PENN HIGHLANDS HEALTHCARE: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- PENN HIGHLANDS HEALTHCARE (EIN 32-0345810)
- Tax period
- 2018-07-01 to 2019-06-30
- Filed
- 2020-07-15
- IRS object ID
- 202021979349305942
- Schema version
- 2018v3.3
- 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 D
- Schedule G
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-07-15T15:12:30-05:00 | ReturnTs |
| Tax Period End | 2019-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E ST LOUIS 200/PO BOX 1190 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 658062523 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 320345810 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PENN HIGHLANDS HEALTHCARE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % BRIAN S KLINE CFO PH DUBO | InCareOfNm |
| Business Name Control | PENN | BusinessNameControlTxt |
| Phone | 8143756432 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 447 | AddressLine1Txt |
| City | DUBOIS | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 15801 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEVEN FONTAINE | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 8143756432 | PhoneNum |
| Signature | 2020-06-22 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Brian D Todd | PreparerPersonNm |
| PTIN | P00422601 | PTIN |
| Phone | 4178658701 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 167.68.126.162 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 43032920201975000236 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2020-07-15 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 0CBE7C12A7D19235FD4067AEEEE3D426BE4745FB | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | EADA8263F67F30EEC173F90D1C5FD4FB3EC213FF | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | STEVEN FONTAINE CEO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 447 100 HOSPITAL AVE | AddressLine1Txt |
| City | DUBOIS | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 15801 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $33,714,191 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PHHEALTHCARE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2011 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | PENN HIGHLANDS HEALTHCARE IS A COMMUNITY-BASED AND CONTROLLED HEALTH CARE SYSTEM THAT EXISTS TO IMPROVE REGIONAL ACCESS TO QUALITY HEALTHCARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 20 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $112,375 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,628,100 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $22,348,404 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $30,032,459 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $34,470 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$14,283 | PYOtherRevenueAmt |
| CY Other Revenue | -$10,882 | CYOtherRevenueAmt |
| PY Total Revenue | $22,446,496 | PYTotalRevenueAmt |
| CY Total Revenue | $33,684,147 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $98,092 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $118,300 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $17,193,080 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $21,452,853 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,949,312 | PYOtherExpensesAmt |
| CY Other Expenses | $8,583,926 | CYOtherExpensesAmt |
| PY Total Expenses | $22,240,484 | PYTotalExpensesAmt |
| CY Total Expenses | $30,155,079 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $206,012 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,529,068 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $40,657,646 | TotalAssetsBOYAmt |
| Total Assets EOY | $49,134,226 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $10,106,391 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $15,053,903 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $30,551,255 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $34,080,323 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | OUR COMMUNITY-BASED AND CONTROLLED HEALTH CARE SYSTEM EXISTS TO IMPROVE REGIONAL ACCESS TO A WIDE ARRAY OF PREMIER PRIMARY CARE AND ADVANCED HEALTH SERVICES WHILE SUPPORTING A REVERENCE FOR LIFE AND THE WORTH AND DIGNITY OF EACH INDIVIDUAL. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $25,026,259 | ExpenseAmt |
| Grant | $118,300 | GrantAmt |
| Revenue | $30,032,459 | RevenueAmt |
| Desc | PENN HIGHLANDS HEALTHCARE WAS FORMED IN CONJUNCTION WITH THE AFFILIATION OF DUBOIS REGIONAL MEDICAL CENTER AND ITS AFFILIATED ENTITIES INCLUDING BROOKVILLE HOSPITAL, CLEARFIELD HOSPITAL AND ITS AFFILIATED ENTITIES AND ELK REGIONAL HOSPITAL AND ITS AFFILIATED ENTITIES. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. | Desc |
