Skip to content
Nonprofiteer
← EAGLEVILLE HOSPITAL WORKERS COMPENSATION TRUST

Form 990 for tax year 2022

Filed by EAGLEVILLE HOSPITAL WORKERS COMPENSATION TRUST.

Totals

Total revenue
$309,427
Total expenses
$239,853
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$300,000
Investment income
$9,427
Other revenue
$0
Total assets, end of year
$481,728
Total liabilities, end of year
$284,274
Net assets or fund balances, end of year
$197,454
Program services expenses (Part IX)
$102,515
Management and general expenses
$137,338
Fundraising expenses
$0
Program service expenses (Part III)
$102,515

Program services were 42.7% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 2a · Program service revenue: PROGRAM CONTRIBUTIONS

    total $300,000 · related or exempt $300,000

  • 3 · Investment income

    total $9,427 · excluded $9,427

Functional expenses

Part IX, the statement of functional expenses.

  • 4 · Benefits paid to or for members

    total $102,515 · program services $102,515

  • 11c · Fees: accounting

    total $10,634 · management and general $10,634

  • 11g · Fees: other

    total $6,229 · management and general $6,229

  • 24a · Other expenses: EXCESS LIABILITY INSURA

    total $101,454 · management and general $101,454

  • 24b · Other expenses: ADMINISTRATIVE FEES

    total $8,355 · management and general $8,355

  • 24c · Other expenses: STATE ASSESSMENTS

    total $5,894 · management and general $5,894

  • 24d · Other expenses: TRUSTEE FEES

    total $4,000 · management and general $4,000

  • 24e · All other expenses

    total $772 · management and general $772

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $371,788 · end of year $381,202

  • 11 · Investments: publicly traded securities

    beginning of year $46,800 · end of year $100,526

  • 17 · Accounts payable and accrued expenses

    beginning of year $21,503 · end of year $21,503

  • 25 · Other liabilities

    beginning of year $265,242 · end of year $262,771

  • 27 · Net assets without donor restrictions

    beginning of year $131,843 · end of year $197,454

Mission and programs · 2022

Mission

TO PROVIDE WORKER'S COMPENSATION BENEFITS FOR THE EMPLOYEES OF EAGLEVILLE HOSPITAL.

Activities or mission (Part I)

SEE SCHEDULE O

  • PROVIDE WORKER'S COMPENSATION BENEFITS FOR THE EMPLOYEES OF EAGLEVILLEHOSPITAL.

    Expenses $102,515 · Revenue $300,000

As filed on the 2022 return.

Listed in Part VII

  • Eugene J Ott

    CEO

    Total calculated
    $467,390
    From this org
    $0
    From related orgs
    $423,943
    Other
    $43,447
    Hours/week
    2 + 38 related

    Schedule J breakdown matched by us

    Base
    $0 + $373,943 related
    Bonus
    $0 + $50,000 related
    Other
    $0
    Deferred
    $0 + $14,146 related
    Nontaxable benefits
    $0 + $29,301 related
    Filer's total
    $0 + $467,390 related

  • William Keenan

    CFO

    Total calculated
    $277,308
    From this org
    $0
    From related orgs
    $253,019
    Other
    $24,289
    Hours/week
    2 + 38 related

    Schedule J breakdown matched by us

    Base
    $0 + $238,019 related
    Bonus
    $0 + $15,000 related
    Other
    $0
    Deferred
    $0 + $8,804 related
    Nontaxable benefits
    $0 + $15,485 related
    Filer's total
    $0 + $277,308 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

None.

Answered no

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

  • EAGLEVILLE HOSPITAL

    501(C)(3) · IN-PATIENT/OUT-PATIENT TREATMENT · PA · controlled entity

    Directly controlled by EAGLEVILLE FOUNDATION

  • EAGLEVILLE FOUNDATION

    501(C)(3) · SUPPORTING ORGANZIATION OF EAGLEVILLE HOSPITAL · PA · controlled entity

    Directly controlled by EAGLEVILLE HOSPITAL

Provenance

Return type
form_990
Tax year
2022
Filed
10 April 2024
IRS schema version
2022v5.0
Source object
202421029349300812

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

The source document this was parsed from is served over the API, which is where bulk and document access live.