2015-05-06T13:07:34-05:00 2014-06-30 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 1650 MARKET STREET SUITE 4500 PHILADELPHIA PA 19103 990 2013-07-01 240795682 MOUNT NITTANY MEDICAL CENTER MOUN 8142317000 1800 EAST PARK AVENUE STATE COLLEGE PA 16803 RICHARD J WISNIEWSKI SENIOR VP FINANCE/CFO 8142317000 2015-05-06 1 JULIUS C GREEN CPA JD P00350393 2159720701 2015-05-06 2013 2016-03-07 17:11:31Z STEVEN E BROWN 1800 EAST PARK AVENUE STATE COLLEGE PA 16803 483219703 0 X WWW.MOUNTNITTANY.ORG X 1905 PA PROVIDE INPATIENT, OUTPATIENT & EMERGENCY CARE SERVICES TO RESIDENTS OF THE CENTRE COUNTY REGION. 14 8 2007 770 2789231 1259496 3188138 3144328 278528821 306678986 4073823 12202212 3585815 3967236 289376597 325992762 13850795 23515422 0 0 124390204 133704132 0 0 0 149235483 148020719 287476482 305240273 1900115 20752489 414344237 447908909 276212432 291576696 138131805 156332213 X MOUNT NITTANY HEALTH'S MISSION: WE ARE HERE TO MAKE PEOPLE HEALTHIER.MOUNT NITTANY MEDICAL CENTER WILL PROVIDE EVERY PATIENT WITH THE FINEST, PATIENT-CENTERED CARE IN A SAFE AND COMFORTABLE ENVIROMENT, CONTINUALLY IMPROVING ACCESS TO CARE, AND STRIVING TO ENHANCE THE QUAILITY OF HUMAN LIFE FOR EVERYONE WE SERVE. MOUNT NITTANY MEDICAL CENTER WILL ENHANCE ITS POSITION AS THE PREFERRED REGIONAL HEALTHCARE DESTINATION FOR BOTH PATEINTS AND MEDICAL PROFESSIONALS - PROVIDING VITAL CLINICAL CENTERS OF EXCELLENCE AND SUPERIOR ACCESS TO CARE - SUPPORTED BY A COMMITMENT TO MEDICAL EDUCATION AND BACKED BY A CULTURE OF ADVANCEMENT AND ACCOUNTABILITY - MOVING LIFE FORWARD. 0 0 269266497 23515422 307157819 MOUNT NITTANY MEDICAL CENTER IS COMMITTED TO PROVIDING QUALITY MEDICAL CARE IN AN ATMOSPHERE THAT REFLECTS HIGH STANDARDS OF SOCIAL, ETHICAL, AND FINANCIAL RESPONSIBILITY AND WILL ASSURE THAT THOSE SAME STANDARDS ARE MET IN ALL CONTRACTUAL RELATIONSHIPS. THE BOARD OF TRUSTEES HAS ESTABLISHED THIS STATEMENT OF ORGANIZATIONAL VALUES TO ASSURE THAT MEMBERS OF THE BOARD, THE MEDICAL CENTER STAFF, AND THE MEDICAL STAFF HONOR THE FOLLOWING PRINCIPLES THROUGH OUR BEHAVIORS:ALLIANCES WITH PATIENTS:- WE WILL TREAT ALL PATIENTS WITH DIGNITY AND RESPECT, AND WILL ACCOMMODATE INDIVIDUAL RESPONSES TO THE STRESS OF ILLNESS.- WE FULLY SUPPORT THE PRINCIPLES OUTLINED IN THE STATEMENT OF PATIENT'S RIGHTS AND RESPONSIBILITIES DOCUMENT.- WE COMMIT TO A SERVICE EXCELLENCE PHILOSOPHY THAT STRIVES TO MEET OR EXCEED PATIENT EXPECTATIONS.- ALL PATIENTS RECEIVE A UNIFORM STANDARD OF CARE THROUGHOUT THE FACILITY, REGARDLESS OF SOCIAL, CULTURAL, FINANCIAL, RELIGIOUS, RACIAL, GENDER, OR SEXUAL ORIENTATION FACTORS.- THE MEDICAL CENTER AND MEDICAL STAFF WORK JOINTLY TO ASSURE THAT ONLY APPROPRIATE AND EFFECTIVE TESTS, PROCEDURES, AND TREATMENTS ARE PROVIDED TO PATIENTS.COMMUNITY RELATIONS- WE WILL FAIRLY AND ACCURATELY REPRESENT OURSELVES AND OUR CAPABILITIES TO THE PUBLIC.- WE ARE COMMITTED TO CONSTANT PREPARATION FOR THE LONG-TERM FINANCIAL VIABILITY OF THE MEDICAL CENTER THROUGH RESPONSIBLE UTILIZATION OF RESOURCES AND IN SUPPORT OF OUR COMMITMENT TO MEET THE HEALTHCARE NEEDS OF THE COMMUNITY.- MEDICAL CENTER LEADERSHIP (EXECUTIVES, BOARD OF TRUSTEES, MEDICAL STAFF) WILL DISCLOSE AND AVOID POTENTIAL CONFLICTS OF INTEREST. ALL OTHER HOSPITAL STAFF WILL AVOID SIMILAR CONFLICTS OF INTEREST.- WE WILL MAINTAIN AN OPEN ADMISSIONS POLICY: NO PATIENT WILL BE REFUSED EVALUATION AND SERVICE BASED UPON SEX, AGE, RACE, CREED, NATIONAL ORIGIN, SEXUAL ORIENTATION, INFECTION STATUS, OR THE ABILITY TO PAY. TRANSFERS TO OTHER FACILITIES WILL OCCUR ONLY WHEN WE ARE UNABLE TO PROVIDE NEEDED SERVICES AND ONLY TO FACILITIES THAT PROVIDE AN APPROPRIATE LEVEL OF CARE, BASED ON OUR ASSESSMENT OF THE PATIENTS' NEEDS. PATIENTS MAY ALSO REQUEST ELECTIVE TRANSFER AND AN INFORMED CONSENT PROCESS WILL BE FOLLOWED.GENERAL PROGRAM SERVICE INFORMATIONOPERATIONS & PATIENTSMOUNT NITTANY MEDICAL CENTER, LOCATED IN STATE COLLEGE, PENNSYLVANIA, IS A 260-BED ACUTE-CARE, NOT-FOR-PROFIT FACILITY OFFERING GENERAL MEDICAL AND SURGICAL SERVICES THAT ARE FOCUSED ON HELPING PATIENTS REACH THEIR HEALTH POTENTIAL. FOR THE FISCAL YEAR ENDED JUNE 30, 2014, MOUNT NITTANY MEDICAL CENTER PROVIDED CARE TO THE FOLLOWING NUMBER OF PATIENTS:TOTAL NUMBER OF: INPATIENTS 13,181, OUTPATIENTS 269,579 AND ER VISITS 50,918 TOTAL MEDICARE AND MEDICARE ADVANTAGE: INPATIENTS 6,193, OUTPATIENTS 70,428 AND ER VISITS 7,998 TOTAL MEDICAID AND MEDICAID HMO: INPATIENTS 1,094, OUTPATIENTS 15,313 AND ER VISITS 6,794TOTAL SELF PAY: INPATIENTS 382, OUTPATIENTS 7,837 AND ER VISITS 5,807MOUNT NITTANY MEDICAL CENTER DID NOT DENY MEDICAL SERVICES TO