2024-05-14T16:12:16-05:00 2023-06-30 390859910 BAKER TILLY US LLP 1570 FRUITVILLE PIKE SUITE 400 LANCASTER PA 17601 990 2022-07-01 800866636 CENTRE COUNTY CANCER CENTER CENT 8142317800 1800 E PARK AVENUE STATE COLLEGE PA 16803 THOMAS CHARLES BOARD CHAIR 8142317800 2024-05-10 1 THOMAS CHARLES 999009999 1 KERRI N BOGDA CPA P00760402 7177404863 2024-05-10 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z CANCER CARE PARTNERSHIP THOMAS CHARLES 1800 E PARK AVENUE STATE COLLEGE PA 16803 29580970 0 X WWW.MOUNTNITTANY.ORG/CANCER-CARE-PARTNERSHIP/ X 2012 PA STATE-OF-THE-ART PERSONALIZED CARE FOR OUTPATIENT HEMATOLOGY, MEDICAL ONCOLOGY & INFUSION SVCS. 6 6 0 6 0 0 227659 0 27040412 29567674 0 0 17627 13296 27285698 29580970 0 0 0 0 2937621 3269950 0 0 0 24712256 27778215 27649877 31048165 -364179 -1467195 5168740 5557017 1695157 2100315 3473583 3456702 THE MISSION IS TO ENHANCE THE QUALITY AND AVAILABILITY OF ONCOLOGY SERVICES OFFERED TO PATIENTS IN STATE COLLEGE, PA COMMUNITY AND NEIGHBORING AREAS. 0 0 28951333 29567674 CENTRE COUNTY CANCER CENTER (D/B/A CANCER CARE PARTNERSHIP) IS A PARTNERSHIP BETWEEN MOUNT NITTANY MEDICAL CENTER AND PENN STATE MILTON S. HERSHEY MEDICAL CENTER. THE CENTER PROVIDES STATE-OF-THE-ART, PERSONALIZED CARE FOR OUTPATIENT HEMATOLOGY, MEDICAL ONCOLOGY AND INFUSION SERVICES. OUR PATIENTS BENEFIT FROM THE COMBINED RESOURCES AND EXPERTISE OF MOUNT NITTANY HEALTH, THE COMMUNITY'S TRUSTED HEALTHCARE PROVIDER, AND PENN STATE MILTON S. HERSHEY MEDICAL CENTER, THE REGION'S LEADING ACADEMIC HEALTH CENTER. THE SERVICES INCLUDE BENIGN AND MALIGNANT HEMATOLOGY, CHEMOTHERAPY, BIOTHERAPY, IMMUNOTHERAPY, INFUSION SERVICES, COAGULATION MEDICINE, PALLIATIVE MEDICINE, AND TREATMENT OF ONCOLOGIC MALIGNANCIES. 28951333 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 X 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 PA X BRYAN ROACH 8142317800 1800 E PARK AVENUE STATE COLLEGE PA 16803 TRACY WILLIAMS MOYER CHAIR 2.00 X X 0 0 0 TIFFANY CABIBBO DSC SECRETARY/TREASURER 2.00 X X 0 0 0 THOMAS CHARLES DIRECTOR 2.00 X 0 0 0 RAYMOND HOHL MD DIRECTOR 2.00 X 0 0 0 TOM STOESSEL DIRECTOR 2.00 X 0 0 0 UPENDRA THACKER MD DIRECTOR 2.00 X 0 0 0 MARY RIVERA EXECUTIVE DIRECTOR 40.00 X 181148 0 2636 ADERONKE AJALA MD PHYSICIAN 40.00 X 596056 0 955 LAUREN DELGROSSO MID-LEVEL PROVIDER 40.00 X 134892 0 11727 LYNN WHITTAKER MID-LEVEL PROVIDER 40.00 X 146107 0 3982 PHILIP LOWRY MD PHYSICIAN 40.00 X 169469 0 7530 JAMES V LIEB MD FORMER PHYSICIAN 40.00 X 188819 0 6382 1416491 0 33212 6 1 1 0 MEDICAL HEALTHCARE SOLUTIONS PO BOX 3160 ANDOVER MA 01810 MEDICAL BILLING SERVICES 608377 1 NET PATIENT SERVICE REVENUE 621110 29567674 29567674 29567674 PURCHASE DISCOUNTS 900099 13296 13296 13296 29580970 29567674 0 13296 2534672 2161530 373142 735278 619323 115955 1189 1189 41995 41995 1293173 407738 885435 56872 22521 34351 338659 338659 170005 7088 162917 144339 20717 123622 MEDICAL SUPPLIES 24944079 24944079 BAD DEBT EXPENSE 768226 768226 SPONSORSHIP GIFTS 5500 5500 DUES & SUBSCRIPTIONS 1500 1500 12678 111 12567 31048165 28951333 2096832 0 1124412 1852972 2478678 2302188 669134 846770 541491 485735 91798 55756 535850 401887 268868 97444 5168740 5557017 1185487 1709591 509670 390724 1695157 2100315 X 3473583 3456702 3473583 3456702 5168740 5557017 X -1467195 1450314 X 0 1 X 1 0 X 486041 51669 227659 0 765369 26885513 27103351 24894294 27040412 29567674 135491244 26885513 27589392 24945963 27268071 29567674 136256613 0 0 0 136256613 17627 12296 29923 26885513 27589392 24945963 27285698 29579970 136286536 0.99980 0.99990 0.00000 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: PURCHASE DISCOUNTS - 2021 AMOUNT: $ 17,627. 2022 AMOUNT: $ 12,296. 541491 485735 55756 55756 DUE TO AFFILIATES 390724 390724 30263058 682088 682088 29580970 0 29580970 30279939 0 30279939 768226 768226 31048165 PART XI, LINE 2D - OTHER ADJUSTMENTS: TRANSFERS FROM/(TO) MEMBERS 1,450,314. BAD DEBT EXPENSE NETTED AGAINST REVENUE ON FINANCIALS -768,226. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE NETTED AGAINST REVENUE ON FINANCIALS 768,226. 0 0 0 0 0 0 0 0 0 ADERONKE AJALA MD PHYSICIAN 556938 0 36500 0 2618 0 203 0 752 0 597011 0 0 0 JAMES V LIEB MD FORMER PHYSICIAN 178370 0 0 0 10449 0 203 0 6179 0 195201 0 0 0 MARY RIVERA EXECUTIVE DIRECTOR 175151 0 5782 0 215 0 0 0 2636 0 183784 0 0 0 PHILIP LOWRY MD PHYSICIAN 157506 0 10000 0 1963 0 203 0 7327 0 176999 0 0 0 LYNN WHITTAKER MID-LEVEL PROVIDER 139242 0 0 0 6865 0 0 0 3982 0 150089 0 0 0 SCHEDULE J PART II AND FORM 990, PART VII: UNRELATED ORGANIZATION COMPENSATION: THE FOLLOWING INDIVIDUALS LISTED WERE COMPENSATED BY PENN STATE MILTON S. HERSHEY MEDICAL CENTER FOR SERVICES RENDERED TO CENTRE COUNTY CANCER CENTER: -LYNN WHITTAKER THE FOLLOWING INDIVIDUALS LISTED WERE COMPENSATED BY A MOUNT NITTANY MEDICAL CENTER AFFILIATE FOR SERVICES RENDERED TO CENTRE COUNTY CANCER CENTER: -JAMES V LIEB, MD -LAUREN DELGROSSO -ADERONKE AJALA, MD -MARY RIVERA FORM 990, PART V, LINE 2: SALARIES AND BENEFITS REPORTED ON PART IX ARE ALLOCATED EXPENSES FOR TIME THAT INDIVIDUALS WORK ON CENTRE COUNTY CANCER CENTER. ALL EMPLOYEES ARE EMPLOYEES OF MOUNT NITTANY MEDICAL CENTER ("MNMC") AND PENN STATE MILTON S. HERSHEY MEDICAL CENTER ("HERSHEY"), THE MEMBER ORGANIZATIONS. ALL REQUIRED EMPLOYMENT TAX RETURNS ARE FILED BY MNMC AND HERSHEY. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF THE CORPORATION SHALL BE MOUNT NITTANY MEDICAL CENTER AND PENN STATE MILTON S. HERSHEY MEDICAL CENTER, BOTH OF WHICH ARE NONPROFIT CORPORATIONS IN PENNSYLVANIA. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS ARE RESPONSIBLE FOR THE APPOINTMENT OF EQUAL NUMBERS OF DIRECTORS OF THE CORPORATION AND THE REMOVAL OF SUCH DIRECTORS (SUCH REMOVAL POWER BEING RESERVED TO THE MEMBER WHO APPOINTED THE DIRECTOR) WITH OR WITHOUT CAUSE. FORM 990, PART VI, SECTION A, LINE 7B IN ADDITION TO THE APPOINTMENT AND REMOVAL OF DIRECTORS, THE MEMBERS HAVE THE FOLLOWING POWERS TO APPROVE RESERVED BEFORE THE CORPORATION SHALL TAKE ACTION: -THE ADOPTION, REVOCATION, OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION. -ANY MATERIAL CHANGE IN THE PURPOSES OF THE CORPORATION OR THE NATURE OR SCOPE OF THE BUSINESS CONDUCTED BY THE CORPORATION. -ANY FUNDAMENTAL CHANGE, INCLUDING: (I) THE MERGER OR CONSOLIDATION OF THE CORPORATION WITH OR INTO ANY OTHER ENTITY; (II) THE DIVISION OF THE CORPORATION; (III) THE EXCHANGE OF MEMBERSHIP INTERESTS IN THE CORPORATION FOR EQUITY INTERESTS OF ANY OTHER ENTITY; (IV) THE GRANT OF RESERVED POWERS OR ANY OTHER GOVERNANCE INTEREST TO A THIRD PARTY; OR (V) THE SALE OR LEASE OF ANY MATERIAL PORTION OF THE ASSETS OF THE CORPORATION OTHER THAN IN THE ORDINARY COURSE OF BUSINESS. -THE CORPORATION'S CREATION OF, OR PARTICIPATION BY THE CORPORATION IN, A SUBSIDIARY, JOINT VENTURE, PARTNERSHIP, LIMITED LIABILITY COMPANY OR OTHER SIMILAR ARRANGEMENT. -ANY MATERIAL CHANGE IN THE ACCOUNTING METHOD AFFECTING THE FINANCIAL STATEMENTS OR TAX RETURNS OF THE CORPORATION, OTHER THAN A CHANGE REQUIRED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. -ANY ISSUANCE OF ADDITIONAL, OR TRANSFER OF EXISTING, MEMBERSHIP INTERESTS IN THE CORPORATION (EXCEPT FOR TRANSFERS DESCRIBED IN SECTION 2.03). -ANY LOAN TO ANY PERSON OR ENTITY OTHER THAN FOR PAYABLES AND RECEIVABLES IN THE ORDINARY COURSE OF BUSINESS. -ANY DISTRIBUTIONS BY THE CORPORATION TO ITS MEMBERS, EXCEPT AS AUTHORIZED IN THE CORPORATE MEMBERSHIP AGREEMENT. -THE APPOINTMENT AND REMOVAL OF THE EXECUTIVE DIRECTOR OF THE CENTER. -THE EMPLOYMENT, CONTRACTING, OR LEASING OF A PHYSICIAN TO PROVIDE PROFESSIONAL OR ADMINISTRATIVE SERVICES AT THE CENTER; PROVIDED THAT MEMBER CONSENT SHALL NOT BE REQUIRED FOR LOCUM TENENS PHYSICIANS. -ANY MANDATORY CAPITAL CONTRIBUTIONS OF THE MEMBERS IN EXCESS OF CAPITAL CONTRIBUTIONS REQUIRED BY THE CORPORATE MEMBERSHIP AGREEMENT. -VOLUNTARY DECLARATION OF BANKRUPTCY OR SEEKING OF REORGANIZATION UNDER THE INSOLVENCY LAWS BY THE CORPORATION. -ANY OTHER MATERIAL TRANSACTION INVOLVING THE CORPORATION OR ITS BUSINESS NOT IN THE ORDINARY COURSE OF BUSINESS, EXCEPT THAT EITHER MEMBER AT ANY TIME MAY ELECT TO DISSOLVE THE CORPORATION PURSUANT TO SECTION 4 OF THE CORPORATE MEMBERSHIP AGREEMENT. -IN ADDITION TO THE FOREGOING, THE MEMBERS WILL APPROVE THE EXECUTION OF ANY THIRD PARTY PAYOR CONTRACT WHERE THERE IS DISAGREEMENT AMONG THE DIRECTORS. HOWEVER, WITH RESPECT TO ANY NON-MEDICARE, NON-MEDICAID THIRD PARTY PAYOR CONTRACT PROPOSED BY EITHER MEMBER OR THE DIRECTORS APPOINTED BY SUCH MEMBER, THE NON-PROPOSING MEMBER WILL NOT WITHHOLD OR DELAY APPROVAL UNLESS THE TERMS OF SUCH PROPOSED MANAGED CARE OR THIRD PARTY PAYOR CONTRACT ARE, IN THE AGGREGATE, LESS THAN 125% OF MEDICARE. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE RETURN IS COMPLETED IN DRAFT FORM AND REVIEWED BY MANAGEMENT OF THE ORGANIZATION BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY WHICH COVERS INTERESTED PERSONS. AN INTERESTED PERSON IS ANY PERSON IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE BUSINESS, OPERATIONS, ETHICAL, AND/OR COMPETITIVE POSITION. THIS INCLUDES, BUT IS NOT LIMITED TO, ANY DIRECTOR, EXECUTIVE, KEY EMPLOYEE, AND MEMBER OF THE MEDICAL STAFF. THE BOARD MAY ALSO DETERMINE THAT A PERSON OTHER THAN AN INTERESTED PERSON SHALL BE TREATED AS AN INTERESTED PERSON WITH RESPECT TO A PARTICULAR CONTRACT TRANSACTION, OR ARRANGEMENT. AN INTERESTED PERSON MUST DISCLOSE ALL MATERIAL FACTS RELATED TO THE EXISTENCE OF ANY ACTUAL, APPARENT, OR POTENTIAL CONFLICT OF INTEREST TO DIRECTORS CONSIDERING THE PROPOSED TRANSACTION, ARRANGEMENT, OR POLICY. DIRECTORS, EXECUTIVES, AND KEY EMPLOYEES COMPLETE AN ANNUAL DISCLOSURE STATEMENT. MEMBERS OF THE MEDICAL STAFF COMPLETE A DISCLOSURE STATEMENT EVERY OTHER YEAR, COINCIDING WITH THEIR APPLICATION FOR REAPPOINTMENT TO THE MEDICAL STAFF. THESE INDIVIDUALS ARE ALSO REQUIRED TO DISCLOSE ANY TRANSACTION OR RELATIONSHIP WHICH ARISES BETWEEN SUBMISSIONS OF THE DISCLOSURE STATEMENT. THE BOARD ANNUALLY REVIEWS AND EVALUATES THE DISCLOSURE STATEMENTS AND DETERMINES IF THERE ARE ANY CONFLICTS THAT ARE SO PERVASIVE AS TO RENDER ANY DIRECTOR INELIGIBLE FOR SERVICE. IF A POTENTIAL CONFLICT OF INTEREST ARISES AS A RESULT OF A CONTEMPLATED BOARD ACTION, THE PRESIDENT OR THE INTERESTED PERSON, OR ANY OTHER DIRECTOR, SHALL RAISE THE QUESTION OF THE INTERESTED PERSON'S CONFLICT OF INTEREST. THE BOARD WILL EVALUATE THE DISCLOSURE AND MATERIAL FACTS RELATED TO THE TRANSACTION AND WILL MAKE A DETERMINATION AS TO WHETHER THE INTERESTED PERSON HAS AN IMPERMISSIBLE CONFLICT OF INTEREST. BEFORE MAKING THIS DETERMINATION, AND DEPENDING UPON THE CIRCUMSTANCES, THE INTERESTED PERSON WILL BE ASKED TO LEAVE THE MEETING WHILE THE EVALUATION OF THE CONFLICT AND THE TRANSACTION IS DISCUSSED AND DECIDED UPON. IF THE DETERMINATION IS THAT A CONFLICT EXISTS, THE INTERESTED PERSON IS SO ADVISED. IF IT IS DETERMINED THAT A CONFLICT OF INTEREST EXISTS, THE INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD MEETING CONCERNING THE TRANSACTION OR ARRANGEMENT UNDER CONSIDERATION AND MAY BE ASKED TO REMAIN FOR QUESTIONS ON THIS PRESENTATION; HOWEVER, AFTER THE PRESENTATION AND QUESTION PERIOD, THE INTERESTED PERSON IS ASKED TO LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE CONFLICT OF INTEREST. IF AN INDIVIDUAL WHOSE COMPANY OR EMPLOYER HAS A BUSINESS RELATIONSHIP WITH THE ORGANIZATION, BUT THE INDIVIDUAL DOES NOT HAVE AN IMPERMISSIBLE CONFLICT OF INTEREST WITH RESPECT TO THIS BUSINESS RELATIONSHIP, THE INDIVIDUAL MAY NONETHELESS VOLUNTARILY RECUSE HIM/HERSELF FROM VOTING ON ANY MATTERS RELATED TO THIS RELATIONSHIP. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: TRANSFERS FROM/(TO) MEMBERS 1,450,314.