LAUREL HEALTH FOUNDATION: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- LAUREL HEALTH FOUNDATION (EIN 25-1810488)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2018-05-11
- IRS object ID
- 201831319349301958
- Schema version
- 2016v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-05-11T10:56:08-05:00 | ReturnTs |
| Tax Period End | 2017-06-30 | 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 | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 251810488 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAUREL HEALTH FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % GRETCHEN REGINA CFO | InCareOfNm |
| Business Name Control | LAUR | BusinessNameControlTxt |
| Phone | 5707230605 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 32-36 CENTRAL AVE Suite ACCTG | AddressLine1Txt |
| City | WELLSBORO | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16901 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GRETCHEN E REGINA | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Signature | 2018-03-26 | 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | RONALD BUTLER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 32-36 CENTRAL AVE ACCTG | AddressLine1Txt |
| City | WELLSBORO | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $560,094 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SUSQUEHANNAHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1998 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | LAUREL HEALTH FOUNDATION IS AN AFFILIATE OF UPMC SUSQUEHANNA. ITS MISSION IS AS FOLLOWS: TO EXTEND GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THOSE WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 9 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $357,275 | PYInvestmentIncomeAmt |
| CY Investment Income | $560,094 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $357,275 | PYTotalRevenueAmt |
| CY Total Revenue | $560,094 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $810,777 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $380,348 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $72,234 | PYOtherExpensesAmt |
| CY Other Expenses | $66,801 | CYOtherExpensesAmt |
| PY Total Expenses | $883,011 | PYTotalExpensesAmt |
| CY Total Expenses | $447,149 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$525,736 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $112,945 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $19,057,718 | TotalAssetsBOYAmt |
| Total Assets EOY | $21,410,861 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $51,187 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $61,520 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $19,006,531 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $21,349,341 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE SPECIFIC PURPOSES OF THE LAUREL HEALTH FOUNDATION ARE TO SUPPORT, PROMOTE, ADVANCE AND STRENGTHEN THE SOLDIERS AND SAILORS MEMORIAL HOSPITAL, THE GREEN HOME, NORTH PENN COMPREHENSIVE HEALTH SERVICES AND THE WELLSBORO COMMUNITY FOUNDATION. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $434,839 | ExpenseAmt |
| Grant | $380,348 | GrantAmt |
| Desc | LAUREL HEALTH FOUNDATION PROVIDES FINANCIAL SUPPORT FOR ITS RELATED TAX-EXEMPT SUPPORTED ORGANIZATIONS, SOLDIERS AND SAILORS MEMORIAL HOSPITAL, THE GREEN HOME, NORTH PENN COMPREHENSIVE HEALTH SERVICES, AND THE WELLSBORO COMMUNITY FOUNDATION. | Desc |
| Total Program Service Expenses | $434,839 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | 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 | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | 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 | false | 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 | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | 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 | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| 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 | 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | 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 | 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 | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GRETCHEN REGINA CFO | PersonNm |
| Phone | 5707230605 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 32-36 CENTRAL AVE | AddressLine1Txt |
| City | WELLSBORO | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16901 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (11 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 | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| RONALD J BUTLER | ||||||||
| PRESIDENT | 2.0 | 0.0 | Yes (X) | Yes (X) | $0 | $335,670 | $0 | |
| R ROBERT DECAMP | ||||||||
| SECRETARY | 2.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| WALTER J LAIBINIS DO | ||||||||
| DIRECTOR | 2.0 | 42.0 | Yes (X) | $0 | $414,730 | $30,151 | ||
| KATHY J WRIGHT PHD | ||||||||
| TREASURER | 2.0 | 2.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| J DENNIS MURRAY PHD | ||||||||
| DIRECTOR | 2.0 | 12.0 | Yes (X) | $0 | $0 | $0 | ||
| THOMAS M OWLETT ESQ | ||||||||
| CHAIRMAN | 2.0 | 6.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| GLENN B POIRIER | ||||||||
| VICE CHAIRMAN | 2.0 | 12.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JAN E FISHER | ||||||||
| EXECUTIVE VP | 2.0 | 40.0 | Yes (X) | $0 | $551,981 | $31,238 | ||
| KAREN CHAMBERS | ||||||||
| DIRECTOR | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| GRETCHEN E REGINA | ||||||||
| VP/CFO | 2.0 | 40.0 | Yes (X) | $0 | $108,376 | $6,742 | ||
| RONALD M GILBERT | ||||||||
| FORMER VP/CFO ENDING 02/2015 | 0.0 | 0.0 | $0 | $212,989 | $19,385 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,623,746 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $87,516 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
| Total Program Service Revenue | $0 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $384,748 | TotalRevenueColumnAmt |
| Exclusion | $384,748 | 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 |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $175,346 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $175,346 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $175,346 | TotalRevenueColumnAmt |
| Exclusion | $175,346 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| 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 | $560,094 | TotalRevenueColumnAmt |
| Exclusion | $560,094 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $380,348 | TotalAmt |
| Program Services | $380,348 | 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 | $0 | TotalAmt |
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 | $0 | TotalAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
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 | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,580 | TotalAmt |
| Management And General | $3,580 | 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 | $54,392 | TotalAmt |
| Program Services | $54,392 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $99 | TotalAmt |
| Program Services | $99 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $358 | TotalAmt |
| Management And General | $358 | 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 | $0 | TotalAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
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 | $0 | TotalAmt |
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 | $0 | TotalAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,372 | TotalAmt |
| Management And General | $8,372 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $447,149 | TotalAmt |
| Program Services | $434,839 | ProgramServicesAmt |
| Management And General | $12,310 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $460,073 | BOYAmt |
| EOY | $818,434 | 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 | $0 | BOYAmt |
| EOY | $0 | 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 | $6,279 | BOYAmt |
| EOY | $6,279 | EOYAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,128,361 | BOYAmt |
| EOY | $18,236,749 | 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 | $0 | BOYAmt |
| EOY | $0 | 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 | $2,463,005 | BOYAmt |
| EOY | $2,349,399 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,057,718 | BOYAmt |
| EOY | $21,410,861 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,631 | BOYAmt |
| EOY | $8,591 | 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 | $0 | 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 | $39,556 | BOYAmt |
| EOY | $52,929 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,187 | BOYAmt |
| EOY | $61,520 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,880,050 | BOYAmt |
| EOY | $21,074,708 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $126,481 | BOYAmt |
| EOY | $274,633 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,006,531 | BOYAmt |
| EOY | $21,349,341 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,057,718 | BOYAmt |
| EOY | $21,410,861 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $112,945 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $2,125,320 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $104,545 | 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 | 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 Type2 | Yes (X) | SupportingOrgType2Ind |
| Supported Organizations | 4 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (4 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| SSMH | ||||
| 232176963 | 3 | Yes (true) | $253,231 | $0 |
| GREEN HOME | ||||
| 240804365 | 10 | Yes (true) | $36,367 | $0 |
| NORTH PENN | ||||
| 231889724 | 3 | Yes (true) | $0 | $0 |
| WELLSBORO C F | ||||
| 202680321 | 8 | Yes (true) | $90,750 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 4 | SupportedOrganizationsTotalCnt |
| Support Sum | $380,348 | 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 | false | OrganizationChangeSuprtOrgInd |
| 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Majority Dir Trst Supported Org | Yes (true) | MajorityDirTrstSupportedOrgInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART I, LINE 12G | FormAndLineReferenceDesc |
| Explanation | ORGANIZATIONS SUPPORTED: THE COMPLETE NAMES OF THE ORGANIZATIONS SUPPORTED ARE AS FOLLOWS: (A) SOLDIERS & SAILORS MEMORIAL HOSPITAL (B) THE GREEN HOME (C) NORTH PENN COMPREHENSIVE HEALTH SERVICES (D) WELLSBORO COMMUNITY FOUNDATION | ExplanationTxt |
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 | $12,780,921 | BeginningYearBalanceAmt |
| Contributions | $113,606 | ContributionsAmt |
| Investment Earnings Or Losses | $2,101,133 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $380,348 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $37,760 | AdministrativeExpensesAmt |
| End Year Balance | $14,577,552 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $15,744,999 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$380,234 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $710,126 | GrantsOrScholarshipsAmt |
| Other Expenditures | $1,832,173 | OtherExpendituresAmt |
| Administrative Expenses | $41,545 | AdministrativeExpensesAmt |
| End Year Balance | $12,780,921 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $16,284,168 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $271,234 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $776,184 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $34,219 | AdministrativeExpensesAmt |
| End Year Balance | $15,744,999 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributions | $14,945,981 | ContributionsAmt |
| Investment Earnings Or Losses | $1,358,906 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $20,719 | AdministrativeExpensesAmt |
| End Year Balance | $16,284,168 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Board Designated Balance EOY | 1.00000 | BoardDesignatedBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
| Land | LandGrp | |
| Buildings | BuildingsGrp | |
| Leasehold Improvements | LeaseholdImprovementsGrp | |
| Equipment | EquipmentGrp | |
| Other Land Buildings | OtherLandBuildingsGrp |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE FROM EXEMPT AFFILIATES | Desc |
| Book Value | $2,349,399 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,349,399 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO EXEMPT AFFILIATES | Desc |
| Amt | $52,929 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $52,929 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PART V, LINE 4 | FormAndLineReferenceDesc |
| Explanation | ENDOWMENT FUNDS: THE ENDOWMENT FUNDS ARE USED TO FUND THE MISSION OF THE ORGANIZATION. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| SOLDIERS SAILORS MEMORIAL HOSPITAL | |||||||
| 32-36 CENTRAL AVE | WELLSBORO | PA | 16901 | 232176963 | 501(C)(3) | $253,231 | SUPPORT |
| THE GREEN HOME | |||||||
| 37 CENTRAL AVE | WELLSBORO | PA | 16901 | 240804365 | 501(C)(3) | $36,367 | SUPPORT |
| WELLSBORO COMMUNITY FOUNDATION | |||||||
| PO BOX 243 | WELLSBORO | PA | 16901 | 202680321 | 501(C)(3) | $90,750 | SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 3 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | GRANT MONITORING PROCESS: ALL GRANTEES ARE REQUIRED TO COMPLETE A GRANT COMPLIANCE REPORT AT THE COMPLETION OF THEIR PROJECT. ADDITIONALLY, ALL GRANTEE ORGANIZATIONS ARE SUPPORTED TAX-EXEMPT ORGANIZATIONS AND, THEREFORE, SHARE COMMON MANAGEMENT. | ExplanationTxt |
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 | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RONALD J BUTLER | ||||||||||||||
| PRESIDENT | $0 | $0 | $0 | $0 | $0 | $335,670 | $0 | $0 | $0 | $0 | $0 | $335,670 | $0 | $0 |
| WALTER J LAIBINIS DO | ||||||||||||||
| DIRECTOR | $0 | $229,365 | $0 | $173,818 | $0 | $11,547 | $0 | $9,950 | $0 | $20,201 | $0 | $444,881 | $0 | $0 |
| JAN E FISHER | ||||||||||||||
| EXECUTIVE VP | $0 | $401,814 | $0 | $138,186 | $0 | $11,981 | $0 | $9,950 | $0 | $21,288 | $0 | $583,219 | $0 | $0 |
| RONALD M GILBERT | ||||||||||||||
| FORMER VP/CFO ENDING 02/2015 | $0 | $187,967 | $0 | $23,993 | $0 | $1,029 | $0 | $8,483 | $0 | $10,902 | $0 | $232,374 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 4A | SEVERANCE PAYMENT: Ronald J. Butler, Former Exec VP/CBO retired on 4/15/15. His entire reportable compensation, $335,670 paid by a related organization, is a severance payment. |
| SCHEDULE J, PART I, LINE 6 | EXECUTIVE COMPENSATION: IN ORDER FOR THE LEADERSHIP TEAM TO PARTICIPATE IN THE ANNUAL VARIABLE COMPENSATION INCENTIVE PROGRAM (VCIP), A MINIMUM OPERATING MARGIN MUST BE ACHIEVED FOR THE MOST RECENTLY COMPLETED YEAR ON THE CONSOLIDATED SYSTEM-LEVEL BASIS. INDIVIDUAL GOALS AND OBJECTIVES RELATED TO THE VCIP MAY ALSO INCLUDE INDIVIDUAL ENTITY OPERATING PERFORMANCE. THERE WERE NO PAYMENTS TO THE OFFICERS LISTED ON FORM 990, PART VII, THIS YEAR. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | FAMILY RELATIONSHIP: ROBERT DECAMP AND KAREN CHAMBERS, VOTING DIRECTORS, HAVE A FAMILY RELATIONSHIP. BUSINESS RELATIONSHIP: RONALD J BUTLER, WALTER J LAIBINIS, JAN E FISHER, GRETCHEN E REGINA, AND RONALD M GILBERT ALL HAVE A BUSINESS RELATIONSHIP THROUGH EMPLOYMENT WITH A RELATED TAX-EXEMPT ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | ELECTING MEMBERS OF THE GOVERNING BODY: AT LEAST 50% OF THE BOARD OF DIRECTORS MUST CONSIST OF INDIVIDUALS SERVING AS BOARD MEMBERS OF THE LAUREL SYSTEM ENTITIES AS SYSTEM REPRESENTATIVES. WITH RESPECT TO THE SYSTEM REPRESENTATIVE POSITIONS, UPMC SUSQUEHANNA SUBMITS A LIST OF ITS RECOMMENDED SYSTEM REPRESENTATIVE CANDIDATES TO THE NOMINATING COMMITTEE, WHO REVIEWS THE LIST AND UPON APPROVAL, NOMINATES APPROVED REPRESENTATIVES TO THE BOARD. |
| FORM 990, PART VI, SECTION A, LINE 7B | DECISIONS SUBJECT TO APPROVAL BY MEMBERS: THE BYLAWS REQUIRE PRIOR WRITTEN APPROVAL OF UPMC SUSQUEHANNA ON ANY BYLAW AMENDMENT RELATING TO THE FOLLOWING MATTERS: -ELECTION OR REMOVAL OF DIRECTORS OR OFFICERS -CORPORATE MEMBERS OR MEMBERSHIP OF THE CORPORATION -NUMBER, COMPOSITION, ATTENDANCE, COMPENSATION, VOTING, QUORUM, POWERS, DUTIES, RESPONSIBILITIES OR MANNER OF ACTING OF THE BOARD OF DIRECTORS, OFFICERS OR COMMITTEES -TERMS, QUALIFICATIONS OR DUTIES OF, OR NOTICE TO, DIRECTORS AND/OR OFFICERS -USE OF THE CORPORATION'S FUNDS -CORPORATE PURPOSES, POWERS OR LIMITATIONS -COMPLIANCE WITH SECTION 501(C)(3) OF THE CODE AND/OR ANY OTHER LAW -CONFLICT OF INTEREST POLICIES OR PROCEDURES -INDEMNIFICATION RIGHTS OR OBLIGATIONS -AMENDMENT OF THE ARTICLES OF INCORPORATION OR BYLAWS OR ENGAGEMENT IN ANY FUNDAMENTAL TRANSACTIONS -MATERIAL RIGHTS OR OBLIGATIONS OF UPMC SUSQUEHANNA AND/OR ITS AFFILIATES |
| FORM 990, PART VI, SECTION B, LINE 11B | PROCESS TO REVIEW THE FORM 990: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY MANAGEMENT. A HIGH-LEVEL OVERVIEW OF THE FORM 990 IS PRESENTED TO THE BOARD OF DIRECTORS BEFORE FILING, AND COMPLETE DRAFTS OF ALL RETURNS ARE MADE AVAILABLE TO ALL BOARD MEMBERS THROUGH THE CEO'S AND CFO'S OFFICES. |
| FORM 990, PART VI, SECTION B, LINE 12C | MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: ANNUALLY ON THE 1ST DAY OF JANUARY, UPMC SUSQUEHANNA SENDS TO ALL DIRECTORS, OFFICERS, MANAGEMENT STAFF AND CONTRACTED PHYSICIANS A QUESTIONNAIRE TO BE COMPLETED AND RETURNED BY JANUARY 15. A REPORT IS SUBMITTED TO THE BOARD OF DIRECTORS TO NOTIFY THEM OF ANY CONFLICTS OF INTEREST DISCLOSED. |
| FORM 990, PART VI, SECTION B, LINES 15A & 15B | COMPENSATION REVIEW: ALL TOP MANAGEMENT IS EMPLOYED BY THE WILLIAMSPORT HOSPITAL (TWH), AND THE BOARD OF TWH USES THE FOLLOWING PROCESS TO ESTABLISH COMPENSATION. ON A BI-ANNUAL BASIS, AN INDEPENDENT COMPENSATION CONSULTING FIRM PERFORMS AN ANALYSIS OF THE LEADERSHIP SALARY STRUCTURE IN RELATIONSHIP TO THE LABOR MARKET USING DATA FROM FOUR DIFFERENT SALARY SURVEYS. THEIR ANALYSIS IS REVIEWED WITH THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS. THE FIRM THEN OUTLINES ITS RECOMMENDATIONS FOR THE PROPOSED EXECUTIVE SALARY STRUCTURE TO THE COMMITTEE FOR THEIR CONSIDERATION AND APPROVAL. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENT DISCLOSURE: GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART VII, LINE 1A | BOARD MEMBER COMPENSATION: NO BOARD MEMBERS RECEIVE COMPENSATION FOR THEIR DUTIES AS BOARD MEMBERS. WALTER LAIBINIS AND JAN FISHER ARE COMPENSATED BY RELATED ORGANIZATIONS FOR THEIR MANAGEMENT AND/OR PHYSICIAN POSITIONS. RONALD BUTLER RETIRED FROM A RELATED EXEMPT ORGANIZATION IN APRIL 2015. HIS COMPENSATION IS SEVERANCE FROM THAT RELATED ORGANIZATION. SEE SCHEDULE J FOR ADDITIONAL INFORMATION. |
| FORM 990, PART XI, LINE 9 | OTHER CHANGES IN NET ASSETS: $104,545 TRANSFERS FROM AFFILIATES |
| FORM 990, PART XII, LINE 2C | OVERSIGHT & SELECTION OF INDEPENDENT ACCOUNTANT: THE OVERSIGHT PROCESS AND INDEPENDENT ACCOUNTANT SELECTION ARE PERFORMED BY UPMC SUSQUEHANNA, A RELATED TAX-EXEMPT ORGANIZATION. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (51 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| LAUREL REALTY | |||||||||||
| 15 MEADE STREET | WELLSBORO | PA | 16901 | 231403678 | REAL ESTATE | PA | 501(C)(2) | UPMC SUSQ | false | ||
| LAUREL MANAGEMENT SERVICES | |||||||||||
| 15 MEADE STREET | WELLSBORO | PA | 16901 | 251644910 | MANAGEMENT SV | PA | 501(C)(3) | UPMC SUSQ | false | 12B II | |
| THE GREEN HOME | |||||||||||
| 37 CENTRAL AVENUE | WELLSBORO | PA | 16901 | 240804365 | ASSISTED LIVI | PA | 501(C)(3) | UPMC SUSQ | false | 10 | |
| SOLDIERS AND SAILORS MEMORIAL HOSPITAL | |||||||||||
| 32-36 CENTRAL AVENUE | WELLSBORO | PA | 16901 | 232176963 | HEALTHCARE | PA | 501(C)(3) | UPMC SUSQ | false | 3 | |
| TIOGA HEALTH CARE PROVIDERS | |||||||||||
| 15 MEADE STREET | WELLSBORO | PA | 16901 | 251765538 | HEALTHCARE | PA | 501(C)(3) | UPMC SUSQ | false | 12B II | |
| UPMC SUSQUEHANNA | |||||||||||
| 1205 GRAMPIAN BLVD | WILLIAMSPORT | PA | 17701 | 232751183 | MANAGEMENT | PA | 501(C)(3) | NA | false | 12B II | |
| DIVINE PROVIDENCE HOSPITAL OF THE SISTER | |||||||||||
| 1100 GRAMPIAN BLVD | WILLIAMSPORT | PA | 17701 | 240799343 | HEALTHCARE | PA | 501(C)(3) | UPMC SUSQ | false | 3 | |
| MUNCY VALLEY HOSPITAL | |||||||||||
| 215 E WATER ST | MUNCY | PA | 17756 | 240806023 | HEALTHCARE | PA | 501(C)(3) | UPMC SUSQ | false | 3 | |
| THE WILLIAMSPORT HOSPITAL | |||||||||||
| 700 HIGH ST | WILLIAMSPORT | PA | 17701 | 240795508 | HOSPITAL | PA | 501(C)(3) | UPMC SUSQ | false | 3 | |
| SUSQUEHANNA HEALTH FOUNDATION | |||||||||||
| 1100 GRAMPIAN BLVD | WILLIAMSPORT | PA | 17701 | 232743470 | FUNDRAISING | PA | 501(C)(3) | UPMC SUSQ | false | 12A I | |
| SUSQUEHANNA PHYSICIAN SERVICES | |||||||||||
| 1201 GRAMPIAN BLVD | WILLIAMSPORT | PA | 17701 | 232449454 | PHYSICIANS | PA | 501(C)(3) | UPMC SUSQ | false | 3 | |
| WILLIAMSPORT AREA AMBULANCE SERVICES | |||||||||||
| 700 HIGH ST | WILLIAMSPORT | PA | 17701 | 232416166 | AMBULANCE SVC | PA | 501(C)(3) | WILLIAMSPORT | false | 10 | |
| NORTH PENN COMPREHENSIVE HEALTH SERVICES | |||||||||||
| 22 WALNUT ST | WELLSBORO | PA | 16901 | 231889724 | GENERAL HLTH | PA | 501(C)(3) | NA | false | 3 | |
| LAUREL HEALTH SYSTEM | |||||||||||
| 15 MEADE STREET | WELLSBORO | PA | 16901 | 240795488 | HEALTHCARE | PA | 501(C)(3) | UPMC SUSQ | false | 12B II | |
| WELLSBORO COMMUNITY FOUNDATION | |||||||||||
| 114 MAIN STREET | WELLSBORO | PA | 16901 | 202680321 | FUNDRAISING | PA | 501(C)(3) | NA | false | 7 | |
| SUSQUEHANNA HEALTH INNOVATION CENTER | |||||||||||
| 700 HIGH STREET | WILLIAMSPORT | PA | 17701 | 471600873 | HEALTHCARE | PA | 501(C)(3) | UPMC SUSQ | false | 12A I | |
| UPMC | |||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251423657 | SUPPORT | PA | 501(C)(3) | false | 12C III-FI | N/A | |
| UPMC SENIOR COMMUNITIES INC | |||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251574736 | SR. LIVING | PA | 501(C)(3) | UPMC | false | 10 | |
| PITTSBURGH LIFETIME CARE COMMUNITY | |||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251335247 | CCRC | PA | 501(C)(3) | UPMC SR COMM | false | 10 | |
| CANTERBURY PLACE | |||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 250965334 | SR LIVING | PA | 501(C)(3) | UPMC SR COMM | false | 10 | |
| SENECA PLACE | |||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 721562844 | SR. LIVING | PA | 501(C)(3) | UPMC SR COMM | false | 10 | |
| SHADYSIDE HOSPITAL SUPPORTING FND | |||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 260303394 | FOUNDATION | PA | 501(C)(3) | UPMC | false | 12A I | |
| UPMC LEE | |||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 250613830 | INACTIVE | PA | 501(C)(3) | UPMC | false | 3 | |
| PITTSBURGH CARE PARTNERSHIP INC | |||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251753852 | ADULT DAYCARE | PA | 501(C)(3) | UPMC | false | 10 | |
| UPMC CENTER FOR HIGH VALUE HEALTHCARE | |||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 452178782 | RESEARCH | PA | 501(C)(3) | UPMC | false | 7 | |
| SHADYSIDE HOSPITAL FOUNDATION | |||||||||||
| 532 SOUTH AIKEN AVE | PITTSBURGH | PA | 15232 | 251290546 | FOUNDATION | PA | 501(C)(3) | UPMC PRESBY | false | 12C III-FI | |
| PASSAVANT HOSPITAL FOUNDATION | |||||||||||
| 9100 BABCOCK BLVD | PITTSBURGH | PA | 15237 | 251407815 | FOUNDATION | PA | 501(C)(3) | UPMC PASS | false | 12B II | |
| UPMC NORTHWEST FOUNDATION | |||||||||||
| 100 FAIRFIELD DRIVE | SENECA | PA | 16346 | 251483624 | FOUNDATION | PA | 501(C)(3) | UPMC NORTWE | false | 12D III-O | |
| ST MARGARET FOUNDATION | |||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251520340 | FOUNDATION | PA | 501(C)(3) | UPMC ST MARG | false | 7 | |
| MAGEE-WOMEN RES INST AND FOUNDATION | |||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251462311 | FOUNDATION | PA | 501(C)(3) | NA | false | 7 | |
| UPMC KANE | |||||||||||
| 4372 ROUTE 6 | KANE | PA | 16735 | 250998168 | HOSPITAL | PA | 501(C)(3) | UPMC HAMOT | false | 3 | |
| GREAT LAKES PHYSICIAN PRACTICE | |||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 464186362 | PHYSICIANS | NY | 501(C)(3) | REGNL HEALTH | false | 3 | |
| CHILDREN'S HOSPITAL OF PITTSBURGH FND | |||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251865744 | FOUNDATION | PA | 501(C)(3) | UPMC CHP | false | 7 | |
| HAMOT HEALTH FOUNDATION | |||||||||||
| 302 FRENCH STREET | ERIE | PA | 16507 | 251400999 | FOUNDATION | PA | 501(C)(3) | UPMC HAMOT | false | 12B II | |
| SAFE HARBOR BEHAVIORAL HLTH OF UPMC HA | |||||||||||
| 1330 W 26TH STREET | ERIE | PA | 16508 | 251317492 | BEHAVIORAL | PA | 501(C)(3) | UPMC HAMOT | false | 7 | |
| UPMC JAMESON | |||||||||||
| 1211 WILMINGTON AVE | NEW CASTLE | PA | 16105 | 250965406 | HEALTHCARE | PA | 501(C)(3) | UPMC | false | 3 | |
| JAMESON HEALTHCARE FOUNDATION | |||||||||||
| 1211 WILMINGTON AVE | NEW CASTLE | PA | 16105 | 251536037 | FOUNDATION | PA | 501(C)(3) | UPMC JAMESON | false | 12B II | |
| JAMESON HEALTH SERVICES INC | |||||||||||
| 1211 WILMINGTON AVE | NEW CASTLE | PA | 16105 | 030486993 | HEALTHCARE | PA | 501(C)(3) | UPMC JAMESON | false | 12B II | |
| CHILDREN'S ADVOCACY CENTER OF LAWRENCE | |||||||||||
| 1107 WILMINGTON AVE | NEW CASTLE | PA | 16105 | 251581304 | SUPPORT SYS | PA | 501(C)(3) | UPMC JAMESON | false | 7 | |
| UPMCJAMESON CANCER CENTER | |||||||||||
| 1211 WILMINGTON AVE | NEW CASTLE | PA | 16105 | 201459415 | ONCOLOGY SVC | PA | 501(C)(3) | UPMC JAMESON | false | 10 | |
| JAMESON MEDICAL CARE INC | |||||||||||
| 1211 WILMINGTON AVE | NEW CASTLE | PA | 16105 | 260462696 | HEALTHCARE | PA | 501(C)(3) | UPMC JAMESON | false | 10 | |
| JAMESON CARE CENTER INC | |||||||||||
| 1211 WILMINGTON AVE | NEW CASTLE | PA | 16105 | 232871396 | HEALTHCARE | PA | 501(C)(3) | UPMC SR COMM | false | 10 | |
| VENANGO VNA FOUNDATION | |||||||||||
| 491 ALLEGHENY BLVD | FRANKLIN | PA | 16323 | 251472179 | FOUNDATION | PA | 501(C)(3) | UPMC VISITIN | false | 12D III-O | |
| UPMC CHAUTAUQUA AT WCA | |||||||||||
| 207 FOOTE AVE | JAMESTOWN | NY | 14701 | 160743226 | HOSPITAL | NY | 501(C)(3) | UPMC CHAUTAU | false | 3 | |
| WCA GROUP INC | |||||||||||
| 207 FOOTE AVE | JAMESTON | NY | 14701 | 222392582 | HOLDING CO | NY | 501(C)(3) | UPMC CHAUTAU | false | 12B II | |
| STARFLIGHT INC | |||||||||||
| 135 ALLEN STREET | JAMESTOWN | NY | 14701 | 161557878 | STAT MEDVAC | NY | 501(C)(3) | UPMC CHAUTAU | false | 7 | |
| SOUTH CENTRAL ALPHA HOUSING AND HEALTH | |||||||||||
| 3410 W PITTSBURGH RD | NEW CASTLE | PA | 16101 | 251701701 | SKILLED NURSE | PA | 501(C)(3) | UPMC SR COMM | false | 10 | |
| SOUTH WESTERN ALPHA HOUSING AND HEALTH | |||||||||||
| 745 GREENVILLE RD | MERCER | PA | 16137 | 251701700 | SKILLED NURSE | PA | 501(C)(3) | UPMC SR COMM | false | 10 | |
| KANE COMMUNITY HOSPITAL FOUNDATION | |||||||||||
| 4372 ROUTE 6 | KANE | PA | 16735 | 263906925 | FOUNDATION | PA | 501(C)(3) | UPMC KANE | false | 7 | |
| JUNIOR GUILD OF JAMESON MEMORIAL HOS | |||||||||||
| 1211 WILMINGTON AVE | NEW CASTLE | PA | 16105 | 256005313 | SUPPORT | PA | 501(C)(3) | UPMC JAMESON | false | 12D III-O | |
| WCA FOUNDATION INC | |||||||||||
| 300 FOOTE AVE | JAMESTOWN | NY | 14702 | 222393584 | FOUNDATION | PA | 501(C)(3) | UPMC CHAUTAU | false | 12C III-FI | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (13 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|---|
| COMMUNITY BASKET | ||||||||||
| 1205 GRAMPIAN BLVD | WILLIAMSPORT | PA | 17701 | 201195739 | REAL ESTATE | PA | UPMC SUSQSHF | N/A | false | false |
| SENECA HILLS ASSISTED LIVING | ||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 232873106 | ASSISTED LIVING | PA | NA | N/A | false | false |
| ST MARGARET MEDICAL ARTS ASSOC | ||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251786655 | MED OFFICE BL | PA | NA | N/A | false | false |
| CORE NETWORK LLC | ||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251786209 | HEALTHCARE | PA | NA | N/A | false | false |
| LIFE HOME CARE LP | ||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251847839 | HOMECARE | PA | NA | N/A | false | false |
| SHADYSIDE MEDICAL CENTER ASSOC | ||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251608318 | MED OFFICE BL | PA | NA | N/A | false | false |
| CHARTWELL PA LP | ||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251729714 | HOME HEALTH | PA | NA | N/A | false | false |
| LIFE CARE HOME SRV OF NW PA | ||||||||||
| 1647 SASSAFRAS ST | ERIE | PA | 16507 | 251536879 | HOME HEALTH | PA | NA | N/A | false | false |
| HAMOT-KCH REAL ESTATE VENTURE | ||||||||||
| 300 STATE ST | ERIE | PA | 16507 | 263691782 | MEDICAL OFFICE | PA | NA | N/A | false | false |
| HAMOT SURGERY CENTER LLC | ||||||||||
| 200 STATE STREET | ERIE | PA | 16507 | 251863661 | AMBULATORY SURG | PA | NA | N/A | false | false |
| EPN-HAMOT URGENT CARE LLC | ||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 272147949 | URGENT CARE | PA | NA | N/A | false | false |
| MOUNTAIN VIEW MEDICAL ONCOLOGY | ||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 461449241 | HEALTHCARE | PA | NA | N/A | false | false |
| LAWRENCE COUNTY MRI & DIAGNOST | ||||||||||
| 2526 WILMINGTON AVE | NEW CASTLE | PA | 16105 | 270219891 | IMAGING CENTER | PA | NA | N/A | false | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (65 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 | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TYOGA CARENET | ||||||||||||||
| 114 EAST AVE | WELLSBORO | PA | 16901 | 251810967 | INTEGRATION HC | PA | UPMC SUSQ | C CORP | false | |||||
| SUSQUEHANNA VENTURES INC | ||||||||||||||
| 1201 GRAMPIAN BLVD | WILLIAMSPORT | PA | 17701 | 232470263 | PHARMACY | PA | UPMC SUSQ | C CORP | false | |||||
| SUSQUEHANNA HEALTH SYS INSUR NETWORK LTD | ||||||||||||||
| 980458722 | CAPTIVE INSURANCE | UPMC SUSQ | C CORP | false | PO BOX 1159 KY1-1102 | GRAND CAYMANS | CAYMAN ISLANDS | CJ | CJ | |||||
| HC PHARMACY CENTRAL INC | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251364192 | PHARMACY CO-OP | PA | NA | C CORP | false | |||||
| CHILDREN'S COMMUNITY CARE | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251781887 | PEDIATRIC SVC | PA | NA | C CORP | false | |||||
| UPMC CANCER CENTERS IRELAND LIMITED | ||||||||||||||
| CANCER TREATMENT | NA | C CORP | false | 6TH FLOOR BEACON HOSPITAL | SANDYFORD | DUBLIN | EI | EI | ||||||
| UPMC PHYSICIAN SERVICES HOLDING COMPANY | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251877017 | HOLDING CO | PA | NA | C CORP | false | |||||
| ONCOLOGY HEMATOLOGY ASSOC | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251762980 | HEALTHCARE | PA | NA | C CORP | false | |||||
| TRI-STATE NEUROSURGICAL ASSOC | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251458655 | HEALTHCARE | PA | NA | C CORP | false | |||||
| RENAISSANCE FAMILY PRACTICE-UPMC INC | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 262942206 | HEALTHCARE | PA | NA | C CORP | false | |||||
| UPMC HOLDING COMPANY INC | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251777713 | HOLDING CO | PA | NA | C CORP | false | |||||
| UPMC COVERAGE PRODUCTS INC | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251777710 | HOLDING CO | PA | NA | C CORP | false | |||||
| FREEDOM INSURANCE COMPANY | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 030308944 | INSURANCE | VT | NA | C CORP | false | |||||
| TRI-CENTURY INSURANCE CO | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251500739 | INSURANCE | PA | NA | C CORP | false | |||||
| UPMC DNA INC | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251883237 | INSURANCE | PA | NA | C CORP | false | |||||
| UPMC HEALTH BENEFITS INC | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251844144 | HEALTH INSURANCE | PA | NA | C CORP | false | |||||
| UPMC HEALTH NETWORK INC | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 721527566 | HEALTH INSURANCE | PA | NA | C CORP | false | |||||
| UPMC HEALTH PLAN INC | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 232813536 | HEALTH INSURANCE | PA | NA | C CORP | false | |||||
| UPMC BENEFIT MANAGEMENT SERVICES INC | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251769564 | WORKER'S COMP | PA | NA | C CORP | false | |||||
| UPMC DIVERSIFIED SERVICES INC | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251778454 | HOLDING CO | PA | NA | C CORP | false | |||||
| MONROEVILLE SPECIALTY CLINIC | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251666087 | HEALTHCARE | PA | NA | C CORP | false | |||||
| MEDICAL ARCHIVAL SYSTEMS INC | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 232912501 | SOFTWARE DEVE | DE | NA | C CORP | false | |||||
| PRESBY HEALTH RESOURCE MGMT | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251422155 | HEALTHCARE | PA | NA | C CORP | false | |||||
| RX PARTNERS INC | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251801966 | RETAIL PHARM | PA | NA | C CORP | false | |||||
| BIOTRONICS INC | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251843500 | EQUIP MAINEN | PA | NA | C CORP | false | |||||
| MEDICAL CENTER PROPERTIES INC | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251796940 | REAL ESTATE | PA | NA | C CORP | false | |||||
| ASKESIS DEVELOPMENT GROUP INC | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 541625585 | SOFTWARE DEVE | DE | NA | C CORP | false | |||||
| PANTER REINSURANCE COMPANY LTD | ||||||||||||||
| INSURANCE | NA | C CORP | false | PO BOX 1109 | GRAND CAYMAN | CJ | CJ | |||||||
| FORBES REINSURANCE COMPANY LTD | ||||||||||||||
| INSURANCE | NA | C CORP | false | PO BOX 1109 | GRAND CAYMAN | CJ | CJ | |||||||
| CATHEDRAL (RE) INSURANCE CO | ||||||||||||||
| INSURANCE | NA | C CORP | false | PO BOX 1109 | GRAND CAYMAN | CJ | CJ | |||||||
| UPMC INTERNATIONAL HEALTH INITIATIVES | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 841706741 | INACTIVE | PA | NA | C CORP | false | |||||
| UPMC IRELAND LIMITED | ||||||||||||||
| HEALTHCARE SU | NA | C CORP | false | 6TH FLOOR BEACON HOSPITAL | SANDYFORD | DUBLIN | EI | EI | ||||||
| UPMC UNITED KINGDOM LTD | ||||||||||||||
| 980571026 | SOFTWARE LICE | NA | C CORP | false | C/O NAIRCO 11TH FLOOR | WHITEFRIARS LEWINS MEAD | BRISTOL | UK | UK | |||||
| BAYFRONT REGIONAL DEVELOPMENT CORP | ||||||||||||||
| 300 STATE STREET | ERIE | PA | 16507 | 251401388 | RE HOLDING CO | PA | NA | C CORP | false | |||||
| BAYSIDE DEVELOPMENT CORP | ||||||||||||||
| 300 STATE STREET | ERIE | PA | 16507 | 251401386 | REAL ESTATE | PA | NA | C CORP | false | |||||
| UPMC WORK ALLIANCE INC | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 452825053 | INSURANCE | PA | NA | C CORP | false | |||||
| UPMC CANADA TECHNOLOGIES LIMITED | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | SOFTWARE | NA | C CORP | false | CA | ||||||
| ALLIED ORTHOPEDICS APPLIANCES INC | ||||||||||||||
| 335 E 3RD ST | JAMESTOWN | NY | 14701 | 161092951 | MED APPLIANCE | PA | NA | C CORP | false | |||||
| UPMC HEALTH COVERAGE INC | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 462824537 | INSURANCE | PA | NA | C CORP | false | |||||
| UPMC COMPLETE CARE INC | ||||||||||||||
| 5215 CENTRE AVE | PITTSBURGH | PA | 15232 | 463605753 | HEALTHCARE | PA | NA | C CORP | false | |||||
| AMERICAN HOME HEALTH SERVICES | ||||||||||||||
| 868 CORPORATE WAY | WESTLAKE | OH | 44145 | 311521422 | HOME HEALTH | OH | NA | C CORP | false | |||||
| HEALTH FIDELITY INC | ||||||||||||||
| 210 S B ST | SAN MATEO | CA | 94401 | 452538963 | TECHNOLOGY | CA | NA | C CORP | false | |||||
| FLUENCE HEALTH INC | ||||||||||||||
| 6425 PENN AVE | PITTSBURGH | PA | 15206 | 472684174 | SOFTWARE | DE | NA | C CORP | false | |||||
| CURAVI HEALTH INC | ||||||||||||||
| 6425 PENN AVE | PITTSBURGH | PA | 15206 | 811217377 | HEALTHCARE | DE | NA | C CORP | false | |||||
| PENSIAMO INC | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 812069236 | SUPPLY CHAIN | DE | NA | C CORP | false | |||||
| ALTOONA FAMILY INC | ||||||||||||||
| 620 HOWARD AVE | ALTOONA | PA | 16601 | 251444935 | MGMT SVCS | PA | NA | C CORP | false | |||||
| LEXINGTON HOLDINGS INC | ||||||||||||||
| 620 HOWARD AVE | ALTOONA | PA | 16601 | 251794386 | MEDICAL SVCS | PA | NA | C CORP | false | |||||
| LEXINGTON ONE INC | ||||||||||||||
| 620 HOWARD AVE | ALTOONA | PA | 16601 | 251468889 | RENTAL | PA | NA | C CORP | false | |||||
| LEXINGTON TWO INC | ||||||||||||||
| HOWARD AVE 7TH ST | ALTOONA | PA | 16601 | 251555689 | RENTAL EQPT | PA | NA | C CORP | false | |||||
| LEXINGTON FOUR INC | ||||||||||||||
| 620 HOWARD AVE | ALTOONA | PA | 16601 | 251793736 | HOLDING CO | PA | NA | C CORP | false | |||||
| ALLEGHENY HEALTHCARE STAFFING INC | ||||||||||||||
| 620 HOWARD AVE | ALTOONA | PA | 16601 | 271657362 | EMPLOYMENT SVC | PA | NA | C CORP | false | |||||
| UPMC ALTOONA REGIONAL HELATH SERVICES | ||||||||||||||
| 1414 9TH AVE | ALTOONA | PA | 16602 | 251219302 | MEDICAL SVCS | PA | NA | C CORP | false | |||||
| LEXINGTON ANESTHESIA ASSOCIATES INC | ||||||||||||||
| 620 HOWARD AVE | ALTOONA | PA | 16601 | 251897765 | MEDICAL SVCS | PA | NA | C CORP | false | |||||
| NORTHERN CAMBRIA MEDICAL CENTER INC | ||||||||||||||
| 620 HOWARD AVE | ALTOONA | PA | 16601 | 251530860 | MEDICAL SVCS | PA | NA | C CORP | false | |||||
| PATTON FAMILY MEDICAL CENTER INC | ||||||||||||||
| 620 HOWARD AVE | ALTOONA | PA | 16601 | 251793735 | MEDICAL SVCS | PA | NA | C CORP | false | |||||
| MEDCPU | ||||||||||||||
| 100 WALL STREET | NEW YORK | NY | 10005 | 383805381 | SOFTWARE DEV | DE | NA | C CORP | false | |||||
| UPMC ECESS PL TR | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 826254351 | TRUST | PA | NA | TRUST | false | |||||
| RXANTE INC | ||||||||||||||
| 511 CONGRESS STREET | PORTLAND | ME | 04101 | 454040219 | MEDICATION MGT | DE | NA | C CORP | false | |||||
| VINCENT PAYMENT SOLUTIONS INC | ||||||||||||||
| 6425 PENN AVE | PITTSBURGH | PA | 15219 | 821101143 | PAYMENT SYSTEM | DE | NA | C CORP | false | |||||
| J HEALTH VENTURES INC | ||||||||||||||
| 1211 WILMINGTON AVE | NEW CASTLE | PA | 16105 | 251607893 | INACTIVE | PA | NA | C CORP | false | |||||
| JER MEDICAL ASSOCIATES INC | ||||||||||||||
| 1211 WILMINGTON AVE | NEW CASTLE | PA | 16105 | 251609398 | INACTIVE | PA | NA | C CORP | false | |||||
| WCA SERVICE CORPORATION INC | ||||||||||||||
| 207 FOOTE AVE | JAMESTOWN | NY | 14701 | 161151438 | SUPPORT | NY | NA | C CORP | false | |||||
| FRIENDS OF ALTOONA HOSPITAL | ||||||||||||||
| 620 HOWARD AVE | ALTOONA | PA | 16601 | 861140504 | FUNDRAISING | PA | NA | C CORP | false | |||||
| HEMATOLOGY ONCOLOGY ASSOC | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 12519 | 421648357 | HEALTHCARE | PA | NA | C CORP | false | |||||
| UPMC HEALTH OPTIONS INC | ||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 462824626 | INSURANCE | PA | NA | C CORP | false | |||||
| 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 | false | 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 | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PARTS II, III, AND IV | FormAndLineReferenceDesc |
| Explanation | UPMC SYSTEM ENTITIES: THE ENTITIES MARKED WITH AN ASTERISK ARE NOT TECHNICALLY "RELATED PARTIES," AS DEFINED BY THE IRS FORM 990 INSTRUCTIONS, OF THE FILING ORGANIZATION. HOWEVER, THEY ARE LISTED ON SCHEDULE R TO REFLECT THAT THEY ARE PART OF THE UPMC SYSTEM OF ENTITIES, AS THEY ALL SHARE UPMC AS THEIR ULTIMATE PARENT CORPORATION. | ExplanationTxt |