ANY INDIVIDUALS INCLUDING THOSE THAT HAD PRIVATE INSURANCE, MEDICARE, MEDICAID, PUBLIC HEALTH INSURANCE, OR NO INSURANCE.EMERGENCY DEPARTMENTMOUNT NITTANY MEDICAL CENTER OPERATES AN EMERGENCY ROOM 24 HOURS A DAY, 365 DAYS A YEAR PROVIDING SERVICES TO ALL MEMBERS OF THE COMMUNITY REGARDLESS OF THEIR ABILITY TO PAY AND DENIED ZERO PATIENTS REQUESTING SUCH SERVICES. THE EMERGENCY ROOM DOES NOT HAVE A TRAUMA CENTER CERTIFICATION.MEDICAL STAFF PRIVILEGESALL QUALIFIED PHYSICIANS IN THE COMMUNITY ARE ELIGIBLE FOR MEDICAL STAFF PRIVILEGES AT MOUNT NITTANY MEDICAL CENTER AND ALL QUALIFIED PHYSICIAN APPLICATIONS HAVE BEEN ACCEPTED FOR MEDICAL STAFF PRIVILEGES. MORE THAN 300 PHYSICIANS IN 42 SPECIALTIES AND SUBSPECIALTIES ARE CREDENTIALED AT MOUNT NITTANY MEDICAL CENTER.PROFESSIONAL MEDICAL EDUCATION AND TRAININGMOUNT NITTANY MEDICAL CENTER CONDUCTS PROFESSIONAL MEDICAL EDUCATION AND TRAINING PROGRAMS FOR THE BENEFIT OF THE COMMUNITY WITH A RESULTING FINANCIAL LOSS TO THE MEDICAL CENTER. 269266497 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 73 0 1 2007 1 1 1 0 0 0 0 0 0 0 0 0 X 14 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X RICHARD J WISNIEWSKI SR VP FINANCECFO 8142346148 1800 EAST PARK AVENUE STATE COLLEGE PA 168036797 RICHARD D ALLATT MD DIRECTOR 2.00 X 16856 0 0 CARL A ANDERSON CHAIR (UNTIL FEB 2014) 2.00 4.00 X X 0 0 0 PATRICIA BEST DED VICE CHAIR 2.00 2.00 X 0 0 0 S DIANE BRANNON PHD DIRECTOR (UNTIL SEPT 2013) 2.00 X 0 0 0 STEVEN E BROWN FACHE DIRECTOR/PRESIDENT & CEO 32.00 8.00 X X 995270 0 64548 JONATHON DRANOV MD DIRECTOR 2.00 4.00 X 0 450815 30684 THOMAS J HARRIS SECRETARY 2.00 4.00 X X 0 0 0 EUGENE KEPHART DED DIRECTOR 2.00 X 0 0 0 PHILIP I PARK DIRECTOR 2.00 X 0 0 0 WAYNE SEBASTIANELLI MD DIRECTOR 2.00 2.00 X 29242 0 0 KAREN P SHUTE DIRECTOR 2.00 X 0 0 0 JAMES B THOMAS PHD CHAIR 2.00 4.00 X X 0 0 0 CHARLES WITMER DIRECTOR 2.00 X 0 0 0 PAULA MILONE NUZZO RN PHD DIRECTOR (BEGINNING OCT 2013) 2.00 X 0 0 0 THEODORE ZIFF MD DIRECTOR 2.00 X 0 0 0 THOMAS F BROWN TREASURER 2.00 8.00 X X 0 0 0 RICHARD WISNIEWSKI SR VP OF FINANCE & CFO 36.00 4.00 X 357772 0 53819 JEFFREY RATNER MD SR VP OF MEDICAL AFFAIRS 40.00 X 353069 0 59755 WAYNE THOMPSON EXECUTIVE VP, CORPORATE SERVICES & CIO 40.00 X 288533 0 54401 JANET SCHACHTNER SR VP OF PATIENT CARE SERV 38.00 2.00 X 281928 0 51876 DEBRA LINNES CHIEF OPERATING OFFICER 40.00 X 333812 0 31551 THOMAS CHARLES EXECUTIVE VP SYSTEM DEVELOPMENT & CSO 40.00 X 241148 0 26508 HAROLD BRUNGARD III VP, FACILITIES & PLANT OPS 40.00 X 176610 0 27622 GERALD DITTMANN VP OF HUMAN RESOURCES 40.00 X 183411 0 51148 GAIL MILLER VP OF QUALITY/PATIENT SAFE 40.00 X 168147 0 42647 PATRICIA WATSON VP NURSING/CNO 40.00 X 151359 0 41643 MAUREEN KARSTETTER VP MKTG, COMMUNICATIONS, COMMUNITY OUTREACH 40.00 X 154535 0 47363 LANCE ROSE FORMER PRESIDENT & CEO 0.00 X 14721 0 1126 3746413 450815 584691 77 1 1 0 ALEXANDER BUILDING CONSTRUCTION LLC 315 VAUGHN STREET HARRISBURG PA 17110 CONSTRUCTION 18142928 PENN STATE MILTON S HERSHEY MEDICAL CEN 500 UNIVERSITY DRIVE HERSHEY PA 17033 CONTRACTED PHYSICIAN SERVICES 6758521 STICKLER CONSTRUCTION 211 W HAMILTON AVE 294 STATE COLLEGE PA 16801 CONSTRUCTION 2681740 STAFF CARE INC PO BOX 281923 ATLANTA GA 303841923 STAFFING AGENCY 2516873 PRICEWATERHOUSECOOPERS LLP 125 HIGH STREET BOSTON MA 02110 CONSULTING 1972000 85 1991827 275446 877055 3144328 NET PATIENT SERVICE REV 621110 301227839 301227839 OTHER OPERATING REV 900099 5451147 5451147 306678986 937928 -6572 944500 470068 621165 -151097 -151097 -151097 167870060 156586069 19707 11283991 -19707 11264284 11264284 OUTPATIENT LAB SERVICES 621500 2775495 2775495 CAFETERIA SALES 722210 841199 841199 SNACK BAR REVENUE 722210 288172 288172 213467 20308 193159 4118333 325992762 306678986 2789231 13380217 23515422 23515422 170224 170224 105643250 93268782 12374468 5136056 4534447 601609 15874290 13910602 1963688 6880312 6078651 801661 765167 765167 78974 78974 15278 15278 33736 33736 17860458 11314448 6546010 393132 13347 379785 3689848 267856 3421992 783596 8250 775346 3874694 1221220 2653474 48094 36119 11975 167259 128096 39163 7740381 7740381 15694585 15694585 1652560 1652560 UBIT TAXES 411131 411131 MEDICAL SUPPLIES 68892295 68892295 BAD DEBT EXPENSE 10651807 10651807 MA ASSESSMENT 4087995 4087995 11179729 5653001 5526728 305240273 269266497 35973776 0 3847 3848 12482677 14771688 28403753 31374401 6460349 6469724 2114281 2695962 362631839 166921765 186386185 195710074 163086729 180563642 855196 974528 14551220 15345042 414344237 447908909 85120354 102361229 476134 609543 183678884 181347906 589985 352464 6347075 6905554 276212432 291576696 X 137917694 156042551 35617 35617 178494 254045 138131805 156332213 414344237 447908909 X 20752489 4201482 -6753563 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 15278 15278 0 PART II-B, LINE 1: A PORTION OF THE DUES PAID TO THE HOSPITAL & HEALTHSYSTEM ASSOCIATION OF PENNSYLVANIA ($8,301) AND THE AMERICAN HOSPITAL ASSOCIATION ($6,977) WAS DETERMINED TO BE FOR LOBBYING PURPOSES - TOTAL COST $15,278. 