CLEARFIELD HOSPITAL: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- CLEARFIELD HOSPITAL (EIN 25-0979346)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-05-14
- IRS object ID
- 201901349349309745
- Schema version
- 2017v2.3
- 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 F
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-05-14T17:28:15-05:00 | ReturnTs |
| Tax Period End | 2018-06-30 | 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 | 2017-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 250979346 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLEARFIELD HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % ROBERT SPICHER | InCareOfNm |
| Business Name Control | CLEA | BusinessNameControlTxt |
| Phone | 8147655341 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 809 TURNPIKE AVENUE | AddressLine1Txt |
| City | CLEARFIELD | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16830 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RHONDA HALSTEAD | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 8147655341 | PhoneNum |
| Signature | 2019-05-15 | 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 | 43032920191345000034 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2019-05-14 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 353840E92A19E57AE3D09FB5FB5D869273682438 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | C3432A87FBFF9491E59BD7298F2E512B0D9B3700 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PENN HIGHLANDS CLEARFIELD | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | RHONDA HALSTEAD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 809 TURNPIKE AVENUE | AddressLine1Txt |
| City | CLEARFIELD | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16830 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $43,509,235 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PHHEALTHCARE.ORG | WebsiteAddressTxt |
| Formation | 1901 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | PENN HIGHLANDS CLEARFIELD EXISTS TO POSITIVELY IMPACT THE HEALTH STATUS OF THE REGION BY PROVIDING QUALITY HEALTHCARE COUPLED WITH QUALITY SERVICE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 455 | TotalEmployeeCnt |
| Total Volunteers | 66 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $265 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,842,134 | PYContributionsGrantsAmt |
| CY Contributions Grants | $652,138 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $44,418,567 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $41,268,434 | CYProgramServiceRevenueAmt |
| PY Investment Income | $355,250 | PYInvestmentIncomeAmt |
| CY Investment Income | $114,489 | CYInvestmentIncomeAmt |
| PY Other Revenue | $897,342 | PYOtherRevenueAmt |
| CY Other Revenue | $1,014,788 | CYOtherRevenueAmt |
| PY Total Revenue | $49,513,293 | PYTotalRevenueAmt |
| CY Total Revenue | $43,049,849 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $22,043,929 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $21,765,053 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $27,839,229 | PYOtherExpensesAmt |
| CY Other Expenses | $25,975,831 | CYOtherExpensesAmt |
| PY Total Expenses | $49,883,158 | PYTotalExpensesAmt |
| CY Total Expenses | $47,740,884 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$369,865 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$4,691,035 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $48,017,455 | TotalAssetsBOYAmt |
| Total Assets EOY | $47,515,726 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $25,256,061 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $29,200,262 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $22,761,394 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $18,315,464 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE THE COMMUNITY WITH EXCEPTIONAL CARE THROUGH OUR COMMUNITY-BASED HEALTH SYSTEM WHILE MAINTAINING A REVERENCE FOR LIFE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $42,042,901 | ExpenseAmt |
| Revenue | $41,268,434 | RevenueAmt |
| Desc | AS A PART OF PENN HIGHLANDS HEALTHCARE, PENN HIGHLANDS CLEARFIELD CONTINUES ITS RICH TRADITION OF PROVIDING EXCELLENT CARE TO THE COMMUNITIES IT SERVES. IT CONTINUES TO EXPAND AND CREATE ACCESS TO A LARGE NUMBER OF MEDICAL, SURGICAL AND SUPPORT SERVICES. ITS AWARD-WINNING HOME HEALTH CARE SERVES A LARGE GEOGRAPHIC REGION. PENN HIGHLANDS CLEARFIELD CONSISTS OF AN ACTIVE EMERGENCY DEPARTMENT, MEDICAL-SURGICAL UNITS, BEHAVIORAL HEALTH SERVICES, CARDIAC DIAGNOSTIC SERVICES, REHABILITATION SERVICES, CARDIAC REHAB, CHEMOTHERAPY, IMAGING SERVICES, LABORATORY SERVICES, NUTRITION COUNSELING, PULMONARY REHABILITATION, SURGICAL SERVICES, WOUND CARE AND A SWING-BED PROGRAM. | Desc |
| Total Program Service Expenses | $42,042,901 | 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 | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (true) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | 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 | Yes (true) | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | 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 | 455 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| 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 | false | QuidProQuoContributionsInd |
| 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| 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 | ROBERT SPICHER | PersonNm |
| Phone | 8143756136 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 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 (16 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| RHONDA HALSTEAD | ||||||||
| PRESIDENT BEGIN 6/2018 | 40.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DAVID LEZZER | ||||||||
| CHAIRMAN | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| GERALDINE RADOMSKY | ||||||||
| TREASURER | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| KEVIN TYLER DO | ||||||||
| PRESIDENT OF MEDICAL STAFF | 1.0 | 40.0 | Yes (X) | Yes (X) | $0 | $317,808 | $31,878 | |
| THOMAS CARNEVALE | ||||||||
| SECRETARY | 1.0 | 40.0 | Yes (X) | Yes (X) | $0 | $409,637 | $26,760 | |
| GEORGIA IRWIN | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT E STEWARD JR | ||||||||
| BOARD MEMBER | 1.0 | 40.0 | Yes (X) | $0 | $215,933 | $28,182 | ||
| BRIAN WINGARD | ||||||||
| VICE CHAIRMAN | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| GARY MACIOCE | ||||||||
| PRESIDENT END 11/2017 | 40.0 | 0.0 | Yes (X) | Yes (X) | $0 | $304,473 | $36,321 | |
| MARK NORMAN | ||||||||
| INTERIM PRESIDENT 11/17-05/18 | 40.0 | 0.0 | Yes (X) | Yes (X) | $0 | $308,875 | $34,937 | |
| BRIAN KLINE | ||||||||
| CHIEF FINANCIAL OFFICER | 8.0 | 40.0 | Yes (X) | $0 | $341,194 | $29,448 | ||
| ROBERT R COLL | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $367,070 | $0 | $31,499 | Yes (X) | ||
| SHAUNAK PATEL | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $322,781 | $0 | $18,321 | Yes (X) | ||
| THOMAS L YEAGER | ||||||||
| PHARMACIST | 40.0 | 0.0 | $120,344 | $0 | $34,808 | Yes (X) | ||
| KATHY BEDGER | ||||||||
| CHIEF NURSING OFFICER | 40.0 | 0.0 | $116,895 | $0 | $32,374 | Yes (X) | ||
| KENNETH J SHURER | ||||||||
| PHARMACIST | 40.0 | 0.0 | $102,001 | $0 | $31,506 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,029,091 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,897,920 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $336,034 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | 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 |
|---|---|---|---|---|---|
| STAFF CARE | |||||
| 12400 HIGH BLUFF DR | SAN DIEGO | CA | 92130 | STAFFING SERVICES | $759,769 |
| ASSOCIATED CLINICAL LABORATORIES | |||||
| 15832 COLLECTION CTR DR | CHICAGO | IL | 60693 | LAB SERVICES | $589,865 |
| CLEARFIELD COUNTY INVESTIGATORS | |||||
| 624 ARROWHEAD WAY | CLEARFIELD | PA | 16830 | SECURITY SERVICES | $172,920 |
| VANTAGE MOBILE SERVICES | |||||
| 1305 S MAIN STREET | MEADVILLE | PA | 16335 | MEDICAL SERVICES | $113,200 |
| ALLIED RESOURCES MEDICAL STAFFING | |||||
| 4949 LIBERTY LANE SUITE 330 | ALLENTOWN | PA | 18106 | STAFFING SERVICES | $107,944 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $8,645 | FundraisingAmt |
| Related Organizations | $18,120 | RelatedOrganizationsAmt |
| All Other Contributions | $625,373 | AllOtherContributionsAmt |
| Total Contributions | $652,138 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621990 | $40,016,666 | $40,016,666 |
| CAFETERIA | 722514 | $129,992 | $129,992 |
| PHARMACY | 446110 | $99,499 | $99,499 |
| OTHER REVENUE | 621990 | $1,022,277 | $1,022,277 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $41,268,434 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $111,437 | TotalRevenueColumnAmt |
| Exclusion | $111,437 | 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 |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $790,317 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $435,836 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $354,481 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $354,481 | TotalRevenueColumnAmt |
| Exclusion | $354,481 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $3,052 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $3,052 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,052 | TotalRevenueColumnAmt |
| Exclusion | $3,052 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $6,326 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $8,645 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $5,264 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,062 | TotalRevenueColumnAmt |
| Exclusion | $1,062 | 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 | $30,536 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $18,286 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,250 | TotalRevenueColumnAmt |
| Exclusion | $12,250 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Equity Investee | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $646,995 | TotalRevenueColumnAmt |
| Exclusion | $646,995 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $646,995 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $43,049,849 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $41,268,434 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $1,129,277 | 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 | $0 | TotalAmt |
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 | $340,794 | TotalAmt |
| Management And General | $340,794 | 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 | $16,870,238 | TotalAmt |
| Program Services | $15,998,025 | ProgramServicesAmt |
| Management And General | $872,213 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $730,271 | TotalAmt |
| Program Services | $643,620 | ProgramServicesAmt |
| Management And General | $86,651 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,413,698 | TotalAmt |
| Program Services | $2,073,096 | ProgramServicesAmt |
| Management And General | $340,602 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,410,052 | TotalAmt |
| Program Services | $1,204,517 | ProgramServicesAmt |
| Management And General | $205,535 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,261,150 | TotalAmt |
| Program Services | $2,261,150 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,106 | TotalAmt |
| Management And General | $36,106 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,167 | TotalAmt |
| Management And General | $100,167 | 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 | $35,554 | TotalAmt |
| Management And General | $35,554 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,788,310 | TotalAmt |
| Program Services | $6,538,660 | ProgramServicesAmt |
| Management And General | $2,249,650 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,095 | TotalAmt |
| Management And General | $2,095 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,508,265 | TotalAmt |
| Program Services | $1,000,399 | ProgramServicesAmt |
| Management And General | $507,866 | 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 | $1,339,958 | TotalAmt |
| Program Services | $1,079,003 | ProgramServicesAmt |
| Management And General | $260,955 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,613 | TotalAmt |
| Program Services | $45,540 | ProgramServicesAmt |
| Management And General | $73 | 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 | $39,112 | TotalAmt |
| Program Services | $36,608 | ProgramServicesAmt |
| Management And General | $2,504 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $449,085 | TotalAmt |
| Program Services | $383,624 | ProgramServicesAmt |
| Management And General | $65,461 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,603,745 | TotalAmt |
| Program Services | $2,224,212 | ProgramServicesAmt |
| Management And General | $379,533 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,190,599 | TotalAmt |
| Program Services | $1,028,075 | ProgramServicesAmt |
| Management And General | $162,524 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUGS | $4,711,014 | $4,711,014 | |
| BAD DEBT | $2,508,641 | $2,508,641 | |
| REPAIRS AND MAINTENANCE | $320,648 | $291,782 | $28,866 |
| LICENSES, DUES, SUBSCRIPTIONS | $35,769 | $14,935 | $20,834 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,740,884 | TotalAmt |
| Program Services | $42,042,901 | ProgramServicesAmt |
| Management And General | $5,697,983 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,292 | BOYAmt |
| EOY | $677,032 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,806,849 | BOYAmt |
| EOY | $3,861,439 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $40,000 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,086,430 | BOYAmt |
| EOY | $4,129,202 | 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 | $341,114 | BOYAmt |
| EOY | $305,582 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $658,673 | BOYAmt |
| EOY | $332,440 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $82,511,889 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $62,357,103 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,722,916 | BOYAmt |
| EOY | $20,154,786 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,529,745 | BOYAmt |
| EOY | $9,322,148 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,600,042 | BOYAmt |
| EOY | $5,084,151 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,000 | BOYAmt |
| EOY | $5,000 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,368,347 | BOYAmt |
| EOY | $1,185,907 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,862,047 | BOYAmt |
| EOY | $2,418,039 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,017,455 | BOYAmt |
| EOY | $47,515,726 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,145,615 | BOYAmt |
| EOY | $7,054,041 | 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 | $16,000 | BOYAmt |
| EOY | $30,304 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,929,306 | BOYAmt |
| EOY | $14,764,430 | 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 | $5,138,900 | BOYAmt |
| EOY | $222,403 | 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 | $2,026,240 | BOYAmt |
| EOY | $7,129,084 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,256,061 | BOYAmt |
| EOY | $29,200,262 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,197,466 | BOYAmt |
| EOY | $16,635,040 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $805,103 | BOYAmt |
| EOY | $880,162 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $758,825 | BOYAmt |
| EOY | $800,262 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,761,394 | BOYAmt |
| EOY | $18,315,464 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,017,455 | BOYAmt |
| EOY | $47,515,726 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$4,691,035 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $203,668 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $41,437 | OtherChangesInNetAssetsAmt |
| 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 | false | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $264,223 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$235 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $1,611 | AdministrativeExpensesAmt |
| End Year Balance | $262,377 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $239,593 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $26,045 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $1,415 | AdministrativeExpensesAmt |
| End Year Balance | $264,223 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $242,452 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$1,163 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $1,696 | AdministrativeExpensesAmt |
| End Year Balance | $239,593 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $227,326 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $16,843 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $1,717 | AdministrativeExpensesAmt |
| End Year Balance | $242,452 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $196,807 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $32,128 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $1,609 | AdministrativeExpensesAmt |
| End Year Balance | $227,326 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 1.00000 | BoardDesignatedBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $987,690 | OtherCostOrOtherBasisAmt |
| Book Value | $987,690 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $38,497,164 | OtherCostOrOtherBasisAmt |
| Depreciation | $24,147,411 | DepreciationAmt |
| Book Value | $14,349,753 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $40,766,235 | OtherCostOrOtherBasisAmt |
| Depreciation | $37,495,265 | DepreciationAmt |
| Book Value | $3,270,970 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,260,800 | OtherCostOrOtherBasisAmt |
| Depreciation | $714,427 | DepreciationAmt |
| Book Value | $1,546,373 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $20,154,786 | TotalBookValueLandBuildingsAmt |
| Financial Derivatives | FinancialDerivativesGrp | |
| Closely Held Equity Interests | CloselyHeldEquityInterestsGrp | |
| Total Book Value Securities | $0 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (7 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| BENEFICIAL INTEREST IN TRUST | $788,984 |
| DUE FROM AFFILIATE | $755,276 |
| INSURANCE RECEIVABLE | $450,010 |
| OTHER RECEIVABLE | $315,652 |
| INTEREST RECEIVABLE | $67,171 |
| SECURITY DEPOSITS | $8,030 |
| OTHER ASSET | $32,916 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,418,039 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATE | $5,169,083 |
| DUE TO THIRD PARTY | $1,065,393 |
| DEFERRED COMPENSATION LIABILITY | $894,608 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $7,129,084 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART V, LINE 4 | ENDOWMENT FUNDS: INTENDED USES OF ENDOWMENT FUNDS ARE DIRECTED BY THE BOARD OF CLEARFIELD HOSPITAL AND FOR THE GOOD OF CLEARFIELD HOSPITAL IN CONTINUING THE CHARITABLE AND NON-PROFIT ACTIVITIES OF CLEARFIELD HOSPITAL. |
| SCHEDULE D, PART X, LINE 2 | 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 POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
Schedule F IRS990ScheduleF
Account Activities Outside US AccountActivitiesOutsideUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | Central America and the Caribbean | RegionTxt |
| Offices | 0 | OfficesCnt |
| Employee | 0 | EmployeeCnt |
| Type Of Activities Conducted | Investments | TypeOfActivitiesConductedTxt |
| Region Total Expenditures | $547,619 | RegionTotalExpendituresAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Offices | 0 | SubtotalOfficesCnt |
| Subtotal Employees | 0 | SubtotalEmployeesCnt |
| Total Office | 0 | TotalOfficeCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Subtotal Spent | $547,619 | SubtotalSpentAmt |
| Total Spent | $547,619 | TotalSpentAmt |
| Transfer To Foreign Corp | false | TransferToForeignCorpInd |
| Interest In Foreign Trust | false | InterestInForeignTrustInd |
| Foreign Corp Ownership | false | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | false | PassiveForeignInvestmestCoInd |
| Foreign Partnership | false | ForeignPartnershipInd |
| Boycott Countries | false | BoycottCountriesInd |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $45,353 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $45,353 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,059,284 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,271,868 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,787,416 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03910 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,104,637 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,271,868 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,832,769 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04010 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 14 | ActivitiesOrProgramsCnt |
| Persons Served | 2515 | PersonsServedCnt |
| Total Community Benefit Expns | $41,904 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,950 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $28,954 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,019 | TotalCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 14 | ActivitiesOrProgramsCnt |
| Persons Served | 2515 | PersonsServedCnt |
| Total Community Benefit Expns | $47,923 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,950 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $28,954 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 14 | ActivitiesOrProgramsCnt |
| Persons Served | 2515 | PersonsServedCnt |
| Total Community Benefit Expns | $6,152,560 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,284,818 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,861,723 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04080 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,508,641 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $250,864 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $12,141,372 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $13,539,848 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,398,476 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PENN HIGHLANDS CLEARFIELD | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 809 TURNPIKE AVENUE | AddressLine1Txt |
| City | CLEARFIELD | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16830 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.PHHEALTHCARE.ORG | WebsiteAddressTxt |
| State License | 291301 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PENN HIGHLANDS CLEARFIELD | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 17 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, SECTION C | OwnWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 17 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300. | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 5 | COMMUNITY INPUT: PENN HIGHLANDS AND THE ASSOCIATED HOSPITALS HIRED THE FIRM TRIPP UMBACH TO FACILITATE THE PREPARATION OF THE CHNA AND COLLABORATED WITH HOSPITALS AND OUTSIDE ORGANIZATIONS IN THE SURROUNDING REGION DURING THE CHNA PROCESS INCLUDING ALCOHOL AND DRUG ABUSE SERVICES, ALCOHOLICS ANONYMOUS, FREE CLINIC OF DUBOIS, POLICE DEPARTMENTS, CHAMBER OF COMMERCE AND EMS SERVICES TO JUST NAME A FEW. THE PROCESS INCLUDED PUBLIC COMMENTARY, SECONDARY DATA COLLECTION AND ANALYSIS, STAKEHOLDER INTERVIEWS, HAND-DISTRIBUTED SURVEYS AND COMMUNITY HEALTH FORUM/RETREAT. THE HOSPITAL WORKED WITH LEADERS WITHIN THE HEALTHCARE SYSTEM AS WELL AS WITH SEVERAL MEMBERS OUTSIDE OF THE SYSTEM FROM VARIOUS ORGANIZATIONS AND BACKGROUNDS. THIS LIST IS INCLUDED IN THE CHNA REPORT. |
| SCHEDULE H, PART V, SECTION B, LINE 6A | CHNA CONDUCTED WITH OTHER HOSPITAL FACILITIES: PENN HIGHLANDS DUBOIS, PENN HIGHLANDS BROOKVILLE, AND PENN HIGHLANDS ELK WHICH ARE ALL PART OF THE PENN HIGHLANDS HEALTHCARE SYSTEM. |
| SCHEDULE H, PART V, SECTION B, LINE 7D | CHNA REPORT URL: HTTPS://WWW.PHHEALTHCARE.ORG/HEALTH-WELLNESS/COMMUNITY-HEALTH-NEEDS-ASSESS MENT |
| SCHEDULE H, PART V, SECTION B, LINE 10A | IMPLEMENTATION STRATEGY URL: HTTPS://WWW.PHHEALTHCARE.ORG/HEALTH-WELLNESS/COMMUNITY-HEALTH-NEEDS-ASSESS MENT |
| SCHEDULE H, PART V, SECTION B, LINE 11 | ADDRESSING IDENTIFIED NEEDS: THE HOSPITAL'S CHNA GIVES A VERY DETAILED OVERVIEW OF THE METHODS AND ACTIVITIES THAT WENT INTO DEVELOPING A STRATEGIC PLAN FOR ASSESSING THE NEEDS OF THE COMMUNITY AND CHOOSING WHAT THE MOST IMPORTANT AND ATTAINABLE GOALS WOULD BE. THESE NEEDS ARE PRESENTED IN THE CHNA WITH A DETAILED EXPLANATION OF THE ISSUES, HOW THIS INFORMATION WAS GATHERED, INCLUDING PRIMARY AND SECONDARY DATA, WHAT THE GOALS ARE TO DEAL WITH THE ISSUES AND THE NEXT STEPS TO TAKE TO ATTAIN THESE GOALS. THE REPORT ADDRESSES THE TOP FIVE HEALTH NEEDS OF THE COMMUNITY AND FOCUSES ON THOSE ISSUES. THE IMPLEMENTATION PLAN ONLINE INCLUDES DETAIL OF ANNUAL ACTIVITIES. |
| SCHEDULE H, PART V, SECTION B, LINES 16A, B, AND C | FAP, FAP APPLICATION, PLAIN LANGUAGE SUMMARY URL: HTTPS://WWW.PHHEALTHCARE.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE-POLICY |
| SCHEDULE H, PART V, SECTION B, LINE 20E | OTHER EFFORTS: THE BILLING STATEMENT STATES THAT THERE IS A FAP AVAILABLE AND GIVES INFORMATION ON HOW TO CONTACT SOMEONE FOR THE APPLICATION. |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 7, COLUMN F | PERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25 OF THE FORM 990, WAS REDUCED BY BAD DEBT EXPENSE OF $2,508,641. |
| SCHEDULE H, PART I, LINE 7 | COSTING METHODOLOGY: THE COST TO CHARGE RATIO COMPUTED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATIONS ON IRS WORKSHEETS 1 AND 3. |
| SCHEDULE H, PART III, SECTION A, LINE 2 | BAD DEBT EXPENSE: BASED ON HISTORICAL EXPERIENCES, A SIGNIFICANT PORTION OF THE SYSTEMS UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS THE SYSTEM RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTABLE ACCOUNTS RELATED TO THESE PATIENTS IN THE PERIOD THAT THE SERVICES ARE PROVIDED. THIS PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS PRESENTED ON THE CONSOLIDATED STATEMENT OF OPERATIONS AS A COMPONENT OF NET PATIENT SERVICE REVENUE. |
| SCHEDULE H, PART III, SECTION A, LINE 3 | BAD DEBT ATTRIBUTABLE TO CHARITY CARE: HISTORICALLY THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO CHARITY IS ABOUT 10% OF BAD DEBT EXPENSE. |
| SCHEDULE H, PART III, SECTION A, LINE 4 | BAD DEBT EXPENSE FOOTNOTE: THE HOSPITAL'S FINANCIAL STATEMENTS DID NOT CONTAIN A FOOTNOTE THAT DESCRIBED BAD DEBT EXPENSE. THEY DO HOWEVER HAVE A FOOTNOTE THAT DESCRIBES THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS OF PATIENTS ACCOUNTS RECEIVABLE. SEE FOOTNOTE 1 ON PAGE 12 OF THE AUDIT REPORT. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE SYSTEM ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD- PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE SYSTEM RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. |
| SCHEDULE H, PART III, SECTION B, LINE 8 | COMMUNITY BENEFIT: THE ENTIRE AMOUNT REPORTED SHOULD BE TREATED AS COMMUNITY BENEFIT AS IT REPRESENTS THE AMOUNT NOT RECOVERED BY MEDICARE. THE SOURCE USED FOR THIS WAS THE MEDICARE COST REPORT FOR THE SAME FISCAL YEAR. |
| SCHEDULE H, PART III, SECTION C, LINE 9B | COLLECTION POLICY: THE ACTIONS THAT PHH/PHPN MAY TAKE WITH REGARD TO THE NON-PAYMENT BY AN INDIVIDUAL WHO IS ABLE TO PAY FOR SERVICES, INCLUDING COLLECTION ACTIONS AND POSSIBLE REPORTING TO CREDIT AGENCIES ARE CONTAINED IN PHH/PHPN'S BILLING AND COLLECTION POLICY. FOR INDIVIDUALS WHO QUALIFY FOR FAP AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED MEDICAL BILLS, PHH/PHPN WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTIONS AGENCIES. PHH/PHPN WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS (ECA) SUCH AS LAWSUITS, LIENS ON RESIDENCES OR OTHER SIMILAR LEGAL ACTIONS FOR ANY INDIVIDUAL WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FAP. REASONABLE EFFORTS SHALL INCLUDE: A) NOTIFYING THE INDIVIDUAL OF THE FAP UPON ADMISSION, IN WRITTEN AND ORAL COMMUNICATIONS WITH THE INDIVIDUAL REGARDING THEIR BILL AND INCLUDING INFORMATION ON THE FAP ON STATEMENTS; B) WRITTEN DOCUMENTATION THAT PHH/PHPN HAS ATTEMPTED TO OFFER THE INDIVIDUAL THE OPPORTUNITY TO APPLY FOR FINANCIAL ASSISTANCE PURSUANT TO THIS POLICY AND THAT THE INDIVIDUAL HAS NOT COMPLIED WITH THE APPLICATION REQUIREMENTS; C) VALIDATING THAT THE INDIVIDUAL OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD-PARTY PAYMENTS HAVE BEEN IDENTIFIED AND BILLED BY PHH/PHPN; D) DOCUMENTATION THAT THE INDIVIDUAL HAS BEEN OFFERED A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN. |
| SCHEDULE H, PART VI, LINE 2 | NEEDS ASSESSMENT: PENN HIGHLANDS CLEARFIELD PARTICIPATED IN A COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED BY TRIPP UMBACH. |
| SCHEDULE H, PART VI, LINE 3 | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: THE HOSPITAL NOTIFIED INDIVIDUALS OF THE FINANCIAL ASSISTANCE POLICY ON ADMISSION AND PRIOR TO DISCHARGE. THE HOSPITAL ALSO NOTIFIES INDIVIDUALS OF OUR FINANCIAL ASSISTANCE POLICY WHEN DISCUSSING BILLING MATTER'S WITH THE PATIENT. |
| SCHEDULE H, PART VI, LINE 4 | COMMUNITY INFORMATION: CLEARFIELD HOSPITAL SERVES SEVERAL COUNTIES IN WESTERN AND CENTRAL PA. OUR CORE POPULATION HAS MEDICARE OR MEDICAID. PENN HIGHLANDS CLEARFIELD IS DESIGNATED AS A MEDICARE DEPENDENT HOSPITAL. |
| SCHEDULE H, PART VI, LINE 5 | PROMOTION OF COMMUNITY HEALTH: CLEARFIELD HOSPITAL, DBA PENN HIGHLANDS CLEARFIELD, IS VITAL TO THE COMMUNITIES IT HAS SERVED FOR MORE THAN 100 YEARS. LOCATED IN NORTHWEST CENTRAL PENNSYLVANIA, IT PROVIDES HEALTHCARE ACCESS TO A POPULATION THAT WOULD HAVE TO TRAVEL MORE THAN 20-45 MILES OR NOT RECEIVE CARE AT ALL IF IT DIDN'T EXIST. IT PROVIDES MEDICAL, SURGICAL AND SUPPORT SERVICES, INCLUDING: EMERGENCY SERVICES, A TELEMETRY UNIT, SURGICAL SUITES, CARDIOPULMONARY, CARDIAC REHABILITATION, A WOUND CLINIC, NUCLEAR MEDICINE, CT, MRI, PET SCANNING, LABORATORY SERVICES, AND OCCUPATIONAL, SPEECH AND PHYSICAL THERAPY. PH CLEARFIELD TREATS ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. PATIENTS ARE GIVEN PAYMENT OPTIONS FOR ALL LEVELS OF FINANCIAL NEEDS. THEY MAY BE DIRECTED TO PROGRAMS THAT THEY QUALIFY FOR, SUCH AS MEDICARE, MEDICAID OR VETERANS SERVICES, OR THEY MAY QUALIFY FOR THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM THAT GIVES DISCOUNTS UP TO 100 PERCENT. OUTSIDE OF THE HOSPITAL, EMPLOYEES ATTEND EVENTS TO PROVIDE INFORMATION ON HEALTH AND SAFETY TO THE COMMUNITY. PH CLEARFIELD IS A VALUABLE ASSET, AND WITH THE GUIDANCE OF COMMUNITY LEADERS, HOSPITAL LEADERS AND STAFF, IT WILL REMAIN SO FOR YEARS TO COME. |
| SCHEDULE H, PART VI, LINE 6 | AFFILIATED HEALTH CARE SYSTEM: PENN HIGHLANDS HEALTHCARE (PHH, SYSTEM) IS A NOT-FOR-PROFIT CORPORATION ORGANIZED TO COORDINATE AND MANAGE THE INTEGRATION OF THE DELIVERY OF HEALTHCARE SERVICES TO THE NORTH CENTRAL PENNSYLVANIA AREA. PENN HIGHLANDS HEALTHCARE INCLUDES PENN HIGHLANDS NATURAL THERAPIES, LLC AND PENN HIGHLANDS APOTHECARY, INC. THESE COMPANIES WERE FORMED IN 2017 WITH NO ACTIVITY IN THE FISCAL YEAR. DUBOIS REGIONAL MEDICAL CENTER (DRMC) PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES TO RESIDENTS IN DUBOIS, PENNSYLVANIA, AND SURROUNDING AREAS. DUBOIS INCLUDES BROOKVILLE HOSPITAL (BROOKVILLE), A CRITICAL ACCESS HOSPITAL IN BROOKVILLE, PENNSYLVANIA. BROOKVILLE EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES. BROOKVILLE INCLUDES BROOKCARE, A CORPORATION WHOSE PRIMARY BUSINESS IS TO RENT OFFICE SPACE TO PHYSICIANS AND VARIOUS DEPARTMENTS OF BROOKVILLE HOSPITAL. DUBOIS INCLUDES DUBOIS MEDICAL RISK RETENTION GROUP (DMRRG). DMRRG PROVIDES LIABILITY INSURANCE TO THE DUBOIS COMPANIES. DUBOIS IS THE SOLE MEMBER OF THE CLASS A VOTING AND PARTICIPATING CERTIFICATES OF DMRRG. DUBOIS INCLUDES DUBOIS REGIONAL MEDICAL GROUP (DRMG). DRMG PROVIDES PRIMARY CARE AND SPECIALTY PHYSICIAN SERVICES. ELK REGIONAL HEALTH CENTER (ELK) PROVIDES PRIMARY ACUTE CARE MEDICAL SERVICES AT TWO CAMPUSES, THE ST. MARYS HEALTH CENTER IN ST. MARYS, PENNSYLVANIA, AND THE RIDGWAY HEALTH CENTER IN RIDGWAY, PENNSYLVANIA. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | 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 (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KEVIN TYLER DO | ||||||||||||||
| PRESIDENT OF MEDICAL STAFF | $0 | $308,852 | $0 | $0 | $0 | $8,956 | $0 | $10,810 | $0 | $21,068 | $0 | $349,686 | $0 | $0 |
| BRIAN KLINE | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $0 | $256,000 | $0 | $50,732 | $0 | $34,462 | $0 | $23,040 | $0 | $6,408 | $0 | $370,642 | $0 | $0 |
| THOMAS CARNEVALE | ||||||||||||||
| SECRETARY | $0 | $409,412 | $0 | $225 | $0 | $0 | $0 | $10,800 | $0 | $15,960 | $0 | $436,397 | $0 | $0 |
| ROBERT E STEWARD JR | ||||||||||||||
| BOARD MEMBER | $0 | $202,953 | $0 | $0 | $0 | $12,980 | $0 | $8,118 | $0 | $20,064 | $0 | $244,115 | $0 | $0 |
| GARY MACIOCE | ||||||||||||||
| PRESIDENT END 11/2017 | $0 | $277,421 | $0 | $25,751 | $0 | $1,301 | $0 | $23,175 | $0 | $13,146 | $0 | $340,794 | $0 | $0 |
| ROBERT R COLL | ||||||||||||||
| PHYSICIAN | $367,070 | $0 | $0 | $0 | $0 | $0 | $18,353 | $0 | $13,146 | $0 | $398,569 | $0 | $0 | $0 |
| SHAUNAK PATEL | ||||||||||||||
| PHYSICIAN | $322,781 | $0 | $0 | $0 | $0 | $0 | $12,911 | $0 | $5,410 | $0 | $341,102 | $0 | $0 | $0 |
| THOMAS L YEAGER | ||||||||||||||
| PHARMACIST | $120,344 | $0 | $0 | $0 | $0 | $0 | $21,662 | $0 | $13,146 | $0 | $155,152 | $0 | $0 | $0 |
| MARK NORMAN | ||||||||||||||
| INTERIM PRESIDENT 11/17-05/18 | $0 | $250,000 | $0 | $52,875 | $0 | $6,000 | $0 | $19,039 | $0 | $15,898 | $0 | $343,812 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | CEO COMPENSATION: PENN HIGHLANDS HEALTHCARE, INC. (PHH), A RELATED ORGANIZATION, DETERMINES THE COMPENSATION OF THE CEO. PHH USES THE FOLLOWING METHODS TO DETERMINE THE COMPENSATION: INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY BOARD OR COMPENSATION COMMITTEE. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | BUSINESS RELATIONSHIP: KEVIN TYLER, DO, THOMAS CARNEVALE, MD, ROBERT STEWARD, JR, MD, BRIAN KLINE, MARK NORMAN AND GARY MACIOCE SHARE A BUSINESS RELATIONSHIP THROUGH THEIR EMPLOYMENT WITH A RELATED ORGANIZATION, PENN HIGHLANDS DUBOIS. |
| FORM 990, PART VI, SECTION A, LINE 3 | DELEGATION OF MANAGEMENT DUTIES: PENN HIGHLAND HEALTHCARE, PENN HIGHLAND CLEARFIELD'S RELATED TAX-EXEMPT PARENT ORGANIZATION, PROVIDES ADMINISTRATIVE SERVICES INCLUDING MANAGEMENT DUTIES. |
| FORM 990, PART VI, SECTION A, LINES 6, 7A, AND 7B | MEMBERS: PENN HIGHLANDS HEALTHCARE (PHH) HOLDS CERTAIN POWERS, INCLUDING THE APPROVAL OF THE ELECTION AND REMOVAL OF OFFICERS AND DIRECTORS AND APPROVAL OF ANY AND ALL AMENDMENTS TO THE BYLAWS OR OTHER ORGANIZATIONAL/GOVERNANCE DOCUMENTS. PENN HIGHLANDS HEALTHCARE (PHH) SHALL HAVE THE FOLLOWING POWERS WITH RESPECT TO THE ELECTION AND REMOVAL OF DIRECTORS OF THIS CORPORATION. NOMINATION AND ELECTION OF DIRECTORS: PRIOR TO THE END OF PHH'S FISCAL YEAR, THE PHH BOARD WILL MEET TO ELECT DIRECTORS TO FILL OPEN DIRECTOR POSITIONS, OTHER THAN EX-OFFICIO POSITIONS. AT LEAST SIXTY (60) DAYS IN ADVANCE OF THIS MEETING, PENN HIGHLANDS CLEARFIELD SHALL PROVIDE TO PHH'S GOVERNANCE/NOMINATING COMMITTEE (THE PHH GOVERNANCE/NOMINATING COMMITTEE) A LIST OF ONE OR MORE CANDIDATES (THE NUMBER OF CANDIDATES TO BE DETERMINED IN THE PHH GOVERNANCE/NOMINATING COMMITTEE'S DISCRETION) WHOM IT HAS APPROVED FOR EACH EXPIRING DIRECTOR POSITION (OTHER THAN EX OFFICIO POSITIONS). THE LIST OF CANDIDATES SHALL HAVE BEEN DEVELOPED IN CONSULTATION WITH THE BOARD OF PENN HIGHLANDS CLEARFIELD. THE PHH GOVERNANCE/NOMINATING COMMITTEE SHALL REVIEW EACH CANDIDATE IN ACCORDANCE WITH THE PHH BYLAWS, THE CRITERIA, IF ANY, SET FORTH IN THIS ORGANIZATION'S BYLAWS OR POLICIES FOR WHICH SAID CANDIDATE IS BEING CONSIDERED FOR BOARD SERVICE, AND THE POLICIES AND RULES OF PHH, INCLUDING, WITHOUT LIMITATION, THE CONFLICT OF INTEREST POLICY (ALL OF WHICH SHALL BE REFERRED TO COLLECTIVELY HEREIN AS THE ELIGIBILITY CRITERIA) AND DEVELOP A LIST OF ONE OR MORE CANDIDATES FOR EACH OPEN POSITION (THE NUMBER OF CANDIDATES TO BE DETERMINED IN THE PHH GOVERNANCE/NOMINATING COMMITTEE'S DISCRETION). ONCE THE SLATE OF CANDIDATES FOR EACH OPEN DIRECTOR POSITION IS NOMINATED BY THE PHH GOVERNANCE/NOMINATING COMMITTEE, THE BOARD OF PENN HIGHLANDS CLEARFIELD SHALL SUBMIT SUCH SLATE OF CANDIDATES TO THE PHH BOARD FOR ELECTION. THE PHH BOARD MAY ELECT BY A VOTE OF THE MAJORITY OR REFUSE TO ELECT EACH CANDIDATE SUBMITTED BY THE BOARD OF PENN HIGHLANDS CLEARFIELD AND MAY NOT ELECT ANY CANDIDATE NOT SUBMITTED BY THE BOARD OF PENN HIGHLANDS CLEARFIELD AND NOMINATED BY THE PHH GOVERNANCE/NOMINATING COMMITTEE. IN THE EVENT THE PHH BOARD FAILS TO ELECT A CANDIDATE NOMINATED AS DESCRIBED ABOVE, THEN (I) PHH WILL NOTIFY THIS CORPORATION; AND (II) THE PROCESS DESCRIBED ABOVE SHALL CONTINUE UNTIL ALL OPEN BOARD POSITIONS OF PENN HIGHLANDS CLEARFIELD HAVE BEEN FILLED. UNLESS OTHERWISE SPECIFIED AT THE TIME OF ELECTION, NEW DIRECTORS SHALL BE INSTALLED AT THE FIRST MEETING OF THE BOARD OF DIRECTORS OF PENN HIGHLANDS CLEARFIELD FOLLOWING THEIR ELECTION. REMOVAL: WITH RESPECT TO ANY DIRECTOR OF PENN HIGHLANDS CLEARFIELD, THE BOARD OF PHH HAS THE POWER TO REMOVE SUCH DIRECTOR AT ANY TIME WITH OR WITHOUT CAUSE. VACANCIES: IN THE EVENT THAT PENN HIGHLANDS CLEARFIELD DESIRES TO FILL A VACANCY OCCURRING ON ITS BOARD, THE PHH GOVERNANCE/NOMINATING COMMITTEE AND THE BOARD OF PHH, AT THE REQUEST OF PENN HIGHLANDS CLEARFIELD, SHALL ACT TO FILL SUCH VACANCY. BYLAWS: SUBJECT TO THE APPROVAL OF PHH AS SET FORTH IN THE BYLAWS, THE ARTICLES AND THESE BYLAWS MAY BE ALTERED, AMENDED, OR REPEALED AND NEW ARTICLES OR BYLAWS MAY BE ADOPTED BY THE AFFIRMATIVE VOTE OF TWO-THIRDS (2/3) OF THE BOARD. WRITTEN NOTICE OF THE INTENT TO AMEND THE ARTICLES OR THESE BYLAWS AND A DRAFT OF THE PROPOSED CHANGE SHALL BE SENT TO ALL DIRECTORS, BY THE SECRETARY, AT LEAST FIVE (5) DAYS PRIOR TO ANY MEETING AT WHICH AMENDMENT OF THE ARTICLES OR THESE BYLAWS IS INTENDED. |
| 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 AND MANAGEMENT OF THE ORGANIZATION. THE DRAFT FORM 990 IS REVIEWED BY THE CFO AND THE ACCOUNTING MANAGER. AFTER ALL SUGGESTED CHANGES FROM THE CFO AND THE ACCOUNTING MANAGER ARE MADE, THE UPDATED DRAFT FORM 990 IS PROVIDED FOR REVIEW TO THE FULL BOARD. |
| 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 INTEREST 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 EVALUATE 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 ARISES AS A RESULT OF A CONTEMPLATED PHH SYSTEM ENTITY BOARD (OR COMMITTEE) ACTION, THE CHAIRPERSON OF SAID PHH SYSTEM ENTITY'S BOARD OR 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 EVALUATE 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 DUAL 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 RELATIONSHIP, 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: PENN HIGHLANDS HEALTHCARE, INC. (PHH) PERFORMS THE COMPENSATION REVIEW FOR THE PHH EXECUTIVES, INCLUDING THE CEO OF PH CLEARFIELD. AN INDEPENDENT COMPENSATION CONSULTANT, YAFFE AND COMPANY, IS CONTRACTED TO COMPLETE AN ANNUAL COMPENSATION REVIEW. INCLUDED IN THIS REVIEW IS COMPARATIVE DATA. THE PHH BOARD REVIEWS AND APPROVES THE COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENT AVAILABILITY: THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART VII, SECTION A | BOARD MEMBER COMPENSATION: NO DIRECTORS RECEIVE ANY COMPENSATION FOR THEIR DIRECTOR DUTIES. GARY MACIOCE WAS COMPENSATED FOR HIS DUTIES AS PRESIDENT OF PENN HIGHLANDS CLEARFIELD. MARK NORMAN IS COMPENSATED FOR HIS DUTIES AS COO OF PHH WHILE SERVING AS INTERIM PRESIDENT OF PENN HIGHLANDS CLEARFIELD. KEVIN TYLER, DO, THOMAS CARNEVALE, MD, AND ROBERT STEWARD, JR, MD, ARE COMPENSATED BY A RELATED ORGANIZATION FOR THEIR DUTIES AS PHYSICIANS. |
| FORM 990, PART XI, LINE 9 | OTHER CHANGES IN NET ASSETS: $ 41,437 CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OUTSIDE SERVICES TOTAL FEES:2662929 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:MAINTENANCE CONTRACTS TOTAL FEES:2464410 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONSULTING SERVICES TOTAL FEES:158474 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:1969367 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACT LABOR TOTAL FEES:1533130 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (11 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| PENN HIGHLANDS HEALTHCARE | ||||||||||
| PO BOX 447 | DUBOIS | PA | 15801 | 320345810 | MGMT SERVICES | PA | 501(C)(3) | 12 C III-FI | NA | false |
| CLEAR-MED CORPORATION | ||||||||||
| 809 TURNPIKE AVEENUE | CLEARFIELD | PA | 16830 | 251657668 | OUTPAT. PHYS | PA | 501(C)(3) | 3 | PHH | false |
| ELCO HOUSING | ||||||||||
| 763 JOHNSONBURG ROAD | ST MARYS | PA | 15857 | 251639115 | HOUSING | PA | 501(C)(3) | 12 A I | PHH | false |
| ELK REGIONAL PROFESSIONAL GROUP INC | ||||||||||
| 763 JOHNSONBURG ROAD STE 200 | ST MARYS | PA | 15857 | 251875183 | HEALTHCARE | PA | 501(C)(3) | 3 | PHH | false |
| COMMUNITY NURSES HOME HEALTH AND HOSPICE | ||||||||||
| 757 JOHNSONBURG ROAD STE 200 | ST MARYS | PA | 15857 | 250996070 | HEALTHCARE | PA | 501(C)(3) | 10 | CNI | false |
| COMMUNITY NURSES HOME SUPPORT SERVICES | ||||||||||
| 757 JOHNSONBURG ROAD STE 200 | ST MARYS | PA | 15857 | 251623601 | HEALTHCARE | PA | 501(C)(3) | 10 | CNI | false |
| COMMUNITY NURSES INC | ||||||||||
| 757 JOHNSONBURG ROAD STE 200 | ST MARYS | PA | 15857 | 251623598 | HEALTHCARE | PA | 501(C)(3) | 7 | PHH | false |
| DUBOIS REGIONAL MEDICAL CENTER | ||||||||||
| 100 HOSPITAL AVENUE | DUBOIS | PA | 15801 | 251490707 | HOSPITAL | PA | 501(C)(3) | 3 | PHH | false |
| BROOKVILLE HOSPITAL | ||||||||||
| 100 HOSPITAL ROAD | BROOKVILLE | PA | 15825 | 250984595 | HOSPITAL | PA | 501(C)(3) | 3 | PHH | false |
| DRMC EMPLOYEE BENEFITS PLAN TRUST | ||||||||||
| 100 HOSPITAL AVE | DUBOIS | PA | 15810 | 256332829 | DRMC EMP BENE | PA | 501(C)(9) | PHH | false | |
| ELK REGIONAL HEALTH CENTER | ||||||||||
| 763 JOHNSONBURG ROAD | ST MARYS | PA | 15857 | 250585280 | HOSPITAL | PA | 501(C)(3) | 3 | PHH | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLEARFIELD MEDICAL ASSOCIATES LP | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 807 TURNPIKE AVENUE | 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 |
| Share Of Total Income | $12,673 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $739,626 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| General Or Managing Partner | Yes (true) | GeneralOrManagingPartnerInd |
| Ownership | 0.80000 | OwnershipPct |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CLEAR-CARE CORPORATION | ||||||||||||
| PO BOX 1411 | CLEARFIELD | PA | 16830 | 251512107 | MEDICAL EQUIPMENT | PA | CLEARFIELD HOSP | C-CORPORATION | $115,791 | $994,783 | 1.00000 | Yes (true) |
| CHARITABLE TRUST #1 | ||||||||||||
| PO BOX 171 | CLEARFIELD | PA | 16830 | 256019042 | INVESTMENTS | PA | CLEARFIELD HOSP | TRUST | $18,821 | $715,099 | 1.00000 | Yes (true) |
| CHARITABLE TRUST #2 | ||||||||||||
| PO BOX 171 | CLEARFIELD | PA | 16830 | 256019043 | INVESTMENTS | PA | CLEARFIELD HOSP | TRUST | $2,711 | $73,885 | 1.00000 | Yes (true) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (true) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | 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 | Yes (true) | 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 | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | 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 |