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 private
foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
A For the 2014 calendar year, or tax year beginning 07-01-2014 , and ending 06-30-2015
BCheck if applicable:
CName of organization
MEADVILLE MEDICAL CENTER
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
1034 GROVE STREET
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
MEADVILLE, PA16335
D Employer identification number

25-1512436
E Telephone number

G Gross receipts $ 200,201,193
F Name and address of principal officer:
RENATO SUNTAY
751 LIBERTY STREET
MEADVILLE,PA16335
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.MMCHS.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
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: MMC PROVIDES THE HIGHEST QUALITY HEALTHCARE SERVICES, INCLUDING INPATIENT AND OUTPATIENT SURGERIES ACUTE CARE, AND INTENSIVE CARE TO THE CRAWFORD COUNTY REGION.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 12
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 10
5 Total number of individuals employed in calendar year 2014 (Part V, line 2a) ...... 5 1,406
6 Total number of volunteers (estimate if necessary) ............. 6 250
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 39,692
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 34,723
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 251,721 194,856
9 Program service revenue (Part VIII, line 2g) ......... 163,449,345 174,091,937
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 2,124,893 894,438
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 1,470,810 2,278,271
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 167,296,769 177,459,502
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 25,625 0
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 80,627,890 85,801,659
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 77,491,573 85,443,695
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 158,145,088 171,245,354
19 Revenue less expenses. Subtract line 18 from line 12....... 9,151,681 6,214,148
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 183,485,693 214,154,086
21 Total liabilities (Part X, line 26)............. 82,781,330 124,676,928
22 Net assets or fund balances. Subtract line 21 from line 20..... 100,704,363 89,477,158
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 (2014)
Form 990 (2014)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: COMMUNITY HOSPITAL RESPONDING TO IDENTIFIED COMMUNITY HEALTHCARE NEEDS IN THE CRAWFORD COUNTY REGION AND PROVIDING THE HIGHEST QUALITY HEALTHCARE SERVICES TO ALL PATIENTS REGARDLESS OF ABILITY TO PAY.
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 $ 76,950,502 including grants of $   ) (Revenue $ 89,565,078 )
MMC PROVIDES ACUTE CARE SERVICES TO PATIENTS. AN ACUTE CARE SETTING IS AN INSTITUTION OR MEDICAL FACILITY PROVIDING PATIENTS WITH SHORT-TERM TREATMENT FOR AN ACUTE INJURY OR ILLNESS. ACUTE CARE FACILITIES ARE BENEFICIAL TO PATIENTS WITH ACUTE CONDITIONS BECAUSE THEY ARE ABLE TO FOCUS ON GIVING QUICK, EFFICIENT CARE TO THEIR PATIENTS. SEE SCHEDULE O FOR ADDITIONAL DETAILS.
4b (Code:   ) (Expenses $ 44,819,832 including grants of $   ) (Revenue $ 37,040,066 )
MMC PERFORMS BOTH INPATIENT AND OUTPATIENT SURGERY. THE SURGERY DEPARTMENT UTILIZES THE LATEST IN SURGICAL EQUIPMENT AND TECHNIQUES IN PROVIDING BOTH INPATIENT AND OUTPATIENT CARE. THE SURGICAL TEAM CONSISTS OF SPECIALLY TRAINED NURSES AND ANESTHETISTS, GENERAL AND SPECIALTY SURGEONS AND ANESTHESIOLOGISTS. THE MMC SURGEONS REPRESENT THE AREAS OF GENERAL SURGERY, PERIPHERAL VASCULAR SURGERY, THORACIC SURGERY, OBSTETRICS AND GYNECOLOGY, OPHTHALMOLOGY, ORAL AND MAXILLOFACIAL SURGERY, ORTHOPEDICS, OTOLARYNGOLOGY, PLASTIC AND RECONSTRUCTIVE SURGERY, AND UROLOGY. SEE SCHEDULE O FOR ADDITIONAL DETAILS.
4c (Code:   ) (Expenses $ 30,156,777 including grants of $   ) (Revenue $ 40,857,236 )
MMC PROVIDES ONCOLOGY SERVICES AT THE YOLANDA G. BARCO ONCOLOGY INSTITUTE. A COMPREHENSIVE CANCER CARE PROGRAM, APPROVED BY THE AMERICAN COLLEGE OF SURGEONS, IS AVAILABLE IN MEADVILLE WITH THE LATEST TECHNOLOGY AND PHYSICIAN SPECIALISTS AVAILABLE. WE HAVE ACCESS TO RESEARCH AND THE MOST UP-TO-DATE TREATMENT PROTOCOLS. MEADVILLE MEDICAL CENTER IS A MEMBER OF THE ASSOCIATION FOR COMMUNITY CANCER CENTERS. WE BELIEVE THAT CANCER CARE IS BEST DELIVERED IN A COMMUNITY SETTING. SEE SCHEDULE O FOR ADDITIONAL DETAILS.
4d Other program services (Describe in Schedule O.)
(Expenses $ 2,913,708 including grants of $   ) (Revenue $ 6,629,557 )
4e Total program service expensesMediumBullet154,840,819
Form 990 (2014)
Form 990 (2014)
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)? Click to see attachment...
2
Yes
 
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 IClick to see attachment..........
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 IIClick to see attachment........
4
Yes
 
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 IIIClick to see attachment............................
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
Yes
 
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
Yes
 
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 other assistance to or for any foreign organization? 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 other assistance to or for foreign individuals? 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.... Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government 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 or other assistance to or for domestic individuals 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 25a................ Click to see list of attachments
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
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
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I....
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...................
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II................
26
 
No
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.........
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 ..........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV.....................
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...
28c
 
No
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
Yes
 
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... Click to see attachment
35b
Yes
 
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 (2014)
Form 990 (2014)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
377
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
1,406
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
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
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 FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
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
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?.........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring 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 (2014)
Form 990 (2014)
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 or note to any line 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
12
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
10
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
 
No
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
 
No
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
Yes
 
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
Yes
 
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, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletRENATO SUNTAY
751 LIBERTY STREET
MEADVILLE,PA16335 (814) 333-5000
Form 990 (2014)
Form 990 (2014)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line 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; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) ERIC HOOVER........................................................................
SECRETARY ENDING 08/2014
 1.0
.......................0.0 		X   X       0 0 0
(2) MARK STEVENS........................................................................
CHAIR
 1.0
.......................0.0 		X   X       0 0 0
(3) JUDY SICKLES........................................................................
DIRECTOR
 1.0
.......................1.0 		X           0 0 0
(4) JAMES MULLEN........................................................................
VICE CHAIR
 1.0
.......................0.0 		X   X       0 0 0
(5) MARK STRAUSBAUGH........................................................................
TREASURER ENDING 09/2014
 1.0
.......................2.0 		X   X       0 0 0
(6) JOHN CHRISTIE-SEARLES........................................................................
DIRECTOR
 1.0
.......................1.0 		X           0 0 0
(7) ROGER WILLIS........................................................................
SECRETARY BEGINNING 08/2014
 1.0
.......................0.0 		X   X       0 0 0
(8) DR RON UNICE........................................................................
DIRECTOR
 1.0
.......................0.0 		X           600 0 0
(9) DR ANNALIISA MCGLINN........................................................................
MED STAFF PRES ENDING 12/2014
 40.0
.......................0.0 		X           564,481 0 44,260
(10) JOE LEDFORD........................................................................
TREASURER BEGINNING 09/2014
 1.0
.......................0.0 		X   X       0 0 0
(11) BRIAN NAGEOTTE........................................................................
DIRECTOR
 1.0
.......................0.0 		X           0 0 0
(12) FRANKLIN MCLAUGHLIN DO........................................................................
MED STAFF PRES BEG 12/2014
 1.0
.......................42.0 		X           0 344,568 29,414
(13) NICOLA FISHER........................................................................
DIRECTOR BEGINNING 09/2014
 1.0
.......................0.0 		X           0 0 0
(14) JIM BULMAN........................................................................
DIRECTOR BEGINNING 09/2014
 1.0
.......................1.0 		X           0 0 0
(15) STEPHANIE GALEY........................................................................
DIRECTOR BEGINNING 09/2014
 1.0
.......................0.0 		X           0 0 0
(16) RENATO SUNTAY........................................................................
CFO
 40.0
.......................1.0 		    X       305,294 0 33,291
(17) PHILIP PANDOLPH........................................................................
PRESIDENT & CEO
 40.0
.......................0.0 		    X       499,146 0 90,760
Form 990 (2014)
Form 990 (2014)
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; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) DR DENISE JOHNSON........................................................................
MEDICAL DIRECTOR
 40.0
.......................0.0 		      X     336,597 0 36,495
(19) DAVID P SHAFFER........................................................................
CHIEF NURSE EXECUTIVE
 40.0
.......................0.0 		      X     193,447 0 34,827
(20) DR SARAH JURADO........................................................................
PHYSICIAN
 40.0
.......................0.0 		        X   582,517 0 20,018
(21) DR KENNETH CHALLENER........................................................................
PHYSICIAN
 40.0
.......................0.0 		        X   483,839 0 24,529
(22) DR RANDY ZELEN........................................................................
PHYSICIAN
 40.0
.......................0.0 		        X   567,215 0 46,140
(23) DR HEALTH FALLIN........................................................................
PHYSICIAN
 40.0
.......................0.0 		        X   621,221 0 34,615
(24) DR JASON BROWN........................................................................
PHYSICIAN
 40.0
.......................0.0 		        X   509,514 0 42,101
(25) CORY JACKSON........................................................................
FORMER INT. CFO/CUR CONTROLLER
 40.0
.......................0.0 		          X 127,871 0 34,224










1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 4,791,742 344,568 470,674
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet38
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
Yes
 
