2019-05-14T07:34:21-05:00 2018-06-30 550486667 ARNETT CARBIS TOOTHMAN LLP 5700 CORPORATE DRIVE STE 650 PITTSBURGH PA 15237 990 2017-07-01 250965598 WARREN GENERAL HOSPITAL WARR 8147234973 TWO CRESCENT PARK WEST WARREN PA 16365 LOUIS LONGO CFO 8147234973 2019-05-13 1 KELLY A BROCIOUS CPA P01254262 4126356270 2019-05-08 216.12.119.47 2019-05-13 09:46:49 ED P 727D156719ABEB761CBCFA2B78989F31056D74D8 AD86F7F2406A16AC7B8A9D5584776008676296CD 2017 2019-02-21 02:37:17Z RICHARD L ALLEN TWO CRESCENT PARK WEST WARREN PA 16365 75330188 0 X WWW.WGH.ORG X 1898 PA TO PROVIDE HEALTH CARE SERVICES TO THE PUBLIC INCLUDING INPATIENT ACUTE CARE, PSYCHIATRIC CARE, 24-HR ER CARE, AND OTHER OUTPATIENT SERVICES TO WARREN AND SURROUNDING COUNTIES. 11 6 640 150 188871 187871 487534 507350 70331465 73192548 -36018 203569 1032959 1199759 71815940 75103226 5000 5000 0 0 35272144 32432987 0 0 75225 40928444 41628953 76205588 74066940 -4389648 1036286 45948658 43393169 33793550 28818212 12155108 14574957 WARREN GENERAL HOSPITAL'S MISSION IS TO PROVIDE COMMUNITY HEALTHCARE WITH QUALITY AND COMPASSION. WE STRIVE TO IMPROVE THE COMMUNITY'S HEALTH, LEAD A VISION FOR THE HEALTHCARE FUTURE, AND MAINTAIN FISCAL VIABILITY WHILE PROVIDING CORE HEALTHCARE SERVICES. 0 0 58363405 5000 73432168 THE WARREN GENERAL HOSPITAL (WGH) IS A NON-PROFIT ACUTE CARE HOSPITAL. WGH PROVIDES HEALTHCARE SERVICES TO THE PUBLIC. THESE SERVICES INCLUDE: INPATIENT ACUTE CARE AND PSYCHIATRIC CARE, 24 HOUR EMERGENCY ROOM, OUTPATIENT HOME CARE AND OTHER OUTPATIENT CARE FOR RESIDENTS OF WARREN COUNTY AND SURROUNDING AREAS. IN ADDITION, THE HOSPITAL OFFERS AN OUTPATIENT CANCER CARE CENTER TO RELIEVE THE NEED FOR RESIDENTS TO TRAVEL DURING THESE MOST DIFFICULT TIMES. THE HOSPITAL ALSO OPERATES TWO OUTPATIENT DENTAL CLINICS FOR THOSE UNDER/UNINSURED RESIDENTS IN NEED OF DENTAL SERVICES. 58363405 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 1 41 0 640 1 1 1 0 0 0 0 0 0 0 X 11 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 PA X JULIE JACOBS 8147233300 TWO CRESCENT PARK WARREN PA 16365 CARMEN N FERRANTO PRESIDENT 1.00 X X 0 0 0 TIMOTHY R BEVEVINO ESQ SECRETARY 1.00 X X 0 0 0 LISA HAGBERG TREASURER 1.00 X X 0 0 0 THAD TURNER BOARD MEMBER 1.00 X 0 0 0 GLENN FEGLEY BOARD MEMBER 1.00 X 0 0 0 GARY L MCAFOOS MD BOARD MEMBER 1.00 X 0 0 0 DAVID M MCCONNELL JR MD BOARD MEMBER 10.00 X 11680 0 0 JULIA W MCTAVISH BOARD MEMBER 1.00 X 0 0 0 TIMOTHY STANTON MD BOARD MEMBER 40.00 X 213472 0 22479 MASON TOOTELL MD BOARD MEMBER 40.00 X 235437 0 21338 TREVOR M OLSEN MD BOARD MEMBER 40.00 X 520652 0 24495 RICHARD L ALLEN CEO 40.00 1.00 X 338765 0 29698 JULIE D JACOBS CFO (UNTIL 11/27/17) 40.00 1.00 X 141397 0 9187 LOUIS LONGO CFO (FROM 11/27/17) 40.00 1.00 X 18462 0 0 JOSEPH AKIF COO/CNO 40.00 X 203992 0 22298 RANDY CALIFORNIA COO 40.00 X 205496 0 22307 BERNARD V EDEN MD PHYSICIAN 40.00 X 821239 0 26684 ANNE RASSIGA MD PHYSICIAN 40.00 X 647809 0 14679 PIERRE-JEAN LATTANZIO MD PHYSICIAN 40.00 X 561488 0 24185 SIMON AMSDELL MD PHYSICIAN 40.00 X 585774 0 17685 JUSTIN BROWER MD PHYSICIAN 40.00 X 476154 0 17685 4981817 0 252720 31 0 1 0 ASSOCIATED CLINICAL LABS 1526 PEACH STREET ERIE PA 16501 LABORATORY SERVICES 1481038 GROUP MEDICAL SERVICES CORP PO BOX 68 WARREN PA 16365 PURCHASED SERVICES 1208000 NTHRIVE INC PO BOX 733492 DALLAS TX 753733492 CODING/BILLING CLEARINGHOUSE SERVICES 833826 KING'S MEDICAL COMPANY 1920A GEORGETOWN ROAD HUDSON OH 44236 PURCHASED MEDICAL SERVICES (MRI) 559650 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 75397 PURCHASED MEDICAL SERVICES 538100 22 15830 491520 507350 PATIENT SERVICE REVENUE 623990 69920015 69920015 HOME HEALTH SERVICES 621610 3272533 3272533 73192548 350664 350664 63343 0 210438 63343 -210438 -147095 -147095 82812 15830 16524 66288 66288 VANTAGE/DEERFIELD/CHART 900099 635774 635774 CAFETERIA REVENUE 900099 239620 239620 PINE GROVE AMBULATORY SRUGICAL CE 900099 188871 188871 69206 69206 1133471 75103226 73432168 188871 974837 X 5000 5000 2041156 2041156 22347826 16885825 5443222 18779 1119946 780256 338822 868 4883217 3507853 1371463 3901 2040842 1421837 617424 1581 82374 82374 128841 128841 16081668 13304960 2776708 763388 426852 303213 33323 1662525 1662525 363946 184859 178743 344 267477 267477 2363714 2363714 1033304 1033304 MEDICAL SUPPLIES 14785525 14785525 REPAIRS & MAINTENANCE 2017233 1268586 748647 LICENSES AND FEES 1548002 112242 1435696 64 EQUIPMENT RENTALS AND L 285129 267850 17279 245827 84740 144722 16365 74066940 58363405 15628310 75225 166478 1960 40752 8868248 7731790 1798812 1464712 758467 476379 82731885 67875459 16563192 14856426 7758628 8822569 9994081 10039333 45948658 43393169 7962231 8258316 68895 70259 2378684 2119287 3528000 137099 19855740 18233251 33793550 28818212 X 4488291 6801145 2543507 2604294 5123310 5169518 12155108 14574957 45948658 43393169 X 1036286 95407 1288156 X X 0 1 X 1 0 X 5935311 5136 298052 227975 6010524 5613505 4752 541171 224117 5935311 5892957 4510 -43069 240893 5613505 11127993 21266 135091 5391393 5892957 9106171 1001118 1291010 256830 13476 11127993 0.02270 0.86010 0.11720 1 0 541959 541959 43912699 34942066 8970633 1586159 1586159 36622292 32933393 3688899 68776 68776 14856426 DUE FROM AFFILIATES 5818 OTHER ASSETS 445927 ESTIMATED INSURANCE RECOVERIES 426000 BENEFICIAL INTEREST IN TRUSTS 5456546 INTEREST IN NET ASSETS OF COMMUNITY FOUNDATION OF WARREN 136657 ASSETS LIMITED AS TO USE 2446130 ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYORS 1122255 10039333 ACCRUED POST RETIREMENT BENEFIT 7784 ACCURED PENSION COSTS 15052253 ESTIMATED INSURANCE COSTS 783000 DEFERRED COMPENSATION 2033869 CASH OVERDRAFT 356345 18233251 X PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AND IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN MADE. THE HOSPITAL FOLLOWS THE GUIDANCE FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S CONSOLIDATED FINANCIAL STATEMENTS THAT PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. THE GUIDANCE ALSO ADDRESSES DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, AND DISCLOSURE. THE HOSPITAL'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN MATERIALS, SUPPLIES, AND SERVICES EXPENSES. THERE WERE NO INTEREST OR PENALTIES RECOGNIZED ON THE CONSOLIDATED STATEMENT OF OPERATIONS AS A RESULT OF THIS GUIDANCE. GENERALLY, TAX RETURNS FOR YEARS ENDED JUNE 30, 2015, AND THEREAFTER REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. HOSPITAL BALL 18066 14480 3586 3402 600 905 GOLF OUTING 62450 1350 61100 1790 7766 1045 1 18126 18126 1016 98642 15830 82812 1790 11168 600 2966 16524 66288 1 1 X 1 X 300.000000000000 1 X 1 1 1 0 0 87906 87906 0.00120 9825985 5149874 4676111 0.06310 9913891 5149874 4764017 0.06430 67814 67814 0.00090 5000 5000 0.00010 521750 448927 72823 0.00100 594564 448927 145637 0.00200 10508455 5598801 4909654 0.06630 1 768531 76853 23684708 30039691 -6354983 X 1 1 1 PINEGROVE AMBULATORY OUTPATIENT AMBULATORY SURGERY 0.35000 0.11000 0.54000 2 MEDIPAR ASSOCIATES REAL ESTATE FOR MEDICAL BLDG 0.86000 0.14000 1 1 WARREN GENERAL HOSPITAL TWO CRESCENT PARK WEST WARREN PA 16365 WWW.WGH.ORG X X X WARREN GENERAL HOSPITAL 1 0 0 1 X X X X X X X X X 16 1 0 0 1 X WWW.WGH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT?Q=CHNA X X 1 16 1 WWW.WGH.ORG 0 1 X 300.000000000000 300.000000000000 X X X X 1 1 X X X 1 X WWW.WGH.ORG/FINANCIAL-ASSISTANCE X WWW.WGH.ORG/FINANCIAL-ASSISTANCE X WWW.WGH.ORG/FINANCIAL-ASSISTANCE X X X X X 1 X 1 X X 1 X 0 0 WARREN GENERAL HOSPITAL PART V, SECTION B, LINE 5: THE MAIN OBJECTIVE OF THE INTERACTION WITH COMMUNITY LEADERS WAS TO OBTAIN INFORMATION, KNOWLEDGE, AND IDEAS FROM BUSINESS LEADERS WITHIN THE COMMUNITY ABOUT THE IMPACT OF COMMUNITY HEALTH STATUS ON THEIR ABILITY TO OPERATE AND PROVIDE SERVICES IN WARREN COUNTY. THE DISCUSSION REVOLVED AROUND THREE BASIC QUESTIONS. THE FIRST QUESTION DEALT WITH WHAT THEIR IMPRESSION WAS OF THE ISSUES THAT WERE CURRENTLY IMPACTING THE HEALTH OF THE COMMUNITY. AFTER THIS DISCUSSION, THE GROUP REVIEWED ENVIRONMENTAL FACTORS THAT THEY FELT WERE IMPACTING THE HEALTH OF THE COMMUNITY. THE FINAL DISCUSSION RELATED TO POTENTIAL SOLUTIONS TO ADDRESS EXISTING COMMUNITY HEALTH ISSUES AND IMPROVEMENT IN THE FUTURE. PARTICIPANTS IN INTERVIEWS AND GROUP DISCUSSION:BEN KAFFERLIN, WARREN COUNTY COMMISSIONER CARMEN FERRANTO, RETIRED, CEO, WARREN STATE HOSPITALROB KAEMMERER, EXECUTIVE VICE PRESIDENT, UNITED REFINERY GLENN FEGLEY, RETIRED, CEO, ELLWOOD NATIONAL FORGEBOB SOKOLSKI, CHAIRMAN OF THE BOARD, WHIRLEY INDUSTRIESJOHN HANNA, RETIRED, CEO NORTHWEST SAVINGS BANK RICHARD ALLEN, CEO, WARREN GENERAL HOSPITALRICH HATFIELD, ALLEGHENY NATIONAL FORESTSUSAN STOUT, ALLEGHENY NATIONAL FORESTJASEN DILEY, PRESIDENT, ROUSE HOME HANK LEMEUR, CEO, SUPERIOR TIRE MIKE BARRET, CEO, ELLWOOD NATIONAL FORGETOM MCKEEVER, WARREN COUNTY CHAMBER OF BUSINESS AND INDUSTRY JULIA MCTAVISH, EVP HUMAN RESOURCE, NORTHWEST SAVINGS BANKJIM DECKER, EXECUTIVE DIRECTOR, WARREN COUNTY CHAMBER OF BUSINESS AND INDUSTRY WARREN GENERAL HOSPITAL PART V, SECTION B, LINE 7D: THE CHNA WAS AVAILABLE ON THE HOSPITAL'S WEBSITE - WWW.WGH.ORG - WAS AVAILABLE IN PAPER COPY FOR PUBLIC INSPECTION AT THE HOSPITAL, AND INFORMATION ON HOW TO ACCESS THE CHNA WAS PUBLISHED ON THE WGH QUARTERLY NEWSLETTER. WARREN GENERAL HOSPITAL PART V, SECTION B, LINE 11: THE HOSPITAL DEVELOPED AN IMPLEMENTATION PLAN TO ADDRESS THE SIGNIFICANT NEEDS IDENTIFIED THROUGH ITS CHNA. AS WITH MOST HEATH CARE FACILITIES, WARREN GENERAL HOSPITAL HAS LIMITED FINANCIAL RESOURCES TO ADDRESS ALL ISSUES IDENTIFIED IN THE CHNA. WARREN GENERAL HOSPITAL PART V, SECTION B, LINE 16J: A FINANCIAL ASSISTANCE COUNSELOR IS AVAILABLE TO SPEAK WITH ELIGIBLE INDIVIDUALS REGARDING OUR FAP. WARREN GENERAL HOSPITAL PART V, SECTION B, LINE 20E: THE HOSPITAL EMPLOYS A FINANCIAL COUNSELOR WHO SPEAKS WITH ELIGIBLE INDIVIDUALS REGARDING OUR FINANCIAL ASSISTANCE POLICY. SHE ASSISTS INDIVIDUALS IN APPLYING FOR OUR STATE MEDICAL ASSISTANCE PROGRAM. PART I, LINE 7: A COST-TO-CHARGE RATIO CALCULATED FROM WORKSHEET 2, RATIO OF PATIENT CARE COSTS-TO-CHARGES IS THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNTS REPORTED ON PART I, LINE 7. PART III, LINE 2: PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTABLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. THE ALLOWANCE FOR DOUBTFUL COLLECTIONS IS ESTIMATED BASED UPON PERIODIC REVIEW OF THE ACCOUNTS RECEIVABLE AGING, PAYOR CLASSIFICATIONS, AND APPLICATION OF HISTORICAL WRITE-OFF PERCENTAGES. PART III, LINE 3: THE HOSPITAL CALCULATED AN OVERALL COST TO CHARGE RATIO USING GROSS CHARGES AND TOTAL OPERATING COSTS LESS BAD DEBT EXPENSE. THE HOSPITAL THEN REDUCED ITS BAD DEBT EXPENSE TO COST USING THIS COST TO CHARGE RATIO. PART III, LINE 4: ESTIMATES OF ALLOWANCE FOR ADJUSTMENTS INCLUDED IN NET PATIENT SERVICE REVENUE ARE DESCRIBED IN NOTES 1 AND 2. PART III, LINE 8: THE HOSPITAL'S LARGEST GOVERNMENTAL PAYER IS THE FEDERAL MEDICARE PROGRAM. THE HOSPITAL'S COSTS ARE GREATER THAN PROGRAM REIMBURSEMENTS. IT IS CLEARLY A COMMUNITY BENEFIT FOR THE HOSPITAL TO PROVIDE RURAL ACCESS TO MEDICARE BENEFICIARIES IN TERMS OF TIME, DISTANCE, AND WEATHER CONDITIONS ISSUES. THE ALLOWABLE COSTS ARE OBTAINED FROM THE FISCAL YEAR MEDICARE COST REPORT FOR EACH OF THE HOSPITAL AREAS (INPATIENT, OUTPATIENT, ETC.). PART III, LINE 9B: THE HOSPITAL CONTRACTS WITH A RECEIVABLES MANAGEMENT COMPANY TO HANDLE THE SELF-PAY ACCOUNTS RECEIVABLE FROM DAY 1 TO 120. AT DAY 61, THE RECEIVABLES MANAGEMENT COMPANY RUNS A PUBLIC DATA SEARCH ON THE INDIVIDUALS WITH OUTSTANDING ACCOUNTS AS PART OF A REQUIREMENT FOR 501(R). THE PUBLIC DATA SEARCH REPORT IS GIVEN TO OUR FINANCIAL COUNSELOR WHO FOLLOWS UP WITH THAT PATIENT IN AN EFFORT TO CHECK CHARITY ELIGIBILITY OR STATE MEDICAL ASSISTANCE PROGRAM. AFTER DAY 120 THE ACCOUNTS ARE SENT TO A COLLECTIONS AGENCY WHO AT THAT POINT REPORTS THE INDIVIDUALS TO A CREDIT AGENCY. AT DAY 366, ANY OUTSTANDING ACCOUNTS ARE SENT TO A SECOND COLLECTION AGENCY. A FINANCIAL COUNSELOR IS AVAILABLE AS WELL TO ASSIST THE INDIVIDUALS AT ANY POINT IN THE PROCESS WITH OUR FINANCIAL ASSISTANCE POLICY. PART VI, LINE 2: THE HOSPITAL CONDUCTS ANNUAL STRATEGIC PLANNING SESSIONS AND ONE FOCUS IS THE HEALTH NEEDS OF THE COMMUNITY. PART VI, LINE 3: THE FINANCIAL ASSISTANCE POLICY (FAP), PLAIN LANGUAGE SUMMARY OF THE FAP, AND FAP APPLICATION ARE AVAILABLE ON THE WEBSITE. PAPER COPIES OF THE FAP, PLAIN LANGUAGE SUMMARY OF THE FAP, AND FAP APPLICATION ARE AVAILABLE UPON REQUEST AND COPIES ARE IN THE EMERGENCY ROOM AND ADMISSIONS AREA. THE HOSPITAL HAS SIGNS THAT NOTIFY THE PATIENTS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE IN THE EMERGENCY ROOM AND ADMISSIONS AREA. NOTICES ABOUT THE FAP ARE ON PATIENT STATEMENTS. THE HOSPITAL EMPLOYES A FINANCIAL COUNSELOR TO DISCUSS FAP OPTIONS. PART VI, LINE 4: WARREN COUNTY HAS A POPULATION OF APPROXIMATELY 40,000. THE COUNTY IS A LARGE GEOGRAPHIC SIZE WITH MANY RURAL AND SMALL COMMUNITIES.17.5% OF THE POPULATION IS +65 - STATE AVERAGE 15.2%27% ADULT POPULATION SMOKES - STATE AVERAGE 23%28% ADULT OBESITY - STATE AVERAGE 28%16% POOR HEALTH - STATE AVERAGE 14%12% UNINSURED ADULTS - STATE AVERAGE 12% PART VI, LINE 5: THE BOARD OF TRUSTEES IS MADE UP OF INDIVIDUALS WHO LIVE AND WORK IN THE COMMUNITY WHO VOLUNTEER THEIR TIME AND SERVICES TO ASSIST IN THE GOVERNANCE OF THE ORGANIZATION. WARREN GENERAL HOSPITAL EXTENDS MEDICAL PRIVILEGES TO QUALIFIED PHYSICIANS. 0 SCHOLARSHIPS 5 5000 X X X 0 1 0 0 0 0 0 0 0 TIMOTHY STANTON MD BOARD MEMBER 7920 0 0 0 205552 0 4794 0 17685 0 235951 0 0 0 MASON TOOTELL MD BOARD MEMBER 235437 0 0 0 0 0 3653 0 17685 0 256775 0 0 0 TREVOR M OLSEN MD BOARD MEMBER 490433 0 0 0 30219 0 6810 0 17685 0 545147 0 0 0 RICHARD L ALLEN CEO 305905 0 30000 0 2860 0 6750 0 22948 0 368463 0 0 0 JULIE D JACOBS CFO (UNTIL 11/27/17) 140397 0 1000 0 0 0 3175 0 6012 0 150584 0 0 0 JOSEPH AKIF COO/CNO 203992 0 0 0 0 0 4613 0 17685 0 226290 0 0 0 RANDY CALIFORNIA COO 203206 0 1000 0 1290 0 4622 0 17685 0 227803 0 0 0 BERNARD V EDEN MD PHYSICIAN 703151 0 118088 0 0 0 8999 0 17685 0 847923 0 0 0 ANNE RASSIGA MD PHYSICIAN 480043 0 0 0 167766 0 8667 0 6012 0 662488 0 0 0 PIERRE-JEAN LATTANZIO MD PHYSICIAN 561488 0 0 0 0 0 6500 0 17685 0 585673 0 0 0 SIMON AMSDELL MD PHYSICIAN 555774 0 0 0 30000 0 0 0 17685 0 603459 0 0 0 JUSTIN BROWER MD PHYSICIAN 391321 0 7006 0 77827 0 0 0 17685 0 493839 0 0 0 PART I, LINE 4B THE FOLLOWING EMPLOYEES PARTICIPATE IN A 457(F) PLAN: RICHARD ALLEN - $20,000 JODI BEVEVINO FAMILY MEMBER OF TIMOTHY R. BEVEVINO, BOARD MEMBER 120230 EMPLOYEE OF WARREN GENERAL HOSPITAL 0 FORM 990, PART VI, SECTION A, LINE 6 CARE CORPORATION OF WARREN IS THE SOLE CORPORATE MEMBER OF WARREN GENERAL HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A CARE CORPORATION OF WARREN, THE PARENT COMPANY, APPOINTS THREE OF THE MEMBERS OF THE WARREN GENERAL HOSPITAL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B SPECIFIC DECISIONS OF THE BOARD OF DIRECTORS ARE SUBJECT TO APPROVAL BY THE BOARD OF DIRECTORS OF CARE CORPORATION OF WARREN, THE PARENT COMPANY. FORM 990, PART VI, SECTION B, LINE 11B WARREN GENERAL HOSPITAL HAS A CPA FIRM PREPARE ITS FORM 990. THE RETURN IS COMPLETED IN DRAFT FORM AND REVIEWED BY MANAGEMENT OF THE ORGANIZATION. THE FORM 990 IS THEN PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR THE DIRECTORS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST POLICY AND DISCLOSE ANY BUSINESS OR FAMILY RELATIONSHIPS WHICH MAY CREATE A CONFLICT. EACH BOARD OF DIRECTOR AGREES TO REFRAIN FROM VOTING ON ANY ITEM IN WHICH A CONFLICT MAY EXIST. ANNUALLY, THE CORPORATE COMPLIANCE OFFICER REVIEWS THE POLICY AND AUDITS THE SIGNATURES. FORM 990, PART VI, SECTION B, LINE 15 THE HOSPITAL PARTICIPATES IN THE YAFFEE AND COMPANY HOSPITAL ASSOCIATION OF PENNSYLVANIA COUNCIL OF SMALL HOSPITALS EXECUTIVE COMPENSATION SURVEY. THIS INSTRUMENT SURVEYS HOSPITALS OF LIKE SIZE AND WITHIN OUR GEOGRAPHY. THE HOSPITAL BOARD CHOSE THIS INSTRUMENT DUE TO ITS RELEVANCY TO THE HOSPITAL'S MARKET. THE SURVEY DATA IS USED BY THE HOSPITAL BOARD OF DIRECTORS COMPENSATION COMMITTEE FOR COMPARISONS OF COMPENSATION AND BENEFITS FOR THE CEO AND OTHER TOP MANAGEMENT OFFICIALS. THE COMPENSATION COMMITTEE REPORTS ITS FINDINGS AND MAKES RECOMMENDATIONS TO THE FULL BOARD OF DIRECTORS FOR THEIR REVIEW, DELIBERATION, AND APPROVAL OR MODIFICATION. FORM 990, PART VI, SECTION C, LINE 18 WARREN GENERAL HOSPITAL MAKES ITS FORM 990, 990-T, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 EACH YEAR A COMBINED CORPORATE MEETING IS HELD IN WHICH THE PUBLIC IS WELCOME TO ATTEND. IN ADDITION, DOCUMENTS WILL BE MADE AVAILABLE TO THE PUBLIC IF THEY ARE REQUESTED IN PERSON OR IN WRITING. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 13,304,960. MANAGEMENT AND GENERAL EXPENSES 2,776,708. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,081,668. FORM 990, PART XI, LINE 9: ACCUMULATED CHANGE IN POSTRETIREMENT BENEFIT PLANS 1,148,367. PERM RESTRICTED NET ASSETS CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST 46,208. TRANSFER TO AFFILIATE 47,778. TEMP. RESTRICTED NET ASSETS INVESTMENT RETURN 45,803. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. PART VI, SECTION B, LINE 16: THE HOSPITAL BOARD OF DIRECTORS MUST ULTIMATELY APPROVE ANY INVESTMENTS IN ANY JOINT VENTURE OR SIMILAR ARRANGEMENT. AS PART OF ITS GOVERNANCE AND OVERSIGHT ROLE, THE FULL HOSPITAL BOARD ALSO SUBJECTS ANY JOINT VENTURE ARRANGEMENTS TO LEGAL REVIEW PRIOR TO ANY INVESTMENT BY THE HOSPITAL. CARE CORPORATION OF WARREN 2 CRESCENT PARK WEST WARREN PA 16365 251512016 PARENT CORP PA 501(C)(3) LINE 12C, III-FI N/A 0 MEDIPAR ASSOCIATES 103 WEST ST CLAIR ST WARREN PA 16365 251361787 REAL ESTATE PA WARREN GENERAL HOSPITAL RELATED -15049 230831 0 0 0.82890 GROUP MEDICAL SERVICES CORP 2 CRESCENT PARK WEST WARREN PA 16365 232803659 HEALTH CARE SVCS PA CARE CORPORATION OF WARREN C 0 WEST ST CLAIR INC 103 WEST ST CLAIR ST WARREN PA 16365 251601073 REAL ESTATE PA WARREN GENERAL HOSPITAL C 900 137597 0.82500 1 0 0 0 1 0 0 0 0 0 1 0 1 0 1 1 0 1 0 0