2019-05-07T15:48:02-05:00 2018-06-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2017-07-01 250965210 PUNXSUTAWNEY AREA HOSPITAL INC % JACK SISK CFO PUNX 8149381800 81 HILLCREST DRIVE PUNXSUTAWNEY PA 15767 JACK G SISK CFO 8149381882 2019-02-13 true Brian D Todd P00422601 4178658701 167.68.126.162 43032920191275000019 2019-05-07 P 353840E92A19E57AE3D09FB5FB5D869273682438 C3432A87FBFF9491E59BD7298F2E512B0D9B3700 2017 2019-02-21 02:37:17Z DANIEL D BLOUGH JR 81 HILLCREST DRIVE PUNXSUTAWNEY PA 15767 37781654 false X WWW.PAH.ORG X 1889 PA VALUED AS HIGHEST QUALITY COMMUNITY HOSPITAL IN THE REGION AND YOUR PRIMARY HEALTH CARE PROVIDER, COMMITTED TO CONTINUOUSLY IMPROVING SERVICES WHILE CONTAINING COST. 12 10 452 34 154441 12794 75867 66782 35438514 36859954 139100 148998 215025 379584 35868506 37455318 2814 2330 0 0 22136078 24452328 0 0 0 12051565 12753805 34190457 37208463 1678049 246855 25343680 25531494 6209711 5912781 19133969 19618713 X TO PROVIDE HIGH QUALITY, COST EFFECTIVE, PRIMARY HEALTH CARE AND TO COORDINATE CARE FOR PATIENTS REQUIRING SECONDARY AND TERTIARY SERVICES. false false 27719692 2330 31342019 PUNXSUTAWNEY AREA HOSPITAL PROVIDES ACUTE CARE INPATIENT AND OUTPATIENT HEALTH CARE TO PATIENTS IN A THREE COUNTY AREA. FOR THE FISCAL YEAR ENDED; THERE WERE 1,391 ADMISSIONS TO THE ACUTE CARE SETTING THAT GENERATED 3,908 PATIENT DAYS. THE HOSPITAL ALSO PROVIDED 76,564 OUTPATIENT VISITS TO PATIENTS. ALSO, THE HOSPITAL PROVIDED OVER $719,650 OF CHARITY CARE FOR 2,369 CUSTOMER ENCOUNTERS WHERE THE PATIENT DID NOT HAVE THE MEANS TO PAY FOR SERVICES RENDERED. NO PATIENTS WERE TURNED AWAY FOR LACK OF INSURANCE. SERVICES PROVIDED INCLUDE CARDIOPULMONARY, CLINICAL NUTRITION, COUNSELING, EMERGENCY, INTENSIVE CARE, SURGICAL, PHARMACY, RADIOLOGY, REHABILITATION, AND SHORT PROCEDURE. 2826411 3195758 PUNXSUTAWNEY AREA HOSPITAL PROVIDES SKILLED NURSING SERVICES TO PATIENTS IN A THREE COUNTY AREA. FOR THE FISCAL YEAR ENDED THERE WERE 195 ADMISSIONS INTO THE LONG-TERM CARE UNIT WHICH GENERATED 2,537 PATIENT DAYS. NO PATIENTS WERE TURNED AWAY FOR LACK OF INSURANCE. THE SERVICE PROVIDES SUPERVISED NURSING CARE, MEDICAL, AND OTHER HEALTH SERVICES TO INDIVIDUALS NOT IN NEED OF ACUTE INPATIENT HOSPITALIZATION, BUT WHOSE NEEDS CAN ONLY BE MET IN A SKILLED CARE FACILITY ON AN INPATIENT BASIS BECAUSE OF AGE, ILLNESS, DISEASE, INJURY, CONVALESCENCE, OR PHYSICAL OR MENTAL INFIRMITY. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. 2053793 2322177 PUNXSUTAWNEY AREA HOSPITAL PROVIDES HOME HEALTH CARE TO PATIENTS IN A THREE COUNTY AREA. FOR THE FISCAL YEAR ENDED THERE WERE 18,380 HOME HEALTH VISITS PROVIDED. NO PATIENTS WERE TURNED AWAY FOR LACK OF INSURANCE. THE HOME HEALTH CARE STAFF IS DEDICATED TO PROVIDING THE HIGHEST QUALITY OF PROFESSIONAL HOME HEALTH CARE TO THE PATIENTS THEY SERVE. THE STAFF WORKS WITH EACH PATIENT'S PHYSICIAN TO DEVELOP A DETAILED PLAN OF CARE PERSONALIZED TO THE PATIENT AND FAMILY. PROFESSIONAL NURSES NOT ONLY PROVIDE DIRECT PATIENT CARE, BUT ALSO PROVIDE COUNSELING/EDUCATION IN MEDICATIONS, NUTRITION, AND SPECIFIC DISEASES. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. 32599896 true true false true false false false false false true true true false false true false false true false false false false false false true false true true false false true false false false false false false false false false false false false false true true true false false true 60 0 true 452 true true true false false false false true true false false false false X 12 10 false false false false true false true true true false false true true true true true true true false false PA X JACK SISK CFO 8149381882 81 HILLCREST DRIVE PUNXSUTAWNEY PA 15767 X SAMUEL SMITH DIRECTOR 1.0 0.0 X 0 0 0 MELISSA DUNKEL SECRETARY 1.0 0.0 X X 0 0 0 TIMOTHY CLARK SIMPSON MD DIRECTOR 40.0 0.0 X 375748 0 11297 J THOMAS FRANTZ DIRECTOR 1.0 0.0 X 0 0 0 PHYLLIS BYERLY TREASURER 1.0 0.0 X X 0 0 0 JON JOHNSTON CHAIRMAN 1.0 0.0 X X 0 0 0 MARY CLAIRE JOHNSTON DIRECTOR 1.0 0.0 X 0 0 0 KYLE LINGENFELTER DIRECTOR 1.0 0.0 X 22500 0 0 JOHN PRUSHNOK DIRECTOR 1.0 0.0 X 0 0 0 FRANK ROBERTS VICE CHAIRMAN 1.0 0.0 X X 0 0 0 DAVID SPIGLE DIRECTOR 1.0 0.0 X 0 0 0 KATHY YOUNG DIRECTOR 1.0 0.0 X 0 0 0 DANIEL D BLOUGH JR CEO 40.0 0.0 X 272079 0 10525 JACK G SISK CFO 40.0 0.0 X 169976 0 6482 THOMAS GENTILCORE