J C BLAIR MEMORIAL HOSPITAL: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- J C BLAIR MEMORIAL HOSPITAL (EIN 23-1352159)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-05-14
- IRS object ID
- 201521349349305437
- Schema version
- 2013v4.0
- 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 I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-05-14T14:26:29-05:00 | ReturnTs |
| Tax Period End | 2014-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390859910 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER TILLY VIRCHOW KRAUSE LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 COMMERCE PARK DRIVE SUITE 430 | AddressLine1 |
| City | WILLIAMSPORT | City |
| State | PA | State |
| ZIP Code | 17701 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 231352159 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JC BLAIR MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | JCBL | BusinessNameControlTxt |
| Phone | 8146432290 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1225 WARM SPRINGS AVENUE | AddressLine1 |
| City | HUNTINGDON | City |
| State | PA | State |
| ZIP Code | 16652 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DEBORAH SHUGHART | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 8146432290 | PhoneNum |
| Signature | 2015-05-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JULIUS C GREEN CPA JD | PreparerPersonNm |
| PTIN | P00350393 | PTIN |
| Phone | 5703236023 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JASON HAWKINS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1225 WARM SPRINGS AVENUE | AddressLine1 |
| City | HUNTINGDON | City |
| State | PA | State |
| ZIP Code | 16652 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $46,468,060 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.JCBLAIR.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1909 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | HEALTHCARE PROVIDER - NOT-FOR-PROFIT ACUTE CARE HOSPITAL | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 489 | TotalEmployeeCnt |
| Total Volunteers | 70 | TotalVolunteersCnt |
| Total Gross UBI | $1,240,803 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$457,215 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $335,492 | PYContributionsGrantsAmt |
| CY Contributions Grants | $107,370 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $38,043,469 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $37,397,461 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,513,414 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,956,235 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,872,436 | PYOtherRevenueAmt |
| CY Other Revenue | $4,588,211 | CYOtherRevenueAmt |
| PY Total Revenue | $42,764,811 | PYTotalRevenueAmt |
| CY Total Revenue | $44,049,277 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $167,973 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $171,787 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $23,933,071 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $24,357,432 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $16,247,210 | PYOtherExpensesAmt |
| CY Other Expenses | $18,128,210 | CYOtherExpensesAmt |
| PY Total Expenses | $40,348,254 | PYTotalExpensesAmt |
| CY Total Expenses | $42,657,429 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,416,557 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,391,848 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $40,701,660 | TotalAssetsBOYAmt |
| Total Assets EOY | $43,277,609 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $15,721,820 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $16,616,697 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $24,979,840 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $26,660,912 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | MISSION: J.C. BLAIR MEMORIAL HOSPITAL IS COMMITTED TO BEING THE PREMIER HEALTH RESOURCE FOR THE RESIDENTS OF HUNTINGDON COUNTY AND NEARBY COMMUNITIES AND STRIVES TO DELIVER THE BEST OUTCOME FOR EVERY PATIENT. VISION: TO BE A MODEL OF EXCELLENCE FOR THE PROVISION OF A COMPREHENSIVE RANGE OF HEALTHCARE AND WELLNESS SERVICES DESIGNED TO CONTINUALLY IMPROVE THE HEALTH STATUS AND QUALITY OF LIFE FOR THE RESIDENTS OF HUNTINGDON COUNTY AND NEARBY COMMUNITIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $32,796,268 | ExpenseAmt |
| Grant | $171,787 | GrantAmt |
| Revenue | $40,012,593 | RevenueAmt |
| Desc | J.C. BLAIR MEMORIAL HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES TO FURTHER THE HEALTH AND WELLNESS OF HUNTINGDON, PENNSYLVANIA AND SURROUNDING COMMUNITIES IN HUNTINGDON COUNTY, PENNSYLVANIA. IN FISCAL YEAR 2014, J.C. BLAIR MEMORIAL HOSPITAL PROVIDED THE COMMUNITY WITH CHARITY SERVICES AMOUNTING TO APPROXIMATELY $709,000. PATIENTS RECEIVE MEDICALLY NECESSARY SERVICES REGARDLESS OF ABILITY TO PAY. IN ADDITION, THE REIMBURSEMENT SHORTFALL FROM THE MEDICAID PROGRAM WAS OVER $1,251,000. THE HOSPITAL CONTRIBUTED OVER $1 MILLION IN COMMUNITY BENEFIT PROGRAMS THAT INCLUDED THOUSANDS OF HOURS OF VOLUNTEER SERVICE PROVIDING FREE EDUCATION AND SCREENING PROGRAMS, MENTORING FUTURE HEALTH CARE PROFESSIONALS, PROVIDING LEADERSHIP SERVICE TO COMMUNITY ORGANIZATIONS, AND CONTRIBUTING FINANCIAL AND IN-KIND SUPPORT TO A NUMBER OF LOCAL INITIATIVES. THESE PROGRAMS INCLUDED: FREE DIABETES SELF-MANAGEMENT CLASSES, SPONSORSHIP OF BLOODMOBILE DRIVES THROUGHOUT THE YEAR, FREE BREAST FEEDING EDUCATION AND CONSULTING FOR NEW MOTHERS, FREE NEWBORN SAFETY KITS, FREE YEAR-ROUND EDUCATIONAL PROGRAMS ON NUTRITION, HEART HEALTH, BREAST HEALTH, ETC., FREE OSTEOPOROSIS SCREENINGS, SPONSORSHIP OF FAMILY FITNESS EVENTS, PARTICIPATION IN NUMEROUS HEALTH FAIRS THROUGOUT THE COUNTY, AND WELLNESS CHECK COMPREHENSIVE BLOOD SCREENING AND HEALTH FAIRS. | Desc |
| Total Program Service Expenses | $32,796,268 | 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 | 0 | 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 | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| 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 | Yes (1) | 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 | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 42 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 489 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| 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 |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | 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 | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | 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 | 0 | InvestmentInJointVentureInd |
| 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 | DEBORAH SHUGHART CFO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8146438445 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1225 WARM SPRINGS AVENUE | AddressLine1 |
| City | HUNTINGDON | City |
| State | PA | State |
| ZIP Code | 16652 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 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 |
|---|---|---|---|---|---|---|---|---|
| FRANCES V VAUGHN | ||||||||
| CHAIR | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| FRED E PRICE | ||||||||
| VICE CHAIR | 1.00 | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| GARRY L POTE | ||||||||
| TREASURER | 1.00 | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JOSEPH A MASCIANGELO | ||||||||
| SECRETARY | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ELLEN F SLOAN | ||||||||
| ASSISTANT SECRETARY | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JOHN D COURSEN | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JAMES J LAKSO PHD | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| FRANK X DEMAR | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ARTHUR J DECAMP | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| A KEITH BLACK | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CHARLES R CRUIKSHANK | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JAMES E SCHALL MD | ||||||||
| VICE MEDICAL DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MARIA T PETTINGER MD | ||||||||
| DIRECTOR | 1.00 | 4.00 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT S RITCHEY | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN P THOMPSON | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MELANIE MACDONALD | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MOLLY M ETTINGER | ||||||||
| DIRECTOR/CHIEF OF STAFF | 1.00 | 40.00 | Yes (X) | $0 | $116,259 | $19,915 | ||
| LISA M MALLON | ||||||||
| CEO | 41.00 | 4.00 | Yes (X) | $214,847 | $0 | $16,619 | ||
| EDWARD M QUINN | ||||||||
| CFO | 41.00 | 4.00 | Yes (X) | $165,001 | $0 | $21,579 | ||
| JENNIFER E HOLT | ||||||||
| PHYSICIAN | 40.00 | $333,987 | $0 | $18,515 | Yes (X) | |||
| BREET L ACKER | ||||||||
| PHYSICIAN | 40.00 | $288,110 | $0 | $29,395 | Yes (X) | |||
| JOHN D ROTH | ||||||||
| PHYSICIAN | 40.00 | $265,426 | $0 | $30,536 | Yes (X) | |||
| ALFRED K SUTTON MD | ||||||||
| PHYSICIAN | 20.00 | 20.00 | $219,909 | $0 | $28,821 | Yes (X) | ||
| FRANK J HAMLETT | ||||||||
| PSYCHIATRIST | 40.00 | $219,632 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,706,912 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $116,259 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $165,380 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 13 | 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/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| AMERISOURCE BERGEN | |||||
| PO BOX 29808 | NEW YORK | NY | 100879808 | PHARMACY SERVICES | $1,445,584 |
| US FOODS INC | |||||
| PO BOX 641303 | PITTSBURGH | PA | 152641303 | DIETARY SERVICES | $598,155 |
| BENCHMARK THERAPIES | |||||
| PO BOX 870 | HUNTINGDON | PA | 16652 | THERAPY SERVICES | $504,152 |
| PYRAMID CONSTRUCTION | |||||
| 840 NORTH FRONT STREET | WORMLEYSBURG | PA | 17043 | CONSTRUCTION | $443,429 |
| MICHAEL D CESARE DO | |||||
| 7370 LOVELAND DRIVE | HUNTINGDON | PA | 16652 | ER DEPARTMENT SERVICES | $134,187 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $69,502 | RelatedOrganizationsAmt |
| Government Grants | $32,224 | GovernmentGrantsAmt |
| All Other Contributions | $5,644 | AllOtherContributionsAmt |
| Total Contributions | $107,370 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT REV | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $37,397,461 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $37,397,461 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $37,397,461 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $279,320 | TotalRevenueColumnAmt |
| Exclusion | $279,320 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $291,113 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $136,251 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $154,862 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $154,862 | TotalRevenueColumnAmt |
| Exclusion | $154,862 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,958,847 | SecuritiesAmt |
| Other | $600 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,274,238 | SecuritiesAmt |
| Other | $8,294 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,684,609 | SecuritiesAmt |
| Other | -$7,694 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,676,915 | TotalRevenueColumnAmt |
| Exclusion | $1,676,915 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| MEANINGFUL USE REVENUE | 900099 | $1,326,060 | $1,326,060 | |
| CRNA SERVICES | 623000 | $1,126,183 | $1,126,183 | |
| DIETARY SVCS REVENUE | 812900 | $973,063 | $973,063 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,008,043 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $162,889 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $267,740 | UnrelatedBusinessRevenueAmt |
| Exclusion | $577,414 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $4,433,349 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $44,049,277 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $40,012,593 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,240,803 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,688,511 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $171,787 | TotalAmt |
| Program Services | $171,787 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $594,864 | TotalAmt |
| Management And General | $594,864 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,440,463 | TotalAmt |
| Program Services | $13,607,171 | ProgramServicesAmt |
| Management And General | $4,833,292 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $853,465 | TotalAmt |
| Program Services | $610,057 | ProgramServicesAmt |
| Management And General | $243,408 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,124,740 | TotalAmt |
| Program Services | $2,233,564 | ProgramServicesAmt |
| Management And General | $891,176 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,343,900 | TotalAmt |
| Program Services | $949,211 | ProgramServicesAmt |
| Management And General | $394,689 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $218,243 | TotalAmt |
| Management And General | $218,243 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,170 | TotalAmt |
| Management And General | $95,170 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,680 | TotalAmt |
| Management And General | $4,680 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,089 | TotalAmt |
| Management And General | $93,089 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,920,849 | TotalAmt |
| Program Services | $2,007,358 | ProgramServicesAmt |
| Management And General | $913,491 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,472 | TotalAmt |
| Program Services | $601 | ProgramServicesAmt |
| Management And General | $102,871 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,053,393 | TotalAmt |
| Program Services | $1,512,858 | ProgramServicesAmt |
| Management And General | $540,535 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $222,598 | TotalAmt |
| Management And General | $222,598 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,854,714 | TotalAmt |
| Program Services | $1,854,714 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $107,501 | TotalAmt |
| Program Services | $26,960 | ProgramServicesAmt |
| Management And General | $80,541 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $125,803 | TotalAmt |
| Program Services | $125,803 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,232,146 | TotalAmt |
| Program Services | $1,232,146 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $629,791 | TotalAmt |
| Program Services | $629,791 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MED SUPPLIES & PHARMACY | $3,301,041 | $3,301,041 | |
| BAD DEBT | $2,476,996 | $2,476,996 | |
| REPAIRS & MAINTENANCE | $1,327,695 | $927,102 | $400,593 |
| FOOD | $671,360 | $646,897 | $24,463 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $689,669 | TotalAmt |
| Program Services | $482,211 | ProgramServicesAmt |
| Management And General | $207,458 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,657,429 | TotalAmt |
| Program Services | $32,796,268 | ProgramServicesAmt |
| Management And General | $9,861,161 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,400 | BOYAmt |
| EOY | $2,500 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,299,645 | BOYAmt |
| EOY | $2,733,179 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,265,399 | BOYAmt |
| EOY | $3,588,674 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $10,000 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $724,676 | BOYAmt |
| EOY | $619,524 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $338,852 | BOYAmt |
| EOY | $368,486 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $57,709,212 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $49,333,079 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,063,044 | BOYAmt |
| EOY | $8,376,133 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,184,557 | BOYAmt |
| EOY | $14,522,891 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,823,087 | BOYAmt |
| EOY | $13,056,222 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,701,660 | BOYAmt |
| EOY | $43,277,609 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,377,839 | BOYAmt |
| EOY | $5,616,723 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,447,628 | BOYAmt |
| EOY | $3,947,628 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,896,353 | BOYAmt |
| EOY | $7,052,346 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,721,820 | BOYAmt |
| EOY | $16,616,697 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,507,024 | BOYAmt |
| EOY | $23,897,371 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $749,277 | BOYAmt |
| EOY | $917,791 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,723,539 | BOYAmt |
| EOY | $1,845,750 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,979,840 | BOYAmt |
| EOY | $26,660,912 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,701,660 | BOYAmt |
| EOY | $43,277,609 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,391,848 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $219,816 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | $331,460 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$262,052 | OtherChangesInNetAssetsAmt |
| 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 | $4,680 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $4,680 | 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 | THE HOSPITAL IS A MEMBER OF THE HOSPITAL ASSOCIATION OF PENNSYLVANIA, HOSPITAL COUNCIL OF WESTERN PA AND THE AMERICAN HOSPITAL ASSOCIATION. AS SUCH, A PERCENTAGE OF DUES IS EXPENDED BY THOSE ORGANIZATIONS ON LOBBYING ACTIVITIES. IT IS ESTIMATED THAT $4,680 OF THE DUES PAID WAS USED BY THOSE ORGANIZATIONS FOR LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,707,837 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $137,913 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,845,750 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,652,503 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $55,334 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,707,837 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,662,208 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$9,705 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,652,503 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,534,994 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $127,214 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,662,208 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,486,749 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $48,245 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,534,994 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $518,428 | OtherCostOrOtherBasisAmt |
| Book Value | $518,428 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $23,024,756 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,293,652 | DepreciationAmt |
| Book Value | $3,731,104 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $32,701,987 | OtherCostOrOtherBasisAmt |
| Depreciation | $29,213,265 | DepreciationAmt |
| Book Value | $3,488,722 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,464,041 | OtherCostOrOtherBasisAmt |
| Depreciation | $826,162 | DepreciationAmt |
| Book Value | $637,879 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,376,133 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (7 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM AFFILIATES | $8,116,370 |
| BENEFICIAL INTEREST IN PERPETUAL TRUSTS | $1,731,799 |
| INSURANCE RECOVERIES RECEIVABLE | $1,099,043 |
| ASSETS RECEIVED UNDER REVOCABLE TRUST | $111,972 |
| DEFERRED FINANCING COSTS, NET | $184,306 |
| INTEREST IN NET ASSETS OF AFFILIATE | $708,135 |
| ACCRUED INTEREST AND OTHER RECEIVABLES | $1,104,597 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $13,056,222 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| ESTIMATED MEDICAL MALPRACTICE CLAIMS LIABILITY | $1,478,600 |
| ACCRUED PENSION COST | $4,617,423 |
| REFUNDABLE ADVANCE | $111,972 |
| OBLIGATIONS UNDER CAPITAL LEASE | $395,764 |
| THIRD-PARTY PAYOR SETTLEMENTS | $448,587 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $7,052,346 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $41,502,345 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $219,816 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$2,910,693 | OtherRevenueAmt |
| Revenue Not Reported | -$2,690,877 | RevenueNotReportedAmt |
| Revenue Subtotal | $44,193,222 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$143,945 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$143,945 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $44,049,277 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $40,152,733 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | -$27,700 | OtherExpensesIncludedAmt |
| Expenses Not Reported | -$27,700 | ExpensesNotReportedAmt |
| Expenses Subtotal | $40,180,433 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $2,476,996 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $2,476,996 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $42,657,429 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | J.C. BLAIR MEMORIAL HOSPITAL HAS RECORDED ON ITS BALANCE SHEET ITS INTEREST IN THE NET ASSETS OF THE J.C. BLAIR MEMORIAL HOSPITAL FOUNDATION. THAT AMOUNT IS REPORTED ABOVE AND CATEGORIZED AS A TERM ENDOWMENT. THE FOUNDATION TRANSFERS FUNDS RAISED TO THE HOSPITAL FOR THE PURCHASE OF EQUIPMENT AND BUILDING IMPROVEMENTS. FUNDS RAISED AND NOT YET TRANSFERRED ARE REPORTED AS INTEREST IN NET ASSETS OF THE FOUNDATION. |
| PART X, LINE 2: | THE HOSPITAL ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING 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 BEEN MET. MANAGEMENT HAS DETERMINED THAT THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2014 AND 2013. THE HOSPITAL'S FEDERAL EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURNS FOR THE YEARS ENDED PRIOR TO JUNE 30, 2011 NO LONGER REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE HOSPITAL'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN OPERATING EXPENSES. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | CHANGE IN PERMANENTLY RESTRICTED NET ASSETS 122,211. MINIMUM PENSION LIABILITY ADJUSTMENT -778,928. BAD DEBT EXPENSE NETTED ON FINANCIALS -2,476,996. CHANGE IN NET ASSETS OF FOUNDATION 223,020. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | RENTAL EXPENSE -136,251. LOSS ON SALE OF PPE REPORTED AS EXPENSE ON FINANCIALS -7,694. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSE 136,251. LOSS ON SALE OF PPE REPORTED AS EXPENSE ON FINANCIALS 7,694. FORGIVENESS OF DUE TO AFFILIATE NETTED AGAINST TRANSFERS ON FINANCIALS -171,645. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE NETTED ON FINANCIALS 2,476,996. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| 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 | $709,701 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $31,067 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $678,634 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01690 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,665,718 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,414,164 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,251,554 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03110 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,375,419 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,445,231 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,930,188 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04800 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $63,075 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $63,075 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00160 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $602,588 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $602,588 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01500 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $117,932 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $117,932 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00290 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $783,595 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $783,595 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01950 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,159,014 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,445,231 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,713,783 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06750 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $38,988 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $38,988 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,500 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,500 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,500 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,500 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $43,988 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $43,988 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $865,930 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $432,965 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $10,602,860 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $12,427,168 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,824,308 | 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 | JC BLAIR MEMORIAL HOSPITAL | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1225 WARM SPRINGS AVENUE | AddressLine1 |
| City | HUNTINGDON | City |
| State | PA | State |
| ZIP Code | 16652 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.JCBLAIR.ORG | WebsiteAddressTxt |
| State License | 101101 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | INPATIENT PSYCHIATRIC UNIT | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JC BLAIR MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| 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 |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.JCBLAIR.ORG/COMMUNITY | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | 0 | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Provided On Admission | Yes (X) | ProvidedOnAdmissionInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| 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 (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| J.C. BLAIR MEMORIAL HOSPITAL | PART V, SECTION B, LINE 3: A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED BY J.C. BLAIR MEMORIAL HOSPITAL WITH SUPPORT FROM THE HUNTINGDON COUNTY HEALTHY COMMUNITIES PARTNERSHIP AND ITS STEERING COMMITTEE. THE STEERING COMMITTEE WAS COMPRISED OF REPRESENTATIVES FROM VARIOUS HUNTINGDON COUNTY HEALTH AND HUMAN SERVICE ORGANIZATIONS AND INCLUDED:UNITED WAYJUNIATA COLLEGE COMMUNITY OUTREACH COORDINATORJUNIATA COLLEGE HEALTH MARKETING INTERNJUNIATA COLLEGE HEALTH COMMUNICATIONS INTERNJUNIATA COLLEGE HEALTH COMMUNICATIONS ADVISORJ.C. BLAIR COMMUNITY RELATIONS COORDINATOR AND HUNTINGDON COUNTY SAFE KIDS COORDINATORJ.C. BLAIR DIRECTOR OF COMMUNITY RELATIONSTRI-COUNTY DRUG & ALCOHOL COMMISSIONCENTER FOR COMMUNITY ACTIONHUNTINGDON COUNTY CHILD AND ADULT DEVELOPMENT CORPORATIONJUNIATA COLLEGE INSTITUTIONAL RESEARCHJ.C. BLAIR BEHAVIORAL HEALTH SERVICESHUNTINGDON COUNTY DEPARTMENT OF HEALTH OFFICEJ.C. BLAIR COMMUNITY RELATIONS COORDINATORDIRECTOR OF HUNTINGDON COUNTY PLANNING & DEVELOPMENT OFFICEMAIN STREAM COUNSELINGCENTER FOR COMMUNITY ACTION |
| J.C. BLAIR MEMORIAL HOSPITAL | PART V, SECTION B, LINE 7: AS NOTED EARLIER IN THIS REPORT, J.C. BLAIR HAS SELECTED INITIATIVES AND STRATEGIES FOR THIS IMPLEMENTATION PLAN BASED ON THE HEALTH SYSTEM'S CAPACITY AND THE LIKELIHOOD OF SUCCESS. ANOTHER CONSIDERATION WAS WHETHER OR NOT OTHER AGENCIES IN THE COMMUNITY WERE BETTER SUITED AND ALREADY FOCUSED ON ADDRESSING IDENTIFIED ISSUES OR NEEDS.J.C. BLAIR WILL NOT DIRECTLY ADDRESS THE SOCIO-ECONOMIC NEEDS FOR JOBS, HIGHER INCOME, POST SECONDARY EDUCATION, OR TRANSPORTATION; HOWEVER, THESE NEEDS WILL BE AND ARE ALREADY THE FOCUS OF OTHER ORGANIZATIONS SUCH AS HUNTINGDON COUNTY BUSINESS AND INDUSTRY, HUNTINGDON COUNTY CHAMBER OF COMMERCE, HUNTINGDON CAREERLINK, AND OTHERS. J.C. BLAIR LEADERSHIP PARTICIPATES IN COMMUNITY BUILDING INITIATIVES WITH THESE ORGANIZATIONS AS BOARD AND COMMITTEE MEMBERS, AND THE HOSPITAL'S EDUCATION CENTER SERVES AS A HOST SITE FOR MANY EVENTS AND MEETINGS ADDRESSING THESE NEEDS. DENTAL HEALTH IS ANOTHER NEED IDENTIFIED THAT J.C. BLAIR WILL NOT DIRECTLY ADDRESS DUE TO THE HEALTH SYSTEM'S LIMITED CAPACITY TO ADDRESS THIS ISSUE. J.C. BLAIR WILL, HOWEVER, PARTICIPATE IN ANY COLLABORATIVE EFFORTS TO ADDRESS THIS NEED. |
| J.C. BLAIR MEMORIAL HOSPITAL | PART V, SECTION B, LINE 14G: FINANCIAL COUNSELORS DISCUSS THE AVAILABILITY OF DISCOUNTED AND CHARITY CARE INDIVIDUALLY WITH PATIENTS. |
| J.C. BLAIR MEMORIAL HOSPITAL | PART V, SECTION B, LINE 20D: INDIVIDUALS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY RECEIVE DISCOUNTED OR FREE CARE BASED UPON THE INDIVIDUAL'S CIRCUMSTANCES. |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | THE ORGANIZATION OFFERS A 20% DISCOUNT FOR PROMPT PAYMENT REGARDLESS OF INCOME. |
| PART I, LINE 6A: | J.C. BLAIR HEALTH SYSTEMS, INC., PARENT OF J.C. BLAIR MEMORIAL HOSPITAL, PRODUCES AN ANNUAL REPORT WHICH INCLUDES A REPORT OF COMMUNITY BENEFIT. THE REPORT HIGHLIGHTS THE COST OF CHARITY CARE AND THE SHORTFALL BETWEEN MEDICAL ASSISTANCE PAYMENTS AND THE COST OF CARE, AND THE VALUE OF THE COMMUNITY BENEFIT PROGRAMS CATEGORIZED AS REQUIRED IN THE 990 TAX RETURN. IT ALSO PROVIDES A NARRATIVE SECTION LISTING EXAMPLES OF THE EVENTS HOSPITAL LEADERSHIP, BOARD MEMBERS, MEDICAL STAFF AND EMPLOYEES PARTICIPATE IN OR SPONSOR. THE ANNUAL REPORT IS DISTRIBUTED AT AN ANNUAL PUBLIC MEETING, THROUGH THE MAIL, THROUGH THE HOSPITAL WEBSITE AND THROUGHOUT THE ORGANIZATION. |
| PART I, LINE 7: | THE HOSPITAL USES THE COST TO CHARGE RATIO TO DETERMINE COSTS. |
| PART I, LN 7 COL(F): | THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25 COLUMN (A) BUT SUBTRACTED OUT FOR PURPOSES OF CALCULATING THE PERCENTAGE ON SCH H, PART I, LINE 7, COLUMN (F) IS $2,476,996. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | MUCH OF THE BENEFIT TO THE COMMUNITY COMES FROM PARTICIPATION IN COLLABORATIVE EFFORTS THAT HELP TO ASSESS COMMUNITY NEED AND TO ADDRESS HEALTH ISSUES IN HUNTINGDON COUNTY. SOME OF THE DIRECT SERVICE ACTIVITIES INCLUDE FREE BREAST HEALTH AND HEART HEALTH SCREENINGS FOR WOMEN, SUPPORTED BY TWO GRANTS, FREE DIABETES SELF-MANAGEMENT CLASSES, EDUCATIONAL PROGRAMS, MENTORING FUTURE HEALTH CARE PROFESSIONALS THROUGH INTERNSHIPS AND STUDENT PRACTICUMS, PARTICIPATION IN HEALTH FAIRS, PATIENT ADVOCACY AND PROMOTION OF HEALTHY LIFESTYLES. INDIRECT SUPPORT OF THESE ACTIVITIES INCLUDE HOSPITAL STAFF AND MEDICAL STAFF MEMBERS SERVING IN LEADERSHIP AND WORKING ROLES ON BOARDS AND COMMITTEES THAT IMPACT THE HEALTH STATUS AND WELL-BEING OF COMMUNITY MEMBERS. |
| PART III, LINE 2: | THE AMOUNT OF BAD DEBT EXPENSE AT COST IS TAKEN FROM THE COST REPORT S-10 LINE 29. |
| PART III, LINE 3: | THE HOSPITAL ESTIMATES THAT APPROXIMATELY 50% OF THEIR BAD DEBT EXPENSE IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY FINANCIAL ASSISTANCE POLICY. THE HOSPITAL FEELS THIS SHOULD BE CONSIDERED COMMUNITY BENEFIT AS THEY ARE PROVIDING CARE TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. |
| PART III, LINE 4: | ACCOUNTS RECEIVABLE, PATIENTS, ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. THE ALLOWANCE FOR DOUBTFUL COLLECTIONS IS ESTIMATED BASED UPON A PERIODIC REVIEW OF THE ACCOUNTS RECEIVABLE AGING, PAYOR CLASSIFICATIONS, AND APPLICATION OF HISTORICAL WRITE-OFF PERCENTAGES.COST TO CHARGE RATIO FROM THE COST REPORT WAS USED TO ESTIMATE COSTS. DISCOUNTS AND PAYMENTS ON PATIENTS ACCOUNTS ARE NOT INCLUDED IN BAD DEBT EXPENSE. PAYMENTS MADE AFTER AN ACCOUNT HAS BEEN WRITTEN OFF TO BAD DEBT ARE TREATED AS RECOVERIES OF BAD DEBT AND ARE NETTED AGAINST BAD DEBTS. |
| PART III, LINE 8: | LINE 6 INCLUDES ALLOWABLE COSTS REPORTED ON THE COST REPORT FOR BOTH, PART A AND PART B. LINE 5 REVENUES REPORTED INCLUDE ALL NET REVENUES FOR MEDICARE, INCLUDING PART A AND PART B, AS REPORTED ON THE 2014 COST REPORT.THE HOSPITAL CENTER IS RECEIVING LESS THAN THE COST OF PROVIDING CARE TO PATIENTS THROUGH THE PROSPECTIVE PAYMENT SYSTEM. IN SPITE OF THIS, THE HOSPITAL IS STILL COMMITTED TO MEETING THE MEDICAL NEEDS OF THE COMMUNITY. THEREFORE, MEDICARE SHORTFALL SHOULD BE CONSIDERED COMMUNITY BENEFIT. |
| PART VI, LINE 2: | A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED BY J.C. BLAIR MEMORIAL HOSPITAL WITH SUPPORT FROM THE HUNTINGDON COUNTY HEALTHY COMMUNITIES PARTNERSHIP AND ITS STEERING COMMITTEE. THE STEERING COMMITTEE WAS COMPRISED OF REPRESENTATIVES FROM VARIOUS HUNTINGDON COUNTY HEALTH AND HUMAN SERVICE ORGANIZATIONS AND INCLUDED:KATHY ARMILLEI, UNITED WAYABBEY BAIRD, JUNIATA COLLEGE COMMUNITY OUTREACH COORDINATORTARA BLACK, JUNIATA COLLEGE HEALTH MARKETING INTERNSHELBY CASSELL, JUNIATA COLLEGE HEALTH COMMUNICATIONS INTERNGRACE FALA, JUNIATA COLLEGE HEALTH COMMUNICATIONS ADVISORSTACEY FREITAG, J.C. BLAIR COMMUNITY RELATIONS COORDINATOR AND HUNTINGDON COUNTY SAFE KIDS COORDINATORCHRIS GILDEA, J.C. BLAIR DIRECTOR OF COMMUNITY RELATIONSMARTHA LEISTER, TRI-COUNTY DRUG & ALCOHOL COMMISSIONWENDY MELIUS, CENTER FOR COMMUNITY ACTIONDANA PODRASKY, HUNTINGDON COUNTY CHILD AND ADULT DEVELOPMENT CORPORATIONCARLEE RANALLI, JUNIATA COLLEGE INSTITUTIONAL RESEARCHSHELLY RIVELLO, J.C. BLAIR BEHAVIORAL HEALTH SERVICESTAMMY SCHNARRS, HUNTINGDON COUNTY DEPARTMENT OF HEALTH OFFICEHOLLI SMITH, J.C. BLAIR COMMUNITY RELATIONS COORDINATORRICHARD STAHL, DIRECTOR OF HUNTINGDON COUNTY PLANNING & DEVELOPMENT OFFICEKELLY STATES, MAIN STREAM COUNSELINGCHRISTIE STEIDLE, MAIN STREAM COUNSELINGSTACEY TICE, CENTER FOR COMMUNITY ACTIONSEE ALSO SCHEDULE H PART V RESPONSES |
| PART VI, LINE 3: | IN ORDER TO BE ELIGIBLE FOR CHARITY CARE, A PATIENT WHO DOES NOT HAVE HEALTH INSURANCE MUST COMPLETE AN APPLICATION FOR MEDICAL ASSISTANCE AND BE DENIED COVERAGE. SUCH PATIENTS, DESIGNATED AS SELF-PAY, ARE OFFERED ASSISTANCE BY OUR SELF-PAY FINANCIAL COUNSELORS IN COMPLETING APPLICATIONS FOR MEDICAL ASSISTANCE. COUNSELORS FOLLOW UP WITH PATIENTS IF APPLICATIONS ARE NOT COMPLETED OR INFORMATION IS NOT RETURNED. THE HOSPITAL ALSO HAS ACCESS TO LIMITED FUNDS (THE INCOME FROM A TRUST WHICH HAS BEEN DESIGNATED TO BE USED FOR CHARITY CARE). APPLICANTS FOR CHARITY CARE ARE SCREENED FOR ELIGIBILITY FOR THIS PROGRAM. IN ADDITION, A RESTRICTED DONATION FROM A COMMUNITY MEMBER HAS PROVIDED FOR PAYMENT FOR HEALTH CARE SERVICES WHICH ARE NOT ELIGIBLE FOR ANY OTHER PROGRAMS OR INSURANCE COVERAGES. WHILE THE AMOUNT OF THAT GRANT WAS ONLY $10,000, IT HAS ALREADY PROVIDED COVERAGE FOR COSTS OF CARE FOR SEVERAL PATIENTS FOR NEEDED SERVICES. PATIENT BROCHURES ARE PROVIDED TO EXPLAIN THE AVAILABILITY OF ASSISTANCE AND CHARITY CARE PROGRAMS.THE FEDERAL POVERTY LEVEL GUIDELINES WITH OUR 200% MULTIPLIER ARE POSTED IN LOCATIONS FREQUENTED BY PATIENTS, SUCH AS THE EMERGENCY DEPARTMENT AND REGISTRATION AREAS. IF A PATIENT IS SELF PAY AT THE TIME OF REGISTRATION, THE REGISTRATION CLERK NOTIFIES A PATIENT FINANCIAL COUNSELOR AND PROVIDES THE PATIENT WITH A FINANCIAL ASSISTANCE PROGRAM LETTER. THE PROGRAM LETTER OFFERS A 20% SELF PAY DISCOUNT PROGRAM AND CHARITY CARE PROGRAM OUTLINE. PATIENT COUNSELORS ADVISE AND ASSIST WITH APPLICATION PROCESS. TO APPLY FOR CHARITY CARE, THE PATIENT MUST FIRST APPLY FOR MEDICAL ASSISTANCE. THIS PROCESS CAN TAKE UP TO 30 DAYS FOR MEDICAL ASSISTANCE APPROVAL OR DENIAL. IF MEDICAL ASSISTANCE COVERAGE IS DENIED, THE PATIENT IS ASKED TO CONTACT THE PATIENT COUNSELOR FOR ASSISTANCE WITH COMPLETING THE CHARITY CARE APPLICATION, OR TO HAVE THE APPLICATION MAILED OUT TO THE PATIENT. ONCE THE PATIENT IS DETERMINED TO BE ELIGIBLE, THE PATIENT IS ISSUED AN IDENTIFICATION CARD, WHICH THEY MAY PRESENT AT FUTURE VISITS TO VALIDATE THEY HAVE BEEN DETERMINED TO BE ELIGIBLE FOR CHARITY CARE. ELIGIBILITY MUST BE RENEWED EVERY SIX MONTHS. THE HOSPITAL IS CURRENTLY DEVELOPING A NEW BROCHURE WHICH DESCRIBES THE CHARITY PROGRAM ALONG WITH OTHER FINANCIAL POLICIES, SUCH AS PROMPT PAYMENT DISCOUNTS AND ELIGIBILITY FOR PAYMENT PLANS AND GRANT FUNDED CARE. |
| PART VI, LINE 4: | THE HOSPITAL SERVES THE RESIDENTS OF HUNTINGDON COUNTY AND IS THE ONLY HOSPITAL IN THE COUNTY. THE POPULATION IN THE COUNTY IS APPROXIMATELY 45,875, SPREAD ACROSS MANY SMALL BOROUGHS AND VILLAGES. THERE ARE A NUMBER OF AMISH AND MENNONITE SETTLEMENTS IN THE REGION. THE COMMUNITIES IN THE PRIMARY SERVICE AREA ARE HUNTINGDON, SMITHFIELD, MOUNT UNION, ALEXANDRIA, ORBISONIA, PETERSBURG, THREE SPRINGS, MAPLETON DEPOT, JAMES CREEK, MILL CREEK. A NUMBER OF SMALL COMMUNITIES MAKE UP THE SECONDARY SERVICE AREA. THE AREA IS RURAL. HUNTINGDON COUNTY IS IN THE 'RIDGE AND VALLEY' SECTION OF PENNSYLVANIA, WHICH MAKES FOR SMALL COMMUNITIES CONNECTED BY WINDING AND HILLY SECONDARY ROADS. DAIRY AND OTHER FARMING IS ALSO PREVALENT IN THE VALLEYS. ABOUT 12% OF THE POPULATION LIVES BELOW THE FEDERAL POVERTY LEVEL. AVERAGE PER CAPITA INCOME IS APPROXIMATELY $20,574 AND MEDIAN HOUSEHOLD INCOME IS ABOUT $43,026. 12.1% OF THE POPULATION IS UNINSURED. A FEW OF THE COMMUNITIES SERVED BY THE HOSPITAL ARE DESIGNATED AS MEDICALLY UNDERSERVED OR HEALTH PROFESSIONAL SERVICE AREAS, BUT THE BOROUGH OF HUNTINGDON, WHERE THE HOSPITAL IS LOCATED, IS NOT. |
| PART VI, LINE 5: | THE GOVERNING BODY IS REPRESENTATIVE OF THE COMMUNITIES IN THE PRIMARY AND SECONDARY SERVICE AREAS OF THE HOSPITAL. THE CHIEF AND VICE CHIEF OF THE MEDICAL STAFF ARE VOTING MEMBERS OF THE BOARD. EMPLOYEES ARE GENERALLY NOT ALLOWED TO SERVE AS VOTING MEMBERS OF THE BOARD, HOWEVER, ONE EMPLOYED PHYSICIAN SERVES AS VICE CHIEF OF THE MEDICAL STAFF AND IS A VOTING MEMBER BY VIRTUE OF THAT POSITION. MEMBERS OF THE MEDICAL STAFF WHO SERVE ON THE BOARD MAY HAVE CONTRACTUAL RELATIONSHIPS WITH THE HOSPITAL OR ITS AFFILIATES, WHICH THEY ARE REQUIRED TO DISCLOSE IN CONFLICT OF INTEREST STATEMENTS. ANY CONFLICTS THAT MEET THE REPORTING THRESHOLDS OF THE 990 ARE DULY REPORTED. MEDICAL STAFF PRIVILEGES ARE GRANTED THROUGH AN APPLICATION AND CREDENTIALING PROCESS AND ARE GRANTED IN ACCORDANCE WITH BYLAWS AND RULES AND REGULATIONS OF THE MEDICAL STAFF AND BOARD OF DIRECTORS. J.C. BLAIR MEMORIAL HOSPITAL IS A SMALL, RURAL HOSPITAL THAT IS NOT ENGAGED IN RESEARCH, BUT IT DOES ALLOCATE FUNDS ANNUALLY FOR THE UPGRADE OF PATIENT CARE EQUIPMENT AND FOR EXPENDITURES IN TECHNOLOGY OR FACILITES TO IMPROVE THE SAFETY AND CARE OF PATIENTS. RECENT EXAMPLES OF PURCHASES AND UPGRADES ARE A NEW DIGITAL MAMMOGRAPHY SYSTEM, ORTHOPEDIC SURGERY EQUIPMENT, STEREOTACTIC SPECIMEN IMAGING SYSTEM, AND A DIETARY TRAYLINE SYSTEM. RECENT TECHNOLOGY INVESTMENTS INCLUDE NURSING DOCUMENTATION, ELECTRONIC MEDICATION ADMINISTRATION RECORD AND BEDSIDE MEDICATION VERIFICATION. |
| PART VI, LINE 6: | J.C. BLAIR MEMORIAL HOSITAL IS PART OF J.C. BLAIR HEALTH SYSTEM, INC. THE HEALTH SYSTEM ALSO INCLUDES A FOUNDATION, WHICH RAISES FUNDS THROUGH DONATIONS AND GRANTS TO HELP THE HOSPITAL ACQUIRE NEEDED EQUIPMENT AND PROVIDE HEALTH AND PREVENTION PROGRAMMING, J.C BLAIR REHABILITATIVE SERVICES, INC. WHICH PARTICIPATES IN A JOINT VENTURE TO PROVIDE OUTPATIENT PHYSICAL AND OCCUPATIONAL THERAPY, AND J.C. BLAIR MEDICAL SERVICES, INC. WHICH HAS GROWN QUICKLY OVER THE PAST FEW YEARS OPERATING PHYSICIAN PRACTICES, ALLOWING FOR A TURN KEY SET UP THAT ENHANCES RECRUITMENT OF NEW PROVIDERS. THE COMPANIES WORK TOGETHER UNDER THE PARENT COMPANY UMBRELLA TO DELIVER HEALTH CARE SERVICES AND ACCOMPLISH THE VISION OF THE HEALTH SYSTEM: TO BE A MODEL OF EXCELLENCE FOR THE PROVISION OF A COMPREHENSIVE RANGE OF HEALTHCARE AND WELLNESS SERVICES DESIGNED TO CONTINUALLY IMPROVE THE HEALTH STATUS AND QUALITY OF LIFE FOR THE RESIDENTS OF HUNTINGDON COUNTY AND NEARBY COMMUNITIES.THE SYSTEM ENTERED INTO AN AFFILIATION WITH PINNACLE HEALTH SYSTEM ("PINNACLE") THROUGH A MEMBERSHIP INTEREST PURCHASE AGREEMENT (THE "AGREEMENT"), ON MAY 1, 2014. UNDER THE TERMS OF THE AGREEMENT, THIS AFFILIATION WILL, AMONG OTHER THINGS, (A) PROVIDE THE SYSTEM WITH ACCESS TO PINNACLE'S CLINICAL AND OPERATING CAPABILITIES, INCLUDING ACCESS TO MANAGEMENT AND LEADERSHIP, CONTRACTS FOR PROCUREMENT OF PHARMACEUTICAL SUPPLIES AND OTHER CORPORATE SUPPORT SERVICES; (B) ENSURE THE AVAILABILITY OF ADEQUATE PHYSICIAN AND OTHER HEALTH CARE PROFESSIONALS; (C) IMPLEMENT CLINICAL INTEGRATION INITIATIVES; AND (D) SUPPORT PROGRAMS TO HELP THE SYSTEM ACHIEVE FINANCIAL SUSTAINABLITIY. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | PA |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JC BLAIR MEMORIAL HOSPITAL FOUNDATION INC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 935 14TH STREET | AddressLine1 |
| City | HUNTINGDON | City |
| State | PA | State |
| ZIP Code | 16652 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 251881377 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $171,787 | CashGrantAmt |
| Valuation Method Used | CASH | ValuationMethodUsedDesc |
| Non Cash Assistance | N/A | NonCashAssistanceDesc |
| Purpose Of Grant | PROVIDE FINANCIAL SUPPORT FOR AFFILIATES | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | FUNDS ARE TRANSFERRED TO AN AFFILIATED ORGANIZATION WITH CONSISTENT MANAGEMENT AND USED TO FINANCIALLY SUPPORT THE FURTHERING OF THEIR EXEMPT PURPOSE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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 | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LISA M MALLON | ||||||||||||||
| CEO | $214,847 | $0 | $0 | $0 | $0 | $0 | $10,750 | $0 | $5,869 | $0 | $231,466 | $0 | $0 | $0 |
| EDWARD M QUINN | ||||||||||||||
| CFO | $165,001 | $0 | $0 | $0 | $0 | $0 | $8,250 | $0 | $13,329 | $0 | $186,580 | $0 | $0 | $0 |
| JENNIFER E HOLT | ||||||||||||||
| PHYSICIAN | $333,987 | $0 | $0 | $0 | $0 | $0 | $12,646 | $0 | $5,869 | $0 | $352,502 | $0 | $0 | $0 |
| BREET L ACKER | ||||||||||||||
| PHYSICIAN | $288,110 | $0 | $0 | $0 | $0 | $0 | $13,346 | $0 | $16,049 | $0 | $317,505 | $0 | $0 | $0 |
| JOHN D ROTH | ||||||||||||||
| PHYSICIAN | $265,426 | $0 | $0 | $0 | $0 | $0 | $14,487 | $0 | $16,049 | $0 | $295,962 | $0 | $0 | $0 |
| ALFRED K SUTTON MD | ||||||||||||||
| PHYSICIAN | $219,909 | $0 | $0 | $0 | $0 | $0 | $12,772 | $0 | $16,049 | $0 | $248,730 | $0 | $0 | $0 |
| FRANK J HAMLETT | ||||||||||||||
| PSYCHIATRIST | $219,632 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $219,632 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | FRED PRICE | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | BOARD OF DIRECTORS | RelationshipDescriptionTxt |
| Transaction | $32,042 | TransactionAmt |
| Transaction | SEE PART V | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: | FormAndLineReferenceDesc |
| Explanation | (A) NAME OF PERSON: FRED PRICE(D) DESCRIPTION OF TRANSACTION: MR. PRICE'S SISTER-IN-LAW IS EMPLOYED BY J.C. BLAIR MEDICAL SERVICES, A RELATED ORGANIZATION. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | JOHN COURSEN AND FRANCES VAUGHN ARE EMPLOYED BY THE SAME EMPLOYER, MUTUAL BENEFIT GROUP INSURANCE. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE 990 WAS REVIEWED IN DETAIL BY THE ACCOUNTING DEPARTMENT AND CFO. THE CFO ALSO PRESENTED THE 990 TO THE FINANCE COMMITTEE OF THE BOARD FOR THEIR REVIEW PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD MEMBERS COMPLETE A CONFLICT OF INTEREST STATEMENT ANNUALLY AND RETURN TO THE EXECUTIVE ASSISTANT WHO REVIEWS AND MONITORS COMPLIANCE WITH THE POLICY. BOARD MEMBERS ARE REQUIRED TO ABSTAIN FROM VOTING ON MATTERS THAT INVOLVE CONFLICTS. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION FOR THE CEO AND CFO WAS DETERMINED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS BASED ON SALARY MARKET DATA. IF THE EXECUTIVE IS ELIGIBLE FOR A PERFORMANCE BONUS, THE CRITERIA FOR DETERMINATION OF THE BONUS IS DEVELOPED BY ESTABLISHING OBJECTIVES AND MEASUREMENTS THAT WILL INDICATE THE DEGREE TO WHICH OBJECTIVES HAVE BEEN ACCOMPLISHED. APPROVAL IS DOCUMENTED VIA COMMITTEE MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | MINIMUM PENSION LIABILITY ADJUSTMENT -778,928. CHANGE IN PERMANENTLY RESTRICTED NET ASSETS 122,211. CHANGE IN NET ASSETS OF FOUNDATION 223,020. FORGIVENESS OF DUE TO AFFILIATE 171,645. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| JC BLAIR HEALTH SYSTEMS INC | |||||||||||
| 1225 WARM SPRINGS AVENUE | HUNTINGDON | PA | 16652 | 251881383 | PROVIDE SUPPORT TO RELATED ORGANIZATIONS | PA | 501(C)(3) | 11 TYPE 1 | N/A | 0 | |
| JC BLAIR MEDICAL SERVICES INC | |||||||||||
| 1225 WARM SPRINGS AVENUE | HUNTINGDON | PA | 16652 | 251881378 | PROVIDER OF HOSPITALIST SERVICES AND OPERATIONS OF PHYSICAN PRACTICES | PA | 501(C)(3) | 3 | 0 | JC BLAIR HEALTH SYSTEMS INC | |
| JC BLAIR MEMORIAL HOSPITAL FOUNDATION | |||||||||||
| 935 14TH STREET | HUNTINGDON | PA | 16652 | 231352159 | TO SUPPORT HEALTH CARE PROGRAMS OF THE HOSPTIAL | PA | 501(C)(3) | 11 TYPE 1 | 0 | JC BLAIR HEALTH SYSTEMS INC | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| JC BLAIR REAL ESTATE HOLDINGS | |||||||||
| 1226 WARM SPRINGS AVENUE | HUNTINGDON | PA | 16652 | 251881380 | REAL ESTATE HOLDING | PA | N/A | C | 0 |
| JC BLAIR REHABILITATION SERVICES INC | |||||||||
| 1226 WARM SPRINGS AVENUE | HUNTINGDON | PA | 16652 | 251881385 | REHABILITATION SERVICES | PA | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | 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 | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |