COMMUNITY HOSPICE INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY HOSPICE INC (EIN 31-0970252)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-04-24
IRS object ID
201501149349300605
Schema version
2014v5.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2015-04-24T08:54:08-05:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN611129886PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KELLEY GALLOWAY SMITH GOOLSBY PSCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11200 CORPORATE COURT PO BOX 990AddressLine1Txt
CityASHLANDCityNm
State AbbreviationKYStateAbbreviationCd
ZIP411050990ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN310970252EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HOSPICE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOMMBusinessNameControlTxt
Phone6063291890PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11480 CARTER AVENUEAddressLine1Txt
CityASHLANDCityNm
State AbbreviationKYStateAbbreviationCd
ZIP41101ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSUSAN HUNTPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone6063291890PhoneNum
Signature2015-04-13SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonPHILLIP M LAYNE CPAPreparerPersonNm
PTINP00039427PTIN
Phone6063291811PhoneNum
Preparation2015-04-15PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts$17,318,668GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CHOSPICE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1979FormationYr
Legal Domicile StateKYLegalDomicileStateCd
Activity Or MissionPROVIDING MEDICAL CARE TO TERMINALLY ILL PATIENTSActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent15VotingMembersIndependentCnt
Total Employee130TotalEmployeeCnt
Total Volunteers205TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$155,552PYContributionsGrantsAmt
CY Contributions Grants$353,750CYContributionsGrantsAmt
PY Program Service Revenue$13,555,952PYProgramServiceRevenueAmt
CY Program Service Revenue$11,891,211CYProgramServiceRevenueAmt
PY Investment Income$278,663PYInvestmentIncomeAmt
CY Investment Income$246,047CYInvestmentIncomeAmt
PY Other Revenue$55,836PYOtherRevenueAmt
CY Other Revenue$52,741CYOtherRevenueAmt
PY Total Revenue$14,046,003PYTotalRevenueAmt
CY Total Revenue$12,543,749CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$6,571,147PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$5,836,589CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$6,420,690PYOtherExpensesAmt
CY Other Expenses$5,796,051CYOtherExpensesAmt
PY Total Expenses$12,991,837PYTotalExpensesAmt
CY Total Expenses$11,632,640CYTotalExpensesAmt
PY Revenues Less Expenses$1,054,166PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$911,109CYRevenuesLessExpensesAmt
Total Assets BOY$23,120,712TotalAssetsBOYAmt
Total Assets EOY$24,293,066TotalAssetsEOYAmt
Total Liabilities BOY$1,329,769TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,289,624TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$21,790,943NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$23,003,442NetAssetsOrFundBalancesEOYAmt
MissionPROVIDING MEDICAL CARE TO TERMINALLY ILL PATIENTSMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$10,344,837ExpenseAmt
Revenue$11,891,211RevenueAmt
DescPROVIDING MEDICAL CARE, SOCIAL SERVICES, AND SPIRITUAL SUPPORT TO TERMINALLY ILL PATIENTS AND THEIR FAMILIES.Desc
Total Program Service Expenses$10,344,837TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstYes (true)ReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemYes (true)BusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document79IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld CompliancefalseBackupWthldComplianceInd
Employee130EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member15IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldKYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CHARLOTTE HORNBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6063291890PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11480 CARTER AVENUEAddressLine1Txt
CityASHLANDCityNm
State AbbreviationKYStateAbbreviationCd
ZIP41101ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndAverage Hours Per WeekAverageHoursPerWeekRtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
CONNIE BAYES
BOARD OF DIRYes (X)$0$0$0
JC BROWN
BOARD OF DIRYes (X)$0$0$0
DR TIMOTHY DIXON
BOARD OF DIRYes (X)$0$0$0
WILLIAM ELKINS
BOARD OF DIRYes (X)$0$0$0
MARGUERITE GILNER
BOARD OF DIRYes (X)$0$0$0
MICHAEL HOBBS
TREASURERYes (X)$0$0$0Yes (X)
VERN LINCOLN
BOARD OF DIRYes (X)$0$0$0
JOHN MCMEANS
BOARD OF DIRYes (X)$0$0$0
RAMONA SALYER
BOARD OF DIRYes (X)$0$0$0
JENNIFER SPARKS
BOARD OF DIRYes (X)$0$0$0
PAT STEEN
SECRETARYYes (X)$0$0$0Yes (X)
BRUCE VANHORN
VICE PRESIDEYes (X)$0$0$0Yes (X)
JOHN VINCENT
BOARD OF DIRYes (X)$0$0$0
TYLER WALTERS
PRESIDENTYes (X)$0$0$0Yes (X)
NANCY WYSE
BOARD OF DIRYes (X)$0$0$0
SUSAN HUNT
EXECUTIVE DI$153,472$0$040.00Yes (X)
DR LISA BARKER
DOCTOR$187,131$0$040.00Yes (X)
SANDY ZERKLE
DIRECTOR OF$104,440$0$040.00Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$445,043TotalReportableCompFromOrgAmt
Indiv Rcvd Greater Than100 K3IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
DIVERSICARE LEASING CORP
100 WURTLAND AVEWURTLANDKY41144NURSING HOME SE$998,124
HOSPICE PHARMACIA
BOX 510818PHILADELPHIAPA19175PHARMACY SERVIC$609,493
OAKMONT MANOR
PO BOX 822FLATWOODSKY41139NURSING HOME SE$314,197
WOODLAND OAKS
1820 OAKVIEW RDASHLANDKY41101NURSING HOME SE$278,673
GENESIS RESPIRATORY SERVICES
4132 GALLIA STNEW BOSTONOH45662MEDICAL EQUIPME$132,882
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K7CntrctRcvdGreaterThan100KCnt
All Other Contributions$353,750AllOtherContributionsAmt
Total Contributions$353,750TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT CARE - HOME CARE621610$9,368,585$9,368,585
PATIENT CARE - INPATIENT623000$2,522,626$2,522,626
FieldValueIRS element (for citing)
Total Program Service Revenue$11,891,211TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$187,878TotalRevenueColumnAmt
Related Or Exempt Func Income$187,878RelatedOrExemptFuncIncomeAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$4,815,097SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$4,756,708SecuritiesAmt
Other$220OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$58,389SecuritiesAmt
Other-$220OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$58,169TotalRevenueColumnAmt
Related Or Exempt Func Income$58,169RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$42,171FundraisingGrossIncomeAmt
Fundraising Direct Expenses$17,991FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$24,180TotalRevenueColumnAmt
Exclusion$24,180ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUSDesc
Business900099BusinessCd
Total Revenue Column$28,561TotalRevenueColumnAmt
Exclusion$28,561ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$28,561OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$12,543,749TotalRevenueColumnAmt
Related Or Exempt Func Income$12,137,258RelatedOrExemptFuncIncomeAmt
Exclusion$52,741ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$153,472TotalAmt
Management And General$153,472ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,035,699TotalAmt
Program Services$4,534,244ProgramServicesAmt
Management And General$501,455ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$268,514TotalAmt
Program Services$228,810ProgramServicesAmt
Management And General$39,704ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$378,904TotalAmt
Program Services$331,321ProgramServicesAmt
Management And General$47,583ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$48,920TotalAmt
Program Services$23,950ProgramServicesAmt
Management And General$24,970ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$49,358TotalAmt
Program Services$38,889ProgramServicesAmt
Management And General$10,469ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$42,122TotalAmt
Program Services$27,156ProgramServicesAmt
Management And General$14,966ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$17,239TotalAmt
Program Services$10,205ProgramServicesAmt
Management And General$7,034ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$45,464TotalAmt
Program Services$45,464ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$188,779TotalAmt
Program Services$184,398ProgramServicesAmt
Management And General$4,381ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$29,391TotalAmt
Program Services$21,923ProgramServicesAmt
Management And General$7,468ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$346,878TotalAmt
Program Services$171,990ProgramServicesAmt
Management And General$174,888ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$564,137TotalAmt
Program Services$443,804ProgramServicesAmt
Management And General$120,333ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
CONTRACTED PROFESSIONAL S$2,492,740$2,492,459$281
MEDICATION$665,450$665,450
MEDICAL EQUIPMENT RENTAL$264,159$264,159
MAINTENANCE AND REPAIRS$210,561$168,160$42,401

