LAUREL HEALTH FOUNDATION: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- LAUREL HEALTH FOUNDATION (EIN 25-1810488)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2022-11-03
- IRS object ID
- 202203079349300905
- Schema version
- 2021v4.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-03T07:47:41-04:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 030462703 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALLEN ROGERS & OSGOOD CPA'S | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 125 CANTON ST | AddressLine1Txt |
| City | TROY | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 169471472 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 251810488 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAUREL HEALTH FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LAUR | BusinessNameControlTxt |
| Phone | 5704393992 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 32-36 CENTRAL AVENUE | AddressLine1Txt |
| City | WELLSBORO | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16901 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GRETCHEN TENNIS | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5704393992 | PhoneNum |
| Signature | 2022-10-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | GRETCHEN | PersonFirstNm |
| Person Last | TENNIS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | EDWARD J OSGOOD | PreparerPersonNm |
| PTIN | P01311094 | PTIN |
| Phone | 5702972183 | PhoneNum |
| Preparation | 2022-10-18 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | RONALD BUTLER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 32-36 CENTRAL AVENUE | AddressLine1Txt |
| City | WELLSBORO | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,914,076 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1998 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | THE PURPOSE OF THE LAUREL HEALTH FOUNDATION IS TO SUPPORT THE PROVISION AND OVERALL DELIVERY OF HEALTH CARE SERVICES IN TIOGA COUNTY, PA | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 14 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $2,500 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $846,846 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,302,422 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $849,346 | PYTotalRevenueAmt |
| CY Total Revenue | $1,302,422 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,210,335 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $618,835 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $100,411 | PYOtherExpensesAmt |
| CY Other Expenses | $115,469 | CYOtherExpensesAmt |
| PY Total Expenses | $1,310,746 | PYTotalExpensesAmt |
| CY Total Expenses | $734,304 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$461,400 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $568,118 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $28,625,219 | TotalAssetsBOYAmt |
| Total Assets EOY | $24,250,721 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $431 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $14,162 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $28,624,788 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $24,236,559 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE PURPOSE OF THE LAUREL HEALTH FOUNDATION IS TO SUPPORT THE PROVISION AND OVERALL DELIVERY OF HEALTH CARE SERVICES IN TIOGA COUNTY, PA | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $720,033 | ExpenseAmt |
| Grant | $618,835 | GrantAmt |
| Desc | LAUREL HEALTH FOUNDATION PROVIDES FINANCIAL SUPPORT FOR OTHER TAX-EXEMPT ORGANIZATIONS WITHIN TIOGA COUNTY. | Desc |
| Total Program Service Expenses | $720,033 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (true) | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 3 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | false | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GRETCHEN TENNIS | PersonNm |
| Phone | 5704393992 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 27 QUEEN STREET | AddressLine1Txt |
| City | WELLSBORO | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| RONALD BUTLER | ||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| J DENNIS MURRAY PH D | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| LISA FEIL PH D | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| R ROBERT DECAMP | ||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| ROB FITZGERALD | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| BRENDA FREEMAN | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JANIE HILFIGER | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| HAROLD HOOSE III | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JILL BURNS MD | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| ROBERT MORRIS | ||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| GLENN POIRIER | ||||||
| CHAIRMAN | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| SAMANTHA WILCOX | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| KATHY WRIGHT | ||||||
| VICE- CHAIRM | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| GRETCHEN TENNIS | ||||||
