BROOKVILLE HOSPITAL: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- BROOKVILLE HOSPITAL (EIN 25-0984595)
- Tax period
- 2010-07-01 to 2011-06-30
- Filed
- 2012-05-14
- IRS object ID
- 201241359349305634
- Schema version
- 2010v3.7
- 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 | 2012-05-14T16:47:58-04:00 | Timestamp |
| Tax Period End Date | 2011-06-30 | 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 | 2010-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 250984595 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BROOKVILLE HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | BROO | NameControl |
| Phone | 8148492312 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 HOSPITAL ROAD | AddressLine1 |
| City | BROOKVILLE | City |
| State | PA | State |
| ZIP Code | 15825 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JULIANNE PEER | Name |
| Title | VP OF FINANCE | Title |
| Date Signed | 2012-05-11 | 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 | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JOHN S SUTIKA | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 HOSPITAL ROAD | AddressLine1 |
| City | BROOKVILLE | City |
| State | PA | State |
| ZIP Code | 15825 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 28913193 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.BROOKVILLEHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1915 | YearFormation |
| State Legal Domicile | PA | StateLegalDomicile |
| Activity Or Mission Description | BROOKVILLE HOSPITAL PROVIDES QUALITY HEALTHCARE SERVICES, INCLUDING OUTPATIENT, INPATIENT, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, AND LAB SERVICES, AMONG OTHERS, TO ITS COMMUNITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 3 | NbrIndependentVotingMembers |
| Total Nbr Employees | 284 | TotalNbrEmployees |
| Total Nbr Volunteers | 40 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 315950 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 272249 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 26553772 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 28536712 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 59156 | InvestmentIncomePriorYear |
| Investment Income Current Year | 49191 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 23196 | OtherRevenuePriorYear |
| Other Revenue Current Year | 34529 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 26952074 | TotalRevenuePriorYear |
| Total Revenue Current Year | 28892681 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 3210 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 12053825 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 12285432 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 14098547 | OtherExpensePriorYear |
| Other Expenses Current Year | 15425266 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 26152372 | TotalExpensesPriorYear |
| Total Expenses Current Year | 27713908 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 799702 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1178773 | RevenuesLessExpensesCY |
| Total Assets BOY | 20871606 | TotalAssetsBOY |
| Total Assets EOY | 23573285 | TotalAssetsEOY |
| Total Liabilities BOY | 11937398 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 13464824 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 8934208 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 10108461 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO PROVIDE QUALITY HEALTHCARE SERVICES TO THE COMMUNITIES THAT WE SERVE IN A COST-EFFECTIVE MANNER. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | true | SignificantChange |
| Expense | 19076390 | Expense |
| Revenue | 22829370 | Revenue |
| Description | BROOKVILLE HOSPITAL PROVIDES A WIDE VARIETY OF OUTPATIENT SERVICES TO THE COMMUNITY. WE HAVE A PHYSICIAN STAFFED 24 HOUR EMERGENCY DEPARTMENT THAT PROVIDED OVER 9,800 VISITS THIS YEAR AND A FAMILY PRACTICE CLINIC THAT HAD OVER 6,500 VISITS. WE ALSO PROVIDE OUTPATIENT PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY, GENERAL RADIOLOGY, CAT SCAN, MRI, PET, ULTRASOUND, NUCLEAR MEDICINE, CARDIOLOGY, LABORATORY SERVICES AND A PAIN CLINIC, AND OUTPATIENT PSYCH SERVICES. OUR SURGEONS PERFORMED OVER 1,840 SURGERIES AND OUR HOME HEALTH AGENCY PROVIDED OVER 5,900 VISITS. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 4769098 | Expense |
| Revenue | 5707342 | Revenue |
| Description | BROOKVILLE HOSPITAL IS A 35 BED HOSPITAL THAT PROVIDED INPATIENT SERVICES TO 1,292 PATIENTS THIS YEAR. INPATIENT SERVICES INCLUDED TREATMENTS FOR BOTH MEDICAL AND SURGICAL PATIENTS. MANY OF OUR PATIENTS WERE TREATED IN THE GERO-PSYCHIATRIC UNIT OF THE HOSPITAL. THIS UNIT SPECIALIZES IN PSYCHIATRIC DISORDERS FOR PATIENTS OVER THE AGE OF 55. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 23845488 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | 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 | true | 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 | false | 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 | false | 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 | 42 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 284 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| 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 | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 3 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | true | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | true | InvestmentInJointVenture |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedure |
| 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 | JULIANNE PEER | NamePerson |
| Telephone Number | 8148491408 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 HOSPITAL ROAD | AddressLine1 |
| City | BROOKVILLE | City |
