UPMC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- UPMC (EIN 24-0802108)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-02-12
- IRS object ID
- 201540439349300714
- Schema version
- 2013v4.0
- 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 G
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-02-12T08:33:30-06:00 | ReturnTs |
| Tax Period End | 2014-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E ST LOUIS 200/PO BOX 1190 | AddressLine1 |
| City | SPRINGFIELD | City |
| State | MO | State |
| ZIP Code | 658062523 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 240802108 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHARLES COLE MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % RON RAPP | InCareOfNm |
| Business Name Control | CHAR | BusinessNameControlTxt |
| Phone | 8142749300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 EAST SECOND STREET | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | COUDERSPORT | City |
| State | PA | State |
| ZIP Code | 16915 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | EDWARD C PITCHFORD | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 8142749300 | PhoneNum |
| Signature | 2015-02-10 | 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 | 8142749300 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | EDWARD PITCHFORD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 EAST SECOND STREET | AddressLine1 |
| City | COUDERSPORT | City |
| State | PA | State |
| ZIP Code | 16915 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $121,760,233 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.COLEMEMORIAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1967 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | COLE MEMORIAL PROVIDES EXCELLENT HEALTH CARE SERVICES BY PROVIDING INPATIENT, OUTPATIENT AND PRIMARY CARE SERVICES TO THE SURROUNDING COMMUNITY. SEE SCHEDULE O. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 687 | TotalEmployeeCnt |
| Total Volunteers | 59 | TotalVolunteersCnt |
| Total Gross UBI | $56,786 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $55,519 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,100,072 | PYContributionsGrantsAmt |
| CY Contributions Grants | $435,844 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $80,419,342 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $82,532,092 | CYProgramServiceRevenueAmt |
| PY Investment Income | $662,938 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,239,026 | CYInvestmentIncomeAmt |
| PY Other Revenue | $224,985 | PYOtherRevenueAmt |
| CY Other Revenue | -$712,779 | CYOtherRevenueAmt |
| PY Total Revenue | $82,407,337 | PYTotalRevenueAmt |
| CY Total Revenue | $83,494,183 | 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 | $34,251,160 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $34,879,345 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $18,500 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $35,000 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $35,000 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $44,227,326 | PYOtherExpensesAmt |
| CY Other Expenses | $45,855,489 | CYOtherExpensesAmt |
| PY Total Expenses | $78,496,986 | PYTotalExpensesAmt |
| CY Total Expenses | $80,769,834 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,910,351 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,724,349 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $61,179,485 | TotalAssetsBOYAmt |
| Total Assets EOY | $71,501,755 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $39,271,637 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $45,661,108 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $21,907,848 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $25,840,647 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE PURPOSE OF COLE MEMORIAL IS TO PROVIDE EXCELLENT HEALTHCARE SERVICES, RESPONDING TO THE NEEDS OF THE COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $19,090,626 | ExpenseAmt |
| Revenue | $43,477,319 | RevenueAmt |
| Desc | COLE MEMORIAL OFFERS OUTPATIENT SERVICES, EXCEEDING 368,000 TESTS/TREATMENTS ANNUALLY THROUGHOUT THE HOSPITAL'S FOUR-COUNTY AREA AND INCLUDING IMAGING, LAB, AND REHABILITATION SERVICES. OUTPATIENT SURGERIES EXCEED 4,000 ANNUALLY. THE PATTERSON CANCER CARE CENTER OFFERS FULL SERVICE RADIATION AND MEDICAL ONCOLOGY SERVICES AND HOUSES AN AMERICAN CANCER SOCIETY PATIENT RESOURCE CENTER ONSITE. THE CANCER CENTER IS HOME TO A VARIETY OF SUPPORT GROUPS, AS WELL AS FREQUENT FREE CANCER SCREENINGS FOR THE PUBLIC. COLE MEMORIAL'S HOME HEALTH AND HOSPICE SERVICES ASSIST PATIENTS THROUGHOUT THE REGION, WITH A GROWING NUMBER OF REFERRALS AND LOWER INFECTION RATES AMONG STATE AND NATIONAL AVERAGES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $17,382,480 | ExpenseAmt |
| Revenue | $12,599,481 | RevenueAmt |
| Desc | COLE MEMORIAL PROVIDES PRIMARY CARE TO ITS SURROUNDING COMMUNITIES. THE HOSPITAL PROVIDES PRIMARY CARE TO THE SURROUNDING COMMUNITIES IN FOUR COUNTIES AT RURAL HEALTH CENTERS(RHCS), LOCATED IN COUDERSPORT, GALETON, ULYSSES, WESTFIELD, SHINGLEHOUSE, PORT ALLEGANY, ELDRED, SMETHPORT, AND EMPORIUM. COLLECTIVELY, 90,200 PATIENT VISITS WERE REPORTED LAST YEAR. FOUR OF THOSE LOCATIONS ALSO INCLUDE WELLNESS AND REHABILITATION CENTERS, MAKING IT MORE CONVENIENT FOR PATIENTS TO RECEIVE THE CARE THEY NEED CLOSE TO HOME. SEE SCHEDULE O FOR DETAIL. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $13,686,165 | ExpenseAmt |
| Revenue | $20,775,694 | RevenueAmt |
| Desc | COLE MEMORIAL OFFERS VARIOUS INPATIENT SERVICES. COLE MEMORIAL ADMITTED 1,550 PATIENTS LAST YEAR (5,080 ACUTE CARE DAYS) TO INPATIENT SERVICES INCLUDING MEDICAL/SURGICAL, INTENSIVE CARE AND OBSTETRICS UNITS. COLE MEMORIAL'S 24-HOUR EMERGENCY DEPARTMENT ADMITTED 840 PATIENTS LAST YEAR AND SAW 9,430 VISITS LAST YEAR. THE HOSPITAL'S MATERNITY UNIT WELCOMED 150 BABIES INTO THE WORLD LAST YEAR AND ALSO SUPPORTS MOTHERS-TO-BE WITH REGULAR LAMAZE AND BREASTFEEDING SUPPORT PROGRAMS AND THE HEALTHY BEGINNINGS PLUS PROGRAM FOR LOW INCOME MOTHERS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $19,846,690 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $5,679,598 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $70,005,961 | 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 | Yes (true) | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | 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 | Yes (true) | 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 | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| 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 | Yes (true) | 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 | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 40 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 687 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | 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 | Yes (true) | 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 | RON RAPP | PersonNm |
| Phone | 8142745250 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 EAST SECOND STREET | AddressLine1 |
| City | COUDERSPORT | City |
| State | PA | State |
| ZIP Code | 16915 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| MICHAEL E CALLAHAN | |||||||||
| PHYSICIAN, 2ND VICE CHAIR | 40.0 | 1.0 | Yes (X) | Yes (X) | $109,960 | $0 | $10,883 | ||
| JASON TRONETTI | |||||||||
| PHYSICIAN, DIRECTOR | 40.0 | 1.0 | Yes (X) | $348,561 | $0 | $29,464 | |||
| CHARLES UPDEGRAFF | |||||||||
| TREASURER | 1.0 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| RON CASKEY | |||||||||
| SECRETARY | 1.0 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| REVEREND RANDALL HEADLEY | |||||||||
| CHAIRMAN | 1.0 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| KALLIOPI NESTOR | |||||||||
| PHYSICIAN, DIRECTOR | 40.0 | 1.0 | Yes (X) | $228,883 | $0 | $13,530 | |||
| ROBERT SMITH | |||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| RUSSELL STREICH | |||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| DAVID BUCKLER | |||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| DAVID CRANDALL | |||||||||
| 1ST VICE CHAIRMAN | 1.0 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JEANNE MIGLICIO | |||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| THOMAS SHAFFER | |||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| CLIFFORD WOOD | |||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| EDWARD C PITCHFORD | |||||||||
| PRESIDENT, CEO & ASST. SEC. | 40.0 | 2.0 | Yes (X) | $353,122 | $0 | $31,046 | |||
| CYNTHIA HARDESTY | |||||||||
| VICE PRESIDENT, CNE | 40.0 | 1.0 | $186,687 | $0 | $12,945 | Yes (X) | |||
| BRADLEY GIANNOTTI | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $939,399 | $0 | $24,910 | Yes (X) | |||
| TERRANCE FOUST | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $799,190 | $0 | $17,654 | Yes (X) | |||
| SAKET PRASAD | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $619,605 | $0 | $25,731 | Yes (X) | |||
| CHRISTAN CARAMIA | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $465,115 | $0 | $31,244 | Yes (X) | |||
| PHONG NGUYEN | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $414,614 | $0 | $14,359 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,465,136 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $211,766 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 36 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| ServicesServicesDesc | CompensationCompensationAmt |
|---|---|
| JAMES BARKE MD | |
| PHYSICIAN PRACTICE | $655,800 |
| FOOT ANKLE INNOVATIONS PC | |
| PHYSICIAN | $404,106 |
| BKD LLP | |
| AUDIT/TAX/CONSULTING | $127,560 |
| ALLEGHANY HOSPITAL ASSOCIATES | |
| PHYSICIAN PRACTICE | $323,750 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $321,832 | GovernmentGrantsAmt |
| All Other Contributions | $114,012 | AllOtherContributionsAmt |
| Total Contributions | $435,844 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621990 | $76,829,755 | $76,829,755 |
| PHARMACY | 446110 | $4,704,447 | $4,704,447 |
| CAFETERIA | 722514 | $370,541 | $370,541 |
| OTHER | 621990 | $627,349 | $627,349 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $82,532,092 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $253,903 | TotalRevenueColumnAmt |
| Exclusion | $253,903 | 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 | $265,371 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $279,873 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$14,502 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$14,502 | TotalRevenueColumnAmt |
| Exclusion | -$14,502 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $38,928,190 | SecuritiesAmt |
| Other | $43,110 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $37,872,200 | SecuritiesAmt |
| Other | $113,977 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,055,990 | SecuritiesAmt |
| Other | -$70,867 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $985,123 | TotalRevenueColumnAmt |
| Exclusion | $985,123 | 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 (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| GAIN ON INVESTMENT IN EQUITY INVESTEE | 900099 | $203,202 | $203,202 | |
| INCOME FROM INVESTMENT IN SUBSIDIARIES | 900099 | -$84,487 | -$141,273 | $56,786 |
| LOSS ON EXTINGUISHMENT OF DEBT | 900099 | -$816,992 | -$816,992 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | -$698,277 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $83,494,183 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $82,532,092 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $56,786 | UnrelatedBusinessRevenueAmt |
| Exclusion | $469,461 | 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 | $1,240,033 | TotalAmt |
| Program Services | $639,844 | ProgramServicesAmt |
| Management And General | $600,189 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $333,157 | TotalAmt |
| Program Services | $176,955 | ProgramServicesAmt |
| Management And General | $156,202 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,079,167 | TotalAmt |
| Program Services | $22,141,756 | ProgramServicesAmt |
| Management And General | $3,937,411 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $757,206 | TotalAmt |
| Program Services | $404,392 | ProgramServicesAmt |
| Management And General | $352,814 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,522,833 | TotalAmt |
| Program Services | $3,964,145 | ProgramServicesAmt |
| Management And General | $558,688 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,946,949 | TotalAmt |
| Program Services | $1,490,891 | ProgramServicesAmt |
| Management And General | $456,058 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $683,933 | TotalAmt |
| Program Services | $683,933 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $164,592 | TotalAmt |
| Program Services | $9,397 | ProgramServicesAmt |
| Management And General | $155,195 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $127,164 | TotalAmt |
| Management And General | $127,164 | 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 | $35,000 | TotalAmt |
| Fundraising | $35,000 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,280 | TotalAmt |
| Management And General | $50,280 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,087,429 | TotalAmt |
| Program Services | $15,264,456 | ProgramServicesAmt |
| Management And General | $822,973 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $166,980 | TotalAmt |
| Program Services | $578 | ProgramServicesAmt |
| Management And General | $166,402 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,258,109 | TotalAmt |
| Program Services | $3,735,561 | ProgramServicesAmt |
| Management And General | $1,522,548 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,302,948 | TotalAmt |
| Program Services | $2,133,490 | ProgramServicesAmt |
| Management And General | $169,458 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $386,169 | TotalAmt |
| Program Services | $344,166 | ProgramServicesAmt |
| Management And General | $42,003 | 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 | $292,949 | TotalAmt |
| Program Services | $174,737 | ProgramServicesAmt |
| Management And General | $118,212 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,049,553 | TotalAmt |
| Program Services | $939,731 | ProgramServicesAmt |
| Management And General | $109,822 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,083,021 | TotalAmt |
| Program Services | $2,760,426 | ProgramServicesAmt |
| Management And General | $322,595 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,011,332 | TotalAmt |
| Program Services | $387,803 | ProgramServicesAmt |
| Management And General | $623,529 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUGS | $10,834,937 | $10,834,937 | |
| BAD DEBT | $3,684,986 | $3,684,986 | |
| LICENSES, DUES, SUBSCRIPTIONS | $526,744 | $233,777 | $292,967 |
| RECRUITING & RETENTION | $144,363 | $144,363 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,769,834 | TotalAmt |
| Program Services | $70,005,961 | ProgramServicesAmt |
| Management And General | $10,728,873 | ManagementAndGeneralAmt |
| Fundraising | $35,000 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,751,622 | BOYAmt |
| EOY | $5,496,302 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,572,899 | BOYAmt |
