FURP.ORG / PUBLIC DATA EXPLORER

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 ReturnHeader

FieldValueIRS element (for citing)
Return2015-02-12T08:33:30-06:00ReturnTs
Tax Period End2014-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1910 E ST LOUIS 200/PO BOX 1190AddressLine1
CitySPRINGFIELDCity
StateMOState
ZIP Code658062523ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN240802108EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CHARLES COLE MEMORIAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of% RON RAPPInCareOfNm
Business Name ControlCHARBusinessNameControlTxt
Phone8142749300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11001 EAST SECOND STREETAddressLine1
Address Line2SuiteAddressLine2
CityCOUDERSPORTCity
StatePAState
ZIP Code16915ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonEDWARD C PITCHFORDPersonNm
Person TitleCEOPersonTitleTxt
Phone8142749300PhoneNum
Signature2015-02-10SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBrian D ToddPreparerPersonNm
PTINP00422601PTIN
Phone8142749300PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerEDWARD PITCHFORDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11001 EAST SECOND STREETAddressLine1
CityCOUDERSPORTCity
StatePAState
ZIP Code16915ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$121,760,233GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.COLEMEMORIAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1967FormationYr
Legal Domicile StatePALegalDomicileStateCd
Activity Or MissionCOLE 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 Body13VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee687TotalEmployeeCnt
Total Volunteers59TotalVolunteersCnt
Total Gross UBI$56,786TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$55,519NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,100,072PYContributionsGrantsAmt
CY Contributions Grants$435,844CYContributionsGrantsAmt
PY Program Service Revenue$80,419,342PYProgramServiceRevenueAmt
CY Program Service Revenue$82,532,092CYProgramServiceRevenueAmt
PY Investment Income$662,938PYInvestmentIncomeAmt
CY Investment Income$1,239,026CYInvestmentIncomeAmt
PY Other Revenue$224,985PYOtherRevenueAmt
CY Other Revenue-$712,779CYOtherRevenueAmt
PY Total Revenue$82,407,337PYTotalRevenueAmt
CY Total Revenue$83,494,183CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$34,251,160PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$34,879,345CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$18,500PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$35,000CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$35,000CYTotalFundraisingExpenseAmt
PY Other Expenses$44,227,326PYOtherExpensesAmt
CY Other Expenses$45,855,489CYOtherExpensesAmt
PY Total Expenses$78,496,986PYTotalExpensesAmt
CY Total Expenses$80,769,834CYTotalExpensesAmt
PY Revenues Less Expenses$3,910,351PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,724,349CYRevenuesLessExpensesAmt
Total Assets BOY$61,179,485TotalAssetsBOYAmt
Total Assets EOY$71,501,755TotalAssetsEOYAmt
Total Liabilities BOY$39,271,637TotalLiabilitiesBOYAmt
Total Liabilities EOY$45,661,108TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$21,907,848NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$25,840,647NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE PURPOSE OF COLE MEMORIAL IS TO PROVIDE EXCELLENT HEALTHCARE SERVICES, RESPONDING TO THE NEEDS OF THE COMMUNITIES WE SERVE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$19,090,626ExpenseAmt
Revenue$43,477,319RevenueAmt
DescCOLE 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

FieldValueIRS element (for citing)
Expense$17,382,480ExpenseAmt
Revenue$12,599,481RevenueAmt
DescCOLE 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