| State | PA | State |
| ZIP Code | 15825 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (16 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| JOHN SUTIKA | |||||||
| CEO/DIRECTOR | 40.0 | X | X | 0 | 0 | 0 | |
| L GENE HOAK | |||||||
| SECRETARY | 3.0 | X | X | 0 | 0 | 0 | |
| RONALD KING | |||||||
| CHAIRMAN | 3.0 | X | X | 0 | 0 | 0 | |
| TROY HARPER | |||||||
| TREASURER | 3.0 | X | X | 0 | 0 | 0 | |
| TIMOTHY PENDLETON MD | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| RICHARD PFINGSTLER | |||||||
| VICE CHAIRMAN | 3.0 | X | X | 0 | 0 | 0 | |
| RAYMOND GRAECO | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| SCOTT FORADORA | |||||||
| DIRECTOR | 3.0 | X | 0 | 0 | 0 | ||
| W JAY CHAMBERLAIN | |||||||
| DIRECTOR THROUGH 12/2010 | 1.0 | X | 0 | 0 | 0 | ||
| EDWARD S NASUTI | |||||||
| DIRECTOR BEG. 1/2011 | 1.0 | X | 0 | 0 | 0 | ||
| JULIANNE PEER | |||||||
| VP OF FINANCE | 40.0 | X | 95917 | 0 | 0 | ||
| JAYESHKUMAR PATEL MD | |||||||
| PYSICIAN | 40.0 | 280009 | 0 | 15264 | X | ||
| CRAIG BURKE DO | |||||||
| PHYSICIAN | 40.0 | 186853 | 0 | 15264 | X | ||
| PAUL HARVEY MD | |||||||
| PHYSICIAN | 40.0 | 196976 | 0 | 10836 | X | ||
| EMERSON TURNBULL | |||||||
| CRNA | 40.0 | 164544 | 0 | 15264 | X | ||
| ERNEST BARCH | |||||||
| PHYSICIAN | 40.0 | 201458 | 0 | 15264 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1125757 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 71892 | TotalOtherCompensation |
| Number Individuals GT100 K | 6 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|
| NORTHFORK REHABILITATION | |
| PHYSICAL THERAPY | 765353 |
| SHARED IMAGING INC | |
| MRI SERVICES | 235752 |
| MEDICUS HEALTHCARE SOLUTIONS | |
| PHYSICIAN SERVICES | 1708671 |
| ASSOCIATED CLINICAL LABORATORIES | |
| LAB TESTING | 334961 |
| DUBOIS REGIONAL MED CENTER | |
| HOSPITAL MGMT | 2094572 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 12 | NumberOfContractorsGT100K |
| Fundraising Events | 27127 | FundraisingEvents |
| Government Grants | 193922 | GovernmentGrants |
| All Other Contributions | 51200 | AllOtherContributions |
| Total Contributions | 272249 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | 26086071 | 26086071 |
| MEDICAL RECORDS | 900099 | 1941 | 1941 |
| MEAL TICKETS | 722210 | 76025 | 76025 |
| OTHER REVENUE | 900099 | 2372675 | 2372675 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 28536712 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 34678 | TotalRevenueColumn |
| Exclusion | $34,678 | 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 | 37713 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 37713 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 37713 | TotalRevenueColumn |
| Exclusion | $37,713 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 19207 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 4694 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 14513 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 14513 | TotalRevenueColumn |
| Exclusion | $14,513 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 7235 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 27127 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 12293 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -5058 | TotalRevenueColumn |
| Exclusion | -$5,058 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Gaming | 5399 | GrossIncomeGaming |
| Gaming Direct Expenses | 3525 | GamingDirectExpenses |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1874 | TotalRevenueColumn |
| Exclusion | $1,874 | ExclusionAmount |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 28892681 | TotalRevenueColumn |
| Related Or Exempt Function Income | 28536712 | RelatedOrExemptFunctionIncome |
| Exclusion | $83,720 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3210 | Total |
| Program Services | 3210 | ProgramServices |
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 | 95917 | Total |
| Management And General | 95917 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 158454 | Total |
| Management And General | 158454 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9322959 | Total |
| Program Services | 8769364 | ProgramServices |
| Management And General | 553595 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6280 | Total |
| Program Services | 5750 | ProgramServices |
| Management And General | 530 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2057280 | Total |
| Program Services | 1883723 | ProgramServices |
| Management And General | 173557 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 644542 | Total |
| Program Services | 590167 | ProgramServices |
| Management And General | 54375 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2094572 | Total |
| Program Services | 1598833 | ProgramServices |
| Management And General | 495739 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 51033 | Total |
| Management And General | 51033 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 89152 | Total |
| Management And General | 89152 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5086021 | Total |
| Program Services | 4423175 | ProgramServices |
| Management And General | 662846 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 55340 | Total |
| Management And General | 55340 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 605935 | Total |
| Program Services | 314099 | ProgramServices |
| Management And General | 291836 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22068 | Total |
| Program Services | 13925 | ProgramServices |
| Management And General | 8143 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 625241 | Total |
| Program Services | 421549 | ProgramServices |
| Management And General | 203692 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54334 | Total |
