UPMC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: UPMC (EIN 24-0802108)
Tax period: 2011-07-01 to 2012-06-30
Filed: 2013-04-11
IRS object ID: 201311019349300436
Schema version: 2011v1.5
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule G
Schedule H
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-04-11T16:16:41-05:00	Timestamp
Tax Period End Date	2012-06-30	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	2011-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	240802108	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	CHARLES COLE MEMORIAL HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
In Care Of Name	% RON RAPP CONTROLLER	InCareOfName
Name Control	CHAR	NameControl
Phone	8142749300	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1001 EAST SECOND STREET	AddressLine1
City	COUDERSPORT	City
State	PA	State
ZIP Code	16915	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	EDWARD C PITCHFORD	Name
Title	CEO	Title
Date Signed	2013-01-22	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	2011	TaxYear
Build TS	2016-02-25 16:41:14Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	EDWARD PITCHFORD	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	1001 EAST SECOND STREET	AddressLine1
City	COUDERSPORT	City
State	PA	State
ZIP Code	16915	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	82803029	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	http://www.charlescolehospital.com/	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1967	YearFormation
State Legal Domicile	PA	StateLegalDomicile
Activity Or Mission Description	CCMH PROVIDES EXCELLENT HEALTH CARE SERVICES BY PROVIDING INPATIENT, OUTPATIENT AND PRIMARY CARE SERVICES TO THE SURROUNDING COMMUNITY. SEE SCHEDULE O FOR MORE INFORMATION.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	13	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	10	NbrIndependentVotingMembers
Total Nbr Employees	695	TotalNbrEmployees
Total Nbr Volunteers	74	TotalNbrVolunteers
Total Gross UBI	59861	TotalGrossUBI
Net Unrelated Business Txbl Income	58534	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	350224	ContributionsGrantsPriorYear
Contributions Grants Current Year	702961	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	69567713	ProgramServiceRevenuePriorYear
Program Service Revenue CY	73182076	ProgramServiceRevenueCY
Investment Income Prior Year	1031244	InvestmentIncomePriorYear
Investment Income Current Year	-24785	InvestmentIncomeCurrentYear
Other Revenue Prior Year	361647	OtherRevenuePriorYear
Other Revenue Current Year	200871	OtherRevenueCurrentYear
Total Revenue Prior Year	71310828	TotalRevenuePriorYear
Total Revenue Current Year	74061123	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	0	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	30837009	SalariesEtcPriorYear
Salaries Etc Current Year	32066073	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	84000	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	48000	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	92843	TotalFundrsngExpCurrentYear
Other Expense Prior Year	38318324	OtherExpensePriorYear
Other Expenses Current Year	41140996	OtherExpensesCurrentYear
Total Expenses Prior Year	69239333	TotalExpensesPriorYear
Total Expenses Current Year	73255069	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	2071495	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	806054	RevenuesLessExpensesCY
Total Assets BOY	55302779	TotalAssetsBOY
Total Assets EOY	58973125	TotalAssetsEOY
Total Liabilities BOY	35146860	TotalLiabilitiesBOY
Total Liabilities EOY	43577089	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	20155919	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	15396036	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	THE PURPOSE OF CHARLES COLE MEMORIAL HOSPITAL IS TO PROVIDE EXCELLENT HEALTHCARE SERVICES, RESPONDING TO THE NEEDS OF THE COMMUNITIES WE SERVE.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	17932993	Expense
Revenue	38919673	Revenue
Description	CCMH OFFERS OUTPATIENT SERVICES, EXCEEDING 350,000 TESTS/TREATMENTS ANNUALLY THROUGHOUT THE HOSPITAL'S FOUR-COUNTY AREA AND INCLUDING IMAGING, LAB, AND REHABILITATION SERVICES. OUTPATIENT SURGERIES EXCEED 4,160 ANNUALLY. THE PATTERSON CANCER CARE CENTER OFFERS FULL SERVICE RADIATION AND MEDICAL ONCOLOGY SERVICES AND HOUSES AN AMERICAN CANCER SOCIETY PATIENT RESOURCE CENTER ONSITE. THE CANCER CENTER IS HOME TO A VARIETY OF SUPPORT GROUPS, AS WELL AS FREQUENT FREE CANCER SCREENINGS FOR THE PUBLIC. CCMH'S HOME HEALTH AND HOSPICE SERVICES ASSIST PATIENTS THROUGHOUT THE REGION, WITH A GROWING NUMBER OF REFERRALS AND LOWER INFECTION RATES AMONG STATE AND NATIONAL AVERAGES.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	16653040	Expense
Revenue	11486106	Revenue
Description	CHARLES COLE MEMORIAL HOSPITAL PROVIDES PRIMARY CARE TO ITS SURROUNDING COMMUNITIES. THE HOSPITAL PROVIDES PRIMARY CARE TO THE SURROUNDING COMMUNITIES IN FOUR COUNTIES AT RURAL HEALTH CENTERS (RHCS), LOCATED IN COUDERSPORT, GALETON, ULYSSES, WESTFIELD, SHINGLEHOUSE, PORT ALLEGANY, ELDRED, SMETHPORT, AND EMPORIUM. FOUR OF THOSE LOCATIONS ALSO INCLUDE WELLNESS AND REHABILITATION CENTERS, MAKING IT MORE CONVENIENT FOR PATIENTS TO RECEIVE THE CARE THEY NEED CLOSE TO HOME. ONE OUTLYING CENTER OFFERS IMAGING SERVICES, WHILE ALL RHCS PROVIDE LAB DRAWS SO PATIENTS DON'T HAVE TO DRIVE TO RECEIVE NECESSARY TESTING. SEE SCHEDULE O FOR FURTHER DETAIL.	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	12338161	Expense
Revenue	19467936	Revenue
Description	CHARLES COLE MEMORIAL HOSPITAL OFFERS VARIOUS INPATIENT SERVICES. CCMH ADMITTED 2,770 PATIENTS LAST YEAR (5,260 ACUTE CARE DAYS) TO INPATIENT SERVICES INCLUDING MEDICAL/SURGICAL, INTENSIVE CARE AND OBSTETRICS UNITS. CCMH'S 24-HOUR EMERGENCY DEPARTMENT ADMITTED 865 PATIENTS LAST YEAR AND SAW 9,810 VISITS LAST YEAR. THE HOSPITAL'S MATERNITY UNIT WELCOMED 180 BABIES INTO THE WORLD LAST YEAR AND ALSO SUPPORTS MOTHERS-TO-BE WITH REGULAR LAMAZE AND BREASTFEEDING SUPPORT PROGRAMS AND THE HEALTHY BEGINNINGS PLUS PROGRAM FOR LOW INCOME MOTHERS. SEE SCHEDULE O FOR FURTHER DETAIL.	Description

Field	Value	IRS element (for citing)
Total Of Other Program Service Exp	17147445	TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev	3308361	TotalOfOtherProgramServiceRev
Total Program Service Expense	64071639	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	true	CreditCounseling
Term Or Permanent Endowments	true	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	true	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	true	ProfessionalFundraising
Fundraising Activities	true	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	true	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	44	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	695	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	true	QuidProQuoContributions
Quid Pro Quo Disclosure	true	QuidProQuoDisclosure
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	13	NbrVotingGoverningBodyMembers
Number Independent Voting Members	10	NumberIndependentVotingMembers
Family Or Business Relationship	false	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	false	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	false	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	RON RAPP CONTROLLER	NamePerson
Telephone Number	8142745250	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1001 EAST SECOND STREET	AddressLine1
City	COUDERSPORT	City
State	PA	State
ZIP Code	16915	ZIPCode

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee
MICHAEL E CALLAHAN
PHYSICIAN, 2ND VICE CHAIR	40.0	X	X	182397	0	16720
JASON TRONETTI
PHYSICIAN, DIRECTOR	40.0	X		313542	0	23018
CHARLES UPDEGRAFF
TREASURER	1.0	X	X	0	0	0
RON CASKEY
SECRETARY	1.0	X	X	0	0	0
REVEREND RANDALL HEADLEY
CHAIRMAN	1.0	X	X	0	0	0
KALLIOPI NESTOR
PHYSICIAN, DIRECTOR BEG 11/11	40.0	X		223861	0	21453
ROBERT SMITH
DIRECTOR	1.0	X		0	0	0
RUSSELL STREICH
DIRECTOR	1.0	X		0	0	0
DAVID BUCKLER
DIRECTOR	1.0	X		0	0	0
DAVID CRANDALL
1ST VICE CHAIRMAN	1.0	X	X	0	0	0
JEANNE MIGLICIO
DIRECTOR	1.0	X		0	0	0
THOMAS SHAFFER
DIRECTOR	1.0	X		0	0	0
CLIFFORD WOOD
DIRECTOR BEG 11/11	1.0	X		0	0	0
PAUL PRITCHARD
DIRECTOR THRU 09/11	1.0	X		0	0	0
EDWARD C PITCHFORD
PRESIDENT, CEO & ASST. SEC.	40.0		X	283959	0	25719
CYNTHIA HARDESTY
VICE PRESIDENT, CNE	40.0			164115	0	9762	X
BRADLEY F GIANNOTTI
PHYSICIAN	40.0			871055	0	15142		X
TERRENCE L FOUST
PHYSICIAN	40.0			724802	0	12056		X
SAKET PRASAD
PHYSICIAN	40.0			574075	0	23971		X
CHRISTAN M CARAMIA
PHYSICIAN	40.0			424927	0	24734		X
CELSO BACKES
PHYSICIAN	40.0			382006	0	4775		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	4144739	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	177350	TotalOtherCompensation
Number Individuals GT100 K	34	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Description Of ServicesDescriptionOfServices	CompensationCompensation
JAMES BARKE MD
PHYSICIAN	708963
FOOT ANKLE INNOV
PHYSICIAN	447278
TAYLOR ARMSTRONG
CONTRACTOR	203302
BKD LLP
AUDIT/TAX/CONSULTING	104591