| Total Program Service Expenses | $25,026,259 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | 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 |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | Yes (true) | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | 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 | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| 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 With Officer Ent | Yes (true) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | Yes (true) | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 57 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | 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 |
| Quid Pro Quo Contributions | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| 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 | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | 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 | false | 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 | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | PA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BRIAN S KLINE CFO PH DUBO | PersonNm |
| Phone | 8143756377 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 447 100 HOSPITAL AVENUE | AddressLine1Txt |
| City | DUBOIS | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 15801 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| RONALD KING | ||||||||
| CHAIRMAN | 5.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| RICHARD PFINGSTLER | ||||||||
| VICE CHAIRMAN | 2.0 | 5.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DR RICHARD BEDGER | ||||||||
| SECRETARY | 3.0 | 10.0 | Yes (X) | Yes (X) | $0 | $25,000 | $0 | |
| ROBERT ORDIWAY | ||||||||
| TREASURER | 3.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DR HAZEM EL KASSAS | ||||||||
| TRUSTEE | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||
| THOMAS GASBARRE | ||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| DAVID LEZZER | ||||||||
| TRUSTEE | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| DR CARMINE MARCHIOLI | ||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| EDWARD NASUTI | ||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| ROB O'LEARY | ||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| DR GREGORY ROSCOE | ||||||||
| TRUSTEE | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||
| JIM RYAN | ||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| TODD STOLTZ | ||||||||
| TRUSTEE | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||
| WILLIAM YOUNG | ||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| DR THOMAS CARNEVALE | ||||||||
| TRUSTEE | 2.0 | 40.0 | Yes (X) | $0 | $435,902 | $26,281 | ||
| SCOTT FORADORA | ||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| MARK NORMAN | ||||||||
| CHIEF OPERATING OFFR/TRUSTEE | 40.0 | 1.0 | Yes (X) | Yes (X) | $371,743 | $0 | $43,850 | |
| STEVE FONTAINE | ||||||||
| CEO | 40.0 | 2.0 | Yes (X) | $875,072 | $0 | $125,206 | ||
| DR RUSSELL CAMERON | ||||||||
| CHIEF MEDICAL OFFICER | 1.0 | 40.0 | Yes (X) | $0 | $588,819 | $49,110 | ||
| ROSE CAMPBELL | ||||||||
| VP PATIENT SERVICES/CNO | 1.0 | 40.0 | Yes (X) | $0 | $312,067 | $24,797 | ||
| TARUN GHOSH | ||||||||
| CHIEF FINANCIAL OFFICER | 40.0 | 1.0 | Yes (X) | $429,222 | $0 | $31,916 | ||
| BRIAN KLINE | ||||||||
| VP CHIEF FINANCIAL OFFICER | 1.0 | 40.0 | $0 | $313,061 | $29,929 | Yes (X) | ||
| ROBERT MCKEE | ||||||||
| VP CHIEF HR OFFICER | 1.0 | 40.0 | $0 | $274,574 | $35,573 | Yes (X) | ||
| ISTIKRAM QADERI | ||||||||
| CHIEF QUALITY OFFICER | 1.0 | 40.0 | $0 | $217,557 | $21,120 | Yes (X) | ||
| CLOYD GEEDY | ||||||||
| VP SUPPLY CHAIN MGMT | 1.0 | 40.0 | $0 | $160,890 | $24,562 | Yes (X) | ||
| BRYAN FREDERICKS | ||||||||
| PHYSICIAN NETWORK PRESIDENT | 1.0 | 40.0 | $0 | $275,723 | $29,734 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,676,037 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,603,593 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $442,078 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| WHITAKER CARRIER SERVICE | |||||
| 60 TREASURE LAKE | DUBOIS | PA | 15801 | COURIER SERVICES | $676,159 |
| KL GATES LLP | |||||
| 210 SIXTH AVENUE | PITTSBURGH | PA | 15222 | LEGAL SERVICES | $611,652 |
| BKD LLP | |||||
| 7901 WOODWAY DRIVE | WACO | TX | 76712 | AUDIT/TAX/CONSULTING | $427,080 |
| BALDWIN LAW GROUP | |||||
| 600 FAIRMOUNT AVENUE | TOWSON | MD | 21286 | LEGAL SERVICES | $236,762 |
| CAPTIS HEALTH LLC | |||||
| 7601 FRANCE AVENUE S STE 500 | EDINA | MN | 55435 | SUPPLY CHAIN CONSULT | $105,882 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $129,182 | FundraisingAmt |
| Related Organizations | $3,498,918 | RelatedOrganizationsAmt |
| Total Contributions | $3,628,100 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Management Services | Desc |
| Business | 541611 | BusinessCd |
| Total Revenue Column | $30,032,459 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $30,032,459 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $30,032,459 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $34,470 | TotalRevenueColumnAmt |
| Exclusion | $34,470 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $19,162 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $129,182 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $30,044 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$10,882 | TotalRevenueColumnAmt |