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
ASSOCIATED CLINICAL LABS,
 
  		LAB SERVICES 1,290,003
NAVIN HAFFTY ASSOCIATES LLC,
 
  		CONSULTING 1,084,418
VANTAGE HEALTHCARE LINEN,
 
  		LINEN SERVICES 736,670
HOWE CONTRACTORS INC,
 
  		CONSTRUCTION 701,138
POINT SECURITY COMPANY,
 
  		SECURITY 599,953
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet41
Form 990 (2014)
Form 990 (2014)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 77,631
e Government grants (contributions)1e 38,472
f All other contributions, gifts, grants, and
similar amounts not included above1f 		78,753
g Noncash contributions included in lines
1a-1f:$ 		 
h Total. Add lines 1a-1f.......MediumBullet 194,856
Program Service RevenueAmt Business Code
2a PATIENT SERVICE REVENUE 621990 167,778,063 167,778,063    
b PHARMACY REVENUE 446110 2,634,915 2,634,915    
c MANAGEMENT FEES 561000 1,431,530 1,431,530    
d CAFETERIA INCOME 621990 517,899 517,899    
e AFFILIATED ORGANIZATION RENT 532000 273,131 273,131    
f All other program service revenue . 1,456,399 1,456,399    
g Total. Add lines 2a–2f........MediumBullet 174,091,937
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 661,984     661,984
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 1,319,300  
b Less: rental expenses 130,623  
c Rental income or (loss) 1,188,677 0
d Net rental income or (loss).......MediumBullet 1,188,677   39,692 1,148,985
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 22,627,791 215,731
b Less: cost or other basis and sales expenses 22,358,890 252,178
c Gain or (loss) 268,901 -36,447
d Net gain or (loss)..........MediumBullet 232,454     232,454
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 0    
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 0      
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 0      
Miscellaneous Revenue Business Code
11a INVESTMENT IN EQUITY INVESTEE 900099 1,089,594     1,089,594
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 1,089,594
12 Total revenue. See Instructions......MediumBullet 177,459,502 174,091,937 39,692 3,133,017
Form 990 (2014)
Form 990 (2014)
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 or note to any line 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 domestic organizations and domestic governments. See Part IV, line 21 .... 0  
2 Grants and other assistance to domestic individuals. See Part IV, line 22 .... 0  
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............ 0  
4 Benefits paid to or for members .... 0  
5 Compensation of current officers, directors, trustees, and key employees .... 2,139,198 1,210,707 928,491  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 162,095   162,095  
7 Other salaries and wages .... 62,040,109 56,565,665 5,474,444  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 1,442,763 1,371,434 71,329  
9 Other employee benefits ....... 15,646,819 14,140,079 1,506,740  
10 Payroll taxes ........... 4,370,675 3,933,607 437,068  
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 279,915   279,915  
c Accounting ........... 293,843   293,843  
d Lobbying ........... 0      
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 0      
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) .... 17,917,176 16,125,458 1,791,718  
12 Advertising and promotion .... 0      
13 Office expenses ....... 35,303,882 31,783,655 3,520,227  
14 Information technology ...... 0      
15 Royalties .. 0      
16 Occupancy ........... 2,870,070 2,583,063 287,007  
17 Travel ............ 434,805 391,324 43,481  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 246,447 221,802 24,645  
20 Interest ........... 861,522 775,370 86,152  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 10,184,316 9,165,885 1,018,431  
23 Insurance .............. 1,159,436 1,043,492 115,944  
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 BAD DEBT 10,317,842 10,317,842    
b PROVIDER TAX 1,731,300 1,731,300    
c RECRUITING 1,413,584 1,272,226 141,358  
d LICENSES, DUES, SUBSCRIPTIONS 655,343 589,809 65,534  
e All other expenses 1,774,214 1,618,101 156,113  
25 Total functional expenses. Add lines 1 through 24e 171,245,354 154,840,819 16,404,535 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 (2014)
Form 990 (2014)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 6,485,465 1 23,010,922
2 Savings and temporary cash investments ......... 4,178,998 2 10,202,098
3 Pledges and grants receivable, net ........... 0 3 0
4 Accounts receivable, net ............. 19,184,282 4 28,015,451
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
0 5 0
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
0 6 0
7 Notes and loans receivable, net ............. 0 7 0
8 Inventories for sale or use .............. 3,618,599 8 3,898,655
9 Prepaid expenses and deferred charges .......... 2,216,708 9 4,128,955
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 223,083,002
b Less: accumulated depreciation ..... 10b 135,639,695 75,871,121 10c 87,443,307
11 Investments—publicly traded securities .......... 35,733,969 11 22,477,722
12 Investments—other securities. See Part IV, line 11 ..... 3,090,634 12 3,678,825
13 Investments—program-related. See Part IV, line 11 ..... 3,746,648 13 4,459,550
14 Intangible assets ............... 0 14 0
15 Other assets. See Part IV, line 11 ........... 29,359,269 15 26,838,601
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 183,485,693 16 214,154,086
Liabilities 17 Accounts payable and accrued expenses ......... 19,272,628 17 24,032,244
18 Grants payable ................. 0 18 0
19 Deferred revenue ................ 30,336 19 0
20 Tax-exempt bond liabilities ............. 26,520,319 20 48,159,705
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
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.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 11,610,955 23 15,054,097
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 1,000,000
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.................... 25,347,092 25 36,430,882
26 Total liabilities. Add lines 17 through 25......... 82,781,330 26 124,676,928
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 .............. 95,900,145 27 84,758,111
28 Temporarily restricted net assets ........... 0 28 0
29 Permanently restricted net assets ........... 4,804,218 29 4,719,047
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 ........... 100,704,363 33 89,477,158
34 Total liabilities and net assets/fund balances ........ 183,485,693 34 214,154,086
Form 990 (2014)
Form 990 (2014)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
177,459,502
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
171,245,354
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
6,214,148
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
100,704,363
5
Net unrealized gains (losses) on investments ...............
5
-997,223
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
-16,444,130
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
89,477,158
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line 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 (2014)
Form 990 (2014)
Page 13
Form 990, Special Condition Description:
Special Condition Description
Form 990 (2014)
Form 990 (2014)
Page 14
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 Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
MEADVILLE MEDICAL CENTER
 
Employer identification number

25-1512436
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
a
b
c
d
e
f
Enter the number of supported organizations .............................  
g
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 listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total    

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
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) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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 VI.)..            
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 section 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) 2014
Schedule A (Form 990 or 990-EZ) 2014
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) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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 VI.) ..            
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) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations....
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action, (iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 5
Part IV
Supporting Organizations (continued)

Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 6
Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1.   Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    

Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors (explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    

Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7   Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 7
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity		  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations  
4 Amounts paid to acquire exempt-use assets  
5 Qualified set-aside amounts (prior IRS approval required)  
6 Other distributions (describe in Part VI). See instructions  
7Total annual distributions. Add lines 1 through 6.  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions		  
9 Distributable amount for 2014 from Section C, line 6  
10 Line 8 amount divided by Line 9 amount  

Section E - Distribution Allocations (see instructions) (i)
Excess Distributions 		(ii)
Underdistributions
Pre-2014 		(iii)
Distributable
Amount for 2014
1 Distributable amount for 2014 from Section C, line
6 		 
2 Underdistributions, if any, for years prior to 2014
(reasonable cause required--see instructions)		  
3 Excess distributions carryover, if any, to 2014:
a From 2009.......X
b From 2010.......X
c From 2011.......X
d From 2012.......X
e From 2013.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2014 distributable amount  
i Carryover from 2009 not applied (see
instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2014 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2014 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2014, if any. Subtract lines 3g and 4a from line 2
(if amount greater than zero, see instructions)		  
6 Remaining underdistributions for 2014. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)		  
7 Excess distributions carryover to 2015. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......  
e From 2014.......  
Schedule A (Form 990 or 990-EZ) (2014)
Schedule A (Form 990 or 990-EZ) 2014
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Name of the organization
MEADVILLE MEDICAL CENTER
 
Employer identification number

25-1512436
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 2
Name of organization
MEADVILLE MEDICAL CENTER
  		Employer identification number

25-1512436
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
 
 

   
 
 
  ,    

$RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 3
Name of organization
MEADVILLE MEDICAL CENTER
  		Employer identification number

25-1512436
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 4
Name of organization
MEADVILLE MEDICAL CENTER
  		Employer identification number

25-1512436
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10)
that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd Bullet Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
MEADVILLE MEDICAL CENTER
 
Employer identification number

25-1512436
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ...................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2014

Schedule C (Form 990 or 990-EZ) 2014
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in) 		(a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))		  
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2014


Schedule C (Form 990 or 990-EZ) 2014
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
14,640
j
Total. Add lines 1c through 1i ...............................
14,640
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
SCHEDULE C, PART II-B, LINE 1(I) LOBBYING ACTIVITIES: THE ORGANIZATION PAYS DUES TO ORGANIZATIONS WHICH PARTICIPATE IN LOBBYING ACTIVITIES. THE PORTION OF THE ORGANIZATION'S TOTAL DUES ATTRIBUTABLE TO LOBBYING ARE $6,738 TO THE AMERICAN HOSPITAL ASSOCIATION AND $6,890 TO THE HOSPITAL & HEALTH SYSTEM ASSOCIATION OF PENNSYLVANIA AND $1,012 TO SAFETY NET HOSPITALS FOR PHARMACEUTICAL ACCESS. TOTAL DUES ATTRIBUTABLE TO LOBBYING ARE $14,640.
Schedule C (Form 990 or 990EZ) 2014

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.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
MEADVILLE MEDICAL CENTER
 
Employer identification number

25-1512436
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 value of contributions to (during year)    
3 Aggregate value of 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)
Revenue 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
Revenue 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) 2014

Schedule D (Form 990) 2014
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, for escrow or custodial account liability?
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 .... 4,804,218 4,325,436 4,101,893 4,287,761 3,701,073
b Contributions ........          
c Net investment earnings, gains, and losses -85,171 478,782 223,543 -185,868 586,688
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........ 		         
f Administrative expenses ....          
g End of year balance ...... 4,719,047 4,804,218 4,325,436 4,101,893 4,287,761
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 Bullet100.000 %
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)
Yes
 
(ii) related organizations ........................
3a(ii)
 
No
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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. 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 .................   7,268,258 7,268,258
b Buildings ................ 3,284,074 99,100,386 66,613,961 35,770,499
c Leasehold improvements ............     0  
d Equipment ................   92,653,945 65,441,989 27,211,956
e Other .................   20,776,339 3,583,745 17,192,594
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 87,443,307
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. 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    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) CASH SURRENDER VALUE LIFE INS 1,804,274
(2) ACCRUED INTEREST RECEIVABLE 135,397
(3) DUE FROM AFFILIATES 14,157,990
(4) BENEF. INTEREST IN PERP TRUST 4,719,047
(5) OTHER RECEIVABLES 6,021,893




Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 26,838,601
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes 0
ESTIMATED SELF-INSURANCE COSTS 2,819,648
ACCRUED POSTRETIREMENT BEN LIA 3,118,972
ACCRUED PENSION 24,662,074
INTEREST RATE SWAP LIABILITY 614,678
DUE TO AFFILIATES 5,215,510




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 36,430,882
2. Liability for uncertain tax positions. 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) 2014

Schedule D (Form 990) 2014
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1 149,739,471
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a -997,223
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d -26,889,878
e Add lines 2a through 2d ..................... 2e -27,887,101
3 Subtract line 2e from line 1..................... 3 177,626,572
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 -167,070
c Add lines 4a and 4b....................... 4c -167,070
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 177,459,502
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1 160,881,505
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 167,070
e Add lines 2a through 2d...................... 2e 167,070
3 Subtract line 2e from line 1..................... 3 160,714,435
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 10,530,919
c Add lines 4a and 4b....................... 4c 10,530,919
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 171,245,354
Part XIII
Supplemental Information
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.
Return Reference Explanation
SCHEDULE D, PART V, LINE 4 ENDOWMENT FUND PURPOSE: THE ENDOWMENT FUNDS CONSIST OF TEN SEPARATE FUNDS HELD THROUGH PNC BANK, BANK OF AMERICA, AND MELLON BANK, OF WHICH THE PURPOSE IS TO IMPROVE THE HEALTHCARE FOR RESIDENTS OF THIS COMMUNITY.
SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
SCHEDULE D, PART XI, LINE 2D AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART VIII, LINE 12: $( 10,317,842) BAD DEBT EXPENSE ( 9,249,120) TRANSFERS TO RELATED PARTIES ( 7,240,932) CHANGE IN DEFINED BENEFIT PENSION PLAN ( 213,077) ACQUISITION EXPENSE 131,093 CHANGE IN FAIR VALUE OF INTEREST RATE SWAP ------------ $( 26,889,878)
SCHEDULE D, PART XI, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ (130,623) RENTAL EXPENSE ( 36,447) LOSS ON SALE OF FIXED ASSETS ----------- $ (167,070)
SCHEDULE D, PART XII, LINE 2D AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART IX, LINE 25: $ 130,623 RENTAL EXPENSE 36,447 LOSS ON SALE OF FIXED ASSETS ---------- $ 167,070
SCHEDULE D, PART XII, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 10,317,842 BAD DEBT EXPENSE 213,077 ACQUISTION EXPENSE ------------- $ 10,530,919
Schedule D (Form 990) 2014

