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MILLCREEK MANOR: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
MILLCREEK MANOR (EIN 25-1619204)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-14
IRS object ID
201201359349303995
Schema version
2010v3.4
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)
Timestamp2012-05-14T13:48:45-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

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 Date2010-07-01TaxPeriodBeginDate

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 Signed2012-05-11DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMATTHEW J MINNAUGH CPAName
Phone8144541997Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
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 Receipts3766467GrossReceipts
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 Body10NbrVotingMembersGoverningBody
Nbr Independent Voting Members3NbrIndependentVotingMembers
Total Nbr Employees74TotalNbrEmployees
Total Nbr Volunteers12TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year550ContributionsGrantsPriorYear
Contributions Grants Current Year965ContributionsGrantsCurrentYear
Program Service Revenue Prior Year3681914ProgramServiceRevenuePriorYear
Program Service Revenue CY3735790ProgramServiceRevenueCY
Investment Income Prior Year136InvestmentIncomePriorYear
Investment Income Current Year127InvestmentIncomeCurrentYear
Other Revenue Prior Year1826OtherRevenuePriorYear
Other Revenue Current Year29585OtherRevenueCurrentYear
Total Revenue Prior Year3684426TotalRevenuePriorYear
Total Revenue Current Year3766467TotalRevenueCurrentYear
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 Year1974572SalariesEtcPriorYear
Salaries Etc Current Year2007892SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1259670OtherExpensePriorYear
Other Expenses Current Year1150751OtherExpensesCurrentYear
Total Expenses Prior Year3234242TotalExpensesPriorYear
Total Expenses Current Year3158643TotalExpensesCurrentYear
Revenues Less Expenses Prior Year450184RevenuesLessExpensesPriorYear
Revenues Less Expenses CY607824RevenuesLessExpensesCY
Total Assets BOY5748478TotalAssetsBOY
Total Assets EOY6170069TotalAssetsEOY
Total Liabilities BOY963730TotalLiabilitiesBOY
Total Liabilities EOY778551TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY4784748NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY5391518NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE LONG TERM MEDICAL CARE TO THE COMMUNITY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense2840720Expense
Revenue3735790Revenue
DescriptionMILLCREEK MANOR PROVIDES QUALITY LONG-TERM MEDICAL CARE TO INDIVIDUALS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAPS, AGE, OR ABILITY TO PAY. APPROXIMATELY 47 PERSONS A DAY BENEFITTED FROM THIS PROGRAM DURING THE FISCAL YEAR.Description
Total Program Service Expense2840720TotalProgramServiceExpense
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 Assets0ReportOtherAssets
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 With109611NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees74NumberOfEmployees
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 Members10NbrVotingGoverningBodyMembers
Number Independent Voting Members3NumberIndependentVotingMembers
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 (10 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
JOHN M FERRETTI DO
PRESIDENT5.00XX050173729168
MARY L ECKERT
SECRETARY1.00XX043127729123
RICHARD P OLINGER
TREASURER1.00XX039610135179
SILVIA M FERRETTI DO
TRUSTEE1.00X065812929168
VINCENT S FIERRO JR DO
TRUSTEE1.00X0100000
ESTHER J FUCCI
TRUSTEE1.00X000
JOSEPH S KUJAWA
TRUSTEE1.00X000
MICHAEL CLARK
TRUSTEE/ADMINISTRATOR40.00X05839017718
JOYCE SAVOCCHIO
TRUSTEE1.00X000
JAMES Y LIN DO
TRUSTEE5.00X022673527844
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2282369TotalReportableCompFrmRltdOrgs
Total Other Compensation168200TotalOtherCompensation
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
Compensation243290Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
All Other Contributions965AllOtherContributions
Total Contributions965TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT REVENUEDescription
Business Code623000BusinessCode
Total Revenue Column3735790TotalRevenueColumn
Related Or Exempt Function Income3735790RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue3735790TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column127TotalRevenueColumn
Exclusion$127ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionOTHER REVENUEDescription
Business Code900099BusinessCode
Total Revenue Column29585TotalRevenueColumn
Exclusion$29,585ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue29585TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column3766467TotalRevenueColumn
Related Or Exempt Function Income3735790RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$29,712ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total1629441Total
Program Services1406891ProgramServices
Management And General222550ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total13473Total
Program Services11633ProgramServices
Management And General1840ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total252225Total
Program Services217776ProgramServices
Management And General34449ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total112753Total
Program Services97353ProgramServices
Management And General15400ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total29553Total
Management And General29553ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total545607Total
Program Services543557ProgramServices
Management And General2050ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1841Total
Program Services1841ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total145803Total
Program Services135769ProgramServices
Management And General10034ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total38106Total
Program Services38106ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total755Total
Program Services755ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total133087Total
Program Services132014ProgramServices
Management And General1073ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total28650Total
Program Services28650ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
DIETARY/FOOD109414109414
PHARMACY DRUGS8446084460
REPAIRS AND MAINTENANCE2741327413
MEMBERSHIPS34223422
EDUCATION AND TRAINING15111511

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1129Total
Program Services155ProgramServices
Management And General974ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total3158643Total
Program Services2840720ProgramServices
Management And General317923ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1741674BOY
EOY2194102EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY9274BOY
EOY7972EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY448136BOY
EOY558076EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY7258BOY
EOY7268EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY45802BOY
EOY29527EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis4207805LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1134681LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY3196334BOY
EOY3073124EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY300000BOY
EOY300000EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY5748478BOY
EOY6170069EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY963730BOY
EOY778551EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY963730BOY
EOY778551EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY4776289BOY
EOY5384113EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY8459BOY
EOY7405EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY4784748BOY
EOY5391518EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY5748478BOY
EOY6170069EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses607824ReconcilationRevenueExpenses
Reconcilation Other Changes-1054ReconcilationOtherChanges
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
Depreciation871344Depreciation
Book Value2833483BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis461636OtherCostOrOtherBasis
Depreciation250428Depreciation
Book Value211208BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis41342OtherCostOrOtherBasis
Depreciation12909Depreciation
Book Value28433BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings3073124TotalOfBookValueLandBuildings

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
04816210002011601960009568053090500
MARY L ECKERT
04059780002529901960009523046040000
RICHARD P OLINGER
036696600029135016453018726043128000
SILVIA M FERRETTI DO
06392730001885601960009568068729700
JAMES Y LIN DO
022668600049014242013602025457900

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 Transaction71912AmountOfTransaction
Description Of TransactionINDEPENDENT CONTRACTOR - SELLS MEDICAL SUPPLIES AND SERVICES TO THE FILING ORGANIZATIONDescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
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 CORPORATION.
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.
EACH 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 12C
THE 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 B, LINE 15
THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, BY-LAWS AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:CHANGE IN TEMPORARILY RESTRICTED ASSETSFORM 990, PART XI, LINE 5:
ESTIMATE OF AVERAGE HOURS PER WEEK DEVOTED TO A RELATED ORGANIZATIONDR. 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 WEEKFORM 990, PART VII, SECTION A

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
L357498ACTUAL COST OF SERVICES
MILLCREEK COMMUNITY HOSPITAL
O397820ACTUAL EXPENSES REIMBURSED
MILLCREEK COMMUNITY HOSPITAL
P30184ACTUAL EXPENSES REIMBURSED
LECOM
O37492ACTUAL EXPENSES REIMBURSED