| EOY | $12,027,870 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $65,739 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,099,480 | BOYAmt |
| EOY | $7,852,653 | 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 | $1,160,358 | BOYAmt |
| EOY | $1,167,930 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,603,029 | BOYAmt |
| EOY | $1,319,402 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $70,482,610 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $44,992,834 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,287,965 | BOYAmt |
| EOY | $25,489,776 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,117,001 | BOYAmt |
| EOY | $13,627,429 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,896,128 | BOYAmt |
| EOY | $2,420,079 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $536,314 | BOYAmt |
| EOY | $805,621 | 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 | $1,088,950 | BOYAmt |
| EOY | $1,294,693 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,179,485 | BOYAmt |
| EOY | $71,501,755 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,132,864 | BOYAmt |
| EOY | $12,271,142 | 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 | $17,838,950 | BOYAmt |
| EOY | $30,012,945 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,029 | BOYAmt |
| EOY | $4,070 | 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 | $3,564,725 | BOYAmt |
| EOY | $724,174 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,626,069 | BOYAmt |
| EOY | $2,648,777 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,271,637 | BOYAmt |
| EOY | $45,661,108 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,805,684 | BOYAmt |
| EOY | $21,382,406 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $108,028 | BOYAmt |
| EOY | $37,683 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,994,136 | BOYAmt |
| EOY | $4,420,558 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,907,848 | BOYAmt |
| EOY | $25,840,647 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,179,485 | BOYAmt |
| EOY | $71,501,755 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $2,724,349 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $846,750 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $361,700 | 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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 | $10,250 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $10,250 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1I | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION IS A MEMBER OF HAP, AHA, AND HCWP. $10,250 OF DUES ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| Agent Trustee Etc | false | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (true) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,994,146 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $660,852 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $234,440 | OtherExpendituresAmt |
| End Year Balance | $4,420,558 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,877,382 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $378,612 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $261,848 | OtherExpendituresAmt |
| End Year Balance | $3,994,146 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,280,877 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$106,295 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $297,200 | OtherExpendituresAmt |
| End Year Balance | $3,877,382 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,667,800 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $942,900 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $329,823 | OtherExpendituresAmt |
| End Year Balance | $4,280,877 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,616,355 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $437,150 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $385,705 | OtherExpendituresAmt |
| End Year Balance | $3,667,800 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,135,847 | OtherCostOrOtherBasisAmt |
| Book Value | $1,135,847 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $40,181,580 | OtherCostOrOtherBasisAmt |
| Depreciation | $23,357,963 | DepreciationAmt |
| Book Value | $16,823,617 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $27,031,143 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,278,241 | DepreciationAmt |
| Book Value | $6,752,902 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,134,040 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,356,630 | DepreciationAmt |
| Book Value | $777,410 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $25,489,776 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO THIRD PARTY PAYERS | $2,103,754 |
| MALPRACTICE LIABILITY | $545,023 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,648,777 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $80,217,798 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $846,750 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $7,750 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | -$3,294,290 | OtherRevenueAmt |
| Revenue Not Reported | -$2,439,790 | RevenueNotReportedAmt |
| Revenue Subtotal | $82,657,588 | RevenueSubtotalAmt |
| Other Revenues Not Included | $836,595 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $836,595 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $83,494,183 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $77,322,191 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $7,750 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $279,873 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $287,623 | ExpensesNotReportedAmt |
| Expenses Subtotal | $77,034,568 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $50,280 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $3,684,986 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $3,735,266 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $80,769,834 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART IV, LINE 2B | ESCROW ACCOUNTS: THE CORPORATION HAS AN ESCROW ACCOUNT FOR THEIR SKILLED NURSING FACILITY PATIENTS WHO REQUEST THE USE OF THE ACCOUNT. THIS AMOUNT IS REPORTED ON FORM 990, PART X, LINE 21. |
| SCHEDULE D, PART V, LINE 4 | ENDOWMENT FUND: THE ENDOWMENT FUND WAS ESTABLISHED TO ALLOW THE HOSPITAL TO PROVIDE HEALTHCARE SERVICES TO POOR AND NEEDY PATIENTS. |
| 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 ON FORM 990, PART VIII, LINE 12: $(3,684,986) BAD DEBT EXPENSE (50,280) INVESTMENT MANAGEMENT FEES 440,976 UNRESTRICTED NARR ------------- $(3,294,290) |
| SCHEDULE D, PART XI, LINE 4B | OTHER REVENUE ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ (279,873) RENTAL EXPENSES 242,506 UNRESTRICTED CONTRIBUTIONS 475 UNRESTRICTED INVESTMENT RETURN 192,436 TRNA CONTRIBUTIONS (513) TRNA INVESTMENT RETURN 681,564 PRNA INVESTMENT RETURN ------------ $ 836,595 |
| SCHEDULE D, PART XII, LINE 2D | OTHER EXPENSES ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25: $ 279,873 RENTAL EXPENSES |
| SCHEDULE D, PART XII, LINE 4B | OTHER EXPENSES ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $3,684,986 BAD DEBT EXPENSE |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Solicitation Of Non Govt Grants | Yes (X) | SolicitationOfNonGovtGrantsInd |
| Solicitation Of Govt Grants | Yes (X) | SolicitationOfGovtGrantsInd |
| Agrmt Prof Fundraising Acty | Yes (true) | AgrmtProfFundraisingActyInd |
Fundraiser Activity Info FundraiserActivityInfoGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DELTA DEVELOPMENT GROUP INC | PersonNm |
| Activity | GRANT WRITING | ActivityTxt |
| Fundraiser Control Of Funds | false | FundraiserControlOfFundsInd |