Additional Data


Software ID:  
Software Version:  




SCHEDULE H (Form 990)
Department of the TreasuryInternal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
MEADVILLE MEDICAL CENTER
 
Employer identification number

25-1512436
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
 
No
b
If "Yes," did the organization make it available to the public? ..............
6b
 
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) .. 		    7,075,844   7,075,844 4.400 %
b Medicaid (from Worksheet 3,
column a) .... 		    20,786,708 13,860,219 6,926,489 4.300 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		           
d Total Financial Assistance
and Means-Tested
Government Programs . 		    27,862,552 13,860,219 14,002,333 8.700 %
Other Benefits
     1,645,535 422,228 1,223,307 0.760 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		    850,171 306,310 543,861 0.340 %
g Subsidized health services
(from Worksheet 6) .. 		    25,626,045 13,889,041 11,737,004 7.290 %
h Research (from Worksheet 7)            
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		    403,947   403,947 0.250 %
j Total. Other Benefits ..     28,525,698 14,617,579 13,908,119 8.640 %
k Total. Add lines 7d and 7j .     56,388,250 28,477,798 27,910,452 17.340 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
10,317,842
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
425,000
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
60,882,169
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
81,739,098
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-20,856,929
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?2
Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 MEADVILLE MEDICAL CENTER
751 LIBERTY ST
MEADVILLE,PA16335
WWW.MMCHS.ORG
197101 		X X         X   PHYSICIAN PRACTICES 1
2 MEADVILLE MEDICAL CENTER
1034 GROVE ST
MEADVILLE,PA16335
WWW.MMCHS.ORG
197101 		X X             PHYSICIAN PRACTICES 1
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
1-MEADVILLE MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): HTTP://WWW.MMCHS.ORG/ABOUTUS.ASPX
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

1-MEADVILLE MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14   No
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

1-MEADVILLE MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ................................ 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
SCHEDULE H, PART V, SECTION B, LINE 3 COMMUNITY INPUT: THERE WERE FOCUS GROUPS WITH INTERESTED PARTIES TO DEVELOP THE HOSPICE HOUSE, ONE OF THE TOP PRIORITIES WAS THE UNDERUTILIZATION OF HOSPICE IN OUR SERVICE AREA. SEPARATELY THERE WERE SEVERAL FOCUS GROUPS WITH MANY PEOPLE TO DEVELOP THE MEADVILLE DENTAL CENTER THAT PROVIDES NEEDED DENTAL SERVICES TO LOW INCOME RESIDENTS OF THE HOSPITALS' SERVICE AREA. THREE FOCUS GROUPS HAVE BEEN HELD AND ADDITIONAL MEETINGS MAY BE PLANNED TO REVIEW PROGRESS AND FURTHER PLANS. USERS' COMMENTS ARE SOLICITED, HAVE BEEN RECEIVED AND THE CONCERNS ADDRESSED.
SCHEDULE H, PART V, SECTION B, LINE 6A CHNA CONDUCTED WITH OTHER HOSPITAL FACILITIES: MEADVILLE MEDICAL CENTER'S CHNA WAS CONDUCTED WITH ANOTHER HOSPITAL FACILITY, TITUSVILLE AREA HOSPITAL.
SCHEDULE H, PART V, SECTION B, LINE 7D OTHER METHODS OF PROVIDING THE CHNA TO THE PUBLIC: OTHER METHODS IN WHICH MEADVILLE MEDICAL CENTER MADE ITS CHNA WIDELY AVAILABLE TO THE PUBLIC INCLUDED ITS ANNUAL MEETING OF THE CRAWFORD (COUNTY) HEALTH IMPROVEMENT COALITION, TELEVISING THE RESULTS OF THE REPORT ON LOCAL TELEVISION AND BROADCASTING THE RESULTS OF THE REPORT ON LOCAL RADIO STATIONS.
SCHEDULE H, PART V, SECTION B, LINE 11 GOAL AND STATUS REPORTS FROM THE LAST MMC COMMUNITY HEALTH NEEDS ASSESSMENT 1. ADDRESS ORAL HEALTH PROBLEMS THROUGH IMPROVED ACCESS TO DENTAL CARE FOR LOW INCOME AND UNINSURED PERSONS IN THE MEADVILLE AREA. DEVELOP PLANS FOR IMPROVED PREVENTION OF FUTURE ORAL HEALTH PROBLEMS. STATUS: THE MEADVILLE DENTAL CENTER OPEN IN JULY 2012 AND HAD 100 VISITS IN JULY, ABOUT 90% OF THE PATIENTS ARE LOW INCOME OR MEDICAL ASSISTANCE RECIPIENTS. IN THE MOST RECENT 3 MONTHS THE MDC IS AVERAGING 950 VISITS PER MONTH, STILL WITH OVER 90% OF THE VISITS FROM MA AND LOW INCOME LOCAL RESIDENTS. MOST OF THE CUSTOMERS ARE NEW TO PROFESSIONAL DENTAL CARE. ONE UNRESOLVED ISSUE INVOLVES MULTIPLE REQUESTS TO BEGIN FLUORIDATION OF THE WATER SUPPLY, CONTROLLED BY THE MEADVILLE WATER AUTHORITY THAT COVERS MOST OF THE POPULATION IN NEED. THERE HAS BEEN NO DECISION MADE OR SCHEDULED BUT WE CONTINUE TO PUSH FOR THIS CRITICAL PREVENTATIVE MEASURE. 2. IMPROVE ACCESS TO HOSPICE SERVICES IN CRAWFORD COUNTY. STATUS: THE MARQUETTE HOSPICE HOUSE WAS DEVELOPED FROM A MODEL BASED IN A NEIGHBORING COUNTY WHERE HOSPICE SERVICES WERE UNDERUTILIZED. A 3 BED HOMELIKE SETTING WAS DESIGNED AND THE MEADVILLE MEDICAL CENTER FOUNDATION RAISED THE FUNDS TO PURCHASE, TOTALLY RENOVATE AND OPEN A FACILITY IN A BEAUTIFUL RURAL SETTING AND WITH A FULLTIME CARE TAKER AVAILABLE ON SITE. THE HOUSE HAD STRONG DEMAND WITH A FREQUENT WAITING LIST AND HAD INCREASED PERSONS UTILIZING HOSPICE CARE IN CRAWFORD COUNTY. 3. IMPROVE ACCESS TO TRAUMA SERVICES TO REDUCE THE DEATH RATE FROM MOTOR VEHICLE ACCIDENTS. MEADVILLE MEDICAL CENTER WILL PURSUE THE LEVEL III TRAUMA CENTER DESIGNATION. STATUS: THE LEVEL III TRAUMA DESIGNATION HAS BEEN UNDER DEVELOPMENT FOR THE EMERGENCY DEPARTMENT WITH THE FINAL HEARING DUE IN THE NEAR FUTURE. THE DEATH RATE FROM MOTOR VEHICLE ACCIDENTS HAS DECREASED AND MOTOR VEHICLE ACCIDENTS IS NO LONGER THE LEADING CAUSE OF ACCIDENTAL DEATHS. 4. REDUCE THE DEATH RATE FROM BREAST CANCER THROUGH THE INITIATION OF AWARENESS PROGRAMS TO ADDRESS EARLY DETECTION AND INITIATION OF TREATMENT AND THE RECRUITMENT ADDITIONAL ONCOLOGY PHYSICIAN RESOURCES. STATUS: TWO ADDITIONAL MEDICAL ONCOLOGISTS HAVE BEEN RECRUITED AND ONE ADDITIONAL RADIATION ONCOLOGIST HAS ALSO BEEN RECRUITED AND BEGUN TO WORK AT THE ONCOLOGY INSTITUTE. VOLUME HAS INCREASED, DEATH RATE HAS DECLINED AND MORE SCREENING HAS BEEN OCCURRING. THE BRAND NEW WOMENS IMAGING CENTER HAS OPENED EARLY IN 2016 AND PROGRESS WILL CONTINUE TO BE MONITORED. 5. REDUCE THE DEATH RATE FROM COLON CANCER THROUGH AN INCREASE IN EARLY DETECTION PROCEDURES WITH THE RECRUITMENT OF ADDITIONAL GASTROINTESTINAL PHYSICIAN RESOURCES. IMPLEMENTATION AND FUNDING PLANS WERE DEVELOPED AND SUBMITTED FOR APPROVAL TO THE APPROPRIATE GOVERNING AUTHORITIES: HOSPICE OF CRAWFORD COUNTY, COMMUNITY HEALTH SERVICES, THE MEADVILLE MEDICAL CENTER FOUNDATION AND THE MEADVILLE MEDICAL CENTER. FOLLOWING APPROVAL, THE PROJECTS WILL COMMENCE AND PROGRESS WILL BE ASSESSED. STATUS: ONE ADDITIONAL GI SPECIALIST HAS BEEN RECRUITED AND HAS INCREASED THE NUMBER OF SCREENING PROCEDURES. UNFORTUNATELY, OUR ORIGINAL GI SPECIALIST HAS UNEXPECTEDLY PASSED AWAY AND PLANS ARE BEING DEVELOPED TO FIND AN ADDITIONAL PROVIDER.
SCHEDULE H, PART V, SECTION B, LINE 13B INCOME LEVEL OTHER THAN FPG: FAMILY GROSS INCOME IS USED TO CALCULATE APPLICABILITY OF CATASTROPHIC DISCOUNT FOR BOTH UNINSURED AND INSURED PATIENTS.
SCHEDULE H, PART V, SECTION B, LINE 16B & C FAP WEBSITE: http://www.mmchs.org/PatientsFamilies/Payments.aspx
SCHEDULE H, PART V, SECTION B, LINE 20E OTHER METHODS OF PUBLICIZING FINANCIAL ASSISTANCE POLICY: THE BILLING INVOICE OFFERS A PHONE NUMBER TO CALL FOR EXPLANATION OF THE FINANCIAL ASSISTANCE POLICY.
SCHEDULE H, PART V, SECTION B, LINE 22D MAXIMUM AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: THE HOSPITAL USES BOTH THE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATE AND AVERAGE MEDICARE RATES WHEN CALCULATING THE MAXIMUM AMOUNT CHARGED TO FAP-ELIGIBLE INDIVIDUALS.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?5
Name and address Type of Facility (describe)
1 YOLANDA G BARCO ONCOLOGY CENTER
16792 CONNEAUT LAKE ROAD
MEADVILLE,PA16335 		ONCOLOGY CENTER
2 MIND BODY WELLNESS CENTER
18201 CONNEAUT LAKE ROAD
MEADVILLE,PA16335 		WELLNESS CENTER
3 WELLNESS EXTENSION
11031 PERRY HIGHWAY
MEADVILLE,PA16335 		WELLNESS CENTER
4 MEADVILLE DERMATOLOGY AND SKIN SURGERY I
INSTITUTE 149 N MAIN ST
MEADVILLE,PA16335 		DERMATOLOGY
5 MEADVILLE PAIN MANAGEMENT
1015 GROVE ST
MEADVILLE,PA16335 		PAIN MANAGEMENT
6
7
8
9
10
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
SCHEDULE H, PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25 OF THE FORM 990, WAS REDUCED BY BAD DEBT EXPENSE OF $10,317,842.
SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 3 AND 6. OTHER IRS WORKSHEETS USED THE HOSPITAL'S COST ACCOUNTING SYSTEM, WHICH INCLUDED ALL PATIENT SEGMENTS.
SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT EXPENSE: LINE 2 REPORTS BAD DEBT EXPENSE FROM THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS.
SCHEDULE H, PART III, SECTION A, LINE 3 BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE: BAD DEBT ATTRIBUTABLE TO PATIENTS UNDER THE ORGANIZATION'S CHARITY CARE POLICY FOR LINE 3 WAS DETERMINED USING A MONTHLY AVERAGE OF PATIENTS ATTRIBUTABLE TO CHARITY.
SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT EXPENSE FOOTNOTE: THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE. THAT FOOTNOTE READS AS FOLLOWS: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HEALTH SYSTEM ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HEALTH SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HEALTH SYSTEM RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS.
SCHEDULE H, PART III, SECTION B, LINE 8 COMMUNITY BENEFIT: SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. COST ACCOUNTING WAS USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED ON LINE 6.
SCHEDULE H, PART III, SECTION C, LINE 9B COLLECTION POLICY: FOR UNINSURED PATIENTS ELIGIBLE FOR DISCOUNTS FROM BILLED TO CHARGES, A MEDICAL ASSISTANCE APPLICATION CAN BE COMPLETED. ONCE COMPLETED, IT WILL BE REVIEWED FOR ELIGIBILITY. A CONTRACT FOR PAYMENT CAN BE NEGOTIATED WITH THE FACILITY'S COLLECTIONS PERSONNEL.
SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: MEADVILLE MEDICAL CENTER COMPLETES A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT ON A REGULAR BASIS TO DETERMINE HEALTH CARE NEEDS. THE MOST RECENT PREVIOUS ASSESSMENT WAS COMPLETED IN 2012 AND THE LATEST ASSESSMENT IS CURRENTLY UNDERWAY AND WILL BE COMPLETED IN 2015. MEADVILLE MEDICAL CENTER WORKS WITH MANY COMMUNITY PARTNERS INCLUDING; HEALTH AND HUMAN SERVICE PROVIDERS, EDUCATION, GOVERNMENT, FAITH, LAW ENFORCEMENT, AND OTHER INTERESTED PARTIES IN COMPLETING THE ASSESSMENT OF THE COMMUNITY HEALTH NEEDS.
SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: ELIGIBILITY FOR FINANCIAL ASSISTANCE IS REVIEWED ACCORDING TO THE U.S. GOVERNMENT'S FEDERAL POVERTY MEADVILLE MEDICAL CENTER (MMC) OFFERS A VARIETY OF FINANCIAL ASSISTANCE PROGRAMS TO MEET THE NEEDS OF PATIENTS. PROGRAMS APPLY ONLY TO MEADVILLE MEDICAL CENTER HOSPITAL CHARGES. PATIENTS WILL RECEIVE A SEPARATE BILL FROM EACH INDEPENDENT PRACTITIONER, OR GROUPS OF PRACTITIONERS, FOR CARE, TREATMENT, OR SERVICES PROVIDED. THE MEADVILLE MEDICAL CENTER FINANCIAL ASSISTANCE PROGRAM DOES NOT APPLY TO THESE CHARGES. IN ADDITION TO THE MEADVILLE MEDICAL CENTER FINANCIAL ASSISTANCE PROGRAMS, PATIENTS MAY ALSO BE ELIGIBLE FOR PUBLIC PROGRAMS SUCH AS MEDICAID OR MEDICARE. APPLYING FOR SUCH PROGRAMS MAY BE REQUIRED PRIOR TO APPLYING FOR A MEADVILLE MEDICAL CENTER FINANCIAL ASSISTANCE PROGRAM. MEADVILLE MEDICAL CENTER WILL ASSIST PATIENTS WITH STATE FUNDED PUBLIC PROGRAMS AND THE ENROLLMENT PROCESS. THE MEADVILLE MEDICAL CENTER FINANCIAL ASSISTANCE PROGRAMS INCLUDE FOUR PROGRAMS: 1. UNINSURED FINANCIAL ASSISTANCE - AVAILABLE TO UNINSURED PATIENTS, OFFERS FREE CARE OR DISCOUNTED CARE BASED ON FAMILY SIZE AND INCOME ACCORDING TO THE ELIGIBILITY CRITERIA. 2. SELF-PAY DISCOUNT - AVAILABLE TO UNINSURED PATIENTS, OFFERS A 40% DISCOUNT, NO APPLICATION NECESSARY, DOES NOT APPLY TO MEDICARE, MEDICAID, BCBS AND OTHER INSURANCE/THIRD PARTY PAYER DEDUCTIBLE AND CO-INSURANCE AMOUNTS. 3. CATASTROPHIC DISCOUNT - AVAILABLE TO UNINSURED AND INSURED PATIENTS, LIMITS THE OUT-OF-POCKET COSTS WHEN MEDICAL DEBTS SPECIFIC TO MEDICAL CARE AT MEADVILLE MEDICAL CENTER EXCEED 25% OF THE PATIENT'S FAMILY GROSS INCOME. 4. PAYMENT PLAN PROGRAM - AVAILABLE TO UNINSURED AND INSURED PATIENTS, ASSISTS PATIENTS WITH THEIR FINANCIAL OBLIGATIONS BY ESTABLISHING PAYMENT ARRANGEMENTS. TO QUALIFY FOR FREE SERVICES (100% FINANCIAL ASSISTANCE) THE PATIENT'S HOUSEHOLD INCOME MUST BE AT OR BELOW 200% OF THE CURRENT FEDERAL POVERTY GUIDELINES. TO QUALIFY FOR PARTIAL FINANCIAL ASSISTANCE, YOUR HOUSEHOLD INCOME MUST BE BETWEEN 200% TO 300% OF THE FEDERAL POVERTY GUIDELINES. IF PATIENTS RECEIVE PARTIAL FINANCIAL ASSISTANCE, PATIENTS ARE STILL RESPONSIBLE FOR PAYING THEIR PORTION OF THE BILL. HOWEVER, MMC IS COMMITTED TO WORKING WITH PATIENTS TO DEVELOP PAYMENT TERMS THAT ARE APPROPRIATE BASED ON THEIR INCOME AND ABILITY TO PAY. IF MMC ESTABLISHES A PAYMENT PLAN FOR PATIENTS, MMC WILL NOT CHARGE INTEREST ON THE ACCOUNT BALANCE WHILE PATIENTS MAKE THE PAYMENTS. PATIENTS WHO ARE AT OR BELOW THE 200% GUIDELINE ARE RESPONSIBLE FOR THE FIRST $200.00 OF CHARGES, THEN A FULL WRITE-OFF OF CHARGES. FOR PATIENTS WHO EXCEED THE 200% GUIDELINE, BUT HAVE INCOME LESS THAN THE 300% GUIDELINE, ARE RESPONSIBLE FOR THE FIRST $200.00, THEN A SLIDING SCALE WILL BE USED TO DETERMINE THE PERCENT REDUCTION OF CHARGES THAT WILL APPLY.
SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: MEADVILLE MEDICAL CENTER SERVES ANY PERSON IN NEED OF SERVICE, THE MAJORITY OF WHICH RESIDE IN CENTRAL AND WESTERN CRAWFORD COUNTY IN NORTHWESTERN PENNSYLVANIA, PRIMARILY A RURAL AREA. THE POPULATION OF THE PRIMARILY RURAL SERVICE AREA WAS 76,460. THE AREA HAS A HIGH RATE OF POVERTY, LOWER MEDIAN AND HOUSEHOLD INCOME, AND HIGHER RATE OF MEDICAL ASSISTANCE ELIGIBILITY THAN THE SURROUNDING AREAS AND THE STATE AND NATION AS A WHOLE. THE UNIQUE NEEDS OF THE COMMUNITY ARE CONSIDERED IN ALL PLANNING.
SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: MEADVILLE MEDICAL CENTER TAKES THE LEADERSHIP POSITION IN COMMUNITY BUILDING ACTIVITIES THAT PROMOTE HEALTH IN THE AREAS WE SERVE. WE ARE AN ACTIVE PARTICIPANT IN THE CRAWFORD (COUNTY) HEALTH IMPROVEMENT COALITION THAT ASSESSES NEEDS IN A ONGOING BASIS AND INITIATES NEEDED INTERVENTIONS, MOST RECENTLY FREE FLU SHOTS TO ELDERLY AND LOW INCOME PERSONS. MEADVILLE MEDICAL CENTER SUPPORTS FINANCIALLY AND OPERATIONALLY THE MEADVILLE AREA FREE CLINIC WHICH PROVIDES PRIMARY CARE FOR PERSONS WITH NO HEALTH INSURANCE, MEDICARE OR MEDICAL ASSISTANCE. THE FREE CLINIC IS ALSO SUPPORTED BY THE UNITED WAY COMMUNITY FUND DRIVE AND WAS STARTED TO MEET A COMMUNITY NEED AS DETERMINED IN A PRIOR COMMUNITY HEALTH NEEDS ASSESSMENT. SURPLUS FUNDS ARE INVESTED IN REPLACEMENT EQUIPMENT, NEW AND IMPROVED FACILITIES AND SERVICES TO THE COMMUNITY. TWO RECENT FACILITY IMPROVEMENTS HAVE BEEN COMPLETED TO MEET COMMUNITY NEEDS; THE YOLANDA G. BARCO ONCOLOGY INSTITUTE AND THE SURGERY CENTER AT GROVE TO ADDRESS GROWING NEED FOR ONCOLOGY SERVICES AND INCREASES IN OUTPATIENT SURGERY.
SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: THE PRIMARY PURPOSE OF THE HEALTH SYSTEM IS TO PROVIDE MEDICAL SERVICES TO THE LOCAL AND SURROUNDING COMMUNITIES THROUGH THE OPERATIONS OF THE MEDICAL CENTER, CHS, MPS AND HCC. THE MEDICAL CENTER IS A SOLE COMMUNITY HOSPITAL LOCATED IN MEADVILLE, PENNSYLVANIA, AND PROVIDES PRIMARY ACUTE CARE MEDICAL SERVICES. COMMUNITY HEALTH SERVICES PROVIDES VARIOUS OUTPATIENT SERVICES, SOME OF WHICH ARE FUNDED THROUGH GOVERNMENTAL GRANTS. MEADVILLE PHYSICIANS SERVICES IS COMPRISED OF PHYSICIAN PRACTICES LOCATED WITHIN CRAWFORD COUNTY, PENNSYLVANIA. HOME CARE CONNECTIONS HOLDS THE EQUITY INVESTMENT IN VANTAGE HOLDING COMPANY, LLC. THE MEADVILLE MEDICAL CENTER FOUNDATION WAS ESTABLISHED TO RECEIVE, ADMINISTER AND DISTRIBUTE FUNDS AND PROPERTY FOR THE BENEFIT AND SUPPORT OF THE HEALTH SYSTEM. MEADVILLE HOUSING CORPORATION IS A FOR-PROFIT COMPANY THAT RENTS RESIDENTIAL LIVING ACCOMMODATIONS AT TWO HOUSING SITES, BOTH OF WHICH ARE IN OR NEAR MEADVILLE, PENNSYLVANIA. NEEDS ARE ASSESSED AND PLANNING IS CONDUCTED CENTRALLY WITHIN THE ORGANIZATION WITH THE PARTICIPATION OF AFFILIATES. THE MEADVILLE HEALTH CENTER WAS OPENED TO ADDRESS GROWING NEED FOR MEDICAL CARE FOR PERSONS COVERED BY MEDICAL ASSISTANCE IN CENTRAL CRAWFORD COUNTY.
Schedule H (Form 990) 2014
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, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
MEADVILLE MEDICAL CENTER
 
Employer identification number

25-1512436
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
directors, trustees, officers, including 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), 501(c)(4), and 501(c)(29) organizations 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
 
No
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
Yes
 
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) 2014

Schedule J (Form 990) 2014
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 in column(B) reported as deferred in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1RENATO SUNTAYCFO (i)
(ii)		 265,806
...............................
0 		37,763
...............................
0 		1,725
...............................
0 		14,300
...............................
0 		18,991
...............................
0 		338,585
...............................
0 		0
...............................
0
2PHILIP PANDOLPHPRESIDENT & CEO (i)
(ii)		 424,121
...............................
0 		73,200
...............................
0 		1,825
...............................
0 		63,294
...............................
0 		27,466
...............................
0 		589,906
...............................
0 		0
...............................
0
3CORY JACKSONFORMER INT. CFO/CUR CONTROLLER (i)
(ii)		 122,856
...............................
0 		4,882
...............................
0 		133
...............................
0 		8,454
...............................
0 		25,770
...............................
0 		162,095
...............................
0 		0
...............................
0
4DR DENISE JOHNSONMEDICAL DIRECTOR (i)
(ii)		 301,080
...............................
0 		35,067
...............................
0 		450
...............................
0 		14,300
...............................
0 		22,195
...............................
0 		373,092
...............................
0 		0
...............................
0
5DR ANNALIISA MCGLINNMED STAFF PRES ENDING 12/2014 (i)
(ii)		 472,753
...............................
0 		91,278
...............................
0 		450
...............................
0 		14,300
...............................
0 		29,960
...............................
0 		608,741
...............................
0 		0
...............................
0
6DR SARAH JURADOPHYSICIAN (i)
(ii)		 582,277
...............................
0 		0
...............................
0 		240
...............................
0 		13,000
...............................
0 		7,018
...............................
0 		602,535
...............................
0 		0
...............................
0
7DR KENNETH CHALLENERPHYSICIAN (i)
(ii)		 483,149
...............................
0 		0
...............................
0 		690
...............................
0 		14,300
...............................
0 		10,229
...............................
0 		508,368
...............................
0 		0
...............................
0
8DR RANDY ZELENPHYSICIAN (i)
(ii)		 408,353
...............................
0 		156,882
...............................
0 		1,980
...............................
0 		30,500
...............................
0 		15,640
...............................
0 		613,355
...............................
0 		0
...............................
0
9DAVID P SHAFFERCHIEF NURSE EXECUTIVE (i)
(ii)		 177,235
...............................
0 		15,217
...............................
0 		995
...............................
0 		16,358
...............................
0 		18,469
...............................
0 		228,274
...............................
0 		0
...............................
0
10DR HEALTH FALLINPHYSICIAN (i)
(ii)		 542,779
...............................
0 		77,992
...............................
0 		450
...............................
0 		13,000
...............................
0 		21,615
...............................
0 		655,836
...............................
0 		0
...............................
0
11DR JASON BROWNPHYSICIAN (i)
(ii)		 469,476
...............................
0 		39,768
...............................
0 		270
...............................
0 		14,300
...............................
0 		27,801
...............................
0 		551,615
...............................
0 		0
...............................
0
12FRANKLIN MCLAUGHLIN DOMED STAFF PRES BEG 12/2014 (i)
(ii)		 0
...............................
332,807 		0
...............................
11,552 		0
...............................
209 		0
...............................
14,307 		0
...............................
15,107 		0
...............................
373,982 		0
...............................
0
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
Page 3
Part III
Supplemental Information
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.
Return Reference Explanation
SCHEDULE J, PART I, LINE 1A SOCIAL CLUB DUES: THE ORGANIZATION PAYS SOCIAL CLUB DUES FOR THE PRESIDENT/CEO ONLY. THE POLICY REGARDING PAYMENT OF THE DUES IS WRITTEN INTO HIS CONTRACT. THE CONTRACT STATES THAT DUES TO PROFESSIONAL ASSOCIATIONS AND SOCIETIES AND TO SUCH SERVICE ORGANIZATIONS AND CLUBS OF WHICH HE IS A MEMBER WILL BE PAID SUBJECT TO THE APPROVAL OF THE CHAIRMAN OF THE BOARD AS BEING IN THE BEST INTERESTS OF THE EMPLOYER OR A SUBSIDIARY. THE DUES ARE PAID TO MEADVILLE COUNTRY CLUB AND THE IROQUOIS CLUB. ANY FEES THAT ARE NOT DIRECTLY RELATED TO THE BUSINESS OF THE HOSPITAL ARE THE RESPONSIBILITY OF THE PRESIDENT/CEO. THE PORTION OF DUES RELATED TO PERSONAL USE, $1,375, IS THE AMOUNT INCLUDED IN THE PRESIDENT/CEO'S 2014 W-2.
SCHEDULE J, PART I, LINE 1A TRAVEL FOR COMPANIONS: SPOUSES OCCASIONALLY TRAVEL WITH BOARD MEMBERS TO ATTEND CONTINUING EDUCATION SEMINARS. ANY ADDITIONAL COST INCURRED BY THE ORGANIZATION RELATED TO SPOUSAL TRAVEL IS REIMBURSED BY THE BOARD MEMBER.
SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: THE FOLLOWING SCHEDULED 457(F) CONTRIBUTIONS WERE MADE ON BEHALF OF MEADVILLE MEDICAL CENTER EMPLOYEES: $ 48,994 PHILIP PANDOLPH
SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS: ALL ADMINISTRATIVE STAFF ARE ELIGIBLE TO RECEIVE, AT THE EMPLOYER'S DISCRETION, AN ANNUAL INCENTIVE BONUS AT THE END OF EACH FISCAL YEAR. THE MAXIMUM OPPORTUNITY FOR THE PARTICIPANTS AND AMOUNTS AWARDED ARE DETERMINED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS BASED UPON THE ACCOMPLISHMENT OF SPECIFIC PERFORMANCE GOALS AND CRITERIA ESTABLISHED ANNUALLY BY THE EXECUTIVE COMMITTEE OF THE BOARD. PHYSICIANS HAVE THE POTENTIAL TO RECEIVE A QUARTERLY BONUS BASED ON WORK RELATIVE VALUE UNITS AS COMPUTED USING CMS RBRVS METHODOLOGY AND MUTUALLY AGREED UPON QUALITY METRICS. THE QUARTERLY BONUS IS LIMITED AND SHALL NOT EXCEED 50% OF THE PROFITABILITY OF THE PRACTICE.
Schedule J (Form 990) 2014

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
MEADVILLE MEDICAL CENTER
 
Employer identification number
25-1512436
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer 		(i) Pool
financing
Yes No Yes No Yes No
A CRAWFORD COUNTY HOSPITAL AUTHORITY
  		25-1535164   08-01-2012 6,850,000 YGBOI 2006 BOND REFINANCING   X   X   X
B CRAWFORD COUNTY HOSPITAL AUTHORITY
  		25-1535164   08-29-2008 10,000,000 GROVE ST. SURGERY CENTER ADDITION   X   X   X
C CRAWFORD COUNTY HOSPITAL AUTHORITY
  		25-1535164   03-24-2011 10,000,000 CAPITAL EQUIPMENT SERIES OF 2011   X   X   X
D CRAWFORD COUNTY HOSPITAL AUTHORITY
  		25-1535164   03-25-2011 14,719,759 CAPITAL EQUIPMENT SERIES OF 2012   X   X   X
CRAWFORD COUNTY HOSPITAL AUTHORITY
  		25-1535164   12-31-2012 5,000,000 CAPITAL EQUIPMENT SERIES OF 2012/2   X   X   X
CRAWFORD COUNTY HOSPITAL AUTHORITY
  		25-1535164   12-30-2013 7,000,000 CAPITAL EQUIPMENT SERIES 2013A   X   X   X
CRAWFORD COUNTY HOSPITAL AUTHORITY
  		25-1535164   12-18-2014 10,000,000 CAPITAL EQUIPMENT SERIES 2014A   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 0 0 0 0
2 Amount of bonds legally defeased . . . . . . . . . . . 0 0 0 0
3 Total proceeds of issue . . . . . . . . . . . . . . 6,850,000 10,000,000 10,000,000 4,719,759
4 Gross proceeds in reserve funds . . . . . . . . . . . . 0 0 0 0
5 Capitalized interest from proceeds . . . . . . . . . . . 0 0 0 0
6 Proceeds in refunding escrows . . . . . . . . . . . . 0 0 0 0
7 Issuance costs from proceeds . . . . . . . . . . . . 0 0 37,373 0
8 Credit enhancement from proceeds . . . . . . . . . . . 0 0 0 0
9 Working capital expenditures from proceeds . . . . . . . . . 0 0 0 0
10 Capital expenditures from proceeds . . . . . . . . . . . 6,850,000 10,000,000 9,962,627 4,719,759
11 Other spent proceeds . . . . . . . . . . . . . . 0 0 0 0
12 Other unspent proceeds . . . . . . . . . . . . . . 0 0 0 0
13 Year of substantial completion . . . . . . . . . . . . 2012 2009 2012 2012
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . . X     X   X   X
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X   X   X   X
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X   X
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?                
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .   X   X   X   X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0 % 0 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet        
6 Total of lines 4 and 5 . . . . . . . . . . . . .        
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . . 		X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .   X   X   X   X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X   X   X   X
b Exception to rebate? . . . . . . . . X   X   X   X  
c No rebate due? . . . . . . . .   X   X   X   X
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . . X   X   X   X  
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X X   X   X  
b Name of provider . . . . . . . . . 0
  		FIRST NATIONAL
  		FIRST NIAGARA
  		 
 
c Term of hedge . . . . . . . . . . 15. 15. 5. 5.
d Was the hedge superintegrated? . . . . X   X   X   X  
e Was the hedge terminated? . . . . . .   X   X   X   X
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X   X   X
b Name of provider . . . . . . . . . 0
  		0
  		0
  		0
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
SCHEDULE K, PART IV, LINE 3, COLUMN C QUALIFIED HEDGE: A QUALIFIED HEDGE WAS ENTERED INTO WITH RESPECT TO ONLY $2,300,000 OF THE TOTAL ISSUE PRICE THROUGH AN INTEREST RATE SWAP.
Schedule K (Form 990) 2014

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
MEADVILLE MEDICAL CENTER
 
Employer identification number
25-1512436
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer 		(i) Pool
financing
Yes No Yes No Yes No
A CRAWFORD COUNTY HOSPITAL AUTHORITY
  		25-1535164   08-01-2012 6,850,000 YGBOI 2006 BOND REFINANCING   X   X   X
B CRAWFORD COUNTY HOSPITAL AUTHORITY
  		25-1535164   08-29-2008 10,000,000 GROVE ST. SURGERY CENTER ADDITION   X   X   X
C CRAWFORD COUNTY HOSPITAL AUTHORITY
  		25-1535164   03-24-2011 10,000,000 CAPITAL EQUIPMENT SERIES OF 2011   X   X   X
D CRAWFORD COUNTY HOSPITAL AUTHORITY
  		25-1535164   03-25-2011 14,719,759 CAPITAL EQUIPMENT SERIES OF 2012   X   X   X
CRAWFORD COUNTY HOSPITAL AUTHORITY
  		25-1535164   12-31-2012 5,000,000 CAPITAL EQUIPMENT SERIES OF 2012/2   X   X   X
CRAWFORD COUNTY HOSPITAL AUTHORITY
  		25-1535164   12-30-2013 7,000,000 CAPITAL EQUIPMENT SERIES 2013A   X   X   X
CRAWFORD COUNTY HOSPITAL AUTHORITY
  		25-1535164   12-18-2014 10,000,000 CAPITAL EQUIPMENT SERIES 2014A   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 0 0 0 0
2 Amount of bonds legally defeased . . . . . . . . . . . 0 0 0 0
3 Total proceeds of issue . . . . . . . . . . . . . . 6,850,000 10,000,000 10,000,000 4,719,759
4 Gross proceeds in reserve funds . . . . . . . . . . . . 0 0 0 0
5 Capitalized interest from proceeds . . . . . . . . . . . 0 0 0 0
6 Proceeds in refunding escrows . . . . . . . . . . . . 0 0 0 0
7 Issuance costs from proceeds . . . . . . . . . . . . 0 0 37,373 0
8 Credit enhancement from proceeds . . . . . . . . . . . 0 0 0 0
9 Working capital expenditures from proceeds . . . . . . . . . 0 0 0 0
10 Capital expenditures from proceeds . . . . . . . . . . . 6,850,000 10,000,000 9,962,627 4,719,759
11 Other spent proceeds . . . . . . . . . . . . . . 0 0 0 0
12 Other unspent proceeds . . . . . . . . . . . . . . 0 0 0 0
13 Year of substantial completion . . . . . . . . . . . . 2012 2009 2012 2012
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . . X     X   X   X
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X   X   X   X
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X   X
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?                
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .   X   X   X   X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0 % 0 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet        
6 Total of lines 4 and 5 . . . . . . . . . . . . .        
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . . 		X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .   X   X   X   X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X   X   X   X
b Exception to rebate? . . . . . . . . X   X   X   X  
c No rebate due? . . . . . . . .   X   X   X   X
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . . X   X   X   X  
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X X   X   X  
b Name of provider . . . . . . . . . 0
  		FIRST NATIONAL
  		FIRST NIAGARA
  		 
 
c Term of hedge . . . . . . . . . . 15. 15. 5. 5.
d Was the hedge superintegrated? . . . . X   X   X   X  
e Was the hedge terminated? . . . . . .   X   X   X   X
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X   X   X
b Name of provider . . . . . . . . . 0
  		0
  		0
  		0
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
SCHEDULE K, PART IV, LINE 3, COLUMN C QUALIFIED HEDGE: A QUALIFIED HEDGE WAS ENTERED INTO WITH RESPECT TO ONLY $2,300,000 OF THE TOTAL ISSUE PRICE THROUGH AN INTEREST RATE SWAP.
Schedule K (Form 990) 2014

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 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
MEADVILLE MEDICAL CENTER
 
Employer identification number

25-1512436
Return Reference Explanation
FORM 990, PART I, LINE 6 VOLUNTEERS: MEADVILLE MEDICAL CENTER VOLUNTEERS DONATED OVER 40,000 HOURS IN THE PAST YEAR ASSISTING IN VARIOUS AREAS THROUGHOUT THE FACILITY. DUTIES INCLUDE BUT ARE NOT LIMITED TO TASKS SUCH AS TRANSPORTING AND ESCORTING PATIENTS, DELIVERING FLOWERS AND MAIL, PERFORMING CLERICAL DUTIES, ASSISTING IN THE COFFEE & GIFT SHOPS, HANDING OUT BEEPERS IN THE SURGICAL FAMILY WAITING AREA AND MANNING THE INFORMATION DESKS, TO NAME A FEW. WE RECOGNIZE OUR VOLUNTEERS WITH VARIOUS ACTIVITIES THROUGHOUT VOLUNTEER WEEK INCLUDING A RECEPTION AND RECOGNITION GIFT, IN ADDITION TO A YEARLY CHRISTMAS RECEPTION. WE RECOGNIZE THE DEDICATION AND IMPORTANCE OF OUR VOLUNTEERS, AND READILY WELCOME NEW ADDITIONS TO OUR VOLUNTEER WORKFORCE.
FORM 990, PART III, LINE 4A PROGRAM SERVICE ACTIVITY #1: INPATIENT ACUTE CARE IS THE SYSTEM OF CARE RESERVED AND PROVIDED FOR PATIENTS WHOSE MEDICAL CONDITIONS NECESSITATE THEIR STAY IN A HOSPITAL OR TREATMENT FACILITY WHILE UNDERGOING TREATMENT. PATIENTS SUFFERING FROM DISEASE OR RECOVERING FROM INJURY OR INVASIVE SURGERY TYPICALLY MAKE UP THE LARGEST GROUP OF INPATIENT ACUTE PATIENTS. CONDITIONS UNDER THIS GROUP INCLUDE WOUND CARE, AMPUTEE SERVICES, STROKES AND OTHER TRAUMATIC BRAIN INJURIES, ARTHRITIS AND CANCER. INPATIENT CARE CAN BE QUITE EXPENSIVE FOR PATIENTS. THE FUNDING IS PROVIDED BOTH BY PATIENTS' INSURANCE POLICIES AS WELL AS GOVERNMENT SUBSIDY TO THE CENTER'S BUDGET.
FORM 990, PART III, LINE 4B PROGRAM SERVICE ACTIVITY #2: OVER 70 PERCENT OF SURGERIES ARE DONE ON AN OUTPATIENT BASIS; AND OUTPATIENT SURGERY REMAINS A CONVENIENT, COST-SAVING ALTERNATIVE TO HOSPITAL ADMISSION FOR PATIENTS UNDERGOING CERTAIN PROCEDURES. THESE PATIENTS ARE PROVIDED WITH QUALITY CARE AND SAFETY, PLUS THE AVAILABILITY OF COMPLETE HOSPITAL FACILITIES AND SERVICES IF NEEDED. IN RECENT YEARS THE TREND IS MINIMALLY INVASIVE SURGERY WHICH HELPS PATIENTS TO RECOVER MUCH FASTER, SUFFER LESS PAIN AND RETURN TO WORK MORE QUICKLY. THE HOSPITAL RECENTLY ADDED THE SURGERY CENTER AT GROVE, A NEW WING AT THE GROVE STREET FACILITY THAT BRINGS ALL OUTPATIENT SURGERY AND PROCEDURES TO ONE CONVENIENT, PATIENT- AND FAMILY-FRIENDLY LOCATION ON ONE FLOOR. MOST FREQUENT SURGICAL CASES PERFORMED AT MMC ARE: ORTHOPEDIC -TOTAL HIP REPLACEMENT -TOTAL KNEE REPLACEMENT -JOINT REPLACEMENT -CERVICAL DISCECTOMY WITH FUSION -LUMBAR LAMINECTOMY WITH FUSION (LAPAROSCOPIC, OPEN, AND INNER BODY) -BACK IMPLANT FOR LUMBAR SPINAL FUSION -SHOULDER REPAIR (ARTHROSCOPIC AND OPEN) -KNEE ARTHROSCOPY -HIP AND ANKLE FRACTURES -CARPAL TUNNEL RELEASE -GANGLION CYST EXCISION EAR NOSE THROAT -MYRINGOTOMY -TONSIL AND ADENOID REMOVAL -ADENOIDECTOMY -TONSILLECTOMY -SEPTOPLASTY -THYROIDECTOMY -UVULOPALATOPHARYNGOPLASTY (TO ENLARGE THE LARYNX FOR SNORING/OBSTRUCTION) EYE SURGERY -CATARACT EXTRACTION WITH INTRAOCULAR LENS -IMPLANT -TEAR DUCT PROBING AND IRRIGATION -BLEPHAROPLASTY GENERAL SURGERY -LAPAROSCOPIC PROCEDURES (GALL BLADDER, HERNIA, APPENDECTOMY) -OPEN PROCEDURES (GALL BLADDER, HERNIA, APPENDECTOMY) -BREAST BIOPSY -MASTECTOMY -HEMORRHOIDECTOMY OB-GYN -HYSTERECTOMY -ABDOMINAL/VAGINAL (OPEN AND LAPAROSCOPIC ASSISTED) -D & C -ENDOMETRIAL ABLATION -HYSTEROSCOPY -LAPAROSCOPIC TUBAL OCCLUSION -C-SECTION -COLD CONE BIOPSY OF CERVIX VASCULAR SURGERY -INSERTION OF TOTALLY IMPLANTABLE VASC ACCE PLASTIC SURGERY -BREAST REDUCTION -BREAST AUGMENTATION -LIPOSUCTION -LASER THERAPY OF BIRTHMARKS AND PORT WINE STRAINS -RHINOPLASTY PODIATRY -BUNIONECTOMY -HAMMERTOE CORRECTION -ANKLE STABILIZATION UROLOGY -LITHOTRON -ESWL -LASER LITHOTRIPSY -CYSTOSCOPY -VASECTOMY -DIAGNOSTIC LAPAROSCOPY -TURP, TURBT
FORM 990, PART III, LINE 4C PROGRAM SERVICE ACTIVITY #3: AT THE ONCOLOGY INSTITUTE, MEADVILLE MEDICAL CENTER IS COMMITTED TO YOUR TOTAL CARE AND SUPPORT. OUR TEAM OF HEALTH CARE PROFESSIONALS ARE EXPERIENCED IN COUNSELING AND EDUCATING PATIENTS, HELPING THEM UNDERSTAND AND COPE WITH THEIR ILLNESS AND ITS TREATMENT. WE ENCOURAGE PATIENTS TO PARTICIPATE AS MUCH AS POSSIBLE IN THEIR ON-GOING CARE. YOUR CARE IS COORDINATED BY AN INTERDISCIPLINARY TEAM OF PROFESSIONALS INCLUDING YOUR FAMILY PHYSICIAN, SURGEONS, MEDICAL AND RADIATION ONCOLOGISTS, NURSES, SOCIAL WORKERS AND OTHER SUPPORT STAFF. CANCER CARE CONFERENCES ARE HELD ON A WEEKLY BASIS AS A FORMALIZED REVIEW AND DISCUSSION OF ALL CANCER PATIENTS. THIS IS AN OPPORTUNITY FOR PHYSICIANS TO GET INPUT FROM OTHER PHYSICIANS ON THE TREATMENT OF CANCER PATIENTS. OUR PHYSICIANS SPECIALIZING IN THE CARE OF CANCER ARE BOARD CERTIFIED MEDICAL ONCOLOGISTS AND BOARD CERTIFIED RADIATION ONCOLOGISTS. THE NEW CANCER CENTER EMPLOYS TWO ONCOLOGIST/HEMATOLOGISTS AND A RADIATION ONCOLOGIST, A PHYSICIST AND A MULTI-DISCIPLINARY TEAM CONSISTING OF REGISTERED NURSES CERTIFIED IN ONCOLOGY; A CLINICAL PROTOCOL NURSE; CERTIFIED MEDICAL DOSIMETRISTS; REGISTERED RADIATION THERAPISTS; A TUMOR REGISTRAR; LABORATORY TECHNICIANS; A PHARMACIST; AND PHARMACY TECHNICIANS. THE NURSING STAFF WORKING WITH CANCER PATIENTS HAS EXTENSIVE SPECIALIZED TRAINING. REGISTERED NURSES HAVE BEEN TRAINED AND ARE CERTIFIED IN THE ADMINISTRATION OF CHEMOTHERAPY. DIAGNOSTIC SERVICES STATE-OF-THE-ART DIAGNOSTIC SERVICES SUCH AS CT SCANNING AND PET SCANNING ARE AVAILABLE ON SITE TO HELP DETECT CANCER IN ITS EARLIEST STAGES AND/OR DIAGNOSE THE EXTENT OF THE CANCER. ANOTHER ASSET TO THE DEPARTMENT IS ACCESS TO THE MAMMOTOME PROCEDURE. THE MAMMOTOME ENHANCES A WOMEN'S ALTERNATIVE FOR A CHANCE OF LESS INVASIVE BREAST BIOPSIES. WITH THE MAMMOTOME, BREAST BIOPSIES ARE LESS INVASIVE AND MOST PATIENTS MAY RETURN TO THEIR REGULAR ROUTINE POST-PROCEDURE. THE TRILOGY STEREOTACTIC SYSTEM FROM VARIAN MEDICAL SYSTEMS IS THE MOST ADVANCED, SOPHISTICATED MACHINE OF ITS TYPE IN THE WORLD. AS THE LEADING IMAGE-GUIDED RADIOTHERAPY (IGRT) SYSTEM, TRILOGY MARKS THE BEGINNING OF A NEW GENERATION OF CANCER CARE. RADIOTHERAPY CAN BE USED TO TREAT MORE DIFFERENT TYPES OF CANCER, WHICH MEANS THAT MORE PATIENTS CAN BE SPARED THE INVASIVE TECHNIQUES OF SURGERY AND/OR CHEMOTHERAPY. MEADVILLE MEDICAL CENTER AND OUR PHYSICIANS RECOGNIZE THE IMPORTANCE OF EARLY DETECTION IN CANCER CARE. TO SUPPLEMENT YOUR ANNUAL PHYSICAL EXAMINATION WE OFFER PROGRAMS SUCH AS LOW COST MAMMOGRAPHY, PERIODIC FREE SCREENINGS FOR CANCERS SUCH AS PROSTATE AND SKIN, AND SPECIAL EDUCATIONAL PROGRAM AND/OR MATERIAL ON MANY TYPES OF CANCER. IN ADDITION TO PROVIDING THE HIGHEST QUALITY MEDICAL CARE, THE PROFESSIONAL SUPPORT STAFF IS PREPARED TO DEAL WITH THE PHYSICAL, PSYCHOLOGICAL AND SOCIAL CONSEQUENCES THAT MAY ARISE AS THE RESULT OF CANCER OR ITS TREATMENT. ARRANGEMENTS CAN BE MADE THROUGH MEADVILLE MEDICAL CENTER TO PROVIDE SOCIAL WORKERS AND PASTORAL CARE STAFF FOR INDIVIDUAL COUNSELING, EMOTIONAL SUPPORT AND INFORMATION ON AVAILABLE RESOURCES FOR CANCER PATIENTS. THERAPEUTIC DIETICIANS PROVIDE PRIVATE CONSULTATION TO ASSIST WITH SPECIAL NUTRITIONAL NEEDS. PHARMACISTS, LABORATORY TECHNICIANS, AND OTHERS ARE ALSO AVAILABLE TO ASSIST IN PROVIDING THE TOTAL CARE OF OUR PATIENTS AND THEIR FAMILIES. A WHOLE-PERSON APPROACH AT THE HEART OF THE WHOLE-PERSON APPROACH TO HEALTH AND WELLNESS, THE YOLANDA G. BARCO ONCOLOGY INSTITUTE PROVIDES COORDINATED COUNSELING AND NUTRITION CONSULTATIONS AS WELL AS STRESS REDUCTION OPPORTUNITIES IN THE FORM OF ART AND MUSIC RECREATION THERAPY. AN INNOVATIVE KEYBOARD PROGRAM KNOWN AS THE CLAVINOVA CONNECTION, DEVELOPED BY YAMAHA, ALLOWS PATIENTS WITH NO MUSICAL EXPERIENCE TO SIMPLY FOLLOW KEYBOARD LIGHTS FOR SPECIALLY ARRANGED MUSICAL COMPOSITIONS. THIS MUSICAL "DIVERSION" WILL HELP THEM RELAX AND, AS RECENT RESEARCH SUGGESTS, REVERSE THE DNA SWITCHES THAT LITERALLY TURN ON THE HUMAN STRESS RESPONSE. ALSO AVAILABLE ARE SERVICES THAT PROMOTE "WHOLE BODY HEALING" - MASSAGE THERAPY, TAI CHI, YOGA, EXERCISE CLASSES, MEDITATION, MUSIC THERAPY, ACUPUNCTURE, NUTRITIONAL COUNSELING, PAIN MANAGEMENT AND SUPPORT GROUPS. DOCTORS SAY THESE LIFESTYLE, BEHAVIOR, DIET, AND OVERALL WELLNESS PROGRAMS WILL HELP PATIENTS BE MORE PRO-ACTIVE IN THEIR HEALTH AND RECOVERY.
FORM 990, PART III, LINE 4D OTHER PROGRAM SERVICE ACTIVITIES: OTHER PROGRAM SERVICE ACTIVITIES: MMC OPERATES AN INTENSIVE CARE UNIT. THE INTENSIVE CARE UNIT AT MEADVILLE MEDICAL CENTER IS A 12-BED INTENSIVE CARE UNIT THAT SUPPORTS THE CARDIAC, SURGICAL, AND MEDICAL INTENSIVE CARE PATIENTS. IN ADDITION, A 16-BED TELEMETRY STEP-DOWN NURSING UNIT IS LOCATED ADJACENT TO THE ICU. PATIENTS WITH CARDIAC PROBLEMS ARE MONITORED FROM THEIR ROOMS; WITH THE MOST SOPHISTICATED MONITORING EQUIPMENT AVAILABLE. PHYSICIANS ADMIT THOSE PATIENTS TO THE INTENSIVE CARE UNIT (ICU) WHOM THEY FEEL REQUIRE SPECIALIZED NURSING CARE AFTER SURGERY, AN ILLNESS, OR SOME OTHER SERIOUS MEDICAL CONDITION. AN ICU IS DESIGNED TO PROVIDE 24-HOUR CONCENTRATED MEDICAL AND NURSING CARE TO HELP BRING THE SERIOUSLY ILL PATIENT THROUGH THE CRITICAL PERIOD OF RECOVERY. PATIENTS IN THE ICU ARE TRANSFERRED TO A REGULAR NURSING UNIT WHEN THEIR PHYSICIANS FEEL THAT THE CRITICAL STAGE OF ILLNESS HAS PASSED. THE INTENSIVE CARE UNIT AT MEADVILLE MEDICAL CENTER IS A 12-BED INTENSIVE CARE UNIT THAT SUPPORTS THE CARDIAC, SURGICAL AND MEDICAL INTENSIVE CARE PATIENTS. IN ADDITION, A 16-BED TELEMETRY STEP-DOWN NURSING UNIT IS LOCATED ADJACENT TO THE ICU. PATIENTS WITH CARDIAC PROBLEMS ARE MONITORED FROM THEIR ROOMS; WITH THE MOST SOPHISTICATED MONITORING EQUIPMENT AVAILABLE. IN THE ICU, CONSTANT OBSERVATION AND INDIVIDUALIZED NURSING CARE ARE PROVIDED TO ASSURE THAT THE PATIENT IS COMFORTABLE AND RECEIVES THE BEST IN SKILLED NURSING CARE. THE HIGHLY SKILLED NURSING PERSONNEL WHO STAFF OUR UNIT ARE CERTIFIED CRITICAL CARE REGISTERED NURSES, AND THEY UTILIZE THE LATEST MONITORING AND LIFE-SAVING EQUIPMENT. THIS ATTENTIVE STAFF OF PROFESSIONAL NURSES ENSURES THAT ALL PATIENTS ARE CLOSELY OBSERVED, AND CARED FOR, 24 HOURS A DAY. THE ORGANIZATION ALSO PROVIDES A VARIETY OF OTHER SERVICES, INCLUDING THE FOLLOWING: -MIND BODY WELLNESS CENTER -20 BED INPATIENT PSYCHIATRIC UNIT -22 BED INPATIENT DRUG AND ALCOHOL UNIT -32 SKILLED NURSING UNIT -11 BED REHAB UNIT ADDITIONALLY, THE ORGANIZATION DONATES TO CHARITABLE ORGANIZATIONS.
FORM 990, PART V, LINE 2A W-2'S FILED: MEADVILLE MEDICAL CENTER ALSO FILES W-2'S FOR ONE OF ITS RELATED ORGANIZATIONS, MEADVILLE MEDICAL CENTER FOUNDATION. THE TOTAL NUMBER OF W-2'S FILED INCLUDES THESE W-2'S. THE COMPENSATION, EMPLOYEE BENEFITS AND PAYROLL TAXES AMOUNTS ARE THEN ALLOCATED TO THE ORGANIZATION FOR THE AMOUNT THAT REPRESENTS WORK PERFORMED FOR THE ORGANIZATION. THEREFORE, THE AMOUNT REPORTED ON PART IX INCLUDES ONLY THOSE AMOUNTS ALLOCATED TO WORK PERFORMED DIRECTLY FOR MEADVILLE MEDICAL CENTER. THE HIGHEST PAID EMPLOYEES ARE DETERMINED BY THE WORK PERFORMED FOR EACH ORGANIZATION. THEREFORE, THE FIVE HIGHEST PAID EMPLOYEES LISTED ON PART VII AND SCHEDULE J ARE THOSE EMPLOYEES WHO WORK DIRECTLY FOR MEADVILLE MEDICAL CENTER.
FORM 990, PART VI, SECTION A, LINES 6, 7A, & 7B MEMBERS: MEMBERS ARE ELECTED BY THE MEMBERS OF THE CORPORATION, SERVE A TERM OF FIVE YEARS, AND MAY SERVE AN UNLIMITED NUMBER OF TERMS. MEMBERS HAVE SUCH POWERS AND DUTIES AS ARE SET FORTH IN THE PENNSYLVANIA NONPROFIT CORPORATION LAW OF 1988 (NPCL). PART OF THE RESPONSIBILITY OF THE MEMBERS IS TO ELECT THE DIRECTORS AT THEIR ANNUAL MEETING AFTER NOMINATION HAS BEEN COMPLETED. THE BOARD OF DIRECTORS HAS THE AUTHORITY TO ADOPT, AMEND, AND REPEAL ANY ARTICLE AND/OR BYLAW SUBJECT TO THE POWER OF THE MEMBERS TO CHANGE SUCH AUCTION. THE MEMBERS RETAIN THE EXCLUSIVE RIGHT TO ADOPT, AMEND, AND REPEAL ANY BYLAW OR ARTICLE ON ANY SUBJECT ENUMERATED IN SECTION 5504(B) OF THE NPCL. ANY PERSON WHO HAS SERVED AS A MEMBER OF THIS CORPORATION MAY, IN THE DISCRETION OF THE BOARD OF DIRECTORS, BE ELECTED TO THE STATUS OF A MEMBER EMERITUS. ALL MEMBERS EMERITUS SHALL HAVE THE RIGHT TO PARTICIPATE IN THE AFFAIRS OF THE CORPORATION IN THE SAME MANNER AS MEMBERS OF THE CORPORATION AS DEFINED IN ARTICLE III OF THE BYLAWS, BUT SHALL NOT BE SUBJECT TO THE FOLLOWING PROVISIONS OF ARTICLE III OF THE BYLAWS. (A) RE-ELECTION ON A FIVE-YEAR BASIS UNDER SECTION 3.1 OF THE BYLAWS. MEMBERS EMERITUS SHALL CONTINUE IN PERPETUITY DURING THEIR LIFETIME, OR UNTIL THEIR SPECIFIC RESIGNATION. (B) SECTION 3.4(A), WHICH PROVIDES FOR REMOVAL IN THE EVENT OF FAILURE TO ATTEND FOUR CONSECUTIVE MEETINGS WITHOUT A JUSTIFIABLE EXCUSE. MEMBERS EMERITUS WILL NOT BE REQUIRED TO ATTEND MEETINGS IN ORDER TO MAINTAIN THEIR STATUS. MEMBERS EMERITUS ARE NOT ENTITLED TO VOTE AND ARE NOT COUNTED FOR THE PURPOSE OF DETERMINING A QUORUM UNDER ARTICLE IV, SECTION 4.3 OF THE BYLAWS.
FORM 990, PART VI, SECTION B, LINE 11B REVIEW OF THE FORM 990: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF MEADVILLE MEDICAL CENTER. THE 990 IS INITIALLY INTERNALLY REVIEWED IN-DEPTH BY THE CEO, CFO, AND CONTROLLER. AFTER CHANGES ARE MADE FROM THIS REVIEW, THE 990 IS PLACED ON A WEB PORTAL WHERE EACH BOARD MEMBER HAS THE OPPORTUNITY TO REVIEW AND ASK QUESTIONS OR SUGGEST CHANGES BEFORE FILING. AFTER ALL QUESTIONS AND SUGGESTIONS ARE CONSIDERED, THE FORM 990 IS ELECTRONICALLY FILED.
FORM 990, PART VI, SECTION B, LINE 12C MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: THE ORGANIZATION HAS AN ANNUAL CONFLICT OF INTEREST DISCLOSURE STATEMENT. ANY ACTUAL OR POTENTIAL CONFLICTS ARE EVALUATED AND DEEMED TO EITHER MAKE THE INTERESTED PERSON DISQUALIFIED OR INELIGIBLE TO SERVE. THROUGHOUT THE YEAR, EACH AFFECTED PERSON IS ALSO OBLIGATED TO FILE A SUPPLEMENTARY DISCLOSURE STATEMENT IF THERE IS A CHANGE IN CIRCUMSTANCES WHICH COULD CREATE CONFLICT. DETERMINATION OF ACTUAL CONFLICT WILL BE CONDUCTED BY THE BOARD OF DIRECTORS. ANY DIRECTOR, OFFICER OR DISQUALIFIED PERSON WHO IS DEEMED BY THE BOARD TO BE DISQUALIFIED BECAUSE OF AN ACTUAL OR APPARENT CONFLICT OF INTEREST ON ANY MATTER (I) SHALL NOT VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER, (II) SHALL ABSTAIN FROM VOTING (ALTHOUGH UPON INVITATION OF THE CHAIRMAN, HE OR SHE MAY PARTICIPATE IN BOARD DISCUSSIONS) AND (III) SHALL NOT BE COUNTED IN DETERMINING THE QUORUM FOR THE MEETING, EVEN WHEN PERMITTED BY LAW. THE MINUTES OF THE MEETING SHALL REFLECT THAT A DISCLOSURE WAS MADE, THE ABSTENTION FROM VOTING, AND THE EFFECT ON THE QUORUM. AN INDIVIDUAL WHO HAS A RELATIONSHIP WITH AN ENTITY THAT IN THE BOARD'S VIEW MAKES IT DIFFICULT OR IMPOSSIBLE FOR THAT INDIVIDUAL OR ANY OF THE REMAINING DIRECTORS TO DISCHARGE HIS OR HER RESPONSIBILITIES MAY BE DECLARED INELIGIBLE TO SERVE AND SHALL EITHER RESIGN OR MAY BE REMOVED BY A MAJORITY VOTE OF ALL REMAINING DIRECTORS IN OFFICE.
FORM 990,PART VI, SECTION B, LINES 15A & 15B COMPENSATION REVIEW: THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF MEADVILLE MEDICAL CENTER (MMC), WHICH IS COMPRISED OF INDEPENDENT BOARD MEMBERS DETERMINED TO BE FREE OF ANY CONFLICT OF INTEREST, IS CHARGED WITH DETERMINING EXECUTIVE COMPENSATION AND ESTABLISHING PERFORMANCE CRITERIA ACCORDING TO AN APPROVED COMPENSATION PHILOSOPHY. THE COMMITTEE WORKS WITH AN INDEPENDENT EXECUTIVE COMPENSATION CONSULTING AND ADVISORY FIRM, YAFFE & COMPANY, THAT PROVIDES MARKET SURVEY DATA CONCERNING COMPENSATION AND BENEFIT LEVELS FOR FUNCTIONALLY COMPARABLE HEALTHCARE EXECUTIVES IN SIMILAR HOSPITALS ACROSS THE REGION AND THE NATION BASED ON SEVERAL FACTORS INCLUDING SIZE, GEOGRAPHY, HOSPITAL TYPE AND COMPLEXITY. THE COMMITTEE REVIEWS AND APPROVES THE COMPENSATION OF THE SENIOR EXECUTIVES AND ENSURES THAT ALL FORMS OF EXECUTIVE COMPENSATION ARE REASONABLE, APPROPRIATE AND CONSISTENT WITH ITS COMPENSATION PHILOSOPHY. THE COMMITTEE CONTEMPORANEOUSLY DOCUMENTS ITS DECISIONS IN MEETING MINUTES AND REPORTS ITS DECISIONS TO THE FULL BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: UPON REQUEST, PHOTOCOPIES OF GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE FOR PICKUP BY THE REQUESTING PERSON.
FORM 990, PART VII, SECTION A FORMER EMPLOYEES: CORY JACKSON SERVED AS INTERIM CFO IN 2010 AND RETURNED TO HIS PREVIOUS ROLE AS CONTROLLER AFTER A NEW CFO WAS HIRED.
FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: $( 9,249,120) TRANSFERS TO RELATED PARTIES ( 7,240,932) CHANGE IN DEFINED BENEFIT PENSION PLAN ( 85,171) CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST 131,093 CHANGE IN FAIR VALUE OF INTEREST RATE SWAMP ------------- $(16,444,130)
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2014

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" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
MEADVILLE MEDICAL CENTER
 
Employer identification number

25-1512436
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on 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" on 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) MEADVILLE MEDICAL CENTER FOUNDATION
1034 GROVE STREET

MEADVILLE,PA16335
25-1681342 		SUPPORT PA 501(C)(3) 7 MMC
 
Yes
 
(2) HOSPICE OF CRAWFORD COUNTY INC
1034 GROVE STREET

MEADVILLE,PA16335
25-1480565 		HOSPICE PA 501(C)(3) 7 MMC
 
Yes
 
(3) CONNEAUT VALLEY HEALTH CENTER
1034 GROVE STREET

MEADVILLE,PA16335
25-1490887 		HEALTH CENTER PA 501(C)(3) 3 MMC
 
Yes
 
(4) MEADVILLE PHYSICIANS SERVICES
751 LIBERTY STREET

MEADVILLE,PA16335
25-1602133 		PHYS. OFFICES PA 501(C)(3) 9 MMC
 
Yes
 
(5) COMMUNITY HEALTH SERVICES INC
1034 GROVE STREET

MEADVILLE,PA16335
25-1490886 		PHYS. OFFICES PA 501(C)(3) 9 MMC
 
Yes
 
(6) MEADVILLE MEDICAL CENTER AUXILIARY
751 LIBERTY STREET

MEADVILLE,PA16335
25-1512834 		SUPPORT PA 501(C)(3) 11A I MMC
 
Yes
 
(7) FRENCH CREEK INTERNAL MEDICINE
751 LIBERTY ST

MEADVILLE,PA16335
47-1870077 		PHYS. OFFICES PA 501(C)(3) 9 MPS
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on 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" on 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) HOME CARE CONNECTIONS INC

751 LIBERTY STREET
MEADVILLE,PA16335
25-1605314 		HOLDING COMPA PA MMC
  		C CORP 204,796 2,583,135 100.000 % Yes  
(2) MEADVILLE HOUSING CORPORATION

934 B STREET
MEADVILLE,PA16335
25-0657800 		HOUSING PA MMC
  		C CORP 1,141,929 3,351,449 60.980 % Yes  
(3) CHARITABLE TRUST

 
 
25-6196092 		TRUST PA MMC
  		TRUST -31,265 2,645,973 100.000 % Yes  
(4) CHARITABLE TRUST

 
 
06-6031521 		TRUST PA MMC
  		TRUST -54,556 1,002,058 100.000 % Yes  






Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on 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
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
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
Yes
 
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
Yes
 
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
Yes
 
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
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
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 related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) MEADVILLE PHYSICIANS SERVICES

 A 182,933 FMV
(2) MEADVILLE MEDICAL CENTER FOUNDATION

 A 5,385 FMV
(3) HOSPICE OF CRAWFORD COUNTY

 A 11,176 FMV
(4) CONNEAUT VALLEY HEALTH CENTER

 A 27,740 FMV
(5) COMMUNITY HEALTH SERVICES

 A 29,736 FMV
(6) CHARITABLE TRUST

 C 62,926 FMV
(7) MEADVILLE PHYSICIANS SERVICES

 L 513,098 FMV
(8) COMMUNITY HEALTH SERVICES

 L 864,267 FMV
(9) COMMUNITY HEALTH SERVICES

 P 243,579 FMV
(10) CONNEAUT VALLEY HEALTH CENTER

 R 2,466,020 FMV
(11) MEADVILLE PHYSICIAN SERVICES

 R 6,631,323 FMV
(12) MEADVILLE MEDICAL CENTER FOUNDATION

 R 151,777 FMV
(13) FRENCH CREEK INTERNAL MEDICINE

 A 16,161 FMV
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on 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 sections 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) 2014
Schedule R (Form 990) 2014
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2014
Additional Data


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