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PUNXSUTAWNEY AREA HOSPITAL INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
PUNXSUTAWNEY AREA HOSPITAL INC (EIN 25-0965210)
Tax period
2019-07-01 to 2020-06-30
Filed
2021-05-12
IRS object ID
202121329349302247
Schema version
2019v5.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2021-05-12T12:07:48-05:00ReturnTs
Tax Period End2020-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1910 E ST LOUIS 200/PO BOX 1190AddressLine1Txt
CitySPRINGFIELDCityNm
State AbbreviationMOStateAbbreviationCd
ZIP658062523ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN250965210EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PUNXSUTAWNEY AREA HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% JACK SISK CFOInCareOfNm
Business Name ControlPUNXBusinessNameControlTxt
Phone8149381800PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line181 HILLCREST DRIVEAddressLine1Txt
CityPUNXSUTAWNEYCityNm
State AbbreviationPAStateAbbreviationCd
ZIP15767ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJACK SISKPersonNm
Person TitleCFOPersonTitleTxt
Phone8149381882PhoneNum
Signature2021-05-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBrian D ToddPreparerPersonNm
PTINP00422601PTIN
Phone4178658701PhoneNum
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDANIEL D BLOUGH JRPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line181 HILLCREST DRIVEAddressLine1Txt
CityPUNXSUTAWNEYCityNm
State AbbreviationPAStateAbbreviationCd
ZIP15767ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$39,676,620GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PAH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1889FormationYr
Legal Domicile StatePALegalDomicileStateCd
Activity Or MissionVALUED AS HIGHEST QUALITY COMMUNITY HOSPITAL IN THE REGION AND YOUR PRIMARY HEALTH CARE PROVIDER, COMMITTED TO CONTINUOUSLY IMPROVING SERVICES WHILE CONTAINING COST.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee451TotalEmployeeCnt
Total Volunteers18TotalVolunteersCnt
Total Gross UBI$89,353TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$543NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$56,576PYContributionsGrantsAmt
CY Contributions Grants$966,076CYContributionsGrantsAmt
PY Program Service Revenue$37,047,282PYProgramServiceRevenueAmt
CY Program Service Revenue$37,654,998CYProgramServiceRevenueAmt
PY Investment Income$194,577PYInvestmentIncomeAmt
CY Investment Income$256,989CYInvestmentIncomeAmt
PY Other Revenue$298,285PYOtherRevenueAmt
CY Other Revenue$475,281CYOtherRevenueAmt
PY Total Revenue$37,596,720PYTotalRevenueAmt
CY Total Revenue$39,353,344CYTotalRevenueAmt
PY Grants And Similar Paid$5,875PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$800CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$23,358,019PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$25,276,678CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$12,377,819PYOtherExpensesAmt
CY Other Expenses$11,911,749CYOtherExpensesAmt
PY Total Expenses$35,741,713PYTotalExpensesAmt
CY Total Expenses$37,189,227CYTotalExpensesAmt
PY Revenues Less Expenses$1,855,007PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,164,117CYRevenuesLessExpensesAmt
Total Assets BOY$26,923,951TotalAssetsBOYAmt
Total Assets EOY$41,127,499TotalAssetsEOYAmt
Total Liabilities BOY$6,263,823TotalLiabilitiesBOYAmt
Total Liabilities EOY$19,117,702TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$20,660,128NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$22,009,797NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO PROVIDE HIGH QUALITY, COST EFFECTIVE, PRIMARY HEALTH CARE AND TO COORDINATE CARE FOR PATIENTS REQUIRING SECONDARY AND TERTIARY SERVICES.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$26,635,353ExpenseAmt
Grant$800GrantAmt
Revenue$35,241,313RevenueAmt
DescPUNXSUTAWNEY AREA HOSPITAL PROVIDES ACUTE CARE INPATIENT AND OUTPATIENT HEALTH CARE TO PATIENTS IN A THREE COUNTY AREA. FOR THE FISCAL YEAR ENDED; THERE WERE 1,090 ADMISSIONS TO THE ACUTE CARE SETTING THAT GENERATED 3,433 PATIENT DAYS. THE HOSPITAL ALSO PROVIDED 68,708 OUTPATIENT VISITS TO PATIENTS. ALSO, THE HOSPITAL PROVIDED OVER $583,000 OF CHARITY CARE FOR 1,891 CUSTOMER ENCOUNTERS WHERE THE PATIENT DID NOT HAVE THE MEANS TO PAY FOR SERVICES RENDERED. NO PATIENTS WERE TURNED AWAY FOR LACK OF INSURANCE. SERVICES PROVIDED INCLUDE CARDIOPULMONARY, CLINICAL NUTRITION, COUNSELING, EMERGENCY, INTENSIVE CARE, SURGICAL, PHARMACY, RADIOLOGY, REHABILITATION, AND SHORT PROCEDURE.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$1,600,407ExpenseAmt
Revenue$1,140,946RevenueAmt
DescPUNXSUTAWNEY AREA HOSPITAL PROVIDES HOME HEALTH CARE TO PATIENTS IN A THREE COUNTY AREA. FOR THE FISCAL YEAR ENDED THERE WERE 16,445 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.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$342,944ExpenseAmt
Revenue$1,272,739RevenueAmt
DescPUNXSUTAWNEY AREA HOSPITAL PROVIDES SKILLED NURSING SERVICES TO PATIENTS IN A THREE COUNTY AREA. FOR THE FISCAL YEAR ENDED THERE WERE 149 ADMISSIONS INTO THE LONG-TERM CARE UNIT WHICH GENERATED 2,261 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.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$28,578,704TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (true)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (true)BusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document52IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee451EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsYes (true)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (true)QuidProQuoContriDisclInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldPAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJACK SISK CFOPersonNm
Phone8149381882PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line181 HILLCREST DRIVEAddressLine1Txt
CityPUNXSUTAWNEYCityNm
State AbbreviationPAStateAbbreviationCd
