2017-05-11T08:33:42-05:00 2016-06-30 990 2015-07-01 232421970 NORTHEASTERN PENNSYLVANIA HEALTH CORP NORT 5705014000 700 E BROAD ST HAZLETON PA 18201 EDWARD F O'DEA EXEC. VP & CFO 6104027501 2017-05-11 2015 2021-01-29 14:40:06Z BRIAN A NESTER 700 E BROAD ST HAZLETON PA 18201 143019143 0 X HTTP://HAZLETON.LVHN.ORG/ X 1985 PA WE HEAL, COMFORT AND CARE FOR THE PEOPLE OF OUR COMMUNITY BY PROVIDING ADVANCED AND COMPASSIONATE HEALTH CARE OF SUPERIOR QUALITY AND VALUE, SUPPORTED BY EDUCATION AND CLINICAL RESEARCH. 12 11 921 3 808699 -144962 252029 445078 119840534 124177973 4613882 2520469 1121268 1620969 125827713 128764489 90738 66950 0 0 54545510 59348886 0 0 0 54940094 58446296 109576342 117862132 16251371 10902357 151668170 157916396 62459224 68006680 89208946 89909716 X WE HEAL, COMFORT AND CARE FOR THE PEOPLE OF OUR COMMUNITY BY PROVIDING ADVANCED AND COMPASSIONATE HEALTH CARE OF SUPERIOR QUALITY AND VALUE, SUPPORTED BY EDUCATION AND CLINICAL RESEARCH. 1 0 98795540 66950 125668359 LEHIGH VALLEY HOSPITAL-HAZLETON (LVH-H) PROVIDES HOSPITAL INPATIENT, OUTPATIENT, REHABILITATION CARE, MATERNITY CARE AND EMERGENCY ROOM SERVICES TO THE RESIDENTS OF GREATER HAZLETON REGARDLESS OF RACE, RELIGION OR ECONOMIC STATUS. THE HOSPITAL PROVIDES A FULL RANGE OF MEDICAL CARE TO INPATIENT AND OUTPATIENTS, INCLUDING THERAPEUTIC, DIAGNOSTIC, TELEHEALTH, IMAGING AND REHABILITATION SERVICES. SEE SCHEDULE O FOR NEW PROJECTS IN FY 2016 DESIGNED TO ENHANCE THE QUALITY AND EFFICIENCY OF OUR MISSION. 98795540 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 1 99 0 1 921 1 1 1 0 0 0 0 1 1 0 0 0 0 X 12 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 PA X X X THE ORGANIZATION 5705014972 700 E BROAD ST HAZLETON PA 18201 THOMAS L KENNEDY ESQUIRE CHAIR-BOARD OF TRUSTEE 1.00 0.50 X 0 0 0 ANTHONY CUSATIS VICE CHAIR-BOARD OF TRUSTE 1.00 0.25 X 0 0 0 MARY CELESTE KOSKO MEMBER-BOARD OF TRUSTEE 1.00 0.25 X 0 0 0 MICHAEL J LEIB MEMBER-BOARD OF TRUSTEE 0.50 0.25 X 0 0 0 MANN A SHOFFNER MEMBER-BOARD OF TRUSTEE 0.50 0.25 X 0 0 0 ANTONETTE M FRITZ MEMBER-BOARD OF TRUSTEE 0.50 0.25 X 0 0 0 ANTHONY P VEGLIA MD MEMBER-BOARD OF TRUSTEE 0.50 0.50 X 0 0 0 MARK J LOBITZ DO MEMBER-BOARD OF TRUSTEE 0.50 0.25 X 0 0 0 CRAIG BUTLER MEMBER-BOARD OF TRUSTEE 0.50 0.25 X 0 0 0 SUSAN C YEE MEMBER-BOARD OF TRUSTEE 0.50 40.00 X 0 0 0 JOHN R FLETCHER PRESIDENT, EX OFFICIO 42.00 18.00 X X 420489 0 10533 LINDA L LAPOS MD MEMBER-BOARD OF TRUSTEE 0.50 0.25 X 0 0 0 WILLIAM C BAUER ASSISTANT TREASURER 42.00 18.00 X 283785 0 36415 EDWARD F O'DEA TREASURER 3.00 57.00 X 0 753482 41278 JANE DANISH SECRETARY 28.00 12.00 X 97483 0 24697 BARBARA A FORTE ASSISTANT SECRETARY 28.00 12.00 X 58453 0 3397 ANTHONY VALENTE VP OF MEDICAL AFFAIRS 30.00 0.00 X 229643 0 35053 DONALD A PATTEN PHYSICIAN 32.00 0.00 X 277190 0 35059 JOSEPH G CIOTOLA PHYSICIAN 32.00 0.00 X 217789 0 28896 JOHN P AMENTLER PHYSICIAN 40.00 0.00 X 213880 0 8720 MICHAEL GOLDEN VP OF NURSING 42.00 18.00 X 212934 0 34525 2011646 753482 258573 26 0 1 0 HAZLETON ANESTHESIA SERVICES 10 COMMERCE DR NEW ROCHELLE NY 10801 ANESTHESIA SERVICE 1158883 PHILIPS HEALTHCARE 22100 BOTHELL EVERETT HWY BOTHELL WA 980218431 BIOMEDICAL EQUIP MAINTENANCE SERV 559793 VADIM LOSHAKOV MD 1730 E BROAD ST HAZLETON PA 18201 PHYSICIAN SERVICES 421623 DELL MARKETING LP PO BOX 149256 AUSTIN TX 787149256 IT HOSTING SERVICES 403069 MEDICAL INFORMATION TECH INC MEDITECH CIRCLE WESTWOOD MA 02090 IT MAINTENANCE SERVICES 327148 24 407855 37223 445078 OUTPATIENT REVENUE 621990 72254633 71445934 808699 INPATIENT REVENUE 621990 51923340 51923340 124177973 1798894 1798894 129888 23412 106476 106476 106476 14884867 57456 14136773 83975 748094 -26519 721575 721575 53953 10494 43459 43459 CAFETERIA & GIFT SHOP REVENUE 900099 514292 514292 EQUITY IN AFFILIATES 900003 447904 447904 MSA REVENUE - HWC 541610 188331 188331 320507 320507 1471034 128764489 125668359 808699 1842353 66950 66950 935253 310971 624282 42928828 37145460 5783368 1225189 1060156 165033 11063016 9576371 1486645 3196600 2747215 449385 258482 986 257496 115447 115447 143963 143963 5909426 4769264 1140162 263985 992 262993 1071816 497739 574077 1597328 264648 1332680 3336299 3070469 265830 192494 156463 36031 52066 33027 19039 919530 919530 4586326 2045940 2540386 1139830 656113 483717 MEDICAL SUPPLIES 13567640 13567640 PRACTICE SUPPORT 13136933 13136933 BAD DEBT EXPENSE 6705515 6705515 EQUIPMENT RENTAL & MAIN 2218341 2077112 141229 3230875 905576 2325299 117862132 98795540 19066592 0 1775 1787 3779880 3208727 14634 9125222 8935473 0 0 1760343 1758071 1040830 1437504 53681070 12528823 38328931 41152247 93432701 99245780 202833 0 3995655 2162173 151668170 157916396 11467369 12771851 1125000 375000 25765000 24050000 24101855 30809829 62459224 68006680 X 88447674 89228938 118570 78122 642702 602656 89208946 89909716 151668170 157916396 X 10902357 -3026802 -7174785 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 10233 10233 0 PART II-B, LINE 1: ITEM II-B, LINE 1, ITEM I, REPRESENTS INDIRECT LOBBYING ACTIVITIES PERFORMED BY HOSPITAL ASSOCIATIONS OF WHICH WE ARE MEMBERS. 