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MILLCREEK COMMUNITY HOSPITAL: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
MILLCREEK COMMUNITY HOSPITAL (EIN 25-1002937)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-16
IRS object ID
201121369349303202
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

FieldValueIRS element (for citing)
Timestamp2011-05-16T11:17:15-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

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 Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN251002937EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MILLCREEK COMMUNITY HOSPITALBusinessNameLine1
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 Signed2011-05-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameDENNIS W GROW CPAName
Phone8144541997Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMARY L ECKERTNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line15515 PEACH STREETAddressLine1
CityERIECity
StatePAState
ZIP Code16509ZIPCode
FieldValueIRS element (for citing)
Gross Receipts53079439GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.MILLCREEKCOMMUNITYHOSPITAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1948YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionTHE ORGANIZATION PROVIDES THE COMMUNITY WITH HEALTHCARE SERVICES AND EDUCATION.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees615TotalNbrEmployees
Total Nbr Volunteers13TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year365271ContributionsGrantsPriorYear
Contributions Grants Current Year351844ContributionsGrantsCurrentYear
Program Service Revenue Prior Year37134626ProgramServiceRevenuePriorYear
Program Service Revenue CY40370256ProgramServiceRevenueCY
Investment Income Prior Year5662InvestmentIncomePriorYear
Investment Income Current Year1396554InvestmentIncomeCurrentYear
Other Revenue Prior Year1694247OtherRevenuePriorYear
Other Revenue Current Year1762233OtherRevenueCurrentYear
Total Revenue Prior Year39199806TotalRevenuePriorYear
Total Revenue Current Year43880887TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year20061897SalariesEtcPriorYear
Salaries Etc Current Year19593218SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year18590532OtherExpensePriorYear
Other Expenses Current Year19327350OtherExpensesCurrentYear
Total Expenses Prior Year38652429TotalExpensesPriorYear
Total Expenses Current Year38920568TotalExpensesCurrentYear
Revenues Less Expenses Prior Year547377RevenuesLessExpensesPriorYear
Revenues Less Expenses CY4960319RevenuesLessExpensesCY
Total Assets BOY70060469TotalAssetsBOY
Total Assets EOY76728883TotalAssetsEOY
Total Liabilities BOY7002009TotalLiabilitiesBOY
Total Liabilities EOY7740058TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY63058460NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY68988825NetAssetsOrFundBalancesEOY
Mission DescriptionMILLCREEK COMMUNITY HOSPITAL PROVIDES QUALITY HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONALITY, ORIGIN, HANDICAPS, AGE OR ABILITY TO PAY. THE ORGANIZATION'S MISSION IS TO SERVE THE COMMUNITY BY PROVIDING HEALTHCARE SERVICES AND EDUCATION.MissionDescription
Significant New Program Services1SignificantNewProgramServices
Significant Change0SignificantChange
Expense9906320Expense
Grants0Grants
Revenue11786776Revenue
DescriptionACUTE INPATIENT CARE: MILLCREEK COMMUNITY HOSPITAL (THE HOSPITAL) IS A COMMUNITY BASED HOSPITAL PROVIDING QUALITY HEALTH CARE FOR PATIENTS WITH ILLNESSES, PROMOTING HEALING, AND IMPROVING THE QUALITY OF LIFE AT AFFORDABLE COST. THE HOSPITAL INPATIENT SERVICES INCLUDE, BUT ARE NOT LIMITED TO, SURGERY, RADIOLOGY, INTENSIVE CARE, PHYSICAL THERAPY, ENDOSCOPY, AND A CATH LAB. THE FACILITY HAS 64 BEDS ACCOMODATING THE WELLNESS OF THE COMMUNITY. FOR FISCAL YEAR ENDED JUNE 30, 2010, 9,166 PATIENT DAYS WERE PROVIDED. REFER TO SCHEDULE O FOR ADDITIONAL INFORMATION REGARDING ACUTE INPATIENT CARE.THE HOSPITAL DEMONSTRATES FISCAL RESPONSIBILITY BY PURSUING COST REIMBURSEMENT FOR THOSE PATIENTS WHO HAVE THE MEANS AND ABILITY TO PAY WHILE PROVIDING CARE FOR THOSE WHO LACK THE FINANCIAL RESOURCES TO PAY FOR SOME OR ALL OF THE COST. FOR THE FISCAL YEAR ENDED JUNE 30, 2010, 172 DAYS OF CHARITY CARE WERE PROVIDED AMOUNTING TO $661,530 OF FORGONE REVENUE AT A COST OF $220,087 TO THE HOSPITAL. BAD DEBT CHARGES INCLUDED IN ACUTE CARE - MEDICAL SURGICAL WERE $975,686 AT A COST OF $324,616 TO THE HOSPITAL. THE HOSPITAL ACTIVELY COMMITS TO ITS UNINSURED/UNDERINSURED AND CHARITY DISCOUNT POLICIES, AND IT DOES NOT DISCRIMINATE AGAINST THOSE INDIVIUDALS WHO ARE IN NEED OF FINANCIAL ASSISTANCE FROM THE FACILITY OR THOSE IN NEED OF GOVERNMENT ASSISTANCE.THE HOSPITAL'S COMMUNITY ACTIVITIES INCLUDED SEVERAL BLOOD PRESSURE SCREENING EVENTS HELD AT SENIOR DAY, THE ANNUAL CONSUMER FAIR, AND NATIONAL SENIOR HEALTH & FITNESS DAY. A BLOOD DRIVE IS CONDUCTED TWICE A YEAR TO ASSIST IN THE COMMUNITY NEED FOR BLOOD. THE HOSPITAL PARTICIPATES IN PREVENTIVE HEALTH EDUCATION CLASSES AND PROVIDES LITERATURE FOR HEALTHY LIVING. IN ADDITION, THE HOSPITAL PLAYS A PROACTIVE ROLE IN THE DISASTER/BIOTERRORISM PREPAREDNESS PROGRAM.FOR INDIVIDUALS NEEDING FINANCIAL ASSISTANCE, TRANSPORTATION IS PROVIDED TO THE HOSPITAL'S FACILITIES FOR PHYSICIAN VISITS EITHER BY THE HOSPITAL VAN, BUS TOKENS, OR A CAB. PRESCRIPTIONS AND CLOTHING ARE ALSO PROVIDED TO THOSE IN NEED.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense7582958Expense
Grants0Grants
Revenue8600346Revenue
DescriptionBEHAVIORAL UNIT CARE: IN 2001, A LARGE LOCAL BEHAVIORAL HEALTH INPATIENT PROVIDER ANNOUNCED THAT IS WAS DISCONTINUING ITS LINE OF SERVICE. A COMMUNITY TASK FORCE WAS FORMED TO ADDRESS THE VOID AND, AT THIS GROUP'S REQUEST, MILLCREEK COMMUNITY HOSPITAL FILLED A CRITICAL NEED FOR MENTAL HEALTH CARE FACILITIES IN THE AREA. TODAY, THE HOSPITAL'S BEHAVIORAL HEALTH OFFERINGS INCLUDE AN EIGHT BED DETOXIFICATION UNIT, 62 BEDS OF LICENSED ACUTE PSYCHIATRIC CARE, AND AN ACUTE ADULT PARTIAL HOSPITALIZATION PROGRAM. THE HOSPITAL'S CHILD/ADOLESCENT UNIT IS THE REGION'S ONLY SUCH BEHAVIORAL HEALTH ACUTE CARE FACILITY. REFER TO SCHEULDE O FOR ADDITIONAL INFORMATION REGARDING BEHAVIORAL CARE.FOR THE FISCAL YEAR ENDED JUNE 30, 2010, 2,027 DISCHARGES TOTALING 12,895 PATIENT DAYS WERE PROVIDED.THE HOSPITAL PURSUES COLLABORATION WITH THE ERIE HEALTH CARE AND HUMAN SERVICES COMMUNITY. THE HOSPITAL IS REPRESENTED ON MANY COUNTY-SPONSORED AND OTHER PLANNING COMMITTEES, AND IS PART OF INITIATIVES TO IMPROVE OUTCOMES FOR MUTUAL CLIENTS. THE HOSPITAL IS ALSO REPRESENTED AT COMMUNITY CLINICAL FORUMS TO PROVIDE EXPERT INFORMATION AND INPUT ON DIFFICULT SITUATIONS AND CASES. THE HOSPITAL HOSTS MEETINGS AT THE FACILITY IN ORDER TO IMPROVE CONTINUITY OF CARE; THESE MEETINGS ARE ATTENDED BY REPRESENTATIVES FROM MORE THAN TWENTY LOCAL SCHOOLS, SCHOOL DISTRICTS, AND SERVICE PROVIDERS. THE HOSPITAL ALSO WELCOMES REPRESENTATIVES FROM JUVENILE JUSTICE, THE OFFICE OF CHILDREN AND YOUTH, AND OTHER GOVERNMENTAL ORGANIZATIONS IN THE INTEREST OF IMPROVING THE LIVES OF ITS PATIENTS. wORKING AGREEMENTS ARE DEVELOPED WITH LOCAL SERVICE AGENCIES TO ALLOW BOTH PATIENTS AND RECEIVING PROVIDERS TO BE LINKED WITH EACH OTHER WHILE THE PATIENT IS AT THE HOSPITAL RECEIVING CARE.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense3846357Expense
