Form990
Click to see attachment
Department of the TreasuryInternal 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 Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 07-01-2018 , and ending 06-30-2019
BCheck if applicable:
CName of organization
COLE FOUNDATION INC
 
% RON RAPP CFO
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
1001 EAST SECOND ST
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
COUDERSPORT, PA16915
D Employer identification number

45-5417308
E Telephone number

G Gross receipts $ 236,911
F Name and address of principal officer:
JANIE HILFIGER
1001 EAST SECOND ST
COUDERSPORT,PA16915
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.COLEMEMORIAL.ORG/FOUNDATION.ASPX
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: 2012
M State of legal domicile: PA
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: COLE FOUNDATION IS A NON-PROFIT ORGANIZATION DEDICATED TO SUPPORTING AND ENHANCING THE WORK OF UPMC COLE. SEE SCHEDULE O FOR ADDITIONAL INFO.
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 9
5 Total number of individuals employed in calendar year 2018 (Part V, line 2a) ...... 5 0
6 Total number of volunteers (estimate if necessary) ............. 6 14
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b  
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 262,037 146,800
9 Program service revenue (Part VIII, line 2g) ......... 0 0
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 35,356 16,006
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 20,560 13,021
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 317,953 175,827
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 67,194 108,605
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) 59,144 54,073
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).... 15,290 41,828
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 141,628 204,506
19 Revenue less expenses. Subtract line 18 from line 12....... 176,325 -28,679
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,304,154 1,491,125
21 Total liabilities (Part X, line 26)............. 4,491 7,417
22 Net assets or fund balances. Subtract line 21 from line 20..... 1,299,663 1,483,708
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 (2018)
Form 990 (2018)
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: THE COLE FOUNDATION IS A NON-PROFIT ORGANIZATION DEDICATED TO SUPPORTING AND ENHANCING THE WORK OF UPMC COLE AS IT SERVES ITS COMMUNITIES BY PROMOTING AWARENESS OF NEEDS AND GOALS AND IDENTIFYING AND CONNECTING DONORS TO THOSE NEEDS.
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 $ 191,130 including grants of $ 108,605 ) (Revenue $   )
THE COLE FOUNDATION OPERATES THE GIFT SHOP. THE SHOP IS MANAGED AND RUN BY VOLUNTEERS FIVE DAYS PER WEEK. THE GIFT SHOP HOLDS A CHRISTMAS OPEN HOUSE EACH YEAR. NET GIFT SHOP PROFITS WERE MORE THAN $19,000 FROM SALES THIS YEAR. IN ADDITION, THE COLE FOUNDATION HOLDS SEVERAL SPECIAL EVENTS EACH YEAR, INCLUDING THE ANNUAL GOLF TOURNAMENT THAT RAISED AROUND $29,000, THE ANNUAL LIGHT UP A LIFE TREE LIGHTING EVENT THAT RAISED APPROXIMATELY $15,800 AND OPERATION APPRECIATION THAT MADE $4,500.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet191,130
Form 990 (2018)
Form 990 (2018)
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 I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II..............
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part III.................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part I..................
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 II...
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.............
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 IV..............
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 V......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI....................
11a
 
No
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 VII.......
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 VIII.......
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 IX............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part X
11e
 
No
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 X
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 .................
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
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) ....Click to see attachment
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............ Click to see attachment
18
Yes
 
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...................Click to see attachment
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....
20a
 
No
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
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.....Click to see attachment
21
Yes
 
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........Click to see attachment
22
Yes
 
Form 990 (2018)
Form 990 (2018)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
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...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 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
 
No
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...
35b
 
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
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
1
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
 
Form 990 (2018)
Form 990 (2018)
Page 5
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
0
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
 
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for 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
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
Yes
 
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
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? If "Yes," see instructions and file Form 4720, Schedule N .....
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income?
If "Yes," complete Form 4720, Schedule O ................
16
 
No
Form 990 (2018)
Form 990 (2018)
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
9
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
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
 
No
b
Other officers or key employees of the organization ................
15b
 
No
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
 
No
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
 
 
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-A 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:
MediumBulletRON RAPP CFO1001 EAST SECOND ST   COUDERSPORT,PA16915 (814) 274-5250
Form 990 (2018)
Form 990 (2018)
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) LINDA VOSS-PLUMMER......................................................................
DIRECTOR
1.0
.................
0.0
X           0 0 0
(2) CLIFF WOOD......................................................................
DIRECTOR
1.0
.................
0.0
X           0 0 0
(3) KAREN LARSEN......................................................................
CHAIR BEG 10/2018
1.0
.................
0.0
X   X       0 0 0
(4) EDWARD PITCHFORD......................................................................
ASSIST SEC/TREAS END 1/2019
1.0
.................
49.0
X   X       0 565,997 166,116
(5) TERRY FOUST......................................................................
DIRECTOR
1.0
.................
40.0
X           0 836,959 39,205
(6) J DAVID BUCKLER......................................................................
VICE CHAIRMAN BEG 10/2018
1.0
.................
3.0
X   X       0 0 0
(7) DAVID ERRICK......................................................................
SECRETARY/TREASURER BEG 10/18
1.0
.................
0.0
X   X       0 0 0
(8) AMI FOUST......................................................................
DIRECTOR
1.0
.................
0.0
X           0 0 0
(9) SAMUEL LUSH......................................................................
DIRECTOR
1.0
.................
0.0
X           0 0 0
(10) JOSH COSTA......................................................................
DIRECTOR BEG 4/2019
1.0
.................
0.0
X           0 0 0
(11) JANIE HILFIGER......................................................................
ASSIST SEC/TREAS BEG 1/2019
1.0
.................
0.0
X   X       0 0 0
(12) AMY HUNT......................................................................
EX OFFICIO
1.0
.................
40.0
X           0 152,328 35,586
(13) ROBERT SMITH......................................................................
DIRECTOR BEG 12/2018
1.0
.................
0.0
X           0 0 0
(14) CHARLES HAGERTY......................................................................
VICE CHAIRMAN END 3/2019
1.0
.................
0.0
X   X       0 0 0
(15) ANDREA STREICH......................................................................
EXECUTIVE DIRECTOR
24.0
.................
0.0
    X       0 43,425 1,085




Form 990 (2018)
Form 990 (2018)
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;


























