Civic Intelligence

Dubois Regional Medical Center Employee

990 • Fiscal year 2021 • EIN 25-6332829

Jul 01, 2020 to Jun 30, 2021 • Filed on Jan 15, 2023

Organization ProfileN/A
PO Box 447Dubois, PA 15801

(814) 375-6377

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

43rd percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

2021 filings • 501(c)9 • $1M-$5M nonprofits • Source year 2021

Liabilities / Revenue

45th percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

2021 filings • 501(c)9 • $1M-$5M nonprofits • Source year 2021

Net Margin

31st percentile

-2.3%

Higher net margin than 31% of similar nonprofits.

2021 filings • 501(c)9 • $1M-$5M nonprofits • Source year 2021

Top Officer Pay

99th percentile

$1,074,390

Higher top officer pay than 99% of similar nonprofits.

Top officer pay equals 81.9% of source-year revenue.

2021 filings • 501(c)9 • $1M-$5M nonprofits • Source year 2021

Asset Growth

Score unavailable

No value available

No earlier valid filing was available within the previous three public years.

Source year 2021

Revenue Growth

Score unavailable

No value available

No earlier valid filing was available within the previous three public years.

Source year 2021

Balance Sheet
Liabilities / Assets43rd percentile

Assets

$1,016,609

No earlier filing loaded for comparison.

Net Assets

$1,016,609

No earlier filing loaded for comparison.

Liabilities

$0

No earlier filing loaded for comparison.

Revenue And Expenses
Liabilities / Revenue45th percentileNet Margin31st percentile

Revenue

$1,312,103

No earlier filing loaded for comparison.

Expenses

$1,342,639

No earlier filing loaded for comparison.

Net Income

-$30,536

No earlier filing loaded for comparison.

Historical Trend

Balance Sheet Trend

Asset GrowthScore unavailable

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$1.5M$1.0M$500K$0Assets 2021: $1,016,609Liabilities 2021: $0Net Assets 2021: $1,016,6092021Assets 2022: $913,202Liabilities 2022: $0Net Assets 2022: $913,2022022Assets 2023: $710,641Liabilities 2023: $0Net Assets 2023: $710,6412023

Highlighted filing

2021

Assets$1,016,609
Liabilities$0
Net Assets$1,016,609
Open 2021 Filing

Operations Trend

Revenue GrowthScore unavailable

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$1.5M$1.0M$500K$0-$500KRevenue 2021: $1,312,103Expenses 2021: $1,342,639Net Income 2021: -$30,5362021Revenue 2022: $835,772Expenses 2022: $939,179Net Income 2022: -$103,4072022Revenue 2023: $556,832Expenses 2023: $759,393Net Income 2023: -$202,5612023

Highlighted filing

2021

Revenue$1,312,103
Expenses$1,342,639
Net Income-$30,536
Open 2021 Filing
Jump To
Filing Snapshot
Filing Period
Jul 1, 2020 to Jun 30, 2021
Signed
Jan 15, 2023
Return Version
2020v4.1
Gross Receipts
$1,312,103
Mission and Program Overview

Mission

The employee benefit trust was created for the purpose of funding a dental plan and a flexible spending plan medical and dependent care with contributions from DuBois Regional Medical Center and it's participating employees.

The employee benefit trust was created for the purpose of funding a dental plan and a flex spending plan (med and dependent care) with contributions from drmc and participants.

Balance Sheet Detail
LineBeginningEndChange
Assets
Cash and Non-Interest-Bearing Accounts$1,047,145$1,016,609▼ $30,536
Savings and Temporary Cash Investments$0$0→ $0
Accounts Receivable$0$0→ $0
Other Notes and Loans Receivable, Net$0$0→ $0
Pledges and Grants Receivable$0$0→ $0
Receivable From Disqualified Prsn$0$0→ $0
Receivables From Officers Etc$0$0→ $0
Investments Other Securities$0$0→ $0
Investments Program Related$0$0→ $0
Investments in Publicly Traded Securities$0$0→ $0
Land, Buildings, and Equipment, Net$0$0→ $0
Intangible Assets$0$0→ $0
Inventories for Sale or Use$0$0→ $0
Loans From Officers Directors$0$0→ $0
Prepaid Expenses and Deferred Charges$0$0→ $0
Total Assets$1,047,145$1,016,609▼ $30,536
Other Assets Total$0$0→ $0
Liabilities
Accounts Payable and Accrued Expenses$0$0→ $0
Grants Payable$0$0→ $0
Mortgage Notes Payable Secured by Investment Property$0$0→ $0
Unsecured Notes Loans Payable$0$0→ $0
Other Liabilities$0$0→ $0
Deferred Revenue$0$0→ $0
Escrow Account Liability$0$0→ $0
Tax Exempt Bond Liabilities$0$0→ $0
Total Liabilities$0$0→ $0
Net Assets / Fund Balance
Net Assets Without Donor Restrictions$1,047,145$1,016,609▼ $30,536
Net Assets With Donor Restrictions$0$0→ $0
Total Net Assets Fund Balance$1,047,145$1,016,609▼ $30,536
Total Liabilities and Net Assets / Fund Balance$1,047,145$1,016,609▼ $30,536
Compensation and Service Providers
Top Officer Pay99th percentile

Board Members and Trustees

NameTitle
Steven M FontainePresident of Phhc
John S SutikaPresident/CEO of Drmc
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$1,309,739
Investment Income
$2,364
Other Revenue
$0
Change in Net Assets
$-30,536
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$100,619
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Salaries, Compensation, and Employee Benefits$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Benefits to Members---$1,242,020
Other Expenses---$12,743
Total Functional Expenses$0$0$0$1,342,639
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Fundraising Direct Expenses$0
Fundraising Gross Income$0
Gaming Direct Expenses$0
Gaming Gross Income$0
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Subject to proxy tax
No
Insider Transactions and Loans

Loans and Receivables

Line ItemBeginningEndChange
Loans from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Receivables from Disqualified Persons$0$0→ $0
Receivables from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Business relationship with 35% controlled entity
No
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
Conflict-of-interest policy
No
Audited financial statements prepared
No
Key decisions subject to board approval
No
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section B, Line 11B

“Form is completed by drmc staff accountant and reviewed with/by accounting manager. Form is forwarded to ceo, trustee of drmc employee benefit plan trust, for review and signatures, and then to independent accounting firm for e-filing.”

Form 990, Part VI, Section B, Line 19

“Financial statement availability: financial statements are made available to the public in the offices of drmc's cfo and ceo, or by request.”

Filing and Contact Details

Filer

Filer Name
Dubois Regional Medical Center Employee
EIN
25-6332829
In Care Of
% JOHN S SUTIKA
Phone
8143756377
Address
PO BOX 447, DUBOIS, PA 15801

Signing Officer

Name
John S Sutika
Title
Trustee
Phone
8143756392
Signed
2023-01-15
Discuss with paid preparer
Yes

Organization Details

Principal Officer
John S Sutika
Formed
1988
Legal Domicile
Pa
Voting Board Members
2
Independent Board Members
0
Employees
0

Preparer

Firm
Forvis Llp
Address
910 E ST LOUIS 200/PO BOX 1190, SPRINGFIELD, MO 65806-2523
Preparer
Brian D Todd
Phone
4178658701
Raw XML Appendix378 raw XML fields

This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.

