STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

MILLCREEK MANOR: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
MILLCREEK MANOR (EIN 25-1619204)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-14
IRS object ID
201341349349304359
Schema version
2011v1.5
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)
Timestamp2013-05-14T13:27:32-05:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN251690617EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1SCHAFFNER KNIGHT MINNAUGH & CO PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11001 STATE STREET SUITE 1300AddressLine1
CityERIECity
StatePAState
ZIP Code16501ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN251619204EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MILLCREEK MANORBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMILLNameControl
Phone8148644031Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line15515 PEACH STREETAddressLine1
CityERIECity
StatePAState
ZIP Code16509ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRICHARD P OLINGERName
TitleTREASURERTitle
Phone8148644031Phone
Date Signed2013-05-09DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameDENNIS W GROW CPAName
PTINP00190259PTIN
Phone8144541997Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDR JOHN M FERRETTI DONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line15515 PEACH STREETAddressLine1
CityERIECity
StatePAState
ZIP Code16509ZIPCode
FieldValueIRS element (for citing)
Gross Receipts3974517GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.MILLCREEKCOMMUNITYHOSPITAL.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1989YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE LONG TERM MEDICAL CARE TO THE COMMUNITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members4NbrIndependentVotingMembers
Total Nbr Employees92TotalNbrEmployees
Total Nbr Volunteers12TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year965ContributionsGrantsPriorYear
Contributions Grants Current Year605ContributionsGrantsCurrentYear
Program Service Revenue Prior Year3735790ProgramServiceRevenuePriorYear
Program Service Revenue CY3970533ProgramServiceRevenueCY
Investment Income Prior Year127InvestmentIncomePriorYear
Investment Income Current Year348InvestmentIncomeCurrentYear
Other Revenue Prior Year29585OtherRevenuePriorYear
Other Revenue Current Year3031OtherRevenueCurrentYear
Total Revenue Prior Year3766467TotalRevenuePriorYear
Total Revenue Current Year3974517TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year2007892SalariesEtcPriorYear
Salaries Etc Current Year2258216SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1150751OtherExpensePriorYear
Other Expenses Current Year1121491OtherExpensesCurrentYear
Total Expenses Prior Year3158643TotalExpensesPriorYear
Total Expenses Current Year3379707TotalExpensesCurrentYear
Revenues Less Expenses Prior Year607824RevenuesLessExpensesPriorYear
Revenues Less Expenses CY594810RevenuesLessExpensesCY
Total Assets BOY6170069TotalAssetsBOY
Total Assets EOY6704239TotalAssetsEOY
Total Liabilities BOY778551TotalLiabilitiesBOY
Total Liabilities EOY720611TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY5391518NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY5983628NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE LONG TERM MEDICAL CARE TO THE COMMUNITY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense2986381Expense
Revenue3970533Revenue
DescriptionMILLCREEK MANOR PROVIDES QUALITY LONG-TERM MEDICAL CARE TO INDIVIDUALS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAPS, AGE, OR ABILITY TO PAY. APPROXIMATELY 48 PERSONS A DAY BENEFITTED FROM THIS PROGRAM DURING THE FISCAL YEAR.Description
Total Program Service Expense2986381TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109614NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees92NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members4NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1RICHARD P OLINGER CFOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8148687767TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line15515 PEACH STREETAddressLine1
CityERIECity
StatePAState
ZIP Code16509ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (9 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
JOHN M FERRETTI DO
PRESIDENT5.00XX051377829347
MARY L ECKERT
SECRETARY1.00XX044888729159
RICHARD P OLINGER
TREASURER1.00XX041034134805
SILVIA M FERRETTI DO
TRUSTEE1.00X067411129635
VINCENT S FIERRO JR DO
TRUSTEE1.00X019500
ESTHER J FUCCI
TRUSTEE1.00X000
JOSEPH S KUJAWA
TRUSTEE1.00X000
JOYCE SAVOCCHIO
TRUSTEE1.00X000
JAMES Y LIN DO
TRUSTEE5.00X019921028751
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2248277TotalReportableCompFrmRltdOrgs
Total Other Compensation151697TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1CONCEPT REHAB INCBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line17150 GRANITE CIRCLEAddressLine1
CityTOLEDOCity
StateOHState
ZIP Code436173113ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesTHERAPY SERVICESDescriptionOfServices
Compensation241060Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
All Other Contributions605AllOtherContributions
Total Contributions605TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT REVENUEDescription
Business Code623000BusinessCode
Total Revenue Column3970533TotalRevenueColumn
Related Or Exempt Function Income3970533RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue3970533TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column348TotalRevenueColumn
Exclusion$348ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionOTHER REVENUEDescription
Business Code900099BusinessCode
Total Revenue Column3031TotalRevenueColumn
Exclusion$3,031ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue3031TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column3974517TotalRevenueColumn
Related Or Exempt Function Income3970533RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$3,379ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total1796885Total
Program Services1532824ProgramServices
Management And General264061ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total19025Total
Program Services16229ProgramServices
Management And General2796ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total308975Total
Program Services263570ProgramServices
Management And General45405ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total133331Total
Program Services113737ProgramServices
Management And General19594ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total47170Total
Management And General47170ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total482990Total
Program Services481762ProgramServices
Management And General1228ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total419Total
Program Services419ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total140541Total
Program Services129677ProgramServices
Management And General10864ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total33096Total
Program Services33096ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total18164Total
Program Services18164ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total136543Total
Program Services135538ProgramServices
Management And General1005ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total42624Total
Program Services42624ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
DIETARY/FOOD112423112423
PHARMACY DRUGS6348463484
REPAIRS AND MAINTENANCE3475834758
MEMBERSHIPS57695769