720750 51261 1813 773824 615509 97914 7328 720750 305935 306824 2750 615509 279801 3991 22143 305935 275745 4056 279801 1.00000 0 1 1 9 9 218367365 71341279 147026086 5209266 831526 4377740 126779974 91668908 35111066 12275225 3080052 9195173 195710074 DEFERRED COMPENSATION 287398 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 5123733 ACCRUED INTEREST 1494423 6905554 X 322047582 4201482 -6753563 -2552081 324599663 33736 1359363 1393099 325992762 303847174 -1359363 -1359363 305206537 33736 33736 305240273 PART V, LINE 4: PERMANENT ENDOWMENT FUNDS ARE HELD BY THE FOUNDATION FOR MOUNT NITTANY MEDICAL CENTER, INC. AND EARNINGS ARE DESIGNATED TO FUND FUTURE EXPENDITURES AND CAPITAL ACQUISITONS FOR MOUNT NITTANY MEDICAL CENTER. 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 DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2014 AND 2013. ALL REQUIRED FEDERAL EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURNS FOR THE CORPORATION HAVE BEEN FILED UP TO, AND INCLUDING, THE TAX YEAR ENDED JUNE 30, 2013. THE CORPORATION'S FEDERAL INCOME TAX RETURNS FOR YEARS ENDED BEFORE JUNE 30, 2011 ARE NO LONGER SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE ("IRS"). PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN INTEREST IN THE FOUNDATION FOR MOUNT NITTANY MEDICAL CENTER, INC. 1,112,693. PENSION LIABILITY ADJUSTMENT -7,889,076. CHANGE IN FAIR VALUE OF DERVATIVE INSTRUMENTS 22,820. PART XI, LINE 4B - OTHER ADJUSTMENTS: TRANSFERS FROM RELATED ORGANIZATIONS (NETTED ON FINANCIAL STATEMENTS) 1,379,070. LOSS ON SALE OF EQUIPMENT -19,707. PART XII, LINE 2D - OTHER ADJUSTMENTS: TRANSFERS FROM RELATED ORGANIZATIONS (NETTED ON FINANCIAL STATEMENTS) -1,379,070. LOSS ON SALE OF EQUIPMENT 19,707. 1 1 1 X 250.000000000000 0 1 1 0 1 1 1496183 1496183 0.00510 16545562 11256259 5289303 0.01800 18041745 11256259 6785486 0.02310 240876 2195 238681 0.00080 182399 57310 125089 0.00040 4830000 2921915 1908085 0.00650 284415 284415 0.00100 5537690 2981420 2556270 0.00870 23579435 14237679 9341756 0.03180 2735 2735 0.00000 684 684 0.00000 10709 10709 0.00000 14128 14128 1 3242189 47556521 63688173 -16131652 X 1 1 1 ADG HOSPITAL DRIVE ASSOCIATES LEASING REAL PROPERTY FOR MEDICAL OFFICE AND SURGICAL CENTER 0.24260 1 1 MOUNT NITTANY MEDICAL CENTER 1800 EAST PARK AVENUE STATE COLLEGE PA 16803 X X X MOUNT NITTANY MEDICAL CENTER 1 1 X X X X X X X X X 12 1 0 1 X WWW.MOUNTNITTANY.ORG/HEALTHNEEDS X X X X X X 1 0 1 1 250.000000000000 0 1 X 1 1 X X X X X 1 X 0 X X X X 1 X 0 0 MOUNT NITTANY MEDICAL CENTER PART V, SECTION B, LINE 3: DURING THE RECENT COMMUNITY NEEDS ASSESSMENT, MNMC PERSONNEL MET WITH COMMUNITY REPERSENTATIVES DURING THE HEALTH SUMMIT, AS WELL AS DURING KEY STAKEHOLDER INTERVIEWS. A TOTAL OF 36 INDIVIDUAL INTERVIEWS WERE CONDUCTED DURING THE FALL AND WINTER OF 2012/13. INTERVIEWEES INCLUDED THE DIRECTORS OF A VARIETY OF MAJOR HEALTH AND HUMAN SERVICE ORGANIZATIONS IN AND AROUND CENTRE COUNTY, HEALTH-RELATED FACULTY AND LEADERS FROM THE PENNSYLVANIA STATE UNIVERSITY, STUDENT HEALTH SERVICES STAFF, PUBLIC SAFETY OFFICIALS, SCHOOL DISTRICT ADMINISTRATORS, PHYSICIANS, AND TRANSPORTATION MANAGERS. MOUNT NITTANY MEDICAL CENTER PART V, SECTION B, LINE 11: A DISCOUNT OF 50% OFF OF CHARGES IS OFFERED TO UNINSURED PATIENTS ON HOSPITAL ACCOUNT BALANCES. THE FOLLOWING ARE EXAMPLES THAT QUALIFY PATIENTS AS UNINSURED: TERMINATED COVERAGE EITHER DUE TO JOB TERMINATION OR UNINSURED PERIODS DURING INSURANCE TRANSITION, EMPLOYED PATIENTS WHO MAY BE IN A "WAITING/GRACE" PERIOD FOR INSURANCE, OR INSURED PATIENTS WHERE COVERAGE HAS EXHAUSTED. MOUNT NITTANY MEDICAL CENTER PART V, SECTION B, LINE 20D: PATIENTS WHOSE FAMILY INCOME IS AT OR BELOW 250% OF THE FEDERAL POVERTY GUIDELINES ARE ELIGIBLE TO RECEIVE A 100% DISCOUNT FOR FREE CHARITY/FREE CARE. PATIENTS WHOSE FAMILY INCOME EXCEEDS 250% OF THE FEDERAL POVERTY GUIDELINES MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, SUCH AS CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE, AT THE DISCRETION OF THE MEDICAL CENTER. PART I, LINE 3C: A DISCOUNT OF 50% OFF OF CHARGES IS OFFERED TO UNINSURED PATIENTS ON HOSPITAL ACCOUNT BALANCES. THE FOLLOWING ARE EXAMPLES THAT QUALIFY PATIENTS AS UNINSURED: TERMINATED COVERAGE EITHER DUE TO JOB TERMINATION OR UNINSURED PERIODS DURING INSURANCE TRANSITION, EMPLOYED PATIENTS WHO MAY BE IN A "WAITING/GRACE" PERIOD FOR INSURANCE, OR INSURED PATIENTS WHERE COVERAGE HAS EXHAUSTED. PART I, LINE 7: COST TO CHARGE RATIO WAS COMPUTED USING WORKSHEET 2 AS DESCRIBED IN THE IRS INSTRUCTIONS TO FORM 990 FOR LINES 7A, 7B, AND 7G. COST ACCOUNTING SYSTEM WAS USED FOR SUBSIDIZED HEALTH SERVICES. FOR ALL OTHERS, COSTS INCLUDED THE VALUE OF STAFF DONATED HOURS (WITH ESTIMATED BENEFITS), MONETARY CONTRIBUTIONS, ESTIMATED VALUE OF MATERIALS USED IN DELIVERING PROGRAMS, AND ESTIMATED SPACE COSTS. THE INDIRECT COST ALLOCATION APPLIES THE INDIRECT-TO-DIRECT COST RATIO FROM THE MEDICAL CENTER'S MOST RECENT MEDICARE COST REPORT ( AS OF 6/30/2014 APPROX. 30%). PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 10,651,807. PART II, COMMUNITY BUILDING ACTIVITIES: OUR ENTRIES FOR COALITION BUILDING INCLUDE STAFF TIME FOR PARTICIPATION ON LOCAL COMMUNITY BOARDS OR STEERING COMMITTEES THAT FOCUS ON COMMUNITY HEALTH, FOR EXAMPLE, THE ADMINISTRATIVE DIRECTOR OF THE CANCER PROGRAM SERVES ON THE PA PATIENT NAVIGATOR INTERWORK STEERING COMMITTEE, MNMC'S DIRECTOR OF EDUCATION SERVED ON THE BOARD FOR CENTRE COUNTY PARTNERSHIP FOR COMMUNITY HEALTH, OUR INFECTION CONTROL NURSE SERVES ON THE INFECTION CONTROL COMMITTEE AT HEALTHSOUTH, AND OUR CFO SERVES ON THE BOARD FOR CENTRE VOLUNTEERS IN MEDICINE. THESE ARE JUST A FEW EXAMPLES. PART III, LINE 2: BAD DEBT (AT COST) IS CALCULATED BY APPLYING THE PATIENT CARE COST-TO-CHARGE RATIO FROM WORKSHEET 2 TO THE MEDICAL CENTER'S PROVISION FOR DOUBTFUL COLLECTIONS AS OF JUNE 30, 2014. THE MEDICAL CENTER'S ACCOUNTING DEPARTMENT RECORDS PAYMENTS, WHILE PATIENT ACCOUNTING STAFF MAKES APPROPRIATE ADJUSTMENTS TO PATIENT ACCOUNTS FOR BAD DEBT, DISCOUNTS, OR FREE CARE WRITE-OFFS. PART III, LINE 3: THE MEDICAL CENTER IS UNABLE TO ESTIMATE THE AMOUNT OF BAD DEBT THAT COULD BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. PATIENTS DO NOT PROVIDE INCOME INFORMATION PRIOR TO RECEIVING CARE. THE REGISTRATION DEPARTMENT GIVES EVERY PATIENT A COPY OF OUR FINANCIAL ASSISTANCE PROGRAM TO ENSURE EVERY PATIENT HAS THE OPPORTUNITY AS APPROPRIATE TO QUALIFY FOR OUR ASSISTANCE PROGRAM. THE MEDICAL CENTER OFFERS DETAILED INFORMATION ABOUT THE CHARITY CARE PROGRAM WHEN PATIENTS OFFER INFORMATION THAT IS NEEDED TO DETERMINE ELIGIBILITY. SEE RESPONSE TO PART VI, LINE 3 HEREIN. MOUNT NITTANY MEDICAL CENTER PROVIDES SERVICES TO ALL PATIENTS REGARDLESS OF ABILITY TO PAY AS PART OF THE HOSPITAL'S MISSION. A PORTION OF THE MOUNT NITTANY MEDICAL CENTER'S BAD DEBT WOULD RELATE TO PATIENTS THAT COULD QUALIFY FOR CHARITY CARE BUT WERE UNWILLING OR UNABLE TO PROVIDE THE APPROPRIATE DOCUMENTATION TO ALLOW THAT CLASSIFICATION. AS SUCH A PORTION OF THE HOSPITAL'S BAD DEBT SHOULD BE CONSIDERED COMMUNITY BENEFIT. PART III, LINE 4: ACCOUNTS RECEIVABLE, PATIENTS, 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. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS ESTIMATED BASED ON A PERIODIC REVIEW OF THE ACCOUNTS RECEIVABLE AGING, PAYOR CLASSIFICATIONS, AND APPLICATION OF HISTORICAL WRITE-OFF PERCENTAGES. 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.BAD DEBT IS PUBLISHED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ON THE STATEMENT OF OPERATIONS ON THE LINE ENTITLED, "PROVISION FOR BAD DEBTS." PART III, LINE 8: THE MEDICAL CENTER CONTINUES TO PROVIDE CARE TO ALL PRESENTING AND ADMITTED PATIENTS, REGARDLESS OF ABILITY TO PAY. THROUGH DILIGENT COST CONTROL PROCESSES, THE MEDICAL CENTER SEEKS WAYS TO KEEP COSTS OF PROVIDING CARE TO A MINIMUM, WHILE STILL PROVIDING THE SAFETY MEASURES, TECHNOLOGICAL CAPABILITIES, AND APPROPRIATE STAFFING LEVELS TO ENSURE THE BEST POSSIBLE OUTCOMES. NOTWITHSTANDING THE COSTS TO PROVIDE CARE, RECEIVING "LESS" THAN WHAT IT COSTS TO PROVIDE ADEQUATE CARE TO MEDICARE COVERED LIVES DOES THE MEDICAL CENTER A DISSERVICE. THIS SHORTFALL SHOULD COUNT AS A COMMUNITY BENEFIT AS THE MEDICAL CENTER STRIVES TO PROVIDE THE BEST CARE POSSIBLE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE MEDICAL CENTER USES A STEP-DOWN COST ALLOCATION METHOD AND THEN APPLIES A COST-TO-CHARGE RATIO. PART III, LINE 9B: IF PATIENTS ARE FOUND TO QUALIFY FOR FINANCIAL ASSISTANCE, THE MEDICAL CENTER IMMEDIATELY CEASES COLLECTIONS AND ADJUSTS CHARGES OFF AS CHARITY CARE. PART VI, LINE 2: MOUNT NITTANY HEALTH SYSTEM ("MNHS") HAS HISTORICALLY USED INFORMAL COMMUNITY FEEDBACK MECHANISMS SUCH AS PATIENT AND STAFF INTERACTIONS, AS WELL AS MORE FORMAL MEANS SUCH AS CONSULTANT-LED MARKET RESEARCH AND SOLICITING FEEDBACK FROM DONORS, NON-EMPLOYED PHYSICIANS, AND COMMUNITY LEADERS TO UNDERSTAND THE NEEDS OF REGIONAL POPULATIONS. IN ADDITION, MNHS CONTINUES TO HOLD ONGOING AND MEANINGFUL DISCUSSIONS WITH MAJOR COMMUNITY STAKEHOLDERS, INCLUDING, BUT NOT LIMITED TO, THE PENNSYLVANIA STATE UNIVERSITY AND MILTON S. HERSHEY MEDICAL CENTER, TO DEVELOP RESPONSIVE PROGRAMS AND SOLUTIONS TO THE HEALTH CARE NEEDS OF PROMINENT SEGMENTS OF THE LOCAL POPULATION IN CENTRE COUNTY.DURING FISCAL YEAR 2013, MOUNT NITTANY MEDICAL CENTER CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE CHNA EFFORT CONSISTED OF THE COLLECTION, ANALYSIS, AND SYNTHESIS OF DATA FROM A WIDE VARIETY OF PRIMARY AND SECONDARY SOURCES IN ORDER TO CHARACTERIZE THE POPULATION AND PRIORITY HEALTH NEEDS OF CENTRE COUNTY AND THE SURROUNDING REGION. MNMC BEGAN ITS COMPREHENSIVE CHNA IN THE SUMMER OF 2012. PRELIMINARY MEETINGS WERE HELD WITH COMMUNITY LEADERS TO EXPLORE THE COMMUNITY'S PERCEPTION OF THE SCOPE OF MOUNT NITTANY MEDICAL CENTER'S EFFORTS, RESOURCES AVAILABLE FOR COLLABORATION, AND LEVEL OF INTEREST IN COMMUNITY-BASED AND COMMUNITY-OWNED SOLUTIONS. THESE DISCUSSIONS LED TO A FIVE PART APPROACH WHEREBY WE CONDUCTED:1. KEY STAKEHOLDER INTERVIEWS - A TOTAL OF 36 INDIVIDUAL INTERVIEWS WERE CONDUCTED DURING THE FALL AND WINTER OF 2012/13. INTERVIEWEES INCLUDED THE DIRECTORS OF A VARIETY OF MAJOR HEALTH AND HUMAN SERVICE ORGANIZATIONS IN AND AROUND CENTRE COUNTY, HEALTH-RELATED FACULTY AND LEADERS FROM THE PENNSYLVANIA STATE UNIVERSITY, STUDENT HEALTH SERVICES STAFF, PUBLIC SAFETY OFFICIALS, SCHOOL DISTRICT ADMINISTRATORS, PHYSICIANS, AND TRANSPORTATION MANAGERS. 2. HEALTH NEEDS SURVEY - AN ONLINE AND PAPER-BASED SURVEY WAS WIDELY DISTRIBUTED TO THE COMMUNITY AND WITHIN MOUNT NITTANY MEDICAL CENTER'S FACILITIES. BY THE END OF MARCH 2013, 1,133 COMPLETED SURVEYS WERE RECEIVED. RESULTS ARE INCLUDED IN THE CHNA. 3. INTERNAL ADVISORY TEAM - BEGINNING IN LATE FALL 2012, AN INTERNAL TEAM OF EXPERIENCED MOUNT NITTANY MEDICAL CENTER CLINICAL AND CASE MANAGEMENT STAFF MET FOR A SERIES OF DISCUSSIONS TO DOCUMENT HEALTH NEEDS AS UNDERSTOOD BY THE PROVIDER COMMUNITY. 4. SECONDARY DATA - MOUNT NITTANY MEDICAL CENTER PARTNERED WITH THE PENNSYLVANIA STATE UNIVERSITY FACULTY AND STUDENTS IN THE DEPARTMENT OF HEALTH POLICY AND ADMINISTRATION TO IDENTIFY, REVIEW, AND SYNTHESIZE SECONDARY DATA ABOUT THE HEALTH OF CENTRAL PENNSYLVANIANS. 5. HEALTH NEEDS SUMMIT - MOUNT NITTANY MEDICAL CENTER IDENTIFIED CENTRE COUNTY'S SOLE STATE HEALTH IMPROVEMENT PLAN (SHIP) PARTNERSHIP AS A LOGICAL COLLABORATOR TO HELP BRING COMMUNITY LEADERS TOGETHER TO ENSURE COMPREHENSIVE INPUT INTO LOCAL AND REGIONAL POCKETS OF NEED. THE SHIP PARTNERSHIP, CENTRE COUNTY PARTNERSHIP FOR COMMUNITY HEALTH (CCPCH), HOSTED THIS EVENT ON FEBRUARY 25, 2013. THIS SUMMIT WAS THE FIRST IN A SERIES OF ONGOING MEETINGS ORGANIZED AND HOSTED BY CCPCH WITH SUPPORT FROM MOUNT NITTANY MEDICAL CENTER. THESE ONGOING EVENTS PROVIDE INCLUSIVE FORUMS TO MONITOR NEEDS, ADJUST IMPLEMENTATION TACTICS, AND CONDUCT ONGOING NEEDS ASSESSMENTS MORE EFFICIENTLY OVER TIME.SEE ALSO SCHEDULE H PART V. PART VI, LINE 3: MOUNT NITTANY MEDICAL CENTER IS DEDICATED TO IMPROVING THE HEALTH AND WELL-BEING OF ALL ITS CONSTITUENTS. AS MENTIONED PREVIOUSLY, MNMC CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT DURING FISCAL YEAR 2013. THIS ASSESSMENT RESULTED IN SIX MAJOR COMMUNITY HEALTH NEEDS AND GAPS WHICH INCLUDE ACCESS TO CARE, HEALTHY AGING, MENTAL HEALTH, OBESITY/DIABETES, ORAL HEALTH AND SUBSTANCE ABUSE. REFER TO THE CHNA FOR ANALYSIS AND RESPONSE TO THESE AREAS. THROUGH THE FINANCIAL ASSISTANCE PROGRAM, MOUNT NITTANY MEDICAL CENTER PROVIDES MEDICAL CARE REGARDLESS OF A PATIENT'S ABILITY TO PAY, INSUFFICIENT HEALTH INSURANCE OR WHETHER A GOVERNMENT-SPONSORED PROGRAM COVERS THE FULL COST OF SERVICES. AND AS THE COUNTRY'S ECONOMIC FUTURE REMAINS UNCERTAIN, MOUNT NITTANY MEDICAL CENTER WILL CONTINUE TO PROVIDE CARE FOR THOSE WHO NEED IT. MOUNT NITTANY MEDICAL CENTER WILL PROVIDE SERVICES AT NO CHARGE OR REDUCED CHARGES TO THOSE WHO ARE FINANCIALLY UNABLE TO PAY FOR THOSE SERVICES. MOUNT NITTANY MEDICAL CENTER WILL NOT ARBITRARILY RESTRICT THE PROVISIONS OF HEALTH SERVICES TO CERTAIN INDIVIDUALS OR GROUPS.MOUNT NITTANY MEDICAL CENTER'S REGISTRATION DEPARTMENT REPRESENTATIVES WILL GIVE A COPY OF OUR FINANCIAL ASSISTANCE PROGRAM TO EVERY PATIENT ALONG WITH OTHER IMPORTANT BILLING INFORMATION. OUR FINANCIAL COUNSELOR WILL DISCUSS THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS SUCH AS MEDICAID OR STATE PROGRAMS TO ASSIST THE PATIENT WITH QUALIFICATIONS FOR THESE PROGRAMS. THE FINANCIAL COUNSELOR WILL ALSO ASSIST THE PATIENT IN COMPLETING THE PROPER PAPERWORK FOR ASSISTANCE. IN ADDITION, OUR VENDOR DEBIASE & LEVINE, REPRESENTATIVE, WHO IS WORKING ON BEHALF OF MOUNT NITTANY MEDICAL CENTER, WILL ALSO ASSIST PATIENTS WITH THE MEDICAL ASSISTANCE PROCESS. OUR VENDOR WORKS ON BEHALF OF THE ORGANIZATION TO FOLLOW THE HOSPITAL'S POLICIES REGARDING PATIENT NOTIFICATION AND THE AVAILABILITY OF FINANCIAL ASSISTANCE. MOUNT NITTANY MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY IS POSTED ON OUR WEBSITE ALONG WITH AN APPLICATION FOR PATIENTS TO COMPLETE FOR FINANCIAL ASSISTANCE. THE FINANCIAL COUNSELORS AND CASE MANAGEMENT STAFF WILL ALSO WORK CLOSELY TO IDENTIFY AND ASSIST ELIGIBLE PATIENTS.MOUNT NITTANY MEDICAL CENTER WILL MAKE AVAILABLE A WRITTEN NOTICE TO EACH PATIENT OR THEIR REPRESENTATIVE OF THE EXISTENCE, CRITERIA AND MECHANISM FOR RECEIVING FINANCIAL ASSISTANCE. THE HOSPITAL WILL CREATE AND MAINTAIN RECORDS AND DOCUMENT THAT AN APPLICATION WAS SENT TO THE PATIENT DEMONSTRATING THAT THE REQUIRED CRITERIA AND MECHANISM ARE ESTABLISHED (MOUNT NITTANY MEDICAL CENTER WILL RECORD ANY AND ALL REQUESTS FOR FINANCIAL ASSISTANCE, THE DISPOSITION AND THE DOLLAR AMOUNT OF MOUNT NITTANY MEDICAL CENTER'S FINANCIAL ASSISTANCE PROGRAM PROVIDED). THE COMPLETED APPLICATIONS ARE GIVEN TO THE PATIENT ACCOUNTS DEPARTMENT SHOWING WHETHER THE APPLICATION WAS APPROVED OR DENIED. IN ALL INSTANCES, PATIENT CONFIDENTIALITY WILL BE PROTECTED.ELIGIBILITY WILL BE DETERMINED BY COMPARING HOUSEHOLD FAMILY INCOME TO THE INCOME POVERTY GUIDELINES. INCOME IS DEFINED AS THE TOTAL ANNUAL CASH RECEIPTS BEFORE TAXES FROM ALL SOURCES.A NOTICE OF AVAILABILITY OF MOUNT NITTANY MEDICAL CENTER'S FINANCIAL ASSISTANCE PROGRAM WILL BE GIVEN TO EACH PATIENT OR THEIR REPRESENTATIVE PRIOR TO SERVICES BEING RENDERED, WITH THE EXCEPTION OF EMERGENCY SERVICES WHEREBY THE PATIENT IS TRIAGED PRIOR TO COMPLETING THE REGISTRATION PROCESS. THESE PATIENTS WOULD RECEIVE THE NOTICE REGARDING THE FINANCIAL ASSISTANCE PROGRAM AT SOME POINT DURING THAT VISIT. THESE NOTICES ARE DISPLAYED AND MADE AVAILABLE IN ALL REGISTRATION AREAS OF THE HOSPITAL AND INCLUDES THE MOST CURRENT AVAILABLE "HOUSEHOLD INCOME GUIDELINES" AS PUBLISHED IN THE FEDERAL REGISTER. MOUNT NITTANY MEDICAL CENTER'S CURRENT FINANCIAL ASSISTANCE PROGRAM ELIGIBILITY IS BASED ON 2.5 TIMES THE "HOUSEHOLD INCOME GUIDELINES".THE PATIENT ACCOUNTS DIRECTOR OR HIS/HER DESIGNEE SHALL REVIEW ALL APPLICATIONS FOR THE MOUNT NITTANY MEDICAL CENTER FINANCIAL ASSISTANCE PROGRAM. IT IS THE APPLICANT'S RESPONSIBILITY TO PROVIDE PROOF OF INCOME. PART VI, LINE 4: THE MEDICAL CENTER'S PRIMARY SERVICE AREA INCLUDES CENTRE COUNTY AND PARTS OF THE SURROUNDING COUNTIES. CENTRE COUNTY'S POPULATION IS APPROXIMATELY 155,000. APPROXIMATELY 16% OF THE POPULATION IS AGED 0-14, 72% AGED 15-64, AND 12% IS 65 OR OLDER. THE ESTIMATE FOR THE POPULATION LIVING BELOW THE POVERTY LINE IS 19%. THE MEDIAN AGE IN CENTRE COUNTY IS 26.6 (39.9 FOR ALL OF PA). 40% OF THOSE AGED 25 OR OLDER HAVE AT LEAST A BACHELOR'S DEGREE VS. 26.4% FOR ALL OF PA. THE MEDIAN HOUSEHOLD INCOME IS $48,262, WHILE THE PA MEDIAN IS $51,651. 40,000+ COLLEGE STUDENTS LIVE IN STATE COLLEGE. MOUNT NITTANY MEDICAL CENTER IS THE SOLE GENERAL ACUTE CARE HOSPITAL IN CENTRE COUNTY. THE NEAREST LEVEL II TRAUMA CENTER IS APPROX. 43 MILES AWAY. PART OF CENTRE COUNTY IS A DESIGNATED MEDICALLY UNDERSERVED AREA. PART VI, LINE 5: THE MEDICAL CENTER'S BOARD OF TRUSTEES AND ITS VARIOUS COMMITTEES INCLUDE COMMUNITY MEMBERS AS WELL AS MEDICAL STAFF. THE COMMUNITY MEMBERS ARE NOT DIRECTLY INVOLVED IN THE MEDICAL CENTER'S OPERATIONS. THE MEDICAL CENTER'S MEDICAL STAFF EXCEEDS 300 PHYSICIANS. THE MEDICAL CENTER CONTINUES TO INVEST IN STRONG AND BENEFICIAL RELATIONSHIPS WITH ALL PHYSICIANS WHO HAVE AN INTEREST IN WORKING WITH THE MEDICAL CENTER. ALL REVENUES IN EXCESS OF EXPENSES ARE RE-INVESTED IN THE COMMUNITY, INCLUDING SIGNIFICANT DONATIONS TO THE COUNTY'S ONLY FREE MEDICAL AND DENTAL CLINIC, AS WELL AS INTERNAL IMPROVEMENTS TO TECHNOLOGY SO THAT THE PEOPLE AND COMMUNITIES WE SERVE HAVE IMMEDIATE ACCESS TO THE BEST AND MOST APPROPRIATE DIAGNOSTIC AND TREATMENT OPTIONS AVAILABLE. PART VI, LINE 6: AS OF JUNE 30, 2014, MOUNT NITTANY HEALTH SYSTEMS HAS TWO CONTROLLED CORPORATIONS, WHICH ARE THE MOUNT NITTANY MEDICAL CENTER (INPATIENT AND OUTPATIENT SERVICES) AND MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES, INC. (A PHYSICIAN PRACTICE D/B/A MOUNT NITTANY PHYSICAN GROUP). THE FOUNDATION FOR MOUNT NITTANY MEDICAL CENTER, INC. (FUNDRAISING) AND THE MOUNT NITTANY SURGICAL CENTER, INC. (OUTPATIENT SURGICAL CENTER) ARE CONTROLLED BY MOUNT NITTANY MEDICAL CENTER.COMMUNITY BENEFIT SERVICES OFFERED BY MOUNT NITTANY MEDICAL CENTER ARE AFFORDED TO THE BROAD COMMUNITY WITH THE INTENT OF IMPROVING COMMUNITY HEALTH. PROGRAMS AND SERVICES ARE DESIGNED TO RESPOND TO IDENTIFIED COMMUNITY NEEDS. COMMUNITY BENEFIT ACTIVITIES FALL INTO THESE MAJOR CATEGORIES: COMMUNITY HEALTH IMPROVEMENT SERVICES - INCLUDES ACTIVITIES THAT ARE CARRIED OUT TO IMPROVE COMMUNITY HEALTH. MOUNT NITTANY MEDICAL CENTER PROVIDES COMMUNITY HEALTH EDUCATION, HEALTH SCREENINGS, SUPPORT GROUPS, AND TRANSPORTATION ASSISTANCE. THIS PAST YEAR OFFERED NUMEROUS SCREENINGS AND EDUCATION EVENTS FOR MEMBERS OF OUR COMMUNITY. HEALTH PROFESSIONS EDUCATION - MOUNT NITTANY MEDICAL CENTER IS ADVANCING HEALTHCARE BY ADVANCING ACCESS TO EDUCATION AND TRAINING. IN 2013, MOUNT NITTANY AWARDED CONTINUING EDUCATION CREDITS FOR NURSES AND PHYSICIANS, AS WELL AS TRAININGS IN THE AMERICAN HEART ASSOCIATION TRAINING CENTER. CASH AND IN-KIND DONATIONS - MOUNT NITTANY MEDICAL CENTER REPORTED ITS SUPPORT OF MORE THAN FORTY LOCAL ORGANIZATIONS THROUGH IN-KIND AND CASH DONATIONS. THE LEAD BENEFICIARY OF MOUNT NITTANY'S SUPPORT IS CENTRE VOLUNTEERS IN MEDICINE. OTHER NON-PROFIT GROUPS INCLUDE AMERICAN HEART ASSOCIATION, PEOPLE CENTRE'D ON DIABETES, YMCA OF CENTRE COUNTY, AND MORE. COMMUNITY-BUILDING ACTIVITIES - MOUNT NITTANY IS A LEAD FACILITATOR IN LOCAL AND REGIONAL PREPAREDNESS ACTIVITIES, ENSURING THAT CENTRE COUNTY IS PREPARED SHOULD A DISASTER STRIKE. IN ADDITION, MOUNT NITTANY PROVIDES ACCESS TO CARE IN RURAL AREAS TO ENSURE THAT EVERY COMMUNITY HAS ACCESS TO CARE, SUCH AS PROVIDING DIABETES EDUCATION AT RURAL DOCTORS' OFFICES. SUBSIDIZED HEALTH SERVICES - MOUNT NITTANY MEDICAL CENTER PROVIDES THE COMMUNITY MENTAL HEALTH SERVICES AT ITS INPATIENT UNIT, ONCOLOGY PATIENT NAVIGATOR PROGRAM, TRANSPORTATION SERVICES FOR PATIENTS WITH CANCER, PEDIATRIC MEDICAL HOME PROGRAM FOR AT-RISK CHILDREN AND SEVERAL FREE SUPPORT GROUPS.THE MOUNT NITTANY PHYSICIAN GROUP OFFERS A COMMUNITY BENEFIT BY SEEING CENTRE VOLUNTEERS IN MEDICINE (CVIM) PATIENTS FOR SPECIALTY SERVICES AT NO COST TO THE PATIENT OR TO CVIM. THIS GROUP ALSO PROVIDES VARIOUS INTERNSHIPS, PRESENTATIONS AND NEWSLETTERS TO THE COMMUNITY INCLUDING TOPICS LIKE HEART HEALTH AND PEDIATRICS. PART VI, LINE 7, REPORTS FILED WITH STATES PA 1 MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES INC 1800 EAST PARK AVENUE STATE COLLEGE PA 16803 510426500 501(C)(3) 23080371 CASH N/A PROVIDE FINANCIAL SUPPORT TO AFFILIATE MOUNT NITTANY HEALTH SYSTEM 1800 EAST PARK AVENUE STATE COLLEGE PA 16803 800663092 501(C)(3) 408196 CASH N/A PROVIDE FINANCIAL SUPPORT TO AFFILIATE CENTRE COUNTY CHILDREN'S ADVOCACY CENTER 1800 EAST PARK AVENUE STATE COLLEGE PA 16803 460871813 501(C)(3) 26855 CASH N/A PROVIDE FINANCIAL SUPPORT TO AFFILIATE 3 0 PART I, LINE 2: ASSISTANCE IS PROVIDED TO RELATED ENTITIES FOR FINANCIAL SUPPORT. MANAGEMENT OF THE ORGANIZATION OVERSEES THE USE OF FUNDS AT THE AFFILIATED ENTITIES. X X X X X 0 1 0 0 0 1 1 0 0 STEVEN E BROWN FACHE DIRECTOR/PRESIDENT & CEO 496383 0 151200 0 347687 0 19625 0 44923 0 1059818 0 319533 0 JONATHON DRANOV MD DIRECTOR 0 426842 0 0 0 23973 0 0 0 30684 0 481499 0 0 RICHARD WISNIEWSKI SR VP OF FINANCE & CFO 296137 0 61635 0 0 0 19625 0 34194 0 411591 0 0 0 JEFFREY RATNER MD SR VP OF MEDICAL AFFAIRS 319383 0 33686 0 0 0 19625 0 40130 0 412824 0 0 0 WAYNE THOMPSON EXECUTIVE VP, CORPORATE SERVICES & C 223358 0 54000 0 11175 0 19625 0 34776 0 342934 0 0 0 JANET SCHACHTNER SR VP OF PATIENT CARE SERV 230759 0 51169 0 0 0 19625 0 32251 0 333804 0 0 0 DEBRA LINNES CHIEF OPERATING OFFICER 299363 0 30000 0 4449 0 0 0 31551 0 365363 0 0 0 THOMAS CHARLES EXECUTIVE VP SYSTEM DEVELOPMENT & CS 196015 0 42500 0 2633 0 0 0 26508 0 267656 0 0 0 HAROLD BRUNGARD III VP, FACILITIES & PLANT OPS 148982 0 27628 0 0 0 14671 0 12951 0 204232 0 0 0 GERALD DITTMANN VP OF HUMAN RESOURCES 163045 0 17172 0 3194 0 16388 0 34760 0 234559 0 0 0 GAIL MILLER VP OF QUALITY/PATIENT SAFE 137812 0 27642 0 2693 0 13820 0 28827 0 210794 0 0 0 PATRICIA WATSON VP NURSING/CNO 131301 0 17489 0 2569 0 13181 0 28462 0 193002 0 0 0 MAUREEN KARSTETTER VP MKTG, COMMUNICATIONS, COMMUNITY O 132155 0 19728 0 2652 0 13606 0 33757 0 201898 0 0 0 LANCE ROSE FORMER PRESIDENT & CEO 14721 0 0 0 0 0 0 0 1126 0 15847 0 0 0 PART I, LINE 4B NONQUALIFIED RETIREMENT PLAN PAYMENTS RECEIVED DURING THE YEAR: * STEVEN E. BROWN - $319,533 * LANCE ROSE - $14,721 PART I, LINE 6 THE EXECUTIVE TEAM MEMBERS OF MOUNT NITTANY MEDICAL CENTER AND THE MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES' (D/B/A MOUNT NITTANY PHYSICIAN GROUP) EXECUTIVE DIRECTOR RECEIVED A PORTION OF THEIR ANNUAL VARIABLE-PAY BASED UPON THE CONSOLIDATED OPERATING MARGIN, MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES' (D/B/A MOUNT NITTANY PHYSICIAN GROUP) OPERATING MARGIN, CONTRIBUTIONS, AND OTHER CORPORATE GOALS. THE CORPORATE GOALS FOCUSED ON (1) PROVIDING LOCALIZED CARE, INTEGRATED CARE, EFFICIENT CARE, AND ALIGNED CARE; (2) FINANCE; (3) QUALITY/PATIENT SAFETY; AND (4) THE WORK ENVIRONMENT. A CENTRE COUNTY HOSPITAL AUTHORITY 203197497 156273CU6 2011-05-05 70552972 FUND EMERG. DEPT. EXPANSION & OTHER CAPITAL EXPENDITURES 0 1 0 B CENTRE COUNTY HOSPITAL AUTHORITY 203197497 156273ED2 2012-10-15 69404972 REFUNDING OF THE SERIES 2009 BONDS & PAY ISSUANCE COSTS 0 1 0 C CENTRE COUNTY HOSPITAL AUTHORITY 203197497 156273DK7 2012-10-15 44591375 FUND PERIOPERATIVE EXPANSION & OTHER CAPITAL EXPENDITURES 0 1 0 A 1400000 70552972 1033856 69519116 2013 0 0 1 1 B 895000 69404972 811090 68593882 2013 0 1 1 1 C 450000 44591375 3000747 537964 39344571 1708093 2014 0 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 SCHEDULE K, PART III, LINE 3: THERE ARE NO MANAGEMENT OR SERVICE CONTRACTS OR RESEARCH AGREEMENTS RELATING TO THE FINANCED PROPERTIES FOR THE 2011 OR 2012 BONDS. EDWARD BELL SEE PART V 129784 SEE PART V 0 APRIL HARRIS SEE PART V 27593 SEE PART V 0 SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTEREST PERSONS: (A) NAME OF PERSON: EDWARD BELL(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF KAREN SHUTE, BOARD MEMBER(D) DESCRIPTION OF TRANSACTION: SALARY COMPENSATION(A) NAME OF PERSON: APRIL HARRIS(B) RELATIONSHIP BETWEEN INTEREST PERSON AND ORGANIZATION: FAMILY MEMBER OF THOMAS HARRIS, BOARD MEMBER(D) DESCRIPTION OF TRANSACTION: SALARY COMPENSATION FORM 990, PART VI, SECTION B, LINE 11 THE 990 WAS PROVIDED TO THE BOARD OF TRUSTEES AND TO THE MOUNT NITTANY HEALTH SYSTEM AUDIT COMMITTEE BEFORE BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, THE CONFLICT OF INTEREST POLICY IS DISTRIBUTED TO KEY MEMBERS OF THE ORGANIZATION INCLUDING BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES. EACH PERSON MUST REPORT ANY POTENTIAL CONFLICTS OF INTEREST. REPORTED CONFLICTS ARE THEN REVIEWED BY THE CORPORATE COMPLIANCE OFFICER AND THE HEALTH SYSTEM'S AUDIT COMMITTEE. THE CONFLICT OF INTEREST REPORT IS THEN SUBMITTED TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMPENSATION COMMITTEE FROM THE BOARD OF TRUSTEES REVIEWS COMPENSATION PAID TO EXECUTIVE MANAGEMENT TEAM IN CONJUNCTION WITH AN INDEPENDENT THIRD PARTY CONSULTING FIRM TO ENSURE COMPENSATION IS REASONABLE AND APPROPRIATE FOR DUTIES AND RESPONSIBILITES ASSIGNED. REVIEW AND APPROVAL OF COMPENSATION IS DOCUMENTED VIA MINUTES OF COMMITTEE MEETINGS. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN THE FOUNDATION FOR MOUNT NITTANY MEDICAL CENTER, INC. 1,112,693. PENSION LIABILITY ADJUSTMENT -7,889,076. CHANGE IN FAIR VALUE OF DERIVATIVE 22,820. THE FOUNDATION FOR MOUNT NITTANY MEDICAL CENTER INC 1800 EAST PARK AVENUE STATE COLLEGE PA 168036796 571138956 FUNDRAISING AND SUPPORT FOR MOUNT NITTANY MEDICAL CENTER PA 501(C)(3) 11A MOUNT NITTANY MEDICAL CENTER 1 MOUNT NITTANY MEDICAL CENTER WORKMEN'S COMPENSATION SELF INSURANCE TRUST 1800 EAST PARK AVENUE STATE COLLEGE PA 168036796 256440788 PROVIDE WORKMEN'S COMPENSATION BENEFITS TO EMPLOYEES OF MNMC PA 501(C)(3) 11A MOUNT NITTANY MEDICAL CENTER 1 MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES INC 1800 EAST PARK AVENUE STATE COLLEGE PA 168036796 510426500 PROFESSIONAL SERVICES TO SUPPORT MNMC PA 501(C)(3) 11A MOUNT NITTANY HEALTH SYSTEM 0 MOUNT NITTANY SURGICAL CENTER INC 1850 EAST PARK AVENUE STATE COLLEGE PA 168036796 251712099 HEALTHCARE PA 501(C)(3) 11A MOUNT NITTANY MEDICAL CENTER 1 MOUNT NITTANY HEALTH SYSTEM 1800 EAST PARK AVENUE STATE COLLEGE PA 168036796 800663092 PROVIDE MANAGEMENT AND ADMINISTRATIVE SUPPORT TO MNMC & SUBSIDIARIES PA 501(C)(3) 11A N/A 0 CENTRE COUNTY CHILDREN'S ADVOCACY CENTER 1800 EAST PARK AVENUE STATE COLLEGE PA 16803 460871813 CHILD-FOCUSED APPROACH TO CHILD ABUSE CASES PA 501(C)(3) 7 MOUNT NITTANY MEDICAL CENTER 1 0 1 1 0 0 0 0 0 0 1 1 0 1 1 1 0 1 1 1 FOUNDATION FOR MOUNT NITTANY MEDICAL CENTER C 1379070 CASH FOUNDATION FOR MOUNT NITTANY MEDICAL CENTER O 378868 COST OF SHARING PAID EMPLOYEES MOUNT NITTANY SURGICAL CENTER O 3303359 COST OF SHARING PAID EMPLOYEES