2020-07-14T13:42:20-05:00 2019-06-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2018-07-01 250984595 BROOKVILLE HOSPITAL % JULIANNE PEER BROO 8148491461 100 HOSPITAL ROAD BROOKVILLE PA 15825 JULIANNE PEER PRESIDENT 8148491408 2020-05-15 true Brian D Todd P00422601 4178658701 167.68.126.162 43032920201965000168 2020-07-14 P 74C51B083D6172D3D43AC87F1A33B4712A418457 EADA8263F67F30EEC173F90D1C5FD4FB3EC213FF 2018 2020-09-23 17:36:50Z PENN HIGHLANDS BROOKVILLE JULIANNE PEER 100 HOSPITAL ROAD BROOKVILLE PA 15825 52796491 false X WWW.PHHEALTHCARE.ORG X 1915 PA BROOKVILLE HOSPITAL IS A 35 BED CRITICAL ACCESS HOSPITAL THAT PROVIDES QUALITY HEALTHCARE SERVICES. OUTPATIENT SERVICES INCLUDE RADIOLOGY, LAB AND REHABILITATION. 8 5 253 10 0 0 63436 21742811 30778349 30607058 274021 427145 -9942 19278 31105864 52796292 2000 0 0 0 16325837 16367625 0 0 0 14411151 14053554 30738988 30421179 366876 22375113 22454723 45503134 11530734 12348865 10923989 33154269 X TO PROVIDE YOU WITH EXCEPTIONAL CARE THROUGH OUR COMMUNITY-BASED HEALTH SYSTEM WHILE MAINTAINING A REVERENCE FOR LIFE. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. false false 21279813 25005610 BROOKVILLE HOSPITAL PROVIDES A WIDE VARIETY OF OUTPATIENT SERVICES TO THE COMMUNITY. WE HAVE A PHYSICIAN STAFFED 24 HOUR EMERGENCY DEPARTMENT THAT PROVIDED OVER 7,800 VISITS THIS YEAR AND 3 FAMILY PRACTICE RURAL HEALTH CLINICS AND AN URGENT CARE CLINIC THAT HAD OVER 30,000 VISITS. WE ALSO PROVIDE OUTPATIENT PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY, GENERAL RADIOLOGY, CAT SCAN, MRI, PET, ULTRASOUND, NUCLEAR MEDICINE, CARDIOLOGY, LABORATORY SERVICES, PAIN CLINIC, AND OUTPATIENT PSYCH SERVICES. OUR SURGEONS PERFORMED 1,473 SURGERIES. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. 4766841 5601448 BROOKVILLE HOSPITAL IS A 35 BED HOSPITAL THAT PROVIDED INPATIENT SERVICES TO OVER 890 PATIENTS THIS YEAR. INPATIENT SERVICES INCLUDED TREATMENTS FOR BOTH MEDICAL AND SURGICAL PATIENTS. MANY OF OUR PATIENTS WERE TREATED IN THE GERO-PSYCHIATRIC UNIT OF THE HOSPITAL. THIS UNIT SPECIALIZES IN PSYCHIATRIC DISORDERS FOR PATIENTS OVER THE AGE OF 55. 26046654 true true false true false false false false false false true false false true true false false true false false true false false false false false true true false false true false false false false false false false false false false false false false true true true false false true 40 0 true 253 true false false false false false false false false false false false false X 8 5 false false true false true true true true true false false true true true true true true true false false PA X JULIANNE PEER 8148491461 100 HOSPITAL ROAD BROOKVILLE PA 15825 X H ED RICHARDS DMO DIRECTOR BEGIN 04/2019 1.0 1.0 X 0 0 0 GENE HOAK CHAIRMAN 2.0 0.0 X X 0 0 0 WILLIAM YOUNG VICE CHAIRMAN 2.0 0.0 X X 0 0 0 JUDITH A GROMLEY SECRETARY/TREASURER 2.0 0.0 X X 0 0 0 JAY CHAMBERLIN DIRECTOR 1.0 0.0 X 0 0 0 STEVEN FONTAINE DIRECTOR/PHH CEO 2.0 40.0 X 0 887830 106706 JULIANNE PEER PRESIDENT 40.0 0.0 X X 192847 0 24954 KUMARESAN GANABATHI MEDICAL STAFF PRESIDENT 1.0 40.0 X 0 512473 25249 TABITHA JEFFERSON PHYSICIAN - EMERGENCY 36.0 0.0 X 511112 0 29186 JOSEPH NOVAK ANESTHESIOLOGIST 40.0 0.0 X 400000 0 29186 JEFFREY PADZER PHYSICIAN 36.0 0.0 X 330180 0 0 PATRICK SHILALA PHYSICIAN 36.0 0.0 X 316441 0 26762 LUIS TOMACRUZ PHYSICIAN 36.0 0.0 X 396570 0 0 2147150 1400303 242043 7 false true false NORTHFORK REHABILITATION INC 445 FERGUSON ROAD BROOKVILLE PA 15825 PHYSICAL THERAPY SVC 869223 STAFF CARE 1240 HIGH BLUFF DRIVE SAN DIEGO CA 92130 MEDICAL STAFFING 525762 ASSOCIATED CLINICAL LABORATORIES 15832 COLLECTION CTR DR CHICAGO IL 60693 LABORATORY SERVICES 297268 ADVANCED LITHO CARELTD 1305 S MAIN STREET MEADVILLE PA 16335 MEDICAL SERVICES 294521 JACKSON COKER LOCUMTENENS LLC 3000 OLD ALABAMA ROAD ALPHARETTA GA 30022 PHYSICIAN SERVICES 134134 5 21504318 8942 229551 21742811 NET PATIENT SERVICE REVENUE 621110 30220077 30220077 PHARMACY REVENUE 446110 203791 203791 MEAL TICKETS 722210 57472 57472 OTHER REVENUE 900099 125718 125718 30607058 410212 410212 0 0 69863 69863 0 69863 69863 17132 199 -199 17132 16933 16933 0 0 0 0 0 0 0 0 0 LOSS FROM EQUITY INVESTEES 900099 -50585 -50585 -50585 52796292 30607058 446423 X 0 0 0 0 217801 217801 0 13091624 12579657 511967 245349 238875 6474 2141546 2045047 96499 671305 635690 35615 0 2476 2476 88035 88035 0 0 21223 21223 7454516 4601193 2853323 0 1144577 894647 249930 0 0 742876 676772 66104 61711 52758 8953 0 19108 15530 3578 113236 95527 17709 0 1040593 877857 162736 306434 287298 19136 MEDICAL SUPPLIES & DRUGS 3012056 3012056 LICENSES, DUES, SUBSCRIPTIONS 46713 33747 12966 30421179 26046654 4374525 0 953850 378179 1042148 1273422 0 0 3300432 3914137 0 0 0 0 0 0 599720 703455 294560 605098 38861673 33936887 4697322 4924786 9580822 9786302 249280 269238 0 0 0 0 1736589 23648517 22454723 45503134 2821274 4201032 0 0 0 0 7923884 7782498 0 0 0 0 320843 147280 0 0 464733 218055 11530734 12348865 X 10643170 32878093 53456 276176 227363 0 10923989 33154269 22454723 45503134 22375113 -144833 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 1800 1800 false SCHEDULE C, PART II-B, LINE 1(I) OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAYS DUES TO HOSPITAL COUNCIL OF WESTERN PENNSYLVANIA. A PORTION OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING. 205546 205546 4738079 4228846 509233 186931 186931 31487895 29498857 1989038 2243222 22253 2220969 4924786 BEN INT IN PERPETUAL TRUST 201569 INTEREST IN JEFFCO 21480737 OTHER ASSETS 32607 DUE FROM AFFILIATES 1479407 EST AMT DUE FROM THIRD PARTIES 450295 ACCRUED INTEREST 3902 23648517 0 DUE TO BROOKCARE 183055 DUE TO AFFILIATE 35000 218055 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. Central America and the Caribbean 0 0 Investments 375648 0 0 0 0 375648 375648 false false false false false false true true X true X true X true true true false false 239061 239061 0.00790 3827969 2026912 1801507 0.05920 4067030 2026912 2040568 0.06710 3246 3246 0.00010 17973 17973 0.00060 21219 21219 0.00070 4088249 2026912 2061787 0.06780 true 941295 135546 10495480 10681970 -186490 X true true 1 1 BROOKVILLE HOSPITAL 100 HOSPITAL ROAD BROOKVILLE PA 15825 WWW.PHHEALTHCARE.ORG 28050101 X X X X BROOKVILLE HOSPITAL 1 false false true X X X X X X X X X 17 true true false true X SEE PART V, SECTION C X true 17 true SEE PART V, SECTION C false true X 200. 300. X X X X true true X 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 X true X false X X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY INPUT: THE CHNA ASSESSMENT CONDUCTED BY TRIPP UMBACH FOR BROOKVILLE HOSPITAL INCLUDED PRIMARY AND SECONDARY DATA COLLECTION, INTERVIEWS WITH COMMUNITY STAKEHOLDERS, FOCUS GROUPS WITH KEY AUDIENCES, AND A COMMUNITY PLANNING RETREAT. THE CHNA REPRESENTED A COMPREHENSIVE COMMUNITY-WIDE PROCESS WHERE BROOKVILLE HOSPITAL CONNECTED WITH A WIDE RANGE OF PUBLIC AND PRIVATE ORGANIZATIONS SUCH AS EDUCATIONAL INSTITUTIONS, HEALTH-RELATED PROFESSIONALS, LOCAL GOVERNMENT OFFICIALS, HUMAN SERVICE ORGANIZATIONS, AND FAITH-BASED ORGANIZATIONS TO EVALUATE THE COMMUNITY'S HEALTH AND SOCIAL NEEDS. SCHEDULE H, PART V, SECTION B, LINE 6A CHNA CONDUCTED WITH OTHER HOSPITAL FACILITIES: THE CHNA WAS CONDUCTED ALONG WITH DUBOIS REGIONAL MEDICAL CENTER, CLEARFIELD HOSPITAL, AND ELK REGIONAL HEALTH CENTER, RELATED ORGANIZATIONS. SCHEDULE H, PART V, SECTION B, LINE 7D WEBSITE WHERE CHNA IS AVAILABLE: HTTPS://WWW.PHHEALTHCARE.ORG/HEALTH-WELLNESS/COMMUNITY-HEALTH-NEEDS-ASSESS MENT SCHEDULE H, PART V, SECTION B, LINE 10A WEBSITE WHERE IMPLEMENTATION STRATEGY IS AVAILABLE: HTTPS://WWW.PHHEALTHCARE.ORG/HEALTH-WELLNESS/COMMUNITY-HEALTH-NEEDS-ASSESS MENT SCHEDULE H, PART V, SECTION B, LINE 11 ADDRESSING IDENTIFIED NEEDS: PENN HIGHLANDS BROOKVILLE, PENN HIGHLANDS DUBOIS, PENN HIGHLANDS CLEARFIELD AND PENN HIGHLANDS ELK ALSO PARTNERED WITH VARIOUS LOCAL ORGANIZATIONS IN A COLLABORATIVE MANNER DURING 2018 IN ORDER TO CARRY OUT THE INTENDED GOALS AND OUTCOMES OF OUR PREVIOUS CHNA STRATEGY. PENN HIGHLANDS BROOKVILLE LISTENS TO COMMUNITY CONCERNS, ANALYZES HEALTHCARE UTILIZATION AND COSTS, EXPLORES ACCESS ISSUES, COLLABORATES WITH AND DEVELOPS EFFECTIVE PROGRAMS TO IMPROVE THE HEALTH OF THOSE IN THIS PORTION OF WEST CENTRAL PENNSYLVANIA. BASED ON THE COMMUNITY HEALTH NEEDS ASSESSMENT FINDINGS AND THE PRIORITIZED NEEDS, THREE COMMUNITY NEEDS WILL BE