FieldValueIRS element (for citing)
Expense$13,686,165ExpenseAmt
Revenue$20,775,694RevenueAmt
DescCOLE 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
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$19,846,690TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue$5,679,598TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$70,005,961TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingYes (true)CreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingYes (true)ProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (true)BusinessRlnWithFamMemInd
Business Rln With Officer EntYes (true)BusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document40IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee687EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldPAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonRON RAPPPersonNm
Phone8142745250PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11001 EAST SECOND STREETAddressLine1
CityCOUDERSPORTCity
StatePAState
ZIP Code16915ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
MICHAEL E CALLAHAN
PHYSICIAN, 2ND VICE CHAIR40.01.0Yes (X)Yes (X)$109,960$0$10,883
JASON TRONETTI
PHYSICIAN, DIRECTOR40.01.0Yes (X)$348,561$0$29,464
CHARLES UPDEGRAFF
TREASURER1.01.0Yes (X)Yes (X)$0$0$0
RON CASKEY
SECRETARY1.01.0Yes (X)Yes (X)$0$0$0
REVEREND RANDALL HEADLEY
CHAIRMAN1.01.0Yes (X)Yes (X)$0$0$0
KALLIOPI NESTOR
PHYSICIAN, DIRECTOR40.01.0Yes (X)$228,883$0$13,530
ROBERT SMITH
DIRECTOR1.01.0Yes (X)$0$0$0
RUSSELL STREICH
DIRECTOR1.01.0Yes (X)$0$0$0
DAVID BUCKLER
DIRECTOR1.01.0Yes (X)$0$0$0
DAVID CRANDALL
1ST VICE CHAIRMAN1.01.0Yes (X)Yes (X)$0$0$0
JEANNE MIGLICIO
DIRECTOR1.01.0Yes (X)$0$0$0
THOMAS SHAFFER
DIRECTOR1.01.0Yes (X)$0$0$0
CLIFFORD WOOD
DIRECTOR1.01.0Yes (X)$0$0$0
EDWARD C PITCHFORD
PRESIDENT, CEO & ASST. SEC.40.02.0Yes (X)$353,122$0$31,046
CYNTHIA HARDESTY
VICE PRESIDENT, CNE40.01.0$186,687$0$12,945Yes (X)
BRADLEY GIANNOTTI
PHYSICIAN40.00.0$939,399$0$24,910Yes (X)
TERRANCE FOUST
PHYSICIAN40.00.0$799,190$0$17,654Yes (X)
SAKET PRASAD
PHYSICIAN40.00.0$619,605$0$25,731Yes (X)
CHRISTAN CARAMIA
PHYSICIAN40.00.0$465,115$0$31,244Yes (X)
PHONG NGUYEN
PHYSICIAN40.00.0$414,614$0$14,359Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$4,465,136TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$211,766TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K36IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

ServicesServicesDescCompensationCompensationAmt
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
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt
Government Grants$321,832GovernmentGrantsAmt
All Other Contributions$114,012AllOtherContributionsAmt
Total Contributions$435,844TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE621990$76,829,755$76,829,755
PHARMACY446110$4,704,447$4,704,447
CAFETERIA722514$370,541$370,541
OTHER621990$627,349$627,349
FieldValueIRS element (for citing)
Total Program Service Revenue$82,532,092TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$253,903TotalRevenueColumnAmt
Exclusion$253,903ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$265,371RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$279,873RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$14,502RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$14,502TotalRevenueColumnAmt
Exclusion-$14,502ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$38,928,190SecuritiesAmt
Other$43,110OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$37,872,200SecuritiesAmt
Other$113,977OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$1,055,990SecuritiesAmt
Other-$70,867OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$985,123TotalRevenueColumnAmt
Exclusion$985,123ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
GAIN ON INVESTMENT IN EQUITY INVESTEE900099$203,202$203,202
INCOME FROM INVESTMENT IN SUBSIDIARIES900099-$84,487-$141,273$56,786
LOSS ON EXTINGUISHMENT OF DEBT900099-$816,992-$816,992
FieldValueIRS element (for citing)
Other Revenue Total-$698,277OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$83,494,183TotalRevenueColumnAmt
Related Or Exempt Func Income$82,532,092RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$56,786UnrelatedBusinessRevenueAmt
Exclusion$469,461ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,240,033TotalAmt
Program Services$639,844ProgramServicesAmt
Management And General$600,189ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$333,157TotalAmt
Program Services$176,955ProgramServicesAmt
Management And General$156,202ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$26,079,167TotalAmt
Program Services$22,141,756ProgramServicesAmt
Management And General$3,937,411ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$757,206TotalAmt
Program Services$404,392ProgramServicesAmt
Management And General$352,814ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,522,833TotalAmt
Program Services$3,964,145ProgramServicesAmt
Management And General$558,688ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,946,949TotalAmt
Program Services$1,490,891ProgramServicesAmt
Management And General$456,058ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$683,933TotalAmt
Program Services$683,933ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$164,592TotalAmt
Program Services$9,397ProgramServicesAmt
Management And General$155,195ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$127,164TotalAmt
Management And General$127,164ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$35,000TotalAmt
Fundraising$35,000FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$50,280TotalAmt
Management And General$50,280ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$16,087,429TotalAmt
Program Services$15,264,456ProgramServicesAmt
Management And General$822,973ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$166,980TotalAmt
Program Services$578ProgramServicesAmt
Management And General$166,402ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$5,258,109TotalAmt
Program Services$3,735,561ProgramServicesAmt
Management And General$1,522,548ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,302,948TotalAmt
Program Services$2,133,490ProgramServicesAmt
Management And General$169,458ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$386,169TotalAmt
Program Services$344,166ProgramServicesAmt
Management And General$42,003ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$292,949TotalAmt
Program Services$174,737ProgramServicesAmt
Management And General$118,212ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,049,553TotalAmt
Program Services$939,731ProgramServicesAmt
Management And General$109,822ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,083,021TotalAmt
Program Services$2,760,426ProgramServicesAmt
Management And General$322,595ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,011,332TotalAmt
Program Services$387,803ProgramServicesAmt
Management And General$623,529ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement 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

FieldValueIRS element (for citing)
Total$80,769,834TotalAmt
Program Services$70,005,961ProgramServicesAmt
Management And General$10,728,873ManagementAndGeneralAmt
Fundraising$35,000FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$3,751,622BOYAmt
EOY$5,496,302EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,572,899BOYAmt
EOY$12,027,870EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$65,739BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$9,099,480BOYAmt
EOY$7,852,653EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,160,358BOYAmt
EOY$1,167,930EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,603,029BOYAmt
EOY$1,319,402EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$70,482,610LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$44,992,834LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$25,287,965BOYAmt
EOY$25,489,776EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$15,117,001BOYAmt
EOY$13,627,429EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$1,896,128BOYAmt
EOY$2,420,079EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$536,314BOYAmt
EOY$805,621EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,088,950BOYAmt
EOY$1,294,693EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$61,179,485BOYAmt
EOY$71,501,755EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$15,132,864BOYAmt
EOY$12,271,142EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$17,838,950BOYAmt
EOY$30,012,945EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$9,029BOYAmt
EOY$4,070EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$3,564,725BOYAmt
EOY$724,174EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$100,000BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,626,069BOYAmt
EOY$2,648,777EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$39,271,637BOYAmt
EOY$45,661,108EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$17,805,684BOYAmt
EOY$21,382,406EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$108,028BOYAmt
EOY$37,683EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,994,136BOYAmt
EOY$4,420,558EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$21,907,848BOYAmt
EOY$25,840,647EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$61,179,485BOYAmt
EOY$71,501,755EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$2,724,349ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$846,750NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$361,700OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsYes (true)DirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$10,250OtherActivitiesAmt
Total Lobbying Expenditures$10,250TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-B, LINE 1IFormAndLineReferenceDesc
ExplanationTHE ORGANIZATION IS A MEMBER OF HAP, AHA, AND HCWP. $10,250 OF DUES ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
Agent Trustee EtcfalseAgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (true)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,994,146BeginningYearBalanceAmt
Investment Earnings Or Losses$660,852InvestmentEarningsOrLossesAmt
Other Expenditures$234,440OtherExpendituresAmt
End Year Balance$4,420,558EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,877,382BeginningYearBalanceAmt
Investment Earnings Or Losses$378,612InvestmentEarningsOrLossesAmt
Other Expenditures$261,848OtherExpendituresAmt
End Year Balance$3,994,146EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,280,877BeginningYearBalanceAmt
Investment Earnings Or Losses-$106,295InvestmentEarningsOrLossesAmt
Other Expenditures$297,200OtherExpendituresAmt
End Year Balance$3,877,382EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,667,800BeginningYearBalanceAmt
Investment Earnings Or Losses$942,900InvestmentEarningsOrLossesAmt
Other Expenditures$329,823OtherExpendituresAmt
End Year Balance$4,280,877EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,616,355BeginningYearBalanceAmt
Investment Earnings Or Losses$437,150InvestmentEarningsOrLossesAmt
Other Expenditures$385,705OtherExpendituresAmt
End Year Balance$3,667,800EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (true)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,135,847OtherCostOrOtherBasisAmt
Book Value$1,135,847BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$40,181,580OtherCostOrOtherBasisAmt
Depreciation$23,357,963DepreciationAmt
Book Value$16,823,617BookValueAmt
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$27,031,143OtherCostOrOtherBasisAmt
Depreciation$20,278,241DepreciationAmt
Book Value$6,752,902BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,134,040OtherCostOrOtherBasisAmt
Depreciation$1,356,630DepreciationAmt
Book Value$777,410BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$25,489,776TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
DUE TO THIRD PARTY PAYERS$2,103,754
MALPRACTICE LIABILITY$545,023
FieldValueIRS element (for citing)
Total Liability$2,648,777TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$80,217,798TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$846,750NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$7,750DonatedServicesAndUseFcltsAmt
Other Revenue-$3,294,290OtherRevenueAmt
Revenue Not Reported-$2,439,790RevenueNotReportedAmt
Revenue Subtotal$82,657,588RevenueSubtotalAmt
Other Revenues Not Included$836,595OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$836,595RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$83,494,183TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$77,322,191TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$7,750DonatedServicesUseFcltsAmt
Other Expenses Included$279,873OtherExpensesIncludedAmt
Expenses Not Reported$287,623ExpensesNotReportedAmt
Expenses Subtotal$77,034,568ExpensesSubtotalAmt
Investment Expenses Not Incld2$50,280InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$3,684,986OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$3,735,266ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$80,769,834TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART IV, LINE 2BESCROW 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 4ENDOWMENT FUND: THE ENDOWMENT FUND WAS ESTABLISHED TO ALLOW THE HOSPITAL TO PROVIDE HEALTHCARE SERVICES TO POOR AND NEEDY PATIENTS.
SCHEDULE D, PART X, LINE 2UNCERTAIN 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 2DOTHER 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 4BOTHER 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 2DOTHER EXPENSES ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25: $ 279,873 RENTAL EXPENSES
SCHEDULE D, PART XII, LINE 4BOTHER EXPENSES ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $3,684,986 BAD DEBT EXPENSE

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Solicitation Of Non Govt GrantsYes (X)SolicitationOfNonGovtGrantsInd
Solicitation Of Govt GrantsYes (X)SolicitationOfGovtGrantsInd
Agrmt Prof Fundraising ActyYes (true)AgrmtProfFundraisingActyInd

Fundraiser Activity Info FundraiserActivityInfoGrp

FieldValueIRS element (for citing)
PersonDELTA DEVELOPMENT GROUP INCPersonNm
ActivityGRANT WRITINGActivityTxt
Fundraiser Control Of FundsfalseFundraiserControlOfFundsInd
Retained By Contractor$35,000RetainedByContractorAmt
FieldValueIRS element (for citing)
Total Retained By Contractors$35,000TotalRetainedByContractorsAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE G, PART I, LINE 2BFormAndLineReferenceDesc
ExplanationFUNDRAISING 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

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailablefalseReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$970,473TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$970,473NetCommunityBenefitExpnsAmt
Total Expense0.01260TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$13,676,937TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,192,539DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,484,398NetCommunityBenefitExpnsAmt
Total Expense0.03220TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,647,410TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,192,539DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,454,871NetCommunityBenefitExpnsAmt
Total Expense0.04480TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$100,062TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$20,254DirectOffsettingRevenueAmt
Net Community Benefit Expns$79,808NetCommunityBenefitExpnsAmt
Total Expense0.00100TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,118,120TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,118,120NetCommunityBenefitExpnsAmt
Total Expense0.01450TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$28,048,659TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$20,560,743DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,487,916NetCommunityBenefitExpnsAmt
Total Expense0.09710TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,210TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,210NetCommunityBenefitExpnsAmt

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$29,270,051TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$20,580,997DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,689,054NetCommunityBenefitExpnsAmt
Total Expense0.11260TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$43,917,461TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$31,773,536DirectOffsettingRevenueAmt
Net Community Benefit Expns$12,143,925NetCommunityBenefitExpnsAmt
Total Expense0.15740TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Activities Or Programs4ActivitiesOrProgramsCnt
Persons Served120PersonsServedCnt
Total Community Benefit Expns$1,588TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,588NetCommunityBenefitExpnsAmt

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Activities Or Programs10ActivitiesOrProgramsCnt
Persons Served791PersonsServedCnt
Total Community Benefit Expns$28,171TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$15,707DirectOffsettingRevenueAmt
Net Community Benefit Expns$12,464NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Activities Or Programs33ActivitiesOrProgramsCnt
Persons Served863PersonsServedCnt
Total Community Benefit Expns$4,549TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,549NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs3ActivitiesOrProgramsCnt
Persons Served280PersonsServedCnt
Total Community Benefit Expns$1,017TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,017NetCommunityBenefitExpnsAmt