PHYSICIAN 40.0 0.0 X 537552 0 5644 ANAS ALZUHAILI PHYSICIAN 40.0 0.0 X 331686 0 10884 MAZEN HASAN PHYSICIAN 40.0 0.0 X 391911 0 11210 JAMES SHAFFER PHYSICIAN 40.0 0.0 X 353425 0 9892 EYAD KHABBAZ PHYSICIAN 40.0 0.0 X 340184 0 9642 2795061 0 75576 26 false true false ASSOCIATED CLINICAL LABORATORIES 1526 PEACH STREET ERIE PA 16501 LAB SERVICES 719037 CURA HOSPITALITY LLC 2400 ANSYS DRIVE SUITE 404 CANONSBURG PA 15317 FOOD SERVICE 190421 AUDIOLOGICAL AND SPEECH ASSOCIATION 270 PHILADELPHIA STREET INDIANA PA 15701 THERAPY SERVICE 171175 JOSEPH MEYN MD 841 HOSPITAL RD SUITE 2500 INDIANA PA 15701 OB/GYN SERVICES 163700 PARIS HEALTHCARE LINEN SERVICE 67 HOOVER AVE PO BOX 1043 DUBOIS PA 15801 CLEANING SERVICE 125078 7 10006 11761 45015 66782 NET PATIENT SERVICE REVENUE 900099 34582075 34427634 154441 PHYSICIAN SERVICES 621110 1772157 1772157 BILLING 541900 40740 40740 OTHER 900099 464982 464982 36859954 148798 148798 0 0 339389 309883 29506 0 29506 29506 200 200 200 200 15400 10006 16453 -1053 -1053 0 0 0 0 0 0 GAIN ON INVESTMENT IN EQUITY INVESTEE 900099 351131 351131 351131 37455318 36705513 154441 528582 X 0 2330 2330 0 0 868607 409545 459062 0 19314823 17372180 1942643 0 2994961 2706911 288050 1273937 1097202 176735 0 13484 13484 94756 94756 0 0 0 4238662 3849477 389185 96847 5745 91102 1336462 1107806 228656 350722 350722 0 559240 496057 63183 222397 155767 66630 0 0 5312 5312 0 1459902 1356742 103160 573350 309301 264049 MEDICAL SUPPLIES & DRUGS 2568479 2568479 BAD DEBT 947720 947720 REPAIRS & MAINTENANCE 216956 209322 7634 RECRUITING & RETENTION 69516 69516 37208463 32599896 4608567 0 142872 982135 5294742 4687391 0 0 2863547 2914724 23186 0 0 0 235160 212243 814199 779118 1029785 1294250 36879896 30417548 6498983 6462348 5050918 4975928 2306033 2012081 649117 690724 0 0 435138 520552 25343680 25531494 5528167 5770709 0 0 0 0 0 0 0 0 0 0 191368 93238 0 0 490176 48834 6209711 5912781 X 18657816 19143600 179484 178479 296669 296634 19133969 19618713 25343680 25531494 X 246855 -101607 339496 X false true X true false X false false false false false false false false true 2354 2354 false SCHEDULE C, PART II-B, LINE 1(I) OTHER LOBBYING ACTIVITIES: THE HOSPITAL IS NOT INVOLVED IN POLITICAL OR DIRECT LOBBYING ACTIVITIES BUT DOES BELONG TO TWO PROFESSIONAL ASSOCIATIONS THAT PARTAKE IN SOME LOBBYING (A SMALL PORTION OF MEMBERSHIP DUES IS UTILIZED FOR LOBBYING): THE HOSPITAL ASSOCIATION OF PENNSYLVANIA, $2,182, AND THE HOSPITAL 340(B) HEALTH, $172. 426667 19956 20683 425940 413467 34836 21636 426667 442169 -12927 15775 413467 461125 -1644 17312 442169 425535 55084 19494 461125 0.30360 0.69640 true false 40000 40000 12029127 9104983 2924144 23632157 20333328 3298829 1178612 979237 199375 6462348 INVESTMENT IN TRI-STATE 37241 C INVESTMENT IN CHART 1418414 C POTENTIAL CHART CLAIMS 556426 C 2012081 0 DUE TO THIRD PARTY PAYERS 48834 48834 36733332 -101607 -945390 -1046997 37780329 -325011 -325011 37455318 36587079 326336 326336 36260743 947720 947720 37208463 SCHEDULE D, PART V, LINE 4 USES OF ENDOWMENT FUNDS: INCOME FROM THE ENDOWMENT FUND IS USED TO PURCHASE CAPITAL EQUIPMENT. PERMANENT FUNDS OF $296,634 ARE RESTRICTED FROM USE. SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITION: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 2D AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12: $ (947,720) BAD DEBT 2,330 NET ASSETS RELEASED ----------- $ (945,390) SCHEDULE D, PART XI, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12C, BUT NOT ON LINE 1: $ (309,883) RENTAL EXPENSES 1,325 TEMPORARILY RESTRICTED CONTRIBUTIONS ( 16,453) FUNDRAISING EXPENSES ----------- $ (325,011) SCHEDULE D, PART XII, LINE 2D AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25: $ 309,883 RENTAL EXPENSES 16,453 FUNDRAISING EXPENSES ----------- $ 326,336 SCHEDULE D, PART XII, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 947,720 BAD DEBT GOLF TOURNAMENT 25406 10006 15400 2275 1899 3520 3956 4803 0 25406 10006 15400 2275 1899 3520 3956 4803 16453 -1053 true true X true X true X true true true false false 2111 291925 291925 0.00810 13849 7125194 4123210 3001984 0.08280 15960 7417119 4123210 3293909 0.09090 823 4850 4850 0.00010 276 712123 413149 298974 0.00820 6 2330 2330 0.00010 1105 719303 413149 306154 0.00840 17065 8136422 4536359 3600063 0.09930 false 947720 134576 17063708 16427861 635847 X true true 1 1 PUNXSUTAWNEY AREA HOSPITAL 81 HILLCREST DRIVE PUNXSUTAWNEY PA 15767 WWW.PAH.ORG 163701 X X X SKILLED NURSING SERVICES PUNXSUTAWNEY AREA HOSPITAL 1 false false true X X X X X X X X X 17 true true false true X SEE PART V, SECTION C X SEE PART V, SECTION C X true 17 true SEE PART V, SECTION C false true X 150. 250. X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY INPUT: THE 2018 COMMUNITY HEALTH NEEDS ASSESSMENT FOR PUNXSUTAWNEY AREA HOSPITAL AND THE 3 COUNTY AREA WAS BUILT ON INPUT FROM PEOPLE REPRESENTING THE BROAD AND LOCAL COMMUNITY, AS WELL AS LOW INCOME, MINORITY AND OTHER MEDICALLY UNDERSERVED POPULATIONS. THIS INPUT WAS SOLICITED THROUGHOUT 2017/2018 AND WAS GATHERED AND CONSIDERED IN MULTIPLE WAYS. THE HOSPITAL HAD A CHNA PLANNING GROUP WITH A SPECIAL FOCUS ON REVIEWING DATA AND LOOKING AT UNDERSERVED POPULATIONS WITHIN THE HOSPITAL AND COMMUNITY SERVICE AREA. THE COMMITTEE MET IN BOTH 2017 AND 2018 AND CREATED AN ONLINE SURVEY TO DETERMINE, ASSESS AND VALIDATE THE PRIORITY ISSUES. THE COMMITTEES ROLE WAS TO GUIDE THE ASSESSMENT PROCESS AND SELECT THE PRIORITY ISSUES OF THE HOSPITALS DEFINED SERVICE AREA. SPECIFIC COMMITTEE FUNCTIONS INCLUDE: 1. REVIEW OF ALL PRIMARY AND SECONDARY DATA PRIORITIZATION OF KEY ISSUES IDENTIFIED IN THE ASSESSMENT 2. SELECTION OF PRIORITY ISSUES TO BE ADDRESSED BY THE HOSPITAL 3. PARTICIPATION IN THE COMMUNITY STAKEHOLDER SURVEYS 4. DEVELOPMENT OF THE IMPLEMENTATION STRATEGIES TO ADDRESS THE PRIORITY ISSUES IDENTIFIED IN THE ASSESSMENT. PLANNING TEAM MEMBERS: BEN HUGHES. VP PROFESSIONAL AND CORPORATE SERVICES, PUNXSUTAWNEY AREA HOSPITAL LISA WANCHISN. EDUCATION MANAGER, PUNXSUTAWNEY AREA HOSPITAL ROBIN MORAN. PUNXSUTAWNEY EMS BOARD MEMBER LAURIE KLINGENSMITH. PHYSICIAN RELATIONS/PUBLIC RELATIONS, PUNXSUTAWNEY AREA HOSPITAL JACKIE SANSIG. (MASTERS STUDENT, PENN STATE UNIVERSITY- HEALTH PLANNING) DATA FOR THE CHNA CAME FROM NATIONAL, STATE AND LOCAL LEVELS. NATIONALLY, THIS INCLUDED ROBERT WOOD JOHNSON, 2018 COUNTY HEALTH RANKINGS FOR THE 67 RANKED COUNTIES IN PENNSYLVANIA, HEALTHY PEOPLE 2020 AND 2030 AND CMS RURAL HEALTH STRATEGY. STATE DATA INCLUDED USE OF PENNSYLVANIA DEPARTMENT OF HEALTH COUNTY HEALTH PROFILES STATISTICS. LOCALLLY, A COMMUNITY SURVEY WAS COMPLETED. THE MULTI COUNTY ASSESSMENT THAT COVERED JEFFERSON INDIANA AND CLEARFIELD COUNTIES WAS DONE IN COLLABORATION WITH THE PENNSYLVANIA MOUNTAINS CARE NETWORK PARTNERS OF INDIANA REGIONAL MEDICAL CENTER AND CLARION HOSPITALS. EACH HOSPITAL COMPLETED AN INDEPENDENT ASSESSMENT, BUT THE GOALS WERE DISCUSSED AND SHARED AT THE LEADERSHIP LEVEL TO VALIDATE SHARED OBJECTIVES AND CONSIDER FUTURE QUALITY AND OPERATIONAL INITIATIVES FOR PMCN PENNSYLVANIA MOUNTAIN CARE NETWORK IS A COLLABORATIVE AFFILIATION BETWEEN 3 HOSPITALS: PUNXSUTAWNEY AREA HOSPITAL, CLARION HOSPITAL AND INDIANA REGIONAL MEDICAL CENTER. THE 3 HOSPITALS HAVE BEEN WORKING COLLABORATIVELY WITH THE CHNA PROCESS AND WILL BE EMBRACING SOME SHARED GOALS AS PART OF THE OVERALL PROCESS. BUILDING ON PAST SUCCESSES, THE ORGANIZATIONS ARE COMMITTED TO LOOKING BEYOND THE TRADITIONAL HOSPITAL WALLS TO IMPACT COMMUNITY HEALTH. RECOGNIZING THE UNIQUE NEEDS OF RURAL RESIDENTS, THE 3 HOSPITALS TOGETHER CAN ASSESS AND IMPACT A 6 COUNTY COMBINED SERVICE AREA. SCHEDULE H, PART V, SECTION B, LINE 6A THE COMMUNITY NEEDS ASSESSMENT SERVED PUNXSUTAWNEY AREA HOSPITAL, CLARION HOSPITAL, AND INDIANA REGIONAL MEDICAL CENTER. SCHEDULE H, PART V, SECTION B, LINE 7A THE CHNA REPORT HAS BEEN MADE WIDELY AVAILABLE ON THE PAH WEBSITE: HTTPS://WWW.PAH.ORG/CONTENT/2015-COMMUNITY-HEALTH-NEEDS-ASSESSMENT SCHEDULE H, PART V, SECTION B, LINE 7B THE CHNA REPORT WAS MADE AVAILABLE ON THE FOLLOWING OTHER WEBSITES: HTTPS://WWW.CLARIONHOSPITAL.ORG/COMMUNITY_EDUCATION/COMMUNITY_HEALTH_NEEDS _ASSESSMENT.ASPX HTTP://WWW.INDIANARMC.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ SCHEDULE H, PART V, SECTION B, LINE 10A THE HOSPITAL'S MOST RECENT IMPLEMENTATION STRATEGY HAS BEEN POSTED ON THE FOLLOWING WEBSITE: HTTPS://WWW.PAH.ORG/CONTENT/2018-COMMUNITY-HEALTH-NEEDS-ASSESSMENT SCHEDULE H, PART V, SECTION B, LINE 11 ADDRESSING IDENTIFIED NEEDS: POPULATION HEALTH HAS BEEN DEFINED AS "THE HEALTH OUTCOMES OF A GROUP OF INDIVIDUALS". IT IS AN APPROACH TO HEALTH THAT AIMS TO IMPROVE THE HEALTH OF AN ENTIRE HUMAN POPULATION- FOR PURPOSES OF PUNXSUTAWNEY AREA HOSPITALS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), IMPROVE THE HEALTH OF THE ENTIRE POPULATION OF THE PUNXSUTAWNEY AREA HOSPITAL SERVICE AREA. WORKING IN CONJUNCTION WITH CLARION HOSPITAL AND INDIANA REGIONAL MEDICAL CENTER, THE HOSPITAL IS COLLABORATING WITH THE PENNSYLVANIA DEPARTMENT OF HEALTH AND THE HEALTHY PEOPLE 2020 GOALS TO ASSURE THERE IS AN EVIDENCE BASED APPROACH TO POPULATION HEALTH INITIATIVES. THE OPIOID CRISIS. PUNXSUTAWNEY AREA HOSPITAL LIKE MOST ORGANIZATIONS HAS BEEN MONITORING, REPORTING AND RESPONDING TO THE OPIOID CRISIS IN PENNSYLVANIA. THE HOSPITAL IS WORKING WITH LAW ENFORCEMENT, AND STATE AND NATIONAL RESOURCES TO ASSURE THE ORGANIZATION IS POSITIONED TO ADDRESS THIS MORE RECENTLY IDENTIFIED POPULATION HEALTH ISSUE. INITIAL RESEARCH AND DATA COLLECTION WILL BE PART OF THE 2018/2019 CHNA. A NEW PLAN FOR 2018/2019. IN THE FALL OF 2017, PUNXSUTAWNEY AREA HOSPITAL IN COLLABORATION WITH INDIANA REGIONAL MEDICAL CENTER AND CLARION HOSPITAL BEGAN TO REVIEW CURRENT PLANS AND ESTABLISH TIMELINES AND RESOURCES FOR THE COMPLETION OF A NEW CHNA FOR 2018. THE HOSPITAL IS EMBRACING TECHNOLOGY TO REACH OUT TO COMMUNITY MEMBERS TO COLLECT DATA AND ESTABLISH PRIORITIES FROM A MYRIAD OF HEALTH CARE AND SOCIAL SERVICE PROVIDERS IN THE REGION. ADDITIONALLY, THE COMMUNITY IS BEING SURVEYED TO ASSURE THEIR VOICE IS BEING HEARD IN THE PROCESS. UPDATE ON IDENTIFIED OBJECTIVES GOAL 1 REDUCE OBESITY IN THE COMMUNITY THROUGH AN INCREASE IN PHYSICAL ACTIVITY AND OTHER WELLNESS/PREVENTION STRATEGIES. OBJECTIVE: CREATE AND LAY THE GROUNDWORK FOR A PUNXSUTAWNEY AREA HOSPITAL WORKPLACE WELLNESS PROGRAM ACTION STEP 1: OUTLINE WHAT THE WELLNESS PROGRAM WILL ENTAIL AND WHICH STAFF MEMBERS WILL BE RESPONSIBLE FOR WHICH PIECES AND PARTS IMPACT MEASURED BY: PLANNING MEETING HELD IN CONJUNCTION WITH THE 2019 BUDGET PREP. UPDATE: SCHEDULE APRIL 2019 ACTION STEP 2: EXPAND ON OFFERINGS TO LOCAL BUSINESSES BASED ON THEIR INDIVIDUALIZED NEEDS. IMPACT MEASURED BY: IDENTIFICATION OF BUSINESSES, INITIATION OF SERVICE PROVISION/TRAINING/TESTING. UPDATE: PHYSICIAN OFFICES IDENTIFIED AS NEXT STEP ACTION STEP 3: EXPAND THE HOSPITALS WEIGHT LOSS PROGRAM TO CONNECT WITH NATIONAL BENCHMARKING IMPACT MEASURED BY: CREATING A LISTING OF EVIDENCE BASED OBESITY STRATEGIES AND EXPAND CURRENT PROGRAM TO TRACKING UPDATE: TRACKING IN PLACE FOR CURRENT PARTICIPANTS HP 2020 GUIDELINES IDENTIFIED OBJECTIVE: CONNECT WITH THE PUNXSUTAWNEY SCHOOL DISTRICT TO ASSESS AND ESTABLISH COLLABORATIVE GOALS WITH HEALTHCARE/EDUCATION. ACTION STEP 1: ASSESS THE SCHOOLS PLANS TO ADDRESS CHILDHOOD OBESITY IN CONJUNCTION WITH ATHLETIC TRAINING DEVELOPMENT. IMPACT MEASURED BY: DOCUMENTS ACQUIRED UPDATE: NOT INITIATED AT THIS TIME OBJECTIVE: EXPAND EMPLOYEE WELLNESS PROGRAM TO OTHER COUNTY EMPLOYEES ACTION STEP 1: MEET WITH OCCUPATIONAL HEALTH TO DETERMINE LIST OF POTENTIAL EMPLOYERS IMPACT MEASURED BY: NUMBER OF EMPLOYERS AND EMPLOYEES PARTICIPATING UPDATE: NOT INITIATED AT THIS TIME ACTION STEP 2: DETERMINE HOW THE HOSPITAL PROGRAM WOULD BE BEST IMPLEMENTED WITH OTHER EMPLOYERS IMPACT MEASURED BY: TBD UPDATE: NOTE INITIATED AT THIS TIME ACTION STEP 3: MEET WITH LOCAL EMPLOYERS TO DETERMINE INTEREST IN THE PROGRAM IMPACT MEASURED BY: NUMBER OF EMPLOYERS CONTRACTED UPDATE: NOT INITIATED AT THIS TIME ACTION STEP 4: IMPLEMENT PROGRAM IN OTHER SITES IMPACT MEASURED BY: NUMBER OF EMPLOYERS PARTICIPATING IN PROGRAM UPDATE: NOT INITIATED AT THIS TIME OBJECTIVE: CONNECT SCREENINGS TO HEALTHY PEOPLE 2020 INITIATIVES ACTION STEP 1: CONTINUE TO OFFER PROGRAM IN OCTOBER OF EACH YEAR IMPACT MEASURED BY: NUMBER OF PEOPLE CONTACTED UPDATE: NOT INITIATED AT THIS TIME ACTION STEP 2: OFFER EDUCATIONAL PROGRAMS AT EVENT TO OUTREACH TO TARGETED TO COMMUNITY MEMBERS IMPACT: INCREASE IN KNOWLEDGE OF PROGRAM TOPIC UPDATE: HEALTH PEOPLE 2020 REVIEW COMPLETED BHDK SCHEDULE EDUCATIONAL PROGRAMS FOR MAY 2019 ACTION STEP 3: REVIEW HEALTHY PEOPLE 2020 AND CONNECT OBJECTIVES TO NATIONAL PRIORITIES IMPACT MEASURED BY: REVIEW OF HEALTHY PEOPLE 2020/2030 UPDATE: SCREENINGS IDENTIFIED FOR SPRING 2019 IN CONJUNCTION WITH CHNA AND HP 2020 ACTION STEP 4: ATTEND CONFERENCE TO BE POSITIONED FOR HEALTHY PEOPLE 2030 IMPACT MEASURED BY: ATTENDANCE BY PLANNING STAFF UPDATE: NOT INITIATED AT THIS TIME OBJECTIVE: HIRE ATHLETIC TRAINER TO WORK IN CONJUNCTION WITH THE SCHOOL TO LINK HOSPITAL AND SCHOOL SYSTEM PRIORITIES ACTION STEP 1: CREATE A JOB DESCRIPTION IDENTIFY PRIORITIES IMPACT MEASURED BY: POSITION HIRED UPDATE: COMPLETED GOAL 2 IMPROVE PREVENTATIVE CARE/SCREENINGS AND EDUCATE THE COMMUNITY REGARDING INFECTIOUS AND CHRONIC DISEASE MANAGEMENT OBJECTIVE: FLU SHOT CLINIC IN THE COMMUNITY ACTION STEP: PARTNER WITH A LOCAL INDUSTRY TO PROVIDE FLU SHOTS TO THEIR EMPLOYEES IMPACT MEASURED BY: NUMBER OF EMPLOYEES RECEIVING FLU SHOTS, UPDATE: 90+% FOR EMPLOYEES MEDICAL STAFF VOLUNTEERS OBJECTIVE: CPR TRAINING ACTION STEP: OPEN CLASSES THAT ANYONE CAN PARTICIPATE, PRIVATE INDUSTRIES IN THE AREA, COLLABORATIVE RELATIONSHIP WITH OUR LOCAL EMS TO PROVIDE CPR TRAINING THROUGH REFERRALS IMPACT MEASURED BY: NUMBER OF PEOPLE CERTIFIED EVERY YEAR UPDATE: TRAININGS COMPLETED OBJECTIVE: FIRST AID TRAINING ACTION STEP: OPEN CLASSES THAT ANYONE CAN PARTICIPATE, PRIVATE INDUSTRIES IN THE AREA, COLLABORATIVE RELATIONSHIP WITH OUR LOCAL EMS TO PROVIDE CPR TRAINING THROUGH REFERRALS, LOCAL NURSING PROGRAMS IMPACT MEASURED BY: NUMBER OF PEOPLE CERTIFIED EACH YEAR UPDATE: BUSINESSES/NURSING FACILITIES AND PERSONAL CARE HOMES HAVE PARTICIPATED IN TRAINING THROUGHOUT THE CHNA IMPLEMENTATION PERIOD. OBJECTIVE: LYME DISEASE ACTION STEP: CONTINUE EDUCATIONAL PROGRAM FOR INFORMING THE COMMUNITY REGARDING LYME DISEASE IMPACT MEASURED BY: UPDATED WEB INFORMATION/LINKS, POSTED NOTICES ON SOCIAL MEDIA, POSTED LOCAL STATISTICS CREATE AWARENESS UPDATE: IN PLACE AND NEW WEBPAGE TO BE COMPLETED SUMMER 2019 OBJECTIVE: WOMENS HEALTH SCREENINGS ACTION STEP: OFFER 3-D MAMMOGRAPHY, SELF-BREAST EXAM, PAP SCREENING IMPACT MEASURED BY: NUMBER OF WOMEN RECEIVING 3D MAMMOGRAPHY, NUMBER OF WOMEN RECEIVING SELF-BREAST EXAM, NUMBER OF WOMEN RECEIVING PAP SCREENING UPDATE: SCHEDULE FOR FALL 2019 OBJECTIVE: COLORECTAL SCREENINGS ACTION STEP: CONTINUE TO OFFER COLORECTAL SCREENINGS IMPACT MEASURED BY: NUMBER OF PEOPLE BEING SCREENED, NUMBER OF PEOPLE DIAGNOSED WITH COLON CANCER UPDATE: SCHEDULED FOR FALL 2019 OBJECTIVE: SKIN SCREENINGS ACTION STEP: CONTINUE TO OFFER SKIN SCREENINGS IMPACT MEASURED BY: NUMBER OF PEOPLE RECEIVING SKIN SCREENINGS, NUMBER OF PEOPLE SENT FOR REFERRAL, NUMBER OF PEOPLE WITH SKIN CANCER, NUMBER OF PEOPLE WITH SKIN CANCER BY STAGE UPDATE: SCHEDULE FOR FALL 2019 OBJECTIVE: CONDUCT ANNUAL MULTI-PHASIC BLOOD SCREENING PROGRAM ACTION STEP 1: CONTINUE TO OFFER TESTING PROGRAM ANNUALLY IMPACT MEASURED BY: NUMBER OF PHYSICIANS PARTICIPATING UPDATE: SCHEDULED APRIL/MAY 2019 ACTION STEP 2: IDENTIFY STRATEGY TO TRACK PERCENTAGE OF ATTENDEES WHO FOLLOW UP WITH PUNXSUTAWNEY AREA HOSPITAL PHYSICIANS AND RESULTS OVER TIME IMPACT MEASURED BY: NUMBER OF PEOPLE CONNECTED TO PHYSICIANS UPDATE: EXPLORING HIPPA ISSUES AND WORKING WITH ROTARY TO CONNECT PATIENTS IN THE PROGRAM ACTION STEP 3: CREATE AN OPT BUTTON TO GAIN PERMISSION TO TRACK DATA IN CONJUNCTION WITH REGISTRATION IMPACT MEASURED BY NUMBER OF PEOPLE COMPLETING SCREENING AND NUMBER OF PEOPLE IDENTIFIED WITH HIGH/LOW LEVELS RELATED TO ANEMIA, CORONARY DISEASE, KIDNEY DISEASE, DIABETES, LIVER DISEASE, AND THYROID DISEASE UPDATE: SCHEDULE FOR 2020 SCREENING AND MEETING WITH ROTARY HELD IN FEBRUARY 2019 TO REVIEW PROCESS OBJECTIVE: OFFER PHYSICIAN OUTREACH PROGRAM ACTION STEP: CONTINUE TO OFFER BLOOD PRESSURE SCREENINGS, GLUCOSE SCREENINGS, AND CHOLESTEROL TESTING AS WELL AS OTHER EDUCATIONAL OPPORTUNITIES THROUGHOUT THE WEEK OF THE FAIR IMPACT MEASURED BY: NUMBER OF PEOPLE PARTICIPATING AND NUMBER OF PEOPLE REFERRED FOR FOLLOW UP WITH PHYSICIAN UPDATE: COMPLETE IN 2018 AND SCHEDULED FOR 2019 OBJECTIVE: PARTICIPATE IN THE ANNUAL GROUNDHOG FESTIVAL THROUGH A HEALTH FAIR ACTION STEPS: CONTINUE TO OFFER BLOOD PRESSURE SCREENINGS, GLUCOSE SCREENINGS AND CHOLESTEROL TESTING AS WELL AS OTHER EDUCATIONAL OPPORTUNITIES THROUGHOUT THE WEEK OF THE FAIR. IMPACT MEASURED BY: NUMBER OF PEOPLE PARTICIPATING, NUMBER OF PEOPLE REFERRED FOR FOLLOW UP WITH PHYSICIAN UPDATE: COMPLETED IN 2018 AND SCHEDULED FOR 2019 GOAL 3 INCREASE AWARENESS AND PREVENTION OF CARDIOVASCULAR DISEASE (HEART DISEASE, CHOLESTEROL, ETC.) OBJECTIVE: DECREASE READMISSIONS THROUGH BETTER CHRONIC CARE MANAGEMENT ACTION STEP 1: DISCHARGE PLANNING RISK FACTOR SCORE OF 10 AND ABOVE THE PATIENT IS SCHEDULED FOR AN APPOINTMENT WITHIN 7 DAYS WITH THEIR PRIMARY CARE PROVIDER; THEY GET A DISCHARGE PHONE CALL WITHIN 72 HOURS THEY LOO SCHEDULE H, PART V, SECTION B, LINE 13H OTHER CRITERIA EXPLAINED IN THE FAP: THERE IS A PRESUMPTIVE CHARITY SCORE PROCESS USING ACCOUNTS WITH MEDICARE OR DUAL ELIGIBILITY. SCHEDULE H, PART V, SECTION B, LINES 16 A, 16B, & 16C FAP, PLS, AND APPLICATION WEBSITE: FINANCIAL ASSISTANCE POLICY, APPLICATION FORM AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE AT THE FOLLOWING WEBSITE: HTTPS://WWW.PAH.ORG/CONTENT/FINANCIAL-ASSISTANCE-PROGRAM SCHEDULE H, PART V, LINE 16I LEP TRANSLATIONS: THERE ARE NO GROUPS WITH LIMITED ENGLISH PROFICIENCY THAT RISE TO THE THRESHOLD REQUIRED UNDER IRC SECTION 501(R). HOWEVER, LANGUAGE TRANSLATIONS OF THE FINANCIAL ASSISTANCE POLICY AND APPLICATION ARE AVAILABLE BY REQUEST AT THE FINANCIAL COUNSELING DEPARTMENT OF THE HOSPITAL. 1 HHCS OF PUNXSUTAWNEY AREA HOSPITAL 602 EAST MAHONING STREET PUNXSUTAWNEY PA 15767 MEDICARE CERTIFIED HOME HEALTH AGENCY SCHEDULE H, PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25 OF THE FORM 990, WAS REDUCED BY BAD DEBT EXPENSE OF $947,720 SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1 AND 3. COST COMPUTED ON IRS WORKSHEET 6 WAS COMPUTED FROM THE ORGANIZATION'S COST ACCOUNTING SOFTWARE, INCLUDING DIRECT COSTS PLUS OVERHEAD ALLOCATIONS COMPUTED IN THE COST ACCOUNTING. SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT EXPENSE: THE AMOUNT REPORTED FOR BAD DEBT IS THE TOTAL ACTUAL ACCOUNT BALANCES TRANSFERRED TO A COLLECTION AGENCY OFFSET BY MONIES COLLECTED FROM THE AGENCY. ALSO AN ESTIMATE BASED ON HISTORICAL COLLECTION PERCENTAGES OF SELF PAY FOR THE ACTIVE ACCOUNTS RECEIVABLE BALANCE IS CALCULATED MONTHLY AND THIS DIFFERENCE IS ADDED TO OR SUBTRACTED FROM BAD DEBT EXPENSE. SCHEDULE H, PART III, SECTION A, LINE 3 BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE: THIS FIGURE WAS CALCULATED USING THE ESTIMATED PERSONS UNDER POVERTY FOR JEFFERSON COUNTY OF 14.2%. SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT FINANCIAL STATEMENT FOOTNOTE: THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE. THAT FOOTNOTE READS AS FOLLOWS: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PAYMENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE HOSPITAL'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS DECREASED FROM 98% OF SELF-PAY ACCOUNTS RECEIVABLE AT JUNE 30, 2017, TO 98% OF SELF-PAY ACCOUNTS RECEIVABLE AT JUNE 30, 2018. IN ADDITION, THE HOSPITAL'S WRITE-OFFS INCREASED $107,784 FROM $671,936 FOR THE YEAR ENDED JUNE 30, 2017, TO $779,720 FOR THE YEAR ENDED JUNE 30, 2018. SCHEDULE H, PART III, SECTION C, LINE 8 COMMUNITY BENEFIT: SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. SCHEDULE H, PART III, SECTION C, LINE 9B COLLECTION POLICY: PATIENTS WHO QUALIFY FOR CHARITY CARE ARE FLAGGED IN ORDER TO PROCESS THEM SEPARATELY FROM OTHER SELF PAY ACCOUNTS. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: THE HOSPITAL DETERMINES COMMUNITY NEEDS BASED ON MULTIPLE SURVEYS AND MEETINGS WITH MEMBERS OF THE BUSINESS COMMUNITY, MEDICAL STAFF PHYSICIANS AND RANDOM COMMUNITY MEMBERS FROM THE SERVICE AREA. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: AT REGISTRATION, PATIENTS WITHOUT INSURANCE ARE PHYSICALLY PROVIDED INFORMATION ABOUT MEDICAID AND OUR CHARITY CARE POLICY AND ENCOURAGED TO ENROLL (WE ARE AVAILABLE TO ASSIST THE CUSTOMER WITH ENROLLMENT). SIGNAGE IS ALSO POSTED THROUGHOUT THE FACILITY OUTLINING OUR CHARITY CARE PROGRAM. ALSO, ALL PATIENT STATEMENTS REFLECT INFORMATION ABOUT FINANCIAL ASSISTANCE PROGRAMS AVAILABLE TO THE PATIENTS. CHARITY CARE INFORMATION IS ALSO REFERENCED ON THE HOSPITAL'S WEB SITE. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: STATISTICS AVAILABLE FROM THE UNITED STATES CENSUS BUREAU REVEAL THAT JEFFERSON COUNTY HAS A POPULATION OF JUST OVER 44,000 IN APPROXIMATELY 650 SQUARE MILES. THE POPULATION AGED 65 AND OLDER IS 20.5%. THE POPULATION WITH INCOME BELOW THE POVERTY LEVEL IS 14.2% AND THE COUNTY'S PER CAPITA PERSONAL INCOME IS $23,895. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: THE HOSPITAL CONDUCTS SEVERAL FREE HEALTH SCREENINGS EACH YEAR THAT ARE OFFERED TO MEMBERS OF THE COMMUNITY WITHOUT HEALTH INSURANCE. ALSO, MULTIPLE FREE MEDICAL EDUCATION PROGRAMS ARE OFFERED TO PROVIDE AWARENESS OF TOPICAL AND TIMELY HEALTH ISSUES. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: PUNXSUTAWNEY AREA HOSPITAL AND ITS WHOLLY OWNED SUBSIDIARY, PUNXSUTAWNEY MEDICAL SERVICES, INC., PRIMARILY EARN REVENUES BY PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES TO PATIENTS IN THE PUNXSUTAWNEY, PENNSYLVANIA, AREA AND ALSO OPERATES A HOME HEALTH AGENCY. X X X X false false false false false false false false false TIMOTHY CLARK SIMPSON MD DIRECTOR 357748 0 0 0 18000 0 0 0 11297 0 387045 0 0 0 DANIEL D BLOUGH JR CEO 253489 0 0 0 18590 0 0 0 10525 0 282604 0 0 0 JACK G SISK CFO 169976 0 0 0 0 0 0 0 6482 0 176458 0 0 0 THOMAS GENTILCORE PHYSICIAN 537552 0 0 0 0 0 0 0 5644 0 543196 0 0 0 ANAS ALZUHAILI PHYSICIAN 331686 0 0 0 0 0 0 0 10884 0 342570 0 0 0 MAZEN HASAN PHYSICIAN 385960 0 0 0 5951 0 0 0 11210 0 403121 0 0 0 JAMES SHAFFER PHYSICIAN 353425 0 0 0 0 0 0 0 9892 0 363317 0 0 0 EYAD KHABBAZ PHYSICIAN 340005 0 0 0 179 0 0 0 9642 0 349826 0 0 0 FORM 990, PART I, LINE 6 TOTAL NUMBER OF VOLUNTEERS: TOTAL NUMBER OF VOLUNTEERS INCLUDED NON-COMPENSATED MEMBERS OF THE BOARD OF DIRECTORS AND MEMBERS OF THE ORGANIZATION AUXILIARY. FORM 990, PART III, LINE 4B PROGRAM ACHIEVEMENTS: THE CARE IS THE PROVISION OF SKILLED SERVICES NEEDED BY THE PATIENT ON A DAILY BASIS, ORDERED BY A PHYSICIAN, REQUIRING CARE FURNISHED DIRECTLY BY OR UNDER SUPERVISION OF TECHNICAL OR PROFESSIONAL PERSONNEL, NOT LIMITED TO REGISTERED NURSES, LICENSED PRACTICAL NURSES, SPEECH PATHOLOGISTS, PHYSICAL THERAPISTS, AND OCCUPATIONAL THERAPISTS. THE CARE INCLUDES SKILLED NURSING, SKILLED REHABILITATION, OR RESTORATIVE CARE THAT BECAUSE OF SPECIAL MEDICAL CONDITIONS REQUIRED THAT THE CARE BE MONITORED BY OR UNDER THE DIRECT OBSERVATION AND ASSESSMENT OF SKILLED NURSING OR REHABILITATION PERSONNEL. FORM 990, PART III, LINE 4C PROGRAM ACHIEVEMENTS: SPECIALTY NURSING PROGRAMS INCLUDE: MATERNAL/CHILD CARE, IV THERAPY AND ENTEROSTOMAL CARE. IN ADDITION TO PROFESSIONAL NURSING SERVICES, THE AGENCY PROVIDES REHABILITATIVE SERVICES INCLUDING PHYSICAL, SPEECH, AND OCCUPATIONAL THERAPIES. FORM 990, PART VI, SECTION A, LINES 6 & 7B GOVERNANCE DECISIONS: AS SET FORTH IN THE NETWORK AFFILIATION AGREEMENT ("NETWORK AGREEMENT") BY THE CORPORATION, CLARION HEALTHCARE SYSTEM, INC. AND INDIANA HEALTHCARE CORPORATION, PENNSYLVANIA MOUNTAIN CARE NETWORK ("PMNC"), A PENNSYLVANIA NONPROFIT CORPORATION, SHALL BE AND ACT AS THE "OTHER BODY" WITH RESPECT TO THE CORPORATION AND ITS SUBSIDIARIES, IF ANY, AS THAT TERM IS DEFINED IN SECTION 5103 OF THE PENNSYLVANIA NONPROFIT CORPORATION LAW. IN THE CAPACITY, PMNC SHALL EXERCISE THE FOLLOWING RESERVED POWERS WITH RESPECT TO THE CORPORATION AND ITS SUBSIDIARIES. ANY OF THE FOLLOWING ACTIONS TAKEN BY THE CORPORATION OR ANY OF ITS SUBSIDIARIES SHALL REQUIRE THE APPROVAL OF THE BOARD OF PMCN PRIOR TO BECOMING EFFECTIVE, PROVIDED, IF THE PMCN BOARD HAS NOT ACTED UPON SUCH ACTION WITHIN 60 DAYS OF THE ORIGINAL RECOMMENDATION, THE ACTION TAKEN SHALL BE DEEMED TO HAVE BEEN APPROVED. A VOTE OF 80% OF THE WHOLE NUMBER OF THE PMCN DIRECTORS IS REQUIRED FOR APPROVAL (OR DISAPPROVAL FOR (10) AND (11) BELOW: (1) AMENDMENT OF ARTICLES OF INCORPORATION AND CORPORATE BYLAWS; (2) MERGER, CONSOLIDATION, DISSOLUTION OR SALE OF ALL OR SUBSTANTIALLY ALL ASSETS; (3) STRATEGIC PLANS NOT OTHERWISE ADDRESSED IN AN APPROVED CAPITAL BUDGET; (4) FUNDAMENTAL CHANGES IN MISSION, CONVERSION TO A FOR-PROFIT ENTITY OR ANY OF FUNDAMENTAL CHANGES DESCRIBED IN THE SUBCHAPTERS TO CHAPTER 59 OF THE PENNSYLVANIA NONPROFIT CORPORATION LAW; (5) INITIATING NEW CLINICAL PROGRAMS; (6) TERMINATING EXISTING CLINICAL PROGRAMS; (7) ENTERING INTO A MANAGEMENT CONTRACT WITH ANY THIRD PARTY (OTHER THAN EXISTING MANAGEMENT CONTRACTS); (8) A PROPOSED ENTRY INTO A SIGNIFICANT JOINT VENTURE OR AFFILIATION OR MANAGEMENT AGREEMENT WITH ANY OTHER NON-PMCN ENTITY THAT HAS SIGNIFICANT IMPLICATIONS FOR THE ENTITY INVOLVED AND/OR FOR PMCN AND/OR THE OTHER PMCN ENTITIES, AND FOR WHICH THE ENTITY'S CEO DOES NOT HAVE SUFFICIENT AUTHORITY TO APPROVE HIMSELF AND WOULD HAVE TO BRING TO HIS BOARD. EXAMPLES OF SIGNIFICANT INCLUDE A NEW RELATIONSHIP THAT WOULD REQUIRE CAPITAL INVESTMENT BY THE ENTITY, A CLINICAL AFFILIATION IN WHICH THE ENTITY CEDES MANAGEMENT CONTROL TO THE NON-PMCN ENTITY, OR A JOINT SERVICE LINE OR ANY OTHER JOINT VENTURE, AFFILIATION OR AGREEMENT WITH A NON-PMCN ENTITY IN WHICH IT WOULD BE EXPECTED THAT PMCN OR ANY PMCN ENTITY WOULD BE INTERESTED; (9) INCURRENCE OR GUARANTEE OR NEW DEBT THAT MEETS THE FINANCIAL TERMS DESCRIBED WITHIN THE NETWORK AGREEMENT; (10) DISAPPROVAL OF ANY RECOMMENDED, NEW PRESIDENT AND CHIEF EXECUTIVE OFFICER (THE CEO) AS DECIDED BY PMCN IN ACCORDANCE WITH THE FOLLOWING: (A) ANY DECISION TO DISAPPROVE A CEO RECOMMENDATION MUST BE BASED ON THE MOST EXTRAORDINARY CIRCUMSTANCES AND MUST OTHERWISE BE A REASONABLE EXERCISE OF THE PMCN'S DISCRETION; (B) ANY DECISION BY PMCN TO DISAPPROVE THE CEO RECOMMENDED BY THE CORPORATION OR THE HOSPITAL MUST BE APPROVED BY A VOTE OF AT LEAST 80% OF THE WHOLE NUMBER OF PMCN DIRECTORS; (C) THE SPECIFIC REASONS FOR DISAPPROVAL MUST BE ARTICULATED BY PMCN TO THE CORPORATION OR THE HOSPITAL, IN WRITING; AND (D) THE WRITING MUST BE RECEIVED BY THE CORPORATION OR THE HOSPITAL WITHIN 30 DAYS AFTER THE DATE OF THE CORPORATION'S OR THE HOSPITAL'S CEO RECOMMENDATION TO PMCN. IF THE CORPORATION OR THE HOSPITAL DOES NOT RECEIVE WRITTEN NOTICE OF DISAPPROVAL WITHIN SUCH TIME, THE CEO RECOMMENDED BY THE CORPORATION OR THE HOSPITAL SHALL BE DEEMED TO BE APPROVED BY PMCN. (11) DISAPPROVAL OF ANY PAYOR CONTRACT. IF THE CORPORATION DOES NOT RECEIVE PMCN'S WRITTEN NOTICE OF DISAPPROVAL WITHIN 30 DAYS, THE PAYOR CONTRACT SHALL BE DEEMED TO BE APPROVED BY PMCN; AND (12) ANY OTHER ACTION THAT MAY NOR OR HEREAFTER BE DESCRIBED IN THE NETWORK AGREEMENT AS AMENDED IN ACCORDANCE WITH ITS TERMS. THE CORPORATION SHALL ALSO CAUSE ITS SUBSIDIARIES, IF ANY, TO BE SUBJECT TO THESE RESERVED POWERS OF PMCN AND SHALL TAKE NO ACTION WITH RESPECT TO ITS SUBSIDIARIES EXCEPT IN ACCORDANCE WITH THESE RESERVED POWERS AND THE TERMS OF THE NETWORK AGREEMENT. FORM 990, PART VI, SECTION B, LINE 11B 990 REVIEW POLICY: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. PRIOR TO FILING, A DRAFT OF THE 990 WILL BE REVIEWED BY TOP MANAGEMENT AND WILL BE DISCUSSED AT A MEETING OF THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS. A FINAL DRAFT WILL BE MADE AVAILABLE TO THE FULL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY REVIEW: ANNUALLY THE OFFICERS AND DIRECTORS COMPLETE CONFLICT OF INTEREST DISCLOSURES. THESE DISCLOSURES ARE THEN SHARED WITH THE FULL BOARD. ANY BOARD MEMBER WITH A CONFLICT OF INTEREST ABSTAINS FROM VOTING ON ANY MATTER RELATED TO THAT CONFLICT. CORPORATE OFFICERS AND KEY EMPLOYEES ARE ALSO REQUIRED TO ANNUALLY DISCLOSURE POTENTIAL CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION REVIEW POLICY: THE CHAIRMAN OF THE BOARD ANNUALLY RECEIVES A SALARY SURVEY FROM THE HOSPITAL ASSOCIATION OF PENNSYLVANIA THAT INDEXES THE CEO'S SALARY BY UTILIZING THE SMALL AND RURAL CLASSIFICATIONS OF THE SURVEY AS PER THE CEO'S CONTRACT. ALL BOARD DELIBERATIONS ARE DOCUMENTED. THE SURVEY WAS RECEIVED IN SPRING OF 2017 AND PROVIDED TO THE EXECUTIVE COMMITTEE OF THE BOARD. THE CEO ANNUALLY RECEIVES A SALARY SURVEY FROM THE HOSPITAL ASSOCIATION OF PENNSYLVANIA. HE USES THIS SURVEY TO SET THE OTHER OFFICERSKEY EMPLOYEES' SALARY LEVELS. THE CEO SUBSEQUENTLY SHARES THE FINDINGS WITH THE BOARD EXECUTIVE COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: SOME FINANCIAL DATA IS AVAILABLE THROUGH THE PENNSYLVANIA HEALTH CARE COST CONTAINMENT COUNCIL. OTHER ORGANIZATION DOCUMENTS, INCLUDING GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS, ARE MADE AVAILABLE BY WRITTEN REQUEST FOR LEGITIMATE PURPOSE (AS DETERMINED BY THE FINANCE OFFICE). FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: $ 339,531 TRANSFER TO AFFILIATES (35) CHANGE IN BENEFICIAL INTEREST OF PERPETUAL TRUST ---------- $ 339,496 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:2668914 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN TOTAL FEES:804542 FORM 990 PART IX LINE 11G DESCRIPTION:MAINTENANCE SERVICES TOTAL FEES:730068 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING TOTAL FEES:35138 PUNXSUTAWNEY MEDICAL SERVICES INC 81 HILLCREST DRIVE PUNXSUTAWNEY PA 15767 251773035 PHY SPECIALIS PA 501(C)(3) 3 PUNXSY HOSP true PERPETUAL TRUST TRUST PA PUNXSY HOSPITAL TRUST -35 243134 1.00000 true false false true false false false false false false false false false false false false false false true false PUNXSUTAWNEY MEDICAL SERVICES INC R 112032 FMV PUNXSUTAWNEY MEDICAL SERVICES INC C 227500 FMV