| Program Services | 51833 | ProgramServices |
| Management And General | 2501 | 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 | 29608 | Total |
| Program Services | 13630 | ProgramServices |
| Management And General | 15978 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 287514 | Total |
| Program Services | 219466 | ProgramServices |
| Management And General | 68048 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1436763 | Total |
| Program Services | 1096713 | ProgramServices |
| Management And General | 340050 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 437190 | Total |
| Program Services | 95470 | ProgramServices |
| Management And General | 341720 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT | 1502241 | 1502241 | |
| LICENSES, DUES & SUBSCRIPTIONS | 95895 | 43697 | 52198 |
| REPAIRS & MAINTENANCE | 200998 | 170346 | 30652 |
| MEDICAL SUPPLIES & DRUGS | 2593721 | 2593721 | |
| RECRUITING | 130314 | 7250 | 123064 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27326 | Total |
| Program Services | 27326 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27713908 | Total |
| Program Services | 23845488 | ProgramServices |
| Management And General | 3868420 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2368282 | BOY |
| EOY | 46079 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3592972 | BOY |
| EOY | 5583658 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4372196 | BOY |
| EOY | 3811635 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 67682 | BOY |
| EOY | 22563 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 60468 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 86382 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 441386 | BOY |
| EOY | 480016 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 441139 | BOY |
| EOY | 462187 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 38975681 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 29853920 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7474452 | BOY |
| EOY | 9121761 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30395 | BOY |
| EOY | 17607 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1996720 | BOY |
| EOY | 3967311 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20871606 | BOY |
| EOY | 23573285 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4640343 | BOY |
| EOY | 5262847 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10640 | BOY |
| EOY | 658945 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7286415 | BOY |
| EOY | 7543032 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11937398 | BOY |
| EOY | 13464824 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8664491 | BOY |
| EOY | 9835803 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 96988 | BOY |
| EOY | 104449 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 172729 | BOY |
| EOY | 168209 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8934208 | BOY |
| EOY | 10108461 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20871606 | BOY |
| EOY | 23573285 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 1178773 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -4520 | 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 | true | DirectContactLegislators |
| Direct Contact Legislators | $12,538 | DirectContactLegislatorsAmount |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $3,603 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 16141 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
| Form4720 Filed4912 Tax | false | Form4720Filed4912Tax |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DIRECT CONTACT WITH LEGISLATORS | Identifier |
| Return Reference | SCHEDULE C, PART II-B, LINE 1(G) | ReturnReference |
| Explanation | THE ORGANIZATION CONTRACTED WITH S.R. WOJDAK AND ASSOC. FOR STATE FUNDING LOBBYING ACTIVITIES. OTHER LOBBYING ACTIVITIES SCHEDULE C, PART II-B, LINE 1(I) THE ORGANIZATION PAYS DUES TO THE HOSPITAL COUNCIL AND TO THE HOSPITAL AND HEALTH SYSTEM ASSOCIATION OF PA (HAP). A PORTION OF THESE DUES ARE USED FOR LOBBYING ACTIVITIES. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 205546 | OtherCostOrOtherBasis |
| Book Value | 205546 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 8138354 | OtherCostOrOtherBasis |
| Depreciation | 5887764 | Depreciation |
| Book Value | 2250590 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 204286 | OtherCostOrOtherBasis |
| Depreciation | 185401 | Depreciation |
| Book Value | 18885 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 29004401 | OtherCostOrOtherBasis |
| Depreciation | 22585468 | Depreciation |
| Book Value | 6418933 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1423094 | OtherCostOrOtherBasis |
| Depreciation | 1195287 | Depreciation |
| Book Value | 227807 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 9121761 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (6 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| OTHER RECEIVABLES | 2309600 |
| INTEREST RECEIVABLE | 23512 |
| OTHER ASSETS | 12991 |
| BEN INT IN PERPETUAL TRUST | 168209 |
| EST AMT DUE FROM THIRD PARTIES | 86363 |
| DUE FROM AFFILIATES | 1366636 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 3967311 | TotalBookValueOtherAssets |
| Total Revenue | 28892681 | TotalRevenue |
| Total Expenses | 27713908 | TotalExpenses |
| Excess Or Deficit For Year | 1178773 | ExcessOrDeficitForYear |
| Other | -$4,520 | OtherAmount |
| Total Adjustments | -4520 | TotalAdjustments |
| Excess Or Deficit Per FS | 1174253 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 28903979 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | -4520 | OtherRevenues |
| Revenue Not Rptd F990 | -4520 | RevenueNotRptdF990 |
| Revenue Subtotal | 28908499 | RevenueSubtotal |
| Other Revenues Not Included | -15818 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | -15818 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 28892681 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 27729726 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 15818 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 15818 | ExpensesNotRptdF990 |
| Expenses Subtotal | 27713908 | ExpensesSubtotal |
| Total Expenses Per Form990 | 27713908 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| 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 RECONCILING CHANGE IN NET ASSETS | SCHEDULE D, PART XI, LINE 8 | CHANGE IN BENEFICIAL INTEREST IN TRUST $(4,520) |
| OTHER REVENUE INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12 | SCHEDULE D, PART XII, LINE 2D | CHANGE IN BENEFICIAL INTEREST IN TRUST $(4,520) |
| OTHER REVENUE INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1 | SCHEDULE D, PART XII, LINE 4B | SPECIAL EVENTS EXPENSES RECLASSED TO REVENUE $(15,818) |
| OTHER EXPENSE INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25 | SCHEDULE D, PART XIII, LINE 2D | SPECIAL EVENTS EXPENSES RECLASSED TO REVENUE $15,818 |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF OUTING | NameOfEvent1 |
| Gross Receipts Event1 | 23424 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 18520 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 4904 | GrossRevenueEvent1 |
| Non Cash Prizes Event1 | 2220 | NonCashPrizesEvent1 |
| Food And Beverage Event1 | 2160 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 2744 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 1736 | OtherDirectExpensesEvent1 |
| Name Of Event2 | 1-100 EVENT | NameOfEvent2 |
| Gross Receipts Event2 | 10938 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 8607 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 2331 | GrossRevenueEvent2 |
| Rent Facility Costs Event2 | 445 | RentFacilityCostsEvent2 |
| Food And Beverage Event2 | 2331 | FoodAndBeverageEvent2 |
| Other Direct Expenses Event2 | 657 | OtherDirectExpensesEvent2 |
| Total Number Of Other Events | 0 | TotalNumberOfOtherEvents |
| Gross Receipts Total | 34362 | GrossReceiptsTotal |
| Charitable Contributions Total | 27127 | CharitableContributionsTotal |
| Gross Revenue Total Events | 7235 | GrossRevenueTotalEvents |
| Non Cash Prizes Total Events | 2220 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 445 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 4491 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 2744 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 2393 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 12293 | DirectExpenseSummaryEvents |
| Net Income Summary | -5058 | NetIncomeSummary |
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 | false | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | false | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 90968 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 90968 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00350 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2615496 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2082604 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 532892 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02030 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 294559 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 86233 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 208326 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00790 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3001023 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2168837 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 832186 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03170 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 26062 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7659 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 18403 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3210 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3210 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 29272 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7659 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 21613 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3030295 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2176496 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 853799 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03250 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReported |
| Bad Debt Expense | $683,649 | BadDebtExpenseAmount |
| Amount Attributable To | 93660 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 10429068 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 10576876 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -147808 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| 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 | BROOKVILLE HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 HOSPITAL ROAD | AddressLine1 |
| City | BROOKVILLE | City |
| State | PA | State |
| ZIP Code | 15825 | 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 | BROOKVILLE HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 4 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (4 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| PHYSICAL THERAPY BUILDING | ||||
| 88 INDUSTRIAL PARK RD | BROOKVILLE | PA | 15825 | OUTPATIENT PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY |
| CHARLES PROFESSIONAL BUILDING | ||||
| 240 ALLEGHENY BLVD | BROOKVILLE | PA | 15825 | FAMILY PRACTICE CLINIC, GENERAL RADIOLOGY, HOME HLTH |
| DAVID L MILLER MEDICAL CENTER | ||||
| BROOKVILLE STREET | FAIRMOUNT CITY | PA | 16224 | RADIOLOGY, LAB, PHYSICAL AND OCCUPATIONAL THERAPY |
| ALLEGHENY HEALTH CENTER | ||||
| 22 INDUSTRIAL PARK RD | BROOKVILLE | PA | 15825 | RURAL HEALTH CLINIC |
Form990 Schedule H Part VI Form990ScheduleHPartVI (10 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| PERCENT OF TOTAL EXPENSE | SCHEDULE H, PART I, LINE 7 | TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25 OF THE FORM 990 WAS REDUCED BY BAD DEBT EXPENSE. |
| COST TO CHARGE RATIO | SCHEDULE H, PART I, LINE 7 | THE COST TO CHARGE RATIO COMPUTED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATIONS ON IRS WORKSHEETS 1 AND 3. |
| 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: THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HOSPITAL BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. THE ORGANIZATION CALCULATED BAD DEBT AT COST BY TAKING THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TIMES THE RATIO OF PATIENT CARE COST TO CHARGES USED FOR SCHEDULE H, PART I CALCULATIONS. BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING POVERTY LIMIT DEMOGRAPHIC INFORMATION OBTAINED THROUGH THE U.S. CENSUS BUREAU. THE MOST RECENT US CENSUS BUREAU INDICATES THAT 13.7 PERCENT OF JEFFERSON COUNTY WAS CONSIDERED TO LIVE IN POVERTY. |
| COMMUNITY BENEFIT | SCHEDULE H, PART III, SECTION B, LINE 8 | 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 | A CHARITY CARE APPLICATION IS GOOD FOR SIX MONTHS ONCE APPROVED. ALSO PATIENTS ARE SENT THREE STATEMENTS BEFORE BEING SENT TO COLLECTION AGENCY, SO THEY HAVE TIME TO CONTACT THE BILLING OFFICE FOR CHARITY CARE. |
| NEEDS ASSESSMENT: | A COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED BY TRIPP UMBACH BETWEEN MARCH AND AUGUST 2011 FOR CLEARFIELD AND JEFFERSON COUNTIES. NEEDS IDENTIFIED INCLUDED LACK OF ECONOMIC DEVELOPMENT AND GROWTH, HIGH UNEMPLOYMENT RATES, AND AN UNATTRACTIVE REGION FOR YOUNG FAMILIES REGARDING POOR ECONOMIC CONDITIONS. THE OVERALL WELL-BEING OF THE AREA INDICATES CHRONIC DISEASES, ENGAGEMENT OF POOR HEALTH BEHAVIORS, LACK OF HEALTH EDUCATION, DIET AND EXERCISE OPTIONS, DRUG AND ALCOHOL ABUSE, AND MENTAL HEALTH ISSUES. THERE ARE LIMITED FUNDING RESOURCES AT HEALTH AND COMMUNITY ORGANIZATIONS, TRANSPORTATION ISSUES, AND HOUSING LIMITATIONS, AS WELL AS ACCESS ISSUES FOR LARGE UNDERINSURED AND UNINSURED POPULATIONS, LIMITED PROGRAMS TO ADDRESS HEALTH NEEDS, LIMITED BASIC CARE SERVICES, AND AN INABILITY AND/OR LACK OF KNOWLEDGE ON HOW TO ACCESS EXISTING HEALTH SERVICES. THE TOP COMMUNITY HEALTH NEEDS IDENTIFIED WERE ACCESSING PRIMARY HEALTHCARE AND PREVENTIVE CARE, BASIC COMMUNITY SERVICES (ESPECIALLY DENTAL SERVICES), DRUG/ALCOHOL PREVENTION, AND HEALTH EDUCATION/COMMUNICATION. | |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: | INFORMATION IS POSTED AT REGISTRATION AREA AND IN WAITING AREAS. SELF PAY PATIENTS ARE GIVEN INFORMATION WITH THE FIRST BILL. THE CARE MANAGEMENT DEPARTMENT WORKS WITH ALL INPATIENTS AND WITH OUTPATIENTS AS NEEDED/REQUESTED. | |
| COMMUNITY INFORMATION: | BROOKVILLE HOSPITAL SERVES BROOKVILLE AND THE SURROUNDING COMMUNITIES. THE SERVICE AREA EXTENDS NORTH TO MARIENVILLE AND SOUTH TO NEW BETHLEHEM, AND INCLUDES JEFFERSON COUNTY, FOREST COUNTY AND CLARION COUNTY. THIS SERVICE AREA IS IN A RURAL PART OF WESTERN PENNSYLVANIA, WITH MANY RESIDENTS LIVING BELOW OR WELL BELOW THE NATIONAL AND STATE INCOME AVERAGE. ACCORDING TO THE US CENSUS BUREAU'S MOST RECENT DATA, APPROXIMATELY 14 PERCENT OF INDIVIDUALS LIVING IN THIS AREA WERE CONSIDERED TO LIVE IN POVERTY. THE MEDIAN HOUSEHOLD INCOME IN THE SERVICE AREA IS APPROXIMATELY $38,500. FROM THE RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT, THE SERVICE AREA INCLUDES 22% OF UNINSURED ADULTS, 7.8% OF CHILDREN WHO ARE UNINSURED. UNEMPLOYMENT RATES FOR CLEARFIELD AND JEFFERSON COUNTY WERE JUST OVER 8%. THE MEDIAN AGE OF THE POPULATION IS ABOUT 42, WITH ABOUT 18% 65 AND OVER. CLEARFIELD COUNTY HAS A 45.9% URBAN POPULATION, WHILE JEFFERSON HAS A 33.8% URBAN POPULATION. | |
| OTHER INFORMATION: | BROOKVILLE HOSPITAL PARTICIPATES IN AND PROVIDES MANY HEALTH FAIR AND COUNSELING OPPORTUNITIES THROUGHOUT THE YEAR, INCLUDING THOSE ASSOCIATED WITH MENTAL HEALTH, DIABETES, NUTRITION AND WEIGHT MANAGEMENT. ALSO, THE ORGANIZATION WORKS TO PROMOTE LEARNING THROUGH THE MEDICAL EXPLORERS PROGRAM AND LOCAL CAREER DAYS. | |
| AFFILIATED HEALTH CARE SYSTEM: | BROOKVILLE HOSPITAL HAS AN AFFILIATION AGREEMENT WITH DUBOIS REGIONAL MEDICAL CENTER, A 501(C)(3) NON-PROFIT ORGANIZATION. |
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 | true | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAYESHKUMAR PATEL MD | |||||||||||||
| 279964 | 0 | 0 | 0 | 45 | 0 | 0 | 0 | 15264 | 0 | 295273 | 0 | 0 | 0 |
| CRAIG BURKE DO | |||||||||||||
| 186655 | 0 | 0 | 0 | 198 | 0 | 0 | 0 | 15264 | 0 | 202117 | 0 | 0 | 0 |
| PAUL HARVEY MD | |||||||||||||
| 196595 | 0 | 0 | 0 | 381 | 0 | 0 | 0 | 10836 | 0 | 207812 | 0 | 0 | 0 |
| EMERSON TURNBULL | |||||||||||||
| 164475 | 0 | 0 | 0 | 69 | 0 | 0 | 0 | 15264 | 0 | 179808 | 0 | 0 | 0 |
| ERNEST BARCH | |||||||||||||
| 201401 | 0 | 0 | 0 | 57 | 0 | 0 | 0 | 15264 | 0 | 216722 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | BONUS AND NON-FIXED PAYMENTS | Identifier |
| Return Reference | SCHEDULE J, PART I, LINES 6A & 7 | ReturnReference |
| Explanation | JULIANNE PEER, VP OF FINANCE, RECEIVED A BONUS DURING CALENDAR YEAR 2010. THE BONUS WAS DETERMINED BASED ON VARIOUS GOALS OBJECTIVES, ENCOMPASSING FINANCIAL, GROWTH, QUALITY/SAFETY, PEOPLE, AND SERVICE ASPECTS OF PERFORMANCE. PART OF THE BONUS IS DETERMINED BASED ON OPERATING INCOME, AND THE BONUS IS PARTLY DETERMINED BASED ON BOARD DISCRETION. | Explanation |
Schedule L IRS990ScheduleL
Loan Table LoanTable (2 entries)
| Loan From OrganizationLoanFromOrganization | Original PrincipalOriginalPrincipalAmount | Balance DueBalanceDue | DefaultDefault | Approved By BoardApprovedByBoard | Written AgreementWrittenAgreement |
|---|---|---|---|---|---|
| TIMOTHY PENDLETON MD | |||||
| X | $135,358 | 22563 | false | true | true |
| TANIS PENDLETON MD | |||||
| X | $185,000 | 60468 | false | true | true |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 83031 | TotalBalanceDue |
Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| TANIS PENDLETON | |||
| SISTER OF T PENDLETON | 120000 | MEDICAL DIRECTOR FEES | false |
| LINDA GRINDER | |||
| SISTER OF RON KING | 38454 | EMPLOYEE OF HOSPITAL | false |
| BROOKCARE INC | |||
| SEE PART V | 103401 | SEE PART V | false |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | BUSINESS TRANSACTIONS WITH INTERESTED PERSONS | Identifier |
| Return Reference | SCHEDULE L, PART IV, LINE 3 | ReturnReference |
| Explanation | BOARD MEMBERS JOHN SUTIKA, RON KING, TROY HARPER, L. GENE HOAK, AND RICHARD PFINGSTLER ARE ALSO BOARD MEMBERS OF BROOKCARE, INC., A RELATED, CONTROLLED TAXABLE ENTITY. TRANSACTIONS INCLUDE RENT PAID TO BROOKCARE OF $88,810 AND PAYMENTS FOR HOUSEKEEPING SERVICES OF $14,591. THE ORGANIZATIONS ALSO SHARE SOME OTHER SERVICES, SUCH AS MAINTENANCE AND ACCOUNTING, BUT NO DOLLARS ARE EXCHANGED. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (11 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| BOARD MEMBER INDEPENDENCE | FORM 990, PART I, LINE 4 AND PART VI, SECTION A, LINE 1B | BOARD MEMBERS JOHN SUTIKA, RON KING, TROY HARPER, L. GENE HOAK, AND RICHARD PFINGSTLER ARE BOARD MEMBERS OF BROOKCARE, INC., A RELATED, CONTROLLED TAXABLE ENTITY. JOHN SUTIKA, TROY HARPER, GENE HOAK, AND RICHARD PFINGSTLER ARE CONSIDERED NON-INDEPENDENT SOLELY BECAUSE OF THIS RELATIONSHIP. SEE SCHEDULE L FOR DETAILS. ORGANIZATION'S MISSION FORM 990, PART III, LINE 1 MISSION STATEMENT: OUR MISSION IS TO PROVIDE QUALITY HEALTHCARE SERVICES TO THE COMMUNITIES THAT WE SERVE IN A COST EFFECTIVE MANNER. VISION STATEMENT: OUR VISION IS TO BE THE PROVIDER OF CHOICE IN PROMOTING HEALTHCARE FOR THE COMMUNITIES THAT WE SERVE. VALUE STATEMENT: -SERVICE EXCELLENCE THAT IS RESPONSIVE TO THE NEEDS OF THOSE WE SERVE. -DIGNITY & COMPASSION IN CARING FOR PATIENTS AND THEIR FAMILIES. -RESPECT TREATING EACH OTHER WITH FAIRNESS, HONESTY, AND TRUST. -TEAMWORK CHARACTERIZED BY UNITY OF PURPOSE, FLEXIBILITY AND EMPOWERMENT OF PEOPLE. -PLANNING BUILDING ON THE PAST AND ANTICIPATING THE FUTURE TO MEET OUR GOALS. -FINANCIAL HEALTH TO ENSURE THE CONTINUATION OF OUR MISSION. -ACTIVE PARTICIPATION BY PATIENTS AND FAMILIES IN THEIR HEALTHCARE. CHANGES TO PROGRAM SERVICES FORM 990, PART III, LINE 3 BROOKVILLE HOSPITAL CLOSED THE INTENSIVE CARE UNIT OF THE HOSPITAL ON JANUARY 1, 2011. |
| PROGRAM SERVICE | FORM 990, PART III, LINE 4A | BROOKVILLE HOSPITAL ESTIMATED VALUE OF FREE CARE, COMMUNITY SERVICE, CHARITABLE CONTRIBUTIONS, AND PROFESSIONAL AND COMMUNITY EDUCATION UNCOMPENSATED CARE MEDICAL ASSISTANCE/MA HMO SHORTFALL THE MEDICAL ASSISTANCE SHORTFALL IS THE DIFFERENCE BETWEEN THE COST TO PROVIDE HEALTH CARE TO MA PATIENTS AND WHAT THE HOSPITAL GETS PAID. FOR THE FISCAL YEAR ENDED JUNE 30, 2011, THIS SHORTFALL IS BEING COMPENSATED BY THE STATE AND FEDERAL GOVERNMENT. UNCOMPENSATED CHARITY CARE UNCOMPENSATED CHARITY CARE CHARGES WRITTEN OFF WERE $590,000. THE TOTAL DOES NOT INCLUDE BAD DEBT. THE HOSPITAL'S DETERMINATION OF INABILITY TO PAY DIFFERENTIATES CHARITY CARE FROM BAD DEBT, WHICH IS DETERMINED BY ABILITY TO PAY BUT UNWILLINGNESS TO DO SO. BAD DEBT THE HOSPITAL'S BAD DEBT AMOUNT WRITTEN OFF WAS $1,502,241 IN FY 2011. CHARITY CARE SERVICE THE HOSPITAL OWNS AND OPERATES THE ALLEGHENY HEALTH CENTER, A RURAL HEALTH CLINIC THAT IS AVAILABLE TO THE COMMUNITY. CHARITY CARE IS OFFERED TO PATIENTS OF THE CLINIC. COMMUNITY VOLUNTEER ASSISTANCE APPROXIMATELY 40 ACTIVE HOSPITAL VOLUNTEERS ASSISTED WITH THE PROVISION OF SERVICES BY THE HOSPITAL. THE AUXILIARY HAS ABOUT 25 MEMBERS THAT HOLD FUND RAISING EVENTS THROUGHOUT THE YEAR. THE FUNDS FROM THESE EVENTS ARE GIVEN BACK TO THE HOSPITAL FOR VARIOUS PROJECTS. PASTORAL CARE THE HOSPITAL HAS VOLUNTEER PASTORS THAT PERFORM MINISTRY TO THE HOSPITAL'S PATIENTS, PATIENTS' FAMILIES, AND STAFF. THIS SERVICE IS AVAILABLE 24 HOURS A DAY/ 7 DAYS A WEEK. PATIENT COMMENT SURVEYS THE HOSPITAL DISTRIBUTES SURVEYS TO INPATIENT, OUTPATIENTS, AMBULATORY SURGERY, EMERGENCY ROOM, AND HOME CARE PATIENTS TO ASSESS THE NEEDS OF THE PATIENTS IN OUR COMMUNITY REGARDING CARE AND OPPORTUNITIES TO IMPROVE THAT CARE. RESULTS ARE RECEIVED QUARTERLY AND COMPARED TO PRIOR RESULTS. TIME IS SPENT BY HOSPITAL STAFF IN EVALUATING RESULTS, WITH DEPARTMENTAL AND CONSUMER FOLLOW-UP AND WORK PROCESS REDESIGN TO IMPROVE CARE AND SATISFACTION. FOREIGN LANGUAGE & SIGN LANGUAGE INTERPRETING SERVICE THE HOSPITAL PROVIDES INTERPRETING SERVICES AT NO CHARGE TO FOREIGN LANGUAGE AND SIGN LANGUAGE SPEAKING PATIENTS AND PATIENT FAMILY MEMBERS. THESE SERVICES ARE PERFORMED ON AN ON-CALL BASIS. HOSPITAL EMPLOYEES WHO SPEAK A FOREIGN LANGUAGE OR ARE TRAINED IN SIGN LANGUAGE CAN BE USED TO TRANSLATE. THE HOSPITAL ALSO SUBSCRIBES TO AN ON-LINE INTERPRETING SERVICE, LANGUAGE LINE SERVICES. COMMUNITY EDUCATION / PUBLIC AFFAIRS ACTIVITIES IN OUR ROLES AS A LEADING PROVIDER OF HEALTH AND HEALTH-RELATED SERVICES TO JEFFERSON AND SURROUNDING COUNTIES, BROOKVILLE HOSPITAL RECOGNIZES OUR RESPONSIBILITY TO HELP THE PEOPLE OF OUR SERVICE AREA ACHIEVE AND MAINTAIN OPTIMUM HEALTH STATUS. THE ADMINISTRATION AND EDUCATION DEPARTMENT AND THE HEALTHY COMMUNITY COMMITTEE, OFFERS A SERIES OF PROGRAMS THROUGHOUT THE YEAR TO ACHIEVE THIS ROLE. BROOKVILLE HOSPITAL'S EDUCATIONAL EFFORTS ARE HEALTH-RELATED TO HELP FULFILL OUR MISSION OF HELPING PEOPLE IN OUR SERVICE AREA ACHIEVE AND MAINTAIN OPTIMUM HEALTH STATUS. EFFORTS IN THIS AREA INCLUDE FREE COMMUNITY HEALTH AND PATIENT EDUCATION PUBLICATIONS, MATERIALS TO PROMOTE HEALTH-RELATED ACTIVITIES, A PHYSICIAN REFERRAL LINE, AND PARTICIPATION IN LOCAL HEALTH FAIRS. PATIENT SUPPORT AND EDUCATION NUTRITIONAL COUNSELING A REGISTERED DIETITIAN IS AVAILABLE TO MEET WITH PATIENTS AND FAMILIES TO ASSESS NUTRITIONAL NEEDS AND DETERMINE APPROPRIATE NUTRITIONAL GOALS AND STRATEGIES. IN ADDITION, CLASSES ARE OFFERED THROUGHOUT THE YEAR TO THE COMMUNITY ON HEALTHY COOKING, LOW FAT DIET, DIABETES, CARDIO-VASCULAR HEALTH. MAMMOGRAMS IN COOPERATION WITH AREA PHYSICIANS, THE HOSPITAL PROVIDES REDUCED FEE MAMMOGRAMS WITH INTERPRETATIONS ON AN ANNUAL BASIS FOR HIGH RISK WOMEN WHO ARE LOW INCOME AND GENERALLY UNINSURED. COMMUNITY CLASSES THE HOSPITAL OFFERS A VARIETY OF COMMUNITY EDUCATION CLASSES THAT INCLUDES CPR, DIABETES EDUCATION, AND A NEW WEIGH OF LIFE. COMMUNITY BLOOD PRESSURES BROOKVILLE/NEW BETHLEHEM HOME HEALTH CARE NURSES PROVIDED BLOOD PRESSURE SCREENINGS AT A VARIETY OF LOCATIONS AT THE REQUEST OF AREA AGENCIES OF AGING. PATIENT EDUCATION PUBLICATIONS INCLUDES A VARIETY OF PUBLICATIONS SUCH AS THE PATIENT VISITOR GUIDE, THE PATIENT RIGHTS & RESPONSIBILITIES BOOKLET, ADVANCE DIRECTIVES, ETC. MATERIALS TO PROMOTE HEALTH-RELATED ACTIVITIES MATERIALS INCLUDE PROMOTING A VARIETY OF ACTIVITIES INCLUDING HEALTH SCREENING ADS, CANCER ASSESSMENT AND BREAST HEALTH AWARENESS MATERIALS, AND DIABETES EDUCATION CLASSES. VOLUNTARISM BROOKVILLE HOSPITAL'S WORK FORCE, ONE OF THE LARGEST IN THE REGION, IS COMPRISED OF MANY INDIVIDUALS WHO ENGAGE IN PERSONAL COMMUNITY SERVICE. THESE INDIVIDUALS GIVE OF THEIR TIME, TALENT, AND RESOURCES TO MAKE OUR COMMUNITY A BETTER PLACE TO LIVE AND WORK. PHYSICIANS AND EMPLOYEES VOLUNTEER THEIR TIME INDIVIDUALLY, BENEFITING COMMUNITY ORGANIZATIONS AND CAUSES. DURING THE YEAR. EMPLOYEES SPEND TIME PROVIDING CARE, EDUCATING THE COMMUNITY, AND SERVING ON BOARDS OF SOCIAL SERVICE AGENCIES. EMPLOYEES ALSO VOLUNTEER THEIR TIME FOR ADOPT A HIGHWAY, MARCH OF DIMES WALK AMERICA, THE M/S WALK, AND SIT ON VARIOUS COMMUNITY BOARDS. CONTRIBUTIONS EACH YEAR, BROOKVILLE HOSPITAL RECEIVES REQUESTS FOR FINANCIAL SUPPORT FROM NUMEROUS ORGANIZATIONS PROVIDING VALUABLE SERVICES TO OUR COMMUNITY. WHILE WE ARE A NOT-FOR-PROFIT ORGANIZATION, WE DO PROVIDE SUPPORT ON A LIMITED BASIS. UNITED FUND CAMPAIGN BROOKVILLE HOSPITAL EMPLOYEES CONTRIBUTE FUNDS TO THE COMMUNITY THROUGH THE UNITED FUND CAMPAIGN. INFECTION CONTROL COMMUNITY SERVICE THE INFECTION CONTROL DEPARTMENT SHARES POLICIES, PROCEDURES, AND EXPERTISE WITH OTHER HOSPITALS, NURSING HOMES, AND HEALTH CARE PROVIDERS. IN SOLVING INFECTION-RELATED PROBLEMS, HELPING TO DEVELOP PROGRAMS, ETC., AS REQUESTED. THE INFECTION CONTROL DEPARTMENT ALSO PROVIDES FOLLOW-UP TO BLOOD/BODY FLUID EXPOSURES EXPERIENCED BY HOSPITAL PERSONNEL. FOLLOW-UP IS GENERALLY COMPLICATED AND INVOLVES BLOOD WORK FOR EMPLOYEES AND PATIENTS AND COUNSELING AS PROVIDED AFTER EACH EXPOSURE. INFECTION CONTROL COMMUNICATES REGULARLY WITH ALL AREA HEALTH BUREAUS REPORTING COMMUNICABLE DISEASES, THUS AFFORDING CONTINUITY OF FOLLOW-UP INVESTIGATION FOR POTENTIALLY EXPOSED PATIENTS AND STAFF. COMMUNITY EDUCATION WE WORK WITH HIGH SCHOOL STUDENTS TO EDUCATE THEM ABOUT HEALTHCARE CAREERS THROUGH JOB FAIRS AT THE SCHOOL AND BY OFFERING JOB SHADOWING OPPORTUNITIES. BROOKVILLE HOSPITAL PROVIDED SHADOWING OPPORTUNITIES FOR HIGH SCHOOL STUDENTS IN A VARIETY OF CLINICAL AND NON-CLINICAL POSITIONS IN 2011. |
| BOARD MEMBER RELATIONSHIPS | FORM 990, PART VI, SECTION A, LINE 2 | RAY GRAECA AND JOHN SUTIKA HAVE A BUSINESS RELATIONSHIP. DELEGATED MANAGEMENT DUTIES FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION HAS A MANAGEMENT CONTRACT WITH DUBOIS REGIONAL MEDICAL CENTER (DRMC) IN WHICH DRMC PROVIDES INDIVIDUALS WHO PERFORM DUTIES AS THE CEO AND VP OF PATIENT CARE SERVICES FOR BROOKVILLE. THESE INDIVIDUALS REPORT TO THE BOARD OF THE HOSPITAL. |
| MEMBERS/STOCKHOLDERS | FORM 990, PART VI, SECTION A, LINE 6 | DUBOIS REGIONAL MEDICAL CENTER (DRMC) IS THE SOLE MEMBER OF BROOKVILLE HOSPITAL. |
| DECISION APPROVALS | FORM 990, PART VI, SECTION A, LINE 7A & 7B | PER THE BYLAWS, ARTICLE IV, SECTION 4.3, APART FROM EX-OFFICIO BOARD MEMBERS, THE BOARD SHALL BE DIVIDED INTO TWO CATEGORIES DESIGNATED AS THE BROOKVILLE HOSPITAL DIRECTORS AND THE DRMC MEMBERS. FOR EACH DRMC CATEGORY DIRECTOR POSITION WHOSE TERM IS DUE TO EXPIRE, THE REMAINING DRMC CATEGORY DIRECTORS SHALL NOMINATE CANDIDATE(S) TO FILL SUCH POSITION DURING THE NEXT TERM TO THE SOLE MEMBER'S NOMINATING COMMITTEE AT LEAST THIRTY (30) DAYS PRIOR TO THE ANNUAL MEETING OF THE SOLE MEMBER (OR A SPECIAL MEETING CALLED FOR THE PURPOSE OF APPROVING DIRECTORS). THE SOLE MEMBER'S NOMINATING COMMITTEE SHALL REVIEW EACH CANDIDATE IN ACCORDANCE WITH THE POLICIES, RULES AND REGULATIONS OF THE SOLE MEMBER. THE SOLE MEMBER'S NOMINATING COMMITTEE MAY DECLINE ANY CANDIDATE IN GOOD FAITH AND SHALL BE REQUIRED TO SUBMIT THE BASIS THEREOF TO DRMC CATEGORY DIRECTORS WHO NOMINATED SUCH CANDIDATE. IF A CANDIDATE IS DECLINED, THE DRMC CATEGORY DIRECTORS MUST NOMINATE ALTERNATIVE CANDIDATE(S) TO THE SOLE MEMBER'S NOMINATING COMMITTEE AND THE SAME PROCESS SHALL APPLY. PER THE ORGANIZATIONS BYLAWS ARTICLE III, SECTION 3.1(C): RESERVED POWERS. EXCEPT AS TO MATTERS DELEGATED EXCLUSIVELY TO THE BH CATEGORY DIRECTORS PURSUANT TO SECTION 4.1 1D(III), WITH RESPECT TO WHICH THE APPROVAL OF THE SOLE MEMBER SHALL NOT BE REQUIRED, THE BOARD OF DIRECTORS SHALL NOT HAVE THE POWER OR AUTHORITY TO TAKE ANY OF THE FOLLOWING ACTIONS ON BEHALF OF THE CORPORATION UNLESS (A) A PROPOSAL FOR ANY SUCH ACTION HAS BEEN ADOPTED BY THE BOARD OF DIRECTORS IN THE MANNER CONTEMPLATED BY ARTICLE IV OF THESE BYLAWS AND SUBMITTED TO THE SOLE MEMBER AND (B) THE ACTION HAS BEEN APPROVED BY THE SOLE MEMBER: (I) APPROVE ALL FUNDAMENTAL TRANSACTIONS OF THE CORPORATION AS DESCRIBED IN CHAPTER 59 OF THE NPCL, INCLUDING, WITHOUT LIMITATION, ANY AMENDMENTS TO ARTICLES OF THE CORPORATION AND ANY MERGER, CONSOLIDATION, DIVISION, TRANSFER OF ALL OR SUBSTANTIALLY ALL ASSETS, DISSOLUTION, OR LIQUIDATION OF THE CORPORATION OR ANY TRANSACTION OUTSIDE OF THE ORDINARY COURSE OF BUSINESS; (II) APPROVE ALL STRATEGIC PLANS, ALL CAPITAL AND OPERATING BUDGETS, AND ALL FEASIBILITY PLANS OF THE CORPORATION AND ANY AMENDMENTS THERETO; (III) APPROVE THE INCURRENCE, RE-FINANCING OR PREPAYMENT OF ALL INDEBTEDNESS OF THE CORPORATION IN EXCESS OF $10,000 WITH RESPECT TO EITHER A SINGLE TRANSACTION OR IN THE AGGREGATE FOR ANY ROLLING TWELVE-MONTH PERIOD OR THE DEFEASANCE OF ANY SUCH INDEBTEDNESS, OR SUCH OTHER AMOUNTS AS ESTABLISHED BY RESOLUTION OF THE SOLE MEMBER FROM TIME TO TIME; (IV) APPROVE THE SECURING OF ANY MORTGAGE, DEED OF TRUST, PLEDGE, SECURITY INTEREST OR OTHER ENCUMBRANCE OF SOME OR ALL OF THE CORPORATION'S ASSETS, OTHER THAN SECURITY INTERESTS ARISING FROM PURCHASE MONEY INDEBTEDNESS INCURRED BY THE CORPORATION AT THE TIME OF, OR WITHIN 20 DAYS AFTER, THE INITIAL ACQUISITION OF ANY FIXED ASSETS BY CORPORATION FOR THE PURPOSE OF FINANCING ALL OR ANY PART OF THE ACQUISITION COST THEREOF AND SECURED ONLY BY SUCH ASSETS ACQUIRED PROVIDED SUCH INDEBTEDNESS DOES NOT NEED TO OTHERWISE BE APPROVED AS SET FORTH IN (III) ABOVE OR (V) BELOW; (V) EXCEPT AS MAY BE INVOLVED THEREAFTER IN ORDINARY REPAIRS, MAINTENANCE AND REPLACEMENT, MAKE ANY CAPITAL EXPENDITURES OR ANY CAPITAL ADDITIONS OR IMPROVEMENTS REQUIRING THE PAYMENT OF MORE THAN (A) $10,000 FOR ANY ONE CAPITAL ITEM OR (B) IF ANY ONE CAPITAL ITEM IS LESS THAN SAID AMOUNT, $25,000 IN THE AGGREGATE FOR ANY ROLLING TWELVE-MONTH PERIOD, OR SUCH OTHER AMOUNTS AS ESTABLISHED BY RESOLUTION OF THE SOLE MEMBER FROM TIME TO TIME; (VI) APPROVE ANY AND ALL AMENDMENTS OF THE ARTICLES AND/OR THESE BYLAWS; (VII) APPROVE ANY CHANGE IN MISSION OR DIRECTION OF THE CORPORATION, INCLUDING, WITHOUT LIMITATION, APPROVE ANY DECISION TO ADD OR DISCONTINUE A LINE OF SERVICE, ADD OR DISCONTINUE AN INPATIENT OR OUTPATIENT LOCATION OR UNIT, OR ADD OR DISCONTINUE ANY OF THE CLINICAL SERVICES PROVIDED BY THE CORPORATION EITHER DIRECTLY OR INDIRECTLY; (VIII) APPROVE THE ESTABLISHMENT OF, OR TERMINATION OR WITHDRAWAL FROM, ANY SUBSIDIARY, JOINT VENTURE, OR OTHER PARTNERSHIP OR SHARED GOVERNANCE ARRANGEMENT; (IX) APPROVE ENTERING INTO OR AMENDING ANY AGREEMENT PURSUANT TO WHICH THE CORPORATION PAYS OR RECEIVES COMPENSATION ABOVE $50,000 DURING A PERIOD OF ONE YEAR OR LESS; (X) APPROVE ENTERING INTO, AMENDING, OR TERMINATING (A) ANY AGREEMENT WITH A MATERIAL THIRD PARTY PAYOR OF THE CORPORATION, AS DETERMINED BY THE SOLE MEMBER IN ITS SOLE DISCRETION, OR (B) ANY AGREEMENT BETWEEN THE CORPORATION AND THE SOLE MEMBER; (XI) APPROVE ENTERING INTO, AMENDING, OR TERMINATING ANY UNION OR COLLECTIVE BARGAINING AGREEMENT; AND (XII) APPROVE AND/OR TAKE ANY OTHER ACTIONS AS ARE RESERVED TO THE SOLE MEMBER BY VIRTUE OF THESE BYLAWS OR ANY RESOLUTIONS OF THE BOARD OF DIRECTORS ENACTED FROM TIME TO TIME OR AS REQUIRED OF THE SOLE MEMBER BY VIRTUE OF ITS STATUS AS MEMBER OF THE CORPORATION. |
| 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 FORM 990 IS REVIEWED BY THE CFO AND CEO AND A COPY IS PROVIDED TO THE BOARD MEMBERS WHO HAVE AN OPPORTUNITY TO ASK QUESTIONS BEFORE THE 990 IS FILED. |
| CONFLICT OF INTEREST POLICY | FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST STATEMENTS ARE REVIEWED BY THE CEO. ANY BOARD MEMBER WITH A CONFLICT OR POTENTIAL CONFLICT WOULD ABSTAIN FROM VOTING ON ANY MATTER RELATED TO THAT CONFLICT. ADDITIONALLY, THE BOARD MEMBERS ARE GIVEN A QUESTIONNAIRE TO COMPLETE TO ASSIST THE ORGANIZATION IN PROPERLY ANSWERING THE QUESTIONS FOR THE NEW FORM 990. CORPORATE OFFICERS AND KEY EMPLOYEES ARE ALSO REQUIRED TO ANNUALLY DISCLOSE CONFLICTS OF INTEREST. |
| CEO COMPENSATION REVIEW | FORM 990, PART VI, SECTION B, LINE 15A | THE CEO'S COMPENSATION IS NOT PAID BY BROOKVILLE HOSPITAL AS HIS SERVICES ARE PROVIDED TO THE HOSPITAL AS PART OF THE DUBOIS REGIONAL MEDICAL CENTER (DRMC) MANAGEMENT CONTRACT. DRMC DOES COMPLETE A SALARY REVIEW USING AN INDEPENDENT CONSULTANT AND A COMPENSATION COMMITTEE. HIS SALARY IS ULTIMATELY APPROVED BY THE BOARD OF DRMC. COMPENSATION WAS LAST REVIEWED IN JUNE 2011. |
| OFFICER, KEY EMPLOYEE COMPENSATION REVIEW | FORM 990, PART VI, SECTION B, LINE 15B | THE BOARD OF DIRECTORS USE AN INDEPENDENT CONSULTANT TO REVIEW BOTH THE VP OF FINANCE AND VP OF PATIENT CARE SERVICES SALARIES. SALARIES ARE APPROVED BY THE BOARD OF DIRECTORS. COMPENSATION WAS LAST REVIEWED IN JUNE 2011. |
| DOCUMENT DISCLOSURE | FORM 990, PART VI, SECTION C, LINE 19 | A FINANCIAL SUMMARY IS PUBLISHED IN THE PAPER EACH YEAR WITH THE ANNUAL REPORT TO THE COMMUNITY. THIS FINANCIAL SUMMARY AND ANNUAL REPORT CAN ALSO BE REVIEWED IN THE HOSPITAL ADMINISTRATIVE OFFICES. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC. |
| OTHER CHANGES IN NET ASSETS | FORM 990, PART XI, LINE 5 | CHANGE IN BENEFICIAL INTEREST IN TRUST $(4,520) |
Schedule R IRS990ScheduleR
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|
| BROOKCARE INC | |||||||||||
| 100 HOSPITAL ROAD | BROOKVILLE | PA | 15825 | 251477768 | OFFICE SPACE | PA | NA | C CORP | 18445 | 891750 | 1.00000 |
| JOSEPH BEACH TRUST | |||||||||||
| PO BOX 220 | INDIANA | PA | 15701 | 256171730 | TRUST | PA | NA | TRUST | 0 | 168209 | 1.00000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 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 | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | 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
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BROOKCARE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | J | TransactionType |
| Amount Involved | 88810 | AmountInvolved |