Grants0Grants
Revenue3082882Revenue
DescriptionRESIDENT TRAINING:IN AN EFFORT TO ADDRESS THE CRITICAL SHORTAGE OF PHYSICIANS, MILLCREEK COMMUNITY HOSPITAL ACTS AS A TEACHING HOSPITAL AND OFFERS MORE PHYSICIAN RESIDENCY PROGRAMS THAN ANY OTHER HOSPITAL IN NORTHWESTERN PENNSYLVANIA. FOR THE FISCAL YEAR ENDED JUNE 30, 2010, THE HOSPTIAL UTILIZED 57 INTERNS ACROSS A WIDE RANGE OF MEDICAL CARE SPECIALTIES INCLUDING FAMILY PRACTICE, EAR/NOSE/THROAT, INTERNAL MEDICINE, OPHTHALMOLOGY, ORTHOPEDICS, PSYCHIATRY, GASTROINTESTINAL, PODIATRY, SPORTS MEDICINE, AND NEUROMUSCULOSKETAL MEDICINE.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense13421454Expense
Grants0Grants
Revenue17036921Revenue
DescriptionOTHER PROGRAM ACTIVITIES:OTHER PROGRAM ACTIVITIES INCLUDED 11,517 OUTPATIENT VISITS INCLUDING 919 OUTPATIENT SURGERIES, 14,839 EMERGENCY ROOM VISITS, 252 ADMISSIONS FOR 4,271 DAYS TO THE TRANSITIONAL CARE UNIT, 434 OBSTETRICAL DAYS, AND 732 ADMISSIONS FOR 2,425 DAYS TO THE DETOX UNIT.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp13421454TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev17036921TotalOfOtherProgramServiceRev
Total Program Service Expense34757089TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
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
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109671NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees615NumberOfEmployees
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
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
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
States Where Copy Of Return Is FiledPAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1RICHARD P OLINGERBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8148644031TelephoneNumber

Address US AddressUS

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

Form990 Part VII Section A Form990PartVIISectionA (18 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
MARY L ECKERT
PRESIDENT/CEO72.00XX432450385928905
RICHARD P OLINGER
CFO/TREASURER31.00XX21319819249834663
DR JOHN M FERRETTI DO
CHAIRMAN10.00XX047793029246
DR SILVIA M FERRETTI DO
TRUSTEE2.00X067514429246
MARIO EJ LANNI DSC
tRUSTEE1.00X000
NANCY Z O'NEILL
TRUSTEE1.00X000
MARK R RENDULIC
TRUSTEE1.00X000
JAMES A SCHAFFNER
SECRETARY1.00XX000
DALE P SPARBER
TRUSTEE1.00X000
WILLIAM F MCCARTHY
TRUSTEE1.00X000
RICHARD B SEAGER
TRUSTEE1.00X000
DR JOHN J KALATA DO
TRUSTEE/CHIEF OF STAFF7.00X3634600
DR RUSSELL REICHTER MD
RADIOLOGY DIRECTOR40.0018420104575X
DR PAUL A KOHUT DO
DIRECTOR OF EMERGENCY ROOM40.00271003027641X
THOMAS ZIEGLER MD
CLINICAL LAB PHYSICIAN40.00245602023637X
ELISEO ROQUIZ MD
ANETHESIOLOGIST40.00361077019868X
DR MARVIN WIELAND
RADIOLOGY ANESTHESIOLOGIST40.00337640011215X
willIAM SWAGLER III DO
EMERGENCY ROOM PHYSICIAN40.001182642907721889X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2199781TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1378508TotalReportableCompFrmRltdOrgs
Total Other Compensation230885TotalOtherCompensation
Number Individuals GT100 K13NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
AMERISOURCE BERGEN
PO BOX 959VALLEY FORGEPA19482PROFESSIONAL PHARMACEUTICAL SERVICES813425
CLINICAL PATHOLOGY INSTITUTE
1526 PEACH STREETERIEPA16501PROFESSIONAL PATHOLOGY SERVICES756999
OWENS & MINOR
PO BOX 360878PITTSBURGHPA152516878MEDICAL SURGICAL SUPPLIES659919
PRESQUE ISLE PSYCHIATRIC
2808 STATE STREETERIEPA16508PSYCHIATRIC AND BEHAVIORAL HEALTH SERVIC565852
HOSPITAL BUILDING AND EQUIPMENT
11330 OLIVE BLVDST LOUISMO63114PROFESSIONAL ENGINEERS AND CONTRACTORS523857
FieldValueIRS element (for citing)
Number Of Contractors GT100 K17NumberOfContractorsGT100K
Related Organizations5000RelatedOrganizations
Government Grants298921GovernmentGrants
All Other Contributions47923AllOtherContributions
Total Contributions351844TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT REVENUE9000993848724638487246
RESIDENT CONTRACT REV90009918830101883010
FieldValueIRS element (for citing)
Total Program Service Revenue40370256TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1032881TotalRevenueColumn
Exclusion$1,032,881ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real890892Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real83736Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real807156Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column807156TotalRevenueColumn
Exclusion$807,156ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities9478489Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities9114816Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities363673Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column363673TotalRevenueColumn
Exclusion$363,673ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
CAFETERIA REVENUE900099338436$338,436
MISCELLANEOUS REVENUE900099237329$237,329
SNACKBAR/ VEND MACH RE900099173620$173,620

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column205692TotalRevenueColumn
Related Or Exempt Function Income136669RelatedOrExemptFunctionIncome
Exclusion$69,023ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue955077TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column43880887TotalRevenueColumn
Related Or Exempt Function Income40506925RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$3,022,118ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total736962Total
Program Services545352ProgramServices
Management And General191610ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total15146508Total
Program Services13422857ProgramServices
Management And General1723651ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total442266Total
Program Services381221ProgramServices
Management And General61045ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2046426Total