ZIP15767ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtHighest Compensated EmployeeHighestCompensatedEmployeeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerInd
EYAD KHABBAZ
PHYSICIAN40.00.0Yes (X)$679,029$0$16,146
THOMAS GENTILCORE
PHYSICIAN40.00.0Yes (X)$552,247$0$10,438
MAZEN HASAN
PHYSICIAN40.00.0Yes (X)$396,638$0$15,973
TIMOTHY CLARK SIMPSON MD
DIRECTOR40.00.0$384,776$0$18,291Yes (X)
KRISTINA BRUBAKER
PHYSICIAN40.00.0Yes (X)$348,452$0$18,037
GUSTAVO FRANCO
PHYSICIAN40.00.0Yes (X)$334,747$0$16,504
DANIEL D BLOUGH JR
CEO40.00.0$294,324$0$16,945Yes (X)
JACK G SISK
CFO40.00.0$184,908$0$16,964Yes (X)
KYLE LINGENFELTER
DIRECTOR1.00.0$31,000$0$0Yes (X)
SAMUEL SMITH
DIRECTOR1.00.0$0$0$0Yes (X)
MELISSA DUNKEL
SECRETARY1.00.0$0$0$0Yes (X)Yes (X)
J THOMAS FRANTZ
DIRECTOR1.00.0$0$0$0Yes (X)
PHYLLIS BYERLY
TREASURER1.00.0$0$0$0Yes (X)Yes (X)
JON JOHNSTON
CHAIRMAN1.00.0$0$0$0Yes (X)Yes (X)
MARY CLAIRE JOHNSTON
DIRECTOR1.00.0$0$0$0Yes (X)
JOHN PRUSHNOK
DIRECTOR1.00.0$0$0$0Yes (X)
FRANK ROBERTS
VICE CHAIRMAN1.00.0$0$0$0Yes (X)Yes (X)
DAVID SPIGLE
DIRECTOR1.00.0$0$0$0Yes (X)
KATHY YOUNG
DIRECTOR1.00.0$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,206,121TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$129,298TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K30IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
LABORATORY CORP OF AMERICA HOLDINGS
PO BOX 12140BURLINGTONNC16501LAB SERVICES$396,451
CURA HOSPITALITY LLC
2400 ANSYS DRIVE SUITE 404CANONSBURGPA15317FOOD SERVICE$318,119
HH RESOURCES LLC
49 CAMPBELL TOWN ROADLUTHERSBURGPA15848AGENCY NURSING$287,049
PENNSYLVANIA MOUNTAIN HEALTHCARE
150 MCCRACKEN RUN ROADDUBOISPA15801REVENUE CYCLE$230,453
AUDIOLOGICAL AND SPEECH ASSOCIATION
270 PHILADELPHIA STREETINDIANAPA15701THERAPY SERVICE$154,004
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K8CntrctRcvdGreaterThan100KCnt
Fundraising$22,115FundraisingAmt
Government Grants$140,737GovernmentGrantsAmt
All Other Contributions$803,224AllOtherContributionsAmt
Total Contributions$966,076TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT SERVICE REVENUE900099$34,689,378$34,600,025$89,353
OTHER900099$2,864,220$2,864,220
BILLING541900$101,400$101,400
FieldValueIRS element (for citing)
Total Program Service Revenue$37,654,998TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$253,937TotalRevenueColumnAmt
Exclusion$253,937ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$343,631RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$307,479RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$36,152RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$36,152TotalRevenueColumnAmt
Exclusion$36,152ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$3,052OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$3,052OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,052TotalRevenueColumnAmt
Exclusion$3,052ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$15,400FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$22,115ContriRptFundraisingEventAmt
Fundraising Direct Expenses$15,797FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$397TotalRevenueColumnAmt
Exclusion-$397ExclusionAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescGAIN ON INVESTMENT IN EQUITY INVESTEEDesc
Business900099BusinessCd
Total Revenue Column$439,526TotalRevenueColumnAmt
Exclusion$439,526ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$439,526OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$39,353,344TotalRevenueColumnAmt
Related Or Exempt Func Income$37,565,645RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$89,353UnrelatedBusinessRevenueAmt
Exclusion$732,270ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$800TotalAmt
Program Services$800ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$947,208TotalAmt
Program Services$434,067ProgramServicesAmt
Management And General$513,141ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$59,430TotalAmt
Program Services$59,430ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$19,703,939TotalAmt
Program Services$16,049,510ProgramServicesAmt
Management And General$3,654,429ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$552,675TotalAmt
Program Services$404,584ProgramServicesAmt
Management And General$148,091ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,771,669TotalAmt
Program Services$2,259,757ProgramServicesAmt
Management And General$511,912ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,241,757TotalAmt
Program Services$911,779ProgramServicesAmt
Management And General$329,978ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$11,045TotalAmt
Management And General$11,045ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$99,197TotalAmt
Management And General$99,197ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,394,257TotalAmt
Program Services$2,266,344ProgramServicesAmt
Management And General$1,127,913ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$122,654TotalAmt
Program Services$24,896ProgramServicesAmt
Management And General$97,758ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,377,980TotalAmt
Program Services$1,104,936ProgramServicesAmt
Management And General$273,044ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$419,179TotalAmt
Management And General$419,179ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$489,621TotalAmt
Program Services$157,031ProgramServicesAmt
Management And General$332,590ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$192,683TotalAmt
Program Services$126,430ProgramServicesAmt
Management And General$66,253ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$12,510TotalAmt
Program Services$12,510ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,303,153TotalAmt
Program Services$924,567ProgramServicesAmt
Management And General$378,586ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$693,289TotalAmt
Program Services$378,173ProgramServicesAmt
Management And General$315,116ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES & DRUGS$3,356,799$3,356,799
RECRUITING & RETENTION$246,136$246,136
REPAIRS & MAINTENANCE$193,246$107,091$86,155

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$37,189,227TotalAmt
Program Services$28,578,704ProgramServicesAmt
Management And General$8,610,523ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$740,925BOYAmt
EOY$1,762,189EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$4,866,361BOYAmt
EOY$17,218,153EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,835,335BOYAmt
EOY$2,181,815EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$187,243BOYAmt
EOY$153,395EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$770,106BOYAmt
EOY$827,107EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,634,966BOYAmt
EOY$1,892,598EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$37,615,226LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$31,215,712LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$6,012,768BOYAmt
EOY$6,399,514EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$6,073,764BOYAmt
EOY$6,754,762EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$2,343,132BOYAmt
EOY$2,386,866EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$762,323BOYAmt
EOY$984,358EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$697,028BOYAmt
EOY$566,742EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$26,923,951BOYAmt
EOY$41,127,499EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$6,263,823BOYAmt
EOY$6,237,884EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$4,505,104EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$4,519,585EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$3,855,129EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,263,823BOYAmt
EOY$19,117,702EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$20,197,960BOYAmt
EOY$21,560,129EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$462,168BOYAmt
EOY$449,668EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$20,660,128BOYAmt
EOY$22,009,797EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$26,923,951BOYAmt
EOY$41,127,499EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$2,164,117ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$157,124NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$971,572OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$762OtherActivitiesAmt
Total Lobbying Expenditures$762TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceOTHER LOBBYING ACTIVITIESFormAndLineReferenceDesc
ExplanationOTHER LOBBYING ACTIVITIES: 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, $576, AND THE HOSPITAL 340(B) HEALTH, $186.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$409,994BeginningYearBalanceAmt
Investment Earnings Or Losses-$17,074InvestmentEarningsOrLossesAmt
Other Expenditures$9,016OtherExpendituresAmt
End Year Balance$383,904EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$425,940BeginningYearBalanceAmt
Investment Earnings Or Losses$4,951InvestmentEarningsOrLossesAmt
Other Expenditures$20,897OtherExpendituresAmt
End Year Balance$409,994EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$426,667BeginningYearBalanceAmt
Investment Earnings Or Losses$19,956InvestmentEarningsOrLossesAmt
Other Expenditures$20,683OtherExpendituresAmt
End Year Balance$425,940EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$413,467BeginningYearBalanceAmt
Investment Earnings Or Losses$34,836InvestmentEarningsOrLossesAmt
Other Expenditures$21,636OtherExpendituresAmt
End Year Balance$426,667EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$442,169BeginningYearBalanceAmt
Investment Earnings Or Losses-$12,927InvestmentEarningsOrLossesAmt
Other Expenditures$15,775OtherExpendituresAmt
End Year Balance$413,467EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.28170BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.71830PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (true)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$40,000OtherCostOrOtherBasisAmt
Book Value$40,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,220,039OtherCostOrOtherBasisAmt
Depreciation$9,779,702DepreciationAmt
Book Value$2,440,337BookValueAmt
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$24,106,916OtherCostOrOtherBasisAmt
Depreciation$20,372,529DepreciationAmt
Book Value$3,734,387BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,248,271OtherCostOrOtherBasisAmt
Depreciation$1,063,481DepreciationAmt
Book Value$184,790BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$6,399,514TotalBookValueLandBuildingsAmt
Financial DerivativesFinancialDerivativesGrp
Closely Held Equity InterestsCloselyHeldEquityInterestsGrp

Other Securities OtherSecuritiesGrp (3 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
INVESTMENT IN TRI-STATE$46,511C
INVESTMENT IN CHART$1,525,756C
POTENTIAL CHART CLAIMS$814,599C
FieldValueIRS element (for citing)
Total Book Value Securities$2,386,866TotalBookValueSecuritiesAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
DUE TO THIRD PARTY PAYERS$575,623
MEDICARE ADVANCE$3,279,506
FieldValueIRS element (for citing)
Total Liability$3,855,129TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$39,833,984TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$157,124NetUnrealizedGainsInvstAmt
Other Revenue$800OtherRevenueAmt
Revenue Not Reported$157,924RevenueNotReportedAmt
Revenue Subtotal$39,676,060RevenueSubtotalAmt
Other Revenues Not Included-$322,716OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$322,716RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$39,353,344TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$37,512,503TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$323,276OtherExpensesIncludedAmt
Expenses Not Reported$323,276ExpensesNotReportedAmt
Expenses Subtotal$37,189,227ExpensesSubtotalAmt