8410000 8410000 26456201 4169200 22287001 107440 6248 101192 17163659 8353375 8810284 1543770 1543770 41152247 CAPITALIZED LEASES 4980 PENSION LIABILITIES 19061518 THIRD-PARTY SETTLEMENTS 8809814 INSURANCE LIABILITY 2539704 INTERCOMPANY PAYABLE 163839 OTHER LIABILITIES-MISC 229974 30809829 X PART X, LINE 2: LVHN, ITS HOSPITALS, AND OTHER SUBSIDIARIES ARE GENERALLY EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, EXCEPT FOR TAX IMPOSED ON UNRELATED BUSINESS INCOME. THE MOST RECENT DETERMINATION LETTER, RECEIVED BY THE ORGANIZATION, IS DATED MAY 1, 2014. LVHN AND ITS SUBSIDIARIES ACCOUNT FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740. THE ORGANIZATION'S FOR-PROFIT COMPONENTS RECOGNIZE DEFERRED TAX ASSETS AND LIABILITIES FOR THE FUTURE TAX IMPACT OF TEMPORARY DIFFERENCES BETWEEN AMOUNTS RECORDED IN THE CONSOLIDATED FINANCIAL STATEMENTS AND THEIR RESPECTIVE TAX BASES AND THE FUTURE BENEFIT OF UTILIZATION NET OPERATING LOSS CARRYFORWARDS. INCOME TAXES OF THE ORGANIZATION'S TAX-EXEMPT AND FOR-PROFIT COMPONENTS ARE NOT MATERIAL TO THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. 0 PA GOLF TOURNAMENT 53953 53953 373 8477 1033 611 53953 53953 373 8477 1033 611 10494 43459 1 1 1 X 1 X 1 1 0 1 1 266113 0 266113 0.00240 25303946 17971817 7332129 0.06600 0 0 25570059 17971817 7598242 0.06840 590663 156506 434157 0.00390 127833 18857 108976 0.00100 523561 0 523561 0.00470 0 0 68025 0 68025 0.00060 1310082 175363 1134719 0.01020 26880141 18147180 8732961 0.07860 282388 282388 0.00250 7134 7134 0.00010 41321 41321 0.00040 7333 7333 0.00010 252209 252209 0.00230 590385 590385 0.00540 1 1377313 626402 41317355 41152701 164654 X 1 1 1 BELTWAY HEALTH LP MEDICAL OFFICE SPACE RENTAL 0.43780 1 1 NORTHEASTERN PENNSYLVANIA HEALTH CORP 700 E BROAD ST HAZLETON PA 18201 HTTP://HAZLETON.LVHN.ORG/ 083701 X X X NORTHEASTERN PENNSYLVANIA HEALTH CORPORA 1 0 0 1 X X X X X X X X X 16 1 0 1 1 X HTTPS://WWW.LVHN.ORG/ABOUT_US X 1 15 1 HTTPS://WWW.LVHN.ORG/ABOUT_US 1 0 1 X 200.000000000000 400.000000000000 X X 1 1 X X X X 1 X HTTP://HAZLETON.LVHN.ORG X HTTP://HAZLETON.LVHN.ORG X HTTP://HAZLETON.LVHN.ORG X X X X 1 X 0 X X X X 1 X 0 0 NORTHEASTERN PENNSYLVANIA HEALTH CORPORATION PART V, SECTION B, LINE 5: THE MISSION OF THE LEHIGH VALLEY HOSPITAL-HAZLETON (LVH-H) COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS TO UNDERSTAND AND PLAN FOR THE CURRENT AND FUTURE HEALTH NEEDS OF THE RESIDENTS OF ITS COMMUNITY. THE GOAL OF THE PROCESS IS TO IDENTIFY THE HEALTH NEEDS OF THE COMMUNITIES SERVED BY LVH-H, WHILE DEVELOPING A DEEPER UNDERSTANDING OF COMMUNITY NEEDS AND IDENTIFYING COMMUNITY HEALTH PRIORITIES.IMPORTANT TO THE SUCCESS OF THE COMMUNITY NEEDS ASSESSMENT PROCESS IS MEANINGFUL ENGAGEMENT AND INPUT FROM A BROAD CROSS-SECTION OF COMMUNITY BASED ORGANIZATIONS, WHO WERE PARTNERS IN THE COMMUNITY HEALTH NEEDS ASSESSMENT.REPRESENTATIVES OF THE COMMUNITY INCLUDED MEMBERS INVOLVED IN THE HAZLETON INTEGRATION PROJECT, PENN STATE UNIVERSITY, CITY OF HAZLETON POLICE DEPARTMENT, RESIDENTS OF THE LOCAL AREA, AS WELL AS REPRESENTATIVES FROM LVH-HAZLETON AND LVH-ALLENTOWN. NORTHEASTERN PENNSYLVANIA HEALTH CORPORATION PART V, SECTION B, LINE 6A: IN ACCORDANCE WITH THE ONGOING MISSION OF LEHIGH VALLEY HOSPITAL - HAZLETON TO UNDERSTAND AND PLAN FOR THE CURRENT AND FUTURE HEALTH NEEDS OF THE RESIDENTS OF ITS COMMUNITY, AND WITH THE REGULATIONS IN THE IRS FORM 990 H DESCRIBING THE CHNA PROCESS, LVHN ENGAGED 35TH ST. CONSULTING TO CONDUCT A NEW COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR IMPLEMENTATION IN FY17, FY18 AND FY19. AS THE NEWEST MEMBER TO THE LEHIGH VALLEY HEALTH NETWORK, IN 2015 LEHIGH VALLEY HEALTH NETWORK STROVE TO INCLUDE LVHN-HAZLETON IN ITS SYSTEM-WIDE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. IN LINE WITH ITS EMPHASIS ON COLLABORATION, LVHN HOSPITALS IN LEHIGH AND NORTHAMPTON COUNTIES WORKED TOGETHER WITH OTHER HEALTH PARTNERS IN THE LEHIGH VALLEY THROUGH THE HEALTH CARE COUNCIL OF THE LEHIGH VALLEY (HCC) TO CREATE A BROAD COMMUNITY HEALTH NEEDS ASSESSMENT HEALTH PROFILE FOR ALL FIVE NON-PROFIT HEALTH SYSTEMS AND THE TWO HEALTH BUREAUS IN LEHIGH AND NORTHAMPTON COUNTIES. IN RECOGNIZING BOTH THE VALUE OF COLLABORATION AND THE REALITY OF REGIONAL DIFFERENCES, LVHN ENGAGED THE HCC PROJECT MANAGER TO CONDUCT THE SAME CHNA RESEARCH PROCESS AND TOOLS USED IN THE LEHIGH VALLEY TO CRAFT A CHNA HEALTH PROFILE FOR LVHN-HAZLETON. NORTHEASTERN PENNSYLVANIA HEALTH CORPORATION PART V, SECTION B, LINE 6B: REPRESENTATIVES OF THE COMMUNITY INCLUDED MEMBERS INVOLVED IN THE HAZLETON INTEGRATION PROJECT, PENN STATE UNIVERSITY, CITY OF HAZLETON POLICE DEPARTMENT, RESIDENTS OF THE LOCAL AREA, AS WELL AS REPRESENTATIVES FROM LVH-HAZLETON AND LVH-ALLENTOWN. NORTHEASTERN PENNSYLVANIA HEALTH CORPORATION PART V, SECTION B, LINE 7D: OUR COMMUNITY HEALTH NEEDS ASSESSMENT IS ALSO AVAILABLE UPON REQUEST. NORTHEASTERN PENNSYLVANIA HEALTH CORPORATION PART V, SECTION B, LINE 11: ACCORDING TO THE IRS 990 H, THE QUALITATIVE RESEARCH COMPONENT OF THE CHNA SHOULD NOT ONLY