Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2012
Open to Public Inspection
A For the 2012 calendar year, or tax year beginning 07-01-2012 , 2012, and ending 06-30-2013
BCheck if applicable:
CName of organization
HOME NURSING AGENCY AFFILIATES
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
201 CHESTNUT AVENUE PO BOX 352
 
Room/suite
City or town, state or country, and ZIP + 4
ALTOONA, PA166030352
D Employer identification number

25-1518698
E Telephone number

G Gross receipts $ 9,679,915
F Name and address of principal officer:
ROBERT PACKER
20 SHERATON DRIVE
ALTOONA,PA16601
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.HOMENURSINGAGENCY.COM
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1986
M State of legal domicile: PA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: HOME NURSING AGENCY AFFILIATES IS REFERRED TO AS "HNA AFFILIATES" WITHIN THIS FORM 990. IN ADDITION, HOME NURSING AGENCY IS REFERRED TO AS "HNA", PART I, LINE 1 AND PART III, LINE 1 AS PROVIDED IN ITS ARTICLES, THE CORPORATION IS ORGANIZED AND SHALL BE OPERATED EXCLUSIVELY FOR EXEMPT PURPOSES WITHIN THE MEANING OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED(OR THE CORRESPONDING PROVISION OF ANY FUTURE UNITED STATES INTERNAL REVENUE LAW)(THE "CODE"), AND, IN FURTHERANCE THEREOF, OPERATING EXCLUSIVELY FOR THE BENEFIT OF AND TO SUPPORT HOME NURSING AGENCY VISITING NURSE ASSOCIATION AND HOME NURSING AGENCY COMMUNITY SERVICES, EACH OF WHICH IS A PENNSYLVANIA NONPROFIT CORPORATION, PROVIDED THAT EACH SUCH CORPORATION IS AN ORGANIZATION DESCRIBED IN SECTION 509(A)(1) OR 509(A)(2) OF THE CODE.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 15
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 11
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...... 5 3
6 Total number of volunteers (estimate if necessary) ............. 6  
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b  
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) .........   0
9 Program service revenue (Part VIII, line 2g) ......... 3,874,694 3,853,127
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 56,648 40,912
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 2,522 2,604
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 3,933,864 3,896,643
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...   0
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 983,268 1,085,274
16a Professional fundraising fees (Part IX, column (A), line 11e).....   0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 2,930,474 2,883,738
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 3,913,742 3,969,012
19 Revenue less expenses. Subtract line 18 from line 12....... 20,122 -72,369
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 9,997,316 9,788,621
21 Total liabilities (Part X, line 26)............. 7,295,834 7,058,460
22 Net assets or fund balances. Subtract line 21 from line 20..... 2,701,482 2,730,161
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2012)
Form 990 (2012)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III ...............
1
Briefly describe the organization’s mission: HOME NURSING AGENCY AFFILIATES IS REFERRED TO AS "HNA AFFILIATES" WITHIN THIS FORM 990. IN ADDITION, HOME NURSING AGENCY IS REFERRED TO AS "HNA", PART I, LINE 1 AND PART III, LINE 1 AS PROVIDED IN ITS ARTICLES, THE CORPORATION IS ORGANIZED AND SHALL BE OPERATED EXCLUSIVELY FOR EXEMPT PURPOSES WITHIN THE MEANING OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED(OR THE CORRESPONDING PROVISION OF ANY FUTURE UNITED STATES INTERNAL REVENUE LAW)(THE "CODE"), AND, IN FURTHERANCE THEREOF, OPERATING EXCLUSIVELY FOR THE BENEFIT OF AND TO SUPPORT HOME NURSING AGENCY VISITING NURSE ASSOCIATION AND HOME NURSING AGENCY COMMUNITY SERVICES, EACH OF WHICH IS A PENNSYLVANIA NONPROFIT CORPORATION, PROVIDED THAT EACH SUCH CORPORATION IS AN ORGANIZATION DESCRIBED IN SECTION 509(A)(1) OR 509(A)(2) OF THE CODE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If “Yes,” describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 2,152,085 including grants of $   ) (Revenue $ 2,036,416 )
PROVIDES FACILITIES MANAGEMENT AND FACILITIES ACCOUNTING FOR OWNED AND RENTED BUILDINGS OCCUPIED BY HOME NURSING AGENCY & VISITING NURSE AGENCY, HOME NURSING AGENCY FOUNDATION, AND HOME NURSING AGENCY COMMUNITY SERVICES OPERATIONS.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
THE EXPENSES OF THE HNA AFFILIATES LEADERSHIP AND STRATEGIC ASSISTANCE ARE INCLUDED IN PART IX - STATEMENT OF FUNCTIONAL EXPENSES, COLUMN C - MANAGEMENT AND GENERAL EXPENSES. SEE SCHEDULE O SUPPORTING SERVICES AS WELL AS PROVIDING LEADERSHIP AND STRATEGIC ASSISTANCE TO HOME NURSING AGENCY VISITING NURSE ASSOCIATION AND HOME NURSING AGENCY COMMUNITY SERVICES. ADVANCING EFFICIENCY & EXCELLENCE IN SERVICES, CLINICAL OUTCOMES REALIGNING HOME NURSING AGENCY'S SERVICE DELIVERY MODEL AND STRENGTHENING ITS ABILITY TO ACHIEVE CLINICAL OUTCOMES THAT EXCEED NORMS REQUIRES ONGOING DEDICATION AND ATTENTION TO DETAIL DUE TO THE NEW AND EVOLVING PROCESSES OF HEALTHCARE REFORM. TO BE CONSIDERED AS A VALUED PARTNER IN AN EVER-CHANGING LANDSCAPE AND TO REMAIN AS THE PROVIDER OF CHOICE TO REFERRALS/PATIENTS, HOME NURSING AGENCY AFFILIATES UNDERSTAND AND ENDORSE THE AGENCY'S COMMITMENT TO PROVIDE THE LOWEST UNIT COST AND THE HIGHEST QUALITY OF CARE, BOTH IN POST-ACUTE CARE AND BEHAVIORAL HEALTH SERVICES. THE AFFILIATES ARE COMMITTED TO THE AGENCY'S CORE PRINCIPLES OF CUSTOMER SATISFACTION, EMPLOYEE SATISFACTION, QUALITY, LEADERSHIP AND PROFITABLE GROWTH AND ARE PREPARED TO CONFRONT THE COMPLEXITIES OF HEALTHCARE REFORM AND REGULATORY CONSTRAINTS IMPACTING MANY OF OUR PROGRAMS AND SERVICES. WE'RE CONTINUING TO PROVIDE THE PEOPLE WE SERVE WITH REMARKABLE CARE THAT IS OUR TRADEMARK, BEGINNING IN 1968. OUR SUCCESS IN THESE ENDEAVORS IS EVIDENCED IN THE INCREASED RATING OF OUR CUSTOMERS' "LIKELIHOOD OF RECOMMENDING" THE AGENCY TO FAMILY AND FRIENDS AS WELL AS IN OUR RANKING BEST PLACES TO WORK IN PA 8 OF THE LAST 9 YEARS. EXCEEDING OUR BENCHMARK GOAL IS A RESULT OF EMPLOYEES' EXTRAORDINARY EFFORTS FROM ALL HOME NURSING AGENCY'S SERVICES AND PROGRAMS. WE KNOW OUR SERVICE DELIVERY MODELS AND BUSINESS LINES ARE FAR ADVANCED , AND THAT WE ARE UNIQUELY POSITIONED TO BE THE NEW POST ACUTE PROVIDER IN ANY REGION OR STATE THAT WE CHOOSE TO ENTER. WE WANT TO BE THE 'KEY PLAYER' AS HOSPITALS, PHYSICIANS AND PAYORS/PROVIDERS DELVE INTO THE EMERGING CARE DELIVERY MODELS SUCH AS VALUE-BASED PURCHASING PARTNERSHIPS, ACCOUNTABLE CARE ORGANIZATIONS AND MEDICAL HOMES. RIGHT NOW, NEW PAYMENT MODELS FOR POST ACUTE SERVICES LIKE OURS ARE ONCE AGAIN BEING EXPLORED AND REDESIGNED FROM A PROSPECTIVE PAYMENT SYSTEM PPS, INITIATED IN 1998 WHEN I STARTED, TO WHAT IS NOW REFERRED TO AS "BUNDLED PAYMENTS" OR "VALUE-BASED PURCHASING". IN LIGHT OF THESE DEVELOPMENTS, WE WANT TO KNOW HOW TO BEST ALIGN OUR RESOURCES AROUND THE NEEDS OF OUR PATIENT POPULATION TO ENSURE THE GREATEST EFFICIENCIES AND OUTCOMES FOR PATIENTS AND PROVIDERS ALIKE. WE ALSO WANT TO SUCCESSFULLY ALIGN WITHIN OUR OWN AGENCY TO CREATE A CENTRALIZED POST ACUTE NETWORK, WHICH ALLOWS US TO BETTER HARNESS OUR DIVERSE CAPABILITES AND RESOURCES. THROUGH THE AFFILIATES' LEADERSHIP, THE AGENCY HAS GARNERED THE FOLLOWING RECOGNITION OVER THE PAST YEAR: A NATIONAL PILOT FOR A QUALITY IMPROVEMENT INITIATIVE IN BEHAVIORAL HEALTH OUTPATIENT, SPONSORED AND FUNDED BY THE NATIONAL COUNCIL FOR COMMUNITY BEHAVIORAL HEALTHCARE. AN ACCREDITED AND CERTIFIED HOME HEALTH AND HOSPICE PROGRAMS FROM CHAP (COMMUNITY HEALTH ACCREDITATION PROGRAM) A BEST PLACE TO WORK IN PA, 2004-2010, 2012 A STRONG, VIABLE HOME NURSING AGENCY FOUNDATION, GRANTING 857,000 SINCE 2005 TO IMPACT PATIENT CARE AND SERVICES PROVIDED IN THE HOME AND IN THE COMMUNITY. AN ACTIVE AND LEADING MEMBER OF NATIONAL ALLIANCE ON MENTAL ILLNESS 100% COMPLIANCE FROM PA DEPARTMENT OF HEALTH/WELFARE 2011, HOSPICE, PRIVATE DUTY SERVICES, TARTAGLIO PERSONAL CARE HOME, ADULT/CHILDREN'S PARTIAL HOSPITALIZATION AND CENTER FOR COUNSELING A MEMBER OF HOME CARE ELITE, EIGHT YEARS RUNNING A PROUD MEMBER OF UNITED WAY OF LAUREL HIGHLANDS, BEDFORD, BLAIR, HUNTINGDON A LEADING MEMBER OF THE NATIONAL NURSE-FAMILY PARTNERSHIP PROGRAM HELPING FIRST TIME PARENTS SUCCEED A RECIPIENT OF SEVERAL GRANTS TO ENHANCE EXISTING PROGRAMS AND SERVICES FROM LEE INITIATIVES, UNITED WAY OF LAUREL HIGHLANDS, BEDFORD, BLAIR, HUNTINGDON COUNTIES, CENTRAL PENNSYLVANIA COMMUNITY FOUNDATION, AND COMMUNITY FOUNDATION OF THE ALLEGHENIES
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet2,152,085
Form 990 (2012)
Form 990 (2012)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? ...
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If “Yes,” complete Schedule C, Part II........
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C,
Part III............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,” complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If “Yes,” complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part XClick to see attachment.........................
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the United States? If “Yes,” complete Schedule F, Parts II and IV
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the United States? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I (see instructions)....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If “Yes,” complete Schedule H....
20a
 
No
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
Form 990 (2012)
Form 990 (2012)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II...
21
 
No
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I........ Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highest compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II.......................... Click to see attachment
26
Yes
 
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV..................... Click to see attachment
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If “Yes,” complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2...
35b
 
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2012)
Form 990 (2012)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V ...............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
39
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
3
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes,” to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
No
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
No
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?............
8
 
No
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?..........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?.......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2012)
Form 990 (2012)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI ...............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
15
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
11
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
 
No
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
No
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
PA
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletGREGG LAVERICK20 SHERATON DRIVEALTOONAPA16601 (814) 946-5411
Form 990 (2012)
Form 990 (2012)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII ...............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) GERALD MURRAY........................................................................
DIRECTOR
 1.00
.......................50.00 		X           0 697,319 352,226
(2) ROBERT R PACKER........................................................................
DIRECTOR & C
 60.00
.......................   		X   X X     354,789 0 72,686
(3) BRUCE ERB........................................................................
CHAIRMAN
 1.00
.......................1.00 		X   X       0 0 0
(4) JOHN BEYER........................................................................
DIRECTOR
 1.00
.......................1.00 		X           0 0 0
(5) JOHN J WOLF........................................................................
DIRECTOR
 1.00
.......................   		X           0 0 0
(6) DONALD DEVORRIS........................................................................
DIRECTOR
 1.00
.......................1.00 		X           0 0 0
(7) FREDERICK CIOCCA........................................................................
DIRECTOR
 1.00
.......................   		X           0 0 0
(8) MORLEY COHN........................................................................
DIRECTOR
 1.00
.......................1.00 		X           0 0 0
(9) DONALD DETWILER........................................................................
DIRECTOR
 1.00
.......................   		X           0 0 0
(10) ALLAN HANCOCK........................................................................
DIRECTOR
 1.00
.......................1.00 		X           0 0 0
(11) ROBERT SCHOLL........................................................................
DIRECTOR
 1.00
.......................   		X           0 0 0
(12) TIMOTHY SISSLER........................................................................
VICE CHAIRMA
 1.00
.......................   		X   X       0 0 0
(13) BERNARD CREPPAGE........................................................................
TREASURER
 1.00
.......................1.00 		X   X       0 0 0
(14) JAY DRENNING........................................................................
SECRETARY
 1.00
.......................1.00 		X   X       0 0 0
(15) BARRY HALBRITTER........................................................................
DIRECTOR
 1.00
.......................1.00 		X           0 0 0
(16) REBECCA A WILLNECKER........................................................................
CPO
 50.00
.......................   		    X X     193,371 0 12,393
(17) GREGG A LAVERICK........................................................................
CFO
 50.00
.......................   		    X X     182,865 0 33,535
Form 990 (2012)
Form 990 (2012)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;


























