UPMC: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- UPMC (EIN 24-0802108)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-03-15
- IRS object ID
- 201140749349300109
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-03-15T12:05:43-04:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E ST LOUIS 200/PO BOX 1190 | AddressLine1 |
| City | SPRINGFIELD | City |
| State | MO | State |
| ZIP Code | 658062523 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 240802108 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHARLES COLE MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CHAR | NameControl |
| Phone | 8142749300 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 EAST SECOND STREET | AddressLine1 |
| City | COUDERSPORT | City |
| State | PA | State |
| ZIP Code | 16915 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | EDWARD PITCHFORD | Name |
| Title | CEO | Title |
| Date Signed | 2010-01-07 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Brian D Todd | Name |
| Phone | 4178658701 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | EDWARD PITCHFORD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 EAST SECOND STREET | AddressLine1 |
| City | COUDERSPORT | City |
| State | PA | State |
| ZIP Code | 16915 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 69452002 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | http://www.charlescolehospital.com/ | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1967 | YearFormation |
| State Legal Domicile | PA | StateLegalDomicile |
| Activity Or Mission Description | THE PURPOSE OF CHARLES COLE MEMORIAL HOSPITAL IS TO PROVIDE EXCELLENT HEALTHCARE SERVICES, RESPONDING TO THE NEEDS OF THE COMMUNITIES WE SERVE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 685 | TotalNbrEmployees |
| Total Nbr Volunteers | 65 | TotalNbrVolunteers |
| Total Gross UBI | 73131 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 71775 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 976043 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 692259 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 60590802 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 63883574 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -197348 | InvestmentIncomePriorYear |
| Investment Income Current Year | 882589 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 4610 | OtherRevenuePriorYear |
| Other Revenue Current Year | 63394 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 61374107 | TotalRevenuePriorYear |
| Total Revenue Current Year | 65521816 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 27483500 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 29387358 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 54904 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 56082 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 34188602 | OtherExpensePriorYear |
| Other Expenses Current Year | 36868321 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 61672102 | TotalExpensesPriorYear |
| Total Expenses Current Year | 66310583 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -297995 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -788767 | RevenuesLessExpensesCY |
| Total Assets BOY | 53913783 | TotalAssetsBOY |
| Total Assets EOY | 52729110 | TotalAssetsEOY |
| Total Liabilities BOY | 36337133 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 37784281 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 17576650 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 14944829 | NetAssetsOrFundBalancesEOY |
| Mission Description | SEE SCHEDULE O. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 12825232 | Expense |
| Revenue | 16761321 | Revenue |
| Description | CHARLES COLE MEMORIAL HOSPITAL OFFERS VARIOUS INPATIENT SERVICES. CCMH ADMITTED 2,900 PATIENTS LAST YEAR (5,600 ACUTE CARE DAYS) TO INPATIENT SERVICES INCLUDING MEDICAL/SURGICAL, INTENSIVE CARE AND OBSTETRICS UNITS. CCMH'S 24-HOUR EMERGENCY DEPARTMENT ADMITTED 960 PATIENTS LAST YEAR AND SAW 9,300 VISITS LAST YEAR. THE HOSPITAL'S MATERNITY UNIT WELCOMED 250 BABIES INTO THE WORLD LAST YEAR AND ALSO SUPPORTS MOTHERS-TO-BE WITH REGULAR LAMAZE AND BREASTFEEDING SUPPORT PROGRAMS AND THE HEALTHY BEGINNINGS PLUS PROGRAM FOR LOW INCOME MOTHERS. INPATIENT SATISFACTION RANKS IN THE TOP 6% ACROSS THE NATION. SEE SCHEDULE O FOR FURTHER DETAIL. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 18838098 | Expense |
| Revenue | 31165357 | Revenue |
| Description | CHARLES COLE MEMORIAL HOSPITAL OFFERS VARIOUS OUTPATIENT SERVICES. OUTPATIENT SERVICES EXCEED 348,400 VISITS ANNUALLY. SERVICES ARE OFFERED THROUGHOUT THE HOSPITAL'S FOUR-COUNTY AREA AND INCLUDE IMAGING, LAB, AND REHABILITATION SERVICES. OUTPATIENT SURGERIES EXCEED 3,900 ANNUALLY. THE PATTERSON CANCER CARE CENTER OFFERS FULL SERVICE RADIATION AND MEDICAL ONCOLOGY SERVICES AND HOUSES AN AMERICAN CANCER SOCIETY PATIENT RESOURCE CENTER ONSITE. THE CANCER CENTER IS HOME TO A VARIETY OF SUPPORT GROUPS, AS WELL AS FREQUENT FREE CANCER SCREENINGS FOR THE PUBLIC. SEE SCHEDULE O FOR FURTHER DETAIL. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 11432812 | Expense |
| Revenue | 6835807 | Revenue |
| Description | CHARLES COLE MEMORIAL HOSPITAL PROVIDES PRIMARY CARE TO ITS SURROUNDING COMMUNITIES. THE HOSPITAL PROVIDES PRIMARY CARE TO THE SURROUNDING COMMUNITIES IN FOUR COUNTIES AT RURAL HEALTH CENTERS (RHCS), LOCATED IN COUDERSPORT, GALETON, ULYSSES, WESTFIELD, SHINGLEHOUSE, PORT ALLEGANY, ELDRED, SMETHPORT, AND EMPORIUM. FOUR OF THOSE LOCATIONS ALSO INCLUDE WELLNESS AND REHABILITATION CENTERS, MAKING IT MORE CONVENIENT FOR PATIENTS TO RECEIVE THE CARE THEY NEED CLOSE TO HOME. SEE SCHEDULE O FOR FURTHER DETAIL. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 14852936 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Rev | 9121089 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 57949078 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | true | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | true | ProfessionalFundraising |
| Fundraising Activities | true | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | true | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 51 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 685 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | true | QuidProQuoContributions |