1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 0 1,598,709 241,992
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet0
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet0
Form 990 (2018)
Form 990 (2018)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c 51,318
d Related organizations1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and similar amounts not included above1f 95,482
g Noncash contributions included in lines 1a - 1f:$  
h Total. Add lines 1a-1f.......MediumBullet 146,800
 Program Service RevenueAmt Business Code
2a
b
c
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f ....MediumBullet 0
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 16,006     16,006
4 Income from investment of tax-exempt bond proceedsMediumBullet 0      
5 Royalties...........MediumBullet 0      
(ii) Personal (i) Real
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss) 0 0
d Net rental income or (loss)......MediumBullet 0      
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory    
b Less: cost or other basis and sales expenses    
c Gain or (loss)    
d Net gain or (loss).....MediumBullet 0      
8a Gross income from fundraising events (not including $ 51,318of contributions reported on line 1c). See Part IV, line 18 ....
a 9,135
b Less: direct expenses ...b 15,222
c Net income or (loss) from fundraising events..MediumBullet -6,087   -6,087
9a Gross income from gaming activities.
See Part IV, line 19 ...
a 0
b Less: direct expenses ...b 0
c Net income or (loss) from gaming activities..MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances ..
a 64,970
b Less: cost of goods sold ..b 45,862
c Net income or (loss) from sales of inventory..MediumBullet 19,108     19,108
Business Code Miscellaneous Revenue
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 0
12 Total revenue. See Instructions......MediumBullet 175,827     29,027
Form 990 (2018)
Form 990 (2018)
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 72,657 72,657
2 Grants and other assistance to domestic individuals. See Part IV, line 22 35,948 35,948
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16. 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 0      
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 50,557 45,824 4,733  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 0      
9 Other employee benefits ....... 3,516 3,187 329  
10 Payroll taxes ........... 0      
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 0      
c Accounting ........... 5,600   5,600  
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) 12,053 11,163 890  
12 Advertising and promotion .... 1,086 984 102  
13 Office expenses ....... 21,103 19,567 1,536  
14 Information technology ...... 0      
15 Royalties .. 0      
16 Occupancy ........... 0      
17 Travel ............ 198 179 19  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials . 0      
19 Conferences, conventions, and meetings .... 0      
20 Interest ........... 0      
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization .. 0      
23 Insurance ... 0      
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 LICENSES, DUES, SUBSCRIPTIONS 1,788 1,621 167  
b
c
d
e All other expenses        
25 Total functional expenses. Add lines 1 through 24e 204,506 191,130 13,376 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 (2018)
Form 990 (2018)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 300 1 300
2 Savings and temporary cash investments ......... 95,687 2 33,032
3 Pledges and grants receivable, net ...... 0 3 0
4 Accounts receivable, net ............. 0 4 0
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 ........ 0 8 0
9 Prepaid expenses and deferred charges ...... 0 9 0
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a  
b Less: accumulated depreciation 10b   0 10c 0
11 Investments—publicly traded securities . 1,208,167 11 1,457,793
12 Investments—other securities. See Part IV, line 11 ..... 0 12 0
13 Investments—program-related. See Part IV, line 11 .. 0 13 0
14 Intangible assets ............... 0 14 0
15 Other assets. See Part IV, line 11 ........... 0 15 0
16 Total assets. Add lines 1 through 15 (must equal line 34)... 1,304,154 16 1,491,125
Liabilities 17 Accounts payable and accrued expenses ..... 4,491 17 7,417
18 Grants payable ... 0 18 0
19 Deferred revenue ......... 0 19 0
20 Tax-exempt bond liabilities ......... 0 20 0
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 .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .. 0 24 0
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 0 25 0
26 Total liabilities. Add lines 17 through 25.. 4,491 26 7,417
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 1,018,376 27 1,259,833
28 Temporarily restricted net assets ........... 281,287 28 223,875
29 Permanently restricted net assets 0 29 0
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 ........... 1,299,663 33 1,483,708
34 Total liabilities and net assets/fund balances ........ 1,304,154 34 1,491,125
Form 990 (2018)
Form 990 (2018)
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
175,827
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
204,506
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-28,679
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
1,299,663
5
Net unrealized gains (losses) on investments ...............
5
28,604
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
184,120
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
1,483,708
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
 
No
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
 
 
Form 990 (2018)
Form 990 (2018)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
COLE FOUNDATION INC
 
Employer identification number

45-5417308
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 12, check only one box.)
1
2
3
4
5
6
7
8
9

10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................1
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- 10 above (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
(A) UPMC COLE
 
240802108 3 Yes   72,657 0
Total
1
72,657  
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 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) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
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) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (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) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (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) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (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) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d 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
Yes
 
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
 
No
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
 
No
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 12a or 12b in Part I, answer (b) and (c) below.
4a
 
No
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
 
No
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 (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) 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
 
No
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
7
 
No
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 I of Schedule L (Form 990 or 990-EZ).
8
 
No
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
 
No
b
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
No
c
Did a disqualified person (as defined in line 9a) 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
 
No
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
No
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
 
 
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
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
 
No
b
A family member of a person described in (a) above?
11b
 
No
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
 
No
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
Yes
 
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
 
No
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, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) 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) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)
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 2018 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-2018
(iii)
Distributable
Amount for 2018
1 Distributable amount for 2018 from Section C, line
6
 
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2018:
a From 2013.......  
b From 2014.......  
c From 2015.......  
d From 2016.......  
e From 2017.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2018 distributable amount  
i Carryover from 2013 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2018 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2018 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2018, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions.
 
6 Remaining underdistributions for 2018. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions.
 
7 Excess distributions carryover to 2019. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2014......  
b Excess from 2015.....  
c Excess from 2016.....  
d Excess from 2017.....  
e Excess from 2018.....  
Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018
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) 2018


Additional Data


Software ID:  
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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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Name of the organization
COLE FOUNDATION INC
 
Employer identification number

45-5417308
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 isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2
Name of organization
COLE FOUNDATION INC
 
Employer identification number
45-5417308
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) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Page 3
Name of organization
COLE FOUNDATION INC
 
Employer identification number

45-5417308
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) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Page 4
Name of organization
COLE FOUNDATION INC
 
Employer identification number

45-5417308
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) (2018)

Additional Data


Software ID:  
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SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrowAttach to Form 990 or Form 990-EZ.
right arrowGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
COLE FOUNDATION INC
 
Employer identification number

45-5417308
Part I
Fundraising Activities. Complete if the organization answered "Yes" on Form 990, Part IV, line 17.
Form 990-EZ filers are not required to complete this part.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.


(i) Name and address of individual
or entity (fundraiser)
(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity
(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i)
(vi) Amount paid to
(or retained by)
organization
Yes No
             
             
             
             
             
             
             
             
             
             
Total . . . . . . . . . . . . . . . . . . . . right arrow      
3
List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2018
Schedule G (Form 990 or 990-EZ) 2018
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.




VerticalRevenue
(a) Event #1

GOLF TOURNAMENT
(event type)
(b) Event #2

LIGHT UP A LIFE
(event type)
(c) Other events

0
(total number)
(d) Total events
(add col. (a) through col. (c))

1

Gross receipts . . . . .

43,513

16,940

 

60,453

2

Less: Contributions . . . .

34,378

16,940

 

51,318
3 Gross income (line 1 minus
line 2) . . . . . .

9,135

 

 

9,135



VerticalDirectExpenses
4 Cash prizes . . . . .        
5 Noncash prizes . . . . 3,862     3,862
6 Rent/facility costs . . . . 3,353     3,353
7 Food and beverages . . . 5,554 378   5,932
8 Entertainment . . . .        
9 Other direct expenses . . . 1,374 701   2,075
10 Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . . right arrow 15,222
11 Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . . right arrow -6,087
Part III
Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue
(a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo
(c) Other gaming (d) Total gaming (add col.(a) through col.(c))

1

Gross revenue . . . . .

 

 

 

 
VerticalDirectExpenses

2

Cash prizes . . . . .

 

 

 

 

3

Noncash prizes . . . .

 

 

 

 

4

Rent/facility costs . . . .

 

 

 

 

5

Other direct expenses . . .

 

 

 

 


6


Volunteer labor . . . .
%
%
%


7

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

 

8

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

 

9
Enter the state(s) in which the organization conducts gaming activities:
a
Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .
b
If "No," explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .
b
If "Yes," explain:
 
Schedule G (Form 990 or 990-EZ) 2018
Schedule G (Form 990 or 990-EZ) 2018
Page 3
11
Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? . . . . . . . . . . . . . . . . .
13
Indicate the percentage of gaming activity conducted in:
a
The organization's facility . . . . . . . . . . . . . . . . . .
13a
%
b
An outside facility . . . . . . . . . . . . . . . . . . . .
13b
%
14
Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? . . . . . . . . . . . . . . . . . . . . . . . .
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address of the third party:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? . . . . . . . . . . . . . . . . . . .
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.
Return Reference Explanation
Schedule G (Form 990 or 990-EZ) 2018
Additional Data


Software ID:  
Software Version:  

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
COLE FOUNDATION INC
 
Employer identification number
45-5417308
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
(if applicable)
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
noncash assistance
(h) Purpose of grant
or assistance
(1) CHARLES COLE MEMORIAL HOSPITAL
1001 EAST SECOND ST
COUDERSPORT,PA16915
24-0802108 501(C)(3) 72,657       SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
1
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2018

Schedule I (Form 990) 2018
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients
(c) Amount of
cash grant
(d) Amount of
noncash assistance
(e) Method of valuation (book,
FMV, appraisal, other)
(f) Description of noncash assistance
(1) COMMUNITY FUNDS 764 35,948      
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
SCHEDULE I, PART I, LINE 2 MONITORING OF GRANT FUNDS: THE GRANT FUNDS WERE PROVIDED TO THEIR RELATED, TAX-EXEMPT PARENT ORGANIZATION AND AS SUCH, THE FOUNDATION AND OVERLAPPING MANAGEMENT CAN MONITOR THE USE OF THE GRANT FUNDS. THE COMMUNITY FUNDS ARE GIVEN TO INDIVIDUALS AS PART OF THE FOUNDATION PROGRAMS CORA'S CUDDLES, HEART OF COLE HUMANITARIAN, HEART OF COLE COMMUNITY FUND, READING FOR FUN, AND NURSING SCHOLARSHIPS. EACH PROGRAM HAS PROCEDURES FOR INDIVIDUALS TO FOLLOW TO RECEIVE FUNDS.
Schedule I (Form 990) 2018