1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 731,025 697,319 470,840
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet3
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
CLEAN SERVICE AND SUPPLY, 811 SCOTCH VALLEY ROADHOLLIDAYSBURGPA16648 OFFICE CLEANING 136,402
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet1
Form 990 (2012)
Form 990 (2012)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response to any question in this Part VIII ..............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		 
g Noncash contributions included in lines
1a-1f:$ 		 
h Total. Add lines 1a-1f.......MediumBullet  
Program Service Revenue Business Code
2a RENTAL INCOME 532000 2,036,416 2,036,416    
b MANAGEMENT SERVICES 551112 1,816,711 1,816,711    
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 3,853,127
Other Revenue 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 42,293     42,293
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties...........MediumBullet        
(i) Real (ii) Personal
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 5,781,891  
b Less: cost or other basis and sales expenses 5,783,272  
c Gain or (loss) -1,381  
d Net gain or (loss)..........MediumBullet -1,381     -1,381
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a MISCELLANEOUS   2,604     2,604
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 2,604
12 Total revenue. See Instructions......MediumBullet 3,896,643 3,853,127   43,516
Form 990 (2012)
Form 990 (2012)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response to any question in this Part IX ...............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21    
2 Grants and other assistance to individuals in the United States. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 846,330   846,330  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages        
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 81,892   81,892  
9 Other employee benefits ....... 111,924   111,924  
10 Payroll taxes ........... 45,128   45,128  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 28,069   28,069  
c Accounting ........... 54,975   54,975  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 778   778  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 98,494   98,494  
12 Advertising and promotion ....        
13 Office expenses ....... 215,980 47,875 168,105  
14 Information technology ...... 1,460 1,460    
15 Royalties ..        
16 Occupancy ........... 1,776,471 1,729,848 46,623  
17 Travel ............ 15,018   15,018  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 1,170   1,170  
20 Interest ...........        
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 429,445 372,866 56,579  
23 Insurance .............. 228,234   228,234  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MISCELLANEOUS 33,644 36 33,608  
b
c
d
e All other expenses        
25 Total functional expenses. Add lines 1 through 24e 3,969,012 2,152,085 1,816,927 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2012)
Form 990 (2012)
Page 11
Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing ............. 200 1 200
2 Savings and temporary cash investments ......... 2,635,088 2 454,098
3 Pledges and grants receivable, net ...........   3  
4 Accounts receivable, net ............. 370,717 4 492,233
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
276,410 5 171,835
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
  6  
7 Notes and loans receivable, net ............. 47,850 7 1,547,519
8 Inventories for sale or use ..............   8 1,667
9 Prepaid expenses and deferred charges .......... 655,183 9 774,821
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 8,948,532
b Less: accumulated depreciation ..... 10b 4,439,412 4,919,642 10c 4,509,120
11 Investments—publicly traded securities .......... 896,915 11 1,611,724
12 Investments—other securities. See Part IV, line 11 ..... 195,311 12 225,404
13 Investments—program-related. See Part IV, line 11 .....   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ...........   15  
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 9,997,316 16 9,788,621
Liabilities 17 Accounts payable and accrued expenses ......... 1,451,470 17 1,485,605
18 Grants payable .................   18  
19 Deferred revenue ................   19  
20 Tax-exempt bond liabilities .............   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties .. 2,493,388 23 2,416,209
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 3,350,976 25 3,156,646
26 Total liabilities. Add lines 17 through 25......... 7,295,834 26 7,058,460
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 2,512,040 27 2,730,161
28 Temporarily restricted net assets ........... 189,442 28  
29 Permanently restricted net assets ...........   29  
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 2,701,482 33 2,730,161
34 Total liabilities and net assets/fund balances ........ 9,997,316 34 9,788,621
Form 990 (2012)
Form 990 (2012)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI ...............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
3,896,643
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
3,969,012
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-72,369
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
2,701,482
5
Net unrealized gains (losses) on investments ...............
5
 
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
101,048
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
2,730,161
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII ..............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If “Yes,” to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits
3b
Yes
 
Form 990 (2012)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

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.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
HOME NURSING AGENCY AFFILIATES
 
Employer identification number

25-1518698
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
f
g
(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 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 monetary support
Yes No Yes No Yes No
(A) HOME NURSING AGENCY AND VISITING NURSE ASSOCIATION
  		251188570 9 Yes   Yes   Yes   1,360,099
(B) HOME NURSING AGENCY COMMUNITY SERVICES
  		251517533 9 Yes   Yes   Yes   650,408
Total                 2,010,507

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..            
11 Total support (Add lines 7 through 10).            
12
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........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
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 ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 3
Part III
Support Schedule for Organizations Described in Section 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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 4
Part IV
Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2012

Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
HOME NURSING AGENCY AFFILIATES
 
Employer identification number

25-1518698
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) .....    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance ....          
b Contributions ........          
c Net investment earnings, gains, and losses          
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........ 		         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   640,711 640,711
b Buildings ................   6,374,777 3,452,054 2,922,723
c Leasehold improvements ............   1,409,005 617,876 791,129
d Equipment ................   524,039 369,482 154,557
e Other .................        
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 4,509,120
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests 50,000  
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 225,404
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes  
DUE TO HNA VNA 1,646,836
LIABILITIES-WORKER COMP TRUST 991,707
PENSION LIABILITY 294,983
ANNUITY LIABILITY 213,120
RESERVES FOR CONTINGENCY 10,000




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 3,156,646
2. Fin 48 (ASC 740) Footnote. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII .....................................................
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 3,896,643
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3 3,896,643
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 3,896,643
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ........... 1 3,969,012
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3 3,969,012
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 3,969,012
Part XIII
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
Schedule D (Form 990) 2012

