SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2016
Open to Public
Inspection
Name of the organization
NHS PENNSYLVANIA
 
Employer identification number

23-2799679
Return Reference Explanation
FORM 990, PART V, LINE 1A NHS HUMAN SERVICES, INC. USES A CASH MANAGEMENT SYSTEM THAT ISSUES ALL FORM 1099S THROUGH THE PARENT ORGANIZATION FOR ALL SUBSIDIARIES.
FORM 990, PART VI, SECTION B, LINE 11B FORM 990 WAS PREPARED BY THE ORGANIZATION'S TAX MANAGER AND REVIEWED BY AN EXTERNAL TAX ADVISOR. COMMENTS AND THE 990 WERE REVIEWED BY THE SENIOR MANAGEMENT. THE FORM 990 WAS THEN SENT TO EACH BOARD MEMBER FOR REVIEW PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C AN ANNUAL QUESTIONNAIRE IS SENT TO AND COMPLETED BY EACH DIRECTOR. ANY BOARD MEMBER WITH A CONFLICT OF INTEREST IS REQUIRED TO RECUSE HIMSELF/HERSELF FROM ANY DISCUSSIONS, NEGOTIATIONS, DELIBERATIONS OR DECISION MAKING INVOLVING THE TRANSACTION CAUSING THE CONFLICT. ALL CONFLICTS OF INTEREST INVOLVING KEY EMPLOYEES ARE REVIEWED BY THE CHIEF FINANCIAL OFFICER AND THE VICE PRESIDENT OF HUMAN RESOURCES. THE CONFLICT OF INTEREST POLICY IS MONITORED BY THE ORGANIZATION'S OFFICE OF QUALITY AND COMPLIANCE AND ANY POTENTIAL CONFLICTS ARE INVESTIGATED IMMEDIATELY. ANY DISCLOSED RELATIONSHIPS ARE COMMUNICATED TO THE CORPORATE CONTROLLER FOR PURPOSE OF THE AUDIT, COMPLETING FORM 990 AND FOR ANY POSSIBLE INTERNAL CONTROL ISSUES THAT MAY TAKE PLACE DUE TO THE CONFLICT.
FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,878,469. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,878,469. PURCHASED PROVIDERS: PROGRAM SERVICE EXPENSES 3,117,367. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,117,367. PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 11,171,595. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,171,595.
FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT 195,045.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2016


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