Form990
Click to see attachment
Click to see attachment
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
2021
Open to Public Inspection
A For the 2021 calendar year, or tax year beginning 07-01-2021 , and ending 06-30-2022
BCheck if applicable:
CName of organization
Williamsport Area Ambulance Service
Cooperative
% CHRISTOPHER STOCKHAUSEN
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
600 GRANT ST 58TH FL C/O CORP TAX
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
PITTSBURGH, PA15219
D Employer identification number

23-2416166
E Telephone number

G Gross receipts $ 6,256,971
F Name and address of principal officer:
STEVEN JOHNSON
600 GRANT ST
PITTSBURGH,PA15219
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.susquehannahealth.org
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. See instructions.
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1986
M State of legal domicile: PA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: Medical transport
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 6
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 5
5 Total number of individuals employed in calendar year 2021 (Part V, line 2a) ...... 5 118
6 Total number of volunteers (estimate if necessary) ............. 6  
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 12,204
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 528,431 552,848
9 Program service revenue (Part VIII, line 2g) ......... 5,802,894 5,700,485
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 2,513 3,638
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 0 0
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 6,333,838 6,256,971
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 4,117,218 4,748,716
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).... 2,055,045 1,866,314
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 6,172,263 6,615,030
19 Revenue less expenses. Subtract line 18 from line 12....... 161,575 -358,059
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 2,910,391 2,645,116
21 Total liabilities (Part X, line 26)............. 17,269 110,053
22 Net assets or fund balances. Subtract line 21 from line 20..... 2,893,122 2,535,063
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 (2021)
Form 990 (2021)
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: SEE SCHEDULE O
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 $ 5,754,935 including grants of $   ) (Revenue $ 6,256,971 )
See Schedule O
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 expensesMediumBullet5,754,935
Form 990 (2021)
Form 990 (2021)
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 Rev. Proc. 98-19? If "Yes," complete Schedule C, Part III..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D, Part IIIClick to see attachment..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X, as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D, Part VI. Click to see attachment...................
11a
 
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 VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
 
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 XClick to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XIIClick to see attachment......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
 
No
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I. See instructions. ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....
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.....
21
 
No
Form 990 (2021)
Form 990 (2021)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
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 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) 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 the Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in line 28a or 28b? 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 on 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
0
b
Enter the number of Forms W-2G included on 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 (2021)
Form 990 (2021)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
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
118
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. See instructions.
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
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 the 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
17
Section 501(c)(21) organizations. Did the trust, any disqualified person, or mine operator engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2021)
Form 990 (2021)
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
6
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
5
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 on 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 on 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 on 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 (1024 or 1024-A, if applicable), 990, and 990-T (section 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:
MediumBulletCHRISTOPHER STOCKHAUSEN700 HIGH STREET   WILLIAMSPORT,PA17701 (570) 321-3175
Form 990 (2021)
Form 990 (2021)
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 the 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, Form 1099-MISC, and/or box 1 of Form 1099-NEC) 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.

See the instructions for the order in which to list the persons above.
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/1099-NEC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC) 		(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) Steven Johnson......................................................................
Regional President
 1.0
.................
50.0 		    X       0 1,104,076 132,926
(2) Donald Owrey......................................................................
Chief Operating Officer
 1.0
.................
50.0 		    X       0 732,656 49,557
(3) Christopher Stockhausen......................................................................
Chief Financial Officer
 1.0
.................
50.0 		    X       0 480,390 55,812
(4) Gregory Frailey......................................................................
Medical Director
 1.0
.................
40.0 		      X     0 335,452 41,531
(5) Brian Engel......................................................................
Finance Officer
 1.0
.................
40.0 		      X     0 114,380 27,369
(6) Robert Kane......................................................................
President
 1.0
.................
40.0 		    X       0 65,657 156
(7) Paula Vavra......................................................................
Director
 1.0
.................
0.0 		X           0 26,467 3,574
(8) Nancy Butts......................................................................
Director
 1.0
.................
0.0 		X           0 0 0
(9) Charles Kiessling......................................................................
Director
 1.0
.................
0.0 		X           0 0 0
(10) Jeffrey Neyhart......................................................................
Director
 1.0
.................
0.0 		X           0 0 0
(11) Joseph Neyhart......................................................................
Director
 1.0
.................
0.0 		X           0 0 0
(12) Charles Stutzman......................................................................
Board Chairman
 1.0
.................
0.0 		X   X       0 0 0










Form 990 (2021)
Form 990 (2021)
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/1099-NEC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC) 		(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 2,859,078 310,925
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 $100,000 of compensation from the organization MediumBullet0
Form 990 (2021)
Form 990 (2021)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 500,000
e Government grants (contributions)1e 51,351
f All other contributions, gifts, grants, and similar amounts not included above1f 1,497
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 552,848
Program Service RevenueAmt Business Code
2a NET PATIENT REVENUE 621910 5,107,604 5,107,604    
b OTHER PROGRAM SERVICE REVENUE 621910 592,881 580,677 12,204  
c
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 5,700,485
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 3,638     3,638
4 Income from investment of tax-exempt bond proceedsMediumBullet 0      
5 Royalties...........MediumBullet 0      
(ii) Personal (i) Real
6a Gross rents     6a
b Less: rental expenses     6b
c Rental income or (loss) 0 0 6c
d Net rental income or (loss).......MediumBullet 0      
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory     7a
b Less: cost or other basis and sales expenses     7b
c Gain or (loss)     7c
d Net gain or (loss).........MediumBullet 0      
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a 0
b Less: direct expenses ... 8b 0
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a 0
b Less: direct expenses ... 9b 0
c Net income or (loss) from gaming activities..MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances ..
10a 0
b Less: cost of goods sold .. 10b 0
c Net income or (loss) from sales of inventory..MediumBullet 0      
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 6,256,971 5,688,281 12,204 3,638
Form 990 (2021)
Form 990 (2021)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 0  
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 0  
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. ............. 0  
4 Benefits paid to or for members ....... 0  
5 Compensation of current officers, directors, trustees, and key employees ........... 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........ 3,726,386 3,371,303 355,083  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 0      
9 Other employee benefits ....... 742,709 671,937 70,772  
10 Payroll taxes ........... 279,621 252,976 26,645  
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 0      
c Accounting ........... 0      
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) 0      
12 Advertising and promotion .... 0      
13 Office expenses ....... 53,103 44,471 8,632  
14 Information technology ...... 68,895 38,013 30,882  
15 Royalties .. 0      
16 Occupancy ........... 105,292 54,438 50,854  
17 Travel ............ 319,745 289,278 30,467  
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 ... 180,000 180,000    
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a BAD DEBT 566,863 566,863    
b MEDICAL/PATIENT SUPPLIES 156,180 156,180    
c PURCHASED SERVICES 384,561 103,265 281,296  
d LAUNDRY AND LINEN SERVICES 369 369    
e All other expenses 31,306 25,842 5,464  
25 Total functional expenses. Add lines 1 through 24e 6,615,030 5,754,935 860,095 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 (2021)
Form 990 (2021)
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 ........ 9,973 1 13,306
2 Savings and temporary cash investments ......... 0 2 0
3 Pledges and grants receivable, net ...... 0 3 0
4 Accounts receivable, net ............. 717,449 4 723,059
5 Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
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 . 0 11 0
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 ........... 2,182,969 15 1,908,751
16 Total assets. Add lines 1 through 15 (must equal line 33)... 2,910,391 16 2,645,116
Liabilities 17 Accounts payable and accrued expenses ..... 13,869 17 110,053
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 any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
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 3,400 25 0
26 Total liabilities. Add lines 17 through 25.. 17,269 26 110,053
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 2,893,122 27 2,535,063
28 Net assets with donor restrictions ........... 0 28 0
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 2,893,122 32 2,535,063
33 Total liabilities and net assets/fund balances ........ 2,910,391 33 2,645,116
Form 990 (2021)
Form 990 (2021)
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
6,256,971
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
6,615,030
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-358,059
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
2,893,122
5
Net unrealized gains (losses) on investments ...............
5
 
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
 
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
2,535,063
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 on
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 (2021)
Form 990 (2021)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990)

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 instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
Williamsport Area Ambulance Service
Cooperative
Employer identification number

23-2416166
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 ...............................  
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
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed 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) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (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) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (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 5 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) 2021

Schedule A (Form 990) 2021
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) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . 533,500 474,020 625,607 528,431 552,848 2,714,406
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 5,289,632 5,619,290 5,426,057 5,805,407 5,691,919 27,832,305
3 Gross receipts from activities that are not an unrelated trade or business under section 513 .....           0
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...           0
5 The value of services or facilities furnished by a governmental unit to the organization without charge           0
6 Total. Add lines 1 through 5 5,823,132 6,093,310 6,051,664 6,333,838 6,244,767 30,546,711
7a Amounts included on lines 1, 2, and 3 received from disqualified persons           0
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.           0
c Add lines 7a and 7b..           0
8 Public support. (Subtract line 7c from line 6.) 30,546,711
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (f) Total
9 Amounts from line 6... 5,823,132 6,093,310 6,051,664 6,333,838 6,244,767 30,546,711
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..           0
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.           0
c Add lines 10a and 10b.           0
11 Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. 9,068 8,922 9,385 9,457 12,204 49,036
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..           0
13 Total support. (Add lines 9, 10c, 11, and 12.).. 5,832,200 6,102,232 6,061,049 6,343,295 6,256,971 30,595,747
14
Section C. Computation of Public Support Percentage
15
15
99.840 %
16
16
99.844 %
Section D. Computation of Investment Income Percentage
17
17
0 %
18
18
0 %
19a
b
20
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (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
 
 
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) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined on 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
 
 
c
Did a disqualified person (as defined on 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
 
 
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
 
 
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) 2021

Schedule A (Form 990) 2021
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 on lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described on 11a above?
11b
 
 
c
A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (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 line 2 above, 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 lines 2a and 2b 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 on line 2a, above 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 lines 3a and 3b 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?If "Yes" or "No", 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) 2021

Schedule A (Form 990) 2021
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 0.015 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 0.035 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) 2021

Schedule A (Form 990) 2021
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 1  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity 		2  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations 3  
4 Amounts paid to acquire exempt-use assets 4  
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) 5  
6 Other distributions (describe in Part VI). See instructions 6  
7Total annual distributions. Add lines 1 through 6. 7  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions 		8  
9 Distributable amount for 2021 from Section C, line 6 9  
10 Line 8 amount divided by Line 9 amount 10  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions 		(ii)
Underdistributions
Pre-2021 		(iii)
Distributable
Amount for 2021
1 Distributable amount for 2021 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI).
See instructions.		  
3 Excess distributions carryover, if any, to 2021:
a From 2016.......  
b From 2017.......  
c From 2018.......  
d From 2019.......  
e From 2020.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2021 distributable amount  
i Carryover from 2016 not applied (see
instructions) 		 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2021 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2021 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2021, 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 2021. 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 2022. Add lines
3j and 4c. 		 
8 Breakdown of line 7:
a Excess from 2017.....  
b Excess from 2018.....  
c Excess from 2019.....  
d Excess from 2020.....  
e Excess from 2021.....  
Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021
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) 2021


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990)
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
2021
Name of the organization
Williamsport Area Ambulance Service
Cooperative
Employer identification number

23-2416166
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) (2021)
Schedule B (Form 990) (2021) Page 2
Name of organization
Williamsport Area Ambulance Service
Cooperative 		Employer identification number
23-2416166
Part I
Contributors
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) (2021)
Schedule B (Form 990) (2021)
Page 3
Name of organization
Williamsport Area Ambulance Service
Cooperative 		Employer identification number

23-2416166
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) (2021)
Schedule B (Form 990) (2021)
Page 4
Name of organization
Williamsport Area Ambulance Service
Cooperative 		Employer identification number

23-2416166
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) (2021)
Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
SchDMd Bullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
Williamsport Area Ambulance Service
Cooperative
Employer identification number

23-2416166
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back
1a Beginning of year balance ....          
b Contributions ...          
c Net investment earnings, gains, and losses          
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ... 		         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Term endowment SchDMd Bullet  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
 
(ii) Related organizations .................
3a(ii)
 
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment) 		(b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .....      
b Buildings ....        
c Leasehold improvements        
d Equipment ....        
e Other .....        
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet  
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 3
Part VII
Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) Financial derivatives.........    
(2) Closely-held equity interests........    
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)DUE FROM EXEMPT AFFILIATES 1,908,751
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 1,908,751
Part X
Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes  
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet  
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
Form 990, Part X, Line 2 UPMC has no uncertain tax positions recorded. Tax benefits are recognized when it is more likely than not that a tax position will be sustained upon examination by the tax authorities based on the technical merits of the position. Such tax positions are measured as the largest amount of tax benefit that is greater than 50% likely to be realized upon ultimate settlement with the tax authorities assuming full knowledge of the position and all relevant facts. As of June 30, 2022, UPMC does not have any unrecorded tax benefits. An external audit is completed at a consolidated UPMC System level only, including UPMC and all taxable and tax-exempt subsidiaries.
Schedule D (Form 990) 2021


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
2021
Open to Public Inspection
Name of the organization
Williamsport Area Ambulance Service
Cooperative
Employer identification number

23-2416166
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 on 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 on 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) 2021

Schedule J (Form 990) 2021
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, 1099-MISC compensation, and/or 1099-NEC (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
1Gregory Frailey
Medical Director 		(i)

(ii)		  
-------------
327,762 		 
-------------
2,600 		 
-------------
5,090 		 
-------------
20,452 		 
-------------
21,079 		 
-------------
376,983 		 
-------------
0
2Steven Johnson
Regional President 		(i)

(ii)		  
-------------
539,667 		 
-------------
470,000 		 
-------------
94,409 		 
-------------
122,593 		 
-------------
10,333 		 
-------------
1,237,002 		 
-------------
78,600
3Christopher Stockhausen
Chief Financial Officer 		(i)

(ii)		  
-------------
213,230 		 
-------------
188,000 		 
-------------
79,160 		 
-------------
47,003 		 
-------------
8,809 		 
-------------
536,202 		 
-------------
19,500
4Donald Owrey
Chief Operating Officer 		(i)

(ii)		  
-------------
239,298 		 
-------------
304,000 		 
-------------
189,358 		 
-------------
42,700 		 
-------------
6,857 		 
-------------
782,213 		 
-------------
33,775
5Brian Engel
Finance Officer 		(i)

(ii)		  
-------------
105,485 		 
-------------
8,700 		 
-------------
195 		 
-------------
8,373 		 
-------------
18,996 		 
-------------
141,749 		 
-------------
0
Schedule J (Form 990) 2021

Schedule J (Form 990) 2021
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 1, QUEST. 7 UPMC PROVIDES INCENTIVE COMPENSATION AS PART OF ITS TOTAL COMPENSATION PROGRAM FOR OFFICERS AND KEY EMPLOYEES. THIS COMPONENT IS BASED UPON THE ACCOMPLISHMENT OF PREDETERMINED PERFORMANCE GOALS AND OBJECTIVES WHICH FOCUS ON THE ACHIEVEMENT OF MULTIPLE ANNUAL AND THREE YEAR INDIVIDUAL AND GROUP PERFORMANCE CRITERIA IN THE CONTEXT OF APPROPRIATE RISK TAKING. THESE CRITERIA DIRECTLY SUPPORT UPMC'S MISSION AND INCLUDE: PATIENT QUALITY AND SATISFACTION, COMMUNITY BENEFITS, OPERATIONAL AND FINANCIAL STRENGTH, LEADERSHIP DEVELOPMENT, AND STRATEGIC BUSINESS INITIATIVES AMONG OTHERS.
SCHEDULE J, PART 1, QUEST. 4B ALL PERSONS PARTICIPATING IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN ARE DISCLOSED IN SCHEDULE J WITH CORRESPONDING AMOUNTS DISCLOSED WITHIN THE TOTAL AMOUNT IN SCHEDULE J COLUMN C "RETIREMENT AND OTHER DEFERRED COMPENSATION". DUE TO RESTRICTIONS IMPOSED BY THE INTERNAL REVENUE CODE ("CODE"), CERTAIN OFFICERS AND KEY EMPLOYEES ARE LIMITED IN THE AMOUNT OF BENEFITS WHICH MAY BE RECEIVED UNDER A TAX QUALIFIED RETIREMENT PROGRAM. LIKE MANY EMPLOYERS, UPMC SUPPLEMENTS ITS RETIREMENT BENEFITS THROUGH A SUPPLEMENTAL RETIREMENT PROGRAM. THE SUPPLEMENTAL RETIREMENT PROGRAM IS SUBJECT TO MULTI YEAR VESTING WHICH PLACES THE OFFICERS AND KEY EMPLOYEES' RETIREMENT BENEFIT AT RISK OF FORFEITURE IF THE VESTING REQUIREMENTS ARE NOT SATISFIED. ONCE VESTED HOWEVER, PROVISIONS OF THE CODE REQUIRE THAT THE VESTED AMOUNTS BE REPORTED ON THE FORM 990 AND THE VESTED OFFICER OR KEY EMPLOYEE INCLUDE IN CURRENT INCOME THE VALUE OF HER OR HIS SUPPLEMENTAL RETIREMENT BENEFIT. NOTWITHSTANDING THE TAX REQUIREMENT TO RECOGNIZE THE VESTED AMOUNT OF THE SUPPLEMENTAL RETIREMENT BENEFIT AS CURRENT INCOME FOR FICA TAXATION AND REPORTING PURPOSES, THIS BENEFIT, WHICH GENERALLY HAS BEEN EARNED OVER THE EMPLOYEES' ENTIRE CAREER, HAS NOT AND WILL NOT BE DISTRIBUTED UNTIL THE OFFICER OR KEY EMPLOYEE RETIRES OR SEPARATES FROM SERVICE FROM UPMC. THE SUPPLEMENTAL RETIREMENT PROGRAM PROVIDES FOR THE CURRENT DISTRIBUTION OF ONLY THE AMOUNT NECESSARY TO SATISFY ANY INCOME TAX LIABILITY RESULTING FROM THE VESTING DURING ACTIVE EMPLOYMENT. FINALLY, IT SHOULD BE NOTED THAT IN ACCORDANCE WITH IRS INSTRUCTIONS, A SUBSTANTIAL PORTION OF THE AMOUNT REPORTED ON THE FORM 990 ATTRIBUTABLE TO SUPPLEMENTAL RETIREMENT PROGRAM VESTING HAS BEEN REPORTED IN PREVIOUSLY FILED FORMS 990.
Schedule J (Form 990) 2021

Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990)

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
2021
Open to Public
Inspection
Name of the organization
Williamsport Area Ambulance Service
Cooperative
Employer identification number

23-2416166
Return Reference Explanation
PART III STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS Williamsport Area Ambulance Cooperative EIN: 23-2416166 FY ending June 30, 2022 Form 990, Part III, Statement of Program Service Accomplishments Williamsport Area Ambulance Service Cooperative transports emergency patients in the greater Lycoming county area through the county 911 system. For FY 2022, WAASC transported 7,179 emergency patients. Williamsport Area Ambulance Service Cooperative transports non-emergency patients in the greater Lycoming county area. For FY 2022, WAASC transported 6,208 non-emergency patients. On an annual basis WAASC devotes a portion of its revenue and assets to community program services. Community building activities and other financial contributions totaling $190,528 reflects the amount of quantifiable community benefits reported for FY 2022.
PART VI GOVERNANCE, MANAGEMENT, AND DISCLOSURE QUESTION 6: WILLIAMSPORT AREA AMBULANCE SERVICE COOPERATIVE HAS A MAJORITY MEMBER OF 51% IN THE FEDERALLY TAX EXEMPT ENTITY UPMC WILLIAMSPORT AS WELL AS OTHER MEMBERS;16.34% IN DUBOISTOWN FIRE DEPARTMENT; 16.33% IN OLD LYCOMING TOWNSHIP VOLUNTEER FIRE COMPANY; 16.33% IN FIRST WARD FIRE COMPANY.
PART VI GOVERNANCE, MANAGEMENT, AND DISCLOSURE SECTION B: POLICIES QUESTION 11 B - THE BOARD OF DIRECTORS MEMBERS OF THE FILING ENTITY HAVE BEEN PROVIDED A COPY OF THE FORM 990 PRIOR TO FILING.
QUESTION 12 C UPMC REQUIRES KEY EMPLOYED AND NON-EMPLOYED PERSONNEL TO COMPLY WITH ITS CONFLICT OF INTEREST POLICIES WHEN THEY ENGAGE IN UPMC RELATED BUSINESS. PERSONS COVERED BY THE POLICIES INCLUDED UPMC BOARD MEMBERS, BOARD COMMITTEE MEMBERS, CORPORATE OFFICERS, KEY EMPLOYEES, UPMC PHYSICIANS AND NON PHYSICIANS EMPLOYEES WHO HOLD A POSITION OF INFLUENCE, NON EMPLOYED MEMBERS OF THE UPMC MEDICAL STAFF WHO HOLD A POSITION OF INFLUENCE OR TRUST, INDIVIDUALS CONDUCTING CLINICAL RESEARCH AT UPMC WHETHER OR NOT THEY ARE EMPLOYED BY UPMC. THESE PEOPLE ARE REQUIRED TO COMPLETE A QUESTIONNAIRE AT LEAST ANNUALLY, WHICH ALONG WITH OTHER DATA IS USED TO IDENTIFY POSSIBLE INDIVIDUAL AND INSTITUTIONAL CONFLICTS OF INTEREST. IF A POTENTIAL CONFLICT IS IDENTIFIED REGARDING A SPECIFIC UPMC ACTIVITY, THE CORPORATE COMPLIANCE DEPARTMENT, WITH THE ASSISTANCE OF THE LEGAL DEPARTMENT, EITHER DEVELOPS A WRITTEN PLAN DESIGNED TO PREVENT THE CONFLICT FROM INFLUENCING DECISIONS RELATED TO THAT ACTIVITY, OR REQUIRES THAT THE CONFLICTING RELATIONSHIP BE DIVESTED, AS APPROPRIATE. FOR EMPLOYED PERSONNEL AND NON BOARD MEMBERS, NON EMPLOYED PERSONNEL, THE CONFLICT OF INTEREST IDENTIFICATION AND MANAGEMENT PROCESS IS ULTIMATELY OVERSEEN BY AN ETHICS AND COMPLIANCE COMMITTEE OF THE UPMC BOARD OF DIRECTORS ON BEHALF OF UPMC AND ALL OF ITS SUBSIDIARIES. POTENTIAL CONFLICT OF INTEREST TRANSACTIONS INVOLVING UPMC BOARD MEMBERS AND ENTITIES WITH WHICH THEY ARE AFFILIATED ARE MONITORED AND SUBJECT TO PRE-APPROVAL BY THE GOVERNANCE AND NOMINATING COMMITTEE OF THE UPMC BOARD OF DIRECTORS. IN ADDITION TO THE GENERAL CORPORATE AND BOARD POLICIES DESCRIBED ABOVE, UPMC HAS ALSO DEVELOPED AND IMPLEMENTED A SEPARATE TAX QUESTIONNAIRE DISTRIBUTED TO OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES ANNUALLY THAT SPECIFICALLY ADDRESSES DISCLOSURE REQUIREMENTS OF FORM 990.
PART VI GOVERNANCE, MANAGEMENT, AND DISCLOSURE SECTION B: POLICIES QUESTION 15 - TO SUPPORT UPMC'S MISSION AS SET FORTH IN THE UPMC BYLAWS, THE BOARD OF DIRECTORS HAS FORMED AN EXECUTIVE COMPENSATION COMMITTEE ("COMMITTEE") AND DELEGATED TO IT THE RESPONSIBILITY FOR ESTABLISHMENT AND IMPLEMENTATION OF OFFICER AND KEY EMPLOYEE TOTAL COMPENSATION PROGRAMS. AS PART OF THIS RESPONSIBILITY THE COMMITTEE REPORTS REGULARLY TO THE BOARD OF DIRECTORS. WITH BOARD OF DIRECTORS APPROVAL, THE COMMITTEE HAS ADOPTED A FORMAL CHARTER, WHICH INCLUDES THE ESTABLISHMENT OF A COMPENSATION PHILOSOPHY AND RELATED POLICIES WITH RESPECT TO THE TOTAL COMPENSATION PAID BY UPMC TO ITS OFFICERS AND KEY EMPLOYEES. THE UPMC TOTAL COMPENSATION PROGRAM FOR OFFICERS AND KEY EMPLOYEES IS PREDICATED UPON AN INCENTIVE COMPENSATION COMPONENT. THIS COMPONENT IS BASED UPON THE ACCOMPLISHMENT OF PREDETERMINED PERFORMANCE GOALS AND OBJECTIVES WHICH FOCUS ON THE ACHIEVEMENT OF MULTIPLE ANNUAL AND THREE YEAR INDIVIDUAL AND GROUP PERFORMANCE CRITERIA IN THE CONTEXT OF APPROPRIATE RISK TAKING. THESE CRITERIA DIRECTLY SUPPORT UPMC'S MISSION AND INCLUDE PATIENT QUALITY AND SATISFACTION, COMMUNITY BENEFITS, OPERATIONAL AND FINANCIAL STRENGTH, LEADERSHIP DEVELOPMENT, AND STRATEGIC BUSINESS INITIATIVES AMONG OTHERS. THE TOTAL COMPENSATION PROGRAM IS INTEGRATED WITH AND REINFORCES THE UPMC BUSINESS PLANNING CYCLE AS WELL AS MANAGEMENT DEVELOPMENT AND SUCCESSION PLANNING PROCESSES. IT IS THE COMMITTEE'S JUDGMENT THAT THE STRUCTURE OF THE TOTAL COMPENSATION PROGRAM IS VITAL TO, AND STRONGLY SUPPORTIVE OF, THE HIGH LEVEL OF ONGOING SUCCESS OF UPMC AND FOSTERS THE RETENTION OF CRITICAL OFFICER AND KEY EMPLOYMENT TALENT. THE TOTAL COMPENSATION DETERMINATION PROCESS UTILIZED BY THE COMMITTEE IS INTENDED TO SATISFY THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" AS SET FORTH IN THE REGULATIONS TO SECTION 4958 OF THE INTERNAL REVENUE CODE ("CODE").THIS MEANS THAT COMPENSATION PROGRAMS AND LEVELS ARE APPROVED IN ADVANCE BY THE COMMITTEE WHICH IS COMPOSED ENTIRELY OF OUTSIDE DIRECTORS WHO DO NOT HAVE A CONFLICT OF INTEREST, AS DEFINED BY THE RELEVANT REGULATIONS, WITH RESPECT TO THE COMPENSATION PROGRAM AND LEVELS. THE COMMITTEE OBTAINS AND RELIES UPON A BROAD RANGE OF APPROPRIATE DATA AS TO COMPARABILITY PRIOR TO MAKING ITS DETERMINATIONS. THE COMMITTEE THEN CONTEMPORANEOUSLY DOCUMENTS, INFORMAL MEETING MINUTES, THE BASIS AND REASONS FOR ITS DETERMINATIONS. THE TOTAL COMPENSATION PROGRAM IS DESIGNED AND ADMINISTERED IN ACCORDANCE WITH THE UPMC BYLAWS, SOUND BUSINESS PRACTICES, THE TENETS OF COMMON LAW BUSINESS JUDGMENT AND FIDUCIARY RESPONSIBILITY AS WELL AS ADHERENCE TO ALL RELEVANT FEDERAL, STATE AND LOCAL LAWS. IN ADDITION TO CODE SECTION 4958, AS SET FORTH ABOVE, THIS INCLUDES BUT IS NOT LIMITED TO CODE SECTION 501(C)(3) AND THE APPLICABLE REGULATIONS THEREUNDER AS WELL AS ALL LAWS AND REGULATIONS PROHIBITING PRIVATE INUREMENT, PRIVATE BENEFIT TRANSACTIONS AND DISCRIMINATION. FURTHER, THE COMMITTEE HAS IDENTIFIED AND ADOPTED AS APPROPRIATELY MODIFIED FOR UPMC, COMPENSATION PROGRAM "BEST PRACTICES" FROM THE BUSINESS WORLD (E.G. SARBANES OXLEY, SEC,ETC.). THE COMMITTEE BELIEVES THAT WHILE THESE PRACTICES ARE NOT REQUIRED IN THE TAX EXEMPT SECTOR, THEY ARE IN THE BEST INTERESTS OF THE ORGANIZATION AND FURTHER SUPPORT UPMC'S NONPROFIT MISSION. IN ACCORDANCE WITH THE ABOVE, DETERMINATION OF TOTAL COMPENSATION FOR THE CEO IS MADE EXCLUSIVELY BY THE COMMITTEE. DETERMINATION OF TOTAL COMPENSATION FOR OTHER OFFICERS AND KEY EMPLOYEES IS RECOMMENDED BY THE CEO AND SUBJECT TO REVIEW AND APPROVAL BY THE COMMITTEE. THE COMMITTEE, WHICH MEETS AT LEAST FOUR TIMES A YEAR, OBTAINS PROFESSIONAL ADVICE FROM ITS OWN EXPERTS, INCLUDING ACCOUNTANTS, EXECUTIVE COMPENSATION CONSULTANTS AND LEGAL COUNSEL.
PART VI GOVERNANCE, MANAGEMENT, AND DISCLOSURE SECTION C: DISCLOSURE QUESTION 19 FORM 990 IS AVAILABLE TO THE PUBLIC UPON REQUEST. OTHER GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS MAY BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
PART XII FINANCIAL STATEMENTS AND REPORTING QUESTION 2B : THE ORGANIZATION'S FINANCIAL STATEMENTS ARE PART OF A CONSOLIDATED FINANCIAL STATEMENT AUDIT PERFORMED BY EY FOR UPMC AND ALL SUBSIDIARIES. THE ENTIRE SYSTEM'S FINANCIAL STATEMENTS, OF WHICH THIS ORGANIZATIONS IS PART OF, ARE POSTED ON THE UPMC WEBSITE. (WWW.UPMC.COM) THE FINANCIAL STATEMENT AUDIT DURING THE 990 FILING PERIOD IS FOR THE CALENDAR YEAR ENDED DECEMBER 31, 2021. QUESTION 2C: UPMC HAS AN AUDIT COMMITTEE THAT IS ESTABLISHED TO ASSIST THE BOARD OF DIRECTORS IN FULFILLING ITS OVERSIGHT RESPONSIBILITIES BY MONITORING UPMC CONSOLIDATED FINANCIAL REPORTS AND OTHER FINANCIAL INFORMATION PROVIDED BY UPMC TO GOVERNMENTAL BODIES, THE PUBLIC OR OTHER EXTERNAL ENTITIES. THE UPMC'S SYSTEM OF INTERNAL CONTROLS REGARDING FINANCE, ACCOUNTING, LEGAL COMPLIANCE AND ETHICS THAT MANAGEMENT AND THE BOARD HAVE ESTABLISHED AND UPMC'S INTERNAL AUDITING, ACCOUNTING AND FINANCIAL REPORTING PROCESSES ALSO PROVIDED OVERSIGHT.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


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
2021
Open to Public Inspection
Name of the organization
Williamsport Area Ambulance Service
Cooperative
Employer identification number

23-2416166
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)UPMC SENIOR COMMUNITIES INC
600 GRANT STREET

PITTSBURGH,PA15219
25-1574736 		SR LIVING PA 501(C)(3) 10 UPMC
 
Yes
 
(2)PITTSBURGH LIFETIME CARE COMMUNITY
600 GRANT STREET

PITTSBURGH,PA15219
25-1335247 		CCRC PA 501(C)(3) 10 UPMC SR COMM
 
Yes
 
(3)CANTERBURY PLACE
600 GRANT STREET

PITTSBURGH,PA15219
25-0965334 		SR LIVING PA 501(C)(3) 10 UPMC SR COMM
 
Yes
 
(4)SENECA PLACE
600 GRANT STREET

PITTSBURGH,PA15219
72-1562844 		SR LIVING PA 501(C)(3) 10 UPMC SR COMM
 
Yes
 
(5)SHADYSIDE HOSPITAL SUPPORTING FOUNDATION
600 GRANT STREET

PITTSBURGH,PA15219
26-0303394 		FOUNDATION PA 501(C)(3) 12(A) I UPMC
 
Yes
 
(6)UPMC LEE
600 GRANT STREET

PITTSBURGH,PA15219
25-0613830 		INACTIVE PA 501(C)(3) 3 UPMC
 
Yes
 
(7)PITTSBURGH CARE PARTNERSHIP INC
600 GRANT STREET

PITTSBURGH,PA15219
25-1753852 		SR CARE MGMT PA 501(C)(3) 10 UPMC
 
Yes
 
(8)UPMC CENTER FOR HIGH VALUE HEALTHCARE
600 GRANT STREET

PITTSBURGH,PA15219
45-2178782 		RESEARCH PA 501(C)(3) 7 UPMC
 
Yes
 
(9)SHADYSIDE HOSPITAL FOUNDATION
532 SOUTH AIKEN AVENUE

PITTSBURGH,PA15232
25-1290546 		FOUNDATION PA 501(C)(3) 12(C)III UPMC PRESBY
 
Yes
 
(10)PASSAVANT HOSPITAL FOUNDATION
9100 BABCOCK BLVD

PITTSBURGH,PA15237
25-1407815 		FOUNDATION PA 501(C)(3) 12(B)II UPMC PASS
 
Yes
 
(11)NORTHWEST HOSPITAL FOUNDATION
100 FARFIELD DRIVE

SENECA,PA16346
25-1483624 		FOUNDATION PA 501(C)(3) 12(D)III UPMC NORTHWE
 
Yes
 
(12)ST MARGARET FOUNDATION
600 GRANT STREET

PITTSBURGH,PA15219
25-1520340 		FOUNDATION PA 501(C)(3) 7 UPMC ST MARG
 
Yes
 
(13)CHILDREN'S HOSPITAL OF PITTSBURGH FND
600 GRANT STREET

PITTSBURGH,PA15219
25-1865744 		FOUNDATION PA 501(C)(3) 7 UPMC CHP
 
Yes
 
(14)MAGEE-WOMEN RES INST AND FOUNDATION
600 GRANT STREET

PITTSBURGH,PA15219
25-1462312 		FOUNDATION PA 501(C)(3) 7 NA
 
 
No
(15)Great Lakes Physician Practice PC
600 Grant Street 58th Floor

PITTSBURGH,PA15219
46-4186362 		PHYSICIAN SRV NY 501(C)(3) 3 Regnl Health
 
Yes
 
(16)Hamot Health Foundation
302 FRENCH STREET

ERIE,PA16507
25-1400999 		FOUNDATION PA 501(C)(3) 12(B)II UPMC HAMOT
 
Yes
 
(17)UPMCJAMESON CANCER CENTER
600 GRANT STREET 58TH FL

PITTSBURGH,PA15219
20-1459415 		ONCOLOGY SVC PA 501(C)(3) 10 UPMC Jameson
 
Yes
 
(18)JAMESON CARE CENTER INC
1211 WILMINGTON AVE

NEW CASTLE,PA16105
23-2871396 		SR SERVICES PA 501(C)(3) 10 UPMC SR COMM
 
Yes
 
(19)LAUREL REALTY INC
32-36 CENTRAL AVENUE

WELLSBORO,PA16901
23-1403678 		REAL ESTATE PA 501(C)(2) N/A UPMC SUSQUEH
 
Yes
 
(20)THE GREEN HOME
37 CENTRAL AVENUE

WELLSBORO,PA16901
24-0804365 		SKILLED NURSI PA 501(C)(3) 10 UPMC SUSQUEH
 
Yes
 
(21)UPMC CHAUTAUQUA AT WCA
207 FOOTE AVENUE

JAMESTOWN,NY14701
16-0743226 		HOSPITAL NY 501(C)(3) 3 UPMC CHAUTAU
 
Yes
 
(22)WCA GROUP INC
207 FOOTE AVENUE

JAMESTOWN,NY14701
22-2392582 		HOLDING CO NY 501(C)(3) 12 (B)(II) CHAUT AT WCA
 
Yes
 
(23)STARFLIGHT INC
135 ALLEN STREET

JAMESTOWN,NY14701
16-1557878 		AIR AMBULANCE NY 501(C)(3) 7 CHAUT AT WCA
 
Yes
 
(24)SOUTH CENTRAL ALPHA HOUSING & HEALTH
3410 W PITTSBURG ROAD

NEW CASTLE,PA16101
25-1701701 		SNF & AL PA 501(C)(3) 10 UPMC SR COMM
 
Yes
 
(25)SOUTH WESTERN ALPHA HOUSING & HEALTH
745 GREENVILLE ROAD

MERCER,PA16137
25-1701700 		SNF & IL PA 501(C)(3) 10 UPMC SR COMM
 
Yes
 
(26)KANE COMMUNITY HOSPITAL FOUNDATION
4372 ROUTE 6

KANE,PA16735
26-3906925 		FOUNDATION PA 501(C)(3) 12 (B)(II) NA
 
 
No
(27)JUNIOR GUILD OF THE JAMESON MEMORIAL HOS
1211 WILMINGTON AVENUE

NEW CASTLE,PA16105
25-6005313 		SUPPORT PA 501(C)(3) 12(D)III NA
 
 
No
(28)LAUREL HEALTH FOUNDATION
32-36 CENTRAL AVENUE

WELLSBORO,PA16901
25-1810488 		FOUNDATION PA 501(C)(3) 12(B)II NA
 
 
No
(29)WCA FOUNDATION INC
300 FOOTE AVENUE PO BOX 840

JAMESTOWN,NY14702
22-2393584 		FOUNDATION PA 501(C)(3) 12(C)III NA
 
 
No
(30)VENANGO VNA FOUNDATION
491 ALLEGHENY BOULEVARD

FRANKLIN,PA16323
25-1472179 		FOUNDATION PA 501(C)(3) 12(D) III NA
 
 
No
(31)UPMC PINNACLE
409 SOUTH SECOND STREET

HARRISBURG,PA17104
25-1778658 		SUPPORTING OR PA 501(C)(3) 12(B)II UPMC
 
Yes
 
(32)UPMC CARLISLE
361 ALEXANDER SPRING ROAD

CARLISLE,PA17105
82-0880337 		HOSPITAL PA 501(C)(3) 3 UPMC PINNACL
 
Yes
 
(33)UPMC PINNACLE LANCASTER
250 COLLEGE AVENUE

LANCASTER,PA17603
82-0896436 		HOSPITAL PA 501(C)(3) 3 UPMC PINNACL
 
Yes
 
(34)UPMC LITITZ
1500 HIGHLANDS AVENUE

LITITZ,PA17543
82-0844453 		HOSPITAL PA 501(C)(3) 3 UPMC PINNACL
 
Yes
 
(35)UPMC MEMORIAL
325 SOUTH BELMONT STREET

YORK,PA17405
82-0912090 		HOSPITAL PA 501(C)(3) 3 UPMC PINNACL
 
Yes
 
(36)PINNACLE HEALTH REGIONAL PHYSICIANS
409 SOUTH SECOND STREET

HARRISBURG,PA17104
82-0947698 		PHYSICIAN SRV PA 501(C)(3) 3 UPMC PINNACL
 
Yes
 
(37)UPMC PINNACLE FOUNDATION
409 SOUTH SECOND STREET

HARRISBURG,PA17104
22-2691718 		FOUNDATION PA 501(C)(3) 12(B)II UPMC PINNACL
 
Yes
 
(38)COMMUNITY LIFE TEAM INC
409 SOUTH SECOND STREET

HARRISBURG,PA17104
23-1890444 		MED TRANSPORT PA 501(C)(3) 7 UPMC PINNACL
 
Yes
 
(39)HANOVER HEALTHCARE PLUS INC
300 HIGHLAND AVENUE

HANOVER,PA17331
22-2658574 		SUPPORTING OR PA 501(C)(3) 12(A)(I) UPMC PINNACL
 
Yes
 
(40)UPMC HANOVER
300 HIGHLAND AVENUE

HANOVER,PA17331
23-1360851 		HOSPITAL PA 501(C)(3) 3 HANNOVER HEA
 
Yes
 
(41)UPMC PINNACLE HOSPITALS
409 SOUTH SECOND STREET

HARRISBURG,PA17104
25-1778644 		HOSPITAL PA 501(C)(3) 3 UPMC PINNACL
 
Yes
 
(42)PINNACLE HEALTH MEDICAL SERVICES
409 SOUTH SECOND STREET

HARRISBURG,PA17104
25-1709054 		PHYSICIAN SRV PA 501(C)(3) 3 UPMC PINNACL
 
Yes
 
(43)CHARLES E COLE MEMORIAL HOSPITAL
1001 EAST SECOND STREET

COUDERSPORT,PA16915
24-0802108 		HOSPITAL PA 501(C)(3) 3 UPMC
 
Yes
 
(44)COLE FOUNDATION INC
1001 EAST SECOND STREET

COUDERSPORT,PA16915
45-5417308 		FOUNDATION PA 501(C)(3) 12(A)(I) C COLE MEM H
 
Yes
 
(45)HAMOT COLE VENTURES
1001 EAST SECOND STREET

COUDERSPORT,PA16915
27-3172100 		CLINIC SITES PA 501(C)(3) 12(A)(I) C COLE MEM H
 
Yes
 
(46)HENDORN INC
1001 EAST SECOND STREET

COUDERSPORT,PA16915
23-1972659 		RES. CARE PA 501(C)(3) 12(A)(I) C COLE MEM H
 
Yes
 
(47)ASBURY HEIGHTS OF UPMC
600 GRANT STREET

PITTSBURGH,PA15219
25-1555687 		SUPPORTING OR PA 501(C)(3) 12(B)(II) UPMC SR COMM
 
Yes
 
(48)ASBURY HEALTH CENTER
600 GRANT STREET

PITTSBURGH,PA15219
25-0969472 		CCRC PA 501(C)(3) 10 ASBURY HEIGH
 
Yes
 
(49)ASBURY VILLAS
600 GRANT STREET

PITTSBURGH,PA15219
25-1819952 		PERSONAL CARE PA 501(C)(3) 10 ASBURY HEIGH
 
Yes
 
(50)ASBURY PLACE
600 GRANT STREET

PITTSBURGH,PA15219
25-1729266 		PERSONAL CARE PA 501(C)(3) 10 ASBURY HEIGH
 
Yes
 
(51)WESLEY HILLS
600 GRANT STREET

PITTSBURGH,PA15219
25-1507472 		INDEP LIVING PA 501(C)(3) N/A ASBURY HEIGH
 
Yes
 
(52)ASBURY FOUNDATION
600 GRANT STREET

PITTSBURGH,PA15219
25-1555688 		FOUNDATION PA 501(C)(3) 7 ASBURY HEIGH
 
Yes
 
(53)UPMC SOMERSET
225 SOUTH CENTER AVENUE

SOMERSET,PA15501
25-0965570 		HOSPITAL PA 501(C)(3) 3 UPMC
 
Yes
 
(54)SOMERSET COMMUNITY HOSPITAL FOUNDATION
225 SOUTH CENTER AVENUE

SOMERSET,PA15501
25-1441863 		FOUNDATION PA 501(C)(3) 12(C)III UPMC SOMERSE
 
Yes
 
(55)SOMERSET HEALTH SERVICES INC
225 SOUTH CENTER AVENUE

SOMERSET,PA15501
25-1441920 		PHYSICIAN SRV PA 501(C)(3) 3 UPMC SOMERSE
 
Yes
 
(56)UPMC WESTERN MARYLAND CORPORATION
PO BOX 539

CUMBERLAND,MD21501
52-0591531 		HOSPITAL MD 501(C)(3) 3 UPMC
 
Yes
 
(57)WESTERN MARYLAND HEALTH SYSTEM FND
PO BOX 539

CUMBERLAND,MD21501
35-2289841 		FOUNDATION MD 501(C)(3) 12(C)III UPMC WESTERN
 
Yes
 
(58)HANOVER HOSPITAL FOUNDATION
300 HIGHLAND AVENUE

HANOVER,PA17331
82-2553293 		FOUNDATION PA 501(C)(3) 12(C)III UPMC PINNACL
 
Yes
 
(59)RUSH TO CRUSH CANCER
200 LOTHROP STREET

PITTSBURGH,PA15213
87-4771624 		FOUNDATION PA 501(C)(3) 7 UOFP CANCER
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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) SENECA HILLS ASSISTED LIVING LP

600 GRANT STREET
PITTSBURGH,PA15219
23-2873106 		ASSISTED LIVI PA NA
  		        No        
(2) ST MARGARET MEDICAL ARTS ASSOCIATES

600 GRANT STREET
PITTSBURGH,PA15219
25-1786655 		MED OFFICE BL PA NA
  		        No        
(3) SHADYSIDE MEDICAL CENTER ASSOCIATION

600 GRANT STREET
PITTSBURGH,PA15219
25-1608318 		MED OFFICE BL PA NA
  		        No        
(4) CHARTWELL PA LP

600 GRANT STREET
PITTSBURGH,PA15219
25-1729714 		HOMEHEALTH PA UPMC COMM PROV
  		        No        
(5) LIFE Care Home SRV OF NW PA

1647 SASSAFRAS STREET
ERIE,PA16501
25-1536879 		HOME HEALTH S PA UPMC HAMOT
  		        No        
(6) HAMOT-KCH REAL ESTATE VENTURE

300 STATE STREET
ERIE,PA16507
26-3691782 		MEDICAL OFFIC PA UPMC HAMOT
  		        No        
(7) HAMOT SURGERY CENTER LLC

200 STATE STREET
ERIE,PA16507
25-1863661 		AMBULATORY SU PA UPMC HAMOT
  		        No        
(8) EPN-Hamot Urgent Care LLC

600 Grant Street
Pittsburgh,PA15219
27-2147949 		Urgent Care PA VARIOUS
  		        No        
(9) MEDCARE SUSQUEHANNA VALLEY LLC

409 SOUTH SECOND STREET
HARRISBURG,PA17104
82-1673688 		DME PA PINNACLE HEALTH
  		        No        
(10) OMICELO RE I LP

2525 LIBERTY AVENUE
PITTSBURGH,PA15222
47-5603393 		REAL ESTATE D DE UPMC FOR YOU
  		        No        
(11) UPMC LEADER SURGERY CENTER LLC

1703 INNOVATION DRIVE
YORK,PA17408
23-3035083 		SURGERY CENT PA UPMC MEMORIAL
  		        No        
(12) BAYFRONT PROFESSIONAL BUILDING LLC

3645 WEST LAKE ROAD
ERIE,PA16505
25-1480837 		REAL ESTATE PA UPMC HAMOT
  		        No        
(13) CHAUTAUQUA INTEGRATED DELIVERY SYSTEM I

200 HARRISON STREET 2ND FLOOR
JAMESTOWN,NY14701
16-1542139 		INTEGRATED DE NY UPMC CHAUTAUQUA
  		        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) HCPHARMACY CENTRAL INC

600 GRANT STREET
PITTSBURGH,PA15219
25-1364192 		PHARMACY CO-O PA VARIOUS
  		C          
(2) CHILDREN'S COMMUNITY CARE

600 GRANT STREET
PITTSBURGH,PA15219
25-1781887 		PHYSICIAN SRV PA NA
  		C          
(3) UPMC PHYSICIAN SERVICES HOLDING COMPANY

600 GRANT STREET
PITTSBURGH,PA15219
25-1877017 		HOLDING CO PA NA
  		C          
(4) HEMATOLOGY ONCOLOGY ASSOCIATION INC

600 GRANT STREET
PITTSBURGH,PA15219
42-1648357 		PHYSICIAN SRV PA NA
  		C          
(5) ONCOLOGY HEMATOLOGY ASSOCATION INC

600 GRANT STREET
PITTSBURGH,PA15219
25-1762980 		PHYSICIAN SRV PA NA
  		C          
(6) TRI-STATE NEUROSURGICAL ASSOCIATES UPMC

600 GRANT STREET
PITTSBURGH,PA15219
25-1458655 		PHYSICIAN SRV PA NA
  		C          
(7) RENAISSANCE FAMILY PRACTICE - UPMC INC

600 GRANT STREET
PITTSBURGH,PA15219
26-2942406 		PHYSICIAN SRV PA NA
  		C          
(8) UPMC HOLDING COMPANY INC

600 GRANT STREET
PITTSBURGH,PA15219
25-1777713 		HOLDING CO PA NA
  		C          
(9) UPMC COVERAGE PRODUCTS INC

600 GRANT STREET
PITTSBURGH,PA15219
25-1777710 		HOLDING CO PA NA
  		C          
(10) FREEDOM INSURANCE COMPANY

600 GRANT STREET
PITTSBURGH,PA15219
03-0308944 		INSURANCE VT NA
  		C          
(11) TRI-CENTURY INSURANCE CO

600 GRANT STREET
PITTSBURGH,PA15219
25-1500739 		INSURANCE PA NA
  		C          
(12) UPMC DnA INC

600 GRANT STREET
PITTSBURGH,PA15219
25-1883237 		INSURANCE PA NA
  		C          
(13) UPMC HEALTH BENEFITS INC

600 GRANT STREET
PITTSBURGH,PA15219
25-1844144 		HEALTH INSUR PA NA
  		C          
(14) UPMC HEALTH NETWORK INC

600 GRANT STREET
PITTSBURGH,PA15219
72-1527566 		HEALTH INSUR PA NA
  		C          
(15) UPMC HEALTH PLAN INC

600 GRANT STREET
PITTSBURGH,PA15219
23-2813536 		HEALTH INSUR PA NA
  		C          
(16) UPMC BENEFIT MANAGEMENT SERVICES INC

600 GRANT STREET
PITTSBURGH,PA15219
25-1769564 		WORKERS' COMP PA NA
  		C          
(17) UPMC DIVERSIFIED SERVICES INC

600 GRANT STREET
PITTSBURGH,PA15219
25-1778454 		HOLDING CO PA NA
  		C          
(18) MONROEVILLE SPECIALTY CLINIC

600 GRANT STREET
PITTSBURGH,PA15219
25-1666087 		AMB SURG PA NA
  		C          
(19) MEDICAL ARCHIVAL SYSTEMS INC

600 GRANT STREET
PITTSBURGH,PA15219
23-2912501 		SOFTWARE DEVE DE NA
  		C          
(20) RX PARTNERS INC

600 GRANT STREET
PITTSBURGH,PA15219
25-1801966 		PHARMACY PA NA
  		C          
(21) BIOTRONICS INC

600 GRANT STREET
PITTSBURGH,PA15219
25-1843500 		EQUIP MAINTEN PA NA
  		C          
(22) MEDICAL CENTER PROPERTIES INC

600 GRANT STREET
PITTSBURGH,PA15219
25-1796940 		REAL ESTATE PA NA
  		C          
(23) ASKESIS DEVELOPMENT GROUP INC

600 GRANT STREET
PITTSBURGH,PA15219
54-1625585 		SOFTWARE DEVE DE NA
  		C          
(24) BAYFRONT REGIONAL DEVELOPMENT CORP

300 STATE STREET
ERIE,PA16507
25-1401388 		RE HOLDING CO PA NA
  		C          
(25) BAYSIDE DEVELOPMENT CORP

300 STATE STREET
ERIE,PA16507
25-1401386 		REAL ESTATE PA NA
  		C          
(26) UPMC WORK ALLIANCE INC

600 GRANT STREET
PITTSBURGH,PA15219
45-2825053 		INSURANCE PA NA
  		C          
(27) UPMC HEALTH COVERAGE INC

600 GRANT STREET 58TH FLOOR
PITTSBURGH,PA15219
46-2824537 		INSURANCE PA NA
  		C          
(28) UPMC HEALTH OPTIONS INC

600 GRANT STREET
PITTSBURGH,PA15219
46-2824626 		INSURANCE PA NA
  		C          
(29) UPMC COMPLETE CARE INC

5215 CENTRE AVENUE
Pittsburgh,PA15232
46-3605753 		PHYSICIAN SRV PA NA
  		C          
(30) AMERICAN HOME HEALTH SERVICES

868 CORPORATE WAY
WESTLAKE,OH44145
31-1521422 		HOME HEALTH C OH QUALITY FIRST
  		C          
(31) HEALTH FIDELITY INC

210 S B STREET
SAN MATEO,CA94401
45-2538963 		TECHNOLOGY SV CA NA
  		C          
(32) PENSIAMO INC

600 GRANT STREET 59TH FL
PITTSBURGH,PA15219
81-2069236 		SUPPLY CHAIN DE NA
  		C          
(33) ALTOONA FAMILY INC

620 HOWARD AVE
ALTOONA,PA16601
25-1444935 		MGMT SVCS PA UPMC ALTOONA
  		C          
(34) LEXINGTON HOLDINGS INC

620 HOWARD AVE
ALTOONA,PA16601
25-1794386 		HOLDING CO PA CTRL PA MED FND
  		C          
(35) LEXINGTON ONE INC

620 HOWARD AVE
ALTOONA,PA16601
25-1468889 		RENTAL PA LEXINGTON HOLD
  		C          
(36) LEXINGTON TWO INC

HOWARD AVE 7TH ST
ALTOONA,PA16601
25-1555689 		DME PA LEXINGTON HOLD
  		C          
(37) LEXINGTON FOUR INC

620 HOWARD AVE
ALTOONA,PA16601
25-1793736 		HOLDING CO DE LEXINGTON HOLD
  		C          
(38) UPMC ALTOONA REGIONAL HEALTH SERVICES

1414 9TH AVENUE
ALTOONA,PA16602
25-1219302 		PHYSICIAN SRV PA LEXINGTON FOUR
  		C          
(39) LEXINGTON ANESTHESIA ASSOCIATES INC

620 HOWARD AVE
ALTOONA,PA16601
25-1897765 		PHYSICIAN SRV PA LEXINGTON FOUR
  		C          
(40) UPMC EXCESS PL TRUST

600 GRANT STREET
PITTSBURGH,PA15219
82-6254351 		TRUST PA NA
  		TRUST          
(41) RXANTE INC

511 CONGRESS STREET 803
PORTLAND,ME04101
45-4040219 		MEDICATION MG DE NA
  		C          
(42) SUSQUEHANNA VENTURES INC

1201 GRAMPIAN BOULEVARD
WILLIAMSPORT,PA17701
23-2470623 		PHARMACY PA NA
  		C          
(43) WCA SERVICE CORPORATION INC

207 FOOTE AVENUE
JAMESTOWN,NY14701
16-1151438 		SUPPORT NY CHAUT AT WCA
  		C          
(44) PINNACLE HEALTH CARDIOVASCULAR INSTITUT

409 SOUTH SECOND STREET
HARRISBURG,PA17104
32-0321362 		PHYSICIAN SRV PA NA
  		C          
(45) HANOVER HEALTH CORPORATION

300 HIGHLAND AVENUE
HANOVER,PA17331
90-0498067 		HOLDING CO PA NA
  		C          
(46) HANOVER APOTHECARY INC

310 STOCK STREET SUITE 1
HANOVER,PA17331
03-0594526 		PHARMACY PA NA
  		C          
(47) UNITED CENTRAL PA RECIPROCAL RISK RETEN

76 SAINT PAUL STREET SUITE 500
BURLINGTON,VT05401
13-4224033 		INSURANCE VT NA
  		C          
(48) PINNACLE HEALTH VENTURES INC

409 SOUTH SECOND STREET
HARRISBURG,PA17104
61-1677624 		HOLDING CO PA NA
  		C          
(49) PINNACLE HEALTH IMAGING INC

409 SOUTH SECOND STREET
HARRISBURG,PA17104
23-1718571 		IMAGING SVC PA NA
  		C          
(50) COLE CARE INC

1001 EAST 2ND STREET
COUDERSPORT,PA16915
25-1497347 		DME PA NA
  		C          
(51) UPMC ITALY HEALTH SERVICES SRL

VIA DISCESA DEI GIUDICI 4
PALERMO   90133
IT
HEALTH SVC IT UPMC ITALY SRL
  		C          
(52) UPMC INVESTMENTS LTD

C/O UPMC WHITFIELD CORK ROAD BUTLER
WATERFORD    
EI
HOLDING CO EI UPMC IRELAND LT
  		C          
(53) UPMC PROPERTY LTD

C/O UPMC WHITFIELD CORK ROAD BUTLER
WATERFORD    
EI
PROPERTY EI UPMC INVEST LTD
  		C          
(54) EURO CARE INFRASTRUCTURE LTD

C/O UPMC WHITFIELD CORK ROAD BUTLER
WATERFORD    
EI
PROPERTY MGMT EI UPMC INVEST LTD
  		C          
(55) EURO CARE PROPERTY MANAGEMENT LTD

C/O UPMC WHITFIELD CORK ROAD BUTLER
WATERFORD    
EI
PROPERTY MGMT EI UPMC INVEST LTD
  		C          
(56) UPMC WHITFIELD HOSPITAL LTD

C/O UPMC WHITFIELD CORK ROAD BUTLER
WATERFORD    
EI
HOSPITAL EI UPMC INVEST LTD
  		C          
(57) UPMC GLOBAL OPERATIONS CENTER LTD

6TH FLOOR BEACON HOSPITAL
SANDYFORD   DUBLIN 18
EI
CANCER TREATM EI UPMC IRELAND LT
  		C          
(58) PANTHER REINSURANCE COMPANY LTD

PO BOX 1109
GRAND CAYMAN,CAYMAN ISLANDS  
CJ
98-1402742 		INSURANCE CJ NA
  		C          
(59) FORBES REINSURANCE COMPANY LTD

PO BOX 1109
GRAND CAYMAN,CAYMAN ISLANDS  
CJ
98-1400710 		INSURANCE CJ NA
  		C          
(60) CATHEDRAL (RE) INSURANCE CO

PO BOX 1109
GRAND CAYMAN,CAYMAN ISLANDS  
CJ
98-1400837 		INSURANCE CJ NA
  		C          
(61) UPMC IRELAND LIMITED

6TH FLOOR BEACON HOSPITAL
SANDYFORD   DUBLIN 18
EI
HEALTHCARE SU EI UPMC INT'L HOLD
  		C          
(62) UPMC CANADA TECHNOLOGIES LIMITED

600 GRANT STREET
PITTSBURGH,PA15219
 SOFTWARE CA UPMC INT'L HOLD
  		C          
(63) BLUESPHERE BIO

6425 PENN AVENUE STE 200
PITTSBURGH,PA15206
82-4979766 		IMMUNOTHERAPY DE NA
  		C          
(64) INFECTIOUS DISEASE CONNECT INC

6425 PENN AVENUE STE 200
PITTSBURGH,PA15206
83-3311071 		TELEMEDICINE DE NA
  		C          
(65) NOVASENTA INC

6425 PENN AVENUE STE 200
PITTSBURGH,PA15206
82-5443222 		IMMUNOTHERAPY DE NA
  		C          
(66) UPMC HILLMAN CANCER CENTER - PINNACLE

101 ERFORD ROAD
CAMP HILL,PA17701
83-3640945 		CANCER TREATM PA NA
  		C          
(67) SHANGHAI UPMC CO LTD

288 Shimen 1st Road Jingan Distric
Shanghai   200041
CH
HEALTHCARE MG CH UPMC INT'L HOLD
  		C          
(68) SALVATOR MUNDI INTERNATIONAL HOSPITAL

ROMA VIALE DELLE
MURA GIANICOLENSI   CAP 00152
IT
HOSPITAL IT UPMC ITALY SRL
  		C          
(69) SOMERSET ANESTHESIA INC

600 GRANT STREET
PITTSBURGH,PA15219
45-5135437 		PHYSICIAN SRV PA NA
  		C          
(70) SOMERSET MANAGEMENT SERVICES INC

600 GRANT STREET
PITTSBURGH,PA15219
25-1512960 		MOB OWNERSHIP PA NA
  		C          
(71) GENERIAN PHARMACEUTICALS INC

2425 SIDNEY STREET
PITTSBURGH,PA15203
82-1101143 		PHARMACY DE NA
  		C          
(72) WORK PARTNERS NATIONAL INC

600 GRANT STREET
PITTSBURGH,PA15219
84-3141950 		INSURANCE PA NA
  		C          
(73) ASTRATA INC

6425 PENN AVENUE STE 200
PITTSBURGH,PA15206
84-4804493 		SOFTWARE DE NA
  		C          
(74) VEGAVECT

6425 PENN AVENUE STE 200
PITTSBURGH,PA15206
84-4280784 		GENE THERAPY DE NA
  		C          
(75) NOVIMAB

6425 PENN AVENUE STE 200
PITTSBURGH,PA15206
84-1494905 		CLINICAL RESE DE NA
  		C          
(76) REALYZE INTELLEGENCE INC

6425 PENN AVENUE STE 200
PITTSBURGH,PA15206
85-0873923 		SOFTWARE DE NA
  		C          
(77) HAYSTACK CONSOLIDATED SERVICES INC

12500 WILLOWBROOK ROAD
CUMBERLAND,MD21502
52-1335895 		INACTIVE PA NA
  		C          
(78) WESTERN MARYLAND INSURANCE COMPANY LTD

PO BOX 10233
GRAND CAYMAN,CAYMAN ISLANDS  
CJ
INSURANCE CJ NA
  		C          
(79) GENERIAN PHARMACEUTICALS AUSTRALIA PTY L

LEVEL 5 63 PIRIE STREET
ADELAIDE   5001
AU
PHARMACY AU GENERIAN PHARM
  		C          
(80) WILLOWBROOK HEALTHCARE CONDO

12401 WILLOWBROOK ROAD
CUMBERLAND,MD21502
37-1538510 		REAL ESTATE DE NA
  		C          
(81) RXANTE PHARMACY SERVICES INC

511 CONGRESS STREET 803
PORTLAND,ME04101
83-3402761 		PHARMACY DE NA
  		C          
(82) CLANE HOSPITAL DEVELOPMENT ASSOCIATES L

C/O UPMC WHITFIELD CORK ROAD
BUTLERSTOWN NORTH WATERFORD   X91 DH9W EI
EI
MANAGEMENT EI UPMC IRELAND LT
  		C          
(83) UPMC KILDARE HOSPITAL LTD

PROSPEROUS ROAD
CLANE COUNTY KILDARE,CLANEW91 W535
EI
HOSPITAL EI CLANE HOSPITAL
  		C          
(84) UPMC AUT EVEN HOSPITAL LTD

FRESHFORD ROAD
COUNTY KILKENNY   R95 D3760
EI
HOSPITAL EI UPMC INVEST LTD
  		C          
(85) AVISTA THERAPEUTICS INC

6425 PENN AVENUE STE 200
PITTSBURGH,PA15206
85-3454001 		GENE THERAPY PA NA
  		C          
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
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
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
Yes
 
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) UPMC WILLIAMSPORT

 M 165,257 COST
(2) UPMC WILLIAMSPORT

 K 70,269 COST




Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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) 2021
Schedule R (Form 990) 2021
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. See instructions.
Return Reference Explanation
FORM 990, SCHEDULE R, PART II, III, & IV 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 THE ULTIMATE PARENT.
IDENTIFICATION OF RELATED TAX-EXEMPT ORGANIZATIONS THERE ARE ORGANIZATIONS INCLUDED IN THE UPMC GROUP FORM 990 TAX RETURN FOR FISCAL YEAR 2022 WHICH ARE "RELATED" TO WILLIAMSPORT AREA AMBULANCE SERVICE (SEE PRIOR NOTE). THESE ORGANIZATIONS ARE NOT REQUIRED TO BE LISTED IN SCHEDULE R. THE ORGANIZATION OR RELATED ORGANIZATIONS ARE RELATED THROUGH DIRECT AND INDIRECT CONTROL.
Schedule R (Form 990) 2021

Additional Data


Software ID:  
Software Version: