2014-11-13T09:23:40-06:00 2013-12-31 232932984 PARENTEBEARD LLC 400 MARKET STREET WILLIAMSPORT PA 17701 990 2013-06-01 463243949 CENTRE CARE INC CENT 8143556777 502 E HOWARD STREET BELLEFONTE PA 16823 CARL RAUP TREASURER 8143556777 2014-11-12 1 RICK BAIR P00062995 5703236023 2014-11-12 2013 2015-11-30 17:44:51Z X CENTRE CREST BETSY BOYER 502 E HOWARD STREET BELLEFONTE PA 16823 24676319 0 X WWW.CENTRECREST.ORG X 2013 PA OPERATION OF A SKILLED NURSING FACILITY 9 9 251 100 0 0 21892963 2700727 280 82349 24676319 0 0 1980117 0 0 2001298 3981415 20694904 23364785 2669881 20694904 PROVIDING FOR THE LONG-TERM CARE NEEDS OF THE RESIDENTS OF CENTRE COUNTY, PENNSYLVANIA 0 0 3631047 2775545 OPERATION OF SKILLED NURSING FACILITY, FOCUSING ON LOWER-INCOME RESIDENTS FUNDED BY MEDICAID PROGRAMS OR PROVIDING CHARITY CARE TO FINANCIALLY INDIGENT RESIDENTS OF CENTRE COUNTY, PENNSYLVANIA REQUIRING LONG-TERM CARE SERVICES. CENTRE CREST HAD A TOTAL CENSUS FOR LOW INCOME MEDICAID RESIDENTS OF 9,381 DAYS IN 2013 (74% OF TOTAL RESIDENTS SERVED). THE REIMBURSEMENT FOR THESE RESIDENTS WAS AN AVERAGE OF $179.61 PER DAY, WHILE THE COST OF PROVIDING SERVICE TO THESE RESIDENTS WAS APPROXIMATELY $226 PER DAY. REIMBURSEMENT WAS APPROXIMATELY $434,000 LESS THAN THE COST TO PROVIDE SERVICES TO THESE LOW INCOME MEDICAID ELIGIBLE RESIDENTS - THIS SHORTFALL CONSTITUTES "CHARITY CARE" PROVIDED BY CENTRE CREST. 3631047 1 1 0 0 0 0 0 0 1 0 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 14 0 1 251 1 0 0 0 0 0 0 0 0 0 0 X 9 9 1 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X X LORI JAMISON 8143556777 502 E HOWARD STREET BELLEFONTE PA 16823 BETSY BOYER PRESIDENT 1.00 X X 0 0 0 LARRY BICKFORD VICE PRESIDENT 1.00 X X 0 0 0 CARL RAUP SECRETARY/TREASURER 1.00 X X 0 0 0 STEVEN BROWN DIRECTOR 1.00 X 0 0 0 CONTSTANCE CORL DIRECTOR 1.00 X 0 0 0 ALFRED JONES JR DIRECTOR 1.00 X 0 0 0 WILLIAM H ROCKEY DIRECTOR 1.00 X 0 0 0 SALLY WALKER DIRECTOR 1.00 X 0 0 0 RICH WISNIEWSKI DIRECTOR 1.00 X 0 0 0 JENNIFER ESLINGER INTERIM ADMINISTRATOR 40.00 X 0 0 0 ED RUTLEDGE FACILITY CONTROLLER (AS OF NOV 2013) 40.00 X 9821 0 0 ZETA SMOYER BUSINESS OFFICE MANAGER (AS OF NOV 2013) 40.00 X 5171 0 0 14992 0 0 0 0 0 0 APEX REHAB SOLUTIONS INC 209 SIGMA DRIVE PITTSBURGH PA 15238 THERAPY REHABILITATION SERVICES 310302 GRANE SUPPLY INC PO BOX 558 PITTSBURGH PA 15230 PHARMACEUTICAL DRUGS AND SERVICES 190654 COMPLETE HEALTHCARE RESOURCES - EASTERN 200 DRYDEN ROAD SUITE 3100 DRESHER PA 19025 MANAGEMENT SERVICES 108610 SYSCO F S OF CENTRAL PA PO BOX 3641 HARRISBURG PA 17105 FOOD AND DIETARY SERVICES 104029 3 21850121 42842 20746682 21892963 ROOM & BOARD 623000 2565871 2565871 ANCILLARY SERVICES 623000 134856 134856 2700727 280 280 PA NURSING HOME ASSESSMENT 623000 74818 74818 FOOD 900099 6133 6133 VENDING 900099 359 359 1039 1039 82349 24676319 2775545 0 7811 1462348 1380359 81989 319829 300897 18932 197940 189860 8080 80000 80000 4266 4266 110 110 362551 313994 48557 13511 1082 12429 9002 788 8214 11219 11219 285263 220990 64273 790 790 581071 581071 38056 38056 MEDICAL SUPPLIES 186619 186619 BAD DEBT EXPENSE 182699 182699 PA NURSING HOME ASSESSM 100659 100659 DIETARY SUPPLIES 99500 99500 45982 34473 11509 3981415 3631047 350368 0 1600 2512094 1556256 7388 385637 14498 0 371139 4800000 0 14116308 0 23364785 2531494 138387 0 2669881 X 9361937 11332967 0 20694904 0 23364785 20694904 0 X 0 1 X 1 0 X 21892963 21892963 21892963 21892963 21892963 280 280 82349 82349 21975592 2700727 X SCHEDULE A, PART II, LINE 13: CENTRE CARE, INC. BEGAN OPERATIONS DURING 2013. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 385637 14498 371139 371139 RESIDENT TRUST FUNDS 138387 THIRD-PARTY PAYOR SETTLEMENTS 99325 ASSETS WHOSE USE IS LIMITED 112201 CONTRIBUTED RENT 11332967 LEASEHOLD ESTATE INTEREST, NET 2433428 14116308 X 24676319 0 24676319 0 24676319 3981415 0 3981415 0 3981415 PART IV, LINE 2B: ESCROW ACCOUNTS ARE PATIENT FUNDS HELD IN TRUST FOR THEIR PERSONAL EXPENDITURES IN ACCORDANCE WITH DEPARTMENT OF HEALTH REGULATIONS. PART X, LINE 2: THE ORGANIZATION FOLLOWS THE PROVISIONS OF ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES WHICH PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. THE PROVISION ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, AND DISCLOSURES. MANAGEMENT HAS DETERMINED THAT THESE PROVISIONS DO NOT HAVE A MATERIAL IMPACT ON THE FINANCIAL STATEMENTS. THE ORGANIZATION EXPECTS TO FILE ITS INITIAL FEDERAL RETURN OF AN EXEMPT ORGANIZATION IN 2014. X AR AND PP&E, 1 20746682 APPRAISAL 0 0 0 FORM 990, PART VI, SECTION A, LINE 2 STEVE BROWN AND RICHARD WISNIEWSKI HAVE A BUSINESS RELATIONSHIP - BOTH ARE OFFICERS OF MOUNT NITTANY HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 3 COMPLETE HEALTHCARE RESOURCES - EASTERN, INC. ("CHR") WAS PAID $80,000 IN 2013 TO PROVIDE MANAGEMENT SERVICES. ADDITIONALLY, JENNIFER ESLINGER ACTED AS INTERIM ADMINISTRATOR IN 2013 AND WAS PAID BY CHR FOR HER SERVICES - $26,810 FOR 2013. FORM 990, PART VI, SECTION B, LINE 11 MANAGEMENT COMPANY HAS PROVIDED A "SHAREPOINT" SYSTEM ACCESS TO ALL FINANCIAL STATEMENTS, TAX RETURNS, OPERATING REPORTS, AND OTHER RELEVANT REPORTS THAT ALL MEMBERS OF THE BOARD HAVE ACCESS TO IN ORDER TO REVIEW OF DOWNLOAD SUCH REPORTS OR DOCUMENTS. THE FORM 990 WILL BE POSTED AND MEMBERS NOTIFIED OF ITS AVAILABILITY PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C CODE OF CONDUCT AND CONFLICT OF INTEREST POLICIES TAKEN INTO CONSIDERATION IN EVALUATING AND AWARDING CONTRACTS; BOARD HAS ENGAGED THIRD PARTY MANAGEMENT COMPANY (COMPLETE HEALTHCARE RESOURCES, "CHR") TO OVERSEE DAY-TO-DAY OPERATIONS, INCLUDING BIDS FOR CONTRACTS AND MANAGEMENT COMPANY PROVIDES RECOMMENDATIONS TO BOARD FOR FINAL APPROVAL. CHR PROVIDES ANNUAL TRAINING TO THE BOARD ON CORPORATE COMPLIANCE. THE COO OF CHR AND/OR RVP OF CHR, ALONG WITH ADMINISTRATOR ARE RESPONSIBLE FOR THE REVIEW. DIRECTORS AND OFFICERS ARE REQUIRED TO SIGN OFF ON THE CODE OF CONDUCT AND CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION B, LINE 15 NO BOARD MEMBER OR OFFICER RECEIVES COMPENSATION FOR THEIR SERVICES. ADMINISTRATOR OF THE FACILITY IS AN EMPLOYEE OF THE MANAGEMENT COMPANY, WHICH ESTABLISHES PAY RATES FOR ADMINISTRATOR POSITIONS IN LINE WITH THE PENNSYLVANIA MARKET PLACE. CANDIDATES AND ASSOCIATED COMPENSATION ARE REVIEWED BY MANAGEMENT COMPANY WITH BOARD PRIOR TO HIRING. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY WILL BE MADE AVAILABLE UPON REQUEST.