Path#Value
IRS990/AccountantCompileOrReviewInd0false
IRS990/AccountsPayableAccrExpnssGrp/BOYAmt00
IRS990/AccountsPayableAccrExpnssGrp/EOYAmt00
IRS990/AccountsReceivableGrp/BOYAmt00
IRS990/AccountsReceivableGrp/EOYAmt00
IRS990/ActivitiesConductedPrtshpInd0false
IRS990/ActivityOrMissionDesc0THE EMPLOYEE BENEFIT TRUST WAS CREATED FOR THE PURPOSE OF FUNDING A DENTAL PLAN AND A FLEX SPENDING PLAN (MED AND DEPENDENT CARE) WITH CONTRIBUTIONS FROM DRMC AND PARTICIPANTS.
IRS990/AdvertisingGrp/TotalAmt00
IRS990/BenefitsToMembersGrp/TotalAmt01242020
IRS990/BooksInCareOfDetail/PersonNm0JOHN S SUTIKA
IRS990/BooksInCareOfDetail/PhoneNum08143756392
IRS990/BooksInCareOfDetail/USAddress/AddressLine1Txt0PO BOX 447
IRS990/BooksInCareOfDetail/USAddress/CityNm0DUBOIS
IRS990/BooksInCareOfDetail/USAddress/StateAbbreviationCd0PA
IRS990/BooksInCareOfDetail/USAddress/ZIPCd015801
IRS990/BusinessRlnWith35CtrlEntInd0false
IRS990/BusinessRlnWithFamMemInd0false
IRS990/BusinessRlnWithOrgMemInd0false
IRS990/CashNonInterestBearingGrp/BOYAmt01047145
IRS990/CashNonInterestBearingGrp/EOYAmt01016609
IRS990/ChangeToOrgDocumentsInd0false
IRS990/CntrctRcvdGreaterThan100KCnt00
IRS990/CollectionsOfArtInd0false
IRS990/CompCurrentOfcrDirectorsGrp/TotalAmt00
IRS990/CompDisqualPersonsGrp/TotalAmt00
IRS990/CompensationFromOtherSrcsInd0false
IRS990/ConferencesMeetingsGrp/TotalAmt00
IRS990/ConflictOfInterestPolicyInd0false
IRS990/ConservationEasementsInd0false
IRS990/ConsolidatedAuditFinclStmtInd0false
IRS990/CostOfGoodsSoldAmt00
IRS990/CreditCounselingInd0false
IRS990/CYBenefitsPaidToMembersAmt01242020
IRS990/CYContributionsGrantsAmt00
IRS990/CYGrantsAndSimilarPaidAmt00
IRS990/CYInvestmentIncomeAmt02364
IRS990/CYOtherExpensesAmt0100619
IRS990/CYOtherRevenueAmt00
IRS990/CYProgramServiceRevenueAmt01309739
IRS990/CYRevenuesLessExpensesAmt0-30536
IRS990/CYSalariesCompEmpBnftPaidAmt00
IRS990/CYTotalExpensesAmt01342639
IRS990/CYTotalFundraisingExpenseAmt00
IRS990/CYTotalProfFndrsngExpnsAmt00
IRS990/CYTotalRevenueAmt01312103
IRS990/DecisionsSubjectToApprovaInd0false
IRS990/DeductibleArtContributionInd0false
IRS990/DeductibleNonCashContriInd0false
IRS990/DeferredRevenueGrp/BOYAmt00
IRS990/DeferredRevenueGrp/EOYAmt00
IRS990/DelegationOfMgmtDutiesInd0false
IRS990/DepreciationDepletionGrp/TotalAmt00
IRS990/Desc0THE EMPLOYEE BENEFIT TRUST WAS CREATED FOR THE PURPOSE OF FUNDING A DENTAL PLAN AND A FLEXIBLE SPENDING PLAN (MEDICAL AND DEPENDENT CARE) WITH CONTRIBUTIONS FROM DUBOIS MEDICAL CENTER AND ITS PARTICIPATING EMPLOYEES
IRS990/DescribedInSection501c3Ind0false
IRS990/DisregardedEntityInd0false
IRS990/DocumentRetentionPolicyInd0false
IRS990/DonorAdvisedFundInd0false
IRS990/DonorRestrictionNetAssetsGrp/BOYAmt00
IRS990/DonorRestrictionNetAssetsGrp/EOYAmt00
IRS990/DonorRstrOrQuasiEndowmentsInd0false
IRS990/ElectionOfBoardMembersInd0false
IRS990/EmployeeCnt00
IRS990/EngagedInExcessBenefitTransInd0false
IRS990/EscrowAccountLiabilityGrp/BOYAmt00
IRS990/EscrowAccountLiabilityGrp/EOYAmt00
IRS990/FamilyOrBusinessRlnInd0false
IRS990/FederalGrantAuditRequiredInd0false
IRS990/FeesForServicesAccountingGrp/TotalAmt00
IRS990/FeesForServicesLegalGrp/TotalAmt00
IRS990/FeesForServicesLobbyingGrp/TotalAmt00
IRS990/FeesForServicesManagementGrp/TotalAmt00
IRS990/FeesForServicesOtherGrp/TotalAmt00
IRS990/FeesForServicesProfFundraising/TotalAmt00
IRS990/FeesForSrvcInvstMgmntFeesGrp/TotalAmt00
IRS990/ForeignActivitiesInd0false
IRS990/ForeignFinancialAccountInd0false
IRS990/ForeignGrantsGrp/TotalAmt00
IRS990/ForeignOfficeInd0false
IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt00.0
IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRltdOrgRt10.0
IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt00.0
IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt10.0
IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd0X
IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd1X
IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt082616
IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt164855
IRS990/Form990PartVIISectionAGrp/PersonNm0STEVEN M FONTAINE
IRS990/Form990PartVIISectionAGrp/PersonNm1JOHN S SUTIKA
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt00
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt10
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt0991774
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt1442679
IRS990/Form990PartVIISectionAGrp/TitleTxt0PRESIDENT OF PHHC
IRS990/Form990PartVIISectionAGrp/TitleTxt1PRESIDENT/CEO OF DRMC
IRS990/Form990ProvidedToGvrnBodyInd0false
IRS990/FormationYr01988
IRS990/FormerOfcrEmployeesListedInd0false
IRS990/FSAuditedInd0false
IRS990/FundraisingActivitiesInd0false
IRS990/FundraisingDirectExpensesAmt00
IRS990/FundraisingGrossIncomeAmt00
IRS990/GamingActivitiesInd0false
IRS990/GamingDirectExpensesAmt00
IRS990/GamingGrossIncomeAmt00
IRS990/GoverningBodyVotingMembersCnt02
IRS990/GrantsPayableGrp/BOYAmt00
IRS990/GrantsPayableGrp/EOYAmt00
IRS990/GrantsToDomesticIndividualsGrp/TotalAmt00
IRS990/GrantsToDomesticOrgsGrp/TotalAmt00
IRS990/GrantsToIndividualsInd0false
IRS990/GrantsToOrganizationsInd0false
IRS990/GrantToRelatedPersonInd0false
IRS990/GrossReceiptsAmt01312103
IRS990/GrossSalesOfInventoryAmt00
IRS990/GroupReturnForAffiliatesInd0false
IRS990/IncludeFIN48FootnoteInd0false
IRS990/IncmFromInvestBondProceedsGrp/TotalRevenueColumnAmt00
IRS990/IndependentAuditFinclStmtInd0false
IRS990/IndependentVotingMemberCnt00
IRS990/IndivRcvdGreaterThan100KCnt00
IRS990/IndoorTanningServicesInd0false
IRS990/InfoInScheduleOPartVIInd0X
IRS990/InformationTechnologyGrp/TotalAmt00
IRS990/InsuranceGrp/TotalAmt00
IRS990/IntangibleAssetsGrp/BOYAmt00
IRS990/IntangibleAssetsGrp/EOYAmt00
IRS990/InterestGrp/TotalAmt00
IRS990/InventoriesForSaleOrUseGrp/BOYAmt00
IRS990/InventoriesForSaleOrUseGrp/EOYAmt00
IRS990/InvestmentIncomeGrp/ExclusionAmt02364
IRS990/InvestmentIncomeGrp/TotalRevenueColumnAmt02364
IRS990/InvestmentInJointVentureInd0false
IRS990/InvestmentsOtherSecuritiesGrp/BOYAmt00
IRS990/InvestmentsOtherSecuritiesGrp/EOYAmt00
IRS990/InvestmentsProgramRelatedGrp/BOYAmt00
IRS990/InvestmentsProgramRelatedGrp/EOYAmt00
IRS990/InvestmentsPubTradedSecGrp/BOYAmt00
IRS990/InvestmentsPubTradedSecGrp/EOYAmt00
IRS990/IRPDocumentCnt00
IRS990/IRPDocumentW2GCnt00
IRS990/LandBldgEquipBasisNetGrp/BOYAmt00
IRS990/LandBldgEquipBasisNetGrp/EOYAmt00
IRS990/LegalDomicileStateCd0PA
IRS990/LoanOutstandingInd0false
IRS990/LoansFromOfficersDirectorsGrp/BOYAmt00
IRS990/LoansFromOfficersDirectorsGrp/EOYAmt00
IRS990/LocalChaptersInd0false
IRS990/MaterialDiversionOrMisuseInd0false
IRS990/MembersOrStockholdersInd0false
IRS990/MethodOfAccountingAccrualInd0X
IRS990/MinutesOfGoverningBodyInd0false
IRS990/MissionDesc0THE EMPLOYEE BENEFIT TRUST WAS CREATED FOR THE PURPOSE OF FUNDING A DENTAL PLAN AND A FLEXIBLE SPENDING PLAN (MEDICAL AND DEPENDENT CARE) WITH CONTRIBUTIONS FROM DUBOIS REGIONAL MEDICAL CENTER AND ITS PARTICIPATING EMPLOYEES.
IRS990/MoreThan5000KToIndividualsInd0false
IRS990/MoreThan5000KToOrgInd0false
IRS990/MortgNotesPyblScrdInvstPropGrp/BOYAmt00
IRS990/MortgNotesPyblScrdInvstPropGrp/EOYAmt00
IRS990/NetAssetsOrFundBalancesBOYAmt01047145
IRS990/NetAssetsOrFundBalancesEOYAmt01016609
IRS990/NetGainOrLossInvestmentsGrp/TotalRevenueColumnAmt00
IRS990/NetIncmFromFundraisingEvtGrp/TotalRevenueColumnAmt00
IRS990/NetIncomeFromGamingGrp/TotalRevenueColumnAmt00
IRS990/NetIncomeOrLossGrp/TotalRevenueColumnAmt00
IRS990/NetRentalIncomeOrLossGrp/TotalRevenueColumnAmt00
IRS990/NoDonorRestrictionNetAssetsGrp/BOYAmt01047145
IRS990/NoDonorRestrictionNetAssetsGrp/EOYAmt01016609
IRS990/NondeductibleContributionsInd0false
IRS990/OccupancyGrp/TotalAmt00
IRS990/OfficeExpensesGrp/TotalAmt00
IRS990/OfficerMailingAddressInd0false
IRS990/OperateHospitalInd0false
IRS990/Organization501cInd0X
IRS990/OrganizationFollowsFASB117Ind0X
IRS990/OtherAssetsTotalGrp/BOYAmt00
IRS990/OtherAssetsTotalGrp/EOYAmt00
IRS990/OtherEmployeeBenefitsGrp/TotalAmt00
IRS990/OtherExpensesGrp/Desc0PROCESS CLAIMS
IRS990/OtherExpensesGrp/Desc1ADMIN FEES
IRS990/OtherExpensesGrp/TotalAmt087876
IRS990/OtherExpensesGrp/TotalAmt112743
IRS990/OtherLiabilitiesGrp/BOYAmt00
IRS990/OtherLiabilitiesGrp/EOYAmt00
IRS990/OtherRevenueTotalAmt00
IRS990/OtherSalariesAndWagesGrp/TotalAmt00
IRS990/OthNotesLoansReceivableNetGrp/BOYAmt00
IRS990/OthNotesLoansReceivableNetGrp/EOYAmt00
IRS990/PartialLiquidationInd0false
IRS990/PaymentsToAffiliatesGrp/TotalAmt00
IRS990/PayrollTaxesGrp/TotalAmt00
IRS990/PensionPlanContributionsGrp/TotalAmt00
IRS990/PledgesAndGrantsReceivableGrp/BOYAmt00
IRS990/PledgesAndGrantsReceivableGrp/EOYAmt00
IRS990/PoliticalCampaignActyInd0false
IRS990/PrepaidExpensesDefrdChargesGrp/BOYAmt00
IRS990/PrepaidExpensesDefrdChargesGrp/EOYAmt00
IRS990/PrincipalOfficerNm0JOHN S SUTIKA
IRS990/ProfessionalFundraisingInd0false
IRS990/ProgramServiceRevenueGrp/BusinessCd0525920
IRS990/ProgramServiceRevenueGrp/Desc0EMPLOYEE CONTRIBUTIONS
IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt01309739
IRS990/ProgramServiceRevenueGrp/TotalRevenueColumnAmt01309739
IRS990/ProhibitedTaxShelterTransInd0false
IRS990/PYBenefitsPaidToMembersAmt01161274
IRS990/PYContributionsGrantsAmt00
IRS990/PYExcessBenefitTransInd0false
IRS990/PYGrantsAndSimilarPaidAmt00
IRS990/PYInvestmentIncomeAmt09052
IRS990/PymtTravelEntrtnmntPubOfclGrp/TotalAmt00
IRS990/PYOtherExpensesAmt090317
IRS990/PYOtherRevenueAmt00
IRS990/PYProgramServiceRevenueAmt01431123
IRS990/PYRevenuesLessExpensesAmt0188584
IRS990/PYSalariesCompEmpBnftPaidAmt00
IRS990/PYTotalExpensesAmt01251591
IRS990/PYTotalProfFndrsngExpnsAmt00
IRS990/PYTotalRevenueAmt01440175
IRS990/RcvblFromDisqualifiedPrsnGrp/BOYAmt00
IRS990/RcvblFromDisqualifiedPrsnGrp/EOYAmt00
IRS990/ReceivablesFromOfficersEtcGrp/BOYAmt00
IRS990/ReceivablesFromOfficersEtcGrp/EOYAmt00
IRS990/ReconcilationRevenueExpnssAmt0-30536
IRS990/RelatedEntityInd0true
IRS990/RelatedOrganizationCtrlEntInd0false
IRS990/RentalIncomeOrLossGrp/PersonalAmt00
IRS990/RentalIncomeOrLossGrp/RealAmt00
IRS990/ReportInvestmentsOtherSecInd0false
IRS990/ReportLandBuildingEquipmentInd0false
IRS990/ReportOtherAssetsInd0false
IRS990/ReportOtherLiabilitiesInd0false
IRS990/ReportProgramRelatedInvstInd0false
IRS990/RoyaltiesGrp/TotalAmt00
IRS990/RoyaltiesRevenueGrp/TotalRevenueColumnAmt00
IRS990/SavingsAndTempCashInvstGrp/BOYAmt00
IRS990/SavingsAndTempCashInvstGrp/EOYAmt00
IRS990/ScheduleBRequiredInd0false
IRS990ScheduleJ/EquityBasedCompArrngmInd0false
IRS990/ScheduleJRequiredInd0true
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompensationBasedOnRltdOrgsAmt0442679
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompensationBasedOnRltdOrgsAmt1991774
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompRltdOrgsAmt064855
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompRltdOrgsAmt182616
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm0JOHN S SUTIKA
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm1STEVEN M FONTAINE
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt0PRESIDENT/CEO OF DRMC
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt1PRESIDENT OF PHHC
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationRltdOrgsAmt0507534
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationRltdOrgsAmt11074390
IRS990ScheduleJ/SeverancePaymentInd0false
IRS990ScheduleJ/SupplementalInformationDetail/ExplanationTxt0SHARED FORMAL GOVERNANCE: JOHN S. SUTIKA, TRUSTEE, IS EMPLOYED BY RELATED ORGANIZATION DUBOIS REGIONAL MEDICAL CENTER AS PRESIDENT/CEO AND IS COMPENSATED BY DUBOIS REGIONAL MEDICAL CENTER FOR THAT POSITION. STEVEN M. FONTAINE, TRUSTEE, IS EMPLOYED BY RELATED ORGANIZATION PENN HIGHLANDS HEALTHCARE, INC. AS PRESIDENT/CEO AND IS COMPENSATED BY PENN HIGHLANDS HEALTHCARE, INC FOR THAT POSITION.
IRS990ScheduleJ/SupplementalInformationDetail/FormAndLineReferenceDesc0SCHEDULE J, PART II
IRS990ScheduleJ/SupplementalNonqualRtrPlanInd0false
IRS990/ScheduleORequiredInd0true
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0FORM IS COMPLETED BY DRMC STAFF ACCOUNTANT AND REVIEWED WITH/BY ACCOUNTING MANAGER. FORM IS FORWARDED TO CEO, TRUSTEE OF DRMC EMPLOYEE BENEFIT PLAN TRUST, FOR REVIEW AND SIGNATURES, AND THEN TO INDEPENDENT ACCOUNTING FIRM FOR E-FILING.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1FINANCIAL STATEMENT AVAILABILITY: FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC IN THE OFFICES OF DRMC'S CFO AND CEO, OR BY REQUEST.
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990, PART VI, SECTION B, LINE 11B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PART VI, SECTION B, LINE 19
IRS990ScheduleR/AssetExchangeInd0false
IRS990ScheduleR/AssetPurchaseFromOtherOrgInd0false
IRS990ScheduleR/AssetSaleToOtherOrgInd0false
IRS990ScheduleR/DivRelatedOrganizationInd0false
IRS990ScheduleR/GiftGrntCapContriFromOthOrgInd0false
IRS990ScheduleR/GiftGrntOrCapContriToOthOrgInd0false
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ControlledOrganizationInd0false
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ControlledOrganizationInd1false
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DirectControllingEntityName/BusinessNameLine1Txt0NA
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DirectControllingEntityName/BusinessNameLine1Txt1NA
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt0DUBOIS REGIONAL MEDICAL CENTER
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt1PENN HIGHLANDS HEALTHCARE INC
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/EIN0251490707
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/EIN1320345810
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt0501(C)(3)
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt1501(C)(3)
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileStateCd0PA
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileStateCd1PA
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PrimaryActivitiesTxt0HOSPITAL
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PrimaryActivitiesTxt1HOME OFFICE
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PublicCharityStatusTxt03
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PublicCharityStatusTxt112CIII
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/AddressLine1Txt0PO BOX 447
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/AddressLine1Txt1PO BOX 447
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/CityNm0DUBOIS
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/CityNm1DUBOIS
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/StateAbbreviationCd0PA
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/StateAbbreviationCd1PA
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/ZIPCd015801
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/ZIPCd115801
IRS990ScheduleR/LoansOrGuaranteesFromOthOrgInd0false
IRS990ScheduleR/LoansOrGuaranteesToOtherOrgInd0false
IRS990ScheduleR/PaidEmployeesSharingInd0true
IRS990ScheduleR/PerformOfServicesByOtherOrgInd0false
IRS990ScheduleR/PerformOfServicesForOthOrgInd0false
IRS990ScheduleR/ReceiptOfIntAnntsRntsRyltsInd0false
IRS990ScheduleR/ReimbursementPaidByOtherOrgInd0false
IRS990ScheduleR/ReimbursementPaidToOtherOrgInd0false
IRS990ScheduleR/RentalOfFacilitiesToOthOrgInd0false
IRS990ScheduleR/RentalOfFcltsFromOthOrgInd0false
IRS990ScheduleR/SharingOfFacilitiesInd0true
IRS990ScheduleR/TransferFromOtherOrgInd0false
IRS990ScheduleR/TransferToOtherOrgInd0false
IRS990/SchoolOperatingInd0false
IRS990/SignificantChangeInd0false
IRS990/SignificantNewProgramSrvcInd0false
IRS990/StatesWhereCopyOfReturnIsFldCd0PA
IRS990/SubjectToExcsTaxNetInvstIncInd0false
IRS990/SubjectToProxyTaxInd0false
IRS990/SubjToTaxRmnrtnExPrchtPymtInd0false
IRS990/TaxablePartyNotificationInd0false
IRS990/TaxExemptBondLiabilitiesGrp/BOYAmt00
IRS990/TaxExemptBondLiabilitiesGrp/EOYAmt00
IRS990/TaxExemptBondsInd0false
IRS990/TerminateOperationsInd0false
IRS990/TotalAssetsBOYAmt01047145
IRS990/TotalAssetsEOYAmt01016609
IRS990/TotalAssetsGrp/BOYAmt01047145
IRS990/TotalAssetsGrp/EOYAmt01016609
IRS990/TotalCompGreaterThan150KInd0true
IRS990/TotalContributionsAmt00
IRS990/TotalEmployeeCnt00
IRS990/TotalFunctionalExpensesGrp/TotalAmt01342639
IRS990/TotalGrossUBIAmt00
IRS990/TotalLiabilitiesBOYAmt00
IRS990/TotalLiabilitiesEOYAmt00
IRS990/TotalLiabilitiesGrp/BOYAmt00
IRS990/TotalLiabilitiesGrp/EOYAmt00
IRS990/TotalNetAssetsFundBalanceGrp/BOYAmt01047145
IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt01016609
IRS990/TotalOtherCompensationAmt0147471
IRS990/TotalProgramServiceRevenueAmt01309739
IRS990/TotalReportableCompFromOrgAmt00
IRS990/TotalRevenueGrp/ExclusionAmt02364
IRS990/TotalRevenueGrp/RelatedOrExemptFuncIncomeAmt01309739
IRS990/TotalRevenueGrp/TotalRevenueColumnAmt01312103
IRS990/TotLiabNetAssetsFundBalanceGrp/BOYAmt01047145
IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt01016609
IRS990/TotReportableCompRltdOrgAmt01434453
IRS990/TravelGrp/TotalAmt00
IRS990/TypeOfOrganizationTrustInd0X
IRS990/UnrelatedBusIncmOverLimitInd0false
IRS990/UnsecuredNotesLoansPayableGrp/BOYAmt00
IRS990/UnsecuredNotesLoansPayableGrp/EOYAmt00
IRS990/UponRequestInd0X
IRS990/USAddress/AddressLine1Txt0PO BOX 447
IRS990/USAddress/CityNm0DUBOIS
IRS990/USAddress/StateAbbreviationCd0PA
IRS990/USAddress/ZIPCd015801
IRS990/VotingMembersGoverningBodyCnt02
IRS990/VotingMembersIndependentCnt00
IRS990/WebsiteAddressTxt0N/A
IRS990/WhistleblowerPolicyInd0false
ReturnHeader/BuildTS02023-04-26 12:10:37Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd0true
ReturnHeader/BusinessOfficerGrp/PersonNm0JOHN S SUTIKA
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0TRUSTEE
ReturnHeader/BusinessOfficerGrp/PhoneNum08143756392
ReturnHeader/BusinessOfficerGrp/SignatureDt02023-01-15
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0DUBOIS REGIONAL MEDICAL CENTER EMPLOYEE
ReturnHeader/Filer/BusinessName/BusinessNameLine2Txt0BENEFIT PLAN TRUST
ReturnHeader/Filer/BusinessNameControlTxt0DUBO
ReturnHeader/Filer/EIN0256332829
ReturnHeader/Filer/InCareOfNm0% JOHN S SUTIKA
ReturnHeader/Filer/PhoneNum08143756377
ReturnHeader/Filer/USAddress/AddressLine1Txt0PO BOX 447
ReturnHeader/Filer/USAddress/CityNm0DUBOIS
ReturnHeader/Filer/USAddress/StateAbbreviationCd0PA
ReturnHeader/Filer/USAddress/ZIPCd015801
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0FORVIS LLP
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt0910 E ST LOUIS 200/PO BOX 1190
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0SPRINGFIELD
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0MO
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd0658062523
ReturnHeader/PreparerPersonGrp/PhoneNum04178658701
ReturnHeader/PreparerPersonGrp/PreparerPersonNm0Brian D Todd
ReturnHeader/ReturnTs02023-03-07T16:01:09-06:00
ReturnHeader/ReturnTypeCd0990
ReturnHeader/SigningOfficerGrp/PersonFullName/PersonFirstNm0JOHN S
ReturnHeader/SigningOfficerGrp/PersonFullName/PersonLastNm0SUTIKA
ReturnHeader/TaxPeriodBeginDt02020-07-01
ReturnHeader/TaxPeriodEndDt02021-06-30
ReturnHeader/TaxYr02020

Document Assets

No mirrored PDF or thumbnail assets are attached yet.

Filings

Displayed year

2021 • Form 990Detailed filing. Detailed filing data is available for this year.

Open filing
Assets
$1,016,609
Liabilities
$0
Net assets
$1,016,609
Revenue
$1,312,103
Expenses
$1,342,639
Net income
-$30,536
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2023Facts available. Structured filing facts are available, but richer extracted sections are limited.$0.71$0.00$0.71$0.56$0.76$0.20
2022Facts available. Structured filing facts are available, but richer extracted sections are limited.$0.91$0.00$0.91$0.84$0.94$0.10
2021Detailed filing. Detailed filing data is available for this year.$1.02$0.00$1.02$1.31$1.34$0.03