Program Services1763963ProgramServices
Management And General282463ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1221056Total
Program Services1052516ProgramServices
Management And General168540ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total93675Total
Program Services83652ProgramServices
Management And General10023ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total34051Total
Management And General34051ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total83145Total
Management And General83145ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total167637Total
Management And General167637ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total4627802Total
Program Services4136765ProgramServices
Management And General491037ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total15863Total
Program Services14166ProgramServices
Management And General1697ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total3648440Total
Program Services3258057ProgramServices
Management And General390383ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total416874Total
Program Services372268ProgramServices
Management And General44606ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total678289Total
Program Services605712ProgramServices
Management And General72577ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total43718Total
Program Services39040ProgramServices
Management And General4678ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2117653Total
Program Services1891064ProgramServices
Management And General226589ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1341559Total
Program Services1248040ProgramServices
Management And General93519ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
provision for bad debt40805904080590
PHARMACY DRUGS730693730693
REPAIRS AND MAINTENANCE64690157768369218
MISCELLANEOUS25696522947027495
MRI EXPENSE188521188521

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total154974Total
Program Services135459ProgramServices
Management And General19515ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total38920568Total
Program Services34757089ProgramServices
Management And General4163479ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY4939627BOY
EOY2928743EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY5312728EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY4923073BOY
EOY4409323EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY739407BOY
EOY731802EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY557675BOY
EOY630043EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis57095243LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec21472186LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY35292622BOY
EOY35623057EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY14236688BOY
EOY16378309EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY917581BOY
EOY917581EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY8453796BOY
EOY9797297EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY70060469BOY
EOY76728883EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY3078630BOY
EOY3262971EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY57174BOY
EOY42259EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY3866205BOY
EOY4434828EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY7002009BOY
EOY7740058EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY63017876BOY
EOY68978825EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY40584BOY
EOY10000EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY63058460BOY
EOY68988825EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY70060469BOY
EOY76728883EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis8563271OtherCostOrOtherBasis
Book Value8563271BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis32345706OtherCostOrOtherBasis
Depreciation10069196Depreciation
Book Value22276510BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis15017761OtherCostOrOtherBasis
Depreciation11178261Depreciation
Book Value3839500BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1168505OtherCostOrOtherBasis
Depreciation224729Depreciation
Book Value943776BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings35623057TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
IRREVOCABLE SELF-INSURED TRUST FUND8493626
OTHER RECEIVABLES561738
DUE FROM AFFILIATES741933
FieldValueIRS element (for citing)
Total Book Value Other Assets9797297TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
ACCRUED MEDICAL MALPRACTICE$3,685,717
DUE TO THIRD PARTY PAYERS$749,111
FieldValueIRS element (for citing)
Total Of Amounts4434828TotalOfAmounts
Total Revenue43880887TotalRevenue
Total Expenses38920568TotalExpenses
Excess Or Deficit For Year4960319ExcessOrDeficitForYear
Net Unrealized GL On Investments1500630NetUnrealizedGLOnInvestments
Other-$530,584OtherAmount
Total Adjustments970046TotalAdjustments
Excess Or Deficit Per FS5930365ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt45297616TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments1500630NetUnrealizedGainsInvestments
Revenue Not Rptd F9901500630RevenueNotRptdF990
Revenue Subtotal43796986RevenueSubtotal
Other Revenues Not Included83901OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt83901RevenueNotRptdOnFinStmt
Total Revenue Per Form99043880887TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt38836667TotExpensesEtcAuditedFinclStmt
Other Expenses Included83736OtherExpensesIncluded
Expenses Not Rptd F99083736ExpensesNotRptdF990
Expenses Subtotal38752931ExpensesSubtotal
Other Expenses Not Included167637OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt167637ExpensesNotRptdOnFinStmt
Total Expenses Per Form99038920568TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part X:Description of Uncertain Tax Positions Under FIN 48:THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AND IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED. THE HOSPITAL ADOPTED THE STANDARD FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S FINANCIAL STATEMENTS THE PRESCRIBES 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 NOT BEEN MET. THE STANDARD ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING FOR INTERIM PERIODS, AND DISCLOSURE. MANAGEMENT HAS DETERMINED THAT ADOPTION OF THE STANDARD DID NOT HAVE A MATERIAL EFFECT ON THE FINANCIAL STATEMENTS. THE HOSPITAL'S INCOME TAX RETURNS FOR THE YEARS ENDED 2009, 2008, AND 2007, REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE AND STATE AGENCIES.
Part XI, Line 8 - Other Adjustments:equity transfer to affiliate: -500000. DECREASE IN TEMPORARILY RESTRICTED NET ASSETS: -30584.
Part XII, Line 4b - Other Adjustments:INVESTMENT MANAGEMENT FEES NETTED AGAINST DIVIDEND INCOME: 167637. DEPRECIATION EXPENSE RELATED TO RENTAL INCOME: -83736.
Part XIII, Line 2d - Other Adjustments:DEPRECIATION EXPENSE REFLECTED ON STMT OF REVENUE: 83736.
Part XIII, Line 4b - Other Adjustments:INVESTMENT MANAGEMENT FEES NETTED AGAINST DIVIDEND INCOME: 167637.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage140.000000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care0AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report0AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Number Of Activities Or Programs14NumberOfActivitiesOrPrograms
Persons Served496PersonsServed
Total Community Benefit Expense220087TotalCommunityBenefitExpense
Direct Offsetting Revenue52981DirectOffsettingRevenue
Net Community Benefit Expense167106NetCommunityBenefitExpense
Percent Of Total Expense0.00480PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Number Of Activities Or Programs14NumberOfActivitiesOrPrograms
Persons Served1693PersonsServed
Total Community Benefit Expense9056392TotalCommunityBenefitExpense
Direct Offsetting Revenue8507561DirectOffsettingRevenue
Net Community Benefit Expense548831NetCommunityBenefitExpense
Percent Of Total Expense0.01570PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs28NumberOfActivitiesOrPrograms
Persons Served2189PersonsServed
Total Community Benefit Expense9276479TotalCommunityBenefitExpense
Direct Offsetting Revenue8560542DirectOffsettingRevenue
Net Community Benefit Expense715937NetCommunityBenefitExpense
Percent Of Total Expense0.02050PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Persons Served0PersonsServed
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs10NumberOfActivitiesOrPrograms
Persons Served57PersonsServed
Total Community Benefit Expense3846357TotalCommunityBenefitExpense
Direct Offsetting Revenue3082882DirectOffsettingRevenue
Net Community Benefit Expense763475NetCommunityBenefitExpense
Percent Of Total Expense0.02190PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Persons Served450PersonsServed
Total Community Benefit Expense3478507TotalCommunityBenefitExpense
Direct Offsetting Revenue2286035DirectOffsettingRevenue
Net Community Benefit Expense1192472NetCommunityBenefitExpense
Percent Of Total Expense0.03420PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs13NumberOfActivitiesOrPrograms
Persons Served507PersonsServed
Total Community Benefit Expense7324864TotalCommunityBenefitExpense
Direct Offsetting Revenue5368917DirectOffsettingRevenue
Net Community Benefit Expense1955947NetCommunityBenefitExpense
Percent Of Total Expense0.05610PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs41NumberOfActivitiesOrPrograms
Persons Served2696PersonsServed
Total Community Benefit Expense16601343TotalCommunityBenefitExpense
Direct Offsetting Revenue13929459DirectOffsettingRevenue
Net Community Benefit Expense2671884NetCommunityBenefitExpense
Percent Of Total Expense0.07660PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$1,357,587BadDebtExpenseAmount
Amount Attributable To678793AmountAttributableTo
Amount Reimbursed By Medicare9617697AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare8373012CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall1244685MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV (2 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalTeaching HospitalTeachingHospitalEr24 HoursEr24HoursOtherOther
MILLCREEK COMMUNITY HOSPITAL
5515 PEACH STREETERIEPA16509XXXXSKILLED NURSING BEHAVIORAL UNIT
(no name)
PARTIAL HOSPITALIZATION PROGRAM

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Costing Method UsedPart I, Line 7: LINE 7A CHARITY CARE - RATIO OF PATIENT CARE COSTS TO CHARGESLINE 7B MEDICARE - RATIO OF PATIENT CARE COSTS TO CHARGESLINE 7F HEALTH PROFESSIONAL EDUCATION - A COMBINATION OF ACTUAL COST AND COST TO CHARGES IS USED. ACTUAL IS USED FOR DIRECT EXPENSE AND COST TO CHARGES FOR COMMON EXPENSE FROM THE MEDICARE COST REPORT.LINE 7G SUBSIDIZED HEALTH SERVICES - THE COSTING METHODOLOGY WAS DETERMINED BASED ON THE PARTICULAR ACTIVITY/PROGRAM AND THE TYPE OF EXPENSE. ACTUAL COST WAS USED WHERE DIRECT EXPENSES WERE IDENTIFIABLE. A RATIO OF PATIENT CARE COST TO CHARGES WAS USED IN THE CASE OF INDIRECT EXPENSES.CostingMethodUsed
Subsidized Health Services ExplnPart I, Line 7g: EXPENSE INCLUDES $541,831 FOR MEDICAL ASSISTANCE CLINICSSubsidizedHealthServicesExpln
Percent Of Total Expense ExplnPart I, Line 7f: BAD DEBT OF $4,080,590 IS EXCLUDED FROM THE DENOMINATOR FOR PURPOSES OF PART 1, LINE 7, COLUMN F - "PERCENT OF TOTAL EXPENSE"PercentOfTotalExpenseExpln
