2025-09-25T10:39:06-05:00 2023-06-30 135565207 KPMG LLP 1735 MARKET STREET 6TH FLOOR PHILADELPHIA PA 19103 990 2022-07-01 231352159 JC BLAIR MEMORIAL HOSPITAL JCBL 8146432290 1225 WARM SPRINGS AVENUE HUNTINGDON PA 16652 DOUGLAS WINNER CFO 8146438445 2025-09-22 1 0 PHILLIP E GROFF P01247783 2672567000 2025-09-22 2022 2025-03-06 01:10:19Z PENN HIGHLANDS HUNTINGDON JOSEPH MYERS 1225 WARM SPRINGS AVENUE HUNTINGDON PA 16652 65515398 0 X WWW.PHHEALTHCARE.ORG X 1909 PA HEALTHCARE PROVIDER - NOT-FOR-PROFIT ACUTE CARE HOSPITAL 12 12 445 75 882283 0 2836156 594548 55788211 57676246 207352 127169 588993 208764 59420712 58606727 0 0 0 0 24292232 25801973 0 0 0 31020359 37009492 55312591 62811465 4108121 -4204738 87016603 64585589 47454143 23485507 39562460 41100082 X J.C. BLAIR MEMORIAL HOSPITAL IS COMMITTED TO BEING THE PREMIER HEALTH RESOURCE FOR THE RESIDENTS OF HUNTINGDON COUNTY AND NEARBY COMMUNITIES AND STRIVES TO DELIVER THE BEST OUTCOME FOR EVERY PATIENT. SEE SCHEDULE O FOR ADDITIONAL DETAIL. 0 0 58328754 56793963 J.C. BLAIR MEMORIAL HOSPITAL PROVIDES INPATIENT, OUTPATIENT, EMERGENCY CARE SERVICES, AND URGENT CARE SERVICES TO FURTHER THE HEALTH AND WELLNESS OF HUNTINGDON, PENNSYLVANIA AND SURROUNDING COMMUNITIES IN HUNTINGDON COUNTY, PENNSYLVANIA. IN FISCAL YEAR 2023, CHARITY CARE SERVICES AMOUNTED TO APPROXIMATELY $562,000. PATIENTS RECEIVE MEDICALLY NECESSARY SERVICES REGARDLESS OF ABILITY TO PAY. SEE SCHEDULE O FOR ADDITIONAL DETAIL. 58328754 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 65 0 1 445 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 1 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 0 PA X JOSEPH MYERS 8146432290 1225 WARM SPRINGS AVENUE HUNTINGDON PA 16652 ANTOINETTE GRAY DIRECTOR (END 12/31/2022) 1.00 1.00 X 0 0 0 FRANCES V VAUGHN DIRECTOR (END 12/31/2022) 1.00 1.00 X 0 0 0 CHERYL SHOPE DIRECTOR (END 12/31/2022) 1.00 1.00 X 0 0 0 MARIA PETTINGER MD DIRECTOR (END 12/31/2022) 1.00 1.00 X 0 0 0 FRED PRICE DIRECTOR (END 12/31/2022) 1.00 1.00 X 0 0 0 PETER HOPSICKER DIRECTOR 1.00 1.00 X 0 0 0 JAMES A TROHA DIRECTOR (END 12/31/2022) 1.00 1.00 X 0 0 0 DR MARGARET HALLAHAN DIRECTOR (END 12/31/2022) 1.00 1.00 X 0 0 0 JOHN D COURSEN DIRECTOR (END 12/31/2022) 1.00 1.00 X 0 0 0 MICHAEL SABATINI DIRECTOR (END 12/31/2022) 1.00 1.00 X 0 0 0 A KEITH BLACK DIRECTOR (END 12/31/2022) 1.00 1.00 X 0 0 0 DAVID HILEMAN DIRECTOR (START 1/1/2023) 1.00 1.00 X 0 0 0 WILLIAM HOOVER DIRECTOR (START 1/1/2023) 1.00 1.00 X 0 0 0 DR KARA KIMBERLY DIRECTOR (START 1/1/2023) 1.00 1.00 X 0 0 0 BUD BOOM DIRECTOR (END 3/13/2023) 1.00 1.00 X 0 0 0 LINDA DELGROSSO RN DIRECTOR (END 6/8/2023) 1.00 1.00 X 0 0 0 JOHN STEINBUGL DIRECTOR (END 3/22/2023) 1.00 1.00 X 0 0 0 ROBERT SLOSS DIRECTOR (START 12/31/2022) 1.00 1.00 X 0 0 0 MARK MINOR DIRECTOR (END 12/31/2022) 1.00 1.00 X 0 0 0 MIRANDA K PERUSO CHAIR 2.00 2.00 X X 0 0 0 LESLIE ESTEP SECRETARY (END 12/31/2022) 2.00 2.00 X X 0 0 0 TODD LEWIS TREASURER (START 1/1/2023) 2.00 2.00 X X 0 0 0 OSCAR JOHNSTON VICE CHAIR 2.00 2.00 X X 0 0 0 IVALOU NOUTLON MLT ASCP DIRECTOR 1.00 1.00 X 0 0 0 JOSEPH MYERS PRESIDENT 40.00 0.00 X 258960 0 13159 JOELLE KAMINSKY DIRECTOR OF PHARMACY 40.00 0.00 X 141276 0 7780 JOHN LEYTHAM DIRECTOR OF PHYSICAL THERAPY 40.00 0.00 X 106630 0 21951 TODD FORTNEY PHARMACIST 40.00 0.00 X 140009 0 16560 MUHAMMAD QAMAR PSYCHIATRIST 40.00 0.00 X 157874 0 21168 DEBORAH FRONTZ RN 40.00 0.00 X 118419 0 9194 923168 0 89812 5 0 1 0 AMN HEALTHCARE INC 2735 COLLECTION CENTER DRIVE CHICAGO IL 606932735 NURSING 968196 ALLIANCE RECRUITING RESOURCES INC PO BOX 223901 DALLAS TX 752223901 PSYCHIATRY 771027 CARDIOLOGY ASSOCIATES OF ALTOONA 1321 ELEVENTH AVENUE ALTOONA PA 16601 CARDIOLOGY 433808 MAXIM HEALTHCARE STAFFING SERVICES INC 12558 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 NURSING 361257 LOCUMTENENS LLC PO BOX 405547 ATLANTA GA 303845547 NURSING 222883 10 67008 431651 95889 594548 NET PATIENT REVENUE 621110 56293946 56293946 MEAL & UTILITY CONTRACT SRVCS 810000 1115656 233373 882283 CAFETERIA REVENUE 621500 151746 151746 HPSA/PCIP/HSIP INCENTIVE PMT 621110 104876 104876 OTHER REVENUE 900099 10022 10022 57676246 74992 74992 1876959 1668195 208764 208764 208764 5292653 5240476 52177 52177 52177 58606727 56793963 882283 335933 X 275621 275621 21173511 19479630 1693881 340425 313191 27234 2058446 1893770 164676 1953970 1797652 156318 90439 90439 8208 8208 9223756 8485856 737900 1161243 1068344 92899 2655510 2434059 221451 165676 152422 13254 1477189 1359014 118175 MEDICAL AND DRUGS 11194283 11194283 ASSESSMENT EXPENSE 9912697 9119681 793016 REPAIR AND MAINTENANCE 1120491 1030852 89639 62811465 58328754 4482711 0 4279 2300 73647 991178 106129 7184069 14025593 999532 765189 303794 146684 46767918 25775380 16776293 20992538 4408538 5246781 57160322 22415326 87016603 64585589 6367422 5370504 634112 15184523 13184523 25268086 4930480 47454143 23485507 X 37062081 39147170 2500379 1952912 39562460 41100082 87016603 64585589 X -4204738 735001 5007359 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 8208 8208 0 PART II-B, LINE 1: OTHER LOBBYING ACTIVITIES: THE HOSPITAL IS A MEMBER OF THE HOSPITAL ASSOCIATION OF PENNSYLVANIA, HOSPITAL COUNCIL OF WESTERN PA ("HAP"), AS SUCH, A PERCENTAGE OF DUES IS EXPENDED ON LOBBYING ACTIVITIES. IT IS ESTIMATED THAT $8,208 OF THE DUES PAID WAS USED BY HAP FOR LOBBYING ACTIVITIES. 1705073 107738 1812811 2126131 -421058 1705073 1876612 249519 2126131 1876855 -243 1876612 1806323 70532 1876855 0.95000 0.05000 0 0 1141612 1141612 20686108 9863629 10822479 3282970 1550490 1732480 14774276 13808780 965496 6882952 552481 6330471 20992538 INTERCOMPANY RECIEVABLES 18015720 INVESTMENTS IN AFFILIATES 3251090 RENT RECEIVABLE 514429 OTHER ASSETS 491100 ROU ASSET 142987 22415326 INTERCOMPANY PAYABLE 2704482 CURRENT PORITON OF LT DEBT 1000000 MALPRACTICE CLAIMS 1080644 CURRENT PORTION OF CAPITAL LEASES 145354 4930480 X PART V, LINE 4: ENDOWMENT FUNDS: J.C. BLAIR MEMORIAL HOSPITAL HAS RECORDED ON ITS BALANCE SHEET ITS INTEREST IN THE NET ASSETS OF THE J.C. BLAIR MEMORIAL HOSPITAL FOUNDATION. THE AMOUNT IS REPORTED ABOVE AND CATEGORIZED AS A TERM ENDOWMENT. THE FOUNDATION TRANSFERS FUNDS RAISED TO THE HOSPITAL FOR THE PURCHASE OF EQUIPMENT AND BUILDING IMPROVEMENTS. FUNDS RAISED AND NOT YET TRANSFERRED ARE REPORTED AS INTEREST IN NET ASSETS OF THE FOUNDATION. PART X, LINE 2: UNCERTAIN TAX POSITIONS: JC BLAIR MEMORIAL HOSPITAL IS INCLUDED IN PENN HIGHLANDS HEALTHCARE'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS. THE FOLLOWING NARRATIVE IS THE FOOTNOTE FROM THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS: THE SYSTEM AND ITS SUBSIDIARIES HAVE GENERALLY BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501 OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. HOWEVER, THESE ENTITIES ARE SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THE SYSTEM CONSOLIDATES CERTAIN ENTITIES, WHICH ARE ORGANIZED AS CORPORATIONS AND SUBJECT TO FEDERAL AND STATE INCOME TAXES ON RELATED INCOME. OTHER CONSOLIDATED AFFILIATES HAVE ELECTED TO BE TAXED AS A PARTNERSHIP UNDER PROVISIONS OF THE INTERNAL REVENUE CODE AND A SIMILAR SECTION OF THE STATE INCOME TAX LAW. THEREFORE, TAXABLE INCOME OR LOSS IS REPORTED TO THE INDIVIDUAL MEMBERS FOR INCLUSION IN THEIR RESPECTIVE TAX RETURNS. TO THE EXTENT THAT THE OPERATIONS OF THE PARTNERSHIP ENTITIES ARE RELATED TO THE SYSTEM'S TAX-EXEMPT PURPOSE, ITS INCOME WILL BE EXEMPT FROM INCOME TAXES. THE SYSTEM AND ITS SUBSIDIARIES ACCOUNT FOR UNCERTAIN TAX POSITIONS USING A TWO-STEP APPROACH FOR RECOGNIZING AND MEASURING TAX BENEFITS TAKEN, OR EXPECTED TO BE TAKEN, IN AN UNRELATED BUSINESS ACTIVITY TAX RETURN, AND DISCLOSURES REGARDING UNCERTAINTIES IN TAX POSITIONS. THE SYSTEM'S FOR-PROFIT CORPORATIONS RECOGNIZE DEFERRED TAX ASSETS AND LIABILITIES FOR THE FUTURE TAX IMPACT OF TEMPORARY DIFFERENCES BETWEEN AMOUNTS RECORDED IN THE CONSOLIDATED FINANCIAL STATEMENTS AND THEIR RESPECTIVE TAX BASES, AND THE FUTURE BENEFIT OF UTILIZING AVAILABLE NET OPERATING LOSSES. DEFERRED TAX ASSETS AND LIABILITIES ARE MEASURED USING ENACTED TAX RATES EXPECTED TO APPLY TO TAXABLE INCOME IN THE YEARS IN WHICH THOSE TEMPORARY DIFFERENCES ARE EXPECTED TO BE RECOVERED OR SETTLED. INCOME TAXES OF THE SYSTEM'S TAX-EXEMPT, FOR-PROFIT AND PARTNERSHIP ENTITIES ARE RECORDED IN ACCRUED EXPENSES ON THE CONSOLIDATED BALANCE SHEET. 1 1 X 1 X 1 X 1 1 1 0 0 1043001 1043001 0.01660 10749777 5849795 4899982 0.07800 11792778 5849795 5942983 0.09460 9088 9088 0.00010 2431362 1893953 537409 0.00860 2440450 1893953 546497 0.00870 14233228 7743748 6489480 0.10330 1 2869240 562054 7580624 8019220 -438596 X 1 1 1 1 JC BLAIR MEMORIAL HOSPITAL 1225 WARM SPRINGS AVENUE HUNTINGDON PA 16652 WWW.JCBLAIR.ORG 101101 X X X INPATIENT PSYCHIATRY JC BLAIR MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X X 20 1 1 0 1 X SEE PART V, SECTION C 1 21 1 SEE PART V, SECTION C 0 1 X 200.000000000000 300.000000000000 X X X X 1 1 X X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 X 0 X X X X X 1 X 0 0 J.C. BLAIR MEMORIAL HOSPITAL PART V, SECTION B, LINE 5: COMMUNITY INPUT:A COMPREHENSIVE COMMUNITY-WIDE CHNA PROCESS WAS COMPLETED FOR PENN HIGHLANDS HUNTINGDON, PREVIOUSLY JC BLAIR HEALTH SYSTEM. THE 2021 CHNA BROUGHT TOGETHER HOSPITAL AND COMMUNITY PARTNERS TO IDENTIFY AND EVALUATE THE NEEDS OF THE COMMUNITY. HOSPITAL LEADERSHIP WAS INTERESTED IN HEARING FROM KEY COMMUNITY LEADERS TO OBTAIN AN OUTSIDE PERSPECTIVE OF THE HEALTH OF THE COMMUNITY AS WELL AS HELP REACH INPUT FROM UNDERSERVED POPULATIONS. THIS WAS ACCOMPLISHED THROUGH COMMUNITY LEADER INTERVIEWS, PROVIDER SURVEYS, AND PUBLIC COMMENTARY, SELECT QUESTIONS WERE UTILIZED TO SUPPORT THE PENN HIGHLANDS HUNTINGDON CHNA. KEY STAKEHOLDERS IN THE COMMUNITY WERE IDENTIFIED TO GIVE INTERVIEWS OR PUBLIC COMMENTARY. HOSPITAL STAFF DEVELOPED THE INTERVIEW AND SURVEY QUESTIONS. THE INTERVIEWS AND SURVEYS WERE USED TO OBTAIN VITAL INFORMATION ABOUT THE COMMUNITY FROM THE SOCIAL AND HEALTH SERVICES PROVIDERS WHO SERVE THEM. THE SURVEYS WERE ACTIVE FROM DECEMBER 2020 TO FEBRUARY 2021. FEEDBACK FROM 26 COMMUNITY STAKEHOLDERS WAS COLLECTED. THE HOSPITAL IDENTIFIED TARGET STAKEHOLDERS TO BE INTERVIEWED. DEVELOPED THE STAKEHOLDER INTERVIEW GUIDE AND CREATED ALL DATA COLLECTION TOOLS. INTERVIEW QUESTIONS INCLUDED THE FOLLOWING TOPICS: TOP COMMUNITY HEALTH NEEDS, ENVIRONMENTAL FACTORS DRIVING THE NEEDS, EFFORTS CURRENTLY UNDERWAY TO ADDRESS NEEDS AND ADVICE FOR THE HOSPITAL. J.C. BLAIR MEMORIAL HOSPITAL PART V, SECTION B, LINE 6A: CHNA CONDUCTED WITH OTHER HOSPITAL FACILITIES:- PENN HIGHLANDS BROOKVILLE- PENN HIGHLANDS CLEARFIELD- PENN HIGHLANDS DUBOIS- PENN HIGHLANDS ELK- PENN HIGHLANDS TYRONE SCHEDULE H, PART V, SECTION B, LINE 7AWEBSITE WHERE CHNA IS AVAILABLE:HTTPS://WWW.PHHEALTHCARE.ORG/HEALTH-WELLNESS/CHNA-PLANS-2021SCHEDULE H, PART V, SECTION B, LINE 10AWEBSITE WHERE IMPLEMENTATION STRATEGY IS AVAILABLE:HTTPS://WWW.PHHEALTHCARE.ORG/HEALTH-WELLNESS/CHNA-PLANS-2021 J.C. BLAIR MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: ADDRESSING IDENTIFIED NEEDS:PENN HIGHLANDS HUNTINGDON DEVELOPED SPECIFIC GOALS AND STRATEGIES FOR THEIR 2021 CHNA IMPLEMENTATION PLAN BASED ON THE IDENTIFIED PRIORITIES. THE HEALTH SYSTEM LEVERAGED ITS STRENGTHS AND RESOURCES AND WORKED COLLABORATIVELY WITH ITS COMMUNITY PARTNERS TO ADDRESS THE IDENTIFIED NEEDS. THE IMPLEMENTATION PLAN INCLUDES MEASURES, STRATEGIES AND GOALS AS TO HOW THE HEALTH SYSTEM ADDRESSES PRIORITY AREAS.PENN HIGHLANDS HUNTINGDON IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITY AND WORKS DILIGENTLY WITH PUBLIC HEALTH AGENCIES AND COMMUNITY ORGANIZATIONS TO IMPLEMENT RELEVANT AND EFFECTIVE STRATEGIES TO ADDRESS THE IDENTIFIED AREAS OF NEED. THE HOSPITAL ROUTINELY EVALUATES PROGRESS AND ADJUSTS THEIR PLAN AS NEEDED TO BEST MEET THE NEEDS OF THE COMMUNITY. WHEREVER POSSIBLE THE HOSPITAL COLLABORATES WITH COMMUNITY AGENCIES TO BUILD ON CORE STRENGTHS AND LEVERAGE COMMUNITY ASSETS. TO STRENGTHEN THE HEALTH AND VITALITY OF THE COMMUNITY, THE FOLLOWING ACTIONS WERE TAKEN:- DEVELOP EFFECTIVE COMMUNICATION STRATEGIES TO SHARE THE RESULTS OF THE CHNA WITH STAFF, PROVIDERS, LEADERSHIP, BOARD, COMMUNITY STAKEHOLDERS AND THE COMMUNITY AT LARGE.- CONTINUE TO WORK WITH COMMUNITY PARTNERS TO IDENTIFY AND LEVERAGE EXISTING COMMUNITY RESOURCES AND IDENTIFY OPPORTUNITIES FOR COLLABORATION.- MAINTAIN ONGOING MEETINGS WITH THE CHNA STEERING COMMITTEE TO EVALUATE PROGRESS MADE TOWARDS THE IMPLEMENTATION PLAN AS WELL AS STRENGTHEN WORKING RELATIONSHIPS AND SYNERGIES AMONG PROVIDERS.- CREATE IMPLEMENTATION STRATEGY TEAMS TO DEVELOP THE CHNA IMPLEMENTATION PLAN WHICH WILL ADDRESS KEY AREAS OF NEED AND PRIORITIES IDENTIFIED DURING THE CHNA PROCESS.- UTILIZE COMMUNITY STAKEHOLDERS AND REGIONAL PARTNERS WHEN POSSIBLE TO HELP ADDRESS IDENTIFIED NEEDS IN THE COMMUNITY.- ROUTINELY EVALUATE THE GOALS AND STRATEGIES OUTLINED IN THE CHNA IMPLEMENTATION PLAN AND ADJUST AS NEEDED TO ENSURE THE NEEDS OF THE COMMUNITY ARE BEING MET.SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, & 16CFINANCIAL ASSISTANCE POLICY APPLICATION FORM AVAILABILITY:FAP, FAP APPLICATION, PLAIN LANGUAGE SUMMARY:HTTPS://WWW.PHHEALTHCARE.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE-POLICYSCHEDULE H, PART V, SECTION B, LINE 16ILEP TRANSLATION:THERE ARE NO GROUPS WITH LIMITED ENGLISH PROFICIENCY THAT RISE TO THE THRESHOLD REQUIRED UNDER THE IRC SECTION 501(R). HOWEVER, THE ORGANIZATION HAS A CONTRACT WITH A TRANSLATIONS SERVICE PROVIDERS. J.C. BLAIR MEMORIAL HOSPITAL PART V, SECTION B, LINE 16J: FAP AVAILABILITY:FINANCIAL COUNSELORS DISCUSS THE AVAILABILITY OF DISCOUNTED AND CHARITY CARE INDIVIDUALLY WITH PATIENTS. J.C. BLAIR MEMORIAL HOSPITAL 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. 3 1 - CONVENIENT CARE CENTER 7651 RAYSTOWN SHOPPING CENTER DR HUNTINGDON PA 16652 HEALTH CLINIC LAB & DIAGNOSTIC TESTING 2 - 611 MRI 611 UNIVERSITY DRIVE STATE COLLEGE PA 16801 MRI, CT, X-RAY DIGITAL MAMMOGRAPHY CENTER 3 - ORBISONIA QUICK LAB 626 WATER ST 1 ORBISONIA PA 17243 LAB 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. PART I, LN 7 COL(F): PERCENT OF TOTAL EXPENSES:THE PERCENT OF TOTAL EXPENSES ON SCHEDULE H, PART I, LINE 7, COLUMN (F), WAS CALCULATED USING TOTAL EXPENSES ON FORM 990, PART IX, LINE 25, COLUMN (A). PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIES:MAJOR RENOVATION OF THE 3RD FLOOR OF THE MAIN HOSPITAL BUILDING TO UPDATE AND INCREASE CAPACITY FOR BEHAVIORAL HEALTH SERVICES AND INFUSION/ONCOLOGY SERVICES. THESE ACTIVITIES HELP THE HOSPITAL MAKE HIGH QUALITY HEALTHCARE ACCESSIBLE TO RESIDENTS OF HUNTINGDON COUNTY. PART III, LINE 2: BAD DEBT EXPENSE METHODOLOGY:THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE 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, 2023. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2. PART III, LINE 3: BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE:THE SYSTEM HAS DETERMINED IT HAS PROVIDED IMPLICIT PRICE CONCESSIONS TO UNINSURED PATIENTS AND PATIENTS WITH OTHER UNINSURED BALANCES SUCH AS COPAYS AND DEDUCTIBLES. THE IMPLICIT PRICE CONCESSIONS INCLUDED IN ESTIMATING THE TRANSACTION PRICE REPRESENT THE DIFFERENCE BETWEEN AMOUNTS BILLED TO PATIENTS AND THE AMOUNTS THE SYSTEM EXPECTS TO COLLECT BASED ON ITS COLLECTION HISTORY WITH THOSE PATIENTS. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE FOR FINANCIAL REPORTING. LINE 3 REPORTS THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS FROM THE INTERNAL FINANCIAL STATEMENTS. BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING POVERTY LIMIT DEMOGRAPHIC INFORMATION OBTAINED THROUGH THE US CENSUS BUREAU. PART III, LINE 4: BAD DEBT EXPENSE FOOTNOTE:THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBE BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE, THAT NOTE CAN BE FOUND ON THE ATTACHED AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: 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.ORGANIZATION USES INFORMATION FROM THE MEDICARE COST REPORT TO COMPUTE THE MEDICARE ALLOWABLE COSTS OF CARE ON LINE 6. PART III, LINE 9B: COLLECTION POLICY:IF A PATIENT IS DETERMINED TO BE FINANCIALLY INDIGENT, THE CREDIT DEPARTMENT WILL ASSIST THE PATIENT IN APPLYING FOR OTHER FINANCIAL ASSISTANCE SUCH AS STATE AND FEDERAL PROGRAMS, CIVIC ORGANIZATIONS, REHABILITATION PROGRAMS, RELIGIOUS ORGANIZATIONS, RELATIVES OR FRIENDS. IF NO SOURCE OF FINANCIAL ASSISTANCE IS AVAILABLE, THE HOSPITAL WILL REVIEW THE ACCOUNT FOR A CHARITY ALLOWANCE ONLY ON THE CURRENT ACCOUNT. NO BAD DEBT ACCOUNTS WILL BE INCLUDED IN THIS REVIEW. ALL CHARITY ALLOWANCES MUST BE APPROVED BY THE CHIEF FINANCIAL OFFICER OR DELEGATED REPRESENTATIVE. PART VI, LINE 2: NEEDS ASSESSMENT: IN ADDITION TO THE CHNA THAT WAS COMPLETED IN MAY 2021, THE ORGANIZATION RECEIVES INFORMATION FROM COMMUNITY MEMBERS ON THE BOARD AND FROM THE LOCAL AUXILIARY. WE ALSO MEET FROM TIME TO TIME WITH COMMUNITY MEMBERS TO ADDRESS CERTAIN NEEDS AS THEY ARISE. WE ARE ALWAYS OPEN TO LISTENING TO ANY CONCERNS OF COMMUNITY MEMBERS AND/OR ORGANIZATIONS. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:IN ORDER TO BE ELIGIBLE FOR CHARITY CARE, A PATIENT WHO DOES NOT HAVE HEALTH INSURANCE MUST COMPLETE AN APPLICATION FOR MEDICAL ASSISTANCE AND BE DENIED COVERAGE. SUCH PATIENTS, DESIGNATED AS SELF-PAY, ARE OFFERED ASSISTANCE BY OUR SELF-PAY FINANCIAL COUNSELORS. IN COMPLETING APPLICATIONS FOR MEDICAL ASSISTANCE COUNSELORS FOLLOW UP WITH PATIENTS. IF APPLICATIONS ARE NOT COMPLETED OR INFORMATION IS NOT RETURNED THE HOSPITAL ALSO HAS ACCESS TO LIMITED FUNDS (THE INCOME FROM A TRUST WHICH HAS BEEN DESIGNATED TO BE USED FOR CHARITY CARE). APPLICANTS FOR CHARITY CARE ARE SCREENED FOR ELIGIBILITY FOR THIS PROGRAM. IN ADDITION, A RESTRICTED DONATION FROM A COMMUNITY MEMBER HAS PROVIDED FOR PAYMENT FOR HEALTH CARE SERVICES WHICH ARE NOT ELIGIBLE FOR ANY OTHER PROGRAMS OR INSURANCE COVERAGES. A GENEROUS AMOUNT OF $10,000 HAS ALREADY PROVIDED COVERAGE FOR COSTS OF CARE FOR SEVERAL PATIENTS FOR NEEDED SERVICES. PATIENT BROCHURES ARE PROVIDED TO EXPLAIN THE AVAILABILITY OF ASSISTANCE AND CHARITY CARE PROGRAMS. THE FEDERAL POVERTY LEVEL GUIDELINES WITH OUR 250% MULTI PLIER ARE POSTED IN LOCATIONS FREQUENTED BY PATIENTS, SUCH AS THE EMERGENCY DEPARTMENT AND REGISTRATION AREAS. IF A PATIENT IS SELF PAY AT THE TIME OF REGISTRATION, THE REGISTRATION CLERK NOTIFIES A PATIENT FINANCIAL COUNSELOR AND PROVIDES THE PATIENT WITH A FINANCIAL ASSISTANCE PROGRAM LETTER. THE PROGRAM LETTER OFFERS A 20% SELF PAY DISCOUNT PROGRAM AND CHARITY CARE PROGRAM OUTLINE PATIENT COUNSELORS ADVISE AND ASSIST WITH THE APPLICATION PROCESS. TO APPLY FOR CHARITY CARE, THE PATIENT MUST FIRST APPLY FOR MEDICAL ASSISTANCE THIS PROCESS CAN TAKE UP TO 30 DAYS FOR MEDICAL ASSISTANCE APPROVAL OR DENIAL. IF MEDICAL ASSISTANCE COVERAGE IS DENIED, THE PATIENT IS ASKED TO CONTACT THE PATIENT COUNSELOR FOR ASSISTANCE WITH COMPLETING THE CHARITY CARE APPLICATION, OR TO HAVE THE APPLICATION MAILED OUT TO THE PATIENT. ONCE THE PATIENT IS DETERMINED TO BE ELIGIBLE, THE PATIENT IS ISSUED AN IDENTIFICATION CARD, WHICH THEY MAY PRESENT AT FUTURE VISITS TO VALIDATE THEY HAVE BEEN DETERMINED. TO BE ELIGIBLE FOR CHARITY CARE ELIGIBILITY MUST BE RENEWED EVERY SIX MONTHS. THE HOSPITAL IS CURRENTLY DEVELOPING A NEW BROCHURE WHICH DESCRIBES THE CHARITY PROGRAM ALONG WITH OTHER FINANCIAL POLICIES, SUCH AS PROMPT PAYMENT DISCOUNTS AND ELIGIBILITY FOR PAYMENT PLANS AND GRANT FUNDED CARE. PART VI, LINE 4: COMMUNITY INFORMATION:PENN HIGHLANDS HUNTINGDON IS THE HEALTHCARE LEADER IN HUNTINGDON COUNTY, SERVING THE COMMUNITY'S HEALTHCARE NEEDS AND STRIVING TO DELIVER THE BEST OUTCOME FOR EVERY PATIENT FOR OVER 100 YEARS. THE HOSPITAL IS THE ONLY HOSPITAL IN RURAL HUNTINGDON COUNTY, SERVING OVER 45,000 COUNTY RESIDENTS SPREAD ACROSS MANY SMALL BOROUGHS AND VILLAGES. THE HOSPITAL'S REGION INCLUDES BEDFORD, BLAIR, HUNTINGDON, JUNIATE AND MIFFLIN COUNTIES. THERE ARE A NUMBER OF AMISH AND MENNONITE SETTLEMENTS IN THE REGION. THE COMMUNITIES IN THE PRIMARY SERVICE AREA ARE HUNTINGDON, SMITHFIELD, MOUNT UNION, ALEXANDRIA, ORBISONIA, PETERSBURG, THREE SPRINGS, MAPLETON DEPOT, JAMES CREEK AND MILL CREEK. A NUMBER OF SMALL COMMUNITIES MAKE UP THE SECONDARY SERVICE AREA. ACCORDING TO THE MOST RECENTLY COMPLETED CHNA, 9.5% OF THE POPULATION LIVES BELOW THE FEDERAL POVERTY LEVEL. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:THE GOVERNING BODY IS REPRESENTATIVE OF THE COMMUNITIES IN THE PRIMARY AND SECONDARY SERVICE AREAS OF THE HOSPITAL.PENN HIGHLANDS HUNTINGDON IS A SMALL, RURAL HOSPITAL THAT IS NOT ENGAGED IN RESEARCH, BUT IT DOES ALLOCATE FUNDS ANNUALLY FOR THE UPGRADE OF PATIENT CARE EQUIPMENT AND FOR EXPENDITURES IN TECHNOLOGY OR FACILITIES TO IMPROVE THE SAFETY AND CARE OF PATIENTS RECENT EXAMPLES OF PURCHASES AND UPGRADES ARE A NEW DIGITAL MAMMOGRAPHY SYSTEM, ORTHOPEDIC SURGERY EQUIPMENT, STEREOTACTIC SPECIMEN IMAGING SYSTEM, AND A DIETARY TRAYLINE SYSTEM RECENT TECHNOLOGY INVESTMENTS INCLUDE NURSING DOCUMENTATION, ELECTRONIC MEDICATION ADMINISTRATION RECORD AND BEDSIDE MEDICATION VERIFICATION. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM:PENN HIGHLANDS HUNTINGDON IS PART OF PENN HIGHLANDS HEALTHCARE (PHH, SYSTEM). PHH IS A NOT-FOR-PROFIT CORPORATION ORGANIZED TO COORDINATE AND MANAGE THE INTEGRATION OF THE DELIVERY OF HEALTHCARE SERVICES TO THE NORTH CENTRAL PENNSYLVANIA AREA. THE SYSTEM INCLUDES THE CONSOLIDATED FINANCIAL STATEMENTS OF PENN HIGHLANDS HEALTHCARE, PENN HIGHLANDS DUBOIS, PENN HIGHLANDS ELK, PENN HIGHLANDS CLEARFIELD, PENN HIGHLANDS TYRONE, PENN HIGHLANDS MON VALLEY AND PENN HIGHLANDS CONNELLSVILLE.THE PENN HIGHLANDS HUNTINGDON PORTION OF THE PHH SYSTEM INCLUDES THE FOLLOWING ENTITIES AND OPERATIONS:-PENN HIGHLANDS HUNTINGDON PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT, EMERGENCY CARE SERVICES AND URGENT CARE SERVICES TO FURTHER THE HEALTH AND WELLNESS OF RESIDENTS IN HUNTINGDON, PENNSYLVANIA, AND SURROUNDING AREAS.-PENN HIGHLANDS HUNTINGDON FOUNDATION EARNS REVENUE THROUGH FUNDRAISING TO SUPPORT HEALTH CARE PROGRAMS OF PENN HIGHLANDS HUNTINGDON.THE PENN HIGHLANDS DUBOIS PORTION OF THE PHH SYSTEM INCLUDES THE FOLLOWING ENTITIES AND OPERATIONS:-DUBOIS REGIONAL MEDICAL CENTER (DRMC) PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES TO RESIDENTS IN DUBOIS, PENNSYLVANIA, AND SURROUNDING AREAS.-BROOKVILLE HOSPITAL (BROOKVILLE), A CRITICAL ACCESS HOSPITAL IN BROOKVILLE, PENNSYLVANIA. BROOKVILLE EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES.-BROOKVILLE INCLUDES BROOKCARE, A CORPORATION WHOSE PRIMARY BUSINESS IS TO RENT OFFICE SPACE TO PHYSICIANS AND VARIOUS DEPARTMENTS OF BROOKVILLE HOSPITAL.-JEFFCO HEALTH SERVICES, A POST-ACUTE HEALTHCARE SERVICE PROVIDER.-DUBOIS MEDICAL RISK RETENTION GROUP (DMRRG), PROVIDES LIABILITY INSURANCE TO DUBOIS COMPANIES AS WELL AS EMPLOYEE HEALTH INSURANCE FOR THE SYSTEM. DUBOIS IS THE SOLE MEMBER OF THE CLASS A VOTING AND PARTICIPATING CERTIFICATES OF DMRRG.-DUBOIS REGIONAL MEDICAL GROUP (DRMG), PROVIDES PRIMARY CARE AND SPECIALTY PHYSICIAN SERVICES.-WRC SENIOR SERVICES IS A HOUSING, HEALTHCARE, AND RESIDENT SERVICE PROVIDER IN WESTERN PENNSYLVANIA.-WRC PENNSYLVANIA MEMORIAL HOME, A CORPORATION THAT OWNS AND OPERATES A CONTINUING CARE RETIREMENT COMMUNITY.-WRC HEALTH CARE SUPPORTIVE SERVICES, A HOME AND COMMUNITY-BASED SERVICES PROVIDER.-WRC NORTH FORK HEIGHTS, A HOUSING PROJECT FOR LOW-INCOME ELDERLY INDIVIDUALS REGULATED BY THE UNITED STATES DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT (HUD).THE PENN HIGHLANDS ELK (ELK) PORTION OF THE PHH SYSTEM INCLUDES THE FOLLOWING ENTITIES AND OPERATIONS:-ELK REGIONAL HEALTH CENTER (ELK) PROVIDES PRIMARY ACUTE CARE MEDICAL SERVICES AT TWO CAMPUSES, THE ST. MARYS HEALTH CENTER IN ST. MARYS, PENNSYLVANIA, AND THE RIDGWAY HEALTH CENTER IN RIDGWAY, PENNSYLVANIA.-COMMUNITY NURSES, INC. AND SUBSIDIARIES (COMMUNITY NURSES), IS COMPRISED OF COMMUNITY NURSES HOME HEALTH AND HOSPICE, INC., WHICH PROVIDES SKILLED NURSING, PROFESSIONAL HOME HEALTH AND HOSPICE SERVICES, HOME HEALTH AIDE, PHYSICAL THERAPY, SPEECH THERAPY AND OCCUPATIONAL THERAPY; COMMUNITY NURSES HOME HEALTH SUPPORT SERVICES, INC., WHICH PROVIDES VARIOUS NONPROFESSIONAL HOME HEALTH RELATED SUPPORTIVE SERVICES, AND HELPMATES WHICH PROVIDES PRIVATE DUTY HOME COMPANION, RESPITE, PERSONAL CARE AND HOMEMAKER SERVICES.-ELK REGIONAL PROFESSIONAL GROUP, INC., IS COMPRISED OF VARIOUS PHYSICIAN PRACTICES. -ELCO HOUSING, INC., WAS FORMED TO OPERATE EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF AND TO CARRY OUT THE PURPOSES OF ELK BY SERVING AS A GENERAL PARTNER IN ELCO GLEN LIMITED PARTNERSHIP, THE PURPOSE OF WHICH IS TO ACQUIRE, CONSTRUCT, PROVIDE AND OPERATE RENTAL HOUSING AND RELATED FACILITIES SUITED TO THE NEEDS AND LIVING REQUIREMENTS OF ELIGIBLE OCCUPANTS AS DETERMINED BY THE FARMERS HOME ADMINISTRATION (FMHA).-ELK VENTURES, LLC (ELK VENTURES), A SINGLE MEMBER LLC OF ELK REGIONAL HEALTH CENTER, WAS FORMED TO OPERATE EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF AND TO CARRY OUT THE PURPOSES OF ELK.THE PENN HIGHLANDS CLEARFIELD (CLEARFIELD) PORTION OF THE PHH SYSTEM INCLUDES THE FOLLOWING ENTITIES AND OPERATIONS:-CLEARFIELD HOSPITAL PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES TO PATIENTS IN CLEARFIELD COUNTY AND THE SURROUNDING AREAS.-CLEARFIELD MEDICAL ASSOCIATES (CMA), OWNS AND OPERATES THE MEDICAL ARTS BUILDING LOCATED ON CLEARFIELD HOSPITAL'S CAMPUS.-CLEAR-CARE CORPORATION (CLEAR-CARE), PROVIDES MEDICAL EQUIPMENT TO CUSTOMERS.THE PENN HIGHLANDS TYRONE PORTION OF THE PHH SYSTEM INCLUDES THE FOLLOWING ENTITIES AND OPERATIONS:-TYRONE HOSPITAL WHICH PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE HOSPITAL SERVICES.-TYRONE FOUNDATION WHICH PROVIDES SUPPORT.THE PENN HIGHLANDS MON VALLEY PORTION OF THE PHH SYSTEM INCLUDED THE FOLLOWING ENTITIES AND OPERATIONS:-MON VALE HOSPITAL WHICH PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE HOSPITAL SERVICES.-MONONGAHELA VALLEY HOSPITAL FOUNDATION WHICH PROVIDES SUPPORT.THE PENN HIGHLANDS CONNELLSVILLE PORTION OF THE PHH SYSTEM INCLUDES THE FOLLOWING ENTITIES AND OPERATIONS:-HIGHLANDS HOSPITAL WHICH PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE HOSPITAL SERVICES;-HIGHLANDS FOUNDATION WITH PROVIDES SUPPORT. PART VI, LINE 7, REPORTS FILED WITH STATES PA X X X 0 0 0 0 0 0 0 1 0 JOSEPH MYERS PRESIDENT 248130 0 10000 0 830 0 10000 0 3159 0 272119 0 0 0 MUHAMMAD QAMAR PSYCHIATRIST 156631 0 0 0 1243 0 0 0 21168 0 179042 0 0 0 TODD FORTNEY PHARMACIST 138318 0 1600 0 91 0 0 0 16560 0 156569 0 0 0 PART I, LINE 7 THE ORGANIZATION REPORTED AMOUNTS ON SCHEDULE J, PART II, COLUMN B(II) THAT QUALIFY AS NON-FIXED PAYMENTS. WHILE THE AMOUNTS ARE BASED ON CERTAIN PRESET METRICS, THERE IS DISCRETION OVER DECIDING WHETHER TO MAKE THE PAYMENT, AS THE AMOUNTS ARE SUBJECT TO FINAL APPROVAL. THE AMOUNT PAID TO THE PRESIDENT IS APPROVED BY THE BOARD, WHILE THE AMOUNT PAID TO THE PHARMACIST IS APPROVED BY THE PRESIDENT. PART 990, PART III, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: VISION - TO BE A MODEL OF EXCELLENCE FOR THE PROVISION OF A COMPREHENSIVE RANGE OF HEALTHCARE AND WELLNESS SERVICES DESIGNED TO CONTINUALLY IMPROVE THE HEALTH STATUS AND QUALITY OF LIFE FOR THE RESIDENTS OF HUNTINGDON COUNTY AND NEARBY COMMUNITIES. FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS: THE HOSPITAL CONTRIBUTED A GREAT DEAL IN COMMUNITY BENEFIT PROGRAMS THAT INCLUDED THOUSANDS OF HOURS OF VOLUNTEER SERVICE PROVIDING FREE EDUCATION AND SCREENING PROGRAMS, MENTORING FUTURE HEALTH CARE PROFESSIONALS, PROVIDING LEADERSHIP SERVICE TO COMMUNITY ORGANIZATIONS, AND CONTRIBUTING FINANCIAL AND IN-KIND SUPPORT TO A NUMBER OF LOCAL INITIATIVES. THESE PROGRAMS INCLUDED: FREE DIABETES SELF-MANAGEMENT CLASSES, FREE BREAST-FEEDING EDUCATION AND CONSULTING FOR NEW MOTHERS, FREE NEWBORN SAFETY KITS, FREE YEAR ROUND EDUCATIONAL PROGRAMS ON NUTRITION, HEART HEALTH, BREAST HEALTH, ETC., FREE OSTEOPOROSIS SCREENINGS, PARTICIPATION IN NUMEROUS HEALTH FAIRS THROUGHOUT THE COUNTY, AND ANNUAL WELLNESS CHECK COMPREHENSIVE BLOOD SCREENINGS. OUR COMMUNITY BENEFIT PROGRAMS ARE ALL FOCUSED ON THE GOALS, STRATEGIES, AND ACTION PLANS OUTLINED IN OUR COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN. FORM 990, PART VI, SECTION A, LINE 4 PENN HIGHLANDS HUNTINGDON REVISED ITS BYLAWS IN OCTOBER 2022 AND HAS MADE SEVERAL SIGNIFICANT CHANGES TO ITS BYLAWS, AS DEFINED BY THE IRS INSTRUCTIONS. THESE CHANGES ARE SUMMARIZED BELOW: BOARD OF DIRECTORS: THE NUMBER OF DIRECTORS HAS BEEN ADJUSTED FROM A MINIMUM OF 12 AND A MAXIMUM OF 19 TO NO MORE THAN 16, INCLUDING ACTIVE MEDICAL STAFF MEMBERS. 2 MEMBERS OF THE MEDICAL STAFF IN GOOD STANDING, THE CHIEF OF STAFF, THE VICE CHIEF OF STAFF, AND A MEMBER OF THE PHHD AUXILIARY WERE REMOVED AS EX-OFFICIO DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS: EFFECTIVE JUNE 1, 2019, PENN HIGHLANDS HEALTHCARE EXECUTED AN ACQUISITION WITH J.C. BLAIR HOSPITAL AND RELATED ENTITIES. AS PART OF THE AGREEMENT, PENN HIGHLANDS HEALTHCARE BECAME THE SOLE MEMBER OF J.C. BLAIR MEMORIAL HOSPITAL AND RELATED ENTITIES. IN ITS CAPACITY AS SOLE MEMBER OF J.C. BLAIR MEMORIAL HOSPITAL, PENN HIGHLANDS HEALTHCARE HAS THE RIGHT TO, AMONG OTHER THINGS, APPOINT TRUSTEES, APPROVE MAJOR EXPENDITURES, AND APPROVE LONG-TERM BORROWING. FORM 990, PART VI, SECTION A, LINE 7A SEE LINE 6 NARRATIVE ABOVE. FORM 990, PART VI, SECTION A, LINE 7B SEE LINE 6 NARRATIVE ABOVE. FORM 990, PART VI, SECTION A, LINE 8B THE GOVERNING BODY HAS NOT AUTHORIZED ANY COMMITTEES TO ACT ON ITS BEHALF. 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 DRAFT FORM 990 IS REVIEWED BY THE CFO AND THE CONTROLLER OF PENN HIGHLANDS HEALTHCARE SYSTEM. AFTER ALL SUGGESTED CHANGES FROM THE CFO AND CONTROLLER ARE MADE, THE UPDATED DRAFT FORM 990 IS PROVIDED FOR REVIEW TO THE FULL BOARD. ANY QUESTIONS OR COMMENTS FROM THE BOARD ARE ADDRESSED BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C MONITORING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY: PENN HIGHLANDS HEALTHCARE, INC. (PHH), MAINTAINS A CONFLICT OF INTEREST POLICY WHICH APPLIES TO ALL SUBSIDIARIES. THE CONFLICT OF INTEREST POLICY APPLIES TO BOARD MEMBERS, OFFICERS, EXECUTIVE EMPLOYEES, AND ANY OTHER MANAGER OR SUPERVISOR EXERCISING SUBSTANTIAL INFLUENCE OVER OPERATIONS. EACH COVERED PERSON WILL PROMPTLY AND FULLY DISCLOSE ALL MATERIAL FACTS OF EVERY ACTUAL OR POTENTIAL DUAL INTEREST EXISTING AT THE TIME WHEN HE/SHE BECOMES A COVERED PERSON, AND ANNUALLY THROUGH EACH PHH SYSTEM ENTITY'S DISCLOSURE STATEMENT, WHICH REQUESTS DISCLOSURE OF RELATIONSHIPS, INVESTMENTS, AND TRANSACTIONS THAT MAY LEAD TO AN ACTUAL CONFLICT OF INTEREST. ALL COMPLETED DISCLOSURE STATEMENTS WILL BE PROVIDED TO THE PHH GOVERNANCE/NOMINATING COMMITTEE. THIS COMMITTEE, IN CONSULTATION WITH THE CHAIRPERSON OR VICE CHAIRPERSON OF EACH PHH SYSTEM ENTITY'S BOARD, SHALL EVALUATE THE COMPLETED DISCLOSURE STATEMENTS AND DETERMINE IF THERE ARE ANY CONFLICTS THAT ARE SO PERVASIVE AS TO RENDER ANY COVERED PERSON INELIGIBLE FOR SERVICE. THE CHAIRPERSON OF EACH PHH SYSTEM ENTITY'S BOARD WILL DISCLOSE TO THE FULL BOARD OF SAID PHH SYSTEM ENTITY ALL DUAL INTERESTS REPORTED TO HIM OR HER UNDER THE POLICY AND WILL ALSO MAKE THE DISCLOSURE STATEMENTS OF ALL COVERED PERSONS AVAILABLE TO DIRECTORS AT ANY TIME DURING THE YEAR. IF A POTENTIAL DUAL INTEREST ARISES AS A RESULT OF A CONTEMPLATED PHH SYSTEM ENTITY BOARD (OR COMMITTEE) ACTION, THE CHAIRPERSON OF SAID PHH SYSTEM ENTITY'S BOARD OR THE INTERESTED PERSON SHALL, OR ANY OTHER DIRECTOR MAY, RAISE THE QUESTION OF THE INTERESTED PERSON'S DUAL INTEREST. THE DISINTERESTED MEMBERS OF THE PHH SYSTEM ENTITY'S BOARD (OR COMMITTEE) WILL EVALUATE THE DISCLOSURES AND THE MATERIAL FACTS RELATING TO THE TRANSACTION, ARRANGEMENT, OR POLICY GIVING RISE TO THE DUAL INTEREST TO DETERMINE WHETHER THEY INVOLVE ACTUAL CONFLICTS OF INTEREST AND MAY ATTEMPT TO DEVELOP ALTERNATIVES TO REMOVE THE CONFLICT FROM THE TRANSACTION, ARRANGEMENT, OR POLICY. A COVERED PERSON WHO HAS A DUAL INTEREST SHALL NOT BE PRESENT FOR OR SHALL LEAVE ANY PORTION OF A MEETING AT WHICH A PHH SYSTEM ENTITY'S BOARD (OR COMMITTEE) IS VOTING TO DETERMINE WHETHER A CONFLICT EXISTS, BUT MAY BE PRESENT PRIOR TO THE VOTE TO MAKE A PRESENTATION TO SAID BOARD (OR COMMITTEE), TO DISCLOSE ADDITIONAL FACTS, OR TO RESPOND TO QUESTIONS. IF A PHH SYSTEM ENTITY'S BOARD (OR COMMITTEE DETERMINES THAT AN ACTUAL CONFLICT OF INTEREST EXISTS, THE INTERESTED PERSON SHALL BE SO ADVISED AND THE CHAIRPERSON OF A PHH SYSTEM ENTITY'S BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE OR DIRECT MANAGEMENT TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, IF THIS HAS NOT ALREADY BEEN DONE. ANY INTERESTED PERSON WHO HAS AN ACTUAL CONFLICT OF INTEREST WITH RESPECT TO THE TRANSACTION OR ARRANGEMENT DOES NOT PARTICIPATE IN AND IS NOT PRESENT FOR THE VOTE REGARDING ANY SUCH TRANSACTION OR ARRANGEMENT. IF AN INDIVIDUAL WHOSE COMPANY OR EMPLOYER HAS A BUSINESS RELATIONSHIP WITH A PHH SYSTEM ENTITY, BUT THE INDIVIDUAL DOES NOT HAVE AN ACTUAL CONFLICT OF INTEREST WITH RESPECT TO THIS BUSINESS RELATIONSHIP, THE INDIVIDUAL MAY NONETHELESS VOLUNTARILY RECUSE HIM/HERSELF FROM VOTING ON ANY MATTERS RELATED TO THE RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 15A OFFICER COMPENSATION: COMPENSATION FOR THE CEO WAS DETERMINED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS BASED ON SALARY MARKET DATA. IF THE EXECUTIVE IS ELIGIBLE FOR A PERFORMANCE BONUS, THE CRITERIA FOR DETERMINATION OF THE BONUS IS DEVELOPED BY ESTABLISHING OBJECTIVES AND MEASUREMENTS THAT WILL INDICATE THE DEGREE TO WHICH OBJECTIVES HAVE BEEN ACCOMPLISHED. APPROVAL IS DOCUMENTED VIA COMMITTEE MINUTES. FORM 990, PART VI, SECTION B, LINE 15B: THERE WERE NO OTHER OFFICERS OR KEY EMPLOYEES COMPENSATED, THEREFORE, PART VI, LINE 15B IS ANSWERED "NO" IN ACCORDANCE WITH THE IRS INSTRUCTIONS. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENT AVAILABILITY: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 8,485,856. MANAGEMENT AND GENERAL EXPENSES 737,900. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,223,756. FORM 990, PART XI, LINE 9: OTHER CHANGES IN NET ASSETS 5,007,359. PENN HIGHLANDS HEALTHCARE PO BOX 447 DUBOIS PA 15801 320345810 MGMT SERVICES PA 501(C)(3) LINE 7 N/A 0 DUBOIS REGIONAL MEDICAL CENTER 100 HOSPITAL AVENUE DUBOIS PA 15801 251490707 HOSPITAL PA 501(C)(3) 3 PHH 1 ELCO HOUSING 759 JOHNSONBURG ROAD ST MARYS PA 15857 251639115 HOUSING PA 501(C)(3) 12 A I PHH 1 ELK REGIONAL PROFESSIONAL GROUP INC 763 JOHNSONBURG ROAD ST MARYS PA 15857 251875183 HEALTHCARE PA 501(C)(3) 3 PHH 1 COMMUNITY NURSES HOME HEALTH & HOSPICE 757 JOHNSONBURG ROAD ST MARYS PA 15857 250996070 HEALTHCARE PA 501(C)(3) 10 CNI 1 COMMUNITY NURSES INC 757 JOHNSONBURG ROAD STE 200 ST MARYS PA 15857 251623598 HEALTHCARE PA 501(C)(3) 10 PHH 1 COMMUNITY NURSES HOME SUPPORT SERVICES 757 JOHNSONBURG ROAD ST MARYS PA 15857 251623601 HEALTHCARE PA 501(C)(3) 10 CNI 1 DRMC EMPLOYEE BENEFITS PLAN TRUST 100 HOSPITAL AVENUE DUBOIS PA 15810 256332829 DRMC EMP BENE PA 501(C)(9) DRMC 1 JEFFCO HEALTH SERVICES INC 417 ROUTE 28 BROOKVILLE PA 15825 251505478 HEALTHCARE PA 501(C)(3) 10 BROOKVILLE 1 JC BLAIR MEMORIAL HOSPITAL FOUNDATION 935 14TH STREET HUNTINGDON PA 16652 251881377 SUPPORT HOSP PA 501(C)(3) 12 A I PHH 1 DRMC WORKERS COMPENSATION TRUST PO BOX 447 DUBOIS PA 15801 251741497 SUPPORT HOSP PA 501(C)(3) 12 B II DRMC 1 HELPMATES INC 757 JOHNSONBURG RD ST MARYS PA 15857 251555968 HEALTHCARE PA 501(C)(3) 10 CNI 1 PENN HIGHLANDS TYRONE 187 HOSPITAL DRIVE TYRONE PA 16686 231440116 HOSPITAL PA 501(C)(3) 3 PHH 1 TYRONE REGIONAL HEALTH NETWORK FOUNDATIO 187 HOSPITAL DRIVE TYRONE PA 16686 814504606 SUPPORT PA 501(C)(3) 12 A I PH TYRONE 1 HIGHLANDS HOSPITAL 401 EAST MURPHY AVENUE CONNELSVILLE PA 15425 251494705 HOSPITAL PA 501(C)(3) 3 PHH 1 HIGHLANDS HOSPITAL FOUNDATION 401 EAST MURPHY AVENUE CONNELSVILLE PA 15425 843713870 SUPPORT HOSP PA 501(C)(3) 12 A I PHH 1 WRC HEALTH CARE SUPPORT SERVICES 985 ROUTE 28 BROOKVILLE PA 15825 251601734 HEALTHCARE PA 501(C)(3) 10 WRC SR SRVCS 1 WRC SENIOR SERVICES 985 ROUTE 28 BROOKVILLE PA 15825 251552925 HEALTHCARE PA 501(C)(3) 10 DRMC 1 WRC NORTH FORK HEIGHTS 985 ROUTE 28 BROOKVILLE PA 15825 251684846 HEALTHCARE PA 501(C)(3) 10 WRC SR SRVCS 1 WRC PENNSYLVANIA MEMORIAL HOME 985 ROUTE 28 BROOKVILLE PA 15825 250718600 HEALTHCARE PA 501(C)(3) 10 WRC SR SRVCS 1 MONONGAHELA VALLEY HOSPITAL FOUNDATION 1163 COUNTRY CLUB ROAD MONONGAHELA PA 15063 825336533 FUNDRAISING PA 501(C)(3) 12 B II PHH 1 MONONGAHELA VALLEY HOSPITAL INC 1163 COUNTRY CLUB ROAD MONONGAHELA PA 15063 237218917 HOSPITAL PA 501(C)(3) 3 PHH 1 CLEARFIELD EMS 713 W FRONT ST CLEARFIELD PA 16830 251672659 EMS SERVICE PA 501(C)(3) 10 PHH 1 BROOKVILLE HOSPITAL 100 HOSPITAL RD BROOKVILLE PA 15825 250984595 HOSPITAL PA 501(C)(3) 3 DRMC 1 ELK REGIONAL HEALTH CENTER 763 JOHNSONBURG RD ST MARYS PA 15857 250585280 HOSPITAL PA 501(C)(3) 3 PHH 1 JC BLAIR MEDICAL SERVICES INC 1225 WARM SPRINGS AVENUE HUNTINGDON PA 16652 251881378 HEALTH CARE PA PHH C 0 BENNETTS VALLEY PHARMACY PO BOX 112 ST MARYS PA 15857 251601794 PHARMACY PA N/A S 0 E NICHOLSON PHARMACY 265 ALLEGHENY BLVD BROOKVILLE PA 15825 473117408 PHARMACY PA N/A S 0 0 0 1 0 0 0 0 0 0 1 0 1 1 1 1 1 1 1 1 JC BLAIR MEMORIAL HOSPITAL FOUNDATION C 67008 COST PENN HIGHLANDS HEALTHCARE INC M 9912697 COST PENN HIGHLANDS HEALTHCARE INC O 951900 COST PENN HIGHLANDS HEALTHCARE INC Q 1900800 COST PENN HIGHLANDS HEALTHCARE INC S 7665760 COST DUBOIS REGIONAL MEDICAL CENTER S 4108259 COST