2025-05-15T18:43:31-05:00 2023-06-30 135565207 KPMG LLP 1735 MARKET STREET 6TH FLOOR PHILADELPHIA PA 19103 990 2022-07-01 250585280 ELK REGIONAL HEALTH CENTER ELKR 8147888233 763 JOHNSONBURG ROAD ST MARYS PA 15857 DOUGLAS WINNER CFO 8147888233 2025-05-15 1 0 PHILLIP E GROFF P01247783 2672567000 2025-05-14 2022 2025-03-06 01:10:19Z PENN HIGHLANDS ELK JULIANNE PEER 763 JOHNSONBURG ROAD ST MARYS PA 15857 71032713 0 X WWW.PHHEALTHCARE.ORG X 1999 PA PROVIDE PREMIER HEALTHCARE SERVICES INCLUDING INPATIENT AND OUTPATIENT CARE (SEE SCHEDULE O) FAMILY, INTERNAL AND GENERAL MEDICINE, AND LONG TERM CARE SERVICES TO OUR SURROUNDING COMMUNITIES. 15 12 486 27 44569 0 3447230 1389688 69191896 68660678 -615592 370555 322650 495405 72346184 70916326 0 0 0 0 29637273 28926335 0 0 0 35377233 38451805 65014506 67378140 7331678 3538186 107688058 94844455 48000869 42510994 59687189 52333461 X ELK REGIONAL HEALTH CENTER D/B/A PENN HIGHLANDS ELK WILL BE THE HEALTHCARE PROVIDER OF CHOICE FOR OUR COMMUNITIES THROUGH A COMMITMENT TO SERVICE, QUALITY, PEOPLE, FINANCE AND GROWTH. 0 0 61126860 68660678 PH ELK IS A CRITICAL ACCESS HOSPITAL PROVIDING PRIMARY ACUTE CARE MEDICAL SERVICES TO TWO CAMPUSES, THE ST. MARYS HEALTH CENTER IN ST. MARYS, PENNSYLVANIA, AND THE RIDGWAY HEALTH CENTER IN RIDGWAY, PENNSYLVANIA. PH ELK PROVIDES A 138-BED LONG TERM CARE FACILITY SERVING THE NEEDS OF ELK AND CAMERON COUNTIES AND THE SURROUNDING COMMUNITIES. WE ARE AT A 66% OCCUPANCY RATE. WE PROVIDE SOCIAL SERVICES AND RESIDENT ACTIVITIES. PH ELK IS A CRITICAL ACCESS HOSPITAL PROVIDING PRIMARY ACUTE CARE MEDICAL SERVICES TO TWO CAMPUSES, THE ST. MARYS HEALTH CENTER IN ST. MARYS, PENNSYLVANIA, AND THE RIDGWAY HEALTH CENTER IN RIDGWAY, PENNSYLVANIA. OUR TEAM OF QUALIFIED PROFESSIONALS PROVIDES 24-HOUR NURSING CARE AND REHABILITATIVE THERAPY WITH PERSONALIZED ATTENTION TO EACH RESIDENT. CONTINUED ON SCHEDULE O.OTHER SERVICES OFFERED AT THE FACILITY INCLUDE HOSPICE SERVICES, TRANSPORTATION TO OUTSIDE HEALTH APPOINTMENTS, DIETICIANS, AND PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY. 61126860 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 1 1 1 0 0 0 0 1 1 1 0 0 0 1 51 0 1 486 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 0 PA X DOUGLAS WINNER 8147888743 763 JOHNSONBURG ROAD ST MARYS PA 15857 X DR STEVEN KOCH DIRECTOR/PHYSICIAN 1.00 40.00 X 0 660051 39083 DR JULIA WONDERLING DIRECTOR/PHYSICIAN 40.00 1.00 X 0 839303 39582 BRAD CHAPMAN PRESIDENT (UNTIL 11/1/2023) 40.00 3.50 X X 0 344597 41558 DAVID OBLEY MD DIRECTOR/RADIOLOGY MEDICAL DIR. 3.00 0.00 X 25000 0 0 DON FLEMING DIRECTOR 1.00 4.00 X 0 0 0 JOHN PICCOLO CHAIRMAN 1.00 1.00 X X 0 0 0 CHERYL RUFFNER SECRETARY 1.00 1.00 X X 0 0 0 KEVIN OKNEFSKI DIRECTOR 1.00 3.00 X 0 0 0 STEVE STOLTZ DIRECTOR 1.00 0.00 X 0 0 0 JEFF AZZATO TREASURER 1.00 1.00 X X 0 0 0 KATE BROCK DIRECTOR 1.00 0.00 X 0 0 0 FRANK STRAUB VICE CHAIRMAN 1.00 1.00 X X 0 0 0 CORINE CHRISTOFF DIRECTOR 1.00 0.00 X 0 0 0 JEFF RADKOWSKI DIRECTOR 1.00 0.00 X 0 0 0 ADAM BREM DIRECTOR 1.00 0.00 X 0 0 0 SAM MACDONALD DIRECTOR 1.00 0.00 X 0 0 0 LAURIE MACDONALD CFO (UNTIL 5/4/2023) 20.00 20.00 X 0 238479 38601 CHRISTINE GARNER CHIEF NURSING OFFICER 40.00 0.00 X 173504 0 15181 CHRIS BARACKMAN PHARMACY DIRECTOR 40.00 0.00 X 120976 0 27649 ERIN WILLIAMS PHYSICIAN ASSISTANT 40.00 0.00 X 127921 0 25660 RENEA WOLFE REGISTERED NURSE 40.00 0.00 X 188943 0 27160 DR PERRY YOUNGER EYE CLINIC PHYS 40.00 0.00 X 130683 0 3362 MEGAN BOLDEN NURSING HOME ADMINISTRATOR 40.00 0.00 X 101537 0 32456 868564 2082430 290292 21 0 1 0 MAXIM HEALTHCARE SERVICES 7227 LEE DEFOREST DRIVE COLUMBIA MD 21046 LOCUM PROVIDERS 1928832 CORTHALL HEALTHCARE 1500 LIBERTY RIDGE DRIVE WAYNE PA 19087 HOUSEKEEPING SVCS 1387240 MORRISON HEALTHCARE 400 NORTHRIDGE ROAD SANDY SPRINGS GA 30350 NUTRITION SVCS 1319165 ASSOCIATED CLINICAL LABORATORIES 1526 PEACH STREET ERIE PA 16501 LAB SVCS 1186499 AMN HEALTHCARE 12400 HIGH BLUFF DRIVE SAN DIEGO CA 92130 LOCUM PROVIDERS 556850 11 1113226 276462 1389688 NET PATIENT SERVICE RE 621110 67239106 67239106 OTHER SERVICE REVENUE 621110 1231280 1231280 CAFETERIA INCOME 722514 127343 127343 AUXILIARY INCOME 900099 62949 62949 68660678 185103 185103 567223 116387 450836 450836 450836 176500 8952 0 0 176500 8952 185452 185452 MOB HOUSEKEEPING 561720 44569 44569 44569 70916326 68660678 44569 821391 X 195916 195916 213626 70270 143356 23036861 20749012 2287849 632795 568642 64153 3191083 2849791 341292 1656054 1473888 182166 7537 7537 10570633 10010732 559901 1850135 1752071 98064 1276950 1189926 87024 61813 59195 2618 399 390 9 1062480 808000 254480 3916513 2719726 1196787 PENN HIGHLANDS ASSESSME 10229167 9410834 818333 MEDICAL SUPPLIES & DRUG 9328735 9328735 LICENSES, DUES, SUBSCRI 118005 108565 9440 29438 27083 2355 67378140 61126860 6251280 0 17434277 7499799 10692848 3545682 8420340 10856920 647314 618184 14026 23838 60991580 30250991 33423535 30740589 14582726 5794384 3763993 3728093 1874520 1321413 16834479 30715553 107688058 94844455 8032524 11671679 1244581 0 26094586 25708590 51187 0 12577991 5130725 48000869 42510994 X 59687189 52333461 59687189 52333461 107688058 94844455 X 3538186 -19192 -10872722 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4122843 4122843 38817762 17017375 21800387 16077519 11978372 4099147 1973456 1255244 718212 30740589 OTHER RECEIVABLES 27968946 OTHER ASSETS 2746607 30715553 OTHER LIABILITIES 5130725 5130725 X PART X, LINE 2: ELK REGIONAL HEALTH CENTER IS INCLUDED IN PENN HIGHLANDS HEALTHCARE'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS. THE FOLLOWING NARRATIVE IS THE FOOTNOTE FROM THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS: THE SYSTEM AND ITS SUBSIDIARIES HAVE GENERALLY BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501 OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. HOWEVER, THESE ENTITIES ARE SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THE SYSTEM CONSOLIDATES CERTAIN ENTITIES, WHICH ARE ORGANIZED AS CORPORATIONS AND SUBJECT TO FEDERAL AND STATE INCOME TAXES ON RELATED INCOME. OTHER CONSOLIDATED AFFILIATES HAVE ELECTED TO BE TAXED AS A PARTNERSHIP UNDER PROVISIONS OF THE INTERNAL REVENUE CODE AND A SIMILAR SECTION OF THE STATE INCOME TAX LAW. THEREFORE, TAXABLE INCOME OR LOSS IS REPORTED TO THE INDIVIDUAL MEMBERS FOR INCLUSION IN THEIR RESPECTIVE TAX RETURNS. TO THE EXTENT THAT THE OPERATIONS OF THE PARTNERSHIP ENTITIES ARE RELATED TO THE SYSTEM'S TAX-EXEMPT PURPOSE, ITS INCOME WILL BE EXEMPT FROM INCOME TAXES. THE SYSTEM AND ITS SUBSIDIARIES ACCOUNT FOR UNCERTAIN TAX POSITIONS USING A TWO-STEP APPROACH FOR RECOGNIZING AND MEASURING TAX BENEFITS TAKEN, OR EXPECTED TO BE TAKEN, IN AN UNRELATED BUSINESS ACTIVITY TAX RETURN, AND DISCLOSURES REGARDING UNCERTAINTIES IN TAX POSITIONS. THE SYSTEM'S FOR-PROFIT CORPORATIONS RECOGNIZE DEFERRED TAX ASSETS AND LIABILITIES FOR THE FUTURE TAX IMPACT OF TEMPORARY DIFFERENCES BETWEEN AMOUNTS RECORDED IN THE CONSOLIDATED FINANCIAL STATEMENTS AND THEIR RESPECTIVE TAX BASES, AND THE FUTURE BENEFIT OF UTILIZING AVAILABLE NET OPERATING LOSSES. DEFERRED TAX ASSETS AND LIABILITIES ARE MEASURED USING ENACTED TAX RATES EXPECTED TO APPLY TO TAXABLE INCOME IN THE YEARS IN WHICH THOSE TEMPORARY DIFFERENCES ARE EXPECTED TO BE RECOVERED OR SETTLED. INCOME TAXES OF THE SYSTEM'S TAX-EXEMPT, FOR-PROFIT AND PARTNERSHIP ENTITIES ARE RECORDED IN ACCRUED EXPENSES ON THE CONSOLIDATED BALANCE SHEET. 1 1 X 1 X 1 X 1 1 0 0 117785 117785 0.00170 10109757 6818502 3291255 0.04880 10227542 6818502 3409040 0.05050 21782 15447 6335 0.00010 71195 13370 57825 0.00090 20160242 13427970 6732272 0.09990 20253219 13456787 6796432 0.10090 30480761 20275289 10205472 0.15140 1 2330422 267998 14666752 14749855 -83103 X 1 1 1 1 ELK REGIONAL HEALTH CENTER 763 JOHNSONBURGH ROAD ST MARYS PA 15857 WWW.PHHEALTHCARE.ORG 010901 X X X SKILLED NURSING PHYSICIAN OFFICES ELK REGIONAL HEALTH CENTER 1 0 0 1 X X X X X X X X X 20 1 1 0 1 X SEE PART V, SECTION C 1 21 1 SEE PART V, SECTION C 0 1 X 200.000000000000 300.000000000000 X X X X 1 1 X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X 1 X 0 X X X X X 1 X 0 0 ELK REGIONAL HEALTH CENTER PART V, SECTION B, LINE 5: COMMUNITY INPUT:THE CHNA ASSESSMENT CONDUCTED BY TRIPP UMBACH FOR ELK REGIONAL HEALTH CENTER INCLUDED PRIMARY AND SECONDARY DATA COLLECTION, INTERVIEWS WITH COMMUNITY STAKEHOLDERS, FOCUS GROUPS WITH KEY AUDIENCES, AND A COMMUNITY PLANNING RETREAT. THE CHNA REPRESENTED A COMPREHENSIVE COMMUNITY-WIDE PROCESS WHERE ELK REGIONAL HEALTH CENTER CONNECTED WITH A WIDE RANGE OF PUBLIC AND PRIVATE ORGANIZATIONS SUCH AS EDUCATIONAL INSTITUTIONS, HEALTH-RELATED PROFESSIONALS, LOCAL GOVERNMENT OFFICIALS, HUMAN SERVICE ORGANIZATIONS, AND FAITH-BASED ORGANIZATIONS TO EVALUATE THE COMMUNITY'S HEALTH AND SOCIAL NEEDS. ELK REGIONAL HEALTH CENTER PART V, SECTION B, LINE 6A: CHNA CONDUCTED WITH OTHER HOSPITAL FACILITIES:- PENN HIGHLANDS BROOKVILLE- PENN HIGHLANDS CLEARFIELD- PENN HIGHLANDS DUBOIS- PENN HIGHLANDS ELK- PENN HIGHLANDS HUNTINGDON- PENN HIGHLANDS TYRONESCHEDULE H, PART V, SECTION B, LINE 7AWEBSITE WHERE CHNA IS AVAILABLE:HTTPS://WWW.PHHEALTHCARE.ORG/HEALTH-WELLNESS/CHNA-PLANS-2021SCHEDULE H, PART V, SECTION B, LINE 10AWEBSITE WHERE IMPLEMENTATION STRATEGY IS AVAILABLE:HTTPS://WWW.PHHEALTHCARE.ORG/HEALTH-WELLNESS/CHNA-PLANS-2021 ELK REGIONAL HEALTH CENTER PART V, SECTION B, LINE 11: ADDRESSING IDENTIFIED NEEDS:PENN HIGHLANDS ELK LISTENS TO COMMUNITY CONCERNS, ANALYZES HEALTHCARE UTILIZATION AND COSTS, EXPLORES ACCESS ISSUES, AND COLLABORATES WITH AND DEVELOPS EFFECTIVE PROGRAMS TO IMPROVE THE HEALTH OF THOSE IN WEST CENTRAL PENNSYLVANIA. BASED ON THE ABOVE COMMUNITY HEALTH NEEDS ASSESSMENT FINDINGS AND THE PRIORITIZED NEEDS, THREE COMMUNITY NEEDS WILL BE IMPLEMENTED AND FURTHER EXPLORED. OF THE IDENTIFIED CHNA AND PRIORITIZED HEALTH NEEDS, PENN HIGHLANDS ELK WILL FOCUS ON THREE OF THE COMMUNITY NEEDS:1) ACCESS TO HEALTH CARE2) CHRONIC CONDITIONS3) BEHAVIORAL HEALTH (MENTAL HEALTH & SUBSTANCE ABUSE)SCHEDULE H, PART V, SECTION B, LINES 16A, 16B & 16CFINANCIAL ASSISTANCE POLICY:HTTPS://WWW.PHHEALTHCARE.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE-POLICY ELK REGIONAL HEALTH CENTER PART V, SECTION B, LINE 20E: OTHER EFFORTS:THE BILLING STATEMENT STATES THAT THERE IS A FAP AVAILABLE AND GIVES INFORMATION ON HOW TO CONTACT SOMEONE FOR THE APPLICATION. 1 1 - ERHC RIDGWAY CAMPUS 304 METOXET STREET RIDGWAY PA 15853 Q CARE, PHYSICIAN OFFICE, PHYSICAL THERAPY, LAB RADIOLOGY SERVICES PART I, LINE 7: COSTING METHODOLOGY:THE COST TO CHARGE RATIO COMPUTED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATIONS ON IRS WORKSHEETS 1 AND 3. WORKSHEET 6 USED ACTUAL COST DATA.PART I, LINE 7:PERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR EQUALS TOTAL OPERATING EXPENSES PER PART OF IX, LINE 25 OF THE FORM 990. PART III, LINE 2: BAD DEBT EXPENSE METHODOLOGY:THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HEALTH SYSTEM DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HEALTH CENTER'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2023. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2. PART III, LINE 3: THE SYSTEM HAS DETERMINED IT HAS PROVIDED IMPLICIT PRICE CONCESSIONS TO UNINSURED PATIENTS AND PATIENTS WITH OTHER UNINSURED BALANCES SUCH AS COPAYS AND DEDUCTIBLES. THE IMPLICIT PRICE CONCESSIONS INCLUDED IN ESTIMATING THE TRANSACTION PRICE REPRESENT THE DIFFERENCE BETWEEN AMOUNTS BILLED TO PATIENTS AND THE AMOUNTS THE SYSTEM EXPECTS TO COLLECT BASED ON ITS COLLECTION HISTORY WITH THOSE PATIENTS. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE FOR FINANCIAL REPORTING. LINE 3 REPORTS THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS FROM THE INTERNAL FINANCIAL STATEMENTS. BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING POVERTY LIMIT DEMOGRAPHIC INFORMATION OBTAINED THROUGH THE US CENSUS BUREAU. PART III, LINE 4: THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBE BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE, THAT NOTE CAN BE FOUND ON THE ATTACHED AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: ALL OF THE $83,103 SHORTFALL RELATED TO MEDICARE SCOPE OF BUSINESS SHOULD BE CONSIDERED AS COMMUNITY BENEFIT DUE TO ELK BEING A CRITICAL ACCESS HOSPITAL WITH MEDICARE BEING ITS LARGEST PAYER SOURCE. PART III, LINE 9B: COLLECTION POLICY:COLLECTION PRACTICES FROM DAY 1 SELF-PAY ARE CONSISTENT ACROSS THE ENTIRE SELF-PAY POPULATION. ONCE A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE (IE CHARITY CARE TO SOME DEGREE) THEN THAT PATIENT'S ACCOUNT(S) ARE PROCESSED ACCORDINGLY BALANCE-WISE. PART VI, LINE 2: NEEDS ASSESSMENT:IN ADDITION TO THE CHNA THAT WAS COMPLETED IN MAY 2021, THE ORGANIZATION RECEIVES INFORMATION FROM COMMUNITY MEMBERS ON THE BOARD AND FROM THE LOCAL AUXILIARY. WE ALSO MEET FROM TIME TO TIME WITH COMMUNITY MEMBERS TO ADDRESS CERTAIN NEEDS AS THEY ARISE. WE ARE ALWAYS OPEN TO LISTENING TO ANY CONCERNS OF COMMUNITY MEMBERS AND/OR ORGANIZATIONS. PART VI, LINE 3: PATIENT EDUCATION ELIGIBILITY FOR ASSISTANCE:THE CHARITY CARE POLICY, IN ITS ENTIRETY, APPEARS ON THE HOSPITAL WEBSITE. THE ASSOCIATED ELIGIBILITY FORM IS OBTAINABLE HERE AS WELL. THE SELF-PAY COLLECTION PROCESS PROVIDES FOR A CHARITY CARE APPLICATION AND EXPLANATION LETTER TO BE SENT ON EVERY OUTSTANDING PATIENT ACCOUNT FOR WHICH THERE IS NOT A PAYMENT MADE SUBSEQUENT TO THE INITIAL STATEMENT BEING RECEIVED. THERE ARE ALSO SIGNS POSTED IN CERTAIN AREAS OF THE HEALTH CENTER WHICH PROMOTE THE EXISTENCE OF THE CHARITY CARE POLICY AND DIRECT INTERESTED INDIVIDUALS ACCORDINGLY. PART VI, LINE 4: COMMUNITY INFORMATION:THE ORGANIZATION PROVIDES SERVICES TO RESIDENTS OF ALL AGES IN ELK AND CAMERON COUNTIES AND THE SURROUNDING AREAS. ELK AND CAMERON COUNTIES HAVE A POPULATION OF APPROXIMATELY 34,000. ADULTS OVER AGE 65 REPRESENT ABOUT 24% OF THE POPULATION. THE AVERAGE HOUSEHOLD INCOME IS APPROXIMATELY $47,000. ELK REGIONAL IS ONE OF TWO MAJOR HEALTH SYSTEMS THAT SERVE THEELK AND CAMERON COUNTY COMMUNITIES. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:ERHC STRIVES TO PROVIDE WELLNESS AND EDUCATIONAL PROGRAMS FOR COMMUNITY MEMBERS TO MAINTAIN A HEALTHY LIFESTYLE. ERHC PROVIDES SMOKE DETECTORS TO PARENTS OF NEWBORNS TO TAKE HOME WITH THEM AND INSTALL IN THEIR HOMES. ERHC WORKS WITH THE LOCAL LIONS CLUB AND ROTARY CLUB TO PROVIDE SERVICES TO THE COMMUNITY. ERHC PARTICIPATES IN ACTIVITIES WITH THE ST. MARYS CHAMBER OF COMMERCE AND BELONGS TO THE BOARDS OF THE FAMILY RESOURCE NETWORK AND THE STATE HEALTH IMPROVEMENT PLAN. ERHC PROVIDES JOB SHADOWING TO THE LOCAL HIGH SCHOOL STUDENTS AND HAS A SCHOOL TO WORK PROGRAM FOR STUDENTS. ERHC ALSO PARTICIPATES IN THE PHEAA PROGRAM TO HIRE STUDENTS AS SUMMER WORKERS TO GIVE THEM WORK EXPERIENCE IN VARIOUSFIELDS. THE ORGANIZATION HAS AN OPEN MEDICAL STAFF AND THE BOARD IS COMPRISED OF PEOPLE WHO ARE LEADERS IN THE COMMUNITY. THE PHYSICIAN OFFICES AND OUTPATIENT THERAPY OFFICES LOCATED THROUGHOUT THE COMMUNITIES GIVE PATIENTS EASIER ACCESS TO VARIOUS SERVICES. ERHC PARTICIPATES IN AND HOLDS HEALTH FAIRS WHERE FREE SCREENINGS AND LOW OR NO COSTS TESTING ARE PROVIDED TO PROMOTE PREVENTATIVE CARE AND HEALTH LIFESTYLES. ERHC HOLDS MANY EDUCATIONAL CLASSES FOR THE PUBLIC SUCH AS DIABETES EDUCATION, WOMEN'S HEALTH ISSUES, SUPPORT GROUPS, ETC. DUBOIS REGIONAL MEDICAL CENTER PROVIDED AN EMPLOYEE TO PROVIDE EDUCATION TO VARIOUS SENIORCENTERS ON BEHALF OF ERHC. ERHC ALSO OFFERS VARIOUS EXERCISE CLASSES SUCH AS PILATES, BOOT CAMP, YOGA, ETC., ALONG WITH WELLNESS CLASSES. THE ORGANIZATION PERIODICALLY HAS PRESS RELEASES ON DIFFERENT HEALTH ISSUES. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM:ELK REGIONAL HEALTH CENTER IS A FULLY-ACCREDITED, NOT-FOR-PROFIT 25 BED GENERAL ACUTE CARE INSTITUTION BACKED BY THE EXPERTISE OF A DEDICATED, PHYSICIAN GROUP. WITH CAMPUSES IN ST. MARYS AND RIDGWAY AND PHYSICIAN OFFICES IN A NUMBER OF LOCATIONS THROUGHOUT THE REGION, ELK REGIONAL PROUDLY SERVES THE RESIDENTS OF ELK AND CAMERON COUNTIES. IT IS THE ONGOING MISSION OF THE ELK REGIONAL HEALTH SYSTEM TO PROVIDE PREMIER HEALTHCARE SERVICES TO PATIENTS THROUGH COMMITMENTS TO SERVICE, QUALITY, PEOPLE, FINANCE AND GROWTH - ALL WHILE MAINTAINING ECONOMIC VIABILITY AND KEEPING AN EYE ON THE FUTURE. THE HOSPITAL AND PHYSICIAN OFFICES WORKWITH COMMUNITY NURSES INC., TO PROVIDE FLU SHOT CLINICS TO THE COMMUNITY. THE FOUNDATION AND AUXILIARY, OPERATING UNDER ERHC, PROVIDE EDUCATIONAL CLASSES AND SCHOLARSHIPS. THERE ARE MANY SCREENINGS AND HEALTH CLINICS HELD THROUGHOUT THE YEAR TO PROMOTE HEALTHY LIVING AND PREVENTATIVE CARE. ERHC ALSO OFFERS EXERCISE, NUTRITION, AND RELAXATION CLASSES. THE HEALTH SYSTEM FOUNDATION PROVIDES FUNDS FOR TWO SCHOLARSHIPS EACH YEAR TO STUDENTS PURSUING HEALTH CARE FIELDS. THESE SCHOLARSHIPS ARE ADMINISTERED BY THE ELK COUNTY COMMUNITY FOUNDATION.COMMUNITY NURSES INC ESTABLISHED A SERENITY GARDEN FOR PINE CREST MANOR (SKILLED NURSING FACILITY) RESIDENTS AND FAMILY AND FOR THE GENERAL PUBLIC TO USE AS A MEDIATION GARDEN. CNI ALSO PROVIDES ADULT DAY CARE SERVICES FOR THE COMMUNITY. THE HOSPITAL AUXILIARY GIVES A SCHOLARSHIP TO A TEEN VOLUNTEER FROM EACH LOCAL SCHOOL WHO ARE GOING TO STUDY A HEALTHCARE RELATED FIELD. THE PHYSICIAN OFFICES AND COMMUNITY NURSES WORK TOGETHER TO PUT ON VARIOUS FLU CLINICS TO PROVIDE ANNUAL FLU SHOTS TO MEMBERS OF THE COMMUNITY.THE AFFILIATED HEALTH CARE SYSTEM INCLUDES THE COMMUNITY NURSES, INC. AND SUBSIDIARIES, ELK REGIONAL PROFESSIONAL GROUP, INC., AND ELCO HOUSING, INC.IN OCTOBER 2012, THE ELK ENTITIES SIGNED AN AFFILIATION AGREEMENT EFFECTIVE JULY 1, 2013, WITH PENN HIGHLANDS HEALTHCARE, A PENNSYLVANIA NONPROFIT CORPORATION (PENN HIGHLANDS). PENN HIGHLANDS BECAME THE SOLE MEMBER OF ERHC. THIS AFFILIATION EXPANDS TO INCLUDE RELATIONSHIPS WITH ADDITIONAL PENNSYLVANIA NOT-FOR-PROFIT HOSPITALS INCLUDING DUBOIS REGIONAL MEDICAL CENTER LOCATED IN DUBOIS, PA, BROOKVILLE HOSPITAL LOCATED IN BROOKVILLE, PA, CLEARFIELD HOSPITAL LOCATED IN CLEARFIELD, PA, AND TYRONE HOSPITAL, LOCATED IN RIDGWAY, PA, AS WELL AS THEIR SUBSIDIARY ORGANIZATIONS.IN MAY 2020, HELPMATES INC BECAME PART OF COMMUNITY NURSES INC. HELPMATES IS A HOME SUPPORT PROVIDING HOME SUPPORT TO MANY COUNTIES IN CENTRAL AND WESTERN PA. 0 0 0 0 0 0 0 1 0 DR JULIA WONDERLING DIRECTOR/PHYSICIAN 0 812992 0 24910 0 1401 0 11600 0 27982 0 878885 0 0 DR STEVEN KOCH DIRECTOR/PHYSICIAN 0 459981 0 199461 0 609 0 8351 0 30732 0 699134 0 0 BRAD CHAPMAN PRESIDENT (UNTIL 11/1/2023) 0 293905 0 30566 0 20126 0 11114 0 30444 0 386155 0 0 LAURIE MACDONALD CFO (UNTIL 5/4/2023) 0 228771 0 9000 0 708 0 8050 0 30551 0 277080 0 0 RENEA WOLFE REGISTERED NURSE 140330 0 48588 0 25 0 0 0 27160 0 216103 0 0 0 CHRISTINE GARNER CHIEF NURSING OFFICER 157418 0 15345 0 741 0 5454 0 9727 0 188685 0 0 0 ERIN WILLIAMS PHYSICIAN ASSISTANT 125399 0 2455 0 67 0 5015 0 20645 0 153581 0 0 0 PART I, LINE 3 CEO COMPENSATION: PENN HIGHLANDS HEALTHCARE, INC. (PHH), A RELATED ORGANIZATION, DETERMINES THE COMPENSATION OF THE CEO. PHH USES THE FOLLOWING METHODS TO DETERMINE THE COMPENSATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY BOARD OR COMPENSATION COMMITTEE. PART I, LINE 7 THE ORGANIZATION PROVIDED DISCRETIONARY BONUSES TO THE REPORTABLE INDIVIDUALS ON PART VII, SECTION A TO THE EXTENT BONUSES WERE PAID BY THE FILING ORGANIZATION. ST MARY'S PHARMACYHOME MEDIC SEE PART V. 162765 SEE PART V. 0 KAREN GASPARI SEE PART V. 32364 SEE PART V. 0 REBECCA PICCOLO SEE PART V. 110992 SEE PART V. 0 LEANNE RUFFNER SEE PART V. 70270 SEE PART V. 0 SCHEDULE L, PART IV BUSINESS TRANSACTIONS:(1) FRANK STRAUB, DIRECTOR, IS THE OWNER OF ST. MARYS PHARMACY AND SMP HOME MEDICAL. THE ORGANIZATION PURCHASED PHARMACY DRUGS FOR PINECREST MANOR AND OXYGEN CONCENTRATORS AT A TOTAL COST OF $162,765 FOR FYE 06/30/2023.(2) KAREN GASPARI IS THE SISTER OF LAURIE MACDONALD, ERHC FORMER CFO. SHE IS EMPLOYED BY ERHC AND RECEIVED TOTAL COMPENSATION AND BENEFITS $32,364.(3) REBECCA PICCOLO IS THE WIFE OF JOHN PICCOLO, A DIRECTOR OF THE BOARD. SHE IS EMPLOYED AS AN OCCUPATIONAL THERAPIST AND RECEIVED COMPENSATION OF $110,992.(4) LEANNE RUFFNER IS THE DAUGHTER-IN-LAW OF CHERYL RUFFNER, A DIRECTOR OF THE BOARD. SHE IS EMPLOYED AS A REGISTERED NURSE AND RECEIVED COMPENSATION OF $70,270. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS: PENN HIGHLANDS HEALTHCARE (PHH) HOLDS CERTAIN POWERS, INCLUDING THE APPROVAL OF THE ELECTION AND REMOVAL OF OFFICERS AND DIRECTORS AND APPROVAL OF ANY AND ALL AMENDMENTS TO THE BYLAWS OR OTHER ORGANIZATIONAL/GOVERNANCE DOCUMENTS. PHH SHALL HAVE THE FOLLOWING POWERS WITH RESPECT TO THE ELECTION AND REMOVAL OF DIRECTORS: PRIOR TO THE END OF PHH'S FISCAL YEAR, THE PHH BOARD WILL MEET TO ELECT THE DIRECTORS, WITH THE EXCEPTION OF EX-OFFICIO DIRECTORS. AT LEAST SIXTY (60) DAYS IN ADVANCE OF THIS MEETING, ELK SHALL PROVIDE TO PHH'S GOVERNANCE/NOMINATING COMMITTEE (THE PHH GOVERNANCE/NOMINATING COMMITTEE) A LIST OF ONE OR MORE CANDIDATES (THE NUMBER OF CANDIDATES TO BE DETERMINED IN THE PHH GOVERNANCE/NOMINATING COMMITTEE'S DISCRETION) FOR EACH EXPIRING DIRECTOR POSITION, WITH THE EXCEPTION OF ANY EX-OFFICIO DIRECTORS. THE LIST OF CANDIDATES SHALL HAVE BEEN DEVELOPED BY ELK IN CONSULTATION WITH THIS ORGANIZATION'S BOARD. THE PHH GOVERNANCE/NOMINATING COMMITTEE SHALL REVIEW EACH CANDIDATE IN ACCORDANCE WITH THE CRITERIA SET FORTH IN THE PHH BYLAWS, THE CRITERIA, IF ANY, SET FORTH IN THIS ORGANIZATION'S BYLAWS OR POLICIES FOR WHICH SAID CANDIDATE IS BEING CONSIDERED FOR BOARD SERVICE, AND THE POLICIES AND RULES OF PHH, INCLUDING, WITHOUT LIMITATION, THE CONFLICT OF INTEREST POLICY (ALL OF WHICH SHALL BE REFERRED TO COLLECTIVELY HEREIN AS THE ELIGIBILITY CRITERIA) AND DEVELOP A LIST OF ONE OR MORE CANDIDATES FOR EACH OPEN POSITION (THE NUMBER OF CANDIDATES TO BE DETERMINED IN THE PHH GOVERNANCE/NOMINATING COMMITTEE'S DISCRETION). ONCE THE SLATE OF CANDIDATES IS NOMINATED BY THE PHH GOVERNANCE/NOMINATING COMMITTEE, THE BOARD OF ELK SHALL SUBMIT TO THE PHH BOARD FOR ELECTION SUCH SLATE OF CANDIDATES FOR THE OPEN BOARD POSITIONS. THE PHH BOARD MAY ELECT BY A VOTE OF THE MAJORITY OR REFUSE TO ELECT EACH CANDIDATE SUBMITTED BY THE BOARD OF ELK AND MAY NOT ELECT ANY CANDIDATE NOT SUBMITTED BY THE BOARD OF ELK AND NOMINATED BY THE PHH GOVERNANCE/NOMINATING COMMITTEE. THE BOARD OF PHH HAS THE POWER TO REMOVE SUCH DIRECTOR AT ANY TIME WITH OR WITHOUT CAUSE. IN THE EVENT THAT THIS ORGANIZATION DESIRES TO FILL A VACANCY OCCURRING ON ITS BOARD, THE PHH GOVERNANCE/NOMINATING COMMITTEE AND THE BOARD OF PHH, AT THE REQUEST OF ELK, SHALL ACT TO FILL SUCH VACANCY. SUBJECT TO THE APPROVAL OF PHH AS SET FORTH IN THE BYLAWS, THE ARTICLES AND THE BYLAWS MAY BE ALTERED, AMENDED, OR REPEALED AND NEW BYLAWS OR ARTICLES MAY BE ADOPTED BY THE AFFIRMATIVE VOTE OF TWO-THIRDS (2/3) OF THE BOARD. WRITTEN NOTICE OF THE INTENT TO AMEND THE BYLAWS OR THE ARTICLES AND A DRAFT OF THE PROPOSED CHANGE SHALL BE SENT TO ALL DIRECTORS, BY THE SECRETARY, AT LEAST FIVE (5) DAYS PRIOR TO ANY MEETING AT WHICH AMENDMENT OF THE BYLAWS OR THE ARTICLES IS INTENDED. FORM 990, PART VI, SECTION A, LINE 7A SEE SCHEDULE O LINE 6 EXPLANATION ABOVE. FORM 990, PART VI, SECTION A, LINE 7B SEE SCHEDULE O LINE 6 EXPLANATION ABOVE. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS: 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. THE DRAFT FORM 990 IS REVIEWED BY THE CFO AND THE CONTROLLER. AFTER ALL SUGGESTED CHANGES FROM THE CFO AND CONTROLLER ARE MADE, THE UPDATED DRAFT FORM 990 IS PROVIDED FOR REVIEW TO THE FULL BOARD. ANY QUESTIONS OR COMMENTS FROM THE BOARD ARE ADDRESSED BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C MONITORING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY: PENN HIGHLANDS HEALTHCARE, INC. (PHH), MAINTAINS A CONFLICT OF INTEREST POLICY WHICH APPLIES TO ALL SUBSIDIARIES. THE CONFLICT OF INTEREST POLICY APPLIES TO BOARD MEMBERS, OFFICERS, EXECUTIVE EMPLOYEES, AND ANY OTHER MANAGER OR SUPERVISOR EXERCISING SUBSTANTIAL INFLUENCE OVER OPERATIONS. EACH COVERED PERSON WILL PROMPTLY AND FULLY DISCLOSE ALL MATERIAL FACTS OF EVERY ACTUAL OR POTENTIAL DUAL INTEREST EXISTING AT THE TIME WHEN HE/SHE BECOMES A COVERED PERSON, AND ANNUALLY THROUGH EACH PHH SYSTEM ENTITY'S DISCLOSURE STATEMENT, WHICH REQUESTS DISCLOSURE OF RELATIONSHIPS, INVESTMENTS, AND TRANSACTIONS THAT MAY LEAD TO AN ACTUAL CONFLICT OF INTEREST. ALL COMPLETED DISCLOSURE STATEMENTS WILL BE PROVIDED TO THE PHH GOVERNANCE/NOMINATING COMMITTEE. THIS COMMITTEE, IN CONSULTATION WITH THE CHAIRPERSON OR VICE CHAIRPERSON OF EACH PHH SYSTEM ENTITY'S BOARD, SHALL EVALUATE THE COMPLETED DISCLOSURE STATEMENTS AND DETERMINE IF THERE ARE ANY CONFLICTS THAT ARE SO PERVASIVE AS TO RENDER ANY COVERED PERSON INELIGIBLE FOR SERVICE. THE CHAIRPERSON OF EACH PHH SYSTEM ENTITY'S BOARD WILL DISCLOSE TO THE FULL BOARD OF SAID PHH SYSTEM ENTITY ALL DUAL INTERESTS REPORTED TO HIM OR HER UNDER THE POLICY AND WILL ALSO MAKE THE DISCLOSURE STATEMENTS OF ALL COVERED PERSONS AVAILABLE TO DIRECTORS AT ANY TIME DURING THE YEAR. IF A POTENTIAL DUAL INTEREST ARISES AS A RESULT OF A CONTEMPLATED PHH SYSTEM ENTITY BOARD (OR COMMITTEE) ACTION, THE CHAIRPERSON OF SAID PHH SYSTEM ENTITY'S BOARD OR THE INTERESTED PERSON SHALL, OR ANY OTHER DIRECTOR MAY, RAISE THE QUESTION OF THE INTERESTED PERSON'S DUAL INTEREST. THE DISINTERESTED MEMBERS OF THE PHH SYSTEM ENTITY'S BOARD (OR COMMITTEE) WILL EVALUATE THE DISCLOSURES AND THE MATERIAL FACTS RELATING TO THE TRANSACTION, ARRANGEMENT, OR POLICY GIVING RISE TO THE DUAL INTEREST TO DETERMINE WHETHER THEY INVOLVE ACTUAL CONFLICTS OF INTEREST AND MAY ATTEMPT TO DEVELOP ALTERNATIVES TO REMOVE THE CONFLICT FROM THE TRANSACTION, ARRANGEMENT, OR POLICY. A COVERED PERSON WHO HAS A DUAL INTEREST SHALL NOT BE PRESENT FOR OR SHALL LEAVE ANY PORTION OF A MEETING AT WHICH A PHH SYSTEM ENTITY'S BOARD (OR COMMITTEE) IS VOTING TO DETERMINE WHETHER A CONFLICT EXISTS, BUT MAY BE PRESENT PRIOR TO THE VOTE TO MAKE A PRESENTATION TO SAID BOARD (OR COMMITTEE), TO DISCLOSE ADDITIONAL FACTS, OR TO RESPOND TO QUESTIONS. IF A PHH SYSTEM ENTITY'S BOARD (OR COMMITTEE DETERMINES THAT AN ACTUAL CONFLICT OF INTEREST EXISTS, THE INTERESTED PERSON SHALL BE SO ADVISED AND THE CHAIRPERSON OF A PHH SYSTEM ENTITY'S BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE OR DIRECT MANAGEMENT TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, IF THIS HAS NOT ALREADY BEEN DONE. ANY INTERESTED PERSON WHO HAS AN ACTUAL CONFLICT OF INTEREST WITH RESPECT TO THE TRANSACTION OR ARRANGEMENT DOES NOT PARTICIPATE IN AND IS NOT PRESENT FOR THE VOTE REGARDING ANY SUCH TRANSACTION OR ARRANGEMENT. IF AN INDIVIDUAL WHOSE COMPANY OR EMPLOYER HAS A BUSINESS RELATIONSHIP WITH A PHH SYSTEM ENTITY, BUT THE INDIVIDUAL DOES NOT HAVE AN ACTUAL CONFLICT OF INTEREST WITH RESPECT TO THIS BUSINESS RELATIONSHIP, THE INDIVIDUAL MAY NONETHELESS VOLUNTARILY RECUSE HIM/HERSELF FROM VOTING ON ANY MATTERS RELATED TO THE RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 15B THE PENN HIGHLANDS HEALTHCARE (PHH) EXECUTIVE COMPENSATION COMMITTEE CONSULTS WITH THE HEALTHCARE CONSULTING FIRM, YAFEE & COMPANY TO OBTAIN COMPARABLE DATA TO MAKE RECOMMENDATIONS TO THE BOARD OF DIRECTORS REGARDING EXECUTIVE COMPENSATION. THE PENN HIGHLANDS HEALTHCARE BOARD OF DIRECTORS IS ACUTELY AWARE OF THE HEIGHTENED PUBLIC SCRUTINY OF EXECUTIVE COMPENSATION AND THE NEED TO CONSIDER REGULATORY COMPLIANCE WHEN SETTING EXECUTIVE PAY. COMPENSATION REVIEWS ARE DONE ON A CONTINUOUS BASIS. COMPENSATION DETERMINATIONS OF PHH EMPLOYED OFFICERS ARE MADE BY THE PHH COMPENSATION COMMITTEE. COMPENSATION DETERMINATIONS OF CERTAIN EMPLOYED OFFICERS ARE ALSO REVIEWED AND APROVED BY THE PHH COMPENSATION COMMITTEE AND SHARED WITH THE COMPENSATION COMMITTEE OR BOARD. THE COMPENSATION COMMITTEE OF PHH STRIVE TO TAKE THE STEPS NECESSARY TO QUALIFY FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER FEDERAL TAX LAW. THE PHH EXECUTIVE COMPENSATION COMMITTEES ARE RESPONSIBLE FOR (1) DETERMINING THE OVERALL TOTAL COMPENSATION STRATEGY FOR ALL THEIR RESPECTIVE CORPORATE OFFICERS, (2) APPROVING ALL COMPENSATION AND BENEFITS DECISIONS FOR CORPORATE OFFICERS, AND (3) REPORTING SUCH ACTIONS TO THE PHH BOARD ON A CONTINUOUS BASIS. IN ADDITION, THE EXECUTIVE COMPENSATION COMMITTEES, AS APPLICABLE, EXPRESSLY DETERMINE THE REASONABLENESS OF TOTAL COMPENSATION AND BENEFITS FOR ALL CORPORATE OFFICERS, AND ASSURES THAT ALL OFFICER COMPENSATION DECISIONS ARE MADE AFTER THOROUGH CONSIDERATION OF AND COMPARISON TO THE MARKET PRACTICES OF OTHER SIMILARLY SITUATED NOT-FOR-PROFIT HEALTHCARE EXECUTIVES IN COMPARABLE ORGANIZATIONS. THE EXECUTIVE COMPENSATION COMMITTEES CONSIST OF BOARD MEMBERS WHO DO NOT HAVE MATERIAL FINANCIAL INTERESTS THAT COULD BE AFFECTED BY THE OFFICER COMPENSATION DECISIONS MADE BY THE COMMITTEES. THE COMPARABILITY DATA USED TO ASSIST THE EXECUTIVE COMPENSATION COMMITTEES IN THEIR COMPENSATION DELIBERATIONS ARE COMPILED BY AN INDEPENDENT, NATIONAL COMPENSATION CONSULTING FIRM THAT IS RETAINED BY AND REPORTS DIRECTLY TO THE EXECUTIVE COMPENSATION COMMITTEES. THE DATA COLLECTED BY THE CONSULTANT CONSISTS OF MARKET INFORMATION FOR EXECUTIVES IN FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS. THE DELIBERATIONS AND DECISIONS OF THE EXECUTIVE COMPENSATION COMMITTEES ARE CONTEMPORANEOUSLY DOCUMENTED, REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEES, AND PROVIDED TO THE BOARD OF PHH, AS APPLICABLE. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENT AVAILABILITY: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A: BOARD MEMBER COMPENSATION: NO DIRECTORS RECEIVE ANY COMPENSATION FOR THEIR DIRECTOR DUTIES. BRAD CHAPMAN, STEVEN KOCH, JULIA WONDERLING AND DAVID OBLEY ARE COMPENSATED FOR THEIR DUTIES AS EMPLOYEES OR INDEPENDENT CONTRACTORS OF THE ORGANIZATION AND/OR RELATED ORGANIZATIONS. FORM 990, PART IX, LINE 11G CONTRACT LABOR: PROGRAM SERVICE EXPENSES 4,953,716. MANAGEMENT AND GENERAL EXPENSES 481,367. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,435,083. LAB SERVICES: PROGRAM SERVICE EXPENSES 1,167,346. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,167,346. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 932,614. MANAGEMENT AND GENERAL EXPENSES 78,534. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,011,148. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,902,072. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,902,072. COLLECTION FEES: PROGRAM SERVICE EXPENSES 54,984. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 54,984. FORM 990, PART XI, LINE 9: CHG IN ACCRUED PENSION LIAB 6,678,441. NET PERIODIC PENSION COSTS 120,894. TRANSFERS TO AFFILIATES -17,673,217. OTHER CHANGES IN NET ASSETS 1,160. 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