Additional Data


Software ID:  
Software Version:  




Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
HOME NURSING AGENCY AFFILIATES
 
Employer identification number

25-1518698
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all officers,
directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? .......
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
Yes
 
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2012

Schedule J (Form 990) 2012
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)GERALD MURRAYDIRECTOR (i)
(ii)		  
536,612 		 
159,120 		 
1,587 		 
327,355 		 
24,871 		 
1,049,545 		 
 
(2)ROBERT R PACKERDIRECTOR & CEO (i)
(ii)		 267,835
  		34,826
  		52,128
  		68,977
  		3,709
  		427,475
  		 
 
(3)REBECCA A WILLNECKERCPO (i)
(ii)		 171,025
  		14,869
  		7,477
  		12,393
  		 
  		205,764
  		 
 
(4)GREGG A LAVERICKCFO (i)
(ii)		 153,431
  		10,141
  		19,293
  		33,535
  		 
  		216,400
  		 
 
Schedule J (Form 990) 2012

Schedule J (Form 990) 2012
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Identifier Return Reference Explanation
OTHER ADDITIONAL INFORMATION SCHEDULE J, PART III PART 1, LINE 6B. INCENTIVE PAY FOR CEO, OFFICERS AND KEY EMPLOYEES IS BASED ON A FORMULA BASED ON OPERATING EXCESS OF HNA VISITING NURSE ASSOCIATES AND HNA COMMUNITY SERVICES. AN INCENTIVE WILL BE PAID WHEN THE COMBINED COMPANIES EXCEED 4% RETURN ON REVENUE. FOR CEO, THE MINIMUM PAYOUT FOR MEETING THE RETURN ON REVENUE IS 10% OF BASE PAY, WITH A MAXIMUM OF 30% OF BASE PAY. OTHER KEY EXECUTIVES RANGES ARE PRORATED, WITH THE MINIMUM BEING 4% TO MAXIMUM OF 18% OF BASE PAY. INCENTIVE COMPENSATION IS REVIEWED AND APPROVED BY AN INDEPENDENT COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. PART II, LINE 4: MR. MURRAY WAS AN EMPLOYEE OF THE ALTOONA REGIONAL HEALTH SYSTEM ("ARHS") DURING THE 2013 FISCAL YEAR. ARHS IS A RELATED ORGANIZATION OF HNA AFFILIATES - SEE FORM 990, SCHEDULE R.
Schedule J (Form 990) 2012

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
HOME NURSING AGENCY AFFILIATES
 
Employer identification number

25-1518698
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501(c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





2
Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
(1) ROBERT PACKER   COMP LIFE INSURANCE PREMIUMS   X   91,254   No Yes   Yes  
(2) GREGG LAVERICK   COMP LIFE INSURANCE PREMIUMS   X   77,273   No Yes   Yes  
(3) REBECCA WILLNECKER   COMP LIFE INSURANCE PREMIUMS   X   3,308   No Yes   Yes  
Total ......Small Bullet $ 171,835
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2012
Schedule L (Form 990 or 990-EZ) 2012
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) DONALD DEVORRIS DIRECTOR 601,491 RENT   No
(2) TIM SISSLER DIRECTOR 153,780 MORTGAGE SERVICES   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
ADDITIONAL INFORMATION SCHEDULE L PART V IIC THE ORGANIZATION HAS A LIFE COMPENSATION PLAN WHICH IS A NONQUALIFIED KEY EXECUTIVE PENSION SUPPLEMENT TO EXISTING GROUP PENSION PLANS ANDOR 401K PLANS PART IV THE ITEM IN LINE 1 WITH TRANSACTION AMOUNT OF 601491 REPRESENTS RENTS PAID TO DONALD DEVORRIS CORPORATION PART IV THE ITEM IN LINE 2 WITH TRANSACTION AMOUNT OF 153780 REPRESENTS MORTGAGE PAYMENTS TO THE EMPLOYER OF TIM SISSLER
Schedule L (Form 990 or 990-EZ) 2012

Additional Data


Software ID:  
Software Version:  




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.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
HOME NURSING AGENCY AFFILIATES
 
Employer identification number

25-1518698
Identifier Return Reference Explanation
ORGANIZATION'S MISSION FORM 990 - ORGANIZATION'S MISSION HOME NURSING AGENCY AFFILIATES IS REFERRED TO AS "HNA AFFILIATES" WITHIN THIS FORM 990. IN ADDITION, HOME NURSING AGENCY IS REFERRED TO AS "HNA", PART I, LINE 1 AND PART III, LINE 1 AS PROVIDED IN ITS ARTICLES, THE CORPORATION IS ORGANIZED AND SHALL BE OPERATED EXCLUSIVELY FOR EXEMPT PURPOSES WITHIN THE MEANING OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED(OR THE CORRESPONDING PROVISION OF ANY FUTURE UNITED STATES INTERNAL REVENUE LAW)(THE "CODE"), AND, IN FURTHERANCE THEREOF, OPERATING EXCLUSIVELY FOR THE BENEFIT OF AND TO SUPPORT HOME NURSING AGENCY VISITING NURSE ASSOCIATION AND HOME NURSING AGENCY COMMUNITY SERVICES, EACH OF WHICH IS A PENNSYLVANIA NONPROFIT CORPORATION, PROVIDED THAT EACH SUCH CORPORATION IS AN ORGANIZATION DESCRIBED IN SECTION 509(A)(1) OR 509(A)(2) OF THE CODE.
SECOND ACCOMPLISHMENT DESCRIPTION FORM 990, PAGE 2, PART III, LINE 4B SUPPORTING SERVICES AS WELL AS PROVIDING LEADERSHIP AND STRATEGIC ASSISTANCE TO HOME NURSING AGENCY VISITING NURSE ASSOCIATION AND HOME NURSING AGENCY COMMUNITY SERVICES. ADVANCING EFFICIENCY & EXCELLENCE IN SERVICES, CLINICAL OUTCOMES REALIGNING HOME NURSING AGENCY'S SERVICE DELIVERY MODEL AND STRENGTHENING ITS ABILITY TO ACHIEVE CLINICAL OUTCOMES THAT EXCEED NORMS REQUIRES ONGOING DEDICATION AND ATTENTION TO DETAIL DUE TO THE NEW AND EVOLVING PROCESSES OF HEALTHCARE REFORM. TO BE CONSIDERED AS A VALUED PARTNER IN AN EVER-CHANGING LANDSCAPE AND TO REMAIN AS THE PROVIDER OF CHOICE TO REFERRALS/PATIENTS, HOME NURSING AGENCY AFFILIATES UNDERSTAND AND ENDORSE THE AGENCY'S COMMITMENT TO PROVIDE THE LOWEST UNIT COST AND THE HIGHEST QUALITY OF CARE, BOTH IN POST-ACUTE CARE AND BEHAVIORAL HEALTH SERVICES. THE AFFILIATES ARE COMMITTED TO THE AGENCY'S CORE PRINCIPLES OF CUSTOMER SATISFACTION, EMPLOYEE SATISFACTION, QUALITY, LEADERSHIP AND PROFITABLE GROWTH AND ARE PREPARED TO CONFRONT THE COMPLEXITIES OF HEALTHCARE REFORM AND REGULATORY CONSTRAINTS IMPACTING MANY OF OUR PROGRAMS AND SERVICES. WE'RE CONTINUING TO PROVIDE THE PEOPLE WE SERVE WITH REMARKABLE CARE THAT IS OUR TRADEMARK, BEGINNING IN 1968. OUR SUCCESS IN THESE ENDEAVORS IS EVIDENCED IN THE INCREASED RATING OF OUR CUSTOMERS' "LIKELIHOOD OF RECOMMENDING" THE AGENCY TO FAMILY AND FRIENDS AS WELL AS IN OUR RANKING BEST PLACES TO WORK IN PA 8 OF THE LAST 9 YEARS. EXCEEDING OUR BENCHMARK GOAL IS A RESULT OF EMPLOYEES' EXTRAORDINARY EFFORTS FROM ALL HOME NURSING AGENCY'S SERVICES AND PROGRAMS. WE KNOW OUR SERVICE DELIVERY MODELS AND BUSINESS LINES ARE FAR ADVANCED , AND THAT WE ARE UNIQUELY POSITIONED TO BE THE NEW POST ACUTE PROVIDER IN ANY REGION OR STATE THAT WE CHOOSE TO ENTER. WE WANT TO BE THE 'KEY PLAYER' AS HOSPITALS, PHYSICIANS AND PAYORS/PROVIDERS DELVE INTO THE EMERGING CARE DELIVERY MODELS SUCH AS VALUE-BASED PURCHASING PARTNERSHIPS, ACCOUNTABLE CARE ORGANIZATIONS AND MEDICAL HOMES. RIGHT NOW, NEW PAYMENT MODELS FOR POST ACUTE SERVICES LIKE OURS ARE ONCE AGAIN BEING EXPLORED AND REDESIGNED FROM A PROSPECTIVE PAYMENT SYSTEM PPS, INITIATED IN 1998 WHEN I STARTED, TO WHAT IS NOW REFERRED TO AS "BUNDLED PAYMENTS" OR "VALUE-BASED PURCHASING". IN LIGHT OF THESE DEVELOPMENTS, WE WANT TO KNOW HOW TO BEST ALIGN OUR RESOURCES AROUND THE NEEDS OF OUR PATIENT POPULATION TO ENSURE THE GREATEST EFFICIENCIES AND OUTCOMES FOR PATIENTS AND PROVIDERS ALIKE. WE ALSO WANT TO SUCCESSFULLY ALIGN WITHIN OUR OWN AGENCY TO CREATE A CENTRALIZED POST ACUTE NETWORK, WHICH ALLOWS US TO BETTER HARNESS OUR DIVERSE CAPABILITES AND RESOURCES. THROUGH THE AFFILIATES' LEADERSHIP, THE AGENCY HAS GARNERED THE FOLLOWING RECOGNITION OVER THE PAST YEAR: A NATIONAL PILOT FOR A QUALITY IMPROVEMENT INITIATIVE IN BEHAVIORAL HEALTH OUTPATIENT, SPONSORED AND FUNDED BY THE NATIONAL COUNCIL FOR COMMUNITY BEHAVIORAL HEALTHCARE. AN ACCREDITED AND CERTIFIED HOME HEALTH AND HOSPICE PROGRAMS FROM CHAP (COMMUNITY HEALTH ACCREDITATION PROGRAM) A BEST PLACE TO WORK IN PA, 2004-2010, 2012 A STRONG, VIABLE HOME NURSING AGENCY FOUNDATION, GRANTING 857,000 SINCE 2005 TO IMPACT PATIENT CARE AND SERVICES PROVIDED IN THE HOME AND IN THE COMMUNITY. AN ACTIVE AND LEADING MEMBER OF NATIONAL ALLIANCE ON MENTAL ILLNESS 100% COMPLIANCE FROM PA DEPARTMENT OF HEALTH/WELFARE 2011, HOSPICE, PRIVATE DUTY SERVICES, TARTAGLIO PERSONAL CARE HOME, ADULT/CHILDREN'S PARTIAL HOSPITALIZATION AND CENTER FOR COUNSELING A MEMBER OF HOME CARE ELITE, EIGHT YEARS RUNNING A PROUD MEMBER OF UNITED WAY OF LAUREL HIGHLANDS, BEDFORD, BLAIR, HUNTINGDON A LEADING MEMBER OF THE NATIONAL NURSE-FAMILY PARTNERSHIP PROGRAM HELPING FIRST TIME PARENTS SUCCEED A RECIPIENT OF SEVERAL GRANTS TO ENHANCE EXISTING PROGRAMS AND SERVICES FROM LEE INITIATIVES, UNITED WAY OF LAUREL HIGHLANDS, BEDFORD, BLAIR, HUNTINGDON COUNTIES, CENTRAL PENNSYLVANIA COMMUNITY FOUNDATION, AND COMMUNITY FOUNDATION OF THE ALLEGHENIES
