2020-07-15T12:24:00-05:00 2019-06-30 PricewaterhouseCoopers LLP 2001 MARKET ST SUITE 1800 PHILADELPHIA PA 19103 990 2018-07-01 240786657 GUTHRIE TOWANDA MEMORIAL HOSPITAL % MICHELE SISTO GUTH 5702652191 91 HOSPITAL DRIVE TOWANDA PA 188489703 PAUL VERVALIN EVP/COO 5708874625 2020-07-14 true ANTONIO C RUSSO P00858539 2673303000 2020-07-14 155.201.35.117 23522320201975000061 2020-07-15 P F8589C0032B8451DCBF29827E42EE0CF632BAB53 1165BB5F41A71AB0D781DA876A823BF1466164C1 2018 2021-01-29 14:40:06Z JOHN L SCHOONOVER III 91 HOSPITAL DRIVE TOWANDA PA 188489703 29200251 false X WWW.GUTHRIE.ORG X 1946 PA THE PROVISION OF CHARITABLE HEALTHCARE SERVICES TO RESIDENTS OF THE SURROUNDING COMMUNITY ON AN IN-PATIENT AND OUT-PATIENT BASIS. 15 13 431 0 0 0 432769 189902 28853872 28539209 16909 287742 789765 1523735 30093315 30540588 0 2700 0 0 17367917 16211031 0 0 0 14746839 20108363 32114756 36322094 -2021441 -5781506 43592026 27403656 24208934 13318123 19383092 14085533 X THE PROVISION OF CHARITABLE HEALTHCARE SERVICES TO RESIDENTS OF THE SURROUNDING COMMUNITY ON AN IN-PATIENT AND OUT-PATIENT BASIS. false false 24571542 2700 29903804 GUTHRIE TOWANDA MEMORIAL HOSPITAL IS A NOT-FOR-PROFIT ACUTE CARE HOSPITAL AND LONG TERM CARE FACILITY LOCATED IN TOWANDA, PA. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, EMERGENCY CARE, LONG-TERM CARE AND HOME HEALTH SERVICES TO RESIDENTS OF TOWANDA, PA AND SURROUNDING COMMUNITIES. HOSPITAL DOCTORS CONTINUOUSLY WORK WITH QUALIFIED SPECIALISTS AND MANY OTHERS WITHIN THE BRADFORD AND SULLIVAN COUNTY MEDICAL COMMUNITITES, AS WELL AS OUTSIDE OF THIS AREA, IN ORDER TO PROVIDE PATIENTS WITH ACCESS TO QUALITY SPECIALTY CARE. THE HOSPITAL ROUTINELY WORKS WITH SPECIALISTS IN SAYRE, PA; ELMIRA, NY; BINGHAMTON, NY; WILLIAMSPORT, PA; SCRANTON, PA; DANVILLE, PA; AND PHILADELPHIA, PA, TO MEET PATIENTS' HEALTHCARE NEEDS. 24571542 true true false true false false false false true false true true false false true true false true false false false false false false false false true true false false true false false false false false false false false false false false false true true true false false false true 0 0 true 431 true false false false false false false false false false false false false X 15 13 false false false false false false false true true false false true true true true true true true true false PA X MICHELE SISTO 5708874625 ONE GUTHRIE SQUARE SAYRE PA 18840 X RAY DEPAOLA ESQ MEMBER - BOD 1.0 1.0 X 0 0 0 MARK GANNON MEMBER - BOD 1.0 1.0 X 0 0 0 LARRY HUBER CHAIRMAN - BOD 1.0 0.0 X X 0 0 0 MARJORY KREISCHER MEMBER - BOD 1.0 1.0 X 0 0 0 JAMES PARKS VICE CHAIRMAN - BOD 1.0 0.0 X X 0 0 0 JODY PLACE MEMBER - BOD 1.0 1.0 X 0 0 0 ERIC R ROWE TREASURER - BOD 1.0 0.0 X X 0 0 0 JOHN L SCHOONOVER III MEMBER - BOD 1.0 1.0 X 0 0 0 MARGUERITE SHANER SECRETARY - BOD 1.0 0.0 X X 0 0 0 BARBARA YANAK MEMBER - BOD 1.0 0.0 X 0 0 0 PAUL VERVALIN MEMBER - BOD 1.0 39.0 X 0 505067 73195 REV RACHEL S STAHLE PH D MEMBER - BOD 1.0 0.0 X 0 0 0 JOSEPH CAMA MD MEMBER - BOD 1.0 0.0 X 0 0 0 LEO LAMBERT MEMBER - BOD 1.0 1.0 X 0 0 0 STACI COVEY RETIRED 123118 PRESIDENT & MEMBER - BOD 1.0 39.0 X X 0 243887 30092 FELISSA KOERNIG AS OF 22519 PRESIDENT & MEMBER - BOD 40.0 0.0 X X 0 0 0 JEFFREY HUNDMAN CFO 1.0 39.0 X 0 76115 12673 LYNN DIBBLE CNO 40.0 0.0 X 191264 0 21433 CYNTHIA E LAMBERT MANAGER, PHARMACY 40.0 0.0 X 155571 0 28196 DEBORAH MARTIN MANAGER, NURSING 40.0 0.0 X 116482 0 26144 OLIVER A MCKEITHAN PHARMACIST 0.0 0.0 X 0 0 0 TINA MAYNARD DIRECTOR, PHYSICAL THERAPY 40.0 0.0 X 103211 0 25448 566528 825069 217181 4 false true false EMCARE PHYSICIAN SERVICES INC 7032 COLLECTION CENTER DRIVE CHICAGO IL 60693 ED PHYSICIANS SRVCS 869549 GULFSTREAM ANESTHESIA CONSULTANTS PO BOX 212110 ROYAL PALM BEACH FL 33421 ANESTHESIA SRVCS 676288 COMPLETE HEALTHCARE RESOURCES EASTE 200 DRYDEN ROAD SUITE 3100 DRESHER PA 19025 NURSING FACILITY MGT 420057 MORRISON HEALTHCARE PO BOX 102289 ATLANTA GA 30368 FOOD SERVICE MGMT 277123 CARE FIRST PHARMACY SERVICES 1015 N VINE STREET BERWICK PA 18603 PHARMACY MGMT 185348 8 105012 84890 10628 189902 NET PATIENT SERVICE REVENUES 621990 14064143 14064143 MEDICARE AND MEDICAID PAYMENTS 621990 14475066 14475066 28539209 266108 266108 0 5230 5230 97315 20008 77307 0 77307 77307 -1376613 37903 -1414695 54350 38082 -16447 21634 21634 0 0 0 0 0 0 0 0 0 CAFETERIA/VENDING 722514 76603 76603 MITIGATION/STABILITY/MCO 900099 363504 363504 ALL OTHER 900099 1001091 1001091 1441198 30540588 29903804 446882 X 0 0 2700 2700 0 0 0 0 0 0 0 0 0 0 0 0 12384807 10448534 1936273 0 461308 389186 72122 0 2465179 2081930 383249 0 899737 759070 140667 0 3472856 0 3472856 0 29552 0 29552 0 313578 5000 308578 0 0 0 0 0 0 0 0 0 0 0 6557012 6375669 181343 2310 2147 163 0 1531660 1063925 467735 0 560565 76849 483716 0 0 0 0 0 728720 116491 612229 0 39553 36308 3245 0 0 0 0 0 9639 9507 132 0 399522 0 399522 0 0 0 0 0 2004261 928462 1075799 0 1598873 0 1598873 0 CORPORATE TAXES 2842 0 2842 0 MEDICAL SUPPLY EXPENSE 1678942 1677949 993 0 ALL OTHER EXPENSES 1178478 597815 580663 0 36322094 24571542 11750552 0 X 817 904 390453 368893 0 0 4045306 3546036 0 0 0 0 0 0 322200 284348 456549 419237 26261514 7316282 20552585 18945232 65764 66211 1544101 3368217 0 0 0 0 16214251 404578 43592026 27403656 3096984 