TITUSVILLE AREA HOSPITAL: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- TITUSVILLE AREA HOSPITAL (EIN 25-0965579)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-14
- IRS object ID
- 201431349349306698
- Schema version
- 2012v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-14T16:35:18-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E ST LOUIS 200/PO BOX 1190 | AddressLine1 |
| City | SPRINGFIELD | City |
| State | MO | State |
| ZIP Code | 658062523 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 250965579 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TITUSVILLE AREA HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % JILL NEELY | InCareOfName |
| Name Control | TITU | NameControl |
| Phone | 8148271851 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 406 WEST OAK STREET | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | TITUSVILLE | City |
| State | PA | State |
| ZIP Code | 16354 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ANTHONY J NASRALLA | Name |
| Title | CEO | Title |
| Phone | 8148271851 | Phone |
| Date Signed | 2014-04-04 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Brian D Todd | Name |
| Phone | 4178658701 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | ANTHONY J NASRALLA | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 406 WEST OAK STREET | AddressLine1 |
| City | TITUSVILLE | City |
| State | PA | State |
| ZIP Code | 16354 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 31875310 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.TITUSVILLEHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1900 | YearFormation |
| State Legal Domicile | PA | StateLegalDomicile |
| Activity Or Mission Description | TITUSVILLE AREA HOSPITAL IS A COMMUNITY BASED, ACUTE CARE HOSPITAL PROVIDING INPATIENT, OUTPATIENT, EMERGENCY AND HOME CARE SERVICES TO MORE THAN 30,000 PEOPLE IN FOUR COUNTIES IN PENNSYLVANIA. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 350 | TotalNbrEmployees |
| Total Nbr Volunteers | 60 | TotalNbrVolunteers |
| Total Gross UBI | 1939 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 939 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 111640 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 276891 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 33149694 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 30852804 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 145443 | InvestmentIncomePriorYear |
| Investment Income Current Year | 86692 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 365511 | OtherRevenuePriorYear |
| Other Revenue Current Year | 297511 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 33772288 | TotalRevenuePriorYear |
| Total Revenue Current Year | 31513898 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 5000 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 9399 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 16864274 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 17189889 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 15383780 | OtherExpensePriorYear |
| Other Expenses Current Year | 16059321 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 32253054 | TotalExpensesPriorYear |
| Total Expenses Current Year | 33258609 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1519234 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1744711 | RevenuesLessExpensesCY |
| Total Assets BOY | 19295236 | TotalAssetsBOY |
| Total Assets EOY | 19814251 | TotalAssetsEOY |
| Total Liabilities BOY | 14570759 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 16327300 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 4724477 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 3486951 | NetAssetsOrFundBalancesEOY |
| Mission Description | TITUSVILLE AREA HOSPITAL IS COMMITTED TO PROVIDING QUALITY HEALTHCARE SERVICES WITH AN EMPHASIS ON PERSONAL ATTENTION, COMPASSION AND RESPECT. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 24097800 | Expense |
| Grants | 9399 | Grants |
| Revenue | 30852804 | Revenue |
| Description | TITUSVILLE AREA HOSPITAL IS AN ACUTE CARE RURAL HOSPITAL WITH 1,612 ADMISSIONS, 7,058 PATIENT DAYS, 169 BIRTHS AND 64,016 OUTPATIENT VISITS. | Description |
