2024-05-13T15:27:52-05:00 2023-06-30 390859910 BAKER TILLY US LLP 20 STANWIX STREET PITTSBURGH PA 15222 990 2022-07-01 250965404 INDIANA REGIONAL MEDICAL CENTER INDI 7243577008 835 HOSPITAL ROAD INDIANA PA 15701 MICHAEL F ICKOWSKI CFO 7243577008 2024-05-09 1 MICHAEL ICKOWSKI 999009999 1 JEFFREY J PETRELL P00138808 4126976400 2024-05-09 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z STEPHEN A WOLFE 835 HOSPITAL ROAD INDIANA PA 15701 218868486 0 X WWW.INDIANARMC.ORG X 1944 PA TO SERVE THE HEALTHCARE NEEDS OF EVERY LIFE WE TOUCH WITH COMPASSION, RESPECT, AND DIGNITY. 13 8 1257 8 382748 377895 5990336 8717956 164057306 198591030 5260452 4382506 4320789 6299042 179628883 217990534 0 0 0 0 79189639 89405319 0 0 0 83483876 113366012 162673515 202771331 16955368 15219203 279036107 256016534 134263654 116089369 144772453 139927165 X THE MISSION OF INDIANA REGIONAL MEDICAL CENTER IS TO SERVE THE HEALTHCARE NEEDS OF EVERY LIFE WE TOUCH WITH COMPASSION, RESPECT, AND DIGNITY. 0 0 161886245 198591030 IRMC CONTINUES TO BE A RESOURCE TO THE COMMUNITY PROVIDING FREE HEALTHCARE RELATED EVENTS PROMOTING EDUCATION, SCREENING PROGRAMS AND FIRST AID SERVICE. THE INSTITUTE FOR HEALTHY LIVING AT IRMC OFFERS HEALTH SERVICES AND EDUCATIONAL PROGRAMS AT NO CHARGE SUCH AS: BLOOD PRESSURE CLINICBONE DENSITY SCREENINGBOTHERED BY BUNIONS EVENTBREAST HEALTH EVENT DR. CLARK VIRTUAL EVENTCHEERS TO YOUR HEARTCHOLESTEROL SCREENINGCOLORECTAL EDUCATION SEMINARCOMMUNITY HEALTH COACHINGDIABETES EDUCATIONDR. SCHOLL - VIRTUAL CHRONIC PAIN EVENTFARMERS MARKET TABLEFREE S&T WELLNESS GYM MEMBERSHIPSGET YOUR REAR IN GEAR COLORECTAL WALKGINGERBREAD MAN SPORTS NUTRITION SOCIAL EMOTION LEARNING DAYHEART HEALTH EDUCATION AND PILATES - DR. LINTON FRAZIERHEART HEALTH EXPOHERNIA SCREENINGIMPERFECT HEART SEMINARINDIANA CHAMBER OF COMMERCE WOMEN'S SUMMITINDIANA COUNTY FAIRIUP HEALTH FAIRLISTEN TO YOUR HEART - HEART HEALTH SCREENINGMENTAL NOTES - MENTAL HEALTH SEMINARPARKINSON SUPPORT GROUP EDUCATIONPELVIC FLOOR SEMINARPROSTATE SCREENINGSENIOR EXPOSMOKING CESSATION PROGRAMSTROKE EDUCATION EVENTTOUCHDOWN FOR HEALTH ORTHOPEDIC EDUCATIONUNTIL THERE'S A CURE - WOMEN'S CANCER EDUCATIONWALK WITH THE DOCSWOMEN'S HEALTH EDUCATION ZOOMYOU ARE THE ONE IN 2022 HEALTH EDUCATION SERIESPREVENTIVE HEALTH SERVICES, GENERAL/OTHER: M. DORCAS CLARK WOMEN'S IMAGING CENTER: THE WOMEN'S IMAGING CENTER AND THEIR STAFF HAVE PARTICIPATED IN NUMEROUS COMMUNITY EVENTS PROVIDING INFORMATION ABOUT THE IMPORTANCE OF BREAST HEALTH. BIRDIE'S CLOSET, A PROJECT DESIGNED TO HELP WOMEN COPE WITH APPEARANCE-RELATED SIDE-EFFECTS OF CANCER TREATMENT, WAS OPENED IN THE WOMEN'S IMAGING CENTER. 161886245 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 254 0 1257 1 1 1 0 0 0 0 0 0 0 0 0 X 13 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X ROBERT A GONGAWARE CFO 7243577008 835 HOSPITAL ROAD INDIANA PA 15701 NATHAN KOVALCHICK CHAIRMAN 1.00 1.00 X X 0 0 0 T MICHAEL PRICE VICE CHAIRMAN 1.00 1.00 X X 0 0 0 FRANK ROBERTS SECRETARY 1.00 1.00 X X 0 0 0 BECKY STAPLETON TREASURER 1.00 X X 0 0 0 STEPHEN A WOLFE PRESIDENT & CEO 34.00 6.00 X X 802111 0 42593 TODD BRICE BOARD MEMBER 1.00 1.00 X 0 0 0 HILLARY CREELY BOARD MEMBER 1.00 1.00 X 0 0 0 RUSSELL A DROZDIAK MD BOARD MEMBER 40.00 1.00 X 159630 0 3362 MATTHEW N KLAIN MD BOARD MEMBER 1.00 X 0 0 0 LAURIE A KUZNESKI BOARD MEMBER 1.00 X 0 0 0 CHRISTINA B LUBOLD MD BOARD MEMBER 5.00 X 37920 0 0 JAMES R MARTIN BOARD MEMBER 1.00 1.00 X 0 0 0 TIMOTHY CLARK SIMPSON MD BOARD MEMBER 1.00 39.00 X 0 497409 19946 ROBERT A GONGAWARE CHIEF FINANCIAL OFFICER 34.00 6.00 X 323825 0 34321 RICHARD NEFF MD CHIEF MEDICAL OFFICER 34.00 6.00 X 397918 0 28299 BRETT BRAUN CHIEF OPERATING OFFICER 34.00 6.00 X 220307 0 29609 WENDY HAISLIP CHIEF NURSING OFFICER 34.00 6.00 X 227299 0 24264 JAMES KINNEER CHIEF HUMAN RESOURCE OFFICER 20.00 20.00 X 227352 0 34514 MARK VOLOVIC CHIEF INFORMATION OFFICER 34.00 6.00 X 280240 0 32304 ADENIRAN HAASTRUP MD PHYSICIAN 40.00 X 559271 0 22356 TOLUTOPE OZAH MD PHYSICIAN 40.00 X 492728 0 21848 PATRICK SHANNON DO PHYSICIAN 40.00 X 430726 0 27721 BENJAMIN L PARK DO PHYSICIAN 40.00 X 483874 0 18007 KYUNG PARK MD PHYSICIAN 40.00 X 336451 0 11518 4979652 497409 350662 70 0 1 0 CENTER FOR ORTHO & SPORTS MEDICINE 120 IRMC DR STE 160 INDIANA PA 15701 ORTHOPEDIC SERVICES 3712677 AHN ERHOSPITALIST GROUP 4535 DRESSLER RD NW CANTON OH 44718 HOSPITALISTS 1725436 MAYO COLLABORATIVE SERVICES INC PO BOX 9146 MINNEAPOLIS MN 554809146 REFERENCE LAB SERVICES 1465820 COSM REALTY GROUP LTD 120 IRMC DR STE 160 INDIANA PA 15701 RENT 870421 MATTHEW KLAIN GROUP 1265 WAYNE AVENUE SUITE 102 INDIANA PA 15701 PHYSICIAN SERVICES 775321 32 6697198 2020758 8717956 NET PATIENT SVC REV 621990 198451919 198451919 HEALTH CLASSES/COUNSEL 624100 86064 86064 RENTAL REVENUE-AFFILIATES 531120 40942 40942 HOSPICE PRESCRIPTIONS 621990 12105 12105 198591030 2906833 2906833 7988 7988 2693963 792663 1901300 1901300 1901300 1560962 0 85289 1560962 -85289 1475673 1475673 CAFETERIA REV 900099 768556 768556 CHART REVENUE 900099 754293 754293 MANAGEMENT FEES 900099 624351 624351 2242554 382748 1859806 4389754 217990534 198591030 382748 10298800 X 2905868 2905868 65389059 54411689 10977370 4130646 3302038 828608 12851658 10456891 2394767 4128088 3299994 828094 450280 450280 402397 402397 314382 314382 108828 108828 273411 273411 29495922 23735368 5760554 800752 31149 769603 1923498 1886182 37316 4711246 1697933 3013313 946438 695253 251185 445552 246836 198716 21131 21131 2305489 2305489 11586397 10070896 1515501 2656061 2123255 532806 MEDICAL SUPPLIES 44778046 43909352 868694 BAD DEBT EXPENSE 7556208 7556208 CLEANING SVCS & SUPPLIE 1429684 1142889 286795 DIETARY/FOOD 1012626 809493 203133 2147664 1740407 407257 202771331 161886245 40885086 0 7259 7308 14185735 2808230 18802310 24271534 3168324 3136769 1968905 1709339 227970224 126477180 105088547 101493044 89831542 91889776 15027284 17803094 194770 166945 30761431 12730495 279036107 256016534 29608459 23973258 5171329 32069404 31054253 18633723 17870585 48780739 43191273 134263654 116089369 X 137321182 130656719 7451271 9270446 144772453 139927165 279036107 256016534 X 15219203 1928691 -21993182 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 75240 0 1 3308 78548 0 PART II-B, LINE 1: THE MEDICAL CENTER IS A MEMBER OF NATIONAL AND STATE HOSPITAL AND HEALTHCARE ASSOCIATIONS THAT PERFORM LOBBYING ACTIVITIES. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS IS LISTED AS LOBBYING EXPENDITURES. 3282303 3282303 78791599 37003548 41788051 139480565 86220244 53260321 6415757 3253388 3162369 101493044 17803094 C 17803094 ESTIMATED 3RD PARTY 515192 OPERATING LEASE OBLIGATIONS 6291920 MALPRACTICE LIABILITY 5283386 PENSION LIABILITY 20191470 DEFERRED COMPENSATION LIABILITY 1481049 CAPITAL LEASE OBLIGATIONS 2919266 CONTRACT LIABILITIES 6508990 43191273 X 219200734 1928691 7111128 9039819 210160915 7829619 7829619 217990534 195734375 792663 792663 194941712 7829619 7829619 202771331 PART X, LINE 2: INDIANA REGIONAL MEDICAL CENTER IS A TAX-EXEMPT ORGANIZATION AND NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES IN ACCORDANCE WITH SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ON SUCH BASIS, IT WILL NOT INCUR ANY LIABILITY FOR INCOME TAXES, EXCEPT FOR POSSIBLE UNRELATED BUSINESS INCOME. MANAGEMENT ANNUALLY REVIEWS ITS TAX PROVISIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: TRANSFER (TO)/FROM AFFILIATES 55,716. CHANGE IN INTEREST IN INDIANA HEALTHCARE FOUNDATION 692,708. CHANGE IN PENSION AND POST-RETIREMENT LIABILITIES 5,570,041. RENTAL EXPENSES 792,663. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBTS NETTED AGAINST REVENUE ON FINANCIALS 7,556,208. INVESTMENT MGT. FEES NETTED AGAINST REVENUE ON FINANCIALS 273,411. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 792,663. PART XII, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT MANAGEMENT FEES NETTED AGAINST REVENUE ON FINANCIALS 273,411. BAD DEBTS NETTED AGAINST REVENUE ON FINANCIALS 7,556,208. 1 1 X 1 X 1 X 1 1 0 1 1 1419 1844212 1844212 0.00940 53975 25589280 18602402 6986878 0.03580 128748 4911521 4911521 0.02520 184142 32345013 18602402 13742611 0.07040 22925 1673479 166994 1506485 0.00770 48 257091 257091 0.00130 9878 21522615 11171066 10351549 0.05300 32851 23453185 11338060 12115125 0.06200 216993 55798198 29940462 25857736 0.13240 1 7556208 736700 26574681 31199566 -4624885 X 1 1 1 COSM REALTY GROUP LTD REAL ESTATE 0.40000 0.00000 0.30000 2 INDIANA REHABILITATION SERVICES REHABILITATION SERVICES 0.51000 0.00000 0.49000 1 1 INDIANA REGIONAL MEDICAL CENTER 835 HOSPITAL ROAD INDIANA PA 15701 WWW.INDIANARMC.ORG 090701 X X X URGENT CARE FACILITY; OFFSITE TESTING CENTERS INDIANA REGIONAL MEDICAL CENTER 1 0 0 1 X X X X X X X X X 21 1 1 0 1 X IRMC.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ X PAH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT X 1 21 1 IRMC.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ 0 1 X 100.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X HTTPS://WWW.IRMC.ORG/PATIENTS-AND-VISITORS/FINANCIAL-SERVICES/ X HTTPS://WWW.IRMC.ORG/PATIENTS-AND-VISITORS/FINANCIAL-SERVICES/ X HTTPS://WWW.IRMC.ORG/PATIENTS-AND-VISITORS/FINANCIAL-SERVICES/ X X X X X X 1 X 0 X X X 1 X 0 0 INDIANA REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 5: IN THE FALL OF 2020, INDIANA REGIONAL MEDICAL CENTER (IRMC) AND PUNXSUTAWNEY AREA HOSPITAL (PAH) FORMALIZED A COLLABORATION UNDER ONE GOVERNING BOARD OF DIRECTORS CALLED THE PENNSYLVANIA MOUNTAINS CARE NETWORK (PMCN). THIS COLLABORATION HELPS TO SUSTAIN A HIGH LEVEL OF PATIENT CARE RESIDENTS ALREADY RECEIVE IN BOTH INDIANA AND JEFFERSON COUNTY.THE HOSPITAL WORKED WITH A CONSULTING FIRM, STRATEGY SOLUTIONS, INC. (SSI). THE PROCESS WAS LED BY THE VP OF PROFESSIONAL AND CORPORATE SERVICES. THE 2021 IRMC AND PAH CHNA WAS CONDUCTED TO IDENTIFY PRIMARY HEALTH ISSUES, CURRENT HEALTH STATUS AND NEEDS TO PROVIDE CRITICAL INFORMATION TO THOSE IN A POSITION TO MAKE A POSITIVE IMPACT ON THE HEALTH OF THE REGION'S RESIDENTS. THE RESULTS ENABLE COMMUNITY MEMBERS TO MORE STRATEGICALLY ESTABLISH PRIORITIES, DEVELOP INTERVENTIONS, AND DIRECT RESOURCES TO IMPROVE THE HEALTH OF PEOPLE LIVING IN THE COMMUNITY.IRMC IDENTIFIED COMMUNITY HEALTH NEEDS THROUGH A COLLABORATIVE PROCESS WITH PENNSYLVANIA MOUNTAIN HEALTH CARE NETWORK (PMCN) HOSPITALS. BUILDING PAST INITIATIVES, THE FY2021 PROCESS INCLUDED A COMPREHENSIVE SURVEY PROCESS, A IRMC CHNA TEAM PRIORITIZATION EXERCISE TO DETERMINE PRIORITIES AND ASSESSMENT OF PAST SUCCESSES AND FAILURES. AS THE CHNA LEVERAGED AND UTILIZED THE HOSPITAL'S PLANNING STAFF, A MULTI-PART PROCESS WAS EMPLOYED TO DEVELOP THIS IMPLEMENTATION STRATEGY AND COMMUNITY BENEFIT PLAN, INCLUDING THE FOLLOWING:- QUANTITATIVE DATA REVIEW AND ANALYSIS:- LITERATURE REVIEWS TO IDENTITY STATE AND NATIONAL BENCHMARKS, AND EVIDENCE BASED STRATEGIES THAT RELATED TO THE INDICATORS/METRICS MEASURED THROUGH THE QUANTITATIVE DATA SOURCES- QUALITATIVE DATA PROVIDED THROUGH THE SURVEY PROCESS AND DIALOGUES WITH COMMUNITY AND HEALTHCARE LEADERS IN THE REGION. THE CHNA UTILIZATIONS OF MULTIPLE TYPES OF RESEARCH ALLOWED FOR DATA COLLECTION ACROSS A BROAD RANGE OF INDICATORS RELATED TO OVERALL POPULATION HEALTH, SOCIAL DETERMINANTS OF HEALTH INCLUDED GEOGRAPHIC LOCATION DIFFERENCES IN HEALTH OUTCOMES AND THE NEEDS OF DISADVANTAGED POPULATIONS INCLUDING UNINSURED PERSON, LOW INCOME PERSONS AND MINORITY GROUPS WITHIN THE REGION. THE PENNSYLVANIA MOUNTAIN HEALTH CARE NETWORK HOSPITALS ARE COMMITTED TO SERVING PATIENTS IN THE REGION AND ARE USING SOUND AVAILABLE DATA TO GUIDE THE PLANNING PROCESS. IN ADDITION TO DATA COLLECTION AND RESEARCH, THE IRMC CHNA TEAM CONDUCTED A COMPREHENSIVE ONLINE SURVEY TO ASSESS THE NEEDS OF THE COMMUNITY AND IDENTIFY HEALTH PRIORITIES AT THE LOCAL LEVEL.IN ADDITION TO THE ASSESSMENT IRMC CHNA ALSO REVIEWED ITS EXISTING COMMUNITY BENEFIT ACTIVITIES- BOTH INTERNALLY AND IN CONJUNCTION WITH ITS PMCN PARTNERS TO ASSESS WHETHER THESE SERVICES WERE PROVIDING VALUE CONSISTENT WITH THE NEEDS OF THE COMMUNITY AND ITS RESIDENTS. SPECIFICALLY, THESE CONSIDERED KEY HEALTH FACTORS AND OUTCOMES RESULTANT FROM ASSOCIATED DEMOGRAPHIC, SOCIAL AND ECONOMIC IMPACTS, THE PHYSICAL ENVIRONMENT, HEALTHCARE ACCESS AND RESOURCE COORDINATION AND BEHAVIORAL TRENDS. BASICALLY CONNECTING THE REGIONS NEEDS TO THAT OF STATE AND NATION. WITH HEALTHY PEOPLE 2020, AND THE CMS STRATEGY CONNECTED TO THE PENNSYLVANIA DEPARTMENT OF HEALTH PRIORITIES, THIS CHNA IS CONNECTED TO EVIDENCE AND DATA BASED PRIORITIES. INDIANA REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 6A: THE COMMUNITY NEEDS ASSESSMENT SERVED INDIANA REGIONAL MEDICAL CENTER AND PUNXSUTAWNEY AREA HOSPITAL. INDIANA REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 11: DURING JULY AND AUGUST 2022 AND THEN OCTOBER 2022, IRMC CONDUCTED AN EVALUATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT IMPLEMENTATION STRATEGIES THAT HAVE BEEN UNDERWAY OVER THE FIRST YEAR OF THE IMPLEMENTATION PLAN (JULY 1, 2021, THROUGH JUNE 2022). THE EVALUATION PROCESS INCLUDED SUBMISSION AND REVIEW OF THE OUTCOMES AND IMPACT DATA THAT WAS TRACKED AND REPORTED DURING THE LAST FISCAL YEAR.GOAL 1: IMPROVE HEALTH STATUS BY INCREASING PARTICIPATION IN EDUCATION AND WELLNESS, FOCUSING ON OVERWEIGHT/OBESITY IRMC HAS CONTINUED TO OFFER OUR WELLNESS PROGRAM TO EMPLOYEES AND COMMUNITY PARTNERS - 1,327 PARTICIPANTS THIS YEAR - 833.6 TOTAL POUNDS LOST BY PROGRAM PARTICIPANTS, WITH AN AVERAGE WEIGHT LOSS OF 6.4 POUNDS - OFFERED 25 NUTRITIONAL CHALLENGES WITH 700 PARTICIPANTS, OF WHICH 75 COMPLETED THE CHALLENGE (10.7%)- PROVIDED 245 HEALTH COACHING SESSIONS AND HAD 15 EDUCATIONAL ENCOUNTERS IRMC HAS CONTINUED TO PROMOTE HEALTH AND WELLNESS TO THE COMMUNITY AT-LARGE - 901 PARTICIPANTS IN CORPORATE BEWELL PROGRAM - 15,179 VISITS TO S&T WELLNESS CENTER WITH 1,264 VISITS ON AVERAGE PER MONTH - PROVIDED MEDICAL NUTRITION THERAPY TO 891 PARTICIPANTS WHO LOST A TOTAL OF 25 POUNDS - PROVIDED SERVICES THROUGH THE BARIATRIC CENTER 323 NEW PATIENTS OF WHICH 55 WERE SURGICALFOLLOWED UP WITH 255 PATIENTS PERFORMED 8 BARIATRIC PROCEDURES SURGICAL PATIENTS LOST A TOTAL OF 161.3 POUNDS - OFFERED 23 EDUCATIONAL SESSIONS WITH A TOTAL OF 299 PARTICIPANTS - CONTINUED LEAN WEIGHT MANAGEMENT PROGRAM ONLINE WITH 34 PARTICIPANTS, WITH AVERAGE WEIGHT LOSS OF 11.7 POUNDSGOAL 2: INCREASE ACCESS TO MENTAL HEALTH SERVICES AND SUPPORTS IRMC SERVED A COMMUNITY NEED BY IMPLEMENTING A BH OUTREACH PROGRAM TO CONNECT EMERGENCY DEPARTMENT BH PATIENTS WITH OUTPATIENT - AMBULATORY SOCIAL WORKERS MADE 1,088 REFERRALS - AMBULATORY SOCIAL WORKERS CONNECTED WITH 158 PATIENTS - SPOKE WITH 55 BH PATIENTS POST-DISCHARGE - THE EMERGENCY DEPARTMENT HAD 1,209 BH RELATED VISITS (68% WERE FROM INDIANA COUNTY), WITH AVERAGE WAIT TIME TO TRANSFER TO MENTAL HEALTH FACILITY OF 14.86 HOURS IRMC CONTINUES TO PROVIDE EDUCATION AND OUTREACH - PARTICIPATED IN MENTAL HEALTH AWARENESS MONTH, HAD A TABLE OF RESOURCES AVAILABLE AT IRMC PARK AND ENGAGED IN CONVERSATIONS WITH COMMUNITY MEMBERS - IRMC IS AN ACTIVE MEMBER OF THE SUICIDE TASKFORCE AND INTERVENTION SUBCOMMITTEE IRMC MADE ONLINE RESOURCES AVAILABLE THROUGH THE HOSPITAL'S WEBPAGE AND ADDED LINKS TO OUTSIDE RESOURCESGOAL 3: DECREASE DRUG AND ALCOHOL USE IN INDIANA COUNTY BY CONTINUING TO COLLABORATE WITH THE ARMSTRONG-INDIANA-CLARION DRUG & ALCOHOL COMMISSION AND ARMOT ON PREVENTION, EDUCATION, INTERVENTION AND TREATMENT STRATEGIES IRMC CONTINUES OUR RELATIONSHIP WITH LOCAL PARTNERS - PARTICIPATED IN 7 COMMUNITY COLLABORATIVES - DISTRIBUTED 12 NARCAN KITS IN THE ED- ED LEADERSHIP AND ARMOT COLLABORATED TO DEVELOP STANDARD PROTOCOL FOR THOSE WHO SHOW UP IN ED OF AN OVERDOSE/RECEIVE SUBSTANCE USE DISORDER DIAGNOSIS. PROCESS CHANGED FROM OPT IN TO OPT OUT WHICH INCREASED THE NUMBER OF REFERRALS. - 307 PATIENTS PRESENTED TO THE ED WITH SUBSTANCE USE AS A FACTOR IRMC HAS CONTINUED TO REFER ED PATIENTS TO COMMUNITY PARTNERS - 245 REFERRED TO ARMOT - 85 COMPLETED TREATMENT - 18 PATIENTS RECEIVED BUPRENORPHINE IN THE ED- 8 PATIENTS REFERRED TO OPEN DOOR OR CROSSROADS BY ARMOTIRMC PROVIDES EDUCATION TO STAFF, PROVIDERS AND THE BROADER COMMUNITY IN AN EFFORT TO REDUCE STIGMA - 101 EDUCATIONAL EVENTS WITH 1,117 PARTICIPANTS - 1,117 NARCAN KITS DISTRIBUTED - EDUCATED 61 IRMC STAFF ON STIGMA REDUCTION WITH 100% REPORTING REDUCED STIGMA PRE/POST TRAINING IRMC HAS INCREASED ACCESS TO INPATIENT REHAB THROUGH LOCAL PARTNERSHIPS - 43 PATIENTS CONNECTED TO INPATIENT TREATMENT- 6 PATIENTS REFERRED TO OUTPATIENT TREATMENT- ARMOT PROGRAM HELPS TO INCREASE ACCESS TO INPATIENT TREATMENT FOR PATIENTS AT IRMC IRMC IS WORKING TO INCREASE AWARENESS OF AVAILABLE SERVICES - MARKETING EFFORTS TO PROMOTE WARMLINE FOR 24/7 ACCESS TO SERVICES - MEDIA CAMPAIGN TO PROMOTE AICDAC SERVICES. IRMC MADE ONLINE RESOURCES AVAILABLE THROUGH THE HOSPITAL WEBPAGE WITH LINKS TO EXTERNAL RESOURCES INDIANA REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 16J: DIRECT MAILING TO THE COMMUNITY. PART I, LINE 7: THE HOSPITAL USED A COST-TO-CHARGE RATIO IN DETERMINING THE FIGURES REPORTED IN THIS TABLE. THIS COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2 RATIO OF PATIENT CARE COST TO CHARGES AND AS CALCULATED AND REPORTED ON THE MEDICARE COST REPORT. COMMUNITY PROGRAMS ARE RECORDED IN SPECIFIC GENERAL LEDGER COST CENTERS AND STRUCTURE ON THE COMMUNITY BENEFIT FORMS WITH NUMBER OF PERSONS SERVED. PART I, LINE 7G: NO COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC WERE INCLUDED IN THE AMOUNT ON PART I, LINE 7G. PART I, LN 7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $7,556,208. PART II, COMMUNITY BUILDING ACTIVITIES: OUR MISSION IS TO SERVE THE HEALTHCARE NEEDS OF EVERY LIFE WE TOUCH WITH COMPASSION, RESPECT AND DIGNITY. ALL OF THE PROGRAMS OFFERED MEET COMMUNITY BENEFIT OBJECTIVES AND ARE RELATED TO OUR MISSION. IRMC OFFERS PROGRAMS THAT IMPROVE ACCESS TO HEALTH CARE SERVICES, ENHANCES HEALTH OF THE COMMUNITY WE SERVE, PROVIDES ADVANCED MEDICAL OR HEALTHCARE KNOWLEDGE AND RELIEVES SOME OF THE FINANCIAL OR PROGRAMMATIC BURDEN OF GOVERNMENT ON OUR COMMUNITY.INDIANA REGIONAL MEDICAL CENTER PROVIDES NUMEROUS COMMUNITY PROGRAMS AND ACTIVITIES THAT PROVIDE TREATMENT OR PROMOTE HEALTH AND HEALING TO OUR COMMUNITIES. OUR MOBILE MEDICAL SERVICES CONTINUES TO PROVIDE FREE BLOOD PRESSURE SCREENINGS IN VARIOUS OUTLYING AREAS IN INDIANA COUNTY, INCLUDING STRONGSTOWN, SHELOCTA, BLACKLICK, AND SMICKSBURG. WE ALSO CONTINUE TO PARTICIPATE IN NUMEROUS FREE COMMUNITY EVENTS PROVIDING EDUCATION, SCREENING PROGRAMS, SOCIAL SERVICES, AND FIRST AID SERVICES. OVER THE PAST YEAR, THE MOBILE MEDICAL HEALTH AND/OR COMMUNITY PROGRAMS LOGGED OVER 2,000 PARTICIPANTS.WE ALSO PROVIDE NUMEROUS HEALTH FAIRS REACHING ALMOST 2,000 PARTICIPANTS, AND CLASSES AND EDUCATION PROGRAMS WITH OVER 2,000 PARTICIPANTS. A FEW OF THE FAIRS OR SERVICES PROVIDED ARE: FREE PROSTATE SCREENING, SKIN CANCER SCREENING, WEIGHT CHECKS, ORTHOPEDIC/JOINT REPLACEMENT SEMINAR, BREAST HEALTH SEMINAR, DIABETES EDUCATION PROGRAMS, PHYSICIAN/PROVIDER COMMUNITY MEET AND GREET, BARIATRIC SURGERY SEMINAR, WEIGHT LOSS SUPPORT GROUP, BREAST CANCER SUPPORT GROUP, COMMUNITY CHOLESTEROL SCREENING, COLORECTAL CANCER EVENT, BARIATRIC SURGERY SUPPORT GROUP, STROKE EDUCATION EVENT, HEALTHY KIDS CAMP, HEALTHY KIDS DAY, "BIKE TO SCHOOL" (SAFETY FOR CHILDREN), LUNCH AND LEARN FOR KEYSTONE GENERATING STATION, LUNCH AND LEARN FOR MOOREHEAD PLACE, SERVICES AT LOCAL SENIOR CENTERS, IRMC PARK EVENTS, AS WELL AS NUMEROUS OTHERS. THE INSTITUTE FOR HEALTHY LIVING AT INDIANA REGIONAL MEDICAL CENTER OFFERS HEALTH SERVICES AND EDUCATION PROGRAMS TO THE COMMUNITY AT NO CHARGE.THE DIABETES EDUCATION CENTER CONTINUES TO OFFER FREE EDUCATION SERVICES AT VARIOUS LOCATIONS THROUGHOUT THE COUNTY. EACH MONTH STAFF AND MANAGEMENT AT IRMC PROVIDE SUPPORT TO A LOCAL FOOD BANK (ICAAP). THE DIABETES EDUCATION CENTER PROVIDES DIABETIC COMPETENCY TRAININGS FOR EMPLOYEES OF PERSONAL CARE HOMES, ASSISTED LIVING FACILITIES AND HOME HEALTH AGENCIES. CENTER ALSO PROVIDES COMMUNITY SUPPORT PROGRAMS AT NO COST FOR INSULIN PUMP TRAINING, GLUCOSE MONITORING, AND MORE. PREVENTIVE HEALTH SERVICES - M. DORCAS CLARK WOMEN'S IMAGING CENTER/COMPREHENSIVE BREAST CENTER AND THEIR STAFF HAVE PARTICIPATED IN NUMEROUS COMMUNITY EVENTS PROVIDING INFORMATION ABOUT THE IMPORTANCE OF BREAST HEALTH. BIRDIE'S CLOSET, A PROJECT DESIGNED TO HELP WOMEN COPE WITH APPEARANCE RELATED SIDE-EFFECTS OF CANCER TREATMENT WAS OPENED IN THE WOMEN'S IMAGING CENTER. WEIGHT LOSS SUPPORT SERVICES THE IRMC WEIGHT MANAGEMENT & BARIATRIC SURGERY INSTITUTE OPENED IN 2021. INSTITUTE FOR HEALTHY LIVING'S REGISTERED DIETITIANS ARE DEPLOYED TO THE INSTITUTE TO MEET WITH PATIENTS ON ONE AS PART OF THEIR PRE-SURGICAL REQUIREMENTS. REGISTERED DIETITIANS ALSO SUPPORT PATIENTS BY LEADING BARIATRIC SUPPORT GROUPS AND INFORMATIONAL SESSIONS. IRMC'S CONGESTIVE HEART FAILURE PROGRAM SUPPORTS PATIENTS WITH CARDIAC MONITORING.SUPPORT HEALTH GROUPSFAMILY PROGRAMS BREASTFEEDING BASICS, CHILDBIRTH PREP, NEWBORN BASICSCOMMUNITY CLASSES POP PILATES, JOURNEY TO LEAN, WALK WITH A DOC, AND THOSE LISTED ABOVEIN 2009, INDIANA REGIONAL MEDICAL CENTER OPENED A NEW FACILITY OFFERING URGENT CARE SERVICES IN THE BLAIRSVILLE COMMUNITY AS A RESPONSE TO MEDICAL SERVICES NEEDED IN THAT AREA. THIS FACILITY IS 12 MILES FROM THE HOSPITAL CAMPUS.IN 2012, INDIANA REGIONAL MEDICAL CENTER OPENED ITS SECOND URGENT CARE FACILITY TO SERVICE THE PRIMARY MARKET SHARE WHERE THERE WAS A NOTED DEMAND FOR THESE SERVICES. THE URGENT CARE CENTERS REQUIRE ADDITIONAL STAFFING ON BEHALF OF THE HOSPITAL AS IT IS A NEW/ADDED LOCATION; HOWEVER, THESE FACILITIES SIGNIFICANTLY IMPROVE THE CYCLE TIME OF THE PATIENT THROUGHOUT AND SERVICES FOR THE NON-EMERGENT SERVICES NEEDED. PART III, LINE 2: THE AMOUNT REPORTED IN PART III, LINE 2 IS ACTUAL BAD DEBTS (AT NET, NOT GROSS CHARGES) FOR THE YEAR. PART III, LINE 3: THE AMOUNT REPORTED IN PART III, LINE 3 IS DERIVED BY USING THE MEDICARE COST TO CHARGE RATIO FROM THE COST REPORT.A PORTION OF THE BAD DEBT SHOULD BE INCLUDED AS COMMUNITY BENEFIT AS THE HOSPITAL IS NOT ABLE TO DENY SERVICES TO ANY PATIENT PRESENTING TO THE EMERGENCY DEPARTMENT, REGARDLESS IF THE PATIENTS HAVE THE MEANS TO PAY. THE DEDUCTIBLE AND CO-INSURANCE BALANCES THAT ARE NOT PAID REDUCE THE NET REVENUES DUE TO THE HOSPITAL AS PART OF THE RESPECTIVE PATIENT'S INSURANCE COVERAGE. IN ADDITION, THERE IS A "COST" TO THE HOSPITAL FOR TREATING ALL PATIENTS. AS WITH THE UNREIMBURSED AMOUNTS OF THE MEDICAID PATIENT SERVICES, THE HOSPITAL SHOULD BE ABLE TO INCLUDE THE UNREIMBURSED COSTS OF THE SERVICES THAT RESULTED IN NO PAYMENT. PART III, LINE 4: THE FOLLOWING IS THE TEXT OF THE FOOTNOTE FROM THE AUDITED FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE: PATIENTS ACCOUNTS RECEIVABLE ARE RECORDED AT NET REALIZABLE VALUE AT THE TRANSACTION PRICE BASED ON STANDARD CHARGES FOR SERVICES PROVIDED, REDUCED BY CONTRACTUAL ADJUSTMENTS PROVIDED TO THIRD-PARTY PAYORS, DISCOUNTS PROVIDED TO UNINSURED OR UNDERINSURED PATIENTS IN ACCORDANCE WITH ORGANIZATION'S POLICIES, AND/OR IMPLICIT PRICE CONCESSIONS PROVIDED TO UNINSURED OR UNDERINSURED PATIENTS AND DO NOT BEAR INTEREST. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT REVENUES IN THE PERIOD OF THE CHANGE. PART III, LINE 8: 100% OF THE SHORTFALL IS A COMMUNITY BENEFIT. THE MEDICARE PROGRAM WAS DESIGNED TO COVER THE COSTS OF THE HOSPITALS USING THE COST BASE YEAR(S). IRMC IS A VERY LOW COST PROVIDER AND IS NOT ABLE TO COVER COSTS SINCE THE SEQUESTRATION REDUCTION, THE LESS ALL THE OTHER DOWNWARD ADJUSTMENTS TO THE NET MBI WHILE THE COSTS OF DRUGS, SUPPLIES, IMPLANTS, CLINCAL STAFF AND HEALTH BENEFITS CONTINUE TO INCREASE 5-20%. IRMC IS A SOLE COMMUNITY PROVIDER NOT RECEIVING SUFFICIENT SCH ADD ON TO COVER COSTS FOR ALL CARE NEEDED (BASE YEAR WAS TOO LONG AGO AND NOT AS RELEVANT TO CURRENT COSTS) TO BE PROVIDED AS THE ONLY PROVIDER IN THE DEFINED GEOGRAPHICAL AREA. ACTUAL AMOUNTS PER THE MEDICARE COST REPORT THAT DETERMINE THE REIMBURSEMENTS, PAYMENTS RECEIVED (THUS SETTLEMENTS) AND COSTS. PART III, LINE 9B: PATIENTS ARE EXPECTED TO PAY ALL BALANCES IN FULL WITHIN FIFTEEN DAYS OF A FINAL BILLING. IF THIS IS NOT POSSIBLE, PATIENTS WILL BE COUNSELED ON THE USE OF MEDICAL ASSISTANCE OR THE INDIANA CHARITY CARE PROGRAM, I-CARE.ON A MONTHLY BASIS, THE CREDIT SUPERVISOR WILL COMPILE A REPORT LISTING ALL ACCOUNTS, WHICH HAVE BEEN BILLED TO MEDICARE, AND ANY SECONDARY INSURANCE CARRIER WHERE APPLICABLE. A LISTING OF ACCOUNTS WHICH HAVE BEEN BILLED TO MEDICAL ASSISTANCE AS A SECONDARY PAYOR ARE REVIEWED BY THE CREDIT SUPERVISOR FOR AN AUTOMATIC WRITE OFF AFTER MEDICAL ASSISTANCE HAS PROCESSED THE ACCOUNT. ACCOUNTS WHICH HAVE BALANCES AFTER MEDICARE AND ALL SECONDARY PAYORS HAVE BEEN BILLED WILL BE PLACED WITH AN OUTSIDE COLLECTION AFTER TWO UNANSWERED STATEMENTS. AN EXCEPTION WILL BE MADE IN THE EVENT A PATIENT/GUARANTOR DOES NOT FOLLOW THROUGH WITH THE MEDICAL ASSISTANCE APPLICATION PROCESS, WHEN REQUESTED TO DO SO. THE AGENCY WILL ATTEMPT TO COLLECT THE ACCOUNT FOR SIX MONTHS. AFTER THAT TIME THE ACCOUNT WILL BE WRITTEN OFF AS MEDICARE BAD DEBT.THE IRMC COLLECTION POLICY CONTAINS PROVISIONS TO PROVIDE A SOFTER APPROACH FOR THOSE THAT IRMC HAS LEARNED WOULD QUALIFY FOR FINANCIAL ASSISTANCE. UPON RECEIPT OF THE CALL FROM THE PATIENT THAT THERE IS HARDSHIP IN PAYING THE BILL, THE IRMC COLLECTION REPRESENTATIVE SHARES THE INFORMATION FOR APPLICATION FOR BOTH MEDICAL ASSISTANCE AND CHARITY CARE. WHILE THE PATIENT'S ACCOUNT IS IN THIS PROCESS, THEIR ACCOUNT WILL NOT BE PROVIDED TO THE COLLECTION AGENCY. PART VI, LINE 2: THE IRMC CHNA WAS CONDUCTED TO IDENTIFY PRIMARY HEALTH ISSUES, CURRENT HEALTH STATUS, AND HEALTH NEEDS TO PROVIDE CRITICAL INFORMATION TO THOSE IN A POSITION TO MAKE A POSITIVE IMPACT ON THE HEALTH OF THE REGION'S RESIDENTS. THE RESULTS ENABLE COMMUNITY MEMBERS TO MORE STRATEGICALLY ESTABLISH PRIORITIES, DEVELOP INTERVENTIONS, AND DIRECT RESOURCES TO IMPROVE THE HEALTH OF PEOPLE LIVING IN THE COMMUNITY.TO GUIDE THIS ASSESSMENT, THE LEADERSHIP AT IRMC FORMED A STEERING COMMITTEE THAT CONSISTED OF HOSPITAL AND COMMUNITY LEADERS WHO REPRESENTED THE BROAD INTERESTS OF THEIR LOCAL REGION. THESE INCLUDED REPRESENTATIVES WHO UNDERSTOOD THE NEEDS AND ISSUES RELATED TO VARIOUS UNDERREPRESENTED GROUPS INCLUDING MEDICALLY UNDERSERVED POPULATIONS, LOW-INCOME PERSONS, MINORITY GROUPS, AND THOSE WITH CHRONIC DISEASE NEEDS, INDIVIDUALS WITH EXPERTISE IN PUBLIC HEALTH, AND INTERNAL PROGRAM MANAGERS. THE IRMC STEERING COMMITTEE MET TWO TIMES BETWEEN MARCH 2021 AND APRIL 2021 TO PROVIDE GUIDANCE ON THE VARIOUS COMPONENTS OF THE CHNA.SEE PART V OF SCHEDULE H FOR FURTHER DISCUSSION ON NEEDS ASSESSMENT. PART VI, LINE 3: AT REGISTRATION, PATIENTS WITHOUT INSURANCE ARE PHYSICALLY PROVIDED INFORMATION ABOUT MEDICAID AND OUR CHARITY CARE POLICY AND ENCOURAGED TO ENROLL (WE ARE AVAILABLE TO ASSIST THE CUSTOMER WITH ENROLLMENT). SIGNAGE IS ALSO POSTED THROUGHOUT THE FACILITY OUTLINING OUR CHARITY CARE PROGRAM. ALSO, ALL PATIENT STATEMENTS REFLECT INFORMATION ABOUT FINANCIAL ASSISTANCE PROGRAMS AVAILABLE TO THE PATIENTS. CHARITY CARE INFORMATION IS ALSO REFERENCED ON THE HOSPITAL'S WEB SITE. PART VI, LINE 4: THE POPULATION IN INDIANA COUNTY HAS BEEN DECREASING AND IS PROJECTED TO CONTINUE TO DECREASE INTO 2026. THE POPULATION IS PREDOMINATELY CAUCASIAN (94.3%) AND THERE IS A COMPARABLE NUMBER OF MALES (50.1%) AND FEMALES (49.9%). THE MEDIAN AGE IS 40.2 AND IS PROJECTED TO REMAIN STEADY OVER THE NEXT FIVE YEARS. JUST UNDER HALF OF THE POPULATION IS MARRIED (47.1%), WHILE 9.1% ARE DIVORCED AND 5.6% ARE WIDOWED. ONE IN TEN RESIDENTS (9.7%) DID NOT GRADUATE HIGH SCHOOL, WHILE 42.7% ARE HIGH SCHOOL OR EQUIVALENT GRADUATES. ONE IN TEN (11.0%) HAVE AN ADVANCED DEGREE. THE AVERAGE HOUSEHOLD INCOME IS $65,781, WITH A MEDIAN INCOME OF $50,130. MOST OF THE LABOR FORCE IS EMPLOYED (94.1%), WITH APPROXIMATELY HALF OF THOSE EMPLOYED HOLDING WHITE COLLAR OCCUPATIONS (49.2%). PART VI, LINE 5: IN THE MID-NINETIES, HOSPITALS AND HEALTHCARE FACILITIES BEGAN TO SHIFT THEIR ATTENTION FROM JUST SICK OR HOSPITAL BASED CARE TO INCLUDE ADDRESSING COMMUNITY HEALTH AND DISEASE PREVENTION. AS A FIRST STEP IN THAT DIRECTION, IRMC FORMED A COMMUNITY SERVICE DEPARTMENT WHOSE PURPOSE WAS TO DELIVER EDUCATION AND PREVENTATIVE SCREENINGS TO THE COMMUNITY-AT-LARGE. IN 2005, REALIZING THAT ALMOST EVERY DEPARTMENT IN THE HOSPITAL HAD OPPORTUNITIES TO PROMOTE HEALTH AND WELLNESS, IRMC CREATED THE INSTITUTE FOR HEALTHY LIVING, A VIRTUAL ORGANIZATION COORDINATING ALL ASPECTS OF COMMUNITY OUTREACH AND HEALTH IMPROVEMENT. IMPROVING AND SUSTAINING COMMUNITY HEALTH, HOWEVER, IS A COLLABORATIVE ENDEAVOR THAT INTEGRATES AS MANY KEY STAKEHOLDERS AS POSSIBLE. IN THAT REGARD, IRMC SPEARHEADED THE FORMATION OF THE INDIANA COUNTY COMMUNITY HEALTH ADVISORY COUNCIL (CHAC), AN ENTERPRISE REPRESENTING MEMBERS FROM VARIOUS COMMUNITY AGENCIES, ORGANIZATIONS AND SCHOOLS WHOSE PURPOSE IT IS TO IDENTIFY HEALTH NEEDS IN OUR COUNTY AND TO FIND WAYS TO MEET THEM. THE CHAC HAS BEEN ACTIVE SINCE 1996 AND IRMC SERVES AS ITS BASE AND CHAIRMANSHIP. INDIANA REGIONAL MEDICAL CENTER USES ITS OWN FUNDS TO ENHANCE BOTH THE CLINICAL STRATEGIES AND THE COMMUNITY STRATEGIES.CLINICAL STRATEGIES (A FEW EXAMPLES): RECRUITING ADDITIONAL PHYSICIANS FOR IDENTIFIED COMMUNITY NEEDS, EXPLORE DEVELOPMENT OF A FAMILY PRACTICE RESIDENCY PROGRAM TO FACILITATE RECRUITMENT AND RETENTION, ENLARGE THE MEDICAL FITNESS CENTER, ESTABLISH A WEIGHT LOSS TASK FORCE, DEVELOP A MEDICAL WEIGHT MANAGEMENT CENTER, PROVIDE FLU SHOTS TO ALL INPATIENTS DURING FLU SEASON, PROVIDE PNEUMONIA VACCINE TO ALL NON-VACCINATED INPATIENTS, ETC. COMMUNITY STRATEGIES (A FEW EXAMPLES): PARTNER WITH AGENCIES PROVIDING SERVICES AND EDUCATION TO YOUNG TEENS AND WOMEN, EVALUATE A PARTNERSHIP WITH EARLY HEAD START, IMPROVE VISIBILITY AND INFORMATION AVAILABLE ABOUT THE OB/GYN CLINIC, WORKED TO ESTABLISH PRACTICES IN THE MORE RURAL AREAS OF THE COUNTY THAT REQUIRE THE MEDICAL CENTER TO SUBSIDIZE DELIVERING CARE THERE, ESTABLISHED THE INDIANA AT CHESTNUT RIDGE FACILITY THAT OFFERS PRIMARY CARE AND URGENT-CARE AND WAS A SIGNIFICANT CAPITAL INVESTMENT, IMPLEMENT A PATIENT PORTAL TO IMPROVE PATIENT ACCESS TO MEDICAL RECORDS, BECAME A PROVIDER OF THE WE CAN! (WAYS TO ENHANCE CHILDREN'S ACTIVITY AND NUTRITION), PARTNERED WITH 7 ELEMENTARY SCHOOLS TO INSTALL PROJECT FIT AMERICA, IMPLEMENTED GROCERY STORE TOURS TO ASSIST PEOPLE WITH SEEKING HEALTHY CHOICES, PARTNER WITH 4 GROCERY STORES TO HAVE A DIETICIAN AVAILABLE TO HELP SHOPPERS MAKE HEALTHY CHOICES, CONDUCT THE ANNUAL "VACCINE FOR VETERANS" PROGRAM ON VETERANS DAY, EVALUATE THE POTENTIAL FOR PUBLIC PNEUMONIA VACCINE CLINICS, CONTINUE TO PROVIDE FREE FLU AND PNEUMONIA VACCINE TO HIGH-RISK, LOW INCOME RESIDENTS, ETC. PART VI, LINE 6: INDIANA REGIONAL MEDICAL CENTER HAS THE FOLLOWING AFFILIATED ENTITIES:INDIANA HEALTHCARE FOUNDATION CONDUCTS FUNDRAISING ACTIVITIES, SUCH AS THE COLUMBUS DAY GOLF OUTING AND LOVE OF LIFE GALA, IN SUPPORT OF INDIANA REGIONAL MEDICAL CENTER. INDIANA REGIONAL MEDICAL CENTER AND PUNXSUTAWNEY AREA HOSPITAL JOINTLY FORMED INDIANA JEFFERSON RADIATION ONCOLOGY, INC. FOR THE PURPOSE OF ENHANCING THE QUALITY AND AVAILABILITY OF RADIATION ONCOLOGY SERVICES OFFERED TO PATIENTS IN INDIANA AND JEFFERSON COUNTIES, PA AND SURROUNDING AREAS.INDIANA HEALTHCARE PHYSICIAN SERVICES, INC. IS A NON-PROFIT HOSPITAL OWNED GROUP OF PRACTICES OWNED AND OPERATED TO SERVE THE RURAL AREAS OF INDIANA AND SURROUNDING COMMUNITIES. WE PROVIDE ACCESSIBLE, COST EFFECTIVE QUALITY HEALTHCARE WITHIN THE RURAL COMMUNITIES OF INDIANA AND SURROUNDING COUNTIES. WE SUPPORT AND WORK COLLABORATIVELY WITH OTHER NON-PROFIT AGENCIES WITHIN OUR SITES.INDIANA HEALTHCARE PROPERTIES HOLDS AND MANAGES PROPERTY IN SUPPORT OF INDIANA REGIONAL MEDICAL CENTER. PART VI, LINE 7: N/A X 1 1 X X X X 0 1 0 0 0 0 0 0 0 STEPHEN A WOLFE PRESIDENT & CEO 607396 0 93339 0 101376 0 23994 0 18599 0 844704 0 0 0 ADENIRAN HAASTRUP MD PHYSICIAN 480771 0 78500 0 0 0 3956 0 18400 0 581627 0 0 0 TIMOTHY CLARK SIMPSON MD BOARD MEMBER 0 464480 0 12429 0 20500 0 0 0 19946 0 517355 0 0 TOLUTOPE OZAH MD PHYSICIAN 473728 0 19000 0 0 0 3782 0 18066 0 514576 0 0 0 BENJAMIN L PARK DO PHYSICIAN 462874 0 21000 0 0 0 0 0 18007 0 501881 0 0 0 PATRICK SHANNON DO PHYSICIAN 295784 0 0 0 134942 0 8572 0 19149 0 458447 0 0 0 RICHARD NEFF MD CHIEF MEDICAL OFFICER 359873 0 38045 0 0 0 9150 0 19149 0 426217 0 0 0 ROBERT A GONGAWARE CHIEF FINANCIAL OFFICER 297705 0 26120 0 0 0 21386 0 12935 0 358146 0 0 0 KYUNG PARK MD PHYSICIAN 304946 0 31505 0 0 0 0 0 11518 0 347969 0 0 0 MARK VOLOVIC CHIEF INFORMATION OFFICER 254522 0 25718 0 0 0 13155 0 19149 0 312544 0 0 0 JAMES KINNEER CHIEF HUMAN RESOURCE OFFICER 206778 0 20574 0 0 0 15365 0 19149 0 261866 0 0 0 WENDY HAISLIP CHIEF NURSING OFFICER 204559 0 22740 0 0 0 6453 0 17811 0 251563 0 0 0 BRETT BRAUN CHIEF OPERATING OFFICER 199570 0 20737 0 0 0 10893 0 18716 0 249916 0 0 0 RUSSELL A DROZDIAK MD BOARD MEMBER 159611 0 0 0 19 0 2325 0 1037 0 162992 0 0 0 PART I, LINE 1A INDIANA REGIONAL MEDICAL CENTER PAYS COUNTRY CLUB MEMBERSHIP DUES FOR THE PRESIDENT & CEO, WHICH IS NOT INCLUDED IN HIS COMPENSATION. THE MEMBERSHIP IS A CORPORATE MEMBERSHIP USED FOR BUSINESS PURPOSES ONLY. PART I, LINE 4B INDIANA REGIONAL MEDICAL CENTER HAS A SUPPLEMENTAL, NONQUALIFIED RETIREMENT PLAN UNDER IRC SECTION 457(F) FOR PRESIDENT & CEO, STEPHEN A. WOLFE. NO AMOUNTS WERE PAID TO HIM, AND CONTRIBUTIONS TO THE PLAN WERE $90,000 DURING CALENDAR YEAR 2022. INDIANA HEALTHCARE PHYSICIAN SERVICES HAS A 457(F) PLAN AVAILABLE FOR THEIR PHYSICIANS. FOLLOWING PHYSICIANS WERE MEMBERS OF THE PLAN DURING THE CALENDAR YEAR 2022: - DR. PATRICK SHANNON: NO AMOUNTS WERE PAID TO HIM, AND CONTRIBUTIONS TO THE PLAN WERE $20,000. A INDIANA COUNTY HOSPITAL AUTHORITY - SERIES 2018 251697319 2018-06-01 36200000 SEE PART VI 0 0 0 B INDIANA COUNTY HOSPITAL AUTHORITY - SERIES 2022 251697319 2022-06-27 18873900 REFINANCING OF 2014A BONDS 0 0 0 A 4850000 36200000 369993 35830007 2020 1 1 1 1 B 777266 18873900 242897 18631003 2022 1 1 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 SCHEDULE K, PART I, BOND ISSUES: (A) ISSUER NAME: INDIANA COUNTY HOSPITAL AUTHORITY - SERIES 2018 (F) DESCRIPTION OF PURPOSE: PAYMENT OF 2009 S&T NOTE, 2011 DEBT, 2014B BONDS, 2014C NOTE, FINANCE CAPITAL PROJECTS, AND PAY ISSUANCE COSTS MATTHEW KLAIN DIRECTOR 774746 SEE PART V 0 SCHEDULE L, PART IV: MATTHEW KLAIN IS A DIRECTOR OF THE IRMC BOARD. HE IS THE OWNER OF THE MATTHEW KLAIN GROUP WHICH IS COMPENSATED FOR PHYSICIAN SERVICES PROVIDED TO IRMC. FORM 990, PART VI, SECTION A, LINE 6 PENNSYLVANIA MOUNTAINS CARE NETWORK ("PMCN") IS THE SOLE CORPORATE MEMBER OF INDIANA REGIONAL MEDICAL CENTER ("IRMC"). FORM 990, PART VI, SECTION A, LINE 7A THE INDIVIDUALS WHO SERVE AS DIRECTORS OF PMCN SHALL CONSTITUTE THE BOARD OF THIS CORPORATION. THEIR TERM OF OFFICE SHALL COINCIDE WITH THEIR TERM OF OFFICE AS DIRECTORS OF PMCN. RESIGNATION OR REMOVAL AS A DIRECTOR OF PMCN SHALL CONSTITUTE RESIGNATION OR REMOVAL AS A DIRECTOR OF THIS CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B PMCN SHALL POSSESS ALL OF THE RIGHTS OF A MEMBER, AS DEFINED BY THE PENNSYLVANIA NONPROFIT CORPORATION LAW, AND SHALL EXERCISE THE FOLLOWING RESERVED POWERS WITH RESPECT TO THIS CORPORATION: (A) AMENDMENT TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THIS CORPORATION; (B) THE SALE, LEASE OR EXCHANGE OF ALL OR SUBSTANTIALLY ALL THE PROPERTY OR ASSETS OF THIS CORPORATION; (C) MERGER OR CONSOLIDATION OF THIS CORPORATION WITH ANY OTHER CORPORATION; (D) DISSOLUTION OF THIS CORPORATION; (E) APPROVAL OF THE OPERATING AND CAPITAL BUDGETS FOR THIS CORPORATION; AND (F) ANY OTHER MATTER RELATING TO THIS CORPORATION THAT BY LAW REQUIRES THE APPROVAL OF THE MEMBERS OF A NONPROFIT CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. PRIOR TO FILING, A DRAFT OF THE 990 WILL BE REVIEWED BY TOP MANAGEMENT AND WILL BE DISCUSSED AT A MEETING OF THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS. A FINAL DRAFT IS PROVIDED TO THE FULL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C EVERY MEMBER OF THE BOARD, AND EVERY INDIVIDUAL APPOINTED TO THE BOARD OR BOARD COMMITTEES, AS WELL AS ALL KEY MANAGEMENT PERSONNEL AND PHYSICIAN LEADERS, ARE REQUIRED TO EXECUTE A CONFLICT OF INTEREST DISCLOSURE STATEMENT, WHICH WILL BE UPDATED AT LEAST ON AN ANNUAL BASIS OR AS ADDITIONAL CONFLICTING INTERESTS ARISE. IN ADDITION, EVERY MEMBER OF THE BOARD WILL SPECIFICALLY ACKNOWLEDGE THE CONFLICT OF INTEREST POLICY AND HIS/HER ATTEMPT TO ABIDE BY IT BY SIGNING THE ACKNOWLEDGEMENT FORM. EVERY BOARD COMMITTEE MEMBER, OFFICER, KEY MANAGEMENT EMPLOYEE, AND PHYSICIAN LEADER IS REQUIRED TO SIGN THIS ACKNOWLEDGEMENT AS WELL. THE ACKNOWLEDGEMENT AND DISCLOSURE FORMS WILL BE KEPT ON FILE BY THE CHIEF EXECUTIVE OFFICER, AND THE CHAIRMAN AND VICE-CHAIRMAN WILL BE FAMILIAR WITH THE STATEMENTS THAT ARE FILED BY BOARD MEMBERS IN ORDER TO GUIDE THEIR CONDUCT IN THE EVENT A CONFLICT ARISES. EVERY PERSON COVERED BY THIS POLICY SHALL SUBMIT IN WRITING TO THE CHIEF EXECUTIVE OFFICER A CONFLICT OF INTEREST DISCLOSURE STATEMENT LISTING ALL FINANCIAL AND CONFLICTING INTERESTS. EACH STATEMENT WILL BE RESUBMITTED WITH ANY NECESSARY CHANGES EACH YEAR OR AS ANY ADDITIONAL CONFLICTING OR FINANCIAL INTERESTS ARISE. THE CHAIRMAN OF THE BOARD SHALL BECOME FAMILIAR WITH ALL SUCH DISCLOSURE STATEMENTS IN CASE A CONFLICT ARISES. THE VICE CHAIRMAN OF THE BOARD SHALL BE FAMILIAR WITH THE DISCLOSURE STATEMENT FILED BY THE CHAIRMAN. PENALTIES FOR NON-COMPLIANCE: FAILURE TO COMPLY WITH THIS POLICY SHALL CONSTITUTE GROUNDS FOR REMOVAL FROM OFFICE AND, IN THE CASE OF KEY MANAGEMENT PERSONNEL, TERMINATION OF EMPLOYMENT. FORM 990, PART VI, SECTION B, LINE 15 POSITIONS FOR OFFICERS AND KEY EMPLOYEES ARE REVIEWED ON AN ANNUAL BASIS. APPROPRIATE COMPARISONS ARE MADE ON A REGIONAL AND NATIONAL LEVEL IN ORDER TO MAINTAIN A FAIR AND EQUITABLE COMPENSATION STRUCTURE. AN EXTERNAL CONSULTANT IS UTILIZED TO PREPARE COMPARATIVE SALARY DATA FOR THE BOARD'S REVIEW. ALL RECOMMENDATIONS ARE APPROVED BY IRMC'S BOARD OF DIRECTORS AND DOCUMENTED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PHYSICIANS FEES: PROGRAM SERVICE EXPENSES 10,021,522. MANAGEMENT AND GENERAL EXPENSES 2,432,215. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,453,737. CONSULTATION FEES: PROGRAM SERVICE EXPENSES 2,281,610. MANAGEMENT AND GENERAL EXPENSES 553,745. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,835,355. COLLECTIONS: PROGRAM SERVICE EXPENSES 1,498,759. MANAGEMENT AND GENERAL EXPENSES 363,747. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,862,506. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 4,890,020. MANAGEMENT AND GENERAL EXPENSES 1,186,804. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,076,824. PRINTING & MICROFILMING: PROGRAM SERVICE EXPENSES 39,059. MANAGEMENT AND GENERAL EXPENSES 9,480. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 48,539. OUTSIDE MEDICAL FEES: PROGRAM SERVICE EXPENSES 1,939,763. MANAGEMENT AND GENERAL EXPENSES 470,779. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,410,542. MAINTENANCE SERVICES: PROGRAM SERVICE EXPENSES 2,425,806. MANAGEMENT AND GENERAL EXPENSES 588,741. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,014,547. RECRUITMENT SERVICES: PROGRAM SERVICE EXPENSES 638,829. MANAGEMENT AND GENERAL EXPENSES 155,043. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 793,872. FORM 990, PART XI, LINE 9: TRANSFER (TO)/FROM AFFILIATES -28,336,540. CHANGE IN INTEREST IN INDIANA HEALTHCARE FOUNDATION 692,708. CHANGE IN PENSION AND POST-RETIREMENT LIABILITIES 5,570,041. OTHER CHANGES TO NET ASSETS 80,609. INDIANA JEFFERSON ONCOLOGY LLC 835 HOSPITAL ROAD INDIANA PA 15701 900406301 RADIATION ONCOLOGY SERVICES PA 501(C)(3) LINE 12A, I INDIANA REGIONAL MEDICAL CENTER 1 INDIANA TOTAL THERAPY INC 835 HOSPITAL ROAD INDIANA PA 15701 263843582 THERAPY SERVICES PA 501(C)(3) LINE 10 INDIANA HEALTHCARE PHYSICIAN SERVICES 0 INDIANA HEALTHCARE FOUNDATION 835 HOSPITAL ROAD INDIANA PA 15701 251574302 FUNDRAISING IN SUPPORT OF INDIANA REGIONAL MEDICAL CENTER PA 501(C)(3) LINE 12A, I INDIANA REGIONAL MEDICAL CENTER 1 INDIANA HEALTHCARE PHYSICIAN SERVICES INC 835 HOSPITAL ROAD INDIANA PA 15701 251842046 PROVIDE HEALTH CARE PA 501(C)(3) LINE 3 INDIANA REGIONAL MEDICAL CENTER 1 INDIANA HEALTHCARE PROPERTIES 835 HOSPITAL ROAD INDIANA PA 15701 251524635 HOLD & MANAGE PROPERTY IN SUPPORT OF INDIANA REGIONAL MEDICAL CENTER PA 501(C)(3) LINE 12A, I INDIANA REGIONAL MEDICAL CENTER 1 SPIRITLIFE INC 170 FR MARTIN TELENSON LANE PENN RUN PA 15765 463997001 DETOXIFICATION AND REHABILITATIVE SERVICES PA 501(C)(3) LINE 10 INDIANA REGIONAL MEDICAL CENTER 1 INDIANA AMBULATORY SURGICAL ASSOCIATES INC 835 HOSPITAL ROAD INDIANA PA 15701 232923182 AMBULATORY SURGERY PA 501(C)(3) LINE 12A, I INDIANA REGIONAL MEDICAL CENTER 1 PENNSYLVANIA MOUNTAINS CARE NETWORK 835 HOSPITAL ROAD INDIANA PA 15701 474638568 SUPPORT FOR HEALTHCARE ORGNAIZATIONS PA 501(C)(3) LINE 12A, I N/A 0 PUNXSUTAWNEY AREA HOSPITAL INC 81 HILLCREST DRIVE PUNXSUTAWNEY PA 15767 250965210 HOSPITAL PA 501(C)(3) LINE 3 PENNSYLVANIA MOUNTAINS CARE NETWORK 0 PUNXSUTAWNEY AREA HOSPITAL FOUNDATION 81 HILLCREST DRIVE PUNXSUTAWNEY PA 15701 932244487 TO SUPPORT THE HOSPITAL PA 501(C)(3) LINE 12A, I PUNXSUTAWNEY AREA HOSPITAL INC 0 PUNXSUTAWNEY MEDICAL SERVICES INC 81 HILLCREST DRIVE PUNXSUTAWNEY PA 15767 251773035 ANESTHESIA SERVICES PA 501(C)(3) LINE 3 PUNXSUTAWNEY AREA HOSPITAL INC 0 INDIANA REHABILITATION SERVICES LLC 855 SPRINGDALE DR STE 200 EXTON PA 19341 202214391 REHABILITATION SERVICES PA INDIANA REGIONAL MEDICAL CENTER UNRELATED 0 0 0.51000 0 1 1 1 0 0 0 0 0 1 1 0 1 0 1 1 1 0 0 INDIANA HEALTHCARE PHYSICIAN SERVICES INC P 1413538 FMV INDIANA HEALTHCARE PHYSICIAN SERVICES INC Q 911942 FMV INDIANA HEALTHCARE PROPERTIES P 51696 FMV