HIGHMARK HEALTH: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- HIGHMARK HEALTH (EIN 16-0743222)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-13
- IRS object ID
- 201743179349302599
- Schema version
- 2016v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-13T10:35:39-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRANT THORNTON LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2001 MARKET ST SUITE 700 | AddressLine1Txt |
| City | PHILADELPHIA | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 19103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 160743222 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WESTFIELD MEMORIAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % TINA GOWEN CPA | InCareOfNm |
| Business Name Control | WEST | BusinessNameControlTxt |
| Phone | 4125446668 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | C/O HIGHMARK TAX DEPT SUITE 922 | AddressLine1Txt |
| City | PITTSBURGH | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 15222 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SCOTT A WHALEN | PersonNm |
| Person Title | PRESIDENT & CEO | PersonTitleTxt |
| Phone | 4125446668 | PhoneNum |
| Signature | 2017-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Frank Giardini | PreparerPersonNm |
| PTIN | P00532355 | PTIN |
| Phone | 2155614200 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 38.69.39.117 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 36941220173175000003 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2017-11-13 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | EBDF4F6BE16B4FBB18BCB4302BFCA50C1EC55CD5 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 95F700AB41AF8210FE65E78AA0BE95D9785B9642 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2018-03-14 21:41:22Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARTHA SMITH | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 232 WEST 25TH STREET | AddressLine1Txt |
| City | ERIE | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16544 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $9,329,536 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.AHN.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1944 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | WESTFIELD MEMORIAL HOSPITAL IS A TEAM OF OF CARE GIVERS COMMITTED TO IMPROVING HEALTH AND PROMOTING WELLNESS IN OUR COMMUNITIES. SEE FORM 990, PAGE 2, PART III, QUESTION 1 | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 110 | TotalEmployeeCnt |
| Total Volunteers | 17 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $218,135 | PYContributionsGrantsAmt |
| CY Contributions Grants | $227,706 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $8,076,597 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $8,140,071 | CYProgramServiceRevenueAmt |
| PY Investment Income | $280,689 | PYInvestmentIncomeAmt |
| CY Investment Income | $98,372 | CYInvestmentIncomeAmt |
| PY Other Revenue | $863,765 | PYOtherRevenueAmt |
| CY Other Revenue | $851,695 | CYOtherRevenueAmt |
| PY Total Revenue | $9,439,186 | PYTotalRevenueAmt |
| CY Total Revenue | $9,317,844 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,913,308 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,059,886 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,722,451 | PYOtherExpensesAmt |
| CY Other Expenses | $5,857,288 | CYOtherExpensesAmt |
| PY Total Expenses | $10,635,759 | PYTotalExpensesAmt |
| CY Total Expenses | $10,917,174 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,196,573 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,599,330 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $9,204,736 | TotalAssetsBOYAmt |
| Total Assets EOY | $7,929,072 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,282,670 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,620,605 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $7,922,066 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,308,467 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | WESTFIELD MEMORIAL HOSPITAL, INC. (WMH) IS A TEAM OF CARE GIVERS COMMITTED TO IMPROVING HEALTH AND PROMOTING WELLNESS IN OUR COMMUNITIES, ONE PERSON AT A TIME. IT PLEDGES TO CONSISTENTLY DELIVER SAFE, COMPASSIONATE QUALITY HEALTHCARE BY TREATING THE WHOLE PERSON - BODY, MIND AND SPIRIT. TO COMPLETE THIS MISSION, WESTFIELD MEMORIAL HOSPITAL PROVIDES SERVICES TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $9,246,201 | ExpenseAmt |
| Revenue | $8,984,179 | RevenueAmt |
| Desc | WESTFIELD MEMORIAL HOSPITAL, INC. IS A TEAM OF CARE GIVERS COMMITTED TO IMPROVING HEALTH AND PROMOTING WELLNESS IN OUR COMMUNITIES, ONE PERSON AT A TIME. IT PLEDGES TO CONSISTENTLY DELIVER SAFE, COMPASSIONATE QUALITY HEALTHCARE BY TREATING THE WHOLE PERSON - BODY, MIND AND SPIRIT. REFER TO SCHEDULE O FOR A COMPLETE NARRATIVE OF OUR PROGRAM SERVICE ACCOMPLISHMENTS. | Desc |
| Total Program Service Expenses | $9,246,201 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 19 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 110 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TINA GOWEN CPA | PersonNm |
| Phone | 8144525055 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 232 WEST 25TH STREET | AddressLine1Txt |
| City | ERIE | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16544 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| HELEN BARAN | |||||||||
| CHAIR | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JOHN HAMELS PHD | |||||||||
| VICE CHAIR | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SANDRA BROWN | |||||||||
| SECRETARY | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MARTHA SMITH | |||||||||
| TREASURER | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| TOM BERKHOUSE | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| TRACY BENNETT | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| MAUREEN CHADWICK | |||||||||
| DIRECTOR | 1.0 | 39.0 | Yes (X) | $0 | $252,070 | $46,762 | |||
| NORMA CUMMINGS | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT CRANE | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| DAVID HAZELTON | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| ROBERTA PATTERSON | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| JILLIAN ROCHE | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| THOMAS TARPLEY | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| MARK HAGEN MD | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| DIANA HOLT | |||||||||
| EX-OFFICIO, Foundation | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| ALEX SELIOUTSKI MD | |||||||||
| Member of the Board-Nonvoting | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| SCOTT WHALEN | |||||||||
| EX-OFFICIO, President/CEO | 1.0 | 39.0 | Yes (X) | Yes (X) | $0 | $729,072 | $170,696 | ||
| RUSSELL ELWELL | |||||||||
| MEDICAL DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| PETER PASCALE | |||||||||
| ADMINISTRATOR | 20.0 | 20.0 | $0 | $149,981 | $6,019 | Yes (X) | |||
| PATRICIA BALLMAN | |||||||||
| ADMINISTRATOR (THRU 4/16/2016) | 20.0 | 20.0 | $0 | $165,331 | $6,515 | Yes (X) | |||
| PRAGNA SUTARIA MD | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $194,654 | $0 | $10,750 | Yes (X) | |||
| RONALD FILIPPI MD | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $268,718 | $0 | $4,086 | Yes (X) | |||
| BRADFORD BUEGE DO | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $277,013 | $0 | $16,769 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $740,385 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,296,454 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $261,597 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| AHN EMERGENCY GROUP OF ERIE COUNTY | |||||
| 4535 DRESSLER ROAD NW | CANTON | OH | 44718 | PHYSICIAN SERVICES | $419,790 |
| CPS PAYMENT SERVICES LLC | |||||
| 501 CONGRESSIONAL BLVD SUITE 250 | CARMEL | IN | 46032 | PAYMENT SERVICES | $317,038 |
| CARDINAL HEALTH | |||||
| 2675 SOUTH MILFORD ROAD - UNIT B | HIGHLAND | MI | 48357 | PHARMACY SERVICES | $273,440 |
| TRI-STATE ANESTHESIA SERVICE | |||||
| 312 WEST 25TH STREET | ERIE | PA | 16502 | CRNA SERVICES | $234,418 |
| Family health medical services | |||||
| PO Box 168 | MAYVILLE | NY | 14757 | hospitalist services | $143,250 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $7,635 | RelatedOrganizationsAmt |
| Government Grants | $198,480 | GovernmentGrantsAmt |
| All Other Contributions | $21,591 | AllOtherContributionsAmt |
| Total Contributions | $227,706 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT FEES | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $8,140,071 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,140,071 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $8,140,071 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $100,380 | TotalRevenueColumnAmt |
| Exclusion | $100,380 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $13,433 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $5,846 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $7,587 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,587 | TotalRevenueColumnAmt |
| Exclusion | $7,587 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,688 | SecuritiesAmt |
| Other | $150 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $5,846 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$2,158 | SecuritiesAmt |
| Other | $150 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$2,008 | TotalRevenueColumnAmt |
| Exclusion | -$2,008 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| ELECTRONIC HEALTH RECORDS | 621110 | $679,702 | $679,702 |
| REIMBURSEMENT FOR FOUNDATION SALARIES | 621110 | $71,725 | $71,725 |
| PHYSICAL THERAPY | 621110 | $25,904 | $25,904 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $66,777 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $66,777 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $844,108 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,317,844 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,984,179 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $105,959 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,264 | TotalAmt |
| Management And General | $94,264 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,147,239 | TotalAmt |
| Program Services | $3,662,758 | ProgramServicesAmt |
| Management And General | $484,481 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,335 | TotalAmt |
| Program Services | $81,548 | ProgramServicesAmt |
| Management And General | $10,787 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $442,294 | TotalAmt |
| Program Services | $384,433 | ProgramServicesAmt |
| Management And General | $57,861 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $283,754 | TotalAmt |
| Program Services | $244,120 | ProgramServicesAmt |
| Management And General | $39,634 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,825 | TotalAmt |
| Management And General | $28,825 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,615 | TotalAmt |
| Management And General | $15,615 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,794,054 | TotalAmt |
| Program Services | $1,473,877 | ProgramServicesAmt |
| Management And General | $320,177 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,487 | TotalAmt |
| Management And General | $54,487 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $241,081 | TotalAmt |
| Program Services | $74,751 | ProgramServicesAmt |
| Management And General | $166,330 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,791 | TotalAmt |
| Program Services | $46,791 | ProgramServicesAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,944 | TotalAmt |
| Program Services | $11,808 | ProgramServicesAmt |
| Management And General | $10,136 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $892,980 | TotalAmt |
| Program Services | $690,516 | ProgramServicesAmt |
| Management And General | $202,464 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $150,765 | TotalAmt |
| Program Services | $130,044 | ProgramServicesAmt |
| Management And General | $20,721 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $1,134,319 | $1,085,108 | $49,211 |
| BAD DEBTS | $961,176 | $961,176 | |
| MAINTENANCE CONTRACTS | $388,925 | $377,345 | $11,580 |
| FREIGHT | $18,196 | $18,196 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $108,130 | TotalAmt |
| Program Services | $3,730 | ProgramServicesAmt |
| Management And General | $104,400 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,917,174 | TotalAmt |
| Program Services | $9,246,201 | ProgramServicesAmt |
| Management And General | $1,670,973 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100 | BOYAmt |
| EOY | $100 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $396,018 | BOYAmt |
| EOY | $396,231 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $783,840 | BOYAmt |
| EOY | $896,886 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $271,519 | BOYAmt |
| EOY | $267,566 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $80,096 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $8,616,547 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,097,920 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,221,427 | BOYAmt |
| EOY | $5,518,627 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,531,832 | BOYAmt |
| EOY | $769,566 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,204,736 | BOYAmt |
| EOY | $7,929,072 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,138,513 | BOYAmt |
| EOY | $1,476,448 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $144,157 | BOYAmt |
| EOY | $144,157 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,282,670 | BOYAmt |
| EOY | $1,620,605 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,796,948 | BOYAmt |
| EOY | $6,167,603 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,756 | BOYAmt |
| EOY | $44,502 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $96,362 | BOYAmt |
| EOY | $96,362 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,922,066 | BOYAmt |
| EOY | $6,308,467 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,204,736 | BOYAmt |
| EOY | $7,929,072 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,599,330 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $8,365 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$22,634 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $125,118 | BeginningYearBalanceAmt |
| Contributions | $227,706 | ContributionsAmt |
| Investment Earnings Or Losses | $855 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $212,815 | OtherExpendituresAmt |
| End Year Balance | $140,864 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $120,320 | BeginningYearBalanceAmt |
| Contributions | $218,135 | ContributionsAmt |
| Investment Earnings Or Losses | -$5,866 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $207,471 | OtherExpendituresAmt |
| End Year Balance | $125,118 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $96,362 | BeginningYearBalanceAmt |
| Contributions | $515,637 | ContributionsAmt |
| Investment Earnings Or Losses | $6,372 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $498,051 | OtherExpendituresAmt |
| End Year Balance | $120,320 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $60,155 | BeginningYearBalanceAmt |
| Contributions | $36,207 | ContributionsAmt |
| End Year Balance | $96,362 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $55,433 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $4,722 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $60,155 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.50000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.50000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $190,000 | OtherCostOrOtherBasisAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $4,599,442 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,079,566 | DepreciationAmt |
| Book Value | $3,519,876 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $3,457,605 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,953,880 | DepreciationAmt |
| Book Value | $1,503,725 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $369,500 | OtherCostOrOtherBasisAmt |
| Depreciation | $64,474 | DepreciationAmt |
| Book Value | $495,026 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,518,627 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ESTIMATED THIRD PARTY PAYOR | Desc |
| Amt | $144,157 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $144,157 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $8,017,015 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$988,819 | OtherRevenueAmt |
| Revenue Not Reported | -$988,819 | RevenueNotReportedAmt |
| Revenue Subtotal | $9,005,834 | RevenueSubtotalAmt |
| Other Revenues Not Included | $312,010 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $312,010 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $9,317,844 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $9,966,563 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | -$956,457 | OtherExpensesIncludedAmt |
| Expenses Not Reported | -$956,457 | ExpensesNotReportedAmt |
| Expenses Subtotal | $10,923,020 | ExpensesSubtotalAmt |
| Other Expenses Not Included | -$5,846 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | -$5,846 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $10,917,174 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule D, Part V, Line 4 | ENDOWNMENT FUNDS THE INTENDED USE OF THE WESTFIELD MEMORIAL HOSPITAL PERMANENT ENDOWMENTS ARE FOR, BUT NOT EXCLUSIVE TO: CAPITAL IMPROVEMENTS, RESEARCH, EDUCATION, DEPARTMENTAL NEEDS, OPERATING EFFICIENCIES, AND OVERALL PATIENT CARE. THE EARNINGS OFF OF THE PERMANENT AMOUNT ARE EXPENDABLE, BASED ON THE SPECIFIC USE OF THE FUND. |
| SCHEDULE D, PART X, LINE 2 | ASC 740 Footnote Highmark Health records uncertain tax positions in accordance with FASB accounting standards codification (ASC) 740, income taxes. ASC 740 clarifies the accounting for uncertainty in income taxes by defining criteria that a tax positon on an individual matter must meet before that position is recognized. ASC 740 also provides guidance on measurement, classification, interest and penalties, disclosure and accounting in interim periods. Based on an analysis prepared by Highmark Health, it was determined that the application of FASB ASC 740 had no material effect on the recorded assets and liabilities of HH on a standalone basis. The following is the footnote to the audited consolidated financial statements of Highmark Health for FASB ASC 740: At December 31, 2016 and 2015, gross unrecognized tax benefits (excluding the federal benefit received from state positions) were $158,491 and $151,436, respectively, and, if recognized, would have impacted the effective tax rate. The Corporation does not anticipate that any significant increase or decrease to unrecognized tax benefits will be recorded in 2017. SCHEDULE D, PART XI, LINE 2d Bad Debt -957,452 A/R Adjustment -38,150 Other 6,783 Total -988,819 Schedule D, Part XI, Line 4b Contribution Revenue 227,706 Investment Income not on AFS 89,295 Other Additions to net assets 855 Rental Expense -5,846 Total 312,010 Schedule D, Part XII, Line 2d Bad Debt -957,452 Other 955 Total -956,497 Schedule D, Part XII, Line 4b Rental Expense -5,846 Total -5,846 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 250. | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $241,910 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $241,910 | DirectOffsettingRevenueAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,748,383 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,080,098 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $668,285 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06710 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,990,293 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,322,008 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $668,285 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06710 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,862 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,862 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $43,534 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $43,534 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00440 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,676 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,676 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $48,072 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $48,072 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00490 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,038,365 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,322,008 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $716,357 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07200 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $8,044 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,044 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $8,044 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,044 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $961,176 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $2,299,735 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $2,656,386 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$356,651 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WESTFIELD MEMORIAL HOSPITAL INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 189 EAST MAIN STREET | AddressLine1Txt |
| City | WESTFIELD | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14787 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.ahn.org | WebsiteAddressTxt |
| State License | 0632000H | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Facility Reporting Group | 1 | FacilityReportingGroupCd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WESTFIELD MEMORIAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.AHN.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | false | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (true) | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 250. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 0. | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | www.ahn.org | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | www.ahn.org | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | www.ahn.org | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, PART V, SECTION B, LINE 5 | The Community Health Needs Assessment, which was conducted and implemented in 2015, was overseen by a Steering Committee of key health system representatives and an Advisory Committee made up of individual hospital leaders and community stakeholders who represent individuals who are medically underserved, low income, minorities or other special populations within the Allegheny Health Network service area. Taken together, the Steering and Advisory Committees drove the Community Health Needs Assessment process. In addition to the internal employed personnel engaged in the Community Health Needs Assessment process, the following individuals participated in the Community Health Needs Assessment planning and oversight process as part of the Allegheny Health Network Community Health Needs Assessment Steering and Advisory Committees: Honorable Robert Brooks, Mayor, Municipality of Monroeville; Aggie Brose, Deputy Executive Director, Bloomfield Garfield Corporation; Leslie Grenfell, Executive Director, SWPA Area Agency on Aging; Karen Hacker, MD, Director, Allegheny County Health Department; AJ Harper, President, Hospital Counsel of Western PA; Jack Krah, President, Allegheny County Medical Society; Sharon Wolf, Executive Director, North Hills Community Outreach Doris Carson Williams, President and CEO, African American Chamber of Commerce and Board Member; David Blandino, MD, Board Member; Basil Cox, Board Member; Joseph Macerelli, Esq., Board Member Qualitative research was conducted with key community stakeholders and others representing the broad interests of the community, including experts in public health, members of medically underserved, low-income, and minority populations, and other representatives of special populations within the communities. Qualitative research methodology used to solicit feedback from community stakeholders included: Key Informant Survey of 107 community representatives to solicit feedback on community health priorities, underserved populations and partnership; Six focus groups were conducted with target populations including pregnant and postpartum mothers, seniors, behavioral health consumers, EMS providers, and care coordinators to inform implementation strategies. In addition to the CHNA above, Hospital management and staff utilize multiple strategies to continually monitor and assess the health care needs of the communities it serves. This includes outreach to community members in an effort to receive input related to current health needs and trends. The hospital acts on specific requests received for health related matters such as screenings, programs and related events. Hospital participates in area groups and partnerships in an effort to understand the community and obtain a sense of specific issues. The hospital also acts on survey results received from patients and the patient families as well as being connected to world-wide, national and local health trends and needs and acting accordingly to ensure our patients have the best care available to them. |
| Schedule H, PART V, SECTION B, LINE 6A | The following hospital facilities conducted a joint community health needs assessment: -Allegheny General Hospital -Alle-Kiski Medical Center -Canonsburg General Hospital -Forbes Regional Hospital -Highlands Hospital -Jefferson Regional Medical Center -Saint Vincent Health Center -Westfield Memorial Hospital -Western Pennsylvania Hospital |
| Schedule H, PART V, SECTION B, LINE 7 & 8 | Our joint Community Health Needs Assessment can be found here: https://www.ahn.org/community-health-needs-assessments |
| Schedule H, Part V, Line 11 | The Allegheny Health Network developed a Community Health Improvement Plan (CHIP) to guide community benefit and population health improvement activities across the Allegheny Health Network service area in accordance with needs identified through the Community Health Needs Assessment process. The CHIP aligns with the Allegheny County Health Departments plan for a Healthy Allegheny and Erie County Health Departments Community Health Improvement Plan to ensure ongoing collaboration with public health and other community partners to address the regions most pressing community health needs. The following details the health priority, goal, objectives and the target population associated with the Allegheny Health Network CHIP: Health Priority: Behavioral Health Goal: Reduce mortality and morbidity related to mental and substance use disorders. Objectives: -Increase utilization of outpatient behavioral health services, particularly for the most vulnerable populations; -Increase knowledge and skills of first responders and community members around behavioral health; -Increase the number of healthcare providers integrating behavioral health and physical health. Target Populations: Minority Groups, Low Income and Senior Populations. Health Priority: Cancer Goal: Reduce the number of cancer cases, as well as the illness, disability, and death caused by cancer. Objectives: -Increase the percentage of adults who receive timely age-appropriate cancer screenings based on the most recent guidelines; -Reduce the incidence rate for the top four most commonly diagnosed cancers: prostate (male), lung and bronchus, colon and rectum and breast (female) and the overall mortality rate by promoting healthy lifestyle behaviors related to tobacco use and diet and exercise; -Provide health screenings and education to high-risk populations. Target Populations: Minority Groups, Low Income and Senior Populations. Health Priority: Chronic Disease Goal: Decrease preventable chronic disease by ensuring access to resources, knowledge, and opportunities for residents to adopt healthy behaviors. Objectives: -Increase primary care provider (PCP) recommendations for preventive screenings per risk and age guidelines. -Provide health screenings and education to high-risk populations; -Partner with community organizations to promote healthy lifestyles. Goal: Improve management and outcomes for patients diagnosed with a chronic disease. Objectives: -Reduce hospital 30-day readmission rates for chronic disease; -Manage high risk populations through care coordination and partnership with social service partners; -Partner with community organizations to promote healthy lifestyles. Target Populations: Ethnic minority groups, individuals with behavior health or substance abuse comorbidity, low income individuals and families and senior populations. Health Priority: Maternal and Child Health Goal: Reduce morbidity and mortality by improving the health and quality of life of woman, infants, children, caretakers and their families, especially in vulnerable communities. Objectives: -Reduce the proportion of preterm and low birth weights and reduce the disparity between White, Black and Hispanic populations; -Reduce the disparity between White, Black and Hispanic mothers who receive prenatal care within the first trimester; -Reduce occurrence of Neonatal Abstinence Syndrome (NAS); -Increase the proportion of mothers who breastfeed for the first six months after birth and reduce the disparity between White, Black and Hispanic populations; -Reduce the disparity between White, Black and Hispanic births resulting in infant mortality; -Partner with community organizations to improve prenatal indicators (including not smoking during pregnancy, not drinking during pregnancy and prenatal care in the first trimester). Target Populations: Minority racial groups (especially Black and Hispanic women), low income families, single mothers and women with behavioral health or substance abuse conditions. |
| Plain language summary available in foreign languages | Part V, Section B, Line 16I The hospital currently does not have the financial assistance policies and summaries available in foreign languages. However, this entity has an action plan in place with the target date of 12/31/16. Presently, they have foreign language interpreters available on-site to assist patients on a real-time basis. CHARGES EQUAL TO GROSS CHARGES FOR PATIENT SERVICES Schedule H, PART V, LINE 22D THE WESTFIELD MEMORIAL HOSPITAL BOARD OF DIRECTORS APPROVED A FINANCIAL ASSISTANCE POLICY IN THE FOURTH QUARTER OF 2015. THIS POLICY WAS ADOPTED BY WMH. THE POLICY DOES NOT ALLOW ANY FACILITY TO REPORT TO A CREDIT AGENCY BEFORE MAKING A REASONABLE EFFORT TO DETERMINE IF THE PATIENT QUALIFIES FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY.THE HOSPITAL OFFERS A 100% OR 75% DISCOUNT TO ALL UNINSURED PATIENTS BASED ON FEDERAL POVERTY QUIDELINES. |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Financial assistance and community care benefits | Schedule H, Part I, Line 3c WESTFIELD MEMORIAL HOSPITAL (WMH) PROVIDES MEDICALLY NECESSARY SERVICES TO ALL PATIENTS, REGARDLESS OF RACE, COLOR, CREED, GENDER OR COUNTRY OF NATIONAL ORIGIN AND WITHOUT REGARD TO THE PATIENT'S ABILITY TO PAY. THE AMOUNT OF CARE PROVIDED UNDER THE POLICY IS DETERMINED BY NEED AND IS NOT LIMITED OR RATIONED BY BUDGETED AMOUNTS UNDER THE POLICY. |
| Related Organization Report | Schedule H, Part I, Line 6a SAINT VINCENT HEALTH SYSTEM, THE SOLE CORPORATE MEMBER OF WMH, PREPARES THE COMMUNITY BENEFIT REPORT OF WMH. |
| Costing Methodology | Schedule H, Part I, Line 7 The costs entered for Financial Assistance at Cost and Medicaid are calculated using the Hospital's cost to charge ratio derived from Worksheet 2. All Other Benefits are the actual expenses incurred by the Hospital. |
| Community Building Activities | Schedule H, Part II The community building activities are the Hospital's direct support of the local community organizations via its membership in these organizations. Westfield/Mayville Rotary Club, Chautauqua County Chamber of Commerce and the HealthCare Association of New York. |
| BAD DEBT EXPENSE FINANCIAL STATEMENT FOOTNOTE AND COSTING METHODOLOGY | Schedule H, Part III, Line 3 and 4 WMH DOES NOT ISSUE SEPARATE AUDITED FINANCIAL STATEMENTS AND THEREFORE A FOOTNOTE DOES NOT EXIST. PATIENTS WHO ARE UNINSURED ARE SCREENED AS CLOSE TO TIME OF SERVICE AS POSSIBLE BY FINANCIAL COUNSELORS. UNINSURED IN-PATIENTS ARE USUALLY CONTACTED WITHIN A DAY OF ADMISSION (OR THEIR FAMILIES DEPENDING ON THE MEDICAL CIRCUMSTANCES) AS MANY UNINSURED EMERGENCY DEPARTMENT PATIENTS AS POSSIBLE ARE SEEN FOLLOWING MEDICAL SCREEN BY PHYSICIANS. DIAGNOSTIC OUT-PATIENTS AND THOSE WITH SCHEDULED PROCEDURES THAT ARE WITHOUT COVERAGE ARE OFTEN PRE-ADMITTED AND PART OF THE CALL INCLUDES CONVERSATION REGARDING PAYMENT EXPECTATIONS. IN ALL CASES, SCREENING INCLUDES SEARCHING FOR PAYMENT OPTIONS THROUGH INSURANCE CARRIERS OR IN LIABILITY SITUATIONS. FOR THOSE WHO REMAIN UNCOVERED, WE ATTEMPT TO ESTABLISH POTENTIAL QUALIFICATION FOR STATE MEDICAID COVERAGE. FAILING THAT, PATIENTS ARE GIVEN INFORMATION REGARDING OUR CHARITY CARE PROGRAM AND ARE GIVEN THE OPTION TO APPLY. ALL PATIENTS, WHETHER UNINSURED OR WHO OWE BALANCES AFTER INSURANCE PAYMENTS ARE RECEIVED, ARE BILLED AT THE SAME INCREMENTAL TIMES. ACTIVITIES DURING THIS PERIOD INCLUDE OUR SENDING REGULAR STATEMENTS WHICH INCLUDE REFERENCES TO OUR CHARITY CARE AND DISCOUNT POLICIES. ADDITIONALLY, PHONE CONTACT IS ATTEMPTED BASED ON ACCOUNT AGE AND AMOUNT DUE. DISCOUNTS ARE OFFERED TO THE UNINSURED IN THE SPIRIT OF EQUITY WITH THOSE WHO ARE INSURED. WE OFFER 50 PERCENT OFF OF CHARGES TO THIS GROUP AND ALSO OFFER A 10 PERCENT PROMPT PAY DISCOUNT FOR FULL PAYMENT WITHIN A TEN DAY TIME FRAME FROM CONTACT. AFTER NOTICE OF FINAL BILLING, THEY ARE CLASSIFIED AS BAD DEBT BY VIRTUE OF THEIR BEING WRITTEN OFF OF THE ACTIVE ACCOUNTS RECEIVABLES AND TRANSFERRED TO A BAD DEBT FILE WHERE THEY RESIDE UNTIL SUCH TIME AS THEY ARE PAID OR REMAIN UNCOLLECTIBLE. ANY PAYMENTS RECEIVED ON ACCOUNT AS WELL AS ANY DISCOUNTS TAKEN OVER THE LIFE OF THE ACCOUNT, EXCLUDING THOSE IN THE BAD DEBT FILE, ARE RECORDED AS SUCH WHEN THEY OCCUR AND WOULD THEREFORE NOT BE INCLUDED IN THE FINAL AMOUNTS DETERMINED TO BE BAD DEBT. HOWEVER, PAYMENTS MADE SUBSEQUENT TO BAD DEBT REPORTING ARE POSTED AGAINST THE ACCOUNTS AND WOULD OFFSET THE BAD DEBT EXPENSE WITHIN THAT PARTICULAR MONTH AS REPORTED ON THE FINANCIAL STATEMENTS. AS PART OF OUR CHARITY CARE POLICY PROCESS, WE TRY TO DETERMINE IF PATIENTS WHO ARE NOT PAYING AND/OR ARE NOT RESPONDING TO ANY ATTEMPTS FOR COMMUNICATION, MIGHT REASONABLY BE CONSIDERED AS CHARITY. A SECTION OF THE POLICY IS LABELED PRESUMPTIVE FINANCIAL ASSISTANCE POLICY AND ALLOWS US TO SCREEN FOR CHARITY CARE EVEN WITHOUT THE PATIENT"S APPLICATION. DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS, NOT INCLUDED IN BAD DEBT EXPENSE. |
| Debt Collection Policy | Schedule H, Part III, Line 9b IN AN UNCERTAIN ECONOMIC ENVIROMENT, WMH FINANCIAL COUNSELORS REMAIN COMMITTED TO ASSISTING THOSE IN OUR COMMUNITY WHO ARE UNABLE TO AFFORD THEIR MEDICAL EXPENSE, YET SEEK EXPERT CARE. THE FINANCIAL COUNSELORS WORK WITH PATIENTS AND THEIR FAMILIES TO HELP THEM QUALIFY FOR THE COMMUNITY CARE PROGRAMS, ANSWERING THEIR QUESTIONS AND HELPING THEM THROUGH THE ENROLLMENT PROCESS. COMMUNITY CARE INFORMATION IS AVAILABLE IN THE WMH COMMUNITY CARE BROCHURE OR VISIT THE WEBSITE AT WWW.AHN.ORG. FOR PATIENTS WHO RECEIVE BILLS IN THE MAIL FOLLOWING THEIR TREATMENT, THE COMMUNITY CARE PROGRAM IS INTRODUCED ON THE BOTTOM OF THEIR BILL WITH THE APPROPRIATE CONTACT INFORMATION. FINANCIAL ADVISORS ARE AVAILABLE WEEKDAYS AND ARE CONVIENTLY LOCATED NEXT TO PATIENT REGISTRATION. IT IS OUR POLICY NOT TO PURSUE COLLECTION PRACTICES AGAINST PATIENTS KNOWN TO QUALIFY FOR CHARITY CARE OR OTHER FINANCIAL ASSISTANCE. |
| Community Health Needs Assessment | Schedule H, Part VI, LINE 2 THE WESTFIELD MEMORIAL HOSPITAL (WMH) COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS IS COMPLETED AS PART OF THE LARGER ALLEGHENY HEALTH NETWORK WHICH WESTFIELD'S SOLE CORPROATE SPONSER - SAINT VINCENT HEALTH SYSTEM IS A MEMBER. IN 2015, WMH, ALONG WITH THE 8 OTHER HOSPITALS IN THE ALLEGHENY HEALTH NETWORK, EMBARKED ON A COMPREHENSIVE COMMUNITY HEATLH NEEDS ASSESSMENT (CHNA) TO COLLECT HEALTH AND SOCIO-ECONOMIC DATA TO DETERMINE HEALTH NEEDS OF THE GREATER ERIE/WESTERN NEW YORK AREAS. THE CHNA SOUGHT TO TAKE A COMMUNITY WIDE APPROACH TO IDENTIFYING REGIONAL HEALTH TRENDS AND UNIQUE DISPARITIES WITHIN HOSPITAL SERVICE AREAS |
| PATIENT EDUCATION FOR ELIGIBILITY FOR ASSISTANCE | Schedule H, Part VI, Line 3 INFORMING THE PUBLIC THAT CHARITY CARE IS AVAILABLE IS AN IMPORTANT ELEMENT OF OUR CHARITY CARE PROGRAM AND WMH CONTINUOUSLY STRIVES TO IMPROVE ITS COMMUNICATIONS WITH PATIENTS ON THE AVAILABILITY OF CHARITY CARE INFORMATION ABOUT THE CHARITY CARE POLICY. A SUMMARY DESCRIPTION OF THE CHARITY CARE POLICY IS AVAILABLE IN PATIENT REGISTRATION AREAS AND FROM FINANCIAL COUNSELORS WHO ARE PRESENT ON-SITE TO ASSIST PATIENTS IN QUALIFYING FOR GOVERNMENTAL ASSISTANCE PROGRAMS AND CHARITY CARE. |
| COMMUNITY SERVED INFORMATION | Schedule H, Part VI, Line 4 WMH SERVES RESIDENTS LOCATED IN CHAUTAUQUA COUNTY NEW YORK. CHAUTAUQUA COUNTY IS A RURAL AREA OF APPROXIMATELY 1500 SQUARE MILES AND HAS A POPULATION OF 133,000. THE COST OF LIVING INDEX IS LESS THAN AVERAGE AND THE PERCENT OF RESIDENTS LIVING IN POVERTY WAS 18.9%. |
| PROMOTION OF COMMUNITY HEALTH | Schedule H, Part VI, Line 5 WMH GOVERNING BOARD IS MADE UP OF TWO MEMBERS FROM ITS SOLE MEMBER, SAINT VINCENT HEALTH SYSTEM, AND THE BALANCE FROM THE COMMUNITY AT LARGE WHO DIRECT AND GUIDE MANAGEMENT IN CARRYING OUT THE MISSION OF WMH DIRECTORS ARE SELECTED ON THE BASIS OF THEIR EXPERTISE AND EXPERIENCE IN A VARIETY OF AREAS BENEFICIAL TO WMH AND ARE NOT COMPENSATED FOR THEIR SERVICES. |
| AFFILIATED HEALTH CARE SYSTEM | Schedule H, Part VI, Line 6 WMH IS A HOSPITAL FACILITY WHICH IS PART OF THE SAINT VINCENT HEALTH SYSTEM, AN INTEGRATED HEALTH SYSTEM CONSISTING OF SAINT VINCENT HEALTH CENTER (SVHC), SAINT VINCENT FOUNDATION FOR HEALTH AND HUMAN SERVICES, PHYSICIAN PRACTICE SITES, VAROIUS ANCILLARY SERVICES, OVER ONE HUNDRED EMPLOYED PHYSICIANS AND A VARIETY OF OTHER HEALTH-RELATED PROVIDERS. SAINT VINCENT HEALTH SYSTEM IS ALSO A MEMBER OF THE INTEGRATED DELIVERY SYSTEM NAMED ALLEGHENY HEALTH NETWORK. THE ALLEGHENY HEALTH NETWORK IS MADE UP OF EIGHT HOSPITALS: ALLEGHENY GENERAL, ALLEGHENY VALLEY, CANONSBURG, FORBES, JEFFERSON, SAINT VINCENT, WESTFIELD MEMORIAL, AND WEST PENN AND MORE THAN 200 PRIMARY AND SPECIALTY- CARE PRACTICES. AHN EMPLOYS APPROXIMATELY 1,700 PHYSICIANS IN EVERY CLINICAL SPECIALTY, 17,000 STAFF MEMBERS AND 2,000 VOLUNTEERS. TOGETHER, THEY PROVIDE WORLD CLASS MEDICINE TO ALL PATIENTS IN THEIR COMMUNITIES. |
| STATE FILING OF COMMUNITY BENEFIT REPORT | Schedule H, Part VI, Line 7 SAINT VINCENT HEALTH CENTER FILES THE COMMUNITY BENEFIT REPORT WITH THE STATE OF NEW YORK AS PART OF OUR OBLIGATION TO FURNISH THE STATE OF NEW YORK WITH A COPY OF THE IRS FORM 990 AND RELATED SCHEDULES. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MAUREEN CHADWICK | ||||||||||||||
| DIRECTOR | $0 | $221,226 | $0 | $0 | $0 | $30,844 | $0 | $34,879 | $0 | $13,052 | $0 | $300,001 | $0 | $21,928 |
| SCOTT WHALEN | ||||||||||||||
| EX-OFFICIO, President/CEO | $0 | $594,962 | $0 | $0 | $0 | $134,110 | $0 | $160,165 | $0 | $13,618 | $0 | $902,855 | $0 | $120,960 |
| PETER PASCALE | ||||||||||||||
| ADMINISTRATOR | $0 | $149,497 | $0 | $0 | $0 | $484 | $0 | $6,019 | $0 | $1,040 | $0 | $157,040 | $0 | $0 |
| PATRICIA BALLMAN | ||||||||||||||
| ADMINISTRATOR (THRU 4/16/2016) | $0 | $162,658 | $0 | $0 | $0 | $2,673 | $0 | $6,515 | $0 | $4,973 | $0 | $176,819 | $0 | $0 |
| PRAGNA SUTARIA MD | ||||||||||||||
| PHYSICIAN | $194,654 | $0 | $0 | $0 | $0 | $0 | $7,686 | $0 | $3,064 | $0 | $205,404 | $0 | $0 | $0 |
| RONALD FILIPPI MD | ||||||||||||||
| PHYSICIAN | $237,799 | $0 | $0 | $0 | $30,919 | $0 | $0 | $0 | $5,202 | $0 | $273,920 | $0 | $0 | $0 |
| BRADFORD BUEGE DO | ||||||||||||||
| PHYSICIAN | $276,615 | $0 | $0 | $0 | $398 | $0 | $9,652 | $0 | $8,507 | $0 | $295,172 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Supplemental Nonqualified Retirement Plan | FormAndLineReferenceDesc |
| Explanation | Part I, Line 4b The following individuals participated in a nonqualified retirement plan. The amounts below were included under a 457(f) plan. Distributions from the plan are included in their box 5 of their IRS Forms W-2. SCOTT WHALEN: $121,110 OF WHICH $120,960 WAS REPORTED AS ACCRUED IN A PRIOR PERIOD, AND DISTRIBUTED AS OF 12/31/16. MAUREEN MELIA CHADWICK: $21,955 OF WHICH $21,928 WAS REPORTED AS ACCRUED IN A PRIOR PERIOD, AND DISTRIBUTED AS OF 12/31/16. The following individuals received employer contributions to nonqualified plans that are currently nonvested: Scott Whalen $131,365 Maureen Chadwick $7,799 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | Introduction to Westfield Memorial Hospital (WMH) Westfield Memorial Hospital, Inc. (WMH) is a member of the Allegheny Health Network (AHN). The AHN is an integrated delivery network focused on preserving health care choice and providing affordable, high-quality care to the people in our communities. In addition to Westfield Memorial Hospital, the AHN consists of seven hospitals and numerous health and wellness entities dedicated to serving the community. You can visit the AHN at AHN.org. Westfield Memorial Hospital is a not-for-profit acute care hospital located in Westfield, New York. WMH provides limited inpatient (4 beds), outpatient and emergency care services for residents of the northern Chautauqua County, New York area. Westfield was founded in 1942 as a way to provide patient care and improve the effectiveness of the remaining physicians not serving in World War II. Since then, WMH has evolved through new technologies, services and partnerships, offering patients the most sophisticated medical advancements, while keeping the ease and familiarity of a community hospital. In January 1999, Westfield became affiliated with Saint Vincent Health System which provides the hospital with a mechanism to share medical services and resources otherwise unavailable to a small rural hospital. Saint Vincent is the sole corporate sponsor of Westfield Memorial Hospital. On July 1, 2013, Saint Vincent joined the Allegheny Health Network, a Pennsylvania not-for-profit corporation, designed to form an integrated delivery care system that focuses on preserving health care choice and providing affordable, high quality care. For the 12 months ending December 31, 2016, WMH served 27 inpatients, registered 23,264 outpatient visits (including outpatient emergency department visits), treated 7,348 patients in the emergency department, transferring 621 of those patients for further treatment at Saint Vincent and performed 1,165 surgeries. During the summer months of June, July and August, Westfield providers will staff a clinic at the Chautauqua Institution, a very popular resort community. This allows the hospital to provide immediate medical care to those individuals at the Institution versus having to travel to 10-15 miles away to receive medical attention. They had 559 clinic visits in 2016. Mission/Vision Statement Mission Highmark Health is an interdependent system designed to deliver high quality, accessible, understandable and affordable experiences, outcomes and solutions for our customers. Vision Highmark Healths dedicated and respected employees will be leaders in the health care industry, working to improve the total healthcare experience of our customers. Uncompensated Care To enhance the health status of the community in which it operates and consistent with its tax-exempt status, Westfield Memorial Hospital provides necessary health care services to individuals regardless of their ability to pay-for all or part of the services rendered. These services include both inpatient and outpatient services as well as an emergency room that remains available 24 hours a day. Consistent with the filing of Schedule H, the components of uncompensated care include charity care and unreimbursed Medicaid costs. Westfield Memorial Hospital had $1,990,293 of uncompensated care expenses which was offset by $1,322,008 of uncompensated care revenue. This resulted in unfavorable net benefits of $668,285. Community Health Improvement Services and Community Benefit Operations Community health improvement services and community benefit operations include activities intended to improve health and wellness. They extend beyond patient care activities and are subsidized by the hospital. There were a number of programs and activities that the hospital was involved in. The hospital promoted a number of Diabetes/Nutrition Education programs such as the community outreach 'Diabetes Prevention Program'. This is a program designed for at risk individuals referred by their physicians. The course consists of 22 hour long sessions. Additionally, during a community health fair the hospital presented an Educational program of healthy eating and the prevention of Type 2 diabetes. There were several smaller activities that the hospital was involved in including; the 'Stepping On' program to promote better balance, fall prevention and increased safety in the elderly population, as well as sponsoring a number of Community Health Fairs & Blood Pressure Screenings that were put on by the Hospitals auxiliary. Consistent with the filing of Schedule H, Westfield Memorial Hospital provided $1,862 of community health services during calendar year 2016. Health Professions Education Westfield Memorial Hospital provides aspiring health professionals with an opportunity to gain an understanding in the area of physical therapy. Consistent with the filing of Schedule H, Westfield Memorial Hospital provided these services at a cost of $43,534 in calendar year 2016. Subsidized Health Services Subsidized health services represent those programs provided to the community by Westfield Memorial Hospital despite the fact the organization incurs a financial loss to do so. Westfield Memorial Hospital recognizes the needs of its community and voluntarily subsidizes these programs in support of its charitable mission. In this regard, Westfield Memorial Hospital is unable to determine those subsidized service lines at this time. Consistent with the filing of Schedule H, Westfield Memorial Hospital provided subsidized health services at a cost of $0.00 in calendar year 2016. Cash and In-Kind Contributions This category includes monetary and in-kind services donated to individuals and the community at large. In-kind services include hours donated by staff to the community during hospital work hours, overhead expenses of meetings, other space donated to not-for-profit community groups, and donations of food, equipment and supplies. Consistent with the filing of Schedule H, Westfield Memorial Hospital provided financial contributions during calendar year 2016 totaling $591. Cash Donations Westfield Memorial Hospital supports the community through cash contributions made at the discretion of the Hospital and its directors, benefiting not only the non-profit recipient but ultimately the community as a whole. The organization did not make any direct cash contributions in 2016. In-Kind Donations Westfield Memorial Hospital also made in-kind donations of time and resources to help support various community functions. For Calendar year 2016, in-kind contributions amounted to $2,676 and consisted of the following: List of contributions: Donation of staff members time during business hours to serve on the board of the Westfield Rotary Club Donation of time by staff to direct employee charitable giving Volunteer hours donated to Westfield Summer Kids program Movie Night Volunteer hours towards collecting Christmas gifts for needy families as well as food stuffs Chautauqua County Health Network support of as well as contributed meeting space Community Building Activities Community Building Activities include activities specifically designated for the purpose of improving or protecting the health, future and well being of the community. Westfield Memorial Hospital is a supporting member of the Westfield/Mayville Rotary Club and actively participates in the clubs community events and activities. Additionally, Westfield Memorial Hospital is a member of the Healthcare Association of New York and a member of the Chautauqua County Chamber of Commerce. Westfield Memorial Hospital also donates the use of the Hospital meeting areas to a number of community groups. Consistent with the filing of Schedule H, Westfield Memorial Hospital provided these services at a cost of $8,044 in calendar 2016. |
| Members Or Stockholders | Form 990, Part VI, Section A, Line 6 WMH HAS A BOARD OF DIRECTORS THAT ARE RESPONSIBLE FOR THE OVERSIGHT OF THE COMMUNITY ASSET - WMH. THE BOARD MEMBERS WILL SELECT MEMBERS OF THE COMMUNITY TO SERVE ON THE BOARD. THESE MEMBERS WILL HAVE VOTING RIGHTS TO THE ELECT OTHER GOVERNING BODY MEMBERS AS WELL AS APPROVING SIGNIFICANT DECISIONS MADE BY THE BOARD OF DIRECTORS. BOARD MEMBERS WILL NOT RECEIVE ANY SHARE OF THE ORGANIZATION'S PROFITS, EXCESS DUES, OR NET ASSETS UPON LIQUIDATION. |
| Members or Stockholders who may elect | Form 990, Part VI, Section A, Line 7A THERE ARE TWO TYPES OF BOARD MEMEBERS THAT CAN SERVE ON THE WMH BOARD OF DIRECTORS - VOTING AND NON-VOTING. VOTING MEMBERS CAN CAST THEIR VOTES FOR THE ELECTION OF OTHER BOARD MEMBERS AS WELL AS ADMINITRATIVE DECISIONS MADE BY THE BOARD. NON-VOTING MEMBERS PROVIDE THE BOARD WITH THEIR EXPERTISE AND KNOWLEDGE BUT DO NOT HAVE THE ABILITY TO VOTE ON THE ELECTION OF OTHER BOARD MEMBERS AND/OR ADMINISTRATIVE DECISIONS TAKEN BY THE BOARD. |
| Decisions Subject to Approval | Form 990, Part VI, Section A, Line 7B SAINT VINCENT HEALTH SYSTEM AS THE SOLE CORPORATE SPONSOR OF WMH WHO HAS THE AUTHORITY TO REVIEW/APPROVE THE DECISIONS MADE BY THE BOARD OF DIRECTORS OF WMH. |
| OPERATIONAL OVERSIGHT AND FORM 990 REVIEW PROCESS | Form 990, Part VI, Section B, Line 11b Westfield memorial hospital IRS form 990 was prepared by its external advisors grant thronton, llp and reviewed by the highmark health tax department, senior management of the organization, and the audit and compliance committee. before filing the tax return with the internal revenue service, a final copy was provided to all members of the board of directors. |
| Conflict of Interest Policy Monitoring & Enforcement | Form 990, Part VI, Section B, Line 12C HIGHMARK HEALTH (HH), HAS A CORPORATE COMPLIANCE DEPARTMENT THAT MONITORS AND OVERSEES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY FOR ALL ENTITIES WITHIN THE FILING GROUP. THE FOLLOWING DESCRIBES THE MANNER IN WHICH THE CORPORATE COMPLIANCE DEPARTMENT MONITORS AND OVERSEES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY: CONFLICT OF INTEREST DISCLOSURE FORMS ARE COMPLETED ON AN ANNUAL BASIS BY ALL BOARD MEMBERS, OFFICERS, AND ANY PERSON WHO HAS AUTHORITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS, KEY EMPLOYEES, MANAGERS AND ABOVE, PERSONS WITH PURCHASING AUTHORITY INCLUDING PROCUREMENT DEPARTMENT EMPLOYEES AND COMMITTEE WHICH MAY INFLUENCE PURCHASING DECISIONS, AND ANY OTHER EMPLOYEES AS DESIGNATED BY THE COMPLIANCE DEPARTMENT. UPON COMPLETION OF THE ABOVE DISCLOSURE STATEMENT BY ALL APPLICABLE INDIVIDUALS, THE INTEGRITY AND COMPLIANCE DEPARTMENT REVIEWS ALL DISCLOSURES. THOSE THAT REQUIRE ADDITIONAL INFORMATION OR CLARIFICATION ARE CONTACTED BY THE INTEGRITY AND COMPLIANCE DEPARTMENT REQUESTING SUCH. ONCE RECEIVED, ALL INFORMATION IS EVALUATED IN CONSULTATION WITH THE LEGAL DEPARTMENT AND SENIOR MANAGEMENT AS APPLICABLE TO DETERMINE WHETHER A REAL OR POTENTIAL CONFLICT OF INTEREST EXISTS. THOSE CONFLICTS THAT REQUIRE A MITIGATION PLAN ARE DEVELOPED AND APPROVED IN COORDINATION WITH THE RESPECTIVE RESPONSIBLE SENIOR MANAGEMENT. THE SENIOR MANAGERS ARE RESPONSIBLE FOR DISCUSSING THE MITIGATION PLAN WITH THE INDIVIDUAL AS NEEDED AND MONITORING COMPLIANCE WITH THE MITIGATION PLAN. A FINAL REPORT OF ALL BOARD AND EXECUTIVE LEVEL MANAGEMENT DISCLOSURES IS SUBMITTED FOR REVIEW TO THE AUDIT AND COMPLIANCE SUBCOMMITTEE OF THE BOARD, AS WELL AS BY THE BOARD OF DIRECTORS |
| PROCESS FOR DETERMINING EXECUTIVE COMPENSATION | Form 990, Part VI, Section B, Line 15 THE AHN CORPORATE FOLLOWS A PROCESS FOR DETERMINING COMPENSATION FOR EXECUTIVE POSITIONS, (INCLUDING OFFICERS, KEY EMPLOYEES AND OTHER MANAGEMENT POSITIONS), AND ARE COVERED BY THE AHN EXECUTIVE COMPENSATION POLICY. THE POLICY WAS APPROVED BY THE HIGHMARK HEALTH BOARD OF DIRECTORS. IT IS THE POLICY OF AHN MANAGEMENT TO COMPENSATE ITS EXECUTIVES IN ACCORDANCE WITH THE MARKET AND IN RELATION TO THE EXPERIENCE, SERVICE AND ACCOMPLISHMENTS OF THE INDIVIDUAL BOTH PRIOR TO AND DURING THEIR SERVICE WITH AHN. THE PERSONNEL AND COMPENSATION COMMITTEE (PEC) APPROVES THE COMPENSATION FOR THE PRESIDENT AND CEO OF AHN AND ALL NON-HOSPITAL SENIOR EXECUTIVES WHO REPORT DIRECTLY TO THE PRESIDENT AND CEO OF AHN. THE PERSONNEL AND COMPENSATION COMMITTEE USES COMPARABILITY DATA PROVIDED BY AN INDEPENDENT COMPENSATION CONSULTANT. THE EXTERNAL CONSULTANT PROVIDES A LETTER OF REASONABILITY FOR ALL OFFERS MADE TO NEW EXECUTIVES THAT REPORT TO THE AHN CEO. EACH PEC COMMITTEE MEMBER VOTING ON A SENIOR EXECUTIVE'S COMPENSATION ARRANGEMENT ENSURES THAT HE OR SHE HAS NO CONFLICT OF INTEREST, INCLUDING THAT HE OR SHE (A) DOES NOT ECONOMICALLY BENEFIT FROM THE PROPOSED EMPLOYMENT; (B) DOES NOT RECEIVE COMPENSATION SUBJECT TO THE APPROVAL OF THE PROPOSED EMPLOYEE; AND (C) HAS NO MATERIAL FINANCIAL INTEREST AFFECTED BY THE TRANSACTION. THE EXECUTIVE COMPENSATION PROGRAM FOR THE HOSPITAL ENTITIES WITHIN THE GROUP IS ADMINISTERED BY THE CEO OF ALLEGHENY HEALTH NETWORK WITH RESPECT TO THE CEOS, COOS AND CFOS OF EACH HOSPITAL, PURSUANT TO OVERALL GUIDELINES ESTABLISHED BY THE PERSONNEL AND COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF HIGHMARK HEALTH. IT IS THE POLICY OF AHN TO COMPENSATE ITS EXECUTIVES IN ACCORDANCE WITH COMPETITIVE MARKET PRACTICES, TAKING INTO ACCOUNT ORGANIZATIONAL PERFORMANCE AND THE SKILLS, EXPERIENCE, QUALIFICATIONS AND PERFORMANCE OF EACH EXECUTIVE. AHN GENERALLY TARGETS THE MEDIAN OF THE RELEVANT MARKET WITH REASONABLE VARIATION BASED ON EACH EXECUTIVE'S SKILLS, EXPERIENCE, PERFORMANCE AND CURRENT POSITIONING RELATIVE TO MARKET. THE HUMAN RESOURCES DEPARTMENT OF ALLEGHENY HEALTH NETWORK OBTAINS APPROPRIATE MARKET COMPARABILITY DATA FOR EACH ENTITY, INCLUDING NATIONALLY PUBLISHED COMPENSATION SURVEYS AND/OR SPECIFIC ORGANIZATION PEER GROUPS, TO PREPARE COMPENSATION RECOMMENDATIONS FOR ALL KEY EXECUTIVES, INCLUDING OFFICERS, KEY EMPLOYEES, AND OTHER DISQUALIFIED PERSONS. RECOMMENDATIONS ARE REVIEWED AND APPROVED BY A COMMITTEE THAT IS INDEPENDENT WITH RESPECT TO THE COMPENSATION PROVIDED TO THE EXECUTIVES. COMPENSATION MAY INCLUDE SEVERAL FORMS OF CASH COMPENSATION, INCLUDING BASE SALARY, PERFORMANCE-BASED INCENTIVE COMPENSATION, AND A COMPETITIVE EMPLOYEE BENEFITS PROGRAM. BASE SALARY IS THE FIXED ELEMENT OF COMPENSATION INTENDED TO ALIGN WITH EACH EXECUTIVE'S ROLE, RESPONSIBILITIES, OVERALL PERFORMANCE AND OTHER CONTRIBUTIONS. INCENTIVE COMPENSATION IS USED TO PROVIDE VARIABLE, OR "AT RISK" COMPENSATION BASED ON THE PERFORMANCE OF BOTH THE EXECUTIVE AND THE ORGANIZATION. THE HOSPITAL EXECUTIVES CAN EARN INCENTIVE COMPENSATION ONLY IF THE ORGANIZATION ACHIEVES CERTAIN PRE-DETERMINED FINANCIAL GOALS. THE PLANS ARE INTENDED TO HOLD EXECUTIVES ACCOUNTABLE FOR ACHIEVING PERFORMANCE THAT IS CONSISTENT WITH THE LONG-TERM GOALS AND OBJECTIVES OF THE HOSPITAL. Westfield memorial hospital FOLLOWs THE REQUIREMENT IN THE REGULATIONS TO COMPLY WITH THE REBUTTABLE PRESUMPTION OF THE REASONABLENESS OF COMPENSATION. |
| How Documents are Made Available to the Public | Form 990, Part VI, Section C, Line 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS AND CONFLICTS OF INTEREST POLICY AVAILABLE TO THE PUBLIC. FINANCIAL STATEMENTS ARE ON A CONSOLIDATED BASIS, AND ARE AVAILABLE UPON REQUEST AND APPROVAL BY THE CFO OF HIGHMARK HEALTH. |
| OTHER CHANGES IN NET ASSETS AND FUND BALANCES | Form 990, Part XI, Line 9 THE FOLLOWING IS A RECONCILIATION OF THE OTHER CHANGES IN NET ASSETS OF WMH FOR THE YEAR ENDED DECEMBER 31, 2016: Transfers to Affiliate Organizations ($22,634) |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:528077 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:EQUIPMENT REPAIRS TOTAL FEES:15107 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PURCHASED LAB SERVICES TOTAL FEES:60696 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:BANK FEES TOTAL FEES:28089 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:DATA PROCESSING TOTAL FEES:51460 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PRO FEES TOTAL FEES:1110625 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (13 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Canonsburg Hospital & Health Foundation | ||||||||||
| 100 Medical Boulevard | Canonsburg | PA | 15317 | 251818505 | Inactive | PA | 501(c)(3) | 12-Type I | NA | false |
| Clinical Pathology Institute Cooperative | ||||||||||
| 1526 Peach Street | Erie | PA | 16501 | 251528055 | Healthcare | PA | 501(c)(3) | 3 | SVHC | false |
| Community Blood Bank | ||||||||||
| 232 West 25th Street | Erie | PA | 16544 | 251181389 | Healthcare | PA | 501(c)(3) | 12-Type I | SVHC | false |
| Energycare Inc | ||||||||||
| 232 West 25th Street | Erie | PA | 16544 | 251430922 | Healthcare | PA | 501(c)(3) | 10 | SVHC | false |
| Greater Canonsburg Health System | ||||||||||
| 100 Medical Boulevard | Canonsburg | PA | 15317 | 251488089 | Inactive | PA | 501(c)(3) | 12-Type I | NA | false |
| Regional Cancer Center | ||||||||||
| 232 West 25th Street | Erie | PA | 16544 | 251385705 | Healthcare | PA | 501(c)(3) | 3 | SVHS | false |
| Regional Heart Network | ||||||||||
| 232 West 25th Street | Erie | PA | 16544 | 251856341 | Healthcare | PA | 501(c)(3) | 3 | SVHC | false |
| Regional Home Health and Hospice | ||||||||||
| 232 West 25th Street | Erie | PA | 16544 | 830371265 | Healthcare | PA | 501(c)(3) | 10 | SVHS | false |
| Suburban Health Foundation | ||||||||||
| 100 South Jackson Ave | Pittsburgh | PA | 15202 | 251472073 | Fundraising | PA | 501(c)(3) | 12-Type I | WPAHS INC | false |
| Vantage Health Group | ||||||||||
| 232 West 25th Street | Erie | PA | 16544 | 251498145 | Healthcare | PA | 501(c)(3) | 3 | SVHC | false |
| West Allegheny Hospital | ||||||||||
| 100 Medical Boulevard | Pittsburgh | PA | 15317 | 251054206 | Inactive | PA | 501(c)(3) | 3 | NA | false |
| Gateway Health Foundation | ||||||||||
| 444 Liberty Avenue | Pittsburgh | PA | 15222 | 811343916 | Fundraising | PA | 501(c)(3) | 12-Type I | Gateway LP | false |
| Highmark Health | ||||||||||
| 120 Fifth Avenue Suite 922 | Pittsburgh | PA | 15222 | 453674900 | HEALTHCARE | PA | 501(c)(3) | 12-Type I | NA | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (27 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|
| 5148 Liberty Avenue Associates | |||||||
| 5989 Centre Avenue | Pittsburgh | PA | 15206 | 251689871 | Property Rental | PA | WPAHS Inc |
| Allegheny Health Network Home Infusion | |||||||
| 312 West 25th Street | Erie | PA | 16502 | 251736527 | Medical Practice | PA | SVHS |
| Allegheny Imaging of Mccandles | |||||||
| 4800 Friendship Ave | Pittsburgh | PA | 15224 | 300314897 | Medical Practice | PA | NA |
| Associated Clinical Lab LP | |||||||
| 312 West 25th Street | Erie | PA | 16502 | 251533746 | Medical Practice | PA | NA |
| Associated Clinical Lab of PA | |||||||
| 312 West 25th Street | Erie | PA | 16502 | 453688292 | Medical Practice | PA | NA |
| Erie Medical Complex LLC | |||||||
| 312 West 25th Street | Erie | PA | 16502 | 201017545 | Medical Practice | DE | NA |
| Gateway Health Plan LP | |||||||
| 444 Liberty Avenue Suite 2100 | Pittsburgh | PA | 15222 | 251691945 | Health Plan | PA | NA |
| Jefferson Medical Associates L | |||||||
| 565 Coal Valley Rd | Jefferson Hills | PA | 15236 | 251740456 | Medical Practice | PA | NA |
| Jenkins Empire Associates | |||||||
| 120 Fifth Avenue Suite 922 | Pittsburgh | PA | 15222 | 251524682 | Property Mgmt | PA | NA |
| JV Holdco LLC | |||||||
| 30 Isabella St | Pittsburgh | PA | 15212 | 472368587 | Holding Company | PA | WPAHS Inc |
| Mccandless Endoscopy Center | |||||||
| 4800 Friendship Ave | Pittsburgh | PA | 15224 | 261284448 | Medical Practice | PA | NA |
| North Shore Endoscopy Center | |||||||
| 4800 Friendship Ave | Pittsburgh | PA | 15224 | 251880238 | Medical Practice | PA | NA |
| Provider PPI LLC | |||||||
| 120 Fifth Avenue Suite 922 | Pittsburgh | PA | 15222 | 320429947 | Facilities Suppor | PA | HMPG |
| Saint Vincent Professional Bld | |||||||
| 312 West 25th Street | Erie | PA | 16502 | 251578290 | Property Mgmt | PA | CSI |
| Silver Rain LP | |||||||
| 30 Isabella St | Pittsburgh | PA | 15212 | 273035436 | Property Mgmt | PA | HMPG North |
| South Hills Surgery Center LL | |||||||
| 6161 Clairton Rd | West Mifflin | PA | 15122 | 274011352 | Medical Practice | PA | NA |
| Thryve Digital Health LLP | |||||||
| 120 Fifth Avenue Suite 922 | Pittsburgh | PA | 15222 | 981311003 | Informational Tec | NA | |
| Tri State Regional Assoc LLP | |||||||
| 312 West 25th Street | Erie | PA | 16502 | 232919277 | Medical Practice | PA | NA |
| UPMC VNA Home Health LP | |||||||
| 565 Coal Valley Rd | Jefferson Hills | PA | 15236 | 251844485 | Medical Practice | PA | NA |
| Upper Midwest Consol Services | |||||||
| 565 Coal Valley Rd | Jefferson Hills | PA | 15236 | 263112347 | Medical Practice | MN | NA |
| Vantage Capital Management Ltd | |||||||
| 312 West 25th Street | Erie | PA | 16502 | 233099689 | Capital Mgmt | PA | NA |
| Vantage Holding Company LLC | |||||||
| 312 West 25th Street | Erie | PA | 16502 | 030477182 | Capital Mgmt | PA | CSI |
| Waterfront Surgery Center LLC | |||||||
| 565 Coal Valley Rd | Jefferson Hills | PA | 15236 | 251898743 | Medical Practice | PA | NA |
| WSC Realty Partners LP | |||||||
| 565 Coal Valley Rd | Jefferson Hills | PA | 15236 | 251874990 | Property Mgmt | PA | NA |
| AHN Emergency Medicine Mgmt | |||||||
| 30 Isabella St | Pittsburgh | PA | 15212 | 465705484 | Medical Practice | PA | NA |
| Healthcare Supply Chain Innovations | |||||||
| 30 Isabella St | Pittsburgh | PA | 15212 | 472509307 | Group Purch. | DE | NA |
| Celtic Hospice and Palliative Care LLC | |||||||
| 30 Isabella St | Pittsburgh | PA | 15212 | 205661063 | Medical Practice | PA | WPAHS Inc |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (89 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| Clinical Services Inc | |||||||||
| 232 West 25th Street | Erie | PA | 16544 | 251403846 | Holding Company | PA | SVHS | C Corp | false |
| Davis Vision IPA Inc | |||||||||
| 175 East Houston Street | San Antonio | TX | 78205 | 112958041 | TPA | NY | Davis Vision | C Corp | false |
| Davis Vision Inc | |||||||||
| 175 East Houston Street | San Antonio | TX | 78205 | 113051991 | Medical Practice | NY | HVHC | C Corp | false |
| ECCA Managed Vision Care Inc | |||||||||
| 175 East Houston Street | San Antonio | TX | 78205 | 742759084 | Medical Practice | TX | VW of Amer | C Corp | false |
| Empire Vision Center Inc | |||||||||
| 175 East Houston Street | San Antonio | TX | 78205 | 141586016 | Retail Sales | NY | VW of Amer | C Corp | false |
| Eye Drx Retail Management Inc | |||||||||
| 175 East Houston Street | San Antonio | TX | 78205 | 742924030 | Office Administra | DE | VW of Amer | C Corp | false |
| Family Practice Medical Assoc South Inc | |||||||||
| 2414 Lytle Rd Ste 300 | Bethel Park | PA | 15102 | 251684735 | Medical Practice | PA | JRMC | C Corp | false |
| First Priority Life Insurance Co Inc | |||||||||
| 19 North Main Street | WilkesBarre | PA | 18711 | 232905083 | Insurance | PA | Highmark Inc | C Corp | false |
| Gateway Health Plan of Ohio Inc | |||||||||
| 444 Liberty Avenue Suite 2100 | Pittsburgh | PA | 15222 | 300282076 | Insurance | OH | Gateway LP | C Corp | false |
| Gateway Health Plan Inc | |||||||||
| 444 Liberty Avenue Suite 2100 | Pittsburgh | PA | 15222 | 251505506 | Insurance | PA | Gateway LP | C Corp | false |
| Grandis Rubin Shanahan & Assoc | |||||||||
| 565 Coal Valley Rd | Jefferson Hills | PA | 15025 | 453355906 | Medical Practice | PA | JRMC | C Corp | false |
| HCI Inc | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 753002215 | Insurance | VT | Highmark Inc | C Corp | false |
| Health System Services Corp & Subs | |||||||||
| 565 Coal Valley Rd | Jefferson Hills | PA | 15025 | 251403745 | Real Estate Opera | PA | JRMC | C Corp | false |
| Highmark BCBSD Health Options Inc | |||||||||
| 800 Delaware Avenue | Wilmington | DE | 198011368 | 471817274 | Insurance | DE | HM DE | C Corp | false |
| Highmark BCBSD Inc | |||||||||
| 800 Delaware Avenue | Wilmington | DE | 198011368 | 510020405 | Insurance | DE | Highmark Inc | C Corp | false |
| Highmark Benefits Group Inc | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 464763378 | Insurance | PA | Highmark Inc | C Corp | false |
| Highmark Casualty Insurance Company | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 251334623 | Insurance | PA | HMIG | C Corp | false |
| Highmark Coverage Advantage Inc | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 464757476 | Insurance | PA | Highmark Inc | C Corp | false |
| Highmark Inc | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 231294723 | Insurance | PA | HM Health | C Corp | false |
| Highmark Select Resources Inc | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 202353206 | Insurance | PA | Highmark Inc | C Corp | false |
| Highmark Senior Health Company | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 464156633 | Insurance | PA | Highmark Inc | C Corp | false |
| Highmark Senior Solutions Company | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 464156854 | Insurance | WV | Highmark WV | C Corp | false |
| Highmark Ventures Inc | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 251645888 | Holding Company | PA | Highmark Inc | C Corp | false |
| Highmark West Virginia | |||||||||
| PO Box 1948 | Parkersburg | WV | 26102 | 550624615 | Insurance | WV | Highmark Inc | C Corp | false |
| HM Benefits Administrators Inc | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 251128451 | Funds Administrat | PA | HMIG | C Corp | false |
| HM Casualty Insurance Company | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 870807723 | Insurance | PA | HMIG | C Corp | false |
| HM Centered Health | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 205457337 | Insurance | PA | Highmark Inc | C Corp | false |
| HM Health Holdings Company | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 810919390 | Holding Company | PA | HM Health | C Corp | false |
| HM Health Insurance Company | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 541637426 | Insurance | PA | Highmark Inc | C Corp | false |
| HM Health Solutions Inc | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 463823617 | Info Technology | PA | HM Health | C Corp | false |
| HM Insurance Group | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 251646315 | Holding Company | PA | Highmark Inc | C Corp | false |
| HM Life Insurance Company | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 061041332 | Insurance | PA | HMIG | C Corp | false |
| HM Life Insurance Company of New York | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 251800302 | Insurance | NY | HMIG | C Corp | false |
| HMO of Northeastern Pennsylvania Inc | |||||||||
| 19 North Main Street | WilkesBarre | PA | 18711 | 232413324 | Insurance | PA | Highmark Inc | C Corp | false |
| HMPG Inc | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 453444325 | Holding Company | PA | AHN | C Corp | false |
| HVHC Inc | |||||||||
| 175 East Houston Street | San Antonio | TX | 78205 | 251801124 | Holding Company | DE | Highmark Inc | C Corp | false |
| JEA Inc | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 251712017 | Real Estate Opera | PA | Highmark Inc | C Corp | false |
| Jefferson Hills Surgical Specialists PA | |||||||||
| 1200 Brooks Ln 150 | Clairton | PA | 15025 | 300477313 | Medical Practice | PA | JRMC | C Corp | false |
| JRMC Physician Service Corp | |||||||||
| 565 Coal Valley Rd | Jefferson Hills | PA | 15025 | 861159658 | Medical Practice | PA | JRMC | C Corp | false |
| JRMC Specialty Group Practice | |||||||||
| 565 Coal Valley Rd | Jefferson Hills | PA | 15025 | 721529332 | Medical Practice | PA | JRMC | C Corp | false |
| Highmark Choice Company | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 251522457 | Insurance | PA | Highmark Inc | C Corp | false |
| Klingensmith Inc | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 251375204 | Health Equip. | PA | HMPG Inc | C Corp | false |
| Lake Erie Medical Group PC | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 453444157 | Medical Practice | PA | AC | C Corp | false |
| Optima Imaging | |||||||||
| 4800 Friendship Avenue | Pittsburgh | PA | 15224 | 251652874 | Inactive | PA | WPAHS Inc | S Corp | false |
| Palladium Risk Retention Group | |||||||||
| 409 Broad St Ste 270 | Sewickley | PA | 15143 | 463476730 | Insurance | VT | WPAHS Inc | C Corp | false |
| Park Cardiothoracic & Vascular Inst | |||||||||
| 565 Coal Valley Rd | Jefferson Hills | PA | 15025 | 721529328 | Medical Practice | PA | JRMC | C Corp | false |
| Parker Benefits | |||||||||
| PO Box 1948 | Parkersburg | WV | 26102 | 550625743 | TPA | WV | Highmark WV | C Corp | false |
| Physician Landing Zone PC | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 453913973 | Health Care | PA | AC | C Corp | false |
| Pittsburgh Bone Joint and Spine Inc | |||||||||
| 1200 BROOKS LN STE G20 | Jefferson Hills | PA | 15025 | 900925581 | Medical Practice | PA | JRMC | C Corp | false |
| Pittsburgh Pulmonary & Critical Care | |||||||||
| 1200 BROOKS LN STE 130 | Clairton | PA | 15025 | 463274101 | Medical Practice | PA | JRMC | C Corp | false |
| Premier Medical Associates PC | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 251742869 | Medical Practice | PA | AC | C Corp | false |
| Premier Women's Health | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 464682160 | Medical Practice | PA | AC | C Corp | false |
| Primary Care Group 2 Inc | |||||||||
| 6011 Baptist Rd Ste 220 | Pittsburgh | PA | 15236 | 900451375 | Medical Practice | PA | JRMC | C Corp | false |
| Primary Care Group 3 Inc | |||||||||
| 5426 Mifflin Rd | Pittsburgh | PA | 15227 | 900451380 | Medical Practice | PA | JRMC | C Corp | false |
| Primary Care Group 4 Inc | |||||||||
| 1907 Lebanon Church Rd | West Mifflin | PA | 15122 | 800403090 | Medical Practice | PA | JRMC | C Corp | false |
| Primary Care Group 5 Inc | |||||||||
| 624 Monongahela Ave | Glassport | PA | 15045 | 800403100 | Medical Practice | PA | JRMC | C Corp | false |
| Primary Care Group 6 Inc | |||||||||
| PO Box 333 | West Mifflin | PA | 15122 | 900503600 | Medical Practice | PA | JRMC | C Corp | false |
| Primary Care Group 7 Inc | |||||||||
| 575 Coal Valley Rd | Jefferson Hills | PA | 15025 | 251287041 | Medical Practice | PA | JRMC | C Corp | false |
| Primary Care Group 8 Inc | |||||||||
| 803 Miller Ave | Clairton | PA | 15025 | 010927360 | Medical Practice | PA | JRMC | C Corp | false |
| Primary Care Group 10 Inc | |||||||||
| 3726 Brownsville Rd | Pittsburgh | PA | 15227 | 383807173 | Medical Practice | PA | JRMC | C Corp | false |
| Primary Care Group 11 Inc | |||||||||
| 455 Valley Brook Rd Ste 300 | McMurray | PA | 15317 | 800494617 | Medical Practice | PA | JRMC | C Corp | false |
| Primary Care Group 12 Inc | |||||||||
| 17 Arentzen Blvd Ste 101 | Charleroi | PA | 15022 | 900614054 | Medical Practice | PA | JRMC | C Corp | false |
| Prime Medical Group PCG 1 | |||||||||
| 1200 Brooks Ln 110 | Clairton | PA | 15025 | 264194208 | Medical Practice | PA | JRMC | C Corp | false |
| Remworks Sleep Store Inc | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 251411844 | Rental & Sales | PA | Highmark Inc | C Corp | false |
| South Pittsburgh Urology Associates | |||||||||
| 1200 BROOKS LN STE 220 | Clairton | PA | 15025 | 464954859 | Medical Practice | PA | JRMC | C Corp | false |
| Specialty Group Practice 1 Inc | |||||||||
| 575 Coal Valley Rd Ste 365 | Clairton | PA | 15025 | 352367818 | Medical Practice | PA | JRMC | C Corp | false |
| Standard Property Corporation | |||||||||
| 120 Fifth Ave Suite 922 | Pittsburgh | PA | 15222 | 251668093 | Real Estate Opera | PA | Highmark Inc | C Corp | false |
| Steel Valley Orthopedics & Sports Medici | |||||||||
| 1200 Brooks Ln 240 | Clairton | PA | 15025 | 453540378 | Medical Practice | PA | JRMC | C Corp | false |
| United Concordia Companies Inc | |||||||||
| 4401 Deer Path Road | Harrisburg | PA | 17110 | 251687586 | Dental Insurance | PA | Highmark Inc | C Corp | false |
| United Concordia Dental Corp of Alabama | |||||||||
| 4401 Deer Path Road | Harrisburg | PA | 17110 | 631028262 | Dental Insurance | AL | UCCI | C Corp | false |
| United Concordia Dental Plans of Ca | |||||||||
| 4401 Deer Path Road | Harrisburg | PA | 17110 | 237328765 | Dental Insurance | CA | UCCI | C Corp | false |
| United Concordia Dental Plans of Ky | |||||||||
| 4401 Deer Path Road | Harrisburg | PA | 17110 | 611012900 | Dental Insurance | KY | UCCI | C Corp | false |
| United Concordia Dental Plans of PA | |||||||||
| 4401 Deer Path Road | Harrisburg | PA | 17110 | 232541529 | Dental Insurance | PA | UCCI | C Corp | false |
| United Concordia Dental Plans of TX Inc | |||||||||
| 4401 Deer Path Road | Harrisburg | PA | 17110 | 742489037 | Dental Insurance | TX | UCCI | C Corp | false |
| United Concordia Dental Plans of the Mid | |||||||||
| 4401 Deer Path Road | Harrisburg | PA | 17110 | 382289438 | Dental Insurance | MI | UCCI | C Corp | false |
| United Concordia Dental Plans Inc | |||||||||
| 4401 Deer Path Road | Harrisburg | PA | 17110 | 521542269 | Dental Insurance | MD | UCCI | C Corp | false |
| United Concordia Insurance Company | |||||||||
| 4401 Deer Path Road | Harrisburg | PA | 17110 | 860307623 | Dental Insurance | AZ | UCL&H | C Corp | false |
| United Concordia Insurance Co of New | |||||||||
| 4401 Deer Path Road | Harrisburg | PA | 17110 | 113008245 | Dental Insurance | NY | UCCI | C Corp | false |
| United Concordia Life & Health Insurance | |||||||||
| 4401 Deer Path Road | Harrisburg | PA | 17110 | 231661402 | Dental Insurance | PA | UCCI | C Corp | false |
| Visionary Properties Inc | |||||||||
| 175 East Houston Street | San Antonio | TX | 78205 | 742849554 | Real Estate Opera | DE | VW of Amer | C Corp | false |
| Visionary Retail Management Inc | |||||||||
| 175 East Houston Street | San Antonio | TX | 78205 | 742849552 | Office Administra | DE | VW of Amer | C Corp | false |
| Visionworks Distribution Services Inc | |||||||||
| 175 East Houston Street | San Antonio | TX | 78205 | 043742989 | Optical Retail | TX | VW of Amer | C Corp | false |
| Visionworks Enterprises Inc | |||||||||
| 175 East Houston Street | San Antonio | TX | 78205 | 352196998 | Trademarks | DE | VW of Amer | C Corp | false |
| Visionworks Lab Services Inc | |||||||||
| 175 East Houston Street | San Antonio | TX | 78205 | 043742977 | Optical Retail | TX | VW of Amer | C Corp | false |
| Visionworks of America Inc | |||||||||
| 175 East Houston Street | San Antonio | TX | 78205 | 742337775 | Retail Sales | TX | HVHC | C Corp | false |
| Visionworks Inc | |||||||||
| 175 East Houston Street | San Antonio | TX | 78205 | 020677066 | Optical Retail | DE | VW of Amer | C Corp | false |
| West Penn Corporate Medical ServicesInc | |||||||||
| 4800 Friendship Avenue | Pittsburgh | PA | 15224 | 251437405 | Inactive | PA | WPAHS Inc | C Corp | false |
| West Penn Neurosurgery PC | |||||||||
| 4800 Friendship Avenue | Pittsburgh | PA | 15224 | 251630719 | Inactive | PA | WPAHS Inc | C Corp | false |
| West Virginia Family Health Plan Inc | |||||||||
| 1219 Virginia Street East | Charleston | WV | 25301 | 452763165 | Insurance | WV | Highmark WV | C Corp | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Saint vincent health center | ||
| p | $1,012,913 | invoicing |
| regional heart network | ||
| m | $60,107 | invoicing |