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DUBOIS REGIONAL MEDICAL CENTER: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
DUBOIS REGIONAL MEDICAL CENTER (EIN 25-1490707)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-13
IRS object ID
201431339349300913
Schema version
2012v2.0
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-05-13T06:07:48-07:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Catalano Case Catalano & FanninBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11773 Kiwanis Trail / PO Box 46AddressLine1
CityDuboisCity
StatePAState
ZIP Code15801ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN251490707EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1DuBois Regional Medical CenterBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlDUBONameControl
Phone8143756105Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 447AddressLine1
CityDuBoisCity
StatePAState
ZIP Code15801ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJohn SutikaName
TitlePresidentTitle
Date Signed2014-05-13DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameW CRAIG CASE JRName
PTINP00232174PTIN
Phone8143713000Phone
Self EmployedXSelfEmployed
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts233982910GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web Sitewww.drmc.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1985YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionDuBois Regional Medical Center offers residents of West Central Pennsylvania a rare combination of advanced healthcare in a warm, friendly environment. DRMC is an oasis of clinical and technical excellence, with a focus on patient-centered care. See Statement of Community Benefit.ActivityOrMissionDescription
Nbr Voting Members Governing Body19NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees1951TotalNbrEmployees
Total Nbr Volunteers246TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year624822ContributionsGrantsPriorYear
Contributions Grants Current Year215183ContributionsGrantsCurrentYear
Program Service Revenue Prior Year211432640ProgramServiceRevenuePriorYear
Program Service Revenue CY224465191ProgramServiceRevenueCY
Investment Income Prior Year2400893InvestmentIncomePriorYear
Investment Income Current Year1800901InvestmentIncomeCurrentYear
Other Revenue Prior Year7244872OtherRevenuePriorYear
Other Revenue Current Year3882594OtherRevenueCurrentYear
Total Revenue Prior Year221703227TotalRevenuePriorYear
Total Revenue Current Year230363869TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year135105651SalariesEtcPriorYear
Salaries Etc Current Year134727035SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year165807TotalFundrsngExpCurrentYear
Other Expense Prior Year87734090OtherExpensePriorYear
Other Expenses Current Year97177261OtherExpensesCurrentYear
Total Expenses Prior Year222839741TotalExpensesPriorYear
Total Expenses Current Year231904296TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-1136514RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1540427RevenuesLessExpensesCY
Total Assets BOY213226338TotalAssetsBOY
Total Assets EOY222847152TotalAssetsEOY
Total Liabilities BOY67255398TotalLiabilitiesBOY
Total Liabilities EOY74826495TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY145970940NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY148020657NetAssetsOrFundBalancesEOY
Mission DescriptionDuBois Regional Medical Center offers residents of West Central Pennsylvania a rare combination of advanced healthcare in a warm, friendly environment. DRMC is an oasis of clinical and technical excellence, with a focus on patient-centered care. See Statement of Community Benefit.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense203061769Expense
Revenue230363869Revenue
DescriptionDuBois Regional Medical Center provides a variety of comprehensive inpatient care and outpatient medical services to the residents of West Central Pennsylvania. The facility is licensed for 221 beds. In fiscal year 2011, DRMC served 9,409 inpatients with a total of 39,361 inpatient days and provided more than 482,013 outpatients visits. In addition to direct medical services, the hospital also provides other medical programs to the community including community outreach programs, clinics, support groups, education programs, health fairs and health screenings.Description
Total Program Service Expense203061769TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096170NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1951NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionstrueQuidProQuoContributions
Quid Pro Quo DisclosuretrueQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members19NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledPAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonBrian Kline CFONamePerson
Telephone Number8143756377TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1100 Hospital AvenueAddressLine1
CityDUBOISCity
StatePAState
ZIP Code15801ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (32 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
William Young
Trustee1.000.00X000
Todd Stoltz
Trustee1.000.00X000
Dr Gary Ott
Trustee1.000.00X000
Dr Rajat Malik
Trustee40.000.00X587536020507
Dr Gregory Roscoe
Trustee1.000.00X000
Anita McDonald
Trustee1.000.00X000
Sister Mary Ann Bader
Foundation Mana1.000.00X000
Richard Pfingstler
Trustee1.000.00X000
Lisa M Zocco
Trustee0.000.00X000
Anthony Viglione
Trustee0.000.00X000
James E Devlin MD
Trustee1.000.00X000
Sister Mary Felice Duska
Trustee1.000.00X000
Sister Margaret Park
Trustee0.000.00X000
Gene Hoak
Trustee1.000.00X000
Dr Hazem F El Kassas MD
Trustee0.000.00X000
Nancy Micks
Secretary1.000.00X000
Dr Jonathan Pope
Trustee40.000.00X336200024700
Raymond A Graeca
President & CEO40.0040.00X0616106106276X
Edward S Nasuti
President1.000.00000X
Edward Yahner
Vice President1.000.00000X
James D Curtis
Treasurer1.000.00000X
John Sutika
President40.000.00324636038202X
Patricia Cressley
Vice President40.000.00277207033500X
Robert McKee
Vice President40.000.00198928030044X
Denise Lucas
Vice President40.000.0020174805359X
Dr Gary Dugan
Vice President40.000.00349049039593X
Janice Hamscher
Vice President40.000.00171874016332X
Dr Robert Armstrong
Physician40.000.00705261024936X
Dr Keith Zeliger
Physician40.000.00657741023525X
Dr Alexander Krot
Physician40.000.00655000022396X
Dr John Fabre
Physician40.000.00646239020318X
Dr Norman Hetzler
Physician40.000.00693811023716X
FieldValueIRS element (for citing)
Total Reportable Comp From Org5805230TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs616106TotalReportableCompFrmRltdOrgs
Total Other Compensation429404TotalOtherCompensation
Number Individuals GT100 K13NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Perfusion Professionals
101 Bradford RoadWexfordPA15090Perfusion Services813756
Linde Healthcare Staffing
PO Box 915214DallasTX75391Healthcare Staffing858613
Comphealth
PO Box 972651DallasTX75397Healthcare Staffing1437634
Associated Clinical Laboratories
1526 Peach StreetEriePA16501Lab Services1709993
Allied Resources Medical Staffing
135 Dowlin Forge RoadExtonPA19341Staffing Services993022
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Fundraising Events82063FundraisingEvents
All Other Contributions133120AllOtherContributions
Total Contributions215183TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
R&B, Ancillary IP165593031165593031
Other Program72143237214323
Contractual Adj-322012573-322012573
Ancillary OP & Physician373670410373670410
FieldValueIRS element (for citing)
Total Program Service Revenue224465191TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1610553TotalRevenueColumn
Exclusion$1,610,553ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real639156Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real639156Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column639156TotalRevenueColumn
Related Or Exempt Function Income639156RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities576213Securities
Other3205181Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities373347Securities
Other3217699Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities202866Securities
Other-12518Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column190348TotalRevenueColumn
Related Or Exempt Function Income190348RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Gross Income Fundraising Events22720GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events82063CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses27995FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-5275TotalRevenueColumn
Exclusion-$5,275ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Restricted Operating Re182313182313
Other Income16548141654814
Earnings from Affiliate14115861411586
FieldValueIRS element (for citing)
Total Other Revenue3248713TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column230363869TotalRevenueColumn
Related Or Exempt Function Income228543408RelatedOrExemptFunctionIncome
Exclusion$1,605,278ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1590212Total
Program Services687942ProgramServices
Management And General902270ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total109935480Total
Program Services96743222ProgramServices
Management And General13043968ManagementAndGeneral
Fundraising148290Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2700539Total
Program Services2376474ProgramServices
Management And General324065ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total13637804Total
Program Services12001268ProgramServices
Management And General1636536ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total6863000Total
Program Services6039440ProgramServices
Management And General823560ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total4232747Total
Program Services3724817ProgramServices
Management And General507930ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total180201Total
Management And General180201ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total103624Total
Management And General103624ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total60000Total
Management And General60000ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total11181567Total
Program Services9839779ProgramServices
Management And General1341788ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total506382Total
Program Services445616ProgramServices
Management And General60666ManagementAndGeneral
Fundraising100Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total986205Total
Program Services867860ProgramServices
Management And General116862ManagementAndGeneral
Fundraising1483Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total4084934Total
Program Services3594742ProgramServices
Management And General490192ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3694140Total
Program Services3250843ProgramServices
Management And General443297ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total381093Total
Program Services335362ProgramServices
Management And General45540ManagementAndGeneral
Fundraising191Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total393121Total
Program Services345946ProgramServices
Management And General46664ManagementAndGeneral
Fundraising511Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total1362418Total
Program Services1198928ProgramServices
Management And General163490ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total14017012Total
Program Services12334971ProgramServices
Management And General1682041ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total3460876Total
Program Services3045571ProgramServices
Management And General415305ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Maintenance Contracts1910813168151522927919
Bad Debt66572145858348798866
Purchased Services8018678705643794752914712
Supplies3436804130243876412409372

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1578195Total
Program Services1388812ProgramServices
Management And General188954ManagementAndGeneral
Fundraising429Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total231904296Total
Program Services203061769ProgramServices
Management And General28676720ManagementAndGeneral
Fundraising165807Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY3514239BOY
EOY1633087EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1019671BOY
EOY1047006EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY30367878BOY
EOY32676525EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2923553BOY
EOY3717326EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis231289763LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec128291695LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY104951853BOY
EOY102998068EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY51335463BOY
EOY55249876EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY19113681BOY
EOY25525264EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY213226338BOY
EOY222847152EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY23809549BOY
EOY25108977EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY1294812BOY
EOY1781591EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY34490435BOY
EOY30576851EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY5324552BOY
EOY15225920EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2336050BOY
EOY2133156EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY67255398BOY
EOY74826495EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY144699012BOY
EOY146674500EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1271928BOY
EOY1346157EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY145970940BOY
EOY148020657EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY213226338BOY
EOY222847152EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-1540427ReconcilationRevenueExpenses
Reconciliation Unrealized Invest3009681ReconciliationUnrealizedInvest
Reconcilation Other Changes580463ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Form4720 Filed4955 TaxfalseForm4720Filed4955Tax
Correction MadefalseCorrectionMade
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MemberstrueMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationstrueGrantsOtherOrganizations
Grants Other Organizations$60,000GrantsOtherOrganizationsAmount
Direct Contact LegislatorstrueDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB60000TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance41013BeginningOfYearBalance
Contributions6401Contributions
Investment Earnings Or Losses55InvestmentEarningsOrLosses
End Of Year Balance47469EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance38372BeginningOfYearBalance
Contributions2545Contributions
Investment Earnings Or Losses96InvestmentEarningsOrLosses
End Of Year Balance41013EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance36194BeginningOfYearBalance
Contributions1965Contributions
Investment Earnings Or Losses213InvestmentEarningsOrLosses
End Of Year Balance38372EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance33369BeginningOfYearBalance
Contributions2553Contributions
Investment Earnings Or Losses272InvestmentEarningsOrLosses
End Of Year Balance36194EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance31274BeginningOfYearBalance
Contributions1710Contributions
Investment Earnings Or Losses385InvestmentEarningsOrLosses
End Of Year Balance33369EndOfYearBalance
FieldValueIRS element (for citing)
Endowments Held By Unrelated OrgstrueEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis3758414OtherCostOrOtherBasis
Book Value3758414BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis125233671OtherCostOrOtherBasis
Depreciation60556728Depreciation
Book Value64676943BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis676118OtherCostOrOtherBasis
Depreciation423774Depreciation
Book Value252344BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis97298208OtherCostOrOtherBasis
Depreciation63977748Depreciation
Book Value33320460BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis4323352OtherCostOrOtherBasis
Depreciation3333445Depreciation
Book Value989907BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings102998068TotalOfBookValueLandBuildings

Other Assets OtherAssets (8 entries)

DescriptionDescriptionBook ValueBookValue
Pledged Guarantees - Workers Comp664
Other Assets1271860
Miscellaneous Receivables13660071
Investment in Affiliates4758129
Inventory for use2662277
Goodwill1350028
Deferred Financing15373
Deferred Pension Plan1806862
FieldValueIRS element (for citing)
Total Book Value Other Assets25525264TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionThird Party Rate Adj.&Compliance ReserveDescription
Amount$2,133,156Amount
FieldValueIRS element (for citing)
Total Of Amounts2133156TotalOfAmounts

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierPart V, Line 4Identifier
Return ReferencePart V, Line 4: Intended uses of the endowment fund.ReturnReference
ExplanationDRMC's Endowment Fund will be used for purchase of capital items used in patient care.Explanation

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Solicitation Of Non Govt GrantsXSolicitationOfNonGovtGrants
Solicitation Of Govt GrantsXSolicitationOfGovtGrants
Special Fundraising EventsXSpecialFundraisingEvents
Agreement Ref FundraisingfalseAgreementRefFundraising

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Golf TournamentNameOfEvent1
Gross Receipts Event1104783GrossReceiptsEvent1
Charitable Contributions Event182063CharitableContributionsEvent1
Gross Revenue Event122720GrossRevenueEvent1
Cash Prizes Event112973CashPrizesEvent1
Rent Facility Costs Event15812RentFacilityCostsEvent1
Food And Beverage Event19210FoodAndBeverageEvent1
Gross Receipts Total104783GrossReceiptsTotal
Charitable Contributions Total82063CharitableContributionsTotal
Gross Revenue Total Events22720GrossRevenueTotalEvents
Cash Prizes Total Events12973CashPrizesTotalEvents
Rent Facility Costs Total Events5812RentFacilityCostsTotalEvents
Food And Beverage Total Events9210FoodAndBeverageTotalEvents
Direct Expense Summary Events27995DirectExpenseSummaryEvents
Net Income Summary-5275NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CarefalseFPGReferenceDiscountedCare
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReportfalseAnnualCommunityBenefitReport
Report Publically AvailablefalseReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense2896868TotalCommunityBenefitExpense
Net Community Benefit Expense2896868NetCommunityBenefitExpense
Percent Of Total Expense0.01250PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense34728583TotalCommunityBenefitExpense
Direct Offsetting Revenue26774219DirectOffsettingRevenue
Net Community Benefit Expense7954364NetCommunityBenefitExpense
Percent Of Total Expense0.03430PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense37625451TotalCommunityBenefitExpense
Direct Offsetting Revenue26774219DirectOffsettingRevenue
Net Community Benefit Expense10851232NetCommunityBenefitExpense
Percent Of Total Expense0.04680PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense558470TotalCommunityBenefitExpense
Net Community Benefit Expense558470NetCommunityBenefitExpense
Percent Of Total Expense0.00240PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense841525TotalCommunityBenefitExpense
Net Community Benefit Expense841525NetCommunityBenefitExpense
Percent Of Total Expense0.00360PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense619379TotalCommunityBenefitExpense
Net Community Benefit Expense619379NetCommunityBenefitExpense
Percent Of Total Expense0.00270PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense63579TotalCommunityBenefitExpense
Net Community Benefit Expense63579NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense2082953TotalCommunityBenefitExpense
Net Community Benefit Expense2082953NetCommunityBenefitExpense
Percent Of Total Expense0.00900PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense39708404TotalCommunityBenefitExpense
Direct Offsetting Revenue26774219DirectOffsettingRevenue
Net Community Benefit Expense12934185NetCommunityBenefitExpense
Percent Of Total Expense0.05580PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$2,995,746BadDebtExpenseAmount
Amount Reimbursed By Medicare62501746AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare64128108CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-1626362MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
Kidney Care ServicesDuBois
Dialysis Services0.690000.31000
Kidney Care Services LLC
Dialysis Services0.740000.26000
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1DuBois Regional Medical CenterBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1100 Hospital AvenueAddressLine1
CityDuBoisCity
StatePAState
ZIP Code15801ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1DuBois Regional Medical CenterBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedtrueCHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into AccounttrueTakeIntoAccount
Other FacilitiesfalseOtherFacilities
CHNA Widely AvailabletrueCHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Include Operational PlansXIncludeOperationalPlans
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs AddressedtrueAllNeedsAddressed
Organization Incur Excise TaxfalseOrganizationIncurExciseTax
File Form4720 Report Excise TaxfalseFileForm4720ReportExciseTax
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent200.0000FPGFreePercent
Uses FPG DiscountedfalseUsesFPGDiscounted
Explains BasisfalseExplainsBasis
Explains Application MethodfalseExplainsApplicationMethod
Includes Publicity MeasuresfalseIncludesPublicityMeasures
Actions On NonpaymentfalseActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (9 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part VI - States Where Community Benefit Report FiledPA
Part VI - Explanation Of How Organization Furthers Its Exempt PurposeDuBois Regional Medical Center offers residents of West Central Pennsylvania a rare combination of advanced healthcare in a warm, friendly environment. Widely recognized as one of the leading health centers of its kind in the Commonwealth, DRMC is an oasis of clinical and technical excellence, with a focus on patient-centered care. Our combined vision is to be positioned as the premier provider of comprehensive, quality services to our broad region. Providing inpatient and outpatient hospital care represents the largest portion of these services. DRMC's mission in maintaining these services is accomplished by providing access to healthcare services for all, including individuals who are unable to pay for such services. DRMC has a tradition of serving the poor and underprivileged of the area by providing care, programs and services to enhance their quality of life. Beyond the inpatient and outpatient hospital care, there are many other ways in which DRMC and our employees serve our community every day. DRMC has an ongoing commitment to the communities it serves with a range of community outreach programs, such as clinics, support groups, educational programs, health fairs and health screenings. Our employees volunteer their time and talents to improve our community in many ways. In addition to giving to organizations, they provide information on health and safety to the community. They provide direct patient care on a volunteer basis at the local DuBois Free Clinic. The Clinic was established for low-income people who could not afford health insurance. The success and reputation of DRMC is a direct result of the dedicated efforts of our Board of Directors, Administration, Physicians and Staff. With the continued support of the DRMC family and the communities we serve, DRMC will remain a valuable resource to our area.
Part VI - Community InformationDRMC's 221 licensed beds are housed in two facilities two miles from one another in DuBois, a small town in West Central Pennsylvania. The combined tradition of providing high quality, compassionate care began with its predecessors, DuBois Hospital and Maple Avenue Hospital in 1897. In 1985, the two organizations joined to create DRMC, and since then, the medical center has grown for the benefit of the entire community. DRMC West, houses acute inpatient care and a full range of ancillary services. In addition DRMC offers access to primary and specialty care health centers in seven communities. DRMC's primary care physicians bring family health care close to home in Brockway, Curwensville, Force, Penn Township (Grampian), Reynoldsville, Sykesville, Punxsutawney, and multiple DuBois locations. As one of the largest private employers in Clearfield County, DRMC is a significant part of the area's economy. We take pride in the role we play in shaping the quality of life for residents of the communities we serve. We also believe that the population we serve is both very proud and greatful to have DRMC as their primary health care provider.
Part VI - Patient Education of Eligibility for AssistanceDRMC posts a "Notice of Charity Care" at all points of registration, including all employed physician practices. The "notices" include a statement as to the availability of charity care and how to apply. DRMC employs a Financial Counselor who meets individually with all inpatients admitted to the facility who indicate no health care coverage. The Financial Counselor interviews the patient, and if appropriate, discusses and educates the patient relative to Medical Assistance, Blue Chip and the hospital's charity care program. The Financial Counselor completes and/or assists the patient with the necessary applications, and follow-thru with the physician and the assigned County Board of Assistance caseworker. The Financial Counselor also contacts other patients with larger dollar account balances to discuss and educate the patient's need for financial assistance. Additionally, DuBois Regional Medical Center employs a credit/collections staff who also contact, educate and offer assistance to other patients with financial need to help with health care costs.
Part VI - Needs AssessmentA) The hospital collects data on an ongoing basis regarding patients who travel to outlying areas for services not offered by DRMC. Based on this data, services are added and/or improved upon in order to serve the needs of the community as effectively and efficiently as possible.B) DRMC routinely sends patient satisfaction surveys to those receiving medical services. These surveys allow patients to offer suggestions regarding how the hospital could better serve them as patients and the community as a whole.C) DRMC offers a variety of educational programs that allow employees to interact on a one-on-one basis with the residents of the community as a whole.D) The medical staff of the hospital consistently participates in research and continuing medical education. This knowledge allows the hospital to remain updated on the latest medical news and techniques in order to offer patients the highest and most innovative levels of care.E) DRMC hired an outside firm to assist with conducting a Community Health Needs Assessment (CHNA). The assessment took place between March and August, 2011. The contractor gathered secondary data in Clearfield and surrounding counties; conducted various focus groups with key audiences and users of healthcare/social services to identify areas for perspective improvement within the community. DRMC held a community retreat with community leaders to report and present the findings of the collection phase. The community leaders provided input to help determine and prioritize which issues needed to be addressed within the community. The contractor is currently in the process of developing a master plan of initiatives for DRMC to be posted to its web site.
Part V, Line 20d - Other Billing Determination of Individuals Without InsuranceA 25% discount is provided to uninsured patients not eligible for charity care to allow for a match to the 25% discount provided to the Intergroup/Vantage large multi-payer groups. These multi-payer groups are our Commercial Insurances taht are outside of a managed care contract. All uninsured patients receive this discount regardless of income. The only qualification is for the patient to be uninsured.In addition, a 40% discount is provided to uninsured and underinsured patients not eligible for charity care with a patient-pay balance exceeding 25% of the family's annual income. There are no income guidelines. Proof of income is requested only to verify that the patient-pay balance exceeds 25% of the family's annual income.Number of Hospital Faciltiy - 1
Part V, Line 3 - Account Input from Person Who Represent the CommunityIn order to complete the Community Health Needs Assessment, DuBois Regional Medical Center spoke to several community leaders including buisness owners, politicians and other government workers, hospital administraiton and personnel and others involved in the area's healthcare community. Several organizatons were invited to meet with the committe including Susan Ford from the county Drug and Alcohol Commission, Nanci Mattison from Catholic Charties, Robert Newell from the American Red Cross and Gene Kephert from Senclair Child Services, just to name a few.Number of Hospital Faciltiy - 1
Part III, Line 9b - Provisions On Collection Practices For Qualified PatientsThe hospital offers free charity care to those patients who qualify. A patient with family income at or below 200% of Schedule A of the poverty guidelines, or below this level due to medical indigency, is eligible to receive free medical services provided liquid assets are not in excess of $25,000. See (3) (below) "Patient Education of Eligibility for Assistance" for "Notice of Charity Care" policy.
Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used)A discount of 25% is extended to uninsured patients not qualifyig for charity care. Additionally, a 40% discount is offered to uninsured/under-insured patients who have a patient-pay balance exceeding 25% of the family annual income but are not eligible for charity care. A 60% discount is applied for patients with non-covered pharmacy expenses.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrg
Robert McKee
Vice President177493214351595714087228972
Raymond A Graeca
President & CEO488871113999132368402922247722382
Patricia Cressley
Vice President18605827866224061109431070763283
John Sutika
President2665734701837194100836283811045
Janice Hamscher
Vice President1461542572073089024188206
Dr Robert Armstrong
Physician5500001552611000014936730197
Dr Rajat Malik
Trustee5873082281000010507608043
Dr Norman Hetzler
Physician623361704501000013716717527
Dr Keith Zeliger
Physician628041297001000013525681266
Dr Jonathan Pope
Trustee261000752001000014700360900
Dr John Fabre
Physician6454398001000010318666557
Dr Gary Dugan
Vice President29698135033248491474438864217035
Dr Alexander Krot
Physician6550001000012396677396
Denise Lucas
Vice President19395677925359207107

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1Hospital Authority of CleBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN251718944IssuerEIN
CUSIP Number000000000CUSIPNumber
Date Issued2007-08-22DateIssued
Issue Price15000000IssuePrice
Description Of PurposeCapital PurchasesDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Amount Retired2282293AmountRetired
Total Proceeds15000000TotalProceeds
Capital Expenditures15000000CapitalExpenditures
Current RefundingfalseCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Any Research AgreementsfalseAnyResearchAgreements
Bond Iss Meet Prvt Security Pay TestfalseBondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed PropfalseChangeInUseBondFinancedProp
Non Qualified Bond Remed ProcdrstrueNonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledtrueForm8038TFiled
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC
Gross Proceeds InvestedfalseGrossProceedsInvested
Written Proc To Monitor ReqsfalseWrittenProcToMonitorReqs

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuer
Hospital Authority of City of DuBois
D2517189440000000002007-08-229205969Refinancingfalsefalse
Hospital Authority of City of DuBois
C2517189440000000002008-12-179770204Refinancingfalsefalse
Clearfield County Ind Dev Authority
B2514304760000000002007-08-225155433Refinancingfalsefalse
Hospital Authority of City of DuBois
A2517189440000000002007-08-229114708Refinancingfalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Bond ReferenceBondReferenceCdAmount RetiredAmountRetiredTotal ProceedsTotalProceedsCapital ExpendituresCapitalExpendituresCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
D228707292059699205969truefalsetruetrue
C620372797702049770204truefalsetruetrue
B476743751554335155433truefalsetruetrue
A238303191147089114708truefalsetruetrue

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
Dfalsefalsefalsefalsefalsefalsetrue
Cfalsefalsefalsefalsefalsefalsetrue
Bfalsefalsefalsefalsefalsefalsetrue
Afalsefalsefalsefalsefalsefalsetrue

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqsHedge TerminatedHedgeTerminated
Dtruefalsefalsefalsefalse
Ctruefalsefalsefalsefalse
Btruefalsefalsefalsefalse
Atruefalsefalsefalsefalsefalse

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (13 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
Megan Devlin
See Part V87360Compensationfalse
Lauren Dale
See Part V64947Compensationfalse
ClearJeff Primary Care
See Part V223740Guaranteed Paymentsfalse
Dr Nico Roscoe
See Part V66674Education Loan Pmtsfalse
Dr Brandon Roscoe
See Part V83239Education Loan Pmtsfalse
Andrew Sutika
See Part V95979Compensationfalse
Douglas Dale
See Part V28396Compensationfalse
Linda McKee
See Part V34918Compensationfalse
Jill Zimmerman
See Part V59205Compensationfalse
Michelle Sutika Bennett
See Part V115969Compensationfalse
Kristy Yount
See Part V79605Compensationfalse
Dr Steve Graeca
See Part V524727Compensationfalse
Women's Care of Western PA
See Part V1037846Payments for Servicesfalse

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
Explanation(1) Women's Care of Western PA is owned by Board Member, Dr. Gary Ott. $473,846 is payment for services and $600,000 is payment for the purchase of his physician practice.(2) Dr. Steven Graeca is the son of Raymond Graeca, the President of DRMC's parent company, Penn Highlands Healthcare. (3) Kristy Yount is the daughter of a DRMC Board member, Nancy Micks.(4) Michelle Bennett is the daughter of DRMC President, John Sutika.(5) Jill Zimmerman is the sister of a DRMC senior management member, Patricia Cressley.(6) Linda McKee is the wife of a DRMC senior management member, Bob McKee.(7) Doug Dale is a relative of DRMC President, John Sutika.(8) Andrew Sutika is the brother of a DRMC President, John Sutika.(9) Dr. Brandon Roscoe is the son of Board Member Dr. Gregory Roscoe.(10) Dr. Nicco Roscoe is the daughter-in-law of Board Member Dr. Gregory Roscoe(11) Clearfield Jefferson Primary Care Assoiciates is owned by Dr. Brandon and Dr. Nico Roscoe, family members of Board Memeber Dr. Gregory Roscoe.(12) Lauren Dale is a relative of DRMC's President, John Sutika.(13) Megan Devlin is a relative of Board Member, Dr. James Devlin.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VIIJohn Sutika, President and CEO and Patricia Cressley, CFO performed management services for Kidney Care Services, LLC and Kidney Care Services, DuBois, both of which are related entities. Each officer dedicates approximately one hour per week for each entity.
Other Changes In Net Assets Or Fund Balances - Other IncreasesOther = $580463Form 990, Part XI, Line 9
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableThe conflict of interest statement and other governing documents are available to the public at the public's request. They are located in a "Public Binder" in the administrative offices of DRMCForm 990, Part VI, Line 19
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesAn independant firm is hired to compare, review, and recommend all senior officers' compensation. The Board of Directors provides the final approval.Form 990, Part VI, Line 15b
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsYearly, Board members are required to complete a new conflict of interest statement. At any time, any Board member may question a possible conflict of interest and a thorough review would then be completed.Form 990, Part VI, Line 12c
Form 990, Part VI, Line 11b: Form 990 Review ProcessDRMC will be submitting the Form 990 to meet the May 15th deadline for filing. The complete Form 990 will be provided to the finance committee and board of directors at the May meetings which are on May 20 and 21. At that time, the committees will review the Form 990 and have an opportunity to discuss any information contained within the Form 990.Form 990, Part VI, Line 11b
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing BodyEffective October 1, 2011, PHH became the other body of DRMC. It holds certain reserved powers over DRMC, including the power to elect the directors of DRMC (other than ex-officio directors) from a panel of individuals submitted to PHH by DRMC's board and nominated by PHH's Governance/Nominating Committee. The Sisters of Mercy have a right to nominate up to three of its sisters to sit on the DRMC board of directors (subject to certain restrictions). PHH also has the power to remove directors.Form 990, Part VI, Line 7a

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Penn Highlands Healthcare
100 Hospital AvenueDuBoisPA15801320345810Hospital Mgmt ServicesPA501(c)(3)N/Afalse
Clearfield Hospital
809 Turnpike AveClearfieldPA16830250979346HospitalPA501(c)(3)truePenn Highlands Healthcare
Brookville Hospital
100 Hospital RoadBrookvillePA15825250984595HospitalPA501(c)(3)truePenn Highlands Healthcare
Nathan D Yingling Cancer Center
815 Doctors DriveClearfieldPA16830205114093Radiation/OncologyPA501(c)(3)trueClearfield Hospital and DRMC

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Share Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
Kidney Care Services DuBois LLC
635 Maple Ave Suite DDuBoisPA15801510644566DialysisPAna192081020866falsetrue0.72000
Kidney Care Services LLC
635 Maple Ave Suite DDuBoisPA15801510644566DialysisPAna-22517639531falsetrue0.69000

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipControlled OrgControlledOrg
DuBois Medical Risk Retention Group
PO BOX 447WashingtonDC20005200324622Insurance ServicesPAnaCorp265282391859931.00000false
DuBois Regional Medical Group
PO BOX 447DuBoisPA15801251856569Pediatric ServicesPAnaCorp-104865716421481.00000false
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiestrueReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (13 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
DuBois Medical Risk Retention Group
m1092263Cost
Kidney Care Services DuBois LLC
q49668Cost
Kidney Care Services DuBois LLC
m228600Cost
Kidney Care Services DuBois LLC
k77901Cost
Kidney Care Services DuBois LLC
a34355Cost
Kidney Care Services LLC
q74959Cost
Kidney Care Services LLC
a53692Cost
Clearfield Hospital
q5547104Cost
Clearfield Hospital
o802693Cost
Brookville Hospital
q493289Cost
Brookville Hospital
o1010586Cost
Brookville Hospital
k52370Cost
Brookville Hospital
j165253Cost