ADDITIONAL INFORMATION FORM 990, PART VI FORM 990, PART VI, LINE 12B DIRECTORS ARE REQUIRED TO DISCLOSE CONFLICTS OF INTEREST ANNUALLY THROUGH COMPLETION OF A SPECIFIC QUESTIONAIRE. ALL ORGANIZATION LEADERS, INCLUDING OFFICERS AND KEY EMPLOYEES, HAVE SIGNED A CONFLICT OF INTEREST AGREEMENT, WHICH REQUIRES THEM TO DISCLOSE CONFLICTS AS THEY OCCUR.
MATERIAL DIFFERENCES IN VOTING RIGHTS EXPLANATION FORM 990, PAGE 6, PART VI ARTICLE 1V, SECTION 4.2 OF THE HOME NURSING AGENCY AFFILIATES BYLAWS INDICATES THAT THE EXECUTIVE COMMITTE SHALL CONSIST OF THE CHAIRPERSON, PRESIDENT AND CEO, VICE PRESIDENT (IF ANY), SECRETERY, TREASURER, AND THE CHAIRPERSONS OF THE STANDING COMMITTEES, PROVIDED THAT ALL SUCH INDIVIDUALS ARE DIRECTORS OF THE CORPORATION. MEETINGS OF THIS COMMITTEE SHALL BE CALLED BY THE CHAIRPERSONS OR BY ANY THREE (3) OF ITS MEMBERS. A QUORUM SHALL CONSIST OF A MAJORITY OF THE MEMBERS (WHICH MUST INCLUDE AT LEASE ONE (1) OF ITS OFFICERS). THE ACT OF A MAJORITY OF THE MEMBERS ENTITILED TO VOTE AT A MEETING AT WHICH A QUORUM IS PRESENT SHALL BE THE ACT OF THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL HAVE THE POWERS OF THE BOARD FOR THE TRANSACTIONS OF BUSINESS BETWEEN BOARD MEETINGS OR IN AN EMERGENCY, EXCEPT THAT IT SHALL NOT RESERVE ANY PREVIOUS ACTION OF THE BOARD. ANY ACTION TAKEN BY THE EXECUTIVE COMMITTEE SHALL BE REPORTED AT THE NEXT MEETING OF THE BOARD. ARTICLE II, SECTION 2.5 INDICATES THAT NO COMPENSATION SHALL BE PAID TO ANY DIRECTOR FOR SERVICES AS A DIRECTOR.
RELATED PARTY INFORMATION AMONG OFFICERS FORM 990, PAGE 6, PART VI, LINE 2 MORLEY COHN; D DEVORRIS, J BEYER, BUSINESS RELATIONSHIPS MORLEY COHN; J. DRENNING BUSINESS RELATIONSHIPS MORLEY COHN; B. ERB BUSINESS RELATIONSHIPS MORLEY COHN; B. CREPPAGE BUSINESS RELATIONSHIPS MORLEY COHN; G. MURRAY BUSINESS RELATIONSHIPS DONALD DETWILER; DONALD DEVORRIS BUSINESS RELATIONSHIPS DONALD DEVORRIS; M COHN, D DETWILER BUSINESS RELATIONSHIPS DONALD DEVORRIS; B CREPPAGE, B ERB BUSINESS RELATIONSHIPS DONALD DEVORRIS; J DRENNING BUSINESS RELATIONSHIPS DONALD DEVORRIS; K WAGNER BUSINESS RELATIONSHIPS FRED CIOCCA; NAME NOT DISCLOSED BUSINESS RELATIONSHIPS T. SISSLER; K. SMITH, D. DEVORRIS BUSINESS RELATIONSHIPS T. SISSLER; OTHER NAMES NOT DISCLOS BUSINESS RELATIONSHIPS ROBERT PACKER; FRAN VAUGHN BUSINESS RELATIONSHIPS JAMES DRENNING; B. CREPPAGE BUSINESS RELATIONSHIPS JAMES DRENNING; D. DEVORRIS, B. ERB BUSINESS RELATIONSHIPS JOHN BEYER; M COHN. J DRENNING BUSINESS RELATIONSHIPS JOHN BEYER: G MURRAY BUSINESS RELATIONSHIPS BERNARD CREPPAGE; D DEVORRIS BUSINESS RELATIONSHIPS BERNARD CREPPAGE; J DRENNING BUSINESS RELATIONSHIPS BERNARD CREPPAGE; B ERB BUSINESS RELATIONSHIPS BERNARD CREPPAGE: M COHN, G MURRAY BUSINESS RELATIONSHIPS BRUCE ERB; B CREPPAGE, D DEVORRIS BUSINESS RELATIONSHIPS BRUCE ERB; J DRENNING, M COHN BUSINESS RELATIONSHIPS
SIGNIFICANT CHANGES TO ORGANIZATIONAL DOCUMENTS FORM 990, PAGE 6, PART VI, LINE 4 ON MARCH 13, 2013, THE ORGANIZATION'S BOARD OF DIRECTORS AMENDED AND RESTATED THE BYLAWS. THE ARTICLES OF INCORPORATION WERE ALSO MODIFIED TO REFLECT THE SIGNIFICANT CHANGES WHICH INCLUDED: A. SECTION 2.2(A), (B) AND (C) REVISED AND AMENDED TO PROVIDE ALTOONA REGIONAL HEALTH SYSTEM (ARHS) WITH THE EXPRESS POWER TO INITIATE THE ACTIONS DESCRIBED THEREIN. B. SECTION 2.2(E) REVISED AND AMENDED TO PROVIDE THAT ARHS SHALL BE THE SOLE MEMBER OF THE CORPORATION. C. THE ARTICLES OF INCORPORATION SHALL BE REVISED AND AMENDED TO PROVIDE THAT THE CORPORATION SHALL HAVE MEMBERS, AND ARHS IS THE SOLE MEMBER OF THE CORPORATION. D. SECTION 2.3 REVISED AND AMENDED TO PROVIDE THAT THE PRESIDENT AND CEO OF ARHS SHALL BECOME A VOTING EX OFFICIO MEMBER OF THE BOARD OF DIRECTORS OF THE CORPORATION. E. ARTICLE IX AND EXHIBIT A ARE DELETED IN THIER ENTIRETY FROM THE CORPORATE BYLAWS. F. REFERENCE TO EASTER SEALS CENTRAL PENNSYLVANIA IS DELETED IN ITS ENTIRETY FROM THE CORPORATE BYLAWS.
CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PAGE 6, PART VI, LINE 6 ARTICLE II, SECTION 2.2, (E) OF THE HOME NURSING AGENCY AFFILIATES BYLAWS INDICATES THAT THE SOLE MEMBER OF THIS CORPORATION IS ARHS.
ELECTION OF MEMBERS AND THEIR RIGHTS FORM 990, PAGE 6, PART VI, LINE 7A ARTICLE II, SECTION 2.3, (B) OF THE HOME NURSING AGENCY AFFILIATES BYLAWS PERMITS THE ALTOONA REGIONAL HEALTH SYSTEM TO ELECT OR REFUSE TO ELECT EACH PERSON NOMINATED BY THE NOMINATING COMMITTEE, BUT MAY NOT ELECT ANY PERSON NOT NOMINATED BY THE NOMINATING COMMITTEE.
