2025-05-14T07:22:28-05:00 2024-06-30 390859910 BAKER TILLY ADVISORY GROUP LP 1570 FRUITVILLE PIKE SUITE 400 LANCASTER PA 17601 990 2023-07-01 240795682 MOUNT NITTANY MEDICAL CENTER MOUN 8142317000 155 WELLNESS WAY STATE COLLEGE PA 16803 BRYAN ROACH SR. EXECUTIVE VP & CFO 8142317000 2025-05-10 1 1 KERRI N BOGDA CPA P00760402 7177404863 2025-05-10 2023 2025-03-06 01:10:19Z KATHLEEN RHINE 155 WELLNESS WAY STATE COLLEGE PA 16803 780471639 0 X WWW.MOUNTNITTANY.ORG X 1905 PA INPATIENT, OUTPATIENT & EMERGENCY CARE SERVICES TO CENTRE COUNTY AND THE SURROUNDING AREAS. 9 3 2167 45 2462043 802843 5861679 3528386 458777195 500156254 823955 17285749 16652484 18863549 482115313 539833938 37804941 48119503 0 0 204375777 217646265 0 0 0 199614377 212844333 441795095 478610101 40320218 61223837 1177993229 1353777578 546528654 562820688 631464575 790956890 X MOUNT NITTANY'S MISSION: WE ARE HERE TO MAKE PEOPLE HEALTHIER.MOUNT NITTANY MEDICAL CENTER WILL PROVIDE EVERY PATIENT WITH THE FINEST, PATIENT-CENTERED CARE IN A SAFE AND COMFORTABLE ENVIRONMENT. CONTINUED ON SCHEDULE O.CARE WILL BE PROVIDED WHILE CONTINUALLY IMPROVING ACCESS TO CARE, AND STRIVING TO ENHANCE THE QUALITY OF HUMAN LIFE FOR EVERYONE WE SERVE. MOUNT NITTANY MEDICAL CENTER WILL ENHANCE ITS POSITION AS THE PREFERRED REGIONAL HEALTHCARE DESTINATION FOR BOTH PATIENTS AND MEDICAL PROFESSIONALS - PROVIDING VITAL CLINICAL CENTERS OF EXCELLENCE AND SUPERIOR ACCESS TO CARE - SUPPORTED BY A COMMITMENT TO MEDICAL EDUCATION AND BACKED BY A CULTURE OF ADVANCEMENT AND ACCOUNTABILITY - MOVING LIFE FORWARD. 0 0 365721053 48119503 500156254 MOUNT NITTANY MEDICAL CENTER IS AN ACUTE CARE HOSPITAL AND IS AN MOUNT NITTANY MEDICAL CENTER, MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES, CENTRE COUNTY CHILDREN'S ADVOCACY CENTER, AND THE FOUNDATION FOR MOUNT NITTANY MEDICAL CENTER.CONTINUED ON SCHEDULE O.MOUNT NITTANY MEDICAL CENTER IS COMMITTED TO PROVIDING QUALITY MEDICAL CARE IN AN ATMOSPHERE THAT REFLECTS HIGH STANDARDS OF SOCIAL, ETHICAL, AND FINANCIAL RESPONSIBILITY AND WILL ASSURE THAT THOSE SAME STANDARDS ARTHE BOARD OF TRUSTEES HAS ESTABLISHED THIS STATEMENT OF ORGANIZATIONAL VALUES TO ASSURE THAT MEMBERS OF THE BOARD, THE MEDICAL CENTER STAFF, AND THE MEDICAL STAFF HONOR THE FOLLOWING PRINCIPLES THROUGH OUR BEHAVIORS:1) ALLIANCES WITH PATIENTS:- WE WILL TREAT ALL PATIENTS WITH DIGNITY AND RESPECT, AND WILL ACCOMMODATE INDIVIDUAL RESPONSES TO THE STRESS OF ILLNESS.- WE FULLY SUPPORT THE PRINCIPLES OUTLINED IN THE STATEMENT OF PATIENT'S RIGHTS AND RESPONSIBILITIES DOCUMENT.- WE COMMIT TO A SERVICE EXCELLENCE PHILOSOPHY THAT STRIVES TO MEET OR EXCEED PATIENT EXPECTATIONS.- ALL PATIENTS RECEIVE A UNIFORM STANDARD OF CARE THROUGHOUT THE FACILITY, REGARDLESS OF SOCIAL, CULTURAL, FINANCIAL, RELIGIOUS, RACIAL, GENDER, OR SEXUAL ORIENTATION FACTORS.- THE MEDICAL CENTER AND MEDICAL STAFF WORK JOINTLY TO ASSURE THAT ONLY APPROPRIATE AND EFFECTIVE TESTS, PROCEDURES, AND TREATMENTS ARE PROVIDED TO PATIENTS.2) COMMUNITY RELATIONS:- WE WILL FAIRLY AND ACCURATELY REPRESENT OURSELVES AND OUR CAPABILITIES TO THE PUBLIC.- WE ARE COMMITTED TO CONSTANT PREPARATION FOR THE LONG-TERM FINANCIAL VIABILITY OF THE MEDICAL CENTER THROUGH RESPONSIBLE UTILIZATION OF RESOURCES AND IN SUPPORT OF OUR COMMITMENT TO MEET THE HEALTHCARE NEEDS OF THE COMMUNITY.- MEDICAL CENTER LEADERSHIP (EXECUTIVES, BOARD OF TRUSTEES, MEDICAL STAFF) WILL DISCLOSE AND AVOID POTENTIAL CONFLICTS OF INTEREST. ALL OTHER HOSPITAL STAFF WILL AVOID SIMILAR CONFLICTS OF INTEREST.- WE WILL MAINTAIN AN OPEN ADMISSIONS POLICY: NO PATIENT WILL BE REFUSED EVALUATION AND SERVICE BASED UPON SEX, AGE, RACE, CREED, NATIONAL ORIGIN, SEXUAL ORIENTATION, INFECTION STATUS, OR THE ABILITY TO PAY. TRANSFERS TO OTHER FACILITIES WILL OCCUR ONLY WHEN WE ARE UNABLE TO PROVIDE NEEDED SERVICES AND ONLY TO FACILITIES THAT PROVIDE AN APPROPRIATE LEVEL OF CARE, BASED ON OUR ASSESSMENT OF THE PATIENTS' NEEDS. PATIENTS MAY ALSO REQUEST ELECTIVE TRANSFER AND AN INFORMEDCONSENT PROCESS WILL BE FOLLOWED.GENERAL PROGRAM SERVICE INFORMATION:-1) OPERATIONS & PATIENTS:MOUNT NITTANY MEDICAL CENTER, LOCATED IN STATE COLLEGE, PENNSYLVANIA, IS A 260-BED ACUTE-CARE, NOT-FOR-PROFIT FACILITY OFFERING GENERAL MEDICAL AND SURGICAL SERVICES THAT ARE FOCUSED ON HELPING PATIENTS REACH THEIR HEALTH POTENTIAL. FOR THE FISCAL YEAR ENDED JUNE 30, 2024,MOUNT NITTANY MEDICAL CENTER PROVIDED CARE TO THE FOLLOWING NUMBER OF PATIENTS:TOTAL NUMBER OF: INPATIENTS 12,920, OUTPATIENTS 316,708 AND ER VISITS 57,592TOTAL MEDICARE AND MEDICARE ADVANTAGE: INPATIENTS 6,214, OUTPATIENTS 98,940 AND ER VISITS 16,584TOTAL MEDICAID AND MEDICAID HMO: INPATIENTS 1,324, OUTPATIENTS 18,118 AND ER VISITS 10,272TOTAL SELF PAY: INPATIENTS 224, OUTPATIENTS 13,260 AND ER VISITS 1,584.MOUNT NITTANY MEDICAL CENTER DID NOT DENY MEDICAL SERVICES TO ANY INDIVIDUALS INCLUDING THOSE THAT HAD PRIVATE INSURANCE, MEDICARE, MEDICAID, PUBLIC HEALTH INSURANCE, OR NO INSURANCE.2) EMERGENCY DEPARTMENT:MOUNT NITTANY MEDICAL CENTER OPERATES AN EMERGENCY ROOM 24 HOURS A DAY, 365 DAYS A YEAR PROVIDING SERVICES TO ALL MEMBERS OF THE COMMUNITY REGARDLESS OF THEIR ABILITY TO PAY AND DENIED ZERO PATIENTS REQUESTING SUCH SERVICES. THE EMERGENCY ROOM DOES NOT HAVE A TRAUMA CENTER CERTIFICATION.3) MEDICAL STAFF PRIVILEGES:ALL QUALIFIED PHYSICIANS IN THE COMMUNITY ARE ELIGIBLE FOR MEDICAL STAFF PRIVILEGES AT MOUNT NITTANY MEDICAL CENTER AND ALL QUALIFIED PHYSICIAN APPLICATIONS HAVE BEEN ACCEPTED FOR MEDICAL STAFF PRIVILEGES. MORE THAN 300 PHYSICIANS IN 42 SPECIALTIES AND SUBSPECIALTIES ARE CREDENTIALED AT MOUNT NITTANY MEDICAL CENTER.4) PROFESSIONAL MEDICAL EDUCATION AND TRAINING:MOUNT NITTANY MEDICAL CENTER CONDUCTS PROFESSIONAL MEDICAL EDUCATION AND TRAINING PROGRAMS FOR THE BENEFIT OF THE COMMUNITY WITH A RESULTING FINANCIAL LOSS TO THE MEDICAL CENTER MET IN ALL CONTRACTUAL RELATIONSHIPS. 365721053 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 29 0 2167 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 9 3 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X BRYAN ROACH SR EXECUTIVE VP & CFO 8142346148 155 WELLNESS WAY STATE COLLEGE PA 16803 THOMAS QUIGLEY CHAIR 2.00 X X 0 0 0 KRISTIE KAUFMAN MD SECRETARY/TREASURER 2.00 38.00 X X 0 365330 35370 KATHLEEN RHINE CEO/TRUSTEE 32.00 8.00 X X 2332581 0 296030 DUSTIN CASE DO TRUSTEE 2.00 38.00 X 0 802149 36804 GAIL HURLEY TRUSTEE 2.00 X 0 0 0 JEFFREY PRO MD TRUSTEE 2.00 38.00 X 0 426843 34865 NANCY L SILVIS TRUSTEE 2.00 X 0 0 0 BARRY R STEIN DMD TRUSTEE 2.00 10.00 X 0 100000 0 FAOUD ISHMAEL MD TRUSTEE 2.00 38.00 X 0 454190 34893 BRYAN ROACH EXECUTIVE VP & CFO 32.00 8.00 X 690811 0 77045 NIRMAL JOSHI MD SYSTEM CHIEF MEDICAL OFFICER (UNTIL 12/23) 40.00 0.00 X 264299 0 28237 UPENDRA THACKER MD CHIEF MEDICAL OFFICER 40.00 0.00 X 513154 0 68878 THOMAS CHARLES EXEC VP SYSTEM DVLMT (UNTIL 1/24) 40.00 0.00 X 233519 0 61336 TIFFANY CABIBBO EVP PATIENT CARE SVCS/CNO 40.00 0.00 X 402214 0 54415 AMY TRITHART CHIEF HUMAN RESOURCE OFFICER 40.00 0.00 X 344874 0 79731 KURT KISSINGER VP SYSTEM DEVELOPMENT 40.00 0.00 X 342446 0 52683 ERIC MATAVA CHIEF LEGAL OFFICER 40.00 X 306526 0 45686 ROBERT DONAHUE CHIEF FACILITY MGMT OFFICER 40.00 X 278713 0 35599 JENNIFER GILBERT PHYSICIAN 40.00 X 665995 0 25903 BRIAN PETER YUSKEVICH PHYSICIAN 40.00 X 581981 0 34622 PETER JONATHAN GAMBINO PHYSICIAN 40.00 X 537576 0 29349 ANDREW T LEE PHYSICIAN 40.00 X 535992 0 13961 WILLIAM HOWARD JUSTICE PHYSICIAN 40.00 X 529973 0 34655 LANCE ROSE FORMER CEO/OFFICER/DIRECTOR 0.00 X 14721 0 0 8575375 2148512 1080062 245 1 1 0 ALEXANDER BUIDLING CONSTRUCTION LLC 315 VAUGHN STREET HARRISBURG PA 17110 CONSTRUCTION SERVICES 47645723 WHITING TURNER CONTRACTING PO BOX 17596 BALTIMORE MD 21297 CONSTRUCTION SERVICES 45571399 MEDEFIS CONSOLIDATED PO BOX 5068 NEW YORK NY 10087 STAFFING SERVICES 15603712 STANTEC INTERNATIONAL 13980 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 CONSTRUCTION SERVICES 4700954 JJP RECRUITING LLC PO BOX 1708 WATKINSVILLE GA 30677 LOCUM PHYSICIAN SERVICES 2751289 87 3526731 1655 3528386 NET PATIENT SERVICE RE 621110 497980897 497980897 OTHER OPERATING REVENU 900099 2175357 2175357 500156254 16601680 16601680 338475 402998 -64523 -64523 -64523 240683188 235584 240147621 87082 535567 148502 684069 684069 85433 0 85433 85433 SERVICES SOLD TO RELAT 621110 13856731 13856731 OUTPATIENT LAB SERVICE 621500 2462043 2462043 CAFETERIA SALES 722514 1266363 1266363 1257502 1257502 18842639 539833938 500156254 2462043 33687255 48119503 48119503 5620826 2192122 3428704 160447148 130825396 29621752 12469616 10138764 2330852 27484060 18782543 8701517 11624615 9134161 2490454 1027798 1027798 165118 165118 41471 41471 3264805 3264805 28087043 20136844 7950199 1615526 3320 1612206 4697455 1292157 3405298 13112789 3116772 9996017 6241880 5464835 777045 139065 115932 23133 86121 18630 67491 12956960 12956960 20981656 2196 20979460 3024136 3024136 MEDICAL SUPPLIES 73962954 73566848 396106 BAD DEBT EXPENSE 17378833 17378833 NEEDS HEALTH ASSESSMENT 9952757 9952757 PATHOLOGY LAB 3472385 3472385 12635581 9002852 3632729 478610101 365721053 112889048 0 3786 3786 33035300 33917377 40519916 53128709 9363254 8182107 9833253 13737996 741536455 353630335 244063753 387906120 142762541 79374354 647311746 728466814 51099680 49060315 1177993229 1353777578 48253625 71968905 443912 554182 182290773 474727175 298033613 17506731 15570426 546528654 562820688 X 623260527 781908909 8204048 9047981 631464575 790956890 1177993229 1353777578 X 61223837 72800006 25468472 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 41471 41471 0 PART II-B, LINE 1: A PORTION OF THE DUES PAID TO THE HOSPITAL & HEALTHSYSTEM ASSOCIATION OF PENNSYLVANIA ($32,876) AND THE AMERICAN HOSPITAL ASSOCIATION ($8,595) WAS DETERMINED TO BE FOR LOBBYING PURPOSES. 3966063 537537 4503600 3497404 20830 447829 3966063 4158932 30000 -691528 3497404 3414155 10250 734527 4158932 3422460 10000 -18305 3414155 0.36620 0.62830 0.00550 0 1 1 13135349 13135349 277875384 148333380 129542004 17051223 14710951 2340272 225638207 184593901 41044306 207836292 5992103 201844189 387906120 INVESTMENT IN PARTNERSHIP - EQUITY METHOD 1283046 C ALTERNATIVE INVESTMENT 727183768 F 728466814 CAPITAL LEASE OBLIGATIONS 863601 ACCRUED INTEREST 2633598 OPERATING LEASE OBLIGATIONS 11980442 DUE TO AFFILIATES 92785 15570426 614503045 72800006 4824834 77624840 536878205 2955733 2955733 539833938 455010730 -2955733 -2955733 457966463 20643638 20643638 478610101 PART V, LINE 4: PERMANENT ENDOWMENT FUNDS ARE HELD BY THE FOUNDATION FOR MOUNT NITTANY MEDICAL CENTER, INC. AND EARNINGS ARE DESIGNATED TO FUND FUTURE EXPENDITURES AND CAPITAL ACQUISITIONS FOR MOUNT NITTANY MEDICAL CENTER. PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSES NETTED AGAINST REVENUE ON FINANCIALS -17,378,833. CHANGE IN INTEREST IN FOUNDATION 3,425,676. CHANGE IN INTEREST IN PARTNERSHIP -1,318,922. INVESTMENT EXPENSES NETTED AGAINST REVENUE ON FINANCIALS -3,264,805. PENSION LIABILITY ADJUSTMENT 19,690,945. CHANGE IN FAIR VALUE OF DERIVATIVE 1,950,207. NET PERIODIC PENSION COST 1,720,566. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -402,998. RELATED PARTY CONTRIBUTIONS NETTED AGAINST GRANTS ON FINANCIALS 3,358,731. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 402,998. RELATED PARTY CONTRIBUTIONS NETTED AGAINST GRANTS ON FINANCIALS -3,358,731. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSES NETTED AGAINST REVENUE ON FINANCIALS 17,378,833. INVESTMENT EXPENSES NETTED AGAINST REVENUE ON FINANCIALS 3,264,805. 1 1 1 X 250.000000000000 0 1 1 1 0 1 1 1030152 1030152 0.00220 34037054 12011838 22025216 0.04780 35067206 12011838 23055368 0.05000 566425 566425 0.00120 331359 6300 325059 0.00070 7729823 3436638 4293185 0.00930 156641 156641 0.00030 562508 562508 0.00120 9346756 3442938 5903818 0.01270 44413962 15454776 28959186 0.06270 90498 90498 0.00020 90498 90498 0.00020 1 17378833 62361322 63374332 -1013010 X 1 1 1 1 MOUNT NITTANY MEDICAL CENTER 155 WELLNESS WAY STATE COLLEGE PA 16803 WWW.MOUNTNITTANY.ORG 550301 X X X MOUNT NITTANY MEDICAL CENTER 1 0 0 1 X X X X X X X X X 21 1 0 1 1 X MOUNTNITTANY.ORG/COMMUNITY-ENGAGEMENT/COMMUNITY-HEALTH/COMMUNITY-HEALTH-NEE X 1 21 1 MOUNTNITTANY.ORG/COMMUNITY-ENGAGEMENT/COMMUNITY-HEALTH/COMMUNITY-HEALTH-NEE 0 1 X 250.000000000000 X 1 1 X X X 1 X MOUNTNITTANY.ORG/BILLING-INSURANCE/FINANCIAL-ASSISTANCE X MOUNTNITTANY.ORG/BILLING-INSURANCE/FINANCIAL-ASSISTANCE X MOUNTNITTANY.ORG/BILLING-INSURANCE/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X 1 X 0 0 MOUNT NITTANY MEDICAL CENTER PART V, SECTION B, LINE 5: THE FOLLOWING RESEARCH METHODS WERE USED TO DETERMINE COMMUNITY HEALTH NEEDS:1) ELECTRONIC SURVEY OF KEY STAKEHOLDERS, INCLUDING EXPERTS IN PUBLIC HEALTH AND INDIVIDUALS REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. A LIST OF KEY INFORMANTS AND THEIR RESPECTIVE ORGANIZATION IS INCLUDED IN APPENDIX B OF THE 2022 CHNA. 2) ELECTRONIC MNH PROVIDER ENGAGEMENT SURVEY TO BETTER UNDERSTAND AND RESPOND TO THE IMPACT OF SOCIAL DETERMINANTS OF HEALTH ON PATIENT HEALTH OUTCOMES AND ASSESS SYSTEMWIDE DIVERSITY, EQUITY, AND INCLUSION INITIATIVES 3) A PARTNER FORUM WITH COMMUNITY AGENCY REPRESENTATIVES TO GARNER INSIGHT ON EXISTING HEALTH IMPROVEMENT EFFORTS AND OPPORTUNITIES FOR PARTNERSHIP. A LIST OF PARTNERS IS INCLUDED IN APPENDIX C OF THE 2023 CHNA. MOUNT NITTANY MEDICAL CENTER PART V, SECTION B, LINE 6B: THE 2023 CHNA WAS CONDUCTED IN PARTNERSHIP WITH CENTRE FOUNDATION, CENTRE COUNTY UNITED WAY, CENTRE COUNTY GOVERNMENT AND MORE THAN 80 HUMAN SERVICES PROVIDERS. MOUNT NITTANY MEDICAL CENTER PART V, SECTION B, LINE 11: THE 2022 CHNA CONSISTENTLY IDENTIFIED BEHAVIORAL HEALTH AND CHRONIC DISEASE AS THE MOST SIGNIFICANT HEALTH NEEDS FOR CENTRE COUNTY RESIDENTS. UNDERLYING THESE NEEDS WERE THE CROSS-CUTTING ISSUES OF SOCIAL DETERMINANTS OF HEALTH AND RURAL DISPARITIES IN ACCESS TO CARE AND OVERALL HEALTH AND WELLNESS. IN DEVELOPING THE 2022-2025 IMPLEMENTATION PLAN, MNH SOUGHT TO PRIORITIZE STRATEGIES THAT ADDRESS THESE UNDERLYING ISSUES TO PROMOTE AN UPSTREAM, PREVENTIVE APPROACH TO COMMUNITY HEALTH IMPROVEMENT.THE IMPLEMENTATION STRATEGY ADDRESSES EACH OF THESE THREE PRIORITY AREAS, WITH KEY OBJECTIVES, AREAS OF FOCUS, MNH RESOURCES AND POTENTIAL COLLABORATION PARTNERS. SPECIFIC INITIATIVES AND PROGRAMS ARE INTEGRATED INTO MNH'S OVERALL SYSTEM STRATEGIC PLAN, WHICH IS UPDATED ANNUALLY. MOUNT NITTANY MEDICAL CENTER PART V, SECTION B, LINE 13B: INCOME GUIDELINES FOR ELIGIBILITY ARE BASED ON THE SIZE OF A FAMILY: ONE MEMBER: $33,975, TWO MEMBERS: $45,775, FOR FAMILY UNITS WITH MORE THAN TWO MEMBERS, ADD $11,800 FOR EACH ADDITIONAL MEMBER. PART I, LINE 3C: IN ADDITION TO THE FINANCIAL ASSISTANCE (FREE CARE POLICY) BASED ON FPG, THE HOSPITAL ALSO OFFERS A DISCOUNT OF 55% OFF OF CHARGES TO UNINSURED PATIENTS ON HOSPITAL ACCOUNT BALANCES (THIS DISCOUNT IS FOR PATIENTS WHO DO NOT QUALIFY UNDER OUR 250% FPG FINANCIAL ASSISTANCE POLICY.) THE FOLLOWING ARE EXAMPLES THAT QUALIFY PATIENTS AS UNINSURED: TERMINATED COVERAGE EITHER DUE TO JOB TERMINATION OR UNINSURED PERIODS DURING TRANSITION, EMPLOYED PATIENTS WHO MAY BE IN A "WAITING/GRACE" PERIOD FOR INSURANCE, OR INSURED PATIENTS WHERE COVERAGE HAS EXHAUSTED. PART I, LINE 7: COST TO CHARGE RATIO WAS COMPUTED USING WORKSHEET 2 AS DESCRIBED IN THE IRS INSTRUCTIONS TO FORM 990 FOR LINES 7A, 7B, AND 7G. COST ACCOUNTING SYSTEM WAS USED FOR SUBSIDIZED HEALTH SERVICES. FOR ALL OTHERS, COSTS INCLUDED THE VALUE OF STAFF DONATED HOURS (WITH ESTIMATED BENEFITS), MONETARY CONTRIBUTIONS, ESTIMATED VALUE OF MATERIALS USED IN DELIVERING PROGRAMS, AND ESTIMATED SPACE COSTS. THE INDIRECT COST ALLOCATION APPLIES THE INDIRECT-TO-DIRECT COST RATIO FROM THE MEDICAL CENTER'S MOST RECENT MEDICARE COST REPORT. PART I, LN 7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24B AMOUNTS TO $17,378,833 FOR THE YEAR ENDED JUNE 30, 2024. PART II, COMMUNITY BUILDING ACTIVITIES: OUR ENTRIES FOR WORKFORCE DEVELOPMENT INCLUDE STAFF TIME TO PROVIDE EDUCATION TO LOCAL HIGH SCHOOL STUDENTS REGARDING STROKE CARE AT MNMC, INCLUDING PREVENTION, IN-HOSPITAL CARE, & POST-HOSPITAL CARE & THE PRESENTATION OF ROLES & RESPONSIBILITIES OF THE CLINICAL TRIALS OFFICE AT MNMC. PART III, LINE 2: BAD DEBT (AT COST) IS CALCULATED BY APPLYING THE PATIENT CARE COST-TO-CHARGE RATIO FROM WORKSHEET 2 TO THE MEDICAL CENTER'S PROVISION FOR DOUBTFUL COLLECTIONS AS OF JUNE 30, 2024. THE MEDICAL CENTER'S ACCOUNTING DEPARTMENT RECORDS PAYMENTS, WHILE THE PATIENT ACCOUNTING STAFF MAKES THE APPROPRIATE ADJUSTMENT TO THE PATIENT ACCOUNTS FOR BAD DEBT, DISCOUNTS, OR FREE CARE WRITE-OFFS. PART III, LINE 3: THE MEDICAL CENTER IS UNABLE TO ESTIMATE THE AMOUNT OF BAD DEBT THAT COULD BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. PATIENTS DO NOT PROVIDE INCOME INFORMATION PRIOR TO RECEIVING CARE. THE REGISTRATION DEPARTMENT GIVES EVERY PATIENT A COPY OF OUR FINANCIAL ASSISTANCE PROGRAM TO ENSURE EVERY PATIENT HAS THE OPPORTUNITY AS APPROPRIATE TO QUALIFY FOR OUR ASSISTANCE PROGRAM. THE MEDICAL CENTER OFFERS DETAILED INFORMATION ABOUT THE CHARITY CARE PROGRAM WHEN PATIENTS OFFER INFORMATION THAT IS NEEDED TO DETERMINE ELIGIBILITY. SEE RESPONSE TO PART VI, LINE 3.MOUNT NITTANY MEDICAL CENTER PROVIDES SERVICES TO ALL PATIENTS REGARDLESS OF ABILITY TO PAY AS PART OF THE HOSPITAL'S MISSION. A PORTION OF THE MOUNT NITTANY MEDICAL CENTER'S BAD DEBT WOULD RELATE TO PATIENTS THAT COULD QUALIFY FOR CHARITY CARE BUT WERE UNWILLING OR UNABLE TO PROVIDE THE APPROPRIATE DOCUMENTATION TO ALLOW THAT CLASSIFICATION. AS SUCH A PORTION OF THE HOSPITAL'S BAD DEBT SHOULD BE CONSIDERED COMMUNITY BENEFIT. PART III, LINE 4: ACCOUNTS RECEIVABLE PATIENTS, ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENTS' ASSESSMENT OF INDIVIDUAL ACCOUNTS. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS ESTIMATED BASED ON A PERIODIC REVIEW OF THE ACCOUNTS RECEIVABLE AGING, PAYOR CLASSIFICATIONS, AND APPLICATION OF HISTORICAL WRITE-OFF PERCENTAGES. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE CORPORATION ANALYZES CONTRACTUAL AMOUNTS DUE AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND INSURED PATIENTS WITH DEDUCTIBLE AND CO-PAYMENT BALANCES, THE CORPORATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBT IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE BILLED RATES AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. PART III, LINE 8: THE MEDICAL CENTER CONTINUES TO PROVIDE CARE TO ALL PRESENTING AND ADMITTED PATIENTS, REGARDLESS OF ABILITY TO PAY. THROUGH DILIGENT COST CONTROL PROCESSES, THE MEDICAL CENTER SEEKS WAYS TO KEEP COSTS OF PROVIDING CARE TO A MINIMUM, WHILE STILL PROVIDING THE SAFETY MEASURES, TECHNOLOGICAL CAPABILITIES, AND APPROPRIATE STAFFING LEVELS TO ENSURE THE BEST POSSIBLE OUTCOMES. NOTWITHSTANDING THE COSTS TO PROVIDE CARE, RECEIVING "LESS" THEN WHAT IT COSTS TO PROVIDE ADEQUATE CARE TO MEDICARE COVERED LIVES DOES THE MEDICAL CENTER A DISSERVICE. THIS SHORTFALL SHOULD COUNT AS A COMMUNITY BENEFIT AS THE MEDICAL CENTER STRIVES TO PROVIDE THE BEST CARE POSSIBLE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY.THE MEDICAL CENTER USES A STEP-DOWN COST ALLOCATION METHOD AND THEN APPLIES A COST-TO-CHARGE RATIO. PART III, LINE 9B: IF PATIENTS ARE FOUND TO QUALIFY FOR FINANCIAL ASSISTANCE, THE MEDICAL CENTER IMMEDIATELY CEASES COLLECTIONS AND ADJUSTS CHARGES OFF AS CHARITY CARE. PART VI, LINE 2: THE 2022 CHNA WAS CONDUCTED FROM AUGUST 2021 TO MAY 2022. QUANTITATIVE AND QUALITATIVE METHODS, REPRESENTING BOTH PRIMARY AND SECONDARY RESEARCH, WERE USED TO ILLUSTRATE AND COMPARE HEALTH AND SOCIAL TRENDS AND DISPARITIES ACROSS CENTRE COUNTY. SPECIFIC CHNA STUDY METHODS INCLUDED:- ELECTRONIC SURVEY OF KEY STAKEHOLDERS, INCLUDING EXPERTS IN PUBLIC HEALTH AND INDIVIDUALS REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS;- REVIEW OF MOUNT NITTANY MEDICAL CENTER UTILIZATION DATA TO ANALYZE HOW CONSUMERS ARE ACCESSING CARE AND WHERE GAPS IN SERVICE EXIST - ELECTRONIC MNH PROVIDER ENGAGEMENT SURVEY TO BETTER UNDERSTAND AND RESPOND TO THE IMPACT OF SOCIAL DETERMINANTS OF HEALTH ON PATIENT HEALTH OUTCOMES AND ASSESS SYSTEMWIDE DIVERSITY, EQUITY, AND INCLUSION INITIATIVES - A PARTNER FORUM WITH COMMUNITY AGENCY REPRESENTATIVES TO GARNER INSIGHT ON EXISTING HEALTH IMPROVEMENT EFFORTS AND OPPORTUNITIES FOR PARTNERSHIP THE 2021 CHNA BUILT UPON MNH'S PREVIOUS CHNAS AND SUBSEQUENT IMPLEMENTATION PLANS. THE CHNA WAS CONDUCTED IN A TIMELINE TO COMPLY WITH IRS TAX CODE 501(R) REQUIREMENTS TO CONDUCT A CHNA EVERY THREE YEARS AS SET FORTH BY THE AFFORDABLE CARE ACT (ACA). THE FINDINGS WILL BE USED TO GUIDE COMMUNITY BENEFIT INITIATIVES FOR THE HOSPITALS AND ENGAGE LOCAL PARTNERS TO COLLECTIVELY ADDRESS IDENTIFIED HEALTH NEEDS. PART VI, LINE 3: THE 2022 CHNA CONSISTENTLY IDENTIFIED CHRONIC DISEASE AND BEHAVIORAL HEALTH AS THE MOST SIGNIFICANT HEALTH NEEDS FOR CENTRE COUNTY RESIDENTS. THESE HEALTH NEEDS WERE CONFIRMED BY QUANTITATIVE AND QUALITATIVE RESEARCH, AS WELL AS COMMUNITY STAKEHOLDERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY. COMMUNITY STAKEHOLDERS BROUGHT WIDE PERSPECTIVES ON RESIDENT HEALTH NEEDS, EXISTING COMMUNITY RESOURCES AVAILABLE TO MEET THOSE NEEDS, AND GAPS IN THE SERVICE DELIVERY SYSTEM. THE PRIORITIZED HEALTH NEEDS ARE CONSISTENT WITH THE HEALTH NEEDS IDENTIFIED AS PART OF THE 2019 CHNA. MOUNT NITTANY HEALTH, IN PARTNERSHIP WITH COMMUNITY AGENCIES, HAS MADE SIGNIFICANT PROGRESS IN ADDRESSING THESE NEEDS, BOTH FROM A COMMUNITY AND POPULATION HEALTH MANAGEMENT PERSPECTIVE. IMPROVED ACCESS TO CARE WILL CONTINUE TO BE A CROSS-CUTTING STRATEGY FOR ALL PRIORITY NEEDS. THROUGH THE FINANCIAL ASSISTANCE PROGRAM, MOUNT NITTANY MEDICAL CENTER PROVIDES MEDICAL CARE REGARDLESS OF A PATIENT'S ABILITY TO PAY, INSUFFICIENT HEALTH INSURANCE OR WHETHER A GOVERNMENT-SPONSORED PROGRAM COVERS THE FULL COST OF SERVICES. AS THE COUNTRY'S ECONOMIC FUTURE REMAINS UNCERTAIN, MNMC WILL PROVIDE SERVICES AT NO CHARGE OR REDUCED CHARGES TO THOSE WHO ARE FINANCIALLY UNABLE TO PAY FOR THOSE SERVICES. MNMC WILL NOT ARBITRARILY RESTRICT THE PROVISIONS OF HEALTH SERVICES TO CERTAIN INDIVIDUALS OR GROUPS.MNMC'S REGISTRATION DEPARTMENT REPRESENTATIVES WILL GIVE A COPY OF OUR FINANCIAL ASSISTANCE PROGRAM TO EVERY PATIENT ALONG WITH OTHER IMPORTANT BILLING INFORMATION. OUR FINANCIAL COUNSELOR WILL DISCUSS THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS SUCH AS MEDICAID OR STATE PROGRAMS TO ASSIST THE PATIENT WITH QUALIFICATIONS FOR THESE PROGRAMS. THE FINANCIAL COUNSELOR WILL ALSO ASSIST THE PATIENT IN COMPLETING THE PROPER PAPERWORK FOR ASSISTANCE. IN ADDITION, OUR VENDOR DEBIASE & LEVINE REPRESENTATIVE, WHO IS WORKING ON BEHALF OF MNMC, WILL ALSO ASSIST PATIENTS WITH THE MEDICAL ASSISTANCE PROCESS. OUR VENDOR WORKS ON BEHALF OF THE ORGANIZATION TO FOLLOW THE HOSPITAL'S POLICIES REGARDING PATIENT NOTIFICATION AND THE AVAILABILITY OF FINANCIAL ASSISTANCE. MNMC'S FINANCIAL ASSISTANCE POLICY IS POSTED ON OUR WEBSITE ALONG WITH AN APPLICATION FOR PATIENTS TO COMPLETE FOR FINANCIAL ASSISTANCE. THE FINANCIAL COUNSELORS AND CASE MANAGEMENT STAFF WILL ALSO WORK CLOSELY TO IDENTIFY AND ASSIST ELIGIBLE PATIENTS.A NOTICE OF AVAILABILITY OF MNMC'S FINANCIAL ASSISTANCE PROGRAM WILL BE GIVEN TO EACH PATIENT OR THEIR REPRESENTATIVE PRIOR TO SERVICES BEING RENDERED, WITH THE EXCEPTION OF EMERGENCY SERVICES WHEREBY THE PATIENT IS TRIAGED PRIOR TO COMPLETING THE REGISTRATION PROCESS. THESE PATIENTS WOULD RECEIVE THE NOTICE REGARDING THE FINANCIAL ASSISTANCE PROGRAM AT SOME POINT DURING THAT VISIT. THESE NOTICES ARE DISPLAYED AND MADE AVAILABLE IN ALL REGISTRATION AREAS OF THE HOSPITAL AND INCLUDES THE MOST CURRENT AVAILABLE "HOUSEHOLD INCOME GUIDELINES" AS PUBLISHED IN THE FEDERAL REGISTER. MNMC'S CURRENT FINANCIAL ASSISTANCE PROGRAM ELIGIBILITY IS BASED ON 2.5 TIMES THE "HOUSEHOLD INCOME GUIDELINES". THE PATIENT ACCOUNTS DIRECTOR OR HIS/HER DESIGNEE SHALL REVIEW ALL APPLICATIONS FOR THE MNMC FINANCIAL ASSISTANCE PROGRAM. IT IS THE APPLICANT'S RESPONSIBILITY TO PROVIDE PROOF OF INCOME. PART VI, LINE 4: THE MEDICAL CENTER'S PRIMARY SERVICE AREA INCLUDES CENTRE COUNTY AND PARTS OF THE SURROUNDING COUNTIES. CENTRE COUNTY'S POPULATION IS APPROXIMATELY 162,000. THE POPULATION INCREASED 5.2% FROM THE 2010 CENSUS. SEVERAL COMMUNITIES SERVED BY MOUNT NITTANY MEDICAL CENTER ARE DESIGNATED MEDICALLY UNDERSERVED AREAS, DETERMINED BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, HEALTH RESOURCES AND SERVICES ADMINISTRATION AS HAVING TOO FEW PRIMARY CARE PROVIDERS, HIGH INFANT MORTALITY, HIGH POVERTY, OR A HIGH ELDERLY POPULATION. IN ADDITION, THE FOLLOWING GEOGRAPHIES/POPULATIONS ARE DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREAS (HPSA) FOR EITHER PRIMARY CARE OR DENTAL CARE:- LOW-INCOME RESIDENTS IN PHILIPSBURG (PRIMARY CARE)- SNOW SHOE (PRIMARY CARE)- LOW-INCOME RESIDENTS ACROSS CENTRE COUNTY (DENTAL CARE). THE CENTRE COUNTY POPULATION IS PRIMARILY WHITE WITH LESS THAN 14% OF RESIDENTS IDENTIFYING AS ANOTHER RACE AND 3.1% OF RESIDENTS IDENTIFYING AS HISPANIC OR LATINO. THE MEDIAN AGE OF CENTRE COUNTY (29.8) IS LOWER THAN THE STATE AND NATIONAL MEDIANS (40.4 AND 37.4 YEARS RESPECTIVELY) AS REPORTED ON THE 2016 CHNA, BUT INCREASED FROM THE 2013 CHNA (28.7). CENTRE COUNTY REPRESENTS A DIVERSE SOCIOECONOMIC ENVIRONMENT. THE OVERALL POVERTY LEVEL IN CENTRE COUNTY DECREASED TO 19.1% FROM THE 2016 CHNA OF 20.9%. THE UNEMPLOYMENT RATE ALSO DECREASED FROM 6.7% TO 4.3% FROM 2016 TO 2019. INDIVIDUALS WITH LESS THAN A HIGH SCHOOL DIPLOMA DECREASED FROM 7.4% OF CENTRE COUNTY'S POPULATION TO 6.0%. POVERTY RATES IN CENTRE COUNTY MAY BE INFLUENCED BY STUDENTS ATTENDING THE PENNSYLVANIA STATE UNIVERSITY. POVERTY AND EDUCATION RATES MAY BE INFLUENCED BY AMISH POPULATIONS RESIDING IN CERTAIN ZIP CODES WITHIN CENTRE COUNTY. PART VI, LINE 5: THE MEDICAL CENTER'S BOARD OF TRUSTEES AND ITS VARIOUS COMMITTEES INCLUDE COMMUNITY MEMBERS AS WELL AS MEDICAL STAFF. THE COMMUNITY MEMBERS ARE NOT DIRECTLY INVOLVED IN THE MEDICAL CENTER'S OPERATIONS. THE MEDICAL CENTER'S MEDICAL STAFF EXCEEDS 300 PHYSICIANS. THE MEDICAL CENTER CONTINUES TO INVEST IN STRONG AND BENEFICIAL RELATIONSHIPS WITH ALL PHYSICIANS WHO HAVE AN INTEREST IN WORKING WITH THE MEDICAL CENTER. ALL REVENUES IN EXCESS OF EXPENSES ARE RE-INVESTED IN THE COMMUNITY, INCLUDING SIGNIFICANT DONATIONS TO THE COUNTY'S ONLY FREE MEDICAL AND DENTAL CLINIC, AS WELL AS FUNDING INTERNAL IMPROVEMENTS TO TECHNOLOGY SO THAT THE PEOPLE AND COMMUNITIES WE SERVE HAVE THE IMMEDIATE ACCESS TO HE BEST AND MOST APPROPRIATE DIAGNOSTIC AND TREATMENT OPTIONS AVAILABLE. PART VI, LINE 6: MOUNT NITTANY HEALTH SYSTEMS HAS TWO CONTROLLED CORPORATIONS, WHICH ARE THE MOUNT NITTANY MEDICAL CENTER (INPATIENT AND OUTPATIENT SERVICES) AND MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES, INC. (A PHYSICIAN PRACTICE D/B/A MOUNT NITTANY PHYSICIAN GROUP). THE FOUNDATION FOR THE MNMC (FUNDRAISING) IS CONTROLLED BY THE MOUNT NITTANY MEDICAL CENTER.COMMUNITY BENEFIT SERVICES OFFERED BY MOUNT NITTANY MEDICAL CENTER ARE AFFORDED TO THE BROAD COMMUNITY WITH THE INTENT OF IMPROVING COMMUNITY HEALTH. PROGRAMS AND SERVICES ARE DESIGNED TO RESPOND TO IDENTIFIED COMMUNITY NEEDS. COMMUNITY BENEFIT ACTIVITIES FALL INTO THESE MAJOR CATEGORIES: COMMUNITY HEALTH IMPROVEMENT SERVICES - INCLUDES ACTIVITIES THAT ARE CARRIED OUT TO IMPROVE COMMUNITY HEALTH. MOUNT NITTANY MEDICAL CENTER PROVIDES COMMUNITY HEALTH EDUCATION, HEALTH SCREENINGS, SUPPORT GROUPS, AND TRANSPORTATION ASSISTANCE. THIS PAST YEAR MNMC OFFERED NUMEROUS SCREENING AND EDUCATION EVENTS FOR MEMBERS OF OUR COMMUNITY. HEALTH PROFESSIONS EDUCATION - MOUNT NITTANY MEDICAL CENTER IS ADVANCING HEALTHCARE BY ADVANCING ACCESS TO EDUCATION AND TRAINING. MOUNT NITTANY AWARDED CONTINUING EDUCATION CREDITS FOR NURSES AND PHYSICIANS AS WELL AS TRAININGS IN THE AMERICAN HEART ASSOCIATION TRAINING CENTER. CASH AND IN-KIND DONATIONS - MOUNT NITTANY MEDICAL CENTER REPORTED ITS SUPPORT OF MORE THE FORTY LOCAL ORGANIZATIONS THROUGH IN-KIND AND CASH DONATIONS. THE LEAD BENEFICIARY OF MOUNT NITTANY'S SUPPORT IS CENTRE VOLUNTEERS IN MEDICINE. OTHER NON-PROFIT GROUPS INCLUDE AMERICAN HEART ASSOCIATION, PEOPLE CENTRE'D ON DIABETES, YMCA OF CENTRE COUNTY AND MORE. COMMUNITY-BUILDING ACTIVITIES - MOUNT NITTANY IS A LEAD FACILITATOR IN LOCAL AND REGIONAL PREPAREDNESS ACTIVITIES, ENSURING THAT CENTRE COUNTY IS PREPARED SHOULD A DISASTER STRIKE. IN ADDITION, MOUNT NITTANY PROVIDES ACCESS TO CARE IN RURAL AREAS TO ENSURE THAT EVERY COMMUNITY HAS ACCESS TO CARE, SUCH AS PROVIDING DIABETES EDUCATION AT RURAL DOCTOR'S OFFICES. SUBSIDIZED HEALTH SERVICES - MOUNT NITTANY MEDICAL CENTER PROVIDES THE COMMUNITY MENTAL HEALTH SERVICES AT ITS INPATIENT UNIT, ONCOLOGY PATIENT NAVIGATOR PROGRAM, TRANSPORTATION SERVICES FOR THE PATIENTS WITH CANCER, PEDIATRIC MEDICAL HOME PROGRAM FOR AT-RISK CHILDREN AND SEVERAL FREE SUPPORT GROUPS.THE MOUNT NITTANY PHYSICIAN GROUP OFFERS A COMMUNITY BENEFIT BY SEEING CENTRE VOLUNTEERS IN MEDICINE (CVIM) PATIENTS FOR SPECIALTY SERVICES AT NO COST TO THE PATIENT OR TO CVIM. THIS GROUP ALSO PROVIDES VARIOUS INTERNSHIPS, PRESENTATIONS, AND NEWSLETTERS TO THE COMMUNITY INCLUDING TOPICS LIKE HEART HEALTH AND PEDIATRICS. PART VI, LINE 7, REPORTS FILED WITH STATES PA 1 MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES INC 155 WELLNESS WAY STATE COLLEGE PA 16803 510426500 501(C)(3) 47279720 0 CASH N/A PROVIDE FINANCIAL SUPPORT TO AFFILIATE MOUNT NITTANY HEALTH SYSTEM INC 155 WELLNESS WAY STATE COLLEGE PA 16803 800663092 501(C)(3) 751537 0 CASH N/A PROVIDE FINANCIAL SUPPORT TO AFFILIATE CENTRE COUNTY CHILDREN'S ADVOCACY CENTER 155 WELLNESS WAY STATE COLLEGE PA 16803 460871813 501(C)(3) 88246 0 CASH N/A PROVIDE FINANCIAL SUPPORT TO AFFILIATE 3 0 PART I, LINE 2: ASSISTANCE IS PROVIDED TO RELATED ENTITIES FOR FINANCIAL SUPPORT. MANAGEMENT OF THE ORGANIZATION OVERSEES THE USE OF FUNDS AT THE AFFILIATED ENTITIES. X X X X 1 1 0 0 0 0 0 1 0 KATHLEEN RHINE CEO/TRUSTEE 885294 0 805522 0 641765 0 282688 0 13342 0 2628611 0 320352 0 DUSTIN CASE DO TRUSTEE 0 752520 0 24825 0 24804 0 1707 0 35097 0 838953 0 0 BRYAN ROACH EXECUTIVE VP & CFO 533676 0 153706 0 3429 0 20304 0 56741 0 767856 0 0 0 JENNIFER GILBERT PHYSICIAN 590486 0 72512 0 2997 0 420 0 25483 0 691898 0 0 0 BRIAN PETER YUSKEVICH PHYSICIAN 524235 0 49600 0 8146 0 371 0 34251 0 616603 0 0 0 UPENDRA THACKER MD CHIEF MEDICAL OFFICER 461011 0 46588 0 5555 0 20283 0 48595 0 582032 0 0 0 PETER JONATHAN GAMBINO PHYSICIAN 502071 0 32800 0 2705 0 404 0 28945 0 566925 0 0 0 WILLIAM HOWARD JUSTICE PHYSICIAN 495396 0 31200 0 3377 0 404 0 34251 0 564628 0 0 0 ANDREW T LEE PHYSICIAN 499687 0 33600 0 2705 0 554 0 13407 0 549953 0 0 0 FAOUD ISHMAEL MD TRUSTEE 0 425077 0 5250 0 23863 0 207 0 34686 0 489083 0 0 JEFFREY PRO MD TRUSTEE 0 392131 0 10000 0 24712 0 207 0 34658 0 461708 0 0 TIFFANY CABIBBO EVP PATIENT CARE SVCS/CNO 329231 0 70397 0 2586 0 20164 0 34251 0 456629 0 0 0 AMY TRITHART CHIEF HUMAN RESOURCE OFFICER 269770 0 72843 0 2261 0 20130 0 59601 0 424605 0 0 0 KRISTIE KAUFMAN MD SECRETARY/TREASURER 0 314091 0 29860 0 21379 0 0 0 35370 0 400700 0 0 KURT KISSINGER VP SYSTEM DEVELOPMENT 287218 0 52084 0 3144 0 20145 0 32538 0 395129 0 0 0 ERIC MATAVA CHIEF LEGAL OFFICER 281208 0 23515 0 1803 0 19884 0 25802 0 352212 0 0 0 ROBERT DONAHUE CHIEF FACILITY MGMT OFFICER 232393 0 43813 0 2507 0 11832 0 23767 0 314312 0 0 0 THOMAS CHARLES EXEC VP SYSTEM DVLMT (UNTIL 1/24) 232505 0 0 0 1014 0 13092 0 48244 0 294855 0 0 0 NIRMAL JOSHI MD SYSTEM CHIEF MEDICAL OFFICER (UNTIL 180930 0 82278 0 1091 0 9328 0 18909 0 292536 0 0 0 LANCE ROSE FORMER CEO/OFFICER/DIRECTOR 0 0 0 0 14721 0 0 0 0 0 14721 0 0 0 PART I, LINES 4A-B THE FORMER CEO, LANCE ROSE, RECEIVED A NONQUALIFIED RETIREMENT PLAN PAYMENT OF $14,721 DURING THE CALENDAR YEAR. THE CHIEF EXECUTIVE OFFICER, KATHLEEN RHINE, PARTICIPATES IN 457(F) NON-QUALIFIED RETIREMENT PLAN. CONTRIBUTIONS MADE DURING THE CALENDAR YEAR WERE $262,806. PART I, LINE 7 THE EXECUTIVE TEAM MEMBERS OF MOUNT NITTANY MEDICAL CENTER AND THE MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES' (D/B/A MOUNT NITTANY PHYSICIAN GROUP) EXECUTIVE DIRECTOR RECEIVED A PORTION OF THEIR ANNUAL VARIABLE-PAY BASED UPON THE CONSOLIDATED OPERATING MARGIN, MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES' (D/B/A MOUNT NITTANY PHYSICIAN GROUP) OPERATING MARGIN, CONTRIBUTIONS, AND OTHER CORPORATE GOALS. THE CORPORATE GOALS FOCUSED ON (1) PROVIDING LOCALIZED CARE, INTEGRATED CARE, EFFICIENT CARE, AND ALIGNED CARE; (2) FINANCE; (3) QUALITY/PATIENT SAFETY; AND (4) THE WORK ENVIRONMENT. A CENTRE COUNTY HOSPITAL AUTHORITY (SERIES 2016A) 203197497 156273FF6 2016-04-15 80895596 SEE PART VI 0 0 0 B CENTRE COUNTY HOSPITAL AUTHORITY (SERIES 2016B) 203197497 156273GE8 2016-04-15 20208892 SEE PART VI 0 0 0 C CENTRE COUNTY HOSPITAL AUTHORITY (SERIES 2018 A & B) 203197497 156273HC1 2018-03-21 52073401 SEE PART VI 0 0 0 D CENTRE COUNTY HOSPITAL AUTHORITY (SERIES 2020B) 203197497 2020-03-04 22255000 SEE PART VI 0 0 0 A 4615000 80895596 18878230 764512 61240000 2016 0 1 1 1 B 2220000 20208892 199179 20009713 2017 0 0 0 1 C 14470000 52073401 350023 51723378 2021 0 0 0 1 D 360000 22255000 110000 22145000 2020 0 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 0 0 1 0 0 0 0 1 D 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CENTRE COUNTY HOSPITAL AUTHORITY (SERIES 2016A) DATE THE REBATE COMPUTATION WAS PERFORMED: 04/01/2021 ISSUER NAME: CENTRE COUNTY HOSPITAL AUTHORITY (SERIES 2016B) DATE THE REBATE COMPUTATION WAS PERFORMED: 04/01/2021 ISSUER NAME: CENTRE COUNTY HOSPITAL AUTHORITY (SERIES 2018 A & B) DATE THE REBATE COMPUTATION WAS PERFORMED: 03/01/2021 SCHEDULE K, PART I, BOND ISSUES: (A) ISSUER NAME: CENTRE COUNTY HOSPITAL AUTHORITY (SERIES 2016 A) (F) DESCRIPTION OF PURPOSE: ADVANCE PARTIAL REFUNDING OF THE 2011 BONDS AND PAY 2016A BOND ISSUANCE COSTS A) ISSUER NAME: CENTRE COUNTY HOSPITAL AUTHORITY (SERIES 2016 B) (F) DESCRIPTION OF PURPOSE: TO FUND 2016 CAPITAL PROJECTS AND PAY ISSUANCE COSTS FOR BOND SERIES 2016B (A) ISSUER NAME: CENTRE COUNTY HOSPITAL AUTHORITY (SERIES 2018 A & B) (F) DESCRIPTION OF PURPOSE: REFUNDING OF CALLABLE BONDS, FINANCING CAPITAL PROJECTS, AND COSTS OF ISSUANCE (A) ISSUER NAME: CENTRE COUNTY HOSPITAL AUTHORITY (SERIES 2020 B) (F) DESCRIPTION OF PURPOSE: CURRENT REFUNDING OF 2012 BONDS (A) ISSUER NAME: CENTRE COUNTY HOSPITAL AUTHORITY (SERIES 2022 A) (F) DESCRIPTION OF PURPOSE: REFUNDING OF 2012 BONDS SCHEDULE K, PART III, LINE 3: THERE ARE NO MANAGEMENT OR SERVICE CONTRACTS OR RESEARCH AGREEMENTS THAT RESULT IN PRIVATE BUSINESS USE RELATING TO THE FINANCED PROPERTIES FOR THE BONDS. A CENTRE COUNTY HOSPITAL AUTHORITY (SERIES 2022A) 203197497 2022-08-17 45770000 SEE PART VI 0 0 0 A 930000 45770000 45770000 2020 0 1 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 1 0 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 7A AS THE PARENT ENTITY, MOUNT NITTANY HEALTH SYSTEM (MNHS) HAS THE POWER TO APPOINT AND REMOVE, OR APPROVE THE REMOVAL OF, ANY AND ALL TRUSTEES OF THE CORPORATION, WITH THE EXCEPTION OF EX-OFFICIO TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B MNHS HAS THE FOLLOWING POWERS: (A) TO APPOINT AND REMOVE, OR APPROVE THE REMOVAL OF, ANY AND ALL TRUSTEES OF THE CORPORATION, WITH THE EXCEPTION OF EX-OFFICIO TRUSTEES; (B) TO APPROVE THE ELECTION OF AND TO REMOVE ANY AND ALL OFFICERS OF THE CORPORATION; (C) TO DEVELOP AND APPROVE ALL ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION (INCLUDING ALL AMENDMENTS THERETO); (D) TO APPROVE THE INCURRENCE, RE-FINANCING, OR PREPAYMENT OF ANY INDEBTEDNESS OF THE CORPORATION; (E) TO APPROVE THE SECURING OF ANY MORTGAGE, DEED OF TRUST, PLEDGE, SECURITY INTEREST, OR OTHER ENCUMBRANCE OF THE CORPORATION; (F) EXCEPT AS MAY BE INVOLVED THEREAFTER IN ORDINARY REPAIRS, MAINTENANCE, AND REPLACEMENT, AND EXCEPT AS MAY HAVE ALREADY BEEN APPROVED AS PART OF THE CAPITAL BUDGET, TO APPROVE THE MAKING OF ANY CAPITAL EXPENDITURE OR CAPITAL ADDITION OR IMPROVEMENT; (G) TO APPROVE ALL UNBUDGETED EXPENDITURES IN EXCESS OF 1% OF EACH SUCH BUDGET; (H) TO APPROVE THE MOVEMENT OF FUNDS TO AND FROM THIS CORPORATION TO THE PARENT OR OTHER ENTITIES RELATED TO THE PARENT; (I) TO APPROVE ALL STRATEGIC PLANS OF THE CORPORATION; (J) TO SELECT THE INDEPENDENT AUDITORS AND LEGAL COUNSEL OF THE CORPORATION; (K) TO AMEND OR TO APPROVE AMENDMENTS, ALTERATIONS AND MODIFICATIONS TO OR REPEALS OF THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION IN ACCORDANCE WITH SECTION 12.1; (L) TO ENTER INTO, AMEND, OR TERMINATE ANY AGREEMENT WITH A MATERIAL THIRD PARTY PAYOR OF THE CORPORATION, AS DETERMINED BY THE PARENT IN ITS SOLE DISCRETION; (M) TO APPROVE ALL AMENDMENTS TO ARTICLES OF INCORPORATION, MERGERS, CONSOLIDATIONS, DIVISIONS, SALES OF SUBSTANTIALLY ALL ASSETS, LIQUIDATION OR DISSOLUTION OF THE CORPORATION, AND ALL OTHER FUNDAMENTAL CHANGE TRANSACTIONS, AS WELL AS ALL TRANSACTIONS OUTSIDE THE ORDINARY COURSE OF BUSINESS; (N) TO ESTABLISH, TERMINATE, OR WITHDRAW FROM ANY SUBSIDIARY, JOINT VENTURE, OR OTHER PARTNERSHIP OR SHARED GOVERNANCE AGREEMENT; TO ENTER INTO, AMEND, OR TERMINATE ANY AGREEMENT BETWEEN THE CORPORATION AND THE PARENT; (P) TO ENTER INTO, AMEND, OR TERMINATE AN AFFILIATION AGREEMENT WITH ANY HOSPITAL, PROVIDER, PAYOR, OR HEALTH CARE SYSTEM; (Q) TO APPROVE ANY MATERIAL CHANGE IN MISSION OR STRATEGIC DIRECTION OF THE CORPORATION; AND (R) TO TAKE ANY OTHER ACTION THAT IS RESERVED TO THE PARENT FROM TIME TO TIME BY THE CORPORATION'S BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 11B THE 990 WAS PROVIDED TO THE BOARD OF DIRECTORS AND TO THE MOUNT NITTANY HEALTH SYSTEM AUDIT COMMITTEE BEFORE BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, THE CONFLICT OF INTEREST POLICY IS DISTRIBUTED TO KEY MEMBERS OF THE ORGANIZATION INCLUDING BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES. EACH PERSON MUST REPORT ANY POTENTIAL CONFLICTS OF INTEREST. REPORTED CONFLICTS ARE THEN REVIEWED BY THE CORPORATE COMPLIANCE OFFICER AND THE HEALTH SYSTEM'S AUDIT COMMITTEE. THE CONFLICT OF INTEREST REPORT IS THEN SUBMITTED TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS' EXECUTIVE & PHYSICIAN COMPENSATION COMMITTEE REVIEWS COMPENSATION PAID TO EXECUTIVE MANAGEMENT TEAM IN CONJUNCTION WITH AN INDEPENDENT THIRD PARTY CONSULTING FIRM TO ENSURE COMPENSATION IS REASONABLE AND APPROPRIATE FOR DUTIES AND RESPONSIBILITIES ASSIGNED. THE PROCESS IS DESIGNED TO ENABLE THE HEALTH SYSTEM TO ATTRACT, MOTIVATE AND RETAIN THE HIGHLY SKILLED EXECUTIVE TALENT NEEDED TO CARRY OUT ITS MISSION AND STRATEGIC OBJECTIVES THROUGH THE ESTABLISHMENT OF SALARIES, BENEFITS, AND VARIABLE PAY OPPORTUNITIES THAT ARE REASONABLE, COMPARABLE WITH THOSE FOR SIMILAR POSITIONS IN SIMILARLY SITUATED NOT-FOR-PROFIT ORGANIZATIONS, AND REWARD ACHIEVEMENT OF ORGANIZATIONAL AND INDIVIDUAL OBJECTIVES. THE EXECUTIVE & PHYSICIAN COMPENSATION COMMITTEE ENSURES THAT THE BOARD FULLY UNDERSTANDS THE PROCESS BY WHICH THE ORGANIZATION'S OFFICERS/KEY EMPLOYEE COMPENSATION DECISIONS ARE MADE. THE COMMITTEE REVIEWS AND APPROVES EXECUTIVE COMPENSATION IN A MANNER THAT QUALIFIES FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE IRS INTERMEDIATE SANCTIONS RULES. THE COMMITTEE REPORTS ITS ACTIVITIES TO THE BOARD, INCLUDING THE SPECIFIC DETAILS OF COMPENSATION ACTIONS. THE BOARD HAS DELEGATED TO THE COMMITTEE THE AUTHORITY TO MAKE COMPENSATION DECISIONS. THE BOARD BEARS THE ULTIMATE RESPONSIBILITY FOR ENSURING SOUND DECISION-MAKING IN THIS AREA. REVIEW AND APPROVAL OF COMPENSATION IS DOCUMENTED VIA MINUTES OF COMMITTEE MEETINGS. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN PARTNERSHIP -1,318,922. CHANGE IN INTEREST IN THE FOUNDATION FOR MNMC 3,425,676. PENSION LIABILITY ADJUSTMENT 19,690,945. NET PERIODIC PENSION COST 1,720,566. CHANGE IN FAIR VALUE OF DERIVATIVE 1,950,207. MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES INC 155 WELLNESS WAY STATE COLLEGE PA 168036796 510426500 PROFESSIONAL SERVICES TO SUPPORT MNMC PA 501(C)(3) LINE 10 MOUNT NITTANY HEALTH SYSTEM 0 THE FOUNDATION FOR MOUNT NITTANY MEDICAL CENTER INC 155 WELLNESS WAY STATE COLLEGE PA 168036796 571138956 FUNDRAISING AND SUPPORT FOR MOUNT NITTANY MEDICAL CENTER PA 501(C)(3) LINE 12A, I MOUNT NITTANY MEDICAL CENTER 1 MOUNT NITTANY MEDICAL CENTER WORKMEN'S COMPENSATION SELF INSURANCE TRUST 155 WELLNESS WAY STATE COLLEGE PA 168036796 256440788 PROVIDE WORKMAN'S COMPENSATION BENEFITS TO EMPLOYEES OF MNMC PA 501(C)(3) LINE 12A, I MOUNT NITTANY MEDICAL CENTER 1 CENTRE COUNTY CHILDREN'S ADVOCACY CENTER 155 WELLNESS WAY STATE COLLEGE PA 168036796 460871813 CHILD-FOCUSED APPROACH TO CHILD ABUSE CASES PA 501(C)(3) LINE 7 MOUNT NITTANY MEDICAL CENTER 1 MOUNT NITTANY HEALTH SYSTEM 155 WELLNESS WAY STATE COLLEGE PA 168036796 800663092 PROVIDE MANAGEMENT AND ADMINISTRATIVE SUPPORT TO MNMC & SUBSIDIARIES PA 501(C)(3) LINE 12A, I N/A 0 MOUNT NITTANY VENTURES 155 WELLNESS WAY STATE COLLEGE PA 168036796 922882921 AMBULATORY SURGICAL AND MEDICAL SERVICES PA 501(C)(3) LINE 12B, II MOUNT NITTANY HEALTH SYSTEM 0 0 1 1 0 0 0 0 0 0 1 1 0 1 1 1 0 1 1 1 CENTRE COUNTY CHILDREN'S ADVOCACY CENTER B 88246 CASH FOUNDATION FOR MOUNT NITTANY MEDICAL CENTER C 3526731 CASH FOUNDATION FOR MOUNT NITTANY MEDICAL CENTER O 210222 COST OF SHARING PAID EMPLOYEES CENTRE COUNTY CHILDREN'S ADVOCACY CENTER O 50000 COST OF SHARING PAID EMPLOYEES