| CFO | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $515,623 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $515,623 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $4,398,453 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,611,654 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $786,799 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $786,799 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $786,799 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,302,422 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,302,422 | RelatedOrExemptFuncIncomeAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $508,928 | TotalAmt |
| Program Services | $508,928 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $109,907 | TotalAmt |
| Program Services | $109,907 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,600 | TotalAmt |
| Management And General | $5,600 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,427 | TotalAmt |
| Program Services | $95,427 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $352 | TotalAmt |
| Management And General | $352 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,219 | TotalAmt |
| Management And General | $2,219 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| PURCHASED SERVICES | $6,000 | $6,000 | |
| ANNUITY PAYOUT | $5,771 | $5,771 | |
| MISCELLANEOUS EXPENSE | $100 | $100 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $734,304 | TotalAmt |
| Program Services | $720,033 | ProgramServicesAmt |
| Management And General | $14,271 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,519,462 | BOYAmt |
| EOY | $24,250,721 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $105,757 | BOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,625,219 | BOYAmt |
| EOY | $24,250,721 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $431 | BOYAmt |
| EOY | $14,162 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $431 | BOYAmt |
| EOY | $14,162 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,326,941 | BOYAmt |
| EOY | $3,938,712 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,297,847 | BOYAmt |
| EOY | $20,297,847 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,624,788 | BOYAmt |
| EOY | $24,236,559 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,625,219 | BOYAmt |
| EOY | $24,250,721 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $568,118 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$4,956,347 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | Yes (true) | AccountantCompileOrReviewInd |
Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FS Audited | false | FSAuditedInd |
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type2 | Yes (X) | SupportingOrgType2Ind |
| Supported Organizations | 4 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (4 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| UPMC WELLSBORO | ||||
| 232176963 | 3 | Yes (true) | $475,123 | $0 |
| NORTH PENN COMPREHENSIVE HEALTH SERVICE | ||||
| 231889724 | 10 | Yes (true) | $18,759 | $0 |
| GREEN HOME | ||||
| 240804365 | 3 | Yes (true) | $10,846 | $0 |
| WELLSBORO COMMUNITY FOUNDATION | ||||
| 202680321 | 7 | Yes (true) | $4,200 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 4 | SupportedOrganizationsTotalCnt |
| Support Sum | $508,928 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (true) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | false | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | false | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | false | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | false | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | false | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | false | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | false | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | false | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | false | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | false | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | false | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | false | ContributionControllerInd |
| Contribution Family | false | ContributionFamilyInd |
| Contribution35 Controlled | false | Contribution35ControlledInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Majority Dir Trst Supported Org | Yes (true) | MajorityDirTrstSupportedOrgInd |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $21,453,762 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$2,716,963 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $616,795 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $81,691 | AdministrativeExpensesAmt |
| End Year Balance | $18,038,313 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $17,017,199 | BeginningYearBalanceAmt |
| Contributions | $2,500 | ContributionsAmt |
| Investment Earnings Or Losses | $500,856 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $500,705 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $66,088 | AdministrativeExpensesAmt |
| End Year Balance | $21,453,762 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $15,885,620 | BeginningYearBalanceAmt |
| Contributions | $2,109,922 | ContributionsAmt |