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$830,853TotalAmt
Program Services$692,455ProgramServicesAmt
Management And General$138,398ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$11,632,640TotalAmt
Program Services$10,344,837ProgramServicesAmt
Management And General$1,287,803ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,697,750BOYAmt
EOY$3,016,509EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$6,567,830BOYAmt
EOY$6,572,379EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,661,286BOYAmt
EOY$1,281,893EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$64,753BOYAmt
EOY$45,163EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$40,200BOYAmt
EOY$44,597EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$9,437,259LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,760,285LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$6,938,036BOYAmt
EOY$6,676,974EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$6,133,756BOYAmt
EOY$6,637,896EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$17,101BOYAmt
EOY$17,655EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$23,120,712BOYAmt
EOY$24,293,066EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,329,769BOYAmt
EOY$1,289,624EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,329,769BOYAmt
EOY$1,289,624EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$21,790,943BOYAmt
EOY$23,003,442EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$21,790,943BOYAmt
EOY$23,003,442EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$23,120,712BOYAmt
EOY$24,293,066EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$911,109ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$301,390NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$153,971CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$300,136CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$152,358CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$155,552CurrentTaxYearMinus1YearAmt
Current Tax Year$353,750CurrentTaxYearAmt
Total$1,115,767TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$153,971CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$300,136CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$152,358CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$155,552CurrentTaxYearMinus1YearAmt
Current Tax Year$353,750CurrentTaxYearAmt
Total$1,115,767TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$214,021SubstantialContributorsTotAmt
Public Support Total170$901,746PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$152,035CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$138,557CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$154,122CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$170,349CurrentTaxYearMinus1YearAmt
Current Tax Year$187,878CurrentTaxYearAmt
Total$802,941TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$136,847CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$103,013CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$70,313CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$55,836CurrentTaxYearMinus1YearAmt
Current Tax Year$52,741CurrentTaxYearAmt
Total$418,750TotalAmt
FieldValueIRS element (for citing)
Total Support$2,337,458TotalSupportAmt
Gross Receipts Rltd Activities$12,079,089GrossReceiptsRltdActivitiesAmt
Public Support CY1700.38580PublicSupportCY170Pct
Public Support PY1700.41310PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferencePART II, LINE 10FormAndLineReferenceDesc
ExplanationMISCELLANEOUS 418,750ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$917,458OtherCostOrOtherBasisAmt
Book Value$917,458BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,524,204OtherCostOrOtherBasisAmt
Depreciation$1,262,805DepreciationAmt
Book Value$5,261,399BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$72,053OtherCostOrOtherBasisAmt
Depreciation$19,214DepreciationAmt
Book Value$52,839BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,518,888OtherCostOrOtherBasisAmt
Depreciation$1,224,153DepreciationAmt
Book Value$294,735BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$404,656OtherCostOrOtherBasisAmt
Depreciation$254,113DepreciationAmt
Book Value$150,543BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$6,676,974TotalBookValueLandBuildingsAmt

Invst Program Related Org InvstProgramRelatedOrgGrp (8 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
PUBLICLY TRADED SECURITIES$3,455,254F
CORPORATE BONDS$967,724F
CDS & MONEY MARTKET ACCOUNTS$777,697F
US GOVERNMENT AGENCIES$737,641F
FIXED ACCOUNTS$283,647F
MUNICIPAL BONDS$166,342F
US GOVERNMENT BONDS$139,628F
MUTUAL FUNDS$109,963F
FieldValueIRS element (for citing)
Total Book Value Program Rltd$6,637,896TotalBookValueProgramRltdAmt
Total Rev Etc Audited Fincl Stmt$12,863,350TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$301,390NetUnrealizedGainsInvstAmt
Other Revenue$220OtherRevenueAmt
Revenue Not Reported$301,610RevenueNotReportedAmt
Revenue Subtotal$12,561,740RevenueSubtotalAmt
Other Revenues Not Included-$17,991OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$17,991RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$12,543,749TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$11,650,851TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$18,211OtherExpensesIncludedAmt
Expenses Not Reported$18,211ExpensesNotReportedAmt
Expenses Subtotal$11,632,640ExpensesSubtotalAmt
Total Expenses Per Form990$11,632,640TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PAGE 4, PART XI, LINE 2DNET LOSS ON SALE OF ASSETS 220
SCHEDULE D, PAGE 4, PART XI, LINE 4BFUNDRASING EXPENSES -17,991
SCHEDULE D, PAGE 4, PART XII, LINE 2DNET LOSS ON SALE OF ASSETS 220 FUNDRAISING EXPENSES 17,991

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1WINERY DINNEREvent1Nm
Gross Receipts Event1$15,761GrossReceiptsEvent1Amt
Gross Revenue Event1$15,761GrossRevenueEvent1Amt
Rent Facility Costs Event1$500RentFacilityCostsEvent1Amt
Food And Beverage Event1$4,378FoodAndBeverageEvent1Amt
Entertainment Event1$300EntertainmentEvent1Amt
Other Direct Expenses Event1$2,818OtherDirectExpensesEvent1Amt
Event2MEMORIAL BRICKSEvent2Nm
Gross Receipts Event2$9,400GrossReceiptsEvent2Amt
Gross Revenue Event2$9,400GrossRevenueEvent2Amt
Other Direct Expenses Event2$2,300OtherDirectExpensesEvent2Amt
Other Events Total3OtherEventsTotalCnt
Gross Receipts Other Events$17,010GrossReceiptsOtherEventsAmt
Gross Revenue Other Events$17,010GrossRevenueOtherEventsAmt
Food And Beverage Other Events$3,442FoodAndBeverageOtherEventsAmt
Oth Direct Expnss Other Events$4,253OthDirectExpnssOtherEventsAmt
Gross Receipts Total$42,171GrossReceiptsTotalAmt
Gross Revenue Total Events$42,171GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$500RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$7,820FoodAndBeverageTotalEventsAmt
Entertainment Total Events$300EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$9,371OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$17,991DirectExpenseSummaryEventsAmt
Net Income Summary$24,180NetIncomeSummaryAmt

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
SUSAN HUNT
EXECUTIVE DIRECTOR$153,472$153,472
DR LISA BARKER
DOCTOR$187,131$187,131

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
KINGS DAUGHTERS MEDICAL CENTER
DIRECTOR IS EMP$82,532MEDICAL SERVICES PROfalse
OUR LADY OF BELLEFONTE HOSPITAL
DIRECTOR IS EMP$28,295MEDICAL SERVICES PROfalse
TOWN SQUARE BANK
DIR. IS PRESIDE$530,448BANK CDfalse

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE L, PART VFormAndLineReferenceDesc
ExplanationKINGS DAUGHTERS MEDICAL CENTER: DIRECTOR IS THE PATIENT SERVICES DIRECTOR. OUR LADY OF BELLEFONTE HOSPITAL: DIRECTOR IS THE DIRECTOR OF MISSIONS. TOWN SQUARE BANK: DIRECTOR IS PRESIDENT OF THE BANK.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 11BTHE 990 IS REVIEWED BY THE EXECUTIVE DIRECTOR, THE DIRECTOR OF FINANCE, AND THE FINANCE COMMITTEE. THE GOVERNING BOARD IS THEN NOTIFIED THAT THE RETURN IS COMPLETED AND THEY ARE NOTIFIED OF THE DUE DATE AND THAT THE RETURN IS AVAILABLE TO THEM FOR REVIEW IF THEY DEEM NECESSARY IN THE BUSINESS OFFICE.
FORM 990, PAGE 6, PART VI, LINE 12CCONFLICT OF INTEREST FORMS ARE COMPLETED WHEN FIRST JOINING THE BOARD.
FORM 990, PAGE 6, PART VI, LINE 19COPIES ARE PROVIDED AT OUR ADMINISTRATIVE OFFICES UPON REQUEST.
FORM 990, PART XI, LINE 9NET LOSS ON SALE OF ASSETS 220 FUNDRASING EXPENSES 17,991 NET LOSS ON SALE OF ASSETS -220 FUNDRAISING EXPENSES -17,991

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