2020-07-13T12:19:37-05:00 2019-06-30 550486667 ARNETT CARBIS TOOTHMAN LLP 5700 CORPORATE DRIVE STE 650 PITTSBURGH PA 15237 990 2018-07-01 251619204 MILLCREEK MANOR MILL 8148644031 5515 PEACH STREET ERIE PA 16509 STEVEN G INMAN CPA CGMA VP FISCAL AFFAIRS/CFO 8148644031 2020-07-08 1 KELLY A BROCIOUS CPA P01254262 4126356270 2020-07-08 216.12.119.47 2020-07-08 11:42:15 ED P AA33865D103AC6BAEDC6D52EC28D34883AF57A1F 722E68A3860333A1F75A7ACEB82B7EB352F0136F 2018 2020-09-22 18:59:49Z LECOM SENIOR LIVING CENTER JOHN M FERRETTI DO 5515 PEACH STREET ERIE PA 16509 23256918 0 X HTTPS://LECOMHEALTH.COM/SENOR-LIVING X 1989 PA TO PROVIDE LONG TERM MEDICAL CARE TO THE COMMUNITY. 8 4 542 18 0 0 73 28 19981841 22337719 13246 57193 402420 861978 20397580 23256918 0 0 0 0 13234928 13493355 0 0 0 9098981 10011128 22333909 23504483 -1936329 -247565 80167765 83682096 2300005 2272621 77867760 81409475 X TO PROVIDE LONG TERM MEDICAL CARE TO THE COMMUNITY. 0 0 20518973 23199697 IN MID-2015, MILLCREEK MANOR, DOING BUSINESS AS LECOM SENIOR LIVING CENTER, MOVED TO A NEW NURSING FACILITY. MILLCREEK MANOR IS A 138 BED FACILITY. IN ADDITION TO THE OPENING OF THIS FACILITY, MILLCREEK MANOR ALSO PURCHASED THREE INDEPENDENT LIVING CENTERS IN 2015. THE FACILITIES HAVE A LITTLE MORE THAN 240 UNITS COMBINED. TWO OF THE FACILITIES ARE ALSO LICENSED PERSONAL CARE HOMES.MILLCREEK MANOR PROVIDES QUALITY LONG-TERM MEDICAL CARE TO INDIVIDUALS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAPS, AGE, OR ABILITY TO PAY. APPROXIMATELY 132 PERSONS A DAY BENEFITTED FROM THIS PROGRAM DURING THE FISCAL YEAR. WITH THE PURCHASE OF THE THREE FACILITIES IN 2015, MILLCREEK MANOR ALSO PROVIDES INDEPENDENT AND PERSONAL CARE SERVICES. 20518973 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 59 0 542 1 0 0 0 0 0 0 0 0 0 0 X 8 4 1 0 0 0 1 0 1 1 1 0 0 1 1 1 1 1 1 0 0 0 PA X STEVEN G INMAN CPA CGMA 8148644031 5515 PEACH STREET ERIE PA 16509 JOHN M FERRETTI DO PRESIDENT 4.00 76.00 X X 0 982429 32004 RICHARD P OLINGER TREASURER 1.00 64.00 X X 0 712025 42746 MARY L ECKERT SECRETARY 1.00 79.00 X X 0 907761 33010 SILVIA M FERRETTI DO TRUSTEE 1.00 64.00 X 0 1216066 32182 VINCENT S FIERRO JR DO TRUSTEE 1.00 2.00 X 0 0 0 ESTHER J FUCCI TRUSTEE 1.00 X 0 0 0 JOSEPH S KUJAWA TRUSTEE 1.00 X 0 0 0 JOYCE SAVOCCHIO TRUSTEE 1.00 X 0 0 0 STEVEN G INMAN CPA CGMA VP FISCAL AFFAIRS/CFO 1.00 64.00 X 0 181998 19837 SHOLIN MONTGOMERY NURSING HOME ADMINISTRATOR 40.00 X 101264 0 15553 ASHLEY KING PHARMACIST 40.00 X 101308 0 13673 JAMES CZARNECKI DIRECTOR OF IT 40.00 X 124293 0 17140 JAIME BABIAK PHARMD MHSA DIRECTOR OF PHARMACY 40.00 X 116518 0 9315 MELANIE TITZEL PHD DIRECTOR OF SENIOR COMMUNITIES 40.00 1.00 X 107486 0 18762 550869 4000279 234222 5 0 1 0 BUILDING SYSTEMS INC 7335 OLD PERRY HIGHWAY ERIE PA 16509 CONSTRUCTION SERVICES 1095145 EAT'N PARK - CURA HOSPITALITY PO BOX 743676 ATLANTA GA 303743676 DIETARY SERVICES 952664 US FOODSERVICE INC PO BOX 643190 PITTSBURGH PA 152643160 FOOD SERVICES 334619 ROTH MARZ PARTNERSHIP PC 3505 CHAPIN STREET ERIE PA 16508 ARCHITECTURAL/ SCHEMATIC DESIGN 286599 LM WANDER & SONS LANDSCAPING 8711 PEACH STREET ERIE PA 16509 LANDSCAPING SERVICES 236959 9 28 28 NET PATIENT REVENUE 623000 22337719 22337719 22337719 57193 57193 OTHER REVENUE 900099 861978 861978 861978 23256918 23199697 0 57193 10383977 8989308 1394669 305007 265519 39488 2024094 1762044 262050 780277 679258 101019 40667 40667 2290449 1964040 326409 66866 59975 6891 733355 630993 102362 1251882 945434 306448 88647 54245 34402 2653264 2559010 94254 180011 143303 36708 PHARMACY DRUGS 1638913 1638913 FOOD 574254 574254 REPAIRS AND MAINTENANCE 317492 194294 123198 EDUCATION AND TRAINING 29801 27161 2640 145527 31222 114305 23504483 20518973 2985510 0 1339231 1258936 3313363 3262449 1006226 1536418 150781 228963 398516 598740 74056403 12099987 56530714 61956416 14482135 14482135 2946799 358039 80167765 83682096 2240758 2214582 59247 58039 2300005 2272621 X 77808513 81351436 59247 58039 77867760 81409475 80167765 83682096 X -247565 3789280 X 0 0 0 X 5180123 5180123 58095085 7158012 50937073 9159817 4874644 4285173 1621378 67331 1554047 61956416 RESIDENT TRUST FUNDS 58039 58039 0 0 0 0 0 0 0 0 0 JOHN M FERRETTI DO PRESIDENT 0 950115 0 0 0 32314 0 21154 0 10850 0 1014433 0 0 RICHARD P OLINGER TREASURER 0 687728 0 0 0 24297 0 22000 0 20746 0 754771 0 0 MARY L ECKERT SECRETARY 0 872202 0 0 0 35559 0 22000 0 11010 0 940771 0 0 SILVIA M FERRETTI DO TRUSTEE 0 1190543 0 0 0 25523 0 21154 0 11028 0 1248248 0 0 STEVEN G INMAN CPA CGMA VP FISCAL AFFAIRS/CFO 0 181907 0 0 0 91 0 13655 0 6182 0 201835 0 0 PART I, LINE 3 MILLCREEK MANOR'S TOP MANAGEMENT OFFICIAL AND CERTAIN MEMBERS OF ITS BOARD OF TRUSTEES ARE PAID BY LECOM. LECOM USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE CEO: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -FORM 990 OF OTHER ORGANIZATIONS -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE FORM 990, PART VI, SECTION A, LINE 2 SILVIA M. FERRETTI JOHN M. FERRETTI TREASURER PRESIDENT FAMILY RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 6 MILLCREEK HEALTH SYSTEM, THE FILING ORGANIZATION'S PARENT CORPORATION, IS THE SOLE MEMBER OF THE FILING ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B MILLCREEK HEALTH SYSTEM IS THE PARENT ORGANIZATION OF MILLCREEK MANOR. IN ACCORDANCE WITH MILLCREEK HEALTH SYSTEM'S BY-LAWS, ITS BOARD OF TRUSTEES HAS THE RIGHT TO APPROVE ANY AND ALL TRANSACTIONS THAT CHANGE, OR HAVE THE EFFECT OF CHANGING, THE OWNERSHIP AND/OR CONTROL OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING ITS FORM 990, THE ORGANIZATION PROVIDED ITS BOARD MEMBERS WITH ACCESS TO AN ELECTRONIC COPY OF THE TAX RETURN AND INVITED COMMENTS AND QUESTIONS FROM THE BOARD MEMBERS. PRIOR TO FILING FORM 990, MEMBERS OF THE ORGANIZATION'S FINANCIAL MANAGEMENT CONDUCTED A DETAILED REVIEW OF THE TAX FILING. THROUGHOUT THE REVIEW PROCESS, THERE WAS ONGOING DISCUSSION BETWEEN THE ORGANIZATION'S FINANCIAL MANAGEMENT AND THE TAX PREPARER. FORM 990, PART VI, SECTION B, LINE 12C EACH MEMBER OF THE BOARD OF TRUSTEES IS REQUIRED TO COMPLETE A STANDARDIZED CONFLICT OF INTEREST FORM ON AN ANNUAL BASIS. ANY POTENTIAL CONFLICTS OF INTEREST ARE ADDRESSED BY AN APPOINTED COMMITTEE WHOSE MEMBERS ARE INDEPENDENT WITH REGARD TO THE MATTER BEING REVIEWED. IF A POTENTIAL CONFLICT OF INTEREST ARISES, IT IS REVIEWED AND DOCUMENTED BY THE APPOINTED COMMITTEE, AND THEN THE APPOINTED COMMITTEE REPORTS THE RESULTS OF ITS REVIEW TO THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 15 THE SALARIES OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL AND CERTAIN MEMBERS OF ITS BOARD OF TRUSTEES ARE DETERMINED BY THE EMPLOYING ORGANIZATION'S BUDGET/FINANCE COMMITTEE, WHICH ALSO FUNCTIONS AS A COMPENSATION COMMITTEE. THE BUDGET/FINANCE COMMITTEE REVIEWED A STUDY PERFORMED BY AN INDEPENDENT COMPENSATION CONSULTANT. ON AN ANNUAL BASIS, THE COMMITTEE REVIEWS VARIOUS FORM 990 FILINGS BY COMPARATIVE ORGANIZATIONS IN ORDER TO MAKE EXECUTIVE PAY COMPARISONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, BY-LAWS AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC. FORM 990, PART XI, LINE 9: CHANGE IN TEMPORARILY RESTRICTED ASSETS -210,720. TRANSFER FROM RELATED ENTITY 4,000,000. MILLCREEK HEALTH SYSTEM (MHS) 5515 PEACH ST ERIE PA 16509 251766164 PARENT CORPORATION PA 501(C)(3) LINE 12C, III-FI N/A 0 LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE 1858 W GRANDVIEW BLVD ERIE PA 16509 251698677 MEDICAL SCHOOL PA 501(C)(3) LINE 2 MILLCREEK HEALTH SYSTEM 0 MILLCREEK COMMUNITY HOSPITAL 5515 PEACH ST ERIE PA 16509 251002937 HOSPITAL PA 501(C)(3) LINE 3 MILLCREEK HEALTH SYSTEM 0 MEDICAL ASSOCIATES OF ERIE ONE LECOM PLACE ERIE PA 16509 113716896 PHYSICIAN MANAGEMENT PA 501(C)(3) LINE 10 MILLCREEK HEALTH SYSTEM 0 MILLCREEK HEALTH SYSTEM MEDICAL PRO 5515 PEACH ST ERIE PA 16509 576204119 LIABILITY INSURANCE PA 501(C)(3) LINE 12C, III-FI 0 ERIE CENTER ON HEALTH AND AGING 406 PEACH ST ERIE PA 16507 251361363 SENIOR HEALTH PA 501(C)(3) LINE 7 MILLCREEK HEALTH SYSTEM 0 VISITING NURSE ASSOCIATION OF ERIE COUNTY 2253 WEST GRANDVIEW BOULEVARD ERIE PA 16506 250969488 HOME HEALTH PA 501(C)(3) LINE 7 MILLCREEK HEALTH SYSTEM 0 CORRY MEMORIAL HOSPITAL ASSN (CMH) 965 SHAMROCK LANE CORRY PA 16407 250987222 HOSPITAL PA 501(C)(3) LINE 3 MILLCREEK HEALTH SYSTEM 0 CORRY MEDICAL SERVICES 965 SHAMROCK LANE CORRY PA 16407 251425220 HEALTH CARE PA 501(C)(3) LINE 12B, II CORRY MEMORIAL HOSPITAL ASSOCIATION 0 CORRY MEMORIAL HOSPITAL FOUNDATION 965 SHAMROCK LANE CORRY PA 16407 208285800 FUNDRAISING PA 501(C)(3) LINE 12B, II CORRY MEMORIAL HOSPITAL ASSOCIATION 0 LECOM AT PRESQUE ISLE 4114 SCHAPER AVE ERIE PA 16508 475049201 LONG TERM CARE PA 501(C)(3) LINE 10 MILLCREEK HEALTH SYSTEM 0 MCH CORPORATION 5515 PEACH ST ERIE PA 16509 251549695 REAL ESTATE PA MILLCREEK HEALTH SYSTEM C 0 CORRY HEALTH SERVICES INC 965 SHAMROCK LAME CORRY PA 16407 251488214 HEALTH CARE PA CORRY MEMORIAL HOSPITAL ASSOCIATION C 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 1