2021-05-12T12:07:48-05:00 2020-06-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2019-07-01 250965210 PUNXSUTAWNEY AREA HOSPITAL INC % JACK SISK CFO PUNX 8149381800 81 HILLCREST DRIVE PUNXSUTAWNEY PA 15767 JACK SISK CFO 8149381882 2021-05-15 true Brian D Todd P00422601 4178658701 2019 2022-09-23 18:48:47Z DANIEL D BLOUGH JR 81 HILLCREST DRIVE PUNXSUTAWNEY PA 15767 39676620 false X WWW.PAH.ORG X 1889 PA VALUED AS HIGHEST QUALITY COMMUNITY HOSPITAL IN THE REGION AND YOUR PRIMARY HEALTH CARE PROVIDER, COMMITTED TO CONTINUOUSLY IMPROVING SERVICES WHILE CONTAINING COST. 12 10 451 18 89353 543 56576 966076 37047282 37654998 194577 256989 298285 475281 37596720 39353344 5875 800 0 0 23358019 25276678 0 0 0 12377819 11911749 35741713 37189227 1855007 2164117 26923951 41127499 6263823 19117702 20660128 22009797 X TO PROVIDE HIGH QUALITY, COST EFFECTIVE, PRIMARY HEALTH CARE AND TO COORDINATE CARE FOR PATIENTS REQUIRING SECONDARY AND TERTIARY SERVICES. false false 26635353 800 35241313 PUNXSUTAWNEY AREA HOSPITAL PROVIDES ACUTE CARE INPATIENT AND OUTPATIENT HEALTH CARE TO PATIENTS IN A THREE COUNTY AREA. FOR THE FISCAL YEAR ENDED; THERE WERE 1,090 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. 1600407 1140946 PUNXSUTAWNEY 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. 342944 1272739 PUNXSUTAWNEY 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. 28578704 true true false true false false false false false true true true false false true false false true false false false false false false true false true true false false true false false false false false false true false false false false false false true true true false false true 52 0 true 451 true true true false false false false true true false false false false false false X 12 10 false false false false true false true true true false false true true true true true true true false false PA X JACK SISK CFO 8149381882 81 HILLCREST DRIVE PUNXSUTAWNEY PA 15767 EYAD KHABBAZ PHYSICIAN 40.0 0.0 X 679029 0 16146 THOMAS GENTILCORE PHYSICIAN 40.0 0.0 X 552247 0 10438 MAZEN HASAN PHYSICIAN 40.0 0.0 X 396638 0 15973 TIMOTHY CLARK SIMPSON MD DIRECTOR 40.0 0.0 X 384776 0 18291 KRISTINA BRUBAKER PHYSICIAN 40.0 0.0 X 348452 0 18037 GUSTAVO FRANCO PHYSICIAN 40.0 0.0 X 334747 0 16504 DANIEL D BLOUGH JR CEO 40.0 0.0 X 294324 0 16945 JACK G SISK CFO 40.0 0.0 X 184908 0 16964 KYLE LINGENFELTER DIRECTOR 1.0 0.0 X 31000 0 0 SAMUEL SMITH DIRECTOR 1.0 0.0 X 0 0 0 MELISSA DUNKEL SECRETARY 1.0 0.0 X X 0 0 0 J THOMAS FRANTZ DIRECTOR 1.0 0.0 X 0 0 0 PHYLLIS BYERLY TREASURER 1.0 0.0 X X 0 0 0 JON JOHNSTON CHAIRMAN 1.0 0.0 X X 0 0 0 MARY CLAIRE JOHNSTON DIRECTOR 1.0 0.0 X 0 0 0 JOHN PRUSHNOK DIRECTOR 1.0 0.0 X 0 0 0 FRANK ROBERTS VICE CHAIRMAN 1.0 0.0 X X 0 0 0 DAVID SPIGLE DIRECTOR 1.0 0.0 X 0 0 0 KATHY YOUNG DIRECTOR 1.0 0.0 X 0 0 0 3206121 0 129298 30 false true false LABORATORY CORP OF AMERICA HOLDINGS PO BOX 12140 BURLINGTON NC 16501 LAB SERVICES 396451 CURA HOSPITALITY LLC 2400 ANSYS DRIVE SUITE 404 CANONSBURG PA 15317 FOOD SERVICE 318119 HH RESOURCES LLC 49 CAMPBELL TOWN ROAD LUTHERSBURG PA 15848 AGENCY NURSING 287049 PENNSYLVANIA MOUNTAIN HEALTHCARE 150 MCCRACKEN RUN ROAD DUBOIS PA 15801 REVENUE CYCLE 230453 AUDIOLOGICAL AND SPEECH ASSOCIATION 270 PHILADELPHIA STREET INDIANA PA 15701 THERAPY SERVICE 154004 8 22115 140737 803224 966076 NET PATIENT SERVICE REVENUE 900099 34689378 34600025 89353 OTHER 900099 2864220 2864220 BILLING 541900 101400 101400 37654998 253937 253937 0 0 343631 307479 36152 0 36152 36152 3052 3052 3052 3052 15400 22115 15797 -397 -397 0 0 0 0 0 0 GAIN ON INVESTMENT IN EQUITY INVESTEE 900099 439526 439526 439526 39353344 37565645 89353 732270 0 800 800 0 0 947208 434067 513141 59430 59430 19703939 16049510 3654429 552675 404584 148091 2771669 2259757 511912 1241757 911779 329978 0 11045 11045 99197 99197 0 0 0 3394257 2266344 1127913 122654 24896 97758 1377980 1104936 273044 419179 419179 0 489621 157031 332590 192683 126430 66253 0 0 12510 12510 0 1303153 924567 378586 693289 378173 315116 MEDICAL SUPPLIES & DRUGS 3356799 3356799 RECRUITING & RETENTION 246136 246136 REPAIRS & MAINTENANCE 193246 107091 86155 37189227 28578704 8610523 0 740925 1762189 4866361 17218153 0 0 2835335 2181815 0 0 0 0 187243 153395 770106 827107 1634966 1892598 37615226 31215712 6012768 6399514 6073764 6754762 2343132 2386866 762323 984358 0 0 697028 566742 26923951 41127499 6263823 6237884 0 0 0 4505104 0 0 0 0 0 0 0 0 0 4519585 0 3855129 6263823 19117702 X 20197960 21560129 462168 449668 20660128 22009797 26923951 41127499 X 2164117 157124 -971572 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 762 762 false OTHER LOBBYING ACTIVITIES OTHER 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. 409994 -17074 9016 383904 425940 4951 20897 409994 426667 19956 20683 425940 413467 34836 21636 426667 442169 -12927 15775 413467 0.28170 0.71830 true false 40000 40000 12220039 9779702 2440337 24106916 20372529 3734387 1248271 1063481 184790 6399514 INVESTMENT IN TRI-STATE 46511 C INVESTMENT IN CHART 1525756 C POTENTIAL CHART CLAIMS 814599 C 2386866 0 DUE TO THIRD PARTY PAYERS 575623 MEDICARE ADVANCE 3279506 3855129 39833984 157124 800 157924 39676060 -322716 -322716 39353344 37512503 323276 323276 37189227 37189227 SCHEDULE D, PART V, LINE 4 USES 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 2 UNCERTAIN 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 2D AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12: $ 800 NET ASSETS RELEASED SCHEDULE D, PART XI, LINE 4B AMOUNTS 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 2D AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25: $ 307,479 RENTAL EXPENSES 15,797 FUNDRAISING EXPENSES ----------- $ 323,276 GOLF TOURNAMENT 37515 22115 15400 2675 1325 3360 4762 3675 0 37515 22115 15400 2675 1325 3360 4762 3675 15797 -397 true true X true X true X true true true false false 1442 235996 235996 0.00640 11473 6505516 4941270 1564246 0.04210 12915 6741512 4941270 1800242 0.04850 570 2650 2650 0.00010 331 1388302 553700 834602 0.02250 2 800 800 903 1391752 553700 838052 0.02260 13818 8133264 5494970 2638294 0.07110 false 529607 86856 16455615 16302167 153448 X true true 1 1 PUNXSUTAWNEY AREA HOSPITAL 81 HILLCREST DRIVE PUNXSUTAWNEY PA 15767 WWW.PAH.ORG 163701 X X X SKILLED NURSING SERVICES PUNXSUTAWNEY AREA HOSPITAL 1 false false true X X X X X X X X X 18 true true false true X SEE PART V, SECTION C X SEE PART V, SECTION C X true 18 true SEE PART V, SECTION C false true X 150. 250. X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY 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 6A THE COMMUNITY NEEDS ASSESSMENT SERVED PUNXSUTAWNEY AREA HOSPITAL, CLARION HOSPITAL, AND INDIANA REGIONAL MEDICAL CENTER. SCHEDULE H, PART V, SECTION B, LINE 7A THE 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 7B THE 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 10A THE 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 11 ADDRESSING 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 13H OTHER 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, & 16C FAP, 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 16I LEP TRANSLATIONS: THERE ARE NO GROUPS WITH LIMITED ENGLISH PROFICIENCY THAT RISE TO THE THRESHOLD REQUIRED UNDER IRC SECTION 501(R). HOWEVER, LANGUAGE TRANSLATIONS OF THE FINANCIAL ASSISTANCE POLICY AND APPLICATION ARE AVAILABLE BY REQUEST AT THE FINANCIAL COUNSELING DEPARTMENT OF THE HOSPITAL. 1 HHCS OF PUNXSUTAWNEY AREA HOSPITAL 602 EAST MAHONING STREET PUNXSUTAWNEY PA 15767 MEDICARE CERTIFIED HOME HEALTH AGENCY SCHEDULE H, PART I, LINE 7, COLUMN F PERCENT 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 7 COSTING 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 2 BAD 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 3 BAD 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 4 BAD 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 8 COMMUNITY 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 9B COLLECTION 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 2 NEEDS 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 3 PATIENT 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 4 COMMUNITY 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 5 PROMOTION 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 6 AFFILIATED 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. X X X X false false false false false false false false false TIMOTHY CLARK SIMPSON MD DIRECTOR 365776 0 0 0 19000 0 1380 0 16911 0 403067 0 0 0 DANIEL D BLOUGH JR CEO 277773 0 0 0 16551 0 1200 0 15745 0 311269 0 0 0 JACK G SISK CFO 184908 0 0 0 0 0 1380 0 15584 0 201872 0 0 0 THOMAS GENTILCORE PHYSICIAN 552247 0 0 0 0 0 1380 0 9058 0 562685 0 0 0 KRISTINA BRUBAKER PHYSICIAN 348452 0 0 0 0 0 1380 0 16657 0 366489 0 0 0 MAZEN HASAN PHYSICIAN 390306 0 0 0 6332 0 0 0 15973 0 412611 0 0 0 GUSTAVO FRANCO PHYSICIAN 334057 0 0 0 690 0 1380 0 15124 0 351251 0 0 0 EYAD KHABBAZ PHYSICIAN 678307 0 0 0 722 0 0 0 16146 0 695175 0 0 0 0 SHANNON BYERLY DAUGHTER OF P. BYERLY 59430 WAGES false FORM 990, PART I, LINE 6 TOTAL 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 4B PROGRAM 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 4C PROGRAM 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 & 7B GOVERNANCE 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 11B 990 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 12C CONFLICT 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 15A COMPENSATION 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 19 DOCUMENT 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 9 OTHER CHANGES IN NET ASSETS: $ (959,312) TRANSFERS TO AFFILIATES ( 12,260) CHANGE IN BENEFICIAL INTEREST OF PERPETUAL TRUST ----------- $ (971,572) PUNXSUTAWNEY MEDICAL SERVICES INC 81 HILLCREST DRIVE PUNXSUTAWNEY PA 15767 251773035 ANESTH. SERV. PA 501(C)(3) 3 PUNXSY HOSP true PERPETUAL TRUST TRUST PA PUNXSY HOSPITAL TRUST -12259 222775 1.00000 true false false false false false false false false false false false false false false true true false false true PUNXSUTAWNEY MEDICAL SERVICES INC O 1420966 FMV PUNXSUTAWNEY MEDICAL SERVICES INC P 238345 FMV PUNXSUTAWNEY MEDICAL SERVICES INC S 700000 FMV