J C BLAIR MEMORIAL HOSPITAL: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- J C BLAIR MEMORIAL HOSPITAL (EIN 23-1352159)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-05-13
- IRS object ID
- 201141339349303319
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-05-13T15:21:52-05:00 | 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 | 231352159 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JC BLAIR MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | JCBL | NameControl |
| Phone | 8146432290 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1225 WARM SPRINGS AVENUE | AddressLine1 |
| City | HUNTINGDON | City |
| State | PA | State |
| ZIP Code | 16652 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | NANCY GLIDDEN | Name |
| Title | VP FINANCE/CFO | Title |
| Phone | 8146432290 | Phone |
| Date Signed | 2011-05-12 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | JOSEPH J PELUSO | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1225 WARM SPRINGS AVENUE | AddressLine1 |
| City | HUNTINGDON | City |
| State | PA | State |
| ZIP Code | 16652 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 44153018 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.JCBLAIR.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1909 | YearFormation |
| State Legal Domicile | PA | StateLegalDomicile |
| Activity Or Mission Description | HEALTHCARE PROVIDER - NOT-FOR-PROFIT ACUTE CARE HOSPITAL | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 16 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 565 | TotalNbrEmployees |
| Total Nbr Volunteers | 86 | TotalNbrVolunteers |
| Total Gross UBI | 1051849 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -385468 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1012920 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 611861 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 36683834 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 37233365 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 661060 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2253424 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1286768 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1213211 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 39644582 | TotalRevenuePriorYear |
| Total Revenue Current Year | 41311861 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 710500 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 539466 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 20776501 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 22527897 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 8629 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 18246837 | OtherExpensePriorYear |
| Other Expenses Current Year | 17800937 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 39733838 | TotalExpensesPriorYear |
| Total Expenses Current Year | 40868300 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -89256 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 443561 | RevenuesLessExpensesCY |
| Total Assets BOY | 34981712 | TotalAssetsBOY |
| Total Assets EOY | 36298447 | TotalAssetsEOY |
| Total Liabilities BOY | 17405214 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 18263218 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 17576498 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 18035229 | NetAssetsOrFundBalancesEOY |
| Mission Description | Mission: J.C. Blair Health System is committed to being the premier health resource for the residents of Huntingdon County and nearby communities and strives to deliver the best outcome for every patient. Vision: To be a model of excellence for the provision of a comprehensive range of healthcare and wellness services designed to continually improve the health status and quality of life for the residents of Huntingdon County and nearby communities. | MissionDescription |
| Significant New Program Services | 1 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 31543477 | Expense |
| Grants | 539266 | Grants |
| Revenue | 37295436 | Revenue |
| Description | J.C. Blair Memorial Hospital provides inpatient, outpatient, and emergency care services to further the health and wellness of Huntingdon, Pennsylvania and surrounding communities in Huntingdon County, Pennsylvania. In fiscal year 2010, J.C. Blair Memorial Hospital provided the community with charity services amounting to $642,431, the cost of which is estimated at $244,751. Patients receive medically necessary services regardless of ability to pay. Please see attached summary of activities and programs provided for or supported by J.C. Blair Memorial Hospital and its staff for the benefit of the community. The Hospital admitted 2,361 adult and pediatric patients, delivered 299 newborns, provided outpatient services to 100,762 patients, and provided emergency services to 16,245 patients. Services provided included 397,854 laboratory tests and procedures, 37,458 radiologic procedures, and 4,313 surgical procedures. In addition to general surgery, J.C. Blair Memorial Hospital provides urological, ENT, ophthalmology, podiatry, and outpatient orthopedic surgical services.During the year, the hospital continued its path to improved customer service and quality of care, participating in all required quality of care reporting programs and a voluntary pay for performance program under agreement with its largest commercial payer. | Description |
| Total Program Service Expense | 31543477 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | 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 | 1 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 1 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | 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 | 38 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 565 | 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 | 16 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | 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 | 1 | 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 | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | 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 | Nancy Glidden - CFO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8146438445 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1225 WARM SPRINGS AVENUE | AddressLine1 |
| City | HUNTINGDON | City |
| State | PA | State |
| ZIP Code | 16652 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (21 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 |
|---|---|---|---|---|---|---|---|
| JOHN D COURSEN | |||||||
| CHAIRMAN | 1.00 | X | X | 0 | 0 | 0 | |
| FRANCES V VAUGHN | |||||||
| VICE CHAIRMAN | 1.00 | X | X | 0 | 0 | 0 | |
| GARRY L POTE | |||||||
| TREASURER | 1.00 | X | X | 0 | 0 | 0 | |
| JOSEPH A MASCIANGELO | |||||||
| SECRETARY | 1.00 | X | X | 0 | 0 | 0 | |
| ELLEN SLOAN | |||||||
| ASSISTANT SECRETARY | 1.00 | X | X | 0 | 0 | 0 | |
| FRANK DEMAR | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| ARTHUR DECAMP | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| KEITH BLACK | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| FRED PRICE | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| CHARLES CRUIKSHANK | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| JAMES E SCHALL MD | |||||||
| DIRECTOR | 1.00 | X | 24000 | 0 | 0 | ||
| JAMES LAKSO PHD | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| BARBARA EASTMAN | |||||||
| AUXILIARY PRESIDENT | 1.00 | X | 0 | 0 | 0 | ||
| Alfred K Sutton | |||||||
| Director / Physician | 40.00 | X | 227940 | 0 | 58307 | X | |
| MARIA PETTINGER | |||||||
| DIRECTOR/CHIEF OF STAFF | 80.00 | X | 0 | 0 | 0 | ||
| JOSEPH PELUSO | |||||||
| CEO | 40.00 | X | X | 176171 | 0 | 42176 | |
| Nancy Glidden | |||||||
| CFO | 40.00 | X | 127633 | 0 | 30690 | ||
| john d roth | |||||||
| Physician | 40.00 | 262321 | 0 | 67102 | X | ||
| david finch | |||||||
| anesthetist | 40.00 | 223554 | 0 | 57185 | X | ||
| Glenn G Williams | |||||||
| Physician | 40.00 | 217055 | 0 | 55523 | X | ||
| brent acker | |||||||
| Physician | 40.00 | 234245 | 0 | 59920 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1492919 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 370903 | TotalOtherCompensation |
| Number Individuals GT100 K | 11 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| QUORUM HEALTH RESOURCES | |||||
| 105 CONTINENTAL PLACE | BRENTWOOD | TX | 37027 | MANAGEMENT SERVICES | 759858 |
| QUEST DIAGNOSTICS | |||||
| 2769 COLLECTION CENTER DRIVE | CHICAGO | IL | 60693 | OUTSIDE LAB TESTING | 415392 |
| Revenue Cycle Solutions Inc | |||||
| 4524 SOUTHLAKE PARKWAY SUITE 15 | HOOVER | AL | 35244 | Cash Retrievers | 265415 |
| rasik lal | |||||
| 1225 WARM SPRINGS AVENUE | HUNTINGDON | PA | 16652 | Psychiatrist | 261850 |
| ALLIANCE HEALTHCARE SYSTEMS | |||||
| 100 BAYVIEW CIRCLE SUITE 400 | NEWPORT BEACH | CA | 92660 | MRI AND PET SCAN SERVICES | 175567 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 9 | NumberOfContractorsGT100K |
| Related Organizations | 321325 | RelatedOrganizations |
| Government Grants | 94327 | GovernmentGrants |
| All Other Contributions | 196209 | AllOtherContributions |
| Total Contributions | 611861 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SERVICE RE | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 37233365 | TotalRevenueColumn |
| Related Or Exempt Function Income | 37233365 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 37233365 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 295731 | TotalRevenueColumn |
| Exclusion | $295,731 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 182905 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 535365 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -352460 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -352460 | TotalRevenueColumn |
| Exclusion | -$352,460 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 4262585 | Securities |
| Other | 900 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 2305158 | Securities |
| Other | 634 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1957427 | Securities |
| Other | 266 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1957693 | TotalRevenueColumn |
| Exclusion | $1,957,693 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|
| DIETARY SVCS REVENUE | 812900 | 833341 | 833341 | |
| PLANT OPERATIONS SVCS | 541610 | 218508 | 218508 | |
| CAFETERIA REVENUE | 722210 | 205019 | $205,019 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 308803 | TotalRevenueColumn |
| Related Or Exempt Function Income | 62071 | RelatedOrExemptFunctionIncome |
| Exclusion | $246,732 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1565671 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 41311861 | TotalRevenueColumn |
| Related Or Exempt Function Income | 37295436 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1051849 | UnrelatedBusinessRevenue |
| Exclusion | $2,352,715 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 503466 | Total |
| Program Services | 503466 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 36000 | Total |
| Program Services | 36000 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17089952 | Total |
| Program Services | 13035734 | ProgramServices |
| Management And General | 4045589 | ManagementAndGeneral |
| Fundraising | 8629 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1476061 | Total |
| Program Services | 1125898 | ProgramServices |
| Management And General | 350163 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2748593 | Total |
| Program Services | 2096549 | ProgramServices |
| Management And General | 652044 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1213291 | Total |
| Program Services | 904538 | ProgramServices |
| Management And General | 308753 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 109063 | Total |
| Management And General | 109063 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 354372 | Total |
| Management And General | 354372 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 92524 | Total |
| Management And General | 92524 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3485148 | Total |
| Program Services | 1790209 | ProgramServices |
| Management And General | 1694939 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 101413 | Total |
| Management And General | 101413 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6683055 | Total |
| Program Services | 5574044 | ProgramServices |
| Management And General | 1109011 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9055 | Total |
| Management And General | 9055 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 597952 | Total |
| Program Services | 597952 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49736 | Total |
| Program Services | 28735 | ProgramServices |
| Management And General | 21001 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 138564 | Total |
| Program Services | 138564 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1789557 | Total |
| Program Services | 1789557 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 453744 | Total |
| Program Services | 453744 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT | 2816647 | 2816647 | |
| FOOD | 646385 | 603024 | 43361 |
| PHYSICIAN RECRUITMENT | 367452 | 367452 | |
| ADMINISTRATIVE EXPENSES | 38225 | 38225 | |
| ANESTHESIOLOGY EXPENSES | 25000 | 25000 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43045 | Total |
| Program Services | 23816 | ProgramServices |
| Management And General | 19229 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40868300 | Total |
| Program Services | 31543477 | ProgramServices |
| Management And General | 9316194 | ManagementAndGeneral |
| Fundraising | 8629 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 300 | BOY |
| EOY | 300 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1572042 | BOY |
| EOY | 749485 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5024949 | BOY |
| EOY | 4971280 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27070 | BOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 495543 | BOY |
| EOY | 525120 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 432275 | BOY |
| EOY | 413374 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 54179249 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 43079201 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12188794 | BOY |
| EOY | 11100048 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12506274 | BOY |
| EOY | 14547103 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 83500 | BOY |
| EOY | 83500 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2650965 | BOY |
| EOY | 3908237 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34981712 | BOY |
| EOY | 36298447 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3262772 | BOY |
| EOY | 4405552 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3470000 | BOY |
| EOY | 3185000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2947000 | BOY |
| EOY | 2567000 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7725442 | BOY |
| EOY | 8105666 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17405214 | BOY |
| EOY | 18263218 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15356091 | BOY |
| EOY | 15827252 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 690496 | BOY |
| EOY | 636469 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1529911 | BOY |
| EOY | 1571508 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17576498 | BOY |
| EOY | 18035229 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34981712 | BOY |
| EOY | 36298447 | 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 Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $6,228 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 6228 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part II-B, Line 1i: | Identifier |
| Return Reference | Explanation of Other Lobbying Activities: | ReturnReference |
| Explanation | THE HOSPITAL IS A MEMBER OF THE HOSPITAL ASSOCIATION OF PENNSYLVANIA, Hospital Council of Western PA AND THE AMERICAN HOSPITAL ASSOCIATION. AS SUCH, A PERCENTAGE OF DUES IS EXPENDED BY THOSE ORGANIZATIONS ON LOBBYING ACTIVITIES. IT IS ESTIMATED THAT $6,228 OF THE DUES PAID WAS USED BY THOSE ORGANIZATIONS FOR LOBBYING ACTIVITIES. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 14901804 | BeginningOfYearBalance |
| Contributions | 442718 | Contributions |
| Investment Earnings Or Losses | 2438363 | InvestmentEarningsOrLosses |
| Other Expenditures | 703555 | OtherExpenditures |
| End Of Year Balance | 17079330 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 17238317 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -1536513 | InvestmentEarningsOrLosses |
| Other Expenditures | 800000 | OtherExpenditures |
| End Of Year Balance | 14901804 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.87000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.09000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.04000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 518428 | OtherCostOrOtherBasis |
| Book Value | 518428 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 22914657 | OtherCostOrOtherBasis |
| Depreciation | 17270182 | Depreciation |
| Book Value | 5644475 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 29834898 | OtherCostOrOtherBasis |
| Depreciation | 25032018 | Depreciation |
| Book Value | 4802880 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 911266 | OtherCostOrOtherBasis |
| Depreciation | 777001 | Depreciation |
| Book Value | 134265 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 11100048 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (6 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DUE FROM AFFILIATES | 1557386 |
| BENEFICIAL INTEREST IN PERPETUAL TRUSTS | 1457558 |
| ASSETS RECEIVED UNDER REVOCABLE TRUST | 77436 |
| DEFERRED FINANCING COSTS, NET | 177089 |
| INTEREST IN NET ASSETS OF AFFILIATE | 344849 |
| ACCRUED INTEREST AND OTHER RECEIVABLES | 293919 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 3908237 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (6 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ESTIMATED MEDICAL MALPRACTICE CLAIMS LIABILITY | $528,807 |
| ACCRUED PENSION COST | $6,357,277 |
| REFUNDABLE ADVANCE | $77,436 |
| OBLIGATIONS UNDER CAPITAL LEASE | $186,180 |
| ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | $732,461 |
| Due to Affiliates | $223,505 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 8105666 | TotalOfAmounts |
| Total Revenue | 41311861 | TotalRevenue |
| Total Expenses | 40868300 | TotalExpenses |
| Excess Or Deficit For Year | 443561 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 226517 | NetUnrealizedGLOnInvestments |
| Prior Period Adjustments | -218934 | PriorPeriodAdjustments |
| Other | $7,587 | OtherAmount |
| Total Adjustments | 15170 | TotalAdjustments |
| Excess Or Deficit Per FS | 458731 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 42081330 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 226517 | NetUnrealizedGainsInvestments |
| Other Revenues | 7587 | OtherRevenues |
| Revenue Not Rptd F990 | 234104 | RevenueNotRptdF990 |
| Revenue Subtotal | 41847226 | RevenueSubtotal |
| Other Revenues Not Included | -535365 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | -535365 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 41311861 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 41403665 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 535365 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 535365 | ExpensesNotRptdF990 |
| Expenses Subtotal | 40868300 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 40868300 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Part V, Line 4: | Description of Intended Use of Endowment Funds: | J.C. Blair Memorial Hospital has recorded on its balance sheet its interest in the net assets of the J.C. Blair Memorial Hospital Foundation. That amount is reported above and categorized as a term endowment. The Foundation transfers funds raised to the hospital for the purchase of equipment and building improvements. Funds raised and not yet transferred are reported as interest in net assets of the Foundation |
| Part X: | Description of Uncertain Tax Positions Under FIN 48: | The Hospital accounts for uncertainty in income taxes 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 has determined that there were no tax uncertainties that met the recognition threshold in 2010 and 2009. |
| Part XI, Line 8 - Other Adjustments: | MINIMUM PENSION LIABILITY ADJUSTMENT: 37408. VALUATION Gain, BENEFICIAL INTEREST IN PERPETUAL TRUST: 41597. CHANGE IN NET ASSETS OF AFFILIATE: -71418. | |
| Part XII, Line 2d - Other Adjustments: | VALUATION GAIN, BENEFICIAL INTEREST IN PERPETUAL TRUST: 41597. MINIMUM PENSION LIABILITY ADJUSTMENT: 37408. CHANGE IN NET ASSETS OF AFFILIATES: -71418. | |
| Part XII, Line 4b - Other Adjustments: | RENTAL EXPENSE: -535365. | |
| Part XIII, Line 2d - Other Adjustments: | RENTAL EXPENSE: 535365. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 0 | FPGReferenceFreeCare |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | 0 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 779 | PersonsServed |
| Total Community Benefit Expense | 244751 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 154497 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 90254 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00240 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 15166 | PersonsServed |
| Total Community Benefit Expense | 5845514 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3386349 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2459165 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06460 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 15945 | PersonsServed |