Total Expenses Per Form990$37,189,227TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART V, LINE 4USES OF ENDOWMENT FUNDS: INCOME FROM THE ENDOWMENT FUND IS USED TO PURCHASE CAPITAL EQUIPMENT. PERMANENT FUNDS OF $276,275 ARE RESTRICTED FROM USE.
SCHEDULE D, PART X, LINE 2UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
SCHEDULE D, PART XI, LINE 2DAMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12: $ 800 NET ASSETS RELEASED
SCHEDULE D, PART XI, LINE 4BAMOUNTS INCLUDED ON FROM 990, PART VIII, LINE 12C, BUT NOT ON LINE 1: $ (307,479) RENTAL EXPENSES ( 15,797) FUNDRAISING EXPENSES 560 TEMPORARILY RESTRICTED CONTRIBUTIONS ----------- $ (322,716)
SCHEDULE D, PART XII, LINE 2DAMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25: $ 307,479 RENTAL EXPENSES 15,797 FUNDRAISING EXPENSES ----------- $ 323,276

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GOLF TOURNAMENTEvent1Nm
Gross Receipts Event1$37,515GrossReceiptsEvent1Amt
Charitable Contri Event1$22,115CharitableContriEvent1Amt
Gross Revenue Event1$15,400GrossRevenueEvent1Amt
Cash Prizes Event1$2,675CashPrizesEvent1Amt
Non Cash Prizes Event1$1,325NonCashPrizesEvent1Amt
Rent Facility Costs Event1$3,360RentFacilityCostsEvent1Amt
Food And Beverage Event1$4,762FoodAndBeverageEvent1Amt
Other Direct Expenses Event1$3,675OtherDirectExpensesEvent1Amt
Other Events Total0OtherEventsTotalCnt
Gross Receipts Total$37,515GrossReceiptsTotalAmt
Charitable Contributions Tot$22,115CharitableContributionsTotAmt
Gross Revenue Total Events$15,400GrossRevenueTotalEventsAmt
Cash Prizes Total Events$2,675CashPrizesTotalEventsAmt
Non Cash Prizes Total Events$1,325NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$3,360RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$4,762FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events$3,675OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$15,797DirectExpenseSummaryEventsAmt
Net Income Summary-$397NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent250Yes (X)Percent250Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportfalseAnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Persons Served1442PersonsServedCnt
Total Community Benefit Expns$235,996TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$235,996NetCommunityBenefitExpnsAmt
Total Expense0.00640TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Persons Served11473PersonsServedCnt
Total Community Benefit Expns$6,505,516TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,941,270DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,564,246NetCommunityBenefitExpnsAmt
Total Expense0.04210TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Persons Served12915PersonsServedCnt
Total Community Benefit Expns$6,741,512TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,941,270DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,800,242NetCommunityBenefitExpnsAmt
Total Expense0.04850TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Persons Served570PersonsServedCnt
Total Community Benefit Expns$2,650TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,650NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Persons Served331PersonsServedCnt
Total Community Benefit Expns$1,388,302TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$553,700DirectOffsettingRevenueAmt
Net Community Benefit Expns$834,602NetCommunityBenefitExpnsAmt
Total Expense0.02250TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Persons Served2PersonsServedCnt
Total Community Benefit Expns$800TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$800NetCommunityBenefitExpnsAmt

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Persons Served903PersonsServedCnt
Total Community Benefit Expns$1,391,752TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$553,700DirectOffsettingRevenueAmt
Net Community Benefit Expns$838,052NetCommunityBenefitExpnsAmt
Total Expense0.02260TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Persons Served13818PersonsServedCnt
Total Community Benefit Expns$8,133,264TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,494,970DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,638,294NetCommunityBenefitExpnsAmt
Total Expense0.07110TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$529,607BadDebtExpenseAmt
Bad Debt Expense Attributable$86,856BadDebtExpenseAttributableAmt
Reimbursed By Medicare$16,455,615ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$16,302,167CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$153,448MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PUNXSUTAWNEY AREA HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line181 HILLCREST DRIVEAddressLine1Txt
CityPUNXSUTAWNEYCityNm
State AbbreviationPAStateAbbreviationCd
ZIP15767ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.PAH.ORGWebsiteAddressTxt
State License163701StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherSKILLED NURSING SERVICESOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1PUNXSUTAWNEY AREA HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART V, SECTION COwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLSEE PART V, SECTION COtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt18ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSEE PART V, SECTION CStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care150.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care250.FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART V, SECTION CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART V, SECTION CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART V, SECTION CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 5COMMUNITY INPUT: THE HOSPITAL WORKED WITH A CONSULTING FIRM, STRATEGY SOLUTION INTERNALLY. THE PROCESS WAS LED BY THE VP OF PROFESSIONAL AND CORPORATE SERVICES. A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS LED BY PUNXSUTAWNEY AREA HOSPITAL IN THE SPRING OF 2018 FOR APPROXIMATELY 50,000 RESIDENTS IN THE THREE (3) COUNTY SERVICE AREA OF CLEARFIELD, JEFFERSON, AND INDIANA COUNTIES. PUNXSUTAWNEY AREA HOSPITAL COLLABORATED WITH INDIANA REGIONAL MEDICAL CENTER AND CLARION HOSPITAL. PREVIOUS CHNAS WERE DONE WORKING DIRECTLY TOGETHER. THE 2018 PROCESS WAS COMPLETED INDEPENDENTLY, WITH DISCUSSIONS AND PLANNING SESSIONS WITH THE THREE HOSPITALS TO LINK THE INITIATIVES AND STRATEGIES. PUNXSUTAWNEY AREA HOSPITAL IDENTIFIED COMMUNITY HEALTH NEEDS THROUGH A COLLABORATIVE PROCESS WITH PENNSYLVANIA MOUNTAIN HEALTH CARE NETWORK (PMCN) HOSPITALS. BUILDING PAST INITIATIVES, THE 2018 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 BOARD 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.
