2017-05-11T10:10:44-05:00 2016-06-30 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 1650 MARKET STREET SUITE 4500 PHILADELPHIA PA 19103 990 2015-07-01 250967480 OHIO VALLEY HOSPITAL OHIO 4127776829 25 HECKEL ROAD MCKEES ROCKS PA 15136 DAVID W SCOTT PRESIDENT AND CEO 4127776829 2017-05-05 1 JULIUS C GREEN CPA P00350393 2159720701 2015 2021-01-29 14:40:06Z DAVID W SCOTT 25 HECKEL ROAD MCKEES ROCKS PA 15136 86568027 0 X WWW.OHIOVALLEYHOSPITAL.ORG X 1906 PA TO DELIVER QUALITY, PERSONALIZED HEALTH CARE SERVICES TO OUR PATIENTS AND FAMILIES IN A CARING MANNER, AND TO PROVIDE EDUCATIONAL PROGRAMS FOR FUTURE HEALTH CARE PROFESSIONALS. 13 13 757 101 0 0 242644 188301 64777459 61390361 3635827 3762213 3058172 2040896 71714102 67381771 0 20168 0 0 28843893 28864204 0 0 0 40942675 39342313 69786568 68226685 1927534 -844914 143062076 135126577 52812189 56115157 90249887 79011420 X OHIO VALLEY HOSPITAL'S MISSION IS TO DELIVER QUALITY, PERSONALIZED HEALTH CARE SERVICES TO OUR PATIENTS AND FAMILIES IN A CARING MANNER, AND TO PROVIDE EDUCATIONAL PROGRAMS FOR FUTURE HEALTH CARE PROFESSIONALS. 0 0 33013050 20168 54933626 THE HOSPITAL:SINCE ITS BEGINNING, OHIO VALLEY HAS NURTURED A COMMITMENT TO PROVIDE THE COMMUNITY WITH A PERSONALIZED APPROACH TO HIGH QUALITY HEALTH CARE. THIS DEDICATION HAS ESTABLISHED THE FOUNDATION FOR THE HOSPITAL TO GROW AND MEET THE COMMUNITY'S HEALTH CARE NEEDS WITH EXPANDED SERVICES, NEW PROGRAMS, ADVANCED TECHNOLOGY AND EDUCATION. WITH ITS CLOSE PROXIMITY TO THE CITY OF PITTSBURGH, THE HOSPITAL HAS THE UNIQUE ADVANTAGE OF A MEDICAL STAFF WHOSE SPECIALISTS PRACTICE AT BOTH THE HOSPITAL AS WELL AS TERTIARY-CARE HOSPITALS LOCATED IN THE CITY. FOR OUR COMMUNITY WE PROVIDE PROGRAMS AND SERVICE TO IMPROVE THE QUALITY OF LIFE: PROGRAMS SUCH AS: DIABETES AWARENESS AND PREVENTION. WE OFFER NUTRITION SERVICES, INCLUDING INPATIENT AND OUTPATIENT DIETITIAN HELP, AND A DIABETES PROGRAM FOR THOSE SUFFERING FROM DIABETIC HEALTH CONCERNS. THIS INCLUDES A SUPPORT GROUP MEETING, AS WELL AS PERSONAL NUTRITION COACHING AND OUR LIVING WELL WITH DIABETES PROGRAM. WE ALSO PROVIDE SPACE FOR THE WESTERN AREA YMCA TO HOLD PRE-DIABETES WEEKLY MEETINGS AT OUR HOSPITAL. CPR AND FIRST AID CLASSES, AN ANNUAL 5K COMMUNITY RACE (NOW IN ITS 35 YEAR), ALZHEIMER AND PARKINSON'S CLASSES, FREE BLOOD PRESSURE SCREENINGS, BLOOD SCREENINGS, LIFELINE, VOLUNTEER SERVICES PROGRAM, AND OUR SENIORITY PROGRAM.OUR SENIORITY PROGRAM MEETS MONTHLY AND GETS INVOLVED WITH OTHER COMMUNITY GROUPS, LIKE THE FOCUS ON RENEWAL GROUP, AND THE WESTERN AREA YMCA IN ORDER TO HAVE NEW ACTIVITIES AND LECTURES FOR OUR ATTENDEES TO GET INVOLVED WITH. WE SEND OUT A TRI-ANNUAL NEWSLETTER WITH LOCAL HOSPITAL NEWS AND COMMUNITY ORGANIZATION INFORMATION. WE ALSO DO A LOT OF HEALTH FAIRS WITH OUR NURSING STUDENTS AND SOME OF OUR ANCILLARY SERVICES, RANGING FROM HIGH SCHOOLS WHERE WE PROVIDE INFORMATION TO TEACHERS ON SOME OF OUR AVAILABLE SERVICES, TO FLU SHOT CLINICS ORGANIZED BY LOCAL REPRESENTATIVES. FOR OUR PATIENTS, WE PROVIDE PERSONALIZED HEALTH CARE SERVICE IN A FRIENDLY, CARING, AND COST-EFFECTIVE MANNER. SERVICES SUCH AS: AN ACUTE REHABILITATION UNIT, OCCUPATIONAL MEDICINE, CARDIAC REHABILITATION, CARDIOLOGY SERVICES, CRITICAL CARE, EMERGENCY DEPARTMENT, LABORATORY, MEDICAL/SURGICAL UNIT, IMC/ICU UNIT, NUCLEAR MEDICINE, PULMONARY REHABILITATION, RESPIRATORY SERVICES, SLEEP LAB, WILLOW BROOK GEROSPYCHIATRIC INPATIENT UNIT, PAIN TREATMENT CENTER, ORTHOPEDIC SERVICES WITH A KNEE AND HIP JOINT PROGRAM THAT RECEIVED A BLUE CROSS DISTINCTION CENTER PLUS RATING, REHABILITATION SERVICES INCLUDING PHYSICAL THERAPY, PILATES, OSTEOPOROSIS TREATMENT, AND OCCUPATIONAL THERAPY, RADIOLOGY SERVICES INCLUDING CT SCANS (AND A BRAND NEW LOW-DOSE CT SCANNER), MAMMOGRAPHY, AND X-RAY, LABORATORY SERVICES WITH OUR CAP-ACCREDITED PROGRAM, INPATIENT AND OUTPATIENT SURGICAL SERVICES, TWO WOUND CARE CENTERS WITH HYPERBARIC OXYGEN THERAPY CHAMBERS AVAILABLE. OUR PROGRAM WAS RECENTLY GIVEN THE HEALOGICS CENTER OF DISTINCTION AWARD. IN 2016, THE WOUND CARE CENTER HAD A PATIENT SATISFACTION RATE ABOVE 92% AND A WOUND HEALING RATE OF MORE THAN 93%! FOR OUR STUDENTS WE PROVIDE THE ENVIRONMENT FOR THE EDUCATION OF FUTURE HEALTH CARE PROFESSIONALS THROUGH A SOLID CLINICAL AND THEORETICAL BACKGROUND. THE SCHOOL OF NURSING PROVIDES A THEORETICAL AND CLINICAL ENVIRONMENT WHERE PROSPECTIVE NURSES WILL BE CHALLENGED AND MOTIVATED TO ACHIEVE THEIR BEST. THE SCHOOL OF RADIOGRAPHY STRIVES TO MEET THE NEEDS OF THE COMMUNITIES IT SERVES BY OFFERING A PROGRAM THAT DEVELOPS COMPETENT AND PROFESSIONAL FUTURE RADIOLOGICAL TECHNOLOGISTS. IN 1901, THE SCHOOL OF NURSING WAS INAUGURATED WITH SIX STUDENTS ENROLLED IN A THREE YEAR COURSE. THEIR FIRST STUDENT GRADUATED IN 1904. THE HOSPITAL AND THE SCHOOL OPERATED IN THIS ORIGINAL FACILITY UNTIL THE HOSPITAL WAS REPLACED BY NEWER FACILITIES IN A NEARBY LOCATION, WHICH OPENED IN 1949. THE SCHOOL RECEIVED A NEW FACILITY IN 1956. OUR SCHOOL OF RADIOGRAPHY OPENED IN 1963, AND CELEBRATED ITS 50TH COMMENCEMENT IN 2015. HISTORICAL PERSPECTIVE:AFTER ITS RELOCATION TO KENNEDY TOWNSHIP IN 1949, THE HOSPITAL FACILITIES HAD A CAPACITY OF 130 BEDS AND 35 BASSINETS. EXTENSIVE FACILITY IMPROVEMENTS AND EQUIPMENT ACQUISITION PROJECTS HAVE BEEN COMPLETED, AND NEW PROGRAMS INITIATED, SINCE THEN IN THE YEARS INDICATED BELOW:- 1963 EXPANSION OF THE HOSPITAL FACILITIES FEATURING THE ADDITION OF 21 NEW BEDS AND NEW OPERATING ROOMS, AND THE RELOCATION OF ANCILLARY DEPARTMENTS TO FACILITATE GROWTH OF OUTPATIENT SERVICES- 1978 ADDITION TO THE HOSPITAL FACILITIES FEATURING IMPROVEMENT TO OUTPATIENT AND ANCILLARY DEPARTMENTS, AND THE ADDITION OF ANOTHER 27 BEDS- 1987 INSTALLATION OF A CT SCANNER IN THE RADIOLOGY DEPARTMENT- 1988 OPENING OF THE MEDICAL OFFICE BUILDING - 1987 - 1992 EXTENSIVE RENOVATIONS TO VARIOUS PATIENT FLOORS, THE NUCLEAR MEDICINE DEPARTMENT AND THE MAIN ENTRANCE AND LOBBY- 1992 OPENING OF A 25,000 SQUARE-FOOT ADDITION TO THE SOUTH WING OF THE HOSPITAL FACILITIES WHICH PROVIDED SPACE FOR A CRITICAL CARE SUITE, CARDIOLOGY DEPARTMENT, RESPIRATORY THERAPY DEPARTMENT AND CARDIAC REHABILITATION UNIT. - 1992 OPENING OF THE WOUND CARE CENTER FOR THE SPECIALIZED TREATMENT OF CHRONIC WOUNDS, ONE OF THE FIRST PROGRAMS OF THIS TYPE IN WESTERN PENNSYLVANIA - 1994 EXTENSIVE RENOVATIONS TO THE HOSPITAL FACILITIES' SECOND FLOOR WHICH PROMOTED THE CONSOLIDATION OF OUTPATIENT REGISTRATION AND NUMEROUS OUTPATIENT PROGRAM IN A SINGLE LOCATION READILY ACCESSIBLE BY ELEVATED WALKWAY FROM THE MEDICAL OFFICE BUILDING, AND EXTENSIVE UPGRADES TO THE REHABILITATION SERVICES DEPARTMENT, THE LABORATORY AND THE RADIOLOGY DEPARTMENT. - 1997 COMPLETE REDESIGN OF THE EMERGENCY DEPARTMENT, INCLUDING THE INTERIOR PATIENT CARE AREAS, AS WELL AS THE EXTERIOR AMBULANCE AND AUTOMOBILE ACCESS ROADWAY. - 1999 CLOSURE OF THE HOSPITAL'S TRANSITIONAL (SUB-ACURE) CARE UNIT TO MAKE WAY FOR A 15-BED INPATIENT REHABILITATION UNIT, WHICH WAS SUBSEQUENTLY EXPANDED TO 16 BEDS. - 2001 ESTABLISHMENT OF A CARDIAC CATHETERIZATION LABORATORY (THE 'CATH LAB') WITH NEW EQUIPMENT. - 2001 OPENING OF THE HOSPITAL'S PAIN TREATMENT CENTER - 2003 OPENING OF THE HOSPITAL'S PULMONARY HEALTH CENTER - 2010 OPENING OF THE WILLOW BROOK GEROPSYCHIATRIC UNIT- 2014 WE ADDED ROBOTIC-ASSISTED SURGERY WITH FIREFLY TECHNOLOGY.- 2015 REOPENING OF OUR ARU UNIT ON OUR NEWLY RENOVATED 3RD FLOOR; THIS WAS MOVED FROM OUR 5TH FLOOR AT THAT TIME.- 2016 WE TURNED OUR 5TH FLOOR INTO OUR ORTHOPEDIC UNIT, WITH A FOCUS ON OUR KNEE AND HIP JOINT PROGRAM. IT OFFERS PRIVATE ROOMS AND A LOW PATIENT-TO-NURSE RATIO. WE ALSO HAVE A NEW GYM FOR PHYSICAL AND OCCUPATIONAL THERAPY. WE ALSO OFFER A CLASS PRIOR TO THE SURGERY THAT WALKS PATIENTS THROUGH WHAT THEY CAN EXPECT BEFORE, DURING, AND AFTER THEIR SURGERY, AS WELL AS DURING THEIR RECOVERY. - 2016 WE CELEBRATED OUR 35TH ANNUAL OVH AND KENNEDY TOWNSHIP 5K, WITH 187 REGISTERED RUNNERS, AND MORE THAN 60 LOCAL VOLUNTEERS.- 2016 OUR RADIOLOGY DEPARTMENT BEGAN WORKING WITH A NEW LOW-DOSE RADIATION SCANNER. DESIGNED TO MAKE THE IMAGING PROCESS SAFER AND FASTER FOR PATIENTS, ITS IMPROVED IMAGE QUALITY AIDS OUR RADIOLOGISTS AND PHYSICIANS IN THEIR DIAGNOSIS. THE SCANNER ALSO ALLOWS US TO PERFORM NEW SERVICES SUCH AS A CTA OF THE HEART AND LUNG CANCER SCREENINGS. OUR DOSE REDUCTION SOFTWARE THAT REDUCES RADIATION EXPOSURE BY AN AVERAGE OF 38%.IN THE FISCAL YEAR 2016, OVH CURRENTLY HAS 126 BEDS, INCLUDING 16 REHABILITATION AND 21 GEROPSYCHIATRIC BEDS. 3637688 0 4308236 THE RESIDENCE AT WILLOW LANE: THE RESIDENCE AT WILLOW LANE IS A CONTEMPORARY PERSONAL CARE SENIOR LIVING COMMUNITY THAT COMBINES ALL OF THE COMFORTS OF HOME WITH THE ACTIVITY AND SECURITY OF A SMALL COMMUNITY OF PEOPLE WHO CARE. RESIDENTS ENJOY A WIDE VARIETY OF SOCIAL ACTIVITIES IN AN ELEGANT SETTING, ALONG WITH SPECIALLY-PLANNED PROGRAMS, GOOD FOOD, FRIENDS, AND HELP FROM A CARING STAFF, TAILORED TO EACH RESIDENT'S NEEDS. AT THE RESIDENCE AT WILLOW LANE, GOOD HEALTH COMES FIRST. WILLOW LANE OFFERS SECURITY, WITH STAFF AVAILABLE 24 HOURS A DAY, AND COMFORT, WITH APARTMENTS OFFERING MANY OF THE FEATURES OF HOME. 1469068 0 1650694 WILLOW HEIGHTS INDEPENDENT LIVING:WILLOW HEIGHTS INDEPENDENT LIVING IS A UNIQUE RESIDENCE FOR INDEPENDENT SENIOR LIVING, WHERE SENIORS WILL FIND A VARIETY OF ACTIVITIES AND AMENITIES DESIGNED TO SUIT THEIR ACTIVE LIFESTYLES, ALL IN AN INVITING ATMOSPHERE OF COMFORT AND COMMUNITY. THE RESIDENTS ALSO ENJOY ENTERTAINING FAMILY AND FRIENDS, WHETHER IN THEIR OWN APARTMENT OR AT ONE OF THE MANY PARLORS, PATIOS OR ENTERTAINMENT AREAS SPECIFICALLY DESIGNED WITH FUN IN MIND. WITH A HOST OF ACTIVITIES, SOCIAL EVENTS, SERVICES AND AMENITIES, WILLOW HEIGHTS TRULY BRINGS NEW MEANING TO SENIOR LIVING. 476501 0 853967 PATHWAYS AT THE WILLOWS, A MEMORY CARE COMMUNITY:PATHWAYS AT THE WILLOWS IS AN EXCEPTIONAL OPTION FOR SENIORS WITH MEMORY IMPAIRMENTS, ONE THAT PROVIDES MAXIMUM COMFORT FOR RESIDENTS, AND PEACE OF MIND FOR FAMILIES. THE PATHWAYS PROGRAM OFFERS A STATE-OF-THE-ART RESIDENCE DESIGNED FOR THE SPECIFIC NEEDS OF SENIORS WITH ALZHEIMER'S OR RELATED DEMENTIA. OUR MEMORY CARE RESIDENCE HAS BEEN DESIGNED TO CREATE MEANINGFUL AND PERSONAL ROUTINES BASED ON EACH RESIDENT'S LIFE STORY AND HISTORY. OUR PATHWAYS PROGRAM OFFERS A HOME-LIKE ENVIRONMENT CONDUCIVE TO BOTH YOUR EMOTIONAL HEALTH AND WELL-BEING. EVERY ROOM AT PATHWAYS HAS BEEN DESIGNED TO STIMULATE THE SENSES AND INVOKE A FEELING OF FAMILIARITY AND WARMTH. 476501 0 853967 38596307 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 157 0 1 757 1 0 0 0 0 0 1 1 0 0 0 0 X 13 13 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X JACK B NELSON VP OF FINANCECFO 4127776829 25 HECKEL ROAD MCKEES ROCKS PA 15136 MARK R SCHOLL CHAIRMAN 1.00 2.00 X X 0 0 0 GENE M BATTISTELLA DO VICE CHAIRMAN 1.00 2.00 X X 0 0 0 MARK S BRENNAN TREASURER 1.00 2.00 X X 0 0 0 KURT R GINGRICH ESQ SECRETARY 1.00 2.00 X X 0 0 0 JENNIFER W BLACK DIRECTOR 1.00 2.00 X 0 0 0 DAVID A CORRAL PRESIDENT-ELECT, MEDICAL STAFF 1.00 2.00 X 0 0 0 MICHAEL P DICLEMENTE DIRECTOR 1.00 2.00 X 0 0 0 JANE A DIXON DIRECTOR 1.00 2.00 X 0 0 0 MICHAEL E LALLY MD DIRECTOR 1.00 2.00 X 0 0 0 STEPHEN N LEIBENSPERGER PRESIDENT, MEDICAL STAFF 1.00 2.00 X 0 0 0 ANTHONY F LISANTI DIRECTOR (TERM 11/14/2015) 1.00 2.00 X 0 0 0 DANIEL B LONG DIRECTOR 1.00 2.00 X 0 0 0 ANGELO D LUPARIELLO MD DIRECTOR 1.00 2.00 X 0 0 0 GARY G SAUER MD DIRECTOR 1.00 2.00 X 0 0 0 DAVID W SCOTT PRESIDENT AND CEO 40.00 2.00 X 361669 0 175362 MAUREEN HEILMANN CHIEF CLINICAL OFFICER 40.00 0.00 X 120948 0 26035 JACK NELSON VICE PRESIDENT FINANCE, CFO 40.00 2.00 X 121517 0 26158 HUWAIDA MANSOUR DIRECTOR BUSINESS FIT 40.00 0.00 X 206530 0 44457 ERIC LAWLOR EXECUTIVE VICE PRESIDENT 40.00 0.00 X 166196 0 35775 LORRIE MITCHAM CRNA 40.00 0.00 X 155843 0 33546 LAJENNEPHER ZEVOLA CRNA 40.00 0.00 X 153894 0 33127 VICTORIA MELL VP HR AND SUPPORT SERVICES 40.00 0.00 X 130452 0 28081 GETTE CHEROK PHARMACIST 40.00 0.00 X 121430 0 26139 TADESSE TEFERA FORMER CFO 40.00 2.00 X 162307 0 34938 1700786 0 463618 14 1 1 0 CARDINAL HEALTH 71 MILL ACRES DRIVE WHEELING WV 26003 SUPPLIER 2215865 UPMC EMERGENCY MEDICAL INC 2 HOT METAL STREET PITTSBURGH PA 15203 HEALTH CARE PROVIDER 1018859 PT UNLIMITED INC 1638 TIFFANY RIDGE DRIVE PITTSBURGH PA 15241 HEALTH CARE PROVIDER 874212 OWENS & MINOR PO BOX 644783 PITTSBURGH PA 15264 SUPPLIER 872959 ARAMARK HEALTH SUPPORT 25271 NETWORK PLACE CHICAGO IL 60673 SERVICE PROVIDER 842362 89 40065 1000 147236 188301 PATIENT REVENUE 621400 54577124 54577124 NURSING/ASSISTED LIVING 623000 6813237 6813237 61390361 1631450 1631450 859845 501720 358125 358125 358125 20771435 11370 18652042 0 2119393 11370 2130763 2130763 13595 40065 32494 -18899 -18899 EMR & ARRA INCENTIVE REVENUE 900099 866544 866544 NURSING ENTRANCE FEES 611600 356162 356162 CAFETERIA 722210 182816 182816 296148 296148 1701670 67381771 61746523 0 5446947 X 20168 20168 1002470 1002470 22937549 13221863 9715686 285513 164578 120935 2706083 1559864 1146219 1932589 1114000 818589 1641273 946077 695196 224532 129427 95105 268152 154571 113581 19535 11261 8274 266582 266582 10084259 5812858 4271401 489221 273458 215763 908950 523945 385005 4648365 2679451 1968914 68727 39616 29111 1573921 907253 666668 5036328 2903084 2133244 746650 430391 316259 PATIENT SUPPLIES 9897965 5705472 4192493 BAD DEBT 1619213 933361 685852 MEDICAID ASSESSMENT 837305 482647 354658 EDUCATION & RECRUITING 318262 183455 134807 693073 399507 293566 68226685 38596307 29630378 0 9887 4350 3025312 1291523 6013820 5087932 916254 1023777 1038385 892937 135231212 78174633 56164697 57056579 57968846 47737925 1965063 17924875 20066491 143062076 135126577 19851562 23944841 24674344 24263415 7812483 7432483 473800 474418 52812189 56115157 X 86384297 76977714 3865590 2033706 90249887 79011420 143062076 135126577 X -844914 -4335070 -6058483 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 19535 19535 0 PART II-B, LINE 1: CRANMER CONSULTANTS HAVE BEEN RETAINED TO LOBBY THE CONGRESS OF THE UNITED STATES AND VARIOUS FEDERAL AGENCIES ON BEHALF OF OHIO VALLEY HOSPITAL. CRANMER CONSULTING MAINTAINS THE APPROPRIATE LOBBYING REGISTRATIONS WITH THE U.S. SENATE AND U.S. HOUSE COMMITTEES ON ETHICS. SPECIFICALLY, THIS GROUP SEEKS AND SECURES FUNDING FOR OHIO VALLEY THROUGH CONGRESSIONALLY DIRECTED SPENDING INITIATIVES, FOR VARIOUS CAPITAL PROJECTS, TECHNOLOGICAL UPGRADES AND PROGRAMMATIC NEEDS. OHIO VALLEY HOSPITAL BELONGS TO THE HEALTHCARE COUNCIL OF WESTERN PENNSYLVANIA AND THE HOSPITAL AND HEALTHSYSTEM ASSOCIATION OF PENNSYLVANIA. WE ALSO BELONG TO THE AMERICAN HOSPITAL ASSOCIATION. A PORTION OF THE ANNUAL DUES FOR THESE ORGANIZATIONS IS USED FOR LOBBYING FEDERAL AND STATE AGENCIES IN MATTERS OF HEALTH CARE REGULATORY ISSUES. 92646 92646 85568670 41560315 44008355 47810393 36614318 11196075 1759503 1759503 57056579 DEFERRED FINANCING COSTS 340804 DUE FROM AFFILIATES 19452587 THIRD PARTY PAYOR SETTLEMENTS 40984 OTHER ASSETS 232116 20066491 DERIVATIVE FINANCIAL INSTRUMENTS 474418 474418 X 55636637 -4335070 -7944278 -12279348 67915985 -534214 -534214 67381771 66875104 534214 534214 66340890 1885795 1885795 68226685 PART X, LINE 2: THE CORPORATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD IS MET. MANAGEMENT HAS DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2016 AND 2015. THE CORPORATION'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN OPERATING EXPENSES. PART XI, LINE 2D - OTHER ADJUSTMENTS: PENSION LIABILITY ADJUSTMENT -5,919,393. CHANGE IN FAIR VALUE OF DERIVATIVE -139,090. PROVISION FOR BAD DEBT -1,619,213. INVESTMENT MANAGEMENT FEES -266,582. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -501,720. FUNDRAISING EXPENSES -32,494. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 501,720. FUNDRAISING EXPENSES 32,494. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT 1,619,213. INVESTMENT MANAGEMENT FEES 266,582. TOAST TO THE COMMUNITY 53660 40065 13595 3731 21831 2243 840 3849 53660 40065 13595 3731 21831 2243 840 3849 32494 -18899 1 1 1 X 1 X 1 1 1 0 0 318819 318819 0.00480 6179884 3650765 2529119 0.03800 6498703 3650765 2847938 0.04280 68172 9730 58442 0.00090 289861 289861 0.00440 4099891 3666336 433555 0.00650 20168 20168 0.00030 4478092 3676066 802026 0.01210 10976795 7326831 3649964 0.05490 20782 20782 0.00030 4642 4642 0.00010 25424 25424 0.00040 1 655239 10140293 11882075 -1741782 X 1 1 1 1 OHIO VALLEY HOSPITAL 25 HECKEL ROAD MCKEES ROCKS PA 15136 X X X X OHIO VALLEY HOSPITAL 1 0 0 1 X X X X X X X X 15 1 0 0 1 X OHIOVALLEYHOSPITAL.ORG/PATIENTS-VISITORS/2016-COMMUNITY-HEALTH-NEEDS-ASSESS X 1 15 1 OHIOVALLEYHOSPITAL.ORG/PATIENTS-VISITORS/2016-COMMUNITY-HEALTH-NEEDS-ASSESS 0 0 1 X 200.000000000000 250.000000000000 X X X X X 1 1 X X X 1 X HTTPS://OHIOVALLEYHOSPITAL.ORG/PATIENTS-VISITORS/PRICE-OF-SERVICE/PATIENT-F X HTTPS://OHIOVALLEYHOSPITAL.ORG/PATIENTS-VISITORS/PRICE-OF-SERVICE/CHARITY-C X X X X 1 X 0 X X X X 1 X X 0 0 OHIO VALLEY HOSPITAL PART V, SECTION B, LINE 5: TO GUIDE THIS ASSESSMENT, THE HOSPITAL'S LEADERSHIP TEAM FORMED A STEERING COMMITTEE THAT CONSISTED OF HOSPITAL AND COMMUNITY AGENCIES WHO REPRESENTED THE BOARD INTERESTS OF THE LOCAL REGION. THESE INCLUDED REPRESENTATIVES WHO UNDERSTOOD THE NEEDS AND ISSUES RELATED TO VARIOUS UNDERREPRESENTED GROUPS INCLUDING MEDICALLY UNDERSERVED POPULATIONS, LOW-INCOME PERSONS, MINORITY GROUPS, AND THOSE WITH CHRONIC DISEASE AND MENTAL HEALTH NEEDS, INDIVIDUALS WITH EXPERTISE IN PUBLIC HEALTH, AND INTERNAL PROGRAM MANAGERS. THE OVH STEERING COMMITTEE MET THREE TIMES TO PROVIDE GUIDANCE ON THE VARIOUS COMPONENTS OF THE CHNA. THE STAFF, STEERING COMMITTEE MEMBERS AND CONSULTING TEAM MADE SIGNIFICANT EFFORTS TO ENSURE THAT THE ENTIRE PRIMARY SERVICE TERRITORY, ALL SOCIO-DEMOGRAPHIC GROUPS AND ALL POTENTIAL NEEDS, ISSUES AND UNDERREPRESENTED POPULATIONS WERE CONSIDERED IN THE ASSESSMENT. THIS WAS ACCOMPLISHED BY IDENTIFYING FOCUS GROUPS AND KEY STAKEHOLDERS THAT REPRESENTED THE VARIOUS SUBGROUPS IN THE COMMUNITY. IN ADDITION, THE PROCESS INCLUDED PUBLIC HEALTH PARTICIPATION AND INPUT, THROUGH EXTENSIVE USE OF THE PA HEALTH DEPARTMENT AND CENTERS FOR DISEASE CONTROL DATA. OHIO VALLEY HOSPITAL PART V, SECTION B, LINE 11: OHIO VALLEY HOSPITAL (OVH) IS COMMITTED TO ACHIEVING THE "TRIPLE AIM": IMPROVED HEALTH THROUGH BETTER QUALITY OF CARE AT LOWER COSTS. TO THAT END, TO ADDRESS THE NEEDS OF THE COMMUNITY, OVH IDENTIFIED AND APPROVED BY THE OVH BOARD OF DIRECTORS TO BE ADDRESSED OVER THE NEXT THREE YEARS ARE: DIABETES, CARDIOVASCULAR DISEASE, TRANSPORTATION FOR SELF/HEALTHCARE WORKERS, KNOWLEDGE OF ALL SERVICES IN THE AREA, MENTAL HEALTH, SMOKING, AND EATING HABITS/ACCESS TO HEALTHY FOODS.AN IMPLEMENTATION COMMITTEE MADE UP OF HOSPITAL ADMINISTRATORS AND SERVICE LINE MANAGERS REVIEWED THE SEVEN PRIORITIES AND CREATED TWO OVERALL IMPLEMENTATION GOALS, GROUPING THE PRIORITIES INTO APPROPRIATE AND COMMON AREAS. WITHIN THOSE TWO GOALS ARE SPECIFIC IMPLEMENTATION EFFORTS, EITHER EXISTING OR TO BE DEVELOPED, WHICH THE HOSPITAL WILL BUDGET FOR, MANAGE, IMPLEMENT AND EVALUATE AND REPORT ON OVER THE NEXT THREE YEARS.GOAL 1: IMPROVE HEALTH STATUS THROUGH CHRONIC DISEASE AND CARE MANAGEMENT ACROSS THE CONTINUUM, ESPECIALLY AS IT RELATES TO DIABETES, CARDIOVASCULAR DISEASE AND MENTAL HEALTH. IN ORDER TO ACCOMPLISH THIS GOAL OVH IS IMPLEMENTING A NUMBER OF PRIORITY PROGRAM & INITIATIVES. THESE INCLUDE:1. CONTINUE OFFERING DIABETES PROGRAMS TO THE COMMUNITY A. ANNUAL DIABETES DAY (OFFERS SPEAKERS, FREE HEALTH SCREENINGS, INCLUDING: BONE DENSITY SCANS, FOOT SCREENINGS, BLOOD GLUCOSE, BLOOD PRESSURE, HEIGHT, WEIGHT, BODY MASS INDEX, BODY FAT ANALYSIS AND A1C TESTING, AND OFFER DIABETIC INFORMATION THROUGH VENDORS) B. LIVING WELL WITH DIABETES CLASSES C. DIABETES SUPPORT GROUP D. PRE-DIABETES CLASSES IN PARTNERSHIP WITH THE WESTERN AREA YMCA E. CONTINUE TO PROMOTE WOUND CARE HEALTH FOR THOSE PERSONS WITH DIABETES2. PROMOTE CHRONIC DISEASE MANAGEMENT SERVICES TO INCREASE UTILIZATION: A. NUTRITION PROGRAMS B. DIABETES PROGRAMS C. CARDIAC REHAB PROGRAMS D. PULMONARY REHAB E. CONTINUE TO PROVIDE EDUCATIONAL MATERIALS (INCLUDING INFORMATION GUIDE ON VARIOUS CHRONIC DISEASES) AT HEALTH FAIRS AND OTHER PUBLIC EVENTS F. GEROPSYCH AND OUTPATIENT PSYCH3. CONTINUE TO OFFER HEALTH/WELLNESS ACTIVITIES A. ANNUAL COMMUNITY 5K B. CONTINUE OFFERING NUTRITION AND HEALTHY EATING CLASSES C. INVESTIGATE PARTNERSHIPS WITH THE WESTERN AREA YMCA REGARDING NUTRITION AND EXERCISE PROGRAMS D. CONTINUE FUNDING OF WESTERN AREA YMCA AFTER SCHOOL NUTRITION PROGRAM4. INSTITUTE SMOKING CESSATION PROGRAM A. SMOKING CESSATION CLASSES FOR EMPLOYEES AND THE COMMUNITY B. TRANSITION OVH CAMPUS TO A SMOKE-FREE CAMPUS5. CONTINUE TO WORK ON KEEPING THE READMISSION RATES FOR CHRONIC DISEASE LOW FROM YEAR TO YEAR6. CONTINUE TO OFFER THE FOLLOWING CHRONIC DISEASE EDUCATION CLASSES A. CARDIAC REHAB CLASSES B. PULMONARY REHAB CLASSES C. SENIORITY GROUP MONTHLY MEETINGS7. CONTINUE TO OFFER POPULATION HEALTH PROVIDER MEETINGS8. CONTINUE OVH'S HEALTH CARE AT HOME PARTNERSHIP9. PROMOTE AND INCREASE MENTAL HEALTH SERVICES A. INVESTIGATE BECOMING A CENTER OF EXCELLENCE FOR MENTAL HEALTH AND NUTRITION B. CONTINUE WORKING WITH THE MENTAL HEALTH PROVIDER GROUP C. INVESTIGATE PARTNERING WITH A DESIGNATED COLLABORATING ORGANIZATION - CHARTIERS AND MERCY BEHAVIORAL HEALTH (CREATE A REFERRAL SYSTEM FOR THOSE PATIENTS NOT SERVED BY OVH) D. CONTINUE TO LEND SUPPORT FOR MENTAL HEALTH AWARENESS WEEK E. CONTINUE TO PARTICIPATE IN MENTAL HEALTH HEALTH FAIRSGOAL 2: INCREASE EDUCATION AND AWARENESS OF SERVICES PROVIDED BY OVH TO ITS PRIMARY SERVICE AREA, AS WELL AS IMPROVED ACCESS TO OVH SERVICES. IN ORDER TO ACCOMPLISH THIS GOAL, OVH IS IMPLEMENTING A NUMBER OF PRIORITY PROGRAMS INCLUDING:1. INCREASE AWARENESS OF ACCESS TO OVH MEDICAL CAMPUS THROUGH OVH'S TRANSPORTATION VANS A. PURCHASE 1 ADDITIONAL TRANSPORTATION VAN2. RESEARCH WHAT OUTSIDE MATERIALS FOR HEALTH ARE GIVEN/OFFERED TO PATIENTS UPON DISCHARGE FROM THE EMERGENCYDEPARTMENT A. CREATE EDUCATION FOLDERS WITH OVH INFORMATION AND INFORMATION OF SHARED RESOURCES B. CREATE A PATIENT INFORMATION GUIDE OF ALL SERVICES AVAILABLE IN THE PRIMARY SERVICE AREA3. CONTINUE TO PARTICIPATE IN COMMUNITY HEALTH FAIRS BY OFFERING A TRACKING PROGRAM IN OVH'S COMPUTER SYSTEM AND CREATING TESTING CARDS FOR PARTICIPANTS TO KEEP TRACK OF THEIR READINGS FROM TEST TO TEST FOR ITEMS LIKE FLU SHOTS, BONE DENSITY TESTS AND BLOOD PRESSURE SCREENING4. INVESTIGATE BECOMING A CERTIFIED MEDICAL HOME5. ADD AN EDUCATION PIECE TO EMPLOYEE ORIENTATION FOCUSING ON SERVICES OFFERED BY THE HOSPITAL TO BETTER EQUIP EMPLOYEES TO UNDERSTAND AND REFER TO OVH SERVICES6. CONTINUE WORKING WITH THE ROTARY THROUGH THE WILLOWS AND OVH TO PROMOTE HEALTH CARE INITIATIVES7. CONTINUE TO OFFER HEALTH CARE INFORMATION AND SPEAKERS TO RESIDENTS OF WILLOWS8. EXPAND PRIMARY CARE TO PROMOTE NUTRITION, SMOKING CESSATION AND PSYCHOLOGICAL SCREENINGSWHILE THERE ARE MANY PRIORITIES BEING ADDRESSED BY OVH'S NEEDS ASSESSMENT, THERE WERE OTHER HEALTH INDICATORS THAT WERE NOT CONSIDERED A HIGH PRIORITY AND SUBSEQUENTLY ARE NOT ADDRESSED THROUGH THESE IMPLEMENTATION STRATEGIES BECAUSE THEY ARE ALREADY BEING ADDRESSED BY THE HOSPITAL, EXISTING COMMUNITY ASSETS, NECESSARY RESOURCES TO MEET THESE NEEDS ARE LACKING, OR THESE NEEDS FALL OUTSIDE OF THE OVH MISSION. THESE INDICATORS INCLUDE: COPD/CHRONIC BRONCHITIS, CEREBROVASCULAR DISEASE, LUNG CANCER, ACCESS TO PATIENT ADVOCATE, ALZHEIMER'S DISEASE, PRESCRIPTION DRUG AND ALCOHOL MISUSE/ABUSE/MORTALITY, ARTHRITIS, PNEUMONIA, MEDICATION MANAGEMENT, ASTHMA, COLORECTAL CANCER, PROSTATE CANCER, SHORT-TERM HOME HEALTH ASSISTANCE, AFFORDABILITY OF HEALTH CARE INCLUDING INSURANCE COSTS, CO-PAYS, AND DEDUCTIBLES, COMMUNICATION BETWEEN DOCTORS, SPECIALISTS, INSURANCE COMPANIES, HEALTH/INSURANCE LITERACY, MELANOMA/SKIN CANCER, AT-HOME RISK ASSESSMENTS, FALLS, SUICIDE, HIV TESTING, PRE-APPROVAL WAIT TIME, ACCESSIBILITY OF DOCTOR'S OFFICE, COMMUNICATION BETWEEN HOME HEALTH WORKERS, PATIENT, AND FAMILY, TOBACCO USE DURING PREGNANCY, TEEN PREGNANCY AND BIRTH OUTCOMES, BREASTFEEDING, AUTO ACCIDENTS AND FIREARMS. OTHER NONHEALTHCARE INDICATORS NOTED WERE RELATED TO POVERTY, UNEMPLOYMENT AND LACK OF JOBS, WHILE THE HOSPITAL OFFERS NUMEROUS HEALTH AND WELLNESS PROGRAMS ADDRESSING THE FINANCIAL NEEDS OF OVH'S SERVICE AREA RESIDENTS, ADDRESSING THESE SPECIFIC ITEMS IS OUTSIDE OF THE SCOPE OF THE MISSION OF THE HOSPITAL. OHIO VALLEY HOSPITAL PART V, SECTION B, LINE 22D: OHIO VALLEY HOSPITAL USES FEDERAL POVERTY GUIDELINES BASED AT 200% FREE CARE. A SLIDING SCALE OF 250% OF THE FEDERAL POVERTY GUIDELINES FOR A 30% AND 300% FOR A 20% REDUCTION.NON INSURED INPATIENT CHARGES ARE DISCOUNTED TO THE MEDICARE INPATIENT RATES AND OUTPATIENTS CHARGES ARE DISCOUNTED TO A BLENDED RATE. 7 1 - THE RESIDENCE AT WILLOW LANE 15 HECKEL ROAD MCKEES ROCKS PA 15136 PERSONAL CARE 2 - WILLOW HEIGHTS INDEPENDENT LIVING 32 HECKEL ROAD MCKEES ROCKS PA 15136 INDEPENDENT LIVING 3 - HEALTH CENTER AT KENNEDY TOWNSHIP KENMAWR PLAZA 500 PINE HOLLOW ROAD MCKEES ROCKS PA 15136 WOUND AND PAIN CLINIC 4 - HEALTH CENTER AT MT NEBO COMMONS 107 MOUNT NEBO POINT DRIVE PITTSBURGH PA 15237 WOUND 5 - HEALTH CENTER AT CORAOPOLIS 1308 FIFTH AVENUE CORAOPOLIS PA 15108 PROFESSIONAL SERVICES 6 - WILLOW BROOK 32 HECKEL ROAD MCKEES ROCKS PA 15136 GEROPSYCHIATRIC UNIT 7 - PATHWAYS MEMORY CARE UNIT 30 HECKEL ROAD MCKEES ROCKS PA 15136 MEMORY CARE RESIDENCE PART I, LINE 3C: OHIO VALLEY HOSPITAL USES FEDERAL POVERTY GUIDELINES AS A BASIS FOR ELIGIBILITY TO QUALIFY FOR FREE AND DISCOUNTED CARE. CURRENTLY THESE RATES ARE 200% FOR FREE CARE 250% AND 300% FOR DISCOUNTED SERVICES USING A SLIDING SCALE. PART I, LINE 7: AMOUNTS WERE DERIVED USING OUR MEDICARE COST TO CHARGE RATIO FOR FISCAL YEAR ENDING JUNE 30, 2016. THE EDUCATION DEPARTMENT DIRECT EXPENSES WERE DIVIDED BY TOTAL EDUCATION DEPARTMENT TO CALCULATE THE INDIRECT EXPENSES.THE GENERAL SERVICES COST CENTERS DIRECT EXPENSES WERE DIVIDED BY TOTAL EXPENSES OF THAT COST CENTER TO CALCULATE INDIRECT EXPENSES. PART I, LINE 7G: INCLUDED IN SUBSIDIZED HEALTH SERVICES ARE COSTS ATTRIBUTABLE TO OUR TWENTY FOUR HOUR EMERGENCY DEPARTMENT OPERATION. TOTAL COSTS WERE $4,099,891. PART I, LN 7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN A THAT WAS REMOVED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN SCHEDULE H, PART I, LINE 7, COLUMN (F) WAS $1,619,213. PART II, COMMUNITY BUILDING ACTIVITIES: THE HOSPITAL PROMOTES THE HEALTH OF THE COMMUNITY BY IDENTIFYING NEEDS, CONSTRUCTING FACILITIES, AND STARTING NEW PROGRAMS. THIS INCLUDES MEMORY CARE AND GEROPSYCHIATRIC PROGRAMS THAT HELP OUR COMMUNITY AND IMPROVE PATIENT CARE. THE HOSPITAL EXTENDS MEDICAL PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN OUR COMMUNITY.OVH CONTINUES TO BE INVOLVED WITH MANY COMMUNITY-BASED ORGANIZATIONS. THIS INCLUDES THE GREATER AREA MCKEES ROCKS ROTARY, FOCUS ON RENEWAL, THE STO-ROX FAMILY HEALTH CENTER, ROBINSON TOWNSHIP LIBRARY, THE WESTERN AREA YMCA, PARKWAY WEST ROTARY, THE MCKEES ROCKS COMMUNITY DEVELOPMENT CENTER, AND THE AIRPORT AREA CHAMBER OF COMMERCE, INCLUDING THE CHOICES PROGRAM.SOME OF THE SERVICES PROVIDED SOLELY BY OVH ARE: AN EMERGENCY DEPARTMENT OPEN TO ALL PERSONS REGARDLESS OF RACE, COLOR, SEX OR CREED, OR ABILITY TO PAY. OPERATES AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS, DIABETIC EDUCATION AND TRAINING, SAFE HAVEN, ORTHOPEDIC EDUCATION PROGRAMS, CONTINUOUS EDUCATION PROGRAMS FOR EMTS AND PARAMEDICS, INDEPENDENT, ASSISTED AND MEMORY CARE UNITS, CARDIAC REHAB AND OCCUPATIONAL REHAB AND MEDICINE. ADDITIONALLY, OHIO VALLEY HOSPITAL HAS A 19-MONTH RN DIPLOMA PROGRAM. THIS PROGRAM IS FULLY ACCREDITED BY THE PENNSYLVANIA STATE BOARD OF NURSING (PASBON) AND BY THE ACCREDITATION COMMISSION FOR EDUCATION IN NURSING. IT IS ALSO APPROVED BY THE DEPARTMENT OF EDUCATION. WE ALSO HAVE A 24-MONTH SCHOOL OF RADIOGRAPHY PROGRAM. STUDENTS WHO SUCCESSFULLY COMPLETE THE PROGRAM ARE AWARDED A CERTIFICATE IN RADIOLOGIC TECHNOLOGY AND AN ASSOCIATE DEGREE IN HEALTH SCIENCE WITH A CONCENTRATION IN RADIOLOGIC TECHNOLOGY FROM LA ROCHE COLLEGE. THEY ARE THEN ELIGIBLE TO TAKE THE NATIONAL CERTIFICATION EXAMINATION ADMINISTERED BY THE AMERICAN REGISTRY OF RADIOLOGIC TECHNOLOGISTS (ARRT). PART III, LINE 2: BAD DEBT WAS CALCULATED USING THE MEDICARE COST TO CHARGE RATIOS IN ORDERTO REPORT AT COST. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE CORPORATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE CORPORATION ANALYZES CONTRACTUAL AMOUNTS DUE AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND INSURED PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES, THE CORPORATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE BILLED RATES AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE CORPORATION'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS WAS 77% AT JUNE 30, 2016 AND 82% AT JUNE 30, 2015. THE DECREASE IS DUE TO THE AGING OF THE SELF-PAY ACCOUNTS RECEIVABLE. THE CORPORATION HAS NOT CHANGED ITS FINANCIAL ASSISTANCE POLICY IN 2016 OR 2015. THE CORPORATION DOES NOT MAINTAIN A MATERIAL ALLOWANCE FOR DOUBTFUL ACCOUNTS FROM THIRD-PARTY PAYORS, NOR DID IT HAVE SIGNIFICANT WRITE-OFFS FROM THIRD-PARTY PAYORS. PART III, LINE 8: 27 PERCENT OF OHIO VALLEY HOSPITAL PATIENTS RECEIVE MEDICARE AND 41 PERCENT OF PATIENTS ARE COVERED BY MEDICARE MANAGED CARE INSURANCE GROUPS. THIS IS A DEMONSTRATED NEED OF THE COMMUNITY. MEDICARE'S PARTICIPATION AT OVH MEETS A COMMUNITY BENEFIT OBJECTIVE, BECAUSE THE PATIENT POPULATION INCLUDES VULNERABLE AND UNDERSERVED MEDICARE PATIENTS. OUR CURRENT YEAR'S MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT. THE AMOUNTS WERE TAKEN DIRECTLY FROM THE MEDICARE COST REPORT. SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY.THE LOCAL UNEMPLOYMENT RATE FOR JUNE 2016 WAS 5.6 AND THE NATIONAL RATE WAS 4.9. PART III, LINE 9B: ALL PATIENTS PRESENTING WITH NO INSURANCE OR LIMITED COVERAGE ARE PROVIDED WITH THE GUIDELINES FOR THE OHIO VALLEY CARE PROGRAM. PATIENTS CAN QUALIFY FOR FREE CARE BASED ON THE INFORMATION THEY PROVIDE. IF A PATIENT IS PLACED INTO A BAD DEBT STATUS THEY MAY STILL ESTABLISH INDIGENCE AT ANY TIME AND BE COMPATIBLE WITH THE OHIO VALLEY CARE PROGRAM POLICY AND PROCEDURE GUIDELINES. DOCUMENTATION SUPPORTING THE DETERMINATION OF INDIGENCE WILL BE AVAILABLE UPON REQUEST. THE DOCUMENTATION WILL INCLUDE NOTES ON THE PATIENT'S ACCOUNT IN OUR PATIENT ACCOUNTING SYSTEM AND OTHER INFORMATION THAT CAN BE RETRIEVED AS NEEDED TO SUPPORT THE INDIGENCE STATUS OF THE PATIENT OR RESPONSIBLE PARTY.IF AN ACCOUNT QUALIFIES FOR INDIGENCE THE DEBT MAY BE DEEMED UNCOLLECTIBLE WITHOUT APPLYING ANY FURTHER COLLECTION EFFORTS. THERE WILL NOT BE ANY OTHER LEGAL SOURCE OF RESPONSIBILITY FOR PAYMENT. PART VI, LINE 2: OHIO VALLEY HOSPITAL CONTINUED TO ADVANCE ITS COMMUNITY HEALTH NEEDS ASSESSMENT INITIATIVES IN 2015-2016. THESE IMPLEMENTATION STRATEGIES WERE CONTINUOUSLY MONITORED AND DISCUSSED BY OUR IMPLEMENTATION COMMITTEE, AND IN PREPARATION OF 2016'S NEW COMMUNITY HEALTH NEEDS ASSESSMENT, AREAS IN THIS PLAN WERE MARKED FOR POTENTIAL EXPANSION. THE HOSPITAL PROMOTES THE HEALTH OF THE COMMUNITY BY IDENTIFYING NEEDS, CONSTRUCTING FACILITIES, AND STARTING NEW PROGRAMS. THIS INCLUDES MEMORY CARE AND GEROPSYCHIATRIC PROGRAMS THAT HELP OUR COMMUNITY AND IMPROVE PATIENT CARE. THE HOSPITAL EXTENDS MEDICAL PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN OUR COMMUNITY. THE HOSPITAL'S EMERGENCY DEPARTMENT IS OPEN 24 HOURS PER DAY. PAIN AND WOUND CARE DEPARMENTS SERVE THE COMMUNITY IN TWO SITES OFF THE HOSPITAL CAMPUS.SOME OF OUR OTHER OBJECTIVES THIS YEAR WERE AS FOLLOWS:1. HOST OUR 8TH ANNUAL DIABETES DAY EVENTOUR 8TH ANNUAL DIABETES DAY WAS A LARGE SUCCESS. NEW THIS YEAR, WE ADDED IN A PASSPORT TO HEALTHY LIVING, ENCOURAGING EVERYONE WHO CAME TO TAKE PART IN OUR PASSPORT CHALLENGE. WE GAVE EACH REGISTERED GUEST A CARD WITH 5 VENDOR TABLE SPACES, PLUS THE OVH TABLE, AND ONE LECTURE SPACE. IF THEY FILLED THEIR CARD OUT, THEY WERE REGISTERED TO WIN A NUTRIBLENDER!OUR SPEAKERS WITH QUESTION AND ANSWER SESSIONS WERE AS FOLLOWS:SPEAKERS WITH Q&A SESSIONS ON:9:00AM TO 9:30AM PHYSICAL THERAPIST, "NEW GUIDELINES FOR DIABETIC EXERCISE" 9:30AM TO 10:15AM - PRIMARY CARE PHYSICIAN, "DIABETES MELLITUS" 10:15AM TO 11:15AM - NUTRITION SERVICES/DIABETES OUTREACH, "HEALTHY SNACKING" 11:15AM TO 12:00PM - EYE DOCTOR, "SPOTLIGHT ON EYE DISEASE"12:00PM TO 12:45PM OUTPATIENT DIETITIAN - DIABETIC DIET AND A HEALTHY LIFESTYLE COOKING DEMONSTRATIONSWE HAD APPROXIMATELY 120 PARTICIPANTS. OF THOSE MORE THAN HALF COMPLETED OUR SECOND COMMUNITY NEEDS ASSESSMENT SURVEY. 99% INDICATED AN OVERALL POSITIVE EXPERIENCE. WE HAD SEVERAL EVENT VENDORS. WE OFFERED A FREE A1C HEALTH CHECK, WHICH 40 PEOPLE TOOK ADVANTAGE OF. THIS WAS AT A COST OF $3,600 WHICH WAS WRITTEN OFF BY OVH. WE ALSO OFFERED THE FOLLOWING FOR FREE: BONE DENSITY SCANS (29 TOTAL), DIABETIC FOOT EXAMS (22 TOTAL), BLOOD GLUCOSE (36 TOTAL), BLOOD PRESSURE (40 TOTAL), HEIGHT, WEIGHT, BMI, BODY FAT ANALYSIS, VISUAL ACUITY & GLAUCOMA SCREENINGS. A TOTAL OF 59 PEOPLE RECEIVED SOME OR ALL OF THE TESTING.WE ENCOURAGED OUR SENIORITY MEMBERS TO ATTEND BY MAKING THIS EVENT THEIR MONTHLY MEETING. 15 OF THEM DID, AND RECEIVED SPECIAL BUTTONS FOR ATTENDING. DIABETES DAY WAS PROMOTED ON THE OVH WEBSITE, AS WELL AS FLYERS SENT THROUGHOUT THE COMMUNITY AT PLACES LIKE THE FOCUS ON RENEWAL FATHER RYAN ARTS CENTER AND FOOD PANTRY, THE WESTERN AREA YMCA, LOCAL CHURCHES, AND OTHER NEIGHBORHOOD BUSINESSES. WE PLACED ADVERTISEMENTS IN THE GUIDE TO GOOD HEALTH AND IN THE CALENDAR OF ALLEGHENY WEST MAGAZINE. WE ALSO PUT FLYERS, POSTERS AND TABLE TENTS THROUGHOUT THE HOSPITAL, AND A RUNNING AD ON OUR LOBBY TELEVISION. DIABETES DAY WAS ALSO PROMOTED THROUGH THE SENIORITY NEWSLETTER.WE UPDATED OUR WEBSITE TO INCLUDE MORE INFORMATION ON OUR DIABETIC PROGRAMS. WE WILL BE WORKING ON A NEW WEBSITE NEXT YEAR THAT WILL FEATURE A CALENDAR WHEREBY PEOPLE MAY RSVP FOR DIABETES DAY, AS WELL AS FIND THE INFORMATION ABOUT DIABETES DAY MORE EASILY. 500 PEOPLE WERE REACHED VIA EMAIL AND MAIL. MADE UP OF OUR PARTICIPATING CLASS AND COMMUNITY MEMBERS, THEY WERE SENT INFORMATION REGARDING EVENTS LIKE DIABETES DAY AND CLASSES TO OUR PARTICIPATING CLASS AND COMMUNITY MEMBERS. 2. INCREASE AWARENESS REGARDING THE IMPORTANCE OF EDUCATION AND HEALTH SCREENINGS IN THE COMMUNITY3. FACILITATE SENIORITY MEMBER MEETINGS THAT INCLUDE SCREENINGS, TESTING AND EDUCATIONWE HAD SEVERAL DIABETES AND HEALTH EDUCATION RELATED ACTIVITIES AT SENIORITY MEETINGS WITHIN THE LAST CALENDAR YEAR. JULY: "HEALTHY EATING SEMINAR" - OUTPATIENT DIETITIAN AT OVH JANUARY: "GET UP AND MOVING" EXERCISE DEMONSTRATION WITH OVH REHABILITATION SERVICES AND "HEALTHY SNACKING" WITH OUTPATIENT DIETITIAN AND DIRECTOR OF NUTRITION AT OVH FEBRUARY: "HEART HEALTH AND "HEART HEALTHY EXERCISES" PARTNERED WITH WESTERN AREA YMCA INSTRUCTOR. MARCH: OVH 8TH ANNUAL DIABETES DAY; SENIORITY MEMBERS ATTENDED. APRIL: "NATIONAL STRESS AWARNESS MONTH - COPING WITH STRESS AND ANXIETY" OVH OUTPATIENT PSYCHIATRIST AND "ART THERAPY" PARTNERED WITH CRISIS CENTER NORTH MAY: "FAMILY CAREGIVERS" REPRESENTATIVE FROM HEALTHCARE@HOME, PARTNERED WITH OVH. WE CONTINUED WITH HEALTHY FOOD DEMONSTRATIONS AT SENIORITY MEETINGS SO THEY CAN SEE NEW, HEALTHIER WAYS OF SNACKING. NEW SENIORITY MEMBERS ARE ELIGIBLE FOR A FREE BLOOD SCREENING WITH A1C TEST, AND FREE BLOOD PRESSURE CHECKS AT ANY TIME IN OUR EMERGENCY DEPARTMENT. OVH EMPLOYEES AND STUDENTS ATTENDED COMMUNITY FAIRS TO DO GLUCOSE MONITORING, FLU SHOTS, BONE DENSITY TESTS, AND OTHER SCREENINGS. THESE INCLUDED HEALTH FAIRS AND COMMUNITY FAIRS FOR REPRESENTATIVE NICK KOTIK, REPRESENTATIVE MARK MUSTIO AND REPRESENTATIVE DAN DEASY. OUR SCHOOL OF NURSING ALSO PERFORMED AN ANNUAL HEALTH FAIR AT THE CRAFTON TOWERS WITH A VARIETY OF SCREENINGS AND HEALTH LECTURES. OUR OUTPATIENT DIETITIAN SPOKE AT THE YMCA'S PREDIABETES PROGRAM. AS NOTED IN 2015, WITH ALL OF THESE EVENTS, WE DO NOT HAVE A SYSTEM IN PLACE FOR TALLYING HOW MANY PEOPLE WE SERVED. WE HAVE CREATED A TRACKING SHEET FOR ALL DEPARTMENTS TO USE WHEN OUT IN PUBLIC FOR COMMUNITY HEALTH FAIRS AND SCREENINGS. WE ARE DOING A SLOW ROLL-OUT STARTING IN YEAR 1 OF OUR 2016 CHNA TO ENSURE THE PROCESS IS EASY FOR EVERYONE TO USE. WE ARE LOOKING AT HOW TO BETTER ADDRESS POPULATION HEALTH IN THE FUTURE. WE DID ATTEMPT TO HOLD A SERIES OF HEALTH CARE SPECIFIC MEETINGS. THESE MEETINGS FOCUSED ON HEALTH LITERACY AND MEDICATION MANAGEMENT. WE ADVERTISED IN ALL LOCAL NEWSPAPERS AND ONLINE. UNFORTUNATELY, ATTENDANCE WAS MINIMAL. WE HAVE FOUND AFTER-WORK EVENTS ARE NOT AS LIKELY TO BE ATTENDED. WE HAVE PARTNERED WITH ALLEGHENY HEALTH NETWORK'S HEALTHCARE AT HOME, A HOME HEALTH AGENCY, TO FURTHER ADDRESS THE NEEDS OF OUR PATIENTS ONCE THEY ARE DISCHARGED FROM OUR HOSPITAL. WE SPONSORED THE WESTERN AREA YMCA'S AFTER SCHOOL PROGRAM HEALTH EATING AND PHYSICAL ACTIVITY COMPONENT; THE PROGRAM OFFERS KIDS 30 MINUTES OF PHYSICAL ACTIVITY EVERY DAY. OUR SPONSORSHIP OF $7,500 HELPS PAY FOR THEIR HEALTHY SNACKS AND OUTLETS FOR PHYSICAL ACTIVITY. WE OFFERED UP DIABETES AND NUTRITION BROCHURES AND EDUCATIONAL MATERIALS WITHIN OUR 5K PACKETS THIS YEAR. OUR 5K IS A GREAT WAY TO ENCOURAGE AND PROMOTE HEALTHY HABITS THROUGHOUT OUR COMMUNITY. OUR 5K IS LISTED IN OUR COMMUNITY BENEFIT FORM.4. CONDUCT LIVING WELL WITH DIABETES CLASSESCLIENTS USUALLY HAVE 1-2 HOUR PRIVATE SESSION BEFORE THE 8 HOUR DIABETES SELF MANAGEMENT PROGRAM. DIABETES CLASSES USUALLY HAVE 2 PEOPLE PER MONTH. THEY DO REQUIRE A PHYSICIAN REFERRAL TO ATTEND THE CLASSES.CLASS MEMBERS ARE ENCOURAGED TO FOLLOW UP YEARLY WITH OVH STAFF AS WELL AS ATTEND THE DIABETES SUPPORT GROUP MEETINGS OFFERED ON A BI-MONTHLY BASIS. WE ARE ALSO WORKING WITH THE WESTERN AREA YMCA AS THE HOSTING SITE OF A PRE-DIABETES CLASS THAT KICKED OFF IN THE FALL AND RAN FOR ONE YEAR. WE WILL DO ANOTHER ONE NEXT YEAR. 5. OFFER FREE DIABETES SUPPORT GROUP MEETINGSTHE DIABETES SUPPORT GROUP HAD FIVE MEETINGS THIS YEAR, WITH 85 TOTAL PARTICIPANTS. OHIO VALLEY HOSPITAL CONTINUED TO ADVANCE ITS COMMUNITY HEALTH NEEDS ASSESSMENT INITIATIVES IN 2015-2016. THESE IMPLEMENTATION STRATEGIES WERE CONTINUOUSLY MONITORED AND DISCUSSED BY OUR IMPLEMENTATION COMMITTEE, AND IN PREPARATION OF 2016'S NEW COMMUNITY HEALTH NEEDS ASSESSMENT, AREAS IN THIS PLAN WERE MARKED FOR POTENTIAL EXPANSION.OUR CONTINUAL INTENT IS TO IMPLEMENT THESE STRATEGIES THROUGHOUT THE NEXT FISCAL YEAR AS WE BEGIN TO STRATEGIZE OUR 2016 COMMUNITY HEALTH NEEDS ASSESSMENT. PART VI, LINE 3: THE CHARITY CARE POLICY (OHIO VALLEY CARES) AND FINANCIAL ASSISTANCE CONTACT INFORMATION IS AVAILABLE IN THE ADMISSION AREA, THE EMERGENCY ROOM, OUTPATIENT REGISTRATION AND OTHER AREAS OF THE ORGANIZATION IN WHICH PATIENT ARE LIKELY TO BE PRESENT. INTERPRETATION SERVICES ARE AVAILABLE FOR NON-ENGLISH SPEAKING INDIVIDUALS.OHIO VALLEY HOSPITAL (OVH) PROVIDES FINANCIAL COUNSELING TO THOSE IN NEED. OUR POLICY FOR THE PURPOSE OF PROVIDING INPATIENT AND/OR OUTPATIENT SERVICES TO THE INDIGENT STATES:THE FINANCIAL COUNSELOR WILL IDENTIFY PATIENTS AND/OR GUARANTORS THAT MAY QUALIFY FOR CHARITY CARE RELIEF IN ADDITION TO DISCUSSING THE ALTERNATIVE OF PUBLIC ASSISTANCE.THERE ARE TWO (2) OUTSIDE VENDORS THAT ARE AVAILABLE TO ASSIST PATIENTS IN THE APPLICATION PROCESS FOR PUBLIC ASSISTANCE.THE FINANCIAL COUNSELOR WILL CONDUCT A PRIVATE INTERVIEW WITH THE PATIENT AND/OR GUARANTOR AND DISCUSS THE CHARITY ALTERNATIVE AND PARAMETERS. THE FINANCIAL COUNSELOR WILL DISTRIBUTE THE CHARITY CARE APPLICATION AND ASSIST IN ITS COMPLETION AS NECESSARY. THEY WILL FURTHER REQUEST:1. THE MOST RECENT IRS TAX RETURN AND W-2 PROOF OF NON-FILING STATUS2. COPIES OF THE APPLICANTS MOST RECENT PAY STUBS, IF APPROPRIATE3. DENIAL NOTICE RECEIVED FROM MEDICAL ASSISTANCE, IF APPROPRIATETHE FINANCIAL COUNSELOR WILL REFER THE COMPLETED CHARITY CARE APPLICATION AND ANY/ALL ATTACHMENTS TO THE DIRECTOR OF PATIENT FINANCIAL SERVICES FOR REVIEW AND PROCESSING OF THE REQUEST. THE FINANCIAL COUNSELOR WILL ENTER COMMENTS THAT CONVEY ANY AND ALL ACTIONS TAKEN IN THE NOTES FEATURE OF THE HOSPITAL PATIENT ACCOUNTING SYSTEM. THE DIRECTOR OF PATIENT FINANCIAL SERVICES WILL DETERMINE THE CHARITY CARE ELIGIBILITY BASED ON FEDERAL POVERTY GUIDELINES AND:1. INCOME LEVEL2. FAMILY SIZEAN ALTERNATIVE METHOD IS TO HAVE ALL SELF PAY ACCOUNTS AND BALANCES AFTER INSURANCE PROCESSED THROUGH A PRESUMPTIVE CHARITY CARE ANALYSIS TOOL TO DETERMINE ELIGIBILITY BASED ON OVH GUIDELINES OR IN ACCORDANCE WITH FORM 990 SCHEDULE H LANGUAGE. PART VI, LINE 4: OVH IS PART OF THE HIGHLY COMPETITIVE PITTSBURGH, PENNSYLVANIA HEALTH CARE ENVIRONMENT. MANY OF THE HOSPITALS ARE INTERNATIONALLY RECOGNIZED. OVH SERVES A MIX OF FIFTEEN SMALL, URBAN AND SUBURBAN COMMUNITIES IN ITS PRIMARY SERVICE AREA. OVH IS LOCATED IN MCKEES ROCKS, PENNSYLVANIA WHICH IS ITS PRIMARY SERVICE AREA. OVH ALSO SERVES SURROUNDING COMMUNITIES WHICH INCLUDE: KENNEDY TWP, ROBINSON TOWNSHIP, MOON TOWNSHIP, CRAFTON, CORLISS, NORTH FAYETTE, MCDONALD, CORAOPOLIS, SEWICKLEY, BELLEVUE, AVONWORTH, AND OHIO TOWNSHIP. THE COMMUNITIES MENTIONED ABOVE PROVIDE A LARGE CROSS SECTION OF SOCIO-ECONOMIC CLASSES AND A WIDE RANGE OF ETHNIC AND CULTURAL DIVERSITY AS WELL.THE TOTAL POPULATION OF THE HOSPITALS SERVICE AREA IS ESTIMATED TO BE 140,260 WITH LITTLE GROWTH FROM THE 2010 CENSUS, ALTHOUGH THE POPULATION IS EXPECTED TO INCREASE SLIGHTLY OVER THE NEXT SEVERAL YEARS.IN 2015 THE PITTSBURGH METROPOLITAN AREA HAD AN OVERALL UNEMPLOYMENT RATE OF 5.6% WHICH WAS HIGHER THAN THE NATIONAL AVERAGE OF 4.9%.AT THE TIME OF THE HOSPITALS COMMUNITY NEEDS ASSESSMENT 30.3% OF THE ADULT POPULATION WAS OVER WEIGHT AND 28.1% WERE CONSIDERED OBESE, WHICH IS UNDER THE HEALTH PEOPLE 2020 GOAL OF 30.6%. PART VI, LINE 5: THE HOSPITAL PROMOTES THE HEALTH OF THE COMMUNITY BY IDENTIFYING NEEDS, CONSTRUCTING FACILITIES, AND STARTING NEW PROGRAMS. THIS INCLUDES MEMORY CARE AND GEROPSYCHIATRIC PROGRAMS THAT HELP OUR COMMUNITY AND IMPROVE PATIENT CARE. THE HOSPITAL EXTENDS MEDICAL PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN OUR COMMUNITY. FIFTY-FOUR PERCENT OF THE MEMBERS OF THE BOARD OF DIRECTORS LIVE IN THE HOSPITAL'S PRIMARY SERVICE AREA. THE HOSPITAL'S EMERGENCY DEPARTMENT IS OPEN 24 HOURS PER DAY. PAIN AND WOUND CARE DEPARMENTS SERVE THE COMMUNITY IN TWO SITES OFF THE HOSPITAL CAMPUS.THE HOSPITAL CEO, CFO, AUDITOR, HUMAN RESOURCES VP, AND EXECUTIVE VP MAKE RECOMMENDATIONS TO THE BOARD ON IMPROVEMENTS IN PATIENT CARE. AN EXAMPLE OF THIS WOULD BE OUR ORTHOPEDIC CENTER. ANY "SURPLUS" FUNDS ARE USED FOR PATIENT CARE ENHANCEMENTS, EXEMPLIFIED BY ALL OF THE CONSTRUCTION OVH HAS UNDERTAKEN IN RECENT YEARS. PART VI, LINE 6: OHIO VALLEY HOSPITAL IS A FREE-STANDING, INDEPENDENT, NOT-FOR-PROFIT ACUTE CARE HOSPITAL. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES. THE HOSPITAL ALSO OPERATES THE RESIDENCE AT WILLOW LANE, AN 84-BED PERSONAL CARE FACILITY, WILLOW HEIGHTS INDEPENDENT LIVING, A 65-BED INDEPENDENT LIVING FACILITY, WILLOW BROOK, A 21-BED GEROPSYCHIATRIC UNIT, PATHWAYS, A 16-BED MEMORY CARE UNIT, AND A 16-BED ACUTE REHABILITATION UNIT ON ITS CAMPUS. IN ADDITION, THE HOSPITAL CONTROLS OHIO VALLEY MEDICAL SERVICES, INC., AND OHIO VALLEY PROFESSIONAL SERVICES, INC. WHOSE PRINCIPAL PURPOSES ARE TO PROVIDE VARIOUS HEALTHCARE SERVICES TO PATIENTS OF THE HOSPITAL. OHIO VALLEY HOSPITAL ALSO PROVIDES WOUND CARE, PAIN MANAGEMENT, AND PRIMARY CARE SERVICES AT AFFILIATED PRACTICES AT VARIOUS OFF SITE LOCATIONS. FORM 990, PART VI, LINE 7: PENNSYLVANIA 0 WESTERN AREA YMCA 195 MONTOUR RUN ROAD CORAOPOLIS PA 15108 250969497 501(C)(3) 7500 CASH N/A PROGRAM SPONSORSHIP FOCUS ON RENEWAL 701 CHARTIERS AVE MCKEES ROCKS PA 15136 237181440 501(C)(3) 6103 CASH N/A COMMUNITY EVENT SPONSORSHIP 2 0 X X X 0 0 0 0 0 1 0 0 0 DAVID W SCOTT PRESIDENT AND CEO 361669 0 0 0 0 0 97510 0 77852 0 537031 0 0 0 HUWAIDA MANSOUR DIRECTOR BUSINESS FIT 206530 0 0 0 0 0 0 0 44457 0 250987 0 0 0 ERIC LAWLOR EXECUTIVE VICE PRESIDENT 166196 0 0 0 0 0 0 0 35775 0 201971 0 0 0 LORRIE MITCHAM CRNA 155843 0 0 0 0 0 0 0 33546 0 189389 0 0 0 LAJENNEPHER ZEVOLA CRNA 153894 0 0 0 0 0 0 0 33127 0 187021 0 0 0 VICTORIA MELL VP HR AND SUPPORT SERVICES 130452 0 0 0 0 0 0 0 28081 0 158533 0 0 0 TADESSE TEFERA FORMER CFO 162307 0 0 0 0 0 0 0 34938 0 197245 0 0 0 PART I, LINE 6 THERE IS A PERFORMANCE BASED COMPONENT OF THE CEO'S COMPENSATION. THIS COMPONENT IS BASED ON THE CEO BEING RATED AS "MEETING BOARD EXPECTATIONS AND THE CEO'S ATTAINMENT OF PERFORMANCE GOALS SET BY THE COMMITTEE. THE PERFORMANCE GOALS ARE BASED ON YEAR OVER YEAR IMPROVEMENT IN BOTH THE HOSPITAL'S NET OPERATING INCOME AND THE HOSPITAL'S OVERALL AVATAR SCORE. A ALLEGHENY COUNTY HOSPITAL DEVELOPMENT AUTHORITY 251327925 01728AZG4 2003-05-29 9319477 CAPITAL IMPROVEMENTS & EQUIPMENT FOR SCHOOL OF NURSING 0 0 0 B ALLEGHENY COUNTY HOSPITAL DEVELOPMENT AUTHORITY 251327925 01728AB88 2005-04-21 23500623 CONSTRUCTION OF MED SURG & OB GYN WING 0 0 0 A 7995000 9145000 159428 8985572 2003 0 0 1 1 B 1080000 23870000 1004091 376938 23493062 2008 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 A 1 B 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: ALLEGHENY COUNTY HOSPITAL DEVELOPMENT AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 05/01/2013 ISSUER NAME: ALLEGHENY COUNTY HOSPITAL DEVELOPMENT AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 04/01/2015 FORM 990, PART VI, SECTION A, LINE 3 REHABCARE GROUP INC. HAS BEEN CONTRACTED TO MANAGE THE ACUTE REHAB UNIT OF THE HOSPITAL. TELECARE CORPORATION HAS BEEN CONTRACTED TO MANAGE THE HOSPITALS GERIATRIC PSYCHIATRIC UNIT OF THE HOSPITAL. NATIONAL HEALING HAS BEEN CONTRACTED TO MANAGE THE HOSPITAL'S WOUND HEALING FACILITIES. ALL THREE GROUPS RESPONSIBILITIES INCLUDE DEPARTMENTAL BUDGETING, STAFFING, OFFICE MANAGEMENT, AS WELL AS PATIENT SCHEDULING, CARE, AND BILLING FOR THE FACILITY. FORM 990, PART VI, SECTION B, LINE 11 A DRAFT OF THE FORM 990 IS PRESENTED TO THE FINANCE COMMITTEE FOR ITS PRELIMINARY APPROVAL AND THEN TO THE BOARD OF DIRECTORS FOR FINAL APPROVAL BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE (IRS). THE BOARD OF DIRECTORS APPROVES THE FINAL DRAFT OF THE FORM 990 BEFORE IT IS FILED WITH IRS. FORM 990, PART VI, SECTION B, LINE 12C EVERY YEAR, THE BOARD OF DIRECTORS OF OHIO VALLEY HOSPITAL DISTRIBUTES TO ITS DIRECTORS AND KEY HOSPITAL MANAGEMENT THE CONFLICT OF INTEREST POLICY. EACH RECIPIENT MUST LIST ANY POSSIBLE CONFLICT, SIGN AND RETURN THE CONFLICT STATEMENT. INCLUDED IN THE POLICY IS SPECIFIC LANGUAGE REGARDING THE CONDUCT OF THE INDIVIDUAL WITH THE POTENTIAL CONFLICT. PERSONS IN QUESTION ARE REQUIRED ANNUALLY TO COMPLETE THE CONFLICT OF INTEREST QUESTIONNAIRE. ANY POTENTIAL CONFLICTS ARE REVIEWED BY THE CHAIRMAN OF THE BOARD FOR POSSIBLE ACTION. A LIST OF ANNUAL PAYMENTS MADE TO THE DISCLOSED ENTITIES IS MAINTAINED BY THE HOSPITAL'S PRESIDENT'S OFFICE. FORM 990, PART VI, SECTION B, LINE 15 THE HOSPITAL UTILIZES THE HEALTHCARE COUNCIL OF WESTERN PA'S SALARY SURVEY IN DETERMINING COMPENSATION FOR OFFICERS AND KEY EMPLOYEES, IN ORDER TO ENSURE COMPENSATION DOES NOT EXCEED FAIR MARKET VALUE. THE BOARD OF DIRECTORS COMPENSATION COMMITTEE APPROVES ALL SALARY INCREASES FOR THE CEO, CFO, EXECUTIVE VP, HR VP, AND NURSING VP. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,766,625. MANAGEMENT AND GENERAL EXPENSES 1,298,150. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,064,775. TEMPORARY HELP: PROGRAM SERVICE EXPENSES 412,786. MANAGEMENT AND GENERAL EXPENSES 303,324. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 716,110. CONSULTING FEES: PROGRAM SERVICE EXPENSES 77,798. MANAGEMENT AND GENERAL EXPENSES 57,167. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 134,965. CONTRACT AGREEMENTS: PROGRAM SERVICE EXPENSES 2,369,268. MANAGEMENT AND GENERAL EXPENSES 1,740,984. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,110,252. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,186,381. MANAGEMENT AND GENERAL EXPENSES 871,776. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,058,157. FORM 990, PART XI, LINE 9: PENSION LIABILITY ADJUSTMENT -5,919,393. CHANGE IN FAIR VALUE OF DERIVATIVE -139,090. FORM 990, PART XII, LINE 2C THIS ORGANIZATION DOES HAVE A COMMITTEE THAT ASSUMES THE RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THE ORGANIZATION DID NOT CHANGE THIS OVERSIGHT PROCESS OR ITS SELECTION PROCESS FROM THE PREVIOUS YEAR. OVH PROFESSIONAL LIABILITY SELF INSURANCE 25 HECKEL ROAD MCKEES ROCK PA 15136 251619844 PROVIDES MALPRACTICE INSURANCE TO THE HOSPITAL PA 501(C)(3) LINE 11A, I OHIO VALLEY HOSPITAL 1 OVH WORKER COMPENSATION SELF INSURANCE TRUST 25 HECKEL ROAD MCKEES ROCK PA 15136 251619842 FOR THE HOSPITAL TO COVER ITS WORKERS COMPENSATION CLAIMS PA 501(C)(3) LINE 11A, I OHIO VALLEY HOSPITAL 1 OHIO VALLEY MEDICAL SERVICES INC 25 HECKEL ROAD MCKEES ROCK PA 15136 205830183 PROVIDES SURGERY AND ANESTHESIA SERVICES TO PATIENTS PA OHIO VALLEY HOSPITAL C -606475 178966 1.00000 1 OHIO VALLEY ANESTHESIA PAIN MANAGEMENT INC 25 HECKEL ROAD MCKEES ROCK PA 15136 205696032 PROVIDES PAIN MANAGMENT SERVICES TO PATIENTS PA OHIO VALLEY HOSPITAL C 1.00000 1 OHIO VALLEY PROFESSIONAL SERVICES INC 25 HECKEL ROAD MCKEES ROCK PA 15136 205689859 EXTENSION OF THE HOSPITAL TO PROVIDE HEALTH SERVICES TO THE COMMUNITY PA OHIO VALLEY HOSPITAL C -2361326 1688655 1.00000 1 EMBROOKE INCORPORATED 366 HELEN STREET MCKEES ROCK PA 15136 300008536 AMBULANCE SERVICES PA OHIO VALLEY HOSPITAL C 2226369 2754301 0.87500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 OHIO VALLEY PROFESSIONAL SERVICES INC R 5295227 COST OHIO VALLEY MEDICAL SERVICES INC R 2451491 COST OHIO VALLEY PROFESSIONAL SERVICES INC S 2419803 COST OHIO VALLEY MEDICAL SERVICES INC S 1893124 COST