| Total Community Benefit Expense | 6090265 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3540846 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2549419 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06700 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 236 | NumberOfActivitiesOrPrograms |
| Persons Served | 2479 | PersonsServed |
| Total Community Benefit Expense | 104118 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 42660 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 61458 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00160 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 89 | NumberOfActivitiesOrPrograms |
| Persons Served | 411 | PersonsServed |
| Total Community Benefit Expense | 278598 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 278598 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00730 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 7 | NumberOfActivitiesOrPrograms |
| Persons Served | 27072 | PersonsServed |
| Total Community Benefit Expense | 617489 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 617489 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01620 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 102 | NumberOfActivitiesOrPrograms |
| Persons Served | 1591 | PersonsServed |
| Total Community Benefit Expense | 91942 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 91942 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00240 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 434 | NumberOfActivitiesOrPrograms |
| Persons Served | 31553 | PersonsServed |
| Total Community Benefit Expense | 1092147 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 42660 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1049487 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02750 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 436 | NumberOfActivitiesOrPrograms |
| Persons Served | 47498 | PersonsServed |
| Total Community Benefit Expense | 7182412 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3583506 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3598906 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09450 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 41 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 2150 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2150 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 30 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 27063 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 27063 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 175 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 175 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 11 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 975 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 975 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 6 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 1225 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1225 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 12 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 1575 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1575 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 25 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 25 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 75 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 75 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 104 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 33263 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 33263 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $1,101,309 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 12864845 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 14986426 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -2121581 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 0 | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JC Blair Memorial Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1225 Warm Springs Avenue | AddressLine1 |
| City | Huntingdon | City |
| State | PA | State |
| ZIP Code | 16652 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
| Other | Inpatient Psychiatric Unit | Other |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Income Based Criteria | Part I, Line 3c: In addition to the 200% FPG applied to charity care, the organization offers a 20% discount for prompt payment regardless of income. | IncomeBasedCriteria |
| Annual Community Benefit Expln | Part I, Line 6a: J.C. Blair Health Systems, Inc., parent of J.C. Blair Memorial Hospital, produces an annual report which includes a report of community benefit. The report highlights the cost of charity care and the shortfall between Medical Assistance payments and the cost of care, and the value of the community benefit programs categorized as required in the 990 tax return. It also provides a narrative section listing examples of the events hospital leadership, board members, medical staff and employees participate in or sponsor. The annual report is distributed at an annual public meeting, through the mail, and throughout the organization. | AnnualCommunityBenefitExpln |
| Percent Of Total Expense Expln | Part I, Line 7f: The amount of bad debt expense included on Form 990, Part IX, Line 25 column (A) but subtracted out for purposes of calculating the percentage on Sch H, Part I, Line 7, Column (f) is $2,816,647. | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | Part III, Line 4: Cost to charge ratio from the 2009 cost report was used to estimaTE COSTS. Discounts and payments on patients accounts are not included in bad debt expense. Payments made after an account has been written off to bad debt are treated as recoveries of bad debt and are netted against bad debts. | BadDebtFootnote |
| Shortfall As Community Benefit | Part III, Line 8: The value of the cost of unreimbursed Medicare bad debts related to Medicaid crossovers is $42,800, which should be treated as community benefit. This number was calculated by taking the 30% of unreimbursed Medicare bad debts in the 2010 Medicare cost report and applying the cost to charge ratio to that number. line 6 costs were estimated Using ratio of costs to charges as per 2010 cost report, applied to total Medicare revenues including HMO and Part B which are not reported in the cost report. Line 5 revenues reported includes all net revenues for Medicare, including HMO and Part B. | ShortfallAsCommunityBenefit |
| Needs Assessment | Part VI, Line 2: The Community Relations staff at J.C. Blair facilitates the Huntingdon County Healthy PartnerSHIP, a health improvement partnership designated and recognized by the PA Department of Health, which monitors county health status indicators, prioritizes need, and develops initiatives to address those needs. Reports monitored include the Huntingdon County Health Profile, Behavioral Health Risk Factors for PA and Huntingdon County, County Health Rankings, CDC Healthy People 2020, Injuries in PA County Profiles, and others. The PartnerSHIP is comprised of nearly 90 health and human services agencies who network via a listserve and an estimated 20 active members who work together to develop action plans to address priority issues. These active members include representatives from the United Way, PA State Police, drug & alcohol agencies, the American Cancer Society, Home Nursing Agency, tobacco cessation consultant, retirement communities and nursing homes, state health center, Juniata College and others. | NeedsAssessment |
| Patient Education Assistance | Part VI, Line 3: In order to be eligible for charity care, a patient who does not have health insurance must complete an application for Medical Assistance and be denied coverage. Such patients, designated as self-pay, are offered assistance by our self-pay financial counselors in completing applications for Medical Assistance. Counselors follow up with patients if applications are not completed or information is not returned. The Hospital also has access to limited funds (the income from a trust which has been designated to be used for charity care). Applicants for charity care are screened for eligibility for this program. In addition, a restricted donation from a community member has provided for payment for health care services which are not eligible for any other programs or insurance coverages. While the amount of that grant was only $10,000, it has already provided coverage for costs of care for several patients for needed services. Patient brochures are provided to explain the availability of assistance and charity care programs.The federal poverty level guidelines with our 200% multiplier are posted in locations frequented by patients, such as the Emergency Department and registration areas. If a patient is Self Pay at the time of registration, the registration clerk notifies a patient financial counselor and provides the patient with a Financial Assistance Program Letter. The Program letter offers a 20% Self Pay Discount Program and Charity Care Program outline. Patient Counselor advises and assists with application process. To apply for Charity Care is the patient must first apply for Medical Assistance. This process can take up to 30 days for Medical Assistance approval or denial. If Medical Assistance coverage is denied, the patient is asked to contact the patient counselor for assistance with completing the Charity Care Application, or to have the application mailed out to the patient. Once the patient is determined to be eligible, the patient is issued an identification card, which they may present at future visits to validate they have been determined to be eligible for Charity Care. Eligibility must be renewed every six months. The hospital is currently developing a new brochure which describes the charity program along with other financial policies, such as prompt payment discounts and eligibility for payment plans and grant funded care. | PatientEducationAssistance |
| Community Information | Part VI, Line 4: The Hospital serves the residents of Huntingdon County, being the only hospital in the county. The population in the county is approximately 45,000, spread across many small boroughs and villages. There are a number of Amish and Mennonite settlements in the region. The communities in the primary service area are Huntingdon, Smithfield, Mount Union, Alexandria, Orbisonia, Petersburg, Three Springs, Mapleton Depot, James Creek, Mill Creek. A number of small communities make up the secondary service area. The area is rural. Huntingdon County is in the 'ridge and valley' section of Pennsylvania, which makes for small communities connected by winding and hilly secondary roads. Dairy and other farming is also prevalent in the valleys. About 13% of the population lives below the federal poverty level. Average per capita income is approximately $15,400 and median household income is about $41,500. 11.6% of the population is uninsured. A few of the communities served by the hospital are designated as medically underserved or health professional service areas, but the Borough of Huntingdon, where the hospital is located, is not. | CommunityInformation |