| Total Program Service Expense | 24097800 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | true | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 43 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 350 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | PA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | JILL NEELY | NamePerson |
| Telephone Number | 8148271851 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 406 WEST OAK STREET | AddressLine1 |
| City | TITUSVILLE | City |
| State | PA | State |
| ZIP Code | 16354 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (26 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|---|
| ANTHONY J NASRALLA | |||||||||
| CEO/PRESIDENT | 35.0 | 5.0 | X | X | 280324 | 0 | 7495 | ||
| JASON REAGLE | |||||||||
| CHAIRMAN | 1.0 | 0.0 | X | X | 0 | 0 | |||
| JUDY COCHRAN | |||||||||
| DIRECTOR | 1.0 | 0.0 | X | 0 | 0 | ||||
| RICHARD CARR | |||||||||
| DIRECTOR | 1.0 | 1.0 | X | 0 | 0 | ||||
| STEPHEN COLEMAN | |||||||||
| SECRETARY | 1.0 | 1.0 | X | X | 0 | 0 | |||
| EDWARD GRIFFIN MD | |||||||||
| DIRECTOR, BEGINNING 1/2013 | 1.0 | 40.0 | X | 0 | 440975 | 39075 | |||
| BRIAN LOS MD | |||||||||
| DIRECTOR, BEGINNING 1/2013 | 1.0 | 0.0 | X | 0 | 0 | ||||
| SCOTT MCALLISTER MD | |||||||||
| DIRECTOR | 1.0 | 0.0 | X | 0 | 0 | ||||
| LYNN PEDENSKY | |||||||||
| DIRECTOR | 1.0 | 1.0 | X | 0 | 0 | ||||
| LARRY FLEDDERMAN | |||||||||
| DIRECTOR | 1.0 | 2.0 | X | 0 | 0 | ||||
| DONNA POPIESKI | |||||||||
| DIRECTOR | 1.0 | 0.0 | X | 0 | 0 | ||||
| ANIL DUTT MD | |||||||||
| DIRECTOR | 1.0 | 40.0 | X | 0 | 329796 | 23258 | |||
| CHERYL WALKER | |||||||||
| DIRECTOR | 1.0 | 0.0 | X | 0 | 0 | ||||
| JAY PERTZ | |||||||||
| DIRECTOR | 1.0 | 0.0 | X | 0 | 0 | ||||
| PATRICIA WALKER | |||||||||
| DIRECTOR | 1.0 | 0.0 | X | 0 | 0 | ||||
| LEONARD FERREIRA MD | |||||||||
| DIRECTOR ENDING 12/2012 | 1.0 | 0.0 | X | 0 | 0 | ||||
| THOMAS CHESAR MD | |||||||||
| DIRECTOR ENDING 12/2012 | 1.0 | 40.0 | X | 0 | 163191 | 19851 | |||
| JILL NEELY | |||||||||
| CFO/TREASURER | 35.0 | 5.0 | X | 122179 | 0 | 19812 | |||
| JEFF SAINTZ | |||||||||
| VP HUMAN RESOURCES | 40.0 | 0.0 | X | 119577 | 0 | 17603 | |||
| LINDA HARRIS | |||||||||
| VP PATIENT SERVICES | 40.0 | 0.0 | X | 130841 | 0 | 8529 | |||
| MARIO D'ALESSANDRO DO | |||||||||
| MEDICAL DIRECTOR OF ER | 40.0 | 0.0 | 263492 | 0 | 24654 | X | |||
| ARTHUR LEWIS MD | |||||||||
| PHYSICIAN | 40.0 | 0.0 | 225180 | 0 | 18404 | X | |||
| MARY WETHLI MD | |||||||||
| PHYSICIAN | 40.0 | 0.0 | 220622 | 0 | 21939 | X | |||
| SCOTT SMITH | |||||||||
| CRNA | 40.0 | 0.0 | 209351 | 0 | 21705 | X | |||
| ROCK BAKER | |||||||||
| CRNA | 40.0 | 0.0 | 161729 | 0 | 35563 | X | |||
| JEFFRY KARNS | |||||||||
| CRNA | 40.0 | 0.0 | 148524 | 0 | 21584 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1881819 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 933962 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 279472 | TotalOtherCompensation |
| Number Individuals GT100 K | 13 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|
| CPS INC | |
| PHARMACY ADMIN SVCS | 516120 |
| CONIFER HEALTH SOLUTIONS | |
| BILLING/CODING | 400000 |
| MAXIT HEALTHCARE LLC | |
| CONSULTING | 346308 |
| ASSOCIATED CLINICAL | |
| DIAGNOSTIC LAB SVCS | 310532 |
| WARREN GENERAL HOSPITAL | |
| ONCOLOGY SVCS | 157252 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 8 | NumberOfContractorsGT100K |
| Related Organizations | 25000 | RelatedOrganizations |
| Government Grants | 114076 | GovernmentGrants |
| All Other Contributions | 137815 | AllOtherContributions |
| Total Contributions | 276891 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 900099 | 29056261 | 29056261 |
| E H R INCENTIVE REVENUE | 900099 | 1564645 | 1564645 |
| CAFETERIA REVENUE | 722513 | 95235 | 95235 |
| OTHER INCOME | 900099 | 136663 | 136663 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 30852804 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 31040 | TotalRevenueColumn |
| Exclusion | $31,040 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 54717 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 54717 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 54717 | TotalRevenueColumn |
| Exclusion | $54,717 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 407064 | Securities |
| Other | 10000 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 318820 | Securities |
| Other | 42592 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 88244 | Securities |
| Other | -32592 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 55652 | TotalRevenueColumn |
| Exclusion | $55,652 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| INCOME FROM EQUITY INVESTEE | 900099 | 240855 | $240,855 | |
| INCOME FROM INVESTMENTS HELD AT COST | 900099 | 1939 | 1939 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 242794 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 31513898 | TotalRevenueColumn |
| Related Or Exempt Function Income | 30852804 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1939 | UnrelatedBusinessRevenue |
| Exclusion | $382,264 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4399 | Total |
| Program Services | 4399 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5000 | Total |
| Program Services | 5000 | ProgramServices |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1024884 | Total |
| Management And General | 1024884 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34292 | Total |
| Program Services | 34292 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12035585 | Total |
| Program Services | 9392099 | ProgramServices |
| Management And General | 2643486 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 336882 | Total |
| Program Services | 248897 | ProgramServices |
| Management And General | 87985 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2844959 | Total |
| Program Services | 2037133 | ProgramServices |
| Management And General | 807826 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 913287 | Total |
| Program Services | 672802 | ProgramServices |
| Management And General | 240485 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 66016 | Total |
| Management And General | 66016 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 83000 | Total |
| Management And General | 83000 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3663902 | Total |
| Program Services | 1929897 | ProgramServices |
| Management And General | 1734005 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 110317 | Total |
| Program Services | 7679 | ProgramServices |
| Management And General | 102638 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 477018 | Total |
| Program Services | 323357 | ProgramServices |
| Management And General | 153661 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 569076 | Total |
| Management And General | 569076 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1883329 | Total |
| Program Services | 1506663 | ProgramServices |
| Management And General | 376666 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 39281 | Total |
| Program Services | 32575 | ProgramServices |
| Management And General | 6706 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17460 | Total |
| Program Services | 11710 | ProgramServices |
| Management And General | 5750 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 392430 | Total |
| Program Services | 34258 | ProgramServices |
| Management And General | 358172 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1076111 | Total |
| Program Services | 860888 | ProgramServices |
| Management And General | 215223 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 422208 | Total |
| Program Services | 393962 | ProgramServices |
| Management And General | 28246 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| SUPPLIES | 4084898 | 3589394 | 495504 |
| BAD DEBT EXPENSE | 2967957 | 2967957 | |
| LICENSES, DUES, SUBSCRIPTIONS | 140146 | 44328 | 95818 |
| MISCELLANEOUS EXPENSE | 66172 | 510 | 65662 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 33258609 | Total |
| Program Services | 24097800 | ProgramServices |
| Management And General | 9160809 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1021683 | BOY |
| EOY | 655227 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5365642 | BOY |
| EOY | 4734686 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 579980 | BOY |
| EOY | 625484 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 413155 | BOY |
| EOY | 390499 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 38925174 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 31421295 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8108337 | BOY |
| EOY | 7503879 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 3580163 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3250043 | BOY |
| EOY | 1427828 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 120000 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 556396 | BOY |
| EOY | 776485 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19295236 | BOY |
| EOY | 19814251 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6579372 | BOY |
| EOY | 6732338 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10648 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1779846 | BOY |
| EOY | 2314544 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6200893 | BOY |
| EOY | 7280418 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14570759 | BOY |
| EOY | 16327300 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1790479 | BOY |
| EOY | 378238 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2933998 | BOY |
| EOY | 3108713 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4724477 | BOY |
| EOY | 3486951 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19295236 | BOY |
| EOY | 19814251 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -1744711 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | -77909 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 585094 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | OTHER LOBBYING ACTIVITIES | Identifier |
| Return Reference | SCHEDULE C, PART II-B, LINE 1I | ReturnReference |
| Explanation | A PORTION OF THE ORGANIZATION'S DUES TO HOSPITAL COUNCIL AND AMERICAN HOSPITAL ASSOCIATION ARE USED FOR LOBBYING. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years | |
| Current Year Minus4 Years | CurrentYearMinus4Years |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 287721 | OtherCostOrOtherBasis |
| Book Value | 287721 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 14999307 | OtherCostOrOtherBasis |
| Depreciation | 10526016 | Depreciation |
| Book Value | 4473291 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 22527460 | OtherCostOrOtherBasis |
| Depreciation | 20242681 | Depreciation |
| Book Value | 2284779 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1110686 | OtherCostOrOtherBasis |
| Depreciation | 652598 | Depreciation |
| Book Value | 458088 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 7503879 | TotalOfBookValueLandBuildings |
| Financial Derivatives | FinancialDerivatives | |
| Closely Held Equity Interests | CloselyHeldEquityInterests |
Other Securities OtherSecurities (2 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| INVESTMENT - CHART | 1378828 | F |
| INVESTMENT - VANTAGE HOLDING | 49000 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 1427828 | TotalOfBookValueSecurities |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| EST AMT DUE TO 3RD PTY PYR | $910,863 |
| DUE TO AFFILIATES | $6,369,555 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 7280418 | TotalOfAmounts |
| Tot Revenue Etc Audited Fincl Stmt | 27018502 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -77909 | NetUnrealizedGainsInvestments |
| Other Revenues | -4415548 | OtherRevenues |
| Revenue Not Rptd F990 | -4493457 | RevenueNotRptdF990 |
| Revenue Subtotal | 31511959 | RevenueSubtotal |
| Other Revenues Not Included | 1939 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 1939 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 31513898 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 30290652 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 30290652 | ExpensesSubtotal |
| Other Expenses Not Included | 2967957 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 2967957 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 33258609 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| UNCERTAIN TAX POSITION | SCHEDULE D, PART X, LINE 2 | 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. |
| AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART VIII, LINE 12 | SCHEDULE D, PART XI, LINE 2D | $(2,967,957) BAD DEBT EXPENSE 174,715 CHANGE IN BENEFICIAL INTEREST (1,622,306) TRANSFER TO AFFILIATES ------------ $(4,415,548) |
| AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1 | SCHEDULE D, PART XI, LINE 4B | $ 1,939 INCOME FROM INVESTMENT RECORDED AT COST |
| AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1 | SCHEDULE D, PART XII, LINE 4B | $ 2,967,957 BAD DEBT EXPENSE |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | false | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | false | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 341627 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 341627 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01130 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4403646 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2892685 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1510961 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04990 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4745273 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2892685 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1852588 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06120 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 35367 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 310 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 35057 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00120 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9138 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 9138 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 44505 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 310 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 44195 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00150 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4789778 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2892995 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1896783 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06270 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 4399 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 4399 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 4399 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 4399 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReported |
| Bad Debt Expense | $2,967,957 | BadDebtExpenseAmount |
| Amount Attributable To | 480809 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 12198957 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 13859478 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -1660521 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | false | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TITUSVILLE AREA HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 406 WEST OAK STREET | AddressLine1 |
| City | TITUSVILLE | City |
| State | PA | State |
| ZIP Code | 16354 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TITUSVILLE AREA HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | true | CHNAConducted |
| Community Demographics | X | CommunityDemographics |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Needs Assessment Conducted | 11 | NeedsAssessmentConducted |
| Take Into Account | true | TakeIntoAccount |
| Other Facilities | true | OtherFacilities |
| CHNA Widely Available | true | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| All Needs Addressed | true | AllNeedsAddressed |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 150. | FPGFreePercent |
| Uses FPG Discounted | false | UsesFPGDiscounted |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| PERCENT OF TOTAL EXPENSE | SCHEDULE H, PART I, LINE 7, COLUMN F | TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR, WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25, OF THE FORM 990 ($33,258,609), WAS REDUCED BY BAD DEBT EXPENSE ($2,967,957). |
| COSTING METHODOLOGY | SCHEDULE H, PART I, LINE 7 | THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1, 3 AND 6. |
| COMMUNITY SUPPORT | SCHEDULE H, PART II, LINE 3, COLUMN C | COMMUNITY SUPPORT DONATIONS ARE MADE TO VARIOUS ORGANIZATIONS SUCH AS THE YMCA, YWCA, BIG BROTHERS/SISTERS, MARCH OF DIMES, AMERICAN CANCER SOCIETY, AND TITUSVILLE AREA SENIOR CITIZENS. THESE DONATIONS HELP TO SUPPORT ORGANIZATIONS THAT PROMOTE HEALTHY ACTIVITY AND LIVING CHOICES. SOME OF THE DONATIONS ALSO SUPPORT RESEARCH FOR CURES TO CANCER AND BIRTH DEFECTS. |