| Retained By Contractor | $35,000 | RetainedByContractorAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Retained By Contractors | $35,000 | TotalRetainedByContractorsAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE G, PART I, LINE 2B | FormAndLineReferenceDesc |
| Explanation | FUNDRAISING ACTIVITIES: THE ORGANIZATION HIRED DELTA DEVELOPMENT GROUP, INC., FOR GRANT WRITING SERVICES. THE AGREEMENT PROVIDED FOR A MONTHLY FEE FOR PROFESSIONAL FUNDRAISING SERVICES AS WELL AS REIMBURSEMENT OF ADDITIONAL FUNDRAISING EXPENSES. | ExplanationTxt |
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 |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | 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 | false | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $970,473 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $970,473 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01260 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,676,937 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,192,539 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,484,398 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03220 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,647,410 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,192,539 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,454,871 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04480 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $100,062 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,254 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $79,808 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,118,120 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,118,120 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01450 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $28,048,659 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,560,743 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,487,916 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09710 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,210 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,210 | NetCommunityBenefitExpnsAmt |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $29,270,051 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,580,997 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,689,054 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11260 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $43,917,461 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $31,773,536 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $12,143,925 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.15740 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Persons Served | 120 | PersonsServedCnt |
| Total Community Benefit Expns | $1,588 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,588 | NetCommunityBenefitExpnsAmt |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 10 | ActivitiesOrProgramsCnt |
| Persons Served | 791 | PersonsServedCnt |
| Total Community Benefit Expns | $28,171 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,707 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $12,464 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 33 | ActivitiesOrProgramsCnt |
| Persons Served | 863 | PersonsServedCnt |
| Total Community Benefit Expns | $4,549 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,549 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 280 | PersonsServedCnt |
| Total Community Benefit Expns | $1,017 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,017 | NetCommunityBenefitExpnsAmt |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 50 | ActivitiesOrProgramsCnt |
| Persons Served | 2054 | PersonsServedCnt |
| Total Community Benefit Expns | $35,325 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,707 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $19,618 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,684,986 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $556,433 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $14,494,373 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $14,350,865 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $143,508 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| 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 | CHARLES COLE MEMORIAL HOSPITAL | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 EAST 2ND STREET | AddressLine1 |
| City | COUDERSPORT | City |
| State | PA | State |
| ZIP Code | 16915 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.colememorial.org | WebsiteAddressTxt |
| State License | 031801 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHARLES COLE MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| 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 | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | http://www.colememorial.org/about.aspx | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | false | AllNeedsAddressedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (true) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (true) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 400. | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| State Regulation | Yes (X) | StateRegulationInd |
| Residency | Yes (X) | ResidencyInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Attached To Invoice | Yes (X) | AttachedToInvoiceInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Average Negotiated Rates | Yes (X) | AverageNegotiatedRatesInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 3 | COMMUNITY INPUT: COLE MEMORIAL USED A 6-STEP APPROACH TO COMPLETE THE NEEDS ASSESSMENT. INCLUDED IN THIS APPROACH WERE SEVERAL DATA ANALYSES, BASED ON SECONDARY SOURCE DATA AUGMENTED WITH COMMUNITY HEALTH SURVEY DATA. SINCE THE SERVICE AREA DOES NOT COMPRISE SOME OF THE ENTIRE COUNTIES WE SERVE, COLE MEMORIAL ASKED LOCAL RESIDENTS TO NOTE IF THEY PERCEIVED THE PROBLEMS, OR NEEDS IDENTIFIED BY SECONDARY SOURCES TO EXIST IN THEIR PORTION OF THE COUNTY THEY LIVE IN. DATA SOURCES USED INCLUDED SEVERAL WEBSITES TO ASSESS THE HEALTH NEEDS OF THE COUNTIES SERVED, ACCESS CURRENT POPULATION DATA, ASSESS CHARACTERISTICS OF CERTAIN HEALTH OBJECTIVES, ADDRESS THE PROBLEM OF ESCALATING HEALTH COSTS, AND CAPTURE DATA THAT CAN HELP UNDERSTAND HEALTH STATISTICS. TO OBTAIN DATA WITHIN THE COMMUNITIES SERVED BY COLE MEMORIAL, ALL COMMUNITY MEMBERS WERE INVITED TO COMPLETE A SURVEY, WHICH WOULD REMAIN ANONYMOUS. THE ADMINISTRATION OF AN INTERNET-BASED AND PAPER SURVEY WAS PROMOTED THROUGH ADVERTISEMENTS IN LOCAL NEWSPAPERS, BLOGS, AND TELEVISION AND WAS DISTRIBUTED TO LOCAL CIVIC AND HEALTH ORGANIZATIONS. |
| SCHEDULE H, PART V, SECTION B, LINE 6 | IMPLEMENTATION STRATEGY: IN RESPONSE TO THE RESULTS OF COLE MEMORIAL'S MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT, THE ORGANIZATION ADOPTED AN IMPLEMENTATION STRATEGY. THE IMPLEMENTATION STRATEGY CAN BE FOUND AT THE FOLLOWING URL, AS PART OF THE CHNA: HTTP://WWW.COLEMEMORIAL.ORG/ABOUT.ASPX |
| SCHEDULE H, PART V, SECTION B, LINE 7 | ADDRESSING IDENTIFIED NEEDS: ALTHOUGH COLE MEMORIAL RECOGNIZES THE IMPORTANCE OF ALL THE NEEDS IDENTIFIED BY THE COMMUNITY, SUCH AS TRANSPORTATION, WE WILL NOT DIRECTLY DESIGN STRATEGIES FOR THIS ISSUE IN THE IMPLEMENTATION PLAN. TRANSPORTATION DID NOT RANK HIGH IN THE NEEDS ASSESSMENT AND THE STEERING COMMITTEE FELT THAT THERE IS NOT ENOUGH FUNDING AND AVAILABLE RESOURCES TO MAKE THIS A HIGH PRIORITY AT THIS TIME. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 11 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (11 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| PORT ALLEGANY HEALTH CENTER | ||||
