE OF THE MANAGEMENT COMPANY, WHICH ESTABLISHES PAY RATES FOR ADMINISTRATOR POSITIONS IN LINE WITH THE PENNSYLVANIA MARKET PLACE. CANDIDATES AND ASSOCIATED COMPENSATION ARE REVIEWED BY MANAGEMENT COMPANY WITH BOARD PRIOR TO HIRING. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY WILL BE MADE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES - OTHER: PROGRAM SERVICE EXPENSES 650. MANAGEMENT AND GENERAL EXPENSES 17,158. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,808. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 195,268. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 195,268. NURSING AGENCY FEES: PROGRAM SERVICE EXPENSES 358,985. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 358,985. PHYSICIAN/NURSING FEES: PROGRAM SERVICE EXPENSES 39,791. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 39,791. MEDICAL DIRECTOR: PROGRAM SERVICE EXPENSES 96,305. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 96,305. THERAPY SERVICES: PROGRAM SERVICE EXPENSES 1,639,829. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,639,829. PHARMACY SERVICES: PROGRAM SERVICE EXPENSES 37,620. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 37,620.