NORTHERN LANCASTER COUNTY MEDICAL GROUP: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- NORTHERN LANCASTER COUNTY MEDICAL GROUP (EIN 20-3033058)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-05-12
- IRS object ID
- 201121329349300302
- Schema version
- 2009v1.7
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-05-12T06:53:04-05:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ParenteBeard LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1650 Market Street Suite 4500 | AddressLine1 |
| City | Philadelphia | City |
| State | PA | State |
| ZIP Code | 19103 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 203033058 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northern Lancaster County Medical Group | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | NORT | NameControl |
| Phone | 7177386660 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 169 Martin Avenue PO Box 1002 | AddressLine1 |
| City | Ephrata | City |
| State | PA | State |
| ZIP Code | 17522 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | John A Holmes | Name |
| Title | CFO | Title |
| Phone | 7177386660 | Phone |
| Date Signed | 2011-05-10 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Julius Green CPA | Name |
| Phone | 2159720701 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Robert P Graupensperger | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 169 Martin Avenue PO Box 1002 | AddressLine1 |
| City | Ephrata | City |
| State | PA | State |
| ZIP Code | 17522 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 32408910 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.nlcmg.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2005 | YearFormation |
| State Legal Domicile | PA | StateLegalDomicile |
| Activity Or Mission Description | NON-PROFIT GROUP OF PHYSICIAN PRACTICES PROVIDING PREVENTIVE, PRIMARY CARE AND SPECIALTY SERVICES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 5 | NbrIndependentVotingMembers |
| Total Nbr Employees | 391 | TotalNbrEmployees |
| Total Nbr Volunteers | 10 | TotalNbrVolunteers |
| Total Gross UBI | 21260 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -10601 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Current Year | 6989993 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 25545161 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 25185549 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 9 | InvestmentIncomePriorYear |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 22287 | OtherRevenuePriorYear |
| Other Revenue Current Year | 233368 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 25567457 | TotalRevenuePriorYear |
| Total Revenue Current Year | 32408910 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 500 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 575 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 22875924 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 23090261 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 8316832 | OtherExpensePriorYear |
| Other Expenses Current Year | 8257309 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 31193256 | TotalExpensesPriorYear |
| Total Expenses Current Year | 31348145 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -5625799 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1060765 | RevenuesLessExpensesCY |
| Total Assets BOY | 4566753 | TotalAssetsBOY |
| Total Assets EOY | 5444881 | TotalAssetsEOY |
| Total Liabilities BOY | 14169113 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 13986476 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -9602360 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -8541595 | NetAssetsOrFundBalancesEOY |
| Mission Description | Our Mission is to provide quality, compassionate, and cost-effective healthcare in Lancaster County. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 29697404 | Expense |
| Grants | 575 | Grants |
| Revenue | 25249299 | Revenue |
| Description | The Northern Lancaster County Medical Group is a non-profit group of physician practices that provide preventive services, primary care as well as specialty services to the residents of northern Lancaster County and surrounding communities. Our staff includes physicians, physician assistants, nurse practitioners, certified nurse midwives, registered nurses as well as other professionals in 25 office locations across the community. In addition to the care provided in the office or hospital setting, Northern Lancaster County Medical Group providers also presented free health education programs, and offered free health screenings to community residents during the fiscal year that ended June 30, 2010. | Description |
| Total Program Service Expense | 29697404 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 34 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 391 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 5 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | PA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | John A Holmes CFO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7177386753 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 169 Martin Ave PO Box 1002 | AddressLine1 |
