2022-05-16T13:20:24-05:00 2021-06-30 390859910 BAKER TILLY US LLP 1570 FRUITVILLE PIKE SUITE 400 LANCASTER PA 17601 990 2020-07-01 250965210 PUNXSUTAWNEY AREA HOSPITAL INC PUNX 8149381800 81 HILLCREST DRIVE PUNXSUTAWNEY PA 15767 JACK SISK CHIEF FINANCIAL OFFICER 8149381800 2022-05-16 1 JACK SISK 999009999 KERRI N BOGDA CPA P00760402 7177404863 X 0 AAL1 IAL1 2020 2022-09-23 18:48:47Z DANIEL D BLOUGH JR 81 HILLCREST DRIVE PUNXSUTAWNEY PA 15767 53403673 0 X WWW.PAH.ORG X 1889 PA VALUED AS HIGHEST QUALITY COMMUNITY HOSPITAL IN THE REGION AND PRIMARY HEALTH CARE PROVIDER, COMMITTED TO CONTINUOUSLY IMPROVING SERVICES WHILE CONTAINING COST. 13 11 470 15 129467 11930 966076 8967599 37654998 43743746 256989 249509 475281 107554 39353344 53068408 800 0 0 0 25276678 27704746 0 0 0 11911749 17632572 37189227 45337318 2164117 7731090 41127499 41261803 19117702 12137528 22009797 29124275 X TO PROVIDE HIGH QUALITY, COST EFFECTIVE, PRIMARY HEALTH CARE AND TO COORDINATE CARE FOR PATIENTS REQUIRING SECONDARY AND TERTIARY SERVICES. 0 0 33896001 0 39731171 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 1,181 ADMISSIONS TO THE ACUTE CARE SETTING THAT GENERATED 4,198 PATIENT DAYS. THE HOSPITAL ALSO PROVIDED 74,935 OUTPATIENT VISITS TO PATIENTS. ALSO, THE HOSPITAL PROVIDED OVER $508,000 OF CHARITY CARE FOR 1,400 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. 2223361 0 2739071 PUNXSUTAWNEY AREA HOSPITAL PROVIDES HOME HEALTH CARE TO PATIENTS IN A THREE COUNTY AREA. FOR THE FISCAL YEAR ENDED THERE WERE 19,416 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. 755467 0 1144037 PUNXSUTAWNEY AREA HOSPITAL PROVIDES SKILLED NURSING SERVICES TO PATIENTS IN A THREE COUNTY AREA. FOR THE FISCAL YEAR ENDED THERE WERE 150 ADMISSIONS INTO THE LONG-TERM CARE UNIT WHICH GENERATED 2,027 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. 36874829 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 43 0 470 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 13 11 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X JACK SISK CFO 8149381800 81 HILLCREST DRIVE PUNXSUTAWNEY PA 15767 NATHAN KOVALCHICK CHAIRMAN 1.00 X X 0 0 0 T MICHAEL PRICE VICE CHAIRMAN 1.00 X X 0 0 0 FRANK ROBERTS SECRETARY 1.00 X X 0 0 0 BECKY STAPLETON TREASURER 1.00 X X 0 0 0 STEPHEN A WOLFE PRESIDENT & CEO 1.00 40.00 X X 0 561430 54957 JON JOHNSTON CHAIRMAN (UNTIL 10/2020) 1.00 X X 0 0 0 MELISSA DUNKEL SECRETARY (UNTIL 10/2020) 1.00 X X 0 0 0 PHYLLIS BYERLY TREASURER (UNTIL 10/2020) 1.00 X X 0 0 0 HILLIARY CREELY DIRECTOR 1.00 X 0 0 0 RUSSELL A DROZDIAK MD DIRECTOR 1.00 X 0 0 0 MATTHEW N KLAIN MD DIRECTOR 1.00 X 0 8814 0 LAURIE A KUZNESKI DIRECTOR 1.00 X 0 0 0 JAMES R MARTIN DIRECTOR 1.00 X 0 0 0 TIMOTHY CLARK SIMPSON MD DIRECTOR 40.00 X 311000 0 20263 TODD BRICE DIRECTOR 1.00 X 0 0 0 CHRISTINA LUBOLD MD DIRECTOR 1.00 X 0 15250 0 SAMUEL SMITH DIRECTOR (UNTIL 10/2020) 1.00 X 0 0 0 J THOMAS FRANTZ DIRECTOR (UNTIL 10/2020) 1.00 X 0 0 0 MARY CLAIRE JOHNSTON DIRECTOR (UNTIL 10/2020) 1.00 X 0 0 0 JOHN PRUSHNOK DIRECTOR (UNTIL 10/2020) 1.00 X 0 0 0 DAVID SPIGLE DIRECTOR (UNTIL 10/2020) 1.00 X 0 0 0 KATHY YOUNG DIRECTOR (UNTIL 10/2020) 1.00 X 0 0 0 KYLE LINGENFELTER DIRECTOR (UNTIL 10/2020) 1.00 X 0 0 0 DANIEL D BLOUGH JR CHIEF EXECUTIVE OFFICER 40.00 X 317240 0 18927 JACK G SISK CHIEF FINANCIAL OFFICER 40.00 X 198580 0 18784 THOMAS GENTILCORE PHYSICIAN 40.00 X 610269 0 11257 EYAD KHABBAZ PHYSICIAN 40.00 X 685328 0 18558 MAZEN HASAN PHYSICIAN 40.00 X 417783 0 18385 JOSEPH MEYN PHYSICIAN 40.00 X 421005 0 10440 MICHAEL STEVER PHYSICIAN 40.00 X 411398 0 9815 3372603 585494 181386 39 0 1 0 LABORATORY CORP OF AMERICA HOLDINGS PO BOX 12140 BURLINGTON NC 16501 LAB SERVICES 468831 CURA HOSPITALITY LLC 2400 ANSYS DRIVE SUITE 404 CANONSBURG PA 15317 FOOD SERVICE 334045 PENNSYLVANIA MOUNTAINS HEALTHCARE 150 MCCRACKEN RUN ROAD DU BOIS PA 15801 REVENUE CYCLE 254992 AUDIOLOGICAL AND SPEECH ASSOC 270 PHILADELPHIA ST INDIANA PA 15701 THERAPY SERVICE 136115 PARIS HEALTHCARE LINEN SERVICE PO BOX 1043 DU BOIS PA 15801 LINEN SERVICE 130296 8 18695 8739924 208980 8967599 NET PATIENT SERVICES REVENUE 621990 39889858 39760391 129467 OTHER PROGRAM REVENUE 621990 3853888 3853888 43743746 246151 246151 329419 323116 6303 6303 6303 3358 0 3358 3358 3358 12000 18695 12149 -149 -149 CONTRACTED LABOR REV. 541900 101400 101400 101400 53068408 43614279 129467 357063 X 846058 692148 153910 21721463 17770016 3951447 225000 180297 44703 3639553 2916449 723104 1272672 1041155 231517 25385 25385 91436 91436 787 787 5200189 4012713 1187476 154255 154255 893249 667490 225759 224247 167571 56676 214706 214706 13786 13786 1441129 1079480 361649 697412 366507 330905 MEDICAL SUPPLIES & DRUG 6041885 6041885 EQUIPMENT LEASED & RENT 1307876 1307876 BAD DEBT EXPENSE 848840 848840 RECRUITMENT & RETENTION 228895 228895 248495 248495 45337318 36874829 8462489 0 1762189 2220687 17218153 15033667 2181815 1745317 153395 106531 827107 823185 1892598 1384612 39176968 31727698 6399514 7449270 6754762 7831268 2386866 1620117 984358 1113659 566742 1933490 41127499 41261803 6237884 5929461 4505104 4519585 3855129 6208067 19117702 12137528 X 21560129 28614545 449668 509730 22009797 29124275 41127499 41261803 X 7731090 24221 -640833 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 787 787 0 PART II-B, LINE 1: THE HOSPITAL IS NOT INVOLVED IN POLITICAL OR DIRECT LOBBYING ACTIVITIES BUT DOES BELONG TO TWO PROFESSIONAL ASSOCIATIONS THAT PARTAKE IN SOME LOBBYING (A SMALL PORTION OF MEMBERSHIP DUES IS UTILIZED FOR LOBBYING): - THE HOSPITAL ASSOCIATION OF PENNSYLVANIA: $595, AND - THE HOSPITAL 340 (B) HEALTH: $192 383904 101982 7316 478570 409994 -17074 9016 383904 425940 4951 20897 409994 413467 19956 20683 425940 442169 -12927 15775 413467 0.29700 0.70300 0.00000 0 0 40000 40000 13250582 10086569 3164013 24719553 20551420 4168133 1166833 1089709 77124 7449270 MEDICARE ADVANCES 2693922 PENSION & POST-RETIREMENT LIABILITIES 776239 ESTIMATED MEDICAL MALPRACTICE CLAIMS LIABILITY 1428659 CONTRACT LIABILITIES 1081923 CAPITAL LEASE 227324 6208067 X 51938221 24221 -1489673 -1465452 53403673 -335265 -335265 53068408 44823743 335265 335265 44488478 848840 848840 45337318 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: TRANSFERS TO AFFILIATES -1,104,017. CHANGE IN INVESTMENT IN IRREVOCABLE TRUST 59,677. BAD DEBT EXPENSE NETTED AGAINST REVENUE ON FINANCIALS -848,840. CHANGE IN EQUITY INVESTMENTS 403,507. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -323,116. FUNDRAISING EXPENSES -12,149. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 323,116. FUNDRAISING EXPENSES 12,149. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE NETTED AGAINST REVENUE ON FINANCIALS 848,840. GOLF TOURNAMENT 30695 18695 12000 2475 3200 4448 2026 30695 18695 12000 2475 3200 4448 2026 12149 -149 1 1 X 1 X 1 X 1 1 0 1 1 1209 328077 328077 0.00740 12225 7670472 5574153 2096319 0.04710 13434 7998549 5574153 2424396 0.05450 5032 3500 3500 0.00010 431 1399593 551581 848012 0.01910 506 1508 1508 0.00000 5969 1404601 551581 853020 0.01920 19403 9403150 6125734 3277416 0.07370 0 848840 117989 20139331 20209876 -70545 X 1 1 1 1 PUNXSUTAWNEY AREA HOSPITAL 81 HILLCREST DRIVE PUNXSUTAWNEY PA 15767 WWW.PAH.ORG 163701 X X X SKILLED NURSING SERVICES PUNXSUTAWNEY AREA HOSPITAL 1 0 0 1 X X X X X X X X X 20 1 1 0 1 X WWW.PAH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT X WWW.IRMC.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ X 1 20 1 WWW.PAH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT 0 1 X 150.000000000000 250.000000000000 X X 1 1 X X X 1 X WWW.PAH.ORG/ABOUT/FINANCIAL-ASSISTANCE X WWW.PAH.ORG/ABOUT/FINANCIAL-ASSISTANCE X WWW.PAH.ORG/ABOUT/FINANCIAL-ASSISTANCE X X X X X 1 X 0 X X X X 1 X 0 0 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. 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 BUSINESSES GOAL 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. 1 1 - HHCS OF PUNXSUTAWNEY AREA HOSPITAL 602 EAST MAHONING STREET PUNXSUTAWNEY PA 15767 MEDICARE CERTIFIED HOME HEALTH AGENCY 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 $848,840. 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 13.9%.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 NOTE 2, SUBTITLED "PATIENT ACCOUNTS RECEIVABLE." 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 44,492 IN APPROXIMATELY 650 SQUARE MILES. THE POPULATION AGED 65 AND OLDER IS 20.9%. THE POPULATION WITH INCOME BELOW THE POVERTY LEVEL IS 13.9% AND THE COUNTY'S PER CAPITA PERSONAL INCOME IS $28,592. 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. 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. X X X 0 0 0 0 0 0 0 0 0 EYAD KHABBAZ PHYSICIAN 684606 0 0 0 722 0 1223 0 17335 0 703886 0 0 0 THOMAS GENTILCORE PHYSICIAN 606982 0 0 0 3287 0 1223 0 10034 0 621526 0 0 0 STEPHEN A WOLFE PRESIDENT & CEO 0 519242 0 42188 0 0 0 13846 0 41111 0 616387 0 0 MAZEN HASAN PHYSICIAN 411451 0 0 0 6332 0 1223 0 17162 0 436168 0 0 0 JOSEPH MEYN PHYSICIAN 420463 0 0 0 542 0 625 0 9815 0 431445 0 0 0 MICHAEL STEVER PHYSICIAN 408463 0 0 0 2935 0 0 0 9815 0 421213 0 0 0 DANIEL D BLOUGH JR CHIEF EXECUTIVE OFFICER 294166 0 0 0 23074 0 1223 0 17704 0 336167 0 0 0 TIMOTHY CLARK SIMPSON MD DIRECTOR 291500 0 0 0 19500 0 1223 0 19040 0 331263 0 0 0 JACK G SISK CHIEF FINANCIAL OFFICER 198580 0 0 0 0 0 1223 0 17561 0 217364 0 0 0 SHANNON BYERLY SEE PAART V 69744 WAGES 0 SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: SHANNON BYERLY IS THE DAUGHTER OF PHYLLIS BYERLY, DIRECTOR AND IS AN EMPLOYEE OF PUNXSUTAWNEY AREA HOSPITAL. FORM 990, PART VI, SECTION A, LINE 4 EFFECTIVE NOVEMBER 1, 2020, PAH ENTERED INTO A DEFINITIVE AGREEMENT WITH INDIANA REGIONAL MEDICAL CENTER (IRMC) TO BECOME MORE CLOSELY ALIGNED AND OPERATE AS A MORE FULLY INTEGRATED HEALTHCARE SYSTEM. THE PURPOSE OF THE AFFILIATION IS TO PROVIDE QUALITY, AFFORDABLE AND ACCESSIBLE HEALTH CARE SERVICES IN EACH SERVICE AREA AND APPROPRIATELY EXPAND HEALTH CARE SERVICES AND ENHANCE LOCALLY AVAILABLE FACILITIES. THE TERMS OF THE DEFINITIVE AGREEMENT INCLUDED THE FOLLOWING: (1) BY-LAWS WERE AMENDED TO PROVIDE FOR CERTAIN RESERVED POWERS FOR PMCN OVER IRMC AND PAH, INCLUDING APPROVAL OF MERGER, CONSOLIDATION AND DISSOLUTION TRANSACTIONS, APPROVAL OF OPERATING AND CAPITAL BUDGETS, AND APPROVAL OF SALES, LEASE, OR EXCHANGE OF SUBSTANTIALLY ALL ASSETS OF IRMC AND PAH; (2) REORGANIZATION OF THE BOARD OF DIRECTORS (THE BOARD) OF PMCN; THE RECONSTITUTED BOARD NOW SERVES AS THE BOARD OF BOTH PMCN AND IRMC; (3) PRESIDENT OF IRMC BECAME PRESIDENT OF PMCN WITH FULL MANAGERIAL AUTHORITY OVER PMCN, IRMC AND PAH. 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 WILL BE MADE AVAILABLE TO THE FULL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY THE OFFICERS AND DIRECTORS COMPLETE CONFLICT OF INTEREST DISCLOSURES. THESE DISCLOSURES ARE THEN SHARED WITH THE FULL BOARD. ANY BOARD MEMBER WITH A CONFLICT OF INTEREST ABSTAINS FROM VOTING ON ANY MATTER RELATED TO THAT CONFLICT. CORPORATE OFFICERS AND KEY EMPLOYEES ARE ALSO REQUIRED TO ANNUALLY DISCLOSURE POTENTIAL CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE CHAIRMAN OF THE BOARD ANNUALLY RECEIVES A SALARY SURVEY FROM THE HOSPITAL ASSOCIATION OF PENNSYLVANIA THAT INDEXES THE CEO'S SALARY BY UTILIZING THE SMALL AND RURAL CLASSIFICATIONS OF THE SURVEY AS PER THE CEO'S CONTRACT. ALL BOARD DELIBERATIONS ARE DOCUMENTED. THE SURVEY WAS RECEIVED IN SPRING OF 2018 AND PROVIDED TO THE EXECUTIVE COMMITTEE OF THE BOARD. THE CEO ANNUALLY RECEIVES A SALARY SURVEY FROM THE HOSPITAL ASSOCIATION OF PENNSYLVANIA. HE USES THIS SURVEY TO SET THE OTHER OFFICERS AND KEY EMPLOYEES' SALARY LEVEL. THE CEO SUBSEQUENTLY SHARES THE FINDINGS WITH THE BOARD EXECUTIVE COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 SOME FINANCIAL DATA IS AVAILABLE THROUGH THE PENNSYLVANIA HEALTH CARE COST CONTAINMENT COUNCIL. OTHER ORGANIZATION DOCUMENT, INCLUDING GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS, ARE MADE AVAILABLE BY WRITTEN REQUEST FOR LEGITIMATE PURPOSE (AS DETERMINED BY THE FINANCE OFFICE). FORM 990, PART IX, LINE 11G PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 599,466. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 599,466. CONSULTANT: PROGRAM SERVICE EXPENSES 6,185. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,185. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,308,748. MANAGEMENT AND GENERAL EXPENSES 1,187,476. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,496,224. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 1,098,314. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,098,314. FORM 990, PART XI, LINE 9: TRANSFERS TO AFFILIATES -1,104,017. CHANGE IN INVESTMENT IN IRREVOCABLE TRUST 59,677. CHANGE IN EQUITY INVESTMENTS 403,507. PUNXSUTAWNEY MEDICAL SERVICES INC 81 HILLCREST DRIVE PUNXSUTAWNEY PA 15767 251773035 ANESTHESIA SERVICES PA 501(C)(3) LINE 3 PUNXSUTAWNEY AREA HOSPITAL INC 1 INDIANA REGIONAL MEDICAL CENTER 835 HOSPITAL ROAD INDIANA PA 15701 250965404 HOSPITAL PA 501(C)(3) LINE 3 PENNSYLVANIA MOUNTAINS CARE NETWORK 0 PENNSYLVANIA MOUNTAINS CARE NETWORK 835 HOSPITAL ROAD INDIANA PA 15701 474638568 SUPPORT FOR HEALTHCARE ORGANIZATIONS PA 501(C)(3) LINE 12A, I N/A 0 PERPETUAL TRUST TRUST PA PUNXSUTAWNEY AREA HOSPITAL INC T 60677 283452 1.00000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 PUNXSUTAWNEY MEDICAL SERVICES INC O 1572560 COST PUNXSUTAWNEY MEDICAL SERVICES INC P 66661 COST PUNXSUTAWNEY MEDICAL SERVICES INC S 535204 COST