The Pennsylvania State University Right-to-Know Law Report

May 20,2011

This Report is filed in accordance with the provisions of Chapter 15 of the Right-to-Know Law for the Fiscal Year commencing July 1, 2009 and ending June 30, 2010. This Report includes the following information as required by the Right-to-Know Law: 1. Section 1 -- Information required by Form 990 or an equivalent form, of the United States

Department of the Treasury, Internal Revenue Service, entitled the Return of Organization Exempt From Income Tax, regardless of whether the State-related institution is required to file the form by the Federal Government. 2. Section 2 - The salaries of all officers and directors of the State-related 3. Section 3 -- The highest 25 salaries paid to employees of the institution under Section 2. institution. that are not included

Section 1:
All information required by Form 990 or an equivalent form, of the United States Department of the Treasury, Internal Revenue Service, entitled the Return of Organization Exempt From Income Tax, regardless of whether the State-related institution is required to file the form by the Federal Government.

2

Form

990

OMB No. 1545-0047

Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue benefit trust or private foundation) Code (except black lung

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. Open to Public Inspection
~~~~ ___

Department of the Treasury Internal Revenue Service

B Check if applicable:
D D D D D D Address change

:~:~~~~~~~~~~~~~~~~~~~~~~~~~L--------------i
labelor~ __ ~ .~~~~~

Name change Initial return Terminated Amended return

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type. Specific Instructions. F ~~~~~~~~~~~~~~~~~~~~~~------------~H~) H(a)
See

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Application pending

Is this a group returnfor affiliates?DYes Am~laffU~~sinduded? DYes

______________

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2 3 4 5 6 7a b

Check this box ~

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if the organization discontinued its operations or disposed of more than 25% of its net assets.

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Number of voting members of the governing body (Part VI, line 1a) . Number of independent voting members of the governing body (Part VI, line 1b) Total number of employees (Part V, line 2a). Total number of volunteers (estimate if necessary) Total gross unrelated business revenue from Part VIII, column (C), line 12. Net unrelated business taxable income from Form 990- T line 34

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8 Contributions and grants (Part VIII, line 1h) . 9 Program service revenue (Part VIII, line 2g) . 10 Investment income (Part VIII, column (A), lines 3, 4, and 7d) 11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 1Oc, and 11e) 12 Total revenue-add lines 8 th h 11 ust I Part VIII, column line 12 13 14 15 16a b Grants and similar amounts paid (Part IX, column (A), lines 1-3) . Benefits paid to or for members (Part IX, column (A), line 4) . Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10) Professional fundraising fees (Part IX, column (A), line 11e) . Total fundraising expenses (Part IX, column (D), line 25) ~

VI

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c:

_

17 Other expenses (Part IX, column (A), lines 11a-11 d, 11f-24f) . 18 Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25). 19 Revenue less . Subtract line 18 from line 12

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

~

Signature

of officer

Date

Type or print name and title Date Check if self employed Preparer's identifying number (see instructions) ~ D

Paid

For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.

Cat. No. 11282Y

Form

990

(2009)

3

Form 990 (2009)

Page

2

is

_P_~~_I?!f! ~~!!I1_~Y!Y_~1~_,_!~_~ _~_f_ 1J _ fl~_~~I1"_~!!~_ ~~_~ _~C?!!~_ ~~~~_l~9_~~t~_i!!!E!~~~!~_~,_t!!:!?_~~! _ _'!!~~:>~~11_~_~ ~i_f;!~_-_q~~!~tx t~~~~ _ ~!lJl! _~E!~E!?_~C:~ c?~~~E!~_C:~_' ~ 11Y_E!~~_i!y_ ~_fl_~fl~_t!_l!~~I"_1_t.<l.IJ!¥_~ ~~E! ~~_I"!1_I!!?_fl~~_~~~~ ~E!!l_11~¥!Y.<l.i}!~_· J ~ _
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.

_ _

0

Yes

GZl

No

3

4

Did the organization cease conducting, or make significant changes in how it conducts, any program services? . . . . . DYes No If "Yes," describe these changes on Schedule O. Describe the exempt purpose achievements for each of the organization's three largest program services by expenses. Section 501(c)(3) and 501 (c)(4) organizations and section 4947(a)(1) trusts 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

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all.

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(Expenses $

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) (Revenue $ ~~~?f_·gs_Q~5!J _1!9J!1_9_ 9..l!?J 1W_9_f_!If_~ r9_l!9. Iy .!IJ.! P"~9X~~ _1}~_,!l_t_l:!,_th?_p_~9f~_~~j~!)~I _t_~ _
grants of $

----------------------------------------------------------------------------------------------------------------_---------------------------------

4c

) (Revenue $ ?~~~_~~_Q~~_) _R.~?_~?!.~b_:_p_~ 11_1} _?_t_<!t~~~_r~~~~~~h _~ i_~~j~1J _ll?_!9 _9!_~9t~I'!~yy_ rI~~I~<:I.fl~_t1_'!! i!!1J?!'~Y~_l?i_I}~i_~i_g ~!ljy_~~__J!! lY~!_~ __ K ! _ _ ~ _ ~l tt,y
(Code: ) (Expenses $ grants of $

?~~~_~~~~~. including

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_ _

4d Other program services. (Describe in Schedule 0.) (Expenses $ 124674896 including grants of $ 4e Total program service expenses ~ 2953615896

) (Revenue $

555114000 )
Form

990

(2009)

4

1 2 3 4 5 6

Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule A . . . . . . . . . . . . . . . . . . . Is the organization required to complete Schedule B, Schedule of Contributors? . . . Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition candidates for public office? If "Yes, " complete Schedule C, Part I . . . . . Section 501 (c)(3) organizations. Schedule C, Part II . . . .. Did the organization ..... engage in lobbying to

activities? If "Yes," complete . . . . . .

Section 501 (c)(4) , 501 (c)(5), and 501 (c)(6) organizations. Is the organization subject to the section 6033(e) notice and reporting requirement and proxy tax? If "Yes," complete Schedule C, Part III . Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part I . . . . . . . . . . Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part II Did the organization maintain collections complete Schedule D, Part III . of works of art, historical treasures, or other similar assets? If "Yes," . . . . .

7 8 9

10 11 • • • • • •

Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IV . . . . . . . . f--"9=----+_-+-,-_ Did the organization, directly or through a related organization, hold assets in term, permanent, or quasi-endowments? If "Yes," complete Schedule D, Part V. . . .. I---'-~I---'---l-Is the organization's answer to any of the following VII, VIII, IX, or X as applicable questions "Yes"? If so, complete Schedule D, Parts VI, . . . . . . . . .

Did the organization report an amount for land, buildings, and equipment in Part X, line 1O?If "Yes," complete Schedule D, Part VI. Did the organization report an amount for investments-other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VII. Did the organization report an amount for investments-program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIII. Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IX. Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part X. 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? If "Yes," complete Schedule D, Part X. Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete Schedule D, Parts XI, XII, and XIII.

12

12A Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," completing Schedule D, Parts XI, XII, and XIII is optional.. . . . . .. .... 13 14a Is the organization a school described in section 170(b)(1)(A)(ii)?If "Yes," complete Schedule E Did the organization maintain an office, employees, or agents outside of the United States?
r-'-'""'--I---'---l--

b Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If "Yes," complete Schedule F, Part I. . . 15 16 17 18 19 Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the United States? If "Yes," complete Schedule F, Part II. . . . .

1---'-""-11----1--'--

Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the United States? If "Yes, " complete Schedule F, Part 11/. . . . . . . 1---'-""-11---'---1-Did the organization report a total of more than $15,000 of expenses for professional fund raising services on Part IX, column (A), lines 6 and 11 e? If "Yes," complete Schedule G, Part I . . . . . . . . . . 1---'---1_--+_1,--Did the organization report more than $15,000 total of fund raising event gross income Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II. . . . . . . Did the organization report more than $15,000 of gross income from gaming activities If "Yes," complete Schedule G, Part III. . . . . . . . . . . . . . . . and contributions on . . . . . . . . 1---'-""-1--'---+-on Part VIII, line 9a? . . . . . . . . 1---'-""-1_--+_1,--Form

990

(2009)

5

Yes

No

21

Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If "Yes, " complete Schedule I, Parts I and II. . Did the organization report more than $5,000 of grants and other assistance to individuals United States on Part IX, column (A), line 2? If "Yes," complete Schedule I, Parts I and 11/ in the

r--=2__:_1-+-_-+-_

22 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 . . . . . . . . . . . . . . . . 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 25. . . . . . . . . . . . . . . r-=-=--t--'--+--;:Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception? .
r=-=-t---t---'-

24a

b 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? . . . . . . . . . . . .. ..... d Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year? 25a Section 501 (c)(3) and 501 (c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I . . . . . . . . . b

r:2=.:5::.:a=-t-_-t__

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. . . . . . . . . . . .. .... r2=5:..:.:b'-t-_+-_ Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization's tax year? If "Yes," complete Schedule L, Part" . . r--='-=-I----1I--Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If "Yes," complete Schedule L, Part 11/. . . . . . . . . . . . . . . . . . . . . . . . Was the organization a party to a business transaction with one of the following Part IV instructions for applicable filing thresholds, conditions, and exceptions): parties (see Schedule L, . r=-==-il--l--'-. F:.=-t-'--l---

26 27

28 a b c

A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV . A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV. . . . . . . . . . . . . . . . . . . . . . . . . . . . .

An entity of which a current or former officer, director, trustee, or key employee of the organization (or a family member) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV . . . . .. F=-=-t---::-l---'-Did the organization receive more than $25,000 in non-cash contributions? If "Yes, " complete Schedule M Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M . . . . . . . . . . . . . . . . I---"_;;_j---'-I--Did the organization Part I. . . . . liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, . . . . . . . . . . . . . . . . . . . . . . . . . . . 1---"--'-+--+---'-32 33 34 35 36

29
30 31

32
33 34 35 36 37

Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II .. . 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. . . . . . . . . . . Was the organization related to any tax-exempt or taxable entity? If "Yes," complete 11/, IV, and V, line 1 . . . . . . . . . . . . . . . . . . . Schedule R, Parts II,

.f .f

.

.

.

.

.

.

.

.

Is any related organization a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2. . . . . . . . . . . . . . . . . ., . 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. . . . . . . . . . . . . . . . . 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 VI Did the organization complete Schedule 0 and provide explanations in Schedule 0 for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule 0.. . . . . . . . . . . . . .

37 38
Form

38

990

(2009)

6

Form 990 (2009)

Page

5

1a b c

Enter the number reported in Box 3 of Form t 096, Annual Summary and Transmittal U.S. Information Returns. Enter -0- if not applicable . . . . . . . . Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable

of

Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? . .. .

za

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 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-fi/e this return. (see instructions) 3a Did the organization have unrelated business gross income of $1,000 or more during the year covered by this return? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b If "Yes," has it filed a Form 990-T for this year? If "No," provide an explanation in Schedule O. . .

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)? .. . . . . b If "Yes," enter the name of the foreign country: ~ _ _ See the instructions for exceptions and Financial Accounts. 5a b c 6a b 7 a b c d e f g h 8 Was the organization and filing requirements for Form TO F 90-22.1, Report of Foreign Bank at any time during the tax year? . .
f----='-=-j---j---:--

a party to a prohibited

tax shelter transaction

Did any taxable party notify the organization

that it was or is a party to a prohibited

tax shelter transaction?

f----=-=--t--f---'--

If "Yes" to line 5a or 5b, did the organization file Form 8886-T, Disclosure by Tax-Exempt Entity Regarding Prohibited Tax Shelter Transaction? . . . . . . . .. f----=-=-t--I--,-Does the organization have annual gross receipts that are normally greater than $100,000, and did the W!~I--W~ organization solicit any contributions that were not tax deductible? . . If "Yes," did the organization include with every solicitation gifts were not tax deductible? . . . . . . . . . Organizations that may receive deductible contributions an express statement that such contributions . . . . . . . . . under section 170(c). or

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? . . . . . . . . . . . . . . . . . . . If "Yes," did the organization notify the donor of the value of the goods or services provided? personal property . Did the organization sell, exchange, or otherwise dispose of tangible required to file Form 8282? . . . . . . . . . If "Yes," indicate the number of Forms 8282 filed during the year for which it was

Did the organization, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? . . . . . . . . . . . . . . . . . . . . . . . . Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? For all contributions of qualified intellectual property, did the organization file Form 8899 as required? . For contributions of cars, boats, airplanes, and other vehicles, did the organization file a Form 1098-C as required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year? . . . . . Sponsoring organizations maintaining donor advised funds. Did the organization make any taxable distributions under section 4966? . . . .

9 a b 10 a b 11 a

Did the organization make a distribution to a donor, donor advisor, or related person? Section 501 (c)(7) organizations. Enter: Initiation fees and capital contributions included on Part VIII, line 12. . . . . . Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities Section 501 (c)(12) organizations. Enter: Gross income from members or shareholders . . . . . . . .. ....

b Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.). . . . . . . 12a Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in b If "Yes," enter the amount of interest received or accrued d the
Form

990

(2009)

7

Form 990 (2009)

Page

6

IdUI

Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to line se, 8b, or 1Gb below, describe the circumstances, processes, or changes in Schedule O. See instructions.

1 a Enter the number of voting members of the governing body b Enter the number of voting members that are independent 2 3 4 5 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? . . . . . . . . . . . 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? . Did the organization make any significant changes to its organizational documents since the prior Form 990 was filed? Did the organization become aware during the year of a material diversion of the organization's assets? have members or stockholders? . . . . . . . . . . . . . . have members, stockholders, or other persons who may elect one or more members

6 Does the organization 7a Does the organization

of the governing body? . . . . . . . . . . . . . . . . . . . . b Are any decisions of the governing body subject to approval by members, stockholders, or other persons? . . 8 Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following: a The governing body? . . . . . . . b Each committee with authority to act on behalf of the governing body? 9 Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the anization's m address? If "Yes," the names and addresses in Schedule 0 .

I

Section Revenue

icies (This Section B requests information about policies not required by the Internal

10a Does the organization have local chapters, branches, or affiliates? . . . .. . b If "Yes," does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? . . . 11 Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form? . . . . 11A Describe in Schedule 0 the process, if any, used by the organization to review this Form 990. 12a Does the organization have a written conflict of interest policy? If "No," go to line 13 . b Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? . c Does the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule 0 how this is done 13 Does the organization have a written whistleblower policy? 14 Does the organization have a written document retention and destruction policy? . . . . . 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 b Other officers or key employees of the organization . . . . . If "Yes" to line 15a or 15b, describe the process in Schedule O. (See instructions.) 16a Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? . . . . . . . . . . . . . . . . . . . b If "Yes," has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the ization's exem status with to such

1--'-'=-=-f------'-----1i----

Section C. Disclosure
17 18 List the states with which a copy of this Form 990 is required to be filed ~ Section 6104 requires an organization available for public inspection.

.~~_I!~_~yJy_~~_i~
990, and 990- T (501 (c)(3)s only)

_

to make its Forms 1023 (or 1024 if applicable),

Indicate how you make these available. Check all that apply. makes its governing documents, conflict of interest

!ZI
19 20

Own website D Another's website !ZI Upon request Describe in Schedule 0 whether (and if so, how), the organization available to the public. number of the address, and telephone

policy, and financial statements State the name, organization: ~

possesses the books and records of the

1
Form

990

(2009)

8

Form 990 (2009)

IUMf4!I
Section A.

Page

7

Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees for the calendar year ending with or within the regardless of amount

1a Complete this table for all persons required to be listed. Report compensation organization's tax year. Use Schedule J-2 if additional space is needed.

• List all of the organization's current officers, directors, trustees (whether individuals or organizations), of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid. • List all of the organization's current key employees. See instructions for definition of "key employee."

• List the organization's five current highest compensated employees (other than an officer, director, trustee, or key employee) who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the organization and any related organizations. • List all of the organization's former officers, key employees, and highest compensated $100,000 of reportable compensation from the organization and any related organizations. • List all of the organization's former directors or trustees the organization, more than $10,000 of reportable compensation List persons in the following order: individual trustees compensated employees; and former such persons. Check this box if the organization did not compensate
(A) Name and Title (8) Average hours per week Position
0::l _, 0. ::l ~

employees who received more than

that received, in the capacity as a former director or trustee of from the organization and any related organizations. institutional trustees; officers; key employees; highest

or directors;

o

any current officer, director, or trustee.
(C) (check all that apply) 0
~

(0) Reportable corrpensation from the organization ryv-211099-MlSC)

(E) Reportable compensation from related organizations ryv-2/1099-MISC)

(F) Estimated amount of other compensation from the organization and related organizations

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Edward Yr-us-tee- Rendell -- ---------------- -- ----------- -- -----------

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Trustee

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Trustee Thomas-- -Gluck -- - - - - - - -- - - - - - - - - - - - - - - - - -- - - - - -- -- - - - - - - -- - - - - ---Trustee Dennis Wolff Trustee

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Trustee Alvin Clemens -------------------------------------------------------Trustee Michael DiBerardinis Trustee Ira Lubert Trustee

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Trustee Marianne Alexander

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Trustee Jesse Arnelle Trustee Steve Garban Trustee

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Trustee David Jones Trustee

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Trustee

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Form

990

(2009)

9

Form 990 (2009)

Page

8

lII::.F.T1lill'AII

Section A. Officers, Directors,
(A) Name and title

Trustees, Key Employees, and Highest Compensated
(6) Average hours per week Position (C) (check all that apply) (D) Reportable corrpensation from the organization 0N-211099-MISC)

Employees (continued)
(E) Reportable compensation from related organizations 0N-2/1099-MISC) (F) Estimated amount of other compensation from the organization and related organizations

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(1)

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--._PaulSuhey -'rr-ustee ---------------------------------------------Keith Eckel

-Trui;tee ---------------------------------------------Barron Hetherington -Triisiee ----------------------------------------------

Samuel Hayes, Jr.

Keith Masser Tr-ustee- --------------------------------------------Carl Shaffer

I

I

-t-r-ustee---------------------------------------------Kenneth Frazier Trustee Edward Hintz, Jr. Edward Junker Trustee 1b Total. 2 Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organization ~ 2158

Trustee James Broadhurst

-t-r-uslee---------------------------------------------III

3 4

Did the organization list any former officer, director or trustee, key employee, employee on line 1a? If "Yes," complete Schedule J for such individual

or highest compensated

5

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. Did any person listed on line 1a receive or accrue compensation from any unrelated organization for services rendered to the ization? If Schedule J for such Complete this table for your five highest compensated compensation from the organization.
(A) Name and business address

1

independent

contractors

that received more than $100,000 of
(8) of services (e) Compensation

Description

Form

990

(2009)

10

Page

9

(A) Total revenue

(C) Unrelated business

c Fundraising events d Related organizations

e
f

Government grants (contributions).
_ _:"':' '::::'':' ' :' '::':::'' :__::_

All othercontributions, ifts, grants, g and similaramountsnot includedabove L....:.1_:_f----' 9 Noncash contributions includedinlines1a-1f: $ h Total. Add lines 1a-1f

2a b c

_~~_i~~?_rl_':l!:~_ ~~~ ! _~!_~I1_t <?~':I~:~_~~~
Medical Center etc.
w w w ~ ~ _ ~

.__ _ .
.... __...
~ _

e

.~~.I~~. ~_E!~_l!~_~!i.<?~~~ __. f All other program service revenue Total. Add lines 2a-2f

_..

3
4

5

Investment income (including dividends, interest, and other similar amounts) ~ Income from investment of tax-exempt bond proceeds Royalties.

6a Gross Rents b Less: rental expenses c Rental income or (loss) d Net rental income or 7a Gross amount fromsales of assetsotherthaninventory b Less: cost or other basis and sales expenses c Gain or (loss) d Net gain or (loss)

8a Gross

...
~
Q)

income from fundraising events (not including $ ... 7.$~J?4.Q4_ of contributions reported on line 1c). See Part IV, line 18 .

o

b Less: direct expenses c Net income or (loss) from fundraising 9a Gross income from gaming activities. See Part IV, line 19 . b Less: direct expenses. c Net income or (loss) from gaming "''''1\1111'''.'' Gross sales of inventory, returns and allowances . Less: cost of sold

r------

All other revenue

.

Total. Add lines 11a-11d . . Total revenue. See instructions.
Form

990

(2009)

11

Form 990 (2009)

Page

10

151f3

Statement of Functional Expenses
Section 501(c)(3) and 501(c){4) organizations must complete all columns. anizations must com ete column but are not required to complete columns
Total

All other

(B), (e), and (D).
and Fundraising

Do not include amounts reported on lines 6b, and 10b of Part VIII. 1 2 3 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21 Grants and other assistance to individuals in the U.S. See Part IV, line 22 . . . . . Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16 Benefits paid to or for members. . . . Compensation of current officers, directors, trustees, and key employees. . . Compensation not included above, to disqualified persons (as defined under section 4958(fj(1)) and persons described in section 4958(c)(3)(B) . Other salaries and wages . . . . . . Pension plan contributions (include section 401(k) and section 403(b) employer contributions) . Other employee benefits Payroll taxes . . . . Fees for services (non-employees): a Management b c d e f 12 13 14 15 16 17 18 19 20 21 22 23 24 Legal. . Accounting . Lobbying Professional fundraising services.SeePartIV,line 17 Investment management fees

w expenses

~ Program service

~ Management

~

124157047

16856141

4 5 6

3466851

1197142

1600978

668731

7 8 9 10 11

9 Other. . . . . . . . Advertising and promotion. Office expenses . . Information technology Royalties Occupancy. Travel .

Payments of travel or entertainment expenses for any federal, state, or local public officials Conferences, conventions, and meetings Interest . . . . .. Payments to affiliates Depreciation, depletion, Insurance .... . . . . and amortization.

Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)

a ~?_~p}!~_I_~p.~~_~~_~ ~ b ~~_i~~~~<:t~~~

_
_
_

c

R~~~!~_~_I:Ip.I?H~~____!!?~~_~i~l _ ,

d f_<?~~_ ~l!P'p_l!~~ e ~_~~_<?~~_t_'?!Y_ ':Ip'p_I!~~ ~
f

_
_

25 26

All other expenses _ Total functional Add lines 1 24f Joint costs. Check here ~ if following SOP 98-2. Complete this line only if the organization reported in column (8) joint costs from a combined educational campaign and fundraisi solicitation
Form

990

(2009)

12

Page

11

(A) Beginning of year

(8) End of year

1 2 3 4 5

Cash-non-interest-bearing . . . . Savings and temporary cash investments Pledges and grants receivable, net. . Accounts receivable, net

. .

Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part" of Schedule L . . Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(8). Complete Part" of Schedule L. . . Notes and loans receivable, net Inventories for sale or use . Prepaid expenses and deferred charges Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D Less: accumulated Investments-publicly Investments-other depreciation .

6

7 8
9 10a b 11 12 13 14 15 16 17 18 19 20 21 22

1-1.:_:0,,_,a"-l-

_

L!!10Q!bttl_

-I-__ ~~~@l~-!.1~-l- __

__l:~~~~

traded securities securities. See Part IV, line 11

Investments-program-related. See Part IV, line 11 Intangible assets . Other assets. See Part IV, line 11 Total assets. Add lines 1 th h 15 Accounts payable and accrued expenses. Grants payable Deferred revenue . Tax-exempt bond liabilities Escrow or custodial account liability. Complete

.!l:!

III

Part IV of Schedule D

:=
:.:::i

ii
III

Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified persons. Complete Part" of Schedule L. . Secured mortgages and notes payable to unrelated third parties Unsecured notes and loans payable to unrelated third parties Other liabilities. Complete Part X of Schedule D Total liabilities. Add lines 17 h 25. . . . . . . Organizations that follow SFAS 117, check here ~ complete lines 27 through 29, and lines 33 and 34.

23 24 25 26
III

I2l and

o
r:::

CI)

16

III

27 28 29

III
:::l

u..

-g ... o

Unrestricted net assets. . . . Temporarily restricted net assets. . . . Permanently restricted net assets Organizations that do not follow SFAS 117, check here ~ and complete lines 30 through 34 .

0

«
Z

'::l *

30 31 32 33 34

"iii

Capital stock or trust principal, or current funds . . . . . Paid-in or capital surplus, or land, building, or equipment fund Retained earnings, endowment, accumulated income, or other funds Total net assets or fund balances liabilities and net assets/fund balances
Form

990

(2009)

13

Form 990 (2009)

Page

12

1

Accounting

method used to prepare the Form 990: changed its method of accounting financial statements compiled

D

Cash

I2l Accrual

D

Other

If the organization

from a prior year or checked "Other," explain in or reviewed by an independent accountant? .

Schedule O. 2a Were the organization's

b Were the organization's financial statements audited by an independent accountant? ..... 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? . . If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O. d If "Yes" to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a consolidated basis, separate basis, or both:

D Separate basis I2l Consolidated basis D Both consolidated and separate basis 3a As a result of a federal award, was the organization required to undergo an audit or audits as the Single Audit Act and OMB Circular A-133? . . . b If "Yes," did the organization undergo the required audit or audits? If the organization did not in Schedule 0 and describe taken to u

set forth in . . . . undergo the such audits.
Form

990

(2009)

14

SCHEDULE A (Form 990 or 9OO-El)
Department of the Treasury Internal Revenue Service Name of the organization

Public Charity Status and Public Support
Complete if the organization is a section 501 (c)(3) organization 4947(a)(1) nonexempt charitable trust. ~ See separate or a section ~ Attach to Form 990 or Form 990-EZ. instructions.
Employer

OMB No. 1545-0047

~@09
Open to Public Inspection
identification

number

6000376 The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.) 1 0 A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i). 2 0 A school described in section 170(b}(1)(A)(ii). (Attach Schedule E.) 3 0 A hospital or a cooperative hospital service organization described in section 170(b){1)(A)(iii). 4 0 A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state: . _ 5

0 III

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b}(1)(A)(iv). (Complete Part 11.) A federal, state, or local government or governmental unit described in section 170(b)(1}(A)(v). An organization that normally receives a SUbstantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part 11.) A community trust described in section 170(b)(1)(A)(vi}. (Complete Part II.) An organization that normally receives: (1) more than 33% % of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions-subject to certain exceptions, and (2) no more than 33fh % of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part 111.) An organization organized and operated exclusively to test for public safety. See section 509(a)(4). An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

6
7 8 9

0
0 0

10 11

0 0

e

0

a 0 Type I b D Type II c 0 Type III-Functionally integrated d 0 Type III-Qther By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2),
If the organization received a written determination from the IRS that it is a Type I, Type II, or Type iii supporting organization, check this box Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons? (i) A person who directly or indirectly controls, either alone or together with persons described in (ii) and (iii) below, the governing body of the supported organization? (ii) A family member of a person described in (i) above? . . . . .
Yes

f 9

0
No

11am
11g~ij 11gfriij
(vii) Amount of support

(iii) A 35% controlled entity of a person described in (i) or (ii) above?
h Provide the information about the
(iI) EIN (iiQ Type of organization (described on lines 1-9 above or IRC section (see instructions)) (i) Name of supported organization

OV) Is the organization in col. P) listed In your governing document?

Total
For Privacy Act and Paperwork Form 990 or 990-EZ.
Reduction Act Notice, see the Instructions for Cat. No. 11285F Schedule A (Form 990 or 990-EZ) 2009

15

Schedule A (Form 990 or 990-EZ) 2009

Page

'UMIII

2

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and liO(b)(1)(A)(vi) checked the box on line or 8 of Part

Gifts, grants, contributions, and membershipfees received. (Do not include any "unusual grants.") 2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf The value of services or facilities furnished by a governmental unit to the organization without charge Total. Add lines 1 through 3 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) • line5

3

4 5

Calendar year (or fiscal year beginning in) ~ 7 8 Amounts from line 4 . Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources . Net income from unrelated business activities, whether or not the business is regularly carried on Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) Total support Add lines 7 through 10 . Gross receipts from related activities, etc. (see instructions) First ~Iv~ years. If th~ 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 . • . • . . . . . . . • . . . • . . • . . . . . • ~

9

10

11 12 13

0

Section C. Com utation of Public Su
14

ort Percenta e
%

Public support percentage for 2009 (line 6, column (1) divided by line 11, column (1)

15 Public support percentage from 2008 Schedule A, Part II, line 14 % 16a 33% % support test-2009. If the organization did not check the box on line 13, and line. 14 is 33% % or more, check this box and stop here. The organization qualifies as a publicly supported organization .~ 0 b 33% % support test-2008.lf the organization did not check a box on line 13 or 16a, and line 15 is 33'/3% or more, check this box and stop here. The organization qualifies as a publicly supported organization . .~

0 0
D

17a 10%-facts-and-circumstances test-2oo9.lf the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization. . .~ b 10%-facts-and-circumstances test-2008. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part IV how the organizationmeets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization . . . • .~ Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see instructions ~
Schedule

18

0

A (Fonn 990 or 990-EZ) 2009

16

Schedule A (Form 990 or 990-EZ) 2009

Page

:3

IUMIII;

Support Scheduie for Organizations Described in Section 509(a)(2) checked the box on line 9 of Part I

1

2

Gifts, grants, contributions, and men;bershipfees rec,~ived.(Do not include any unusualgrants.) • • • . . . Grossreceiptsfromadmissions, erchandise m sold or services performed,· or facilities furnishedin any activitythat is relatedto the organization's tax-exemptpurpose. • . Grossreceiptsfrom activitiesthat are not an unrelated tradeor business undersection513 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf ...• . • . . . The value of services or facilities furnished by a governmental unit to the organization without charge Total. Add lines 1 through 5

3 4

5

6

7a Amounts included on lines 1, 2, and 3 received from disqualified persons b Amountsincludedon lines2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year

c Add lines 7a and 7b .
8

• • . . • Public support (Subtract line 7c from line
in) ...

Calendar year (or fiscal year begirining

9 Amounts from line 6 • . . . . . 10a Gross income from interest,dividends, payments received on securities loans, rents, royalties and income from similar sources • • . . • . . . . . b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975 Add lines 10a and 10b • . . . . Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on . . • . . • . . . Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) • . . . • . Total support. (Add lines 9, 1Dc, 11, and 12.) • . • • . . . . . . First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ••••.•.••...•.••.

c 11

12

13 14

D

Section C. Computation
15 16

of Public Support Percenta

e
% %

Public support percentage for 2009 (line 8, column (f) divided by line 13, column (f)) Public su port percentage from 2008 Schedule A, Part III, line 15 . . . . • .

Section D. Computation

of Investment

Income Percenta

e

% 17 Investment income percentage for 2009 (line 10c, column (f) divided by line 13, column (f)) • % 18 Investment income percentage from 2008 Schedule A, Part III, line 17. • . • • . . • 19a 33% % support tests-2009. If the organization did not check the box on line 14, and line 15 is more than 33'/3%, and line 17 is not more than 33% %, check this box and stop here. The organization qualifies as a publicly supported organization ~ D b 20 33% % support tests-2008. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33'/3%, and line 18 is not more than 33Ya check this box and stop here. The organization qualifies as a publicly supported organization %, Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
Schedule

D
D

A (Form 990 or 99O-EZ) 2009

17

liMlN

Schedule A (Form 990 or 990-EZ) 2009

Page

4

supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Provide any other additional information. See instructions.

_

w

w

-

-

_

-

-

-----

-

_

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

--

-

-

-

-

-

-

-

--

--

-"_

-

--

-

-

-

-

-

-

-

-

-

-

--

-

-

--

-

-

-

-

-

-

-

-

--

--

Schedule A (Form 990 or 990-EZ) 2009

18

SCHEDULE (Form 990)

0

OMB No. 1545-0047

Supplementai Financiai Statements
~ Complete if the organization answered "Yes," to Form 990, Part IV, line 6,7,8,9,10,11, or 12. ~ Attach to Form 990. ~ See separate instructions.

~@09
Open to Public Inspection
Employer identification number

Department of the Treasury Internal Revenue Service Name of the organization

The Pennsylvania State University

24 Donor ,'Y es" to Advised Funds or Other Similar Form 990, Part IV, line 6.
(0) Donor advised funds

:

6000376 Complete if

.. t he organization
1

Organizations

Maintaining answere d

Funds

or Accounts.

(b) Funds and other accounts

2 3
4 5 6

Total number at end of year Aggregate contributions to (during year) Aggregate grants from (duringyear) Aggregate value at end of year Did the organization inform ali 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? • . .. 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 ,v"nf".,,;,v, . private benefit?

0 Yes 0 No
No

1

D D D
2

Purpose(s) of conservation easements held by the organization (check all that apply). Preservation of land for public use (e.g., recreation or pleasure) D Preservation of an historically important land area Protection of natural habitat D Preservation of a certified historic structure Preservation of open space 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.

a b c d 3 4 5 6 7 8 9

Total number of conservation easements. Total acreage restricted by conservation easements . . . . . . . . . Number of conservation easements on a certified historic structure included in (a) Number of conservation easements included in (c) acquired after 8/17/06. . Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the tax year.. ._ . Number of states where property subject to conservation easement is located ~ _.. _ . Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? . . . . . . . . . . . DYes Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year

0 No

~
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
~$

Does each conservation easement reported on line 2(d} above satisfy the requirements of section 170(h)(4)(8)(i) and section 170(h)(4)(8)(ii)? . . . . . . . . . . . . . . . . . . .

DYes

0 No

In Part XIV, 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. Organizations Maintaining Complete if the organization Collections of Art, Historical Treasures, or Other Similar answered "Yes" to Form 990, Part IV, line 8. Assets.

lumilil

1a If the organization elected, as permitted under SFAS 116, 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 XIV. the text of the footnote to its financial statements that describes these items. b If the organization elected, as permitted under SFAS 116, historical treasures. or other similar assets held for public provide the following amounts relating to these items: (I) Revenues included in Form 990, Part VIII, line 1 . . (iij Assets included in Form 990, Part X . . . . . . to report in its revenue statement and balance sheet works of art. exhibition, education, or research in furtherance of public service, . . . . . . . . . . . . . . . . . . . . . . . . ~ . ~ $ $.

_.~.~?!1~
_

~~~Q4~?.f!

2

If the organization following amounts a Revenues included b Assets included in

received or held works of art. historical treasures, or other similar assets for financial gain, provide the required to be reported under SFAS 116 relating to these items: ~ $-_ __......•....... in Form 990, Part VIII, line 1 ~ $_ _ _ . Form 990, Part X . . . . . . , , . . . . . .
Cat. No. 52283D Schedule 0 (Form 990) 2009

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

19

Schedule D (Form 990) 2009

Page

2

IUIIII
3 a

Organizations Maintaining Coilections of Art, Historical Treasures, or Other Similar Assets (continued)

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): Public exhibition Scholarly research Preservation for future generations Provide a description of the organization's Part XIV. d e

IZJ blZJ clZJ
4 5

D

III

Loan or exchange programs Other

.

collections and explain how they further the organization's exempt purpose in

'UM""

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? •.

D

Yes

ILl No

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

1a Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not included on Form 990, Part X? . . . . . . . . . . . . . • • . . • . . . . . •• Yes b If "Yes," explain the arrangement in Part XIV and complete the following table: Amount

D

D No

c Beginning balance
d Additions during the year e Distributions during the year Ending balance Did the organization include an amount on Form 990, Part X, line 21? If n the in Part XIV.

1c

1d 1e 1f

DYes D

No

1a Beginning of year balance. • • b Contributions . . • • . . • c Net investment earnings, gains, and losses. . . • . . . . d Grants or scholarships. e Other expenditures and programs. • • . . for facilities . . .

f Administrativeexpenses 9 End of year balance. 2

a Board designated or quasi-endowment

Provide the estimated percentage of the year end balance held as: Zp.. % b Permanent endowment H.. % c Term endowment . % Yes 3a(ij 3aCiil 3b No

3a Are there endowment funds not in the possession of the organization that are held and administered for the organization by: 0) unrelated organizations . . . . . . . . . . . • . . . . Oij related organizations. •....•.....•..•. If "Yes" to 3a(iQ, are the related organizations listed as required on Schedule R? Describe in Part XIV the intended uses of the 's endowment funds.

.;
.;

(d) Book value

1a Land . . • . . . b Buildings. . • . . c Leasehold improvements Equipment .• Other. . . . . •

. . . .
Schedule 0 (Form 990) 2009

20

3
(a) Description 01 security or category (including name of security) (b) Book value (e) Method of valuation: Cost or end-of-year market value

Financial derivatives Closely-held equity interests • other

f.r!y~~~.C?~.P.!~~!

.•.....•........•••.•.....•.........•.•......•....

~====~~~!QQn~~~~~~~~~L===
I

............................................ ............................................

-

t------------------------------t-----------------------------------------------------------t------------------------------t-----------------------------------------------------------r-----------------------------1------------------------------------------------------------r-----------------------------1------------------------------------------------------------r-----------------------------1-------------------------------------------------------------

.......................................................... ..........................................................

.........................................................

+-----------------------------11------------'----------------,------'------------------

(a) Description 01 investment type

(b) Book value

(e) Method 01 valuation: Cost or end-of-year market value

2. FIN 48 Footnote. In Part XIV, 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.
Schedule 0 (Form 990) 2009

21

1 2 3 4 5

Total revenue (Form 990, Part VIII, column (A), line 12) Total expenses (Form 990, Part IX, column (A), line 25) Excess or (deficit) for the year. Subtract line 2 from line 1 Net unrealized gains (losses) on investments Donated services and use of facilities

6 7

a b c d e 3 4

Total revenue, gains, and other support per audited financial statements Amounts included on line 1 but not on Form 990, Part VIII, line 12: Net unrealized gains on investments Donated services and use of facilities . Recoveries of prior year grants other (Describe in Part XIV.) Add lines 2a through 2d Subtract line 2e from line 1 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 b other (Describe in Part XIV.) . . . . . . . . c Add lines 4a and 4b

a b c d e 3 4 a b

Total expenses and losses per audited financial statements Amounts included on line 1 but not on Form 990, Part IX, line 25: Donated services and use of facilities Prior year adjustments. . other losses . . . . . other (Describe in Part XIV.) Add lines 2a through 2d Subtract line 2e from line 1 Amounts included on Form 990, Part IX, line 25, but not on line 1: Investment expenses not included on Form 990, Part VIII, line 7b other (Describe in Part XIV.) . . . Add lines 4a and 4b . . . . . Add Jines 3 and 4c.

Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part IV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete !~!~_p_~~ ?,J?:9Xi~~_ __ t ~.r:¥. ~_~~_i!i.~~~I_ !r:!?!!!l.~!i?'r::_ : •..... __ _ __ _.__

Part III - The Palmer Museum of Art on the Penn State University Park campus is a free-admission arts resource for PSU and surrounding communities in central Pennsylvania. The museum offers an ever-changing array of exhibitions and displays of Its permanent collection. With eleven galleries, a print-study room, 150-seat auditorium, and outdoor sculpture garden, the Palmer Museum is a unique cultural resource for residents of and visitors to the region. The Palmer Museum supports the educational mission of the School of Art as well as the entire University and the University's community benefit mission.

Schedule

0 (Form 990) 2009

22

Schedule D (Form 990) 2009

Page

'®iiNJ
endowment,

5

Supplemental information (continued)
through the creation of guidelines, specific to that

Part V - Each endowed gift to Penn State is formalized which provide an opportunity

for donors to express their intentions

for how the gift is to be

directed and used by the University. indicate the particular

Guidelines

are created for the student, faculty, and program support and

college, campus, or program to benefit from the endowed fund.

Schedule

0 (Form 990) 2009

23

SCHEDULE E (Form 990 or 990-EZ)
Department of the Treasury Internal Ravenue Service

Schools
.... Complete if tile organization answered "Yes" to Form 990, Part or Form 900-EZ, Part VI, line 48. Attach to Form 990 or Form 990-EZ.

OMB No. 1545-0047

nT, line

13,

~@09
number

Name

Employer Identification

~
1

~i
Does the organization have a racially nondiscriminatory policy toward students by statement in its charter, bylaws, other governing instrument, or in a resolution of its governing body? . . . . . . . . . Does the organization include a statement of its racially nondiscriminatory policy toward students in all its brochures, catalogues, and other written communications with the public dealing with student admissions, programs, and scholarships? . Has the organization publicized its racially nondiscriminatory policy through newspaper or broadcast media during the period of solicitation for students, or during the registration period if it has no solicitation program, in a way that makes the policy known to all parts of the general community it serves? If "Yes," please describe. If "No," please explain. If you need more space, use Schedule 0 (Form 990) . . . . . .

2

3

4

Does the organization maintain the following?

a Records indicating the racial composition of the student body, faculty, and administrative staff? .
b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory basis? . . . . . . . . . . . . . . . . . . . . . . . . .

c Copies of all catalogues, brochures, announcements, and other written communications to the public dealing d Copies of all material used by the organization or on its behalf to solicit contributions?
. . . . . . . . . . . . If you answered "No" to any of the above, please explain. If you need more space, use Schedule 0 (Form 990). __ with student admissions, programs, and scholarships? . . . . . . . . . . .

5 a b c d e f 9 h

Does the organization discriminate by race in any way with respect to: Students' rights or privileges? • . . . . . . . . . . . . . Admissions policies? Employment of faculty or administrative staff?

.

.

.

.

.

.

.

.

.

.

.

Scholarships or other financial assistance? Educational policies? Use of facilities? Athletic programs? Other extracurricular activities? . . . . . . . . . . . . . . . . . . . . . . . . . .

If you answered "Yes" to any of the above, please explain, If you need more space, use Schedule 0 (Form 990). _

6a Does the organization receive any financial aid or assistance from a governmental agency? b Has the organization's right to such aid ever been revoked or suspended? . . . . . . . . . . If you answered "Yes" to either line 6a or line 6b, explain on Schedule 0 (Form 990). 7 Does the organization certify that it has complied with the applicable requirements of sections 4.01 through 4.05 of Rev. Proc. 75-50, 1975-2 C.B. 587, covering racial nondiscrimination? If "No," explain on Schedule 0 (Form 990) . . . . . . . . . . . . . . • . . . . . . . . . . . . . . . . .
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990 or 99O-EZ. Cat. No. 50085D
Schedule E (Form 990 or 990-EZ) 2009

24

Schedule F (Form 990)

Statement of Activities
.... Complete ~ Attach to Form 990.

Outside the United States
~ See separate instructions.
Employer

OMB No. 1545-0047

if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16.

~@09
Open to Public Inspection
identification number

Department of the Treasury Internal Revenue Service

-

24
General Information on Activities "Yes" to Form 990, Part IV, line 14b. Outside the United States. Complete if the organization

6000376
answered

For grantmakers. Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and the selection criteria used to award the grants or assistance? .

III

Yes

0

No

2

For grantmakers. United States. Activities
(a) Region

Describe in Part IV the organization's

procedures for monitoring

the use of grant funds outside the

3

Schedule F-1
(b) Number of offices in the region (c) Number of employees or agents in region (d) Activities conducted in region (by type) (Le., fundraising, program services, grants to recipients located in the (e) If activity listed in (d) is a program service, describe specific type of service(s) in region (f) Total expenditures region for

Europe East Asia and the Pacific North America Sub-Saharan Africa I Caribbean

1

6

program program program program program program

services

educatlonal/reseach educatlonal/reseach

4080621

services services services services services

educational/reseach educetionat/reseach educatlonal/reseach educatlcnal/reseach educatlonal'reseach educatlonal'reseach educational/reseach

775649

582678 311927 266073 264180 168297 142082

Central America South America South Asia

Middle East & North Africa Russia & Europe East & South Asia I Pacific North America Sub-Saharan Africa f Caribbean States

program program

services services

Investments Investments Investments Investments Investments Investments Investments Investments

Central America South America

Middle East & North Africa Russia & Newly States

Totals
For Privacy Act and Paperwork

~

1

6
for Form 990.
Cat. No. 50082W Schedule

7897980
F (Form 990) 2009

Reduction Act Notice, see the Instructions

25

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27

1m',.,
Schedule

F (Form 990) 2009

Page

4

Suppiemental

Information

Complete this part to provide the information required in Part I, line 2, and any additional information.

appropriate University personnel prior to student enrollment. cannot receive aid.

Students

participating

in a non-Penn State program

Schedule

F (Form 990) 2009

28

SCHEDULE

G
Complete

(Form 990 or 9OO-EL)
Department of the Treasury Inlernal Revenue Service Name of the organlza1ion

Supplemental Information Regarding Fundraising or Gaming Activities
if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line Ga. ~ Attach to Form 990 or Form 990-EZ. ~ See separate instructions. Employer

OMB No. 1545-0047

~@09
Open To Public Inspection
number

Identification

The Pennsylvania State University

24

:

6000376

':&11'
1 a b c d

Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17. Form 990-EZ filers are not required to complete this part.
of the following activities. Check all that apply. Solicitation of non-government grants Solicitation of government grants Special fund raising events

[ZJ [ZJ

GZl !21

Indicate whether the organization raised funds through ~ Mail solicitations e lLJ Internet and email solicitations f [Z] Phone solicitations 9 [Z] In-person solicitations

2a Did the organization have a written or oral agreement with any individual (including officers, directors, trustees or key ernployeesflsted in Form 990, Part VI I) or entity in connection with professional fundraising services?

0
Yes

0 No

b If "Yes," list the ten highest paid individuals or entities (fund raisers} pursuant to agreements under which the fundraiser is to be compensated at least $5,000 by the organization.
(ij Name of individual or entity (fundralser) (Ii) Activity

o iij Old fundraiser
Yes

have custody or control of contributions?

(Iv) Gross receipts from actiVity

(v) Amount paid to (or retained by) fundraiser listed In col. (ij

(vij Amount paid to (or retalned by) organization

No

Total 3 List all states in which the organization registration or licensing. PA

...
is registered or licensed to solicit funds or has been notified it is exempt from

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions

for Form 990 or 99O-EZ.

cat.

No. 50083H

Schedule G (Form 990 or 990-EZ) 2009

29

Schedule G (Form 990 or 990-EZ) 2009

Page

2

.11111

Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.
(a) Event #1 (b) Event #2 (e) Other events

Fundraising

Thon
(event type)
Q)

Miracle Ball
(event type)

eight
(total number)

(d) Total events (add col. (a) through col. (e})

::J I:
Q)

a: 2

iii 1
3

Gross receipts . Less: Charitable contributions_ Gross income (line 1 minus line 2) Cash prizes Noncash prizes Rent/facility costs Food and beverages Entertainment . Other direct expenses

8059291 7618809 440482

183330 129695 53635

477323 186700 290623

8719944 7935204 784740

4 5
Q)

III

6 7

III -I:
Q)

0..

~
U i5

~ 8
9

572226
.

47278
. . . . . . • .

180892
. ~

800396

10 11

Direct expense summary. Add lines 4 through 9 in column (d). Net income summary. Combine line 3, column (d), and line 10.

Gam
than
Q)

Complete on

if the

ization answered line 6a.
(a) Bingo

. . . . . . . ~ "Yes" to Form 990, Part IV, line 19. or reported
(e) Other gaming

. . .

more

::J I:
Q)

(b) Pull tabs/instant bingo/progressive bingo

(d) Total gaming (add col. (a) through col. (e))

>

~
gs
en
I:
Q)

1

Gross revenue Cash prizes Noncash prizes Rent/facility costs Other direct Volunteer labor Yes No

2 3
4

0..

~

zs

y ....

5
6 7 8 9

%

Yes No

%

Yes No

.%

Direct expense summary. Add lines 2 through 5 in column (d) . Net Combine line 1, column d, and line 7 . _ . . . . . . . .

Enter the state(s) in which the organization operates gaming activities:

a Is the organization licensed to operate gaming activities in each of these states? b If "No," explain:

10a Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year?
b If "Yes," explain:

11
12

Does the organization operate gaming activities with nonmembers? . . . . . . . . . • • . Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity inister . . • . . • . . .
Schedule G (Form 990 or 990-EZ) 2009

30

Schedule G

990 or 990-EZ) 2009

13 Indicate the percentage of gaming activity operated in: a The organization's facility. . . . . . . . . . b An outside facility . . . . . . . . . . . . 14 Enter the name and address of the person who prepares the organization's gaming/special and records: Name ~ Address ~ events books

_ _

15a Does the .organization have a contract with a third party from whom the organization receives gaming revenue? . . . . . • . . . . . . . . . . . . . . . . . . . . . . . . . . b If "Yes," enter the amount of gaming revenue received by the organization ~ $ and the amount of gaming revenue retained by the third party ~ $ . c If "Yes," enter name and address of the third party: Name ~ Address ~ 16 Gaming manager information: Name ~ Gaming manager compensation ~ $ -_ _ _

_
~__

Description of services provided ~

D Director/officer
17 a

D Employee

D Independent

contractor

Mandatory distributions: Is the organization required under state law to make charitable distributions from the gaming proceeds to retain the state gaming license? . . . . . . . . . • . . . . . . . . . . . . . . . b Enter the amount of distributions required under state law to be distributed to other exempt organizations or in the own activities the tax ~ $
Schedule G (Form 990 or 990-EZ) 2009

31

SCHEDULE (Form 990)

H
~ Complete if the organization ... ~

OMS No. 1545-0047

Hospitals
answered Attach "Yes" to Form 990, Part IV, question

20.

~@09
Open to Public Inspection
identification number

Department of the Treasury Internal Revenue Service

to Form 990. instructions. Employer

See separate

24 :

6000376

1a Does the organization have a charity care policy? If "No," skip to question 6a . b If "Yes," is it a written policy? 2 If the organization has multiple hospitals, indicate which of the following best describes application charity care policy to the various hospitals. Applied uniformly to all hospitals Applied uniformly to most hospitals Generally tailored to individual hospitals of the

o
3

o

0

Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients. a Does the organization use Federal Poverty Guidelines (FPG)to determine eligibility for providing free care to low income individuals? If "Yes," indicate which of the following is the family income limit for eligibility for free care: 100% 150% 200% Other __ %

o

0

0

IZl

b Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If "Yes," indicate which of the following is the fam1!Y,incomelimit for eligibility for discounted care: . 200% 250% U 300% 350% 400% Other __ %

o

0

0

!Zl

[j

If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care. 4 Does the organization's policy provide free or discounted care to the "medically indigent"? Sa Does the organization budget amounts for free or discounted care provided under its charity care policy? b If "Yes," did the organization's charity care expenses exceed the budgeted amount? If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted care to a patient who was eligible for free or discounted care? 6a Does the organization prepare an annual community benefit report? . b If "Yes," does the organization make it available to the public? . Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H. 7 Charity Care and Certain Other Community Charity Care and Means-Tested Government Programs Benefits at Cost
(b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense (a) Number of activities or programs (optional)

c

c

a

Charity care at cost (from Worksheets 1 and 2) Worksheet 3, column a) Unreimbursedosts--othermeansc testedgovemment rograms(from p Worksheet , colurm b) 3
Total Charity Care and

13504451 37510810

0 34536457

13504451 2974353

0.00% 0.00%

b Unreimbursed Medicaid (from

c
d

Means-Tested Government Programs. Other Benefits e Community health improvement services and community benefit operations (from Worksheet 4) f Health professions (from Worksheet 5) . education

51015261

34536457

16478804

0.00%

50404864

3157378

47247486

0.01%

g Subsidized health services (from Worksheet 6) h Research (from Worksheet 7) . i Cash and in-kind contributions to community groups (from Worksheet 8) j Total. Other Benefits k Total. Add lines 7d and 7j
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions

83367267

75673804

7693463

0.00%

133772131
184787391
for Form 990.

78831182
113367639
Cat. No. 50192T

54940949
71419753
Schedule

0.01%
0.02%

H (Form 990) 2009

32

Schedule H (Form 990) 2009

Page

2

IHIIM

Community Building Activities building activities.

Complete this table if the organization conducted any community
(b) Persons served (optional) (e) Total community building expense (d) Direct offsetting revenue (e) Net community building expense (f) Percent of total expense

(a) Number of activities or programs (optional)

1

Physical improvements Economic Community development support

and housing

2
3 4 5

Environmental

improvements and training

Leadership development for community members Coalition building

6
7 8 9 10

Community advocacy Workforce Other Total

health improvement development

.:t:Ti 1111.
1 2 3 4

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense Does the organization Association Statement report bad debt expense No. 15? . in accordance with Healthcare Financial Management f-'2=-+
c_

Enter the amount of the organization's bad debt expense (at cost) . Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy.

::..c:....:,-,--,,-,-.z:

3=---c

Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including other bad debt amounts in community benefit. Section B. Medicare 5 Enter total revenue received from Medicare (including DSH and IME) 6 Enter Medicare allowable costs of care relating to payments on line 5 7 Subtract line 6 from line 5. This is the surplus or (shortfall) . 8 Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit. Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6. Check the box that describes the method used:

Cost accounting system 0 Cost to charge ratio IZl Other Section C. Collection Practices 9a Does the organization have a written debt collection policy? b If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for who are known to for ch care or financial assistance? Describe in Part VI .

o

9a 9b

.f

.f

(e) Organization's profit % or stock ownership %

(d) Officers, directors, trustees, or key employees' profit % or stock ownership

(e) Physicians' profit % or stock ownership %

Schedule

H (Form 990) 2009

33

Schedule

H (Form 990) 2009

Page

3

1iII::F.Ii

Facility Information
Name and address
0
(1) Vl (1)

c:
:J

G)
(1)

0

:J
(1)

~ a::
til
:J

-I
(l)

Q

:rJ
(1) Vl (l)

m
:rJ I ro

m

OJ 0 ::J \0

a.
zr 0
Vl

e1. 3 (1)
po

~

s: ""

~

Vl-

a.

zr
0
tn

zr
0
(J)

OJ 0 0
(1) Vl Vl

~ ::r ~ ~
W

U

zr 0 c Ul

"'

~ ~
zr

.n I

Other (Describe)

[

~
C

u

U

~

[

::J"

0
Vl

'" <.i3

U

[

a

.;

.;

.'"

Il

physician

clinic,

Schedule

H (Form 990) 2009

34

•a""
Schedule

H (Form 990) 2009

Page

4

Supplemental Information

Complete this part to provide the following information. Provide the description required for Part I, line 3c; Part I, line 6a; Part I, line 7g; Part I, line 7, column (f); Part I, line 7; Part III, line 4; Part III, line 8; Part III, line 9b, and Part V. See Instructions. 2 3 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves.

Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization's charity care policy. Community demographic information. Describe the community constituents it serves. the organization serves, taking into account the geographic area and

4 5 6 7 8

Community building activities. Describe how the organization's the health of the communities the organization serves.

community

building activities, as reported in Part II, promote

Provide any other information important to describing how the organization's hospitals or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.). If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
- Hospital Medicare costs were calculated using MCCR (as filed) Schedule B1, total costs, subtracting

1. Medicare Costing Methodology

out GME costs (reported on part 1, 7f) and then multiplying

that result by the Medicare payer mix for the hospital entity.

The Professional

Medicare costs were calculated

by taking the total WRVU for the professional

entity and Multiplying

that result by the Average cost per

WRVU(inciuding

malpractice

costs) that result is then calculated

by the medicare payer mix for the professional

entity.

2. Needs assessment

- Penn State Hershey Medical Center was the co-sponsor

of a health needs assessment

in 2007. The study, entitled

Enhancing

Public Health In Dauphin County, was commissioned

by the Dauphin County Health Improvement

Partnership

to assess the

feasiblllty

of establishing

a Dauphin County Health Department that might address the many public health threats and challenges

in the

community.

The study was completed

by Drexel University

School of Public Health in August 2007. Penn State Hershey was 1 of 11

sponsors

of the study.

At present planning is underway for a new study, which would be conducted jointly

between Penn State Hershey

Medical Center, Pinnacle Health System and Holy Spirit Hospital and Health System to assess health disparities

and opportunities

in the

Capital Region.

3. Eligibility

for assistance

- Emergency room services are provided to all persons regardless

of ability to pay. Those individuals

without

insurance coverage are assisted by the Medical Center in applying for financial

assistance

through

available programs such as Medical

Assistance.

When insurance coverage is not available or balances remain due after insurance

payments are made, the individual

patient's ability to pay is evaluated by the Medical Center based on the poverty income guidelines

provided

by the Department of Health

and Human Services.

If the individual's

resources

based on these guidelines

are deemed insufficient

to make full or partial payment

without significant

hardship, the amount due is deemed charity care and is written off without any collection

effort.

In non-emergency

room situations,

individual

patients present themselves

through

physician

referral.

The Medical Center, however,
Schedule H (Form 990) 2009

35

':miU
1 2 3

Schedule H (Form 990) 2009

Page

4

Supplemental

Information

Complete this part to provide the following information. Provide the description required for Part I, line 3c; Part I, line 6a; Part I, line 7g; Part I, line 7, column (f); Part 1, line 7; Part III, line 4; Part III, line 8; Part III, line 9b, and Part V. See Instructions. Needs assessment. Describe how the organization assesses the health care needs of the communities it serves.

Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local govemment programs or under the organization's charity care policy. Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves. Community building activities. Describe how the organization's community building activities, as reported in Part II, promote the health of the communities the organization serves. Provide any other information important to describing how the organization's hospitals or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.). If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
the ability of the individual to pay based on the poverty income guidelines Charity care treatment of alternative provided by the Oepartment of Health and Human

4 5 6 7 8

determines

Services in advance of providing (1) appropriate Center.

medical services.

is granted based on the following resources, and (3) financial

considerations: limitations of the Medical

need for medical services,

(2) availability

financial

4. Community community.

information

- Penn State Hershey Medical Center and its Medical Group practices Pittsburgh,

serve an increasingly Baltimore

diverse

As the only teaching and research hospital located between Philadelphia,

and Rochester, Penn State

Hershey serves more than 4 million people in 28 counties. under-served. In addition to providing

Our care settings range from urban to rural, many of which are considered in nearby Lebanon County, we continue to be a distinct in central Pennsylvania.

care to a growing Hispanic population communities

health care destination

for the Amish and Mennonite

that are concentrated

5. N/A.

6. Furtherance of Exempt Purpose - The Medical Center advances a charitable prevention and treatment of disease or injury; and (2) to accomplish objective

purpose because it is organized

and operated (1) for the

a purpose which is recognized

as important

to the public and which

advances a social, moral or physical .. -_ ~ _ and injured, maintains an emergency of the community

-_ .. --_

as required by 10 P.S. §375(b)(4). The Medical Center provides --_ .. ---_ _ .. _ .. - _ -_ _ health education programs

---_

medical care to the sick _;. __ --- __ .. _ to both raise awareness The Medical

..

room open to the public, provides community

of specific health risks and helps patients and their families cope with the ravages of serious diseases. benefits to the community and health education through research, training and community Moreover, the Medical Center supports

Center also provides substantial screenings, free immunizations

services, such as health the educational and research

classes.

Schedule H (Form 990)2009

36

':m;i'd
1 2 3

Schedule H (Form 990) 2009

Page

4

Supplemental

Information

Complete this part to provide the following information. Provide the description required for Part I, line 3c; Part I, line 6a; Part I, line 7g; Part I, line 7, column (f); Part I, line 7; Part III, line 4; Part III, line 8; Part III, line 9b, and Part V. See Instructions. Needs assessment. Describe how the organization assesses the health care needs of the communities it serves.

Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local govemment programs or under the organization's charity care policy. Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves. Community building activities. Describe how the organization's community building activities, as reported in Part II, promote the health of the communities the organization serves. Provide any other information important to describing how the organization's hospitals or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.). If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

4 5 6 7 8

activities of the College of Medicine.

7. Affiliates - The Medical Center is affiliated with The Pennsylvania State University

(the "University")

as described below. Nine of the The Medical

fifteen Members of the Medical Center's Board of Directors are appointed by the Board of Trustees of the University. Center's Articles of Incorporation

provide that its activities shall at all times be consistent with and in furtherance of the obligations of

the University and its mission with respect to education, research, public service and patient care. In addition, a Pennsylvania court decree appointed the University as successor trustee to the Milton Hershey Foundation and charged the University with carrying out the Foundation's mission to establish and maintain a medical school in and about the town of Hershey, Dauphin County, Pennsylvania. Thus the University, as trustee, has become owner and operator of the clinical, research and educational functions of the medical school and university hospital. There is a very close relationship between the Medical Center and the College of Medicine. All physicians on the staff of the Medical No physician may have staff privileges unless he or she is on the faculty. The

Center are on the faculty of the College of Medicine.

Medical Center is a teaching hospital for the students of the College of Medicine and School of Nursing, who in addition to learning in the Medical Center environment provide patient care as residents. Funds from the Medical Center are distributed annually to the College of

Medicine to support the academic programs of the College of Medicine.

8. NfA.

Schedule

H (Form 990) 2009

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39

SCHEDULE J (Form 990)
Department of the Treasury Internal Revenue Service

Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees ~ Complete if the organization answered "Yes" to Form 990, Part IV, line 23. ~ Attach to Form 990. ~ See separate instructions.

OMS No. 1545-0047

~@09
. Open to Public Inspection 6000376

Name of the organization

1a

Check the appropriate box(es) if the organization provided any of the following to or for a person listed in Form 990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

o o
b

IZI IZI

First-class or charter travel Travel for companions Tax indemnification and gross-up Discretionary spending account

payments

IZI 0 IZI
GZI

Housing allowance or residence for personal use Payments for business use of personal residence Health or social club dues or initiation fees Personal services (e.g., maid, chauffeur, chef)

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 Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? of the

2

3

Indicate which, if any, of the following the organization uses to establish the compensation organization's CEO/Executive Director. Check all that apply.

IZI GZI GZI
4 a b c

Compensation committee Independent compensation consultant Form 990 of other organizations

GZI GZI GZI

Written employment contract Compensation surveyor study Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization: Receive a Participate Participate If "Yes" to severance payment or change-of-control payment? . in, or receive payment from, a supplemental nonqualified retirement plan? . in, or receive payment from, an equity-based compensation arrangement? any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III. 501 (c)(3) and 501 (c)(4) organizations must complete lines 5-9. payor accrue any

Only section 5

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization compensation contingent on the revenues of: a The organization? . b Any related organization? . If "Yes" to line 5a or 5b, describe in Part III.

6

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization compensation contingent on the net earnings of:

payor

accrue any

a The organization? . b Any related organization? . If "Yes" to line 6a or 6b, describe in Part III. 7 For persons listed in Form 990, Part VII, Section A, line 1a, did the organization payments not described in lines 5 and 6? If "Yes," describe in Part III . 8

provide any non-fixed

!--'7:.._t---11---

9

Were any amounts reported in Form 990, Part VII, paid or accrued pursuant to a contract that was subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe in Part III If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in ulations section 53.49
Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T Schedule

t---t--+-9
J (Form 990) 2009

8

For Privacy Act and Paperwork

40

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OMB No. 1545-0047

SCHEDULE J-2 (Form 990)
Department of the Treasury Internal Revenue Service

Continuation Sheet for
~ Attach to Form 990 to list additional information lit> See the Instructions for Form 990.

990

for Form 990, Part VII, Section A, line 1a.

~@D9
Open to Public Inspection
number

Name of the Organization

Employer

identification

lvanla State unlverstt

24

:

Continuation Employees
(A) Name and title

of Officers, Directors, Trustees, Key Employees, and Highest Compensated
(8) Average hours per week (e) Position (check all that apply) o '" 'Q.
o c
0-

(0) Reportabe corroersatlon from the organizabon (W-211099-MSC)

(E) Reportable compensation from related organizations (W-2/1099-MISC)

(F) Estimated amount of other compensation from the organization and related organizations

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Linda StrUl~p_f_

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_9_y!1.~~!Cl_?J~_":'II.i_f!_______________________________ ~

I

_P_~!~~<:~Cl_ P..9P-~t~________________________________ _
Trustee Gerald Zahorchak -~-------------------------------------------------Trustee

_~rClh?!!l_§1

1!1_i: 695981 117874

President & Trustee

_~<?5!~_~Y_~~~~!<5-?9_1} ______________________________
Exec. VP & Provost Albert Horvath - - - - - - - - -- -- - - --- -- --- --- -- - - - - - - - ---- - - - - - - - - - - ---Sr. VP - Finance & Business Rod Kirsch ---------------------------------------------------Sr. VP - Development Harold Paz ---------------------------------------------------CEO· Hershev Medical Center Eva Pel! ---------------------------------------------------Sr. VP • Research

424154 366723 358126 978335
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30599 37195 39347 40315 24760 15796 33300 49164 46470 36189 46686 2342

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Sr. VP(January-June,2009)

I

_~~~~ph_l'::'.?!tE}r!1_9 ________________________________
Head Football Coach Alan Brechbill ---------------------------------------------------Executive Dlrector MSHMC
«

_~<?.!:!~!J.H'?_r~?!!g_I'] ______________________________
Chair Dept. of Neurosurgery Ed Dechellis ---------------------------------------------------Head Basketball Coach Kevin Black ---------------------------------------------------Chair Dept. of Orthopaedics/Rehab.

I I I

697916
21165

_~95!~_~Y_HI:l_ghE}§l________________________________
Trustee ----------------------------------------------------

_~~~_9~~~h~!_~~_c:~~P_~~_~§l_t~~IJ_~~_~~~~!y~~ __
from related orqanizatlcns. ---------------------------------------------------For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 49915E Schedule J-2 (Form 990) 2009

43

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49

SCHEDULE L

(Form 990 or 99O-ElI
Department of the

Treasury

... Complete if the organization answered "Yes" on Form 990, Part IV, line 25a, 25b, 26, 27, 28a, 28b, or 280, or Form 990-EZ, Part V, line 38a or 4Ob.
Employer Identification

Transactions

With Interested Persons

OMS

No. 1545-0047

~(Q)09
number

Jlrn~te~rn;al~R~.~ve~nu;e~Se~rvI~c.~Hc;!-

!"':_!.A~tt~a~C:!:h~t~o~F~0~r!:!m~990~~o~r~F~0~r~m~990~-:!E~Z=·2"'~S~e~e:.!~~~~in~s~tr~u~c~t~io~nrs~. ~~;;:;7.i.;;;

j;

24

:

6000376

Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only). Complete if the organization answered "Yes" on Form 990 , Part IV, line 25a or 25b , or Form 990-EZ, Part V, line 40b 1
(a)

Nameof disqualifiedperson

(b)

Descriptionof transaction

(e)

Yes

Corrected? No

2 Enter the amount of tax imposed on the organization
under section 4958 •

managers

or disqualified

persons during the year .

3 Enter the amount of tax, if any, on line 2, above, reimbursed

by the organization

$ $

_ _

Id'il

Loans to and/or ;nn,nJAtA if the

From Interested
nrr,,,,nii7<>1'inn

Persons. (g)Wrttten agreement?

Grants
(a)

or Assistance

Complete I t he organization I 'f
Nameof Interestedperson

Benefiting Interested Persons. • answere d •Yes" on Form 990, Part IV, ine 27,
(b)

RelationshipbetweenInterestedpersonand the organization

(c)

Amount and type of assistance

• :F.Ti.l'.
(a)

Business

Complete

If

Transactions Involving Interested Persons • the organization answered" y es" on Form 990, Part IV, I' me 28a, 28b , or 28 c.
(b) Relationshipbetween interestedpersonand the organization (c)

Nameof Interestedperson

Amountof transaction

(d)

Descriptionof transaction

(e) Sharing f o organization's revenues? Yes

No

See schedule

0

For Privacy Act and Paperwork Instructions

Reduction

Act Notice, see the

Cat.

No. 50056A

Schedule

L (Form 990 or 990-EZ) 2009

for Form 990 or 99O-EZ.

50

SCHEDULE M (Form 990)
Department of the Treasury Internal Revenue Service

OMB No. 1545-0047

Noncash Contributions
I» Complete
if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30. ... Attach to Form 990. Employer

~@09
Open To Public Inspection
Identification number

24
(a) Check if applicable (b) Number of contributions (e) Revenues reported on Form 990, Part VIII, line 19

:

6000376
(d) Method of determining revenues

1 2 3 4 5 6 7 8 9 10 11 12 13

Art-Works of art Art-Historical treasures Art-Fractional interests Books and publications Clothing and household goods . . . . . . Cars and other vehicles Boats and planes Intellectual property. . Securities-Publicly traded Securities-Closely held stock Securities- Partnership, LLC, or trust interests . . . . Securities-Miscellaneous Qualified conservation contribution - Historic structures . . . • Qualified conservation contribution - Other . Real estate - Residential Real estate-Commercial Real estate-Other Collectibles Food inventory Drugs and medical supplies Taxidermy. . . . Historical artifacts Scientific specimens Archeological artifacts Other ~ ( __ IJ9.t_l5_~!=_l,Irit_I~~ Other ~ r. Other ~ ( Other ~ (

14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29

)

)
) )

Number of Forms 8283 received by the organization during the tax year for contributions for which the organization completed Form 8283, Part IV, Donee Acknowledgement . . . .

30a During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it must hold for at least three years from the date of the initial contribution, and which is not required to be used for exempt purposes for the entire holding period? . . . . . . . . . . . • b If "Yes," describe the arrangement in Part II. 31 Does the organization have a gift acceptance contributions? .........•.......... policy that requires the review of any non-standard • . • . . •

32a Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash contributions? . b If "Yes," describe in Part II. 33 If the did not report revenues in column (c) for a type of property for which column (a) is checked,
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 51227J Schedule M (Form 990) 2009

51

Schedule M (Form 990) 2009

Page

2

Ihlll

Supplemental Information. Complete this part to provide the intormatlon required by Part I, lines 30b, 32b, and 33. Also complete this part for any additional information.

Schedule

M (Form 990) 2009

52

SCHEDULE 0 (Form 990)

OMB No. 1545-0047

Supplemental Information to Form 990
Complete to provide information for responses to specific questions Form 990 or to provide any additional information. on ~ Attach to Form 990.

~@09
Open to Public Inspection

Department of the Treasury Internal Revenue Service

Name of the organization

The

_1='_~~_Iy'"

._~~_~~_r~~,?~j!1__~~~~i_~~

(_~l(~l

_

_ e.>!_ !~_~t;:_~!1_1_~C?!1_~~~I_th~f_J?_~I1_~?X~\I?_~!?: _ _

_

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_

advisors and data found in compensation
For Privacy Act and Paperwork

surveys.
for Form 990.
Cat. No. 51056K Schedule 0 (Form 990) 2009

Reduction Act Notice, see the Instructions

53

Schedule

0 (Form 990) 2009

Page

2

Name of the organization

_~_~~~E?~:>_ ~~5>j~(;!:

_

fair and reasonable.

Schedule

0 (Form 990) 2009

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64

Section 2:
The salaries of all officers and directors of the State-related institution.
*No member of the Board of Trustees received a salary for services rendered as a Trustee. Name Graham Spanier Rodney Erickson Albert Horvath Rod Kirsch Harold Paz President of the University Executive VP & Provost Sr. VP - Finance & Business Sr. VP - Development CEO - Hershey Medical Center Salary 620,004 420,012 363,000 350,004 656,004

65

Section 3:
The highest 25 salaries paid to employees of the institution that are not included under Section 2.
Employee
Robert Harbaugh, M.D. John Myers, M.D. Alan Brechbill Jonas Sheehan, M.D. Peter Dillon, M.D. Kevin Black, M.D. Joseph Paterno Carlo de Luna, M.D. John Reid, M.D. Akash Agarwal, M.D. Kathleen Eggli, M.D. Mario Gonzalez, M.D. Thomas Terndrup, M.D. Berend Mets, M.B. Walter Koltun, M.D. David Quillen, M.D. Kevin Cockroft, M.D. Thomas Loughran, M.D. John Repke, M.D. Walter Pae, M.D. Douglas Armstrong, M.D. William Hennrikus, M.D. Lawrence Sinoway, M.D Chandra Belani, M.D. Craig Hillemeier, M.D. Chair Department of Neurosurgery Staff Physician - Pediatric Surgery Executive Director - MSHMC Staff Physician - Neurosurgery Chair Department of Surgery Chair Orthopaedics/Rehabilitation Head Football Coach Staff Physician - Neurosurgery Staff Physician - Orthopaedics Staff Physician - Neurosurgery Chair Department of Radiology Staff Physician - Electrophysiology Chair Emergency Medicine Chair Department Chair Department of Anesthesiology of Ophthalmology Staff Physician - Colorectal Surgery Staff Physician - Neurosurgery Director Penn State Cancer Institute Chair Obstetrics/Gynecology Staff Physician - Surgery Staff Physician - Orthopaedics Staff Physician - Orthopaedics Director Penn State Heart & Vascular Institute Staff Physician - Hematology Oncology Chair Department of Pediatrics

Salary
709,847 657,960 592,053 625,043 570,870 562,121 554,136 540,030 527,331 515,028 492,896 471,528 480,961 459,573 492,521 459,313 470,036 453,743 438,710 438,351 602,038 602,038 467,087 460,472 427,494

66