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs50ActivitiesOrProgramsCnt
Persons Served2054PersonsServedCnt
Total Community Benefit Expns$35,325TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$15,707DirectOffsettingRevenueAmt
Net Community Benefit Expns$19,618NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$3,684,986BadDebtExpenseAmt
Bad Debt Expense Attributable$556,433BadDebtExpenseAttributableAmt
Reimbursed By Medicare$14,494,373ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$14,350,865CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$143,508MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CHARLES COLE MEMORIAL HOSPITALBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line11001 EAST 2ND STREETAddressLine1
CityCOUDERSPORTCity
StatePAState
ZIP Code16915ZIPCode
FieldValueIRS element (for citing)
Website Addresswww.colememorial.orgWebsiteAddressTxt
State License031801StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1CHARLES COLE MEMORIAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Facility1FacilityNum
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted12CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttp://www.colememorial.org/about.aspxOwnWebsiteURLTxt
Rpt Available Upon RequestYes (X)RptAvailableUponRequestInd
Adopt Implementation StrategyYes (X)AdoptImplementationStrategyInd
Exec Implementation StrategyYes (X)ExecImplementationStrategyInd
Prioritize Health NeedsYes (X)PrioritizeHealthNeedsInd
Prioritize ServicesYes (X)PrioritizeServicesInd
All Needs AddressedfalseAllNeedsAddressedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Used Deter Elig Free CareYes (true)FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care200.FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt CareYes (true)FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care400.FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (true)ExplainedBasisInd
Income LevelYes (X)IncomeLevelInd
Asset LevelYes (X)AssetLevelInd
Medical IndigencyYes (X)MedicalIndigencyInd
Insurance StatusYes (X)InsuranceStatusInd
Uninsured DiscountYes (X)UninsuredDiscountInd
Medicaid MedicareYes (X)MedicaidMedicareInd
State RegulationYes (X)StateRegulationInd
ResidencyYes (X)ResidencyInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
Posted On WebsiteYes (X)PostedOnWebsiteInd
Attached To InvoiceYes (X)AttachedToInvoiceInd
Posted In Emergency RoomYes (X)PostedInEmergencyRoomInd
Posted In Admission OfficeYes (X)PostedInAdmissionOfficeInd
Available On RequestYes (X)AvailableOnRequestInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Collection ActivitiesfalseCollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Average Negotiated RatesYes (X)AverageNegotiatedRatesInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 3COMMUNITY 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 6IMPLEMENTATION 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 7ADDRESSING 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.
FieldValueIRS element (for citing)
Facility11FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (11 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeFacilityFacilityTxt
PORT ALLEGANY HEALTH CENTER
45 PINE STREETPORT ALLEGANYPA16743RURAL HEALTH CENTER REHABILITATION LAB SERVICES, RADIOLOGY
SHINGLEHOUSE HEALTH CENTER
128 LYONS STREETSHINGLEHOUSEPA16748RURAL HEALTH CENTER LAB SERVICES
ELDRED HEALTH CENTER
139 MAIN STREETELDREDPA16371RURAL HEALTH CENTER LAB SERVICES
EMPORIUM HEALTH CENTER
SIZERVILLE ROADEMPORIUMPA15834RURAL HEALTH CENTER LAB SERVICES
GALETON HEALTH CENTER
30 RIVER STREETGALETONPA16922RURAL HEALTH CENTER LAB SERVICES
WESTFIELD RURAL HEALTH CLINIC
222 CHURCH STREETWESTFIELDPA16950RURAL HEALTH CENTER LAB SERVICES
HEWITT MANOR
111 WEST HONEOYE STREETSHINGLEHOUSEPA16748REHABILITATION
SMETHPORT HEALTH CENTER
83 MARVIN STREETSMETHPORTPA16749RURAL HEALTH CENTER LAB SERVICES
NORTHERN POTTER HEALTH CENTER
511 ACADEMY STREETULYSSESPA16948RURAL HEALTH CENTER LAB SERVICES
CENTRAL POTTER HEALTH CENTER
46 ELK STREETCOUDERSPORTPA16915RURAL HEALTH CENTER LAB SERVICES
HOME HEALTH
269 ROUTE 6COUDERSPORTPA16915HOME HEALTH OFFICES

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART I, LINE 7, COLUMN FPERCENT 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 7GSUBSIDIZED 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 7COSTING 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 IICOMMUNITY BUILDING ACTIVITIES: SEE NARRATIVE AT SCHEDULE H, PART VI, LINE 4.
SCHEDULE H, PART III, SECTION A, LINES 2 & 3BAD 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 4BAD 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 8COMMUNITY 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 9BCOLLECTION 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 2NEEDS 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 3PATIENT 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 4COMMUNITY 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 5PROMOTION 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 6AFFILIATED 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