IDENTIFY KEY ISSUES AFFECTING COMMUNITY HEALTH, BUT ALSO WORK TO PRIORITIZE THOSE KEY ISSUES. SEE PDF ATTACHMENT TO RETURN FOR THE SIGNIFICANT NEEDS IDENTIFIED IN OUR MOST RECENTLY CONDUCTED CHNA AND HOW WE ARE ADDRESSING THOSE NEEDS. NORTHEASTERN PENNSYLVANIA HEALTH CORPORATION PART V, SECTION B, LINE 18D: BILLING ACTIVITIES INCLUDE HOSPITAL SENDING FOUR STATEMENTS REQUESTING PAYMENT, ALONG WITH AN SPO-1 LETTER WHICH REQUESTS INSURANCE INFORMATION AND INCLUDES INFORMATION ON APPLYING FOR MEDICAL ASSISTANCE, BEFORE ANY COLLECTION ACTIONS OCCUR. THE STATEMENTS INCLUDE INFORMATION ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, SOLICITING THE PATIENT'S PARTICIPATION IN THE FINANCIAL ASSISTANCE PROGRAM. PART I, LINE 3C: LEHIGH VALLEY HOSPITAL-HAZLETON ALSO USES AN ASSET TEST TO DETERMINE WHETHER AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE. THE ONLY ASSETS THAT ARE USED FOR THIS TEST ARE CASH BALANCES IN BANK ACCOUNTS. PART I, LINE 6A: THE COMMUNITY BENEFIT REPORT IS ISSUED BY LEHIGH VALLEY HEALTH NETWORK - EIN 22-2458317, THE PARENT COMPANY OF LEHIGH VALLEY HOSPITAL-HAZLETON. PART I, LINE 7: THE COSTING METHODOLOGY IS COST TO CHARGE RATIO FOR PROGRAMS WITH GROSS CHARGES AND DIRECT COSTS FOR PROGRAMS WITHOUT GROSS CHARGES. PART I, LINE 7G: THE SUBSIDIZED HEALTH SERVICES OF $523,561 INCLUDES THE TELEMEDICINE SERVICES AND THE HOSPITALIST PROGRAM. THESE SERVICE EXPENSES ARE NOT INCLUDED IN THE MEDICAL ASSISTANCE SHORTFALL OR UNCOMPENSATED CHARITY CARE VALUE REPORTED ABOVE. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A) IS $6,705,515. PART II, COMMUNITY BUILDING ACTIVITIES: OUR COMMUNITY BUILDING ACTIVITIES INCLUDE THE FOLLOWING:COMMUNITY SUPPORT INCLUDES PATIENT ADVOCATES, INTERPRETATION SERVICES AND PATIENT SATISFACTION SURVEYS.COALITION BUILDING INCLUDES ACTIVITIES RELATED TO COMMUNITY BOARDS SUCH AS UNITED WAY AND THE YMCACOMMUNITY HEALTH IMPROVEMENT ADVOCACY INCLUDES EMPLOYEE TIME VOLUNTEERING FOR THE FREE CLINIC.WORKFORCE DEVELOPMENT INCLUDES RECRUITMENT COSTS, JOB SHADOWING AND STUDENT CLINICAL ADVISORS. PART III, LINE 2: AMOUNTS REPORTED AS BAD DEBT EXPENSE ARE REPORTED NET OF APPLICABLE PATIENT PAYMENTS, INSURANCE PAYMENTS AND CONTRACTUAL ALLOWANCES AS WELL AS OTHER HOSPITAL DISCOUNTS FOR WHICH THE PATIENT IS DEEMED ELIGIBLE. THE RATIO OF COSTS-TO-CHARGES (RCC) IS APPLIED TO TEH NET AMOUNT TO DETERMINE THE BAD DEBT EXPENSE. PART III, LINE 3: IN INSTANCES WHERE THE ORGANIZATION BELIEVES A PATIENT HAS THE ABILITY TO PAY FOR SERVICES AND, AFTER APPROPRIATE COLLECTION EFFORT, PAYMENT IS NOT MADE, THE AMOUNT OF SERVICES NOT PAID IS WRITTEN-OFF AS BAD DEBTS. AMOUNTS RECORDED AS PROVISION FOR BAD DEBTS DO NOT INCLUDE CHARITY CARE. THE PROVISION FOR BAD DEBTS FOR THE YEARS ENDED JUNE 30, 2016 AND 2015, WAS $5,658,000 AND $5,739,000 RESPECTIVELY. PART III, LINE 4: BAD DEBTS - THE ORGANIZATION RECORDS A PROVISION FOR BAD DEBTS RELATED TO UNINSURED ACCOUNTS NET OF THE AGB DISCOUNT TO RECORD THE NET SELF-PAY ACCOUNTS RECEIVABLE AT THE ESTIMATED AMOUNTS THE ORGANIZATION EXPECTS TO COLLECT. COINSURANCES AND DEDUCTIBLES WITHIN THE THIRD-PARTY PAYER AGREEMENTS ARE THE PATIENT'S RESPONSIBILITY SO THE ORGANIZATION INCLUDES THESE AMOUNTS IN THE SELF-PAY ACCOUNTS RECEIVABLE AND CONSIDERS THESE AMOUNTS IN ITS DETERMINATION OF THE PROVISION FOR BAD DEBTS BASED ON HISTORICAL COLLECTION EXPERIENCE.IN INSTANCES WHERE THE ORGANIZATION BELIEVES A PATIENT HAS THE ABILITY TO PAY FOR SERVICES AND, AFTER APPROPRIATE COLLECTION EFFORT, PAYMENT IS NOT MADE, THE AMOUNT OF SERVICES NOT PAID IS WRITTEN-OFF AS BAD DEBTS. AMOUNTS RECORDED AS PROVISION FOR BAD DEBTS DO NOT INCLUDE CHARITY CARE. THE PROVISION FOR BAD DEBTS FOR THE YEARS ENDED ENDED JUNE 30 2016 AND 2015, WAS $5,658,000 AND $5,739,000 RESPECTIVELY. PART III, LINE 8: THE MEDICARE PROGRAM COSTS REPORTED IN THE ANNUAL LVHN COMMUNITY BENEFIT REPORT INCLUDE $8,022,631 IN COSTS THAT ARE CONSIDERED DISALLOWED COSTS ON THE MEDICARE COST REPORT. THESE DISALLOWED COSTS ARE PRIMARILY FOR LVPG-H PRACTICE SUBSIDIES, PHYSICIAN COSTS AND OTHER COSTS DISALLOWED BY THE MEDICARE PROGRAM FOR COST REPORTING PURPOSES. PART III, LINE 9B: FINANCIAL COUNSELING STAFF ASSISTS PATIENTS IN APPLYING FOR MEDICAID, CHIP, AS WELL AS FINANCIAL ASSISTANCE UNDER OUR FINANCIAL ASSISTANCE POLICY. ACCOUNTS THAT DO NOT MEET THE ELIGIBILITY REQUIREMENTS WILL BE FOLLOWED UP IN-HOUSE OR REFERRED TO AN EXTERNAL RECEIVABLES FOLLOW UP AGENCY, AND IF NOT PAID, REFERRED TO A COLLECTION AGENCY, AND, SUBSEQUENTLY, TRANSFERRED TO BAD DEBT STATUS IF THE ACCOUNTS REMAIN UNPAID. SECTION B. MEDICARE, LINE 8 MEDICARE PROGRAM COSTS INCLUDED IN THE ANNUAL LVHN COMMUNITY BENEFIT REPORT NOT INCLUDED OR ALLOWABLE IN THE MEDICARE COST REPORT TOTALED $9,001,301. THE COSTS OF MEDICARE MANAGED CARE, INCLUDED IN THIS AMOUNT IS $2,562,845. THE REMAINING $6,438,456 OF COSTS NOT INCLUDED IN THE MEDICARE COST REPORT CONSISTS PRIMARILY OF LVPG-H PRACTICE SUBSIDIES, PHYSICIAN COSTS IN EXCESS OF ALLOWABLE AMOUNTS, AND OTHER MEDICARE DISALLOWABLE COSTS. PART VI, LINE 2: THE OBJECTIVE OF THIS ASSESSMENT IS TO ANALYZE TRADITIONAL HEALTH-RELATED INDICATORS, AS WELL AS SOCIAL, DEMOGRAPHIC, ECONOMIC, AND ENVIRONMENTAL FACTORS. THIS PROJECT WAS DEVELOPED AND IMPLEMENTED TO MEET THE INDIVIDUAL PROJECT GOALS AS DEFINED BY THE PROJECT OVERSIGHT COMMITTEE, WHICH INCLUDED: (1) ASSURING THAT COMMUNITY MEMBERS, INCLUDING UNDER-REPRESENTED RESIDENTS AND THOSE WITH BROAD-BASED RACIAL, ETHNIC, CULTURAL AND LINGUISTIC BACKGROUNDS ARE INCLUDED IN THE NEEDS ASSESSMENT PROCESS. IN ADDITION, PERSONS WITH SPECIAL KNOWLEDGE OF, OR EXPERTISE IN PUBLIC HEALTH; FEDERAL, TRIBAL, REGIONAL, STATE OR LOCAL HEALTH OR OTHER DEPARTMENTS OR AGENCIES, WITH CURRENT DATA OR OTHER INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY; AND LEADERS, REPRESENTATIVES OR MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS WITH CHRONIC DISEASE NEEDS, IN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY ARE INCLUDED IN THE NEEDS ASSESSMENT PROCESS THROUGH DATA COLLECTION AND KEY STAKEHOLDER INTERVIEWS. (2) OBTAINING STATISTICALLY VALID INFORMATION ON THE HEALTH STATUS AND SOCIO-ECONOMIC AND ENVIRONMENTAL FACTORS RELATED TO THE HEALTH OF RESIDENTS IN THE COMMUNITY AND SUPPLEMENTING THE GENERAL POPULATION SURVEY DATA THAT IS CURRENTLY AVAILABLE. (3) DEVELOPING ACCURATE COMPARISONS TO BASELINE HEALTH MEASURES UTILIZING THE MOST CURRENT VALIDATED DATA. (4) DEVELOPING A CHNA DOCUMENT AS REQUIRED BY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (PPACA). THE CURRENT THREE-YEAR ASSESSMENT COMPLETED IN 2013, ESTABLISHED THE FOLLOWING PRIORITIES: (1) IMPROVING ACCESS TO AFFORDABLE HEALTHCARE (2) HEALTH EDUCATION AND COMMUNICATION (3) BEHAVIORS THAT IMPACT HEALTH. SEE OUR PDF ATTACHMENT TO RETURN FOR THE SIGNIFICANT NEEDS IDENTIFIED IN OUR MOST RECENTLY CONDUCTED CHNA AND HOW WE ARE ADDRESSING THOSE NEEDS. PART VI, LINE 3: CONSISTENT WITH THE MISSION AND VALUES OF LEHIGH VALLEY HEALTH NETWORK, IT IS THE POLICY TO PROVIDE MEDICAL CARE TO ALL INDIVIDUALS WITHOUT REGARD TO THEIR ABILITY TO PAY FOR SERVICES. THE PATIENT FINANCIAL ASSISTANCE PROGRAM APPLIES TO UNINSURED AND UNDER-INSURED INDIVIDUALS WHO PARTICIPATE IN THE PROCESS TO EVALUATE THEIR ABILITY TO PAY FOR LVH-H SERVICES.THE FINANCIAL COUNSELORS HELP PATIENTS COMPLETE THE APPLICATION FOR FINANCIAL ASSISTANCE. LVH-H FOLLOWS THE FEDERAL POVERTY GUIDELINES TO EVALUATE ELIGIBILITY. PATIENTS WHOSE FAMILY INCOME FALLS BELOW 200% OF THE FEDERAL POVERTY GUIDELINE WILL HAVE THEIR ENTIRE BALANCE FORGIVEN FOR THEIR QUALIFYING SERVICES AT LVH-H. PATIENTS WITH A FAMILY INCOME BELOW 400% OF THE FEDERAL POVERTY GUIDELINES WILL HAVE A PORTION OF THEIR BALANCE FORGIVEN FOR QUALIFYING SERVICES AT LVH-H.PATIENTS OFTEN EXPRESS FINANCIAL CONCERN OR NEED BY CONTACTING LVH-H PATIENT FINANCIAL COUNSELING DEPARTMENT. THE COUNSELOR EXPLAINS THE AVAILABLE PROGRAMS, SUCH AS PENNSYLVANIA MEDICAL ASSISTANCE, CHIP, THE FEDERAL INSURANCE EXCHANGE AND PATIENT FINANCIAL ASSISTANCE.PATIENTS WILL BE REFERRED TO THE FINANCIAL COUNSELORS WHO WORK WITH UNINSURED AND UNDER-INSURED PATIENTS TO APPLY FOR PENNSYLVANIA MEDICAL ASSISTANCE. THE FINANCIAL COUNSELORS ARE LOCATED ONSITE. THE FINANCIAL COUNSELORS VISIT INPATIENTS IN THEIR ROOMS AND OUTPATIENTS IN THE EMERGENCY DEPARTMENT (ED).INFORMATION REGARDING FINANCIAL ASSISTANCE IS PROVIDED TO PATIENTS VIA SIGNAGE IN THE REGISTRATION AREAS AS WELL AS THE ED WAITING ROOM. ALSO, WHEN THE FINANCIAL COUNSELORS ASSIST PATIENTS IN COMPLETING A MEDICAL ASSISTANCE UNINSURED AND UNDER-INSURED APPLICATION, THEY ALSO INFORM THE PATIENT ABOUT THE AVAILABILITY OF THE FINANCIAL ASSISTANCE PROGRAM. IN ADDITION, LVH-H ADVERTISES OUR FINANCIAL ASSISTANCE PROGRAM ON OUR PUBLIC WEBSITE, AS WELL AS ON ALL BILLING STATEMENTS SENT TO OUT PATIENTS. PART VI, LINE 4: NORTHEASTERN PENNSYLVANIA HEALTH CORP, D/B/A LEHIGH VALLEY HOSPITAL-HAZLETON (LVH-H) IS A PENNSYLVANIA NOT-FOR-PROFIT CORPORATION EXEMPT FROM FEDERAL INCOME TAXES AS A CORPORATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE.THE PRIMARY SERVICE AREA OF LVH-H CONSISTS OF LUZERNE, SCHUYKILL AND CARBON COUNTIES.DURING THE FISCAL YEAR 2016, 97.36% AND 0.98% OF THE DISCHARGES FROM LVH-H WERE RESIDENTS OF THE PRIMARY SERVICE AND SECONDARY SERVICE AREA, RESPECTIVELY. DURING THE FISCAL YEAR 2016, 1.66% OF THE DISCHARGES FROM LVH-H WERE RESIDENTS OUTSIDE THE PRIMARY AND SECONDARY AREAS. PART VI, LINE 5: LEHIGH VALLEY HOSPITAL-HAZLETON QUALIFIES AS AN INSTITUTE OF PURELY PUBLIC CHARITY IN PENNSYLVANIA. THIS REGULATION IS REFERRED TO AS ACT 55. TO BE CONSIDERED A PURELY PUBLIC CHARITY, NONPROFITS MUST:(1) ADVANCE A CHARITABLE PURPOSE;(2) DONATE OR RENDER GRATUITOUSLY A SUBSTANTIAL PORTION OF ITS SERVICES;(3) BENEFIT A SUBSTANTIAL AND INDEFINITE CLASS OF PERSONS WHO ARE LEGITIMATE SUBJECTS OF CHARITY;(4) RELIEVE THE GOVERNMENT OF SOME BURDEN; AND(5) OPERATE ENTIRELY FREE FROM PRIVATE PROFIT MOTIVE.LVH-H IS REQUIRED TO REAPPLY FOR THIS CHARITABLE STATUS EVERY FIVE YEARS AND CURRENTLY QUALIFIES THROUGH JULY 31, 2018. PART VI, LINE 6: THE MISSION OF THE LEHIGH VALLEY HOSPITAL-HAZLETON (LVH-H) COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS TO UNDERSTAND AND PLAN FOR THE CURRENT AND FUTURE HEALTH NEEDS OF THE RESIDENTS OF ITS COMMUNITY. THE GOAL OF THE PROCESS IS TO IDENTIFY THE HEALTH NEEDS OF THE COMMUNITIES SERVED BY LVH-H, WHILE DEVELOPING A DEEPER UNDERSTANDING OF COMMUNITY NEEDS AND IDENTIFYING COMMUNITY HEALTH PRIORITIES. THE ASSESSMENT ESTABLISHED THE FOLLOWING PRIORITIES: (1) IMPROVING ACCESS TO AFFORDABLE HEALTHCARE (2) HEALTH EDUCATION AND COMMUNICATION (3) BEHAVIORS THAT IMPACT HEALTH. THE CURRENT THREE-YEAR ASSESSMENT COMPLETED IN 2013, ESTABLISHED THE FOLLOWING PRIORITIES: (1) IMPROVING ACCESS TO AFFORDABLE HEALTHCARE (2) HEALTH EDUCATION AND COMMUNICATION (3) BEHAVIORS THAT IMPACT HEALTH. THE FOLLOWING EXPLAINS THE WORK DONE IN YEAR THREE TO ADDRESS EACH INITIATIVE:THE FIRST OBJECTIVE WAS TO IMPROVE THE ACCESS AND HEALTH OF THE COMMUNITY WE SERVE THROUGH THE FINANCIAL SUPPORT OF A FREE CLINIC. FINANCIAL SUPPORT OF $10000 WAS AGAIN PROVIDED TO THE CLINIC.THE SECOND OBJECTIVE WAS TO IMPROVE THE HEALTH OF THE COMMUNITY WE SERVE THROUGH EDUCATION AND OUTREACH. HEALTH PROGRAMS CONTINUE TO BE OFFERED THROUGH OCCUPATIONAL MEDICINE, NURSING AND VARIOUS OTHER CLINICAL DEPARTMENTS, INCLUDING BOTH EDUCATIONAL PROGRAMS AS WELL AS HEALTH FAIRS. PROGRAMS INCLUDED PARTNERSHIP WITH AMERICAN HEART ASSOCIATION'S HEARTCHASE EVENT TO EDUCATE PARTICIPANTS ON HEART HEALTHY CHOICES, HANDS ONLY CPR SESSIONS PROGRAMS, AND LOOK GOOD FEEL GOOD PROGRAM IN CONJUNCTION WITH THE AMERICAN CANCER SOCIETY. PRESENTATIONS ON FOOT PAIN AND THYROID CONDITIONS, DIABETES AND OBESITY WERE PRESENTED IN COLLABORATION WITH THE MANUFACTURERS ASSOCIATION OF EASTERN PENNSYLVANIA ON 11/6/15. AS OF 6/30/16, 22 HEALTH FAIRS AND 48 PROGRAMS WERE HELD. 1047 HEALTH FAIR AND PROGRAM PARTICIPANTS RECEIVED EDUCATION AND VARIOUS HEALTH SCREENINGS.THE THIRD OBJECTIVE WAS TO IMPROVE ACCESS AND THE HEALTH OF THE COMMUNITY WE SERVE BY OFFERING NON-TRADITIONAL HOURS. EXPRESS CARE VOLUMES HAVE EXCEEDED THE EXPECTED OUTCOMES AND CONTINUE TO OFFER CARE FROM 8AM-8PM M-F AND 8AM - 4:30PM SAT AND SUN WITH EXPANDED STAFFING. EVALUATIONS FOR AREAS OF ADDITIONAL ACCESS ARE ONGOING.THE FOURTH OBJECTIVE WAS TO IMPLEMENT PROGRAMS THAT POSITIVELY AFFECT BEHAVIORS THAT IMPACT HEALTH. BREAST HEALTH SCREENINGS ON KOMEN MAMMO DAY, DISTRIBUTION OF 40 OCCULT BLOOD COLON CANCER SCREENING KITS; 92 PEOPLE RECEIVED CAROTID ARTERY ULTRASOUND STROKE SCREENINGS, ASSESSMENTS AND EDUCATION AT THE FALL PREVENTION HEALTH FAIR; ATV SAFETY EVENT IN COLLABORATION WITH PA DIVISION OF AMERICAN TRAUMA SOCIETY AND PRESENTATIONS TO 54 PEOPLE ON SURGICAL AND NON-SURGICAL WEIGHT LOSS OPTIONS. LVH-H LEADERSHIP CONTINUES TO MEET WITH LEADERSHIP OF THE HAZLETON INTEGRATION PROJECT (HIP) TO DETERMINE NEEDS OF ITS UNDERSERVED COMMUNITY MEMBERS AS WELL AS PARTICIPATING IN THE COMMUNITIES THAT CARE (CTC) PROJECT WHICH WORKS COLLABORATIVELY WITH LOCAL AGENCIES, SUCH AS LOCAL GOVERNMENT, SCHOOL DISTRICT, AND CHAMBER OF COMMERCE TO ENSURE NEW COMMUNITY MEMBERS KNOW WHERE TO ACCESS SERVICES SUCH AS HEALTHCARE. IN ADDITION:A DONATION OF $5000 WAS MADE TO THE DOWNTOWN HAZLETON ALLIANCE FOR IMPROVEMENTS IN COMMUNITY SOCIALIZATION AND REVITALIZATION. 65 TRANSLATION IPADS WERE DISTRIBUTED THROUGHOUT LVH-H AND LVPG-H FACILITIES TO FACILITATE IMPROVEMENTS IN HEALTH CARE COMMUNICATION WITH LANGUAGE BARRIERS AND HEARING IMPAIRED PATIENTS. LVH-H PROVIDED FOOD DONATIONS FOR COMMUNITY EASTER, THANKSGIVING AND CHRISTMAS DINNERSCOLLEAGUES PARTICIPATED IN SEVERAL FUNDRAISERS TO SUPPORT THE UNITED WAY OF GREATER HAZLETON. 0 AMERICAN CANCER SOCIETY PO BOX 2306 HAZLETON PA 18201 131788491 501(C)(3) 12500 TO CONTINUE THE MISSION OF THE AMERICAN CANCER SOCIETY TO ELIMINATE CANCER AS A MAJOR HEALTH PROBLEM AMERICAN HEART ASSOCIATION 10900-B STONELAKE BLVD SUITE 320 AUSTIN TX 78759 135613797 501(C)(3) 10000 TO CONTINUE THE MISSION OF THE AMERICAN HEART ASSOCIATION TO ADVANCE THE HEALTH OF COMMUNITIES HAZLETON INTEGRATION PROJECT INC 225 E 4TH ST HAZLETON PA 18201 453444683 501(C)(3) 10000 TO CONTINUE THE MISSION TO REVITALIZE THE DOWNTOWN HAZLETON AREA MINSI TRAILS COUNCIL PO BOX 20624 LEHIGH VALLEY PA 180020624 231708585 501(C)(3) 7500 TO CONTINUE THE MISSION OF THE BOY SCOUTS OF AMERICA GREATER HAZLETON CHAMBER OF COMMERCE 20 W BROAD ST HAZLETON PA 18201 240607160 501(C)(3) 6700 TO SUPPORT THE PROMOTION OF BUSINESS IN THE HAZLETON AREA MOUNTAIN COUNCIL ON GOVERNMENTS 20 W BROAD ST HAZLETON PA 18201 233054092 501(C)(3) 5000 TO CONTINUE THE MISSION TO STUDY COMMUNITY CHALLENGES X X X X X 0 1 0 0 0 0 0 0 0 JOHN R FLETCHER PRESIDENT, EX OFFICIO 319246 0 70000 0 31243 0 7800 0 2733 0 431022 0 0 0 WILLIAM C BAUER ASSISTANT TREASURER 240250 0 43535 0 0 0 7800 0 28615 0 320200 0 0 0 EDWARD F O'DEA TREASURER 0 513070 0 136247 0 104165 0 0 0 41278 0 794760 0 0 ANTHONY VALENTE VP OF MEDICAL AFFAIRS 198143 0 31500 0 0 0 6545 0 28508 0 264696 0 0 0 DONALD A PATTEN PHYSICIAN 277190 0 0 0 0 0 7800 0 27259 0 312249 0 0 0 JOSEPH G CIOTOLA PHYSICIAN 217789 0 0 0 0 0 6789 0 22107 0 246685 0 0 0 JOHN P AMENTLER PHYSICIAN 213880 0 0 0 0 0 6293 0 2427 0 222600 0 0 0 MICHAEL GOLDEN VP OF NURSING 182934 0 30000 0 0 0 6073 0 28452 0 247459 0 0 0 PART I, LINE 4B EDWARD O'DEA $105,668 JOHN FLETCHER $24,043 SUSAN C YEE - TRUSTEE PARTNERSHIP IN 94 BRODHEAD ASSOCIATES - TRUSTEE OF LVHN/LVH/LVHM/LVHH/HWC 126640 94 BRODHEAD ASSOCIATES LEASES OFFICE SPACE TO LVPG AT FAIR MARKET VALUE. 0 ANTHONY VALENTE MD - HIGHLY COMPENS OWNER OF MARVAL MEDICAL - HIGHLY COMPENSATED EMPLOYEE OF LVH-H 304837 MARVAL MEDICAL PROVIDES HOSPITALIST SERVICES TO THE LVH-HAZLETON. 0 SUSAN C YEE - TRUSTEE CEO OF ACTIVE DATA, INC. - TRUSTEE OF LVHN/LVH/LVHM/LVHH/HWC 26720 DONATION OF SOFTWARE LICENSE FOR USE BY LVH 0 FORM 990, PART III, LINE 2 LVH-H CONTINUED TO PURSUE OPPORTUNITIES TO PROVIDE AND/OR ENHANCE QUALITY SERVICES FOR THE COMMUNITY WE SERVE. WE CONTINUED DEVELOPMENT AND IMPLEMENTATION OF THE ELECTRONIC MEDICAL RECORD (EMR) SYSTEM TO MEET MEANINGFUL USE REQUIREMENTS. WE ALSO CONTINUED TO FULFILL OUR COMMITMENT TO A THREE-YEAR FINANCIAL PLEDGE TO SUPPORT A COMMUNITY-BASED ORGANIZATION'S DEVELOPMENT OF A FREE CLINIC FOR THE UNINSURED, AS WELL AS CONTINUED IMPLEMENTATION OF OUR COMMUNITY HEALTH NEEDS ASSESSMENT PLAN BASED ON COMMUNITY NEEDS. ALSO, WE CONTINUED IMPLEMENTATION OF OUR STRATEGIC PLAN TO REDUCE OUTMIGRATION BY SUCCESSFULLY RECRUITING PRIMARY AND SPECIALTY CARE PHYSICIANS TO MEET THE NEEDS OF OUR COMMUNITY. WE DEVELOPED A MEDICAL STAFF DEVELOPMENT PLAN TO SUPPORT AND FURTHER THE MISSION OF THE HOSPITAL; BECAME DESIGNATED AS LEVEL IV TRAUMA CENTER WITH A 3-YEAR CERTIFICATION; OPENED A NEW AMBULATORY HEALTH CENTER IN MOUNTAIN TOP, PA WHICH INCLUDES PHYSICIAN PRACTICES, AS WELL AS OUTPATIENT DIAGNOSTIC TESTING SERVICES. WE ALSO OPENED A CANCER TREATMENT CENTER IN THE GREATER HAZLETON AREA AND RECRUITED TWO HEMATOLOGIST ONCOLOGISTS. IN ADDITION, WE DEVELOPED A MUSCULOSKELETAL SERVICE LINE TO PROVIDE PATIENTS WITH MEDICALLY APPROPRIATE CONTINUUM OF CARE; COMPLETED SUCCESSFUL IMPLEMENTATION OF ICD-10 CODING PROCESS; CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT, WHICH INCLUDED DEVELOPING A THREE-YEAR PLAN TO MEET THE COMMUNITY NEEDS. ALSO, WE DEVELOPED A COMMUNITY AMBASSADOR BOARD OF ASSOCIATES MADE UP OF BUSINESS AND CIVIC LEADERS, FORMER PATIENTS, FORMER EMPLOYEES AND OTHERS. THE PURPOSE OF THE BOARD IS FOR THE HOSPITAL TO PROVIDE INFORMATION ON HEALTH-RELATED MATTERS TO THE GROUP AND THE GROUP, IN TURN, PROVIDES FEEDBACK FROM THE COMMUNITY TO THE HOSPITAL - ALL IN AN EFFORT TO ENHANCE CARE AND PATIENT SATISFACTION. LVH-H ALSO PURCHASED LANGUAGE INTERPRETATION VIDEO IPADS TO MORE EASILY COMMUNICATE WITH PATIENTS WITH LIMITED ENGLISH PROFICIENCY; INSTALLED AN MRI UNIT IN THE HOSPITAL TO PROVIDE MORE CONVENIENT TESTING FOR INPATIENTS. PRIOR TO THIS INSTALLATION, PATIENTS HAD TO BE TRANSPORTATED TO AN OUTPATIENT MRI CENTER. OUTPATIENT MRIS ARE ALSO PERFORMED AT THE HOSPITAL SITE. IN ADDITION, WE BEGAN DISCUSSIONS AND RESEARCH ON THE FEASIBILITY OF BUILDING A NEW ACUTE CARE FACILITY IN OUR COMMUNITY. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION'S SOLE CORPORATE MEMBER IS LEHIGH VALLEY HEALTH NETWORK, INC. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S SOLE CORPORATE MEMBER, LEHIGH VALLEY HEALTH NETWORK, INC., HAS THE POWER TO ELECT, APPOINT, APPROVE, OR REJECT MEMBERS OF THE ORGANIZATION'S GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATION'S SOLE CORPORATE MEMBER, LEHIGH VALLEY HEALTH NETWORK, INC., HAS THE POWER TO APPROVE OR REJECT CERTAIN MAJOR OPERATING DECISIONS MADE BY THE ORGANIZATION'S GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE PROCESS TO REVIEW THE 990'S INCLUDES: DRAFT 1 OF THE RETURNS IS REVIEWED IN DETAIL WITH A FOCUS ON ACCURACY, COMPLETENESS, AND PERSPECTIVE BY THE LVHN VICE-PRESIDENT, FINANCE-CONTROLLER AND THE LVHN CORPORATE LEGAL COUNSEL. DRAFT 2 OF THE RETURNS IS REVIEWED BY THE EXECUTIVE VICE PRESIDENT & CHIEF FINANCIAL OFFICER. ALL COMPENSATION DISCLOSURES ARE REVIEWED BY THE DIRECTOR - COMPENSATION - HUMAN RESOURCES. DRAFT 3 OF THE RETURNS IS REVIEWED TOGETHER WITH THE PRESIDENT & CEO, THE EXECUTIVE VICE PRESIDENT & CHIEF FINANCIAL OFFICER, THE VICE-PRESIDENT, FINANCE-CONTROLLER AND THE DIRECTOR-TAX. FINAL RETURNS ARE REVIEWED WITH THE LVHN BOARD LEADERSHIP GROUP (THE BOARD CHAIR AND THREE VICE CHAIRS). COPIES OF ALL 990'S ARE PROVIDED TO THE FULL BOARD PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C IN JANUARY 2016, LVHN IMPLEMENTED AN ELECTRONIC TOOL DESIGNED TO SEND NOTIFICATIONS AND TRACK DISCLOSURES REPORTED ON CONFLICT OF INTEREST QUESTIONNAIRES. THE NETWORK ALSO EXPANDED THE SCOPE OF THE CONFLICT OF INTEREST OR COMMITMENT POLICY, SUCH THAT ADDITIONAL COLLEAGUES ARE NOW REQUIRED TO COMPLETE A QUESTIONNAIRE EACH YEAR. PRIOR TO JANUARY, THE VP, INTERNAL AUDIT AND COMPLIANCE SERVICES ISSUED A NOTICE TO BOARD MEMBERS AND MEMBERS OF THE SENIOR MANAGEMENT COUNCIL WHEN IT WAS TIME FOR THEM TO SUBMIT THEIR CONFLICT OF INTEREST QUESTIONNAIRES. THE VP ALSO INSTRUCTED MEMBERS OF THE SENIOR MANAGEMENT COUNCIL TO IDENTIFY AND REQUEST COMPLETED CONFLICT OF INTEREST QUESTIONNAIRES FROM INDIVIDUALS WHO HAD POTENTIAL CONFLICTS OF INTEREST AND TO PROVIDE HER WITH THE IDENTITY OF THOSE INDIVIDUALS. COMPLIANCE SERVICES TRACKED COMPLETION OF THE QUESTIONNAIRES. ALL PHYSICIANS ON LVHN'S MEDICAL STAFF ARE ALSO REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY. MEDICAL STAFF SERVICES MONITORS THIS PROCESS TO ENSURE THAT ALL PHYSICIANS COMPLY. POTENTIAL CONFLICTS ARE MANAGED BY THE LVHN CONFLICT OF INTEREST COMMITTEE AND/OR BY THE BOARD OF TRUSTEES, DEPENDING ON WHOSE INTEREST(S) POSE THE CONFLICT AND THE NATURE OF THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 LEHIGH VALLEY HEALTH NETWORK 2016 EXECUTIVE COMPENSATION REVIEW IN COMPLIANCE WITH THE REBUTTABLE PRESUMPTION OF REASONABLENESS PROCESS OUTLINED IN THE INTERMEDIATE SANCTIONS REGULATIONS (ISSUED UNDER SECTION 4958 OF THE INTERNAL REVENUE CODE); SULLIVAN COTTER AND ASSOCIATES, INC. (SULLIVAN COTTER) QUALIFIES AS AN INDEPENDENT EXECUTIVE COMPENSATION EXPERT, SPECIALIZING IN THE HEALTH CARE INDUSTRY. SULLIVAN COTTER PROVIDES ADVICE TO THE LEHIGH VALLEY HEALTH NETWORK EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES TO SUPPORT ITS ATTAINMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS REGULATIONS. THEY ALSO SUPPORT THE COMMITTEE IN ENSURING THAT THE LVHN EXECUTIVE COMPENSATION PROGRAM IS COMPETITIVE AND ALIGNED WITH THE ORGANIZATION'S EXECUTIVE COMPENSATION PHILOSOPHY. CHIEF EXECUTIVE OFFICER TOTAL COMPENSATION REVIEW: PROGRAM ANALYSIS: ANALYZE THE MARKET POSITION OF TOTAL COMPENSATION (BASE SALARY, INCENTIVE, BENEFITS, AND PERQUISITES) FOR LVHN'S PRESIDENT AND CHIEF EXECUTIVE OFFICER (CEO) IN RELATION TO CEO MARKET DATA OBTAINED FOR A DEFINED PEER GROUP OF COMPARABLE HEALTH SYSTEMS. THIS INCLUDES THE PREPARATION OF TALLY SHEETS FOR THE PRESIDENT AND CEO AS WELL AS AN ANALYSIS OF FORM 990 COMPENSATION DATA. THEY ASSESS THE ALIGNMENT OF THE PRESIDENT AND CEO'S COMPENSATION WITH LVHN'S COMPENSATION PHILOSOPHY AND NOTE THE IMPLICATIONS OF THE REVIEW. SULLIVAN COTTER'S ANALYSES AND FINDINGS ARE SUMMARIZED IN A REPORT TO THE COMMITTEE THAT PROVIDES A REASONABLENESS OPINION FOR THE INTERMEDIATE SANCTIONS COMPLIANCE. THE REPORT WAS PROVIDED BY SULLIVAN COTTER AT THE AUGUST 17, 2015 EXECUTIVE COMPENSATION COMMITTEE MEETING. SENIOR MANAGEMENT COUNCIL (SMC) TOTAL COMPENSATION REVIEW: PROGRAM ANALYSIS: ANALYZE THE MARKET POSITION OF TOTAL COMPENSATION (SALARIES, INCENTIVES, BENEFITS, AND PERQUISITES) FOR LVHN'S SMC EXECUTIVES AND CLINICAL CHAIRS (APPROXIMATELY 30 TOTAL POSITIONS) IN RELATION TO COMPARABLE POSITIONS IN PEER ORGANIZATIONS. THIS INCLUDES THE PREPARATION OF TALLY SHEETS FOR EACH INDIVIDUAL. SULLIVAN COTTER'S ANALYSES AND FINDINGS ARE SUMMARIZED IN A REPORT TO THE COMMITTEE THAT ALSO PROVIDES AN OPINION OF REASONABLENESS FOR INTERMEDIATE SANCTIONS COMPLIANCE. THE REPORT WAS PROVIDED BY SULLIVAN COTTER AT THE AUGUST 17, 2015 EXECUTIVE COMPENSATION COMMITTEE MEETING. SUMMARY OF METHODOLOGY TO CONDUCT THIS ANALYSIS, SULLIVAN COTTER: COLLECTED BACKGROUND INFORMATION REGARDING LVHN'S OPERATIONS, STRUCTURE, SIZE AND SCOPE, AS WELL AS EACH POSITION'S DUTIES. COMPILED MARKET DATA FOR SMC EXECUTIVES CONSISTENT WITH THE EXECUTIVE COMPENSATION PHILOSOPHY APPROVED BY THE COMMITTEE DURING ITS SEPTEMBER 15, 2015 MEETING: THE MARKET DATA USED FOR LVHN SYSTEM EXECUTIVES IN THIS ASSESSMENT ARE AN EQUALLY WEIGHTED BLEND OF (1) A PEER GROUP OF 33 NOT-FOR-PROFIT HEALTH SYSTEMS LOCATED IN THE NORTHEAST REGION (EXCLUDING NEW YORK CITY) WITH NET OPERATING REVENUES BETWEEN $1.0 BILLION AND $4.3 BILLION (AVERAGE OF $1.8 BILLION), AND (2) NATIONAL DATA REFLECTING ORGANIZATIONS OF SIMILAR SCOPE AND SIZE TO LVHN. NATIONAL DATA ARE USED WHERE PEER GROUP DATA ARE NOT AVAILABLE. PEER GROUP AND NATIONAL MARKET DATA WERE ABSTRACTED FROM SULLIVAN COTTER'S 2015 SURVEY OF MANAGER AND EXECUTIVE COMPENSATION IN HOSPITALS AND HEALTH SYSTEMS, AS WELL AS OTHER PUBLISHED COMPENSATION SURVEYS REFLECTING PAY AT COMPARABLY SIZED ORGANIZATIONS, WHICH INCLUDED NATIONAL HOSPITALS AND NATIONAL MEDICAL GROUPS. SULLIVAN COTTER NOTES THAT NO MARKET DATA ARE PROVIDED FOR THE SVP, MEDICAL SERVICES AS THE RESPONSIBILITIES OF THAT POSITION ARE UNIQUE, SO NO BENCHMARK DATA ARE AVAILABLE. THEY RECOMMEND THAT THE COMMITTEE ASSESS THE COMPENSATION FOR THAT POSITION BASED ON INTERNAL EQUITY CONSIDERATIONS. COMPILED MARKET DATA FOR THE LVHN CLINICAL CHAIRS PREPARED BY THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES (AAMC) FOR THE CHAIRS OF CLINICAL DEPARTMENTS IN MEDICAL SCHOOLS, LVHN'S TRADITIONAL COMPARATOR GROUP FOR THESE JOBS. ADJUSTED THE MARKET DATA TO AN EFFECTIVE DATE OF JANUARY 1, 2016 AT AN ANNUALIZED RATE OF 3.0% BASED ON SALARY INCREASE TRENDS. COMPARED EACH COMPONENT OF LVHN'S BENEFIT PROGRAM AGAINST TYPICAL MARKET BENEFIT PRACTICES IN HEALTH SYSTEMS AND HOSPITALS BASED ON MULTIPLE PUBLISHED SURVEYS, SUPPLEMENTED BY SULLIVAN COTTER'S PROPRIETARY DATA AND EXPERIENCE. DEVELOPED MARKET TOTAL COMPENSATION DATA BY COMBINING MARKET TCC WITH TYPICAL MARKET BENEFIT COSTS. COMPARED LVHN'S TC TO MARKET RATES AND ASSESSED OVERALL POSITIONING. FOR PHYSICIAN EXECUTIVES HAVING BOTH CLINICAL AND ADMINISTRATIVE ROLES, RELEVANT MARKET DATA WERE COLLECTED BASED ON FTE ALLOCATION. SULLIVAN COTTER HAS NOT COMPLETED AN ASSESSMENT OF THE PHYSICIAN'S PRODUCTIVITY OR THE FAIR MARKET VALUE (FMV) OF THEIR CLINICAL COMPENSATION, AS LVHN HAS ADVISED THAT SUCH AMOUNTS ARE APPROPRIATE AND WITHIN FMV. SULLIVAN COTTER USED THE FOLLOWING METHODOLOGY TO ASSESS THE COMPETITIVENESS AND REASONABLENESS OF LVHN'S EXECUTIVE TOTAL COMPENSATION LEVELS: COLLECTED BACKGROUND INFORMATION REGARDING LVHN'S OPERATIONS, STRUCTURE, SIZE AND SCOPE. COLLECTED INFORMATION ON EACH SENIOR MANAGEMENT COUNCIL (SMC) MEMBER'S CURRENT COMPENSATION. DATA COLLECTED INCLUDE BASE SALARIES, ANNUAL INCENTIVE OPPORTUNITY LEVELS (TARGET AND MAXIMUM), ACTUAL ANNUAL INCENTIVE PAYOUT AMOUNTS, ANNUAL COSTS OF ALL STANDARD AND SUPPLEMENTAL BENEFITS AND ANNUAL COST AND DESCRIPTION OF EXECUTIVE PERQUISITES. REVIEWED JOB DESCRIPTIONS AND ORGANIZATIONAL CHARTS TO IDENTIFY EACH POSITION'S FUNCTIONAL RESPONSIBILITIES AND REPORTING RELATIONSHIPS. SELECTED THE APPROPRIATE BENCHMARK POSITION MATCH FOR EACH POSITION AND APPLIED PREMIUMS/DISCOUNTS TO THE MARKET DATA IN INSTANCES WHERE LVHN'S JOB DUTIES DIFFER MATERIALLY FROM BENCHMARK POSITION MATCHES. POSITION MATCHES AND MARKET ADJUSTMENTS WERE REVIEWED WITH LVHN'S SENIOR VICE PRESIDENT, HUMAN RESOURCES AND COMPENSATION STAFF. LVHN'S PROJECTED FY2016 NET REVENUES AND PHYSICIAN FTE'S WERE USED AS THE SCOPE SIZE FOR EACH ENTITY. FORM 990, PART VI, SECTION C, LINE 18 ANOTHER'S WEBSITE-GUIDESTAR. UPON REQUEST-HARD COPIES WITH SENIOR MANAGEMENT AND MARKETING. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC THROUGH ITS ANNUAL REPORT TO THE COMMUNITY. THE ANNUAL REPORT IS DISTRIBUTED TO ALL ATTENDEES AT THE ORGANIZATION'S ANNUAL PUBLIC MEETING. IN ADDITION, IT IS DISTRIBUTED VIA MAIL TO MEMBERS OF THE COMMUNITY. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICTS OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: MINIMUM PENSION LIABILITY -8,271,091. TRANSFERS FROM AFFILIATES 1,021,871. MINORITY INTEREST 154,927. CHANGES IN RESTRICTED FUND BALANCE -80,492. LEHIGH VALLEY HEALTH NETWORK 1200 S CEDAR CREST BLVD ALLENTOWN PA 181036202 222458317 PARENT COMPANY PA 501(C)(3) LINE 3 N/A 0 LEHIGH VALLEY HOSPITAL 2100 MACK BLVD ALLENTOWN PA 181035622 231689692 HEALTH CARE ORGANIZATION PA 501(C)(3) LINE 3 LEHIGH VALLEY HEALTH NETWORK 0 LEHIGH VALLEY HOSPITAL-MUHLENBERG 1200 S CEDAR CREST BLVD ALLENTOWN PA 181036202 232367707 HEALTH CARE ORGANIZATION PA 501(C)(3) LINE 3 LEHIGH VALLEY HEALTH NETWORK 0 LEHIGH VALLEY PHYSICIAN GROUP 1200 S CEDAR CREST BLVD ALLENTOWN PA 181036202 232700908 PHYSICIAN PRACTICE ORGANIZATION PA 501(C)(3) LINE 3 LEHIGH VALLEY HEALTH NETWORK 0 MUHLENBERG REALTY CORPORATION 1200 S CEDAR CREST BLVD ALLENTOWN PA 181036202 232245513 REAL ESTATE RENTALS PA 501(C)(3) LINE 3 LEHIGH VALLEY HEALTH NETWORK 0 LEHIGH VALLEY HEALTH NETWORK REALTY HOLDING CO 1200 S CEDAR CREST BLVD ALLENTOWN PA 181036202 232586770 REAL ESTATE HOLDING CO PA 501(C)(2) LEHIGH VALLEY HEALTH NETWORK 0 HAZLETON PROFESSIONAL SERVICES 700 E BROAD ST HAZLETON PA 182016835 205880364 PHYSICIAN PRACTICE ORGANIZATION PA 501(C)(3) LINE 3 LEHIGH VALLEY PHYSICIAN GROUP 0 HAZLETON SURGICAL ALLIANCE 700 E BROAD ST HAZLETON PA 182016835 202038456 SURGICAL SERVICES PA 501(C)(3) LINE 3 NORTHEASTERN PENNSYLVANIA HEALTH CORP 0 HAZLETON HEALTH & WELLNESS CENTER 700 E BROAD ST HAZLETON PA 182016835 232580968 STAFFING SERVICES PA 501(C)(3) LINE 11A, I NORTHEASTERN PENNSYLVANIA HEALTH CORP 0 LVHN RECIPROCAL RISK RETENTION GROUP 151 MEETING STREET SUITE 310 CHARLESTON SC 294012238 200037118 INSURANCE PA N/A HEALTH NETWORK LABORATORIES LLC 794 ROBLE RD ALLENTOWN PA 181099110 232932802 LABORATORY SERVICES PA N/A HEALTH NETWORK LABORATORIES LP 794 ROBLE RD ALLENTOWN PA 181099110 232948774 LABORATORY SERVICES PA N/A LEHIGH MAGNETIC IMAGING CENTER 1230 S CEDAR CREST BLVD ALLENTOWN PA 18103 232429007 IMAGING CENTER PA N/A LEHIGH VALLEY IMAGING LLC 1200 CEDAR CREST BLVD ALLENTOWN PA 181036202 464551937 IMAGING SERVICES PA N/A HAZLETON SURGERY CENTER LLC 17480 DALLAS PKWY STE 210 DALLAS TX 752877304 201232531 SURGICAL SERVICES PA N/A LEHIGH VALLEY HEALTH SERVICES INC 2100 MACK BLVD ALLENTOWN PA 181035622 232263665 HEALTH CARE RELATED SERVICES PA N/A C 0 LEHIGH VALLEY ANESTHESIA SERVICES PC 2100 MACK BLVD ALLENTOWN PA 181035622 233096124 ANESTHESIA SERVICES PA N/A C 0 WESTGATE PROFESSIONAL CENTER INC 2100 MACK BLVD ALLENTOWN PA 181035622 231657333 REAL ESTATE RENTALS PA N/A C 0 LEHIGH VALLEY PHYSICIAN HOSPITAL ORGANIZATION INC 2100 MACK BLVD ALLENTOWN PA 181035622 232750430 HEALTH CARE RELATED SERVICES PA N/A C 0 HAZLETON SAINT JOSEPH MEDICAL OFFICE BUILDING INC 700 E BROAD ST HAZLETON PA 182016835 232500981 MEDICAL OFFICE RENTAL PA NORTHEASTERN PENNSYLVANIA HEALTH CORP C 1.00000 0 0 0 0 1 0 0 0 0 0 1 1 1 1 1 1 1 1 1 1 HAZLETON SAINT JOSEPH MEDICAL OFFICE BUILDING INC K 13406 ACTUAL RENT AMOUNT