COMMUNITY HOSPICE INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY HOSPICE INC (EIN 31-0970252)
Tax period
2013-01-01 to 2013-12-31
Filed
2014-05-09
IRS object ID
201441299349300509
Schema version
2013v3.1
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)
Return2014-05-09T07:38:07-05:00ReturnTs
Tax Period End2013-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KELLEY GALLOWAY & COMPANY PSCBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11200 CORPORATE COURT PO BOX 990AddressLine1
CityASHLANDCity
StateKYState
ZIP Code411050990ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN310970252EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HOSPICE INCBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlCOMMBusinessNameControlTxt
Phone6063291890PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11480 CARTER AVENUEAddressLine1
CityASHLANDCity
StateKYState
ZIP Code41101ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSUSAN HUNTPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone6063291890PhoneNum
Signature2014-05-08SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonPHILLIP M LAYNEPreparerPersonNm
PTINP00039427PTIN
Phone6063291811PhoneNum
Preparation2014-05-08PreparationDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts$17,396,664GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CHOSPICE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1979FormationYr
Legal Domicile StateKYLegalDomicileStateCd
Activity Or MissionPROVIDING MEDICAL CARE TO TERMINALLY ILL PATIENTSActivityOrMissionDesc
Voting Members Governing Body16VotingMembersGoverningBodyCnt
Voting Members Independent16VotingMembersIndependentCnt
Total Employee149TotalEmployeeCnt
Total Volunteers225TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$152,358PYContributionsGrantsAmt
CY Contributions Grants$155,552CYContributionsGrantsAmt
PY Program Service Revenue$13,859,529PYProgramServiceRevenueAmt
CY Program Service Revenue$13,555,952CYProgramServiceRevenueAmt
PY Investment Income$74,920PYInvestmentIncomeAmt
CY Investment Income$278,663CYInvestmentIncomeAmt
PY Other Revenue$46,165PYOtherRevenueAmt
CY Other Revenue$55,836CYOtherRevenueAmt
PY Total Revenue$14,132,972PYTotalRevenueAmt
CY Total Revenue$14,046,003CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$6,187,438PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$6,571,147CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$6,451,021PYOtherExpensesAmt
CY Other Expenses$6,420,690CYOtherExpensesAmt
PY Total Expenses$12,638,459PYTotalExpensesAmt
CY Total Expenses$12,991,837CYTotalExpensesAmt
PY Revenues Less Expenses$1,494,513PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,054,166CYRevenuesLessExpensesAmt
Total Assets BOY$21,879,201TotalAssetsBOYAmt
Total Assets EOY$23,120,712TotalAssetsEOYAmt
Total Liabilities BOY$1,478,461TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,329,769TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$20,400,740NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$21,790,943NetAssetsOrFundBalancesEOYAmt
MissionPROVIDING MEDICAL CARE TO TERMINALLY ILL PATIENTSMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$11,809,487ExpenseAmt
Revenue$13,555,952RevenueAmt
DescPROVIDING MEDICAL CARE, SOCIAL SERVICES, AND SPIRITUAL SUPPORT TO TERMINALLY ILL PATIENTS AND THEIR FAMILIES.Desc
Total Program Service Expenses$11,809,487TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstYes (true)ReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemYes (true)BusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document93IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld CompliancefalseBackupWthldComplianceInd
Employee149EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members16GoverningBodyVotingMembersCnt
Independent Voting Member16IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldKYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CHARLOTTE HORNBusinessNameLine1
FieldValueIRS element (for citing)
Phone6063291890PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11480 CARTER AVENUEAddressLine1
CityASHLANDCity
StateKYState
ZIP Code41101ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
SUSAN HUNT
EXECUTIVE DI40.00Yes (X)Yes (X)$154,650$0$0
JC BROWN
BOARD OF DIRYes (X)$0$0$0
PAT STEEN
BOARD OF DIRYes (X)$0$0$0
DR TIMOTHY DIXON
BOARD OF DIRYes (X)$0$0$0
STEVE KANOUSE
BOARD OF DIRYes (X)$0$0$0
BRUCE VANHORN
BOARD OF DIRYes (X)$0$0$0
WILLIAM ELKINS
BOARD OF DIRYes (X)$0$0$0
VERN LINCOLN
BOARD OF DIRYes (X)$0$0$0
JOHN MCMEANS
BOARD OF DIRYes (X)$0$0$0
RAMONA SALYER
BOARD OF DIRYes (X)$0$0$0
JOHN VINCENT
BOARD OF DIRYes (X)$0$0$0
TYLER WALTERS
BOARD OF DIRYes (X)$0$0$0
CHRISTI MCKINNEY
BOARD OF DIRYes (X)$0$0$0
CONNIE BAYES
BOARD OF DIRYes (X)$0$0$0
MICHAEL HOBBS
BOARD OF DIRYes (X)$0$0$0
NANCY WYSE
Yes (X)$0$0$0
DR LISA BARKER
DOCTOR40.00$188,257$0$0Yes (X)
SANDY ZERKLE
DIRECTOR OF40.00$105,712$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$448,619TotalReportableCompFromOrgAmt
Indiv Rcvd Greater Than100 K3IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
DIVERSICARE LEASING CORP
100 WURTLAND AVEWURTLANDKY41144NURSING HOME SE$850,761
HOSPICE PHARMACIA
BOX 510818PHILADELPHIAPA19175PHARMACY SERVIC$668,211
OAKMONT MANOR
PO BOX 822FLATWOODSKY41139NURSING HOME SE$458,019
WOODLAND OAKS
1820 OAKVIEW RDASHLANDKY41101NURSING HOME SE$325,146
REDLINE MEDICAL SUPPLY
8121 10TH AVE NORTHGOLDEN VALLEYMN55487MEDICAL SUPPLY$225,593
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K8CntrctRcvdGreaterThan100KCnt
All Other Contributions$155,552AllOtherContributionsAmt
Total Contributions$155,552TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT CARE - HOME CARE621610$10,698,849$10,698,849
PATIENT CARE - INPATIENT623000$2,857,103$2,857,103
FieldValueIRS element (for citing)
Total Program Service Revenue$13,555,952TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$170,349TotalRevenueColumnAmt
Related Or Exempt Func Income$170,349RelatedOrExemptFuncIncomeAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$3,435,013SecuritiesAmt
Other$600OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$3,325,141SecuritiesAmt
Other$2,158OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$109,872SecuritiesAmt
Other-$1,558OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$108,314TotalRevenueColumnAmt
Related Or Exempt Func Income$108,314RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$53,774FundraisingGrossIncomeAmt
Fundraising Direct Expenses$23,362FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$30,412TotalRevenueColumnAmt
Exclusion$30,412ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUSDesc
Business900099BusinessCd
Total Revenue Column$25,424TotalRevenueColumnAmt
Exclusion$25,424ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$25,424OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$14,046,003TotalRevenueColumnAmt
Related Or Exempt Func Income$13,834,615RelatedOrExemptFuncIncomeAmt
Exclusion$55,836ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$154,650TotalAmt
Management And General$154,650ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,701,374TotalAmt
Program Services$5,283,384ProgramServicesAmt
Management And General$417,990ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$286,355TotalAmt
Program Services$242,241ProgramServicesAmt
Management And General$44,114ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$428,768TotalAmt
Program Services$386,323ProgramServicesAmt
Management And General$42,445ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$48,575TotalAmt
Program Services$29,145ProgramServicesAmt
Management And General$19,430ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$14,350TotalAmt
Program Services$8,610ProgramServicesAmt
Management And General$5,740ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$58,735TotalAmt
Program Services$50,665ProgramServicesAmt
Management And General$8,070ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$54,069TotalAmt
Program Services$34,770ProgramServicesAmt
Management And General$19,299ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$27,044TotalAmt
Program Services$15,503ProgramServicesAmt
Management And General$11,541ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$51,443TotalAmt
Program Services$51,443ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$233,635TotalAmt
Program Services$229,457ProgramServicesAmt
Management And General$4,178ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$41,197TotalAmt
Program Services$33,683ProgramServicesAmt
Management And General$7,514ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$345,720TotalAmt
Program Services$167,411ProgramServicesAmt
Management And General$178,309ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$594,340TotalAmt
Program Services$502,524ProgramServicesAmt
Management And General$91,816ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
CONTRACTED PROFESSIONAL S$2,639,427$2,639,427
MEDICATION$728,767$728,767
MEDICAL EQUIPMENT RENTAL$331,023$331,023
MAINTENANCE AND REPAIRS$232,529$197,974$34,555

