Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
HEALTH CARE CORPORATION OF NORTHEASTERN PENNSYLVANIA
Employer identification number
23-2337286
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
No
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
No
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
No
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of support?
Yes
No
Yes
No
Yes
No
(1)
MERCY HOSPITAL SCRANTON PA
240795456
3
Yes
Yes
Yes
235,000
(2)
COMMUNITY MEDICAL CENTER
240862246
3
Yes
Yes
Yes
235,000
(3)
MOSES TAYLOR HOSPITAL
240795461
3
Yes
Yes
Yes
235,000
Total
705,000
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3..
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6
Public Support. Subtract line 5 from line 4.
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
7
Amounts from line 4..
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11
Total support (Add lines 7 through 10).
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c
Add lines 7a and 7b..
8
Public Support (Subtract line 7c from line 6.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
9
Amounts from line 6...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13
Total support (Add lines 9, 10c, 11 and 12.).
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
10000128
Software Version:
v2010.1.0
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
HEALTH CARE CORPORATION OF NORTHEASTERN PENNSYLVANIA
Employer identification number
23-2337286
Identifier
Return Reference
Explanation
Classes of members or stockholders
Form 990, Part VI, Section A, Line 6
HCC HAS 3 MEMBERS AS FOLLOWS: 1) COMMUNITY MEDICAL CENTER FOUNDATION, A PENNSYLVANIA NONPROFIT CORPORATION; 2) MERCY HOSPITAL, SCRANTON, A PENNSYLVANIA NONPROFIT CORPORATION; 3) MTH RESOURCES, INC., A PENNSYLVANIA NONPROFIT CORPORATION.
Members or stockholders electing members of governing body
Form 990, Part VI, Section A, Line 7a
THE BOARD OF TRUSTEES SHALL CONSIST OF THE RESPECTIVE CHIEF EXECUTIVE OFFICERS OF COMMUNITY MEDICAL CENTER, MERCY HOSPITAL, SCRANTON AND MOSES TAYLOR HOSPITAL, WHO SHALL BE EX OFFICIO VOTING MEMBERS OF THE BOARD, AND AT LEAST THREE ADDITIONAL ELECTED MEMBERS, THE NUMBER TO BE DETERMINED FROM TIME TO TIME BY RESOLUTION OF THE BOARD; PROVIDED, HOWEVER, THAT THE NUMBER OF ELECTED BOARD MEMBERS MAY ONLY BE INCREASED BY MULTIPLES OF THE NUMBER THREE SO THAT EACH MEMBER IS ENTITLED TO ELECT THE SAME NUMBER OF ELECTED TRUSTEES AT ALL TIMES AS ALL OTHER MEMBERS ARE ENTITLED TO ELECT AS SPECIFIED IN SECTION 4.02. ELECTED MEMBERS OF THE BOARD OF TRUSTEES SHALL BE SELECTED FOR THEIR ABILILTY TO PARTICIPATE EFFECTIVELY IN FULFILLING THE RESPONSIBILITIES OF THE BOARD. SECTION 4.02 - ELECTION - VOTING BY THE MEMBERS OF THE CORPORATION SOLELY FOR THE PURPOSE OF ELECTING TRUSTEES SHALL BE BY CLASS VOTE, WITH EACH MEMBER OF THE CORPORATION CONSTITUTING ITS OWN CLASS, WITH EACH CLASS VOTING SEPARATELY AND WITH EACH CLASS ENTITLED TO CAST ITS VOTES FOR THE ELECTION OF THE SAME NUMBER OF TRUSTEES AT ALL TIMES AS EACH OTHER CLASS IS ENTITLED TO ELECT. THE ELECTED TRUSTEES SHALL HOLD OFFICE FROM THE TIME OF THEIR ELECTION UNTIL THEIR SUCCESSORS HAVE BEEN DULY ELECTED AND HAVE QUALIFIED.
Decisions requiring approval by members or stockholders
Form 990, Part VI, Section A, Line 7b
VACANCIES IN TRUSTEE POSITIONS, INCLUDING VACANCIES RESULTING FROM ANY INCREASE IN THE AUTHORIZED NUMBER OF TRUSTEES, SHALL BE FILLED IN THE SAME MANNER SPECIFIED IN SECTION 4.02, WITH EACH MEMBER OF THE CORPORATION ENTITLED TO ELECT A NEW TRUSTEE OR TRUSTEES AS NECESSARY SO THAT THERE ARE AN EQUAL NUMBER OF ELECTED TRUSTEES REPRESENTING EACH MEMBER OF THE CORPORATION ON THE BOARD OF TRUSTEES AT ALL TIMES. ANY MEMBER OF THE CORPORATION MAY REMOVE ANY TRUSTEE ELECTED BY IT AT ANY TIME. THE BOARD OF TRUSTEES MAY DECLARE VACANT THE OFFICE OF A TRUSTEE WHO IS DECLARED OF UNSOUND MIND BY AN ORDER OF COURT, OR CONVICTED OF A FELONY, OR FOR ANY OTHER PROPER CAUSE, OR IF, WITHIN SIXTY DAYS AFTER NOTICE OF SUCH TRUSTEE'S ELECTION, SUCH TRUSTEE DOES NOT ACCEPT SUCH OFFICE EITHER IN WRITING OR BY ATTENDING A MEETING OF THE BOARD.
Review of form 990 by governing body
Form 990, Part VI, Section B, Line 11b
THE FORM 990 IS PREPARED BY THE CATHOLIC HEALTHCARE PARTNERS TAX DEPARTMENT AND REVIEWED BY THE BOARD OF HEALTHCARE CORPORATION OF NORTHEASTERN PENNSYLVANIA.
Conflict of interest policy
Form 990, Part VI, Section B, Line 12c
IT IS RECOGNIZED THAT OCCASIONS MAY ARISE WHEN A MEMBER OF THE BOARD OF TRUSTEES OR OFFICER OF THE CORPORATION HAS A FINANCIAL INTEREST IN A CONTRACT OR TRANSACTION UPON WHICH ACTION IS TO BE TAKEN OR WITHHELD BY SUCH BOARD OR A COMMITTEE. IT IS THE POLICY OF THE CORPORATION AND OF ITS BOARD OF TRUSTEES THAT: A) ANY MATERIAL FACTS AS TO SUCH FINANCIAL INTEREST SHALL BE DISCLOSED BY SUCH MEMBER OR OFFICER TO THE MEMBERS OF SUCH BOARD OR COMMITTEE. SUCH DISCLOSURE SHALL BE RECORDED IN AN ANNUAL CONFLICT OF INTEREST STATEMENT SIGNED BY SUCH MEMBER AND OFFICER OR, IF NOT PREVIOUSLY DISCLOSED IN SUCH STATEMENT, WHEN THE MATTER AT INTEREST COMES UP FOR ACTION BY SUCH BOARD OR COMMITTEE. B) THE MEMBER OR OFFICER HAVING SUCH FINANCIAL INTEREST ON ANY MATTER SHALL NOT VOTE OR USE ANY PERSONAL INFLUENCE IN REGARD TO THE MATTER (EXCEPT THAT THE MEMBER MAY STATE A POSITION ON THE MATTER AND RESPOND TO QUESTIONS ABOUT IT); HOWEVER, SUCH MEMBER OF OFFICER MAY BE COUNTED IN DETERMINING THE QUORUM FOR THE MEETING AT WHICH THE MATTER IS VOTED UPON. THE MINUTES OF THE MEETING SHALL REFLECT THAT THE DISCLOSURE WAS MADE AND THE ABSTENTION FROM VOTING. C) THE BOARD OR COMMITTEE MAY AUTHORIZE ANY CONTRACT OR TRANSACTION BETWEEN THE CORPORATION AND ANY SUCH MEMBER OR OFFICER, OR BETWEEN THE CORPORATION AND ANY CORPORATION, ASSOCIATION, OR OTHER ORGANIZATION IN WHICH SUCH MEMBER OR OFFICER IS A DIRECTOR OR OFFICER OR HAS A FINANCIAL INTEREST, UNLESS SUCH CONTRACT OR TRANSACTION WOULD BE IN VIOLATION OF APPLICABLE LAW, INCLUDING SECTION 7728 OF THE CODE. THIS POLICY SHALL BE REVIEWED BY THE BOARD ANNUALLY FOR THE INFORMATION AND GUIDANCE OF MEMBERS OF THE BOARD AND OFFICERS, AND BROUGHT TO THE ATTENTION OF NEW MEMBERS OF THE BOARD AND OFFICERS.
Public Disclosure
Form 990, Part VI, Section C, Line 19
HCC'S CONFLICT OF INTEREST POLICY, GOVERNING DOCUMENTS, AND ARTICLES OF INCORPORATION ARE AVAILABLE UPON REQUEST.
AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS BY LISTED PERSONS
FORM 990 PART VII SECTION A COLUMN (B)
KEVIN COOK 40 STEPHEN H. FRANKO, III 40 MICHAEL M. COSTELLO 40 KAREN MURPHY 40 SEAN MCANDREW 40 BARBARA BOSSI 40
Other changes in net assets or fund balances
Form 990, Part XI, Line 5
EQUITY DISTRIBUTIONS - -705000;
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.