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp 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

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART I, LINE 7FormAndLineReferenceDesc
ExplanationNON-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 ReferenceBondReferenceCdBond Issuer EINBondIssuerEINBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
POTTER COUNTY HOSPITAL AUTHORITY
A2566914392013-12-19$20,575,000REFUND BONDS/LOAN,PURCH CAP EQUIPfalsefalsefalse
POTTER COUNTY HOSPITAL AUTHORITY
B2566914392014-06-25$9,800,000OPER ROOM EXPANSION,FACIL UPGRADESfalsefalsefalse

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtBond DefeasedBondDefeasedAmtTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtCapitalized InterestCapitalizedInterestAmtRefunding EscrowRefundingEscrowAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCredit EnhancementCreditEnhancementAmtWorking Capital ExpendituresWorkingCapitalExpendituresAmtCapital ExpendituresCapitalExpendituresAmtOther Spent ProceedsOtherSpentProceedsAmtUnspentUnspentAmtCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$0$0$20,575,000$700,000$0$14,949,169$127,545$0$0$3,954,913$0$843,373Yes (true)falsefalseYes (true)
B$0$0$9,800,000$300,000$0$0$41,073$0$0$65,717$0$9,393,210falsefalsefalseYes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndRemedial Action TakenRemedialActionTakenIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
Afalsefalsefalsefalse0.000000.000000.00000falsefalsefalseYes (true)
Bfalsefalsefalsefalse0.000000.000000.00000falsefalsefalseYes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndBusiness Name Line1GICProviderName/BusinessNameLine1Gross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
0
AfalseYes (true)falsefalsefalsefalsefalse0falseYes (true)
0
BfalseYes (true)falsefalsefalsefalsefalse0falseYes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (true)
BYes (true)

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (5 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
COLE CARE
COMMON BOARD MEMBERS$7,917,971RENT, DIVIDENDS, SERVICESfalse
EDMOND HARDESTY
HUSBAND OF C. HARDESTY$151,114EMPLOYEE OF HOSPITALfalse
ADAM NESTOR
HUSBAND OF K. NESTOR$89,013EMPLOYEE OF HOSPITALfalse
VICTORIA COPP
SISTER OF J. MIGLICIO$36,036EMPLOYEE OF HOSPITALfalse
NANCY RUDOLPH
SISTER OF J. MIGLICIO$45,397EMPLOYEE OF HOSPITALfalse

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART I, LINE 1ORGANIZATION'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 4PROGRAM 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 & 7AMEMBERS: 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 11BFORM 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 12CMONITORING 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 15ACOMPENSATION 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 19DOCUMENT 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 ABOARD 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 11GOTHER 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 9OTHER CHANGES IN NET ASSETS: $361,700 AMORTIZATION OF NET LOSS

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrganizationControlledOrganizationInd
HENDORN INC DBA COLE MANOR
1001 EAST SECOND STREETCOUDERSPORTPA16915231972659RESIDENT CAREPA501(C)(3)11A ICOLE MEMYes (true)
HAMOTCOLE VENTURES INC
1001 EAST SECOND STREETCOUDERSPORTPA16915273172100REAL ESTATEPA501(C)(3)11A INAfalse
COLE FOUNDATION INC
1001 EAST SECOND STCOUDERSPORTPA16915455417308SUPPORTPA501(C)(3)11A ICOLE MEMYes (true)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1COLE CARE INCBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line11001 EAST 2ND STREETAddressLine1
CityCOUDERSPORTCity
StatePAState
ZIP Code16915ZIPCode
FieldValueIRS element (for citing)
EIN251497347EIN
Primary ActivitiesDURABLE MED EQUIPPrimaryActivitiesTxt
Legal Domicile StatePALegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1COLE MEMORIALBusinessNameLine1
FieldValueIRS element (for citing)
Entity TypeC CORPORATIONEntityTypeTxt
Share Of Total Income$9,634,083ShareOfTotalIncomeAmt
Share Of EOY Assets$971,411ShareOfEOYAssetsAmt
Ownership1.00000OwnershipPct
Controlled OrganizationYes (true)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (true)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (6 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
COLE CARE INC
A/J$178,970FMV
COLE CARE INC
L$187,152FMV
HENDORN INC
M$448,322FMV
COLE CARE INC
O$7,500,661FMV
COLE CARE INC
P$51,188FMV
HENDORN INC
R$105,487FMV