ADDRESSED AND FURTHER EXPLORED. DESPITE MANY CHALLENGES FACING A RURAL, CRITICAL ACCESS HOSPITAL, PENN HIGHLANDS BROOKVILLE, IN COLLABORATION WITH OTHER PARTNERS IN OUR REGION, MADE STRIDES TO MEET MANY OF THE COMMUNITY NEEDS. OF THE IDENTIFIED CHNA AND PRIORITIZED HEALTH NEEDS, PENN HIGHLANDS BROOKVILLE FOCUSED ON THREE OF THE COMMUNITY REQUIREMENTS: ACCESS TO CARE, CHRONIC CONDITIONS, AND SUBSTANCE ABUSE. ACCESS TO CARE AND PROVIDER WORKFORCE: WHILE OUR STUDY NOTES THAT THOSE IN NEED OF HEALTHCARE OFTEN CITE THE LACK OF INSURANCE AS THE MAIN BARRIER, PENN HIGHLANDS BROOKVILLE TOOK ON THIS ISSUE IN ORDER TO ADDRESS THE PERCEPTION THAT THERE ARE NOT ENOUGH PROVIDERS TO SERVE COMMUNITY RESIDENTS. TACKLING THE LACK OF AVAILABLE PHYSICIANS AND ALLIED HEALTH PROFESSIONALS IN THE AREA WAS ALSO DONE TO HELP AND IMPROVE COMMUNITY RESIDENTS' ABILITY TO ACCESS AFFORDABLE HEALTHCARE SERVICES AND INFORMATION. ACCESS TO AFFORDABLE HEALTHCARE, PREVENTIVE HEALTHCARE AND WELLNESS WERE IDENTIFIED AS DIRECT NEEDS FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT. DURING THE FISCAL YEAR, THE SYSTEM PHYSICIAN RECRUITERS USED THE FOLLOWING TOOLS TO ENGAGE POTENTIAL CANDIDATES: CONTINGENCY FIRMS; ADVERTISING JOB BOARDS (PRACTICE LINK, CAREER MD, JOURNAL OF FAMILY PRACTICE, HEALTH CAREERS); CAREER FAIRS (PITTSBURGH, GREENSBURG, PHILADELPHIA); COMMUNICATION WITH RESIDENCY PROGRAM DIRECTORS IN SURROUNDING STATES; AND COMMUNICATION WITH COLLEAGUES TO POOL CANDIDATES. THE HOSPITAL HAS THREE RURAL HEALTH CLINICS, INCLUDING LOCATIONS IN MARIENVILLE, NEW BETHLEHEM AND MOSHANNON VALLEY. AN ADDITIONAL PRIMARY CARE PHYSICIAN AND SURGEON WERE RECRUITED IN 2019. PENN HIGHLANDS BROOKVILLE WAS ALSO ABLE TO REESTABLISH ACCESS TO A FELLOWSHIP-TRAINED CARDIOLOGIST BY PARTNERING WITH DUBOIS REGIONAL CARDIOLOGY ASSOCIATES TO STAFF A LOCAL OFFICE AND PROVIDE CONSULTATIONS IN THE HOSPITAL TWO DAYS PER WEEK. IN JUNE 2018 A QCARE CLINIC OPENED INSIDE THE BROOKVILLE COMMUNITY MEDICAL BUILDING. QCARE BROOKVILLE PROVIDES FAST AND CONVENIENT PRIMARY HEALTHCARE SERVICES ON A WALK-IN BASIS, WHICH MEANS PATIENTS ARE NEVER REQUIRED TO SCHEDULE AN APPOINTMENT. PENN HIGHLANDS BROOKVILLE WORKS WITH LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE TO PROVIDE CLINICAL SETTINGS FOR MEDICAL STUDENTS TO GET HANDS-ON OPPORTUNITIES TO EXPAND THEIR MEDICAL EDUCATION. A GENERAL MEDICAL EDUCATION PROGRAM IS PART OF A SYSTEM-WIDE INITIATIVE THAT BRINGS MEDICAL RESIDENTS IN THE FIELDS OF FAMILY MEDICINE, INTERNAL MEDICINE AND EMERGENCY MEDICINE TO PENN HIGHLANDS BROOKVILLE. ADDITIONAL PARTNERSHIPS ALSO INCLUDE A PHYSICIAN ASSISTANT TRAINING PROGRAM WITH LOCK HAVEN UNIVERSITY AND AN EDUCATIONAL/TRAINING PROGRAM FOR MID-LEVEL PROVIDERS WITH THE UNIVERSITY OF PITTSBURGH MEDICAL CENTER. CHRONIC CONDITIONS: PENN HIGHLANDS DUBOIS AND PENN HIGHLANDS BROOKVILLE HAVE PARTNERED TO ADDRESS CHRONIC CONDITIONS DIABETES AND NUTRITION. PLANS HAVE BEEN MADE TO EXPAND DIABETES AND NUTRITION EDUCATION SERVICES BY OPENING A SATELLITE SITE OF THE DIABETES & NUTRITION WELLNESS CENTER IN BROOKVILLE AND PROVIDING DIABETES/NUTRITION EDUCATION ON A BIMONTHLY BASIS. OTHER PLANS INCLUDE OFFERING DIABETES PREVENTION PROGRAMMING THROUGHOUT THE PHH SERVICE AREA BY BEGINNING TWO COHORTS PER YEAR. PATIENTS WHO HAVE HAD GESTATIONAL DIABETES WILL BE PROVIDED LITERATURE AND OFFERED PROGRAMS TO PREVENT TYPE 2 DIABETES. COMMUNITY NUTRITION EDUCATION FOR CHRONIC DISEASE PREVENTION WILL BE PROVIDED TWICE PER YEAR TO THE PUBLIC INCLUDING MY PLATE, FOOD LABEL MATH, HOW TO MEASURE/ PORTIONS, HEALTHY SHOPPING AT THE DOLLAR STORE, COMPARE YOUR DRINKS AND HOW TO BUY/USE FRESH FRUITS & VEGETABLES. NUTRITION EDUCATION PROGRAMS WILL BE DEVELOPED AND PRESENTED TO DAYCARE PROVIDERS. SUBSTANCE ABUSE: THE PENN HIGHLANDS SYSTEM INTENDS TO ADDRESS BARRIERS THAT IMPEDE THE ABILITY TO MEET THE ASSESSMENT AND TREATMENT DEMAND. PLANNED ACTIVITIES ARE TO SUPPORT THE LOCAL DRUG AND ALCOHOL COMMISSION BY ATTENDING MEETINGS, VISITING THE FREE CLINIC, SUPPORT THE HOUSING SPECIALIST MEETING, IDENTIFY AND SECURE TRANSPORTATION TO TREATMENT, EDUCATE STAFF AND ON DRUG TRENDS AND TREATMENT, AND PARTICIPATE ON THE CLEARFIELD-JEFFERSON OPIOID TASK FORCE. SCHEDULE H, PART V, SECTION B, LINES 16A, 16B & 16C FAP, FAP APPLICATION & PLAIN LANGUAGE SUMMARY: HTTPS://WWW.PHHEALTHCARE.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE-POLICY SCHEDULE H, PART V, SECTION B, LINE 20E OTHER EFFORTS: THE BILLING STATEMENT STATES THAT THERE IS A FAP AVAILABLE AND GIVES INFORMATION ON HOW TO CONTACT SOMEONE FOR THE APPLICATION. 6 PHYSICAL THERAPY BUILDING 88 INDUSTRIAL PARK RD BROOKVILLE PA 15825 PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY CHARLES PROFESSIONAL BUILDING 240 ALLEGHENY BLVD BROOKVILLE PA 15825 PHYSICIAN OFFICES, HOME HEALTH DAVID L MILLER MEDICAL CENTER BROOKVILLE STREET FAIRMOUNT PA 16224 RADIOLOGY, LAB, PHYSICAL AND OCCUPATIONAL THERAPY, AND RURAL HEALTH CLINIC ALLEGHENY HEALTH CENTER 22 INDUSTRIAL PARK RD BROOKVILLE PA 15825 RURAL HEALTH CLINIC MARIENVILLE FAMILY HEALTH 125 CHESTNUT ST MARIENVILLE PA 16239 RURAL HEALTH CLINIC MOSHANNON VALLEY RURAL HEALTH CENTER 271 RAILROAD STREET PHILIPSBURG PA 16866 RURAL HEALTH CLINIC SCHEDULE H, PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR EQUALS TOTAL OPERATING EXPENSES PER PART OF IX, LINE 25 OF THE FORM 990. SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY: THE COST TO CHARGE RATIO COMPUTED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATIONS OF IRS WORKSHEETS 1 AND 3. SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT EXPENSE: THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2019. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2. SCHEDULE H, PART III, SECTION A, LINE 3 BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE: BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING POVERTY LIMIT DEMOGRAPHIC INFORMATION OBTAINED THROUGH THE U.S. CENSUS BUREAU. THE MOST RECENT US CENSUS BUREAU INDICATES THAT 14.4 PERCENT OF JEFFERSON COUNTY WAS CONSIDERED TO LIVE IN POVERTY. 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 13 OF THE AUDITED FINANCIAL STATEMENTS UNDER NOTE 1, SUBTITLED "PATIENT ACCOUNTS RECEIVABLE." SCHEDULE H, PART III, SECTION B, 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: THE HOSPITAL OFFERS FREE AND DISCOUNTED CHARITY CARE TO THOSE PATIENTS WHO QUALIFY. A PATIENT WITH FAMILY INCOME AT OR BELOW 200% OF SCHEDULE A OF THE POVERTY GUIDELINES, OR BELOW THIS LEVEL DUE TO MEDICAL INDIGENCY, IS ELIGIBLE TO RECEIVE FREE MEDICAL SERVICES. DISCOUNTED SERVICES ARE OFFERED TO PATIENTS WITH A FAMILY INCOME BETWEEN 201% AND 300% OF SCHEDULE A OF THE POVERTY GUIDELINES. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: THE HOSPITAL COLLECTS DATA ON AN ONGOING BASIS REGARDING PATIENTS WHO TRAVEL TO OUTLYING AREAS FOR SERVICES NOT OFFERED BY PENN HIGHLANDS BROOKVILLE. BASED ON THIS DATA, SERVICES ARE ADDED AND IMPROVED UPON IN ORDER TO SERVE THE NEEDS OF THE COMMUNITY AS EFFECTIVELY AND EFFICIENTLY AS POSSIBLE. PH BROOKVILLE ROUTINELY SENDS PATIENT SATISFACTION SURVEYS TO THOSE RECEIVING MEDICAL SERVICES. THESE SURVEYS ALLOW PATIENTS TO OFFER SUGGESTIONS REGARDING HOW THE HOSPITAL COULD BETTER SERVE PATIENTS AND THE COMMUNITY AS A WHOLE. PH BROOKVILLE OFFERS A VARIETY OF EDUCATION PROGRAMS THAT ALLOW EMPLOYEES TO INTERACT ON A ONE-ON-ONE BASIS WITH THE RESIDENTS OF THE COMMUNITY AS A WHOLE. IN ADDITION, THE MEDICAL STAFF OF THE HOSPITAL CONSISTENTLY PARTICIPATES IN RESEARCH AND CONTINUING EDUCATION. THIS KNOWLEDGE ALLOWS THE HOSPITAL TO REMAIN UPDATED ON THE LATEST MEDICAL NEWS AND TECHNIQUES IN ORDER TO OFFER PATIENTS THE HIGHEST AND MOST INNOVATIVE LEVELS OF CARE. PENN HIGHLANDS HIRED AN OUTSIDE FIRM TO ASSIST WITH CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT. THE CONTRACTOR GATHERED SECONDARY DATA IN JEFFERSON AND SURROUNDING COUNTIES, CONDUCTED VARIOUS FOCUS GROUPS WITH KEY AUDIENCES AND USERS OF HEALTHCARE AND SOCIAL SERVICES TO IDENTIFY AREAS FOR PERSPECTIVE IMPROVEMENT WITHIN THE COMMUNITY. THE CONTRACTOR HAS DEVELOPED A MASTER PLAN OF INITIATIVES FOR PH BROOKVILLE WHICH HAS BEEN POSTED ON THE HOSPITAL'S WEBSITE. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: INFORMATION IS POSTED AT REGISTRATION AREA AND IN WAITING AREAS. SELF PAY PATIENTS ARE GIVEN INFORMATION WITH THE FIRST BILL. THE CARE MANAGEMENT DEPARTMENT WORKS WITH ALL INPATIENTS AND WITH OUTPATIENTS AS NEEDED/REQUESTED. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: BROOKVILLE HOSPITAL SERVES BROOKVILLE AND THE SURROUNDING COMMUNITIES. THE SERVICE AREA EXTENDS NORTH TO MARIENVILLE AND SOUTH TO NEW BETHLEHEM, AND INCLUDES JEFFERSON COUNTY, FOREST COUNTY AND CLARION COUNTY. THIS SERVICE AREA IS IN A RURAL PART OF WESTERN PENNSYLVANIA, WITH MANY RESIDENTS LIVING BELOW OR WELL BELOW THE NATIONAL AND STATE INCOME AVERAGE. ACCORDING TO THE US CENSUS BUREAU'S MOST RECENT DATA, APPROXIMATELY 15 PERCENT OF INDIVIDUALS LIVING IN THIS AREA WERE CONSIDERED TO LIVE IN POVERTY. THE MEDIAN HOUSEHOLD INCOME IN THE SERVICE AREA IS APPROXIMATELY $38,500. FROM THE RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT, THE SERVICE AREA INCLUDES 22% OF UNINSURED ADULTS, 7.8% OF CHILDREN WHO ARE UNINSURED. UNEMPLOYMENT RATES FOR CLEARFIELD AND JEFFERSON COUNTY WERE JUST OVER 8%. THE MEDIAN AGE OF THE POPULATION IS ABOUT 42, WITH ABOUT 18% 65 AND OVER. CLEARFIELD COUNTY HAS A 45.9% URBAN POPULATION, WHILE JEFFERSON HAS A 33.8% URBAN POPULATION. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: BROOKVILLE HOSPITAL PARTICIPATES IN AND PROVIDES MANY HEALTH FAIR AND COUNSELING OPPORTUNITIES THROUGHOUT THE YEAR, INCLUDING THOSE ASSOCIATED WITH MENTAL HEALTH, DIABETES, NUTRITION AND WEIGHT MANAGEMENT. ALSO, THE ORGANIZATION WORKS TO PROMOTE LEARNING THROUGH THE MEDICAL EXPLORERS PROGRAM AND LOCAL CAREER DAYS. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: BROOKVILLE HOSPITAL IS A SUBSIDIARY OF DUBOIS REGIONAL MEDICAL CENTER (DRMC). DRMC HAS AN AFFILIATION AGREEMENT WITH CLEARFIELD HOSPITAL, ELK REGIONAL HEALTH CENTER AND HUNTINGDON HOSPITAL. THESE ORGANIZATIONS ARE OVERSEEN BY PENN HIGHLANDS HEALTHCARE, THE PARENT AND SOLE MEMBER OF DRMC, CLEARFIELD HOSPITAL, ELK REGIONAL HEALTH CENTER AND JC BLAIR MEMORIAL HOSPITAL. false true false false false false false true false STEVEN FONTAINE DIRECTOR/PHH CEO 0 684489 0 203175 0 166 0 88760 0 17946 0 994536 0 0 JULIANNE PEER PRESIDENT 175976 0 15560 0 1311 0 6909 0 18045 0 217801 0 0 0 KUMARESAN GANABATHI MEDICAL STAFF PRESIDENT 0 511742 0 0 0 731 0 11000 0 14249 0 537722 0 0 TABITHA JEFFERSON PHYSICIAN - EMERGENCY 482683 0 28263 0 166 0 11000 0 18186 0 540298 0 0 0 JOSEPH NOVAK ANESTHESIOLOGIST 399269 0 0 0 731 0 11000 0 18186 0 429186 0 0 0 JEFFREY PADZER PHYSICIAN 318930 0 11250 0 0 0 0 0 0 0 330180 0 0 0 PATRICK SHILALA PHYSICIAN 292441 0 24000 0 0 0 10962 0 15800 0 343203 0 0 0 LUIS TOMACRUZ PHYSICIAN 372570 0 24000 0 0 0 0 0 0 0 396570 0 0 0 SCHEDULE J, PART I, LINE 3 CEO COMPENSATION DETERMINATION: PENN HIGHLANDS HEALTHCARE (PHH), A RELATED ORGANIZATION, COMPLETES THE REVIEW OF THE CEO'S COMPENSATION, USING THE FOLLOWING METHODS: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE - WRITTEN EMPLOYMENT CONTRACT SCHEDULE J, PART I, LINE 4B NONQUALIFIED RETIREMENT PLAN: PENN HIGHLANDS DUBOIS EMPLOYEES WHO PARTICIPATED IN A 457(F) PLAN: - STEVEN FONTAINE RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $77,760 SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS: A PORTION OF JULIANNE PEER AND STEVEN FONTAINE'S BONUSES WERE BASED ON BOARD DISCRETION, WHILE THE MAJORITY WAS BASED ON FORMULAS USING INFORMATION BASED ON FINANCE, GROWTH, QUALITY/SAFETY, PEOPLE, AND SERVICE. FORM 990, PART III, LINE 1 ORGANIZATION'S MISSION: VISION STATEMENT OUR VISION IS TO BE THE INTEGRATED HEALTH SYSTEM OF CHOICE THROUGH EXCELLENT QUALITY SERVICE AND OUTCOMES. VALUE STATEMENT -QUALITY & SAFETY: PROVIDE A SAFE ENVIRONMENT WITH HIGH QUALITY OUTCOMES. -TEAMWORK: FOSTER A CULTURE OF TEAMWORK, SUPPORT, TRUST, AND LOYALTY. -INTEGRITY: PRACTICE THE PRINCIPLES OF HONESTY, CONFIDENTIALITY, RESPECT, AND TRANSPARENCY. -PERSON-CENTERED: RECOGNIZE THOSE WE SERVE AS EQUAL PARTNERS. -SERVICE: DEMONSTRATE COMPASSION BY LISTENING, ENGAGING, ANTICIPATING, AND EXCEEDING NEEDS AND EXPECTATIONS. -STEWARDSHIP: COMMIT TO INVESTING IN OUR HUMAN AND MATERIAL RESOURCES WHILE PRACTICING FISCAL RESPONSIBILITY. -PARTNERSHIP: OFFICER SERVICES AND PROGRAMS THROUGH PARTNERSHIPS WITH OUR PHYSICIANS, PROVIDERS, STAKEHOLDERS, AND OTHER ORGANIZATIONS. -EDUCATION: EXPAND OUR EMPHASIS ON EDUCATION AND ENHANCE OUR