| Exclusion | -$10,882 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $33,684,147 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $30,032,459 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $23,588 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $118,300 | TotalAmt |
| Program Services | $118,300 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,877,009 | TotalAmt |
| Management And General | $1,877,009 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,494,487 | TotalAmt |
| Program Services | $16,062,743 | ProgramServicesAmt |
| Management And General | $431,744 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,081,357 | TotalAmt |
| Program Services | $2,901,579 | ProgramServicesAmt |
| Management And General | $179,778 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,645,155 | TotalAmt |
| Management And General | $1,645,155 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $215,200 | TotalAmt |
| Management And General | $215,200 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,819,623 | TotalAmt |
| Program Services | $3,376,547 | ProgramServicesAmt |
| Management And General | $443,076 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $942,602 | TotalAmt |
| Program Services | $833,260 | ProgramServicesAmt |
| Management And General | $109,342 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $848,211 | TotalAmt |
| Program Services | $749,819 | ProgramServicesAmt |
| Management And General | $98,392 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133,577 | TotalAmt |
| Program Services | $118,082 | ProgramServicesAmt |
| Management And General | $15,495 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $131,762 | TotalAmt |
| Program Services | $116,478 | ProgramServicesAmt |
| Management And General | $15,284 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,436 | TotalAmt |
| Program Services | $2,153 | ProgramServicesAmt |
| Management And General | $283 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,513 | TotalAmt |
| Program Services | $26,973 | ProgramServicesAmt |
| Management And General | $3,540 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $170,051 | TotalAmt |
| Program Services | $150,325 | ProgramServicesAmt |
| Management And General | $19,726 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| REPAIRS AND MAINTENANCE | $279,375 | $246,967 | $32,408 |
| LICENSES, DUES, SUBSCRIPTIONS | $183,555 | $162,263 | $21,292 |
| RECRUITING & RETENTION | $181,866 | $160,770 | $21,096 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,155,079 | TotalAmt |
| Program Services | $25,026,259 | ProgramServicesAmt |
| Management And General | $5,128,820 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,845,613 | BOYAmt |
| EOY | $722,597 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $9,428,642 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $306 | BOYAmt |
| EOY | $1,428 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $539,222 | BOYAmt |
| EOY | $1,188,866 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $217,295 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $83,990 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,232 | BOYAmt |
| EOY | $133,305 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,734,257 | BOYAmt |
| EOY | $33,233,175 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,516,016 | BOYAmt |
| EOY | $4,426,213 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,657,646 | BOYAmt |
| EOY | $49,134,226 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,776,391 | BOYAmt |
| EOY | $8,546,826 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $2,455,000 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,330,000 | BOYAmt |
| EOY | $4,052,077 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,106,391 | BOYAmt |
| EOY | $15,053,903 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,539,164 | BOYAmt |
| EOY | $29,842,773 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $803,605 | BOYAmt |
| EOY | $4,029,064 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $208,486 | BOYAmt |
| EOY | $208,486 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,551,255 | BOYAmt |
| EOY | $34,080,323 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,657,646 | BOYAmt |
| EOY | $49,134,226 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $3,529,068 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 Type3 Func Int | Yes (X) | SupportingOrgType3FuncIntInd |
| IRS Written Determination | Yes (X) | IRSWrittenDeterminationInd |
| Supported Organizations | 6 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (6 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| DUBOIS REGIONAL MEDICAL CENTER | ||||
| 251490707 | 3 | Yes (true) | $38,816 | $0 |
| CLEARFIELD HOSPITAL | ||||
| 250979346 | 3 | Yes (true) | $29,281 | $0 |
| BROOKVILLE HOSPITAL | ||||
| 250984595 | 3 | Yes (true) | $23,581 | $0 |
| ELK REGIONAL HEALTH CENTER | ||||
| 250585280 | 3 | Yes (true) | $26,622 | $0 |
| JC BLAIR MEMORIAL HOSPITAL | ||||
| 231352159 | 3 | Yes (true) | $0 | $0 |
| JEFFCO HEALTH SERVICES INC | ||||
| 251505478 | 3 | Yes (true) | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 6 | SupportedOrganizationsTotalCnt |
| Support Sum | $118,300 | SupportSumAmt |
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 | Yes (true) | OrganizationChangeSuprtOrgInd |
| Substitution Beyond Org Cntl | false | SubstitutionBeyondOrgCntlInd |
| 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 |
Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timely Provided Documents | Yes (true) | TimelyProvidedDocumentsInd |
| Officers Close Relationship | Yes (true) | OfficersCloseRelationshipInd |
| Supported Org Voice Investment | Yes (true) | SupportedOrgVoiceInvestmentInd |
Form990 Sch A Type3 Func Int Form990SchAType3FuncIntGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Test | Yes (X) | ActivitiesTestInd |
| Parent Supported Org | Yes (X) | ParentSupportedOrgInd |
| Activities Further Exempt Prps | Yes (true) | ActivitiesFurtherExemptPrpsInd |
| Activities Engaged Org Invlmnt | Yes (true) | ActivitiesEngagedOrgInvlmntInd |
| Appoint Elect Majority Officer | Yes (true) | AppointElectMajorityOfficerInd |
| Exercise Direction Policies | Yes (true) | ExerciseDirectionPoliciesInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE A, PART IV, SECTION A, LINE 5Q | ADDITION OF SUPPORTED ORGANIZATIONS: DURING THE FISCAL YEAR, PENN HIGHLANDS HEALTHCARE ADDED TWO SUPPORTED ORGANIZATIONS: (i) JEFFCO HEALTH SERVICES, INC 25-1505478 AND JC BLAIR MEMORIAL HOSPITAL 23-1352159 (ii) THROUGH THE STRATEGIC ACQUISITION OF JEFFCO HEALTH SERVICES AND JC BLAIR MEMORIAL HOSPITAL, THE ORGANIZATION WILL HAVE THE OPPORTUNITY TO EXPAND ITS SERVICE AREA AND PROVIDE MORE COMPREHENSIVE HEALTH CARE SERVICES IN ITS CURRENT SERVICE AREA. (iii) THE POWER TO ENTER INTO A PURCHASE AGREEMENT, MERGER, CONSOLIDATION OR ACQUISITION IS LISTED IN THE ORGANIZATION'S BYLAWS AS A RESERVED POWER OF PENN HIGHLANDS HEALTHCARE. (iv) THE ACQUISITION WAS ACCOMPLISHED THROUGH AN ACQUISITION AGREEMENT (AFFILIATION) AND AMENDMENTS TO THE ORGANIZING DOCUMENTS OF THE NEWLY SUPPORTED ORGANIZATIONS. |
| SCHEDULE A, PART IV, SECTION D, LINE 3 | SIGNIFICANT VOICE: THE BOARD IS COMPRISED OF INDIVIDUALS APPROVED BY RELATED TAX-EXEMPT ORGANIZATIONS PENN HIGHLANDS DUBOIS, PENN HIGHLANDS CLEARFIELD, PENN HIGHLANDS BROOKVILLE, PENN HIGHLANDS HUNTINGDON, PENN HIGHLANDS JEFFERSON MANOR AND PENN HIGHLANDS ELK. THEREFORE, THE SUPPORTED ORGANIZATIONS HAVE A SIGNIFICANT VOICE IN ALL ACTIVITIES INCLUDING INVESTMENT POLICIES AND DIRECTING THE USE OF THE ORGANIZATION'S INCOME AND ASSETS. |
| SCHEDULE A, PART IV, SECTION E, LINE 2A & 2B | MANAGEMENT SERVICES PROVIDED: PENN HIGHLANDS HEALTHCARE PROVIDED SEVERAL MANAGEMENT SERVICES INCLUDING HR, PAYROLL, IT, DEVELOPMENT, RECRUITMENT, COMPLIANCE, SUPPLY CHAIN, ADVERTISING AND OTHER SERVICES TO THE HOSPITALS IN THE PENN HIGHLANDS HEALTHCARE SYSTEM INCLUDING PENN HIGHLANDS DUBOIS, PENN HIGHLANDS ELK, PENN HIGHLANDS CLEARFIELD PENN HIGHLANDS HUNTINGDON, PENN HIGHLANDS JEFFERSON MANOR AND PENN HIGHLANDS BROOKVILLE. EACH INDIVIDUAL HOSPITAL WOULD NEED TO PAY FOR THESE COSTS IF THE PARENT COMPANY DIDN'T PROVIDE THEM. |
| SCHEDULE A, PART IV, SECTION E, LINE 3A | PARENT OF SUPPORTED ORGANIZATION: PENN HIGHLANDS HEALTHCARE ELECTS THE GOVERNING BODIES OF ALL THE SUPPORTED ORGANIZATIONS. |
| SCHEDULE A, PART IV, SECTION E, LINE 3B | PARENT OF SUPPORTED ORGANIZATION: CONTROL IS EXERCISED THROUGH THE RESERVED POWERS OF THE BYLAWS. THE RESERVED POWERS IN THE BYLAWS INCLUDE BUT ARE NOT LIMITED TO APPROVING ALL FUNDAMENTAL TRANSACTIONS OF A SYSTEM SUBSIDIARY, INCLUDING AMENDMENTS OF THE BYLAWS OR OTHER ORGANIZATIONAL/GOVERNANCE DOCUMENTS, ALL STRATEGIC PLANS, ALL CAPITAL, OPERATING AND CASH FLOW BUDGETS, ALL QUALITY PLANS, ANY CHANGES PROPOSED THAT COULD AFFECT THE NOT-FOR-PROFIT, TAX-EXEMPT STATUS OF THIS CORPORATION OR ANY SYSTEM SUBSIDIARY, ANY CHANGE IN MISSION OR DIRECTION OF A SUBSIDIARY, INCLUDING, WITHOUT LIMITATION, ANY DECISION TO ADD OR DISCONTINUE A LINE OF SERVICE OR ADD OR DISCONTINUE ANY OF THE CLINICAL SERVICES. THE ENTITY OVERSEES ALL TRANSACTIONS FOR THE PURCHASE OF ASSETS WITH A CURRENT FAIR MARKET VALUE IN EXCESS OF $500,000 AND THE ENTERING INTO ANY CONTRACT, MORTGAGE OR ANY OTHER UNBUDGETED OPERATING EXPENDITURE IN EXCESS OF $500,000. RESERVED POWERS ALSO INCLUDE THE NOMINATION AND ELECTION OF CERTAIN SYSTEM SUBSIDIARY DIRECTORS AND CERTAIN SYSTEM SUBSIDIARY OFFICERS AND OTHER SYSTEM-WIDE ITEMS INCLUDING SELECTION OF THE INDEPENDENT AUDITOR AND LEGAL COUNSEL, ESTABLISHMENT OF THE CHARITABLE CARE POLICY, REALLOCATION OF INCOME AND/OR CAPITAL AMONG THE SYSTEM SUBSIDIARIES, THE ADDITION OF NEW SYSTEM SUBSIDIARIES AND THE ESTABLISHMENT AND IMPLEMENTATION OF SYSTEM-WIDE PROGRAMS, POLICIES AND INITIATIVES. |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Land | LandGrp | |
| Buildings | BuildingsGrp | |
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $217,295 | OtherCostOrOtherBasisAmt |
| Depreciation | $83,990 | DepreciationAmt |
| Book Value | $133,305 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildingsGrp | |
| Total Book Value Land Buildings | $133,305 | TotalBookValueLandBuildingsAmt |
| Total Book Value Program Rltd | $0 | TotalBookValueProgramRltdAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE FROM AFFILIATES | Desc |
| Book Value | $4,426,213 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $4,426,213 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Due to Affiliates | Desc |
| Amt | $4,052,077 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,052,077 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PART X, LINE 2 | FormAndLineReferenceDesc |
| Explanation | UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITION TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF TOURNAMENT | Event1Nm |
| Gross Receipts Event1 | $148,344 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $129,182 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $19,162 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $3,325 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $13,219 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $12,203 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $1,297 | OtherDirectExpensesEvent1Amt |
| Other Events Total | 0 | OtherEventsTotalCnt |
| Gross Receipts Total | $148,344 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $129,182 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $19,162 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $3,325 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $13,219 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $12,203 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $1,297 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $30,044 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$10,882 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| BROOKVILLE HOSPITAL | |||||||
| 100 HOSPITAL ROAD | BROOKVILLE | PA | 15825 | 250984595 | 501(C)(3) | $23,581 | PASS-THROUGH SUPPORT |
| CLEARFIELD HOSPITAL | |||||||
| 809 TURNPIKE DRIVE | CLEARFIELD | PA | 16830 | 250979346 | 501(C)(3) | $29,281 | PASS-THROUGH SUPPORT |
| DUBOIS REGIONAL MEDICAL CENTER | |||||||
| 100 HOSPITAL AVENUE | DUBOIS | PA | 15801 | 251490707 | 501(C)(3) | $38,816 | PASS-THROUGH SUPPORT |
| ELK REGIONAL HEALTH CENTER | |||||||
| 763 JOHNSON RD | ST MARYS | PA | 15857 | 250585280 | 501(C)(3) | $26,622 | PASS-THROUGH SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 4 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | MONITORING OF GRANT FUNDS: THE GOLF TOURNAMENT FUNDS ARE DISTRIBUTED BASED ON DESIGNATIONS MADE BY DONORS BUT IF DONORS DO NOT MAKE DESIGNATIONS THEN THE FUNDS ARE DISTRIBUTED EVENLY AMONG THE PENN HIGHLANDS HOSPITALS. THE EXPENSES OF THE TOURNAMENT ARE DISTRIBUTED EVENLY AMONG THE HOSPITALS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR THOMAS CARNEVALE | ||||||||||||||
| TRUSTEE | $0 | $429,171 | $0 | $6,000 | $0 | $731 | $0 | $11,000 | $0 | $15,281 | $0 | $462,183 | $0 | $0 |
| STEVE FONTAINE | ||||||||||||||
| CEO | $641,731 | $0 | $203,175 | $0 | $30,166 | $0 | $107,260 | $0 | $17,946 | $0 | $1,000,278 | $0 | $0 | $0 |
| DR RUSSELL CAMERON | ||||||||||||||
| CHIEF MEDICAL OFFICER | $0 | $460,817 | $0 | $83,175 | $0 | $44,827 | $0 | $34,041 | $0 | $15,069 | $0 | $637,929 | $0 | $0 |
| BRIAN KLINE | ||||||||||||||
| VP CHIEF FINANCIAL OFFICER | $0 | $256,001 | $0 | $56,806 | $0 | $254 | $0 | $23,040 | $0 | $6,889 | $0 | $342,990 | $0 | $0 |
| ROBERT MCKEE | ||||||||||||||
| VP CHIEF HR OFFICER | $0 | $232,150 | $0 | $41,018 | $0 | $1,406 | $0 | $20,504 | $0 | $15,069 | $0 | $310,147 | $0 | $0 |
| ISTIKRAM QADERI | ||||||||||||||
| CHIEF QUALITY OFFICER | $0 | $182,921 | $0 | $20,000 | $0 | $14,636 | $0 | $9,154 | $0 | $11,966 | $0 | $238,677 | $0 | $0 |
| CLOYD GEEDY | ||||||||||||||
| VP SUPPLY CHAIN MGMT | $0 | $160,414 | $0 | $0 | $0 | $476 | $0 | $6,376 | $0 | $18,186 | $0 | $185,452 | $0 | $0 |
| ROSE CAMPBELL | ||||||||||||||
| VP PATIENT SERVICES/CNO | $0 | $252,534 | $0 | $45,540 | $0 | $13,993 | $0 | $22,728 | $0 | $2,069 | $0 | $336,864 | $0 | $0 |
| MARK NORMAN | ||||||||||||||
| CHIEF OPERATING OFFR/TRUSTEE | $298,077 | $0 | $67,500 | $0 | $6,166 | $0 | $25,904 | $0 | $17,946 | $0 | $415,593 | $0 | $0 | $0 |
| TARUN GHOSH | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $352,246 | $0 | $76,500 | $0 | $476 | $0 | $17,000 | $0 | $14,916 | $0 | $461,138 | $0 | $0 | $0 |
| BRYAN FREDERICKS | ||||||||||||||
| PHYSICIAN NETWORK PRESIDENT | $0 | $240,384 | $0 | $30,469 | $0 | $4,870 | $0 | $12,019 | $0 | $17,715 | $0 | $305,457 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | NONQUALIFIED RETIREMENT PLAN: THE FOLLOWING INDIVIDUALS RECEIVED CONTRIBUTIONS TO A 457(F) PLAN DURING THE YEAR: $77,760 STEVE FONTAINE $ 4,541 DR. RUSSELL CAMERON | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPITAL AUTHORITY OF THE CITY OF DUBOIS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 251718944 | BondIssuerEIN |
| CUSIP | 263804BQ8 | CUSIPNum |
| Bond Issued | 2018-05-31 | BondIssuedDt |
| Issue Price | $168,594,544 | IssuePriceAmt |
| Purpose | REFUND 2014, CONSTRUCTION | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $0 | RetiredAmt |
| Bond Defeased | $0 | BondDefeasedAmt |
| Total Proceeds | $168,594,544 | TotalProceedsAmt |
| In Reserve Fund | $0 | InReserveFundAmt |
| Capitalized Interest | $0 | CapitalizedInterestAmt |
| Refunding Escrow | $0 | RefundingEscrowAmt |
| Issuance Costs From Proceeds | $1,514,726 | IssuanceCostsFromProceedsAmt |
| Credit Enhancement | $0 | CreditEnhancementAmt |
| Working Capital Expenditures | $0 | WorkingCapitalExpendituresAmt |
| Capital Expenditures | $6,962,139 | CapitalExpendituresAmt |
| Other Spent Proceeds | $73,615,000 | OtherSpentProceedsAmt |
| Unspent | $89,532,131 | UnspentAmt |
| Refunding Tax Exempt Bonds | Yes (true) | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | false | RefundingTaxableBondsInd |
| Final Allocation Made | false | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | false | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | false | MgmtContractBondFincdPropInd |
| Any Research Agreements | false | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0 | PrivateBusUseByOthersPct |
| Bond Iss Meet Prvt Sec Pymt Test | false | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedPropInd |
| Remedial Action Taken | false | RemedialActionTakenInd |
| Procs Nonqualified Bond Remdtd | Yes (true) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (true) | RebateNotDueYetInd |
| Exception To Rebate | false | ExceptionToRebateInd |
| No Rebate Due | false | NoRebateDueInd |
| Variable Rate Issue | false | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | false | HedgeIdentifiedInBksAndRecInd |
Hedge Provider Name HedgeProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 0 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
GIC Provider Name GICProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 0 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (true) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (true) | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE K, PART 1, LINE A | FormAndLineReferenceDesc |
| Explanation | TAX-EXEMPT BONDS: THE TAX-EXEMPT BONDS LISTED ON SCHEDULE K WERE ISSUED FOR THE BENEFIT OF THE TAX-EXEMPT ENTITIES INCLUDED IN THE AFFILIATED SYSTEM OF PENN HIGHLANDS HEALTHCARE, INCLUDING THE FOLLOWING: PENN HIGHLANDS DUBOIS PENN HIGHLANDS ELK PENN HIGHLANDS CLEARFIELD PENN HIGHLANDS BROOKVILLE PENN HIGHLANDS HUNTINGDON JEFFCO HEALTH SERVICES SCHEDULE K HAS ONLY BEEN PREPARED FOR PENN HIGHLANDS HEALTHCARE AND INCLUDES ALL PROCEEDS OF TAX-EXEMPT BONDS, OF WHICH THE BALANCE ARE SHOWN ON THE BALANCE SHEETS OF THE REALATED TAX-EXEMPT ORGANIZATIONS ABOVE. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| GLWD LP | |||
| OWNED BY TRUSTEE | $121,022 | RENT | false |
| ONCOLOGY HEMATOLOGY ASSOC OF PA | |||
| OWNED BY TRUSTEE | $777,668 | PHYSICIAN SERVICES | false |
| SUSQUEHANNA ANESTHESIOLOGISTS | |||
| OWNED BY TRUSTEE | $815,407 | PHYSICIAN SERVICES | false |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE 990, PART III, LINE 4A | FormAndLineReferenceDesc |
| Explanation | RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: (1) GLWD, LP, IS 100% OWNED BY DR. GREGORY ROSCOE, TRUSTEE. (2) ONCOLOGY HEMATOLOGY ASSOCIATES OF PENNSYLVANIA IS 100% OWNED BY TRUSTEES DR. CARMINE MARCHIOLI AND DR. HAZEM EL KASSAS. (3) SUSQUEHANNA ANESTHESIOLOGISTS IS 100% OWNED BY TRUSTEE DR. RICHARD BEDGER. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 4A | PROGRAM SERVICE ACCOMPLISHMENTS: THE PURPOSE FOR THE AFFILIATION IS TO ENSURE THE ACCESSIBILITY OF HEALTH CARE SERVICES IN THE CLEARFIELD, DUBOIS, ELK AND BROOKVILLE AREAS, ENHANCE ACCESS TO HIGH-QUALITY PATIENT CARE FACILITIES FOR PATIENTS AND MEDICAL STAFFS OF THE HOSPITALS, OFFER A BROADER RANGE OF SERVICES AND CREATE COST EFFICIENCIES IN THE DELIVERY OF HEALTH CARE SERVICES TO THE COMMUNITY. PENN HIGHLANDS HEALTHCARE EXERCISES A SUBSTANTIAL DEGREE OF DIRECTION OVER THE POLICIES, PROGRAMS AND ACTIVITIES OF THE SUPPORTED ORGANIZATIONS AND THE OTHER SUBSIDIARIES, INCLUDING OVERSEEING AND IMPLEMENTING A SYSTEM-WIDE CONFLICT OF INTEREST POLICY AND PASTORAL CARE PROGRAM. |
| FORM 990, PART VI, SECTION A, LINE 2 | BUSINESS RELATIONSHIPS: DR. CARMINE MARCHIOLI AND DR. HAZEM EL KASSAS SHARE A BUSINESS RELATIONSHIP THROUGH OWNERSHIP IN AN UNRELATED ENTITY. COMPENSATED TRUSTEES AND OFFICERS SHARE A BUSINESS RELATIONSHIP THROUGH THEIR EMPLOYMENT WITH A RELATED ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | POWER TO ELECT OR APPOINT BOARD: THE BOARD IS COMPRISED OF INDIVIDUALS APPROVED BY RELATED TAX-EXEMPT ORGANIZATIONS PENN HIGHLANDS, DUBOIS, PENN HIGHLANDS CLEARFIELD, PENN HIGHLANDS BROOKVILLE, PENN HIGHLANDS ELK, PENN HIGHLANDS HUNTINGDON, AND PENN HIGHLANDS JEFFERSON MANOR. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE COMPLETE FORM 990 WILL BE PROVIDED TO THE FINANCE COMMITTEE AND BOARD OF DIRECTORS. AT THAT TIME, THE COMMITTEE WILL REVIEW THE FORM 990 AND HAVE THE OPPORTUNITY TO DISCUSS ANY INFORMATION CONTAINED WITHIN THE DOCUMENT. |
| FORM 990, PART VI, SECTION B, LINE 12C | MONITORING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY: PENN HIGHLANDS HEALTHCARE, INC. (PHH), MAINTAINS A CONFLICT OF INTEREST POLICY WHICH APPLIES TO ALL SUBSIDIARIES. THE CONFLICT OF INTERESTS POLICY APPLIES TO BOARD MEMBERS, OFFICERS, EXECUTIVE EMPLOYEES, AND ANY OTHER MANAGER OR SUPERVISOR EXERCISING SUBSTANTIAL INFLUENCE OVER OPERATIONS. EACH COVERED PERSON WILL PROMPTLY AND FULLY DISCLOSE ALL MATERIAL FACTS OF EVERY ACTUAL OR POTENTIAL DUAL INTEREST EXISTING AT THE TIME WHEN HE/SHE BECOMES A COVERED PERSON, AND ANNUALLY THROUGH EACH PHH SYSTEM ENTITY'S DISCLOSURE STATEMENT, WHICH REQUESTS DISCLOSURE OF RELATIONSHIPS, INVESTMENTS, AND TRANSACTIONS THAT MAY LEAD TO AN ACTUAL CONFLICT OF INTEREST. ALL COMPLETED DISCLOSURE STATEMENTS WILL BE PROVIDED TO THE PHH GOVERNANCE/NOMINATING COMMITTEE. THIS COMMITTEE, IN CONSULTATION WITH THE CHAIRPERSON OR VICE CHAIRPERSON OF EACH PHH SYSTEM ENTITY'S BOARD, SHALL EVALUATED THE COMPLETED DISCLOSURE STATEMENTS AND DETERMINE IF THERE ARE ANY CONFLICTS THAT ARE SO PERVASIVE AS TO RENDER ANY COVERED PERSON INELIGIBLE FOR SERVICE. THE CHAIRPERSON OF EACH PHH SYSTEM ENTITY'S BOARD WILL DISCLOSE TO THE FULL BOARD OF SAID PHH SYSTEM ENTITY ALL DUAL INTERESTS REPORTED TO HIM OR HER UNDER THE POLICY AND WILL ALSO MAKE THE DISCLOSURE STATEMENTS OF ALL COVERED PERSONS AVAILABLE TO DIRECTORS AT ANY TIME DURING THE YEAR. IF A POTENTIAL DUAL INTEREST ARISE AS A RESULT OF A CONTEMPLATED PHH SYSTEM ENTITY BOARD (OR COMMITTEE) ACTION, THE CHAIRPERSON OF SAID PHH SYSTEM ENTITY'S BOARD OF THE INTERESTED PERSON SHALL, OR ANY OTHER DIRECTOR MAY, RAISE THE QUESTION OF THE INTERESTED PERSON'S DUAL INTEREST. THE DISINTERESTED MEMBERS OF THE PHH SYSTEM ENTITY'S BOARD (OR COMMITTEE) WILL EVALUATED THE DISCLOSURES AND THE MATERIAL FACTS RELATING TO THE TRANSACTION, ARRANGEMENT, OR POLICY GIVING RISE TO THE DUAL INTEREST TO DETERMINE WHETHER THEY INVOLVE ACTUAL CONFLICTS OF INTEREST AND MAY ATTEMPT TO DEVELOP ALTERNATIVES TO REMOVE THE CONFLICT FROM THE TRANSACTION, ARRANGEMENT, OR POLICY. A COVERED PERSON WHO HAS A DUEL INTEREST SHALL NOT BE PRESENT FOR OR SHALL LEAVE ANY PORTION OF A MEETING AT WHICH A PHH SYSTEM ENTITY'S BOARD (OR COMMITTEE) IS VOTING TO DETERMINE WHETHER A CONFLICT EXISTS, BUT MAY BE PRESENT PRIOR TO THE VOTE TO MAKE A PRESENTATION TO SAID BOARD (OR COMMITTEE), TO DISCLOSE ADDITIONAL FACTS, OR TO RESPOND TO QUESTIONS. IF A PHH SYSTEM ENTITY'S BOARD (OR COMMITTEE DETERMINES THAT AN ACTUAL CONFLICT OF INTEREST EXISTS, THE INTERESTED PERSON SHALL BE SO ADVISED AND THE CHAIRPERSON OF A PHH SYSTEM ENTITY'S BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE OR DIRECT MANAGEMENT TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, IF THIS HAS NOT ALREADY BEEN DONE. ANY INTERESTED PERSON WHO HAS AN ACTUAL CONFLICT OF INTEREST WITH RESPECT TO THE TRANSACTION OR ARRANGEMENT DOES NOT PARTICIPATE IN AND IS NOT PRESENT FOR THE VOTE REGARDING ANY SUCH TRANSACTION OR ARRANGEMENT. IF AN INDIVIDUAL WHOSE COMPANY OR EMPLOYER HAS A BUSINESS RELATIONSHIP WITH A PHH SYSTEM ENTITY, BUT THE INDIVIDUAL DOES NOT HAVE AN ACTUAL CONFLICT OF INTEREST WITH RESPECT TO THIS BUSINESS RELATIONSHIPS, THE INDIVIDUAL MAY NONETHELESS VOLUNTARILY RECUSE HIM/HERSELF FROM VOTING ON ANY MATTERS RELATED TO THE RELATIONSHIP. |
| FORM 990, PART VI, SECTION B, LINES 15A & 15B | COMPENSATION DETERMINATION: THE PENN HIGHLANDS HEALTHCARE EXECUTIVE COMPENSATION COMMITTEE CONSULTS WITH THE HEALTHCARE CONSULTING FIRM, YAFEE & COMPANY TO OBTAIN COMPARABLE DATA TO MAKE RECOMMENDATIONS TO THE BOARD OF DIRECTORS REGARDING EXECUTIVE COMPENSATION. THE PENN HIGHLANDS HEALTHCARE BOARD OF DIRECTORS IS ACUTELY AWARE OF THE HEIGHTENED PUBLIC SCRUTINY OF EXECUTIVE COMPENSATION AND THE NEED TO CONSIDER REGULATORY COMPLIANCE WHEN SETTING EXECUTIVE PAY. COMPENSATION REVIEWS ARE DONE ON A CONTINUOUS BASIS. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENT AVAILABILITY: THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART VII, SECTION A | BOARD MEMBER COMPENSATION: NO TRUSTEES RECEIVE ANY COMPENSATION FOR THEIR TRUSTEE DUTIES. DR. RICHARD BEDGER IS COMPENSATED AS A PHYSICIAN AT PENN HIGHLANDS CLEARFIELD. DR. THOMAS CARNEVALE IS COMPENSATED AS A PHYSICIAN AT PENN HIGHLANDS DUBOIS. STEVE FONTAINE IS COMPENSATED AS CEO OF THE PENN HIGHLANDS HEALTHCARE SYSTEM. DR. RUSS CAMERON IS COMPENSATED AS CHIEF MEDICAL OFFICER OF THE PENN HIGHLANDS HEALTHCARE SYSTEM. MARK NORMAN IS COMPENSATED AS CHIEF OPERATING OFFICER OF THE PENN HIGHLANDS HEALTHCARE SYSTEM. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OUTSIDE SERVICES TOTAL FEES:2518976 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONSULTANTS TOTAL FEES:1245298 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:39240 |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PENN HIGHLANDS NATURAL THERAPIES LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 447 100 HOSPITAL AVENUE | AddressLine1Txt |
