2012-11-05T08:45:16-06:00 2011-12-31 231973945 PARENTEBEARD LLC 400 MARKET STREET WILLIAMSPORT PA 17701 990 2011-01-01 232626796 LYCOMING COMMUNITY CARE INC LYCO 5704333161 2140 WARRENSVILLE RD MONTOURSVILLE PA 17754 STEPHEN FRY 5704333161 2012-11-01 1 JULIUS C GREEN CPA JD P00350393 5703236023 2011 2016-02-24 21:20:13Z STEPHEN FRY 2140 WARRENSVILLE RD MONTOURSVILLE PA 17754 13444320 0 X WWW.VALLEYVIEW.ORG X 1990 PA PROVIDED SKILLED AND INTERMEDIATE NURSING CARE TO THE MEN AND WOMEN OF LYCOMING COUNTY. 8 8 314 0 0 0 16546 243047 12530270 12709539 -9144 41990 55561 66868 12593233 13061444 0 0 0 0 8363958 7691009 0 0 12492 4708399 4199353 13072357 11890362 -479124 1171082 9003605 9585862 4822552 4264204 4181053 5321658 PROVIDED SKILLED AND INTERMEDIATE NURSING CARE FOR 52,938 RESIDENT DAYS TO THE MEN AND WOMEN OF LYCOMING COUNTY AND SURROUNDING AREAS. 0 0 10999176 12709539 PROVIDED SKILLED AND INTERMEDIATE NURSING CARE FOR 52,938 RESIDENT DAYS TO THE MEN AND WOMEN OF LYCOMING COUNTY AND SURROUNDING AREAS. OF THE TOTAL 52,938 RESIDENT DAYS OF NURSING CARE PROVIDED, 36,574 DAYS WERE PROVIDED TO RESIDENTS RECEIVING MEDICAID. THE MEDICAID DAILY REIMBURSEMENT RATE WAS APPROXIMATELY $173.75 PER DAY COMPARED TO THE DAILY PRIVATE PAY RATE OF $216 FOR SKILLED NURSING AND $222 FOR DEMENTIA CARE. THE ESTIMATED AVERAGE SHORTFALL FOR MEDICAID REIMBURSEMENT IS PROJECTED AT $17.33 PER MEDICAID DAY. BASED ON THIS ESTIMATE, THE ORGANIZATION PROVIDED APPROXIMATELY $634,000 IN CHARITY CARE FOR 2011. 10999176 1 1 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 0 1 12 0 1 314 1 0 0 0 0 0 0 0 0 0 0 X 8 8 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 STEPHEN E SCHOPFER 1.00 X X 0 0 0 NICHOLAS CATINO 1.00 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 LOUISE EAKIN 40.00 X 102916 0 6589 STEPHEN FRY 40.00 X 84950 0 1441 LOUANN SIMPSON 40.00 X 79013 0 1396 266879 0 9426 1 0 0 0 SODEXHO PO BOX 360170 PITTSBURGH PA 152516170 FOOD SERVICE 788835 ENDURACARE PO BOX 53064 PHOENIX AZ 85072 REHAB 678780 OMNICARE INC PO BOX 631285 CINCINNATI OH 452531285 PHARMACY 298377 3 243047 243047 PATIENT SERVICE REVENU 623000 12709539 12709539 12709539 48723 48723 4500 3393 1107 1107 1107 371817 872 379422 0 -7605 872 -6733 -6733 2953 61 2892 2892 TV CABLE 517000 19175 19175 BARBER/BEAUTICIAN SERV 446199 17591 17591 PURCHASE DISCOUNTS 900099 10233 10233 15870 15870 62869 13061444 12709539 0 108858 276305 80409 195896 5897459 5537478 359981 23836 20065 3771 930710 879894 50816 562699 516933 45766 7562 7562 42548 42548 1920 1920 927968 851741 76227 22151 2194 7465 12492 930275 890692 39583 5288 5288 350359 326040 24319 5234 5234 6332 6332 168406 168406 658674 658674 164286 164286 PHARMACY EXPENSE 308316 308316 PA NURSING HOME ASSESSM 278911 278911 LAB EXPENSE 131733 131733 BARBER AND BEAUTY EXPEN 53767 53767 135623 123305 12318 11890362 10999176 878694 12492 36037 33226 1796297 1436251 1374266 1917060 2326 1257 13832054 9816404 3795822 4015650 1542272 1776799 427726 385971 28859 19648 9003605 9585862 1220607 1142328 1658 2600 3565000 3040000 32250 32476 3037 46800 4822552 4264204 X 4179190 5319795 1863 1863 4181053 5321658 9003605 9585862 X 1171082 -30477 X 0 1 1 X 0 X 24430 23552 71680 16546 243047 379255 13503022 13548498 14022249 12530270 12709539 66313578 13527452 13572050 14093929 12546816 12952586 66692833 0 0 0 66692833 198940 111209 39222 58339 53223 460933 31558 32866 7813 72237 230498 144075 47035 58339 53223 533170 47976 13781 19736 50482 62869 194844 13805926 13729906 14160700 12655637 13068678 67420847 0.98920 0.98810 0.00790 0.00960 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 9394183 6619925 2774258 4227810 3048610 1179200 210061 147869 62192 4015650 REFUNDABLE ENTRANCE FEE 46800 46800 13061444 11890362 1171082 -30477 -30477 1140605 13034421 -30477 -30477 13064898 -3454 -3454 13061444 11893816 3454 3454 11890362 0 11890362 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: 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 2011 AND 2010. THE CORPORATION'S FEDERAL RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX FOR 2008, 2009, AND 2010 AND THE FEDERAL EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990-T) FOR 2009 AND 2010 REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE ("IRS"). PART XII, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -3,393. GAMING EXPENSES -61. PART XIII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 3,393. GAMING EXPENSES 61. 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. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -30,477.