| 45 PINE STREET | PORT ALLEGANY | PA | 16743 | RURAL HEALTH CENTER REHABILITATION LAB SERVICES, RADIOLOGY |
| SHINGLEHOUSE HEALTH CENTER | ||||
| 128 LYONS STREET | SHINGLEHOUSE | PA | 16748 | RURAL HEALTH CENTER LAB SERVICES |
| ELDRED HEALTH CENTER | ||||
| 139 MAIN STREET | ELDRED | PA | 16371 | RURAL HEALTH CENTER LAB SERVICES |
| EMPORIUM HEALTH CENTER | ||||
| SIZERVILLE ROAD | EMPORIUM | PA | 15834 | RURAL HEALTH CENTER LAB SERVICES |
| GALETON HEALTH CENTER | ||||
| 30 RIVER STREET | GALETON | PA | 16922 | RURAL HEALTH CENTER LAB SERVICES |
| WESTFIELD RURAL HEALTH CLINIC | ||||
| 222 CHURCH STREET | WESTFIELD | PA | 16950 | RURAL HEALTH CENTER LAB SERVICES |
| HEWITT MANOR | ||||
| 111 WEST HONEOYE STREET | SHINGLEHOUSE | PA | 16748 | REHABILITATION |
| SMETHPORT HEALTH CENTER | ||||
| 83 MARVIN STREET | SMETHPORT | PA | 16749 | RURAL HEALTH CENTER LAB SERVICES |
| NORTHERN POTTER HEALTH CENTER | ||||
| 511 ACADEMY STREET | ULYSSES | PA | 16948 | RURAL HEALTH CENTER LAB SERVICES |
| CENTRAL POTTER HEALTH CENTER | ||||
| 46 ELK STREET | COUDERSPORT | PA | 16915 | RURAL HEALTH CENTER LAB SERVICES |
| HOME HEALTH | ||||
| 269 ROUTE 6 | COUDERSPORT | PA | 16915 | HOME HEALTH OFFICES |
Supplemental Information Detail SupplementalInformationDetail (13 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 $3,684,986. |
| SCHEDULE H, PART I, LINE 7G | SUBSIDIZED HEALTH SERVICES: SEVERAL RURAL HEALTH CLINICS WERE INCLUDED IN THE COMPUTATION OF SUBSIDIZED HEALTH SERVICES ON LINE 7G. COLE MEMORIAL PROVIDES PRIMARY CARE TO THE SURROUNDING COUNTIES AT THESE RURAL HEALTH CENTERS. THESE SERVICES ARE PROVIDED IN RURAL AREAS WHERE THERE WOULD BE A SHORTAGE OF QUALITY MEDICAL CARE WITHOUT THE SERVICES. COLE MEMORIAL CONTINUES TO PROVIDE THESE SERVICES AS A BENEFIT TO THE COMMUNITY DESPITE KNOWING THAT FINANCIAL SHORTFALLS WILL BE SUSTAINED. |
| SCHEDULE H, PART I, LINE 7 | COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1, 3, AND 6. |
| SCHEDULE H, PART II | COMMUNITY BUILDING ACTIVITIES: SEE NARRATIVE AT SCHEDULE H, PART VI, LINE 4. |
| SCHEDULE H, PART III, SECTION A, LINES 2 & 3 | BAD DEBT EXPENSE METHODOLOGY: LINE 2 REPORTS THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS FROM THE AUDITED FINANCIAL STATEMENTS. LINE 3 WAS DETERMINED BY MULTIPLYING THE BAD DEBT EXPENSE (LINE 2) BY THE PERCENT OF PERSONS BELOW THE POVERTY LEVEL BASED ON US CENSUS BUREAU DATA FOR 2008 - 2012. |
| SCHEDULE H, PART III, SECTION A, LINE 4 | BAD DEBT EXPENSE: THE HOSPITAL PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS, WHICH IS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE PATIENT OR THIRD-PARTY PAYER. |
| SCHEDULE H, PART III, SECTION B, LINE 8 | COMMUNITY BENEFIT: MEDICARE DATA COMPUTED USING THE MEDICARE COST REPORT FILED WITH CMS WAS UTILIZED FOR THE COMPUTATIONS IN PART III, SECTION B. MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT, AS COLE MEMORIAL IS CLASSIFIED AS A CRITICAL ACCESS HOSPITAL. THIS CLASSIFICATION SHOWS THAT COLE MEMORIAL IS IN A MEDICALLY UNDERSERVED AREA AND AT A HEALTH PROFESSIONAL SHORTAGE AREA. THIS DEMONSTRATES THAT COLE MEMORIAL IS THE ONLY REASONABLE SOURCE OF HOSPITAL CARE AVAILABLE TO MEDICARE BENEFICIARIES IN OUR SERVICE AREA, AND LIKEWISE TREATS ALL BENEFICIARIES IN OUR SERVICE AREA THAT PRESENT THEMSELVES FOR CARE, DESPITE KNOWING WE WILL GENERALLY LOSE MONEY CARING FOR MEDICARE PATIENTS. ADDITIONALLY, 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: EFFORTS ARE MADE TO IDENTIFY PATIENTS WHO MAY BE ELIGIBLE FOR CHARITY CARE IN ACCORDANCE WITH THE HOSPITAL'S CHARITY CARE POLICY OR THE PHYSICIAN NETWORK SLIDING FEE SCALE PRIOR TO THE STATEMENT PROCESS WHEN POSSIBLE. |
| SCHEDULE H, PART VI, LINE 2 | NEEDS ASSESSMENT: UNDERSTANDING THE HEALTH NEEDS OF THE COMMUNITY ALLOWS COLE MEMORIAL TO DESIGN AND IMPLEMENT COST-EFFECTIVE STRATEGIES THAT IMPROVE THE HEALTH STATUS OF THE POPULATIONS WE SERVE. A COMPREHENSIVE DATA DRIVEN ASSESSMENT PROCESS CAN IDENTIFY PRIORITY HEALTH NEEDS AND ISSUES RELATED TO PREVENTION, DIAGNOSIS AND TREATMENT THROUGH QUANTITATIVE AND QUALITATIVE DATA. COLE MEMORIAL'S COMMUNITY HEALTH NEEDS ASSESSMENT FOCUSES ON THE 28 ZIP CODES THAT WE SERVE. TO HELP GUIDE THE PROCESS USED FOR THE ASSESSMENT, A CHNA STEERING COMMITTEE WAS CONVENED. THIS COMMITTEE'S ROLE WAS TO PROVIDE INPUT ON: (A) IDENTIFICATION OF EXISTING DATA SOURCES FOR THE STUDY; (B) CONTENT OF THE COMMUNITY ONLINE SURVEY QUESTIONNAIRE; (C) INTERPRETATION OF SURVEY FINDINGS; (D) REVIEW OF RECOMMENDATIONS, AND; (E) DATA DISSEMINATION AND A FOLLOW-UP PLAN. IN ADDITION TO THE CHNA STEERING COMMITTEE, COLE MEMORIAL'S ADVISORY COMMITTEES WHICH REPRESENTED PUBLIC HEALTH, GOVERNMENT, FORMER AND PRESENT BOARD MEMBERS, FOUNDATIONS, PASTORS, SCHOOL NURSES, AND VARIOUS OTHER ORGANIZATIONS, PROVIDED CRITICAL INPUT INTO THE NEEDS ASSESSMENT, FROM INITIAL CONCEPT TO HOW THE DATA WOULD BE SHARED WITH COMMUNITIES IN OUR SPRING AND FALL MEETINGS IN 2013. THE SET OF MEASURES USED IN THIS ASSESSMENT WAS SELECTED TO REFLECT EVOLVING NATIONAL AND STATE BENCHMARKS FOR CHRONIC DISEASE MANAGEMENT, ACCESS TO PRIMARY CARE, DENTAL AND SMOKING/TOBACCO. MOST INDICATORS WERE DERIVED FROM PUBLIC DATA SOURCES, INCLUDING U.S. CENSUS DATA, HEALTHY PEOPLE 2020 AND COUNTY HEALTH RANKINGS. A COMPLETE LIST OF DATA SOURCES AND YEARS IS INCLUDED IN APPENDIX E OF THE CHNA. OTHER INDICATORS WERE DERIVED FROM AN ONLINE AND PAPER SURVEY CONDUCTED SPECIFICALLY FOR THIS COMMUNITY HEALTH NEEDS ASSESSMENT. THE ONLINE-BASED AND PAPER FORM SURVEY WAS DEVELOPED BY THE CHNA STEERING COMMITTEE IN JUNE 2012. AN INITIAL REVIEW OF ELEMENTS CONTAINED IN PRIOR COMMUNITY HEALTH NEEDS ASSESSMENT BACK IN 2010 WAS USED. THE SURVEY (APPENDIX C OF THE CHNA) WAS APPROVED AND PROGRAMMED FOR DATA COLLECTION ON AUGUST 1, 2012. THE SURVEY GATHERED INFORMATION FROM CAMERON, MCKEAN, POTTER AND TIOGA RESIDENTS IN THE FOLLOWING AREAS: o HEALTH SERVICES ACCESS AND UTILIZATION o CHRONIC DISEASE MANAGEMENT o YOUTH HEALTH & HEALTH CARE o PRIMARY CARE o WEIGHT o SMOKING o DENTAL CARE o RISK FACTORS o HEALTH INSURANCE o HEALTH CARE BARRIERS o WELLNESS ACTIVITIES AND EXERCISE o DEMOGRAPHICS THE DATA COLLECTION PHASE BEGAN ON AUGUST 1, 2013 AND WAS COMPLETED BY AUGUST 17, 2013. A TOTAL OF 706 COMMUNITY MEMBERS COMPLETED THE SURVEY. THE TOP SIX HEALTH CONCERNS CONVEYED BY THE SURVEY RESPONDENTS AND SECONDARY DATA OF THE COLE MEMORIAL SERVICE AREA INCLUDED OBESITY, ACCESS TO CARE, DIABETES, DENTAL, SMOKING AND HEART DISEASE. WE MADE OUR COMMUNITY HEALTH NEEDS ASSESSMENT WIDELY AVAILABLE VIA WEBSITE. WE ALSO HAVE PLACED HARD COPIES IN OUR ACCOUNTING DEPARTMENT AND COMMUNITY OUTREACH DEPARTMENT. |
| SCHEDULE H, PART VI, LINE 3 | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: THE PATIENT FINANCIAL COUNSELOR CONTACTS SELF-PAY PATIENTS/GUARANTORS TO DISCUSS PAYMENT ARRANGEMENTS. IF THEY ARE UNABLE TO PAY - SHE EXPLAINS THE PROCESS OF APPLYING FOR CHARITY WHICH INCLUDES APPLYING FOR PA MEDICAL ASSISTANCE FIRST AND IF THEY ARE DENIED OR HAVE A PORTION TO PAY, THEN THEY CAN APPLY FOR CHARITY. THE CHARITY APPLICATION IS ON THE BACK OF OUR SELF-PAY STATEMENTS. ALSO, THE HOSPITAL OWNED PHYSICIAN PRACTICES ARE AWARE OF THIS PROGRAM AND REFER PATIENTS/GUARANTORS TO THE PATIENT FINANCIAL COUNSELOR. |
| SCHEDULE H, PART VI, LINE 4 | COMMUNITY INFORMATION: COLE MEMORIAL SERVES PATIENTS MAINLY FROM POTTER, MCKEAN, TIOGA, CAMERON AND ELK COUNTIES IN NORTHCENTRAL PA. ALL OF THE COUNTIES THAT WE SERVE ARE CONSIDERED RURAL AND MOUNTAINOUS. CAMERON COUNTY CURRENTLY HAS THE HIGHEST UNEMPLOYMENT RATE IN THE STATE AND ALL OF THE COUNTIES SERVED ARE BATTLING THE EFFECTS OF THE ECONOMY AND JOB LOSS. OUR POPULATION IS ALSO AGING AS THE AREA OFFERS LITTLE FOR A YOUNGER DEMOGRAPHIC IN THE WAY OF EMPLOYMENT, EDUCATION AND CULTURE. |
| SCHEDULE H, PART VI, LINE 5 | PROMOTION OF COMMUNITY HEALTH: THE MISSION OF COLE MEMORIAL IS LARGELY DEPENDENT ON PROVIDING SERVICES AND CARE TO THOSE INDIVIDUALS WHO MAY NOT HAVE THE RESOURCES TO BE AWARE OF, ABLE TO PAY FOR, OR HAVE THE EDUCATION/KNOWLEDGE ABOUT CARE, PROGRAMS AND SERVICES THAT ARE AVAILABLE TO THEM. THROUGH VARIOUS ACTIVITIES COLE MEMORIAL REACHES OUT TO OUR COMMUNITIES TO EDUCATE, IMPROVE HEALTH, PREVENT AND TREAT DISEASE AND SUPPORT INDIVIDUALS AND GROUPS. COLE MEMORIAL, IN COOPERATION WITH COMMUNITY BASED GROUPS SUCH AS 4 ROTARIES AND OSWAYO VALLEY MEMORIAL LIBRARY, PROVIDE FIVE COMPREHENSIVE BLOOD ANALYSIS ANNUALLY. COMPREHENSIVE BLOOD ANALYSIS SCREENINGS ARE PROVIDED IN FIVE RURAL COMMUNITIES: GALETON, SMETHPORT, PORT ALLEGANY, SHINGLEHOUSE AND COUDERSPORT. CBA'S SCREEN OVER 30 OF THE MOST COMMON BLOOD TESTS THAT DETECT HEALTH ISSUES SUCH AS CORONARY HEART DISEASE, LIVER DISEASE, KIDNEY DISEASE, CANCER, THYROID DISEASE, DIABETES, ANEMIA, BONE DISEASE AND RESPIRATORY DISEASE. THESE SCREENINGS ARE PROVIDED AT A FRACTION OF THE COST OF HAVING THESE TESTS PERFORMED THROUGH A FAMILY PHYSICIAN. ALL PARTICIPANTS AND THEIR PRIMARY MEDICAL PROVIDER ARE SENT THE RESULTS AND PROVIDERS FOLLOW-UP WITH INDIVIDUALS WHOSE SCREENING RESULTS INDICATE ABNORMALITIES. FOR MANY INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED AND LIKELY WOULD NOT SEEK MEDICAL CARE UNTIL IT WAS EMERGENT, THESE EVENTS PROVIDE AN AVENUE TO MONITOR THEIR HEALTH AND DETECT POTENTIAL ISSUES BEFORE THEY BECOME EMERGENT. IN ADDITION, THE LOCAL CO-SPONSORS RECEIVE A PORTION OF THE PROCEEDS FROM THESE EVENTS AND UTILIZE THE FUNDS TO PROVIDE SCHOLARSHIPS AND SUPPORT TO LOCAL STUDENTS AND PROJECTS TO BENEFIT THE COMMUNITY. ANNUALLY, COLE MEMORIAL PARTNERS WITH THE AREA AGENCY ON AGING AND THE PENNSYLVANIA DEPARTMENT OF HEALTH TO ADMINISTER SEASON INFLUENZA AND PNEUMOCOCCAL VACCINE TO POTTER COUNTY RESIDENTS WHO ARE OVER THE AGE OF 60 AT NO COST. HOWEVER, RESIDENTS WHO ARE UNDER THE AGE OF 60 WITH A CHRONIC DISEASE ARE ELIGIBLE AS WELL. FY2011 654 NO-COST INFLUENZA VACCINES AND 50 PNEUMOCOCCAL VACCINES WERE ADMINISTERED THROUGH 11 CLINICS IN 7 COMMUNITIES. IN MANY CASES THE UNDERSERVED POPULATIONS ARE MORE LIKELY TO BECOME ILL AND POTENTIALLY FACE EMERGENT HEALTH NEEDS FROM VACCINE-PREVENTABLE DISEASE. BY PROVIDING CLINICS AT COUNTY SENIOR CENTERS AND IN RURAL COMMUNITY SETTINGS MANY INDIVIDUALS WHO WOULD LIKELY NOT RECEIVE THESE COMMON VACCINES CAN BE IMMUNIZED AT NO COST AND IN CLOSE PROXIMITY TO THEIR HOMES. ALSO IN CONJUNCTION WITH THE AREA AGENCY ON AGING, COLE MEMORIAL PROVIDES NO-COST EDUCATION TO COUNTY SENIOR CENTERS. COLE MEMORIAL PROVIDED 7 HEALTH EDUCATION PROGRAMS, EACH PRESENTED AT 4 SENIOR CENTERS FOR A TOTAL OF 30+ SESSIONS. TOPICS INCLUDED IMMUNIZATIONS, QUESTION TO ASK YOUR HEALTHCARE PROVIDER, INJURY PREVENTION, THE DIABETIC FOOT & GOUT, REDUCE RISK OF CANCER/ SIGNS AND SYMPTOMS OF CANCER, AND QUESTIONS REGARDING YOUR MEDICATIONS. FINALLY, AS AN ON-GOING EFFORT TO PROVIDE FULL-SPECTRUM CANCER CARE TO INDIVIDUALS IN RURAL NORTH CENTRAL PENNSYLVANIA, THE PATTERSON CANCER CARE CENTER PHYSICIANS AND STAFF PROVIDED APPROXIMATELY 170 NO-COST CANCER SCREENINGS. SCREENINGS INCLUDED SCREENINGS FOR PROSTATE, COLORECTAL AND SKIN CANCER. SCREENINGS WERE PERFORMED BY ONCOLOGY PHYSICIANS WHO SPECIALIZE IN THE DETECTION, DIAGNOSIS AND TREATMENT OF CANCER. INDIVIDUALS PARTICIPATING IN THESE SCREENINGS WERE BOTH MALE AND FEMALE, ADULT AND SENIOR AND UNINSURED/UNDERINSURED. ALONG WITH MANY OTHER PROGRAMS SUCH AS SUPPORT GROUPS, SPEAKER'S BUREAU, 9 AGENCY WELLNESS COLLABORATIVE, WORKFORCE DEVELOPMENT, ECONOMIC SUPPORT, COMMUNITY LEADERSHIP, PARTNERSHIPS WITH LOCAL CIVIC, GOVERNMENT, SCHOOL DISTRICTS AND COMMUNITY GROUPS, COLE MEMORIAL CONTINUES EFFORTS TO ASSURE THAT HEALTHCARE, IN ALL FORMS, IS ACCESSIBLE AND AVAILABLE TO THOSE WHO MAY OTHERWISE GO WITHOUT. COLE MEMORIAL PROVIDES THE COMMUNITY WITH SPACE FOR EVENTS, MEETINGS AND PROGRAMS SUCH AS SUPPORT GROUPS, ANNUAL EVENTS, TRAINING SESSIONS AND YOUTH SPORTS. COLE MEMORIAL'S EMPLOYEE GIVING CLUB, HEART OF COLE, HAS A DESIGNATED GROUP THAT FOCUSES ON COMMUNITY CONNECTIONS. COLE MEMORIAL STRIVES TO LIVE UP TO ITS NON-PROFIT MISSION EVERY DAY, PROVIDING EXCELLENT HEALTHCARE SERVICES TO OUR AREA AND LISTENING AND RESPONDING TO THE COMMUNITIES WE SERVE. IN AN EFFORT TO PLAN FOR THE UNIQUE NEEDS OF COMMUNITIES IN THE SERVICE AREA, FIVE COMMUNITY BENEFIT ADVISORY COMMITTEES WERE ESTABLISHED AS A MAJOR INITIATIVE TO DEEPEN AND STRENGTHEN ITS CONNECTION WITH THE COMMUNITY AND TO LINK COMMUNITY BENEFIT ACTIVITIES TO STRATEGIC AND OPERATIONAL PLANS. THE ROLE OF THE COMMITTEES IS TO IDENTIFY THE NEEDS AND CONCERNS OF THE COMMUNITY, ADVISE ABOUT THE BEST WAY TO PARTNER WITH THE COMMUNITY, AID IN THE DEVELOPMENT OF MEANINGFUL COMMUNITY PROGRAMS AND ACTIVITIES, AND PROMOTE IMPROVED COMMUNICATIONS BETWEEN THE HOSPITAL AND THE COMMUNITY. THE HOSPITAL PROVIDES DEDICATED ADMINISTRATIVE TIME TO PLANNING AND CONDUCTING FIVE CBAC MEETINGS IN THE COMMUNITIES WE SERVE THREE TIMES PER YEAR. LASTLY, COLE MEMORIAL OFTEN PARTNERS WITH FUNDING FOUNDATIONS TO PROVIDE HEALTH SPECIFIC IMPROVEMENT INITIATIVES IN THE COMMUNITIES WHICH WE SERVE. AS AN EXAMPLE, COLE MEMORIAL, WITH FUNDING FROM THE MAKING STRIDES AGAINST BREAST CANCER FOUNDATION, TO PROVIDE A NIGHT FOR WOMEN WHO HAVE OR HAD BREAST CANCER. |
| SCHEDULE H, PART VI, LINE 6 | AFFILIATED HEALTH CARE SYSTEM: THE AFFILIATED HEALTH CARE SYSTEM INCLUDES CHARLES COLE MEMORIAL HOSPITAL (COLE MEMORIAL), COLE CARE, INC., HENDORN, INC., AND COLE FOUNDATION. COLE MEMORIAL (THE "HOSPITAL") PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES TO PATIENTS IN COUDERSPORT, PENNSYLVANIA. THE HOSPITAL ALSO OPERATES A HOME HEALTH AGENCY AND A NUMBER OF PHYSICIAN CLINICS IN THE SAME GEOGRAPHIC AREA. COLE CARE, INC., A WHOLLY OWNED SUBSIDIARY OF THE HOSPITAL, OPERATES A DURABLE MEDICAL EQUIPMENT COMPANY FOR THE SALE AND RENTAL OF EQUIPMENT. HENDORN, INC., D/B/A COLE MANOR (COLE MANOR), OF WHICH THE HOSPITAL IS THE SOLE CORPORATE MEMBER, OWNS AND OPERATES A 30-BED PERSONAL CARE RESIDENTIAL FACILITY AND PROVIDES HOMEMAKER SERVICES. COLE FOUNDATION PROVIDES SUPPORT TO THESE ORGANIZATIONS THROUGH FUNDRAISING ACTIVITIES. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| 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 | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JASON TRONETTI | ||||||||||||||
| PHYSICIAN, DIRECTOR | $246,070 | $0 | $102,251 | $0 | $240 | $0 | $6,372 | $0 | $23,092 | $0 | $378,025 | $0 | $0 | $0 |
| KALLIOPI NESTOR | ||||||||||||||
| PHYSICIAN, DIRECTOR | $228,558 | $0 | $0 | $0 | $325 | $0 | $5,750 | $0 | $7,780 | $0 | $242,413 | $0 | $0 | $0 |
| EDWARD C PITCHFORD | ||||||||||||||
| PRESIDENT, CEO & ASST. SEC. | $285,070 | $0 | $43,261 | $0 | $24,791 | $0 | $6,375 | $0 | $24,671 | $0 | $384,168 | $0 | $0 | $0 |
| CYNTHIA HARDESTY | ||||||||||||||
| VICE PRESIDENT, CNE | $149,708 | $0 | $18,011 | $0 | $18,968 | $0 | $4,388 | $0 | $8,557 | $0 | $199,632 | $0 | $0 | $0 |
| BRADLEY GIANNOTTI | ||||||||||||||
| PHYSICIAN | $934,221 | $0 | $4,278 | $0 | $900 | $0 | $6,375 | $0 | $18,535 | $0 | $964,309 | $0 | $0 | $0 |
| TERRANCE FOUST | ||||||||||||||
| PHYSICIAN | $695,681 | $0 | $102,969 | $0 | $540 | $0 | $6,375 | $0 | $11,279 | $0 | $816,844 | $0 | $0 | $0 |
| SAKET PRASAD | ||||||||||||||
| PHYSICIAN | $523,602 | $0 | $77,610 | $0 | $18,393 | $0 | $6,375 | $0 | $19,356 | $0 | $645,336 | $0 | $0 | $0 |
| CHRISTAN CARAMIA | ||||||||||||||
| PHYSICIAN | $464,673 | $0 | $0 | $0 | $442 | $0 | $6,375 | $0 | $24,869 | $0 | $496,359 | $0 | $0 | $0 |
| PHONG NGUYEN | ||||||||||||||
| PHYSICIAN | $414,221 | $0 | $0 | $0 | $393 | $0 | $6,375 | $0 | $7,984 | $0 | $428,973 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | NON-FIXED PAYMENTS: SOME OF THOSE LISTED IN FORM 990, PART VII RECEIVED PAYOUTS OF ACCRUED BONUSES AND ACCRUED ADDITIONAL BONUSES FOR PARTICIPATING IN THE EXECUTIVE TEAM INCENTIVE COMPENSATION PROGRAM. EACH PARTICIPANT HAD AN ESTABLISHED TARGET TOTAL COMPENSATION BASED ON INDUSTRY SURVEYS AND THE INCENTIVE PROGRAM COMPRISED APPROXIMATELY 10% OF THE TARGETED TOTAL COMPENSATION. THE BONUS WAS BASED ON OVERALL PERFORMANCE. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|
| POTTER COUNTY HOSPITAL AUTHORITY | |||||||
| A | 256691439 | 2013-12-19 | $20,575,000 | REFUND BONDS/LOAN,PURCH CAP EQUIP | false | false | false |
| POTTER COUNTY HOSPITAL AUTHORITY | |||||||
| B | 256691439 | 2014-06-25 | $9,800,000 | OPER ROOM EXPANSION,FACIL UPGRADES | false | false | false |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Bond DefeasedBondDefeasedAmt | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Capitalized InterestCapitalizedInterestAmt | Refunding EscrowRefundingEscrowAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Credit EnhancementCreditEnhancementAmt | Working Capital ExpendituresWorkingCapitalExpendituresAmt | Capital ExpendituresCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | UnspentUnspentAmt | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $0 | $0 | $20,575,000 | $700,000 | $0 | $14,949,169 | $127,545 | $0 | $0 | $3,954,913 | $0 | $843,373 | Yes (true) | false | false | Yes (true) |
| B | $0 | $0 | $9,800,000 | $300,000 | $0 | $0 | $41,073 | $0 | $0 | $65,717 | $0 | $9,393,210 | false | false | false | Yes (true) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Remedial Action TakenRemedialActionTakenInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | false | false | false | false | 0.00000 | 0.00000 | 0.00000 | false | false | false | Yes (true) |
| B | false | false | false | false | 0.00000 | 0.00000 | 0.00000 | false | false | false | Yes (true) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Business Name Line1GICProviderName/BusinessNameLine1 | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|---|
| 0 | ||||||||||
| A | false | Yes (true) | false | false | false | false | false | 0 | false | Yes (true) |
| 0 | ||||||||||
| B | false | Yes (true) | false | false | false | false | false | 0 | false | Yes (true) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (true) |
| B | Yes (true) |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (5 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| COLE CARE | |||
| COMMON BOARD MEMBERS | $7,917,971 | RENT, DIVIDENDS, SERVICES | false |
| EDMOND HARDESTY | |||
| HUSBAND OF C. HARDESTY | $151,114 | EMPLOYEE OF HOSPITAL | false |
| ADAM NESTOR | |||
| HUSBAND OF K. NESTOR | $89,013 | EMPLOYEE OF HOSPITAL | false |
| VICTORIA COPP | |||
| SISTER OF J. MIGLICIO | $36,036 | EMPLOYEE OF HOSPITAL | false |
| NANCY RUDOLPH | |||
| SISTER OF J. MIGLICIO | $45,397 | EMPLOYEE OF HOSPITAL | false |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 1 | ORGANIZATION'S MISSION: COLE MEMORIAL IS A FULL SERVICE, COMPREHENSIVE HEALTH SYSTEM, SERVING POTTER, MCKEAN, CAMERON, AND TIOGA COUNTIES IN RURAL, NORTH CENTRAL PA AND PORTIONS OF NEW YORK STATE AND IS THE ONLY HOSPITAL IN POTTER COUNTY (COUDERSPORT, PA). COLE MEMORIAL IS A CRITICAL ACCESS HOSPITAL PROVIDING PRIMARY, EMERGENCY, AND SPECIALTY CARE, AS WELL AS REHABILITATION AND WELLNESS SERVICES TO PATIENTS WITHIN A 50-MILE RADIUS. COLE MEMORIAL STRIVES TO LIVE UP TO ITS NON-PROFIT MISSION EVERY DAY, PROVIDING EXCELLENT HEALTHCARE SERVICES TO OUR AREA AND LISTENING AND RESPONDING TO THE COMMUNITIES WE SERVE. IN AN EFFORT TO PLAN FOR THE UNIQUE NEEDS OF COMMUNITIES IN THE SERVICE AREA, FIVE COMMUNITY BENEFIT ADVISORY COMMITTEES WERE ESTABLISHED AS A MAJOR INITIATIVE TO DEEPEN AND STRENGTHEN OUR CONNECTION WITH THE COMMUNITY AND TO LINK COMMUNITY BENEFIT ACTIVITIES TO STRATEGIC AND OPERATIONAL PLANS. THE ROLE OF THE COMMITTEES ARE TO IDENTIFY THE NEEDS AND CONCERNS OF THE COMMUNITY, ADVISE ABOUT THE BEST WAY TO PARTNER WITH THE COMMUNITY, AID IN THE DEVELOPMENT OF MEANINGFUL COMMUNITY PROGRAMS AND ACTIVITIES, AND PROMOTE IMPROVED COMMUNICATIONS BETWEEN THE HOSPITAL AND THE COMMUNITY. THE HOSPITAL PROVIDES DEDICATED ADMINISTRATIVE TIME TO PLANNING AND CONDUCTING FIVE CBAC MEETINGS IN THE COMMUNITIES WE SERVE THREE TIMES PER YEAR. |
| FORM 990, PART III, LINE 4 | PROGRAM SERVICE ACCOMPLISHMENTS: LINE 4B ONE OUTLYING CENTER OFFERS IMAGING SERVICES, WHILE ALL RHCS PROVIDE LAB DRAWS SO PATIENTS DON'T HAVE TO DRIVE TO RECEIVE NECESSARY TESTING. IN ADDITION TO THE FAMILY AND INTERNAL MEDICINE SERVICES AT RHCS, PHYSICIAN PRACTICES ALSO PROVIDE SPECIALTY CARE INCLUDING PEDIATRICS, GASTROENTEROLOGY, ORTHOPEDICS, PHYSIATRY, SURGERY, PODIATRY, OBSTETRICS/GYNECOLOGY AND ONCOLOGY. LINE 4C IN ADDITION TO THE HOSPITAL'S ACUTE CARE FLOORS, COLE MEMORIAL CARES FOR PATIENTS IN ITS 49-BED SKILLED NURSING AND REHABILITATION UNIT WHICH REPORTED 16,353 DAYS LAST YEAR. A 10-BED INPATIENT GERIATRIC BEHAVIORAL HEALTH UNIT ADMITTED 163 PATIENTS LAST YEAR. LINE 4D THE ORGANIZATION ALSO OFFERS CARDIO-PULMONARY SERVICES, CLINICAL SERVICES, CLINICS, AND CORPORATE SERVICES. |
| FORM 990, PART VI, SECTION A, LINES 6 & 7A | MEMBERS: THE MEMBERS OF THE CORPORATION, COLE MEMORIAL, SHALL BE KNOWN AS COMMUNITY BENEFIT ADVISORS ("ADVISORS"), WHOSE FUNCTIONS AND QUALIFICATIONS SHALL INCLUDE THE FOLLOWING: (A) PROMOTE THE PROGRAMS, GOALS AND OBJECTIVES OF COLE MEMORIAL; (B) EDUCATE THEIR PUBLIC CONTACTS, BOTH ON HEALTH CARE ISSUES AND ON SERVICES AND PROGRAMS AVAILABLE THROUGH COLE MEMORIAL, AND SEEK THEIR SERVICES WHEN NECESSARY AND APPROPRIATE; (C) PROVIDE AN IMPORTANT LINK BETWEEN COLE MEMORIAL, THE OTHER INSTITUTIONS AND BUSINESSES WHICH THEY REPRESENT, AND THE COMMUNITIES SERVED BY THE HOSPITAL; (D) ATTEND REGULAR MEETINGS, TO SHARE INFORMATION ON ACTIVITIES AND TAKE APPROPRIATE ACTION TO SUPPORT AND GUIDE COLE MEMORIAL; (E) PROVIDE SPECIAL ASSISTANCE ON PROJECTS AND ISSUES WHEN REQUESTED; (F) PARTICIPATE IN FUNDRAISING EFFORTS TO BENEFIT PATIENT CARE PROGRAMS FOR COLE MEMORIAL; AND (G) BE A CITIZEN IN GOOD STANDING, AS DETERMINED BY THE EXECUTIVE COMMITTEE OF THE BOARD, IN A COMMUNITY SERVED BY THE HOSPITAL. THE MEMBERS SHALL BE DIVIDED INTO TWO CLASSES: (A) ACTIVE ADVISORS (B) HONORARY ADVISORS THE ADVISORS SHALL ANNUALLY ELECT: (A) SUCCESSORS TO THE BOARD OF DIRECTORS WHOSE TERMS EXPIRE. (B) HONORARY DIRECTORS AND HONORARY ADVISORS. UPON NOMINATION BY THE EXECUTIVE COMMITTEE PER SECTION 5.2.2.(E) OF THESE BYLAWS, ALL ADVISORS SHALL BE ELECTED BY A TWO THIRDS VOTE OF THE MEMBERS PRESENT AND VOTING AT A DULY CALLED MEETING OF THE MEMBERS WHICH A QUORUM IS PRESENT. (A) AN ACTIVE ADVISOR OF COLE MEMORIAL SHALL BE A MEMBER FOR A TERM OF FIVE (5) YEARS AFTER HIS ELECTION, OR UNTIL HIS EARLIER RESIGNATION. THERE IS NO LIMIT ON THE NUMBER OF TERMS AN ADVISOR CAN SERVE. (B) AN HONORARY ADVISOR MAY BE ELECTED BY THE ACTIVE ADVISORS AND SHALL SERVE FOR LIFE, IN RECOGNITION OF MERITORIOUS OR FAITHFUL SERVICE TO COLE MEMORIAL OR IN RECOGNITION OF DISTINGUISHED ACHIEVEMENT. (C) EACH ADVISOR OWES A DUTY OF UNDIVIDED AND UNQUALIFIED LOYALTY TO THE ORGANIZATION. ADVISORS MAY NOT USE THEIR POSITIONS TO PROFIT PERSONALLY OR TO ASSIST OTHERS IN PROFITING IN ANY WAY AT THE EXPENSE OF THE ORGANIZATION. (D) ADVISORS SHALL AVOID ALL CONFLICTS OF INTEREST AND THE APPEARANCE OF ANY CONFLICT OF INTEREST. A CONFLICT OF INTEREST OCCURS IN ANY SITUATION IN WHICH ONE IS POTENTIALLY NOT ABLE TO REMAIN IMPARTIAL OR MAINTAIN OBJECTIVITY IN CHOOSING BETWEEN THE INTERESTS OF THE ORGANIZATION AND ONE'S PERSONAL INTERESTS OR THE INTERESTS OF THIRD PARTIES. TO AVOID THE APPEARANCE OF A CONFLICT OF INTEREST, AN ADVISOR SHALL NOT PARTICIPATE IN THE MAKING OF ANY DECISION OR RECOMMENDATION CONCERNING A MATTER WHICH MAY RESULT IN ANY BENEFIT OR FINANCIAL GAIN, EITHER DIRECTLY OR INDIRECTLY, TO THE ADVISOR OR A MEMBER OF HIS/HER IMMEDIATE FAMILY. IN ADDITION, FULL DISCLOSURE OF THE PERTINENT FACTS REGARDING THE POTENTIAL CONFLICT OF INTEREST SHOULD BE PROVIDED BY THE ADVISOR. (E) NO ADVISOR SHALL HAVE ANY VESTED RIGHT, INTEREST OR PRIVILEGE OF, IN, OR TO THE ASSETS, FUNCTIONS, AFFAIRS OR FRANCHISES OF THE CORPORATION OR ANY SUCH RIGHT, INTEREST OR PRIVILEGE WHICH MAY BE TRANSFERABLE OR INHERITABLE, OR WHICH SHALL CONTINUE IF HIS MEMBERSHIP CEASES. NO ADVISOR SHALL BE AN EMPLOYEE OF THE HOSPITAL OR ANY OF ITS AFFILIATES. (F) ADVISORS SHALL INCLUDE REPRESENTATIVES FROM VARIOUS ECONOMIC, SOCIAL AND OCCUPATIONAL GROUPS BROADLY REPRESENTATIVE OF THE DEMOGRAPHIC CHARACTERISTICS OF THE COMMUNITIES SERVED BY THE HOSPITAL, AND SHALL ALL HAVE AN INTEREST IN AND COMMITMENT TO FURTHER THE HEALTH AND WELL-BEING OF THE CITIZENS OF THE HOSPITAL'S SERVICE AREA. (G) THE SECRETARY OF THE BOARD SHALL ACT AS LIAISON TO THE COMMUNITY BENEFIT ADVISORS. THE NUMBER OF ADVISORS SHALL NOT BE LESS THAN FIFTY (50) NOR MORE THAN ONE HUNDRED (100), EXCLUSIVE OF HONORARY ADVISORS. EVERY ACTIVE ADVISOR SHALL BE ENTITLED TO ONE (1) VOTE AT ANY MEETING OF THE ADVISORS IN WHICH A VOTE IS TAKEN FOR ANY ELECTION OR ON ANY MATTER OR TRANSACTION. IN THE CASE OF VOTING FOR THE ELECTION OF DIRECTORS, EACH ADVISOR MUST CAST ONE (1) VOTE FOR EACH POSITION TO BE FILLED OR THE BALLOT WILL BE VOID AS IT PERTAINS TO THE ELECTION OF DIRECTORS. VOTING FOR DIRECTORS SHALL BE BY WRITTEN BALLOT BY FIRST CLASS MAIL, POSTMARKED NO LATER THAN TWENTY (20) DAYS PRIOR TO THE DATE SELECTED FOR THE ANNUAL MEETING. EVERY ADVISOR SHALL BE ENTITLED IN RETURNING HIS BALLOT FOR THE ANNUAL ELECTION OF DIRECTORS, TO DIRECT THAT HIS VOTE BE WITHHELD FROM ONE (1) OR MORE OF THE CANDIDATES SUBMITTED BY THE NOMINATING COMMITTEE AND ANY SUCH ADVISOR MAY, ON HIS BALLOT, MAY SET FORTH THE NAME OF ANY PERSON FOR WHOM HE WISHES TO RECORD HIS VOTE FOR A DIRECTOR OF THE CORPORATION. RESULTS OF THE ELECTION PROCESS WILL BE ANNOUNCED AT THE ANNUAL MEETING OF THE ADVISORS. HONORARY ADVISORS SHALL RECEIVE NOTICES OF AND MAY ATTEND ALL MEETINGS OF THE ADVISORS BUT SHALL NOT BE ENTITLED TO VOTE ON ANY MATTER. THE ELECTION PROCESS WILL BE ANNOUNCED AT THE ANNUAL MEETING OF THE ADVISORS. HONORARY ADVISORS SHALL RECEIVE NOTICES OF AND MAY ATTEND ALL MEETINGS OF THE ADVISORS BUT SHALL NOT BE ENTITLED TO VOTE ON ANY MATTER. |
| 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. THE 990 IS THEN REVIEWED BY THE ACCOUNTING DEPARTMENT AND THE CONTROLLER. IT IS THEN PRESENTED TO THE GOVERNANCE OVERSIGHT COMMITTEE FOR REVIEW. AFTER THE GOVERNANCE OVERSIGHT COMMITTEE HAS REVIEWED, A FULL COPY IS DISTRIBUTED TO THE BOARD OF DIRECTORS PRIOR TO THE CEO'S FINAL SIGNATURE. THE OVERSIGHT COMMITTEE WILL REPORT THEIR REVIEW OF FORM 990 TO THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 12C | MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: MEMBERS OF THE BOARD OF DIRECTORS; BOARD COMMITTEES; MANAGEMENT EMPLOYEES; AND MEDICAL STAFF WITH ADMINISTRATIVE RESPONSIBILITIES ARE COVERED UNDER THE CONFLICT OF INTEREST POLICY. THE LEVELS AT WHICH ACTUAL CONFLICTS ARE REVIEWED ARE THE COMPLIANCE OFFICER AND GOVERNANCE OVERSIGHT COMMITTEE OF THE BOARD OF DIRECTORS. RESTRICTIONS INCLUDE: A MEMBER OF THE BOARD/BOARD COMMITTEE MUST DISCLOSE THE EXISTENCE OF HIS/HER FINANCIAL INTEREST. A VOTING MEMBER OF ANY COMMITTEE WHOSE SCOPE OF RESPONSIBILITIES INCLUDES COMPENSATION MATTERS AND WHO RECEIVES COMPENSATION, DIRECTLY OR INDIRECTLY, FROM THE HOSPITAL FOR SERVICES IS PRECLUDED FROM VOTING ON MATTERS PERTAINING TO THAT MEMBER'S COMPENSATION. PHYSICIANS WHO RECEIVE COMPENSATION, DIRECTLY OR INDIRECTLY, FROM THE HOSPITAL, WHETHER AS EMPLOYEES OR INDEPENDENT CONTRACTORS, ARE PRECLUDED FROM MEMBERSHIP ON ANY COMMITTEE WHOSE PRIMARY SCOPE OF RESPONSIBILITIES INCLUDES COMPENSATION MATTERS. A MANAGEMENT EMPLOYEE, OR A MEDICAL STAFF MEMBER WITH ADMINISTRATIVE RESPONSIBILITIES MUST DISCLOSE TO THE SENIOR LEADER THE EXISTENCE OF THE FINANCIAL INTEREST AND ALL RELATED MATERIAL FACTS. |
| FORM 990, PART VI, SECTION B, LINE 15A | COMPENSATION DETERMINATION: A REVIEW WAS CONDUCTED IN 2013 FOR PRESIDENT & CEO EDWARD PITCHFORD BY 3C COMPENSATION CONSULTING CONSORTIUM, LLC, LOCATED IN PITTSBURGH, PENNSYLVANIA. THE BOARD WOULD HAVE TO APPROVE ANY INCREASE RECOMMENDED BY THE GOVERNANCE OVERSIGHT COMMITTEE. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENT AVAILABILITY: THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS CAN BE VIEWED ONSITE THROUGH A WRITTEN REQUEST TO THE ORGANIZATION'S CORPORATE COMPLIANCE OFFICER. REQUESTS FOR FINANCIAL STATEMENTS AND 990'S ARE FORWARDED TO THE FINANCE / ACCOUNTING DEPARTMENT AND ARE OPEN FOR PUBLIC INSPECTION. |
| FORM 990, PART VII, SECTION A | BOARD MEMBER COMPENSATION: NO BOARD MEMBERS RECEIVE ANY COMPENSATION FOR THEIR DIRECTOR DUTIES. MICHAEL CALLAHAN IS COMPENSATED BY COLE MEMORIAL AS A PHYSICIAN. JASON TRONETTI IS COMPENSATED BY COLE MEMORIAL AS A PHYSICIAN. KALLIOPI NESTOR IS COMPENSATED BY COLE MEMORIAL AS A PHYSICIAN. EACH WORK APPROXIMATELY 40 HOURS PER WEEK IN THESE ROLES. |
| FORM 990, PART IX, LINE 11G | OTHER FEES FOR SERVICES: $ 9,780,863 PROFESSIONAL FEES 5,788,453 PURCHASED SERVICES 366,076 DIRECTOR FEES 152,037 CONTRACTED SERVICES ---------- $16,087,429 |
| FORM 990, PART XI, LINE 9 | OTHER CHANGES IN NET ASSETS: $361,700 AMORTIZATION OF NET LOSS |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| HENDORN INC DBA COLE MANOR | ||||||||||
| 1001 EAST SECOND STREET | COUDERSPORT | PA | 16915 | 231972659 | RESIDENT CARE | PA | 501(C)(3) | 11A I | COLE MEM | Yes (true) |
| HAMOTCOLE VENTURES INC | ||||||||||
| 1001 EAST SECOND STREET | COUDERSPORT | PA | 16915 | 273172100 | REAL ESTATE | PA | 501(C)(3) | 11A I | NA | false |
| COLE FOUNDATION INC | ||||||||||
| 1001 EAST SECOND ST | COUDERSPORT | PA | 16915 | 455417308 | SUPPORT | PA | 501(C)(3) | 11A I | COLE MEM | Yes (true) |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLE CARE INC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 EAST 2ND STREET | AddressLine1 |
| City | COUDERSPORT | City |
| State | PA | State |
| ZIP Code | 16915 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 251497347 | EIN |
| Primary Activities | DURABLE MED EQUIP | PrimaryActivitiesTxt |
| Legal Domicile State | PA | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLE MEMORIAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C CORPORATION | EntityTypeTxt |
| Share Of Total Income | $9,634,083 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $971,411 | ShareOfEOYAssetsAmt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | Yes (true) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (true) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | 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 | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (6 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| COLE CARE INC | ||
| A/J | $178,970 | FMV |
| COLE CARE INC | ||
| L | $187,152 | FMV |
| HENDORN INC | ||
| M | $448,322 | FMV |
| COLE CARE INC | ||
| O | $7,500,661 | FMV |
| COLE CARE INC | ||
| P | $51,188 | FMV |
| HENDORN INC | ||
| R | $105,487 | FMV |