POSITION AS A LEARNING ORGANIZATION. FORM 990, PART III, LINE 4A PROGRAM SERVICE: BROOKVILLE HOSPITAL ESTIMATED VALUE OF FREE CARE, COMMUNITY SERVICE, CHARITABLE CONTRIBUTIONS, AND PROFESSIONAL AND COMMUNITY EDUCATION. UNCOMPENSATED CHARITY CARE UNCOMPENSATED CHARITY CARE CHARGES WRITTEN OFF WERE $586,361. THE TOTAL DOES NOT INCLUDE BAD DEBT. THE HOSPITAL'S DETERMINATION OF INABILITY TO PAY DIFFERENTIATES CHARITY CARE FROM BAD DEBT, WHICH IS DETERMINED BY ABILITY TO PAY BUT UNWILLINGNESS TO DO SO. BAD DEBT THE HOSPITAL'S BAD DEBT AMOUNT WRITTEN OFF WAS $941,295 IN FY 2019. CHARITY CARE SERVICE THE HOSPITAL OWNS AND OPERATES THE NEW BETHLEHEM, MARIENVILLE, AND MOSHANNON VALLEY HEALTH CENTERS. THESE ARE RURAL HEALTH CLINICS THAT ARE AVAILABLE TO THE COMMUNITY. CHARITY CARE IS OFFERED TO PATIENTS OF THESE CLINICS. COMMUNITY VOLUNTEER ASSISTANCE APPROXIMATELY 10 ACTIVE HOSPITAL VOLUNTEERS ASSISTED WITH THE PROVISION OF SERVICES BY THE HOSPITAL. THE AUXILIARY HAS ABOUT 20 MEMBERS THAT HOLD FUND RAISING EVENTS THROUGHOUT THE YEAR. THE FUNDS FROM THESE EVENTS ARE GIVEN BACK TO THE HOSPITAL FOR VARIOUS PROJECTS. PASTORAL CARE THE HOSPITAL HAS VOLUNTEER PASTORS THAT PERFORM MINISTRY TO THE HOSPITAL'S PATIENTS, PATIENTS' FAMILIES, AND STAFF. THIS SERVICE IS AVAILABLE 24 HOURS A DAY/7 DAYS A WEEK. PATIENT COMMENT SURVEYS THE HOSPITAL DISTRIBUTES SURVEYS TO INPATIENT, OUTPATIENTS, AMBULATORY SURGERY AND EMERGENCY ROOM PATIENTS TO ASSESS THE NEEDS OF THE PATIENTS IN OUR COMMUNITY REGARDING CARE AND OPPORTUNITIES TO IMPROVE THAT CARE. RESULTS ARE RECEIVED MONTHLY AND COMPARED TO PRIOR RESULTS. TIME IS SPENT BY HOSPITAL STAFF I EVALUATING RESULTS, WITH DEPARTMENTAL AND CONSUMER FOLLOW-UP AND WORK PROCESS REDESIGN TO IMPROVE CARE AND SATISFACTION. FOREIGN LANGUAGE AND SIGN LANGUAGE INTERPRETING SERVICE THE HOSPITAL PROVIDES INTERPRETING SERVICES AT NO CHARGE TO FOREIGN LANGUAGE AND SIGN LANGUAGE SPEAKING PATIENTS AND PATIENT FAMILY MEMBERS. THESE SERVICES ARE PERFORMED ON AN ON-CALL BASIS. HOSPITAL EMPLOYEES WHO SPEAK A FOREIGN LANGUAGE OR ARE TRAINED IN SIGN LANGUAGE CAN BE USED TO TRANSLATE. THE HOSPITAL ALSO SUBSCRIBES TO AN ON-LINE INTERPRETING SERVICE, LANGUAGE LINE SERVICES. COMMUNITY EDUCATION / PUBLIC AFFAIRS ACTIVITIES IN OUR ROLES AS A LEADING PROVIDER OF HEALTH AND HEALTH-RELATED SERVICES TO JEFFERSON AND SURROUNDING COUNTIES, BROOKVILLE HOSPITAL RECOGNIZES OUR RESPONSIBILITY TO HELP THE PEOPLE OF OUR SERVICE AREA ACHIEVE AND MAINTAIN OPTIMUM HEALTH STATUS. THE ADMINISTRATION AND EDUCATION DEPARTMENT AND THE HEALTHY COMMUNITY COMMITTEE, OFFERS A SERIES OF PROGRAMS THROUGHOUT THE YEAR TO ACHIEVE THIS ROLE. BROOKVILLE HOSPITAL'S EDUCATIONAL EFFORTS ARE HEALTH-RELATED TO HELP FULFILL OUR MISSION OF HELPING PEOPLE IN OUR SERVICE AREA ACHIEVE AND MAINTAIN OPTIMUM HEALTH STATUS. EFFORTS IN THIS AREA INCLUDE FREE COMMUNITY HEALTH AND PATIENT EDUCATION PUBLICATIONS, MATERIALS TO PROMOTE HEALTH-RELATED ACTIVITIES, A PHYSICIAN REFERRAL LINE, AND PARTICIPATION IN LOCAL HEALTH FAIRS. PATIENT SUPPORT AND EDUCATION NUTRITIONAL COUNSELING A REGISTERED DIETITIAN IS AVAILABLE TO MEET WITH PATIENTS AND FAMILIES TO ASSESS NUTRITIONAL NEEDS AND DETERMINE APPROPRIATE NUTRITIONAL GOALS AND STRATEGIES. IN ADDITION, CLASSES ARE OFFERED THROUGHOUT THE YEAR TO THE COMMUNITY ON HEALTHY COOKING, LOW FAT DIET, DIABETES, CARDIOVASCULAR HEALTH. MAMMOGRAMS IN COOPERATION WITH AREA PHYSICIANS, THE HOSPITAL PROVIDES REDUCED-FEE MAMMOGRAMS WITH INTERPRETATIONS ON AN ANNUAL BASIS FOR HIGH RISK WOMEN WHO ARE LOW-INCOME AND GENERALLY UNINSURED. COMMUNITY CLASSES THE HOSPITAL OFFERS A VARIETY OF COMMUNITY EDUCATION CLASSES THAT INCLUDES CPR AND DIABETES EDUCATION. PATIENT EDUCATION PUBLICATIONS INCLUDES A VARIETY OF PUBLICATIONS SUCH AS THE PATIENT VISITOR GUIDE, THE PATIENT RIGHTS AND RESPONSIBILITIES BOOKLET, ADVANCE DIRECTIVES, ETC. MATERIALS TO PROMOTE HEALTH-RELATED ACTIVITIES MATERIALS INCLUDE PROMOTING A VARIETY OF ACTIVITIES INCLUDING HEALTH SCREENING ADS, CANCER ASSESSMENT AND BREAST HEALTH AWARENESS MATERIALS, AND DIABETES EDUCATION CLASSES. VOLUNTARISM BROOKVILLE HOSPITAL'S WORK FORCE, ONE OF THE LARGEST IN THE REGION, IS COMPRISED OF MANY INDIVIDUALS WHO ENGAGE IN