| Community Building Activities | Part VI, Line 5: Much of the benefit to the community comes from participation in collaborative efforts that help to assess community need and to address health issues in Huntingdon County. Some of the direct service activities include free breast health and heart health screenings for women, supported by two grants, free diabetes self-management classes, educational programs, mentoring future health care professionals through internships and student practicums, participation in health fairs, patient advocacy and promotion of healthy lifestyles. Indirect support of these activities include hospital staff and medical staff members serving in leadership and working roles on boards and committees that impact the health status and well-being of community members. | CommunityBuildingActivities |
| Other Information | Part VI, Line 6: The governing body is representative of the communities in the primary and secondary service areas of the hospital. The Chief and Vice Chief of the Medical Staff are voting members of the board. Employees are generally not allowed to serve as voting members of the Board, however, one employed physician serves as vice chief of the medical staff and is a voting member by virtue of that position. members of the medical staff who serve on the board may have contractual relationships with the hospital or its affiliates, which they are asked to disclose in conflict of interest statements. any conflicts that meet the reporting thresholds of the 990 are duly reported. Medical staff privileges are granted through an application and credentialing process and are granted in accordance with bylaws and rules and regulations of the medical staff and board of directors. J.C. Blair Memorial Hospital is a small, rural hospital that is not engaged in research, but it does allocate funds annually for the upgrade of patient care equipment and for expenditures in tecnology or facilites to improve the safety and care of patients. Recent examples of purchases and upgrades are a new MRI scanner, a new echocardiogram machine, new patient beds and a new maternity and fetal monitoring system. Recent technology investments include nursing documentation, electronic medication administration record and bedside medication verification. | OtherInformation |
| Affiliated Health Care System | Part VI, Line 7: J.C. Blair Memorial Hosital is part of J.C. Blair Health System, Inc. The Health System also includes a Foundation, which raises funds through donations and grants to help the hospital acquire needed equipment and provide health and prevention programming, J.C Blair Rehabilitative Services, Inc. which participates in a joint venture to provide outpatient physical and occupational therapy, and J.C. Blair Medical Services, Inc. which has grown quickly over the past few years operating physician practices, allowing for a turn key set up that enhances recruitment of new providers. The companies work together under the parent company umbrella to deliver health care services and accomplish the vision of the Health System: To be a model of excellence for the provision of a comprehensive range of healthcare and wellness services designed to continually improve the health status and quality of life for the residents of Huntingdon County and nearby communities. | AffiliatedHealthCareSystem |
| Reports Filed With States | PA | ReportsFiledWithStates |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | jc blair memorial hospital foundation inc | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 935 14th street | AddressLine1 |
| City | HUNTINGDON | City |
| State | PA | State |
| ZIP Code | 16652 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 251881377 | EINOfRecipient |
| IRC Section | 501(c)(3) | IRCSection |
| Amount Of Cash Grant | 503466 | AmountOfCashGrant |
| Method Of Valuation | cash | MethodOfValuation |
| Description Of Non Cash Assistance | n/a | DescriptionOfNonCashAssistance |
| Purpose Of Grant | provide financial support for affiliates | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | NURSING LOAN EDUCATIONAL ASSISTANCE | TypeOfGrant |
| Number Of Recipients | 6 | NumberOfRecipients |
| Amount Of Cash Grant | 36000 | AmountOfCashGrant |
| Amount Of Non Cash Assistance | 0 | AmountOfNonCashAssistance |
| Method Of Valuation | CASH | MethodOfValuation |
| Description Of Non Cash Assistance | N/A | DescriptionOfNonCashAssistance |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedure for Monitoring Grants in the U.S.: | Identifier |
| Return Reference | Part I, Line 2: | ReturnReference |
| Explanation | Schedule I, Part I, Line 2: FUNDS ARE TRANSFERRED TO AN AFFILIATED ORGANIZATION WITH CONSISTENT MANAGEMENT AND USED TO FINANCIALLY SUPPORT THE FURTHERING OF THEIR EXEMPT PURPOSE. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Housing Allowance Or Residence | X | HousingAllowanceOrResidence |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| 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 | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Alfred K Sutton | |||||||||||||
| 227940 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 58307 | 0 | 286247 | 0 | 0 | 0 |
| JOSEPH PELUSO | |||||||||||||
| 170000 | 0 | 0 | 0 | 6171 | 0 | 0 | 0 | 42176 | 0 | 218347 | 0 | 0 | 0 |
| Nancy Glidden | |||||||||||||
| 127633 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 30690 | 0 | 158323 | 0 | 0 | 0 |
| john d roth | |||||||||||||
| 262321 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 67102 | 0 | 329423 | 0 | 0 | 0 |
| david finch | |||||||||||||
| 223554 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 57185 | 0 | 280739 | 0 | 0 | 0 |
| Glenn G Williams | |||||||||||||
| 217055 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 55523 | 0 | 272578 | 0 | 0 | 0 |
| brent acker | |||||||||||||
| 234245 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 59920 | 0 | 294165 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | Part I, Line 1a | ReturnReference |
| Explanation | Hospital provided temporary housing to the current CEO, Joseph Peluso, as part of his relocation. This benefit ($5,125) was not included in his taxable compensation. | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PA ECONOMIC DEVELOPMENT FINANCING AUTHORITY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 236003102 | IssuerEIN |
| CUSIP Number | 708693AD8 | CUSIPNumber |
| Date Issued | 2007-03-08 | DateIssued |
| Issue Price | 4000000 | IssuePrice |
| Description Of Purpose | Plant infrastructure upgrades and equipment replacement. | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 4000000 | TotalProceeds |
| Issuance Costs From Proceeds | 80000 | IssuanceCostsFromProceeds |
| Working Capital Expenditures | 60995 | WorkingCapitalExpenditures |
| Capital Expenditures | 3859005 | CapitalExpenditures |
| Year Of Subst Completion | 2010 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Bond Counsel Routinely Engaged | 1 | BondCounselRoutinelyEngaged |
| Prcntge Prvt Business Use By Others | 0.00000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUse |
| Post Issuance Compliance Procdrs | 1 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 1 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | FRED PRICE | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | BOARD OF DIRECTORS - MEMBER | Relationship |
| Amount Of Transaction | 32185 | AmountOfTransaction |
| Description Of Transaction | SISTER-IN-LAW IS EMPLOYED BY J.C. BLAIR MEDICAL SERVICES | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990, Part III, line 2 | New Program Services | Outpatient echocardiograms were added to the hospital's cardiopulmonary department activities. Occupational medicine program was approved in spring 2010 but was not implemented by fiscal year end. |
| Form 990, Part VI, Section A, line 2 | JOHN COURSEN AND FRANCES VAUGHN ARE EMPLOYED BY THE SAME EMPLOYER, MUTUAL BENEFIT GROUP INSURANCE. | |
| Form 990, Part VI, Section A, line 3 | The Hospital contracts with Quorum Health Resources (QHR) for management services. Executives (CEO and CFO) are provided through the contract, along with on-site support from a regional team at QHR and consulting services. The CEO and CFO provide leadership in strategic and business planning, operational improvements, and follow the policy set forth by the board to accomplish organizational objectives and ensure financial viability. | |
| Form 990, Part VI, Section B, line 11 | The 990 was provided in draft form to the Board before filing. the cfo also presented key points of the 990 to the board at a meeting prior to filing. | |
| Form 990, Part VI, Section B, line 12c | The Board members complete a conflict of interest statement annually and return to Executive Assistant who reviews and monitors compliance with the policy. Board members are required to abstain from voting on matters that involve conflicts. | |
| Form 990, Part VI, Section B, line 15 | The CEO and CFO are employeed by Quorum Health Resources ("QHR") but compensation is determined through a collaborative effort between QHR regional staff and the Executive Committee of the Board of Directors. QHR regional staff research salary market data and provide the Executive Committee with recommendation for a base salary both at hire and upon annual review. If the executive is eligible for a performance bonus, the criteria for determination of the bonus is developed by establishing objectives and measurements that will indicate the degree to which objectives have been accomplished. The Executive Committee of the Board must approve the compensation level including potential performance bonuses. | |
| Form 990, Part VI, Section C, line 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|
| JC BLAIR HEALTH SYSTEMS INC | |||||||||
| 1225 WARM SPRINGS AVENUE | HUNTINGDON | PA | 16652 | 251881383 | PROVIDE SUPPORT TO RELATED ORGANIZATIONS | PA | 501(C)(3) | 11 TYPE 1 | N/A |
| JC BLAIR MEDICAL SERVICES INC | |||||||||
| 1225 WARM SPRINGS AVENUE | HUNTINGDON | PA | 16652 | 251881378 | PROVIDER OF HOSPITALIST SERVICES AND OPERATIONS OF PHYSICAN PRACTICES | PA | 501(C)(3) | 3 | N/A |
| JC BLAIR MEMORIAL HOSPITAL FOUNDATION | |||||||||
| 935 14th STREET | HUNTINGDON | PA | 16652 | 231352159 | TO SUPPORT HEALTH CARE PROGRAMS OF THE HOSPTIAL | PA | 501(C)(3) | 11 TYPE 1 | N/A |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity |
|---|---|---|---|---|---|---|---|---|
| JC BLAIR REAL ESTATE HOLDINGS | ||||||||
| 1226 WARM SPRINGS AVENUE | HUNTINGDON | PA | 16652 | 251881380 | REAL ESTATE HOLDING | PA | N/A | C |
| JC BLAIR REHABILITATION SERVICES INC | ||||||||
| 1226 WARM SPRINGS AVENUE | HUNTINGDON | PA | 16652 | 251881385 | REHABILITATION SERVICES | PA | N/A | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | 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 | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |