MOUNT NITTANY MEDICAL CENTER: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
MOUNT NITTANY MEDICAL CENTER (EIN 24-0795682)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-16
IRS object ID
201121369349300432
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)
Timestamp2011-05-16T09:03:59-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PARENTEBEARD LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1400 MARKET STREETAddressLine1
CityWILLIAMSPORTCity
StatePAState
ZIP Code17701ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN240795682EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MOUNT NITTANY MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMOUNNameControl
Phone8142317000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11800 EAST PARK AVENUEAddressLine1
CitySTATE COLLEGECity
StatePAState
ZIP Code16803ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRICHARD J WISNIEWSKIName
TitleSENIOR VP FINANCE/CFOTitle
Phone8142317000Phone
Date Signed2011-05-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJAIME KUNTZName
Phone5703236023Phone
Date Prepared2011-05-13DatePrepared
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSTEVEN E BROWNNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11800 EAST PARK AVENUEAddressLine1
CitySTATE COLLEGECity
StatePAState
ZIP Code16803ZIPCode
FieldValueIRS element (for citing)
Gross Receipts224250285GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.MOUNTNITTANY.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1905YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionPROVIDE INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES TO RESIDENTS OF STATE COLLEGE, PA.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees1526TotalNbrEmployees
Total Nbr Volunteers780TotalNbrVolunteers
Total Gross UBI2135214TotalGrossUBI
Net Unrelated Business Txbl Income945744NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year4051ContributionsGrantsPriorYear
Contributions Grants Current Year481209ContributionsGrantsCurrentYear
Program Service Revenue Prior Year180965733ProgramServiceRevenuePriorYear
Program Service Revenue CY195179149ProgramServiceRevenueCY
Investment Income Prior Year-34933InvestmentIncomePriorYear
Investment Income Current Year367930InvestmentIncomeCurrentYear
Other Revenue Prior Year656267OtherRevenuePriorYear
Other Revenue Current Year690499OtherRevenueCurrentYear
Total Revenue Prior Year181591118TotalRevenuePriorYear
Total Revenue Current Year196718787TotalRevenueCurrentYear
Grants And Similar Amnts CY4566613GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year85155470SalariesEtcPriorYear
Salaries Etc Current Year91112845SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year59083TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY30268TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year33093TotalFundrsngExpCurrentYear
Other Expense Prior Year80069460OtherExpensePriorYear
Other Expenses Current Year85264723OtherExpensesCurrentYear
Total Expenses Prior Year165284013TotalExpensesPriorYear
Total Expenses Current Year180974449TotalExpensesCurrentYear
Revenues Less Expenses Prior Year16307105RevenuesLessExpensesPriorYear
Revenues Less Expenses CY15744338RevenuesLessExpensesCY
Total Assets BOY227974291TotalAssetsBOY
Total Assets EOY248215124TotalAssetsEOY
Total Liabilities BOY141413822TotalLiabilitiesBOY
Total Liabilities EOY140838734TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY86560469NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY107376390NetAssetsOrFundBalancesEOY
Mission DescriptionMount Nittany Medical Center will provide every patient with the finest, patient-centered care in a safe and comfortable environment, continually improving access to care, and striving to enhance the quality of human life for everyone we serve.Mount Nittany Medical Center will enhance its position as the preferred regional healthcare destination for both patients and medical professionals - providing vital clinical centers of excellence and superior access to care - supported by a commitment to medical education and backed by a culture of advancement and accountability - moving life forward.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense158621790Expense
Grants4566613Grants
Revenue193052567Revenue
DescriptionMount Nittany Medical Center is committed to providing quality medical care in an atmosphere that reflects high standards of social, ethical and financial responsibility and will assure that those same standards are met in all contractual relationships. The Board of Trustees has established this statement of organizational values to assure that members of the Board, the Medical Center staff and the Medical Staff honor the following principles through our behaviors:Alliances with Patients:- We will treat all patients with dignity and respect, and will accommodate individual responses to the stress of illness.- We fully support the principles outlined in the Statement of Patient's Rights and Responsibilities document.- We commit to a service excellence philosophy that strives to meet or exceed patient expectations.- All patients receive a uniform standard of care throughout the facility, regardless of social, cultural, financial, religious, racial, gender or sexual orientation factors.- The Medical Center and Medical Staff work jointly to assure that only appropriate and effective tests, procedures and treatments are provided to patients.Community Relations- We will fairly and accurately represent ourselves and our capabilities to the public.- We are committed to constant preparation for the long-term financial viability of the Medical Center through responsible utilization of resources and in support of our commitment to meet the healthcare needs of the community.- Medical Center leadership (executives, Board of Trustees, Medical Staff) will disclose and avoid potential conflicts of interest. All other hospital staff will avoid similar conflicts of interest.