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" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
COLE FOUNDATION INC
 
Employer identification number

45-5417308
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 on 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
 
 
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
 
 
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 on 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 on 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," on line 5a or 5b, describe in Part III.
6
For persons listed on 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," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported on 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" on 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) 2018

Schedule J (Form 990) 2018
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 on 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 on prior Form 990
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1EDWARD PITCHFORD
ASSIST SEC/TREAS END 1/2019
(i)

(ii)
0
-------------
482,977
0
-------------
50,855
0
-------------
32,165
0
-------------
130,875
0
-------------
35,241
0
-------------
732,113
0
-------------
0
2TERRY FOUST
DIRECTOR
(i)

(ii)
0
-------------
828,858
0
-------------
7,476
0
-------------
625
0
-------------
6,875
0
-------------
32,330
0
-------------
876,164
0
-------------
0
3AMY HUNT
EX OFFICIO
(i)

(ii)
0
-------------
139,219
0
-------------
12,798
0
-------------
311
0
-------------
3,940
0
-------------
31,646
0
-------------
187,914
0
-------------
0
Schedule J (Form 990) 2018

Schedule J (Form 990) 2018
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 3 CEO COMPENSATION: A RELATED TAX-EXEMPT ORGANIZATION, UPMC COLE, USES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE FOR DETERMINATION OF THE PRESIDENT & CEO'S COMPENSATION, EDWARD PITCHFORD. THE EXECUTIVE DIRECTOR OF COLE FOUNDATION IS REVIEWED USING A COMPENSATION SURVEY OR STUDY OR APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE, AND IS ALSO PERFORMED BY UPMC COLE.
SCHEDULE J, PART I, LINE 4B NONQUALIFIED RETIREMENT PLAN: A RELATED TAX-EXEMPT ORGANIZATION CONTRIBUTED $124,000 TO A 457(F) PLAN FOR EDWARD PITCHFORD, CEO.
SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS: SOME OF THOSE LISTED IN FORM 990, PART VII RECEIVED PAYOUTS OF ACCRUED BONUSES AND ACCRUED ADDITIONAL BONUSES FOR PARTICIPATING IN THE EXECUTIVE TEAM INCENTIVE COMPENSATION PROGRAM. EACH PARTICIPANT HAD AN ESTABLISHED TARGET TOTAL COMPENSATION BASED ON INDUSTRY SURVEYS AND THE INCENTIVE PROGRAM COMPRISED APPROXIMATELY 10% OF THE TARGETED TOTAL COMPENSATION. THE BONUS WAS BASED ON OVERALL PERFORMANCE.
Schedule J (Form 990) 2018
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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
COLE FOUNDATION INC
 
Employer identification number

45-5417308
Return Reference Explanation
FORM 990, PART I, LINE 1 ORGANIZATION'S MISSION: COLE FOUNDATION'S VISION AS A PHILANTHROPIC ORGANIZATION IS TO ENSURE OUR LONG-TERM GOAL OF KEEPING OUR LOCAL HEALTHCARE SYSTEM PROGRESSIVE AND VIBRANT IN ORDER TO BEST SERVE THE MEDICAL NEEDS OF OUR DIVERSE COMMUNITIES.
FORM 990, PART V, LINE 2A & PART IX, LINES 7 & 9 COMMON PAYMASTER: UPMC COLE, THE ORGANIZATION'S RELATED TAX-EXEMPT PARENT COMPANY, FILES ALL W-2'S AND RELATED EMPLOYEE BENEFITS, PENSION CONTRIBUTIONS, AND PAYROLL TAXES. AS SUCH, COLE FOUNDATION HAS NO W-2 FILINGS TO REPORT ON FORM 990, PART V, LINE 2A. THE AMOUNTS SHOWN ON FORM 990, PART IX, LINES 7 & 9 ARE AMOUNTS ALLOCATED TO THE ORGANIZATION FROM THE HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 2 FAMILY AND BUSINESS RELATIONSHIPS: DIRECTOR AMI FOUST AND DIRECTOR TERRY FOUST HAVE A FAMILY RELATIONSHIP. IN ADDITION, THE FOLLOWING OFFICERS AND DIRECTORS ARE EMPLOYED BY UPMC COLE, A RELATED TAX-EXEMPT ORGANIZATION: - EDWARD PITCHFORD, PRESIDENT, CEO AND ASSISTANT SECRETARY - TERRY FOUST, FOUNDATION DIRECTOR/UPMC COLE PHYSICIAN - ANDREA STREICH, FOUNDATION EXECUTIVE DIRECTOR - AMY HUNT, FOUNDATION EX OFFICIO/UPMC COLE DIRECTOR OF OPERATIONS
