2013-10-07T10:25:56-05:00 2012-12-31 231973945 PARENTEBEARD LLC 400 MARKET STREET WILLIAMSPORT PA 17701 990 2012-01-01 232626796 LYCOMING COMMUNITY CARE INC LYCO 5704333161 2140 WARRENSVILLE RD MONTOURSVILLE PA 17754 STEPHEN FRY 5704333161 2013-10-04 1 JULIUS C GREEN CPA JD P00350393 5703236023 2012 2016-02-24 21:20:13Z STEPHEN FRY 2140 WARRENSVILLE RD MONTOURSVILLE PA 17754 12445556 0 X WWW.VALLEYVIEW.ORG X 1990 PA PROVIDED SKILLED AND INTERMEDIATE NURSING CARE TO THE MEN AND WOMEN OF LYCOMING COUNTY. 9 9 324 30 0 0 243047 15941 12709539 12139630 41990 42790 66868 64679 13061444 12263040 0 0 0 0 7691009 7919872 0 0 13044 4199353 4604000 11890362 12523872 1171082 -260832 9585862 8934041 4264204 3755214 5321658 5178827 PROVIDED SKILLED AND INTERMEDIATE NURSING CARE TO THE MEN AND WOMEN OF LYCOMING COUNTY AND SURROUNDING AREAS. 0 0 11611451 12139630 PROVIDED SKILLED AND INTERMEDIATE NURSING CARE FOR 52,039 RESIDENT DAYS TO THE MEN AND WOMEN OF LYCOMING COUNTY AND SURROUNDING AREAS. OF THE TOTAL RESIDENT DAYS OF NURSING CARE PROVIDED, 35,471 DAYS WERE PROVIDED TO RESIDENTS RECEIVING MEDICAID. THE MEDICAID DAILY REIMBURSEMENT RATE WAS APPROXIMATELY $172.42 PER DAY COMPARED TO THE DAILY PRIVATE PAY RATE OF $220 FOR SKILLED NURSING AND $226 FOR DEMENTIA CARE. THE ESTIMATED AVERAGE SHORTFALL FOR MEDICAID REIMBURSEMENT IS PROJECTED AT $26.26 PER MEDICAID DAY. BASED ON THIS ESTIMATE, THE ORGANIZATION PROVIDED APPROXIMATELY $931,000 IN CHARITY CARE FOR 2012. 11611451 1 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 11 0 1 324 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 1 1 0 PA X STEPHEN FRY - CFO 5704333161 2140 WARRENSVILLE ROAD MONTOURSVILLE PA 17745 PHILIP A PETTER 1.00 X X 0 0 0 NICHOLAS CATINO 2.00 X X 0 0 0 JOSEPH CIPRIANI 1.00 X X 0 0 0 SUE E STACKHOUSE 1.00 X X 0 0 0 JERI DEMEL 1.00 X 0 0 0 MARGARET P PIPER 1.00 X 0 0 0 J MICHAEL WILEY 1.00 X 0 0 0 WANDA BOWER 1.00 X 0 0 0 STEPHEN G KAISER 1.00 X 0 0 0 LOUISE EAKIN 40.00 X 95899 0 5320 STEPHEN FRY 40.00 X 87110 0 1464 LOUANN SIMPSON 40.00 X 82668 0 1465 CHARLOTTE BLETZ 40.00 X 8308 0 0 KIMBERLY KLEES 40.00 X 19385 0 2717 293370 0 10966 0 0 0 0 SODEXHO PO BOX 360170 PITTSBURGH PA 152516170 FOOD SERVICE 856849 SELECT REHABILITATION PO BOX 809056 CHICAGO IL 606809056 REHAB 611064 OMNICARE INC PO BOX 631285 CINCINNATI OH 452531285 PHARMACY 286030 ENDURACARE PO BOX 53064 PHOENIX AZ 85072 REHAB 148730 4 15941 15941 PATIENT SERVICE REVENU 623000 12139630 12139630 12139630 48797 48797 4125 2184 1941 1941 1941 174325 180332 -6007 -6007 -6007 2699 0 2699 2699 TV CABLE 517000 19095 19095 BARBER/BEAUTICIAN SERVICES 446199 13437 13437 PURCHASE DISCOUNTS 900099 8441 8441 19066 19066 60039 12263040 12139630 0 107469 304336 90419 213917 6052958 5676688 376270 24949 21313 3636 974070 919665 54405 563559 514474 49085 272 272 47864 47864 1920 1920 1132236 1070173 62063 22892 9848 13044 942147 904715 37432 8924 907 8017 323268 323268 35379 28460 6919 4683 4683 141760 141760 642447 642447 164989 164989 PA NURSING HOME ASSESSM 353658 353658 PHARMACY EXPENSE 294923 294923 PROVISION FOR DOUBTFUL 196090 196090 LAB EXPENSE 104324 104324 186224 158495 27729 12523872 11611451 899377 13044 33226 34830 1436251 585635 1917060 2472554 1257 188 14104078 10451246 4015650 3652832 1776799 2175959 385971 19648 12043 9585862 8934041 1142328 1167235 2600 1500 3040000 2490000 32476 34079 46800 62400 4264204 3755214 X 5319795 5176964 1863 1863 5321658 5178827 9585862 8934041 -260832 118001 0 X 0 1 X 1 0 X 23552 71680 16546 243047 15941 370766 13548498 14022249 12530270 12709539 12139630 64950186 13572050 14093929 12546816 12952586 12155571 65320952 0 0 0 65320952 111209 39222 58339 53223 52922 314915 32866 7813 40679 144075 47035 58339 53223 52922 355594 13781 19736 50482 62869 62738 209606 13729906 14160700 12655637 13068678 12271231 65886152 0.99140 0.98920 0.00540 0.00790 X 0 1 X 9478634 6946874 2531760 4413976 3340500 1073476 211468 163872 47596 3652832 REFUNDABLE ENTRANCE FEE 62400 62400 X 12383225 118001 118001 12265224 -2184 -2184 12263040 12526056 2184 2184 12523872 0 12523872 PART IV, LINE 2B: LYCOMING COMMUNITY CARE, INC. PROVIDES TRUST FUND SERVICES FOR RESIDENTS' PERSONAL FUNDS IN ACCORDANCE WITH STATE REGULATIONS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE CORPORATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD IS MET. MANAGEMENT DETERMINED THAT THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2012 AND 2011. THE CORPORATION'S FEDERAL RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX AND THE FEDERAL EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990-T) FOR YEARS ENDING PRIOR TO 2009 ARE NO LONGER SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE ("IRS"). PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -2,184. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 2,184. FORM 990, PART VI, SECTION B, LINE 11 A DRAFT COPY OF THE FORM 990 WAS PROVIDED TO ALL BOARD MEMBERS VIA EMAIL AND THEY WERE GIVEN THE OPPORTUNITY TO DISCUSS ANY QUESTIONS WITH THE CFO. THE PRESIDENT OF THE BOARD REVIEWED THE FORM IN DETAIL WITH THE CFO AND APPROVED THE RETURN FOR RELEASE. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST STATEMENTS ARE REQUIRED TO BE UPDATED AND SIGNED ON AN ANNUAL BASIS BY ALL BOARD MEMBERS AND OFFICERS OF THE CORPORATION. THE STATEMENTS ARE REVIEWED BY THE EXECUTIVE DIRECTOR. THE POLICY REQUIRES THAT NO BOARD MEMBER OR OFFICER MAY ENTER INTO ANY TRANSACTION OR ARRANGEMENT WITH AN OUTSIDE PARTY, EITHER DIRECTLY OR INDIRECTLY, WHICH WILL RESULT IN PERSONAL BENEFIT AT THE EXPENSE OF THE CORPORATION WITHOUT THE KNOWLEDGE AND CONSENT OF THE CORPORATION. INDIVIDUALS WHO VIOLATE THIS POLICY ARE, AMONG OTHER THINGS, SUBJECT TO LOSS OF THEIR ELECTION TO THE BOARD OR THEIR ELECTION AS AN OFFICER. FORM 990, PART VI, SECTION B, LINE 15 A PERSONNEL COMMITTEE APPOINTED BY THE BOARD OF DIRECTORS APPROVES SALARIES FOR DEPARTMENT HEAD POSITIONS. THE SALARY RANGES FOR THE VARIOUS POSITIONS ARE COMPARED TO AVAILABLE DATA ON SALARIES FROM OTHER NURSING FACILITIES IN THE STATE TO ENSURE COMPENSATION DOES NOT EXCEED FAIR MARKET VALUE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.