STRATEGY STUDIO / PUBLIC DATA EXPLORER

WCA FOUNDATION INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
WCA FOUNDATION INC (EIN 22-2393584)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-11-13
IRS object ID
202003189349306400
Schema version
2019v5.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2020-11-13T10:08:13-08:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Kelly A Dawson CPABusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12 East Second Street Suite 400AddressLine1Txt
CityJamestownCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14701ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN222393584EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1WCA FOUNDATION INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlWCAFBusinessNameControlTxt
Phone7166648615PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line151 GLASGOW AVENUE PO BOX 840AddressLine1Txt
CityJAMESTOWNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP147020840ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBRIGETTA OVERCASHPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone7166648615PhoneNum
Signature2020-04-08SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKelly A Dawson CPAPreparerPersonNm
PTINP00956772PTIN
Phone7164996398PhoneNum
Preparation2020-11-13PreparationDt
Self EmployedYes (X)SelfEmployedInd

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address172.100.143.142IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-11-13IPDt
IP Tm10:07:59IPTm
IP TimezonePSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdA73E727F16D19885BA00F27C59316FDF9D683BE6AtSubmissionCreationDeviceId
At Submission Filing Device IdA73E727F16D19885BA00F27C59316FDF9D683BE6AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1BRIGETTA OVERCASHBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 840AddressLine1Txt
CityJAMESTOWNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14701ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,922,411GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1981FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionTO PROMOTE AND SUPPORT COMMUNITY HEALTH IN JAMESTOWN, NEW YORK THROUGH THE SUPPORT OF THE UPMC CHAUTAUQUA AND ANY OTHER AFFILIATES OF WCA GROUP, INC.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$217,395TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$112,837PYContributionsGrantsAmt
CY Contributions Grants$113,562CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$637,514PYInvestmentIncomeAmt
CY Investment Income$500,437CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$750,351PYTotalRevenueAmt
CY Total Revenue$613,999CYTotalRevenueAmt
PY Grants And Similar Paid$590,294PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$589,313CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$106,205PYOtherExpensesAmt
CY Other Expenses$115,090CYOtherExpensesAmt
PY Total Expenses$696,499PYTotalExpensesAmt
CY Total Expenses$704,403CYTotalExpensesAmt
PY Revenues Less Expenses$53,852PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$90,404CYRevenuesLessExpensesAmt
Total Assets BOY$13,589,703TotalAssetsBOYAmt
Total Assets EOY$16,083,145TotalAssetsEOYAmt
Total Liabilities BOY$667,877TotalLiabilitiesBOYAmt
Total Liabilities EOY$906,367TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$12,921,826NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$15,176,778NetAssetsOrFundBalancesEOYAmt
MissionTO PROMOTE AND SUPPORT COMMUNITY HEALTH IN JAMESTOWN, NEW YORK THROUGH THE SUPPORT OF THE UPMC CHAUTAUQUA AND ANY OTHER AFFILIATES OF WCA GROUP, INC.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$589,313ExpenseAmt
Grant$0GrantAmt
Revenue$589,313RevenueAmt
DescSUPPORT OF COMMUNITY HEALTH THROUGH GRANTS TO UPMC CHAUTAUQUA AND OTHER AFFILIATES OF WCA GROUP, INC. GRANTS INCLUDE SUPPORT OF RADIOLOGY, DIALYSIS, CANCER TREATMENT, MEDICAL LIBRARIES, NURSING, AND AND THE EMERGENCY ROOM.Desc
Total Program Service Expenses$589,313TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (true)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
DAF Excess Business HoldingsfalseDAFExcessBusinessHoldingsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonBRIGETTA OVERCASHPersonNm
Phone7166645461PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 840AddressLine1Txt
CityJAMESTOWNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP147020840ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
BRIGETTA OVERCASH
EXECUTIVE DIRECTOR5.00Yes (X)Yes (X)$0$37,726$1,319
JAMES PULLAN JR
TREASURER1.00Yes (X)Yes (X)$0$0$0
TIMOTHY BLACK
DIRECTOR1.00Yes (X)$0$0$0
JAMES DOMAGOLA
DIRECTOR1.00Yes (X)$0$0$0
WENDY KANE
SECRETARY1.00Yes (X)$0$0$0
PETER STARK
CHAIR1.00Yes (X)Yes (X)$0$0$0
LAURA OTANDER
VICE CHAIR1.00Yes (X)Yes (X)$0$0$0
ROBERT UNGERER MD
DIRECTOR1.00Yes (X)$0$0$0
RICHARD E TURNER III
DIRECTOR1.00Yes (X)$0$0$0
BETSY KNOWLTON
DIRECTOR1.00Yes (X)Yes (X)$0$0$0
ERIC ARNONE MD
DIRECTOR1.00Yes (X)$0$0$0
BRIAN DURNIOK
DIRECTOR1.00Yes (X)$0$322,067$46,817Yes (X)Yes (X)
WILLIAM EVANS III
DIRECTOR1.00Yes (X)$0$0$0
MELANIE GRITTERS
DIRECTOR1.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$359,793TotReportableCompRltdOrgAmt
Total Other Compensation$48,136TotalOtherCompensationAmt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$113,562AllOtherContributionsAmt
Total Contributions$113,562TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$283,042TotalRevenueColumnAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$283,042ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,525,807SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,308,412SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$217,395SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$217,395TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$217,395UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$613,999TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$217,395UnrelatedBusinessRevenueAmt
Exclusion$283,042ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$589,313TotalAmt
Program Services$589,313ProgramServicesAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$66,271TotalAmt
Program Services$0ProgramServicesAmt
Management And General$66,271ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$13,340TotalAmt
Program Services$0ProgramServicesAmt
Management And General$13,340ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$21,880TotalAmt
Program Services$0ProgramServicesAmt
Management And General$21,880ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,975TotalAmt
Program Services$0ProgramServicesAmt
Management And General$1,975ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
OTHER EXPENSES$3,018$0$3,018$0
TELEPHONE$288$0$288$0
DEVELOPMENT EXPENSE$5,086$0$5,086$0
FUNDRAISING EXPENSE$3,232$0$3,232$0

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$704,403TotalAmt
Program Services$589,313ProgramServicesAmt
Management And General$115,090ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$788,015BOYAmt
EOY$363,966EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$243,184EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$108BOYAmt
EOY$0EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$12,801,580BOYAmt
EOY$15,475,995EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$13,589,703BOYAmt
EOY$16,083,145EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$63,581BOYAmt
EOY$75,122EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$604,220BOYAmt
EOY$588,061EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$76BOYAmt
EOY$243,184EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$667,877BOYAmt
EOY$906,367EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$9,961,876BOYAmt
EOY$11,686,728EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,959,950BOYAmt
EOY$3,490,050EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$12,921,826BOYAmt
EOY$15,176,778EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$13,589,703BOYAmt
EOY$16,083,145EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$90,404ReconcilationRevenueExpnssAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type3 Func IntYes (X)SupportingOrgType3FuncIntInd
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1UPMC CHAUTAUQUA WCABusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN160743226EIN
Organization Type3OrganizationTypeCd
Governing Document ListedYes (true)GoverningDocumentListedInd
Support$657,039SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$657,039SupportSumAmt
Other Support Sum$0OtherSupportSumAmt
Public Support CY1700PublicSupportCY170Pct
Public Support Total509$0PublicSupportTotal509Amt
Public Support CY5090PublicSupportCY509Pct
Investment Income CY0InvestmentIncomeCYPct

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (true)ListedByNameGoverningDocInd
Suprt Org No IRS DeterminationfalseSuprtOrgNoIRSDeterminationInd
Supported Org Section C456falseSupportedOrgSectionC456Ind
Supported Org Not Organized USfalseSupportedOrgNotOrganizedUSInd
Organization Change Suprt OrgfalseOrganizationChangeSuprtOrgInd
Support Non Supported OrgfalseSupportNonSupportedOrgInd
Payment Substantial ContribtrfalsePaymentSubstantialContribtrInd
Loan Disqualified PersonfalseLoanDisqualifiedPersonInd
Controlled Disqualified PrsnfalseControlledDisqualifiedPrsnInd
Disqualified Prsn Controll IntfalseDisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr IntfalseDisqualifiedPrsnOwnrIntInd
Excess Business Holdings RulesfalseExcessBusinessHoldingsRulesInd
Contribution ControllerfalseContributionControllerInd
Contribution FamilyfalseContributionFamilyInd
Contribution35 ControlledfalseContribution35ControlledInd

Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp

FieldValueIRS element (for citing)
Timely Provided DocumentsfalseTimelyProvidedDocumentsInd
Officers Close RelationshipYes (true)OfficersCloseRelationshipInd
Supported Org Voice InvestmentfalseSupportedOrgVoiceInvestmentInd

Form990 Sch A Type3 Func Int Form990SchAType3FuncIntGrp

FieldValueIRS element (for citing)
Activities TestYes (X)ActivitiesTestInd
Activities Further Exempt PrpsYes (true)ActivitiesFurtherExemptPrpsInd
Activities Engaged Org InvlmntfalseActivitiesEngagedOrgInvlmntInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$12,764,476BeginningYearBalanceAmt
End Year Balance$12,764,476EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$14,317,117BeginningYearBalanceAmt
Contributions$102,059ContributionsAmt
Investment Earnings Or Losses-$976,857InvestmentEarningsOrLossesAmt
Other Expenditures$677,843OtherExpendituresAmt
End Year Balance$12,764,476EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$12,499,335BeginningYearBalanceAmt
Contributions$96,982ContributionsAmt
Investment Earnings Or Losses$2,370,159InvestmentEarningsOrLossesAmt
Other Expenditures$649,359OtherExpendituresAmt
End Year Balance$14,317,117EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$12,090,714BeginningYearBalanceAmt
Contributions$72,452ContributionsAmt
Investment Earnings Or Losses$1,088,703InvestmentEarningsOrLossesAmt
Other Expenditures$752,534OtherExpendituresAmt
End Year Balance$12,499,335EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$12,886,919BeginningYearBalanceAmt
Contributions$33,559ContributionsAmt
Investment Earnings Or Losses-$267,379InvestmentEarningsOrLossesAmt
Other Expenditures$562,385OtherExpendituresAmt
End Year Balance$12,090,714EndYearBalanceAmt
FieldValueIRS element (for citing)
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
ADVANCES FROM RELATED PARTY$0
AMOUNTS HELD IN CUSTODY$243,184
FieldValueIRS element (for citing)
Total Liability$243,184TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$2,937,475TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$2,323,476NetUnrealizedGainsInvstAmt
Revenue Not Reported$2,323,476RevenueNotReportedAmt
Revenue Subtotal$613,999RevenueSubtotalAmt
Investment Expenses Not Incld$21,880InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$21,880RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$635,879TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$682,523TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$682,523ExpensesSubtotalAmt
Investment Expenses Not Incld2$21,880InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$21,880ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$704,403TotalExpensesPerForm990Amt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1UPMC CHAUTAUQUABusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1FOOTE AVENUEAddressLine1Txt
CityJAMESTOWNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14701ZIPCd
FieldValueIRS element (for citing)
Recipient EIN160743226RecipientEIN
IRC Section170(B)(1)IRCSectionDesc
Cash Grant$616,443CashGrantAmt
Purpose Of GrantSUPPORT ACTIVITIES RELATED TO COMMUNITY HEALTHPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonBRIAN DURNIOKPersonNm
Base Compensation Filing Org$444,587BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$0CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$22,400DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$7,265NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$474,252TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$0TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Pt VI, Line 11bTHE FORM 990 IS PROVIDED TO THE BOARD FOR THEIR REVIEW BEFORE ITS SUBMISSION TO THE INTERNAL REVENUE SERVICE
Pt VI, Line 12cCONFLICT OF INTEREST DISCLOSURES ARE REVIEWED ON AN ANNUAL BASIS
Pt VI, Line 19GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS ARE AVAILABLE FROM THE ORGANIZATION UPON REQUEST.
Pt XINET UNREALIZED LOSSES ON INVESTMENTS
Pt XII, Line 2cFINANCE/AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT AUDITOR

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
UPMC CHAUTAUQUA
PO BOX 840 FOOTE AVENUEJAMESTOWNNY14701160743226HOSPITALNY501(C)(3)170(B)(1)NAfalse
STARFLIGHT INC
207 FOOTE AVENUEJAMESTOWNNY14701161557878MEDICAL TRANSPORTATIONNY501(C)(3)170(B)(1)NAfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmt
UPMC CHAUTAUQUA
B$590,768
UPMC CHAUTAUQUA
M$66,271