FORM 990, PART VI, SECTION A, LINE 6, 7A & 7B MEMBERS: CHARLES COLE MEMORIAL HOSPITAL ALSO KNOWN AS UPMC COLE, A FEDERALLY TAX EXEMPT 501(C)(3) NONPROFIT CORPORATION, IS THE SOLE MEMBER OF COLE FOUNDATION. WHEN THE TERM OF AN ELECTED DIRECTOR IS EXPIRING, THE EXECUTIVE COMMITTEE SHALL SUBMIT NAMES OF QUALIFIED CANDIDATES FOR EACH ELECTED DIRECTOR VACANCY TO THE BOARD. THE BOARD SHALL ELECT FROM THIS SLATE OF CANDIDATES DIRECTORS TO FILL EACH ELECTED DIRECTOR VACANCY ON THE BOARD. THE MEMBER MUST RATIFY ELECTED DIRECTOR ELECTED TO SERVE ON THE BOARD. THE MEMBER SHALL HAVE THE FOLLOWING RIGHTS AND POWERS: DURING THE INTEGRATION PERIOD, THE DECISIONS AND ACTIONS SPECIFICS IN PARAGRAPHS (I) - (VIII) BELOW SHALL REQUIRE THE APPROVAL OF BOTH THE MEMBER AND UPMC. SUCH DECISIONS AND ACTIONS MAY NOT BE TAKEN BY THE CORPORATION WITHOUT THE SEPARATE CONCURRENCE OF THE MEMBER AND UPMC. (I) APPROVAL OF OPERATING AND CAPITAL BUDGETS OF THE CORPORATION; (II) ENTERING INTO NEW OR MATERIALLY CHANGING EXISTING JOINT VENTURE ARRANGEMENTS OF THE PARTY; (III) APPROVAL OF THE TERMS OF ANY MANAGEMENT ARRANGEMENTS WITH AN UNRELATED THIRD PARTY; (IV) ANY CHANGE IN THE CORPORATE STRUCTURE OF THE CORPORATION; (V) THE SALE, LEASE, TRANSFER OR JOINT VENTURE, WHETHER WITHIN THE SYSTEM OR EXTERNAL THERETO, INVOLVING SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; (VI) THE MERGER, CONSOLIDATION, DIVESTITURE OR DISSOLUTION OF THE CORPORATION; (VII) ANY AMENDMENT OF THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE CORPORATION; (VIII) SALE OF ANY REAL ESTATE OF THE CORPORATION; IF THE MEMBER AND UPMC FAIL TO AGREE ON ANY OF THE ABOVE MATTERS, THE PROCESS DESCRIBED IN SECTION 10.6 OF THE INTEGRATION AGREEMENT WILL BE FOLLOWED. AT THE CONCLUSION OF THE INTEGRATION PERIOD, THE POWER TO MAKE DECISIONS WITH RESPECT TO THOSE MATTERS DESCRIBED IN SECTION 3.2.A ABOVE, SHALL VEST EXCLUSIVELY WITH UPMC, EXCEPT AS EXPRESSLY LIMITED BY SECTIONS 3.3.6, 10,1-10.9 AND 16.3 OF THE INTEGRATION AGREEMENT. THE MEMBER AND UPMC MAY LOOK TO THE BOARD OF DIRECTORS TO PROVIDE GOVERNANCE AND OVERSIGHT WITH RESPECT TO MATTERS WHICH MAY INCLUDE DEVELOPING AND IMPLEMENTING THE GOALS AND OBJECTIVES OF THE CORPORATION IN THE FOUR KEY AREAS OF (1) QUALITY PERFORMANCE; (2) FINANCIAL PERFORMANCE; (3) PLANNING PERFORMANCE; AND (4) GOVERNANCE PERFORMANCE.
FORM 990, PART VI, SECTION B, LINE 11B 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON INFORMATION SUPPLIED BY UPMC COLE. THE DRAFT 990 IS THEN REVIEWED BY UPMC COLE'S FINANCE DEPARTMENT. THE FULL 990 DRAFT IS PRESENTED TO THE BOARD OF DIRECTORS PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: ALL BOARD MEMBERS ARE REQUIRED TO FILL OUT THE CONFLICT OF INTEREST POLICY YEARLY. THE EXECUTIVE DIRECTOR REVIEWS THESE DOCUMENTS. MEMBERS ARE RESTRICTED FROM VOTING ON ANY SUBJECT THAT MAY BE VIEWED AS A CONFLICT OF INTEREST. BOARD MEETING MINUTES REFLECT ANY ABSTENTION FROM VOTING WHERE A POTENTIAL CONFLICT MAY EXIST. ADDITIONALLY, THE BYLAWS STATE THAT ANY MEMBER, DIRECTOR, OFFICER, OR COMMITTEE MEMBER HAVING AN EXISTING OR POTENTIAL INTEREST IN A CONTRACT OR OTHER TRANSACTION SHALL MAKE A PROMPT, FULL, AND FRANK DISCLOSURE OF INTEREST TO THE BOARD OR COMMITTEE PRIOR TO ITS ACTING. THE BODY TO WHICH SUCH DISCLOSURE IS MADE SHALL DETERMINE, BY MAJORITY VOTE, WHETHER THE DISCLOSURE SHOWS THAT THE NON-VOTING AND NON-PARTICIPATION PROVISIONS MUST BE OBSERVED. IF SO, SUCH PERSON SHALL NOT VOTE ON, NOR USE HIS OR HER PERSONAL INFLUENCE ON, NOR PARTICIPATE IN THE DISCUSSIONS OR DELIBERATIONS WITH RESPECT TO SUCH CONTRACT OR TRANSACTION.
FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION DETERMINATION: ER MATTHEW DEAN, SR DIRECTOR OF COMPENSATION UPMC PARTNERS WITH E&Y AND KORN FERRY ANNUALLY TO CONDUCT A MARKET ANALYSIS FOR CEO'S & TOP 10 EXECUTIVE VP'S. THE MARKET REVIEW IS THEN PRESENTED TO THEIR EXECUTIVE COMPENSATION COMMITTEE FOR REVIEW AND APPROVAL.
FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS CAN BE VIEWED ONSITE THROUGH A WRITTEN REQUEST TO THE ORGANIZATION'S CORPORATE COMPLIANCE OFFICER. REQUESTS FOR FINANCIAL STATEMENTS AND 990'S ARE FORWARDED TO THE FINANCE / ACCOUNTING DEPARTMENT AND ARE OPEN FOR PUBLIC INSPECTION.
FORM 990, PART VII, SECTION A BOARD MEMBER COMPENSATION: NO MEMBERS RECEIVE ANY COMPENSATION FOR THEIR DIRECTOR DUTIES. - ANDREA STREICH IS COMPENSATED BY UPMC COLE, A RELATED TAX-EXEMPT ORGANIZATION, AS EXECUTIVE DIRECTOR OF COMMUNITY RELATIONS. 100% OF HER COMPENSATION IS CHARGED TO THE FOUNDATION FROM UPMC COLE. - TERRY FOUST IS COMPENSATED BY UPMC COLE, A RELATED TAX-EXEMPT ORGANIZATION, AS A PHYSICIAN. - EDWARD PITCHFORD SERVES AS THE CEO FOR UPMC COLE, HENDORN, INC., HAMOTCOLE VENTURES, INC., AND COLE CARE, INC. - AMY HUNT IS COMPENSATED BY UPMC COLE, A RELATED TAX-EXEMPT ORGANIZATION, AS DIRECTOR OF OPERATIONS.
FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES: $ 184,120 TRANSFER FROM RELATED PARTY
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2018


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 Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
COLE FOUNDATION INC
 
Employer identification number

45-5417308
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)CHARLES COLE MEMORIAL HOSPITAL
1001 EAST SECOND STREET

COUDERSPORT,PA16915
24-0802108
HOSPITAL PA 501(C)(3) 3 UPMC COLE
 
 
No
(2)HENDORN INC
1001 EAST SECOND STREET

COUDERSPORT,PA16915
23-1972659
RESIDENT CARE PA 501(C)(3) 12A I UPMC COLE
 
 
No
(3)LAUREL REALTY INC
15 MEADE STREET NO U-6

WELLSBORO,PA16901
23-1403678
REAL ESTATE PA 501(C)(2)   UPMC SUSQ
 
 
No
(4)LAUREL MANAGEMENT SERVICES INC
32-36 CENTRAL AVE

WELLSBORO,PA16901
25-1644910
MANAGEMENT SV PA 501(C)(3) 12B II UPMC SUSQ
 
 
No
(5)THE GREEN HOME
37 CENTRAL AVENUE

WELLSBORO,PA16901
24-0804365
ASST LIVING PA 501(C)(3) 10 UPMC SUSQ
 
 
No
(6)SOLDIERS AND SAILORS MEMORIAL HOSPITAL
32-36 CENTRAL AVENUE

WELLSBORO,PA16901
23-2176963
HOSPITAL PA 501(C)(3) 3 UPMC SUSQ
 
 
No
(7)TIOGA HEALTH CARE PROVIDERS
1705 WARREN AVE STE 302

WILLIAMSPORT,PA17701
25-1765538
HEALTHCARE PA 501(C)(3) 12B II UPMC SUSQ
 
 
No
(8)UPMC SUSQUEHANNA
1205 GRAMPIAN BLVD

WILLIAMSPORT,PA17701
23-2751183
MGMT SUPPORT PA 501(C)(3) 12B II UPMC
 
 
No
(9)DIVINE PROVIDENCE HOSP OF THE SISTER
1100 GRAMPIAN BLVD

WILLIAMSPORT,PA17701
24-0799343
HOSPITAL PA 501(C)(3) 3 UPMC SUSQ
 
 
No
(10)MUNCY VALLEY HOSPITAL
215 E WATER ST

MUNCY,PA17756
24-0806023
HOSPITAL PA 501(C)(3) 3 UPMC SUSQ
 
 
No
(11)THE WILLIAMSPORT HOSPITAL
700 HIGH ST

WILLIAMSPORT,PA17701
24-0795508
HOSPITAL PA 501(C)(3) 3 UPMC SUSQ
 
 
No
(12)SUSQUEHANNA HEALTH FOUNDATION
1100 GRAMPIAN BLVD

WILLIAMSPORT,PA17701
23-2743470
FOUNDATION PA 501(C)(3) 12A I UPMC SUSQ
 
 
No
(13)SUSQUEHANNA PHYSICIAN SERVICES
1201 GRAMPIAN BLVD

WILLIAMSPORT,PA17701
23-2449454
PHYSICIAN SRV PA 501(C)(3) 3 UPMC SUSQ
 
 
No
(14)WILLIAMSPORT AREA AMBULANCE SERVICES
700 HIGH ST

WILLIAMSPORT,PA17701
23-2416166
AMBULANCE SVC PA 501(C)(3) 10 WILLIAM HOSP
 
 
No
(15)LAUREL HEALTH SYSTEM
32-36 CENTRAL AVE

WELLSBORO,PA16901
24-0795488
SUPPORT SRV PA 501(C)(3) 12B II UPMC SUSQ
 
 
No
(16)SUSQUEHANNA HEALTH INNOVATION CENTER
700 HIGH STREET

WILLIAMSPORT,PA17701
47-1600873
SUPPORT SRV PA 501(C)(3) 12A I UPMC SUSQ
 
 
No
(17)UPMC
600 GRANT STREET

PITTSBURGH,PA15219
25-1423657
SUPPORTNG ORG PA 501(C)(3) 12C III-FI UPMC
 
 
No
(18)UPMC SENIOR COMMUNITIES INC
600 GRANT STREET

PITTSBURGH,PA15219
25-1574736
SR. LIVING PA 501(C)(3) 10 UPMC
 
 
No
(19)PITTSBURGH LIFETIME CARE COMMUNITY
600 GRANT STREET

PITTSBURGH,PA15219
25-1335247
CCRC PA 501(C)(3) 10 UPMC SR COMM
 
 
No
(20)CANTERBURY PLACE
600 GRANT STREET

PITTSBURGH,PA15219
25-0965334
SR LIVING PA 501(C)(3) 10 UPMC SR COMM
 
 
No
(21)SENECA PLACE
600 GRANT STREET

PITTSBURGH,PA15219
72-1562844
SR. LIVING PA 501(C)(3) 10 UPMC SR COMM
 
 
No
(22)SHADYSIDE HOSPITAL SUPPORTING FND
600 GRANT STREET

PITTSBURGH,PA15219
26-0303394
FOUNDATION PA 501(C)(3) 12A I UPMC
 
 
No
(23)UPMC LEE
600 GRANT STREET

PITTSBURGH,PA15219
25-0613830
INACTIVE PA 501(C)(3) 3 UPMC
 
 
No
(24)PITTSBURGH CARE PARTNERSHIP INC
600 GRANT STREET

PITTSBURGH,PA15219
25-1753852
SR CARE MGMT PA 501(C)(3) 10 UPMC
 
 
No
(25)UPMC CENTER FOR HIGH VALUE HEALTHCARE
600 GRANT STREET

PITTSBURGH,PA15219
45-2178782
RESEARCH PA 501(C)(3) 7 UPMC
 
 
No
(26)SHADYSIDE HOSPITAL FOUNDATION
532 SOUTH AIKEN AVE

PITTSBURGH,PA15232
25-1290546
FOUNDATION PA 501(C)(3) 12C III-FI UPMC PRESBY
 
 
No
(27)PASSAVANT HOSPITAL FOUNDATION
9100 BABCOCK BLVD

PITTSBURGH,PA15237
25-1407815
FOUNDATION PA 501(C)(3) 12B II UPMC PASS
 
 
No
(28)UPMC NORTHWEST FOUNDATION
100 FAIRFIELD DRIVE

SENECA,PA16346
25-1483624
FOUNDATION PA 501(C)(3) 12D III-O UPMC NORTHWE
 
 
No
(29)ST MARGARET FOUNDATION
600 GRANT STREET

PITTSBURGH,PA15219
25-1520340
FOUNDATION PA 501(C)(3) 7 UPMC ST MARG
 
 
No
(30)MAGEE-WOMEN RES INST AND FOUNDATION
600 GRANT STREET

PITTSBURGH,PA15219
25-1462312
FOUNDATION PA 501(C)(3) 7 UPMC ST MARG
 
 
No
(31)UPMC KANE
4372 ROUTE 6

KANE,PA16735
25-0998168
HOSPITAL PA 501(C)(3) 3 UPMC HAMOT
 
 
No
(32)GREAT LAKES PHYSICIAN PRACTICE
600 GRANT STREET 58TH FLOOR

PITTSBURGH,PA15219
46-4186362
PHYSICIAN SRV NY 501(C)(3) 3 REGNL HEALTH
 
 
No
(33)CHILDREN'S HOSPITAL OF PITTSBURGH FND
600 GRANT STREET

PITTSBURGH,PA15219
25-1865744
FOUNDATION PA 501(C)(3) 7 UPMC CHP
 
 
No
(34)HAMOT HEALTH FOUNDATION
302 FRENCH STREET

ERIE,PA16507
25-1400999
FOUNDATION PA 501(C)(3) 12B II UPMC HAMOT
 
 
No
(35)SAFE HARBOR BEHAVIORAL HLTH OF UPMC HA
1330 W 26TH STREET

ERIE,PA16508
25-1317492
BEHAVIOR HLTH PA 501(C)(3) 7 UPMC HAMOT
 
 
No
(36)UPMC JAMESON
1211 WILMINGTON AVE

NEW CASTLE,PA16105
25-0965406
HEALTHCARE PA 501(C)(3) 3 UPMC
 
 
No
(37)JAMESON HEALTHCARE FOUNDATION
1211 WILMINGTON AVE

NEW CASTLE,PA16105
25-1536037
FOUNDATION PA 501(C)(3) 12B II UPMC JAMESON
 
 
No
(38)JAMESON HEALTH SERVICES INC
1211 WILMINGTON AVE

NEW CASTLE,PA16105
03-0486993
SUPPORTNG ORG PA 501(C)(3) 12B II UPMC JAMESON
 
 
No
(39)CHILDREN'S ADVOCACY CENTER OF LAWRENCE
1107 WILMINGTON AVE

NEW CASTLE,PA16105
25-1581304
COORD SRVS PA 501(C)(3) 7 UPMC JAMESON
 
 
No
(40)UPMCJAMESON CANCER CENTER
600 GRANT ST

PITTSBURGH,PA15219
20-1459415
ONCOLOGY SVC PA 501(C)(3) 10 UPMC JAMESON
 
 
No
(41)JAMESON MEDICAL CARE INC
1211 WILMINGTON AVE

NEW CASTLE,PA16105
26-0462696
PHYSICIAN SRV PA 501(C)(3) 10 UPMC JAMESON
 
 
No
(42)JAMESON CARE CENTER INC
1211 WILMINGTON AVE

NEW CASTLE,PA16105
23-2871396
SR SERVICES PA 501(C)(3) 10 UPMC SR COMM
 
 
No
(43)VENANGO VNA FOUNDATION
491 ALLEGHENY BLVD

FRANKLIN,PA16323
25-1472179
FOUNDATION PA 501(C)(3) 12D III-O UPMC VISITIN
 
 
No
(44)UPMC CHAUTAUQUA AT WCA
207 FOOTE AVE

JAMESTOWN,NY14701
16-0743226
HOSPITAL NY 501(C)(3) 3 UPMC CHAUTAU
 
 
No
(45)WCA GROUP INC
207 FOOTE AVE

JAMESTON,NY14701
22-2392582
HOLDING CO NY 501(C)(3) 12B II UPMC CHAUTAU
 
 
No
(46)STARFLIGHT INC
135 ALLEN STREET

JAMESTOWN,NY14701
16-1557878
AIR AMBULANCE NY 501(C)(3) 7 UPMC CHAUTAU
 
 
No
(47)SOUTH CENTRAL ALPHA HOUSING AND HEALTH
3410 W PITTSBURGH RD

NEW CASTLE,PA16101
25-1701701
SNF AND AL PA 501(C)(3) 10 UPMC SR COMM
 
 
No
(48)SOUTH WESTERN ALPHA HOUSING AND HEALTH
745 GREENVILLE RD

MERCER,PA16137
25-1701700
SNF AND IL PA 501(C)(3) 10 UPMC SR COMM
 
 
No
(49)KANE COMMUNITY HOSPITAL FOUNDATION
4372 ROUTE 6

KANE,PA16735
26-3906925
FOUNDATION PA 501(C)(3) 12B II UPMC KANE
 
 
No
(50)JUNIOR GUILD OF JAMESON MEMORIAL HOS
1211 WILMINGTON AVE

NEW CASTLE,PA16105
25-6005313
SUPPORT PA 501(C)(3) 12D III-O UPMC JAMESON
 
 
No
(51)WCA FOUNDATION INC
300 FOOTE AVE PO BOX 840

JAMESTOWN,NY14702
22-2393584
FOUNDATION PA 501(C)(3) 12C III-FI UPMC CHAUTAU
 
 
No
(52)LAUREL HEALTH FOUNDATION
15 MEADE STREET NO U-6

WELLSBORO,PA16101
25-1810488
FOUNDATION PA 501(C)(3) 12B II LAUREL H SYS
 
 
No
(53)UPMC HAMOT
201 STATE STREET

ERIE,PA16550
25-0965387
HOSPITAL PA 501(C)(3) 3 UPMC
 
 
No
(54)HAMOTCOLE VENTURES INC
1001 EAST SECOND STREET

COUDERSPORT,PA16915
27-3172100
REAL ESTATE PA 501(C)(3) 12A I UPMC COLE
 
 
No
(55)UPMC SUSQUEHANNA LOCK HAVEN
700 HIGH STREET

WILLIAMSPORT,PA17701
82-1600494
HOSPITAL PA 501(C)(3) 3 UPMC SUSQUEH
 
 
No
(56)UPMC SUSQUEHANNA SUNBURY
700 HIGH STREET

WILLIAMSPORT,PA17701
82-1592230
HOSPITAL PA 501(C)(3) 3 UPMC SUSQUEH
 
 
No
(57)UPMC PINNACLE
409 SOUTH SECOND STREET

HARRISBURG,PA17104
25-1778658
SUPPORTNG ORG PA 501(C)(3) 12B II UPMC
 
 
No
(58)UPMC PINNACLE CARLISLE
361 ALEXANDER SPRING ROAD

CARLISLE,PA17105
82-0880337
HOSPITAL PA 501(C)(3) 3 UPMC PINNACL
 
 
No
(59)UPMC PINNACLE LANCASTER
250 COLLEGE AVENUE

LANCASTER,PA17603
82-0896436
HOSPITAL PA 501(C)(3) 3 UPMC PINNACL
 
 
No
(60)UPMC PINNACLE LITITZ
1500 HIGHLANDS AVENUE

LITITZ,PA17543
82-0844453
HOSPITAL PA 501(C)(3) 3 UPMC PINNACL
 
 
No
(61)UPMC PINNACLE MEMORIAL
325 SOUTH BELMONT STREET

YORK,PA17405
82-0912090
HOSPITAL PA 501(C)(3) 3 UPMC PINNACL
 
 
No
(62)PINNACLE HEALTH REGIONAL PHYSICIANS
409 SOUTH SECOND STREET

HARRSIBURG,PA17104
82-0947698
PHYSICIAN SRV PA 501(C)(3) 3 UPMC PINNACL
 
 
No
(63)PINNACLE HEALTH FOUNDATION
409 SOUTH SECOND STREET

HARRISBURG,PA17104
22-2691718
FOUNDATION PA 501(C)(3) 12B II UPMC PINNACL
 
 
No
(64)COMMUNITY LIFE TEAM INC
409 SOUTH SECOND STREET

HARRISBURG,PA17104
23-1890444
MED TRANSPORT PA 501(C)(3) 7 UPMC PINNACL
 
 
No
(65)HANOVER HEALTHCARE PLUS INC
300 HIGHLAND AVENUE

HANOVER,PA17331
22-2658574
SUPPORTNG ORG PA 501(C)(3) 12A I UPMC PINNACL
 
 
No
(66)UPMC PINNACLE HANOVER
300 HIGHLAND AVENUE

HANOVER,PA17331
23-1360851
HOSPITAL PA 501(C)(3) 3 HANOVER HEAL
 
 
No
(67)UPMC PINNACLE HOSPITALS
409 SOUTH SECOND STREET

HARRISBURG,PA17104
25-1778644
HOSPITAL PA 501(C)(3) 3 UPMC PINNACL
 
 
No
(68)PINNACLE HEALTH MEDICAL SERVICES
409 SOUTH SECOND STREET

HARRISBURG,PA17104
25-1709054
PHYSICIAN SRV PA 501(C)(3) 2 UPMC PINNACL
 
 
No
(69)ASBURY HEIGHTS OF UPMC
600 GRANT STREET

PITTSBURGH,PA15219
25-1555687
SUPPORTNG ORG PA 501(C)(3) 12B II UPMC SR COMM
 
 
No
(70)ASBURY HEALTH CENTER
600 GRANT STREET

PITTSBURGH,PA15219
25-0969472
CCRC PA 501(C)(3) 10 ASBURY HEIGH
 
 
No
(71)ASBURY VILLAS
600 GRANT STREET

PITTSBURGH,PA15219
25-1819952
PERSONAL CARE PA 501(C)(3) 10 ASBURY HEIGH
 
 
No
(72)ASBURY PLACE
600 GRANT STREET

PITTSBURGH,PA15219
25-1729266
PERSONAL CARE PA 501(C)(3) 10 ASBURY HEIGH
 
 
No
(73)WESLEY HILLS
600 GRANT STREET

PITTSBURGH,PA15219
25-1507472
INDEP LIVING PA 501(C)(3) PF ASBURY HEIGH
 
 
No
(74)ASBURY FOUNDATION
600 GRANT STREET

PITTSBURGH,PA15219
25-1555688
FOUNDATION PA 501(C)(3) 7 ASBURY HEIGH
 
 
No
(75)UPMC HOME CARE MANAGEMENT SERVICES
600 GRANT STREET

PITTSBURGH,PA15219
83-0857507
HOME HEALTH PA 501(C)(3) 10 UPMC COMM PR
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
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
(1) COMMUNITY BASKET

1205 GRAMPIAN BLVD
WILLIAMSPORT,PA17701
20-1195739
REAL ESTATE PA NA
 
N/A       No     No  
(2) SENECA HILLS ASSISTED LIVING

600 GRANT STREET
PITTSBURGH,PA15219
23-2873106
ASSISTED LIVING PA NA
 
N/A       No     No  
(3) ST MARGARET MEDICAL ARTS ASSOC

600 GRANT STREET
PITTSBURGH,PA15219
25-1786655
MED OFFICE BL PA NA
 
N/A       No     No  
(4) CORE NETWORK LLC

600 GRANT STREET
PITTSBURGH,PA15219
25-1786209
HEALTHCARE PA NA
 
N/A       No     No  
(5) LIFE HOME CARE LP

600 GRANT STREET
PITTSBURGH,PA15219
25-1847839
HOMECARE PA NA
 
N/A       No     No  
(6) SHADYSIDE MEDICAL CENTER ASSOC

600 GRANT STREET
PITTSBURGH,PA15219
25-1608318
MED OFFICE BL PA NA
 
N/A       No     No  
(7) CHARTWELL PA LP

600 GRANT STREET
PITTSBURGH,PA15219
25-1729714
HOME HEALTH PA NA
 
N/A       No     No  
(8) LIFE CARE HOME SRV OF NW PA

1647 SASSAFRAS ST
ERIE,PA16507
25-1536879
HOME HEALTH PA NA
 
N/A       No     No  
(9) HAMOT-KCH REAL ESTATE VENTURE

300 STATE ST
ERIE,PA16507
26-3691782
MEDICAL OFFICE PA NA
 
N/A       No     No  
(10) HAMOT SURGERY CENTER LLC

200 STATE STREET
ERIE,PA16507
25-1863661
AMBULATORY SURG PA NA
 
N/A       No     No  
(11) EPN-HAMOT URGENT CARE LLC

600 GRANT STREET
PITTSBURGH,PA15219
27-2147949
URGENT CARE PA NA
 
N/A       No     No  
(12) MOUNTAIN VIEW MEDICAL ONCOLOGY

600 GRANT STREET
PITTSBURGH,PA15219
46-1449241
HEALTHCARE PA NA
 
        No     No  
(13) LAWRENCE COUNTY MRI & DIAGNOST

2526 WILMINGTON AVE
NEW CASTLE,PA16105
27-0219891
IMAGING CENTER PA NA
 
N/A       No     No  
(14) HANOVER SURGICENTER REAL ESTATE LP

300 HIGHLAND AVE
HANOVER,PA17331
35-2342993
INACTIVE PA NA
 
N/A       No     No  
(15) MEDCARE SUSQUEHANNA VALLEY LLC

409 SOUTH SECOND STREET
HARRISBURG,PA17104
82-1673688
DME PA NA
 
N/A       No     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) COLE CARE INC

1001 EAST SECOND STREET
COUDERSPORT,PA16915
25-1497347
DME PA UPMC COLE
 
CORPORATION         No
(2) TYOGA CARENET

114 EAST AVE
WELLSBORO,PA16901
25-1810967
INTEGRATION HC PA NA
 
C CORP         No
(3) SUSQUEHANNA VENTURES INC

1201 GRAMPIAN BLVD
WILLIAMSPORT,PA17701
23-2470263
PHARMACY PA NA
 
C CORP         No
(4) SUSQUEHANNA HEALTH SYS INS NETWORK LTD

PO BOX 1159 KY1-1102
GRAND CAYMANS,CAYMAN ISLANDS  
CJ
98-0458722
CAPTIVE INSURANCE CJ NA
 
C CORP         No
(5) HC PHARMACY CENTRAL INC

600 GRANT STREET
PITTSBURGH,PA15219
25-1364192
PHARMACY CO-OP PA NA
 
C CORP         No
(6) CHILDREN'S COMMUNITY CARE

600 GRANT STREET
PITTSBURGH,PA15219
25-1781887
PEDIATRIC SVC PA NA
 
C CORP         No
(7) UPMC CANCER CENTERS IRELAND LIMITED

6TH FLOOR BEACON HOSPITAL
SANDYFORD,DUBLIN  
EI
CANCER TREATMENT EI NA
 
C CORP         No
(8) UPMC PHYSICIAN SERVICES HOLDING COMPANY

600 GRANT STREET
PITTSBURGH,PA15219
25-1877017
HOLDING CO PA NA
 
C CORP         No
(9) ONCOLOGY HEMATOLOGY ASSOC

600 GRANT STREET
PITTSBURGH,PA15219
25-1762980
HEALTHCARE PA NA
 
C CORP         No
(10) TRI-STATE NEUROSURGICAL ASSOC

600 GRANT STREET
PITTSBURGH,PA15219
25-1458655
HEALTHCARE PA NA
 
C CORP         No
(11) RENAISSANCE FAMILY PRACTICE-UPMC INC

600 GRANT STREET
PITTSBURGH,PA15219
26-2942206
HEALTHCARE PA NA
 
C CORP         No
(12) UPMC HOLDING COMPANY INC

600 GRANT STREET
PITTSBURGH,PA15219
25-1777713
HOLDING CO PA NA
 
C CORP         No
(13) UPMC COVERAGE PRODUCTS INC

600 GRANT STREET
PITTSBURGH,PA15219
25-1777710
HOLDING CO PA NA
 
C CORP         No
(14) FREEDOM INSURANCE COMPANY

600 GRANT STREET
PITTSBURGH,PA15219
03-0308944
INSURANCE VT NA
 
C CORP         No
(15) TRI-CENTURY INSURANCE CO

600 GRANT STREET
PITTSBURGH,PA15219
25-1500739
INSURANCE PA NA
 
C CORP         No
(16) UPMC DNA INC

600 GRANT STREET
PITTSBURGH,PA15219
25-1883237
INSURANCE PA NA
 
C CORP         No
(17) UPMC HEALTH BENEFITS INC

600 GRANT STREET
PITTSBURGH,PA15219
25-1844144
HEALTH INSURANCE PA NA
 
C CORP         No
(18) UPMC HEALTH NETWORK INC

600 GRANT STREET
PITTSBURGH,PA15219
72-1527566
HEALTH INSURANCE PA NA
 
C CORP         No
(19) UPMC HEALTH PLAN INC

600 GRANT STREET
PITTSBURGH,PA15219
23-2813536
HEALTH INSURANCE PA NA
 
C CORP         No
(20) UPMC BENEFIT MANAGEMENT SERVICES INC

600 GRANT STREET
PITTSBURGH,PA15219
25-1769564
WORKER'S COMP PA NA
 
C CORP         No
(21) UPMC DIVERSIFIED SERVICES INC

600 GRANT STREET
PITTSBURGH,PA15219
25-1778454
HOLDING CO PA NA
 
C CORP         No
(22) MONROEVILLE SPECIALTY CLINIC

600 GRANT STREET
PITTSBURGH,PA15219
25-1666087
HEALTHCARE PA NA
 
C CORP         No
(23) MEDICAL ARCHIVAL SYSTEMS INC

600 GRANT STREET
PITTSBURGH,PA15219
23-2912501
SOFTWARE DEVE DE NA
 
C CORP         No
(24) PRESBY HEALTH RESOURCE MGMT

600 GRANT STREET
PITTSBURGH,PA15219
25-1422155
HEALTHCARE PA NA
 
C CORP         No
(25) RX PARTNERS INC

600 GRANT STREET
PITTSBURGH,PA15219
25-1801966
RETAIL PHARM PA NA
 
C CORP         No
(26) BIOTRONICS INC

600 GRANT STREET
PITTSBURGH,PA15219
25-1843500
EQUIP MAINTENANCE PA NA
 
C CORP         No
(27) MEDICAL CENTER PROPERTIES INC

600 GRANT STREET
PITTSBURGH,PA15219
25-1796940
REAL ESTATE PA NA
 
C CORP         No
(28) ASKESIS DEVELOPMENT GROUP INC

600 GRANT STREET
PITTSBURGH,PA15219
54-1625585
SOFTWARE DEVE DE NA
 
C CORP         No
(29) PANTER REINSURANCE COMPANY LTD

PO BOX 1109
GRAND CAYMAN    
CJ
INSURANCE CJ NA
 
C CORP         No
(30) FORBES REINSURANCE COMPANY LTD

PO BOX 1109
GRAND CAYMAN    
CJ
INSURANCE CJ NA
 
C CORP         No
(31) CATHEDRAL (RE) INSURANCE CO

PO BOX 1109
GRAND CAYMAN    
CJ
INSURANCE CJ NA
 
C CORP         No
(32) UPMC INTERNATIONAL HEALTH INITIATIVES

600 GRANT STREET
PITTSBURGH,PA15219
84-1706741
INACTIVE PA NA
 
C CORP         No
(33) UPMC IRELAND LIMITED

6TH FLOOR BEACON HOSPITAL
SANDYFORD,DUBLIN  
EI
HEALTHCARE SU EI NA
 
C CORP         No
(34) UPMC UNITED KINGDOM LTD

C/O NAIRCO 11TH FLOOR
WHITEFRIARS LEWINS MEAD,BRISTOL  
UK
98-0571026
SOFTWARE LICENSE UK NA
 
C CORP         No
(35) BAYFRONT REGIONAL DEVELOPMENT CORP

300 STATE STREET
ERIE,PA16507
25-1401388
RE HOLDING CO PA NA
 
C CORP         No
(36) BAYSIDE DEVELOPMENT CORP

300 STATE STREET
ERIE,PA16507
25-1401386
REAL ESTATE PA NA
 
C CORP         No
(37) UPMC WORK ALLIANCE INC

600 GRANT STREET
PITTSBURGH,PA15219
45-2825053
INSURANCE PA NA
 
C CORP         No
(38) UPMC CANADA TECHNOLOGIES LIMITED

600 GRANT STREET
PITTSBURGH,PA15219
SOFTWARE CA NA
 
C CORP         No
(39) ALLIED ORTHOPEDICS APPLIANCES INC

335 E 3RD ST
JAMESTOWN,NY14701
16-1092951
MED APPLIANCE PA NA
 
C CORP         No
(40) UPMC HEALTH COVERAGE INC

600 GRANT STREET
PITTSBURGH,PA15219
46-2824537
INSURANCE PA NA
 
C CORP         No
(41) UPMC COMPLETE CARE INC

5215 CENTRE AVE
PITTSBURGH,PA15232
46-3605753
HEALTHCARE PA NA
 
C CORP         No
(42) AMERICAN HOME HEALTH SERVICES

868 CORPORATE WAY
WESTLAKE,OH44145
31-1521422
HOME HEALTH OH NA
 
C CORP         No
(43) HEALTH FIDELITY INC

210 S B ST
SAN MATEO,CA94401
45-2538963
TECHNOLOGY CA NA
 
C CORP         No
(44) FLUENCE HEALTH INC

6425 PENN AVE
PITTSBURGH,PA15206
47-2684174
SOFTWARE DE NA
 
C CORP         No
(45) CURAVI HEALTH INC

6425 PENN AVE
PITTSBURGH,PA15206
81-1217377
HEALTHCARE DE NA
 
C CORP         No
(46) PENSIAMO INC

600 GRANT STREET
PITTSBURGH,PA15219
81-2069236
SUPPLY CHAIN DE NA
 
C CORP         No
(47) ALTOONA FAMILY INC

620 HOWARD AVE
ALTOONA,PA16601
25-1444935
MGMT SVCS PA NA
 
C CORP         No
(48) LEXINGTON HOLDINGS INC

620 HOWARD AVE
ALTOONA,PA16601
25-1794386
MEDICAL SVCS PA NA
 
C CORP         No
(49) LEXINGTON ONE INC

620 HOWARD AVE
ALTOONA,PA16601
25-1468889
RENTAL PA NA
 
C CORP         No
(50) LEXINGTON TWO INC

HOWARD AVE 7TH ST
ALTOONA,PA16601
25-1555689
RENTAL EQPT PA NA
 
C CORP         No
(51) LEXINGTON FOUR INC

620 HOWARD AVE
ALTOONA,PA16601
25-1793736
HOLDING CO PA NA
 
C CORP         No
(52) ALLEGHENY HEALTHCARE STAFFING INC

620 HOWARD AVE
ALTOONA,PA16601
27-1657362
EMPLOYMENT SVC PA NA
 
C CORP         No
(53) UPMC ALTOONA REGIONAL HEALTH SERVICES

1414 9TH AVE
ALTOONA,PA16602
25-1219302
MEDICAL SVCS PA NA
 
C CORP         No
(54) LEXINGTON ANESTHESIA ASSOCIATES INC

620 HOWARD AVE
ALTOONA,PA16601
25-1897765
MEDICAL SVCS PA NA
 
C CORP         No
(55) NORTHERN CAMBRIA MEDICAL CENTER INC

620 HOWARD AVE
ALTOONA,PA16601
25-1530860
MEDICAL SVCS PA NA
 
C CORP         No
(56) PATTON FAMILY MEDICAL CENTER INC

620 HOWARD AVE
ALTOONA,PA16601
25-1793735
MEDICAL SVCS PA NA
 
C CORP         No
(57) MEDCPU INC

100 WALL STREET
NEW YORK,NY10005
38-3805381
SOFTWARE DEV DE NA
 
C CORP         No
(58) UPMC ECESS PL TR

600 GRANT STREET
PITTSBURGH,PA15219
82-6254351
TRUST PA NA
 
TRUST         No
(59) RXANTE INC

511 CONGRESS STREET
PORTLAND,ME04101
45-4040219
MEDICATION MGT DE NA
 
C CORP         No
(60) VINCENT PAYMENT SOLUTIONS INC

6425 PENN AVE
PITTSBURGH,PA15219
82-1101143
PAYMENT SYSTEM DE NA
 
C CORP         No
(61) J HEALTH VENTURES INC

1211 WILMINGTON AVE
NEW CASTLE,PA16105
25-1607893
INACTIVE PA NA
 
C CORP         No
(62) JER MEDICAL ASSOCIATES INC

1211 WILMINGTON AVE
NEW CASTLE,PA16105
25-1609398
INACTIVE PA NA
 
C CORP         No
(63) WCA SERVICE CORPORATION INC

207 FOOTE AVE
JAMESTOWN,NY14701
16-1151438
SUPPORT NY NA
 
C CORP         No
(64) HEMATOLOGY ONCOLOGY ASSOC

600 GRANT STREET
PITTSBURGH,PA12519
42-1648357
HEALTHCARE PA NA
 
C CORP         No
(65) UPMC HEALTH OPTIONS INC

600 GRANT STREET
PITTSBURGH,PA15219
46-2824626
INSURANCE PA NA
 
C CORP         No
(66) ITTCCO I INC

600 GRANT STREET
PITTSBURGH,PA15219
82-2590699
INACTIVE DE NA
 
C CORP         No
(67) ITTCCO II INC

600 GRANT STREET
PITTSBURGH,PA15219
82-2597388
INACTIVE DE NA
 
C CORP         No
(68) PINNACLE HEALTH CARDIOVASCULAR INSTITUT

409 SOUTH SECOND STREET
HARRISBURG,PA17104
32-0321362
PHYSICIAN SRV PA NA
 
C CORP         No
(69) HANOVER HEALTH CORPORATION

300 HIGHLAND AVENUE
HANOVER,PA17331
90-0498067
HOLDING CO PA NA
 
C CORP         No
(70) HANOVER APOTHECARY INC

310 STOCK STREET SUITE 1
HANOVER,PA17331
03-0594526
PHARMACY PA NA
 
C CORP         No
(71) UNITED CENTRAL PA RECIPROCAL RISK RETEN

76 SAINT PAUL STREET SUITE 500
BURLINGTON,VT05401
13-4224033
INSURANCE VT NA
 
C CORP         No
(72) PINNACLE HEALTH VENTURES INC

409 SOUTH SECOND STREET
HARRISBURG,PA17104
61-1677624
HOLDING CO PA NA
 
C CORP         No
(73) PINNACLE HEALTH IMAGING INC

409 SOUTH SECOND STREET
HARRISBURG,PA17104
23-1718571
IMAGING SVC PA NA
 
C CORP         No
(74) UPMC ITALY HEALTH SERVICES SRL

VIA DISCESA DEI GIUDICI
PALERMO   90133
IT
HEALTH SVC IT NA
 
C CORP         No
(75) UPMC INVESTMENTS LTD

C/O UPMC WHITFIELD CORK ROAD
BUTLER,WATERFORDX91 DH
EI
HOLDING CO EI NA
 
C CORP         No
(76) UPMC PROPERTY LTD

C/O UPMC WHITFIELD CORK ROAD
BUTLER,WATERFORDX91 DH
EI
PROPERTY EI NA
 
C CORP         No
(77) UPMC PROPERTY II LTD

C/O UPMC WHITFIELD CORK ROAD
BUTLER,WATERFORDX91 DH
EI
PROPERTY EI NA
 
C CORP         No
(78) EURO CARE INFRASTRUCTURE LTD

C/O UPMC WHITFIELD CORK ROAD
BUTLER,WATERFORDX91 DH
EI
PROPERTY MGMT EI NA
 
C CORP         No
(79) EURO CARE PROPERTY MANAGEMENT LTD

C/O UPMC WHITFIELD CORK ROAD
BUTLER,WATERFORDX91 DH
EI
PROPERTY MGMT EI NA
 
C CORP         No
(80) EURO CARE HEALTHCARE LTD

C/O UPMC WHITFIELD CORK ROAD
BUTLER,WATERFORDX91 DH
EI
HOSPITAL EI NA
 
C CORP         No
(81) WATERFORD ONCOLOGY ASSOCIATES LTD

C/O UPMC WHITFIELD CORK ROAD
BUTLER,WATERFORDX91 DH
EI
ONCOLOGY SVC EI NA
 
C CORP         No
(82) UNITED HEALTH RISK LTD

PO BOX HM 2450
HAMILTON    
BD
INSURANCE BD NA
 
C CORP         No
Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
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
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
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
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
Yes
 
o Sharing of paid employees with related organization(s) ............................
1o
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
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
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





Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
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) 2018
Schedule R (Form 990) 2018
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
SCHEDULE R, PARTS II, III, AND IV UPMC SYSTEM ENTITIES: THE ENTITIES MARKED WITH AN ASTERISK ARE NOT TECHNICALLY "RELATED PARTIES," AS DEFINED BY THE IRS FORM 990 INSTRUCTIONS, OF THE FILING ORGANIZATION. HOWEVER, THEY ARE LISTED ON SCHEDULE R TO REFLECT THAT THEY ARE PART OF THE UPMC SYSTEM OF ENTITIES, AS THEY ALL SHARE UPMC AS THEIR ULTIMATE PARENT CORPORATION.
Schedule R (Form 990) 2018

Additional Data


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