| Investment Earnings Or Losses | -$108,598 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $816,849 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $52,896 | AdministrativeExpensesAmt |
| End Year Balance | $17,017,199 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $15,626,751 | BeginningYearBalanceAmt |
| Contributions | $121,831 | ContributionsAmt |
| Investment Earnings Or Losses | $762,572 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $587,461 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $48,073 | AdministrativeExpensesAmt |
| End Year Balance | $15,885,620 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $14,577,552 | BeginningYearBalanceAmt |
| Contributions | $117,646 | ContributionsAmt |
| Investment Earnings Or Losses | $1,646,601 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $653,636 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $51,412 | AdministrativeExpensesAmt |
| End Year Balance | $15,636,751 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 1.00000 | BoardDesignatedBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 4, PART XIII | FormAndLineReferenceDesc |
| Explanation | ENDOWMENT FUNDS: THE ENDOWMENT FUNDS ARE USED TO FUND THE MISSION OF THE ORGANIZATION. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (3 entries)
| Business Name Line2RecipientBusinessName/BusinessNameLine2Txt | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt |
|---|---|---|---|---|---|---|---|
| NORTH PENN COMPREHENSIVE HEALTH | |||||||
| SERVICES | 40 W WELLSBORO STREET | MANSFIELD | PA | 16933 | 231889724 | 501C3 | $18,759 |
| UPMC WELLSBORO | |||||||
| 32-36 CENTRAL AVENUE | WELLSBORO | PA | 16901 | 232176963 | 501C3 | $475,123 | |
| GREEN HOME | |||||||
| 37 CENTRAL AVENUE | WELLSBORO | PA | 16901 | 240804365 | 501C3 | $10,846 | |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | GRANT | GrantTypeTxt |
| Recipient | 10 | RecipientCnt |
| Cash Grant | $109,907 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PAGE 1, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | GRANT MONITORING PROCESS: ALL GRANTEES ARE REQUIRED TO COMPLETE A GRANT COMPLIANCE REPORT AT THE COMPLETION OF THEIR PROJECT. ADDITIONALLY, ALL GRANTEE ORGANIZATIONS ARE TAX-EXEMPT ORGANIZATIONS. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 7A | ELECTING MEMBERS OF THE GOVERNING BODY: AT LEAST 50% OF THE BOARD OF DIRECTORS MUST CONSIST OF INDIVIDUALS SERVING AS BOARD MEMBERS OF THE LAUREL SYSTEM ENTITIES AS SYSTEM REPRESENTATIVES. WITH RESPECT TO THE SYSTEM REPRESENTATIVE POSITIONS, UPMC SUSQUEHANNA SUBMITS A LIST OF ITS RECOMMENDED SYSTEM REPRESENTATIVE CANDIDATES TO THE NOMINATING COMMITTEE, WHO REVIEW THE LIST AND UPON APPROVAL, NOMINATES APPROVED REPRESENTATIVE TO THE BOARD. |
| FORM 990, PAGE 6, PART VI, LINE 7B | DECISIONS SUBJECT TO APPROVAL BY MEMBERS: THE BYLAWS REQUIRE PRIOR WRITTEN APPROVAL OF UPMC SUSQUEHANNA ON ANY BYLAW AMENDMENT RELATING TO THE FOLLOWING MATTERS: -ELECTION OR REMOVAL OF DIRECTORS OR OFFICERS -CORPORATE MEMBERS OR MEMBERSHIP OF THE CORPORATION -NUMBER, COMPOSITION, ATTENDANCE, COMPENSATION, VOTING, QUORUM, POWERS, DUTIES, RESPONSIBLITIES OR MANNER OF ACTING OF THE BOARD OF DIRECTORS, OFFICERS OR COMMITTEES -TERMS, QUALIFICATIONS OR DUTIES OF, OR NOTICE TO, DIRECTORS AND/OR OFFICERS -USE OF THE CORPORATION'S FUNDS -CORPORATE PURPOSES, POWERS OR LIMITATIONS -COMPLIANCE WITH SECTION 501(C)(3) OF THE CODE AND/OR ANY OTHER LAW -CONFLICT OF INTEREST POLICIES OR PROCEDURES -INDEMNIFICATION RIGHTS OR OBLIGATIONS -AMENDMENT OF THE ARTICLES OF INCORPORATIONS OR BYLAWS OR ENGAGEMENT IN ANY FUNDAMENTAL TRANSACTIONS -MATERIAL RIGHTS OR OBLIGATIONS OF UPMC SUSQUEHANNA OR ITS AFFILIATES |
| FORM 990, PAGE 6, PART VI, LINE 11B | A COPY OF THE FORM 990 IS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: LAUREL HEALTH FOUNDATION REQUIRES KEY PERSONNEL TO COMPLY WITH ITS CONFLICT OF INTEREST POLICY. INDIVIDUALS COVERED BY THE POLICY INCLUDE: BOARD MEMEBERS, CORPORATE OFFICERS, KEY EMPLOYEES, AND IDENTIFIED NON-EMPLOYED MEMBERS OF THE STAFF WHO HOLD POSITIONS OF INFLUENCE. THESE INDIVIDUALS ARE REQUIRED TO COMPLETE A QUESTIONAIRE AT LEAST ANNUALLY, WHICH ALONG WITH OTHER DATA IS USED TO IDENTIFY POSSIBLE INDIVIDUAL AND INSTITUTIONAL CONFLICTS OF INTEREST. IF A POTENTIAL CONFLICTS ARE IDENTIFIED REGARDING A SPECIFIC ACTIVITY, THE CORPORATE COMPLIANCE DEPARTMENT, WITH THE ASSISTANCE OF THE LEGAL DEPARTMENT, EITHER DEVELOPS A WRITTEN PLAN DESIGNED TO PREVENT THE CONFLICT FROM INFLUENCING DECISIONS RELATED TO THAT ACTIVITY, OR REQUIRES THAT THE CONFLICTING RELATIONSHIP BE DIVESTED, AS APPROPRIATE. FOR EMPLOYED PERSONNEL AND NON BOARD MEMBER, NON-EMPLOYED PERSONNEL, THE CONFLICT OF INTEREST INDENTIFICATION AND MANAGEMENT PROCESS IS ULTIMATELY OVERSEEN BY AN ETHICS AND COMPLIANCE COMMITTEE OF THE THE BOARD OF DIRECTORS. POTENTIAL CONFLICTS OF INTEREST TRANSACTIONS INVOLVING THE BOARD MEMBERS AND ENTITIES WITH WHICH THEY ARE AFFILIATED ARE MONITORED AND SUBJECT TO PRE-APPROVAL BY THE GOVERNANCE AND NOMINATING COMMITTEE OF THE BOARD OF DIRECTORS. |
| FORM 990, PAGE 6, PART VI, LINE 19 | DOCUMENT DISCLOSURE: GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART XI, LINE 9 | UNREALIZED LOSSES -4,956,347 |