SCHEDULE H, PART V, SECTION B, LINE 6ATHE COMMUNITY NEEDS ASSESSMENT SERVED PUNXSUTAWNEY AREA HOSPITAL, CLARION HOSPITAL, AND INDIANA REGIONAL MEDICAL CENTER.
SCHEDULE H, PART V, SECTION B, LINE 7ATHE CHNA REPORT HAS BEEN MADE WIDELY AVAILABLE ON THE PAH WEBSITE: HTTPS://WWW.PAH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
SCHEDULE H, PART V, SECTION B, LINE 7BTHE CHNA REPORT WAS MADE AVAILABLE ON THE FOLLOWING OTHER WEBSITES: HTTPS://WWW.CLARIONHOSPITAL.ORG/ABOUT-CLARION-HOSPITAL/COMMUNITY-HEALTH-NE EDS-ASSESSMENT/ HTTPS://WWW.IRMC.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/
SCHEDULE H, PART V, SECTION B, LINE 10ATHE HOSPITAL'S MOST RECENT IMPLEMENTATION STRATEGY HAS BEEN POSTED ON THE FOLLOWING WEBSITE: HTTPS://WWW.PAH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
SCHEDULE H, PART V, SECTION B, LINE 11ADDRESSING IDENTIFIED NEEDS: POPULATION HEALTH HAS BEEN DEFINED AS "THE HEALTH OUTCOMES OF A GROUP OF INDIVIDUALS". IT IS AN APPROACH TO HEALTH THAT AIMS TO IMPROVE THE HEALTH OF AN ENTIRE HUMAN POPULATION- FOR PURPOSES OF PUNXSUTAWNEY AREA HOSPITALS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), IMPROVE THE HEALTH OF THE ENTIRE POPULATION OF THE PUNXSUTAWNEY AREA HOSPITAL SERVICE AREA. IN 2019, PUNXSUTAWNEY AREA HOSPITAL CREATED A TRANSFORMATION PLAN IN CONJUNCTION WITH THE PENNSYLVANIA DEPARTMENT OF HEALTHS RURAL HEALTH MODEL. PARTICIPATION IN THE RURAL HEALTH MODEL HAS ALLOWED THE HOSPITAL TO CONNECT THE COMMUNITY HEALTH NEEDS ASSESSMENT STRATEGIES TO THE RHM TRANSFORMATION PLAN. THE HOSPITAL IS WORKING WITH THE PUNXSUTAWNEY ROTARY CLUB TO ENHANCE THE ANNUAL BLOOD SCREENING PROGRAM WHICH SCREENS 10-15% OF ADULTS IN THE SERVICE AREA ANNUALLY. NEW TRACKING SYSTEMS AND PROGRAM DEVELOPMENT INITIATIVES ARE IN PLACE. THE 2020 BLOOD SCREENING HAS BEEN POSTPONED BECAUSE OF THE CORONAVIRUS, BUT THE EVENT AND SUBSEQUENT WRAP AROUND EVENTS WHICH DIRECTLY IMPACT POPULATION HEALTH ARE FORTHCOMING. THE HOSPITAL'S TRANSFORMATION PLAN IS ALSO LOOKING AT 'HIGH RISK' PATIENTS MAKING SURE THERE IS A CONTINUUM OF HOSPITAL AND OTHER HEALTHCARE SERVICES TARGETING ISSUES INCLUDING COPD, HEART DISEASE AND DIABETES. THE OPIOID CRISIS: PUNXSUTAWNEY AREA HOSPITAL LIKE MOST ORGANIZATIONS HAS BEEN MONITORING, REPORTING AND RESPONDING TO THE OPIOID CRISIS IN PENNSYLVANIA. THE HOSPITAL IS EXPLORING OPIOID GRANT FUNDING IN CONJUNCTION WITH BOTH COLLABORATIVE PARTNERSHIPS AND RHM PARTNER HOSPITALS. IN ADDITION, THE HOSPITAL IS LOOKING TO EXPAND SERVICES FOR PATIENTS SUFFERING FROM ADDICTION. PLANNED START DATE SUMMER 2020. UPDATE ON IDENTIFIED OBJECTIVES: IN THE SPRING OF 2018 A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), LED BY PUNXSUTAWNEY AREA HOSPITAL WAS CONDUCTED FOR THE APPROXIMATELY 50,000 RESIDENTS IN THE 3 COUNTY SERVICE AREA OF CLEARFIELD, JEFFERSON AND INDIANA COUNTIES. THERE ARE SEVERAL AREA HOSPITALS IN THE REGION AND PUNXSUTAWNEY AREA HOSPITAL COLLABORATED WITH INDIANA REGIONAL MEDICAL CENTER AND CLARION HOSPITAL AS PART OF THE OVERALL PROCESS. PREVIOUS CHNAS WERE COMPLETED WORKING DIRECTLY WITH A SHARED PROCESS AND STRUCTURE. THIS 2018 PROCESS WAS COMPLETED INDEPENDENTLY; DISCUSSIONS AND PLANNING SESSIONS WERE HELD WITH THE 3 HOSPITALS TO LINK THE INITIATIVES AND STRATEGIES. THIS IMPLEMENTATION STRATEGY AND COMMUNITY BENEFIT PLAN REPORT SUMMARIZES HOW PUNXSUTAWNEY AREA HOSPITAL WILL DEVELOP, CONDUCT AND SUSTAIN COMMUNITY BENEFIT PROGRAMS THAT 1. ADDRESS PRIORITIZED HEALTH NEEDS FROM PREVIOUSLY CONDUCTED PLANNING INITIATIVES 2. RESPOND TO OTHER IDENTIFIED COMMUNITY HEALTH NEEDS. THIS IS THE IMPLEMENTATION PLAN FOR FY 2018-2019. EXECUTION WILL OCCUR IN FY 2018/19-FY 2020. TARGET AREAS AND POPULATIONS: GIVEN THE MULTI-FACETED HEALTH NEEDS OF OUR COMMUNITIES WE HAVE SELECTED A 3 COUNTY TARGET AREA FOR OUR IMPLEMENTATION STRATEGY; THE PREVALENCE OF POOR HEALTH FACTORS AND POOR HEALTH OUTCOMES COMPOUNDED BY CHALLENGING SOCIAL DETERMINANTS OF HEALTH IMPACTING COMMUNITY RESIDENTS ARE LESS THAN IDEAL THROUGHOUT THE COUNTIES TOTAL GEOGRAPHIC AREA. HOW THE IMPLEMENTATION STRATEGY AND COMMUNITY BENEFIT PLAN WERE DEVELOPED - INCLUDING HOW PRIORITIES WERE ESTABLISHED: PUNXSUTAWNEY AREA HOSPITAL IDENTIFIED COMMUNITY HEALTH NEEDS THROUGH A COLLABORATIVE PROCESS WITH PMCN (PENNSYLVANIA MOUNTAIN HEALTH CARE NETWORK) HOSPITALS. BUILDING ON PAST INITIATIVES, THE 2018 PROCESS INCLUDED A COMPREHENSIVE SURVEY, A TEAM PRIORITIZATION EXERCISE TO DETERMINE PRIORITIES AND ASSESSMENT OF PAST SUCCESSES AND FAILURES. AS THE CHNA LEVERAGED AND UTILIZED THE HOSPITALS PLANNING STAFF - A MULTI-PART PROCESS WAS EMPLOYED TO DEVELOP THIS IMPLEMENTATION STRATEGY AND COMMUNITY BENEFIT PLAN, INCLUDING QUANTITATIVE DATA REVIEW AND ANALYSIS, LITERATURE REVIEWS COMPLETED TO IDENTIFY STATE AND NATIONAL BENCHMARKS AND EVIDENCE BASED STRATEGIES THAT RELATE TO THE INDICATORS/METRICS. THE CHNA TEAMS UTILIZATION OF MULTIPLE TYPES OF RESEARCH ALLOWED FOR DATA COLLECTION ACROSS A BROAD RANGE OF INDICATORS RELATING TO OVERALL POPULATION HEALTH, SOCIAL DETERMINANTS OF HEALTH INCLUDING GEOGRAPHIC LOCATION DIFFERENCES IN HEALTH OUTCOMES AND THE NEEDS OF DISADVANTAGED POPULATIONS INCLUDING UNINSURED PERSONS, LOW INCOME PERSONS AND MINORITY GROUPS (INCLUDING AMISH RESIDENTS) WITHIN THE REGION. IN ADDITION TO THE ASSESSMENT PUNXSUTAWNEY AREA HOSPITALS CHNA TEAM 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 ACTIVITIES 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 THE 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. MAJOR HEALTH NEEDS: CRITERIA INCLUDED THE NUMBER OF PERSONS AFFECTED BY THE VARIOUS FACTORS ANALYZED, THE SERIOUSNESS OF THE ISSUES (AS DETERMINED BY SURVEYS AND DATA AVAILABLE) WHETHER THE HEALTH NEEDS PARTICULARLY AFFECTED PERSONS LIVING IN POVERTY OR REFLECTED OTHER DISPARITIES, AND AVAILABILITY OF COMMUNITY RESOURCES TO ADDRESS THE NEEDS. THIS PROCESS IDENTIFIED THE FOLLOWING PRIORITIES FOR THE COMMUNITY: UPDATE ON IDENTIFIED OBJECTIVES GOAL 1 - REDUCE OBESITY IN THE COMMUNITY THROUGH AN INCREASE IN PHYSICAL ACTIVITY AND OTHER WELLNESS/PREVENTION STRATEGIES. OBJECTIVE: CREATE AND LAY THE GROUNDWORK FOR A PUNXSUTAWNEY AREA HOSPITAL WORKPLACE WELLNESS PROGRAM ACTION STEP 1: OUTLINE WHAT THE WELLNESS PROGRAM WILL ENTAIL AND WHICH STAFF MEMBERS WILL BE RESPONSIBLE FOR WHICH PIECES AND PARTS IMPACT MEASURED BY: PLANNING MEETING HELD IN CONJUNCTION WITH THE 2019 BUDGET PREP. UPDATE: SCHEDULE OPENING FOR THE HOSPITALS RAPID CARE WHICH WILL PROVIDE WELLNESS OPPORTUNITIES OF LOCAL BUSINESS. ACTION STEP 2: EXPAND ON OFFERINGS TO LOCAL BUSINESSES BASED ON THEIR INDIVIDUALIZED NEEDS. IMPACT MEASURED BY: IDENTIFICATION OF BUSINESSES, INITIATION OF SERVICE PROVISION/TRAINING/TESTING. UPDATE: PHYSICIAN OFFICES IDENTIFIED AS NEXT STEP ACTION STEP 3: EXPAND THE HOSPITALS' WEIGHT LOSS PROGRAM TO CONNECT WITH NATIONAL BENCHMARKING IMPACT MEASURED BY: CREATING A LISTING OF EVIDENCE BASED OBESITY STRATEGIES AND EXPAND CURRENT PROGRAM TO TRACKING UPDATE: TRACKING IN PLACE FOR CURRENT PARTICIPANTS HP 2020 GUIDELINES IDENTIFIED OBJECTIVE: CONNECT WITH THE PUNXSUTAWNEY SCHOOL DISTRICT TO ASSESS AND ESTABLISH COLLABORATIVE GOALS WITH HEALTHCARE/EDUCATION. ACTION STEP 1: ASSESS THE SCHOOLS PLANS TO ADDRESS CHILDHOOD OBESITY IN CONJUNCTION WITH ATHLETIC TRAINING DEVELOPMENT. IMPACT MEASURED BY: DOCUMENTS ACQUIRED UPDATE: PAH IS WORKING WITH THE SCHOOL ATHLETIC TRAINER AND ALIGNING OBJECTIVES FOR STUDENT ATHLETES PAH IS WORKING TO PROVIDE SCHOOL PHYSICIANS AND LAB TESTING RELATIONSHIPS ARE BEING REVIEWED OBJECTIVE: EXPAND EMPLOYEE WELLNESS PROGRAM TO OTHER COUNTY EMPLOYEES ACTION STEP 1: MEET WITH OCCUPATIONAL HEALTH TO DETERMINE LIST OF POTENTIAL EMPLOYERS IMPACT MEASURED BY: NUMBER OF EMPLOYERS AND EMPLOYEES PARTICIPATING UPDATE: NOT INITIATED AT THIS TIME ACTION STEP 2: DETERMINE HOW THE HOSPITAL PROGRAM WOULD BE BEST IMPLEMENTED WITH OTHER EMPLOYERS IMPACT MEASURED BY: TBD UPDATE: NOT INITIATED AT THIS TIME ACTION STEP 3: MEET WITH LOCAL EMPLOYERS TO DETERMINE INTEREST IN THE PROGRAM IMPACT MEASURED BY: NUMBER OF EMPLOYERS CONTRACTED UPDATE: NOT INITIATED AT THIS TIME ACTION STEP 4: IMPLEMENT PROGRAM IN OTHER SITES IMPACT MEASURED BY: NUMBER OF EMPLOYERS PARTICIPATING IN PROGRAM UPDATE: NOT INITIATED AT THIS TIME OBJECTIVE: CONNECT SCREENINGS TO HEALTHY PEOPLE 2020 INITIATIVES ACTION STEP 1: CONTINUE TO OFFER PROGRAM IN OCTOBER OF EACH YEAR IMPACT MEASURED BY: NUMBER OF PEOPLE ATTENDING UPDATE: NOT INITIATED AT THIS TIME ACTION STEP 2: OFFER EDUCATIONAL PROGRAMS AT EVENT TO OUTREACH TO TARGETED TO COMMUNITY MEMBERS IMPACT: INCREASE IN KNOWLEDGE OF PROGRAM TOPIC UPDATE: NEW EMPLOYEE KD HIRED AND IS ESTABLISHING SCREENINGS TO ALIGN RHM TRANSFORMATION PLAN AND CHNA PLANNING INITIATIVES. ENHANCED TRACKING IS IN PLACE AND BUDGETS HAVE BEEN ESTABLISHED FOR CONNECTION OF ACTIVITIES TO HOSPITAL APPROVED BUDGET. ACTION STEP 3: REVIEW HEALTHY PEOPLE 2020 AND CONNECT OBJECTIVES TO NATIONAL PRIORITIES IMPACT MEASURED BY: REVIEW OF HEALTH PEOPLE 2020/2030 UPDATE: HEALTHY PEOPLE 2030 REVIEWED AND FOLDED IN THE HOSPITALS RHM TRANSFORMATION PLAN. ACTION STEP 4: ATTEND CONFERENCE TO BE POSITIONED FOR HEALTHY PEOPLE 2030 IMPACT MEASURED BY: ATTENDANCE BY PLANNING STAFF UPDATE: NOT INITIATED AT THIS TIME OBJECTIVE: HIRE ATHLETIC TRAINER TO WORK IN CONJUNCTION WITH THE SCHOOL - TO LINK H
SCHEDULE H, PART V, SECTION B, LINE 13HOTHER CRITERIA EXPLAINED IN THE FAP: THERE IS A PRESUMPTIVE CHARITY SCORE PROCESS USING ACCOUNTS WITH MEDICARE OR DUAL ELIGIBILITY.
SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, & 16CFAP, PLS, AND APPLICATION WEBSITE: FINANCIAL ASSISTANCE POLICY, APPLICATION FORM AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE AT THE FOLLOWING WEBSITE: HTTPS://WWW.PAH.ORG/ABOUT/FINANCIAL-ASSISTANCE
SCHEDULE H, PART V, LINE 16ILEP 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.
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HHCS OF PUNXSUTAWNEY AREA HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1602 EAST MAHONING STREETAddressLine1Txt
CityPUNXSUTAWNEYCityNm
State AbbreviationPAStateAbbreviationCd
ZIP15767ZIPCd
FieldValueIRS element (for citing)
FacilityMEDICARE CERTIFIED HOME HEALTH AGENCYFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART I, LINE 7, COLUMN FPERCENT OF TOTAL EXPENSE: TOTAL OPERATING EXPENSES PER FORM 990 WERE USED AS THE DENOMINATOR TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES.
SCHEDULE H, PART I, LINE 7COSTING METHODOLOGY: 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 ORGANIZATION'S COST ACCOUNTING SOFTWARE, INCLUDING DIRECT COSTS PLUS OVERHEAD ALLOCATIONS COMPUTED IN THE COST ACCOUNTING.
SCHEDULE H, PART III, SECTION A, LINE 2BAD DEBT EXPENSE: 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.
SCHEDULE H, PART III, SECTION A, LINE 3BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE: THIS FIGURE WAS CALCULATED USING THE ESTIMATED PERSONS UNDER POVERTY FOR JEFFERSON COUNTY OF 16.4%.
SCHEDULE H, PART III, SECTION A, LINE 4BAD DEBT EXPENSE FOOTNOTE: THE AUDIT FOOTNOTE ADDRESSING BAD DEBT EXPENSE AND PATIENT ACCOUNTS RECEIVABLE IS FOUND ON PAGE 12 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS UNDER NOTE 1, SUBTITLED "PATIENT ACCOUNTS RECEIVABLE."
SCHEDULE H, PART III, SECTION C, LINE 8COMMUNITY BENEFIT: 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.
SCHEDULE H, PART III, SECTION C, LINE 9BCOLLECTION POLICY: PATIENTS WHO QUALIFY FOR CHARITY CARE ARE FLAGGED IN ORDER TO PROCESS THEM SEPARATELY FROM OTHER SELF PAY ACCOUNTS.
SCHEDULE H, PART VI, LINE 2NEEDS ASSESSMENT: 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.
SCHEDULE H, PART VI, LINE 3PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: 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.
SCHEDULE H, PART VI, LINE 4COMMUNITY INFORMATION: STATISTICS AVAILABLE FROM THE UNITED STATES CENSUS BUREAU REVEAL THAT JEFFERSON COUNTY HAS A POPULATION OF JUST UNDER 45,189 IN APPROXIMATELY 650 SQUARE MILES. THE POPULATION AGED 65 AND OLDER IS 21.5%. THE POPULATION WITH INCOME BELOW THE POVERTY LEVEL IS 16.4% AND THE COUNTY'S PER CAPITA PERSONAL INCOME IS $25,509.
SCHEDULE H, PART VI, LINE 5PROMOTION OF COMMUNITY HEALTH: 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.
SCHEDULE H, PART VI, LINE 6AFFILIATED HEALTH CARE SYSTEM: PUNXSUTAWNEY AREA HOSPITAL AND ITS WHOLLY OWNED SUBSIDIARY, PUNXSUTAWNEY MEDICAL SERVICES, INC., PRIMARILY EARN REVENUES BY PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES TO PATIENTS IN THE PUNXSUTAWNEY, PENNSYLVANIA, AREA AND ALSO OPERATES A HOME HEALTH AGENCY.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
TIMOTHY CLARK SIMPSON MD
DIRECTOR$365,776$0$0$0$19,000$0$1,380$0$16,911$0$403,067$0$0$0
DANIEL D BLOUGH JR
CEO$277,773$0$0$0$16,551$0$1,200$0$15,745$0$311,269$0$0$0
JACK G SISK
CFO$184,908$0$0$0$0$0$1,380$0$15,584$0$201,872$0$0$0
THOMAS GENTILCORE
PHYSICIAN$552,247$0$0$0$0$0$1,380$0$9,058$0$562,685$0$0$0
KRISTINA BRUBAKER
PHYSICIAN$348,452$0$0$0$0$0$1,380$0$16,657$0$366,489$0$0$0
MAZEN HASAN
PHYSICIAN$390,306$0$0$0$6,332$0$0$0$15,973$0$412,611$0$0$0
GUSTAVO FRANCO
PHYSICIAN$334,057$0$0$0$690$0$1,380$0$15,124$0$351,251$0$0$0
EYAD KHABBAZ
PHYSICIAN$678,307$0$0$0$722$0$0$0$16,146$0$695,175$0$0$0

Schedule L IRS990ScheduleL

FieldValueIRS element (for citing)
Total Balance Due$0TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonSHANNON BYERLYPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionDAUGHTER OF P. BYERLYRelationshipDescriptionTxt
Transaction$59,430TransactionAmt
TransactionWAGESTransactionDesc
Sharing Of RevenuesfalseSharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART I, LINE 6TOTAL NUMBER OF VOLUNTEERS: TOTAL NUMBER OF VOLUNTEERS INCLUDED NON-COMPENSATED MEMBERS OF THE BOARD OF DIRECTORS AND MEMBERS OF THE ORGANIZATION AUXILIARY.
FORM 990, PART III, LINE 4BPROGRAM ACHIEVEMENTS: 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.
FORM 990, PART III, LINE 4CPROGRAM ACHIEVEMENTS: SPECIALTY NURSING PROGRAMS INCLUDE: MATERNAL/CHILD CARE, IV THERAPY AND ENTEROSTOMAL CARE. IN ADDITION TO PROFESSIONAL NURSING SERVICES, THE AGENCY PROVIDES REHABILITATIVE SERVICES INCLUDING PHYSICAL, SPEECH, AND OCCUPATIONAL THERAPIES.
FORM 990, PART VI, SECTION A, LINE 6 & 7BGOVERNANCE DECISION: AS SET FORTH IN THE NETWORK AFFILIATION AGREEMENT ("NETWORK AGREEMENT") BY AND AMOUNT THE CORPORATION, CLARION HEALTHCARE SYSTEM, INC. AND INDIANA HEALTHCARE CORPORATION, PENNSYLVANIA MOUNTAIN CARE NETWORK ("PMNC"), A PENNSYLVANIA NONPROFIT CORPORATION, SHALL BE AND ACT AS THE "OTHER BODY" WITH RESPECT TO THE CORPORATION AND ITS SUBSIDIARIES, IF ANY, AS THAT TERM IS DEFINED IN SECTION 5103 OF THE PENNSYLVANIA NONPROFIT CORPORATION LAW. IN THE CAPACITY, PMNC SHALL EXERCISE THE FOLLOWING RESERVED POWERS WITH RESPECT TO THE CORPORATION AND ITS SUBSIDIARIES. ANY OF THE FOLLOWING ACTIONS TAKEN BY THE CORPORATION OR ANY OF ITS SUBSIDIARIES SHALL REQUIRE THE APPROVAL OF THE BOARD OF PMCN PRIOR TO BECOMING EFFECTIVE, PROVIDED, IF THE PMCN BOARD HAS NOT ACTED UPON SUCH ACTION WITHIN 60 DAYS OF THE ORIGINAL RECOMMENDATION, THE ACTION TAKEN SHALL BE DEEMED TO HAVE BEEN APPROVED. A VOTE 0F 80% OF THE WHOLE NUMBER OF THE PMCN DIRECTORS IS REQUIRED FOR APPROVAL (OR DISAPPROVAL OF (10) AND (11) BELOW: (1) AMENDMENT OF ARTICLES OF INCORPORATION AND CORPORATE BYLAWS; (2) MERGER, CONSOLIDATION, DISSOLUTION OR SALE OF ALL OR SUBSTANTIALLY ALL ASSETS; (3) STRATEGIC PLANS NOT OTHERWISE ADDRESSED IN AN APPROVED CAPITAL BUDGET; (4) FUNDAMENTAL CHANGES IN MISSION, CONVERSION TO A FOR-PROFIT ENTITY OR ANY OF FUNDAMENTAL CHANGE DESCRIBED IN THE SUBCHAPTERS TO CHAPTER 59 OF THE PENNSYLVANIA NONPROFIT CORPORATION LAW; (5) INITIATING NEW CLINICAL PROGRAMS; (6) TERMINATING EXISTING CLINICAL PROGRAMS; (7) ENTERING INTO A MANAGEMENT CONTRACT WITH ANY THIRD PARTY (OTHER THAN EXISTING MANAGEMENT CONTRACTS); (8) A PROPOSED ENTRY INTO A SIGNIFICANT JOINT VENTURE OR AFFILIATION OF MANAGEMENT AGREEMENT WITH ANY OTHER NON-PMCN ENTITY THAT HAS SIGNIFICANT IMPLICATIONS FOR THE ENTITY INVOLVED AND/OR FOR PMCN AND/OR THE OTHER PMCN ENTITIES, AND FOR WHICH THE ENTITY'S CEO DOES NOT HAVE SUFFICIENT AUTHORITY TO APPROVE HIMSELF AND WOULD HAVE TO BRING TO HIS BOARD. EXAMPLES OF SIGNIFICANT INCLUDE A NEW RELATIONSHIP THAT WOULD REQUIRE CAPITAL INVESTMENT BY THE ENTITY, A CLINICAL AFFILIATION IN WHICH THE ENTITY CEDES MANAGEMENT CONTROL TO THE NON-PMCN ENTITY, OR A JOINT SERVICE LINE OR ANY OTHER JOINT VENTURE, AFFILIATION OR AGREEMENT WITH A NON-PMCN ENTITY IN WHICH IT WOULD BE EXPECTED THAT PMCN OR ANY PMCN ENTITY WOULD BE INTERESTED; (9) INCURRENCE OR GUARANTEE OR NEW DEBT THAT MEETS THE FINANCIAL TERMS DESCRIBED WITHIN THE NETWORK AGREEMENT; (10) DISAPPROVAL OF ANY RECOMMENDED, NEW PRESIDENT AND CHIEF EXECUTIVE OFFICER (THE CEO) AS DECIDED BY PMCN IN ACCORDANCE WITH THE FOLLOWING: (A) ANY DECISION TO DISAPPROVE A CEO RECOMMENDATION MUST BE BASED ON THE MOST EXTRAORDINARY CIRCUMSTANCES AND MUST OTHERWISE BE A REASONABLE EXERCISE OF THE PMCN'S DISCRETION; (B) ANY DECISION BY PMCN TO DISAPPROVE THE CEO RECOMMENDED BY THE CORPORATION OR THE HOSPITAL MUST BE APPROVED BY A VOTE OF AT LEAST 80% OF THE WHOLE NUMBER OF PMCN DIRECTORS; (C) THE SPECIFIC REASONS FOR DISAPPROVAL MUST BE ARTICULATED BY PMCN TO THE CORPORATION OR THE HOSPITAL, IN WRITING; AND (D) THE WRITING MUST BE RECEIVED BY THE CORPORATION OR THE HOSPITAL WITHIN 30 DAYS AFTER THE DATE OF THE CORPORATION'S OR THE HOSPITAL'S CEO RECOMMENDATION TO PMCN. IF THE CORPORATION OR THE HOSPITAL DOES NOT RECEIVE WRITTEN NOTICE OF DISAPPROVAL WITHIN SUCH TIME, THE CEO RECOMMENDED BY THE CORPORATION OF THE HOSPITAL SHALL BE DEEMED TO BE APPROVED BY PMCN. (11) DISAPPROVAL OF ANY PAYOR CONTRACT. IF THE CORPORATION DOES NOT RECEIVE PMCN'S WRITTEN NOTICE OF DISAPPROVAL WITHIN 30 DAYS, THE PAYOR CONTRACT SHALL BE DEEMED TO BE APPROVED BY PMCN; AND (12) ANY OTHER ACTION THAT MAY NOT OR HEREAFTER BE DESCRIBED IN THE NETWORK AGREEMENT AS AMENDED IN ACCORDANCE WITH ITS TERMS. THE CORPORATION SHALL ALSO CAUSE ITS SUBSIDIARIES, IF ANY, TO BE SUBJECT TO THESE RESERVED POWERS OF PMCN AND SHALL TAKE NO ACTION WITH RESPECT TO ITS SUBSIDIARIES EXCEPT IN ACCORDANCE WITH THESE RESERVED POWERS AND THE TERMS OF THE NETWORK AGREEMENT.
FORM 990, PART VI, SECTION B, LINE 11B990 REVIEW POLICY: 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 12CCONFLICT OF INTEREST POLICY REVIEW: 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 15ACOMPENSATION REVIEW POLICY: 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 OFFICERSKEY EMPLOYEES' SALARY LEVEL. THE CEO SUBSEQUENTLY SHARES THE FINDINGS WITH THE BOARD EXECUTIVE COMMITTEE.
FORM 990, PART VI, SECTION C, LINE 19DOCUMENT DISCLOSURE: 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 XI, LINE 9OTHER CHANGES IN NET ASSETS: $ (959,312) TRANSFERS TO AFFILIATES ( 12,260) CHANGE IN BENEFICIAL INTEREST OF PERPETUAL TRUST ----------- $ (971,572)

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1PUNXSUTAWNEY MEDICAL SERVICES INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line181 HILLCREST DRIVEAddressLine1Txt
CityPUNXSUTAWNEYCityNm
State AbbreviationPAStateAbbreviationCd
ZIP15767ZIPCd
FieldValueIRS element (for citing)
EIN251773035EIN
Primary ActivitiesANESTH. SERV.PrimaryActivitiesTxt
Legal Domicile StatePALegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity Status3PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1PUNXSY HOSPBusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationYes (true)ControlledOrganizationInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1PERPETUAL TRUSTBusinessNameLine1Txt
FieldValueIRS element (for citing)
Primary ActivitiesTRUSTPrimaryActivitiesTxt
Legal Domicile StatePALegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1PUNXSY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeTRUSTEntityTypeTxt
Share Of Total Income-$12,259ShareOfTotalIncomeAmt
Share Of EOY Assets$222,775ShareOfEOYAssetsAmt
Ownership1.00000OwnershipPct
Controlled OrganizationYes (true)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
PUNXSUTAWNEY MEDICAL SERVICES INC
O$1,420,966FMV
PUNXSUTAWNEY MEDICAL SERVICES INC
P$238,345FMV
PUNXSUTAWNEY MEDICAL SERVICES INC
S$700,000FMV