4725766 0 0 27810 166986 0 0 13517 15178 0 0 0 0 0 0 21070623 8410193 24208934 13318123 X 18729197 13447782 588895 572751 65000 65000 19383092 14085533 43592026 27403656 X -5781506 -11683 -1742 497372 X X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 4898 4898 false SCHEDULE C, PART II-B, LINE 1I DETAIL OF OTHER LOBBYING ACTIVITITES AMOUNT REPRESENTS MEMBERSHIPS IN AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE HOSPITAL & HEALTH SYSTEM ASSOCIATION OF PENNSYLVANIA (HAP). true 13517 61661 60000 15178 true X 330000 330000 18734875 3388985 15345890 6852282 3791503 3060779 344357 135794 208563 18945232 CAPTIVE INS 1168051 F M&I TRUST CAPTIVE 378627 F MALPRAC CAPTIVE INS FUNDING 43965 F C&N 61629 F FUNDED DEPRECIATION 1415644 F CD 284919 F EMPLOYEE ED 204 F PATIENT ESCROW - SNU 15178 F 3368217 0 AMOUNTS DUE TO AFFILIATES 7796749 ESTIMATED THIRD PARTY SETTLEME 568974 NOTES PAYABLE - STEVENS 27470 ASSET RETIREMENT OBLIGATION 17000 8410193 X SCHEDULE D, PART IV, LINE 1B ESCROW/CUSTODIAL ACCOUNT DETAILS GUTHRIE TOWANDA MEMORIAL HOSPITAL MAINTAINS A SEPARATE ACCOUNT FOR SKILLED NURSING FACILITY RESIDENT FUNDS, OF WHICH THE ORGANIZATION IS THE REPRESENTATIVE PAYEE. FUNDS ARE USED TO PAY PATIENTS' BILLS AND PERSONAL EXPENSES. --------------- SCHEDULE D, PART X, LINE 2 TEXT OF FIN 48 DISCLOSURE THIS ORGANIZATION IS AN AFFILIATE OF THE GUTHRIE CLINIC ("GUTHRIE"). THE FIN 48 (ASC 740) FOOTNOTE BELOW DERIVES FROM THE CONSOLIDATED JUNE 30, 2019 FINANCIAL STATEMENTS OF GUTHRIE: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE CORPORATION TO EVALUATE TAX POSITIONS TAKEN BY THE CORPORATION AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE CORPORATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE CORPORATION HAS CONCLUDED THAT AS OF JUNE 30, 2019 AND 2018, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. --------------- true true X true X true X true true false false 31979 31979 0.00090 7778526 5764677 2013849 0.05540 7810505 5764677 2045828 0.05630 5989792 4860768 1129024 0.03110 5989792 4860768 1129024 0.03110 13800297 10625445 3174852 0.08740 true 2855836 285584 4875274 5788296 -913022 X true true 1 1 GUTHRIE TOWANDA MEMORIAL HOSPITAL 91 HOSPITAL DRIVE TOWANDA PA 18848 LICENSE #650201 X X X GUTHRIE TOWANDA MEMORIAL HOSPITAL 1 false false true X X X X X X X X X 18 true true false true X SEE SUPPLEMENTAL SECTION X true 18 true SEE SUPPLEMENTAL SECTION false true X 100 300. X X X X X true true X X X true X SEE SUPPLEMENTAL SECTION X SEE SUPPLEMENTAL SECTION X SEE SUPPLEMENTAL SECTION X X X X X X true X false X X X X true X false false PART V, SECTION B, LINE 5- INPUT FROM COMMUNITY THE GUTHRIE TOWANDA MEMORIAL HOSPITAL (TMH) COMMUNITY HEALTH NEEDS ASSESSMENT BEGAN WITH A REVIEW OF PRIMARY DATA SOURCES, SPECIFICALLY SURVEY AND FOCUS GROUP DATA THAT HAD BEEN COLLECTED THROUGHOUT 2018 AND EARLY 2019. DUE TO THE LIMITATIONS SURROUNDING HEALTH NEEDS PERCEPTIONS CONTAINED IN THIS COLLECTED INFORMATION FROM THE TWO COUNTIES WE PRIMARILY RELIED ON SECONDARY DATA SOURCES FOR THIS ASSESSMENT. THE SECONDARY DATA SOURCES INCLUDED THE MOST RECENT COUNTY HEALTH RANKINGS AND DATA COLLECTED THROUGH THE STRATEGIC MARKETING DEPARTMENT (DEMOGRAPHIC INFORMATION, DISCHARGE DATA, ETC.). RECENT INDICATORS OF HEALTH WERE COLLECTED FROM COMMUNITY COMMONS AND COMPARED TO COUNTY, STATE, NATIONAL AND HEALTHY PEOPLE 2020 REFERENCE DATA. ALL INFORMATION WAS ASSEMBLED AND A CHNA GROUP OF COMMUNITY MEMBERS, HEALTH CARE PROVIDERS (PHYSICIANS AND NURSES), ADMINISTRATORS, AND AN INDIVIDUAL WITH EXPERIENCE IN PUBLIC HEALTH WAS INVITED TO REVIEW THE FINDINGS. THE DATA WAS STRATIFIED INTO THREE CATEGORIES WHICH INCLUDED CLINICAL CARE, HEALTH BEHAVIORS AND HEALTH OUTCOMES. WITHIN THE TWO COUNTIES THAT COMPRISE THE PRIMARY SERVICE AREA FOR TMH TWENTY-NINE INDICATORS OF HEALTH WERE IDENTIFIED TO BE BELOW THE STATE, NATIONAL, OR HEALTHY PEOPLE 2020 GOAL. ONCE THE TWENTY-NINE INDICATORS WERE IDENTIFIED, THEY WERE PRIORITIZED BY EACH INDIVIDUAL OF THE CHNA GROUP USING THE HANLON METHOD. IN ADDITION TO THE CHNA GROUP, THIS REPORT IN ITS ENTIRETY WILL BE SHARED DURING REGULAR MEETINGS THROUGHOUT 2020 AND 2021 WITH THE S2AY RURAL HEALTH NETWORK, EAST CENTRAL DIVISION OF THE AMERICAN CANCER SOCIETY, TIOGA PARTNERSHIP FOR COMMUNITY HEALTH, AND THE COUNTY HEALTH DEPARTMENTS FOR THEIR REVIEW, INPUT, AND SOLICITATION OF WRITTEN COMMENTS. -------------------- PART V, SECTION B, LINE 6A- JOINT CHNA GUTHRIE TOWANDA MEMORIAL HOSPITAL'S CHNA WAS CONDUCTED JOINTLY WITH ROBERT PACKER HOSPITAL, TROY COMMUNITY HOSPITAL AND CORNING HOSPITAL, AFFILIATED IRC SECTION 501(C)(3) TAX EXEMPT HOSPITAL ORGANIZATIONS. -------------------- PART V, SECTION B, LINE 7 & 10-CHNA & IMP. PLAN PUBLIC AVAILABILITY A COPY OF THE ORGANIZATION'S MOST RECENT CHNA AND IMPLEMENTATION PLAN CAN BE FOUND AT: HTTPS://WWW.GUTHRIE.ORG/ABOUT-US/COMMUNITY-BENEFITS/COMMUNITY-HEALTH-NEEDS -ASSESSMENT -------------------- PART V, SECTION B, LINE 11- ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA FOR A COMPLETE DESCRIPTION ON HOW THE ORGANIZATION IS ADDRESSING THE NEEDS IDENTIFIED IN THE MOST RECENTLY COMPLETED CHNA, SEE THE FOLLOWING: HTTPS://WWW.GUTHRIE.ORG/ABOUT-US/COMMUNITY-BENEFITS/COMMUNITY-HEALTH-NEEDS -ASSESSMENT IN ADDITION TO THE PRIORITIES SET BY THE CHNA GROUP TWO MORE UNMET COMMUNITY NEEDS WERE IDENTIFIED AND WILL BE DESCRIBED WITHIN THE CHNA AS AREAS FOR POTENTIAL HEALTH IMPROVEMENT. HOWEVER, DUE TO AVAILABLE RESOURCES THSES NEEDS WILL NOT BE ADDRESSED THROUGH AN IMPLEMENTATION STRATEGY IN THE SUBSEQUENT FISCAL YEARS. THESE NEEDS INCLUDE: *PREVENTABLE HOSPITAL EVENTS *HIV SCREENING -------------------- PART V, SECTION B, LINE 16A, B & C- FAB PUBLIC AVAILABILITY A COPY OF THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, APPLICATION, AND PLAIN LANGUAGE SUMMARY CAN BE FOUND AT: HTTPS://WWW.GUTHRIE.ORG/PATIENTS-VISITORS/PAY-MY-BILL/FINANCIAL-ASSISTANCE -------------------- SUPPLEMENTAL INFORMATION PART I, LINE 7- COSTING METHODOLOGY USED DUE TO THE ADOPTION OF NEW ACCOUNTING PRONOUNCEMENT ASC 606, CURRENT YEAR IMPLICIT PRICE CONCESSIONS ARE TREATED AS A CONTRA-REVENUE ITEM ON THE STATEMENT OF REVENUE (CONSISTENT WITH THE PRIOR YEAR TREATMENT OF PATIENT SERVICE BAD DEBTS). THE RATIO OF COST TO CHARGES WAS COMPUTED USING PATIENT CHARGES AND PATIENT COST EXCLUDING RELATED IMPLICIT PRICE CONCESSIONS COUNTED ELSEWHERE IN THE COMMUNITY BENEFITS NUMBERS. THE NUMBERS USED IN THE CALCULATION OF THE RATIO WERE OBTAINED FROM THE MEDICARE COST REPORT FOR THE RELATED PERIOD. THIS RATIO WAS USED IN THE CALCULATION OF CHARITY CARE, MEDICAID, OTHER MEANS-TESTED GOVERNMENT PROGRAMS AND SUBSIDIZED HEALTH SERVICES. FOR THE REMAINING LINES, DIRECT EXPENSES WERE IDENTIFIED BY PROGRAMS BASED ON PROGRAM RECORDS. --------------- PART III, SECTION A, LINE 2- IMPLICIT PRICE CONCESSIONS/BAD DEBT EXPENSE THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINES 2 AND 3 ARE BASED ON ACTUAL CHARGES WRITTEN OFF (AMOUNTS THAT ARE DEEMED TO BE UNCOLLECTIBLE AND RECORDED AS IMPLICIT PRICE CONCESSIONS UNDER NEW ACCOUNTING PRONOUNCEMENT ASC 606). GUTHRIE TOWANDA MEMORIAL HOSPITAL PROVIDES CARE TO ALL PATIENTS WHO NEED IT, REGARDLESS OF THEIR ABILITY TO PAY. THIS IS PART OF THE HOSPITAL'S MISSION. THE HOSPITAL ESTIMATES THAT 10% OF THE BAD DEBT EXPENSE AT COST IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY THAT HAVE NOT FILLED OUT THE PROPER FORMS OR PROVIDED THE PROPER INFORMATION TO QUALIFY FOR THE PROGRAM. --------------- PART III, SECTION A, LINE 3- METHODOLOGY USED TO ESTIMATE FAP BAD DEBTS GUTHRIE TOWANDA MEMORIAL HOSPITAL ("MEMORIAL HOSPITAL") PROVIDES CARE TO ALL PATIENTS WHO NEED IT, REGARDLESS OF THEIR ABILITY TO PAY. THIS IS PART OF THE HOSPITAL'S MISSION. THE HOSPITAL ESTIMATES THAT 15% OF THE BAD DEBT EXPENSE AT COST IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY THAT HAVE NOT FILLED OUT THE PROPER FORMS OR PROVIDED THE PROPER INFORMATION TO QUALIFY FOR THE PROGRAM. --------------- PART III, SECTION A, LINE 4- BAD DEBT EXPENSE FOOTNOTE THE TEXT OF THE IMPLICIT PRICE CONCESSION (BAD DEBT EXPENSE)FOOTNOTE CAN BE FOUND ON PAGE 11 OF THE ELECTONICALLY ATTACHED AUDITED FINANCIAL STATEMENTS FOR THE GUTHRIE CLINIC AND AFFILIATES. -------------------- PART III, SECTION B, LINE 8- COSTING METHODOLOGY, MEDICARE SHORTFALL THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINE 6 IS BASED ON THE HOSPITAL'S MEDICARE COST REPORT FILING FOR THE YEAR. CONSISTENT WITH THE CHARITABLE HEALTHCARE MISSION OF GUTHRIE TOWANDA MEMORIAL HOSPITAL AND THE COMMUNITY BENEFIT STANDARD SET FORTH IN IRS REVENUE RULING 69-545, THE HOSPITAL PROVIDES CARE FOR ALL PATIENTS COVERED BY MEDICARE SEEKING MEDICAL CARE AT THE HOSPITAL. SUCH CARE IS PROVIDED REGARDLESS OF WHETHER THE REIMBURSEMENT PROVIDED FOR SUCH SERVICES MEETS OR EXCEEDS THE COSTS INCURRED BY THE GUTHRIE TOWANDA MEMORIAL HOSPITAL TO PROVIDE SUCH SERVICES. AS A RESULT, THE HOSPITAL VIEWS ANY SHORTFALL REPORTED IN LINE 7 AS AN ADDITIONAL ITEM OF COMMUNITY BENEFIT PROVIDED BY THE ORGANIZATION. --------------- PART III, SECTION B, LINE 9B- COLLECTION POLICY PRACTICES ONCE A PATIENT IS APPROVED FOR CHARITY CARE OR AN INSTALLMENT PLAN, THEIR ACCOUNT IS TRANSFERRED TO EITHER THE BUDGET OR CHARITY CARE FINANCIAL CLASS. ACCOUNTS IN THESE FINANCIAL CLASSES ARE NOT PLACED WITH COLLECTIONS. --------------- PART VI, LINE 2- NEEDS ASSESSMENT GUTHRIE TOWANDA MEMORIAL HOSPITAL (TMH) AND THE GUTHRIE CLINIC (TGC) EMPHASIZE PRIMARY HEALTH CARE SERVICES, HEALTH PROMOTION, AND CHRONIC DISEASE PREVENTION AND MANAGEMENT FOR THE COMMUNITY WE SERVE. TMH'S OVERALL APPROACH TO COMMUNITY BENEFIT IS TO EXAMINE THE INTERSECTION OF DOCUMENTED UNMET COMMUNITY NEEDS AND MATCH THESE NEEDS WITH ORGANIZATIONAL STRENGTHS. THESE UNMET COMMUNITY NEEDS CAN BE DEFINED AS A DISCREPANCY OR GAP BETWEEN WHAT IS CURRENTLY AVAILABLE AND WHAT THE COMMUNITY DESIRES. THE OVERARCHING GOALS OF THIS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ARE TO (1) IDENTIFY STRENGTHS AND LIMITATION WITHIN TMH'S SERVICE AREA; (2) DEFINE THE NEEDS AND ASSETS ASSOCIATED WITH THE COMMUNITY WE SERVE; (3) DESCRIBE RESOURCES SUCH AS HEALTH PROFESSIONALS, REGIONAL ECONOMICS AND COMMUNICATION NETWORKS WHOSE GOAL IS TO MAXIMIZE COMMUNITY HEALTH. THE IDENTIFIED NEEDS WILL RESULT IN THE FORMATION OF AN IMPLEMENTATION PLAN THAT WILL BUILD UPON THE CONTINUUM OF CARE CURRENTLY OFFERED AT TMH BY CLEARLY LINKING OUR CLINICAL SERVICES WITH OUT COMMUNITY-BASED SERVICES THROUGH THIS COMMUNITY BENEFIT PROCESS. THE IMPLEMENTED COMMUNITY BENEFIT PLAN WILL BE INTEGRATED INTO STRATEGIC ORGANIZATIONAL GOALS OF TMH. THE PLAN PROGRESS WILL BE MONITORED TO ENSURE TIMELY IMPLEMENTATION. FURTHER COLLABORATIVE PARTNERSHIPS WILL BE INTEGRAL TO THE SUCCESS OF THE PLAN. THE TMH COMMUNITY HEALTH NEEDS ASSESSMENT BEGAN WITH A REVIEW OF PRIMARY DATA SOURCES, SPECIFICALLY SURVEY AND FOCUS GROUP DATA THAT HAD BEEN COLLECTED THROUGHOUT 2018 AND EARLY 2019. DUE TO THE LIMITATIONS SURROUNDING HEALTH NEEDS PRECEPTIONS CONTAINED IN THIS COLLECTED INFORMATION FROM THE TWO COUNTIES WE PRIMARILY RELIED ON SECONDARY DATA SOURCES FOR THIS ASSESSMENT. THE SECONDARY DATA SOURCES INCLUDED THE MOST RECENT COUNTY HEALTH RANKINGS AND DATA COLLECTED THROUGH THE STRATEGIC MARKETING DEPARTMENT (DEMOGRAPHIC INFORMATION, DISCHARGE DATA, ETC.). RECENT INDICATORS OF HEALTH WERE COLLECTED FROM COMMUNITY COMMONS AND COMPARED TO COUNTY, STATE, NATIONAL AND HEALTHY PEOPLE 2020 REFERENCE DATA. ALL INFORMATION WAS ASSEMBLED AND A CHNA GROUP OF COMMUNITY MEMBERS, HEALTH CARE PROVIDERS (PHYSICIANS AND NURSES), ADMINISTRATORS, AND AN INDIVIDUAL WITH EXPERIENCE IN PUBLIC HEALTH WAS INVITED TO REVIEW THE FINDINGS. THE DATA WAS STRATIFIED INTO THREE CATEGORIES WHICH INCLUDED CLINICAL CARE, HEALTH BEHAVIORS AND HEALTH OUTCOMES. WITHIN THE TWO COUNTIES THAT COMPRISE THE PRIMARY SERVICE AREA FOR TMH TWENTY-NINE INDICATORS WERE IDENTIFIED, THEY WERE PRIORITIZED BY EACH INDIVIDUAL OF THE CHNA GROUP USING THE HANLON METHOD. THE HANLON METHOD USES A TWO-STEP PROCESS TO SCORE INDIVATORS OF HEALTH. THE FIRST STEP ENSURES THAT EACH NEED MEETS THE PEARL TEST WHICH INCLUDES: PROPRIETY - IS AN INTERVENTION SUITABLE?; ECONOMICS - DOES IT MAKE ECONOMIC SENSE TO ADDRESS THE NEED?; ACCEPTABILITY - IS THE COMMUNITY OPEN TO ADDRESSING THIS NEED AND WILL IT ACCEPT THE INTERVENTION?; RESOURCES - ARE RESOURCES AVAILABLE?; LEGALITY - IS THE INTERVENTION LAWFUL?. THE SECOND STEP OF THE HANLON METHOD INCLUDED ASSIGNING A SCORE FROM 0-10 FOR EACH NEED BASED REGARDING THE (1) SIZE OF THE PROBLEM (2) SERIOUSNESS OF THE PROBLEM AND (3) EFFECTIVENESS POTENTIAL OF AN INTERVENTION. USING THIS METHODOLOGY, THE CHNA GROUP SCORED EACH OF THE UNMET NEEDS WHICH SEVERAL PRIORITY NEEDS WERE IDENTIFIED FOR THE PRIMARY SERVICE AREA OF TMH. FURTHER, ONCE SCORED, THE RESULTS WERE SHARED WITH THE CHNA GROUP FOR DISCUSSION. THE GROUP WAS ALSO GIVEN THE OPPORTUNITY TO ADJUST ANY RANKINGS. THIS PROCESS OF PRIORITIZATION CLASSIFIED THREE AREAS OF UNMET HEALTH CARE NEEDS. IN SEQUENTIAL ORDER (HIGHEST TO LOWEST SCORE) THESE PRIORITY NEEDS INCLUDED: *ACCESS TO MENTAL HEALTH PROVIDERS (WITH A SUBSET FOCUS OF OPIOID USAGE) *CANCER INCIDENCE - LUNG (WITH A SUBSET FOCUS OF TOBACCO USAGE) *OBESITY (OBESITY WAS NOT ORIGINALLY RANKED IN THE TOP THREE PRIORITY NEEDS, HOWEVER UPON DISCUSSION IT WAS DETERMINED TO BE A TOP PRIORITY NEED - RANKINGS ADJUSTED ACCORDINGLY) IN ADDITION TO THE PRIORITIES SET BY THE CHNA GROUP TWO MORE UNMET COMMUNITY NEEDS WERE IDENTIFIED AND WILL BE DESCRIBED WITHIN THIS CHNA AS AREAS FOR POTENTIAL HEALTH IMPROVEMENT. HOWEVER, DUE TO AVAILABLE RESOURCES THESE NEEDS WILL NOT BE ADDRESSED THROUGH AN IMPLEMENTATION STRATEGY IN THE SUBSEQUENT FISCAL YEARS. THESE NEEDS INCLUDE; *PREVENTABLE HOSPITAL EVENTS *HIV SCREENING HTTP://WWW.GUTHRIE.ORG/ABOUT US/COMMUNITY BENEFITS -------------------- PART VI, LINE 3- PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE CHARITY CARE AVAILABILITY AND CONTACT INFORMATINO ARE POSTED IN ALL REGISTRATION AREAS AND IN THE HOSPITAL'S BUSINESS OFFICE. THE CHARITY CARE POLICY, APPLICATION, AND CONTACT INFORMATION ARE POSTED ON THE HOSPITAL'S WEBSITE. SELF PAY PATIENTS ARE REFERRED TO THE HOSPITAL'S FINANCIAL COUNSELOR FROM PHYSICIAN OFFICES, SOCIAL WORKERS, OR SELF REFERRED. THE FINANCIAL COUNSELOR AS WELL AS THE BUSINESS OFFICE STAFF FOLLOW UP WITH SELF PAY PATIENTS TO ASSESS THEIR NEED AND ASSIST IN DETERMINING THEIR ELIGIBILITY FOR SECURING A PAYMENT SOURCE (I.E. COBRA COVERAGE, SPECIAL NEEDS PROGRAM, MEDICAID, OTHER FEDERAL/STATE PROGRAMS, OR CHARITY CARE). STAFF ALSO ASSIST WITH THE APPLICATION PROCESS AS REQUESTED BY SELF PAY PATIENTS. THE HOSPITAL'S BILLING STATEMENTS ALSO HAVE INFORMATION REGARDING WHO TO CONTACT IN CASE A PATIENT NEEDS ASSISTANCE MEETING ITS FINANCIAL OBLIGATIONS. --------------- PART VI, LINE 4- COMMUNITY INFORMATION TOWANDA MEMORIAL HOSPITAL (TMH) IS A NOT-FOR-PROFIT COMMUNITY HOSPITAL AND AN ENTITY UNDER THE GUTHRIE CLINIC (TGC). TMH JOINED TGC ON APRIL 1, 2015. TMH IS IN TOWANDA, PA AND HAS 35 LICENSED INPATIENT BEDS, 68 SKILLED NURSING BEDS, AND 94 PERSONAL CARE BEDS. THE PRIMARY SERVICE AREA FOR TMH INCLUDES BRADFORD COUNTY, PA, AND SULLICAN COUNTY, PA. OVERALL, TMH PROVIDES INPATIENT CARE, OUTPATIENT CARE, CRITICAL CARE, SURGERY, RADIOLOGY, SPECIALIZED THERAPIES, EMERCENCY CARE AND EMERGENCY MEDICAL TRANSPORT SERVICES. ADDITIONAL SERVICES PROVIDED ALSO INCLUDE LABORATORY SERVICES, PHYSICAL AND OCCUPATIONAL THERAPY, AND SUB-ACUTE CARE. IN FISCAL YEAR 2018, TMH HAD 691 INPATIENT VISITS, 647 OUTPATIENT SURGERIES PERFORMED, AND THE TMH EMERGENCY DEPARTMENT HAD 9,764 VISITS. FURTHER, DURING THE SAME TIME PERIOD, THERE WERE OVER 49,000 OUTPATIENT VISITS, EXCLUDING LABORATORY SERVICES. TMH HAS RECEIVED MULTIPLE AWARDS AND RECOGNITION FOR HIGH QUALITY PATIENT CARE, INCLUDING A FOUR STAR OVERALL QUALITY RATING FROM THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) NURSING HOME COMPARE IN 2017 AND THE WOMEN'S CHOICE AWARD RECOGNIZING AMERICA'S BEST HOSPITALS FOR EMERGENCY CARE IN 2017 AND 2018. TMH SERVES A RURAL POPULATION FROM TWO COUNTIES IN THE TWIN TIER REGION OF PENNSYLVANIA. THE PRIMARY SERVICE AREA OF TMH IS DEFINED AS NINE CONTIGUOUS ZIP CODES FROM WHICH OVER 75% OF THE INPATIENT POPULATION IS DERIVED. THE NINE CONTIGUOUS ZIP CODES INCLUDED OVER 27,500 PEOPLE, THE MAJORITY OF WHICH ARE WHITE, NON-HISPANIC, BETWEEN THE AGES OF 35-54. IN THIS GEOGRAPHIC AREA, 48.3% OF THE INDIVIDUALS AGE 25 PLUS, HAVE AT LEAST A HIGH SCHOOL DEGREE WITH 22.5% AND 17.0% HAVING SOME COLLEGE AND BACHELOR'S DEGREE/HIGHER, RESPECTIVELY. FROM 2010 UNTIL 2018 THERE WAS A 3.74% DECREASE IN THE OVERALL POPULATION SERVED BY TMH. IT IS ANTICIPATED THAT BETWEEN 2018 AND 2023, A DECREASE OF 2.1% WILL BE OBSERVED IN THE OVERALL POPULATION SERVED BY TMH. --------------- PART VI, LINE 5- PROMOTION OF COMMUNITY HEALTH SEE SCHEDULE O, FORM 990, PART III, LINE 1- STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS FOR MORE INFORMATION REGARDING HOW THE HOSPITAL FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUMNITY. --------------- PART VI, LINE 6- DETAIL REGARDING AFFILIATED HEALTH CARE SYSTEM ROLES GUTHRIE TOWANDA MEMORIAL HOSPITAL IS PART OF THE GUTHRIE CLINIC. SEE SCHEDULE O, FORM 990, PART III, LINE 1- STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS FOR MORE INFORMATION. GUTHRIE TOWANDA MEMORIAL HOSPITAL IS ALSO SUPPORTED BY THE MEMORIAL HOSPITAL FOUNDATION, WHICH WAS ESTABLISHED IN 2003 TO FOSTER AND SUPPORT SPECIFIC PROJECTS AND PROGRAMS TO IMPROVE THE HOSPITAL'S SERVICES TO ITS PATIENTS. THE MISSION OF THE MEMORIAL HOSPITAL FOUNDAITON IS TO GENERATE RESOURCES FOR THE SUSTAINABILITY AND ADVANCEMENT OF HEALTHCARE IN THE COMMUNITIES IT HAS THE PRIVILEGE OF SERVING. --------------- PART VI, LINE 7- STATE FILING OF COMMUNITY BENEFIT REPORT N/A X X X X false true false false false false false false false PAUL VERVALIN MEMBER - BOD 0 438255 0 66812 0 0 0 53166 0 20029 0 578262 0 0 LYNN DIBBLE CNO 154786 0 36478 0 0 0 10041 0 11392 0 212697 0 0 0 CYNTHIA E LAMBERT MANAGER, PHARMACY 155571 0 0 0 0 0 8167 0 20029 0 183767 0 0 0 STACI COVEY RETIRED 123118 PRESIDENT & MEMBER - BOD 0 218168 0 25719 0 0 0 17083 0 13009 0 273979 0 0 SCHEDULE J, PART I, LINE 3 TOP MANAGEMENT COMPENSATION EXECUTIVE COMPENSATION IS ESTABLISHES WITHIN A WRITTEN EMPLOYMENT AGREEMENT. COMPENSATION IS DETERMINED BASED ON MARKET STUDIES, PRESENTED TO THE GUTHRIE CLINIC COMPENSATION COMMITTEE ADN SUBSEQUENTLY APPROVED BY THE BOARD OF DIRECTORS. --------------- SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PARTICIPATION THE GUTHRIE CLINIC ("TGC") HAS ESTABLISHED AN EMPLOYEE BENEFIT PLAN KNOWN AS THE GUTHRIE CLINIC 457(F) DEFERRED COMPENSATION PLAN (THE "PLAN") WHICH IS DESIGNED TO PROVIDE ELIGIBLE EMPLOYEES WITH DEFERRED COMPENSATION BENEFITS IN RECOGNITION OF THEIR DEDICATED AND VALUABLE SERVICE TO TGC. THE PLAN IS INTENDED TO BE AN INELIGIBLE DEFERRED COMPENSATION PLAN AS DESCRIBED IN SECTION 457(F) OF THE INTERNAL REVENUE CODE. EACH CONTRIBUTION VESTS AFTER THREE YEARS OF EMPLOYMENT PROVIDED THE PARTICIPANT REMAINS CONTINUOUSLY EMPLOYED. A PARTICIPANT SHALL BECOME FULLY VESTED IN THE PARTICIPANT'S 457(F) ACCOUNT BENEFIT UPON ATTAINING AGE 62, WITH 5 YEARS OF SERVICE. TGC SHALL DISTRIBUTE THE PARTICIPANT'S 457(F) ACCOUNT BENEFIT, LESS TAXES WITHHELD, THIRTY DAYS AFTER THE PARTICIPANT FIRST BECOMES VESTED IN THE PLAN. FOR YEARS SUBSEQUENT TO A PARTICIPANT ATTAINING AGE 62, THE PARTICIPANT SHALL BE ENTITLED TO THE PARTICIPANT'S DEFERRED COMPENSATION AMOUNT AS OF JULY 1ST IMMEDIATELY SUBSEQUENT TO THE DATE WHEN CREDITED. THE FOLLOWING INDIVIDUAL LISTED ON FORM 990, PART VII, SECTION A, LINE 1A PARTICIPATED IN THE PLAN DURING THE YEAR AND/OR RECEIVED DISTRIBTUIONS DURNIG THE YEAR: PAUL VERVALIN - NO DISTRIBUTION FORM 990, PART III STATEMENT OF PROGRAM SERVICES ACCOMPLISHMENTS GUTHRIE TOWANDA MEMORIAL HOSPITAL IS A SUBSIDIARY OF THE GUTHRIE CLINIC. THE GUTHRIE CLINIC IS A NONPROFIT HEALTH CARE ORGANIZATION INCORPORATED FOR THE PURPOSE OF CONDUCTING EXCLUSIVELY CHARITABLE, SCIENTIFIC AND EDUCATIONAL ACTIVITIES. THE GUTHRIE CLINIC (TGC) ACTS AS THE PARENT OF AN INTEGRATED SECTION 501(C)(3) HEALTH CARE DELIVERY SYSTEM, CONSISTING OF THE CORPORATION AND OTHER DIRECTLY AND INDIRECTLY CONTROLLED ENTITIES (SEE FORM 990, SCHEDULE R, FOR A LISTING OF THE AFFILIATES OF TGC) INCLUDING BUT NOT LIMITED TO GUTHRIE MEDICAL GROUP, P.C. (GMG) AND ROBERT PACKER HOSPITAL (RPH). THROUGH THE ACTIVITIES OF GMG, RPH AND ITS OTHER AFFILIATES (COLLECTIVELY REFERRED TO AS "GUTHRIE"), THE GUTHRIE CLINIC PROVIDES CHARITABLE COMMUNITY-BASED HEALTH CARE SERVICES AND PROGRAMS TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE AND COMMUNITIES SERVED BY ITS FACILITIES AND PROVIDERS. THESE CHARITABLE ACTIVITIES INCLUDE PROVIDING PRIMARY CARE AND SPECIALTY PHYSICIAN SERVICES, AS WELL AS OPERATING A TERTIARY CARE TEACHING HOSPITAL, COMMUNITY HOSPITALS, A RESEARCH INSTITUTE, HOME CARE, AND HOSPICE CARE. THE GUTHRIE RESEARCH INSTITUTE AND GUTHRIE CLINICAL RESEARCH FUNCTIONS OF THE DONALD GUTHRIE FOUNDATION, A SUBSIDIARY OF TGC, FURTHERS THESE CHARITABLE ACTIVITIES THROUGH PROVIDING PATIENT ACCESS TO THE REGION'S LARGEST PANEL OF CLINICAL TRIALS. GUTHRIE IS COMPRISED OF A RESEARCH INSTITUTE, HOME CARE/HOSPICE, HOSPITALS IN SAYRE, PA., CORNING, N.Y., TOWANDA, PA., TROY, PA. AND CORTLAND, N.Y., AS WELL AS A MULTI-SPECIALTY GROUP PRACTICE OF MORE THAN 325 PHYSICIANS AND 210 ADVANCED PRACTICE PROVIDERS OFFERING 47 SPECIALTIES THROUGH A REGIONAL OFFICE NETWORK PROVIDING PRIMARY AND SPECIALTY CARE IN 33 COMMUNITIES IN PENNSYLVANIA AND NEW YORK. THE VISION OF GUTHRIE IS TO HELP SHAPE THE DELIVERY OF HEALTH CARE IN THE REGION THROUGH WORKING COLLABORATIVELY WITH PHYSICIANS AND OTHER PROVIDERS, AND BY DISTRIBUTING ITS SERVICES THROUGHOUT THE REGION BASED ON COMMUNITY NEEDS. GUTHRIE SEEKS TO BE THE PROVIDER OF CHOICE FOR PATIENTS IN THE REGION IT SERVES, AND TO BE RECOGNIZED FOR ITS SUPERIOR QUALITY AND SERVICE. IT ALSO STRIVES TO ADVANCE THE PRACTICE OF MEDICINE THROUGH ITS COMMITMENT TO TEACHING AND RESEARCH. IN KEEPING WITH THIS VISION, THE CORE VALUES OF THE GUTHRIE CLINIC ARE AS FOLLOWS: PATIENT-CENTEREDNESS, EXCELLENCE, AND TEAMWORK. GUTHRIE PROVIDERS AND FACILITIES PROVIDE CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE IT DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE ON THE FINANCIAL STATEMENTS OF GUTHRIE ENTITIES. COSTS FOR SERVICES AND SUPPLIES FURNISHED UNDER GUTHRIE'S CHARITY CARE POLICY AMOUNTED TO APPROXIMATELY $2.32 MILLION IN 2019 AND $1.21 MILLION IN 2018 WHEN MEASURED AT THE APPROPRIATE ENTITY'S ESTIMATED COST. AS PART OF ITS CHARITABLE MISSION, GUTHRIE PROVIDES CARE THROUGH ITS HOSPITAL EMERGENCY DEPARTMENTS. IT ENSURES THAT AN EMERGENCY-BASED TREATMENT OR HOSPITAL ADMISSION IS NOT DELAYED OR DENIED PENDING DETERMINATION OF COVERAGE OR A REQUIREMENT FOR PREPAYMENT OR DEPOSIT. AS A RESULT OF THIS POLICY, GUTHRIE EXPERIENCED APPROXIMATELY $3.84 MILLION AND $2.16 MILLION IN BAD DEBTS FOR 2019 AND 2018, RESPECTIVELY. IN ADDITION TO THE CHARITY CARE PROGRAM AND THE EMERGENCY DEPARTMENT BAD DEBTS DISCUSSED ABOVE, GUTHRIE SUPPORTS NUMEROUS OTHER CHARITABLE COMMUNITY ACTIVITIES. EXAMPLES OF THESE ACTIVITIES INCLUDE MEDICAL EDUCATION FOR PHYSICIANS AND NURSES, THE TRAUMA PROGRAM, AND MEDICAL RESEARCH. THE ESTIMATED COST, NET OF REIMBURSEMENT, FOR THESE PROGRAMS WAS $20.5 MILLION AND $16.2 MILLION IN 2019 AND 2018, RESPECTIVELY. GUTHRIE ALSO PROVIDES SERVICES TO PATIENTS WHO PARTICIPATE IN THE MEDICAID PROGRAMS. REVENUES GENERATED FROM PATIENTS WHO PARTICIPATE IN THE MEDICAID PROGRAM ARE SUBJECT TO SUBSTANTIAL DISCOUNTS THAT RESULT IN REIMBURSEMENT FOR SERVICES RENDERED BELOW THE COST OF PROVIDING SUCH SERVICES. IN ORDER FOR PATIENTS TO MEET THE GUIDELINES FOR THE MEDICAID PROGRAM, VARIOUS INCOME-BASED CRITERIA MUST BE MET THAT VALIDATE PATIENTS' INABILITY TO PAY FOR SERVICES AND INELIGIBILITY UNDER OTHER PROGRAMS. THE ESTIMATED LOSS INCURRED BY GUTHRIE FROM PROVIDING SERVICES TO MEDICAID PATIENTS AMOUNTED TO $53.63 MILLION AND $52.15 MILLION IN 2019 AND 2018, RESPECTIVELY. THE TOTAL COST TO GUTHRIE IN SUPPORTING THESE CHARITABLE MISSION PROGRAMS WAS APPROXIMATELY $80.32 MILLION AND $71.72 MILLION IN 2019 AND 2018, RESPECTIVELY. AS DISCUSSED, RPH AND THE GMG WORK CLOSELY TOGETHER IN FULFILLING GUTHRIE'S CHARITABLE MISSION. A REGIONAL LEVEL II TRAUMA CENTER, RPH IS A TERTIARY CARE TEACHING HOSPITAL, LOCATED IN SAYRE, PENNSYLVANIA, SERVING THE SOUTHERN TIER OF NEW YORK AND THE NORTHERN TIER OF PENNSYLVANIA. GUTHRIE ALSO OFFERS RESIDENCY PROGRAMS IN FAMILY PRACTICE, INTERNAL MEDICINE, GENERAL SURGERY, EMERGENCY MEDICINE, AS WELL AS NURSE RESIDENCY AND PHARMACY RESIDENCY. FELLOWSHIP PROGRAMS ARE OFFERED IN CARDIOVASCULAR DISEASE, GASTROENTEROLOGY AND PULMONARY DISEASE/CRITICAL CARE. MEDICAL STUDENT TRAINING IS PROVIDED FOR STUDENTS FROM AFFILIATED MEDICAL SCHOOLS. ALLIED HEALTH EDUCATION IS ALSO PROVIDED FOR RESPIRATORY THERAPY, NURSING, LABORATORY SCIENCE, AND RADIOLOGIC TECHNOLOGY FOR STUDENTS FROM PENNSYLVANIA AND NEW YORK COLLEGES AND UNIVERSITIES. RPH OFFERS A FULL RANGE OF DIAGNOSTIC, MEDICAL AND SURGICAL SERVICES, INCLUDING THE FOLLOWING: GUTHRIE BREAST CARE CENTER; GUTHRIE CANCER CENTER; GUTHRIE CARDIAC AND VASCULAR CENTER; GUTHRIE MUSCULOSKELETAL SERVICES; GUTHRIE IMAGING SERVICES; GUTHRIE SPECIALTY EYE CARE; GUTHRIE SURGICAL SERVICES; WEIGHT LOSS CENTER; LEVEL II TRAUMA CENTER; AND MEDICAL/SURGICAL AND INTENSIVE CARE SERVICES. RPH STRIVES TO ENHANCE THE QUALITY OF LIFE IN THE COMMUNITIES IT SERVES BY PROVIDING SUPERIOR HEALTH CARE SERVICES AND BY LEADING CONTINUOUS IMPROVEMENT OF COMMUNITY HEALTH. IT ACHIEVES THIS MISSION BY ORGANIZING SERVICES AND DIRECTING RESOURCES TOWARD MEETING COMMUNITY HEALTH NEEDS THROUGH COLLABORATION WITH COMMUNITY AGENCIES AND BY COMPASSIONATE, EFFECTIVE, AND AFFORDABLE MEANS. RPH WORKS CLOSELY WITH THE GMG TO ENSURE THAT THE SKILLS AND KNOWLEDGE OF THE MEDICAL STAFF PRODUCE THE MAXIMUM COMMUNITY HEALTH BENEFIT. AS A MEMBER OF GUTHRIE, RPH INTEGRATES ITS PROGRAMS AND ACTIVITIES WITH THOSE OF THE LONG-TERM CARE AND EDUCATION AND RESEARCH DIVISIONS, SO THAT CONTINUITY AND SYNERGY RESULT. AS PART OF TGC, THE VISION OF RPH IS TO PLAY A LEADERSHIP ROLE IN THE DEVELOPMENT AND PROVISION OF TERTIARY-LEVEL ACUTE CARE SERVICES. EVIDENCE THAT RPH IS SUCCESSFULLY FULFILLING THIS ROLE CAN BE SEEN IN ITS CONTINUED ACCOMPLISHMENTS. HIGHLIGHTS OF THOSE ACHIEVEMENTS INCLUDE CONTINUED ACCREDITATION BY THE PENNSYLVANIA TRAUMA SYSTEMS FOUNDATION BOARD AS A LEVEL II TRAUMA CENTER; RECEIPT OF FULL CHEST PAIN CENTER ACCREDITATION WITH PCI (PERCUTANEOUS CORONARY INTERVENTION) FROM THE SOCIETY OF CARDIOVASCULAR PATIENT CARE; NATIONAL ACCREDITATION FOR TWO NEW EDUCATIONAL PROGRAMS; EMERGENCY MEDICINE RESIDENCY AND PULMONARY AND CRITICAL CARE FELLOWSHIP; NAMED TO AMERICA'S 100 BEST FOR CORONARY INTERVENTION; RECEIPT OF CCAP ACCREDITATION FOR GUTHRIE SAYRE LAB; AWARDED ADVANCED CERTIFICATION FOR PRIMARY STROKE CENTER; GUTHRIE ROBERT PACKER HOSPITAL . GUTHRIE WEIGHT LOSS CENTER HAS BEEN ACCREDITED AS A LEVEL 1 FACILITY UNDER THE BARIATRIC SURGERY CENTER NETWORK (BSCN) ACCREDITATION PROGRAM OF THE AMERICAN COLLEGE OF SURGEONS (ACS). AS PART OF A FULLY-INTEGRATED HEALTH DELIVERY SYSTEM THAT ORGANIZES ITS SERVICES ON A REGIONAL BASIS AND IS ACCOUNTABLE FOR IMPROVING THE HEALTH OF THE POPULATION IT SERVES, RPH ACCEPTS RESPONSIBILITY FOR MEETING THE HEALTH CARE NEEDS OF THE COMMUNITY AND IS ABLE TO DOCUMENT THE COST EFFECTIVENESS AND QUALITY OF SERVICES PROVIDED. CORNING HOSPITAL BREAST CARE CENTER WAS AWARDED A FULL THREE-YEAR ACCREDITATION IN STEREOTACTIC BREAST BIOPSY BY THE AMERICAN COLLEGE OF RADIOLOGY (ACR) AND RECEIVED THE AMERICAN HEART ASSOCIATION/AMERICAN STOKE ASSOCIATION'S GET WITH THE GUIDELINES STROKE GOLD PLUS ACHIEVEMENT AWARD. FORM 990 PART III (CONTINUED) THE GMG IS A MULTI-SPECIALTY PHYSICIAN GROUP PRACTICE THAT INCLUDES NEARLY 500 SPECIALIST AND PRIMARY CARE PHYSICIANS AND ADVANCED PRACTICE PROVIDERS, HEADQUARTERED IN A FACILITY ADJACENT TO RPH. PHYSICIANS WITHIN THE GMG PROVIDE COMPREHENSIVE MEDICAL CARE USING ADVANCED TECHNOLOGIES AND METHODOLOGIES FOR BOTH DIAGNOSIS AND TREATMENT. FURTHER, THE GMG PROVIDES A BROAD RANGE OF EDUCATIONAL OPPORTUNITIES FOR PHYSICIANS AND OTHER HEALTH CARE PROVIDERS. IT ALSO WORKS CLOSELY WITH THE RESEARCH INSTITUTE, WHERE RESEARCH CONTRIBUTES TO RECRUITING AND RETAINING PHYSICIAN SPECIALISTS TO SERVE THE REGION AND SUSTAINING PROFICIENT MEDICAL PRACTICES. THE GMG IS COMMITTED TO THE ADVANCEMENT OF MEDICAL KNOWLEDGE AND SKILLS, AND EVERY EFFORT IS MADE TO PROVIDE PERSONAL, COMPASSIONATE MEDICAL CARE. THE GMG OPERATES A REGIONAL OFFICE NETWORK IN 22 COMMUNITIES IN PENNSYLVANIA AND NEW YORK, ENCOMPASSING ALL OF THE MAJOR POPULATION CENTERS IN THE TWIN TIERS AREA. THE GUTHRIE CLINIC HAS DEVELOPED CERTAIN GUIDING PRINCIPLES FOR THE PROVISION OF PATIENT CARE, WHICH INCLUDE A COMMITMENT THE FOLLOWING: * PRACTICE OF CLINICAL EXCELLENCE, * UTILIZATION OF THE SYNERGY OF A MULTI-SPECIALTY MEDICAL GROUP PRACTICE, * DEVELOPMENT OF AN INTEGRATED SYSTEM THAT PROVIDES A CONTINUUM OF CARE, * PROVISION OF LOCAL ACCESS TO CARE THROUGH SUPPORT OF A REGIONAL MEDICAL OFFICE NETWORK, * PROVISION OF SERVICES TO A DISTINCT GEOGRAPHIC REGION, AND * PROACTIVE OPERATIONS. THE GMG, THROUGH THE PROVISION OF PRIMARY CARE SERVICES WITH EASE OF ACCESS TO SPECIALTY AND SUB-SPECIALTY CARE, FOCUSES ON MAKING AN INTEGRATED SYSTEM OF HEALTH CARE EASILY ACCESSIBLE TO PATIENTS. WITH ITS PRIMARY CONCERN THE DIAGNOSIS AND TREATMENT OF DISEASE AND ILLNESS, IT ALSO SEEKS TO ACTIVELY IMPROVE THE HEALTH OF THE COMMUNITY IT SERVES THROUGH PREVENTION, HEALTH SCREENINGS, AND EDUCATION. THE GMG WELCOMES ANY PATIENT SEEKING CARE. --------------- FORM 990 PART IV, LINE 12B DETAIL OF CONSOLIDATED FINANCIAL STATEMENTS THE ORGANIZATION'S FINANCIAL STATEMENTS WERE AUDITED ON A CONSOLIDATED BASIS WITH THE GUTHRIE CLINIC AND AFFILIATES. --------------- FORM 990, PART VI, SECTION A, LINE 6 MEMBERSHIP INFORMATION THE GUTHRIE CLINIC IS THE SOLE MEMBER OF GUTHRIE TOWANDA MEMORIAL HOSPITAL. --------------- FORM 990, PART VI, SECTION A, LINE 7A MEMBERSHIP INFORMATION AS THE SOLE MEMBER OF GUTHRIE TOWANDA MEMORIAL HOSPITAL, THE GUTHRIE CLINIC APPOINTS THE ORGANIZATION'S BOARD OF DIRECTORS. --------------- FORM 990, PART VI, SECTION A, LINE 7B MEMBERSHIP INFORMATION AS THE SOLE MEMBER OF GUTHRIE TOWANDA MEMORIAL HOSPITAL, THE GUTHRIE CLINIC HAS APPROVAL RIGHTS OF CERTAIN BOARD DECISIONS. --------------- FORM 990, PART VI, SECTION B, LINE 11A & 11B FORM 990 REVIEW PROCESS THE FORM 990 OF THE ORGANIZATION IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW AND IS ALSO REVIEWED BY THE ORGANIZATION'S FINANCE PERSONNEL AND AN INDEPENDENT ACCOUNTING FIRM PRIOR TO FILING WITH THE IRS. --------------- FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY THE CONFLICT OF INTEREST DISCLOSURE POLICY SETS FORTH THAT ALL PERSONS, INCLUDING EMPLOYEES, AGENTS AND BOARD/COMMITTEE MEMBERS,PARTICULARLY THOSE INVOLVED IN DECISION-MAKING FOR THE GUTHRIE CLINIC (TGC), ACT IN AN APPROPRIATE MANNER AND WILL NOT PARTICIPATE IN ANY ACTIONS THAT MIGHT CREATE A PERSONAL OR PROFESSIONAL CONFLICT OF INTEREST AND/OR NOT BE IN THE BEST INTEREST OF TGC. ALL MEMBERS OF ANY TGH BOARD/ COMMITTEE AND TGH SENIOR MANAGEMENT MUST MAKE FULL DISCLOSURE OF ANY POSSIBLE CONFLICT OF INTEREST THROUGH THE USE OF THE CONFLICT OF INTEREST DISCLOSURE FORM AND REFRAIN FROM VOTING OR PARTICIPATING IN DECISION-MAKING INVOLVING ANY POSSIBLE CONFLICT OF INTEREST. THE FORM IS DISTRIBUTED TO ALL BOARD/COMMITTEE MEMBERS AND EMPLOYEES (WHEN APPLICABLE) ANNUALLY BY THE TGC ADMINISTRATION OFFICE. TGC BOARD/COMMITTEE MEMBERS OR EMPLOYEES MUST COMPLETE THE CONFLICT OF INTEREST DISCLOSURE FORM. THIS FORM SHOULD BE COMPLETED WHEN THERE IS ANY SITUATION WHERE A POSSIBLE CONFLICT OF INTEREST EXISTS, AND/OR ON AN ANNUAL BASIS AND/OR AT THE TIME OF APPOINTMENT OR ELECTION OF NEW BOARD/COMMITTEE MEMBERS. IF THE FORM IS NOT COMPLETED WITHIN 13 MONTHS OF THE LAST SIGNING, THE TGC BOARD CHAIRMAN WILL BE ADVISED. ANY INDIVIDUAL HAVING A CONFLICT OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON ANY MATTER SHOULD EXCUSE THEMSELVES FROM THE PORTION OF THE MEETING OR MEETINGS WHERE THE MATTER IS DISCUSSED AND NOT VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER. THE MINUTES OF THE MEETING OR MEETINGS SHOULD REFLECT THE DISCLOSURE, THE ABSTENTION FROM VOTING, AND ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST EXISTED. --------------- FORM 990, PART VI, SECTION B, LINE 15A & 15B COMPENSATION REVIEW AND APPROVAL EXECUTIVE COMPENSATION IS GENERALLY ESTABLISHED WITHIN A WRITTEN EMPLOYMENT AGREEMENT. COMPENSATION IS DETERMINED BASED ON MARKET STUDIES, PRESENTED TO THE GUTHRIE CLINIC COMPENSATION COMMITTEE, AND SUBSEQUENTLY APPROVED BY THE BOARD OF DIRECTORS. --------------- FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S FORMS 1023, 990, AND 990-T ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. ---------------- FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. --------------- FORM 990, PART XI, LINE 9 DETAIL OF OTHER CHANGES IN NET ASSETS OR FUND BALANCES EQUITY TRANSFER FROM TMHF $ 7,173,521 EQUITY TRANSFER FROM DGF 11,917 TRANSFER CLOSE-OUT FOUNDATION BS (6,689,266) INTEREST DIVIDEND INCOME ON INVESTMENT 228 NET REALIZED GAINS/LOSS ON REST.INVEST 2,938 EARNINGS DISTRIBUTION (1,949) OTHER (17) ----------- TOTAL $ 497,372 --------------- FORM 990, PART X BALANCE SHEET CERTAIN PRIOR YEAR BALANCES HAVE BEEN RESTATED TO CONFORM TO THE CURRENT YEAR PRESENTATION. --------------- FORM 990 PART IX LINE 11G DESCRIPTION:PURCH SERV-MAINT CONTRACT TOTAL FEES:285355 FORM 990 PART IX LINE 11G DESCRIPTION:PURCH SERV-COLLECTION TOTAL FEES:17530 FORM 990 PART IX LINE 11G DESCRIPTION:PURCH SERV-LABORATORY TOTAL FEES:117319 FORM 990 PART IX LINE 11G DESCRIPTION:PURCH SERV-RADIOLOGY TOTAL FEES:102448 FORM 990 PART IX LINE 11G DESCRIPTION:PURCH SERV-CONSULTANTS TOTAL FEES:40734 FORM 990 PART IX LINE 11G DESCRIPTION:PURCH SERV-HSKG TOTAL FEES:11571 FORM 990 PART IX LINE 11G DESCRIPTION:PURCH SERV-RADIOLOGY PHYS FEES TOTAL FEES:1623 FORM 990 PART IX LINE 11G DESCRIPTION:PURCH SERV-PHYSICIAN FEES TOTAL FEES:1664588 FORM 990 PART IX LINE 11G DESCRIPTION:PURCH SERV-TEMPORARY STAFF TOTAL FEES:126372 FORM 990 PART IX LINE 11G DESCRIPTION:PURCH SERV-OTHER TOTAL FEES:1293390 FORM 990 PART IX LINE 11G DESCRIPTION:PURCH SERV-MAINTENANCE TOTAL FEES:25630 FORM 990 PART IX LINE 11G DESCRIPTION:PURCH SERV-LAUNDRY TOTAL FEES:133930 FORM 990 PART IX LINE 11G DESCRIPTION:PURCH SERV-PHARMACY TOTAL FEES:22643 FORM 990 PART IX LINE 11G DESCRIPTION:PURCH SERV-PHYSICIAN FEES TOTAL FEES:231840 FORM 990 PART IX LINE 11G DESCRIPTION:PURCH SERV-OTHER INT TOTAL FEES:2482039 COMMUNITY HEALTH ASSOCIATES LLC 91 HOSPITAL DRIVE TOWANDA PA 18848 262096228 MEDICAL SRVCS PA 5461162 GTMH THE GUTHRIE CLINIC ONE GUTHRIE SQUARE SAYRE PA 18840 233055017 SUPPORTING PA 501(C)(3) 12B,II NA false GUTHRIE MEDICAL GROUP PC ONE GUTHRIE SQUARE SAYRE PA 18840 250815795 HEALTHCARE PA 501(C)(3) 3 TGC false SAYRE HOUSE OF HOPE ONE GUTHRIE SQUARE SAYRE PA 18840 203979472 HEALTHCARE PA 501(C)(3) 7 TGC false ROBERT PACKER HOSPITAL ONE GUTHRIE SQUARE SAYRE PA 18840 240795463 HEALTHCARE PA 501(C)(3) 3 TGC false DONALD GUTHRIE FOUNDATION ONE GUTHRIE SQUARE SAYRE PA 18840 246022957 MED RESEARCH PA 501(C)(3) 4 TGC false TROY COMMUNITY HOSPITAL INC 275 GUTHRIE DR troy PA 16947 240800337 HEALTHCARE PA 501(C)(3) 3 TGC false GUTHRIE HOME CARE 421 TOMAHAWK RD TOWANDA PA 18848 232394345 HOME HEALTH PA 501(C)(3) 10 TGC false GUTHRIE RISK RETENTION GROUP 151 MEETING ST CHARLESTON SC 29401 201090801 SUPPORTING SC 501(C)(3) 12A,I TGC false THE MEMORIAL HOSPITAL FOUNDATION 91 HOSPITAL DRIVE TOWANDA PA 18848 651160811 SUPPORTING PA 501(C)(3) 12A,I GTMH true CORNING HOSPITAL ONE GUTHRIE DRIVE CORNING NY 14830 160393490 HEALTHCARE NY 501(C)(3) 3 TGC false GUTHRIE CORTLAND MEDICAL CENTER 134 HOMER AVE CORTLAND NY 13045 150532079 HEALTH CARE NY 501(C)(3) 3 TGC false CORTLAND MEMORIAL FOUNDATION INC 134 HOMER AVE CORTLAND NY 13045 222230692 SUPPORTING NY 501(C)(3) 7 GCMC false REGIONAL MEDICAL PRACTICE 134 HOMER AVE CORTLAND NY 13045 204848729 HEALTH CARE NY 501(C)(3) 3 TGC false TWIN TIER MANAGEMENT CORP INC PO BOX 310 SAYRE PA 18840 232209439 MANAGEMENT CORP PA TGC C CORP false CORNING PROPERTIES INC ONE GUTHRIE DRIVE CORNING NY 14830 383977095 REAL ESTATE HOLD NY CH C CORP false CMH SERVICES INC 160 HOMER AVENUE CORTLAND NY 13045 161370440 DURABLE MEDICAL NY GCMC C CORP false CORTLAND MEMORIAL PROPERTIES INC 134 HOMER AVENUE CORTLAND NY 13045 161266826 INCOME ALLOCATION NY N/A C CORP false true false true false false false false false true true true true false true false false false false THE MEMORIAL HOSPITAL FOUNDATION C 7173521 FMV