| City | DUBOIS | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 15801 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 820776018 | EIN |
| Primary Activities | INVESTMENTS | PrimaryActivitiesTxt |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Total Income | -$256 | TotalIncomeAmt |
| End Of Year Assets | $3,334,617 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHH | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (15 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| DUBOIS REGIONAL MEDICAL CENTER | ||||||||||
| 100 HOSPITAL AVENUE | DUBOIS | PA | 15801 | 251490707 | HOSPITAL | PA | 501(C)(3) | 3 | PHH | Yes (true) |
| BROOKVILLE HOSPITAL | ||||||||||
| 100 HOSPITAL ROAD | BROOKVILLE | PA | 15825 | 250984595 | HOSPITAL | PA | 501(C)(3) | 3 | PHH | Yes (true) |
| CLEARFIELD HOSPITAL | ||||||||||
| 809 TURNPIKE DR | CLEARFIELD | PA | 16830 | 250979346 | HOSPITAL | PA | 501(C)(3) | 3 | PHH | Yes (true) |
| ELK REGIONAL HEALTH CENTER | ||||||||||
| 763 JOHNSONBURG RD | ST MARYS | PA | 15857 | 250585280 | HOSPITAL | PA | 501(C)(3) | 3 | PHH | Yes (true) |
| CLEAR-MED PROVIDER CORPORATION | ||||||||||
| PO BOX 1260 | CLEARFIELD | PA | 16830 | 251657668 | PHYSICIAN SVC | PA | 501(C)(3) | 3 | PHH | Yes (true) |
| DRMC EMPLOYEE BENEFITS PLAN TRUST | ||||||||||
| 100 HOSPITAL AVENUE | DUBOIS | PA | 15801 | 256332829 | BENEFIT TRUST | PA | 501(C)(9) | DRMC | Yes (true) | |
| COMMUNITY NURSES HOME HEALTH AND HOSPICE | ||||||||||
| 757 JOHNSONBURG ROAD STE 200 | ST MARYS | PA | 15857 | 250996070 | HEALTH CARE | PA | 501(C)(3) | 10 | CNI | Yes (true) |
| COMMUNITY NURSES HOME SUPPORT SERVICES | ||||||||||
| 757 JOHNSONBURG ROAD STE 200 | ST MARYS | PA | 15857 | 251623601 | HEALTH CARE | PA | 501(C)(3) | 10 | CNI | Yes (true) |
| COMMUNITY NURSES INC | ||||||||||
| 757 JOHNSONBURG ROAD STE 200 | ST MARYS | PA | 15857 | 251623598 | HEALTH CARE | PA | 501(C)(3) | 7 | PHH | Yes (true) |
| ELCO HOUSING | ||||||||||
| 759 JOHNSONBURG ROAD | ST MARYS | PA | 15857 | 251639115 | HOUSING | PA | 501(C)(3) | 12 A I | PHH | Yes (true) |
| ELK REGIONAL PROFESSIONAL GROUP INC | ||||||||||
| 763 JOHNSONBURG ROAD | ST MARYS | PA | 15857 | 251875183 | HEALTH CARE | PA | 501(C)(3) | 3 | PHH | Yes (true) |
| DRMC WORKERS COMPENSATION TRUST | ||||||||||
| PO BOX 447 | DUBOIS | PA | 15801 | 251741497 | SUPPORT | PA | 501(C)(3) | 12 B II | DRMC | Yes (true) |
| JC BLAIR MEMORIAL HOSPITAL | ||||||||||
| 1225 WARM SPRINGS AVE | HUNTINGDON | PA | 16652 | 231352159 | HOSPITAL | PA | 501(C)(3) | 3 | PHH | Yes (true) |
| JEFFCO HEALTH SERVICES INC | ||||||||||
| 417 ROUTE 28 | BROOKVILLE | PA | 15825 | 251505478 | NURSING HOME | PA | 501(C)(3) | 3 | PHH | Yes (true) |
| JC BLAIR MEMORIAL HOSPITAL FOUNDATION | ||||||||||
| 935 14TH STREET | HUNTINGDON | PA | 16652 | 251881377 | SUPPORT HOSP | PA | 501(C)(3) | 12A I | PHH | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLEARFIELD MEDICAL ASSOCIATES | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | CLEARFIELD | AddressLine1Txt |
| City | CLEARFIELD | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16830 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 251369635 | EIN |
| Primary Activities | PHYSICIAN OFFICES | PrimaryActivitiesTxt |
| Legal Domicile State | PA | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLEARFIELD HOSP | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | EXCLUDED | PredominantIncomeTypeTxt |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| DUBOIS REGIONAL MEDICAL GROUP | |||||||||
| 100 HOSPITAL AVENUE | DUBOIS | PA | 15801 | 251856569 | PHYSICIAN SERVICE | PA | DRMC | C CORP | Yes (true) |
| DUBOIS MEDICAL RISK RETENTION GROUP | |||||||||
| 100 HOSPITAL AVE | DUBOIS | PA | 15801 | 200324622 | INSURANCE SERVICE | PA | DRMC | C CORP | Yes (true) |
| BROOKCARE II INC | |||||||||
| 100 HOSPITAL ROAD | BROOKVILLE | PA | 15825 | 251477768 | LEASE OFFICE SPAC | PA | BROOKVILLE HOSP | C CORP | Yes (true) |
| PENN HIGHANDS APOTHECARY INC | |||||||||
| PO BOX 447 100 HOSPITAL AVE | DUBOIS | PA | 15801 | 364862024 | PAIN MGMT | PA | PHH | C CORP | Yes (true) |
| CLEAR-CARE CORPORATION | |||||||||
| PO BOX 1411 | CLEARFIELD | PA | 16830 | 251512107 | MEDICAL EQUIPMENT | PA | CLEARFIELD HOSP | C CORP | Yes (true) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (11 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| JEFFCO HEALTH SERVICES INC | ||
| C | $3,498,918 | FMV |
| DUBOIS REGIONAL MEDICAL CENTER | ||
| K | $191,545 | COST |
| DUBOIS REGIONAL MEDICAL CENTER | ||
| L | $19,847,844 | COST |
| ELK REGIONAL HEALTH CENTER | ||
| L | $4,307,909 | COST |
| CLEARFIELD HOSPITAL | ||
| L | $2,582,331 | COST |
| BROOKVILLE HOSPITAL | ||
| L | $2,024,629 | COST |
| COMMUNITY NURSES INC | ||
| L | $1,269,741 | COST |
| DUBOIS REGIONAL MEDICAL CENTER | ||
| P | $24,627,484 | COST |
| BROOKVILLE HOSPITAL | ||
| P | $261,295 | COST |
| ELK REGIONAL HEALTH CENTER | ||
| P | $1,495,248 | COST |
| CLEARFIELD HOSPITAL | ||
| P | $566,471 | COST |