PUNXSUTAWNEY AREA HOSPITAL INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- PUNXSUTAWNEY AREA HOSPITAL INC (EIN 25-0965210)
- Tax period
- 2022-07-01 to 2023-06-30
- Filed
- 2024-05-14
- IRS object ID
- 202421359349302402
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-05-14T08:15:57-05:00 | ReturnTs |
| Tax Period End | 2023-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390859910 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER TILLY US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 20 STANWIX STREET | AddressLine1Txt |
| City | PITTSBURGH | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 15222 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 250965210 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PUNXSUTAWNEY AREA HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PUNX | BusinessNameControlTxt |
| Phone | 8149381800 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 81 HILLCREST DRIVE | AddressLine1Txt |
| City | PUNXSUTAWNEY | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 15767 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN G SISK | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 8149381800 | PhoneNum |
| Signature | 2024-05-07 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JOHN | PersonFirstNm |
| Person Last | SISK | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JEFFREY J PETRELL | PreparerPersonNm |
| PTIN | P00138808 | PTIN |
| Phone | 4126976400 | PhoneNum |
| Self Employed | Yes (X) | SelfEmployedInd |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOHN G SISK | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 81 HILLCREST DRIVE | AddressLine1Txt |
| City | PUNXSUTAWNEY | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 15767 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $56,046,759 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PAH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1889 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | VALUED AS HIGHEST QUALITY COMMUNITY HOSPITAL IN THE REGION AND PRIMARY HEALTH CARE PROVIDER, COMMITTED TO CONTINUOUSLY IMPROVING SERVICES WHILE CONTAINING COST. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 496 | TotalEmployeeCnt |
| Total Volunteers | 8 | TotalVolunteersCnt |
| Total Gross UBI | $87,120 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $497,971 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,089,318 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $51,468,544 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $53,195,796 | CYProgramServiceRevenueAmt |
| PY Investment Income | $157,304 | PYInvestmentIncomeAmt |
| CY Investment Income | $546,116 | CYInvestmentIncomeAmt |
| PY Other Revenue | $112,824 | PYOtherRevenueAmt |
| CY Other Revenue | $25,021 | CYOtherRevenueAmt |
| PY Total Revenue | $52,236,643 | PYTotalRevenueAmt |
| CY Total Revenue | $55,856,251 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $29,669,879 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $30,813,695 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $21,262,455 | PYOtherExpensesAmt |
| CY Other Expenses | $22,731,729 | CYOtherExpensesAmt |
| PY Total Expenses | $50,932,334 | PYTotalExpensesAmt |
| CY Total Expenses | $53,545,424 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,304,309 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,310,827 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $43,354,821 | TotalAssetsBOYAmt |
| Total Assets EOY | $43,878,525 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $15,240,627 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $13,288,163 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $28,114,194 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $30,590,362 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE HIGH QUALITY, COST EFFECTIVE, PRIMARY HEALTH CARE AND TO COORDINATE CARE FOR PATIENTS REQUIRING SECONDARY AND TERTIARY SERVICES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $38,854,131 | ExpenseAmt |
| Revenue | $47,750,668 | RevenueAmt |
| Desc | PUNXSUTAWNEY AREA HOSPITAL PROVIDES ACUTE CARE INPATIENT AND OUTPATIENT HEALTH CARE TO PATIENTS IN A THREE COUNTY AREA. FOR THE FISCAL YEAR ENDED; THERE WERE 1,132 ADMISSIONS TO THE ACUTE CARE SETTING THAT GENERATED 3,836 PATIENT DAYS. THE HOSPITAL ALSO PROVIDED 84,544 OUTPATIENT VISITS TO PATIENTS. ALSO, THE HOSPITAL PROVIDED OVER $573,853 OF CHARITY CARE FOR 1,407 CUSTOMER ENCOUNTERS WHERE THE PATIENT DID NOT HAVE THE MEANS TO PAY FOR SERVICES RENDERED. NO PATIENTS WERE TURNED AWAY FOR LACK OF INSURANCE. SERVICES PROVIDED INCLUDE CARDIOPULMONARY, CLINICAL NUTRITION, COUNSELING, EMERGENCY, INTENSIVE CARE, SURGICAL, PHARMACY, RADIOLOGY, REHABILITATION, AND SHORT PROCEDURE. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,501,998 | ExpenseAmt |
| Revenue | $2,880,382 | RevenueAmt |
| Desc | PUNXSUTAWNEY AREA HOSPITAL PROVIDES HOME HEALTH CARE TO PATIENTS IN A THREE COUNTY AREA. FOR THE FISCAL YEAR ENDED THERE WERE 18,850 HOME HEALTH VISITS PROVIDED. NO PATIENTS WERE TURNED AWAY FOR LACK OF INSURANCE. THE HOME HEALTH CARE STAFF IS DEDICATED TO PROVIDING THE HIGHEST QUALITY OF PROFESSIONAL HOME HEALTH CARE TO THE PATIENTS THEY SERVE. THE STAFF WORKS WITH EACH PATIENT'S PHYSICIAN TO DEVELOP A DETAILED PLAN OF CARE PERSONALIZED TO THE PATIENT AND FAMILY. PROFESSIONAL NURSES NOT ONLY PROVIDE DIRECT PATIENT CARE, BUT ALSO PROVIDE COUNSELING/EDUCATION IN MEDICATIONS, NUTRITION, AND SPECIFIC DISEASES.SEE SCHEDULE O FOR ADDITIONAL INFORMATION.THE CARE IF THE PROVISION OF SKILLED SERVICES NEEDED BY THE PATIENT ON A DAILY BASIS, ORDERED BY A PHYSICIAN, REQUIRING CARE FURNISHED DIRECTLY BY OR UNDER SUPERVISION OF TECHNICAL OR PROFESSIONAL PERSONNEL, NOT LIMITED TO REGISTERED NURSES, LICENSED PRACTICAL NURSES, SPEECH PATHOLOGISTS, PHYSICAL THERAPISTS, AND OCCUPATIONAL THERAPISTS. THE CARE INCLUDES SKILLED NURSING, SKILLED REHABILITATION, OR RESTORATIVE CARE THAT BECAUSE OF SPECIAL MEDICAL CONDITIONS REQUIRED THAT THE CARE BE MONITORED BY OR UNDER THE DIRECT OBSERVATION AND ASSESSMENT OF SKILLED NURSING OR REHABILITATION PERSONNEL. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $510,500 | ExpenseAmt |
| Revenue | $2,477,626 | RevenueAmt |
| Desc | PUNXSUTAWNEY AREA HOSPITAL PROVIDES SKILLED NURSING SERVICES TO PATIENTS IN A THREE COUNTY AREA. FOR THE FISCAL YEAR ENDED THERE WERE 147 ADMISSIONS INTO THE LONG-TERM CARE UNIT WHICH GENERATED 2,023 PATIENT DAYS. NO PATIENTS WERE TURNED AWAY FOR LACK OF INSURANCE. THE SERVICE PROVIDES SUPERVISED NURSING CARE, MEDICAL, AND OTHER HEALTH SERVICES TO INDIVIDUALS NOT IN NEED OF ACUTE INPATIENT HOSPITALIZATION, BUT WHOSE NEEDS CAN ONLY BE MET IN A SKILLED CARE FACILITY ON AN INPATIENT BASIS BECAUSE OF AGE, ILLNESS, DISEASE, INJURY, CONVALESCENCE, OR PHYSICAL OR MENTAL INFIRMITY. SEE SCHEDULE O FOR ADDITIONAL INFORMATION.PROGRAM ACHIEVEMENTS:SPECIALTY NURSING PROGRAMS INCLUDE: MATERNAL/CHILD CARE, IV THERAPY ANDENTEROSTOMAL CARE. IN ADDITION TO PROFESSIONAL NURSING SERVICES, THE AGENCY PROVIDES REHABILITATIVE SERVICES INCLUDING PHYSICAL, SPEECH, AND OCCUPATIONAL THERAPIES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $41,866,629 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 52 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 496 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | PA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN G SISK PRESIDENT | PersonNm |
| Phone | 8149381800 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 81 HILLCREST DRIVE | AddressLine1Txt |
| City | PUNXSUTAWNEY | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 15767 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| NATHAN KOVALCHICK | ||||||||
| CHAIRMAN | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| T MICHAEL PRICE | ||||||||
| VICE CHAIRMAN | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| FRANK ROBERTS | ||||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| REBECCA STAPLETON | ||||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| STEPHEN A WOLFE | ||||||||
| DIRECTOR/PRESIDENT & CEO | 1.00 | Yes (X) | Yes (X) | $0 | $802,111 | $42,593 | 39.00 | |
| HILLARY CREELY | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RUSSELL A DROZDIAK MD | ||||||||
| DIRECTOR/PHYSICIAN | 1.00 | Yes (X) | $0 | $159,630 | $3,362 | 39.00 | ||
| MATTHEW N KLAIN MD | ||||||||
| DIRECTOR/PHYSICIAN | 1.00 | Yes (X) | $0 | $0 | $0 | 39.00 | ||
| LAURIE A KUZNESKI | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JAMES R MARTIN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| TIMOTHY CLARK SIMPSON MD | ||||||||
| DIRECTOR/PHYSICIAN | 39.00 | Yes (X) | $497,409 | $0 | $19,946 | 1.00 | ||
| TODD BRICE | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CHRISTINA LUBOLD MD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $37,920 | $0 | 39.00 | ||
| JOHN G SISK | ||||||||
| PRESIDENT | 38.00 | Yes (X) | Yes (X) | $257,088 | $0 | $18,554 | 2.00 | |
| DANIEL D BLOUGH JR | ||||||||
| CEO (UNTIL 9/22) | 38.00 | Yes (X) | $351,010 | $0 | $18,452 | 2.00 | ||
| ROBERT A GONGAWARE | ||||||||
| CFO | 1.00 | Yes (X) | $0 | $323,825 | $34,321 | 39.00 | ||
| THOMAS GENTILCORE MD | ||||||||
| PHYSICIAN | 40.00 | $350,325 | $0 | $6,128 | Yes (X) | |||
| EYAD KHABBAZ MD | ||||||||
| PHYSICIAN | 40.00 | $858,206 | $0 | $38,246 | Yes (X) | |||
| KRISTINA BRUBAKER DO | ||||||||
| PHYSICIAN | 40.00 | $352,125 | $0 | $19,211 | Yes (X) | |||
| BRYAN DEMPSEY MD | ||||||||
| PHYSICIAN | 40.00 | $398,197 | $0 | $19,211 | Yes (X) | |||
| MICHAEL STEVER DO | ||||||||
| PHYSICIAN | 40.00 | $576,733 | $0 | $10,628 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,641,093 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,323,486 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $230,652 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 42 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| AYA HEALTHCARE INC | |||||
| DEPT 3519 PO BOX 123519 | DALLAS | TX | 75312 | STAFFING SERVICE | $1,250,459 |
| LABORATORY CORP OF AMERICA HOLDINGS | |||||
| PO BOX 12140 | BURLINGTON | NC | 16501 | LAB SERVICES | $571,212 |
| CURA HOSPITALITY LLC | |||||
| 2400 ANSYS DRIVE SUITE 404 | CANONSBURG | PA | 15317 | FOOD SERVICE | $441,357 |
| AUSTIN MAJOR GROUP | |||||
| 545 E JOHN CARPENTER FREEWAY SUIT | IRVING | TX | 75062 | STAFFING SERVICE | $352,685 |
| PENNSYLVANIA MOUNTAINS HEALTHCARE | |||||
| 150 MCCRACKEN RUN ROAD | DU BOIS | PA | 15801 | REVENUE CYCLE | $323,585 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 18 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $24,145 | FundraisingAmt |
| Government Grants | $1,791,774 | GovernmentGrantsAmt |
| All Other Contributions | $273,399 | AllOtherContributionsAmt |
| Total Contributions | $2,089,318 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT SERVICES REVENUE | 621990 | $53,043,775 | $52,956,655 | $87,120 |
| OTHER PROGRAM REVENUE | 621990 | $152,021 | $152,021 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $53,195,796 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $530,642 | TotalRevenueColumnAmt |
| Exclusion | $530,642 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $140,527 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $175,409 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$34,882 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$34,882 | TotalRevenueColumnAmt |
| Exclusion | -$34,882 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $15,474 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $15,474 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,474 | TotalRevenueColumnAmt |
| Exclusion | $15,474 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $15,600 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $24,145 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $15,099 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $501 | TotalRevenueColumnAmt |
| Exclusion | $501 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CONTRACTED LABOR REV. | Desc |
| Business | 541900 | BusinessCd |
| Total Revenue Column | $59,402 | TotalRevenueColumnAmt |
| Exclusion | $59,402 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $59,402 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $55,856,251 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $53,108,676 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $87,120 | UnrelatedBusinessRevenueAmt |
| Exclusion | $571,137 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,245,367 | TotalAmt |
| Management And General | $1,245,367 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,501,902 | TotalAmt |
| Program Services | $20,071,430 | ProgramServicesAmt |
| Management And General | $3,430,472 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $270,000 | TotalAmt |
| Program Services | $219,427 | ProgramServicesAmt |
| Management And General | $50,573 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,106,533 | TotalAmt |
| Program Services | $3,377,873 | ProgramServicesAmt |
| Management And General | $728,660 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,689,893 | TotalAmt |
| Program Services | $1,373,365 | ProgramServicesAmt |
| Management And General | $316,528 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,703 | TotalAmt |
| Management And General | $10,703 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,501 | TotalAmt |
| Management And General | $1,501 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,859 | TotalAmt |
| Management And General | $13,859 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,567,173 | TotalAmt |
| Program Services | $5,028,557 | ProgramServicesAmt |
| Management And General | $1,538,616 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $214,045 | TotalAmt |
| Program Services | $214,045 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $907,729 | TotalAmt |
| Program Services | $706,875 | ProgramServicesAmt |
| Management And General | $200,854 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $392,710 | TotalAmt |
| Program Services | $257,783 | ProgramServicesAmt |
| Management And General | $134,927 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $255,010 | TotalAmt |
| Program Services | $255,010 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,683 | TotalAmt |
| Program Services | $6,683 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,585,072 | TotalAmt |
| Program Services | $1,063,141 | ProgramServicesAmt |
| Management And General | $521,931 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $948,970 | TotalAmt |
| Program Services | $306,795 | ProgramServicesAmt |
| Management And General | $642,175 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUG | $7,987,893 | $7,987,893 | |
| REPAIRS & MAINTENANCE | $1,595,683 | $356,411 | $1,239,272 |
| BAD DEBT EXPENSE | $1,252,893 | $1,252,893 | |
| EQUIPMENT LEASED & RENT | $570,598 | $570,598 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $421,207 | TotalAmt |
| Program Services | $70,743 | ProgramServicesAmt |
| Management And General | $350,464 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,545,424 | TotalAmt |
| Program Services | $41,866,629 | ProgramServicesAmt |
| Management And General | $11,678,795 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,325,068 | BOYAmt |
| EOY | $850,860 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,043,668 | BOYAmt |
| EOY | $3,577,234 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,617,767 | BOYAmt |
| EOY | $5,250,054 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $96,743 | BOYAmt |
| EOY | $132,795 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $993,051 | BOYAmt |
| EOY | $1,029,173 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,436,347 | BOYAmt |
| EOY | $1,518,142 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $42,772,745 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $33,771,151 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,403,503 | BOYAmt |
| EOY | $9,001,594 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,663,855 | BOYAmt |
| EOY | $17,703,641 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,663,603 | BOYAmt |
| EOY | $1,669,625 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,113,659 | BOYAmt |
| EOY | $1,113,659 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,997,557 | BOYAmt |
| EOY | $2,031,748 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,354,821 | BOYAmt |
| EOY | $43,878,525 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,442,320 | BOYAmt |
| EOY | $7,526,242 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,830,333 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,967,974 | BOYAmt |
| EOY | $5,761,921 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,240,627 | BOYAmt |
| EOY | $13,288,163 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,647,808 | BOYAmt |
| EOY | $30,111,444 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $466,386 | BOYAmt |
| EOY | $478,918 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,114,194 | BOYAmt |
| EOY | $30,590,362 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,354,821 | BOYAmt |
| EOY | $43,878,525 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $2,310,827 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $607,963 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$442,622 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $13,859 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $13,859 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | A PORTION OF THE HOSPITAL'S DUES TO THE HOSPITAL & HEALTHSYSTEM ASSOCIATION OF PENNSYLVANIA (HAP) AND THE HOSPITAL 340 (B) HEALTH ARE USED FOR LOBBYING. HOSPITAL & HEALTHSYSTEM ASSOCIATION OF PENNSYLVANIA - $932 THE HOSPITAL 340 (B) HEALTH - $177 | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $400,171 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $34,683 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $9,825 | OtherExpendituresAmt |
| End Year Balance | $425,029 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $478,570 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$69,098 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $16,617 | OtherExpendituresAmt |
| End Year Balance | $400,171 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $383,904 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $101,982 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $7,316 | OtherExpendituresAmt |
| End Year Balance | $478,570 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $409,994 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$17,074 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $9,016 | OtherExpendituresAmt |
| End Year Balance | $383,904 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $425,940 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $4,951 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $20,897 | OtherExpendituresAmt |
| End Year Balance | $409,994 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.29250 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.70750 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $40,000 | OtherCostOrOtherBasisAmt |
| Book Value | $40,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,695,876 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,766,390 | DepreciationAmt |
| Book Value | $3,929,486 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $26,877,757 | OtherCostOrOtherBasisAmt |
| Depreciation | $21,875,732 | DepreciationAmt |
| Book Value | $5,002,025 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,159,112 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,129,029 | DepreciationAmt |
| Book Value | $30,083 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $9,001,594 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| PENSION & POST-RETIREMENT LIABILITIES | $1,020,167 |
| ESTIMATED MEDICAL MALPRACTICE CLAIMS LIABILITY | $1,614,646 |
| CONTRACT LIABILITIES | $3,127,108 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $5,761,921 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $55,624,762 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $607,963 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$1,029,960 | OtherRevenueAmt |
| Revenue Not Reported | -$421,997 | RevenueNotReportedAmt |
| Revenue Subtotal | $56,046,759 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$190,508 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$190,508 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $55,856,251 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $52,483,039 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $190,508 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $190,508 | ExpensesNotReportedAmt |
| Expenses Subtotal | $52,292,531 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $1,252,893 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $1,252,893 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $53,545,424 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | INCOME FROM ENDOWMENT FUND IS USED TO PURCHASE CAPITAL EQUIPMENT. |
| PART X, LINE 2: | THE HOSPITAL 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: | BAD DEBT EXPENSE NETTED AGAINST REVENUE ON FINANCIALS -1,252,893. CHANGE IN EQUITY INVESTMENTS 222,933. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | RENTAL EXPENSES -175,409. FUNDRAISING EXPENSES -15,099. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES 175,409. FUNDRAISING EXPENSES 15,099. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE NETTED AGAINST REVENUE ON FINANCIALS 1,252,893. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF TOURNAMENT | Event1Nm |
| Gross Receipts Event1 | $39,745 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $24,145 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $15,600 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $3,754 | CashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $3,560 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $5,299 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $2,486 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $39,745 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $24,145 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $15,600 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $3,754 | CashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $3,560 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $5,299 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $2,486 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $15,099 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $501 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $427,863 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $427,863 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00820 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,034,781 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,946,813 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,087,968 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03990 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,462,644 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,946,813 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,515,831 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04810 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,275 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $11,275 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,318,354 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $572,153 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $746,201 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01430 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,512 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,512 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,333,141 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $572,153 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $760,988 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01460 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,795,785 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,518,966 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,276,819 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06270 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,252,893 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $182,922 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $24,909,675 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $23,886,902 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $1,022,773 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PUNXSUTAWNEY AREA HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 81 HILLCREST DRIVE | AddressLine1Txt |
| City | PUNXSUTAWNEY | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 15767 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.PAH.ORG | WebsiteAddressTxt |
| State License | 163701 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | SKILLED NURSING SERVICES | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PUNXSUTAWNEY AREA HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | PAH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | IRMC.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | PAH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 250.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.PAH.ORG/ABOUT/FINANCIAL-ASSISTANCE | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.PAH.ORG/ABOUT/FINANCIAL-ASSISTANCE | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.PAH.ORG/ABOUT/FINANCIAL-ASSISTANCE | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PUNXSUTAWNEY AREA HOSPITAL | 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.PUNXSUTAWNEY AREA HOSPITAL 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 PAH 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 CHNAS 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 PAH 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 PUNXSUTAWNEY AREA HOSPITALS 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. |
| PUNXSUTAWNEY AREA HOSPITAL | PART V, SECTION B, LINE 6A: THE COMMUNITY NEEDS ASSESSMENT SERVED PUNXSUTAWNEY AREA HOSPITAL AND INDIANA REGIONAL MEDICAL CENTER. |
| PUNXSUTAWNEY AREA HOSPITAL | PART V, SECTION B, LINE 11: PAH CONDUCTED AN EVALUATION OF THE IMPLEMENTATION STRATEGIES UNDERTAKEN SINCE THE COMPLETION OF THEIR 2018 CHNA. ALTHOUGH THE STATUS FOR MOST COUNTY LEVEL INDICATORS DID NOT MOVE SUBSTANTIALLY, IT IS CLEAR PAH IS WORKING TO IMPROVE THE HEALTH OF THE COMMUNITY. THE FOLLOWING HIGHLIGHTS THE AREAS OF MAJOR ACCOMPLISHMENTS THAT THE HOSPITAL MADE IN EACH OF THE FIVE GOALS THAT WERE OUTLINED IN THE IMPLEMENTATION STRATEGY ACTION PLAN. IT IS IMPORTANT TO NOTE THAT PAH'S ABILITY TO IMPLEMENT SEVERAL ACTIVITIES IN ITS IMPLEMENTATION STRATEGY ACTION PLAN WERE LIMITED DUE TO COVID-19 RESTRICTIONS DURING 2020 AND 2021.GOAL ONE - REDUCE OBESITY IN THE COMMUNITY THROUGH AN INCREASE IN PHYSICAL ACTIVITY AND OTHER WELLNESS/PREVENTION STRATEGIES:- OPERATIONALIZED RAPID CARE WALK-IN CLINIC WITH EXPANDED EVENING AND WEEKEND HOURS TO MEET THE NEEDS OF THE COMMUNITY- CONTINUED TO COLLABORATE WITH LOCAL SCHOOL DISTRICT, CHAMBER AND BUSINESSES- WELLNESS PROGRAM WAS DELAYED DUE TO COVID BUT HAD APPROXIMATELY 10% OF PAH EMPLOYEES PARTICIPATING - OCCUPATIONAL HEALTH SERVICES EXPANDED TO INCLUDE 8 LOCAL BUSINESSESGOAL TWO - IMPROVE PREVENTATIVE CARE/SCREENINGS AND EDUCATE THE COMMUNITY REGARDING INFECTIOUS AND CHRONIC DISEASE TO IMPACT POPULATION HEALTH:- IMPLEMENTED COMPREHENSIVE VACCINE CLINICS WHICH HAVE PROVIDED OVER 4,700 COVID-19 VACCINES- NEW TRACKING SYSTEM COMING ONLINE IN 2021 TO TRACK THE USAGE OF PROVIDERS IN THE COMMUNITY THAT ARE DIRECTLY RELATED TO OUR COMMUNITY HEALTH EFFORTS AND IF THE COMMUNITY HEALTH EDUCATIONAL EFFORTS ARE SHOWING RESULTS- CONTINUED TO PARTICIPATE IN COMMUNITY EVENTS AND OUTREACH INITIATIVES TO OFFER EDUCATION AND SCREENINGS TO RESIDENTSGOAL THREE - INCREASE AWARENESS AND PREVENTION OF CARDIOVASCULAR DISEASE (HEART DISEASE, CHOLESTEROL, ETC.):- EXPANDED CARDIOLOGY SERVICE LINE AT PAH- DEVELOPED TRANSFORMATIONAL PLAN DESIGNED TO REDUCE READMISSIONS THROUGH CHRONIC CARE MANAGEMENTGOAL FOUR - POSITION THE HOSPITAL AND COMMUNITY TO RESPOND TO THE NATIONAL OPIOD CRISIS BY USING EVIDENCE BASED PRACTICES AND RESEARCH WHILE PARTNERING TO ENSURE EFFICACY:- DEVELOPED COLLABORATIVE PARTNERSHIPS IN THE COMMUNITY TO IMPROVE SERVICE DELIVERY- UPDATED HOSPITAL WEBPAGE TO INCLUDE LINKS TO STATE AND NATIONAL RESOURCES- WORKING COLLABORATIVELY WITH THE PA DEPARTMENT OF HEALTH TO POTENTIALLY OFFER A MEDICAL CLEARANCE DETOX PROGRAMGOAL FIVE - EXPLORE TELE HEALTH/TELE MEDICINE TO IMPROVE ACCESS TO CARE ISSUES FOR RURAL RESIDENTS.- RECEIVED TELEHEALTH GRANT AND ARE CURRENTLY IN IMPLEMENTATION PHASE FOCUSED ON TELEHEALTH RELATED TO NEUROLOGY, BEHAVIORAL HEALTH, OPIOIDS AND OVERALL HEALTH EDUCATION- DURING COVID WAS ABLE TO PROVIDE TELEHEALTH SERVICES FOR RAPID CARE, NEUROLOGY, UROLOGY AND PRIMARY CARE |
| PUNXSUTAWNEY AREA HOSPITAL | PART V, SECTION B, LINE 13H: THERE IS A PRESUMPTIVE CHARITY SCORE PROCESS USING ACCOUNTS WITH MEDICARE OR DUAL ELIGIBILITY. |
| SCHEDULE H, PART V, SECTION B, LINE 16I: | LEP TRANSLATIONS:THERE ARE NO GROUPS WITH LIMITED ENGLISH PROFICIENCY THAT RISE TO THE THRESHOLD REQUIRED UNDER IRC SECTION 501(R). HOWEVER, LANGUAGE TRANSLATIONS OF THE FINANCIAL ASSISTANCE POLICY AND APPLICATION ARE AVAILABLE BY REQUEST AT THE FINANCIAL COUNSELING DEPARTMENT OF THE HOSPITAL. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - HHCS OF PUNXSUTAWNEY AREA HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 240 WEST MAHONING STREET | AddressLine1Txt |
| City | PUNXSUTAWNEY | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 15767 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | MEDICARE CERTIFIED HOME HEALTH AGENCY | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1 AND 3.COST COMPUTED ON IRS WORKSHEET 6 WAS COMPUTED FROM THE ORGANIZATIONS COST ACCOUNTING SOFTWARE INCLUDING DIRECT COSTS PLUS OVERHEAD ALLOCATIONS COMPUTED IN COST ACCOUNTING. |
| PART I, LN 7 COL(F): | THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24, BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $1,252,893. |
| PART III, LINE 2: | THE AMOUNT REPORTED FOR BAD DEBT IS THE TOTAL ACTUAL ACCOUNT BALANCES TRANSFERRED TO A COLLECTION AGENCY OFFSET BY MONIES COLLECTED FROM THE AGENCY. ALSO AN ESTIMATE BASED ON HISTORICAL COLLECTION PERCENTAGES OF SELF PAY FOR THE ACTIVE ACCOUNTS RECEIVABLE BALANCE IS CALCULATED MONTHLY AND THIS DIFFERENCE IS ADDED TO OR SUBTRACTED FROM BAD DEBT EXPENSE. |
| PART III, LINE 3: | WE BELIEVE THAT A PORTION OF OUR BAD DEBTS RESULTS FROM SERVICES PROVIDED TO PATIENTS WHO MEET THE CHARITY CARE GUIDELINES BUT WERE UNABLE OR UNWILLING TO PROVIDE THE APPROPRIATE DOCUMENTATIONS TO ALLOW THAT CLASSIFICATION. THIS FIGURE WAS CALCULATED USING THE ESTIMATED PERSONS UNDER POVERTY FOR JEFFERSON COUNTY OF 14.6%.PUNXSUTAWNEY AREA HOSPITAL PROVIDES CARE TO ALL PATIENTS WHO NEED IT, REGARDLESS OF THEIR ABILITY TO PAY. THIS IS PART OF THE HOSPITAL'S MISSION |
| PART III, LINE 4: | THE AUDIT FOOTNOTE ADDRESSING BAD DEBT EXPENSE AND PATIENT ACCOUNTS RECEIVABLE IS FOUND ON PAGE 8 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS UNDER NOTES TO CONSOLIDATED FINANCIAL STATEMENTS, SECTION 2. |
| PART III, LINE 8: | SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THE HOSPITAL USES THE COST-TO-CHARGE RATIO TO DETERMINE THE MEDICARE ALLOWABLE COSTS. |
| PART III, LINE 9B: | PATIENTS WHO QUALIFY FOR CHARITY CARE ARE FLAGGED IN ORDER TO PROCESS THEM SEPERATELY FROM OTHER SELF PAY ACCOUNTS. |
| PART VI, LINE 2: | THE HOSPITAL DETERMINES COMMUNITY NEEDS BASED ON MULTIPLE SURVEYS AND MEETINGS WITH MEMBERS OF THE BUSINESS COMMUNITY, MEDICAL STAFF PHYSICIANS AND RANDOM COMMUNITY MEMBERS FROM THE SERVICE AREA.SEE ALSO SCHEDULE H PART V FOR COMMUNITY HEALTH NEEDS ASSESSMENT INFORMATION. |
| 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: | STATISTICS AVAILABLE FROM THE UNITED STATES CENSUS NUREAU REVEAL THAT JEFFERSON COUNTY HAS A POPULATION OF JUST UNDER 44,491 IN APPROXIMATELY 650 SQUARE MILES. THE POPULATION AGED 65 AND OLDER IS 21.0%. THE POPULATION WITH INCOME BELOW THE POVERTY LEVEL IS 14.6% AND THE COUNTY'S PER CAPITA PERSONAL INCOME IS $27,548. |
| PART VI, LINE 5: | THE HOSPITAL CONDUCTS SEVERAL FREE HEALTH SCREENINGS EACH YEAR THAT ARE OFFERED TO MEMBERS OF THE COMMUNITY WITHOUT HEALTH INSURANCE. ALSO, MULTIPLE FREE MEDICAL EDUCATION PROGRAMS ARE OFFERED TO PROVIDE AWARENESS OF TOPICAL AND TIMELY HEALTH ISSUES.PAH PROVIDES THE STUDENTS AT THE PUNXSUTAWNEY AREA SCHOOL DISTRICT WITH HYGIENE ITEMS FOR THE STUDENTS AS PART OF THE RURAL HEALTH MODEL. THESE ITEMS ARE DISTRIBUTED TO THE STUDENTS IN NEED BY THE SCHOOL NURSES AND SOCIAL WORKERS. PAH HAS FOOD AVAILABLE FOR PATIENTS WHO SCREEN POSITIVE FOR FOOD INSECURITY AND CAN PROVIDE A LIST OF RESOURCES TO ASSIST WITH ALL SOCIAL DETERMINANTS OF HEALTH. PAH HAS A COMPASSION CLOSET THAT HAS GARMENTS AVAILABLE FOR PATIENTS WHO ARE IN NEED PRIOR TO THEIR DISCHARGE. PAH HOLDS MONTHLY FREE EDUCATIONAL SEMINARS FOR ALL TO ATTEND ON VARIOUS HEALTH TOPICS AS PART OF THE WELLNESS CONNECTIONS PROGRAM. |
| PART VI, LINE 6: | PUNXSUTAWNEY AREA HOSPITAL AND ITS WHOLLY OWNED SUBSIDIARY, PUNXSUTAWNEY MEDICAL SERVICES, INC., PRIMARILY EARN REVENUES BY PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES TO PATIENTS IN THE PUNXSUTAWNEY, PENNSYLVANIA, AREA AND ALSO OPERATES A HOME HEALTH AGENCY. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| EYAD KHABBAZ MD | ||||||||||||||
| PHYSICIAN | $708,101 | $0 | $149,295 | $0 | $810 | $0 | $20,000 | $0 | $18,246 | $0 | $896,452 | $0 | $0 | $0 |
| STEPHEN A WOLFE | ||||||||||||||
| DIRECTOR/PRESIDENT & CEO | $0 | $607,396 | $0 | $93,339 | $0 | $101,376 | $0 | $23,994 | $0 | $18,599 | $0 | $844,704 | $0 | $0 |
| MICHAEL STEVER DO | ||||||||||||||
| PHYSICIAN | $549,375 | $0 | $0 | $0 | $27,358 | $0 | $0 | $0 | $10,628 | $0 | $587,361 | $0 | $0 | $0 |
| TIMOTHY CLARK SIMPSON MD | ||||||||||||||
| DIRECTOR/PHYSICIAN | $464,480 | $0 | $12,429 | $0 | $20,500 | $0 | $0 | $0 | $19,946 | $0 | $517,355 | $0 | $0 | $0 |
| BRYAN DEMPSEY MD | ||||||||||||||
| PHYSICIAN | $398,197 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $19,211 | $0 | $417,408 | $0 | $0 | $0 |
| KRISTINA BRUBAKER DO | ||||||||||||||
| PHYSICIAN | $352,125 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $19,211 | $0 | $371,336 | $0 | $0 | $0 |
| DANIEL D BLOUGH JR | ||||||||||||||
| CEO (UNTIL 9/22) | $246,262 | $0 | $29,487 | $0 | $75,261 | $0 | $0 | $0 | $18,452 | $0 | $369,462 | $0 | $0 | $0 |
| ROBERT A GONGAWARE | ||||||||||||||
| CFO | $0 | $297,705 | $0 | $26,120 | $0 | $0 | $0 | $21,386 | $0 | $12,935 | $0 | $358,146 | $0 | $0 |
| THOMAS GENTILCORE MD | ||||||||||||||
| PHYSICIAN | $350,325 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $6,128 | $0 | $356,453 | $0 | $0 | $0 |
| JOHN G SISK | ||||||||||||||
| PRESIDENT | $198,405 | $0 | $23,183 | $0 | $35,500 | $0 | $0 | $0 | $18,554 | $0 | $275,642 | $0 | $0 | $0 |
| RUSSELL A DROZDIAK MD | ||||||||||||||
| DIRECTOR/PHYSICIAN | $0 | $159,611 | $0 | $0 | $0 | $19 | $0 | $2,325 | $0 | $1,037 | $0 | $162,992 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE CEO'S COMPENSATION IS PAID BY INDIANA REGIONAL MEDICAL CENTER. INDIANA REGIONAL MEDICAL CENTER USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| 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. PUNXSUTAWNEY AREA HOSPITAL HAS A SUPPLEMENTAL, NONQUALIFIED RETIREMENT PLAN UNDER IRC SECTION 457(F) FOR DR. KHABBAZ. DURING 2022, $20,000 WAS CONTRIBUTED TO THE PLAN. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHANNON BYERLY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | SEE PART V | RelationshipDescriptionTxt |
| Transaction | $77,200 | TransactionAmt |
| Transaction | WAGES | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: | FormAndLineReferenceDesc |
| Explanation | SHANNON BYERLY IS THE DAUGHTER OF PHYLLIS BYERLY, FORMER DIRECTOR, AND IS AN EMPLOYEE OF PUNXSUTAWNEY AREA HOSPITAL. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF PUNXSUTAWNEY AREA HOSPITAL, INC. IS PENNSYLVANIA MOUNTAINS CARE NETWORK ("PMCN"). |
| 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 | THE CEO'S COMPENSATION IS PAID BY INDIANA REGIONAL MEDICAL CENTER (IRMC). 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 | PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 1,286,179. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,286,179. CONSULTANT: PROGRAM SERVICE EXPENSES 42,045. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,045. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,700,333. MANAGEMENT AND GENERAL EXPENSES 1,538,616. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,238,949. |
| FORM 990, PART XI, LINE 9: | TRANSFERS TO AFFILIATES -1,605,156. CHANGE IN INVESTMENT IN IRREVOCABLE TRUST 12,194. CHANGE IN EQUITY INVESTMENTS 222,933. NON-CONTROLLING INTEREST IN SUBSIDIARY 337,647. NET ASSET RELEASED FROM RESTRICTION 589,760. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| INDIANA REGIONAL MEDICAL CENTER | |||||||||||
| 835 HOSPITAL ROAD | INDIANA | PA | 15701 | 250965404 | HOSPITAL | PA | 501(C)(3) | LINE 3 | PENNSYLVANIA MOUNTAINS CARE NETWORK | 0 | |
| 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 | 0 | |
| 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 | 0 | |
| 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 | 0 | |
| 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 | 0 | |
| 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 | 0 | |
| 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 | 0 | |
| PENNSYLVANIA MOUNTAINS CARE NETWORK | |||||||||||
| 835 HOSPITAL ROAD | INDIANA | PA | 15701 | 474638568 | SUPPORT FOR HEALTHCARE ORGNAIZATIONS | PA | 501(C)(3) | LINE 12A, I | 0 | N/A | |
| 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 | Yes (1) | |
| PUNXSUTAWNEY MEDICAL SERVICES INC | |||||||||||
| 81 HILLCREST DRIVE | PUNXSUTAWNEY | PA | 15767 | 251773035 | ANESTHESIA SERVICES | PA | 501(C)(3) | LINE 3 | PUNXSUTAWNEY AREA HOSPITAL INC | Yes (1) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| PUNXSUTAWNEY MEDICAL SERVICES INC | ||
| O | $1,515,843 | COST |
| PUNXSUTAWNEY MEDICAL SERVICES INC | ||
| P | $670,000 | COST |
| PUNXSUTAWNEY MEDICAL SERVICES INC | ||
| S | $759,315 | COST |