| Quid Pro Quo Disclosure | true | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | true | InvestmentInJointVenture |
| Written Policy Or Procedure | true | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | PA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | RON RAPP CONTROLLER | NamePerson |
| Telephone Number | 8142749300 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 EAST SECOND STREET | AddressLine1 |
| City | COUDERSPORT | City |
| State | PA | State |
| ZIP Code | 16915 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (19 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| MICHAEL E CALLAHAN | ||||||||
| PHYSICIAN, SECRETARY | 40.0 | X | X | 192147 | 0 | 6916 | ||
| EDWARD C PITCHFORD | ||||||||
| PRESIDENT, CEO, & ASST. SEC. | 40.0 | X | X | 276386 | 0 | 9821 | ||
| JASON TRONETTI | ||||||||
| PHYSICIAN, DIRECTOR | 40.0 | X | 323750 | 0 | 8702 | |||
| SETH P SHIFRIN | ||||||||
| PHYSICIAN, DIRECTOR | 40.0 | X | 246798 | 0 | 9726 | |||
| CHARLES UPDEGRAFF | ||||||||
| CHAIRMAN | 1.0 | X | X | 0 | 0 | 0 | ||
| RON CASKEY | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| REVEREND RANDALL HEADLEY | ||||||||
| 2ND VICE CHAIRMAN | 1.0 | X | X | 0 | 0 | 0 | ||
| ROBERT MARTIN | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| HOWARD MILLER | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| PAUL PRITCHARD | ||||||||
| TREASURER | 1.0 | X | X | 0 | 0 | 0 | ||
| ROBERT SMITH | ||||||||
| 1ST VICE CHAIRMAN | 1.0 | X | X | 0 | 0 | 0 | ||
| RUSSELL STREICH | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| SUSAN KEFOVER | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| CYNTHIA L HARDESTY | ||||||||
| VICE PRESIDENT, CNE | 40.0 | 178216 | 0 | 5550 | X | |||
| BRADLEY F GIANNOTTI | ||||||||
| PHYSICIAN | 40.0 | 880972 | 0 | 7252 | X | |||
| CHRISTAN M CARAMIA | ||||||||
| PHYSICIAN | 40.0 | 605350 | 0 | 9877 | X | |||
| SAKET PRASAD | ||||||||
| PHYSICIAN | 40.0 | 626106 | 0 | 9376 | X | |||
| TERRANCE FOUST | ||||||||
| PHYSICIAN | 40.0 | 478444 | 0 | 9274 | X | |||
| FRANK HORN | ||||||||
| PHYSICIAN | 16.0 | 284679 | 0 | 7518 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 4092848 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 84012 | TotalOtherCompensation |
| Number Individuals GT100 K | 34 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| JAMES BARKE MD | |||||
| PO BOX 110 | SHINGLEHOUSE | PA | 16748 | PHYSICIAN | 586282 |
| CELSO L BACKES MD | |||||
| 1001 E 2ND ST | COUDERSPORT | PA | 16915 | PHYSICIAN | 212758 |
| FOOT ANKLE INNOV | |||||
| 2960 PERMISSION DR | ERIE | PA | 16509 | PHYSICIAN | 198490 |
| BKD LLP | |||||
| PO BOX 1190 | SPRINGFIELD | MO | 65801 | AUDITING & TAX PREP | 122871 |
| ENERGY TECH | |||||
| PO BOX 804 | COUDERSPORT | PA | 16915 | HEATING CONTRACTOR | 115927 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 6 | NumberOfContractorsGT100K |
| Fundraising Events | 27805 | FundraisingEvents |
| Government Grants | 394751 | GovernmentGrants |
| All Other Contributions | 269703 | AllOtherContributions |
| Total Contributions | 692259 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621990 | 63148468 | 63148468 |
| OTHER REVENUE | 621990 | 735106 | 735106 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 63883574 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 162767 | TotalRevenueColumn |
| Exclusion | $162,767 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 62449 | TotalRevenueColumn |
| Exclusion | $62,449 | ExclusionAmount |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 374649 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 423797 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -49148 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -49148 | TotalRevenueColumn |
| Exclusion | -$49,148 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 4092854 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 3432434 | Securities |
| Other | 3047 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 660420 | Securities |
| Other | -3047 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 657373 | TotalRevenueColumn |
| Exclusion | $657,373 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 7920 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 27805 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 11449 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -3529 | TotalRevenueColumn |
| Exclusion | -$3,529 | ExclusionAmount |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 49320 | GrossSalesOfInventory |
| Cost Of Goods Sold | 59459 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -10139 | TotalRevenueColumn |
| Exclusion | -$10,139 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| GAIN ON INVESTMENT IN EQUITY INVESTEE | 900099 | 11200 | $11,200 | |
| INCOME FROM INVESTMENT IN SUBSIDIARIES | 621500 | 115010 | $41,879 | 73131 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 126210 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 65521816 | TotalRevenueColumn |
| Related Or Exempt Function Income | 63883574 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 73131 | UnrelatedBusinessRevenue |
| Exclusion | $872,852 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1258013 | Total |
| Program Services | 788040 | ProgramServices |
| Management And General | 469973 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 141775 | Total |
| Management And General | 141775 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21297601 | Total |
| Program Services | 18019322 | ProgramServices |
| Management And General | 3278279 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 715645 | Total |
| Program Services | 601893 | ProgramServices |
| Management And General | 113752 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4293156 | Total |
| Program Services | 3563782 | ProgramServices |
| Management And General | 729374 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1681168 | Total |
| Program Services | 1394082 | ProgramServices |
| Management And General | 287086 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 272402 | Total |
| Program Services | 272402 | ProgramServices |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 92399 | Total |
| Management And General | 92399 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 133821 | Total |
| Management And General | 133821 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54904 | Total |
| Fundraising | 54904 | Fundraising |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 55016 | Total |
| Management And General | 55016 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13581842 | Total |
| Program Services | 13048988 | ProgramServices |
| Management And General | 532854 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 83945 | Total |
| Program Services | 547 | ProgramServices |
| Management And General | 83398 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13334688 | Total |
| Program Services | 12182694 | ProgramServices |
| Management And General | 1151994 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 955139 | Total |
| Program Services | 816467 | ProgramServices |
| Management And General | 138672 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 309840 | Total |
| Program Services | 272845 | ProgramServices |
| Management And General | 36995 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 238522 | Total |
| Program Services | 120411 | ProgramServices |
| Management And General | 118111 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1248233 | Total |
| Program Services | 1143065 | ProgramServices |
| Management And General | 105168 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2503862 | Total |
| Program Services | 2292904 | ProgramServices |
| Management And General | 210958 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1065618 | Total |
| Program Services | 607890 | ProgramServices |
| Management And General | 457728 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| DUES & SUBSCRIPTIONS | 259183 | 91113 | 168070 | |
| PROVISION FOR BAD DEBTS | 2732633 | 2732633 | ||
| OTHER FUNDRAISING EXPENSES | 1178 | 1178 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 66310583 | Total |
| Program Services | 57949078 | ProgramServices |
| Management And General | 8305423 | ManagementAndGeneral |
| Fundraising | 56082 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4084541 | BOY |
| EOY | 5018474 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 316465 | BOY |
| EOY | 206716 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7508068 | BOY |
| EOY | 7106477 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 845679 | BOY |
| EOY | 981423 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2001805 | BOY |
| EOY | 2099925 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 65211491 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 41156401 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25483447 | BOY |
| EOY | 24055090 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10758111 | BOY |
| EOY | 10756526 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1437522 | BOY |
| EOY | 1171705 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60945 | BOY |
| EOY | 117496 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1417200 | BOY |
| EOY | 1215278 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 53913783 | BOY |
| EOY | 52729110 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6680112 | BOY |
| EOY | 6738312 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21010498 | BOY |
| EOY | 20292611 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2731447 | BOY |
| EOY | 2268171 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5915076 | BOY |
| EOY | 8485187 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36337133 | BOY |
| EOY | 37784281 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13508602 | BOY |
| EOY | 10850438 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 451693 | BOY |
| EOY | 426591 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3616355 | BOY |
| EOY | 3667800 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17576650 | BOY |
| EOY | 14944829 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 53913783 | BOY |
| EOY | 52729110 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $9,698 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 9698 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | LOBBYING ACTIVITIES | Identifier |
| Return Reference | SCHEDULE C, PART II-B, LINE 1I | ReturnReference |
| Explanation | THE ORGANIZATION IS A MEMBER OF HAP, AHA, AND HCWP. $9,698 OF DUES ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3616355 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 437150 | InvestmentEarningsOrLosses |
| Other Expenditures | 385705 | OtherExpenditures |
| End Of Year Balance | 3667800 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 4837234 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -1006344 | InvestmentEarningsOrLosses |
| Other Expenditures | 214535 | OtherExpenditures |
| End Of Year Balance | 3616355 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | true | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 1136374 | OtherCostOrOtherBasis |
| Book Value | 1136374 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 420907 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 27083873 | OtherCostOrOtherBasis |
| Depreciation | 13590664 | Depreciation |
| Book Value | 13914116 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 10125621 | OtherCostOrOtherBasis |
| Depreciation | 5130616 | Depreciation |
| Book Value | 4995005 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 24490970 | OtherCostOrOtherBasis |
| Depreciation | 21282527 | Depreciation |
| Book Value | 3208443 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1953746 | OtherCostOrOtherBasis |
| Depreciation | 1152594 | Depreciation |
| Book Value | 801152 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 24055090 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| PENSION BENEFIT OBLIGATION | $6,702,093 |
| DUE TO 3RD PARTIES | $1,783,094 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 8485187 | TotalOfAmounts |
| Total Revenue | 65521816 | TotalRevenue |
| Total Expenses | 66310583 | TotalExpenses |
| Excess Or Deficit For Year | -788767 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 277382 | NetUnrealizedGLOnInvestments |
| Other | -$2,123,560 | OtherAmount |
| Total Adjustments | -1846178 | TotalAdjustments |
| Excess Or Deficit Per FS | -2634945 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 64110884 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 277382 | NetUnrealizedGainsInvestments |
| Other Revenues | -2097974 | OtherRevenues |
| Revenue Not Rptd F990 | -1820592 | RevenueNotRptdF990 |
| Revenue Subtotal | 65931476 | RevenueSubtotal |
| Other Revenues Not Included | -409660 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | -409660 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 65521816 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 66745829 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 435246 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 435246 | ExpensesNotRptdF990 |
| Expenses Subtotal | 66310583 | ExpensesSubtotal |
| Total Expenses Per Form990 | 66310583 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| FIN 48 DISCLOSURE | SCHEDULE D, PART X, LINE 2 | THE ORGANIZATION ADOPTED THE PROVISIONS OF FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) INTERPRETATION NO. 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. BECAUSE NO MATERIAL UNCERTAIN TAX POSITIONS WERE IDENTIFIED, A DISCLOSURE WAS NOT INCLUDED IN THE FOOTNOTES TO THE FINANCIAL STATEMENTS. |
| ENDOWMENT FUND | SCHEDULE D, PART V, LINE 4 | THE ENDOWMENT FUND WAS ESTABLISHED TO ALLOW THE HOSPITAL TO PROVIDE HEALTHCARE SERVICES TO POOR AND NEEDY PATIENTS. |
| OTHER CHANGES IN NET ASSETS | SCHEDULE D, PART XI, LINE 8 | DEFINED BENEFIT PENSION COSTS: AMORTIZATION OF NET LOSS 175,178 NET LOSS ARISING DURING YEAR (2,273,152) AUXILIARY SPECIAL EVENT REVENUE (35,725) AUXILIARY SALES OF INVENTORY (49,320) AUXILIARY COST OF GOODS SOLD 59,459 |
| OTHER AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART VII, LINE 12 | SCHEDULE D, PART XII, LINE 2D | DEFINED BENEFIT PENSION COSTS: AMORTIZATION OF NET LOSS 175,178 NET LOSS ARISING DURING YEAR (2,273,152) |
| OTHER AMOUNTS INCLUDED ON FORM 990, PART VII, LINE 12, BUT NOT ON LINE 1 | SCHEDULE D, PART XII, LINE 4B | RENTAL EXPENSES (423,797) SPECIAL EVENT EXPENSE (11,449) AUXILIARY SPECIAL EVENT REVENUE 35,725 AUXILIARY SALES OF INVENTORY 49,320 AUXILIARY COST OF GOODS SOLD (59,459) |
| OTHER AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART IX, LINE 25 | SCHEDULE D, PART XIII, LINE 2D | SPECIAL EVENT EXPENSES 11,449 RENTAL EXPENSES 423,797 |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Solicitation Of Non Govt Grants | X | SolicitationOfNonGovtGrants |
| Solicitation Of Govt Grants | X | SolicitationOfGovtGrants |
| Agreement Ref Fundraising | true | AgreementRefFundraising |
Fundraiser Activity Information FundraiserActivityInformation (2 entries)
| Name Of IndividualNameOfIndividual | ActivityActivity | Fundraiser Control Of FundsFundraiserControlOfFunds | Gross ReceiptsGrossReceipts | Amount Retained By ContractorAmountRetainedByContractor | Net To OrganizationNetToOrganization |
|---|---|---|---|---|---|
| AUMAN WEIS ENTERPRISES | GRANT WRITING | false | 40945 | 19904 | 21041 |
| DELTA DEVELOPMENT GROUP INC | GRANT WRITING | false | 35000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Gross Receipts | 40945 | TotalGrossReceipts |
| Total Retained By Contractors | 54904 | TotalRetainedByContractors |
| Total Net To Organization | 21041 | TotalNetToOrganization |
| Licensed States | PA | LicensedStates |
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF TOURNAMENT | NameOfEvent1 |
| Gross Receipts Event1 | 35725 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 27805 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 7920 | GrossRevenueEvent1 |
| Cash Prizes Event1 | 2245 | CashPrizesEvent1 |
| Non Cash Prizes Event1 | 1555 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 3239 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 3857 | FoodAndBeverageEvent1 |
| Other Direct Expenses Event1 | 553 | OtherDirectExpensesEvent1 |
| Total Number Of Other Events | 0 | TotalNumberOfOtherEvents |
| Gross Receipts Total | 35725 | GrossReceiptsTotal |
| Charitable Contributions Total | 27805 | CharitableContributionsTotal |
| Gross Revenue Total Events | 7920 | GrossRevenueTotalEvents |
| Cash Prizes Total Events | 2245 | CashPrizesTotalEvents |
| Non Cash Prizes Total Events | 1555 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 3239 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 3857 | FoodAndBeverageTotalEvents |
| Other Direct Expenses Total Events | 553 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 11449 | DirectExpenseSummaryEvents |
| Net Income Summary | -3529 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 515388 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 515388 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00780 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12831335 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8249525 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4581810 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06910 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13346723 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8249525 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5097198 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07690 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 187812 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 32587 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 155225 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00230 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 315313 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1690 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 313623 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00470 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 18891594 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13643574 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5248020 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07920 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1128 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1128 | NetCommunityBenefitExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 19395847 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13677851 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5717996 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08620 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 32742570 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 21927376 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 10815194 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.16310 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 75 | PersonsServed |
| Total Community Building Expense | 150 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 150 | NetCommunityBuildingExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 5 | NumberOfActivitiesOrPrograms |
| Persons Served | 170 | PersonsServed |
| Total Community Building Expense | 4451 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 4451 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 3956 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 3956 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 11 | NumberOfActivitiesOrPrograms |
| Persons Served | 80 | PersonsServed |
| Total Community Building Expense | 6199 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 6199 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 5 | NumberOfActivitiesOrPrograms |
| Persons Served | 156 | PersonsServed |
| Total Community Building Expense | 2167 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2167 | NetCommunityBuildingExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 26 | NumberOfActivitiesOrPrograms |
| Persons Served | 481 | PersonsServed |
| Total Community Building Expense | 16923 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 16923 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReported |
| Bad Debt Expense | $1,373,695 | BadDebtExpenseAmount |
| Amount Attributable To | 209488 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 20565863 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 22594859 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -2028996 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | X | CostAccountingSystem |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV (10 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Critical Access HospitalCriticalAccessHospital | Er24 HoursEr24Hours | OtherOther |
|---|---|---|---|---|---|---|---|---|
| CHARLES COLE MEMORIAL HOSPITAL | ||||||||
| 1001 EAST 2ND STREET | COUDERSPORT | PA | 16915 | X | X | X | X | |
| ELDRED HEALTH CENTER | ||||||||
| 139 MAIN STREET | ELDRED | PA | 16371 | RURAL HEALTH CENTER | ||||
| EMPORIUM HEALTH CENTER | ||||||||
| SIZERVILLE ROAD | EMPORIUM | PA | 15834 | RURAL HEALTH CENTER REHABILITATION WELLNESS | ||||
| GALETON HEALTH CENTER | ||||||||
| 30 RIVER STREET | GALETON | PA | 16922 | RURAL HEALTH CENTER | ||||
| PORT ALLEGANY HEALTH CENTER | ||||||||
| 45 PINE STREET | PORT ALLEGANY | PA | 16743 | RURAL HEALTH CENTER REHABILITATION WELLNESS, RADIOLOGY | ||||
| SMETHPORT HEALTH CENTER | ||||||||
| 83 MARVIN STREET | SMETHPORT | PA | 16749 | RURAL HEALTH CENTER REHABILITATION WELLNESS | ||||
| SHINGLEHOUSE HEALTH CENTER | ||||||||
| 128 LYONS STREET | SHINGLEHOUSE | PA | 16748 | RURAL HEALTH CENTER | ||||
| NORTHERN POTTER HEALTH CENTER | ||||||||
| 511 ACADEMY STREET | ULYSSES | PA | 16948 | RURAL HEALTH CENTER | ||||
| WESTFIELD RURAL HEALTH CLINIC | ||||||||
| 222 CHURCH STREET | SHINGLEHOUSE | PA | 16950 | RURAL HEALTH CENTER | ||||
| HEWITT MANOR | ||||||||
| 111 WEST HONEOYE STREET | SHINGLEHOUSE | PA | 16748 | REHABILITATION | ||||
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subsidized Health Services Expln | SEVERAL RURAL HEALTH CLINICS WERE INCLUDED IN THE COMPUTATION OF SUBSIDIZED HEALTH SERVICES ON LINE 7G. CCMH PROVIDES PRIMARY CARE TO THE SURROUNDING COUNTIES AT THESE RURAL HEALTH CENTERS. THESE SERVICES ARE PROVIDED IN RURAL AREAS WHERE THERE WOULD BE A SHORTAGE OF QUALITY MEDICAL CARE WITHOUT THE SERVICES. CCMH CONTINUES TO PROVIDE THESE SERVICES AS A BENEFIT TO THE COMMUNITY DESPITE KNOWING THAT FINANCIAL SHORTFALLS WILL BE SUSTAINED. | SubsidizedHealthServicesExpln |
| Bad Debt Footnote | THE HOSPITAL PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS, WHICH IS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE PATIENT OR THIRD-PARTY PAYER. LINE 2 WAS DETERMINED BY TAKING THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TIMES THE RATIO OF PATIENT CARE COST TO CHARGES FROM WORKSHEET 2, LINE 11. LINE 3 WAS DETERMINED BY TAKING THE BAD DEBT EXPENSE AT COST (LINE 2) TIMES THE PERCENT OF PERSONS BELOW THE POVERTY LEVEL FOR 2008 BASED ON US CENSUS BUREAU DATA. | BadDebtFootnote |
| Shortfall As Community Benefit | MEDICARE DATA COMPUTED USING THE MEDICARE COST REPORT FILED WITH CMS WAS UTILIZED FOR THE COMPUTATIONS IN PART III, SECTION B. MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT, AS CCMH IS CLASSIFIED AS A CRITICAL ACCESS HOSPITAL. THIS CLASSIFICATION SHOWS THAT CCMH IS IN A MEDICALLY UNDERSERVED AREA AND AT A HEALTH PROFESSIONAL SHORTAGE AREA. THIS DEMONSTRATES THAT CCMH IS THE ONLY REASONABLE SOURCE OF HOSPITAL CARE AVAILABLE TO MEDICARE BENEFICIARIES IN OUR SERVICE AREA, AND LIKEWISE TREATS ALL BENEFICIARIES IN OUR SERVICE AREA THAT PRESENT THEMSELVES FOR CARE, DESPITE KNOWING WE WILL GENERALLY LOSE MONEY CARING FOR MEDICARE PATIENTS. ADDITIONALLY, SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | EFFORTS ARE MADE TO IDENTIFY PATIENTS WHO MAY BE ELIGIBLE FOR CHARITY CARE IN ACCORDANCE WITH THE HOSPITAL'S CHARITY CARE POLICY OR THE PHYSICIAN NETWORK SLIDING FEE SCALE PRIOR TO THE STATEMENT PROCESS WHEN POSSIBLE. | DebtCollectionPolicy |
| Needs Assessment | CHARLES COLE MEMORIAL HOSPITAL ENGAGED OKLAHOMA STATE UNIVERSITY IN COMPLETING A SERVICE AREA (4 COUNTIES) COMMUNITY HEALTH NEEDS ASSESSMENT WITH THE PROCESS BEGINNING IN JANUARY 2010 AND CONCLUDING IN MARCH 2010 WHEN CHARLES COLE MEMORIAL HOSPITAL RECEIVED OUTCOMES FROM THE SURVEY. SURVEYS WERE CONDUCTED BY TELEPHONE BY OKLAHOMA STATE UNIVERSITY. QUESTIONS WERE DETERMINED AT THE RECOMMENDATION OF OKLAHOMA STATE UNIVERSITY AND REVISED, AS DEEMED NECESARY, BY CCMH. A TOTAL OF 200 PHONE SURVEYS WERE COMPLETED AND 48 ONLINE SURVEYS WERE SUBMITTED FROM ALL SERVICE AREA ZIP CODES. RESULTS WERE TALLIED AND ANALYZED BY OKLAHOMA STATE UNIVERSITY AND THEN PRESENTED TO CCMH AND A GROUP OF APPROXIMATELY 100 INDIVIDUALS FROM OUR COMMUNITY BENEFIT ADVISORY COMMITTEES (NOW KNOWN AS CORPORATE ADVISORS), CCMH PUBLIC RELATIONS COMMITTEE (A BOARD OF DIRECTOR'S SUB-COMMITTEE AND NOW KNOWN AS THE COMMUNITY RELATIONS COMMITTEE), CCMH LEADERSHIP AND CCMH BOARD OF DIRECTORS. IN ADDITION TO THE RECENT COMMUNITY HEALTH NEEDS ASSESSMENT, CCMH DETERMINES HEALTHCARE NEEDS OF THE COMMUNITIES WHICH WE SERVE THROUGH SURVEYS OF OUR COMMUNITY BENEFIT ADVISORY COMMITTEE MEMBERS, INDIVIDUAL RECOMMENDATIONS, BOARD OF DIRECTORS RECOMMENDATIONS, COMMUNITY EVENT SATISFACTION SURVEYS, AND LOCAL AND STATE HEALTHCARE TRENDS. | NeedsAssessment |
| Patient Education Assistance | THE PATIENT FINANCIAL COUNSELOR CONTACTS SELF-PAY PATIENTS/GUARANTORS TO DISCUSS PAYMENT ARRANGEMENTS. IF THEY ARE UNABLE TO PAY - SHE EXPLAINS THE PROCESS OF APPLYING FOR CHARITY WHICH INCLUDES APPLYING FOR PA MEDICAL ASISSTANCE FIRST AND IF THEY ARE DENIED OR HAVE A PORTION TO PAY, THEN THEY CAN APPLY FOR CHARITY. THE CHARITY APPLICATION IS ON THE BACK OF OUR SELF-PAY STATEMENTS. ALSO, THE HOSPITAL OWNED PHYSICIAN PRACTICES ARE AWARE OF THIS PROGRAM AND REFER PATIENTS/GUARANTORS TO THE PATIENT FINANCIAL COUNSELOR. | PatientEducationAssistance |
| Community Information | CCMH SERVES PATIENTS MAINLY FROM POTTER, MCKEAN, TIOGA, CAMERON AND ELK COUNTIES IN NORTHCENTRAL PA. ALL OF THE COUNTIES THAT WE SERVE ARE CONSIDERED RURAL AND MOUNTAINOUS. CAMERON COUNTY CURRENTLY HAS THE HIGHEST UNEMPLOYMENT RATE IN THE STATE AND ALL OF THE COUNTIES SERVED ARE BATTLING THE EFFECTS OF THE ECONOMY AND JOB LOSS. OUR POPULATION IS ALSO AGING AS THE AREA OFFERS LITTLE FOR A YOUNGER DEMOGRAPHIC IN THE WAY OF EMPLOYMENT, EDUCATION AND CULTURE. | CommunityInformation |
| Community Building Activities | THE MISSION OF CHARLES COLE MEMORIAL HOSPITAL INDICATES THAT THE HOSPITAL RESPONDS TO THE HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES AND IS LARGELY DEPENDENT ON PROVIDING SERVICES AND CARE TO THOSE INDIVIDUALS WHO MAY NOT HAVE THE RESOURCES TO BE AWARE OF, ABLE TO PAY FOR, OR HAVE THE EDUCATION/KNOWLEDGE ABOUT CARE, PROGRAMS AND SERVICES THAT ARE AVAILABLE TO THEM. THROUGH VARIOUS ACTIVITIES CHARLES COLE REACHES OUT TO OUR COMMUNITIES TO EDUCATE, IMPROVE HEALTH, PREVENT AND TREAT DISEASE AND SUPPORT INDIVIDUALS AND GROUPS. CHARLES COLE, IN COOPERATION WITH COMMUNITY BASED GROUPS SUCH AS ROTARY, PROVIDE FIVE COMPREHENSIVE BLOOD ANALYSIS ANNUALLY. COMPREHENSIVE BLOOD ANALYSIS SCREENINGS ARE PROVIDED IN FIVE RURAL COMMUNITIES: GALETON, SMETHPORT, PORT ALLEGANY, SHINGLEHOUSE AND COUDERSPORT. CBA'S SCREEN OVER 30 OF THE MOST COMMON BLOOD TESTS THAT DETECT HEALTH ISSUES SUCH AS CORONARY HEART DISEASE, LIVER DISEASE, KIDNEY DISEASE, CANCER, THYROID DISEASE, DIABETES, ANEMIA, BONE DISEASE AND RESPIRATORY DISEASE. THESE SCREENINGS ARE PROVIDED AT A FRACTION OF THE COST OF HAVING THESE TESTS PERFORMED THROUGH A FAMILY PHYSICIAN. ALL PARTICIPANTS AND THEIR PRIMARY MEDICAL PROVIDER ARE SENT THE RESULTS AND PROVIDERS FOLLOW-UP WITH INDIVIDUALS WHOSE SCREENING RESULTS INDICATE ABNORMALITIES. FOR MANY INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED AND LIKELY WOULD NOT SEEK MEDICAL CARE UNTIL IT WAS EMERGENT, THESE EVENTS PROVIDE AN AVENUE TO MONITOR THEIR HEALTH AND DETECT POTENTIAL ISSUES BEFORE THEY BECOME EMERGENT. IN ADDITION, THE LOCAL CO-SPONSORS RECEIVE A PORTION OF THE PROCEEDS FROM THESE EVENTS AND UTILIZE THE FUNDS TO PROVIDE SCHOLARSHIPS AND SUPPORT TO LOCAL STUDENTS AND PROJECTS TO BENEFIT THE COMMUNITY. ANNUALLY, CHARLES COLE PARTNERS WITH THE AREA AGENCY ON AGING AND THE PENNSYLVANIA DEPARTMENT OF HEALTH TO ADMINISTER SEASON INFLUENZA AND PNEUMOCCOCAL VACCINE TO COUNTY SENIORS, THE INDIGENT, THE HOUSE-BOUND AND THE UNINSURED AT NO COST. FY2010 800 NO-COST INFLUENZA VACCINES AND 123 PNEUMOCOCCAL VACCINES WERE ADMINISTERED THROUGH 9 CLINICS IN 7 COMMUNITIES. IN MANY CASES THE UNDERSERVED POPULATIONS ARE MORE LIKELY TO BECOME ILL AND POTENTIALLY FACE EMERGENT HEALTH NEEDS FROM VACCINE-PREVENTABLE DISEASE. BY PROVIDING CLINICS AT COUNTY SENIOR CENTERS AND IN RURAL COMMUNITY SETTINGS MANY INDIVIDUALS WHO WOULD LIKELY NOT RECEIVE THESE COMMON VACCINES CAN BE IMMUNIZED AT NO COST AND IN CLOSE PROXIMITY TO THEIR HOMES. IN ADDITION, WITH THE OUTBREAK OF THE H1N1 INFLUENZA VIRUS IN THE FALL OF 2009, CCMH ADMINISTERED APPROXIMATELY 5500 DOSES OF H1N1 VACCINE TO ANY INDIVIDUAL WHO MET CRITERIA. ALSO IN CONJUNCTION WITH THE AREA AGENCY ON AGING, CHARLES COLE PROVIDES NO-COST EDUCATION TO COUNTY SENIOR CENTERS. IN FY 2010, CCMH PROVIDED 7 HEALTH EDUCATION PROGRAMS, EACH PRESENTED AT 4 SENIOR CENTERS FOR A TOTAL OF 30+ SESSIONS. TOPICS INCLUDED IMMUNIZATIONS, OSTEOPOROSIS, HEEL SCREENINGS, WINTER SKIN & FOOT CARE, THE DIABETIC FOOT & GOUT, INCONTINENCE AND GASTROINTESTINAL ISSUES IN SENIORS. FINALLY, AS AN ON-GOING EFFORT TO PROVIDE FULL-SPECTRUM CANCER CARE TO INDIVIDUALS IN RURAL NORTHCENTRAL PENNSYLVANIA, THE PATTERSON CANCER CARE CENTER PHYSICIANS AND STAFF PROVIDED APPROXIMATELY 170 NO-COST CANCER SCREENINGS. SCREENINGS INCLUDED SCREENINGS FOR PROSTATE, COLORECTAL AND SKIN CANCER. SCREENINGS WERE PERFORMED BY ONCOLOGY PHYSICIANS WHO SPECIALIZE IN THE DETECTION, DIAGNOSIS AND TREATMENT OF CANCER. INDIVIDUALS PARTICIPATING IN THESE SCREENINGS WERE BOTH MALE AND FEMALE, ADULT AND SENIOR AND UNINSURED/UNDERINSURED. IN ADDITION TO THE SCREENINGS, PARTICIPANTS WERE ALSO EDUCATED ON HEALTHY HABITS TO REDUCE RISK OF CANCER AND SIGNS AND SYMPTOMS OF CANCER. ALONG WITH MANY OTHER PROGRAMS SUCH AS SUPPORT GROUPS, SPEAKER'S BUREAU, WORKFORCE DEVELOPMENT, ECONOMIC SUPPORT, COMMUNITY LEADERSHIP, PARTNERSHIPS WITH LOCAL CIVIC, GOVERNMENT, SCHOOL DISTRICTS AND COMMUNITY GROUPS, CHARLES COLE MEMORIAL HOSPITAL CONTINUES EFFORTS TO ASSURE THAT HEALTHCARE, IN ALL FORMS, IS ACCESSIBLE AND AVAILABLE TO THOSE WHO MAY OTHERWISE GO WITHOUT. | CommunityBuildingActivities |
| Other Information | CCMH PROVIDES THE COMMUNITY WITH SPACE FOR EVENTS, MEETINGS AND PROGRAMS SUCH AS SUPPORT GROUPS AND YOUTH SPORTS. CCMH'S EMPLOYEE GIVING CLUB, HEART OF COLE, HAS A DESIGNATED GROUP THAT FOCUSES ON COMMUNITY CONNECTIONS. THE GROUP ANNUALLY UTILIZES APPROXIMATELY $10,000 ON COMMUNITY CONNECTIONS INCLUDING DONATIONS, IN FY09 SPECIFICALLY TO SERVE INDIVIDUALS AND FAMILIES THROUGH MONETARY AND NON-PERISHABLE FOOD DONATIONS TO LOCAL FOOD BANKS AND TO PURCHASE OF HEALTHCARE-RELATED ITEMS TO BE USED AS GIVE-AWAYS AT COMMUNITY EVENTS. CHARLES COLE STRIVES TO LIVE UP TO ITS NON-PROFIT MISSION EVERY DAY, PROVIDING EXCELLENT HEALTHCARE SERVICES TO OUR AREA AND LISTENING AND RESPONDING TO THE COMMUNITIES WE SERVE. IN AN EFFORT TO PLAN FOR THE UNIQUE NEEDS OF COMMUNITIES IN THE SERVICE AREA, FIVE COMMUNITY BENEFIT ADVISORY COMMITTEES WERE ESTABLISHED AS A MAJOR INITIATIVE TO DEEPEN AND STRENGTHEN ITS CONNECTION WITH THE COMMUNITY AND TO LINK COMMUNITY BENEFIT ACTIVITIES TO STRATEGIC AND OPERATIONAL PLANS. THE ROLE OF THE COMMITTEES IS TO IDENTIFY THE NEEDS AND CONCERNS OF THE COMMUNITY, ADVISE ABOUT THE BEST WAY TO PARTNER WITH THE COMMUNITY, AID IN THE DEVELOPMENT OF MEANINGFUL COMMUNITY PROGRAMS AND ACTIVITIES, AND PROMOTE IMPROVED COMMUNICATIONS BETWEEN THE HOSPITAL AND THE COMMUNITY. THE HOSPITAL PROVIDES DEDICATED ADMINISTRATIVE TIME TO PLANNING AND CONDUCTING FIVE CBAC MEETINGS IN THE COMMUNITIES WE SERVE THREE TIMES PER YEAR. CCMH REACHED THE GOAL OF DOUBLING PARTICIPATION/MEMBERS OF THE CBAC GROUPS FROM 50 INDIVIDUALS TO 100 INDIVIDUALS. LASTLY, CCMH OFTEN PARTNERS WITH FUNDING FOUNDATIONS TO PROVIDE HEALTH SPECIFIC IMPROVEMENT INITIATIVES IN THE COMMUNITIES WHICH WE SERVE. AS AN EXAMPLE, CCMH, WITH FUNDING FROM THE GEORGE A. & MARGARET MEE FOUNDATION, PROVIDED COMPREHENSIVE NO-COST PHYSICALS TO THE UNINSURED AND UNDER INSURED POPULATION IN CAMERON COUNTY. IN ADDITION A FAMILY FITNESS PROGRAM WAS OFFERED IN CAMERON COUNTY GEARED TO EDUCATE YOUTH AND THEIR PARENTS ON THE IMPORTANCE OF GOOD HEALTH. THE FAMILY FITNESS CHALLENGE INCLUDES EXERCISE, EDUCATION, HEALTHY EATING, HEALTH INDICATOR GATHERING AND MONITORING. FINALLY, VISION TESTING EQUIPMENT AND NO-COST SCREENINGS WERE PROVIDED THROUGH CCMH BY A LOCAL OPHTHEMOLOGIST TO RESIDENTS MEETING CRITERIA IN CAMERON COUNTY. THIS IS JUST ONE EXAMPLE OF PARTNERSHIPS IN WHICH CCMH IS CLOSELY INVOLVED THAT PROMOTE HEALTH AND ADDRESS COMMUNITY NEEDS. | OtherInformation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|
| MICHAEL E CALLAHAN | |||||||||||
| 191232 | 0 | 0 | 0 | 915 | 0 | 4417 | 0 | 2499 | 0 | 199063 | 0 |
| EDWARD C PITCHFORD | |||||||||||
| 270304 | 0 | 0 | 0 | 6082 | 0 | 6040 | 0 | 3781 | 0 | 286207 | 0 |
| JASON TRONETTI | |||||||||||
| 323602 | 0 | 0 | 0 | 148 | 0 | 6101 | 0 | 2601 | 0 | 332452 | 0 |
| CYNTHIA L HARDESTY | |||||||||||
| 164197 | 0 | 9500 | 0 | 4519 | 0 | 4282 | 0 | 1268 | 0 | 183766 | 0 |
| BRADLEY F GIANNOTTI | |||||||||||
| 879972 | 0 | 0 | 0 | 1000 | 0 | 4532 | 0 | 2720 | 0 | 888224 | 0 |
| CHRISTAN M CARAMIA | |||||||||||
| 604972 | 0 | 0 | 0 | 378 | 0 | 6027 | 0 | 3850 | 0 | 615227 | 0 |
| SETH P SHIFRIN | |||||||||||
| 246636 | 0 | 0 | 0 | 162 | 0 | 6066 | 0 | 3660 | 0 | 256524 | 0 |
| SAKET PRASAD | |||||||||||
| 625558 | 0 | 0 | 0 | 548 | 0 | 5880 | 0 | 3496 | 0 | 635482 | 0 |
| TERRANCE FOUST | |||||||||||
| 477982 | 0 | 0 | 0 | 462 | 0 | 6102 | 0 | 3172 | 0 | 487718 | 0 |
| FRANK HORN | |||||||||||
| 283339 | 0 | 0 | 0 | 1340 | 0 | 5124 | 0 | 2394 | 0 | 292197 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | BONUS | Identifier |
| Return Reference | SCHEDULE J, PART I, LINE 7 | ReturnReference |
| Explanation | CYNTHIA HARDESTY RECEIVED A $9,500 BONUS FOR PARTICIPATING IN THE EXECUTIVE TEAM INCENTIVE COMPENSATION PROGRAM. EACH PARTICIPANT HAD AN ESTABLISHED TARGET TOTAL COMPENSATION BASED ON INDUSTRY SURVEYS AND THE INCENTIVE PROGRAM COMPRISED APPROXIMATELY 10% OF THE TARGETED TOTAL COMPENSATION. THE BONUS WAS BASED ON OVERALL PERFORMANCE. | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| COLE CARE | |||
| COMMON BOARD MEMBERS | 5245200 | RENT, DIVIDENDS, SERVICES | false |
| EDMOND HARDESTY | |||
| HUSBAND OF C. HARDESTY | 141775 | EMPLOYEE OF HOSPITAL | false |
| CITIZEN'S NORTHERN BANK | |||
| C. UPDEGRAFF - VP/COO | 109572 | BANKING | false |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990, PART III, LINE 1 | CHARLES COLE MEMORIAL HOSPITAL IS A FULL SERVICE, COMPREHENSIVE HEALTH SYSTEM, SERVING POTTER, MCKEAN, CAMERON, AND TIOGA COUNTIES IN RURAL, NORTH CENTRAL PA AND PORTIONS OF NEW YORK STATE AND IS THE ONLY HOSPITAL IN POTTER COUNTY (COUDERSPORT, PA). CCMH IS A CRITICAL ACCESS HOSPITAL PROVIDING PRIMARY, EMERGENCY, AND SPECIALTY CARE, AS WELL AS REHABILITATION AND WELLNESS SERVICES TO PATIENTS WITHIN A 50-MILE RADIUS. CHARLES COLE STRIVES TO LIVE UP TO ITS NON-PROFIT MISSION EVERY DAY, PROVIDING EXCELLENT HEALTHCARE SERVICES TO OUR AREA AND LISTENING AND RESPONDING TO THE COMMUNITIES WE SERVE. IN AN EFFORT TO PLAN FOR THE UNIQUE NEEDS OF COMMUNITIES IN THE SERVICE AREA, FIVE COMMUNITY BENEFIT ADVISORY COMMITTEES WERE ESTABLISHED AS A MAJOR INITIATIVE TO DEEPEN AND STRENGTHEN OUR CONNECTION WITH THE COMMUNITY AND TO LINK COMMUNITY BENEFIT ACTIVITIES TO STRATEGIC AND OPERATIONAL PLANS. THE ROLE OF THE COMMITTEES ARE TO IDENTIFY THE NEEDS AND CONCERNS OF THE COMMUNITY, ADVISE ABOUT THE BEST WAY TO PARTNER WITH THE COMMUNITY, AID IN THE DEVELOPMENT OF MEANINGFUL COMMUNITY PROGRAMS AND ACTIVITIES, AND PROMOTE IMPROVED COMMUNICATIONS BETWEEN THE HOSPITAL AND THE COMMUNITY. THE HOSPITAL PROVIDES DEDICATED ADMINISTRATIVE TIME TO PLANNING AND CONDUCTING FIVE CBAC MEETINGS IN THE COMMUNITIES WE SERVE THREE TIMES PER YEAR. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A, 4B, 4C, & 4D LINE 4A IN ADDITION TO THE HOSPITAL'S ACUTE CARE FLOORS, CHARLES COLE CARES FOR PATIENTS IN ITS 49-BED LONG TERM CARE UNIT WHICH REPORTED 14,600 DAYS LAST YEAR. A 10-BED INPATIENT GERIATRIC BEHAVIORAL HEALTH UNIT ADMITTED 200 PATIENTS LAST YEAR. LINE 4B CCMH'S HOME HEALTH AND HOSPICE SERVICES ASSIST PATIENTS THROUGHOUT THE REGION, WITH A GROWING NUMBER OF REFERRALS AND LOWER INFECTION RATES AMONG STATE AND NATIONAL AVERAGES. LINE 4C ONE OUTLYING CENTER OFFERS IMAGING SERVICES, WHILE ALL RHCS PROVIDE LAB DRAWS SO PATIENTS DON'T HAVE TO DRIVE TO RECEIVE NECESSARY TESTING. IN ADDITION TO THE FAMILY AND INTERNAL MEDICINE SERVICES AT RHCS, PHYSICIAN PRACTICES ALSO PROVIDE SPECIALTY CARE INCLUDING PEDIATRICS, GASTROENTEROLOGY, ORTHOPEDICS, PHYSIATRY, SURGERY, PODIATRY, OBSTETRICS/GYNECOLOGY AND ONCOLOGY. COLLECTIVELY, PHYSICIAN PRACTICES REPORTED 74,000 PATIENT VISITS LAST YEAR. LINE 4D THE ORGANIZATION ALSO OFFERS CARDIO-PULMONARY SERVICES, CLINICAL SERVICES, CLINICS, AND CORPORATE SERVICES. |
| MEMBERS | FORM 990, PART VI, SECTION A, LINES 6, 7A, & 7B | THE MEMBERS ARE DIVIDED INTO TWO CLASSES - ACTIVE AND HONORARY. ACTIVE MEMBERS RETAIN MEMBERSHIP IN THE CORPORATION FOR LIFE OR UNTIL THEY RESIGN. ANY ADULT PERSON WHO IS A RESIDENT OF THE CORPORATION'S SERVICE AREA, AS DEFINED IN THE MOST RECENT REVISION OF THE HOSPITAL'S LONG RANGE STRATEGIC PLAN, IS ELIGIBLE FOR MEMBERSHIP IN THE CORPORATION UPON PAYMENT TO THE CORPORATION OF AN ANNUAL MEMBERSHIP CONTRIBUTION IN THE AMOUNT OF FIVE ($5.00) DOLLARS. TO BE A MEMBER IN GOOD STANDING ENTITLED TO VOTE FOR DIRECTORS AT THE ANNUAL MEETING OF THE CORPORATION, A MEMBER MUST HAVE PAID HIS DUES NINETY (90) DAYS PRIOR TO THE ANNUAL MEETING DATE, BE SUBJECT TO AND IN COMPLIANCE WITH THE MEMBER CONFLICT OF INTEREST PROVISIONS AND POLICIES AND NOT POSSESS ANY SUCH MEMBER CONFLICT OF INTEREST IN ANY MATTER SUBJECT TO VOTE. ANY ADULT PERSON ADMITTED TO CHARLES COLE MEMORIAL HOSPITAL AS A PATIENT AUTOMATICALLY BECOMES A MEMBER OF THE CORPORATION ENTITLED TO THE VOTING PRIVILEGES OF AN ACTIVE MEMBER. THE TERM OF ANY PATIENT'S MEMBERSHIP IN THE CORPORATION BEGINS AS OF THE DATE OF THE FIRST ANNUAL MEETING FOLLOWING THE PATIENT'S CONFINEMENT AND ENDS ON THE DAY FOLLOWING THE NEXT SUCCEEDING ANNUAL MEETING DATE. THE NUMBER OF ACTIVE MEMBERS IS UNLIMITED. EVERY ACTIVE MEMBER IS ENTITLED TO ONE VOTE AT ANY MEETING OF THE MEMBERS IN WHICH A VOTE IS TAKEN FOR ANY ELECTION OR ON ANY MATTER OR TRANSACTION. IN THE CASE OF VOTING FOR THE ELECTION OF DIRECTORS, EACH MEMBER MUST CAST ONE VOTE FOR EACH POSITION TO BE FILLED OR THE BALLOT WILL BE VOID AS IT PERTAINS TO THE ELECTION OF DIRECTORS. AN ANNUAL MEETING OF THE MEMBERS SHALL BE HELD EVERY YEAR ON A DATE BETWEEN SEPTEMBER 15 AND OCTOBER 15 FOR THE PURPOSE OF CONFIRMING THE ELECTION OF DIRECTORS, REPORTING ON THE AFFAIRS OF CORPORATION, AND TRANSACTING SUCH OTHER BUSINESS AS MAY PROPERLY COME BEFORE THE MEETING. THE MEMBERS ANNUALLY ELECT: (A) SUCCESSORS TO THE BOARD OF DIRECTORS WHOSE TERMS EXPIRE. (B) HONORARY MEMBERS AND HONORARY DIRECTORS. THE FOLLOWING MATTERS ARE AUTHORIZED ONLY AFTER RECOMMENDATION BY THE BOARD AND UPON APPROVAL OF THE MEMBERS: (A) CERTAIN PROVISIONS IN AND AMENDMENTS TO THE BYLAWS. (B) MERGER OR CONSOLIDATION WITH ANY OTHER CORPORATION OR LEGAL ENTITY. (C) ANY CHANGE IN THE ARTICLES OF INCORPORATION. (D) ANY OTHER MATTERS REQUIRED BY THE LAW TO BE SUBMITTED TO THE MEMBERSHIP OR WHICH THE BOARD DETERMINES BY RESOLUTION TO SUBMIT. |
| FORM 990 REVIEW PROCESS | FORM 990, PART VI, SECTION B, LINE 11A | THE 990 WILL BE REVIEWED BY THE ACCOUNTING DEPARTMENT AND THE CONTROLLER. IT WILL THEN BE PRESENTED TO THE FINANCE COMMITTEE FOR REVIEW. AFTER THE FINANCE COMMITTEE HAS REVIEWED, THE FORM 990 WILL BE PRESENTED TO THE BOARD OF DIRECTORS PRIOR TO THE CEO'S FINAL SIGNATURE. |
| CONFLICT OF INTEREST POLICY | FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY IS MONITORED AS PART OF THE CORPORATE COMPLIANCE PROGRAM. INCLUDED IN THIS PROGRAM ARE A HOTLINE AND A COMPLIANCE OFFICER WHO MONITORS AND ADDRESSES ANY CONFLICTS. ALL OUTCOMES ARE REPORTED TO THE CORPORATE COMPLIANCE COMMITTEE AND RESOLVED. THE COMMITTEE MEETS QUARTERLY AND REPORTS ANNUALLY TO THE BOARD OF DIRECTORS. MEMBERS OF THE ORGANIZATION MAY NOT USE THEIR POSITIONS TO PROFIT PERSONALLY OR TO ASSIST OTHERS IN PROFITING IN ANY WAY AT THE EXPENSE OF THE ORGANIZATION. MEMBERS SHALL AVOID ALL CONFLICTS OF INTEREST AND THE APPEARANCE OF ANY CONFLICT OF INTEREST. TO AVOID THE APPEARANCE OF A CONFLICT OF INTEREST, A MEMBER SHALL NOT PARTICIPATE IN THE MAKING OF ANY DECISION OR RECOMMENDATION CONCERNING A MATTER WHICH MAY RESULT IN ANY BENEFIT OR FINANCIAL GAIN, EITHER DIRECTLY OR INDIRECTLY, TO THE MEMBER OR A MEMBER OF HIS/HER IMMEDIATE FAMILY. IN ADDITION, FULL DISCLOSURE OF THE PERTINENT FACTS REGARDING THE POTENTIAL CONFLICT OF INTEREST SHOULD BE PROVIDED BY THE MEMBER. |
| COMPENSATION DETERMINATION | FORM 990, PART VI, SECTION B, LINES 15A & 15B | A REVIEW WAS CONDUCTED IN OCTOBER 2007 FOR PRESIDENT & CEO EDWARD PITCHFORD'S ORIGINAL EMPLOYMENT AGREEMENT BY 3C COMPENSATION CONSULTING CONSORTIUM, LLC, LOCATED IN PITTSBURGH, PENNSYLVANIA. SINCE OCTOBER 2007, THERE HAVE BEEN NO INCREASES. THE BOARD WOULD HAVE TO APPROVE ANY INCREASE RECOMMENDED BY THE COMPENSATION COMMITTEE. A REVIEW WAS CONDUCTED IN JULY 2008 FOR VICE PRESIDENT & CNE CYNTHIA HARDESTY BY THE SAME COMPANY. THE CEO APPROVES ANY INCREASES FOR THE CNE. |
| DOCUMENT AVAILABILITY | FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS CAN BE VIEWED ONSITE THROUGH A WRITTEN REQUEST TO THE ORGANIZATION'S CORPORATE COMPLIANCE OFFICER. REQUESTS FOR FINANCIAL STATEMENTS AND 990'S ARE FORWARDED TO THE FINANCE / ACCOUNTING DEPARTMENT AND ARE OPEN FOR PUBLIC INSPECTION. |
| FINANCIAL STATEMENTS | FORM 990, PART XI, LINES 2A-2C | THE ORGANIZATION'S FINANCIAL STATEMENTS ARE AUDITED ON A CONSOLIDATED BASIS WITH THE RELATED ORGANIZATIONS. THE ORGANIZATION HAS A FINANCE COMMITTEE THAT ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. |
| FUNDRAISING ACTIVITIES | SCHEDULE G, PART I, LINE 2B | THE ORGANIZATION HIRED DELTA DEVELOPMENT GROUP, INC., FOR GRANT WRITING SERVICES. THE AGREEMENT PROVIDED FOR A MONTHLY FEE FOR PROFESSIONAL FUNDRAISING SERVICES AS WELL AS REIMBURSEMENT OF ADDITIONAL FUNDRAISING EXPENSES. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HENDORN INC DBA COLE MANOR | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 EAST SECOND STREET | AddressLine1 |
| City | COUDERSPORT | City |
| State | PA | State |
| ZIP Code | 16915 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 231972659 | EIN |
| Primary Activities | RESIDENT CARE | PrimaryActivities |
| Legal Domicile State | PA | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | 11A I | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLE CARE INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 EAST 2ND STREET | AddressLine1 |
| City | COUDERSPORT | City |
| State | PA | State |
| ZIP Code | 16915 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 251497347 | EIN |
| Primary Activity | DURABLE MED EQUIP | PrimaryActivity |
| Legal Domicile State | PA | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C CORPORATION | TypeOfEntity |
| Share Of Total Income | 6688681 | ShareOfTotalIncome |
| Share Of EOY Assets | 900401 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | true | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | true | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (7 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| COLE CARE INC | |
| A | 211230 |
| COLE CARE INC | |
| N | 4847711 |
| HENDORN INC | |
| K | 286107 |
| COLE CARE INC | |
| K | 55495 |
| HENDORN INC | |
| L | 60120 |
| COLE CARE INC | |
| L | 146448 |
| HENDORN INC | |
| Q | 75000 |