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total3510Total
Program Services2307ProgramServices
Management And General1203ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total3379707Total
Program Services2986381ProgramServices
Management And General393326ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2194102BOY
EOY2144051EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY7972BOY
EOY6079EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY558076BOY
EOY450094EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY7268BOY
EOY8528EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY29527BOY
EOY25063EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis4830283LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1271224LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY3073124BOY
EOY3559059EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY300000BOY
EOY511365EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY6170069BOY
EOY6704239EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY778551BOY
EOY720611EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY778551BOY
EOY720611EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY5384113BOY
EOY5976223EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY7405BOY
EOY7405EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY5391518BOY
EOY5983628EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY6170069BOY
EOY6704239EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses594810ReconcilationRevenueExpenses
Reconcilation Other Changes-2700ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited0FSAudited
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule D IRS990ScheduleD

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3704827OtherCostOrOtherBasis
Depreciation971092Depreciation
Book Value2733735BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis525496OtherCostOrOtherBasis
Depreciation285261Depreciation
Book Value240235BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis599960OtherCostOrOtherBasis
Depreciation14871Depreciation
Book Value585089BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings3559059TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
SELF-INSURED MALPRACTICE TRUST300000
ESCROW ACCOUNT211365
FieldValueIRS element (for citing)
Total Book Value Other Assets511365TotalBookValueOtherAssets

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
JOHN M FERRETTI DO
04936620002011601960009747054312500
MARY L ECKERT
04236030002528401960009559047804600
RICHARD P OLINGER
038314000027201015898018907044514600
SILVIA M FERRETTI DO
065525500018856019600010035070374600
JAMES Y LIN DO
019916100049013898014853022796100

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
Return ReferencePART IIIReturnReference
ExplanationSCHEDULE J, PART II, COLUMN F: IN ACCORDANCE WITH THE SCHEDULE J INSTRUCTIONS, COLUMN F REPRESENTS ANY PAYMENT REPORTED IN THE CURRENT YEAR'S COLUMN (B) TO THE EXTENT SUCH PAYMENT WAS ALREADY REPORTED AS COMPENSATION TO THE LISTED PERSON ON A PRIOR FORM 990.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1VANTAGEBusinessNameLine1
FieldValueIRS element (for citing)
RelationshipINDEPENDENT CONTRACTOR - SHARES ONE COMMON TRUSTEE WITH FILING ORGANIZATIONRelationship
Amount Of Transaction75719AmountOfTransaction
Description Of TransactionINDEPENDENT CONTRACTOR - SELLS MEDICAL SUPPLIES AND SERVICES TO THE FILING ORGANIZATIONDescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2DR. SILVIA M. FERRETTI, D.O. AND DR. JOHN M. FERRETTI, D.O. - FAMILY RELATIONSHIP
FORM 990, PART VI, SECTION A, LINE 6MILLCREEK HEALTH SYSTEM, THE FILING ORGANIZATION'S PARENT CORPORATION, IS THE SOLE MEMBER OF THE FILING ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7BMILLCREEK HEALTH SYSTEM IS THE PARENT ORGANIZATION OF MILLCREEK MANOR. IN ACCORDANCE WITH MILLCREEK HEALTH SYSTEM'S BY-LAWS, ITS BOARD OF TRUSTEES HAS THE RIGHT TO APPROVE ANY AND ALL TRANSACTIONS THAT CHANGE, OR HAVE THE EFFECT OF CHANGING, THE OWNERSHIP AND/OR CONTROL OF THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 11PRIOR TO FILING ITS FORM 990, THE ORGANIZATION PROVIDED ITS BOARD MEMBERS WITH ACCESS TO AN ELECTRONIC COPY OF THE TAX RETURN AND INVITED COMMENTS AND QUESTIONS FROM THE BOARD MEMBERS. PRIOR TO FILING FORM 990, MEMBERS OF THE ORGANIZATION'S FINANCIAL MANAGEMENT CONDUCTED A DETAILED REVIEW OF THE TAX FILING. THROUGHOUT THE REVIEW PROCESS, THERE WAS ONGOING DISCUSSION BETWEEN THE ORGANIZATION'S FINANCIAL MANAGEMENT AND THE TAX PREPARER.
FORM 990, PART VI, SECTION B, LINE 12CEACH MEMBER OF THE BOARD OF TRUSTEES IS REQUIRED TO COMPLETE A STANDARDIZED CONFLICT OF INTEREST FORM ON AN ANNUAL BASIS. ANY POTENTIAL CONFLICTS OF INTEREST ARE ADDRESSED BY AN APPOINTED COMMITTEE WHOSE MEMBERS ARE INDEPENDENT WITH REGARD TO THE MATTER BEING REVIEWED. IF A POTENTIAL CONFLICT OF INTEREST ARISES, IT IS REVIEWED AND DOCUMENTED BY THE APPOINTED COMMITTEE, AND THEN THE APPOINTED COMMITTEE REPORTS THE RESULTS OF ITS REVIEW TO THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION B, LINE 15THE SALARIES OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL AND CERTAIN MEMBERS OF ITS BOARD OF TRUSTEES ARE DETERMINED BY THE EMPLOYING ORGANIZATION'S BUDGET/FINANCE COMMITTEE, WHICH ALSO FUNCTIONS AS A COMPENSATION COMMITTEE.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, BY-LAWS AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC.
FORM 990, PART XI, LINE 5:CHANGE IN TEMPORARILY RESTRICTED ASSETS -2,700. TOTAL TO FORM 990, PART XI, LINE 5: -2,700.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART VII, SECTION ADR. JOHN M. FERRETTI, D.O.: LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE - 58 HOURS PER WEEK MILLCREEK COMMUNITY HOSPITAL - 10 HOURS PER WEEK MEDICAL ASSOCIATES OF ERIE - 5 HOURS PER WEEK MILLCREEK HEALTH SYSTEM - 1 HOUR PER WEEK MILLCREEK HEALTH SYSTEM MEDICAL PROFESSIONAL LIABILITY SELF-INSURANCE TRUST - 1 HOUR PER WEEK DR. SILVIA M. FERRETTI, D.O.: LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE - 75 HOURS PER WEEK MILLCREEK COMMUNITY HOSPITAL - 2 HOURS PER WEEK MEDICAL ASSOCIATES OF ERIE - 1 HOUR PER WEEK MILLCREEK HEALTH SYSTEM - 1 HOUR PER WEEK MARY L. ECKERT: LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE - 4 HOURS PER WEEK MILLCREEK COMMUNITY HOSPITAL - 72 HOURS PER WEEK MEDICAL ASSOCIATES OF ERIE - 1 HOUR PER WEEK MILLCREEK HEALTH SYSTEM - 1 HOUR PER WEEK MILLCREEK HEALTH SYSTEM MEDICAL PROFESSIONAL LIABILITY SELF-INSURANCE TRUST - 1 HOUR PER WEEK RICHARD P. OLINGER: LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE - 30 HOURS PER WEEK MILLCREEK COMMUNITY HOSPITAL - 31 HOURS PER WEEK MEDICAL ASSOCIATES OF ERIE - 1 HOUR PER WEEK MILLCREEK HEALTH SYSTEM - 1 HOUR PER WEEK MILLCREEK HEALTH SYSTEM MEDICAL PROFESSIONAL LIABILITY SELF-INSURANCE TRUST - 1 HOUR PER WEEK DR. JAMES LIN, D.O.: MILLCREEK COMMUNITY HOSPITAL - 6 HOURS PER WEEK MEDICAL ASSOCIATES OF ERIE - 45 HOURS PER WEEKESTIMATE OF AVERAGE HOURS PER WEEK DEVOTED TO A RELATED ORGANIZATION

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
MILLCREEK HEALTH SYSTEM
5515 PEACH STREETERIEPA16509251766164PARENT CORPORATIONPA501(C)(3)LINE 11C, III-FIN/A0
MILLCREEK COMMUNITY HOSPITAL
5515 PEACH STREETERIEPA16509251002937HOSPITALPA501(C)(3)LINE 30MILLCREEK HEALTH SYSTEM
LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE
5515 PEACH STREETERIEPA16509251698677MEDICAL SCHOOL AND SCHOOL OF PHARMACYPA501(C)(3)LINE 20MILLCREEK HEALTH SYSTEM
MILLCREEK HEALTH SYSTEM MEDICAL PROF LIABILITY SELF-INS TRUST
5515 PEACH STREETERIEPA16509576204119PROVIDE MANDATORY PROFESSIONAL LIABILITY COVERAGE TO AFFILIATED ORGSPA501(C)(3)LINE 11D, III-ON/A0
MEDICAL ASSOCIATES OF ERIE
ONE LECOM PLACEERIEPA16505113716896PHYSICIAN PRACTICE CORPORATIONPA501(C)(3)LINE 90MILLCREEK HEALTH SYSTEM

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1MCH CORPORATIONBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line15515 PEACH STREETAddressLine1
CityERIECity
StatePAState
ZIP Code16509ZIPCode
FieldValueIRS element (for citing)
EIN251549695EIN
Primary ActivityLESSOR OF REAL ESTATEPrimaryActivity
Legal Domicile StatePALegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityCTypeOfEntity
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
MILLCREEK COMMUNITY HOSPITAL
L339695ACTUAL COST OF SERVICES
MILLCREEK COMMUNITY HOSPITAL
O395087ACTUAL EXPENSES REIMBURSED
MILLCREEK COMMUNITY HOSPITAL
P47938ACTUAL EXPENSES REIMBURSED
LECOM
O46779ACTUAL EXPENSES REIMBURSED