- We will maintain an open admissions policy: no patient will be refused evaluation and service based upon sex, age, race, creed, national origin, sexual orientation, infection status or the ability to pay. Transfers to other facilities will occur only when we are unable to provide needed services and only to facilities that provide an appropriate level of care, based on our assessment of the patients' needs. Patients may also request elective transfer and an informed consent process will be followed.GENERAL PROGRAM SERVICE INFORMATIONOperations & PatientsMount Nittany Medical Center, located in State College, Pennsylvania, is a 207-bed acute-care, not-for-profit facility offering general medical and surgical services that are focused on helping patients reach their health potential. For the fiscal year ended June 30, 2010, Mount Nittany Medical Center provided care to the following number of patients:TOTAL NUMBER OF:INPTNTS-12,876, OUTPTNTS-196,986, ER VISITS-42,986NUMBER WITH PRIVATE INSURANCE:INPTNTS-5,489, OUTPTNTS-118,193, ER VISITS-22,043NUMBER WITH MEDICARE:INPTNTS-3,453, OUTPTNTS-28,961, ER VISITS-4,457NUMBER WITH MEDICARE HMO:INPTNTS-2,185, OUTPTNTS-22,711, ER VISITS-2,197NUMBER WITH MEDICAID:INPTNTS-1,193, OUTPTNTS-15,373, ER VISITS-6,595NUMBER WITH MEDICAID HMO:INPTNTS-83, OUTPTNTS-237, ER VISITS-119NUMBER WITH OTHER INSURANCE:INPTNTS-95, OUTPTNTS-3,148, ER VISITS-1,666NUMBER WITH NO INSURANCE/SELF-PAY:INPTNTS-378, OUTPTNTS-8,363, ER VISITS-5,909Mount Nittany Medical Center did not deny medical services to any individuals including those that had private insurance, Medicare, Medicaid, public health insurance, or no insurance.Emergency DepartmentMount Nittany Medical Center operates an emergency room 24 hours a day, 365 days a year providing services to all members of the community regardless of their ability to pay and denied zero patients requesting such services. The emergency room does not have a trauma center certification.Medical Staff PrivilegesAll qualified physicians in the community are eligible for medical staff privileges at Mount Nittany Medical Center and all qualified physician applications have been accepted for medical staff privileges. More than 240 non-employed physicians in 42 specialties and subspecialties are credentialed at Mount Nittany Medical Center.Professional Medical Education and TrainingMount Nittany Medical Center conducts professional medical education and training programs for the benefit of the community with a resulting financial loss to the Medical Center.Description
Total Program Service Expense158621790TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising1ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096744NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1526NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledPAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Richard Wisniewski Sr VP of finance and CFOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8142346148TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11800 EAST PARK AVENUEAddressLine1
CitySTATE COLLEGECity
StatePAState
ZIP Code16803ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (24 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
RICHARD WISNIEWSKI
SR VP FINANCE & CFO40.00XX317709041369
CARL RAUP
CHAIR2.00XX000
GARY WEBER PHD
VICE CHAIR2.00XX000
THOMAS BROWN
TREASURER2.00XX000
THOMAS HARRIS
SECRETARY2.00XX000
CARL ANDERSON
TRUSTEE2.00X000
DIANNE BRANNON PHD
TRUSTEE2.00X000
Wayne SeBASTIANELLI MD
TRUSTEE2.00X1075700
JONATHON DRANOV MD
TRUSTEE2.00X000
KarEN SHUTE
TRUSTEE2.00X000
ThEODORE ZIFF MD
TRUSTEE2.00X000
EUGENE KEPHART DED
TRUSTEE2.00X000
richard d allatt md
TRUSTEE2.00X000
Phil Park
TRUSTEE2.00X000
JAMES THOMAS PhD
TRUSTEE2.00X000
steve brown hired by mnmc 31510
director/oficer2.00XX000
DAVID PETERSON
EXECUTIVE VP & COO40.00X239528040839
neal holter
physicist40.00180470029176X
SADY RIBEIRO MD
PHYSICIAN30.00372475036805X
DR DALE DANNEKER
PhYSICIAN40.00287715045492X
DR WILLIAM HYLBERT
PhYSICIAN40.00189808029726X
Janet Schachtner
VP of Patient Services40.00186016036028X
LANCE H ROSE
former president & ceo1472101126X
THOMAS J MURRAY
FORMER PRES. & CEO (UNTIL 5/09)565216045768X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2364415TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation306329TotalOtherCompensation
Number Individuals GT100 K8NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ALEXANDER BUILDING CONSTRUCTION LLC
315 VAUGHN STREETHARRISBURGPA17110CONSTRUCTION22123704
Stickler Construction LLC
210 W Hamilton Ave 294State CollegePA16801CoNSTRUCTION3066036
state college anesthesia associates pc
Box 1230state CollegePA16803anesthsiology1472654
PAVONE
1006 MARKET STREETHARRISBURGPA17101ADVERTISING & CREATIVE SERVICES1346538
allied mechanical & electrical
2141 sandy drivestate CollegePA16803cONSTRUCTION1314626
FieldValueIRS element (for citing)
Number Of Contractors GT100 K28NumberOfContractorsGT100K
Related Organizations363157RelatedOrganizations
All Other Contributions118052AllOtherContributions
Total Contributions481209TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
NET PATIENT SERVICE RE621110190518582190518582
OTHER OPERATING REV90009925339852533985
OUTPATIENT LAB SERVICE62150021265822126582
FieldValueIRS element (for citing)
Total Program Service Revenue195179149TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1241781TotalRevenueColumn
Exclusion$1,241,781ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real111457Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real56114Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real55343Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column55343TotalRevenueColumn
Exclusion$55,343ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities26584273Securities
Other17260Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities27458874Securities
Other16510Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-874601Securities
Other750Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-873851TotalRevenueColumn
Exclusion-$873,851ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountUnrelated Business RevenueUnrelatedBusinessRevenue
CAFETERIA SALES722210601608$601,608
VENDING MACHINES72221024916$24,916
OUTSIDE CATERING72232084328432