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,019,836TotalAmt
Program Services$877,137ProgramServicesAmt
Management And General$142,699ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$12,991,837TotalAmt
Program Services$11,809,487ProgramServicesAmt
Management And General$1,182,350ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,384,074BOYAmt
EOY$1,697,750EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$5,323,483BOYAmt
EOY$6,567,830EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,656,671BOYAmt
EOY$1,661,286EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$69,297BOYAmt
EOY$64,753EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$34,276BOYAmt
EOY$40,200EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$9,411,523LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,473,487LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$7,103,581BOYAmt
EOY$6,938,036EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$5,292,814BOYAmt
EOY$6,133,756EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$15,005BOYAmt
EOY$17,101EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$21,879,201BOYAmt
EOY$23,120,712EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,478,461BOYAmt
EOY$1,329,769EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,478,461BOYAmt
EOY$1,329,769EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$20,400,740BOYAmt
EOY$21,790,943EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$20,400,740BOYAmt
EOY$21,790,943EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$21,879,201BOYAmt
EOY$23,120,712EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,054,166ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$336,037NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

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

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$180,116CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$153,971CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$300,136CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$152,358CurrentTaxYearMinus1YearAmt
Current Tax Year$155,552CurrentTaxYearAmt
Total$942,133TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$180,116CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$153,971CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$300,136CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$152,358CurrentTaxYearMinus1YearAmt
Current Tax Year$155,552CurrentTaxYearAmt
Total$942,133TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$48,276SubstantialContributorsTotAmt
Public Support Total170$893,857PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$143,675CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$152,035CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$138,557CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$154,122CurrentTaxYearMinus1YearAmt
Current Tax Year$170,349CurrentTaxYearAmt
Total$758,738TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$73,446CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$136,847CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$103,013CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$70,313CurrentTaxYearMinus1YearAmt
Current Tax Year$79,198CurrentTaxYearAmt
Total$462,817TotalAmt
FieldValueIRS element (for citing)
Total Support$2,163,688TotalSupportAmt
Gross Receipts Rltd Activities$13,726,301GrossReceiptsRltdActivitiesAmt
Public Support CY1700.41310PublicSupportCY170Pct
Public Support PY1700.41850PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Form990 Schedule A Part IV Form990ScheduleAPartIVGrp

FieldValueIRS element (for citing)
Form And Line ReferencePART II, LINE 10FormAndLineReferenceDesc
ExplanationMISCELLANEOUS 383,619ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule D IRS990ScheduleD

Land LandGrp

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

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,524,204OtherCostOrOtherBasisAmt
Depreciation$1,067,079DepreciationAmt
Book Value$5,457,125BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$72,053OtherCostOrOtherBasisAmt
Depreciation$4,804DepreciationAmt
Book Value$67,249BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,496,797OtherCostOrOtherBasisAmt
Depreciation$1,145,962DepreciationAmt
Book Value$350,835BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$401,011OtherCostOrOtherBasisAmt
Depreciation$255,642DepreciationAmt
Book Value$145,369BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$6,938,036TotalBookValueLandBuildingsAmt

Invst Program Related Org InvstProgramRelatedOrgGrp (7 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
PUBLICLY TRADED SECURITIES$2,564,169F
CDS & MONEY MARTKET ACCOUNTS$1,166,024F
US GOVERNMENT AGENCIES$1,088,719F
CORPORATE BONDS$999,074F
FIXED ACCOUNTS$127,275F
MUNICIPAL BONDS$112,692F
MUTUAL FUNDS$75,803F
FieldValueIRS element (for citing)
Total Book Value Program Rltd$6,133,756TotalBookValueProgramRltdAmt
Total Rev Etc Audited Fincl Stmt$14,406,960TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$336,037NetUnrealizedGainsInvstAmt
Other Revenue$1,558OtherRevenueAmt
Revenue Not Reported$337,595RevenueNotReportedAmt
Revenue Subtotal$14,069,365RevenueSubtotalAmt
Other Revenues Not Included-$23,362OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$23,362RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$14,046,003TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$13,016,757TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$24,920OtherExpensesIncludedAmt
Expenses Not Reported$24,920ExpensesNotReportedAmt
Expenses Subtotal$12,991,837ExpensesSubtotalAmt
Total Expenses Per Form990$12,991,837TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PAGE 4, PART XI, LINE 2DNET LOSS ON SALE OF ASSETS 1,558
SCHEDULE D, PAGE 4, PART XI, LINE 4BFUNDRASING EXPENSES -23,362
SCHEDULE D, PAGE 4, PART XII, LINE 2DNET LOSS ON SALE OF ASSETS 1,558 FUNDRAISING EXPENSES 23,362

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Name Of Event1WINERY DINNERNameOfEvent1Amt
Gross Receipts Event1$15,372GrossReceiptsEvent1Amt
Gross Revenue Event1$15,372GrossRevenueEvent1Amt
Rent Facility Costs Event1$2,100RentFacilityCostsEvent1Amt
Food And Beverage Event1$4,831FoodAndBeverageEvent1Amt
Entertainment Event1$250EntertainmentEvent1Amt
Other Direct Expenses Event1$1,229OtherDirectExpensesEvent1Amt
Name Of Event2MEMORIAL BRICKSNameOfEvent2Amt
Gross Receipts Event2$13,950GrossReceiptsEvent2Amt
Gross Revenue Event2$13,950GrossRevenueEvent2Amt
Other Direct Expenses Event2$3,907OtherDirectExpensesEvent2Amt
Other Events Total4OtherEventsTotalCnt
Gross Receipts Other Events$24,452GrossReceiptsOtherEventsAmt
Gross Revenue Other Events$24,452GrossRevenueOtherEventsAmt
Food And Beverage Other Events$4,042FoodAndBeverageOtherEventsAmt
Oth Direct Expnss Other Events$7,003OthDirectExpnssOtherEventsAmt
Gross Receipts Total$53,774GrossReceiptsTotalAmt
Gross Revenue Total Events$53,774GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$2,100RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$8,873FoodAndBeverageTotalEventsAmt
Entertainment Total Events$250EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$12,139OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$23,362DirectExpenseSummaryEventsAmt
Net Income Summary$30,412NetIncomeSummaryAmt

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
SUSAN HUNT
EXECUTIVE DIRECTOR$154,650$154,650
DR LISA BARKER
DOCTOR$188,257$188,257

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
KINGS DAUGHTERS MEDICAL CENTER
DIRECTOR IS EMP$152,051MEDICAL SERVICES PROfalse
OUR LADY OF BELLEFONTE HOSPITAL
2 DIR. ARE EMPL$64,872MEDICAL SERVICES PROfalse
MCMEANS PHARMACY
DIR. OWNS$392PHARMACEUTICAL SERVIfalse
TOWN SQUARE BANK
DIR. IS PRESIDE$267,131BANK CDfalse

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE L, PART VFormAndLineReferenceDesc
ExplanationKINGS DAUGHTERS MEDICAL CENTER: DIRECTOR IS THE HEALTH CARE PLANNER OF FACILITIES. OUR LADY OF BELLEFONTE HOSPITAL: TWO DIRECTORS ARE EMPLOYEES AT THE ORGANIZATION. MCMEANS PHARMACY: DIRECTOR OWNS THE BUSINESS. TOWN SQUARE BANK: DIRECTOR IS PRESIDENT OF THE BANK.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 11BTHE 990 IS REVIEWED BY THE EXECUTIVE DIRECTOR, THE DIRECTOR OF FINANCE, AND THE FINANCE COMMITTEE. THE GOVERNING BOARD IS THEN NOTIFIED THAT THE RETURN IS COMPLETED AND THEY ARE NOTIFIED OF THE DUE DATE AND THAT THE RETURN IS AVAILABLE TO THEM FOR REVIEW IF THEY DEEM NECESSARY IN THE BUSINESS OFFICE.
FORM 990, PAGE 6, PART VI, LINE 12CCONFLICT OF INTEREST FORMS ARE COMPLETED WHEN FIRST JOINING THE BOARD.
FORM 990, PAGE 6, PART VI, LINE 19COPIES ARE PROVIDED AT OUR ADMINISTRATIVE OFFICES UPON REQUEST.
FORM 990, PART XI, LINE 9NET LOSS ON SALE OF ASSETS 1,558 FUNDRASING EXPENSES 23,362 NET LOSS ON SALE OF ASSETS -1,558 FUNDRAISING EXPENSES -23,362

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