DECISIONS SUBJECT TO APPROVAL OF MEMBERS FORM 990, PAGE 6, PART VI, LINE 7B ARTICLE II, SECTION 2.2,(A) OF THE HOME NURSING AGENCY AFFILIATES BYLAWS REQUIRES THAT THE FOLLOWING ACTIONS THAT HAVE BEEN APPROVED BY THE AFFILIATES BOARD ALSO HAVE THE AFFIRMATIVE APPROVAL OF THE ALTOONA REGIONAL HEALTH SYSTEM: ANY STRATEGIC PLANS AND ANY OPERATING AND CAPITAL BUDGETS OF THE CORPORATION AND EACH SUBSIDIARY OF THE CORPORATION; AMENDMENTS TO ARTICLES OR THESE BYLAWS OR AMENDMENTS TO THE ARTICLES OR BYLAWS OF EACH SUBSIDIARY OF THE CORPORATION (APART FROM CHANGES OF REGISTERED OFFICE); MERGER, CONSOLIDATION, DISSOLUTION AND SALE OF SUBSTANTIAL ASSETS OF THE CORPORATION OR ANY SUBSIDIARY OF THE CORPORATION; INCURRENCE OF INDEBTEDNESS BY THE CORPORATION OR ANY SUBSIDIARY OF THE CORPORATION (OTHER THAN TRADE AND/OR ACCOUNTS PAYABLE ARISING IN THE ORDINARY COURSE OF BUSINESS) ABOVE THRESHOLDS TO BE DETERMINED BY THE ALTOONA REGIONAL HEALTH SYSTEM AND NOT APART OF AN APPROVAL CAPITAL AND/OR OPERATING BUDGET; THE ESTABLISHMENT, TERMINATION OR WITHDRAWAL FROM JOINT VENTURES INVOLVING THE CORPORATION (OR ANY SUBSIDIARY OF THE CORPORATION) IN WHICH THE CORPORATION OR ANY SUBSIDIARY OF THE CORPORATION, AS APPLICABLE, HAS A CONTROLLING INTEREST; AND THE ELECTION OR APPOINTMENT OF THE PRESIDENT OR CHIEF EXECUTIVE OFFICER OF THE CORPORATION AND EACH SUBSIDIARY OF THE CORPORATION. ARTICLE II, SECTION 2.2, (B) OF THE HOME NURSING AGENCY AFFILIATES BYLAWS ALSO GIVES ALTOONA REGIONAL HEALTH SYSTEM THE FOLLOWING POWERS WITH RESPECT TO THE CORPORATION: ELECTION OF THE DIRECTORS OF THE CORPORATION (APART FROM EX-OFFICIO DIRECTORS); APPROVAL OF ANY PLAN OF DIVISION OF THE CORPORATION; APPROVAL OF ANY PLAN OF MERGER OF THE CORPORATION WITH ANOTHER CORPORATION; INITIATION OR APPROVAL OF ANY CHANGE IN THE MISSION OR DIRECTION OF THE CORPORATION OR ANY AFFILIATE OR SUBSIDIARY OF THE CORPORATION IF THE PRESIDENT AND CEO OF ALTOONA REGIONAL HEALTH SYSTEM AND THE PRESIDENT AND CEO OF THE CORPORATION MUTUALLY DETERMINED THAT SUCH CHANGE IS MATERIAL; AND ALL OTHER APPROVALS AND/OR ACTIONS AS ARE RESERVED TO ALTOONA REGIONAL HEALTH SYSTEM BY VIRTUE OF THESE BYLAWS, ANY AFFILIATION AGREEMENT BETWEEN ALTOONA REGIONAL HEALTH SYSTEM, THE CORPORATION AND ANY OTHER PARTY, OR BY VIRTUE OF ANY RESOLUTIONS ENACTED BY THE CORPORATION FROM TIME TO TIME.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B A SPECIAL SESSION OF THE EXECUTIVE COMMITTEE WAS HELD TO REVIEW THE COMPLETED FORM 990.
ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C TO FAMILIARIZE THEMSELVES WITH POTENTIAL CONFLICTS, THE HOME NURSING AGENCY CEO, CFO, CHIEF PEOPLE OFFICER, AND THE COMPLIANCE OFFICER, REVIEW EACH FORM COMPLETED ANNUALLY BY MEMBERS OF THE BOARDS. ALL BOARD AND COMMITTEE MEETINGS ARE ATTENDED BY AT LEAST ONE PERSON IN THIS GROUP. IF POTENTIAL CONFLICT SURFACES BEFORE OR DURING A MEETING, THEY ARE RESPONSIBLE FOR ENSURING THAT THE CONFLICT IS NOTED AND APPROPRIATE ACTION IS TAKEN.
COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A EXECUTIVE COMPENSATION FOR THE HOME NURSING AGENCY CEO IS REVIEWED AND ANALYZED BY AN INDEPENDENT CONSULTANT TO DETERMINE REGION AND MARKET CONDITIONS FOR BOTH WAGES AND BENEFITS. RESULTS OF THOSE FINDINGS ARE PRESENTED TO AN EXECUTIVE COMPENSATION COMMITTEE FOR FURTHER REVIEW, ANALYSIS, RECOMMENDATIONS, AND APPROVALS.
COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B EXECUTIVE COMPENSATION FOR KEY EMPLOYEES IS REVIEWED AND ANALYZED BY AN INDEPENDENT CONSULTANT TO DETERMINE REGION AND MARKET CONDITIONS FOR BOTH WAGES AND BENEFITS. RESULTS OF THOSE FINDINGS ARE PRESENTED TO AN EXECUTIVE COMPENSATION COMMITTEE FOR FURTHER REVIEW, ANALYSIS, RECOMMENDATIONS, AND APPROVALS.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC. FINANCIAL AND GOVERNANCE INFORMATION IS AVAILABLE IN THE ORGANIZATION'S ANNUAL REPORT AND FORM 990; BOTH OF WHICH ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST.
ADDITIONAL INFORMATION FORM 990, PART VII FORM 990, PART VII, COMPENSATION: COLUMN B AVERAGE HOURS PER WEEK: THE SOFTWARE USED TO SUBMIT THIS FORM 990 ROUNDS THE AVERAGE HOURS TO A WHOLE NUMBER. BELOW ARE LISTED THE ACTUAL AVERAGE HOURS PER WEEK. JOHN BEYER, DIRECTOR - 0.40 HOURS PER WEEK - 0.5 HOURS RELATED ORG FREDERICK CIOCCA, DIRECTOR - 0.40 HOURS PER WEEK - 0 HOURS RELATED ORG MORLEY COHN, DIRECTOR - 0.20 HOURS PER WEEK - 0.25 HOURS RELATED ORG BERNARD CREPPAGE, TREASURER - 0.90 HOURS PER WEEK - 1.9 HOURS RELATED ORG DONALD DETWILER, DIRECTOR - 0.20 HOURS PER WEEK - 0 HOURS RELATED ORG DONALD DEVORRIS, DIRECTOR - 0.40 HOURS PER WEEK - 1.0 HOURS RELATED ORG JAMES DRENNING, SECRETARY - 0.50 HOURS PER WEEK - 1.0 HOURS RELATED ORG BRUCE ERB, CHAIRMAN - 0.90 HOURS PER WEEK - 1.0 HOURS RELATED ORG BARRY HALBRITTER, DIRECTOR - 0.30 HOURS PER WEEK - 0.4 HOURS RELATED ORG ALLAN HANCOCK, DIRECTOR - 0.60 HOURS PER WEEK - 0.5 HOURS RELATED ORG GERALD MURRAY, DIRECTOR - (ARHS CEO) - 0.30 HOURS PER WEEK - 50 HOURS REL O ROBERT SCHOLL, DIRECTOR - 0.50 HOURS PER WEEK - 0 HOURS RELATED ORG TIMOTHY SISSLER, VICE CHAIRMAN - 0.40 HOURS PER WEEK - 0 HOURS RELATED ORG JOHN WOLF, DIRECTOR - 0.20 HOURS PER WEEK - 0 HOURS RELATED ORG GREGG LAVERICK, CFO - 50 HOURS PER WEEK - 0 HOURS RELATED ORG ROBERT PACKER, CEO - 60 HOURS PER WEEK - 0 HOURS RELATED ORG REBECCA WILLNECKER, CPO - 50 HOURS PER WEEK - 0 HOURS RELATED ORG
OTHER CHANGES IN NET ASSETS EXPLANATION FORM 990, PART XI, LINE 9 NET UNREALIZED GAINS ON INVESTMENTS 0 MINIMUM PENSION LIABILITY ADJUSTMENT 101,048
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2012

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
HOME NURSING AGENCY AFFILIATES
 
Employer identification number

25-1518698
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" to Form 990, Part IV, line 33.)
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity










Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1) HNA VISITING NURSE ASSOC
VISITING NURSE
201 CHESTNUT AVENUE

ALTOONA,PA16603
25-1188570 		HEALTH CAR PA 501C 9 AFFILIATES
HOME NURSING AGENCY AFFILIATES
 
No
(2) HNA COMMUNITY SERVICES
COMMUNITY SERVICES
201 CHESTNUT AVENUE

ALTOONA,PA16603
25-1517533 		HEALTH CAR PA 501C 9 AFFILIATES
HOME NURSING AGENCY AFFILIATES
 
No
(3) HNA FOUNDATION
FOUNDATION
201 CHESTNUT AVENUE

ALTOONA,PA16603
25-1467014 		FUNDRAISIN PA 501C 11D AFFILIATES
HOME NURSING AGENCY AFFILIATES
 
No
(4) ALTOONA REGIONAL HEALTH SYSTEM

600 HOWARD AVENUE

ALTOONA,PA16603
 HEALTH CAR PA 501C 3 N/A
 
No
(5) ALTOONA REGIONAL PARTNERSHIP FOR HE
PARTNERSHIP FOR HEALTHY COMMUNITY
600 HOWARD AVENUE

ALTOONA,PA16603
 HEALTH CAR PA 501C 3 ARHS
ALTOONA REGIONAL HEALTH SYSTEM
 
No
(6) ALTOONA REGIONAL HEALTH SYSTEM FOUN
HEALTH SYSTEM FOUNDATION FOR LIFE
600 HOWARD AVENUE

ALTOONA,PA16603
 HEALTH CAR PA 501C 3 ARHS
ALTOONA REGIONAL HEALTH SYSTEM
 
No
(7) CPHSC
MEDICAL FOUNDATION INC
600 HOWARD AVENUE

ALTOONA,PA16603
 HEALTH CAR PA 501C 3 ARHS
ALTOONA REGIONAL HEALTH SYSTEM
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) ALTOONA FAMILY INC

ALTOONA
ALTOONA,PA16601
     N/A
 C CORP         No
(2) BLAIR COUNTY PHO INC

ALTOONA
ALTOONA,PA16601
     N/A
 C CORP         No
(3) QUALITY FIRST HEALTHCARE LLC

201 CHESTNUT AVE
ALTOONA,PA16601
 EXT LIVING PA HNA AFF
  		C CORP         No
(4) AMERICAN HOME HEALTH INC

201 CHESTNUT AVE
ALTOONA,PA16601
31-1521422 		HOME HEALT PA QFH
  		C CORP         No






Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) HNA VISITING NURSE ASSOCIATION

 A 1,360,099 SQ FOOTAGE
(2) HNA COMMUNITY SERVICES

 A 650,408 SQ FOOTAGE
(3) HOME NURSING AGENCY FOUNDATION

 A 23,735 SQ FOOTAGE
(4) HNA VISITING NURSE ASSOCIATION

 L 1,356,077 OF EXPENSES
(5) HNA COMMUNITY SERVICES

 L 425,227 OF EXPENSES
(6) HOME NURSING AGENCY FOUNDATION

 L 12,320 OF EXPENSES
(7) HNA VISITING NURSE ASSOCIATION

 Q 5,680,286 INVOICES OF SALARIES
(8) HNA COMMUNITY SERVICES

 Q 1,617,287 INVOICES OF SALARIES
(9) QUALITY FIRST HEALTHCARE LLC

 Q 35,563 INVOICES OF SALARIES
(10) QUALITY FIRST HEALTHCARE LLC

 D 1,503,358 PROM NOTE PRINCIPAL
(11) QUALITY FIRST HEALTHCARE LLC

 L 23,088 OF EXPENSES
(12) QUALITY FIRST HEALTHCARE LLC

 A 25,400 OF PRIME RATE
(13) HNA VISITING NURSE ASSOCIATION

 A 1,360,099 SQ FOOTAGE
(14) HNA COMMUNITY SERVICES

 A 650,408 SQ FOOTAGE
(15) HOME NURSING AGENCY FOUNDATION

 A 23,735 SQ FOOTAGE
(16) HNA VISITING NURSE ASSOCIATION

 L 1,356,077 OF EXPENSES
(17) HNA COMMUNITY SERVICES

 L 425,227 OF EXPENSES
(18) HOME NURSING AGENCY FOUNDATION

 L 12,320 OF EXPENSES
(19) HNA VISITING NURSE ASSOCIATION

 Q 5,680,286 INVOICES OF SALARIES
(20) HNA COMMUNITY SERVICES

 Q 1,617,287 INVOICES OF SALARIES
(21) QUALITY FIRST HEALTHCARE LLC

 Q 35,563 INVOICES OF SALARIES
(22) QUALITY FIRST HEALTHCARE LLC

 D 1,503,358 PROM NOTE PRINCIPAL
(23) QUALITY FIRST HEALTHCARE LLC

 L 23,088 OF EXPENSES
(24) QUALITY FIRST HEALTHCARE LLC

 A 25,400 OF PRIME RATE
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under section 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V—UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation

Additional Data


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