PERSONAL COMMUNITY SERVICE. THESE INDIVIDUALS GIVE OF THEIR TIME, TALENT, AND RESOURCES TO MAKE OUR COMMUNITY A BETTER PLACE TO LIVE AND WORK. PHYSICIANS AND EMPLOYEES VOLUNTEER THEIR TIME INDIVIDUALLY, BENEFITING COMMUNITY ORGANIZATIONS AND CAUSES. DURING THE YEAR EMPLOYEES SPEND TIME PROVIDING CARE, EDUCATING THE COMMUNITY, AND SERVING ON BOARDS OF SOCIAL SERVICE AGENCIES. EMPLOYEES VOLUNTEER THEIR TIME FOR ADOPT A HIGHWAY, MARCH OF DIMES, WALK AMERICA, THE M/S WALK, AND SIT ON VARIOUS COMMUNITY BOARDS. CONTRIBUTIONS EACH YEAR, BROOKVILLE HOSPITAL RECEIVES REQUESTS FOR FINANCIAL SUPPORT FROM NUMEROUS ORGANIZATIONS PROVIDING VALUABLE SERVICES TO OUR COMMUNITY. WHILE WE ARE A NOT-FOR-PROFIT ORGANIZATION, WE DO PROVIDE SUPPORT ON A LIMITED BASIS. INFECTION CONTROL COMMUNITY SERVICE THE INFECTION CONTROL DEPARTMENT SHARES POLICIES, PROCEDURES, AND EXPERTISE WITH OTHER HOSPITALS, NURSING HOMES, AND HEALTH CARE PROVIDERS IN SOLVING INFECTION-RELATED PROBLEMS, HELPING TO DEVELOP PROGRAMS, ETC., AS REQUESTED. THE INFECTION CONTROL DEPARTMENT ALSO PROVIDES FOLLOW-UP TO BLOOD/BODY FLUID EXPOSURES EXPERIENCED BY HOSPITAL PERSONNEL. FOLLOW-UP IS GENERALLY COMPLICATED AND INVOLVES BLOOD WORK FOR EMPLOYEES AND PATIENTS AND COUNSELING AS PROVIDED AFTER EACH EXPOSURE. INFECTION CONTROL COMMUNICATE REGULARLY WITH ALL AREA HEALTH BUREAUS REPORTING COMMUNICABLE DISEASES, THUS AFFORDING CONTINUITY OF FOLLOW-UP INVESTIGATION FOR POTENTIALLY EXPOSED PATIENTS AND STAFF. COMMUNITY EDUCATION WE WORK WITH HIGH SCHOOL STUDENTS TO EDUCATE THEM ABOUT HEALTHCARE CAREERS THROUGH JOB FAIRS AT THE SCHOOL AND BY OFFERING JOB SHADOWING OPPORTUNITIES IN BOTH CLINICAL AND NON-CLINICAL AREAS. CLINICAL AND NON-CLINICAL AREAS. FORM 990, PART IV, LINE 24A TAX EXEMPT BOND ISSUE: A REFINANCING BOND ISSUE WAS NEGOTIATED BY THE PARENT COMPANY OF BROOKVILLE HOSPITAL, PENN HIGHLANDS HEALTHCARE, INC., TO BENEFIT THE HOSPITALS WITHIN THE PENN HIGHLANDS SYSTEM. PENN HIGHLANDS HEALTHCARE, INC. REPORTED THIS BOND ISSUE ON SCHEDULE K OF ITS FORM 990. PENN HIGHLANDS HEALTHCARE, INC. DOES NOT CARRY THIS LIABILITY ON ITS BALANCE SHEET. RATHER, BROOKVILLE HOSPITAL IS LEGALLY RESPONSIBLE FOR ITS PORTION OF THE LIABILITY AND THUS, REPORTS ITS SHARE ON ITS BALANCE SHEET. FORM 990, PART VI, SECTION A, LINE 4 SIGNIFICANT CHANGES TO THE GOVERNING DOCUMENTS: THE ORGANIZATION AMENDED ITS BYLAWS TO INCLUDE THE DEFINITION OF PH-JEFFERSON MANOR AND THE PHH/PH-JEFFERSON MANOR AFFILIATION AGREEMENT BETWEEN PENN HIGHLANDS HEALTHCARE AND JEFFCO HEALTH SERVICES, INC. D/B/A JEFFERSON MANOR HEALTH CENTER DATED MARCH 7, 2019, WHICH PROVIDED FOR AFFILIATION OF PH-JEFFERSON MANOR WITH PHH AND ITS RELATED ENTITIES, EFFECTIVE AS OF APRIL 1, 2019. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS/STOCKHOLDERS: DUBOIS REGIONAL MEDICAL CENTER (DRMC) IS THE SOLE MEMBER OF BROOKVILLE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A ELECTION OF DIRECTORS: AS THE SOLE MEMBER OF BROOKVILLE HOSPITAL, DRMC'S RESERVED POWERS INCLUDE THE RIGHT TO ELECT THE BOARD OF DIRECTORS OF BROOKVILLE HOSPITAL. CANDIDATES ARE SUBMITTED TO DRMC THROUGH A NOMINATING PROCESS THAT INVOLVES THE APPROVAL OF BROOKVILLE HOSPITAL'S BOARD. AS THE OTHER BODY OF DRMC, PHH HAS THE AUTHORITY TO APPROVE DRMC'S ELECTION OF BROOKVILLE HOSPITAL'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B DECISION APPROVALS: AS THE SOLE MEMBER OF BROOKVILLE HOSPITAL, DRMC'S RESERVED POWERS INCLUDE: - APPROVAL OF ALL FUNDAMENTAL TRANSACTIONS; - APPROVAL OF ALL STRATEGIC PLANS, BUDGETS, AND FEASIBILITY PLANS; - APPROVAL OF THE INCURRENCE, RE-FINANCING OR PREPAYMENT OF ALL INDEBTEDNESS IN EXCESS OF $10,000; - WITH SOME EXCEPTIONS, THE APPROVAL OF THE SECURING OF ANY ENCUMBRANCE OF ASSETS; - WITH SOME EXCEPTIONS, APPROVAL OF THE MAKING OF ANY CAPITAL EXPENDITURES OR ANY CAPITAL ADDITIONS OR IMPROVEMENTS GREATER THAN $10,000; - APPROVAL OF ANY AND ALL AMENDMENTS OF THE ARTICLES AND/OR BYLAWS; - APPROVAL OF ANY CHANGE IN MISSION OR DIRECTION; - APPROVAL OF THE ESTABLISHMENT OF, OR TERMINATION OR WITHDRAWAL FROM, ANY SUBSIDIARY, JOINT VENTURE, OR OTHER PARTNERSHIP OR SHARED GOVERNANCE ARRANGEMENT; - APPROVAL OF AGREEMENTS OF $50,000 OR MORE; AND - APPROVAL OF THIRD PARTY PAYOR AGREEMENTS, COLLECTIVE BARGAINING AGREEMENTS AND AGREEMENTS BETWEEN BROOKVILLE HOSPITAL AND DRMC. AS THE OTHER BODY OF DRMC, PHH HAS THE POWER TO REVIEW AND APPROVE ANY ACTION TAKEN BY DRMC IN EXERCISING THE RESERVED POWERS LISTED ABOVE. FORM 990, PART VI, SECTION B, LINE 11B 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE FORM 990 IS REVIEWED BY THE CEO PRIOR TO BEING FILED. IN ADDITION, THE BOARD REVIEWS AND APPROVES THE FORM 990 BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY: THE CONFLICT OF INTEREST STATEMENTS ARE REVIEWED BY THE CEO. ANY BOARD MEMBER WITH A CONFLICT OR POTENTIAL CONFLICT WOULD ABSTAIN FROM VOTING ON ANY MATTER RELATED TO THAT CONFLICT. ADDITIONALLY, THE BOARD MEMBERS ARE GIVEN A QUESTIONNAIRE TO COMPLETE TO ASSIST THE ORGANIZATION IN PROPERLY ANSWERING THE QUESTIONS FOR THE NEW FORM 990. CORPORATE OFFICERS AND KEY EMPLOYEES ARE ALSO REQUIRED TO ANNUALLY DISCLOSE CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A CEO COMPENSATION REVIEW: PHH COMPLETES A REVIEW OF EXECUTIVE SALARIES USING AN INDEPENDENT CONSULTANT AND A COMPENSATION COMMITTEE. THE INDEPENDENT CONSULTANT USES COMPARABILITY DATA IN THE REVIEW AND THE DECISION IS DOCUMENTED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: THE FINANCIAL SUMMARY AND ANNUAL REPORT CAN ALSO BE REVIEWED IN THE HOSPITAL ADMINISTRATIVE OFFICES. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART VII DIRECTOR COMPENSATION: NO DIRECTORS RECEIVE COMPENSATION FOR THEIR ROLES AS DIRECTORS. JULIANNE PEER, KUMARESAN GANABATHI AND STEVEN FONTAINE RECEIVE COMPENSATION FROM THE ORGANIZATION AND/OR RELATED ORGANIZATIONS FOR THEIR ROLES AS MANAGEMENT AND/OR PHYSICIANS. FORM 990 PART IX LINE 11G DESCRIPTION:ASSESSMENT FEES TOTAL FEES:2024629 FORM 990 PART IX LINE 11G DESCRIPTION:SERVICE CONTRACTS TOTAL FEES:1855148 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:1601642 FORM 990 PART IX LINE 11G DESCRIPTION:OUTSIDE SERVICES TOTAL FEES:1148587 FORM 990 PART IX LINE 11G DESCRIPTION:MAINTENANCE CONTRACTS TOTAL FEES:824510 PENN HIGHLANDS HEALTHCARE 100 HOSPITAL AVENUE DUBOIS PA 15801 320345810 MGMT SERVICES PA 501(C)(3) 12 C III-FI NA false DUBOIS REGIONAL MEDICAL CENTER 100 HOSPITAL AVENUE DUBOIS PA 15801 251490707 HEALTHCARE PA 501(C)(3) 3 PHH false ELCO HOUSING 759 JOHNSONBURG ROAD ST MARYS PA 15857 251639115 HOUSING PA 501(C)(3) 12 A I PHH false ELK REGIONAL PROFESSIONAL GROUP INC 763 JOHNSONBURG ROAD ST MARYS PA 15857 251875183 HEALTH CARE PA 501(C)(3) 3 PHH false COMMUNITY NURSES HOME HEALTH & HOSPICE 757 JOHNSONBURG ROAD STE 200 ST MARYS PA 15857 250996070 HEALTH CARE PA 501(C)(3) 10 CNI false COMMUNITY NURSES HOME SUPPORT SERVICES 757 JOHNSONBURG ROAD STE 200 ST MARYS PA 15857 251623601 HEALTH CARE PA 501(C)(3) 10 CNI false COMMUNITY NURSES INC 757 JOHNSONBURG ROAD STE 200 ST MARYS PA 15857 251623598 HEALTH CARE PA 501(C)(3) 7 PHH false ELK REGIONAL HEALTH CENTER 763 JOHNSONBURG ROAD ST MARYS PA 15857 250585280 HOSPITAL PA 501(C)(3) 3 PHH false CLEARFIELD HOSPITAL 809 TURNPIKE DR CLEARFIELD PA 16830 250979346 HOSPITAL PA 501(C)(3) 3 PHH false CLEAR-MED PROVIDER CORPORATION PO BOX 1260 CLEARFIELD PA 16830 251657668 OUTPAT. PHYS. PA 501(C)(3) 3 PHH false DRMC EMPLOYEE BENEFITS PLAN TRUST 100 HOSPITAL AVE DUBOIS PA 15801 256332829 DRMC EMP BENE PA 501(C)(9) DRMC false JEFFCO HEALTH SERVICES INC 417 ROUTE 28 BROOKVILLE PA 15825 251505478 HEALTH CARE PA 501(C)(3) 3 BROOKVILLE true JC BLAIR MEMORIAL HOSPITAL 1225 WARM SPRINGS AVENUE HUNTINGDON PA 16652 231352159 HOSPITAL PA 501(C)(3) 3 PHH false JC BLAIR MEMORIAL HOSPITAL FOUNDATION 935 14TH STREET HUNTINGDON PA 16652 251881377 SUPPORT HOSP PA 501(C)(3) 12A I PHH false DRMC WORKERS COMPENSATION TRUST PO BOX 447 DUBOIS PA 15801 251741497 SUPPORT PA 501(C)(3) 12 B II DRMC false BROOKCARE INC 100 HOSPITAL ROAD BROOKVILLE PA 15825 251477768 OFFICE SPACE PA BROOKVILLE C CORP 231943 768911 1.00000 true CHARITABLE TRUST 100 HOSPTIAL RD BROOKVILLE PA 15825 256171730 TRUST PA BROOKVILLE TRUST 201637 1.00000 true false false true false false false false false false true true false false true true true true false true JEFFCO HEALTH SERVICES INC C 21480737 FMV BROOKCARE II INC K 65986 FMV