Bad Debt FootnotePart III, Line 4: ACCOUNTS RECEIVABLE ARE STATED AT THE AMOUNT THE HOSPITAL EXPECTS TO COLLECT. THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS EQUAL TO THE ESTIMATED UNCOLLECTIBLE AMOUNTS. THE HOSPITAL'S ESTIMATE IS BASED ON HISTORICAL COLLECTION EXPERIENCE AND REVIEW OF THE CURRENTS STATUS OF PATIENT ACCOUNTS RECEIVABLE. IT IS REASONABLY POSSIBLE THAT THE HOSPITAL'S ESTIMATE OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS WILL CHANGE. PATIENT ACCOUNTS RECEIVABLE ARE PRESENTED NET OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS OF $911,317 AND $839,003 AS OF JUNE 2010 AND 2009, RESPECTIVELY.THE METHODOLOGY FOR DETERMINING THE COST OF BAD DEBT FOR LINE 2 IS THE RATIO OF PATIENT CARE COSTS TO CHARGES TIMES THE GROSS CHARGES ATTRIBUTABLE TO THE BAD DEBT PATIENT ACCOUNTS. OFFERED DISCOUNTS RELATING TO CHARITY CARE EXPENSES ARE RECORDED AS PART OF THE CONTRACTUAL ALLOWANCE OFFSET AGAINST GROSS CHARGES. ACCORDINGLY, A DISCOUNT IN NOT INCLUDED AS PART OF BAD DEBT EXPENSE. BAD DEBT EXPENSE AT COST ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR CHARITY CARE IS BASED ON ESTIMATES.BadDebtFootnote
Shortfall As Community BenefitPart III, Line 8: EXPENSE RELATED TO ACUTE SERVICES WAS BASED ON THE RATIO OF ACUTE MEDICARE CHARGES TO TOTAL PAYOR CHARGES. COST FOR OTHER SERVICES WAS BASED ON A COMBINATION OF ACTUAL DIRECT CHARGES TIMES THE RATIO OF MEDICARE DAYS TO TOTAL DAYS, INDIRECT COSTS BASED ON A COST TO CHARGE RATIO, AND OVERHEAD COSTS BASED ON ALLOCATED COSTS FROM THE MEDICARE REPORT.ShortfallAsCommunityBenefit
Debt Collection PolicyPart III, Line 9b: CHARITY CARE IS NOT CONSIDERED A SUBSTITUTE FOR PERSONAL RESPONSIBILITY. PATIENTS ARE EXPECTED TO FOLLOW THE HOSPITAL'S BILLING PROCEDURES AND PAY HIS/HER SHARE BASED ON FINANCIAL ABILITY. MILLCREEK COMMUNITY HOSPITAL'S COLLECTION PRACTICES TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR CHARITY, A PATIENT'S GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR CHARITY FROM MILLCREEK COMMUNITY HOSPITAL, AND A PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH HIS OR HER PAYMENT AGREEMENTS WITH MILLCREEK COMMUNITY HOSPITAL. FOR PATIENTS WHO QUALIFY FOR CHARITY AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR HOSPITAL BILLS, MILLCREEK COMMUNITY HOSPITAL MAY OFFER EXTENDED PAYMENT PLANS TO ELIGIBLE PATIENTS, WILL NOT IMPOSE WAGE GARNISHMENTS OR LIENS ON PRIMARY RESIDENCES, WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES, AND WILL CEASE ALL COLLECTION EFFORTS.DebtCollectionPolicy
Needs AssessmentPart VI, Line 2: THE HOSPITAL IS CURRENTLY WORKING WITH OTHER HOSPITALS AND INSTITUTIONS WITH SPECIAL KNOWLEDGE REGARDING PUBLIC HEALTH IN ERIE COUNTY TO DEVELOP A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT.NeedsAssessment
Patient Education AssistancePart VI, Line 3: THE HOSPITAL UTILIZES THE FOLLOWING PROCEDURES TO INFORM AND EDUCATE ITS PATIENTS AND PERSONS, WHO MAY BE BILLED FOR PATIENT CARE, ABOUT THEIR ELIGIBLITY FOR ASSISTANCE:- A HOSPITAL EMPLOYEE WITH KNOWLEDGE OF GOVERNMENT PROGRAMS PERSONALLY VISITS APPLICABLE INPATIENTS AND EXPLAINS THE MEDICAL ASSISTANCE ALTERNATIVES AVAILABLE TO THE INPATIENT- PATIENT BILLING STATEMENTS INCLUDE A NOTATION REGARDING THE FACT DISCOUNTS OR SPECIAL PAYMENT ARRANGEMENTS ARE AVAILABLE TO QUALIFYING INDIVIDUALS- A CHARITY CARE CONTACT PHONE NUMBER IS PHYSICALLY POSTED IN THE HOSPITAL'S EMERGENCY ROOM AND PRINTED ON THE PATIENT'S BILLING STATEMENT. THE APPROPRIATE HOSPITAL EMPLOYEES ASSIST PATIENTS IN THE COMPLETION OF THE REQUIRED FORMS.PatientEducationAssistance
Community InformationPart VI, Line 4: THE HOSPITAL SERVES ERIE COUNTY, PENNSYLVANIA AND PERIPHERAL AREAS SURROUNDING THE COUNTY. BASED ON INFORMATION GATHERED FROM 2006-2008 AND PUBLISHED ON ERIEVITALSIGNS.ORG, 15% OF ERIE COUNTY RESIDENTS WERE BELOW THE POVERTY LEVEL DURING THE STUDIED TIME FRAME. POVERTY RATES FOR THE SAME TIME PERIOD EXCEEDED 25% IN THE CITY OF ERIE. MEDIAN HOUSEHOLD INCOME IN ERIE COUNTY FROM 2004-2008 WAS $44,000, WHICH WAS 12.8% BELOW MEDIAN HOUSEHOLD INCOME IN PENNSYLVANIA AND 14.8% BELOW THE NATIONAL AVERAGE.According to a study by Kaufman, Hall & Associates, the population of Erie County is 282,224 and is expected to decrease by 2.1% by 2015 while the population group aged 65 and over is expected to increase by 7.6%. Accordingly, the Hospital will likely see its Medicare percentage of net patient revenue increase from its current percentage of 36.75%.THE HOSPITAL SERVICES A DISPROPORTIONATE SHARE OF LOW INCOME HOUSEHOLDS. MEDICAL ASSISTANCE COMPRISED APPROXIMATELY 22.6% OF THE HOSPITAL'S NET PATIENT REVENUE. THE HOSPITAL'S UNCOMPENSATED CARE IS APPROXIMATELY 4.58%.CommunityInformation
Other InformationPart VI, Line 6: THE FILING ORGANIZATION IS THE ONLY HOSPITAL IN ITS SERVICE AREA THAT OPERATES UNDER THE PRINCIPLES OF OSTEOPATHIC HEALTH CARE. OSTEOPHATHIC MEDICINE'S ROOTS CENTER ON THE BELIEF OF THE BODY BEING ABLE TO HEAL ITSELF. THIS HOLISTIC APPROACH TO MEDICINE WAS BROUGHT TO ERIE, PENNSYLVANIA IN THE FORM OF A COMMUNITY HOSPITAL OVER 50 YEARS AGO THROUGH THE VISION AND EFFORTS OF SIX OSTEOPATHIC PHYSICIANS. THE FOUNDING PHYSICIANS BELIEVED IT WAS NOT UP TO THE PUBLIC TO GIVE THEM A PLACE TO WORK. THEY WANTED TO SUPPLY THE COMMUNITY WITH A PLACE. IN 1950, THE PREDECESSOR TO MILLCREEK COMMUNITY HOSPITAL, ERIE OSTEOPATHIC HOSPITAL, WAS OPENED.THE HOSPITAL EXPERIENCED RAPID GROWTH AND MOVED TO A LARGER FACILITY IN 1958 TO BETTER ACCOMODATE THE NEEDS OF THE COMMUNITY. IN 1981, MILLCREEK COMMUNITY HOSPITAL BECAME A REALITY AFTER 31 YEARS OF COMMUNITY SERVICES AS ERIE OSTEOPATHIC HOSPITAL. THE HOSPITAL PRIDES ITSELF IN ITS COMMITMENT TO PROVIDE THE BEST PERSONAL CARE POSSIBLE FOR ITS PATIENTS.IN RECENT YEARS, THE HOSPITAL HAS CONTINUED TO EXPAND THEREBY IMPROVING THE SERVICES IT PROVIDES TO THE COMMUNITY. SMALLER EXPANSION PROJECTS IN THE AREAS OF PARTIAL HOSPITALIZATION, THE DIETARY DEPARTMENT AND NURSING ADMINISTRATION/SOCIAL SERVICES HAVE ALL BEEN COMPLETED. THE HOSPITAL HAS ALSO UNDERGONE SEVERAL MAJOR EXPANSION PROJECTS IN RECENT YEARS:- A THREE-STORY ADDITION TO THE SOUTHEAST SIDE OF THE HOSPITAL, WHICH INCLUDES A TRANSITIONAL CARE UNIT TO SERVE PATIENTS WHO NO LONGER NEED ACUTE CARE, BUT WHO ARE NOT WELL ENOUGH TO RETURN HOME; A MEDICAL LIBARY; ADDITIONAL CONFERENCE ROOMS AND OFFICES. - AN EMERGENCY ROOM EXPANSION TO BETTER HANDLE ACUTE MEDICAL AND PSYCHIATRIC EMERGENCIES. - A FIFTH-FLOOR ADDITION TO THE MAIN HOSPITAL TOWER FOR A 12-BED GERIATRIC BEHAVIORAL HEALTH CARE UNIT AND AN 18-BED CHILD/ADOLESCENT PSYCHIATRIC UNIT, WHICH WILL SERVE AS THE ONLY CHILD/ADOLESCENT UNIT OF ITS KIND IN NORTHWESTERN PA. THE HOSPITAL'S 4TH FLOOR SERVES AS A 32 BED GENERAL PSYCHIATRIC UNIT. MILLCREEK COMMUNITY HOSPITAL PROVIDES QUALITY HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONALITY, ORIGIN, HANDICAPS, AGE OR ABILITY TO PAY. IT DOES NOT DISCRIMINATE AGAINST THOSE INDIVIUDALS WHO ARE IN NEED OF FINANCIAL ASSISTANCE FROM THE FACILITY OR THOSE IN NEED OF GOVERNMENT ASSISTANCE. FOR INDIVIDUALS NEEDING FINANCIAL ASSISTANCE, TRANSPORTATION IS PROVIDED TO THE HOSPITAL'S FACILITIES FOR PHYSICIAN VISITS EITHER BY THE HOSPITAL VAN, BUS TOKENS, OR A CAB. PRESCRIPTIONS AND CLOTHING ARE ALSO PROVIDED TO THOSE IN NEED.IN AN EFFORT TO ADDRESS THE CRITICAL SHORTAGE OF PHYSICIANS, MILLCREEK COMMUNITY HOSPITAL ACTS AS A TEACHING HOSPITAL AND WORKS CLOSELY WITH ITS AFFILIATE, LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE. FOR THE FISCAL YEAR ENDED JUNE 30, 2010, THE HOSPITAL UTILIZED 57 INTERNS ACROSS A WIDE RANGE OF MEDICAL CARE SPECIALTIES INCLUDING FAMILY PRACTICE, EAR/NOSE/THROAT, INTERNAL MEDICINE, OPHTHALMOLOGY, ORTHOPEDICS, PSYCHIATRY, GASTROINTESTINAL, PODIATRY, SPORTS MEDICINE, AND NEUROMUSCULOSKETAL MEDICINE. IN ADDITION, THE HOSPITAL HAS A SHORT TERM SKILLED TRANSITIONAL CARE UNIT, AND IT WORKS IN CONJUNCTION WITH ITS AFFILIATE, MILLCREEK MANOR, TO PROVIDE LONG TERM RESIDENTIAL NURSING HOME CARE.MILLCREEK COMMUNITY HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN AN EFFORT TO ENSURE HIGH QUALITY CARE IS ACCESSIBLE IN A VARIETY OF PRIMARY AND SPECIALTY CARE AREAS.THE HOSPITAL'S COMMUNITY ACTIVITIES INCLUDED SEVERAL BLOOD PRESSURE SCREENING EVENTS HELD AT SENIOR DAY, THE ANNUAL CONSUMER FAIR, NATIONAL SENIOR HEALTH & FITNESS DAY, AND THE SALVATION ARMY'S ANGEL TREE GIFT PROGRAM. A BLOOD DRIVE IS CONDUCTED TWICE A YEAR TO ASSIST IN THE COMMUNITY NEED FOR BLOOD. THE HOSPITAL HOSTS EVENTS, SUCH AS SMOKE CESSATION CLASSES SPONSORED BY THE AMERICAN LUNG ASSOCIATION AND THE CHIEF RESIDENT WORKSHOP, WHICH IS A TRAINING SESSION FOR CHIEF RESIDENTS FROM VARIOUS HOSPITALS. IN ADDITION, THE HOSPTIAL PARTICIPATES IN PREVENTIVE HEALTH EDUCATION CLASSES, PROVIDES LITERATURE FOR HEALTHY LIVING, AND PLAYS A PROACTIVE ROLE IN THE DISASTER/BIOTERRORISM PREPAREDNESS PROGRAM.THE HOSPITAL IS ACTIVE IN THE BEHAVIORAL HEALTH FIELD AS IT IS REPRESENTED ON MANY COUNTY-SPONSORED AND OTHER PLANNING COMMITTEES. THE HOSPITAL IS ALSO REPRESENTED AT COMMUNITY CLINICAL FORUMS TO PROVIDE EXPERT INFORMATION AND INPUT ON DIFFICULT SITUATIONS AND CASES.OtherInformation
Affiliated Health Care SystemPart VI, Line 7: MEDICAL ASSOCIATES OF ERIE (MAE), AN AFFILIATE OF THE HOSPITAL, SERVES OVER 23,000 PATIENTS ANNUALLY. THE PATIENTS TREATED ARE PREDOMINANTLY LOW INCOME AND RESIDE IN THREE UNDERSERVED AREAS OF ERIE COUNTY. FOR 57% OF MAE'S PATIENTS, THEIR MEDICAL CHARGES ARE EITHER COVERED BY MEDICAL ASSISTANCE OR THE PATIENTS QUALIFY FOR CHARITY CARE. U.S. CENSUS STUDIES INDICATE HOUSEHOLD INCOME IN SOME OF MAE'S PRACTICE AREAS IS ONLY 2/3 OF THE NATIONAL AVERAGE, AND THE THE PERCENTAGE OF THE POPULATION UNDER THE FEDERAL POVERTY GUIDELINES IS 150% OF THE NATIONAL AVERAGE. MAE PATIENTS ALSO INCLUDE A LARGE NUMBER OF REFUGEES FROM AFRICA, THE MIDDLE EAST, AND NAPAL.Despite the rigors of their training to become physicians and pharmacists, STUDENTS ATTENDING THE LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE (LECOM), AN AFFILIATE OF MILLCREEK COMMUNITY HOSPITAL, provide more than 30,000 hours annually for community service. THE President's Higher Education Community Service Honor Roll has recognized the volunteer efforts by LECOM students. Students work with local school children delivering health care education through poison prevention, tobacco cessation, mini-medical school and fit-for-life exercise and nutrition training.LECOM participates in Bridging the Gaps, a summer internship program that places medical students with social service and healthcare agencies who deal directly with underserved populations. Students deliver health education to adults and children served by these agencies.The college has underwritten a six-hour block of health, nutrition and fitness programming aired daily by WQLN-TV in Erie as part of the public broadcasting Create Network. In addition, LECOM physicians host two monthly, half-hour health education programs called Meet the Doctors, on WQLN-TV.LECOM FURTHER DEMONSTRATED ITS COMMITMENT TO THE COMMUNITY WHEN IT CONSTRUCTED AND OPENED AN 82,000 SQUARE FOOT STATE-OF-THE-ART MEDICALLY INTEGRATED FITNESS AND WELLNESS CENTER IN MARCH 2009. THE FACILITY FEATURES CARDIOVASCULAR EQUIPMENT, CIRCUIT/FREE WEIGHT TRAINING AREAS, FOUR GROUP EXERCISE STUDIOS, THREE SWIMMING POOLS: A LAP POOL, EXERCISE POOL, AND THERAPY POOL, A THREE LANE WALKING/RUNNING TRACK, A FULL-SIZED BASKETBALL GYMNASIUM, RACQUETBALL COURTS, AND INDOOR GOLF SIMULATOR. THE FACILITY IS STAFFED BY HEALTH PROMOTION EXPERTS, AND EACH TRAINER IN THE FACILITY POSSESSES AT LEAST A BACHELOR DEGREE IN A FIELD RELATED TO THE MISSION OF THE WELLNESS CENTER. THE WELLNESS CENTER ALSO OFFERS SPA AND MASSAGE THERAPY SERVICES, A HEALTHY CAFE WITH A COOKING DEMONSTRATION KITCHEN, A CONFERENCE/EDUCATION CENTER, AND A SAFE ENVIRONMENT FOR CHILDREN TO PLAY WHILE THEIR RESPONSIBLE ADULTS UTILIZE THE FACILITY. THE FACILITY ALSO HOUSES A DESIGNATED PHYSICAL THERAPY AREA OPERATED BY THE HOSPITAL, AND PHYSICAN OFFICES STAFFED BY DOCTORS EMPLOYED BY THE HOSPITAL'S AFFILIATE, MEDICAL ASSOCIATES OF ERIE.FOR MORE INFORMATION REGARDING THE ACTIVITIES OF THE HOSPITAL AND ITS AFFILIATES, PLEASE VIST THE MILLCREEK COMMUNITY HOSPITAL WEBSITE AT WWW.MILLCREEKCOMMUNITYHOSPITAL.COM. WEBSITE LINKS TO THE HOSPITAL'S AFFILIATES ARE AVAILABLE ON THE HOSPITAL'S WEBSITE.AffiliatedHealthCareSystem

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 (10 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
MARY L ECKERT
38899800043452385919600050054300457055815900
RICHARD P OLINGER
19119816409500220002840316444013919430024356119679800
DR JOHN M FERRETTI DO
04358140004211601960009646050717600
DR SILVIA M FERRETTI DO
06342880004085601960009646070439000
DR RUSSELL REICHTER MD
184201000000045750188776000
DR PAUL A KOHUT DO
254503000165000153490122920298644000
THOMAS ZIEGLER MD
22360200022000018422052150269239000
ELISEO ROQUIZ MD
34626900014808053850144830380945000
DR MARVIN WIELAND
3156400002200006000052150348855000
willIAM SWAGLER III DO
112354290770059100788001400901401532907700

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 THE FILING ORG.Relationship
Amount Of Transaction555977AmountOfTransaction
Description Of TransactionINDEPENDENT CONTRACTOR - SELLS MEDICAL SUPPLIES AND SERVICES TO MILLCREEK COMMUNITY HOSPITAL.DescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part III, line 2New Program ServicesDURING THE FISCAL YEAR ENDED JUNE 30, 2010, MILLCREEK COMMUNITY HOSPITAL COMPLEMENTED ITS ACUTE CARE SERVICES BY ADDING AN ACUTE UNIT GEARED EXCLUSIVELY FOR GERIATRIC PATIENTS. THE UNIT IS DESIGNED FOR THE UNIQUE NEEDS ASSOCIATED WITH THE CARE OF THE ELDERLY. THE HOSPITAL HAS 14 BEDS DESIGNATED FOR THE GERIATRIC UNIT.
Form 990, Part VI, Section A, line 2DR. JOHN M. FERRETTI, D.O. AND DR. SILVIA 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 COMMUNITY HOSPITAL. 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 EXAMINED. 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 ORGANIZATION'S BUDGET/FINANCE COMMITTEE, WHICH ALSO FUNCTIONS AS THE COMPENSATION COMMITTEE, REVIEWED A STUDY PERFORMED BY AN INDEPENDENT COMPENSATION CONSULTANT IN MARCH 2007. IN ADDITION, THE COMMITTEE ALSO REVIEWED VARIOUS FORM 990 FILINGS BY COMPARATIVE ORGANIZATIONS IN ORDER TO MAKE EXECUTIVE PAY COMPARISONS. FOR FISCAL YEARS ENDED JUNE 30, 2008, 2009 AND 2010, THE COMMITTEE REVIEWED THE SAME FORM 990 COMPARISONS.
Form 990, Part VI, Section C, line 19THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
FORM 990, PART XI, LINE 2C:THE FINANCE COMMITTEE ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE ORGANIZATION'S INDEPENDENT FINANCIAL STATEMENT AUDIT. THE PROCESS ASSOCIATED WITH THE OVERSIGHT OF THE INDEPENDENT FINANCIAL STATEMENT AUDIT REMAINS CONSISTENT WITH THE PRIOR FISCAL YEAR.
FORM 990, PART VII, SECTION A:ESTIMATE OF AVERAGE HOURS DEVOTED TO RELATED ORGANIZATIONSDR. JOHN M. FERRETTI, D.O.: MEDICAL ASSOCIATES OF ERIE - 5 HOURS PER WEEK MILLCREEK HEALTH SYSTEM MEDICAL PROFESSIONAL LIABILITY SELF-INSURANCE TRUST - 1 HOUR PER WEEK MILLCREEK MANOR - 5 HOURS PER WEEK MILLCREEK HEALTH SYSTEM - 1 HOUR PER WEEK LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE - 58 HOURS PER WEEK DR. SILVIA M. FERRETTI, D.O.: MEDICAL ASSOCIATES OF ERIE - 1 HOUR PER WEEK MILLCREEK MANOR - 1 HOUR PER WEEK MILLCREEK HEALTH SYSTEM - 1 HOUR PER WEEK LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE - 75 HOURS PER WEEK MARY L. ECKERT: MEDICAL ASSOCIATES OF ERIE - 1 HOUR PER WEEK MILLCREEK HEALTH SYSTEM MEDICAL PROFESSIONAL LIABILITY SELF-INSURANCE TRUST - 1 HOUR PER WEEK MILLCREEK MANOR - 1 HOUR PER WEEK MILLCREEK HEALTH SYSTEM - 1 HOUR PER WEEK LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE - 4 HOURS PER WEEK RICHARD P. OLINGER: MEDICAL ASSOCIATES OF ERIE - 1 HOUR PER WEEK MILLCREEK HEALTH SYSTEM MEDICAL PROFESSIONAL LIABILITY SELF-INSURANCE TRUST - 1 HOUR PER WEEK MILLCREEK MANOR - 1 HOUR PER WEEK MILLCREEK HEALTH SYSTEM - 1 HOUR PER WEEK LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE -30 HOURS PER WEEK
FORM 990, PART IV, LINE 28C:SUPPLEMENTAL DISCLOSURE REGARDING BUSINESS TRANSACTIONSCERTAIN PERSONS LISTED ON FORM 990, PART VII, SECTION A ARE EMPLOYED OR HAVE AN OWNERSHIP INTEREST IN ORGANIZATIONS WITH WHOM MILLCREEK COMMUNITY HOSPITAL (THE HOSPITAL) TRANSACTS BUSINESS. BASED ON THE REPORTING THRESHOLDS STATED IN THE FILING INSTRUCTIONS, THESE BUSINESS TRANSACTIONS ARE NOT REQUIRED TO BE REPORTED ON SCHEDULE L, PART IV. THE HOSPITAL'S BOARD OF TRUSTEES VOLUNTARILY DISCLOSES THE FOLLOWING BUSINESS RELATIONSHIPS: JAMES A. SCHAFFNER, CPA/ABV, CFF, CVA: THE HOSPITAL ENGAGED MR. SCHAFFNER'S EMPLOYER, SCHAFFNER KNIGHT MINNAUGH & CO, P.C., TO PREPARE THE HOSPITAL'S TAX RETURNS AS WELL THE TAX FILINGS FOR RELATED ORGANIZATIONS. MR. SCHAFFNER'S FIRM IS ALSO ENGAGED FOR CONSULTING SERVICES AS NEEDED. THE HOSPITAL PAID ACCOUNTING FEES TOTALING $27,645 TO SCHAFFNER KNIGHT MINNAUGH & COMPANY, P.C. DURING THE FISCAL YEAR ENDED JUNE 30, 2010. AT JUNE 30, 2010, MR. SCHAFFNER'S OWNERSHIP INTEREST IN SCHAFFNER KNIGHT MINNAUGH AND COMPANY, P.C. EXCEEDED 5%. DR. JOHN M. FERRETTI, D.O.: THE HOSPITAL ENGAGED OSTEOPATHIC INTERNAL MEDICINE ASSOCIATES (OIMA) TO PERFORM SPECIFIED MEDICAL SERVICES DURING THE FISCAL YEAR ENDED JUNE 30, 2010. THE HOSPITAL PAID OIMA $48,000 FOR THOSE SERVICES. OIMA IS A PROFESSIONAL CORPORATION IN WHICH DR. FERRETTI HOLDS A 100% OWNERSHIP INTEREST.
FORM 990, PART X:SUPPLEMENTAL BALANCE SHEET DISCLOSURE:THE ASSETS OF A RELATED ORGANIZATION, MILLCREEK HEALTH SYSTEM MEDICAL PROFESSIONAL LIABILITY SELF-INSURANCE TRUST (EIN 57-6204119), ARE INCLUDED ON THE BALANCE SHEET OF THE FILING 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 StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Direct Controlling Entity NADirectControllingEntityNA
LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE
5515 PEACH STREETERIEPA16509251698677MEDICAL SCHOOL AND SCHOOL OF PHARMACYPA501(c)(3)Line 2MILLCREEK HEALTH SYSTEM
MILLCREEK HEALTH SYSTEM
5515 PEACH STREETERIEPA16509251766164PARENT CORPORATIONPA501(c)(3)Line 11c, III-FIN/A
MILLCREEK MANOR
5515 PEACH STREETERIEPA16509251619204LONG TERM CARE NURSING FACILITYPA501(c)(3)Line 3MILLCREEK HEALTH SYSTEM
MILLCREEK HEALTH SYSTEM MEDICAL PROFESSIONAL LIABILITY SELF-INSURANCE TRUST
5515 PEACH STREETERIEPA16509576204119PROVIDES MANDATORY PROFESSIONAL LIABILITY COVERAGE TO AFFILIATE ORGSPA501(c)(3)Line 11d, III-ON/A
MEDICAL ASSOCIATES OF ERIE
ONE LECOM PLACEERIEPA16505113716896PHYSICIAN PRACTICE CORPORATIONPA501(c)(3)Line 9MILLCREEK 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 Org1GiftGrantOrCapContrToOtherOrg
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 Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (12 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE
B5000
LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE
I518892
MEDICAL ASSOCIATES OF ERIE
I60000
MILLCREEK MANOR
K376685
LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE
O62075
LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE
P938199
MILLCREEK MANOR
P436780
MCH CORPORATION
P42349
MILLCREEK HEALTH SYSTEM
Q500000
MILLCREEK HEALTH SYSTEM MEDICAL PROF LIAB SELF-INS TRUST
Q1341957
LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE
J95760
MILLCREEK MANOR
O39695