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	4	NumberOfContractorsGT100K
Fundraising Events	33246	FundraisingEvents
Government Grants	35633	GovernmentGrants
All Other Contributions	634082	AllOtherContributions
Total Contributions	702961	TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE REVENUE	621990	69430673	69430673
OTHER REVENUE	621990	3751403	3751403

Field	Value	IRS element (for citing)
Total Program Service Revenue	73182076	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	270083	TotalRevenueColumn
Exclusion	$270,083	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	266341	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	268048	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	-1707	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	-1707	TotalRevenueColumn
Exclusion	-$1,707	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	8104268	Securities
Other	7666	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	8375507	Securities
Other	31295	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	-271239	Securities
Other	-23629	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	-294868	TotalRevenueColumn
Exclusion	-$294,868	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	7680	GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events	33246	CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses	15067	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	-7387	TotalRevenueColumn
Exclusion	-$7,387	ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	77683	GrossSalesOfInventory
Cost Of Goods Sold	51989	CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	25694	TotalRevenueColumn
Exclusion	$25,694	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount	Unrelated Business RevenueUnrelatedBusinessRevenue
GAIN ON INVESTMENT IN EQUITY INVESTEE	900099	145166	$145,166
INCOME FROM INVESTMENT IN SUBSIDIARIES	900099	39105	-$20,756	59861

Field	Value	IRS element (for citing)
Total Other Revenue	184271	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	74061123	TotalRevenueColumn
Related Or Exempt Function Income	73182076	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	59861	UnrelatedBusinessRevenue
Exclusion	$116,225	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	0	Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	0	Total

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	1340140	Total
Program Services	829771	ProgramServices
Management And General	510369	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	142608	Total
Management And General	142608	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	23442785	Total
Program Services	19973676	ProgramServices
Management And General	3469109	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	717086	Total
Program Services	604353	ProgramServices
Management And General	112733	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	4602668	Total
Program Services	3679928	ProgramServices
Management And General	922740	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	1820786	Total
Program Services	1513115	ProgramServices
Management And General	307671	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	387882	Total
Program Services	387882	ProgramServices

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	83158	Total
Management And General	83158	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	112062	Total
Management And General	112062	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	48000	Total
Fundraising	48000	Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	67918	Total
Management And General	67918	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	15367945	Total
Program Services	14612649	ProgramServices
Management And General	755296	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	115420	Total
Program Services	3785	ProgramServices
Management And General	111635	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	4882150	Total
Program Services	3663225	ProgramServices
Management And General	1218925	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	0	Total

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	2045529	Total
Program Services	1881409	ProgramServices
Management And General	164120	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	340802	Total
Program Services	300010	ProgramServices
Management And General	40792	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	244184	Total
Program Services	147149	ProgramServices
Management And General	97035	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	1124521	Total
Program Services	1006666	ProgramServices
Management And General	117855	ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	2259226	Total
Program Services	2022450	ProgramServices
Management And General	236776	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	1050941	Total
Program Services	575038	ProgramServices
Management And General	475903	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral	FundraisingFundraising
MEDICAL SUPPLIES & DRUGS	9491781	9491781
BAD DEBT	3149056	3149056
LICENSES, DUES, SUBSCRIPTIONS	373578	229696	143882
OTHER AUXILIARY EXPENSES	44843			44843

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	73255069	Total
Program Services	64071639	ProgramServices
Management And General	9090587	ManagementAndGeneral
Fundraising	92843	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	2828824	BOY
EOY	805193	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	3942066	BOY
EOY	1582372	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	71851	BOY
EOY	188609	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	7510740	BOY
EOY	8269567	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	1081698	BOY
EOY	1173740	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	1785764	BOY
EOY	1718605	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	65084813	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	41730718	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	23013598	BOY
EOY	23354095	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	12716424	BOY
EOY	14266810	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	1532975	BOY
EOY	1696602	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	396598	BOY
EOY	385098	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	422241	BOY
EOY	5532434	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	55302779	BOY
EOY	58973125	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	12962644	BOY
EOY	20839387	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	0	BOY
EOY	0	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	19534724	BOY
EOY	18686837	EOY

Escrow Account Liability EscrowAccountLiability

Field	Value	IRS element (for citing)
BOY	14430	BOY
EOY	18092	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	1239449	BOY
EOY	2948230	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	1395613	BOY
EOY	1084543	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	35146860	BOY
EOY	43577089	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	15669621	BOY
EOY	11287807	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	205421	BOY
EOY	230847	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	4280877	BOY
EOY	3877382	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	20155919	BOY
EOY	15396036	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	55302779	BOY
EOY	58973125	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	806054	ReconcilationRevenueExpenses
Reconcilation Other Changes	-5565937	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
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
Other Activities	$10,700	OtherActivitiesAmount
Total Lobbying Expenditures IIB	10700	TotalLobbyingExpendituresIIB
Not Described In501c3	false	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	LOBBYING ACTIVITIES	Identifier
Return Reference	SCHEDULE C, PART II-B, LINE 1I	ReturnReference
Explanation	THE ORGANIZATION IS A MEMBER OF HAP, AHA, AND HCWP. $10,700 OF DUES ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES.	Explanation

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amts		ArtPublicExhibitionAmts
Held Works Of Art Amts		HeldWorksOfArtAmts
Agent Trustee Etc	false	AgentTrusteeEtc
Included On FS	true	IncludedOnFS

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	4280877	BeginningOfYearBalance
Investment Earnings Or Losses	-106295	InvestmentEarningsOrLosses
Other Expenditures	297200	OtherExpenditures
End Of Year Balance	3877382	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	3667800	BeginningOfYearBalance
Investment Earnings Or Losses	942900	InvestmentEarningsOrLosses
Other Expenditures	329823	OtherExpenditures
End Of Year Balance	4280877	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	3616355	BeginningOfYearBalance
Investment Earnings Or Losses	437150	InvestmentEarningsOrLosses
Other Expenditures	385705	OtherExpenditures
End Of Year Balance	3667800	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	4837234	BeginningOfYearBalance
Investment Earnings Or Losses	-1006344	InvestmentEarningsOrLosses
Other Expenditures	214535	OtherExpenditures
End Of Year Balance	3616355	EndOfYearBalance

Field	Value	IRS element (for citing)
Permanent Endowment EOY Balance	1.00000	PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs	true	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	false	EndowmentsHeldByRelatedOrgs

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1135847	OtherCostOrOtherBasis
Book Value	1135847	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	36964876	OtherCostOrOtherBasis
Depreciation	20738910	Depreciation
Book Value	16225966	BookValue

Field	Value	IRS element (for citing)
Leasehold Improvements		LeaseholdImprovements

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	24260927	OtherCostOrOtherBasis
Depreciation	19751659	Depreciation
Book Value	4509268	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	2723163	OtherCostOrOtherBasis
Depreciation	1240149	Depreciation
Book Value	1483014	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	23354095	TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescription	Book ValueBookValue
DUE FROM AFFILIATES	38632
OTHER RECEIVABLES	5493802

Field	Value	IRS element (for citing)
Total Book Value Other Assets	5532434	TotalBookValueOtherAssets
Federal Income Tax Liability	0	FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
Description	DUE TO THIRD PARTY PAYERS	Description
Amount	$1,084,543	Amount

Field	Value	IRS element (for citing)
Total Of Amounts	1084543	TotalOfAmounts
Total Revenue	74061123	TotalRevenue
Total Expenses	73255069	TotalExpenses
Excess Or Deficit For Year	806054	ExcessOrDeficitForYear
Net Unrealized GL On Investments	-265931	NetUnrealizedGLOnInvestments
Other	-$4,979,521	OtherAmount
Total Adjustments	-5245452	TotalAdjustments
Excess Or Deficit Per FS	-4439398	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	65836969	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	-265931	NetUnrealizedGainsInvestments
Other Revenues	-8160237	OtherRevenues
Revenue Not Rptd F990	-8426168	RevenueNotRptdF990
Revenue Subtotal	74263137	RevenueSubtotal
Other Revenues Not Included	-202014	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	-202014	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	74061123	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	70276367	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	283115	OtherExpensesIncluded
Expenses Not Rptd F990	283115	ExpensesNotRptdF990
Expenses Subtotal	69993252	ExpensesSubtotal
Investment Expenses Not Included2	67918	InvestmentExpensesNotIncluded2
Other Expenses Not Included	3193899	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	3261817	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	73255069	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (8 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
ESCROW ACCOUNTS	SCHEDULE D, PART IV, LINE 2B	THE CORPORATION HAS AN ESCROW ACCOUNT FOR THEIR SKILLED NURSING FACILITY PATIENTS WHO REQUEST THE USE OF THE ACCOUNT. THIS AMOUNT IS REPORTED ON FORM 990, PART X, LINE 21.
ENDOWMENT FUND	SCHEDULE D, PART V, LINE 4	THE ENDOWMENT FUND WAS ESTABLISHED TO ALLOW THE HOSPITAL TO PROVIDE HEALTHCARE SERVICES TO POOR AND NEEDY PATIENTS.
UNCERTAIN TAX POSITIONS	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.
OTHER CHANGES IN NET ASSETS	SCHEDULE D, PART XI, LINE 8	DEFINED BENEFIT PENSION COSTS: AMORTIZATION OF NET LOSS $ 187,532 NET GAIN ARISING DURING YEAR ( 5,130,795) AUXILIARY NET INCOME 13,742 AUXILIARY TRANSFER TO CCMH ( 50,000) ------------- NET ADJUSTMENT ($4,979,521)
OTHER REVENUE INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12	SCHEDULE D, PART XII, LINE 2D	DEFINED BENEFIT PENSION COSTS: AMORTIZATION OF NET LOSS $ 187,532 NET GAIN ARISING DURING YEAR ( 5,130,795) BAD DEBT EXPENSE ( 3,149,056) INVESTMENT MANAGEMENT FEES ( 67,918) ------------- NET ADJUSTMENT ($8,160,237)
OTHER REVENUE INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1	SCHEDULE D, PART XII, LINE 4B	RENTAL EXPENSES ($ 268,048) AUXILIARY SPECIAL EVENTS 40,926 AUXILIARY SALES OF INVENTORY 77,683 AUXILIARY COST OF GOODS SOLD ( 51,989) AUXILIARY INTEREST INCOME 33 AUXILIARY OTHER INCOME 14,448 SPECIAL EVENTS EXPENSES ( 15,067) ------------- NET ADJUSTMENT ($ 202,014)
OTHER EXPENSES INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25	SCHEDULE D, PART XIII, LINE 2D	RENTAL EXPENSES $ 268,048 SPECIAL EVENTS EXPENSES 15,067 ------------- NET ADJUSTMENT $ 283,115
OTHER EXPENSES INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1	SCHEDULE D, PART XIII, LINE 4B	OTHER AUXILIARY EXPENSES $ 44,843 BAD DEBT EXPENSE 3,149,056 ------------- NET ADJUSTMENT $3,193,899

Schedule G IRS990ScheduleG

Field	Value	IRS element (for citing)
Solicitation Of Non Govt Grants	X	SolicitationOfNonGovtGrants
Solicitation Of Govt Grants	X	SolicitationOfGovtGrants
Agreement Ref Fundraising	true	AgreementRefFundraising

Fundraiser Activity Information FundraiserActivityInformation

Field	Value	IRS element (for citing)
Name Of Individual	DELTA DEVELOPMENT GROUP INC	NameOfIndividual
Activity	GRANT WRITING	Activity
Fundraiser Control Of Funds	false	FundraiserControlOfFunds
Amount Retained By Contractor	48000	AmountRetainedByContractor

Field	Value	IRS element (for citing)
Total Retained By Contractors	48000	TotalRetainedByContractors
Licensed States	PA	LicensedStates

Events Information EventsInformation

Field	Value	IRS element (for citing)
Name Of Event1	GOLF TOURNAMENT	NameOfEvent1
Gross Receipts Event1	40926	GrossReceiptsEvent1
Charitable Contributions Event1	33246	CharitableContributionsEvent1
Gross Revenue Event1	7680	GrossRevenueEvent1
Cash Prizes Event1	2310	CashPrizesEvent1
Non Cash Prizes Event1	0	NonCashPrizesEvent1
Rent Facility Costs Event1	6394	RentFacilityCostsEvent1
Food And Beverage Event1	4118	FoodAndBeverageEvent1
Entertainment Event1	2245	EntertainmentEvent1
Other Direct Expenses Event1	0	OtherDirectExpensesEvent1
Total Number Of Other Events	0	TotalNumberOfOtherEvents
Gross Receipts Total	40926	GrossReceiptsTotal
Charitable Contributions Total	33246	CharitableContributionsTotal
Gross Revenue Total Events	7680	GrossRevenueTotalEvents
Cash Prizes Total Events	2310	CashPrizesTotalEvents
Non Cash Prizes Total Events	0	NonCashPrizesTotalEvents
Rent Facility Costs Total Events	6394	RentFacilityCostsTotalEvents
Food And Beverage Total Events	4118	FoodAndBeverageTotalEvents
Entertainment Total Events	2245	EntertainmentTotalEvents
Other Direct Expenses Total Events	0	OtherDirectExpensesTotalEvents
Direct Expense Summary Events	15067	DirectExpenseSummaryEvents
Net Income Summary	-7387	NetIncomeSummary

Form990 Schedule G Part IV Form990ScheduleGPartIV

Field	Value	IRS element (for citing)
Identifier	FUNDRAISING ACTIVITIES	Identifier
Return Reference	SCHEDULE G, PART I, LINE 2B	ReturnReference
Explanation	THE ORGANIZATION HIRED DELTA DEVELOPMENT GROUP, INC., FOR GRANT WRITING SERVICES. THE AGREEMENT PROVIDED FOR A MONTHLY FEE FOR PROFESSIONAL FUNDRAISING SERVICES AS WELL AS REIMBURSEMENT OF ADDITIONAL FUNDRAISING EXPENSES.	Explanation

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	true	CharityCarePolicy
Written Policy	true	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	true	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	true	FPGReferenceDiscountedCare
Pcent300	X	Pcent300
Free Disc Care Medically Indigent	true	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	true	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	true	ExpensesExceededBudget
Unable To Provide Care	false	UnableToProvideCare
Annual Community Benefit Report	true	AnnualCommunityBenefitReport
Report Publically Available	true	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	716198	TotalCommunityBenefitExpense
Net Community Benefit Expense	716198	NetCommunityBenefitExpense
Percent Of Total Expense	0.01020	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	11445280	TotalCommunityBenefitExpense
Direct Offsetting Revenue	8238716	DirectOffsettingRevenue
Net Community Benefit Expense	3206564	NetCommunityBenefitExpense
Percent Of Total Expense	0.04570	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Total Community Benefit Expense	0	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	0	NetCommunityBenefitExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	12161478	TotalCommunityBenefitExpense
Direct Offsetting Revenue	8238716	DirectOffsettingRevenue
Net Community Benefit Expense	3922762	NetCommunityBenefitExpense
Percent Of Total Expense	0.05590	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	82839	TotalCommunityBenefitExpense
Direct Offsetting Revenue	14908	DirectOffsettingRevenue
Net Community Benefit Expense	67931	NetCommunityBenefitExpense
Percent Of Total Expense	0.00100	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	333683	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	333683	NetCommunityBenefitExpense
Percent Of Total Expense	0.00480	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	24469066	TotalCommunityBenefitExpense
Direct Offsetting Revenue	18261569	DirectOffsettingRevenue
Net Community Benefit Expense	6207497	NetCommunityBenefitExpense
Percent Of Total Expense	0.08850	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Total Community Benefit Expense	0	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	0	NetCommunityBenefitExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1430	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	1430	NetCommunityBenefitExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	24887018	TotalCommunityBenefitExpense
Direct Offsetting Revenue	18276477	DirectOffsettingRevenue
Net Community Benefit Expense	6610541	NetCommunityBenefitExpense
Percent Of Total Expense	0.09430	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	37048496	TotalCommunityBenefitExpense
Direct Offsetting Revenue	26515193	DirectOffsettingRevenue
Net Community Benefit Expense	10533303	NetCommunityBenefitExpense
Percent Of Total Expense	0.15020	PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	4	NumberOfActivitiesOrPrograms
Persons Served	129	PersonsServed
Total Community Building Expense	171	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	171	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Leadership Development LeadershipDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	12	NumberOfActivitiesOrPrograms
Persons Served	228	PersonsServed
Total Community Building Expense	5686	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	5686	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	4	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Building Expense	3956	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	3956	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	20	NumberOfActivitiesOrPrograms
Persons Served	460	PersonsServed
Total Community Building Expense	4678	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	4678	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	3	NumberOfActivitiesOrPrograms
Persons Served	150	PersonsServed
Total Community Building Expense	353	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	353	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Other Other

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	43	NumberOfActivitiesOrPrograms
Persons Served	967	PersonsServed
Total Community Building Expense	14844	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	14844	NetCommunityBuildingExpense
Percent Of Total Expense	0.00020	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	true	BadDebtExpenseReported
Bad Debt Expense	$3,149,056	BadDebtExpenseAmount
Amount Attributable To	494402	AmountAttributableTo
Amount Reimbursed By Medicare	21408333	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	22119142	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-710809	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost Accounting System	X	CostAccountingSystem

Field	Value	IRS element (for citing)
Written Debt Collection Policy	true	WrittenDebtCollectionPolicy
Provision For Charity Care	true	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	CHARLES COLE MEMORIAL HOSPITAL	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	1001 EAST 2ND STREET	AddressLine1
City	COUDERSPORT	City
State	PA	State
ZIP Code	16915	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Critical Access Hospital	X	CriticalAccessHospital
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	CHARLES COLE MEMORIAL HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
Eligibility Criteria Explained	true	EligibilityCriteriaExplained
Uses FPG Free	true	UsesFPGFree
FPG Free Percent	200.	FPGFreePercent
Uses FPG Discounted	true	UsesFPGDiscounted
FPG Discount Percent	300.	FPGDiscountPercent
Explains Basis	true	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Medical Indigency	X	MedicalIndigency
Insurance Status	X	InsuranceStatus
Uninsured Discount	X	UninsuredDiscount
Medicaid Medicare	X	MedicaidMedicare
State Regulation	X	StateRegulation
Explains Application Method	true	ExplainsApplicationMethod
Includes Publicity Measures	true	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Attached To Invoices	X	AttachedToInvoices
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
Notified All Patients	X	NotifiedAllPatients
Documented Determination	X	DocumentedDetermination
Nondiscrim Emergency Care Policy	true	NondiscrimEmergencyCarePolicy
Average Negotiated Rates	X	AverageNegotiatedRates
Amounts Generally Billed	false	AmountsGenerallyBilled
Gross Charges	false	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	10	NumberOfOtherFacilities

Other Facilities OtherFacilities (10 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
PORT ALLEGANY HEALTH CENTER
45 PINE STREET	PORT ALLEGANY	PA	16743	RURAL HEALTH CENTER REHABILITATION LAB SERVICES, RADIOLOGY
SHINGLEHOUSE HEALTH CENTER
128 LYONS STREET	SHINGLEHOUSE	PA	16748	RURAL HEALTH CENTER LAB SERVICES
ELDRED HEALTH CENTER
139 MAIN STREET	ELDRED	PA	16371	RURAL HEALTH CENTER LAB SERVICES
EMPORIUM HEALTH CENTER
SIZERVILLE ROAD	EMPORIUM	PA	15834	RURAL HEALTH CENTER LAB SERVICES
GALETON HEALTH CENTER
30 RIVER STREET	GALETON	PA	16922	RURAL HEALTH CENTER LAB SERVICES
WESTFIELD RURAL HEALTH CLINIC
222 CHURCH STREET	WESTFIELD	PA	16950	RURAL HEALTH CENTER LAB SERVICES
HEWITT MANOR
111 WEST HONEOYE STREET	SHINGLEHOUSE	PA	16748	REHABILITATION
SMETHPORT HEALTH CENTER
83 MARVIN STREET	SMETHPORT	PA	16749	RURAL HEALTH CENTER LAB SERVICES
NORTHERN POTTER HEALTH CENTER
511 ACADEMY STREET	ULYSSES	PA	16948	RURAL HEALTH CENTER LAB SERVICES
CENTRAL POTTER HEALTH CENTER
46 ELK STREET	COUDERSPORT	PA	16915	RURAL HEALTH CENTER LAB SERVICES

Form990 Schedule H Part VI Form990ScheduleHPartVI (10 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 ($73,255,069) WAS REDUCED BY BAD DEBT EXPENSE ($3,149,056).
SUBSIDIZED HEALTH SERVICES	SCHEDULE H, PART I, LINE 7G	SEVERAL RURAL HEALTH CLINICS WERE INCLUDED IN THE COMPUTATION OF SUBSIDIZED HEALTH SERVICES ON LINE 7G. CCMH PROVIDES PRIMARY CARE TO THE SURROUNDING COUNTIES AT THESE RURAL HEALTH CENTERS. THESE SERVICES ARE PROVIDED IN RURAL AREAS WHERE THERE WOULD BE A SHORTAGE OF QUALITY MEDICAL CARE WITHOUT THE SERVICES. CCMH CONTINUES TO PROVIDE THESE SERVICES AS A BENEFIT TO THE COMMUNITY DESPITE KNOWING THAT FINANCIAL SHORTFALLS WILL BE SUSTAINED. COSTING METHODOLOGY SCHEDULE H, PART I, LINE 7G THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1 AND 3. OTHER IRS WORKSHEETS USED ACTUAL COST METHOD.
BAD DEBT EXPENSE	SCHEDULE H, PART III, SECTION A, LINE 4	THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL 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 HOSPITAL 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 HOSPITAL 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 HOSPITAL'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS INCREASED FROM 40% OF SELF-PAY ACCOUNTS RECEIVABLE AT JUNE 30, 2011, TO 47% OF SELF-PAY ACCOUNTS RECEIVABLE AT JUNE 30, 2012. THE HOSPITAL'S WRITE-OFFS DECREASED APPROXIMATELY $15,000 FROM APPROXIMATELY $3,028,000 FOR THE YEAR ENDED JUNE 30, 2011, TO APPROXIMATELY $3,013,000 FOR THE YEAR ENDED JUNE 30, 2012. OVERALL FOR THE YEAR ENDED JUNE 30, 2012, THE CHANGE IN WRITE-OFFS AND COLLECTION TRENDS REMAINED RELATIVELY CONSISTENT COMPARED TO THE PRIOR YEAR. LINE 2 REPORTS THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS FROM THE AUDITED FINANCIAL STATEMENTS. LINE 3 WAS DETERMINED BY MULTIPLYING THE BAD DEBT EXPENSE (LINE 2) BY THE PERCENT OF PERSONS BELOW THE POVERTY LEVEL BASED ON US CENSUS BUREAU DATA FOR 2006 - 2010.
COMMUNITY BENEFIT	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. MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT, AS CCMH IS CLASSIFIED AS A CRITICAL ACCESS HOSPITAL. THIS CLASSIFICATION SHOWS THAT CCMH IS IN A MEDICALLY UNDERSERVED AREA AND AT A HEALTH PROFESSIONAL SHORTAGE AREA. THIS DEMONSTRATES THAT CCMH IS THE ONLY REASONABLE SOURCE OF HOSPITAL CARE AVAILABLE TO MEDICARE BENEFICIARIES IN OUR SERVICE AREA, AND LIKEWISE TREATS ALL BENEFICIARIES IN OUR SERVICE AREA THAT PRESENT THEMSELVES FOR CARE, DESPITE KNOWING WE WILL GENERALLY LOSE MONEY CARING FOR MEDICARE PATIENTS. ADDITIONALLY, SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY.
COLLECTION POLICY	SCHEDULE H, PART III, SECTION C, LINE 9B	EFFORTS ARE MADE TO IDENTIFY PATIENTS WHO MAY BE ELIGIBLE FOR CHARITY CARE IN ACCORDANCE WITH THE HOSPITAL'S CHARITY CARE POLICY OR THE PHYSICIAN NETWORK SLIDING FEE SCALE PRIOR TO THE STATEMENT PROCESS WHEN POSSIBLE.
NEEDS ASSESSMENT	SCHEDULE H, PART VI, LINE 2	COMPLETING A SERVICE AREA (4 COUNTIES) COMMUNITY HEALTH NEEDS ASSESSMENT WITH THE PROCESS BEGINNING IN JANUARY 2010 AND CONCLUDING IN MARCH 2010 WHEN CHARLES COLE MEMORIAL HOSPITAL RECEIVED OUTCOMES FROM THE SURVEY. SURVEYS WERE CONDUCTED BY TELEPHONE BY OKLAHOMA STATE UNIVERSITY. QUESTIONS WERE DETERMINED AT THE RECOMMENDATION OF OKLAHOMA STATE UNIVERSITY AND REVISED, AS DEEMED NECESSARY, BY CCMH. A TOTAL OF 200 PHONE SURVEYS WERE COMPLETED AND 48 ONLINE SURVEYS WERE SUBMITTED FROM ALL SERVICE AREA ZIP CODES. RESULTS WERE TALLIED AND ANALYZED BY OKLAHOMA STATE UNIVERSITY AND THEN PRESENTED TO CCMH AND A GROUP OF APPROXIMATELY 100 INDIVIDUALS FROM OUR COMMUNITY BENEFIT ADVISORY COMMITTEES (NOW KNOWN AS CORPORATE ADVISORS), CCMH PUBLIC RELATIONS COMMITTEE (A BOARD OF DIRECTOR'S SUB-COMMITTEE AND NOW KNOWN AS THE COMMUNITY RELATIONS COMMITTEE), CCMH LEADERSHIP AND CCMH BOARD OF DIRECTORS. IN ADDITION TO THE RECENT COMMUNITY HEALTH NEEDS ASSESSMENT, CCMH DETERMINES HEALTHCARE NEEDS OF THE COMMUNITIES WHICH WE SERVE THROUGH SURVEYS OF OUR COMMUNITY BENEFIT ADVISORY COMMITTEE MEMBERS, INDIVIDUAL RECOMMENDATIONS, BOARD OF DIRECTORS RECOMMENDATIONS, COMMUNITY EVENT SATISFACTION SURVEYS, AND LOCAL AND STATE HEALTHCARE TRENDS.
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	SCHEDULE H, PART VI, LINE 3	THE PATIENT FINANCIAL COUNSELOR CONTACTS SELF-PAY PATIENTS/GUARANTORS TO DISCUSS PAYMENT ARRANGEMENTS. IF THEY ARE UNABLE TO PAY - SHE EXPLAINS THE PROCESS OF APPLYING FOR CHARITY WHICH INCLUDES APPLYING FOR PA MEDICAL ASSISTANCE FIRST AND IF THEY ARE DENIED OR HAVE A PORTION TO PAY, THEN THEY CAN APPLY FOR CHARITY. THE CHARITY APPLICATION IS ON THE BACK OF OUR SELF-PAY STATEMENTS. ALSO, THE HOSPITAL OWNED PHYSICIAN PRACTICES ARE AWARE OF THIS PROGRAM AND REFER PATIENTS/GUARANTORS TO THE PATIENT FINANCIAL COUNSELOR.
COMMUNITY INFORMATION	SCHEDULE H, PART VI, LINE 4	CCMH SERVES PATIENTS MAINLY FROM POTTER, MCKEAN, TIOGA, CAMERON AND ELK COUNTIES IN NORTHCENTRAL PA. ALL OF THE COUNTIES THAT WE SERVE ARE CONSIDERED RURAL AND MOUNTAINOUS. CAMERON COUNTY CURRENTLY HAS THE HIGHEST UNEMPLOYMENT RATE IN THE STATE AND ALL OF THE COUNTIES SERVED ARE BATTLING THE EFFECTS OF THE ECONOMY AND JOB LOSS. OUR POPULATION IS ALSO AGING AS THE AREA OFFERS LITTLE FOR A YOUNGER DEMOGRAPHIC IN THE WAY OF EMPLOYMENT, EDUCATION AND CULTURE.
PROMOTION OF COMMUNITY HEALTH	SCHEDULE H, PART VI, LINE 5	THE MISSION OF CHARLES COLE MEMORIAL HOSPITAL INDICATES THAT THE HOSPITAL RESPONDS TO THE HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES AND IS LARGELY DEPENDENT ON PROVIDING SERVICES AND CARE TO THOSE INDIVIDUALS WHO MAY NOT HAVE THE RESOURCES TO BE AWARE OF, ABLE TO PAY FOR, OR HAVE THE EDUCATION/KNOWLEDGE ABOUT CARE, PROGRAMS AND SERVICES THAT ARE AVAILABLE TO THEM. THROUGH VARIOUS ACTIVITIES CHARLES COLE REACHES OUT TO OUR COMMUNITIES TO EDUCATE, IMPROVE HEALTH, PREVENT AND TREAT DISEASE AND SUPPORT INDIVIDUALS AND GROUPS. CHARLES COLE, IN COOPERATION WITH COMMUNITY BASED GROUPS SUCH AS ROTARY AND OSWAYO VALLEY MEMORIAL LIBRARY, PROVIDE FIVE COMPREHENSIVE BLOOD ANALYSIS ANNUALLY. COMPREHENSIVE BLOOD ANALYSIS SCREENINGS ARE PROVIDED IN FIVE RURAL COMMUNITIES: GALETON, SMETHPORT, PORT ALLEGANY, SHINGLEHOUSE AND COUDERSPORT. CBA'S SCREEN OVER 30 OF THE MOST COMMON BLOOD TESTS THAT DETECT HEALTH ISSUES SUCH AS CORONARY HEART DISEASE, LIVER DISEASE, KIDNEY DISEASE, CANCER, THYROID DISEASE, DIABETES, ANEMIA, BONE DISEASE AND RESPIRATORY DISEASE. THESE SCREENINGS ARE PROVIDED AT A FRACTION OF THE COST OF HAVING THESE TESTS PERFORMED THROUGH A FAMILY PHYSICIAN. ALL PARTICIPANTS AND THEIR PRIMARY MEDICAL PROVIDER ARE SENT THE RESULTS AND PROVIDERS FOLLOW-UP WITH INDIVIDUALS WHOSE SCREENING RESULTS INDICATE ABNORMALITIES. FOR MANY INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED AND LIKELY WOULD NOT SEEK MEDICAL CARE UNTIL IT WAS EMERGENT, THESE EVENTS PROVIDE AN AVENUE TO MONITOR THEIR HEALTH AND DETECT POTENTIAL ISSUES BEFORE THEY BECOME EMERGENT. IN ADDITION, THE LOCAL CO-SPONSORS RECEIVE A PORTION OF THE PROCEEDS FROM THESE EVENTS AND UTILIZE THE FUNDS TO PROVIDE SCHOLARSHIPS AND SUPPORT TO LOCAL STUDENTS AND PROJECTS TO BENEFIT THE COMMUNITY. ANNUALLY, CHARLES COLE PARTNERS WITH THE AREA AGENCY ON AGING AND THE PENNSYLVANIA DEPARTMENT OF HEALTH TO ADMINISTER SEASON INFLUENZA AND PNEUMOCCOCAL VACCINE TO POTTER COUNTY RESIDENTS WHO ARE OVER THE AGE OF 60 AT NO COST. HOWEVER, RESIDENTS WHO ARE UNDER THE AGE OF 60 WITH A CHRONIC DISEASE ARE ELIGIBLE AS WELL. FY2011 654 NO-COST INFLUENZA VACCINES AND 50 PNEUMOCOCCAL VACCINES WERE ADMINISTERED THROUGH 11 CLINICS IN 7 COMMUNITIES. IN MANY CASES THE UNDERSERVED POPULATIONS ARE MORE LIKELY TO BECOME ILL AND POTENTIALLY FACE EMERGENT HEALTH NEEDS FROM VACCINE-PREVENTABLE DISEASE. BY PROVIDING CLINICS AT COUNTY SENIOR CENTERS AND IN RURAL COMMUNITY SETTINGS MANY INDIVIDUALS WHO WOULD LIKELY NOT RECEIVE THESE COMMON VACCINES CAN BE IMMUNIZED AT NO COST AND IN CLOSE PROXIMITY TO THEIR HOMES. ALSO IN CONJUNCTION WITH THE AREA AGENCY ON AGING, CHARLES COLE PROVIDES NO-COST EDUCATION TO COUNTY SENIOR CENTERS. IN FY 2011, CCMH PROVIDED 7 HEALTH EDUCATION PROGRAMS, EACH PRESENTED AT 4 SENIOR CENTERS FOR A TOTAL OF 30+ SESSIONS. TOPICS INCLUDED IMMUNIZATIONS, QUESTION TO ASK YOUR HEALTHCARE PROVIDER, INJURY PREVENTION, THE DIABETIC FOOT & GOUT, REDUCE RISK OF CANCER/ SIGNS AND SYMPTOMS OF CANCER, AND QUESTIONS REGARDING YOUR MEDICATIONS. FINALLY, AS AN ON-GOING EFFORT TO PROVIDE FULL-SPECTRUM CANCER CARE TO INDIVIDUALS IN RURAL NORTH CENTRAL PENNSYLVANIA, THE PATTERSON CANCER CARE CENTER PHYSICIANS AND STAFF PROVIDED APPROXIMATELY 170 NO-COST CANCER SCREENINGS. SCREENINGS INCLUDED SCREENINGS FOR PROSTATE, COLORECTAL AND SKIN CANCER. SCREENINGS WERE PERFORMED BY ONCOLOGY PHYSICIANS WHO SPECIALIZE IN THE DETECTION, DIAGNOSIS AND TREATMENT OF CANCER. INDIVIDUALS PARTICIPATING IN THESE SCREENINGS WERE BOTH MALE AND FEMALE, ADULT AND SENIOR AND UNINSURED/UNDERINSURED. ALONG WITH MANY OTHER PROGRAMS SUCH AS SUPPORT GROUPS, SPEAKER'S BUREAU, 9 AGENCY WELLNESS COLLABORATIVE, WORKFORCE DEVELOPMENT, ECONOMIC SUPPORT, COMMUNITY LEADERSHIP, PARTNERSHIPS WITH LOCAL CIVIC, GOVERNMENT, SCHOOL DISTRICTS AND COMMUNITY GROUPS, CHARLES COLE MEMORIAL HOSPITAL CONTINUES EFFORTS TO ASSURE THAT HEALTHCARE, IN ALL FORMS, IS ACCESSIBLE AND AVAILABLE TO THOSE WHO MAY OTHERWISE GO WITHOUT. CCMH PROVIDES THE COMMUNITY WITH SPACE FOR EVENTS, MEETINGS AND PROGRAMS SUCH AS SUPPORT GROUPS, ANNUAL EVENTS, TRAINING SESSIONS AND YOUTH SPORTS. CCMH'S EMPLOYEE GIVING CLUB, HEART OF COLE, HAS A DESIGNATED GROUP THAT FOCUSES ON COMMUNITY CONNECTIONS. THE GROUP ANNUALLY UTILIZES APPROXIMATELY $10,000 ON COMMUNITY CONNECTIONS INCLUDING DONATIONS, IN FY11 SPECIFICALLY TO SERVE INDIVIDUALS AND FAMILIES THROUGH MONETARY AND NON-PERISHABLE FOOD DONATIONS TO LOCAL FOOD BANKS AND TO PURCHASE OF HEALTHCARE-RELATED ITEMS TO BE USED AS GIVE-AWAYS AT COMMUNITY EVENTS. CHARLES COLE STRIVES TO LIVE UP TO ITS NON-PROFIT MISSION EVERY DAY, PROVIDING EXCELLENT HEALTHCARE SERVICES TO OUR AREA AND LISTENING AND RESPONDING TO THE COMMUNITIES WE SERVE. IN AN EFFORT TO PLAN FOR THE UNIQUE NEEDS OF COMMUNITIES IN THE SERVICE AREA, FIVE COMMUNITY BENEFIT ADVISORY COMMITTEES WERE ESTABLISHED AS A MAJOR INITIATIVE TO DEEPEN AND STRENGTHEN ITS CONNECTION WITH THE COMMUNITY AND TO LINK COMMUNITY BENEFIT ACTIVITIES TO STRATEGIC AND OPERATIONAL PLANS. THE ROLE OF THE COMMITTEES IS TO IDENTIFY THE NEEDS AND CONCERNS OF THE COMMUNITY, ADVISE ABOUT THE BEST WAY TO PARTNER WITH THE COMMUNITY, AID IN THE DEVELOPMENT OF MEANINGFUL COMMUNITY PROGRAMS AND ACTIVITIES, AND PROMOTE IMPROVED COMMUNICATIONS BETWEEN THE HOSPITAL AND THE COMMUNITY. THE HOSPITAL PROVIDES DEDICATED ADMINISTRATIVE TIME TO PLANNING AND CONDUCTING FIVE CBAC MEETINGS IN THE COMMUNITIES WE SERVE THREE TIMES PER YEAR. LASTLY, CCMH OFTEN PARTNERS WITH FUNDING FOUNDATIONS TO PROVIDE HEALTH SPECIFIC IMPROVEMENT INITIATIVES IN THE COMMUNITIES WHICH WE SERVE. AS AN EXAMPLE, CCMH, WITH FUNDING FROM THE MAKING STRIDES AGAINST BREAST CANCER FOUNDATION, TO PROVIDE A NIGHT FOR WOMEN WHO HAVE OR HAD BREAST CANCER.
AFFILIATED HEALTH CARE SYSTEM	SCHEDULE H , PART VI, LINE 6	THE AFFILIATED HEALTH CARE SYSTEM INCLUDES CHARLES COLE MEMORIAL HOSPITAL, COLE CARE, INC, AND HENDORN, INC. CHARLES COLE MEMORIAL HOSPITAL (THE "HOSPITAL") PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES TO PATIENTS IN COUDERSPORT, PENNSYLVANIA. THE HOSPITAL ALSO OPERATES A HOME HEALTH AGENCY AND A NUMBER OF PHYSICIAN CLINICS IN THE SAME GEOGRAPHIC AREA. COLE CARE, INC., A WHOLLY OWNED SUBSIDIARY OF THE HOSPITAL, OPERATES A DURABLE MEDICAL EQUIPMENT COMPANY FOR THE SALE AND RENTAL OF EQUIPMENT. HENDORN, INC., D/B/A COLE MANOR (COLE MANOR), OF WHICH THE HOSPITAL IS THE SOLE CORPORATE MEMBER, OWNS AND OPERATES A 30-BED PERSONAL CARE RESIDENTIAL FACILITY AND PROVIDES HOMEMAKER SERVICES.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Written Employment Contract	X	WrittenEmploymentContract
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	false	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)

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
MICHAEL E CALLAHAN
181414	0	0	0	983	0	4378	0	12342	0	199117	0	0	0
JASON TRONETTI
213798	0	99563	0	181	0	6009	0	17009	0	336560	0	0	0
KALLIOPI NESTOR
219181	0	4370	0	310	0	5609	0	15844	0	245314	0	0	0
EDWARD C PITCHFORD
236567	0	18047	0	29345	0	6106	0	19613	0	309678	0	0	0
CYNTHIA HARDESTY
134098	0	10566	0	19451	0	4066	0	5696	0	173877	0	0	0
BRADLEY F GIANNOTTI
825418	0	29237	0	16400	0	4515	0	10627	0	886197	0	0	0
TERRENCE L FOUST
617142	0	107120	0	540	0	6070	0	5986	0	736858	0	0	0
SAKET PRASAD
466714	0	90012	0	17349	0	6067	0	17904	0	598046	0	0	0
CHRISTAN M CARAMIA
424541	0	0	0	386	0	6096	0	18638	0	449661	0	0	0
CELSO BACKES
374850	0	0	0	7156	0	4775	0	0	0	386781	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII

Field	Value	IRS element (for citing)
Identifier	BONUS	Identifier
Return Reference	SCHEDULE J, PART I, LINE 7	ReturnReference
Explanation	SOME OF THOSE LISTED IN FORM 990, PART VII RECEIVED PAYOUTS OF ACCRUED BONUSES AND ACCRUED ADDITIONAL BONUSES FOR PARTICIPATING IN THE EXECUTIVE TEAM INCENTIVE COMPENSATION PROGRAM. EACH PARTICIPANT HAD AN ESTABLISHED TARGET TOTAL COMPENSATION BASED ON INDUSTRY SURVEYS AND THE INCENTIVE PROGRAM COMPRISED APPROXIMATELY 10% OF THE TARGETED TOTAL COMPENSATION. THE BONUS WAS BASED ON OVERALL PERFORMANCE.	Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
COLE CARE
COMMON BOARD MEMBERS	6854608	RENT, DIVIDENDS, SERVICES	false
EDMOND HARDESTY
HUSBAND OF C HARDESTY	142608	EMPLOYEE OF HOSPITAL	false

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
ORGANIZATION'S MISSION	FORM 990, PART I, LINE 1	CHARLES COLE MEMORIAL HOSPITAL IS A FULL SERVICE, COMPREHENSIVE HEALTH SYSTEM, SERVING POTTER, MCKEAN, CAMERON, AND TIOGA COUNTIES IN RURAL, NORTH CENTRAL PA AND PORTIONS OF NEW YORK STATE AND IS THE ONLY HOSPITAL IN POTTER COUNTY (COUDERSPORT, PA). CCMH IS A CRITICAL ACCESS HOSPITAL PROVIDING PRIMARY, EMERGENCY, AND SPECIALTY CARE, AS WELL AS REHABILITATION AND WELLNESS SERVICES TO PATIENTS WITHIN A 50-MILE RADIUS. CHARLES COLE STRIVES TO LIVE UP TO ITS NON-PROFIT MISSION EVERY DAY, PROVIDING EXCELLENT HEALTHCARE SERVICES TO OUR AREA AND LISTENING AND RESPONDING TO THE COMMUNITIES WE SERVE. IN AN EFFORT TO PLAN FOR THE UNIQUE NEEDS OF COMMUNITIES IN THE SERVICE AREA, FIVE COMMUNITY BENEFIT ADVISORY COMMITTEES WERE ESTABLISHED AS A MAJOR INITIATIVE TO DEEPEN AND STRENGTHEN OUR CONNECTION WITH THE COMMUNITY AND TO LINK COMMUNITY BENEFIT ACTIVITIES TO STRATEGIC AND OPERATIONAL PLANS. THE ROLE OF THE COMMITTEES ARE TO IDENTIFY THE NEEDS AND CONCERNS OF THE COMMUNITY, ADVISE ABOUT THE BEST WAY TO PARTNER WITH THE COMMUNITY, AID IN THE DEVELOPMENT OF MEANINGFUL COMMUNITY PROGRAMS AND ACTIVITIES, AND PROMOTE IMPROVED COMMUNICATIONS BETWEEN THE HOSPITAL AND THE COMMUNITY. THE HOSPITAL PROVIDES DEDICATED ADMINISTRATIVE TIME TO PLANNING AND CONDUCTING FIVE CBAC MEETINGS IN THE COMMUNITIES WE SERVE THREE TIMES PER YEAR.
PROGRAM SERVICE ACCOMPLISHMENTS	FORM 990, PART III, LINE 4	LINE 4B IN ADDITION TO THE FAMILY AND INTERNAL MEDICINE SERVICES AT RHCS, PHYSICIAN PRACTICES ALSO PROVIDE SPECIALTY CARE INCLUDING PEDIATRICS, GASTROENTEROLOGY, ORTHOPEDICS, PSYCHIATRY, SURGERY, PODIATRY, OBSTETRICS/GYNECOLOGY AND ONCOLOGY. COLLECTIVELY, PHYSICIAN PRACTICES REPORTED 93,600 PATIENT VISITS LAST YEAR. LINE 4C INPATIENT SATISFACTION RANKS IN THE TOP 6% IN OUR OB SERVICES AND TOP 16% IN OUR IP SERVICES ACROSS THE NATION. IN ADDITION TO THE HOSPITAL'S ACUTE CARE FLOORS, CHARLES COLE CARES FOR PATIENTS IN ITS 49-BED LONG TERM CARE UNIT WHICH REPORTED 16,060 DAYS LAST YEAR. A 10-BED INPATIENT GERIATRIC BEHAVIORAL HEALTH UNIT ADMITTED 170 PATIENTS LAST YEAR. LINE 4D THE ORGANIZATION ALSO OFFERS CARDIO-PULMONARY SERVICES, CLINICAL SERVICES, CLINICS, AND CORPORATE SERVICES.
MEMBERS	FORM 990, PART VI, SECTION A, LINES 6 & 7A	THE MEMBERS OF THE CORPORATION, THE CHARLES COLE MEMORIAL HOSPITAL, SHALL BE KNOWN AS COMMUNITY BENEFIT ADVISORS ("ADVISORS"), WHOSE FUNCTIONS AND QUALIFICATIONS SHALL INCLUDE THE FOLLOWING: (A) PROMOTE THE PROGRAMS, GOALS AND OBJECTIVES OF CHARLES COLE MEMORIAL HOSPITAL; (B) EDUCATE THEIR PUBLIC CONTACTS, BOTH ON HEALTH CARE ISSUES AND ON SERVICES AND PROGRAMS AVAILABLE THROUGH CHARLES COLE MEMORIAL HOSPITAL, AND SEEK THEIR SERVICES WHEN NECESSARY AND APPROPRIATE; (C) PROVIDE AN IMPORTANT LINK BETWEEN CHARLES COLE MEMORIAL HOSPITAL, THE OTHER INSTITUTIONS AND BUSINESSES WHICH THEY REPRESENT, AND THE COMMUNITIES SERVED BY THE HOSPITAL; (D) ATTEND REGULAR MEETINGS, TO SHARE INFORMATION ON ACTIVITIES AND TAKE APPROPRIATE ACTION TO SUPPORT AND GUIDE CHARLES COLE MEMORIAL HOSPITAL; (E) PROVIDE SPECIAL ASSISTANCE ON PROJECTS AND ISSUES WHEN REQUESTED; (F) PARTICIPATE IN FUNDRAISING EFFORTS TO BENEFIT PATIENT CARE PROGRAMS FOR CHARLES COLE MEMORIAL HOSPITAL; AND (G) BE A CITIZEN IN GOOD STANDING, AS DETERMINED BY THE EXECUTIVE COMMITTEE OF THE BOARD, IN A COMMUNITY SERVED BY THE HOSPITAL. THE MEMBERS SHALL BE DIVIDED INTO TWO CLASSES: (A) ACTIVE ADVISORS (B) HONORARY ADVISORS THE ADVISORS SHALL ANNUALLY ELECT: (A) SUCCESSORS TO THE BOARD OF DIRECTORS WHOSE TERMS EXPIRE. (B) HONORARY DIRECTORS AND HONORARY ADVISORS. UPON NOMINATION BY THE EXECUTIVE COMMITTEE PER SECTION 5.2.2.(E) OF THESE BYLAWS, ALL ADVISORS SHALL BE ELECTED BY A TWO THIRDS VOTE OF THE MEMBERS PRESENT AND VOTING AT A DULY CALLED MEETING OF THE MEMBERS WHICH A QUORUM IS PRESENT. (A) AN ACTIVE ADVISOR OF CHARLES COLE MEMORIAL HOSPITAL SHALL BE A MEMBER FOR A TERM OF FIVE (5) YEARS AFTER HIS ELECTION, OR UNTIL HIS EARLIER RESIGNATION. THERE IS NO LIMIT ON THE NUMBER OF TERMS AN ADVISOR CAN SERVE. (B) AN HONORARY ADVISOR MAY BE ELECTED BY THE ACTIVE ADVISORS AND SHALL SERVE FOR LIFE, IN RECOGNITION OF MERITORIOUS OR FAITHFUL SERVICE TO CHARLES COLE MEMORIAL HOSPITAL OR IN RECOGNITION OF DISTINGUISHED ACHIEVEMENT. (C) EACH ADVISOR OWES A DUTY OF UNDIVIDED AND UNQUALIFIED LOYALTY TO THE ORGANIZATION. ADVISORS MAY NOT USE THEIR POSITIONS TO PROFIT PERSONALLY OR TO ASSIST OTHERS IN PROFITING IN ANY WAY AT THE EXPENSE OF THE ORGANIZATION. (D) ADVISORS SHALL AVOID ALL CONFLICTS OF INTEREST AND THE APPEARANCE OF ANY CONFLICT OF INTEREST. A CONFLICT OF INTEREST OCCURS IN ANY SITUATION IN WHICH ONE IS POTENTIALLY NOT ABLE TO REMAIN IMPARTIAL OR MAINTAIN OBJECTIVITY IN CHOOSING BETWEEN THE INTERESTS OF THE ORGANIZATION AND ONE'S PERSONAL INTERESTS OR THE INTERESTS OF THIRD PARTIES. TO AVOID THE APPEARANCE OF A CONFLICT OF INTEREST, AN ADVISOR SHALL NOT PARTICIPATE IN THE MAKING OF ANY DECISION OR RECOMMENDATION CONCERNING A MATTER WHICH MAY RESULT IN ANY BENEFIT OR FINANCIAL GAIN, EITHER DIRECTLY OR INDIRECTLY, TO THE ADVISOR OR A MEMBER OF HIS/HER IMMEDIATE FAMILY. IN ADDITION, FULL DISCLOSURE OF THE PERTINENT FACTS REGARDING THE POTENTIAL CONFLICT OF INTEREST SHOULD BE PROVIDED BY THE ADVISOR. (E) NO ADVISOR SHALL HAVE ANY VESTED RIGHT, INTEREST OR PRIVILEGE OF, IN, OR TO THE ASSETS, FUNCTIONS, AFFAIRS OR FRANCHISES OF THE CORPORATION OR ANY SUCH RIGHT, INTEREST OR PRIVILEGE WHICH MAY BE TRANSFERABLE OR INHERITABLE, OR WHICH SHALL CONTINUE IF HIS MEMBERSHIP CEASES. NO ADVISOR SHALL BE AN EMPLOYEE OF THE HOSPITAL OR ANY OF ITS AFFILIATES. (F) ADVISORS SHALL INCLUDE REPRESENTATIVES FROM VARIOUS ECONOMIC, SOCIAL AND OCCUPATIONAL GROUPS BROADLY REPRESENTATIVE OF THE DEMOGRAPHIC CHARACTERISTICS OF THE COMMUNITIES SERVED BY THE HOSPITAL, AND SHALL ALL HAVE AN INTEREST IN AND COMMITMENT TO FURTHER THE HEALTH AND WELL-BEING OF THE CITIZENS OF THE HOSPITAL'S SERVICE AREA. (G) THE SECRETARY OF THE BOARD SHALL ACT AS LIAISON TO THE COMMUNITY BENEFIT ADVISORS. THE NUMBER OF ADVISORS SHALL NOT BE LESS THAN FIFTY (50) NOR MORE THAN ONE HUNDRED (100), EXCLUSIVE OF HONORARY ADVISORS. EVERY ACTIVE ADVISOR SHALL BE ENTITLED TO ONE (1) VOTE AT ANY MEETING OF THE ADVISORS IN WHICH A VOTE IS TAKEN FOR ANY ELECTION OR ON ANY MATTER OR TRANSACTION. IN THE CASE OF VOTING FOR THE ELECTION OF DIRECTORS, EACH ADVISOR MUST CAST ONE (1) VOTE FOR EACH POSITION TO BE FILLED OR THE BALLOT WILL BE VOID AS IT PERTAINS TO THE ELECTION OF DIRECTORS. VOTING FOR DIRECTORS SHALL BE BY WRITTEN BALLOT BY FIRST CLASS MAIL, POSTMARKED NO LATER THAN TWENTY (20) DAYS PRIOR TO THE DATE SELECTED FOR THE ANNUAL MEETING. EVERY ADVISOR SHALL BE ENTITLED IN RETURNING HIS BALLOT FOR THE ANNUAL ELECTION OF DIRECTORS, TO DIRECT THAT HIS VOTE BE WITHHELD FROM ONE (1) OR MORE OF THE CANDIDATES SUBMITTED BY THE NOMINATING COMMITTEE AND ANY SUCH ADVISOR MAY, ON HIS BALLOT, MAY SET FORTH THE NAME OF ANY PERSON FOR WHOM HE WISHES TO RECORD HIS VOTE FOR A DIRECTOR OF THE CORPORATION. RESULTS OF THE ELECTION PROCESS WILL BE ANNOUNCED AT THE ANNUAL MEETING OF THE ADVISORS. HONORARY ADVISORS SHALL RECEIVE NOTICES OF AND MAY ATTEND ALL MEETINGS OF THE ADVISORS BUT SHALL NOT BE ENTITLED TO VOTE ON ANY MATTER. THE ELECTION PROCESS WILL BE ANNOUNCED AT THE ANNUAL MEETING OF THE ADVISORS. HONORARY ADVISORS SHALL RECEIVE NOTICES OF AND MAY ATTEND ALL MEETINGS OF THE ADVISORS BUT SHALL NOT BE ENTITLED TO VOTE ON ANY MATTER.
FORM 990 REVIEW PROCESS	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 990 IS THEN REVIEWED BY THE ACCOUNTING DEPARTMENT AND THE CONTROLLER. IT IS THEN PRESENTED TO THE AUDIT / COMP COMMITTEE FOR REVIEW. AFTER THE AUDIT / COMP COMMITTEE HAS REVIEWED, A FULL COPY IS DISTRIBUTED TO THE BOARD OF DIRECTORS and THE COMMITTEE WILL REPORT THEIR REVIEW OF FORM 990 TO THE ENTIRE BOARD OF DIRECTORS PRIOR TO THE CEO'S FINAL SIGNATURE.
MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY	FORM 990, PART VI, SECTION B, LINE 12C	MEMBERS OF THE BOARD OF DIRECTORS; BOARD COMMITTEES; MANAGEMENT EMPLOYEES; AND MEDICAL STAFF WITH ADMINISTRATIVE RESPONSIBILITIES ARE COVERED UNDER THE CONFLICT OF INTEREST POLICY. THE LEVELS AT WHICH ACTUAL CONFLICTS ARE REVIEWED ARE THE COMPLIANCE OFFICER AND AUDIT COMMITTEE OF THE BOARD OF DIRECTORS. RESTRICTIONS INCLUDE: A MEMBER OF THE BOARD/BOARD COMMITTEE MUST DISCLOSE THE EXISTENCE OF HIS/HER FINANCIAL INTEREST. A VOTING MEMBER OF ANY COMMITTEE WHOSE SCOPE OF RESPONSIBILITIES INCLUDES COMPENSATION MATTERS AND WHO RECEIVES COMPENSATION, DIRECTLY OR INDIRECTLY, FROM THE HOSPITAL FOR SERVICES IS PRECLUDED FROM VOTING ON MATTERS PERTAINING TO THAT MEMBER'S COMPENSATION. PHYSICIANS WHO RECEIVE COMPENSATION, DIRECTLY OR INDIRECTLY, FROM THE HOSPITAL, WHETHER AS EMPLOYEES OR INDEPENDENT CONTRACTORS, ARE PRECLUDED FROM MEMBERSHIP ON ANY COMMITTEE WHOSE PRIMARY SCOPE OF RESPONSIBILITIES INCLUDES COMPENSATION MATTERS. A MANAGEMENT EMPLOYEE, OR A MEDICAL STAFF MEMBER WITH ADMINISTRATIVE RESPONSIBILITIES MUST DISCLOSE TO THE SENIOR LEADER THE EXISTENCE OF THE FINANCIAL INTEREST AND ALL RELATED MATERIAL FACTS.
COMPENSATION DETERMINATION	FORM 990, PART VI, SECTION B, LINE 15A	A REVIEW WAS CONDUCTED IN JUNE 2012 FOR PRESIDENT & CEO EDWARD PITCHFORD BY 3C COMPENSATION CONSULTING CONSORTIUM, LLC, LOCATED IN PITTSBURGH, PENNSYLVANIA. THE BOARD WOULD HAVE TO APPROVE ANY INCREASE RECOMMENDED BY THE AUDIT/COMPENSATION COMMITTEE.
DOCUMENT AVAILABILITY	FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS CAN BE VIEWED ONSITE THROUGH A WRITTEN REQUEST TO THE ORGANIZATION'S CORPORATE COMPLIANCE OFFICER. REQUESTS FOR FINANCIAL STATEMENTS AND 990'S ARE FORWARDED TO THE FINANCE / ACCOUNTING DEPARTMENT AND ARE OPEN FOR PUBLIC INSPECTION.
BOARD MEMBER COMPENSATION & HOURS WORKED FOR RELATED ORGANIZATIONS	FORM 990, PART VII, SECTION A	NO BOARD MEMBERS RECEIVE ANY COMPENSATION FOR THEIR DIRECTOR DUTIES. MICHAEL CALLAHAN IS COMPENSATED BY CHARLES COLE MEMORIAL HOSPITAL AS A PHYSICIAN. JASON TRONETTI IS COMPENSATED BY CHARLES COLE MEMORIAL HOSPITAL AS A PHYSICIAN. KALLIOPI NESTOR IS COMPENSATED BY CHARLES COLE MEMORIAL HOSPITAL AS A PHYSICIAN. EACH WORK APPROXIMATELY 40 HOURS PER WEEK IN THESE ROLES. EDWARD PITCHFORD SERVES AS THE PRESIDENT, CEO, AND ASSISTANT SECRETARY FOR CHARLES COLE MEMORIAL HOSPITAL, HENDORN, INC., AND COLE CARE, INC., AND SPLITS APPROXIMATELY 40 HOURS PER WEEK BETWEEN THESE ENTITIES. ALL BOARD MEMBERS SERVE FOR AN AVERAGE OF ONE HOUR PER WEEK ON THE BOARDS OF CHARLES COLE MEMORIAL HOSPITAL, HENDORN, INC., AND COLE CARE, INC.
OTHER CHANGES IN NET ASSETS	FORM 990, PART XI, LINE 5	DEFINED BENEFIT PENSION COSTS: AMORTIZATION OF NET LOSS $ 187,532 NET GAIN ARISING DURING YEAR ( 5,130,795) AUXILIARY TRANSFER TO CCMH ( 50,000) CHANGE IN ACCOUNTING PRINCIPLE ( 306,743) NET UNREALIZED LOSSES ( 265,931) ------------- NET ADJUSTMENT ($5,565,937)

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg
HENDORN INC DBA COLE MANOR
1001 EAST SECOND STREET	COUDERSPORT	PA	16915	231972659	RESIDENT CARE	PA	501(C)(3)	11A I	CCMH	true
HAMOTCOLE VENTURES INC
1001 EAST SECOND STREET	COUDERSPORT	PA	16915	273172100	REAL ESTATE	PA	501(C)(3)	11A I	NA	false

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	COLE CARE INC	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1001 EAST 2ND STREET	AddressLine1
City	COUDERSPORT	City
State	PA	State
ZIP Code	16915	ZIPCode

Field	Value	IRS element (for citing)
EIN	251497347	EIN
Primary Activity	DURABLE MED EQUIP	PrimaryActivity
Legal Domicile State	PA	LegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	CCMH	BusinessNameLine1

Field	Value	IRS element (for citing)
Type Of Entity	C CORPORATION	TypeOfEntity
Share Of Total Income	8278270	ShareOfTotalIncome
Share Of EOY Assets	851707	ShareOfEOYAssets
Percentage Ownership	1.00000	PercentageOwnership

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	true	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	false	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	false	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	false	LoansOrGuaranteesFromOtherOrg
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	true	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	true	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	false	OtherTransferToOtherOrg
Other Transfer From Other Org	false	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
COLE CARE INC
A/I	174399	FMV
COLE CARE INC
K	56692	FMV
COLE CARE INC
L	174348	FMV
HENDORN INC
K	314226	FMV
HENDORN INC
L	40824	FMV
COLE CARE INC
N	6449169	FMV