2018-05-10T09:05:39-07:00 2017-06-30 990 2016-07-01 320345810 Penn Highlands Healthcare PENN 8143756432 PO Box 447 Du Bois PA 15801 Steven Fontaine CEO 8143756430 2018-05-10 2016 2022-09-23 18:48:47Z Steven Fontaine 100 HOSPITAL AVE DU BOIS PA 15801 18568945 0 X www.phhealthcare.org X 2011 PA Penn Highlands Healthcare is a community-based and controlled health care system that exists to improve regional acess to a wide array of premier primary care and advanced health services while supporting a reverance for life and the worth and dignity of each individual. 16 9 0 15 0 0 0 0 14405397 18201484 0 0 0 332165 14405397 18533649 0 96829 0 0 11679169 14275800 0 0 0 3490567 3662525 15169736 18035154 -764339 498495 4467511 3935915 4863951 3824739 -396440 111176 Our community-based and controlled health care system exists to improve regional access to a wide array of premier primary care and advanced health services while supporting a reverance for life and the worth and dignity of each individual. 0 0 13783694 18201484 Penn Highlands Healthcare was formed in conjunction with the affiliation of DuBois Regional Medcial Center and its affiliated entities including Brookville Hospital, Clearfield Hospital and its affiliated entities and Elk Regional Hospital and its affiliated entities. The purpose for the affiliation is to ensure the accessibility of health care services in the Clearfield, DuBois, Elk and Brookville areas, enhance access to high-quality patient care facilities for patients and medical staffs of the hospitals, offer a broader range of services and create cost efficiencies in the delivery of health care services to the community. Penn Highlands Healthcare exercises a substantial degree of direction over the policies, programs and activities of the supported organizations and the other subsidiaries, including overseeing and implementing a system-wide conflict of interest policy and pastoral care program. 0 0 0 13783694 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 1 0 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 1 1 0 0 1 23 0 1 0 0 0 0 0 0 0 X 16 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X Du Bois Regional Medical Center c/o Brian Kline 8143756377 PO Box 447 100 Hospital Ave Du Bois PA 15801 X Rob O'Leary Chairman 2 0 X X 0 0 0 Ronald King Vice-Chair 2 0 X X 0 0 0 Scott Foradora Treasurer 2 0 X X 0 0 0 Dr Richard Bedger Secretary 2 40 X X 0 25000 0 Dr Thomas Carnevale Trustee 0 40 X 0 372913 26075 Dr Hazem ElKassas Trustee 1 0 X 0 0 0 Thomas G Gasbarre Trustee 1 0 X 0 0 0 David Lezzer Trustee 1 0 X 0 0 0 Dr Carmine Marchioli Trustee 1 0 X 0 0 0 Edward Nasuti Trustee 1 0 X 0 0 0 Robert A Ordiway Trustee 1 0 X 0 0 0 Richard Pfingstler Trustee 1 0 X 0 0 0 Dr Gregory Roscoe Trustee 1 0 X 0 0 0 Jim Ryan Trustee 1 0 X 0 0 0 Todd Stoltz Trustee 1 X 0 0 0 William Wood Trustee 1 0 X 0 0 0 Mark Norman Chief Operating Officer 40 0 X 0 219686 18028 Steven Fontaine CEO 40 0 X 0 655693 101286 David J McConnell Chief Financial Officer 40 0 X 0 407944 62593 Dr Gary Dugan PHH Chief Medical Officer 40 0 X X 0 435005 46452 Dr Russ Cameron PHH Chief Medical Officer 40 0 X 0 705048 47432 Raymond A Graeca President and CEO 40 0 X X 0 850514 66597 Cloyd Geedey VP Supply Chain Management 40 0 X 0 157507 22896 Robert McKee VP Chief HR Officer 40 0 X 0 262318 34819 Thomas Johnson Chief Information Officer 0 40 X 0 258487 19817 Gregory Bauer Business Development Officer 0 40 X 0 258804 42958 Rose Campbell Vice-President Patient Services / Chief Nursing Officer 0 40 X 0 67660 9619 Janice Hamscher Vice-President Patient Services/Chief Nursing Officer 0 40 X X 0 276529 35732 0 4953108 534304 11 1 1 0 Baldwin Law Group 210 West Pennsylvania Ave Suite 220 Baltimore MD 21204 Legal Services 287270 BKD LLP 910 E St Louis St PO Box 1190 Springfield MO 658011190 Audit Services 255665 2 0 Management Services 541611 18201484 18201484 0 0 0 0 0 0 18201484 0 0 0 0 0 0 0 0 0 0 0 0 132125 35296 96829 0 96829 235336 235336 0 0 235336 18533649 18436820 0 96829 96829 96829 0 0 0 0 0 0 2510077 2033162 476915 0 9293489 7527725 1765764 0 0 0 0 0 0 0 0 0 2472234 2002510 469724 0 0 0 0 0 775934 142694 633240 0 334887 334887 0 255000 255000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 633917 633917 0 0 31251 25313 5938 0 0 0 0 0 140805 114052 26753 0 88231 71467 16764 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15142 12265 2877 0 145032 117476 27556 0 1242326 1006284 236042 0 18035154 13783694 4251460 0 3417876 3169016 854688 353854 142431 130671 75709 38335 52516 37374 245000 4467511 3935915 3179237 2170668 0 0 0 0 0 278221 1337762 1406493 316309 4863951 3824739 X 0 0 0 0 -396440 111176 -396440 111176 4467511 3935915 498495 0 0 0 9121 0 X 0 1 X 1 0 X X X 4 DuBois Regional Medical Center 251490707 3 1 0 0 Clearfield Hospital 250979346 3 1 0 0 Brookville Hospital 250984595 3 1 0 0 Elk Regional Health Center 250585280 3 1 0 0 4 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 X X 1 1 1 1 Schedule A, Part IV, Section E, Line 2a Penn Highlands Healthcare Inc provided Management services, HR services, Payroll services, IT services, Development, Recruitment, Compliance, Supply Chain, Advertising and other services to the hospitals in the Penn Highlands Healthcare system including Penn Highlands DuBois, Penn Highlands Elk, Penn Highlands Clearfield and Penn Highlands Brookville. Each individual hospital would have needed to pay for these costs if the parent company didn't provide them. Schedule A, Part IV, Section E, Line 2b Penn Highlands Healthcare Inc provided HR services, Payroll services, IT services, Development, Recruitment, compliance, Supply Chain and Advertising to DuBois Regional Medical center, Elk Regional Health Center, Elk Regional Health Center, Clearfield Hospital and Brookville Hospital. Each individual hospital would have needed to pay for these costs if the parent company didn't provide them. Schedule A, Part IV, Section E, Line 3a The supported organizations recommend officers and directors to the parent corporation and the parent corporation reviews and approves the recommendations. Schedule A, Part IV, Section E, Line 3b Control is exercised through the reserved powers of the bylaws. The reserved powers in the bylaws include but are not limited to approving all fundamental transactions of a System Subsidiary, including amendments of the bylaws or other organizational/governance documents, all strategic plans, all capital, operating and cash flow budgets, all quality plans, any changes proposed that could affect the not-for-profit, tax-exempt status of this Corporation or any System Subsidiary, any change in mission or direction of a Subsidiary, including, without limitation, any decision to add or discontinue a line of service or add or discontinue any of the clinical services. The entity oversees all transactions for the purchase of assets with a current fair market value in excess of $500,000 and the entering into any contract, mortgage or any other unbudgeted operating expenditure in excess of $500,000. Reserved powers also include the nomination and election of certain system subsidiary directors and certain system subsidiary officers and other system-wide items including selection of the independent auditor and legal counsel, establishment of the charitable care policy, reallocation of income and/or capital among the system subsidiaries, the addition of new system subsidiaries and the establishment and implementation of system-wide programs, policies and initiatives. 0 0 0 0 0 0 0 0 0 0 0 75709 0 38335 37374 0 0 0 0 37374 Investment in Affiliate 245000 245000 INTERERST RATE SWAP AGREEMENT 316309 316309 Golf Fundraiser 132125 0 132125 0 9514 9064 12270 0 4448 0 0 132125 0 132125 0 9514 9064 12270 0 4448 35296 96829 1 Brookville Hospital 100 Hospital Rd Brookville PA 15825 250984595 501(c)3 18702 0 Clearfield Hospital 809 Turnpike Dr Clearfield PA 16830 250979346 501(c)(3) 19802 0 DuBois Regional Medical Center 100 Hospital Ave Du Bois PA 15801 251490707 501(c)(3) 38282 0 Elk Regional Health Center 763 Johnsonburg Rd St Marys PA 15857 250585280 501(c)(3) 20042 0 4 0 Schedule I, Part I, Line 2 The Golf Tournament funds are distributed based on designations made by donors but if donors do not make designations then the funds are distributed evenly among the Penn Highlands hospitals. The expenses of the tournament are distributed evenly among the hospitals. X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 Steven Fontaine CEO 0 533005 0 122688 0 0 0 84192 0 17094 0 756979 0 0 Dr Gary Dugan PHH Chief Medical Officer 0 359582 0 75423 0 0 0 28464 0 17988 0 481457 0 0 Robert McKee VP Chief HR Officer 0 222300 0 40018 0 0 0 20007 0 14812 0 297137 0 0 Dr Russ Cameron Chief Operating Officer 0 482286 0 222762 0 0 0 32009 0 15423 0 752480 0 0 Cloyd Geedey VP Supply Chain Management 0 156007 0 1500 0 0 0 4908 0 17988 0 180403 0 0 Mark Norman Chief Operating Officer 0 186840 0 32846 0 0 0 7933 0 10095 0 237714 0 0 Raymond A Graeca President and CEO 0 460237 0 183050 0 207227 0 56700 0 9897 0 917111 0 0 David J McConnell Chief Financial Officer 0 357416 0 50528 0 0 0 42000 0 20593 0 470537 0 0 Thomas Johnson Chief Information Officer 0 233170 0 25317 0 0 0 8930 0 10886 0 278303 0 0 Gregory Bauer Business Development Officer 0 239775 0 19029 0 0 0 26847 0 16111 0 301762 0 0 Janice Hamscher Vice-President Patient Services/Chief Nursing Officer 0 248931 0 27598 0 0 0 18378 0 17354 0 312261 0 Rose Campbell Vice-President Patient Services / Chief Nursing Officer 0 67660 0 0 0 0 0 5763 0 3856 0 77279 0 0 Schedule J, Part I, Line 1a Steven Fontaine, CEO, receives an annual flexible benefit allowance. The expenses available for reimbursement under this allowance are: automobile allowance and auto expenses; supplemental LTD premiums; premiums on term life insurance coverage, health club memberships, and tax/financial planning, all of which are reported as fully taxable compensation on the W-2. Schedule J, Part I, Line 4 Raymond Graeca, Steven Fontaine and Russ Cameron participated in 457F and 457B plans funded by Penn Highlands DuBois. David McConnell participated in 457B plan funded by Penn Highlands Clearfield. A HOSPITAL AUTHORITY OF THE CITY OF DUBOIS 251718944 000000000 2014-06-26 90000000 REFINANCING AND PURCHASE OF CAPITAL ITEMS 0 0 0 A 12998750 0 90000000 0 0 0 0 0 0 0 0 0 1 0 0 1 A 0 0 0 0 0 0 0 1 A 0 1 0 0 1 0 0 0 0 A 0 Schedule K, Part I-06/26/2014 90,000,000 HOSPITAL AUTHORITY OF THE CITY OF DUBOIS The refinancing bond issue was negotiated by the parent company, Penn Highlands Healthcare Inc to benefit the hospitals within the Penn Highlands system. These related parties are: Penn Highlands DuBois, Penn Highlands Elk, Penn Highlands Brookville, and Penn Highlands Clearfield. Penn Highlands Healthcare Inc does not carry this liability on the balance sheet. Each hospital is legally responsible for its portion of the liability and thus, reports this on its balance sheet. Dr Thomas Carnevale Employee of Penn Highlands Clearfield 372913 Physician Services 0 Dr Gregory Roscoe Trustee 102114 Lease of Office Space from Trustee 0 Oncology Hematology Assoc of PA Owned by Dr Elkassas & Dr Marchioli 769364 Payment for on-call and medical director 0 William Nasuti brother of a Board Member 53419 Wages 0 Schedule L, Part IV Dr. C. Marchioli and Dr. H El Kassas are owners of Oncology Hematology Associates of Northern Pennsylvania, PC. Form 990, Part VI, Section B, Line 11b Penn Highlands Healthcare, Inc.'s Finance Committee and the Board of Directors reviewed the 990 at the regularly scheduled meetings. Form 990, Part VI, Section B, Line 12c A system-wide Conflict of Interest Policy and Healthcare Disclosure Statement is sent to each Board Member in July. All documents are required to be returned, reviewed and filed. Form 990, Part VI, Section B, Line 15 The Penn Highlands Healthcare Executive Compensation Committee consults with the healthcare consulting firm, Yaffee & Company to obtain comparable data to make recommendations to the Board of Directors regarding executive compensation. The Penn Highlands Healthcare Board of Directors is acutely aware of the heightened public scrutiny of executive compensation and the need to consider regulatory compliance when setting executive pay. Form 990, Part VI, Section C, Line 19 The organization's governing documents, conflict of interest policy and financial statements are available to the public upon request. Form 990, Part VII, Section A, Line 1a Officers are paid via payroll through DuBois Regional Medical Center (25-1490707) and Clearfield Hospital (25-0979346). These wages are reported as W-2 income through these organizations and billed to Penn Highlands Healthcare Inc. Du Bois Regional Medical Center PO Box 447 100 Hospital Ave Du Bois PA 15801 251490707 Hospital PA 501(c)(3) 3 Penn Highlands Healthcare Inc 1 Brookville Hospital 100 Hospital Rd Brookville PA 15825 250984595 Hospital PA 501(c)(3) 3 Du Bois Regional Medical Center 1 Clearfield Hospital 809 Turnpike Dr Clearfield PA 16830 250979346 Hospital PA 501(c)(3) 3 Penn Highlands Healthcare Inc 1 Elk Regional Health Center 763 Johnsonburg Rd St Marys PA 15857 250585280 Hospital PA 501(c)(3) 3 Penn Highlands Healthcare Inc 1 Clear-Med Provider Corporation PO Box 1260 Clearfield PA 16830 251657668 Outpatient Physician PA 501(c)(3) 3 Clearfield Hospital 1 DRMC Auxiliary 100 Hospital Ave PO Box 447 Du Bois PA 15801 251531359 Support Du Bois Regional Medical Center PA 501(c)(3) 11 N/A 1 DRMC Employee Benefits Plan Trust 100 Hospital Ave Du Bois PA 15801 256332829 DuBois Regional Medical Center's Employee Benefits PA 501(c)(3) 3 Du Bois Regional Medical Center 1 Du Bois Regional Medical Group 100 Hospital Ave Du Bois PA 15801 251856569 Medical practices PA Du Bois Regional Medical Center C 0 Du Bois Medical Risk Retention Group 100 Hospital Ave Du Bois PA 15801 200324622 Insurance Service PA Du Bois Regional Medical Center C 0 Brookcare II Inc 100 Hospital Rd Brookville PA 15825 251477768 Lease Office Space PA Brookville Hospital C 0 0 1 0 1 0 0 0 0 0 0 1 1 0 1 1 1 1 0 0 Brookville Hospital b 18702 Contribution from Golf Tournament Clearfield Hospital b 19802 Contribution from the Golf Tournament Du Bois Regional Medical Center b 38282 Contribution from the Golf Tournament Elk Regional Health Center b 20042 Contribution from the Golf Tournament Du Bois Regional Medical Center k 143475 Cost Brookville Hospital l 1254722 Cost Clearfield Hospital l 1967085 Cost Du Bois Regional Medical Center l 11883365 Cost Elk Regional Health Center l 3096312 Cost Brookville Hospital o 96390 Cost Clearfield Hospital o 1312406 Cost Du Bois Regional Medical Center o 10830370 Cost Elk Regional Health Center o 1275835 Cost Du Bois Regional Medical Center p 59614 Cost