| BAD DEBT EXPENSE | SCHEDULE H, PART III, SECTION A, LINES 2, 3 & 4 | THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. IT DOES, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE. THAT FOOTNOTE READS AS FOLLOWS: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HEALTH CENTER ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HEALTH CENTER ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HEALTH CENTER RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE ORGANIZATION CALCULATED BAD DEBT USING THE AMOUNTS CALCULATED IN THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS. BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING POVERTY LIMIT DEMOGRAPHIC INFORMATION OBTAINED THROUGH THE US CENSUS BUREAU. THIS AMOUNT EXPENSED BY THE ORGANIZATION IS ATTRIBUTABLE TO LOW INCOME INDIVIDUALS IN THEIR TARGET COMMUNITY AND IS CONSIDERED A COMMUNITY BENEFIT. |
| COMMUNITY BENEFIT RATIONALE | SCHEDULE H, PART III, SECTION B, LINE 8 | MEDICARE DATA COMPUTED USING THE MEDICARE COST REPORT FILED WITH CMS WAS UTILIZED FOR THE COMPUTATIONS IN PART III, SECTION B. 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. |
| COMMUNITY INPUT | SCHEDULE H, PART V, SECTION B, LINE 3 | IN ORDER TO GAIN AN UNDERSTANDING AS TO THE HEALTH NEEDS OF THE COMMUNITY, A SURVEY WAS MADE AVAILABLE TO THE COMMUNITY OF CRAWFORD COUNTY. THE SURVEY WAS AVAILABLE ON THE INTERNET, PAPER FORMAT, AND VIA TELEPHONY. THE ORGANIZATIONS RECEIVED 734 COMPLETED SURVEYS. |
| CHNA REPORT | SCHEDULE H, PART V, SECTION B, LINE 4 | IN PREPARING THE CHNA REPORT, THE ORGANIZATION PARTNERED WITH THE CRAWFORD HEALTH IMPROVEMENT COALITION, WHICH IS A COALITION OF AREA HOSPITALS, GOVERNMENT SUBDIVISIONS, AND OTHER ORGANIZATIONS WITH AN INTEREST IN THE HEALTH OF THOSE THAT RESIDE IN CRAWFORD COUNTY, PENNSYLVANIA. |
| IMPLEMENTATION STRATEGY | SCHEDULE H, PART V, SECTION B, LINE 6 | IN RESPONSE TO THE RESULTS OF TITUSVILLE AREA HOSPITAL'S MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT, THE ORGANIZATION ADOPTED AN IMPLEMENTATION STRATEGY. THE IMPLEMENTATION STRATEGY IS ATTACHED. WHILE TITUSVILLE AREA HOSPITAL HAS TAKEN ACTION WITH RESPECT TO THE NEEDS IDENTIFIED IN ITS CHNA AND HAS REVIEWED THESE NEEDS AND THE RESPONSES TO THE NEEDS WITH ITS COMMUNITY HEALTH COMMITTEE, THE BOARD NOR THE COMMITTEE DID NOT FORMALLY APPROVE THE IMPLEMENTATION STRATEGY. THE ORGANIZATION'S LEADERSHIP TEAM JUST DISCOVERED THIS IN MAY, 2014 WHEN COMPLETING THE JUNE 30, 2013 FORM 990. |
| MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS | SCHEDULE H, PART V, SECTION B, LINE 20D | ANY INDIVIDUAL THAT QUALIFIES FOR FINANCIAL ASSISTANCE RECEIVES 100 PERCENT WRITE-OFF FOR SERVICES PROVIDED. THIS ENSURES NO FAP-ELIGIBLE PATIENTS PAYS MORE THAN THE AMOUNTS GENERALLY BILLED. |
| NEEDS ASSESSMENT | SCHEDULE H, PART VI, LINE 2 | TITUSVILLE AREA HOSPITAL DOES NOT CURRENTLY HAVE A FORMALIZED METHOD TO ASSESS THE COMMUNITY FOR ITS HEALTH NEEDS. IN THE NEXT COUPLE YEARS, THE ORGANIZATION PLANS TO LAUNCH A MORE FORMALIZED PROCESS TO ASSESS COMMUNITY NEEDS. |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | SCHEDULE H, PART VI, LINE 3 | THE CHARITY CARE POLICY IS POSTED IN ADMISSIONS AND EMERGENCY ROOM AREAS. COPIES OF THE CHARITY CARE POLICY ARE AVAILABLE IN ADMISSIONS AREA AND EMERGENCY ROOM AREAS. IF A PERSON IS ADMITTED WITH NO INSURANCE THEY ARE VISITED BY A FINANCIAL AID COUNSELOR AND MADE AWARE OF THEIR OPTIONS. |
| COMMUNITY INFORMATION | SCHEDULE H, PART VI, LINE 4 | TITUSVILLE AREA HOSPITAL SERVES RESIDENTS OF CRAWFORD, FOREST, AND VENANGO COUNTIES IN PENNSYLVANIA. THE MAIN SERVICE AREA IS CRAWFORD COUNTY. CRAWFORD COUNTY IS A RURAL AREA WITH A POPULATION OF APPROXIMATELY 88,524. THE 2009 ESTIMATED MEDIAN HOUSEHOLD INCOME WAS $38,192 WHICH IS WELL BELOW THE PENNSYLVANIA ESTIMATED HOUSEHOLD INCOME OF $49,520. APPROXIMATELY 13% OF RESIDENTS LIVE IN POVERTY. |
| PROMOTION OF COMMUNITY HEALTH | SCHEDULE H, PART VI, LINE 5 | OUR STAFF IS COMMITTED TO THE CARE AND IMPROVEMENT OF LIFE. IN RECOGNITION OF THIS COMMITMENT, WE STRIVE TO DELIVER HIGH-QUALITY AND COST-EFFECTIVE HEALTHCARE WITH AN EMPHASIS ON COMPASSION, PERSONAL ATTENTION AND RESPECT. WE BELIEVE IN THE FOLLOWING VALUES: WE WILL MEET OR EXCEED COMMUNITY STANDARDS FOR CARE EXPECTATIONS OF PATIENTS AND FAMILIES. WE WILL MAINTAIN A POSITIVE AND FULFILLING WORKING ATMOSPHERE THAT BOTH MOTIVATES AND ALLOWS CAREGIVERS AND SUPPORT STAFF TO GIVE THEIR BEST. WE WILL ENSURE THAT THE ORGANIZATION IS ADEQUATELY COMPENSATED FOR SERVICES PROVIDED, THEREBY MAINTAINING VIABILITY AS A CRITICAL REGIONAL HEALTHCARE AND ECONOMIC ASSET. OUR VISION IS TO PROVIDE ACCESS TO HIGH QUALITY HEALTHCARE SERVICES ENHANCED BY HIGH TECHNOLOGY APPROPRIATE TO COMMUNITY NEED. WE WILL MAINTAIN A HIGHLY QUALIFIED MEDICAL AND SUPPORT STAFF IN A POSITIVE WORKING ENVIRONMENT FOCUSED ON EXCELLENCE. A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS RESIDING IN PRIMARY SERVICE AREA AND ARE NOT EMPLOYEES OR CONTRACTORS OF THE ORGANIZATION OR FAMILY MEMBERS. THE ORGANIZATION USES SURPLUS FUND TO PROVIDE THE LATEST IN TECHNOLOGY TO IMPROVE PATIENT CARE. |
| AFFILIATED HEALTH CARE SYSTEM | SCHEDULE H, PART VI, LINE 6 | TITUSVILLE AREA HEALTH CENTER, INC. AND AFFILIATES (HEALTH CENTER) CONSISTS OF TITUSVILLE AREA HEALTH CENTER, INC. (PARENT), TITUSVILLE AREA HOSPITAL (HOSPITAL), THE TITUSVILLE AREA HEALTH CENTER FOUNDATION (FOUNDATION) AND TITUSVILLE AREA HEALTH SERVICES, INC. (HEALTH SERVICES). THE HOSPITAL PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES TO PATIENTS IN TITUSVILLE, PENNSYLVANIA, AND THE SURROUNDING AREA. THE FOUNDATION WAS ESTABLISHED TO RECEIVE, ADMINISTER AND DISTRIBUTE FUNDS AND PROPERTY FOR THE BENEFIT AND SUPPORT OF THE HEALTH CENTER AND AFFILIATES. HEALTH SERVICES OPERATES SEPARATELY FROM THE HOSPITAL OFFERING MULTISPECIALTY FAMILY MEDICINE PEDIATRICS TO PATIENTS IN TITUSVILLE, PENNSYLVANIA, AND THE SURROUNDING AREA. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | true | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ANTHONY J NASRALLA | ||||||||||||||
| CEO/PRESIDENT | 210074 | 0 | 67564 | 0 | 2686 | 0 | 5253 | 0 | 2242 | 0 | 287819 | 0 | 0 | 0 |
| EDWARD GRIFFIN MD | ||||||||||||||
| DIRECTOR, BEGINNING 1/2013 | 0 | 438995 | 0 | 0 | 0 | 1980 | 0 | 23250 | 0 | 15825 | 0 | 480050 | 0 | 0 |
| ANIL DUTT MD | ||||||||||||||
| DIRECTOR | 0 | 329106 | 0 | 0 | 0 | 690 | 0 | 6250 | 0 | 17008 | 0 | 353054 | 0 | 0 |
| MARIO D'ALESSANDRO DO | ||||||||||||||
| MEDICAL DIRECTOR OF ER | 261512 | 0 | 0 | 0 | 1980 | 0 | 6250 | 0 | 18404 | 0 | 288146 | 0 | 0 | 0 |
| ARTHUR LEWIS MD | ||||||||||||||
| PHYSICIAN | 224490 | 0 | 0 | 0 | 690 | 0 | 0 | 0 | 18404 | 0 | 243584 | 0 | 0 | 0 |
| MARY WETHLI MD | ||||||||||||||
| PHYSICIAN | 219932 | 0 | 0 | 0 | 690 | 0 | 5550 | 0 | 16389 | 0 | 242561 | 0 | 0 | 0 |
| SCOTT SMITH | ||||||||||||||
| CRNA | 183266 | 0 | 24105 | 0 | 1980 | 0 | 4630 | 0 | 17075 | 0 | 231056 | 0 | 0 | 0 |
| ROCK BAKER | ||||||||||||||
| CRNA | 147121 | 0 | 13715 | 0 | 893 | 0 | 15922 | 0 | 19641 | 0 | 197292 | 0 | 0 | 0 |
| JEFFRY KARNS | ||||||||||||||
| CRNA | 134498 | 0 | 13715 | 0 | 311 | 0 | 3431 | 0 | 18153 | 0 | 170108 | 0 | 0 | 0 |
| THOMAS CHESAR MD | ||||||||||||||
| DIRECTOR ENDING 12/2012 | 0 | 138778 | 0 | 24000 | 0 | 413 | 0 | 0 | 0 | 19851 | 0 | 183042 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| CONTINGENT COMPENSATION | FORM 990, SCHEDULE J, PART I, LINE 6A | THE ORGANIZATION PAYS AN INCENTIVE TO ITS OFFICERS, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES THAT ARE CONTINGENT ON A POSITIVE TOTAL MARGIN OF THE ORGANIZATION. |
| NON-FIXED PAYMENTS | FORM 990, SCHEDULE J, PART I, LINE 7 | CRNA RECEIVES ANNUAL BONUS BASED ON PERCENTAGE OF PAY. |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | JOSEPH DUNN MD | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | STEP-FATHER OF J. REAGLE | Relationship |
| Amount Of Transaction | 34292 | AmountOfTransaction |
| Description Of Transaction | NONEMPLOYEE COMPENSATION | DescriptionOfTransaction |
| Sharing Of Revenues | false | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| FAMILY/BUSINESS RELATIONSHIPS | FORM 990, PART VI, SECTION A, LINE 2 | STEPHEN COLEMAN AND RICHARD CARR HAVE A BUSINESS RELATIONSHIP. |
| CLASSES OF MEMBERS OR STOCKHOLDERS | FORM 990, PART VI, SECTION A, LINE 6 | TITUSVILLE AREA HOSPITAL HAS TWO CLASSES OF MEMBERSHIP. CORPORATE MEMBERSHIP CONSISTS OF ONE MEMBER, TITUSVILLE AREA HEALTH CENTER, INC. COMMUNITY MEMBERSHIP SHALL CONSIST OF FORMER HOLDERS OF SHARES OF THE CORPORATION WHO ELECT TO CONTINUE AS SUCH MEMBERS AND OTHER PERSONS WHO ELECT TO BECOME SUCH MEMBERS OF THE CORPORATION. COMMUNITY MEMBERS SHALL NOT BE ENTITLED TO VOTE ON ANY MATTERS RESPECTING THE ACTIONS OR GOVERNANCE OF THE CORPORATION, SUCH ENTITLEMENT HAVING BEEN RESERVED SOLELY UNTO THE CORPORATION'S CORPORATE MEMBER, AND SHALL HAVE NO INTEREST IN THE PROPERTY, ASSETS OR BUSINESS OF THE CORPORATION. |
| POWER TO ELECT MEMBERS OR STOCKHOLDERS | FORM 990, PART VI, SECTION A, LINE 7A | DIRECTORS SHALL BE APPOINTED BY THE BOARD OF DIRECTORS OF THE CORPORATE MEMBER (TITUSVILLE AREA HEALTH CENTER, INC). |
| GOVERNANCE DECISIONS | FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING POWERS ARE RESERVED UNTO THE BOARD OF DIRECTORS OF THE TITUSVILLE AREA HEALTH CENTER, INC.: A.) REVIEW AND APPROVAL OF THE CAPITAL OPERATING BUDGETS, B.) APPROVAL OF CAPITAL EXPENDITURES IN EXCESS OF AN ESTABLISHED AMOUNT AS MAY BE SET FROM TIME TO TIME BY THE BOARD OF DIRECTORS OF THE CORPORATE MEMBER, C.) APPOINTMENT OF CANDIDATES FOR BOARD MEMBERSHIP; D.) APPROVAL OF BYLAWS AND ANY AMENDMENTS THERETO AND TO THE ARTICLES OF INCORPORATION, E.) APPROVAL OF ANY CORPORATE BORROWING OR ANY ENCUMBERING OF ASSETS, ANY SALES OR LEASES OF CORPORATE THE PROPERTY OR ANY OTHER ACTIONS NOT IN THE ORDINARY COURSE OF BUSINESS OF THE CORPORATION, F.) APPOINTMENT OF THE CHAIRMAN AND PRESIDENT OF THE CORPORATION, AND G.) APPROVAL OF ANY PLAN OF MERGER, CONSOLIDATION, DIVISION OR DISSOLUTION. |
| PROCESS TO REVIEW FORM 990 | FORM 990, PART VI, SECTION B, LINE 11B | 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 RETURN IS COMPLETED IN DRAFT FORM AND REVIEWED BY MANAGEMENT OF THE ORGANIZATION. THE COMPLETED 990 IS MADE AVAILABLE TO BOARD MEMBERS FOR REVIEW AND QUESTIONS PRIOR TO SUBMISSION. |
| PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY | FORM 990, PART VI, SECTION B, LINE 12C | TITUSVILLE AREA HOSPITAL ANNUALLY REQUIRES ITS BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES TO FILL OUT A CONFLICTS OF INTEREST FORM DURING BOARD MEETINGS. ANY CONFLICT OF INTEREST IS REVIEWED BY THE BOARD OF DIRECTORS. IF AN INTERESTED PARTY HAS A CONFLICT, HE OR SHE RECUSES THEMSELVES FROM VOTING. |
| REVIEW OF CEO AND OTHER OFFICERS COMPENSATION | FORM 990, PART VI, SECTION B, LINES 15A & B | AN INDEPENDENT CONSULTING FIRM COMPILED THE SALARY ADMINISTRATION AND PERFORMANCE MANAGEMENT GUIDELINES WHICH THE HOSPITAL UTILIZES ANY TIME A NEW POSITION IS CREATED OR AN EXISTING POSITION'S DESCRIPTION CHANGES. A JOB FACTOR WORKSHEET IS COMPLETED WHICH EVALUATES 6 AREAS BASED ON A POINT SYSTEM. THE SIX AREAS ARE LISTED BELOW: 1.) EDUCATION 2.) EXPERIENCE 3.) CONTACTS 4.) GUIDELINES 5.) BUDGET ACCOUNTABILITY 6.) SUPERVISORY/ACCOUNTABILITY THE TOTAL POINTS ARE USED TO ARRIVE AT A PAY GRADE ON THE SALARY ADMINISTRATION POLICY MANAGEMENT PAY SCALE. THE MANAGEMENT PAY SCALE IS REVIEWED ANNUALLY, AND UPDATED IF NECESSARY, BASED ON THE HOSPITAL COUNCIL OF WESTERN PENNSYLVANIA SURVEYS, WHICH PROVIDES COMPARABLE DATA OF OTHER HOSPITALS IN THE AREA. THE DELIBERATIONS AND DECISIONS OF THE COMPENSATION COMMITTEE ARE DOCUMENTED IN THE COMMITTEE MINUTES. |
| GOVERNING DOCUMENTS | FORM 990, PART VI, SECTION C, LINE 19 | TITUSVILLE AREA HOSPITAL MAKES ITS FORM 990 AND FORM 1023 AVAILABLE TO THE PUBLIC UPON REQUEST. AT THIS TIME, TITUSVILLE AREA HOSPITAL DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC. |
| OTHER FEES FOR SERVICES | FORM 990, PART IX, LINE 11G | $ 3,225,576 PURCHASED SERVICES 333,554 PROFESSIONAL MEDICAL FEES 99,828 PHYSICIAN RECRUITING OUTSOURCING 3,543 COLLECTION EXPENSE 1,401 OTHER FEES ------------ $ 3,663,902 |
| OTHER CHANGES IN NET ASSETS | FORM 990, SECTION XI, LINE 9 | $ 2,034,624 PRIOR PERIOD ADJUSTMENT (1,622,306) TRANSFER TO AFFILIATES 174,715 CHANGE IN BENEFICIAL INTEREST (1,939) INCOME FROM INVESTMENT RECORDED AT COST ------------ $ 585,094 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| TITUSVILLE AREA HEALTH CENTER INC | |||||||||||
| 406 WEST OAK STREET | TITUSVILLE | PA | 16354 | 251517855 | HOLDING CO | PA | 501(C)(3) | 7 | N/A | false | |
| TITUSVILLE HEALTH SERVICES INC | |||||||||||
| 406 WEST OAK STREET | TITUSVILLE | PA | 16354 | 251517865 | COMM HLT CLNC | PA | 501(C)(3) | 3 | false | HEALTH CNTR | |
| TITUSVILLE AREA HEALTH CENTER FOUNDATION | |||||||||||
| 406 WEST OAK STREET | TITUSVILLE | PA | 16354 | 251517854 | SUPPORT | PA | 501(C)(3) | 11A I | false | HEALTH CNTR | |
Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)
| Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|
| PERPETUAL TRUST | |||||||
| TRUST | PA | TAH | TRUST | 2369 | 250702 | 1.00000 | true |
| PERPETUAL TRUST | |||||||
| TRUST | PA | TAH | TRUST | 597 | 63189 | 1.00000 | true |
| PERPETUAL TRUST | |||||||
| TRUST | PA | TAH | TRUST | 245 | 25953 | 1.00000 | true |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | true | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
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