CORRY MEMORIAL HOSPITAL ASSOCIATION: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- CORRY MEMORIAL HOSPITAL ASSOCIATION (EIN 25-0987222)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-12
- IRS object ID
- 201731329349305368
- Schema version
- 2015v3.0
- 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 C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-12T14:24:08-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 550486667 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ARNETT CARBIS TOOTHMAN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5700 CORPORATE DRIVE STE 650 | AddressLine1Txt |
| City | PITTSBURGH | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 15237 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 250987222 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CORRY MEMORIAL HOSPITAL ASSOCIATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CORR | BusinessNameControlTxt |
| Phone | 8146644641 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 965 SHAMROCK LANE | AddressLine1Txt |
| City | CORRY | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16407 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL HELLER | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 8146644641 | PhoneNum |
| Signature | 2017-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JEFFREY J PETRELL CPA | PreparerPersonNm |
| PTIN | P00138808 | PTIN |
| Phone | 4126356270 | PhoneNum |
| Preparation | 2017-05-04 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LECOM HEALTH CORRY MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BARBARA NICHOLS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 965 SHAMROCK LANE | AddressLine1Txt |
| City | CORRY | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16407 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $22,223,062 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CORRYHOSPITAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1894 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | INPATIENT AND OUTPATIENT MEDICAL CARE | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 3 | VotingMembersIndependentCnt |
| Total Employee | 234 | TotalEmployeeCnt |
| Total Volunteers | 75 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $115,589 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $21,400,665 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $21,459,085 | CYProgramServiceRevenueAmt |
| PY Investment Income | $294,725 | PYInvestmentIncomeAmt |
| CY Investment Income | $128,660 | CYInvestmentIncomeAmt |
| PY Other Revenue | $331,756 | PYOtherRevenueAmt |
| CY Other Revenue | $490,368 | CYOtherRevenueAmt |
| PY Total Revenue | $22,027,146 | PYTotalRevenueAmt |
| CY Total Revenue | $22,193,702 | 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 | $9,507,216 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,131,820 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $13,266,091 | PYOtherExpensesAmt |
| CY Other Expenses | $13,940,188 | CYOtherExpensesAmt |
| PY Total Expenses | $22,773,307 | PYTotalExpensesAmt |
| CY Total Expenses | $24,072,008 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$746,161 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,878,306 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $51,504,914 | TotalAssetsBOYAmt |
| Total Assets EOY | $48,667,687 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $40,166,933 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $40,344,857 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $11,337,981 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,322,830 | NetAssetsOrFundBalancesEOYAmt |
| Mission | CORRY MEMORIAL HOSPITAL - A COMMUNITY OF CAREGIVERS COMMITTED TO EXCELLENCE | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $19,482,493 | ExpenseAmt |
| Revenue | $21,459,085 | RevenueAmt |
| Desc | CORRY MEMORIAL HOSPITAL ASSOCIATION IS A NOT FOR PROFIT CRITICAL ACCESS HOSPITAL LOCATED IN CORRY, PENNSYLVANIA. THE ASSOCIATION OPERATES A 20-BED ACUTE CARE FACILITY WHICH PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR RESIDENTS IN NORTHWESTERN PENNSYLVANIA AND SOUTHWESTERN NEW YORK. THE ASSOCIATION MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. | Desc |
| Total Program Service Expenses | $19,482,493 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 17 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 234 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| DAF Excess Business Holdings | 0 | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | 0 | TaxableDistributionsInd |
| Distribution To Donor | 0 | DistributionToDonorInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 3 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | PA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MICHAEL HELLER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8146644641 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 965 SHAMROCK LANE | AddressLine1Txt |
| City | CORRY | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16407 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 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 |
|---|---|---|---|---|---|---|---|---|
| BARBARA NICHOLS | ||||||||
| CEO | 37.00 | 3.00 | Yes (X) | Yes (X) | $210,511 | $0 | $230 | |
| JOHN M FERRETTI DO | ||||||||
| CHAIR, LECOM CEO | 1.00 | 79.00 | Yes (X) | Yes (X) | $0 | $799,067 | $31,857 | |
| RICHARD P OLINGER | ||||||||
| VICE CHAIR, LECOM CFO | 1.00 | 64.00 | Yes (X) | Yes (X) | $0 | $629,323 | $40,315 | |
| DAVID HERR | ||||||||
| SECRETARY | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| TINA FREEMAN | ||||||||
| TREASURER | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JOHN BALMER DO | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| GERRY DAHL | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| PAULA HERR | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| KATHERINE KEMP JENSEN | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| PAUL MCGEEHAN MD | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN WILSON | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| ROGELIO ALLANIGUE MD | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $16,800 | $0 | $0 | ||
| ERNEST FERRO JR | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MARY L ECKERT | ||||||||
| TRUSTEE, MILLCREEK HOSPITAL CEO | 1.00 | 79.00 | Yes (X) | $0 | $723,268 | $31,692 | ||
| ROBERT JOY | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $4,588 | $0 | $0 | ||
| MICHAEL HELLER | ||||||||
| CFO | 37.00 | 3.00 | Yes (X) | $113,993 | $0 | $7,384 | ||
| MARION MACALUSO | ||||||||
| CRNA | 40.00 | $270,287 | $0 | $2,375 | Yes (X) | |||
| DEBRA SILKES MD | ||||||||
| GENERAL SURGEON | 40.00 | $248,556 | $0 | $3,333 | Yes (X) | |||
| MOHAMMAD ELMUSA MD | ||||||||
| FAMILY PRACTICE PHYSICIAN | 40.00 | $219,743 | $0 | $10,494 | Yes (X) | |||
| MICHAEL ANTOON DO | ||||||||
| ER MEDICAL DIRECTOR | 40.00 | $181,417 | $0 | $60 | Yes (X) | |||
| KAREN KELLY | ||||||||
| CRNA | 40.00 | $146,270 | $0 | $3,934 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,412,165 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,151,658 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $131,674 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CLINICAL PATHOLOGY INSTITUTE | |||||
| 1526 PEACH STREET | ERIE | PA | 16501 | LAB EMPLOYEES | $533,195 |
| JERRY GURKOFF DO PA | |||||
| 336 YORK STREET | CORRY | PA | 16407 | PHYSICIAN | $413,333 |
| EMCARE PHYSICIAN SERVICES | |||||
| 7032 COLLECTION CENTER DRIVE | CHICAGO | IL | 60693 | ER PHYSICIANS | $345,365 |
| ASSOCIATED CLINICAL LABS | |||||
| 350 E BAYFRONT PKWY | ERIE | PA | 16507 | LAB SERVICES | $301,484 |
| VANTAGE MOBILE SERVICES | |||||
| 1305 SOUTH MAIN ST | MEADVILLE | PA | 16335 | MOBILE MRI | $253,616 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $115,589 | AllOtherContributionsAmt |
| Total Contributions | $115,589 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $21,459,085 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,459,085 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $21,459,085 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $128,660 | TotalRevenueColumnAmt |
| Exclusion | $128,660 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $58,347 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $29,360 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $28,987 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,987 | TotalRevenueColumnAmt |
| Exclusion | $28,987 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $461,381 | TotalRevenueColumnAmt |
| Exclusion | $461,381 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $461,381 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $22,193,702 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,459,085 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $619,028 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $332,118 | TotalAmt |
| Management And General | $332,118 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,795,319 | TotalAmt |
| Program Services | $7,257,352 | ProgramServicesAmt |
| Management And General | $537,967 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $263,235 | TotalAmt |
| Program Services | $263,235 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,251,242 | TotalAmt |
| Program Services | $10,960 | ProgramServicesAmt |
| Management And General | $1,240,282 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $489,906 | TotalAmt |
| Program Services | $436,174 | ProgramServicesAmt |
| Management And General | $53,732 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,077 | TotalAmt |
| Management And General | $51,077 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,601,397 | TotalAmt |
| Program Services | $2,292,261 | ProgramServicesAmt |
| Management And General | $309,136 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,140 | TotalAmt |
| Program Services | $28,575 | ProgramServicesAmt |
| Management And General | $14,565 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $674,471 | TotalAmt |
| Program Services | $573,005 | ProgramServicesAmt |
| Management And General | $101,466 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $293,537 | TotalAmt |
| Program Services | $221,280 | ProgramServicesAmt |
| Management And General | $72,257 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $602,846 | TotalAmt |
| Program Services | $584,318 | ProgramServicesAmt |
| Management And General | $18,528 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,488 | TotalAmt |
| Program Services | $18,739 | ProgramServicesAmt |
| Management And General | $4,749 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,477,283 | TotalAmt |
| Management And General | $1,477,283 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,927,889 | TotalAmt |
| Program Services | $2,927,889 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $336,251 | TotalAmt |
| Program Services | $88,882 | ProgramServicesAmt |
| Management And General | $247,369 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $2,394,905 | $2,394,905 | |
| BAD DEBT EXPENSE | $1,674,740 | $1,674,740 | |
| REPAIRS & MAINTENANCE | $551,620 | $534,988 | $16,632 |
| MISCELLANEOUS | $287,544 | $175,190 | $112,354 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,072,008 | TotalAmt |
| Program Services | $19,482,493 | ProgramServicesAmt |
| Management And General | $4,589,515 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,230 | BOYAmt |
| EOY | $2,230 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $159,413 | BOYAmt |
| EOY | $368,381 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,354,979 | BOYAmt |
| EOY | $1,255,193 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $208,988 | BOYAmt |
| EOY | $223,414 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $242,616 | BOYAmt |
| EOY | $276,467 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $36,558,329 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $11,491,286 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,616,853 | BOYAmt |
| EOY | $25,067,043 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,095,910 | BOYAmt |
| EOY | $1,701,087 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,710,702 | BOYAmt |
| EOY | $6,575,179 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,553,213 | BOYAmt |
| EOY | $1,553,213 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,560,010 | BOYAmt |
| EOY | $11,645,480 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,504,914 | BOYAmt |
| EOY | $48,667,687 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,886,482 | BOYAmt |
| EOY | $2,452,795 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,918,015 | BOYAmt |
| EOY | $34,309,331 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,362,436 | BOYAmt |
| EOY | $3,582,731 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,166,933 | BOYAmt |
| EOY | $40,344,857 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,230,794 | BOYAmt |
| EOY | $6,222,918 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,057 | BOYAmt |
| EOY | $129,366 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,089,130 | BOYAmt |
| EOY | $1,970,546 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,337,981 | BOYAmt |
| EOY | $8,322,830 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,504,914 | BOYAmt |
| EOY | $48,667,687 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,878,306 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$109,064 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$1,027,781 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | 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 (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $3,967 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $3,967 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | A PORTION OF THE ORGANIZATION'S DUES TO HOSPITAL COUNCIL AND THE HOSPITAL & HEALTHSYTEM ASSOCIATION OF PENNSYLVANIA (HAP) ARE USED FOR LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,089,131 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$5,947 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $91,970 | OtherExpendituresAmt |
| Administrative Expenses | $20,668 | AdministrativeExpensesAmt |
| End Year Balance | $1,970,546 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,134,557 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $64,221 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $87,995 | OtherExpendituresAmt |
| Administrative Expenses | $21,652 | AdministrativeExpensesAmt |
| End Year Balance | $2,089,131 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,914,203 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $324,314 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $83,055 | OtherExpendituresAmt |
| Administrative Expenses | $20,905 | AdministrativeExpensesAmt |
| End Year Balance | $2,134,557 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,794,669 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $217,561 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $79,959 | OtherExpendituresAmt |
| Administrative Expenses | $18,068 | AdministrativeExpensesAmt |
| End Year Balance | $1,914,203 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,874,846 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $12,572 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $77,973 | OtherExpendituresAmt |
| Administrative Expenses | $14,776 | AdministrativeExpensesAmt |
| End Year Balance | $1,794,669 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $147,000 | OtherCostOrOtherBasisAmt |
| Book Value | $147,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $24,662,805 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,373,981 | DepreciationAmt |
| Book Value | $18,288,824 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,631,197 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,505,779 | DepreciationAmt |
| Book Value | $4,125,418 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,117,327 | OtherCostOrOtherBasisAmt |
| Depreciation | $611,526 | DepreciationAmt |
| Book Value | $2,505,801 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $25,067,043 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (7 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| CLINICAL PATHOLOGY INSTITUTE | $18,000 | C |
| COMMUNITY HOSPITAL ALTERNATIVE FOR RISK TRANSFER | $50,000 | C |
| CORRY AMBULANCE SERVICE, INC | $53,054 | C |
| INTEREST IN ASSETS HELD BY CORRY COMMUNITY FOUNDATION | $3,344,911 | F |
| REGIONAL HOME HEALTH AND HOSPICE | $938,791 | F |
| VANTAGE HOLDING COMPANY | $199,877 | C |
| ASSETS HELD IN TRUST | $1,970,546 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $6,575,179 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| ADVANCE DEPOSITS | $22,923 |
| DUE FROM AFFILIATES | $9,447,467 |
| DEFERRED FINANCING COSTS | $1,416,434 |
| ESTIMATED THIRD PARTY SETTLEMENTS | $758,656 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $11,645,480 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| PENSION PLAN LIABILITY | $3,518,534 |
| ESTIMATED MEDICAL MALPRACTICE CLAIM | $64,197 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,582,731 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE ENDOWMENTS ARE USED PRIMARY FOR HOSPITAL PROGRAMS AND NEW EQUIPMENT TO PROVIDE THE LATEST TECHNOLOGY IN PATIENT CARE. |
| PART X, LINE 2: | THE ASSOCIATION IS A NOT-FOR-PROFIT CORPORATION AND IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED. THE ASSOCIATION ADOPTED THE STANDARD FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS THAT PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS NOT BEEN MET. THE STANDARD ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING FOR INTERIM PERIODS, AND DISCLOSURE. MANAGEMENT HAS DETERMINED THAT THE ADOPTION OF THE STANDARD DID NOT HAVE A MATERIAL EFFECT ON THE CONSOLIDATED FINANCIAL STATEMENTS. GENERALLY, TAX RETURNS FOR YEARS ENDED JUNE 30, 2013, AND THEREAFTER REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $29,440 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $29,440 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,189,637 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,662,797 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $526,840 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02350 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,219,077 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,662,797 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $556,280 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02480 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $35,970 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $35,970 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00160 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $35,970 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $35,970 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00160 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,255,047 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,662,797 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $592,250 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02640 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $763,904 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $7,148,014 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $7,077,242 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $70,772 | 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 (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | 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 | CORRY MEMORIAL HOSPITAL ASSOCATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 965 SHAMROCK LANE | AddressLine1Txt |
| City | CORRY | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16407 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CORRY MEMORIAL HOSPITAL ASSOCIATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | 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 |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.CORRYHOSPITAL.COM/ABOUT | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.CORRYHOSPITAL.COM/ABOUT | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| 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 (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | 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 (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.CORRYHOSPITAL.COM/ABOUT/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.CORRYHOSPITAL.COM/ABOUT/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.CORRYHOSPITAL.COM/ABOUT/ | 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 |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| CORRY MEMORIAL HOSPITAL ASSOCIATION | PART V, SECTION B, LINE 5: A STEERING COMMITTEE WAS FORMED WITH REPRESENTATIVES FROM THE ERIE COUNTY DEPARTMENT OF HEALTH (ECDH), COMMUNITY HEALTH NET (A FEDERALLY QUALIFIED HEALTH CENTER), THE ERIE COMMUNITY FOUNDATION, HIGHMARK BLUE CROSS BLUE SHIELD, THE NORTHWEST PENNSYLVANIA AREA HEALTH EDUCATION CENTER, ERIE COUNTY DEPARTMENT OF HUMAN SERVICES, ERIE COUNTY OFFICE OF DRUG & ALCOHOL ABUSE, ERIE COUNTY OFFICE OF MENTAL HEALTH AND INTELLECTUAL DISABILITIES, UNITED WAY OF ERIE COUNTY AND THE FOUR ERIE COUNTY NONPROFIT HOSPITALS OF CORRY MEMORIAL HOSPITAL, MILLCREEK COMMUNITY HOSPITAL, SAINT VINCENT HEALTH SYSTEM, AND UPMC HAMOT. ERIE COUNTY DEPARTMENT OF HEALTH (ECDH) WAS IDENTIFIED AS THE LEAD AGENCY. QUANTITATIVE DATA SOURCES INCLUDED LOCAL HEALTH STATISTICS CALCULATED AND REPORTED BY ECDH EPIDEMIOLOGISTS AND AVAILABLE ON THE ECDH WEBSITE, STATE HEALTH STATISTICS AND HEALTH CARE REPORTS FROM THE PENNSYLVANIA DEPARTMENT OF HEALTH, NATIONAL HEALTH STATISTICS AVAILABLE ON THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) WEBSITE, DEMOGRAPHIC DATA FROM THE U.S. CENSUS BUREAU, HOSPITAL-RELATED INFORMATION FROM THE HOSPITAL AND HEALTHSYSTEM ASSOCIATION OF PENNSYLVANIA, AND RELATED DATA AND INFORMATION FROM VARIOUS LOCAL, STATE, AND NATIONAL ORGANIZATIONS.QUALITATIVE DATA WAS GATHERED VIA FOCUS GROUPS WHICH WERE CONDUCTED TO PROVIDE RESIDENT PERCEPTIONS OF HEALTH ISSUES WITHIN THE COUNTY. GROUPS WERE FACILITATED BY THE NORTHWEST PENNSYLVANIA AREA HEALTH EDUCATION CENTER. |
| CORRY MEMORIAL HOSPITAL ASSOCIATION | PART V, SECTION B, LINE 6A: THE CHNA WAS COMPLETED IN COLLABORATION WITH OTHER ERIE COUNTY HOSPITALS WHICH INCLUDED MILLCREEK COMMUNITY HOSPITAL, SAINT VINCENT HEALTH SYSTEM, AND UPMC HAMOT. |
| CORRY MEMORIAL HOSPITAL ASSOCIATION | PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED WITH THE FOLLOWING ORGANIZATIONS: ERIE COUNTY DEPARTMENT OF HEALTH (ECDH), COMMUNITY HEALTH NET (A FEDERALLY QUALIFIED HEALTH CENTER), THE ERIE COMMUNITY FOUNDATION, HIGHMARK BLUE CROSS BLUE SHIELD, AND THE NORTHWEST PENNSYLVANIA AREA HEALTH EDUCATION CENTER. |
| CORRY MEMORIAL HOSPITAL ASSOCIATION | PART V, SECTION B, LINE 11: CORRY MEMORIAL HOSPITAL DEVELOPED AN IMPLEMENTATION PLAN TO ADDRESS THE SIGNIFICANT NEEDS IDENTIFIED THROUGH ITS CHNA. AS WITH MOST HEATH CARE FACILITIES, CORRY MEMORIAL HOSPITAL HAS LIMITED FINANCIAL RESOURCES TO ADDRESS ALL ISSUES IDENTIFIED IN THE CHNA. |
| CORRY MEMORIAL HOSPITAL ASSOCIATION | PART V, SECTION B, LINE 16I: THE FINANCIAL ASSISTANCE POLICY IS ALSO POSTED IN LOCAL PHYSICIAN OFFICES. |
| CORRY MEMORIAL HOSPITAL ASSOCIATION | PART V, SECTION B, LINE 22D: CORRY MEMORIAL HOSPITAL USES THE LOOK-BACK METHOD TO CALCULATE AMOUNTS GENERALLY BILLED. |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | A COST-TO-CHARGE RATIO CALCULATED FROM WORKSHEET 2, RATIO OF PATIENT CARE COSTS-TO-CHARGES IS THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNTS REPORTED ON PART I, LINE 7. |
| PART I, LN 7 COL(F): | THE BAD DEBT EXPENSE OF 1,674,740 INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN A WAS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE OF TOTAL EXPENSES. |
| PART III, LINE 4: | CORRY MEMORIAL HOSPITAL ASSOCIATION'S FINANCIAL STATEMENTS DO NOT INCLUDE A BAD DEBT FOOTNOTE. THE BAD DEBT EXPENSE CONSISTS OF BALANCES THAT ARE SENT TO COLLECTIONS AS WELL AN ADDITIONAL AMOUNT ASSESSED BY MANAGEMENT. EVERY MONTH MANAGEMENT REVIEWS THE ACCOUNTS RECEIVABLE BALANCE AND WRITES OFF ADDITIONAL AMOUNTS BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL COLLECTIONS AND ECONOMIC CONDITIONS.A COST-TO-CHARGE RATIO CALCULATED FROM WORKSHEET 2, RATIO OF PATIENT CARE COSTS-TO-CHARGES IS THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNTS REPORTED ON LINES 2 AND 3. |
| PART III, LINE 8: | CORRY MEMORIAL HOSPITAL IS A CRITICAL ACCESS HOSPITAL. IF CORRY MEMORIAL HOSPITAL CEASED TO EXIST PATIENTS WOULD HAVE TO TRAVEL A MINIMUM OF 26 MILES TO NEAREST HOSPITAL WHICH WOULD CREATE A HARDSHIP FOR MANY. A COST-TO-CHARGE RATIO CALCULATED FROM WORKSHEET 2, RATIO OF PATIENT CARE COSTS-TO-CHARGES IS THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNTS REPORTED ON PART III, LINE 6. |
| PART III, LINE 9B: | THE HOSPITAL DOES NOT ENGAGE IN EXTRAORDINARY COLLECTION ACTIONS BEFORE MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THE INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE. |
| PART VI, LINE 2: | DURING FISCAL YEAR 2016, CORRY MEMORIAL HOSPITAL ASSOCATION CONDUCTED A COUNTY-WIDE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THIS STUDY WAS CONDUCTED TO: (1) PROVIDE A COMPREHENSIVE OVERVIEW OF THE HEALTH STATUS OF ERIE COUNTY, (2) IDENTIFY PRIORITY HEALTH NEEDS WITHIN THE COUNTY, (3) ORGANIZE THESE PRIORITIES INTO STRATEGIC ISSUES, AND (4) SHARE THIS INFORMATION WITH THE COMMUNITY AT LARGE, INCLUDING STAKEHOLDERS. |
| PART VI, LINE 3: | IF A PERSON IS ADMITTED WITH NO INSURANCE THEY ARE VISITED BY A FINANCIAL AID COUNSELOR AND MADE AWARE OF ASSISTANCE OPTIONS. ALL SELF-PAY PATIENTS ARE MAILED A LETTER THAT DESCRIBES THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM AND HOW TO APPLY. |
| PART VI, LINE 4: | CORRY MEMORIAL HOSPITAL IS A CRITICAL ACCESS HOSPITAL LOCATED IN CORRY PENNSYLVANIA. THE HOSPITAL SERVES THE RESIDENTS OF NORTHWESTERN PENNSYLVANIA AND SOUTHWESTERN NEW YORK. CORRY PENNSYLVANIA IS A RURAL TOWN WITH A POPULATION OF APPROXIMATELY 6,300. THE ESTIMATED MEDIAN HOUSEHOLD INCOME IS $30,474 WHICH IS WELL BELOW THE PENNSYLVANIA AVERAGE OF $49,520. APPROXIMATELY 25% OF RESIDENTS IN CORRY PENNSYLVANIA LIVE IN POVERTY. |
| PART VI, LINE 5: | CORRY MEMORIAL HOSPITAL IS A NOT-FOR-PROFIT CRITICAL ACCESS HOSPITAL THAT PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES. FROM DIABETES EDUCATION TO OCCUPATIONAL HEALTH SERVICES AND MORE, WE WANT TO ENSURE THAT EACH AND EVERY MEMBER OF OUR COMMUNITY RECEIVES THE BEST CARE AVAILABLE NOT FOR THE MONEY, NOT FOR THE ACCOLADES, BUT FOR THE HEALTH AND WELL-BEING OF OUR NEIGHBORS, OUR FRIENDS AND OUR FAMILIES. CORRY MEMORIAL HOSPITAL HAS BEEN ABLE TO PROVIDE "STATE OF THE ART" MEDICAL FACILITIES FOR THE PAST ONE HUNDRED YEARS BECAUSE OF THE EFFORTS OF THE BOARD OF TRUSTEES, THE DOCTORS, NURSES AND EMPLOYEES. THE BOARD OF TRUSTEES IS MADE UP OF INDIVIDUALS WHO LIVE AND WORK IN THE COMMUNITY WHO VOLUNTEER THEIR TIME AND SERVICES TO ASSIST IN THE GOVERNANCE OF THE ORGANIZATION. CORRY MEMORIAL HOSPITAL EXTENDS MEDICAL PRIVILEGES TO QUALIFIED PHYSICIANS SUBJECT TO THE NORMAL APPLICATION PROCESS WHICH MUST BE APPROVED BY THE CREDENTIALS COMMITTEE, THE MEDICAL EXECUTIVE COMMITTEE AND THE BOARD OF TRUSTEES. THE ORGANIZATION USES SURPLUS FUNDS TO PROVIDE THE LATEST IN TECHNOLOGY TO IMPROVE PATIENT CARE. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BARBARA NICHOLS | ||||||||||||||
| CEO | $194,225 | $0 | $16,286 | $0 | $0 | $0 | $0 | $0 | $230 | $0 | $210,741 | $0 | $0 | $0 |
| JOHN M FERRETTI DO | ||||||||||||||
| CHAIR, LECOM CEO | $0 | $774,044 | $0 | $0 | $0 | $25,023 | $0 | $21,200 | $0 | $10,657 | $0 | $830,924 | $0 | $0 |
| RICHARD P OLINGER | ||||||||||||||
| VICE CHAIR, LECOM CFO | $0 | $596,885 | $0 | $0 | $0 | $32,438 | $0 | $21,200 | $0 | $19,115 | $0 | $669,638 | $0 | $0 |
| MARY L ECKERT | ||||||||||||||
| TRUSTEE, MILLCREEK HOSPITAL CEO | $0 | $691,784 | $0 | $0 | $0 | $31,484 | $0 | $21,200 | $0 | $10,492 | $0 | $754,960 | $0 | $0 |
| MARION MACALUSO | ||||||||||||||
| CRNA | $270,287 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $2,375 | $0 | $272,662 | $0 | $0 | $0 |
| DEBRA SILKES MD | ||||||||||||||
| GENERAL SURGEON | $248,556 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $3,333 | $0 | $251,889 | $0 | $0 | $0 |
| MOHAMMAD ELMUSA MD | ||||||||||||||
| FAMILY PRACTICE PHYSICIAN | $219,743 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $10,494 | $0 | $230,237 | $0 | $0 | $0 |
| MICHAEL ANTOON DO | ||||||||||||||
| ER MEDICAL DIRECTOR | $181,417 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $60 | $0 | $181,477 | $0 | $0 | $0 |
| KAREN KELLY | ||||||||||||||
| CRNA | $146,270 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $3,934 | $0 | $150,204 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | THE CEO AND CFO RECEIVE DISCRETIONARY BONUSES, THE AMOUNT OF WHICH WAS DETERMINED BY THE HUMAN RESOURCES COMMITTEE AND APPROVED BY THE BOARD OF TRUSTEES. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERIE COUNTY HOSPITAL AUTHORITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 232302072 | BondIssuerEIN |
| Bond Issued | 2011-01-06 | BondIssuedDt |
| Issue Price | $1,218,000 | IssuePriceAmt |
| Purpose | CONSTRUCTION OF NEW HOSPITAL | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $90,000 | RetiredAmt |
| Total Proceeds | $1,218,000 | TotalProceedsAmt |
| In Reserve Fund | $66,771 | InReserveFundAmt |
| Capitalized Interest | $2,804 | CapitalizedInterestAmt |
| Issuance Costs From Proceeds | $24,360 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $1,121,878 | CapitalExpendituresAmt |
| Unspent | $2,187 | UnspentAmt |
| Substantial Completion | 2013 | SubstantialCompletionYr |
| Current Refunding | 0 | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | 0 | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | Yes (1) | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | DATE REBATE COMPUTATION PERFORMED | FormAndLineReferenceDesc |
| Explanation | ISSUER NAME: ERIE COUNTY HOSPITAL AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 12/21/2016 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | DAVE HERR (BOARD MEMBER) AND PAULA HERR (BOARD MEMBER) ARE MARRIED. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF CORRY MEMORIAL HOSPITAL IS MILLCREEK HEALTH SYSTEM D/B/A LECOM HEALTH SYSTEM, A PENNSYLVANIA NONPROFIT CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SOLE MEMBER, MILLCREEK HEALTH SYSTEM HAS THE RIGHT TO APPOINT OR REMOVE BOARD MEMBERS. THE BOARD SHALL CONSIST OF SEVEN (7) MEMBERS. THREE BOARD MEMBERS SHALL BE NAMED BY THE MEMBER AND FOUR BY THE PRIOR BOARD OF CORRY. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING POWERS, RIGHTS, AND PRIVILEGES ARE EXPRESSLY RESERVED BY THE MEMBER: (1) THE RIGHT TO ALTER, AMEND OR REPEAL THE ARTICLES OF INCORPORATION OF CORRY; (2) THE RIGHT TO APPROVE ANY AND ALL TRANSACTIONS THAT CHANGE, OR HAVE THE EFFECT OF CHANGING, THE OWNERSHIP AND/OR CONTROL OF CORRY. SUCH A TRANSACTION SHALL INCLUDE, BUT NOT BE LIMITED TO, ANY PROPOSED ATTEMPT TO MERGE, ACQUIRE OR COMBINE CORRY WITH ANY OTHER FACILITY, SYSTEM, AFFILIATE, ENTITY OR PERSON, WHETHER SUCH TRANSACTION IS BY CONTRACT, SALE OF ALL OR SUBSTANTIALLY ALL OF ITS ASSETS OR BY OPERATION OF LAW; (3) THE RIGHT TO APPOINT OR REMOVE BOARD MEMBERS OF CORRY; (4) THE RIGHT TO APPROVE THE BUDGET AND ALL PROPOSED CAPITAL EXPENDITURES OF CORRY. |
| FORM 990, PART VI, SECTION B, LINE 11 | CORRY MEMORIAL HOSPITAL ASSOCIATION HAS A CPA FIRM PREPARE ITS FORM 990. THE RETURN IS COMPLETED IN DRAFT FORM AND REVIEWED BY MANAGEMENT OF THE ORGANIZATION. A COPY OF THE 990 IS PROVIDED TO THE BOARD OF DIRECTORS BEFORE IT IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH OFFICER, TRUSTEE AND KEY EMPLOYEE IS REQUIRED TO FILL OUT AN ANNUAL CONFLICT OF INTEREST FORM. THE FORMS ARE REVIEWED INITIALLY BY THE CEO. ANY CONFLICTS ARE REVIEWED BY BOARD MEMBERS. A PERSON WITH A CONFLICT IS RESTRICTED FROM VOTING ON RELATED MATTERS. |
| FORM 990, PART VI, SECTION B, LINE 15 | CORRY MEMORIAL HOSPITAL ASSOCIATION'S EXECUTIVE COMMITTEE APPROVES COMPENSATION FOR ALL OFFICERS AND KEY EMPLOYEES. MEMBERS OF MANAGEMENT MAKE RECOMMENDATIONS TO THE HR COMMITTEE. THE HR COMMITTEE THEN MAKES RECOMMENDATIONS TO THE EXECUTIVE COMMITTEE, WHICH HAS FINAL APPROVAL. PERIODIC REVIEW OF REGIONAL COMPARABLE SALARIES IS TAKEN INTO CONSIDERATION. |
| FORM 990, PART VI, SECTION C, LINE 18 | CORRY MEMORIAL HOSPITAL ASSOCIATION MAKES ITS FORM 990 AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART VI, SECTION C, LINE 19 | CORRY MEMORIAL HOSPITAL ASSOCIATION MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | CHANGE IN INTEREST IN ASSETS HELD BY CORRY COMMUNITY FOUNDATION 41,311. MINIMUM PENSION LIABILITY ADJUSTMENT -1,069,092. |
| FORM 990, PART XII, LINE 2C: | THE ORGANIZATION'S BOARD OF DIRECTORS ASSUME RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT. THE PROCESS IS CONSISTENT WITH PRIOR YEARS AND HAS NOT CHANGED. |
| FORM 990, PART VI, LINE 13 | THE ORGANIZATION'S EMPLOYEE HANDBOOK STATES EMPLOYEES SHALL BE ALLOWED TO VOICE AN UNJUST SITUATION WITHOUT FEAR OF RECRIMINATION. |
| FORM 990, PART VI, LINE 16B | WHEN CORRY MEMORIAL HOSPITAL ASSOCIATION CONTEMPLATES ENTERING INTO A JOINT VENTURE WITH FOR PROFIT ORGANIZATIONS, IT ENGAGES LEGAL COUNSEL AND TAX COUNSEL TO ENSURE THAT THE TAX EXEMPT STATUS OF THE HEALTH CENTER IS SAFEGUARDED. |
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 |
|---|---|---|---|---|---|---|---|---|---|---|
| CORRY MEDICAL SERVICES | ||||||||||
| 965 SHAMROCK LANE | CORRY | PA | 16407 | 251425220 | HEALTH CARE | PA | 501(C)(3) | LINE 11A, I | CORRY MEMORIAL HOSPITAL ASSOCIATION | Yes (1) |
| CORRY MEMORIAL HOSPITAL FOUNDATION | ||||||||||
| 965 SHAMROCK LANE | CORRY | PA | 16407 | 208285800 | FUNDRAISING | PA | 501(C)(3) | LINE 11A, I | CORRY MEMORIAL HOSPITAL ASSOCIATION | Yes (1) |
| MILLCREEK HEALTH SYSTEM (MHS) | ||||||||||
| 5515 PEACH STREET | ERIE | PA | 16509 | 251766164 | PARENT CORPORATION | PA | 501(C)(3) | LINE 11C, III-FI | 0 | |
| MILLCREEK COMMUNITY HOSPITAL | ||||||||||
| 5515 PEACH STREET | ERIE | PA | 16509 | 251002937 | HOSPITAL | PA | 501(C)(3) | LINE 3 | MILLCREEK HEALTH SYSTEM | 0 |
| MILLCREEK MANOR | ||||||||||
| 5515 PEACH STREET | ERIE | PA | 16509 | 251619204 | LONG TERM CARE | PA | 501(C)(3) | LINE 3 | MILLCREEK HEALTH SYSTEM | 0 |
| MILLCREEK HEALTH SYSTEM MEDICAL PRO | ||||||||||
| 5515 PEACH STREET | ERIE | PA | 16507 | 576204119 | LIABILITY INSURANCE | PA | 501(C)(3) | LINE 11C, III-FI | 0 | |
| MEDICAL ASSOCIATES OF ERIE | ||||||||||
| ONE LECOM PLACE | ERIE | PA | 16509 | 113716896 | PHYSICIAN MANAGEMENT | PA | 501(C)(3) | LINE 9 | MILLCREEK HEALTH SYSTEM | 0 |
| ERIE CENTER ON HEALTH AND AGING | ||||||||||
| 406 PEACH STREET | ERIE | PA | 16509 | 251361363 | SENIOR HEALTH | PA | 501(C)(3) | LINE 7 | MILLCREEK HEALTH SYSTEM | 0 |
| LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE | ||||||||||
| 1858 W GRANDVIEW BLVD | ERIE | PA | 16509 | 251698677 | MEDICAL SCHOOL | PA | 501(C)(3) | LINE 2 | MILLCREEK HEALTH SYSTEM | 0 |
| LECOM AT PRESQUE ISLE INC | ||||||||||
| 4114 SCHAPER AVE | ERIE | PA | 16508 | 475049201 | LONG TERM CARE | PA | 501(C)(3) | LINE 9 | MILLCREEK HEALTH SYSTEM | 0 |
| VISITING NURSE ASSOCIATION OF ERIE COUNTY | ||||||||||
| 2253 WEST GRANDVIEW BOULEVARD | ERIE | PA | 16506 | 250969488 | HOME HEALTH | PA | 501(C)(3) | LINE 7 | MILLCREEK HEALTH SYSTEM (MHS) | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CORRY HEALTH SERVICES INC | ||||||||||||
| 965 SHAMROCK LANE | CORRY | PA | 16407 | 251488214 | HEALTH CARE | PA | CORRY MEMORIAL HOSPITAL ASSOCIATION | C | $53,457 | $781,333 | 1.00000 | Yes (1) |
| MCH CORPORATION | ||||||||||||
| 5515 PEACH STREET | ERIE | PA | 16509 | 251549695 | REAL ESTATE | PA | C | 0 | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt |
|---|---|
| CORRY HEALTH SERVICES INC | |
| R | $40,000 |
| CORRY MEDICAL SERVICES | |
| S | $1,215,000 |