| City | Ephrata | City |
| State | PA | State |
| ZIP Code | 175221002 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (16 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| Fred Groff | |||||||
| Chairman | 2.00 | X | X | 0 | 0 | 0 | |
| Dean A Stoesz | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Il Jun Chon MD | |||||||
| Physician/Trustee | 40.00 | X | 0 | 298987 | 37359 | ||
| T Scott Jackson MD | |||||||
| Physician/Trustee | 20.00 | X | 94763 | 0 | 19681 | ||
| Stacie Marrie MD | |||||||
| Physician/Trustee | 28.00 | X | 73596 | 0 | 18168 | ||
| Madonna Talbert MD | |||||||
| Physician/Trustee | 40.00 | X | 228805 | 0 | 36029 | ||
| Kent C Trachte PhD | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Bruce Waskowicz MD | |||||||
| Physician/Trustee | 40.00 | X | 207136 | 0 | 35821 | ||
| Linda Weaver | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Paul M Zimmerman Jr | |||||||
| Secretary | 1.00 | X | X | 0 | 0 | 0 | |
| Cynthia Malizia | |||||||
| Vice President (thru 5/31/10) | 40.00 | X | X | 154822 | 0 | 33171 | |
| Williams C Piepgrass MD | |||||||
| Physician | 40.00 | 600080 | 0 | 37250 | X | ||
| John Joseph MD | |||||||
| Physician | 40.00 | 387798 | 0 | 37250 | X | ||
| Joseph J Irwin MD | |||||||
| Physician | 40.00 | 356222 | 0 | 41192 | X | ||
| Susan R Hovenden MD | |||||||
| Physician | 40.00 | 346461 | 0 | 36465 | X | ||
| John R Frederick MD | |||||||
| Physician | 40.00 | 342410 | 0 | 36639 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2792093 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 298987 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 369025 | TotalOtherCompensation |
| Number Individuals GT100 K | 43 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Weatherby Locums Inc | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 972633 | AddressLine1 |
| City | Dallas | City |
| State | TX | State |
| ZIP Code | 75397 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | Temporary Staffing | DescriptionOfServices |
| Compensation | 202132 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| Related Organizations | 6695993 | RelatedOrganizations |
| All Other Contributions | 294000 | AllOtherContributions |
| Total Contributions | 6989993 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Net patient service re | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 25185549 | TotalRevenueColumn |
| Related Or Exempt Function Income | 25185549 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 25185549 | TotalProgramServiceRevenue |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 15021 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 15021 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 15021 | TotalRevenueColumn |
| Exclusion | $15,021 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|---|
| Billing & Collection R | 561000 | 154597 | 21260 | $133,337 | |
| Miscellaneous Rev | 900099 | 63750 | 63750 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 218347 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 32408910 | TotalRevenueColumn |
| Related Or Exempt Function Income | 25249299 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 21260 | UnrelatedBusinessRevenue |
| Exclusion | $148,358 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 575 | Total |
| Program Services | 575 | ProgramServices |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 901992 | Total |
| Program Services | 713999 | ProgramServices |
| Management And General | 187993 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18978543 | Total |
| Program Services | 18423612 | ProgramServices |
| Management And General | 554931 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 887335 | Total |
| Program Services | 853311 | ProgramServices |
| Management And General | 34024 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1202780 | Total |
| Program Services | 1200789 | ProgramServices |
| Management And General | 1991 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1119611 | Total |
| Program Services | 1080265 | ProgramServices |
| Management And General | 39346 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21861 | Total |
| Management And General | 21861 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 143698 | Total |
| Management And General | 143698 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1104880 | Total |
| Program Services | 966222 | ProgramServices |
| Management And General | 138658 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 155617 | Total |
| Program Services | 142625 | ProgramServices |
| Management And General | 12992 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2173637 | Total |
| Program Services | 2109014 | ProgramServices |
| Management And General | 64623 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2105773 | Total |
| Program Services | 2076993 | ProgramServices |
| Management And General | 28780 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 171024 | Total |
| Program Services | 167091 | ProgramServices |
| Management And General | 3933 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14551 | Total |
| Program Services | 6989 | ProgramServices |
| Management And General | 7562 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27771 | Total |
| Management And General | 27771 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 500377 | Total |
| Program Services | 317753 | ProgramServices |
| Management And General | 182624 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 721458 | Total |
| Program Services | 692413 | ProgramServices |
| Management And General | 29045 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Bad Debt Expense | 581936 | 581936 | |
| Recruitment Expense | 174593 | 11295 | 163298 |
| Professional Developmen | 111851 | 111321 | 530 |
| Repairs & Maintenance | 100581 | 98028 | 2553 |
| Licenses & Dues | 85708 | 82863 | 2845 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 61993 | Total |
| Program Services | 60310 | ProgramServices |
| Management And General | 1683 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31348145 | Total |
| Program Services | 29697404 | ProgramServices |
| Management And General | 1650741 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3687 | BOY |
| EOY | 3687 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 109028 | BOY |
| EOY | 310445 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2053981 | BOY |
| EOY | 2763755 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 75210 | BOY |
| EOY | 58750 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20588 | BOY |
| EOY | 44132 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 4949602 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 3243844 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1668499 | BOY |
| EOY | 1705758 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 334735 | BOY |
| EOY | 432417 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 301025 | BOY |
| EOY | 125937 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4566753 | BOY |
| EOY | 5444881 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2794502 | BOY |
| EOY | 2627566 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 313713 | BOY |
| EOY | 254583 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11060898 | BOY |
| EOY | 11104327 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14169113 | BOY |
| EOY | 13986476 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -9602360 | BOY |
| EOY | -8835595 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 294000 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -9602360 | BOY |
| EOY | -8541595 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4566753 | BOY |
| EOY | 5444881 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type2 | X | SupportingOrg509a3Type2 |
| Certification Checkbox | X | CertificationCheckbox |
| Written IRS Determination | X | WrittenIRSDetermination |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Ephrata Community Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 231470484 | EIN |
| Type Of Organization | 3 | TypeOfOrganization |
| Listed In Governing Doc | 1 | ListedInGoverningDoc |
| Amount | $0 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 0 | SumOfAmounts |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 87842 | OtherCostOrOtherBasis |
| Book Value | 87842 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 509608 | OtherCostOrOtherBasis |
| Depreciation | 263548 | Depreciation |
| Book Value | 246060 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1103086 | OtherCostOrOtherBasis |
| Depreciation | 612331 | Depreciation |
| Book Value | 490755 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3133059 | OtherCostOrOtherBasis |
| Depreciation | 2340996 | Depreciation |
| Book Value | 792063 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 116007 | OtherCostOrOtherBasis |
| Depreciation | 26969 | Depreciation |
| Book Value | 89038 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 1705758 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| PENSION LIABILITY | $2,353,288 |
| Due to affiliate | $8,276,911 |
| Deferred Compensation | $429,128 |
| Estimated Third Party Payor Settlements | $45,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 11104327 | TotalOfAmounts |
| Total Revenue | 32408910 | TotalRevenue |
| Total Expenses | 31348145 | TotalExpenses |
| Excess Or Deficit For Year | 1060765 | ExcessOrDeficitForYear |
| Total Adjustments | 0 | TotalAdjustments |
| Excess Or Deficit Per FS | 1060765 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 32408910 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 32408910 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 32408910 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 31348145 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 31348145 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 31348145 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part X: | Identifier |
| Return Reference | Description of Uncertain Tax Positions Under FIN 48: | ReturnReference |
| Explanation | The organization accounts for uncertainty in income taxes recognized in its financial statements using a recognition threshold of more-likely-than-not to be sustained upon examination by the appropriate taxing authority. Measurement of the tax uncertainty occurs if the recognition threshold has been met. Management determined there were no tax uncertainties that met the recognition threshold in 2010 and 2009. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Il Jun Chon MD | |||||||||||||
| 0 | 280250 | 0 | 14387 | 0 | 4350 | 0 | 12359 | 0 | 25000 | 0 | 336346 | 0 | 0 |
| Madonna Talbert MD | |||||||||||||
| 200012 | 0 | 5000 | 0 | 23793 | 0 | 11029 | 0 | 25000 | 0 | 264834 | 0 | 0 | 0 |
| Bruce Waskowicz MD | |||||||||||||
| 178073 | 0 | 25045 | 0 | 4018 | 0 | 10821 | 0 | 25000 | 0 | 242957 | 0 | 0 | 0 |
| Cynthia Malizia | |||||||||||||
| 134822 | 0 | 20000 | 0 | 0 | 0 | 8171 | 0 | 25000 | 0 | 187993 | 0 | 0 | 0 |
| Williams C Piepgrass MD | |||||||||||||
| 593006 | 0 | 0 | 0 | 7074 | 0 | 12250 | 0 | 25000 | 0 | 637330 | 0 | 0 | 0 |
| John Joseph MD | |||||||||||||
| 328934 | 0 | 48000 | 0 | 10864 | 0 | 12250 | 0 | 25000 | 0 | 425048 | 0 | 0 | 0 |
| Joseph J Irwin MD | |||||||||||||
| 249956 | 0 | 106266 | 0 | 0 | 0 | 16192 | 0 | 25000 | 0 | 397414 | 0 | 0 | 0 |
| Susan R Hovenden MD | |||||||||||||
| 326502 | 0 | 19959 | 0 | 0 | 0 | 11465 | 0 | 25000 | 0 | 382926 | 0 | 0 | 0 |
| John R Frederick MD | |||||||||||||
| 327410 | 0 | 15000 | 0 | 0 | 0 | 11639 | 0 | 25000 | 0 | 379049 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | Part I, Line 7 | ReturnReference |
| Explanation | Non-fixed payments include bonuses which are determined based on individual contracts and may include factors such as productivity, coding accuracy, etc. | Explanation |
Schedule L IRS990ScheduleL
Loan Table LoanTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Madonna L Talbert MD | NamePerson |
| Purpose Of Loan | Employment Agreement-Amount will be forgiven after five years of employment | PurposeOfLoan |
| Loan From Organization | X | LoanFromOrganization |
| Original Principal | $90,000 | OriginalPrincipalAmount |
| Balance Due | 58750 | BalanceDue |
| Default | 0 | Default |
| Approved By Board | 1 | ApprovedByBoard |
| Written Agreement | 1 | WrittenAgreement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 58750 | TotalBalanceDue |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| FORM 990, PART V, LINE 2 | NUMBER OF EMPLOYEES REPORTED ON FORM W-3 | All individuals working at Northern Lancaster County Medical Group ("Medical Group") are employees of Ephrata Community Hospital ("Hospital") and are reported on its Form W-3 under EIN: 23-1370484. The salary and benefit expenses reported on Form 990, Part IX, are the Medical Group's allocated payroll costs based on time spent. The Hospital is an affiliated tax-exempt organization. |
| Form 990, Part VI, Section A, line 6 | Ephrata Community Hospital is the sole corporate member of Northern Lancaster County Medical Group. The Hospital is a related, tax-exempt organization. | |
| Form 990, Part VI, Section A, line 7a | Ephrata Community Hospital, as the sole corporate member, has the right to elect non-physician directors. One of the non-physician directors shall be the Hospital's Chairman of the Board. | |
| Form 990, Part VI, Section A, line 7b | Ephrata Community Hospital, as the sole corporate member, has the right to amend the Articles of Incorporation and the Bylaws of Northern Lancaster County Medical Group. The Board of Directors of Northern Lancaster County Medical Group may submit proposed amendments to the Hospital for approval. | |
| Form 990, Part VI, Section B, line 11 | The organization's Form 990 is reviewed with the Finance Committee after completion and filing due to the timing of the Committee's meeting and filing deadlines. | |
| Form 990, Part VI, Section B, line 12c | Board members, officers, and key employees review and sign the conflict of interest policy annually. The organization's legal department reviews the signed statements and addresses any potential or actual conflicts of interest. | |
| Form 990, Part VI, Section C, line 19 | The organization's governing documents, conflict of interest policy, and financial statements will be made available to the public upon request. The organization reserves the right to deny requests. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Ephrata Community Hospital | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 169 Martin Ave PO Box 1002 | AddressLine1 |
| City | Ephrata | City |
| State | PA | State |
| ZIP Code | 175221002 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 231470484 | EIN |
| Primary Activities | Hospital | PrimaryActivities |
| Legal Domicile State | PA | LegalDomicileState |
| Exempt Code Section | 501(c)(3) | ExemptCodeSection |
| Public Charity Status | Line 3 | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |