2022-11-15T08:49:32-06:00 2021-12-31 390859910 BAKER TILLY US LLP 20 STANWIX STREET PITTSBURGH PA 15222 990 2021-01-01 251352326 DUBOIS CONTINUUM OF CARE COMMUNITY INC DUBO 2154417700 200 SOUTH EIGHTH STREET DUBOIS PA 15801 A KEITH SMITH SECRETARY/TREASURER 2154417700 2022-11-14 1 A KEITH SMITH XXX-XX-XXXX BRIAN R LENART EA P00289136 4126976400 2022-11-14 X 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z A KEITH SMITH 200 SOUTH EIGHTH STREET DUBOIS PA 15801 17085424 0 X WWW.DUBOISCCCI.COM X 1977 PA CONTINUING CARE RETIREMENT COMMUNITY. 9 9 318 24 0 0 1300582 3705392 14197126 13197280 17378 29879 71542 135300 15586628 17067851 0 0 0 0 8996102 7934734 0 0 0 7664294 8186254 16660396 16120988 -1073768 946863 13184059 11892507 8245682 5982791 4938377 5909716 X THE ORGANIZATION OPERATES A CONTINUING CARE RETIREMENT COMMUNITY, WITH 140 NURSING BEDS, 23 INDEPENDENT LIVING UNITS AND A 118-BED PERSONAL CARE FACILITY. 0 0 14616218 0 13197280 OPERATION OF CONTINUING CARE RETIREMENT COMMUNITY, FOCUSING ON LOWER-INCOME RESIDENTS FUNDED BY MEDICAID PROGRAMS OR PROVIDING CHARITY CARE TO FINANCIALLY INDIGENT RESIDENTS OF CLEARFIELD COUNTY, PENNSYLVANIA REQUIRING LONG-TERM CARE SERVICES. DUBOIS CONTINUUM OF CARE COMMUNITY HAD A TOTAL CENSUS FOR LOW INCOME MEDICAID RESIDENTS OF 27,375 DAYS IN 2021 (71% OF TOTAL RESIDENTS SERVED). THE REIMBURSEMENT FOR THESE RESIDENTS WAS AN AVERAGE OF $218.27 PER DAY, WHILE THE COST OF PROVIDING SERVICE TO THESE RESIDENTS WAS APPROXIMATELY $280.83 PER DAY. REIMBURSEMENT WAS APPROXIMATELY $2,136,269 LESS THAN THE COST TO PROVIDE SERVICES TO THESE LOW INCOME MEDICAID ELIGIBLE RESIDENTS - THIS SHORTFALL CONSTITUTES "CHARITY CARE" PROVIDED BY DUBOIS CONTINUUM OF CARE COMMUNITY. 14616218 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 4 0 318 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 0 0 0 1 0 0 0 0 1 1 1 1 1 1 1 0 PA X X MARGARET A ROSS-DRYDEN - CHR 2153285802 200 DRYDEN ROAD SUITE 3100 DRESHER PA 19025 X JOHN ADAMS BOARD MEMBER 11.00 X 0 0 0 JOHN OBERLIN BOARD MEMBER 0.00 X 0 0 0 A KEITH SMITH SECRETARY/TREASURER 11.00 X X 0 0 0 DENNIS MARTELLA BOARD MEMBER 7.00 X 0 0 0 MICHAEL CLEMENT ASSISTANT SECRETARY/TREASURER 10.50 X 0 0 0 KRISTIE JOHNSTON VICE PRESIDENT 8.50 X 0 0 0 ROBERT JAVENS PRESIDENT 10.00 X X 0 0 0 DENNIS ADAMSON BOARD MEMBER 3.00 X 0 0 0 RICHARD KIRSCH BOARD MEMBER 11.00 X 0 0 0 0 0 0 0 0 0 0 PREMIER THERAPY 110 CENTRAL SQUARE DRIVE BEAVER FALLS PA 15010 THERAPY 949033 CHR CONSULTING INC 200 DRYDEN ROAD SUITE 3100 DRESHER PA 19025 CONSULTING 765671 MCKESSON MEDICAL SURGICAL PO BOX 630693 CINCINNATI OH 45263 SUPPLIES 348606 DIAMOND PHARMACY 639 KOLTER DRIVE INDIANA PA 15701 PHARMACY 328087 US FOODS INC PO BOX 643190 PITTSBURGH PA 15264 FOOD 208517 5 7176 3692141 6075 3705392 RESIDENT SERVICES 623000 12826716 12826716 I/C RESIDENT SERVICES 623000 370564 370564 13197280 9606 9606 38156 17573 20583 20583 20583 20273 0 20273 20273 20273 MISCELLANEOUS 623000 59410 59410 MAINTENANCE FEE 623000 24750 24750 PERSONAL SERVICES 812900 17693 17693 12864 12864 114717 17067851 13197280 0 165179 X 6376017 6128332 247685 35532 3573 31959 1053441 992733 60708 469744 445100 24644 244424 244424 26330 26330 43400 43400 3755582 3205785 549797 63765 34603 29162 29637 1055 28582 102995 102995 501802 501802 25449 24794 655 233005 233005 760821 760821 334844 334844 MEDICAL & ACTIVITY SUPP 1520215 1490762 29453 0 PA NURSING HOME ASSESSM 196009 196009 0 0 EQUIPMENT RENTAL 102222 77450 24772 0 MISCELLANEOUS 98250 41725 56525 0 147504 143825 3679 16120988 14616218 1504770 0 2653291 2034161 14169 24757 831003 793788 207406 89421 207239 256523 25739423 17835728 8553269 7903695 423741 433121 293941 357041 13184059 11892507 1075861 946931 178852 98194 5104558 4777950 1886411 159716 8245682 5982791 X 4918668 5890007 19709 19709 4938377 5909716 13184059 11892507 946863 24476 0 X 0 1 X 1 0 X 87317 18942 19803 1300582 3705392 5132036 16117594 15643255 15360297 14197126 13197280 74515552 16204911 15662197 15380100 15497708 16902672 79647588 0 0 0 79647588 10613 13444 23065 9681 47762 104565 10613 13444 23065 9681 47762 104565 86372 79635 80034 71542 114717 432300 16301896 15755276 15483199 15578931 17065151 80184453 0.99330 0.99400 0.00130 0.00110 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 230188 230188 20811368 13577316 7234052 4310167 3926435 383732 387700 331977 55723 7903695 RESIDENTS' SECURITY DEPOSITS 23087 RESIDENTS' TRUST FUNDS 136629 159716 S&T BANK BOARD MEMBER EXPANSION PROJECT X 8217000 4777950 0 1 1 4777950 SCH. L, PART II, LOANS TO AND/OR FROM INTERESTED PERSONS S&T BANK IS AN INTERESTED PERSON BECAUSE JOHN OBERLIN, BOARD MEMBER FOR THE ORGANIZATION, ALSO SERVES AS BANK MANAGER OF S&T BANK. NEGOTIATION FOR THE LOAN BEGAN IN 2009 PRIOR TO HIS ELECTION TO THE BOARD OF THE ORGANIZATION. HE HAD NO INVOLVEMENT IN THE APPROVAL OF THE LOAN. IT WAS REFINANCED IN 2013. FORM 990, PART VI, SECTION A, LINE 3 DUBOIS CONTINUUM OF CARE COMMUNITY HAS ENGAGED THIRD PARTY MANAGEMENT COMPANY (COMPLETE HEALTHCARE RESOURCES-EASTERN, INC. (CHRE) TO OVERSEE DAY-TO-DAY OPERATIONS. KAREN BROWN, EXECUTIVE DIRECTOR OF THE FACILITY IS AN EMPLOYEE OF CHRE - HER COMPENSATION FOR 2021 FOR HER WORK AT DUBOIS CONTINUUM OF CARE COMMUNITY WAS $90,269. CAROLINE ROCKWELL, PC ADMINISTRATOR IS AN EMPLOYEE OF CHRE - HER COMPENSATION FOR 2021 FOR HER WORK AT DUBOIS CONTINUUM OF CARE COMMUNITY WAS $68,385. DANA HEITZENRATER, DNH ADMINISTRATOR IS AN EMPLOYEE OF CHRE - HER COMPENSATION FOR 2021 FOR HER WORK AT DUBOIS CONTINUUM OF CARE COMMUNITY WAS $76,385. FORM 990, PART VI, SECTION A, LINE 8B NO SUCH COMMITTEE EXISTS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PRESENTED TO ALL GOVERNING BODY MEMBERS FOR REVIEW AND SIGNATURE PRIOR TO FILING THE RETURN WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE ANNUALLY. THE DISCLOSURES ARE REVIEWED ANNUALLY BY THE BOARD AND AS NEW CONFLICTS ARISE. FORM 990, PART VI, SECTION B, LINE 15 OFFICERS ARE NOT COMPENSATED. COMPENSATION TO KEY EMPLOYEES IS RECOMMENDED TO THE BOARD BY THE MANAGEMENT COMPANY. THE BOARD DECIDES TO ACCEPT THE RECOMMENDATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION WILL PROVIDE, UPON IN-PERSON, VERBAL OR WRITTEN REQUEST, DOCUMENTS RELATING TO THE GOVERNANCE, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS TO THE PUBLIC. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,082,289. MANAGEMENT AND GENERAL EXPENSES 117,011. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,199,300. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 1,123,496. MANAGEMENT AND GENERAL EXPENSES 432,786. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,556,282. DUBOIS CONTINUUM OF CARE FOUNDATION 212 SOUTH EIGHTH STREET DUBOIS PA 15801 510513213 CHARITABLE FOUNDATION PA 501(C)(3) LINE 12A, I DUBOIS CONTINUUM OF CARE COMMUNITY INC 1 DUBOIS HOME CARE 212 SOUTH EIGHTH STREET DUBOIS PA 15801 474245056 IN-HOUSE NURSING CARE PA 501(C)(3) LINE 10 DUBOIS CONTINUUM OF CARE COMMUNITY INC 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 DUBOIS HOME CARE M 356592 COST