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column200TotalRevenueColumn
Unrelated Business Revenue200UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Other Revenue635156TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column196718787TotalRevenueColumn
Related Or Exempt Function Income193052567RelatedOrExemptFunctionIncome
Unrelated Business Revenue2135214UnrelatedBusinessRevenue
Exclusion$1,049,797ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total4566613Total
Program Services4566613ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1075203Total
Program Services935909ProgramServices
Management And General136469ManagementAndGeneral
Fundraising2825Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total69394939Total
Program Services61539449ProgramServices
Management And General7855490ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total4747321Total
Program Services4145692ProgramServices
Management And General601629ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total11132605Total
Program Services9708817ProgramServices
Management And General1423788ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4762777Total
Program Services4126897ProgramServices
Management And General635880ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1048238Total
Program Services1837ProgramServices
Management And General1046401ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total80092Total
Management And General80092ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total30268Total
Fundraising30268Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total18872Total
Management And General18872ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total9321022Total
Program Services6367901ProgramServices
Management And General2953121ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total517391Total
Program Services22758ProgramServices
Management And General494633ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total45232878Total
Program Services41827653ProgramServices
Management And General3405225ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3018099Total
Program Services663751ProgramServices
Management And General2354348ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total11895Total
Program Services9175ProgramServices
Management And General2720ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total194789Total
Program Services145848ProgramServices
Management And General48941ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2494597Total
Program Services2494597ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total10007598Total
Program Services10007598ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total1642497Total
Program Services1626855ProgramServices
Management And General15642ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
UNRELATED BUSINESS INCO235564235564
Bad Debt Expense64519546451954
Pathology Lab15938211593821
LiCENSES1121019106797253047
MisCELLANEOUS605901490661115240

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1668496Total
Program Services590468ProgramServices
Management And General1078028ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total180974449Total
Program Services158621790ProgramServices
Management And General22319566ManagementAndGeneral
Fundraising33093Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY3796BOY
EOY3796EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY14110025BOY
EOY18934255EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY21359885BOY
EOY23225833EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3943667BOY
EOY4480939EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1839052BOY
EOY2746062EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis214510105LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec116567289LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY72357952BOY
EOY97942816EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY103090635BOY
EOY87538790EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY512879BOY
EOY579809EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY10756400BOY
EOY12762824EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY227974291BOY
EOY248215124EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY60276572BOY
EOY63511372EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY806690BOY
EOY754730EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY69750969BOY
EOY69761131EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY3115104BOY
EOY2453535EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY7464487BOY
EOY4357966EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY141413822BOY
EOY140838734EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY86346358BOY
EOY107162279EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY35617BOY
EOY35617EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY178494BOY
EOY178494EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY86560469BOY
EOY107376390EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY227974291BOY
EOY248215124EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

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)
Volunteers0Volunteers
Paid Staff Or Management1PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations1GrantsOtherOrganizations
Grants Other Organizations$24,000GrantsOtherOrganizationsAmount
Direct Contact Legislators1DirectContactLegislators
Direct Contact Legislators$1,386DirectContactLegislatorsAmount
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$14,037OtherActivitiesAmount
Total Lobbying Expenditures IIB39423TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart IV, Supplemental Information:Identifier
ExplanationMR. WISNIEWSKI AND MS. KIM NEELY MET WITH REPRESENTATIVE GT THOMPSON AND SENATOR CASEY'S STAFF TO REQUEST FEDERAL APPROPRIATIONS - TOTAL COST $1,386. CONTINUED TO WORK WITH OSBORNE CONSULTING, INC., A FEDERAL LOBBYING GROUP, TO REQUEST FEDERAL APPROPRIATIONS - TOTAL COST $24,000. A PORTION OF THE DUES PAID TO THE HOSPITAL & HEALTHSYSTEM ASSOCIATION OF PENNSYLVANIA ($7,316) AND THE AMERICAN HOSPITAL ASSOCIATION ($6,721) WAS DETERMINED TO BE FOR LOBBYING PURPOSES - TOTAL COST $14,037.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance275745BeginningOfYearBalance
Investment Earnings Or Losses4056InvestmentEarningsOrLosses
End Of Year Balance279801EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance281903BeginningOfYearBalance
Contributions1505Contributions
Investment Earnings Or Losses-7663InvestmentEarningsOrLosses
End Of Year Balance275745EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs1EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R1AreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis8OtherCostOrOtherBasis
Book Value8BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis83731368OtherCostOrOtherBasis
Depreciation49073839Depreciation
Book Value34657529BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1203076OtherCostOrOtherBasis
Depreciation268915Depreciation
Book Value934161BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis91107206OtherCostOrOtherBasis
Depreciation65381333Depreciation
Book Value25725873BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis38468447OtherCostOrOtherBasis
Depreciation1843202Depreciation
Book Value36625245BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings97942816TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
INTEREST IN NET ASSETS OF THE FOUNDATION FOR MOUNT NITTANY MEDICAL CTR, INC.8695583
OTHER ASSETS539948
Deferred Financing CostS3527293
FieldValueIRS element (for citing)
Total Book Value Other Assets12762824TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
DEFERRED COMPENSATION$287,232
ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS$3,089,261
Derivative Liability$508,973
Accrued Interest$472,500
FieldValueIRS element (for citing)
Total Of Amounts4357966TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt201464455TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments3118588NetUnrealizedGainsInvestments
Investment Expenses Not Included18872InvestmentExpensesNotIncluded
Tot Expenses Etc Audited Fincl Stmt180648534TotExpensesEtcAuditedFinclStmt
Investment Expenses Not Included218872InvestmentExpensesNotIncluded2

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part V, Line 4:Description of Intended Use of Endowment Funds:Permanent endowment funds are held by the Foundation for Mount Nittany Medical Center, Inc. and earnings are designated to fund future expenditures and capital acquisitons for Mount Nittany Medical Center.
Part X:Description of Uncertain Tax Positions Under FIN 48:The Corporation accounts for uncertainty in income taxes using a recognition threshold of more-likely-than not to be sustained upon examination by the appropriate taxing authority. Measurement of the tax uncertainty occurs if the recognition threshold is met. Management determined there were no tax uncertainties that met the recognition threshold in 2010 and 2009.

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsXMailSolicitations
In Person SolicitationsXInPersonSolicitations
Agreement Ref Fundraising1AgreementRefFundraising

Fundraiser Activity Information FundraiserActivityInformation

Name Of Organization NameOfOrganization

FieldValueIRS element (for citing)
Business Name Line1jeffrey Byrne & Associates IncBusinessNameLine1
FieldValueIRS element (for citing)
ActivityCommittment to DistinctionActivity
Fundraiser Control Of Funds0FundraiserControlOfFunds
Gross Receipts0GrossReceipts
Amount Retained By Contractor0AmountRetainedByContractor
Net To Organization30268NetToOrganization
FieldValueIRS element (for citing)
Total Net To Organization30268TotalNetToOrganization
Licensed StatesPALicensedStates

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage250.000000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care0FPGReferenceDiscountedCare
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available0ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense1236749TotalCommunityBenefitExpense
Net Community Benefit Expense1236749NetCommunityBenefitExpense
Percent Of Total Expense0.00710PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense12671000TotalCommunityBenefitExpense
Direct Offsetting Revenue5996446DirectOffsettingRevenue
Net Community Benefit Expense6674554NetCommunityBenefitExpense
Percent Of Total Expense0.03820PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense13907749TotalCommunityBenefitExpense
Direct Offsetting Revenue5996446DirectOffsettingRevenue
Net Community Benefit Expense7911303NetCommunityBenefitExpense
Percent Of Total Expense0.04530PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense225233TotalCommunityBenefitExpense
Direct Offsetting Revenue2000DirectOffsettingRevenue
Net Community Benefit Expense223233NetCommunityBenefitExpense
Percent Of Total Expense0.00130PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense278327TotalCommunityBenefitExpense
Direct Offsetting Revenue9378DirectOffsettingRevenue
Net Community Benefit Expense268949NetCommunityBenefitExpense
Percent Of Total Expense0.00150PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense3170340TotalCommunityBenefitExpense
Direct Offsetting Revenue1955924DirectOffsettingRevenue
Net Community Benefit Expense1214416NetCommunityBenefitExpense
Percent Of Total Expense0.00700PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense466851TotalCommunityBenefitExpense
Net Community Benefit Expense466851NetCommunityBenefitExpense
Percent Of Total Expense0.00270PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense4140751TotalCommunityBenefitExpense
Direct Offsetting Revenue1967302DirectOffsettingRevenue
Net Community Benefit Expense2173449NetCommunityBenefitExpense
Percent Of Total Expense0.01250PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense18048500TotalCommunityBenefitExpense
Direct Offsetting Revenue7963748DirectOffsettingRevenue
Net Community Benefit Expense10084752NetCommunityBenefitExpense
Percent Of Total Expense0.05780PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense834TotalCommunityBuildingExpense
Net Community Building Expense834NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense2287TotalCommunityBuildingExpense
Net Community Building Expense2287NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense5959TotalCommunityBuildingExpense
Net Community Building Expense5959NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense205786TotalCommunityBuildingExpense
Net Community Building Expense205786NetCommunityBuildingExpense
Percent Of Total Expense0.00120PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense214866TotalCommunityBuildingExpense
Net Community Building Expense214866NetCommunityBuildingExpense
Percent Of Total Expense0.00120PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$2,173,663BadDebtExpenseAmount
Amount Reimbursed By Medicare33860938AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare42853489CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-8992551MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line1ADG-HOSPITAL DRIVE ASSOCIATESBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivityLEASING REAL PROPERTY FOR A SURGICAL CENTER AND MEDICAL OFFICEDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.24260OrganizationProfitOrOwnership

Form990 Schedule H Part V Form990ScheduleHPartV

Name Name

FieldValueIRS element (for citing)
Business Name Line1Mount Nittany Medical CenterBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11800 East Park AvenueAddressLine1
CityState CollegeCity
StatePAState
ZIP Code16803ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Costing Method UsedPart I, Line 7: Cost to charge ratio was computed using Worksheet 2 in the IRS instructions to Form 990 for lines 7a, 7b, and 7g. Cost accounting system was used for Subsidized Health Services. For all others, costs included the value of staff donated hours (with estimated benefits), monetary contributions, estimated value of materials used in delivering programs, and estimated space costs. The indirect cost allocation applies the indirect-to-direct cost ratio from the Medical Center's most recent Medicare Cost Report (approx. 31%).CostingMethodUsed
Percent Of Total Expense ExplnPart I, Line 7f: Amount of bad debt expense from Part IX subtracted in order to calculate percent of total expense in Part I Line 7 column f was $6,451,954.PercentOfTotalExpenseExpln
Bad Debt FootnotePart III, Line 4: Bad debt (at cost) is calculated by applying the patient care cost-to-charge ratio from Worksheet 2 to the Medical Center's provision for doubtful collections as of June 30, 2010. The Medical Center's Accounting Department records payments, while Patient Accounting staff makes appropriate adjustments to patient accounts for bad debt, discounts, or free care write-offs. The Medical Center is unable to estimate the amount of bad debt that could be attributable to patients who likely would qualify for financial assistance under the hospital's charity care policy. Patients do not provide income information prior to receiving care. Patients voluntarily contact the Medical Center to inquire about financial assistance. The Medical Center offers detailed information about the charity care program if and when patients offer information that is needed to determine eligibility. See response to Part VI, Line 2 herein. Bad debt is published in the consolidated audited financial statements on the Statement of Operations on the line entitled, "Provision for doubtful collections."BadDebtFootnote
Shortfall As Community BenefitPart III, Line 8: The Medical Center continues to provide care to all presenting and admitted patients, regardless of ability or pay. Notwithstanding the costs to provide care, receiving "less" than what it costs to provide adequate care to Medicare covered lives does the Medical Center a disservice. This shortfall should count as a community benefit. The Medical Center uses a step-down cost allocation method and then applies a cost-to-charge ratio.ShortfallAsCommunityBenefit
Debt Collection PolicyPart III, Line 9b: If patients are found to qualify, the Medical Center immediately ceases collections and adjusts charges off as charity care.DebtCollectionPolicy
Needs AssessmentPart VI, Line 2: The Medical Center uses, when appropriate, a combination of consultants, consultant reports, focus groups, and strong "grassroots" networking with community members and medical staff to determine needs, trends, preferences, and "best practices" for planning the delivery of care in the communities served by the Medical Center.NeedsAssessment
Patient Education AssistancePart VI, Line 3: The Medical Center posts financial assistance information in patient registration areas and provides literature to patients about financial assistance options.PatientEducationAssistance
Community InformationPart VI, Line 4: The Medical Center's primary service area includes Centre County and parts of the surrounding counties. Centre County's population is approximately 150,000. Approximately 13% of the population is aged 0-14, 76% aged 15-64, and 11% is 65 or older. The estimate for the population living below the poverty line is 14.8%. The median age in Centre County is 27.4 (39.9 for all of PA). 40.4% of those aged 25 or older have at least a bachelor's degree vs. 26.4% for all of PA. The median household income is $48,960, while the PA median is $49,520. 40,000+ college students live in State College. Mount Nittany Medical Center is the sole general acute care hospital in Centre County. The nearest Level II Trauma Center is approx. 43 miles away. Part of Centre County is a designated medically underserved area.CommunityInformation
Community Building ActivitiesPart VI, Line 5: The Medical Center and its staff invest in workforce development by offering training opportunities, such as resource-intensive internships for nursing students in the region, as well as contributing time and resources to regional planning efforts and leadership development. For the internships and related programs, considerable staff time is required to organize these programs and provide "preceptor" or instructor services while continuing to provide direct care for patients with normal job responsibilities.CommunityBuildingActivities
Other InformationPart VI, Line 6: The Medical Center's Board of Trustees and its various committees include community members who are not directly involved in the Medical Center's operations, as well as medical staff. The Medical Center's medical staff exceeds 270 physicians and continues to invest in strong and beneficial relationships with all physicians who have an interest in working with the Medical Center. All revenues in excess of expenses are re-invested in the community, including significant donations to the county's only free medical and dental clinic, as well as internal improvements to technology so that the communities we serve have immediate access to the best and most appropriate diagnostic and treatment options available.OtherInformation
Affiliated Health Care SystemPart VI, Line 7: As of June 30, 2010, the Medical Center (inpatient and outpatient services) had three controlled corporations, including the Foundation for Mount Nittany Medical Center, Inc. (fundraising), Mount Nittany Surgical Center, Inc.(outpatient surgical center), and Mount Nittany Medical Center Health Services, Inc. (physician group practice).AffiliatedHealthCareSystem

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained0RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1Mount Nittany Medical Center Health Services IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11800 East Park AvenueAddressLine1
CityState CollegeCity
StatePAState
ZIP Code16803ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient510426500EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant4566613AmountOfCashGrant
Amount Of Non Cash Assistance0AmountOfNonCashAssistance
Method Of ValuationCASHMethodOfValuation
Description Of Non Cash AssistanceN/ADescriptionOfNonCashAssistance
Purpose Of GrantPROVIDE FINANCIAL SUPPORT TO AFFILIATEPurposeOfGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, Part I, Line 2: ASSISTANCE IS PROVIDED TO RELATED ENTITIES FOR FINANCIAL SUPPORT. MANAGEMENT OF THE HEALTH SYSTEM OVERSEES THE USE OF FUNDS AT THE AFFILIATED ENTITIES.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Housing Allowance Or ResidenceXHousingAllowanceOrResidence
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 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 OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
RICHARD WISNIEWSKI
29044002726900000413690359078000
DAVID PETERSON
21096202856600000408390280367000
neal holter
180470000000029760183446000
SADY RIBEIRO MD
3724750000000368050409280000
DR DALE DANNEKER
2877150000000454920333207000
DR WILLIAM HYLBERT
1898080000000297260219534000
Janet Schachtner
16499002102600000360280222044000
LANCE H ROSE
1472100000001126015847000
THOMAS J MURRAY
474421028824061971000457680610984000

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part I, Line 1aSteve Brown received a housing allowance for personal use when he was hired on 3/15/10. This housing allowance will be included in his taxable income for 2010. Steve Brown did not receive any compensation from Mount Nittany Medical Center during the calendar year 2009 to report on Schedule J or Part VII of the 990.
Part I, Line 4aFormer President and CEO - Thomas Murray was given a severance package during 5/09, which paid him for eighteen months. His last pay was 11/16/2010. Former President and CEO Lance Rose received nonqualified pension payments.
Part I, Line 6The executive team members received a portion of their annual variable-pay based upon net earnings of Mount Nittany Medical Center.
Part I, Line 7The executive team members received a portion of their annual variable-pay based upon the net earnings of Mount Nittany Medical Center and other corporate goals. The corporate goals for 2010 focused on finance, growth, human resources, clinical quality and patient safety.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1Centre County Hospital AuthorityBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN203197497IssuerEIN
CUSIP Number156273CE2CUSIPNumber
Date Issued2009-03-26DateIssued
Issue Price69748005IssuePrice
Description Of PurposeTo fund east wing expansion and other capital expendituresDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer1OnBehalfOfIssuer

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds70000000TotalProceeds
Amount In Reserve Fund15743428AmountInReserveFund
Amount Unspent8191010AmountUnspent
Issuance Costs From Proceeds3721113IssuanceCostsFromProceeds
Capital Expenditures39459562CapitalExpenditures
Year Of Subst Completion2013YearOfSubstCompletion
Current Refunding0CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made0FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Bond Counsel Routinely Engaged0BondCounselRoutinelyEngaged
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Post Issuance Compliance Procdrs0PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed0Form8038TFiled
Variable Rate Issue0VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate0ExceptionToRebate

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section A, line 6At one point in time, physicians on staff at the Hospital paid for a membership in the organization. The members currently have reserve powers to vote on the sale or closing of the Hospital.
Form 990, Part VI, Section A, line 7bThe members currently have reserve powers to vote on the sale or closing of the Hospital.
Form 990, Part VI, Section B, line 11the 990 was reviewed by the Mount Nittany Medical Center Audit Committee before it was filed with the IRS.
Form 990, Part VI, Section B, line 12cANNUALLY PHYSICIANS, KEY STAFF MEMBERS, BOARD OF TRUSTEE MEMBERS ARE REQUESTED TO COMPLETE A CONFLICT OF INTEREST DOCUMENT, WHICH IS REVIEWED BY THE CORPORATE COMPLIANCE OFFICER. THE CORPORATE COMPLIANCE OFFICER REPORTS ANY POTENTIAL ISSUES TO THE AUDIT COMMITTEE FOR THEIR REVIEW AND FINAL APPROVAL.
Form 990, Part VI, Section B, line 15Executive compensation committee from Board of Trustees reviews compensation paid to Executive Management team in conjunction with a third party organization to ensure compensation is reasonable and appropriate for duties and responsibilites assigned.
Form 990, Part VI, Section C, line 19Governing documents, conflict of interest policy and financial statements are made available to the public upon request.
FORM 990, SCHEDULE K, LINE 3 THERE ARE NO MANAGEMENT OR SERVICE CONTRACTS OR RESEARCH AGREEMENTS RELATING TO THE FINANCED PROPERTIES FOR THE 2009 BONDS.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNA
THE FOUNDATION FOR MOUNT NITTANY MEDICAL CENTER INC
1800 EAST PARK AVENUESTATE COLLEGEPA168036796571138956FUNDRAISING AND SUPPORT FOR MOUNT NITTANY MEDICAL CENTERPA501(C)(3)11AN/A
MOUNT NITTANY MEDICAL CENTER WORKMEN'S COMPENSATION SELF INSURANCE TRUST
1800 EAST PARK AVENUESTATE COLLEGEPA168036796256440788PROVIDE WORKMEN'S COMPENSATION BENEFITS TO EMPLOYEES OF MNMCPA501(C)(3)11AN/A
MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES INC
1800 EAST PARK AVENUESTATE COLLEGEPA168036796510426500PROFESSIONAL SERVICES TO SUPPORT MNMCPA501(C)(3)11AN/A
MOUNT NITTANY SURGICAL CENTER INC
1850 EAST PARK AVENUESTATE COLLEGEPA168036796251712099HEALTHCAREPA501(C)(3)11AN/A
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (7 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
FOUNDATION FOR MOUNT NITTANY MEDICAL CENTER
C263157
FOUNDATION FOR MOUNT NITTANY MEDICAL CENTER
K370000
FOUNDATION FOR MOUNT NITTANY MEDICAL CENTER
N210284
mOUNT NITTANY MEDICAL CENTER HEALTH SERVICES INC
B4566613
MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES INC
K845000
MOUNT NITTANY SURGICAL CENTER
C100000
MOUNT NITTANY SURGICAL CENTER
K798000

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