FURP.ORG / PUBLIC DATA EXPLORER

CLARION HOSPITAL: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
CLARION HOSPITAL (EIN 25-1010039)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-13
IRS object ID
201101339349303870
Schema version
2009v1.7
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-05-13T14:11:09-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1910 E ST LOUIS 200/PO BOX 1190AddressLine1
CitySPRINGFIELDCity
StateMOState
ZIP Code658062523ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN251010039EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CLARION HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCLARNameControl
Phone8142269500Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE HOSPITAL DRIVEAddressLine1
CityCLARIONCity
StatePAState
ZIP Code16214ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameVINCENT LAMORELLAName
TitleCFOTitle
Date Signed2011-05-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBrian D ToddName
Phone4178658701Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonVINCENT LAMORELLANameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1ONE HOSPITAL DRIVEAddressLine1
CityCLARIONCity
StatePAState
ZIP Code16214ZIPCode
FieldValueIRS element (for citing)
Gross Receipts52492166GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.CLARIONHOSPITAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1951YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionCLARION HOSPITAL IS THE COMMUNITY'S DYNAMIC RESOURCE FOR QUALITY HEALTHCARE, CONTINUOUS EDUCATION AND THE PROMOTION OF WELLNESS.ActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members5NbrIndependentVotingMembers
Total Nbr Employees562TotalNbrEmployees
Total Nbr Volunteers72TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year84672ContributionsGrantsPriorYear
Contributions Grants Current Year400334ContributionsGrantsCurrentYear
Program Service Revenue Prior Year46843019ProgramServiceRevenuePriorYear
Program Service Revenue CY46379801ProgramServiceRevenueCY
Investment Income Prior Year-660242InvestmentIncomePriorYear
Investment Income Current Year509636InvestmentIncomeCurrentYear
Other Revenue Prior Year407382OtherRevenuePriorYear
Other Revenue Current Year-205561OtherRevenueCurrentYear
Total Revenue Prior Year46674831TotalRevenuePriorYear
Total Revenue Current Year47084210TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year21908402SalariesEtcPriorYear
Salaries Etc Current Year21730607SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year24726094OtherExpensePriorYear
Other Expenses Current Year24159311OtherExpensesCurrentYear
Total Expenses Prior Year46634496TotalExpensesPriorYear
Total Expenses Current Year45889918TotalExpensesCurrentYear
Revenues Less Expenses Prior Year40335RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1194292RevenuesLessExpensesCY
Total Assets BOY43278314TotalAssetsBOY
Total Assets EOY38510675TotalAssetsEOY
Total Liabilities BOY19944932TotalLiabilitiesBOY
Total Liabilities EOY15118239TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY23333382NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY23392436NetAssetsOrFundBalancesEOY
Mission DescriptionPROVIDE EMERGENT, ACUTE, TRANSITIONAL, AND LONG-TERM MEDICAL SERVICES FOR THE RESIDENTS OF CLARION COUNTY AND ITS SURROUNDING COMMUNITIES. FOR ADDITIONAL INFORMATION, SEE SCHEDULE O.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense12681262Expense
Revenue15764493Revenue
DescriptionCLARION HOSPITAL PROVIDED SERVICES TO 2,726 INPATIENTS FOR MEDICAL AND SURGICAL SERVICES AS WELL AS INTENSIVE CARE SERVICES. CLARION HOSPITAL ALSO PROVIDED OBSTETRIC CARE FOR 293 NEW MOTHERS AND BABIES.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense24631056Expense
Revenue30606029Revenue
DescriptionCLARION HOSPITAL PROVIDED SERVICES TO 114,508 OUTPATIENTS AS WELL AS 18,507 EMERGENCY ROOM VISITS. INCLUDED BUT NOT LIMITED TO ARE RADIOLOGY SERVICES WHICH INCLUDE MRI, ULTRASOUND, CT, NUCLEAR MEDICINE AND X-RAY SERVICES, LABORATORY SERVICES, EKG AND PHYSICAL THERAPY SERVICES.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense7464Expense
Revenue9279Revenue
DescriptionCLARION HOSPITAL PROVIDED 28 EDUCATION AND SCREENING OPPORTUNITIES FOR THE COMMUNITY ATTENDED BY 2,785 MEMBERS OF THE COMMUNITY.Description
FieldValueIRS element (for citing)
Total Program Service Expense37319782TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPtrueLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109651NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees562NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members5NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledPAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonVINCENT LAMORELLANamePerson
Telephone Number8142269500TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1ONE HOSPITAL DRIVEAddressLine1
CityCLARIONCity
StatePAState
ZIP Code16214ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (16 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
VICTOR EWY
SECRETARY1.0XX000
MICHAEL CHERICO
CHAIRMAN10.0XX000
BRUCE MCCLEARY
DIRECTOR1.0X000
BARRY GEORGE
VICE CHAIRMAN1.0XX000
THOMAS FREENOCK
DIRECTOR1.0X03294132450
CASSANDRA NEELY
DIRECTOR1.0X000
RODNEY SILVIS
TREASURER1.0XX000
DONNA HARTLE
DIRECTOR1.0X000
CATHERINE CUNNINGHAM
DIRECTOR1.0X018920212201
VINCENT LAMORELLA
CFO40.0X171122010267
BYRON QUINTON
CEO40.0X196743011805
CHARLES BARTLEY
PHYSICIAN40.0152870020251X
HENRY HORNING
PHYSICIAN40.0140485019631X
CLARA MICKLISH
PHYSICIAN40.0136303011717X
THOMAS MORGO
PHYSICIAN40.0144475021732X
WENDY STIVANSON
PHYSICIAN40.0135097021263X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1077095TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs518615TotalReportableCompFrmRltdOrgs
Total Other Compensation131317TotalOtherCompensation
Number Individuals GT100 K8NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcestrueCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Description Of ServicesDescriptionOfServicesCompensationCompensation
CLARION REHABILITATION SERVICES
PHYSICAL THERAPY2637421
DJD ANESTHESIA ASSOCIATES
MEDICAL374517
QUORUM HEALTH RESOURCES
MANAGEMENT GROUP670883
DR CHONG PARK
PHYSICIAN154930
BKD LLP
AUDIT126818
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Related Organizations85000RelatedOrganizations
Government Grants312871GovernmentGrants
All Other Contributions2463AllOtherContributions
Total Contributions400334TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PATIENT REVENUE9000994584097545840975
AMBULANCE621910158409158409
EDUCATION9000992488824888
CAFETERIA722210235373235373
DAYCARE624410107202107202

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column12954TotalRevenueColumn
Related Or Exempt Function Income12954RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue46379801TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column308255TotalRevenueColumn
Exclusion$308,255ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real267069Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real191813Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real75256Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column75256TotalRevenueColumn
Exclusion$75,256ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities5413031Securities
Other4496Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities5215107Securities
Other1036Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities197924Securities
Other3460Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column201381TotalRevenueColumn
Exclusion$201,381ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
GAIN ON EQUITY INVESTEE900099123144$123,144
LOSS ON REFINANCING900099-403961-$403,961
FieldValueIRS element (for citing)
Total Other Revenue-280817TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column47084210TotalRevenueColumn
Related Or Exempt Function Income46379801RelatedOrExemptFunctionIncome
Exclusion$304,075ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total389937Total
Management And General389937ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total84753Total
Management And General84753ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total16481308Total
Program Services14644819ProgramServices
Management And General1836489ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total771975Total
Program Services667620ProgramServices
Management And General104355ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2693280Total
Program Services2348294ProgramServices
Management And General344986ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1309354Total
Program Services1132357ProgramServices
Management And General176997ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total699515Total
Management And General699515ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total36759Total
Management And General36759ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total86743Total
Management And General86743ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total93544Total
Management And General93544ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total6510205Total
Program Services5178896ProgramServices
Management And General1331309ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total181665Total
Management And General181665ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total250993Total
Management And General250993ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total381399Total
Management And General381399ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total941758Total
Program Services189879ProgramServices
Management And General751879ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total5265Total
Program Services2811ProgramServices
Management And General2454ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total71911Total
Program Services62001ProgramServices
Management And General9910ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total742047Total
Program Services586217ProgramServices
Management And General155830ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2739635Total
Program Services2164312ProgramServices
Management And General575323ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total177688Total
Management And General177688ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
DUES & SUBSCRIPTIONS18692645071141855
BAD DEBT25708762570876
MEDICAL SUPPLIES67309466730946
REPAIRS & MAINTENANCE75031469906351251
RECRUITING596596596596

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total404526Total
Program Services296620ProgramServices
Management And General107906ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total45889918Total
Program Services37319782ProgramServices
Management And General8570136ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY14126BOY
EOY3147EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY5762724BOY
EOY3764397EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY5952536BOY
EOY5558941EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY82500BOY
EOY52500EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1083454BOY
EOY1050787EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1354382BOY
EOY729328EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis54661027LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec40886942LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY15578483BOY
EOY13774085EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY8360665BOY
EOY8597772EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY2600779BOY
EOY2671946EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY2023180BOY
EOY2089766EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY465485BOY
EOY218006EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY43278314BOY
EOY38510675EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY3716301BOY
EOY3592868EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY9933516BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY5795969BOY
EOY10764316EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY499146BOY
EOY761055EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY19944932BOY
EOY15118239EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY22974284BOY
EOY23055106EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY232267BOY
EOY197169EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY126831BOY
EOY140161EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY23333382BOY
EOY23392436EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY43278314BOY
EOY38510675EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$31,881OtherActivitiesAmount
Total Lobbying Expenditures IIB31881TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierOTHER LOBBYING ACTIVITYIdentifier
Return ReferenceSCHEDULE C, PART II-B, QUESTION 1IReturnReference
ExplanationA PORTION OF DUES PAID IN FY 2010 TO THE AHA, HAP AND HCWP WERE ATTRIBUTABLE TO LOBBYING, TOTALLING 6,881. IN ADDITION, STRATEGIC MARKETING INNOVATIONS WAS PAID $25,000 FOR LOBBYING SERVICES.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis473420InvestmentCostOrOtherBasis
Book Value473420BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis24635854InvestmentCostOrOtherBasis
Depreciation16703681Depreciation
Book Value7932173BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis302349InvestmentCostOrOtherBasis
Depreciation244147Depreciation
Book Value58202BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis27265075InvestmentCostOrOtherBasis
Depreciation22130386Depreciation
Book Value5134689BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis1984329InvestmentCostOrOtherBasis
Depreciation1808728Depreciation
Book Value175601BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings13774085TotalOfBookValueLandBuildings
Financial DerivativesFinancialDerivatives

Closely Held Equity Interests CloselyHeldEquityInterests

FieldValueIRS element (for citing)
Book Value1839179BookValue

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionINVST INT IN CHARTDescription
Book Value832767BookValue
Method Of ValuationCMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities2671946TotalOfBookValueSecurities

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
DescriptionDUE FROM AFFILIATESDescription
Book Value2089766BookValue
Method Of ValuationCMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Program Related2089766TotalOfBookValueProgramRelated
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionOTHER LIABILITIESDescription
Amount$761,055Amount
FieldValueIRS element (for citing)
Total Of Amounts761055TotalOfAmounts
Total Revenue47084210TotalRevenue
Total Expenses45889918TotalExpenses
Excess Or Deficit For Year1194292ExcessOrDeficitForYear
Net Unrealized GL On Investments636182NetUnrealizedGLOnInvestments
Other-$1,771,420OtherAmount
Total Adjustments-1135238TotalAdjustments
Excess Or Deficit Per FS59054ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt46140785TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments636182NetUnrealizedGainsInvestments
Other Revenues-1771420OtherRevenues
Revenue Not Rptd F990-1135238RevenueNotRptdF990
Revenue Subtotal47276023RevenueSubtotal
Other Revenues Not Included-191813OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-191813RevenueNotRptdOnFinStmt
Total Revenue Per Form99047084210TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt46081731TotExpensesEtcAuditedFinclStmt
Other Expenses Included191813OtherExpensesIncluded
Expenses Not Rptd F990191813ExpensesNotRptdF990
Expenses Subtotal45889918ExpensesSubtotal
Total Expenses Per Form99045889918TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
UNCERTAIN TAX POSITIONSSCHEDULE D, PART X, LINE 2MANAGEMENT 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 TO NET ASSETS SCHEDULE D, PART XI, LINE 8 AND PART XII, LINE 2D (1,664,652) TRANSFER TO AFFILIATE (85,000) CONTRIBUTIONS FROM CLARION HEALTHCARE SYSTEM (35,098) CHANGE IN NET ASSETS OF CLARION HOSPITAL FOUNDATION 13,330 CHANGE IN BENEFICIAL INTEREST OF TRUST ----------- (1,771,420) OTHER CHANGES TO NET ASSETS
RENTAL EXPENSESSCHEDULE D, PART XII, LINE 4B, AND PART XIII, LINE 2DADJUSTMENT TO PROPERLY REPORT EXPENSES PAID OR INCURRED FOR INCOME REPORTED ON FORM 990, PART VIII, LINE 6A (191,813).

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent250XPcent250
Free Disc Care Medically IndigentfalseFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReportfalseAnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense214108TotalCommunityBenefitExpense
Net Community Benefit Expense214108NetCommunityBenefitExpense
Percent Of Total Expense0.00470PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense5237793TotalCommunityBenefitExpense
Direct Offsetting Revenue2152623DirectOffsettingRevenue
Net Community Benefit Expense3085170NetCommunityBenefitExpense
Percent Of Total Expense0.06720PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense5451901TotalCommunityBenefitExpense
Direct Offsetting Revenue2152623DirectOffsettingRevenue
Net Community Benefit Expense3299278NetCommunityBenefitExpense
Percent Of Total Expense0.07190PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense14959TotalCommunityBenefitExpense
Net Community Benefit Expense14959NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1319694TotalCommunityBenefitExpense
Net Community Benefit Expense1319694NetCommunityBenefitExpense
Percent Of Total Expense0.02880PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense1334653TotalCommunityBenefitExpense
Net Community Benefit Expense1334653NetCommunityBenefitExpense
Percent Of Total Expense0.02890PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense6786554TotalCommunityBenefitExpense
Direct Offsetting Revenue2152623DirectOffsettingRevenue
Net Community Benefit Expense4633931NetCommunityBenefitExpense
Percent Of Total Expense0.10080PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$1,214,854BadDebtExpenseAmount
Amount Attributable To173724AmountAttributableTo
Amount Reimbursed By Medicare15728937AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare13409314CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall2319623MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CarefalseProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV (4 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalEr24 HoursEr24HoursOtherOther
CLARION HOSPITAL
ONE HOSPITAL DRIVECLARIONPA16214XXX
SEMEYN FAMILY PRACTICE
82 TOWN RUN ROADFAIRMOUNT CITYPA16224ROUTINE XRAY SVCS
CRICKLEWOOD
1008 SOUTH 5TH AVE SUITE 103CLARIONPA16214SCREENING MAMMOGRAPHY SVCS
AC VALLEY MEDICAL CENTER
855 ROUTE 58PARKERPA16049CLINIC SERVICES

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Bad Debt FootnoteTHE 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 US CENSUS BUREAU. IN 2009, 14.3 PERCENT OF CLARION COUNTY WAS CONSIDERED TO LIVE IN POVERTY.BadDebtFootnote
Shortfall As Community BenefitSERVING 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.ShortfallAsCommunityBenefit
Needs AssessmentCLARION HOSPITAL IS GOVERNED BY A BOARD OF VOLUNTEER DIRECTORS WHO REPRESENT THE COMMUNITY WE SERVE. THROUGH THEIR INPUT AND OCCASIONAL COMMUNITY SURVEYS, CLARION HOSPITAL ASSESSES THE HEALTH CARE NEEDS OF ITS SERVICE AREA.NeedsAssessment
Patient Education AssistanceMEDICAID APPLICATIONS GIVEN TO SELF PAY PATIENTS IN EMERGENCY ROOM AND INPATIENT. HOSPITAL FINANCIAL POLICY AND BUSINESS OFFICE CONTACT INFORMATION ARE AVAILABLE AT REGISTRATION DESKS. FREE CARE GUIDELINES PRINTED ON REVERSE SIDE OF PATIENT STATEMENTS.PatientEducationAssistance
Community InformationCLARION HOSPITAL SERVES CLARION COUNTY (POPULATION 40,000) AND PARTS OF THE SURROUNDING COUNTIES, INCLUDING VENANGO, FOREST, JEFFERSON, AND ARMSTRONG. OUR SERVICE AREA IS IN A RURAL PART OF WESTERN PENNSYLVANIA, WITH MANY LIVING BELOW OR WELL BELOW THE NATIONAL AND STATE INCOME AVERAGE.CommunityInformation
Community Building ActivitiesA NUMBER OF HEALTH AND WELLNESS CLASSES ARE HELD ON THE CLARION HOSPITAL CAMPUS. SOME EXAMPLES ARE PRENATAL, CRP AND NUTRITION. ADDITIONALLY, THE HOSPITAL SERVES AS A MEETING PLACE FOR MANY HEALTH AND HUMAN SERVICE AGENCIES, LIKE THE AMERICAN CANCER SOCIETY, SUPPORT GROUPS, AND HOSPICE PROGRAMS.CommunityBuildingActivities
Other InformationCLARION HOSPITAL PROVIDES MANY HEALTH FAIRS AND EDUCATIONAL EVENTS WITHIN THE COMMUNITY. LOW-COST BLOOD TESTING IS DONE TWICE A YEAR, AND CANCER PREVENTION EXPOS ARE HELD AT LEAST ANNUALLY. CLARION HOSPITAL PROVIDES SPEAKERS TO LOCAL CIVIC GROUPS AND INVITES THE COMMUNITY TO ITS OWN LUNCH'N LEARN PROGRAMS BIMONTHLY. CLARION HOSPITAL ALSO PARTNERS WITH THE YMCA OF CLARION COUNTY TO PROVIDE COMMUNITY FITNESS PROGRAMS. EACH YEAR THE HOSPITAL REINVESTS BETWEEN $800,000 AND $1 MILLION ON UPGRADING AND NEW MEDICAL EQUIPMENT.OtherInformation
Affiliated Health Care SystemCLARION HOSPITAL IS AN AFFILIATE OF CLARION HEALTHCARE SYSTEM. INC. CLARION HEALTHCARE SYSTEM, INC EXISTS TO SUPPORT THE HOSPITAL MISSION AND TO PROVIDE A VITAL LINK BETWEEN THE HOSPITAL SYSTEM AND THE SURROUNDING COMMUNITY. THROUGH THE PROCESSES OF STRATEGIC AND FINANCIAL DEVELOPMENT, THE HEALTH SYSTEM WILL ENHANCE THE PUBLIC'S AWARENESS OF HEALTH CARE AND THE HOSPITAL'S SERVICES; SECURE CHARITABLE GIFTS; INCREASE ITS CURRENT PERMANENTLY RESTRICTED FUNDS TO GENERATE A PERMANENT SOURCE OF INVESTMENT INCOME; AND REGULARLY DISTRIBUTE FINANCIAL ASSISTANCE TO THE SURROUNDING COMMUNITY AND THE HOSPITAL TO ENHANCE HEALTH CARE EDUCATION, TECHNICAL RESOURCES AND QUALITY PATIENT CARE. BY THESE ACTIVITIES, THE SYSTEM WILL SERVE TO LEAD THE WAY FOR THE SURROUNDING COMMUNITY'S HEALTH CARE STABILITY AND GROWTH IN THE TWENTY-FIRST CENTURY.AffiliatedHealthCareSystem

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgs
THOMAS FREENOCK
03085220208910002450000331863
CATHERINE CUNNINGHAM
01868800002322000122010201403
VINCENT LAMORELLA
16941100017110001026701813890
BYRON QUINTON
19477600019670001180502085480
CHARLES BARTLEY
15287000000764301260801731210
HENRY HORNING
14048500000702401260701601160
THOMAS MORGO
14447500000722401450801662070
WENDY STIVANSON
13509700000675501450801563600

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
UNRELATED ORGANIZATION COMPENSATIONSCHEDULE J, PART IIBYRON QUINTON, CEO, AND VINCENT LAMORELLA, CFO, BOTH RECEIVE ALL COMPENSATION FROM QUORUM HEALTH RESOURCES, AN UNRELATED ORGANIZATION, FOR SERVING IN THEIR CAPACITIES AS CEO AND CFO, RESPECTIVELY, OF CLARION HOSPITAL. QUORUM HEALTH RESOURCES IS ALSO CLARION HOSPITAL'S MANAGEMENT COMPANY.
BONUSES PAID BY RELATED ORGANIZATIONSCHEDULE J, PART II, COLUMN B(II)IN ADDITION TO PHYSICIAN'S ANNUAL BASE COMPENSATION, PHYSICIAN MAY BE ENTITLED TO RECEIVE A PRODUCTIVITY BONUS, WHICH SHALL BE BASED ON CASH RECEIPTS EARNED BY THE PHYSICIAN. THESE SHALL BE DEDUCTED FROM CASH RECEIPTS EXPENSES DIRECTLY ASSOCIATED WITH THE PHYSICIAN AS WELL AS A PROPORTIONATE SHARE OF DIRECT EXPENSES FOR THE OPERATION OF THE CLARION INTERNAL MEDICINE PRACTICE. FOR PURPOSES OF CALCULATING THE PHYSICIAN'S SHARE OF DIRECT EXPENSES, THE ONLY EXPENSES WHICH WILL NOT BE DEDUCTED ARE "INDIRECT EXPENSES" ASSOCIATED WITH ADMINISTRATIVE SERVICES PROVIDED BY HEALTH SERVICES OF CLARION, INC. IF THE RESULTING NUMBER IS A POSITIVE NUMBER, IT SHALL BE MULTIPLIED BY 75%. THIS AMOUNT SHALL BE THE AMOUNT OF BONUS EARNED BY THE PHYSICIAN. THE BONUS SHALL BE PAYABLE WITHOUT REGARD TO WHETHER THE SURGICAL PRACTICE HAD BEEN PROFITABLE OR NOT PROFITABLE IN THE PAST.

Schedule L IRS990ScheduleL

Loan Table LoanTable

FieldValueIRS element (for citing)
Name PersonTHOMAS FREENOCKNamePerson
Purpose Of LoanREPAY NONCMPETE AGMTPurposeOfLoan
Loan From OrganizationXLoanFromOrganization
Original Principal$150,000OriginalPrincipalAmount
Balance Due52500BalanceDue
DefaultfalseDefault
Approved By BoardfalseApprovedByBoard
Written AgreementfalseWrittenAgreement
FieldValueIRS element (for citing)
Total Balance Due52500TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
MARLA MCCLEARY
SPOUSE OF BRUCE MCCLEARY55550COMPENSATIONfalse
LANA GEORGE
SPOUSE OF BARRY GEORGE29203COMPENSATIONfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
NUMBER OF VOLUNTEERSFORM 990, PART I, QUESTION 6VOLUNTEER SERVICES OF CLARION HOSPITAL CONSISTS OF APPROXIMATELY 65 VOLUNTEERS WHO WORK WITHIN 25 VARIOUS DEPARTMENTS ASSISTING EMPLOYEES, PATIENTS, AND STAFF TO DELIVER QUALITY BASED HEALTHCARE. IN ADDITION, NON-COMPENSATED MEMBERS OF THE BOARD OF DIRECTORS ARE CONSIDERED VOLUNTEERS.
ORGANIZATION MISSIONFORM 990, PART III, QUESTION 1MISSION: CLARION HOSPITAL, AS THE COMMUNITY'S RESOURCE FOR THE DELIVERY OF QUALITY-BASED HEALTHCARE, IS COMMITTED TO PROVIDE EMERGENT, ACUTE, TRANSITIONAL, AND LONG-TERM MEDICAL SERVICES FOR THE RESIDENTS OF CLARION COUNTY AND ITS SURROUNDING COMMUNITIES. PURPOSE: CLARION HOSPITAL EXISTS TO PROVIDE COMPREHENSIVE, QUALITY HEALTH CARE, APPROPRIATE TO THE NEEDS OF OUR COMMUNITY, IN A COMPASSIONATE AND EMPATHETIC MANNER. THE HOSPITAL ACKNOWLEDGES THE IMPORTANCE OF PREVENTIVE MEDICINE AND FOCUSES ON THE PROMOTION OF A HEALTHY LIFESTYLE FOR ALL. EVERY DEPARTMENT WITHIN CLARION HOSPITAL CONTRIBUTES AN INVALUABLE SERVICE TOWARD THE PROVISION OF QUALITY HEALTH CARE FROM THE ORGANIZATION AS A WHOLE. EACH DEPARTMENT EXISTS FOR A SPECIFIC PURPOSE, YET NO DEPARTMENT EXISTS SOLELY ON ITS OWN. WE ARE ALL INTER-DEPENDENT UPON EACH OTHER. VALUES: *WE BELIEVE IN BEING CUSTOMER FOCUSED. *WE BELIEVE IN COMPETENCY. *WE BELIEVE IN HONESTY. *WE BELIEVE IN CARING. *WE BELIEVE IN COMMITMENT. *WE BELIEVE IN BEING TEAM PLAYERS. *WE BELIEVE IN DEMONSTRATING PROFESSIONALISM. *WE BELIEVE IN THE PRESERVATION OF DIGNITY FOR THOSE WE SERVE. *WE BELIEVE IN MAINTAINING CONFIDENTIALITY. *WE BELIEVE IN EDUCATION AND CONTINUAL LEARNING. *WE BELIEVE IN CONTINUAL IMPROVEMENT. *WE BELIEVE IN DEMONSTRATING MUTUAL RESPECT FOR OUR CO-WORKERS. VISION: CLARION HOSPITAL ENDEAVORS TO EXCEED THE COMMUNITY'S HEALTHCARE EXPECTATIONS THROUGH THE IMPLEMENTATION OF CONTINUOUS QUALITY IMPROVEMENTS, BY REASSESSING THE COMMUNITY'S EVOLVING NEEDS, BY DEVELOPING INNOVATIVE FAMILY-ORIENTED HEALTHCARE SERVICES, AND BY PROVIDING EDUCATIONAL PROGRAMS FOR OUR FUTURE HEALTHCARE PROVIDERS.
MANAGEMENT DUTIESFORM 990, PART VI, QUESTION 3CLARION HOSPITAL HAS A MANAGEMENT CONTRACT WITH QUORUM HEALTH RESOURCES TO PROVIDE MANAGEMENT SERVICES. IN ADDITION, QUORUM HEALTH RESOURCES PROVIDES COMPENSATION FOR THE HOSPITAL'S CEO & CFO. THE HOSPITAL REIMBURSES QUORUM HEALTH RESOURCES WITH MONTHLY MANAGEMENT FEES FOR THE COMPENSATION PAID AND OTHER SERVICES PROVIDED. MEMBERS OF THE ORGANIZATION FORM 990, PART VI, QUESTION 6 & 7 THE BOARD OF CLARION HOSPITAL SHALL CONSIST OF NINE (9) MEMBERS AND SHALL BE APPOINTED BY THE BOARD OF DIRECTORS OF CLARION HEALTHCARE SYSTEM, INC. IN ACCORDANCE WITH HOSPITAL BYLAWS. THE BOARD MEMBERS SHALL BE THE SAME PERSONS WHO SERVE AS THE EXECUTIVE COMMITTEE OF CLARION HEALTHCARE SYSTEM, INC. WHICH INCLUDE THE CHAIRPERSON, VICE CHAIRPERSON, SECRETARY, TREASURER, FORMER CHAIRPERSON (IF APPLICABLE), PRESIDENT & CEO (NON-VOTING), CHIEF OF STAFF (WITH VOTING RIGHTS), ONE MEDICAL STAFF REPRESENTATIVE, AND ANY OTHER DIRECTORS SELECTED BY THE CHAIRPERSON.
FORM 990 REVIEWFORM 990, PART VI, QUESTION 11PRIOR TO FILING, A DRAFT OF THE RETURN IS REVIEWED BY THE CFO IN DETAIL. A FINAL DRAFT IS THEN PRESENTED TO THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS AND THE FULL BOARD FOR REVIEW.
CONFLICT OF INTEREST POLICY REVIEWFORM 990, PART VI, QUESTION 12CLARION HOSPITAL, INC. BOARD MEMBERS ARE ASKED TO COMPLETE A CONFLICT OF INTEREST FORM ON AN ANNUAL BASIS. IF A CONFLICT ARISES, THE BOARD MEMBER WITH A CONFLICT ABSTAINS FROM VOTING ON ANY MATTER RELATED TO THE CONFLICT. POLICY: MEMBERS OF THE GOVERNING BODY SHALL NOT MAINTAIN SUBSTANTIAL PERSONAL OR BUSINESS INTERESTS WHICH CONFLICT WITH THOSE OF THE HOSPITAL. PROCEDURES: ALL GOVERNING BODY MEMBERS SHALL EXECUTE A CONFLICT OF INTEREST STATEMENT. MEMBERS OF THE GOVERNING BODY SHALL NOT ENGAGE IN THE FOLLOWING FORMS OF SELF DEALINGS: A) THE SALE, EXCHANGE, OR LEASING OF PROPERTY OR SERVICES BETWEEN THE HOSPITAL AND A GOVERNING BOARD MEMBER, HIS EMPLOYER, OR AN ORGANIZATION SUBSTANTIALLY CONTROLLED BY HIM ON A BASIS LESS FAVORABLE TO THE HOSPITAL THAN THAT ON WHICH SUCH PROPERTY OR SERVICE IS MADE AVAILABLE TO THE GENERAL PUBLIC. B) FURNISHING OF GOODS, SERVICES, OR FACILITIES BY THE HOSPITAL TO A GOVERNING BOARD MEMBER, UNLESS SUCH FURNISHING IS MADE ON A BASIS NOT MORE FAVORABLE THAN THAT ON WHICH SUCH GOODS, SERVICES, OR FACILITIES ARE MADE AVAILABLE TO THE GENERAL PUBLIC OR EMPLOYEES OF THE HOSPITAL. C) ANY TRANSFER TO OR USE BY OR FOR THE BENEFIT OF A GOVERNING BOARD MEMBER OF THE INCOME OR ASSETS OF THE HOSPITAL EXCEPT BY PURCHASE FOR FAIR MARKET VALUE. ANY DIRECTOR, OFFICER, EMPLOYEE, OR COMMITTEE MEMBER HAVING AN INTEREST IN A CONTRACT OR OTHER TRANSACTION PRESENTED TO THE BOARD OF DIRECTORS OR A COMMITTEE THEREOF FOR AUTHORIZATION, APPROVAL OR RATIFICATION SHALL GIVE PROMPT, FULL AND FRANK DISCLOSURE OF HIS INTEREST TO THE BOARD OR COMMITTEE PRIOR TO ITS ACTING ON SUCH CONTRACT OR TRANSACTION. THE BODY TO WHICH SUCH DISCLOSURE IS MADE SHALL THEREUPON DETERMINE, BY MAJORITY VOTE, WHETHER THE DISCLOSURE SHOWS THAT A CONFLICT OF INTEREST EXISTS OR CAN REASONABLY BE CONSTRUED TO EXIST. IF A CONFLICT IS DEEMED TO EXIST, SUCH PERSON SHALL NOT VOTE ON, NOR USE HIS PERSONAL INFLUENCE ON, NOR PARTICIPATE (OTHER THAN TO PRESENT FACTS) IN THE DISCUSSIONS OR DELIBERATIONS WITH RESPECT TO SUCH CONTRACT OR TRANSACTION. SUCH PERSON MAY NOT BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM AT ANY MEETING WHERE THE CONTRACT OR TRANSACTION IS UNDER DISCUSSION OR IS BEING VOTED UPON. THE MINUTES OF THE MEETING SHALL REFLECT THE DISCLOSURE MADE, THE VOTE THEREON AND, WHERE APPLICABLE, THE ABSTENTION FROM VOTING AND PARTICIPATING, AND WHETHER A QUORUM WAS PRESENT. COMPENSATION REVIEW POLICY FORM 990, PART VI, QUESTION 15 IT SHALL BE THE POLICY OF THE BOARD OF DIRECTORS TO ESTABLISH AND MAINTAIN AN EXECUTIVE COMPENSATION PROGRAM FOR THE PRESIDENT/CEO AND CHIEF FINANCIAL OFFICER WHICH: (1) ENABLES THE BOARD TO ATTRACT AND RETAIN THE EXECUTIVES NEEDED TO EFFECTIVELY CARRY OUT THE MISSION OF THE ORGANIZATION AND THE POLICIES OF THE BOARD. (2) RESPONDS TO MARKET TRENDS. (3) REFLECTS THE VALUE OF THE FUNCTIONAL DEMANDS OF EXECUTIVE WORK. (4) REWARDS PERFORMANCE RESULTS. (5) IS BASED ON FACTORS THAT PROVIDE FOR JUST AND REASONABLE COMPENSATION. COMPENSATION ACTIONS APPROVED BY THE BOARD OF DIRECTORS MUST BE DOCUMENTED, AND SUCH DOCUMENTATION SHALL INCLUDE THE BASES OF EACH COMMITTEE'S ACTIONS AND THE NAMES OF THE COMMITTEE MEMBERS INVOLVED IN THE ACTIONS. THE DOCUMENTED PROCESS FOR DETERMINING EXECUTIVE COMPENSATION SHALL INCLUDE: (1) TERMS OF THE COMPENSATION ARRANGEMENTS. (2) APPROVAL DATE. (3) NAMES OF BOARD MEMBERS WHO APPROVED THE COMPENSATION DECISIONS. (4) DATA USED IN THE COMPENSATION DECISION. (5) DISCLOSURES OF CONFLICT OF INTEREST, IF ANY. (6) ANNUAL REVIEW OF COMPENSATION RECORDS. THE BOARD OF DIRECTORS AUTHORIZES THE HUMAN RESOURCE COMMITTEE TO REVIEW AND RECOMMEND COMPENSATION DECISIONS FOR THE PRESIDENT/CEO. THE BOARD OF DIRECTORS AUTHORIZES THE FINANCE COMMITTEE TO REVIEW AND RECOMMEND COMPENSATION DECISIONS FOR THE CHIEF FINANCIAL OFFICER. SUCH RECOMMENDATIONS ARE REPORTED TO AND ACTED UPON BY THE FULL BOARD OF DIRECTORS. GUIDELINES FOR DETERMINING PROPOSED COMPENSATION FOR THE PRESIDENT/CEO AND THE CHIEF FINANCIAL OFFICER (A) A REVIEW AND APPROVAL OF THE OFFICER'S COMPENSATION SHALL OCCUR INITIALLY UPON HIRE OF THE OFFICER AND WHENEVER THE OFFICER'S COMPENSATION IS MODIFIED. (B) ANNUALLY, THE HUMAN RESOURCE COMMITTEE OF THE BOARD OF DIRECTORS SHALL ESTABLISH PERFORMANCE STANDARDS FOR THE PRESIDENT/CEO WHICH SHALL BE USED IN DETERMINING COMPENSATION ACTIONS. THE HUMAN RESOURCE COMMITTEE SHALL HAVE THE AUTHORITY TO REVIEW THE PERFORMANCE OF THE PRESIDENT/CEO AND RECOMMEND A COMPENSATION ADJUSTMENT, IF WARRANTED IN THE JUDGMENT OF THE COMMITTEE. (C) ANNUALLY, THE PRESIDENT/CEO SHALL ESTABLISH PERFORMANCE STANDARDS FOR THE CHIEF FINANCIAL OFFICER WHICH SHALL BE USED IN DETERMINING COMPENSATION ACTIONS. THE PRESIDENT/CEO SHALL HAVE THE AUTHORITY TO REVIEW THE PERFORMANCE OF THE CHIEF FINANCIAL OFFICER AND PROPOSE A COMPENSATION ADJUSTMENT, IF WARRANTED IN THE JUDGMENT OF THE PRESIDENT/CEO, TO THE FINANCE COMMITTEE. (D) INFORMATION GATHERED AND USED IN COMPENSATION ACTIONS SHALL INCLUDE: 1. COMPENSATION PAID BY SIMILAR ORGANIZATIONS. 2. QHR WILL PROVIDE COMPENSATION COMPARABILITY DATA FOR THE POSITION COMPILED BY INDEPENDENT ORGANIZATIONS. THE DATA MAY BE BASED ON INDUSTRY SURVEYS, EXPERT COMPENSATION STUDIES, OR OTHER COMPARABLE DATA. 3. REFERENCE TO FUNCTIONALLY COMPARABLE POSITIONS. 4. THE AVAILABILITY OF SIMILAR SERVICES IN THE GEOGRAPHIC SERVICE AREA. COMPENSATION WAS LAST REVIEWED, USING THE ABOVE METHOD, IN FEBRUARY 2010.
DOCUMENT DISCLOSUREFORM 990, PART VI, QUESTION 19GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE BY WRITTEN REQUEST FOR A LEGITIMATE BUSINESS PURPOSE, AS DETERMINED BY TOP MANAGEMENT. REQUESTED DOCUMENTS WILL BE MAILED TO THE REQUESTOR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
HEALTH SERVICES OF CLARION
ONE HOSPITAL DRIVECLARIONPA16214753126134PHYSICIN GRPPA501(C)(3)3NA
CLARION HEALTHCARE SYSTEMS INC
ONE HOSPITAL DRIVECLARIONPA16214251534023HOLDING COPA501(C)(3)11NA

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1CLARION DEVELOPMENT CORPORATIONBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line124 DOCTORS LANEAddressLine1
CityCLARIONCity
StatePAState
ZIP Code16214ZIPCode
FieldValueIRS element (for citing)
EIN251516298EIN
Primary ActivityPHARMACYPrimaryActivity
Legal Domicile StatePALegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityC CORPTypeOfEntity
Share Of Total Income0ShareOfTotalIncome
Share Of EOY Assets0ShareOfEOYAssets
Percentage Ownership0.00000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgtrueLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg