2015-05-14T09:19:11-05:00 2014-06-30 390859910 BAKER TILLY VIRCHOW KRAUSE LLP SUITE 200 221 W PHILADELPHIA STREET YORK PA 174012993 990 2013-07-01 251778644 PINNACLE HEALTH HOSPITALS PINN 7172318245 409 SOUTH SECOND ST PO BOX 8700 HARRISBURG PA 171058700 WILLIAM H PUGH TREASURER/CFO 7172318245 2015-05-13 1 JULIUS C GREEN CPA JD P00350393 7178467000 2013 2016-02-25 16:41:14Z WILLIAM H PUGH 409 SOUTH SECOND ST PO BOX 8700 HARRISBURG PA 171058700 932010359 0 X WWW.PINNACLEHEALTH.ORG X 1996 PA INPATIENT AND OUTPATIENT HEALTHCARE FOR CITIZENS OF THE LOCAL & SURROUNDING COMMUNITIES. 22 17 5052 380 5189156 242797 10104993 12163127 712549245 741652505 10203668 4331113 898896 925463 733756802 759072208 0 0 0 0 289037801 282825956 0 0 0 339159493 381550456 628197294 664376412 105559508 94695796 857817222 944382251 572120699 572631197 285696523 371751054 X PROVIDING BOTH INPATIENT AND OUTPATIENT HEALTHCARE SERVICES ON A NON-PROFIT BASIS FOR CITIZENS OF THE SURROUNDING COMMUNITY. 1 0 546845480 740540013 PINNACLE HEALTH HOSPITALS PINNACLE HEALTH HOSPITALS SUBSIDIZES THE COST OF TREATING PATIENTS WHO ARE UNINSURED, UNABLE TO PAY, OR ARE ON GOVERNMENT PROGRAMS WHERE REIMBURSEMENT IS LESS THAN THE COST OF PROVIDING THE SERVICE.AS AN ANCHOR INSTITUTION AND A LEADER IN OUR COMMUNITY, OUR ROLE HAS BEEN TO CARE FOR PATIENTS EVEN IN THESE DIFFICULT ECONOMIC TIMES. IN KEEPING WITH OUR TRADITION OF CARING FOR ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY, PINNACLE HEALTH HOSPITALS IS A FORCE FOR STABILITY, STRENGTH, AND RELIABILITY FOR THOSE WE SERVE. IN ADDITION TO FINANCIAL SUPPORT, OUTREACH TO THE COMMUNITY IS CRUCIAL TO ACHIEVING OUR MISSION. THROUGH VOLUNTEERISM AND ENGAGEMENT, WE STRIVE TO BE A FORCE FOR HEALTH AND WELL-BEING. WE HELP THE UNDERSERVED, MENTOR STUDENTS, LEND EXPERTISE TO COMMUNITY ORGANIZATIONS, AND EDUCATE THE COMMUNITY ON DISEASE PREVENTION AND MANAGEMENT.COMMUNITY HEALTH IMPROVEMENT SERVICESAS ONE OF THE LARGEST PROVIDERS OF HEALTHCARE SERVICES IN THE STATE OF PENNSYLVANIA, PINNACLE HEALTH HOSPITALS OFFERS A VARIETY OF CLINICAL, EDUCATION AND SUPPORT SERVICES FOCUSED ON IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE.COMMUNITY HEALTH EDUCATIONDIABETES EDUCATION FOR DISPARATE POPULATIONS:TO PROVIDE CULTURALLY AND ECONOMICALLY APPROPRIATE EDUCATION THAT ENABLES PERSONS WITH DIABETES TO BETTER MANAGE THEIR DISEASE.KIDSHAPE:9 WEEK PEDIATRIC WEIGHT MANAGEMENT PROGRAM FOR KIDS AGE 6 - 14 YEARS OLD. KIDSHAPE TEACHES THE ENTIRE FAMILY HOW TO EAT MORE NUTRITIOUSLY, MAKE EXERCISE A FUN PART OF THE DAILY ROUTINE, FORM NEW HEALTHY HABITS, AND TO LIKE THEMSELVES, REGARDLESS OF SIZE. A TEAM OF HEALTH EXPERTS CONSISTING OF A REGISTERED DIETITIAN, A MENTAL HEALTH PROFESSIONAL, A PHYSICAL ACTIVITY EXPERT, AND A HEALTH EDUCATOR ADMINISTERS THE KIDSHAPE PROGRAM.ALL KIDSHAPE PROGRAMS ARE FAMILY-BASED. EACH PROGRAM INCORPORATES HANDS-ON ACTIVITIES TO EMPOWER YOUTH AND ADULTS TO EAT HEALTHY, MOVE MORE, AND FEEL GOOD.A VARIETY OF CHILDBIRTH EDUCATION PROGRAMS ARE OFFERED FOR NEW AND EXPECTANT PARENTS AND SIBLINGS INCLUDING INFANT CARE CLASSES. SUPPORT GROUPS ARE OFFERED FREE OF CHARGE TO HELP PEOPLE UNDERSTAND AND COPE WITH PARTICULAR PROBLEMS OR ILLNESSES. THEY INCLUDE DIABETES, BEREAVEMENT, CAREGIVER, TRANSPLANT, AND HEART DISEASE.CHILDREN'S HEALTH FAIR, CONFERENCES AND LECTURES PROVIDE INFORMATION ON HEALTHY LIFESTYLES AND HEALTH CAREER SESSIONS, YOUTH HEALTH SCREENINGS, YOUTH OBESITY PREVENTION, CHILD ABUSE AWARENESS/PREVENTION AND LITERACY PROGRAMS FOR CHILDREN. COMMUNITY HEALTH FAIRSCOMMUNITY LECTURES ON A VARIETY OF TOPICS, INCLUDING CARDIOVASCULAR HEALTH, AIDS, SPORTS MEDICINE, AND ETHICS.TOBACCO CESSATION EDUCATION IN CLINICS. HEALTH EDUCATION STORIES IN THE NEWSPAPER, ON TELEVISION, ON RADIO AND IN HOSPITAL NEWSLETTER.CLERGY ARE AVAILABLE TO PATIENTS AND FAMILY MEMBERS TWENTY-FOUR HOURS A DAY. AS DESCRIBED IN THE HOSPITAL'S MISSION STATEMENT, PINNACLE HEALTH HOSPITALS IS COMMITTED TO PROVIDING COMMUNITY-BASED PROGRAMS AND SERVICES WHICH WILL ENHANCE THE HEALTH STATUS OF THE PEOPLE WE SERVE. TOWARD THAT END, PINNACLE HEALTH HOSPITALS PROVIDED THE FOLLOWING WELLNESS AND SCREENING PROGRAMS:SCREENINGS:CHOLESTEROL SCREENINGSBODY COMPOSITION SCREENINGSPROSTATE SCREENINGSINFANT DEVELOPMENT SCREENINGSSPEECH AND HEARING SCREENINGSDEPRESSION AND ANXIETY SCREENINGSBONE DENSITY SCREENINGSNUTRITION THERAPY EDUCATION PROGRAMSLEAD POISONING SCREENINGS PINNACLE HEALTH CANCER CENTER'S BOARD-CERTIFIED SURGEONS AND MEDICAL ONCOLOGISTS ATTACK ALL TYPES OF CANCER, SUPPORTED BY A TEAM OF PHARMACISTS, SOCIAL WORKERS, REHABILITATION AND PAIN MANAGEMENT SPECIALISTS EACH WITH A UNIQUE AWARENESS OF PATIENT NEEDS. HEART FAILURE CENTER WAS DEVELOPED IN AN EFFORT TO PROVIDE PATIENTS SUFFERING FROM HEART FAILURE AN ALTERNATIVE TO FREQUENT HOSPITALIZATIONS. OUR TEAM OF EXPERIENCED HEALTHCARE PROFESSIONALS ASSISTS YOU IN LEARNING THE SKILLS NEEDED TO HELP SELF-MANAGE YOUR CHRONIC ILLNESS.THE PINNACLE HEALTH WOUND AND HYPERBARIC CENTER WITH HYPERBARIC OXYGEN THERAPY CAPABILITIES IS DEVOTED TO THE TREATMENT, REHABILITATION AND PREVENTION OF CHRONIC WOUNDS. OUR CARING TEAM OF SPECIALTY PHYSICIANS, NURSES, PHYSICAL THERAPISTS AND NUTRITIONISTS CAN HELP ACCELERATE PATIENTS' HEALING, DECREASE DISCOMFORT, REDUCE COMPLICATIONS AND DECREASE RE-OCCURRENCE. SPINE INSTITUTE COMBINES THE EXPERTISE OF NEUROSURGEONS, ORTHOPEDIC SURGEONS, PSYCHIATRISTS, NEUROLOGISTS, PAIN MANAGEMENT SPECIALISTS, NURSES, IMAGING SERVICES AND REHABILITATION SERVICES TO TARGET EVERY PATIENT'S PARTICULAR PROBLEM AND PROVIDE OPTIMAL TREATMENT. BUS PASSES OR TAXI FEES ARE PROVIDED TO PATIENTS AND FAMILIES MEETING THE ORGANIZATION'S FINANCIAL ASSISTANCE GUIDELINES TO ENHANCE PATIENT ACCESS TO CARE. RESIDENT PHYSICIAN TRAINING PROGRAMS FOR ORTHOPEDIC SURGERY, INTERNAL MEDICINE, GENERAL SURGERY, PODIATRY, AND FAMILY PRACTICE.FELLOWSHIP PROGRAMS FOR TOXICOLOGY, SPORTS MEDICINE, AND MATERNAL FETAL MEDICINE.CLINICAL SITE FOR MEDICAL STUDENTSCLINICAL SITE FOR NURSING STUDENTSCLINICAL SITE FOR DIETITIANSCLINICAL SITE FOR EMERGENCY MEDICAL PERSONNELCLINICAL SITE FOR PARAMEDIC STUDENTSCLINICAL SITE FOR RESPIRATORY THERAPY STUDENTSCLINICAL SITE FOR RADIOLOGY STUDENTS INTERNSHIPS FOR MEDICAL ASSISTANTS, SPEECH AND HEARING, PT/OT AND OTHER ALLIED HEALTH PROFESSIONAL TRAINING.SUPERVISION FOR PSYCHOLOGY STUDENTSCONTINUING EDUCATION FOR NURSES AND PHYSICIAN OFFICE STAFF AND FOR LOCAL COMMUNITY PROFESSIONALS SUCH AS SCHOOL NURSES.AUXILIARY ERNEST R. MCDOWELL SCHOLARSHIP PROGRAMEQUIPMENT DONATIONSUNITED WAY FUNDRAISINGBAILEY HOUSE IS OUR HOME AWAY FROM HOME. IT PROVIDES FREE OVERNIGHT LODGING AND A COMFORTABLE, SUPPORTIVE, AND NURTURING ENVIRONMENT FOR FAMILIES FROM OUTSIDE THE HARRISBURG AREA.NURSE/FAMILY PARTNERSHIP PROGRAM WAS IMPLEMENTED BASED ON VERY HIGH TEEN BIRTH RATES AND A HIGH INCIDENCE OF WOMEN NOT RECEIVING PRENATAL CARE DURING THE FIRST TRIMESTER. THIS IS A NATIONALLY RENOWNED, EVIDENCE-BASED, NURSE HOME VISITATION PROGRAM THAT IMPROVES THE HEALTH, WELL-BEING AND SELF SUFFICIENCY OF LOW INCOME, FIRST TIME PARENTS AND THEIR CHILDREN. CHILDREN'S RESOURCE CENTER(CRC) PROVIDES CARE AND COORDINATION TO CHILDREN SUSPECTED OF BEING ABUSED AND ENGAGES MULTIPLE DISCIPLINES TO DIAGNOSE, EVALUATE AND TREAT CHILDREN WHO ARE VICTIMS OF SEXUAL ABUSE. 14906267 0 1112492 PINNACLE HEALTH EMERGENCY DEPARTMENT SERVICESPINNACLE HEALTH EMERGENCY DEPARTMENT SERVICES (PHEDS) IS A TAX EXEMPT, NON-PROFIT CORPORATION ENGAGED IN PROVIDING PROFESSIONAL SERVICES IN THE PINNACLE HEALTH EMERGENCY DEPARTMENT. EMERGENCY SERVICESTWENTY-FOUR HOUR MEDICAL EMERGENCY SERVICE IS PROVIDED IN THREE EMERGENCY DEPARTMENTS, (HARRISBURG HOSPITAL, COMMUNITY GENERAL HOSPITAL, AND WEST SHORE HOSPITAL) STAFFED BY PHYSICIANS AND NURSES SPECIALIZING IN EMERGENCY MEDICINE AND SUPPORT PERSONNEL. SERVICES ARE OPEN TO ALL PERSONS WITHOUT REGARD TO AGE, SEX, RACE, RELIGION, NATIONAL ORIGIN, HANDICAP OR ABILITY TO PAY.MEDICAL COVERAGE IS GIVEN FOR COMMUNITY SPORTING EVENTS.CPR TRAINING PROGRAMS ARE OFFERED TO COMMUNITY GROUPS AND ORGANIZATIONS.TWENTY-FOUR HOUR EMERGENCY MEDICAL COMMAND IS PROVIDED FOR THE TRI-COUNTY AREA.DURING FISCAL YEAR 2014, PINNACLE HEALTH HOSPITALS TREATED 120,840 PATIENTS IN ITS THREE EMERGENCY DEPARTMENTS. THIS WAS AN INCREASE OF 1% OVER THE PRIOR YEAR WHICH IS ATTRIBUTED TO THE OPENING OF THE EMERGENCY ROOM AT THE NEW WEST SHORE HSOPITAL LATE IN THE FISCAL YEAR. 561751747 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 X 0 0 5052 1 1 1 0 0 0 0 0 0 0 0 0 X 22 17 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 PA X WILLIAM H PUGH CFO 7172318245 409 SOUTH SECOND ST HARRISBURG PA 171048700 ROBERT L LYON DIRECTOR (RESIGNED MAY 2013) 0.60 0.60 X 0 0 0 GEORGE F GRODE CHAIRMAN 0.90 0.90 X X 0 0 0 FELIX GUTIERREZ MD DIRECTOR 0.30 39.70 X 0 514313 53622 M RICHARD KLEIMAN DIRECTOR 0.30 0.30 X 0 0 0 DEBORAH S MILLER DIRECTOR 0.60 0.60 X 0 0 0 CLARENCE E ASBURY VICE-CHAIR 0.80 0.80 X X 0 0 0 DENNIS WALSH DIRECTOR 0.40 0.40 X 0 0 0 BONY R DAWOOD DIRECTOR 0.70 0.70 X 0 0 0 STEVEN C KUSIC DIRECTOR 0.80 0.80 X 0 0 0 KENNETH OKEN MD DIRECTOR 0.70 0.70 X 0 75000 0 MICHAEL L FERNANDEZ MD DIRECTOR 0.20 0.20 X 0 0 0 JOHN C HICKEY DIRECTOR 0.60 0.60 X 0 0 0 CAROLYN KREAMER PHD DIRECTOR 0.50 0.30 X 0 0 0 MICHAEL A YOUNG PRESIDENT/CEO 11.30 28.70 X X 0 1238747 25574 JOHN CAVANAUGH PHD DIRECTOR 0.30 0.30 X 0 0 0 KEVIN KELLY MD DIRECTOR 0.60 39.40 X 0 241289 22795 ROGER LEVIN MD DIRECTOR 0.70 0.70 X 0 0 0 TINA NIXON DIRECTOR 0.30 0.30 X 0 0 0 CYNTHIA TOLSMA DIRECTOR 0.80 1.10 X 0 0 0 E GERALD WOODWARD MD DIRECTOR 0.30 0.30 X 0 0 0 BARRY KAIN DIRECTOR 0.10 0.30 X 0 0 0 DANIEL KAMBIC DIRECTOR 0.30 0.30 X 0 110008 25739 MICHAEL MURCHIE DIRECTOR 0.50 0.50 X 0 0 0 CHRISTOPHER P MARKLEY ESQ SEC'Y/SR VP STAT SVCC/GEN COUNSEL 20.00 20.00 X 0 476014 29949 WILLIAM H PUGH TREASURER/SR VP CORP FIN/CFO 24.40 15.60 X 0 749963 23090 NANCY HAMMONDS ASST. TREASURER/CFO 29.60 10.40 X 0 226790 40988 PHILIP GUARNESCHELLI SR VICE PRESIDENT/COO 24.00 16.00 X 0 758047 34618 JOHN DELORENZO ASSISTANT SECRETARY 26.00 14.00 X 0 154859 17869 EDWARD HILDREW ED PHYSICIAN 40.00 X 330138 0 43136 FRANK DITRAGLIA ED PHYSICIAN 40.00 X 454200 0 5100 R SCOTT RANKIN ED PHYSICIAN 40.00 X 480091 0 27800 HARRY MATTA ER PHYSICIAN 40.00 X 425988 0 54300 JED SPRUCE SEITZINGER ER PHYSICIAN 40.00 X 368945 0 33749 2059362 4545030 438329 214 0 1 0 SODEXO PO BOX 905374 CHARLOTTE NC 28290 FOOD SERVICES 18072788 SIEMENS MEDICAL SOLUTIONS USA INC PO BOX 640401 PITTSBURGH PA 15264 SOFTWARE SUPPORT SVCS 16831311 XTEND HEALTHCARE 500 WEST MAIN ST HENDESONVILLE TN 37075 OUTSOURCED BILLING SERVICE 2366231 CPTA INC 205 SOUTH FRONT STREET HARRISBURG PA 17104 TRANSPLANT SERVICES 2141877 MILTON HERSHEY MEDICAL CENTER 500 UNIVERSITY DR HERSHEY PA 17033 MEDICAL SERVICES 2117662 49 38692 313310 4486563 7324562 12163127 PATIENT REVENUE, NET 621500 738187056 732997900 5189156 CONTRACTED MEDICAL SERVICES 621990 2247659 2247659 MEDICAL EDUCATION 900099 401923 401923 MANAGEMENT & SUPPORT 900099 396657 396657 COMMUNITY PROGRAM INCOME 900099 165640 165640 253570 253570 741652505 2308139 2308139 8113088 10825405 -2712317 -2712317 -2712317 163438894 696826 160226610 1886136 3212284 -1189310 2022974 2022974 HITECH REPORTING INCENTIVES 900099 2064884 2064884 VENDOR REBATE INCOME 900099 997146 997146 CAFETERIA SALES 900099 241540 241540 334210 334210 3637780 759072208 736463349 5189156 5256576 X 237775777 212930815 24844962 10035790 8987160 1048630 18595759 16652706 1943053 16418630 14703063 1715567 70100018 31541965 38558053 285765 145740 140025 53492 52957 535 23053 23053 75857062 59557394 16299668 171424 137618 33806 6597730 6326351 271379 8312991 6011950 2301041 39944126 31131906 8812220 380307 264049 116258 1116386 967772 148614 13778195 11808849 1969346 45893323 42021415 3871908 13338 9859 3479 MEDICAL SUPPLIES 117648891 117617360 31531 TEMP. RESTRICTED DONATI 823422 411711 411711 DUES AND SUBSCRIPTIONS 277946 243515 34431 SAFETY COMPLIANCE 14980 13482 1498 258007 214110 43897 664376412 561751747 102624665 0 5134 2813 1043778 1043071 85037195 119798012 0 2390946 2094498 11425874 13949746 10525395 8899715 967473410 475756139 376177753 491717271 326855888 246040102 12289138 11638664 1853669 327069 30212452 48871290 857817222 944382251 143120451 143915525 21823 43743 404515661 398972228 13075340 18731965 11387424 10967736 572120699 572631197 X 253919159 329947539 12153612 20505311 19623752 21298204 285696523 371751054 857817222 944382251 X 94695796 12632077 -21273342 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 12711254 12711254 578666164 272337579 306328585 15292048 9776941 5515107 295881868 175579579 120302289 64922076 18062040 46860036 491717271 DUE FROM RELATED PARTIES 3083722 DEFERRED FINANCING COSTS (NET) 3984053 PERM. RESTRICTED ASSETS HELD BY PINNACLE HEALTH FOUNDATION 21298204 TEMP. RESTRICTED ASSETS HELD BY PINNACLE HEALTH FOUNDATION 20505311 48871290 ADVANCES FROM THIRD-PARTY PAYORS 3809400 DUE TO THIRD PARTY PAYORS 1636772 ACCRUED LONG-TERM SWAP CONTRACT 5521564 10967736 X 761233295 12632077 -21273342 -8641265 769874560 23053 -10825405 -10802352 759072208 675178764 10825405 10825405 664353359 23053 23053 664376412 PART X, LINE 2: THE PINNACLE HEALTH SYSTEM EVALUATES UNCERTAIN TAX POSITIONS USING A TWO-STEP APPROACH FOR RECOGNIZING AND MEASURING TAX BENEFITS TAKEN OR EXPECTED TO BE TAKEN IN AN UNRELATED BUSINESS ACTIVITY TAX RETURN AND DISCLOSURES REGARDING UNCERTAINTIES IN TAX POSITIONS. NO ADJUSTMENTS TO THE CONSOLIDATED FINANCIAL STATEMENTS WERE REQUIRED AS A RESULT OF THIS EVALUATION. PART XI, LINE 2D - OTHER ADJUSTMENTS: FINANCING FRAMEWORK TRANSFERS -22,503,724. CHANGE IN ADDITIONAL PENSION LIABILITY 43,913,212. INTERCOMPANY TRANSFERS - TEMP RESTRICTED 2,230,340. PENSION SETTLEMENT LOSS -44,913,170. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES SHOWN NET OF RENTAL INCOME -10,825,405. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES SHOWN NET OF RENTAL INCOME 10,825,405. 1 1 X 1 X 250.000000000000 1 X 1 1 1 0 1 1 10100248 10100248 0.01520 72079968 52032671 20047297 0.03020 82180216 52032671 30147545 0.04540 4005936 4005936 0.00600 8514356 8514356 0.01280 146220 146220 0.00020 0 3906385 3906385 0.00590 16572897 16572897 0.02490 98753113 52032671 46720442 0.07030 11470 119561 119561 0.00020 2500 21749 21749 0.00000 3500 137898 137898 0.00020 127 2066 2066 0.00000 17597 281274 281274 0.00040 1 19804211 6475463 132805913 130474926 2330987 X 1 1 1 WEST SHORE SURGERY CENTER LTD SURGICAL CARE - MEDICAL SERVICES 0.49000 0.00000 0.49000 2 SUSQUEHANNA VALLEY SURGERY CENTER SURGICAL CARE - MEDICAL SERVICES 0.50000 0.00000 0.50000 3 WALNUT BOTTOM RADIOLOGY LLC OUTPATIENT IMAGING SERVICES 0.50000 0.00000 0.50000 4 RIVER HEALTH ACO SURGICAL CARE - MEDICAL SERVICES 0.70000 0.00000 0.30000 3 1 PINNACLE HEALTH HOSPITALS - HARRISBURG 111 SOUTH FRONT STREET HARRISBURG PA 17101 WWW.PINNACLEHEALTH.ORG 340601 X X X X X 2 PINNACLE HEALTH HOSPITALS - CGOH 4300 LONDONDERRY ROAD HARRISBURG PA 17109 WWW.PINNACLEHEALTH.ORG 340601 X X X X X 3 PINNACLE HEALTH HOSPITALS - WEST SHORE 1995 TECHNOLOGY PARKWAY MECHANICSBURG PA 17050 WWW.PINNACLEHEALTH.ORG 340601 X X X X X PINNACLE HEALTH HOSPITALS - HARRISBURG 1 1 X X X X X X X X 12 1 1 1 X WWW.PINNACLEHEALTH.ORG X WWW.HSH.ORG, WWW.PENNSTATEHERSHEY.ORG X X X X X X X X X X 0 0 1 1 250.000000000000 1 400.000000000000 1 X X 1 1 X X X X X 1 0 X X X X 1 X 0 0 PINNACLE HEALTH HOSPITALS - CGOH 2 1 X X X X X X X X 12 1 1 1 X WWW.PINNACLEHEALTH.ORG X WWW.HSH.ORG, WWW.PENNSTATEHERSHEY.ORG X X X X X X X X X X 0 0 1 1 250.000000000000 1 400.000000000000 1 X X 1 1 X X X X X 1 0 X X X X 1 X 0 0 PINNACLE HEALTH HOSPITALS - WEST SHORE 3 0 1 1 250.000000000000 1 400.000000000000 1 X X 1 1 X X X X X 1 0 X X X X 1 X 0 0 PINNACLE HEALTH HOSPITALS - HARRISBURG PART V, SECTION B, LINE 4: PENN STATE HERSHEY MEDICAL CENTERHOLY SPIRIT HOSPITAL PINNACLE HEALTH HOSPITALS - CGOH PART V, SECTION B, LINE 4: PENN STATE HERSHEY MEDICAL CENTERHOLY SPIRIT HOSPITAL PINNACLE HEALTH HOSPITALS - HARRISBURG PART V, SECTION B, LINE 5D: COMMUNITY EVENTS PINNACLE HEALTH HOSPITALS - CGOH PART V, SECTION B, LINE 5D: COMMUNITY EVENTS PINNACLE HEALTH HOSPITALS - HARRISBURG PART V, SECTION B, LINE 7: PINNACLEHEALTH WILL NOT DIRECTLY ADDRESS THE NEED FOR ACCESS TO MENTAL HEALTH SERVICES; HOWEVER, THE NEED WILL BE ADDRESSED BY THE PENNSYLVANIA PSYCHIATRIC INSTITUTE (PPI) WHICH IS A PARTNERSHIP BETWEEN PINNACLEHEALTH AND PENN STATE HERSHEY MEDICAL CENTER, CREATED IN 2008. PPI STAFFS A COMPREHENSIVE TEAM OF SPECIALISTS WHO PROVIDE CARE FOR CHILDREN, ADOLESCENTS, ADULTS AND OLDER ADULTS. ADVANTAGES OF PPI EXPERTISE INCLUDE:- LICENSED PSYCHIATRISTS, PSYCHOLOGISTS, THERAPISTS, NURSES AND OTHER MENTAL HEALTH PROFESSIONALS- PERSONALIZED TREATMENT PLANS TO MEET UNIQUE PATIENT NEEDS- THE FULL RANGE OF INPATIENT AND OUTPATIENT THERAPIES- MODERN, 74-BED INPATIENT FACILITY- FOUR CONVENIENT LOCATIONS OFFERING OUTPATIENT SERVICESPPI ALSO OFFERS HISPANIC PSYCHIATRIC PROGRAMS WHICH INCLUDE PSYCHIATRIC EVALUATIONS, MEDICATION MANAGEMENT AND THERAPY THAT ARE DESIGNED FORADOLESCENTS AND ADULTS IN INDIVIDUAL, FAMILY OR GROUP SETTINGS. PINNACLE HEALTH HOSPITALS - CGOH PART V, SECTION B, LINE 7: PINNACLEHEALTH WILL NOT DIRECTLY ADDRESS THE NEED FOR ACCESS TO MENTAL HEALTH SERVICES; HOWEVER, THE NEED WILL BE ADDRESSED BY THE PENNSYLVANIA PSYCHIATRIC INSTITUTE (PPI) WHICH IS A PARTNERSHIP BETWEEN PINNACLEHEALTH AND PENN STATE HERSHEY MEDICAL CENTER, CREATED IN 2008. PPI STAFFS A COMPREHENSIVE TEAM OF SPECIALISTS WHO PROVIDE CARE FOR CHILDREN, ADOLESCENTS, ADULTS AND OLDER ADULTS. ADVANTAGES OF PPI EXPERTISE INCLUDE:- LICENSED PSYCHIATRISTS, PSYCHOLOGISTS, THERAPISTS, NURSES AND OTHER MENTAL HEALTH PROFESSIONALS- PERSONALIZED TREATMENT PLANS TO MEET UNIQUE PATIENT NEEDS- THE FULL RANGE OF INPATIENT AND OUTPATIENT THERAPIES- MODERN, 74-BED INPATIENT FACILITY- FOUR CONVENIENT LOCATIONS OFFERING OUTPATIENT SERVICESPPI ALSO OFFERS HISPANIC PSYCHIATRIC PROGRAMS WHICH INCLUDE PSYCHIATRIC EVALUATIONS, MEDICATION MANAGEMENT AND THERAPY THAT ARE DESIGNED FORADOLESCENTS AND ADULTS IN INDIVIDUAL, FAMILY OR GROUP SETTINGS. 7 HORIZON HEALTH CARE SERVICES LLP 607 N DUKE STREET LANCASTER PA 17602 IN-HOME DRUG INFUSION THERAPY PINNACLE HEALTH EMERGENCY DEPARTMENT SER 111 SOUTH FRONT STREET HARRISBURG PA 17101 EMERGENCY MEDICAL SERVICES SUSQUEHANNA VALLEY SURGERY CENTER LLC 4310 LONDONDERRY ROAD SUITE 1 HARRISBURG PA 17109 SURGICAL CARE - MEDICAL SERVICES WEST SHORE SURGERY CENTER LTD 2015 TECHNOLOGY PARKWAY MECHANICSBURG PA 17050 SURGICAL CARE - MEDICAL SERVICES CONCENTRA OCCUPATIONAL HEALTHCARE HARRIS 495 OLD CONNECTICUT PATH SUITE 220 FRAMINGHAM MA 01701 URGENT CARE CENTER - MEDICAL SERVICES WALNUT BOTTOM RADIOLOGY LLC 850 WALNUT BOTTOM ROAD CARLISLE PA 17013 OUTPATIENT RADIOLOGY AND IMAGING SERVICES VNA COMMUNITY CARE SERVICES 1811 OLDE HOMESTEAD LANE PO BOX 10788 LANCASTER PA 17604 HOME HEALTH CARE PROVIDER PART I, LINE 6A: THE COMMUNITY BENEFIT REPORT IS PREPARED BY PINNACLE HEALTH SYSTEM, THE PARENT ORGANIZATION. PART I, LINE 7: THE COSTS OF CHARITY CARE AND UNREIMBURSED MEDICAID COSTS ARE CALCULATED BY THE HOSPITAL'S COST ACCOUNTING SYSTEM FOR EACH OF THE INDIVIDUAL SERVICES PROVIDED TO THE PATIENT. IT UTILIZES HOSPITAL EXPENSES FROM THE GENERAL LEDGER AND REVENUE DETAILS FROM THE PATIENT ACCOUNTING SYSTEM. EACH DEPARTMENT WITHIN THE HOSPITAL IS CLASSIFIED AS EITHER INDIRECT (OVERHEAD) OR DIRECT (PATIENT CARE AREAS). EXPENSES ARE CLASSIFIED AS FIXED OR VARIABLE AS THEY RELATE TO PATIENT VOLUME. LOGICAL STATISTICS ARE USED TO ALLOCATE OVERHEAD EXPENSES TO THE PATIENT CARE DEPARTMENTS. USING EITHER A RATIO OF COST-TO-CHARGE OR RVUS (RELATIVE VALUE UNITS), THE DIRECT AND INDIRECT COSTS FOR EACH DEPARTMENT ARE ALLOCATED TO THE SERVICES THEY PROVIDE. PART I, LN 7 COL(F): BAD DEBT EXPENSE OF $41,970,682 IS INCLUDED IN NET PATIENT REVENUE ON FORM 990, PART VIII LINE 2A, AND THEREFORE IS NOT INCLUDED FOR THE PURPOSES OF CALCULATING THE APPLICABLE EXPENSE PERCENTAGES OF SCHEDULE H. PART II, COMMUNITY BUILDING ACTIVITIES: WITH A FOCUS ON PROVIDING LEADERSHIP IN IMPROVING THE OVERALL HEALTH OF OUR COMMUNITY, PINNACLE HEALTH HOSPITALS VALUES RELATIONSHIPS WITH COMMUNITY PARTNERS AND THE ASSETS THEY BRING TO ANY COLLABORATIVE EFFORTS. PINNACLE HEALTH HOSPITALS HELPED CREATE THE DAUPHIN COUNTY HEALTH IMPROVEMENT PARTNERSHIP (DCHIP) COMPRISED OF REGIONAL HEALTH AND HUMAN SERVICE PROVIDERS, PAYORS, COUNTY GOVERNMENT, BUSINESSES AND EDUCATION. PHH HAS WORKED COLLABORATIVELY WITH PHYSICIANS AND HEALTH AND HUMAN SERVICE ORGANIZATIONS FOR MANY YEARS TO MAXIMIZE COMMUNITY CAPACITY, PROVIDE NECESSARY SERVICES TO THE COMMUNITY AND REDUCE DUPLICATION OF SERVICES. PHH SERVES IN A CONVENING ROLE TO STRENGTHEN COMMUNITY ASSETS THROUGH REFERRAL NETWORKS AND PARTNERSHIPS; SUCH INITIATIVES INCLUDE THE PHARMACY VOUCHER PROGRAM WITH THE HARRISBURG PHARMACY AND WITH THE LOCAL SCHOOL SYSTEM TO PROMOTE HEALTH AWARENESS AND PHYSICAL ACTIVITY AMONG CHILDREN. THE PROGRAM INCLUDES A PREMIUM SYSTEM TO ENCOURAGE STUDENTS TO ADOPT AND MAINTAIN A HEALTHIER LIFESTYLE AND OFFERS OPPORTUNITIES FOR FAMILIES TO PARTICIPATE IN CLASSES TOGETHER TO LEARN ABOUT HEALTHY COOKING AND PHYSICAL ACTIVITY. BASED ON IDENTIFIED COMMUNITY NEEDS AND VULNERABLE POPULATIONS, CONTINUOUS AND FREE PUBLIC PROGRAMS ARE TARGETED AT VARIOUS LOCATIONS THROUGHOUT THE COMMUNITY AND INTO AREAS OF LIMITED ACCESS TO SPECIALTY SERVICES. THESE PROGRAMS ARE INTENDED TO INFORM AND CHANGE THE HEALTH HABITS OF PARTICIPANTS THROUGH SUCH TOPIC AREAS AS DIABETES, HEART DISEASE, SEXUALLY TRANSMITTED DISEASE PREVENTION, CANCER, ACCESSING HEALTHCARE, BEHAVIORAL HEALTH, SMOKING CESSATION AND NUTRITION. EXAMPLES OF PINNACLEHEALTH'S LEADERSHIP IN BUILDING COMMUNITY CAPACITY ARE:FAITH COMMUNITY HEALTH CONNECTION (FCHC) - FORMERLY KNOWN AS CONGREGATIONAL HEALTH NETWORK OR CHNPINNACLEHEALTH SYSTEM KNOWS THAT 70% OF OUR PATIENTS BELONG TO A CONGREGATION IN CENTRAL PENNSYLVANIA. THE FCHC IS A PARTNERSHIP BETWEEN CONGREGATIONS, THE HEALTHCARE SYSTEM AND THE COMMUNITY. BY NETWORKING WITH THESE SPIRITUAL LEADERS AS PARTNERS, IN FY2014 THE FCHC WORKED TO IMPROVE THE HEALTH OF ALL IN OUR REGION. IN FY2014, THE PINNACLEHEALTH'S BILINGUAL OUTREACH COORDINATOR GAVE SPECIAL FOCUS TO THE LATINO CONGREGATIONS AND ENGAGED MORE THAN 25 LATINO SPIRITUAL LEADERS. AS MEMBERS OF A CONGREGATION, AND AS MEMBERS OF THE FCHC, INDIVIDUALS HAVE ACCESS TO A WEALTH OF SUPPORT ON ISSUES SUCH AS PREVENTIVE MEDICINE AND FOLLOW-UP CARE. THE FCHC WORKS WITH CONGREGATIONS TO EDUCATE AND PROVIDE A SUPPORTIVE NETWORK TO HELP INDIVIDUAL MEMBERS NAVIGATE THE HEALTH SYSTEM. TRAINED LEADERS AT LOCAL CONGREGATIONS AND AT PINNACLEHEALTH SYSTEM CAN HELP:- PROVIDE ACCESS TO QUALITY HEALTH CARE AND HELP GUIDE INDIVIDUALS THROUGH THE HEALTHCARE SYSTEM.- PROVIDE ADVOCACY TO EMPOWER CONGREGANTS IN HEALTHCARE DECISION MAKING.- CONNECT FAITH COMMUNITIES TO A NETWORK OF SUPPORT FOLLOWING ILLNESS, INJURY, AND HOSPITALIZATION.- CONNECT PEOPLE WITH EDUCATION AND SERVICES THAT WILL ENABLE THEM TO MAINTAIN OPTIMAL LEVELS OF HEALTH AND WELLBEING.KEYSTONE COMMUNITY CARE CONTINUUM (KCCC) SINCE 2009, PINNACLEHEALTH HAS COLLABORATED WITH FIVE COMMUNITY CLINICS TO IMPROVE ACCESS TO AND INTEGRATION OF CARE FOR OUR REGION'S NEEDIEST POPULATIONS. THIS INNOVATIVE PROGRAM REQUIRES THE COLLABORATION AND COOPERATION OF NUMEROUS ENTITIES BOTH INTERNAL AND EXTERNAL TO PINNACLEHEALTH TO ESTABLISH THE INFRASTRUCTURE TO SUPPORT THE IMPLEMENTATION OF PINNACLEHEALTH'S HEALTH INFORMATION EXCHANGE (HIE) TO COMMUNICATE CARE, DIAGNOSTIC NEEDS AND RESULTS AMONG THE CONTINUUM OF HEALTHCARE PROVIDERS.TO DATE, THE CONTINUUM PROJECT DISBURSED OVER $100,000 IN FREE CARE FUNDS TO COVER THE COST OF DIAGNOSTIC SERVICES TO PATIENTS AT THE HOPE WITHIN CLINIC, BETHESDA MISSION, AND THE COMMUNITY CHECK UP CENTER. BASED ON THE ANALYSIS TO DATE AND PINNACLEHEALTH SYSTEM GOALS, THE FOLLOWING OUTCOMES HAVE BEEN ESTABLISHED FOR THE KCCC PROJECT:- DECREASE READMISSIONS WITHIN THIRTY DAYS FOR COMMUNITY HEALTH CENTER PATIENTS FROM 23% TO 18% IN EIGHTEEN MONTHS.- DECREASE PERCENT OF COMMUNITY HEALTH CENTER PATIENTS WITH ACUITY LEVELS OF 4 OR 5 IN THE ED FROM 55% TO 38% IN EIGHTEEN MONTHS. THIS TRANSFORMATION FROM A TRADITIONAL INPATIENT BASED HEALTH CARE MODEL TO A COLLABORATIVE, PATIENT-CENTERED MEDICAL HOME MODEL FACILITATES A PARTNERSHIP BETWEEN INDIVIDUAL PATIENTS, PHYSICIANS, CLINICS AND THE COMMUNITY-BASED PATIENT SUPPORT SYSTEM. PATIENT CARE IS FACILITATED BY THE COMMUNITY HEALTH NAVIGATION TEAM USING RELATIONSHIPS WITH COMMUNITY BASED ORGANIZATIONS, AND A HEALTH INFORMATION EXCHANGE TO ASSURE THAT PATIENTS GET THE INDICATED CARE WHEN AND WHERE THEY NEED AND WANT IT IN A CULTURALLY AND LINGUISTICALLY APPROPRIATE MANNER.AS A TRUSTED PLACE FOR OUR COMMUNITY TO GO FOR ACCESS TO PUBLIC HEALTH SERVICES AND INFORMATION, THE PHH AND ITS STAFF OF PROFESSIONALS MEET THE NEEDS OF A DIVERSE POPULATION WITH CULTURAL AWARENESS AND SENSITIVITY. THE CHILDREN'S RESOURCE CENTER (CRC) PARTNERS WITH LAW ENFORCEMENT, DISTRICT ATTORNEY OFFICES, SOCIAL SERVICES, PSYCHOLOGICAL SUPPORT SERVICES, CRISIS INTERVENTION, AND CHILD PROTECTION SERVICES TO PROVIDE EFFICIENT, QUALITY CARE IN A SAFE, CHILD-FRIENDLY ENVIRONMENT FOR CHILDREN SUSPECTED OF HAVING BEEN ABUSED OR NEGLECTED. THROUGH ONGOING TRAINING AND EDUCATION IN THE COMMUNITY, THE CRC HAS SEEN AN INCREASE IN PARTICIPATION WITH PARTNER AGENCIES IN AN EVER-WIDENING GEOGRAPHIC SERVICE AREA. IN FISCAL YEAR 2014, 845 CHILDREN WERE SERVED ACROSS 25 COUNTIES IN THE CENTRAL PENNSYLVANIA REGION. WE SERVED APPROXIMATELY 1,200 NON-OFFENDING CAREGIVERS. OUR MAIN SERVICE AREAS ARE DAUPHIN, CUMBERLAND, PERRY, LEBANON, SCHUYLKILL, MIFFLIN, AND JUNIATA COUNTIES.LEAD AND HEALTHY HOMES PROGRAM (LHHP)THE LHHP SEEKS TO CREATE SAFE AND HEALTHY HOUSING BY ADDRESSING ENVIRONMENTAL HEALTH AND SAFETY ISSUES IN HOMES. WHEN HAZARDS ARE PRESENT IN A HOME, THEY CAN AFFECT THE HEALTH OF THE OCCUPANTS, PARTICULARLY THOSE MOST VULNERABLE SUCH AS CHILDREN AND SENIORS. THE PURPOSE OF THE LHHP IS TO REDUCE HOSPITALIZATIONS, INJURIES, ILLNESSES, OR DEATHS FROM PREVENTABLE HOME HEALTH OR SAFETY RISKS.RESOURCE EDUCATION AND COMPREHENSIVE CARE FOR HIV (REACCH)PINNACLEHEALTH SERVES THE HIV/AIDS POPULATION THROUGH THE RESOURCES, EDUCATION, AND COMPREHENSIVE CARE FOR HIV (REACCH) CLINIC. THE PROGRAM SERVES APPROXIMATELY 450 PATIENTS, PRIMARILY IN THE DAUPHIN, CUMBERLAND, OR PERRY COUNTIES. REACCH HAS A HISTORY OF WORKING WITH ETHNICALLY DIVERSE PATIENTS. IN 2014, PATIENTS SELF-IDENTIFIED AS 43% AFRICAN AMERICAN, 43% CAUCASIAN/NON-HISPANIC, 11% HISPANIC, AND 3% MULTI-RACIAL OR OTHER. REACCH ALSO SERVES AN ECONOMICALLY DIVERSE POPULATION. 41% WERE COVERED BY MEDICAID OR MEDICARE AND 11% WERE UNINSURED. IN ORDER TO SERVE AS A COMPREHENSIVE MEDICAL CARE PROGRAM FOR ALL PEOPLE LIVING WITH HIV/AIDS WITHIN THE SOUTH CENTRAL PENNSYLVANIA REGION, REACCH SEEKS TO REMOVE SOCIAL AND ECONOMIC BARRIERS TO CARE. IN 2013 AND 2014 REACCH TESTED HIGH-RISK POPULATIONS IN DAUPHIN COUNTY IN RESPONSE TO THE COUNTY'S HIGH HIV ANNUAL DIAGNOSIS RATE (THIRD ONLY IN THE STATE TO PHILADELPHIA AND DELAWARE COUNTIES) AND TO THE NEED FOR ROUTINE SCREENING FOR AT-RISK POPULATIONS WHO HAVE NO PRIMARY CARE PROVIDER OR INSURANCE. IN 2013 REACCH STARTED A MEDICAL CASE MANAGEMENT PROGRAM TO COACH CLIENTS IN GOAL-SETTING AND FACILITATE INSURANCE AND CHARITY CARE APPLICATIONS. IN LATE 2014, 89% OF REACCH CLIENTS HAD AN UNDETECTABLE AMOUNT OF HIV IN THEIR BLOOD, WHICH FACILITATES HEALTH AND LONGEVITY AND REDUCES THE RISK OF HIV TRANSMISSION. PART III, LINE 4: THE FINANCIAL STATEMENTS DO NOT HAVE A SPECIFIC NOTE ON BAD DEBT EXPENSE; RATHER THE FINANCIAL STATEMENTS EVALUATE BAD DEBTS BASED ON ITS ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE FOOTNOTE RELATED TO THE ALLOWANCE IS SUMMARIZED AS FOLLOWS: "PATIENT RECEIVABLES ARE RECORDED AT THEIR ESTIMATED NET REALIZABLE VALUE. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS ESTIMATED BASED UPON HISTORICAL COLLECTION RATES."THE BAD DEBT EXPENSE ON FORM 990, PART III, LINE 2 WAS CALCULATED BY TAKING THE AMOUNT WRITTEN OFF TO BAD DEBT FOR EACH ACCOUNT AND CONVERTING IT TO CHARGES BY APPROPRIATELY ADJUSTING THE AMOUNT BY THE PAYOR REIMBURSEMENT PERCENTAGE FOR THAT ACCOUNT. THEN, THE COST/CHARGE RATIO FOR EACH SPECIFIC ACCOUNT, UTILIZING THE COSTS FROM THE HOSPITAL COST ACCOUNTING SYSTEM (DESCRIBED IN DETAIL ABOVE), WAS APPLIED TO THIS CALCULATED PORTION OF THE TOTAL CHARGES. FOR THE PORTION OF BAD DEBT EXPENSE THAT IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY, THE HOSPITAL UTILIZES A HISTORICAL PERCENTAGE PROVIDED BY MEDEANALYTICS, A THIRD PARTY INDEPENDENT COMPANY, ON THE PATIENT'S ESTIMATED INCOME WHICH IS DERIVED BY NORMALIZING DATA FROM MULTIPLE, DISPARATE SOURCES TO DETERMINE WHICH OF THE BAD DEBT ACCOUNTS COULD HAVE BEEN ELIGIBLE FOR CHARITY CARE BUT THE PATIENT HAD NOT APPLIED. THIS PATIENT FINANCIAL DATA HAS BEEN FOUND TO BE REASONABLY ACCURATE BASED ON COMPARISONS TO THE PATIENTS' ACTUAL INCOME PER SUPPORTING DOCUMENTATION PROVIDED FOR THOSE THAT HAVE APPLIED FOR CHARITY CARE. AN OVERALL COST TO CHARGE RATIO WAS THEN APPLIED TO THIS AMOUNT TO ARRIVE AT AN EXPENSE FIGURE. PART III, LINE 8: THE MEDICARE COSTS WERE DETERMINED BASED ON THE HOSPITALS' COST ACCOUNTING SYSTEM ALLOCATION OF COSTS BASED ON THE SERVICES RENDERED. PART III, LINE 9B: PATIENTS ARE NOTIFIED OF OUR CHARITY CARE POLICY IN A VARIETY OF WAYS. THERE ARE POSTERS INFORMING PATIENTS OF OUR CHARITY CARE POLICY AND PAMPHLETS OUTLINING THE APPLICATION PROCESS AT ALL THE REGISTRATION SITES. ALL OUR PATIENT ACCOUNT STATEMENTS CONTAIN LANGUAGE THAT INDICATES THERE IS FINANCIAL AID AVAILABLE FOR QUALIFYING INDIVIDUALS. IN ADDITION, THE POLICY AND APPLICATION ARE POSTED ON THE HOSPITAL WEBSITE IN BOTH ENGLISH AND SPANISH. PATIENTS WHO APPLY FOR FINANCIAL ASSISTANCE AND PROVIDE ALL THE NECESSARY DOCUMENTATION REQUIREMENTS ARE NOTIFIED WITHIN TWO WEEKS OF THE HOSPITAL'S DECISION. WHEN THE APPROVAL IS DETERMINED, THE APPROPRIATE DISCOUNT IS POSTED TO THE PATIENT'S ACCOUNT IMMEDIATELY. THE FINANCIAL ASSISTANCE DISCOUNT WILL BE APPLIED TO SERVICES FOR THE PREVIOUS EIGHTEEN MONTHS AND SUBSEQUENT SIX MONTHS. THE HOSPITAL'S COLLECTION POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. FOR THOSE INDIVIDUALS DETERMINED TO FULLY QUALIFY FOR CHARITY CARE (OVER 96% OF APPROVED CHARGES) NO ADDITIONAL COLLECTION EFFORTS ARE MADE. APPLICANTS APPROVED FOR ONLY PARTIAL DISCOUNT WILL BE REQUIRED TO MAKE REASONABLE PAYMENT ARRANGEMENTS ON THEIR BALANCE IN ACCORDANCE WITH THE HOSPITAL'S CREDIT AND COLLECTION POLICY. THIS POLICY DOES PERMIT THE USE OF BOTH INTERNAL COLLECTION STAFF AND EXTERNAL COLLECTION AGENCIES WHO WILL ENGAGE IN STANDARD ACCEPTABLE BUSINESS PRACTICES WHICH INCLUDE PHONE CALLS, MAILINGS AND THE REPORTING OF ITS UNPAID DEBT TO THE CREDIT REPORTING AGENCIES; BUT UNDER NO CIRCUMSTANCES WILL THE HOSPITALS OR ITS CONTRACTED COLLECTION AGENCY ADOPT "EXTRAORDINARY COLLECTION ACTIONS" THAT ENTAIL LEGAL COURSE OF ACTION OR JUDICIAL PROCESS SUCH AS LAWSUITS OR LIENS. PART VI, LINE 2: LED BY THE MISSION EFFECTIVENESS DEPARTMENT, THE CHNA PROCESS REPRESENTS A COMPREHENSIVE COMMUNITY-WIDE PROCESS THAT CONNECTED MORE THAN 500,000 COMMUNITY RESIDENTS, A WIDE RANGE OF PUBLIC AND PRIVATE ORGANIZATIONS, SUCH AS EDUCATIONAL INSTITUTIONS, HEALTH-RELATED PROFESSIONALS, LOCAL GOVERNMENT OFFICIALS, HUMAN SERVICE ORGANIZATIONS, AND FAITH-BASED ORGANIZATIONS TO EVALUATE THE COMMUNITY'S HEALTH AND SOCIAL NEEDS. THE ASSESSMENT UTILIZED SECONDARY DATA COLLECTION, INTERVIEWS WITH KEY COMMUNITY LEADERS, PUBLIC FORUMS AND FOCUS GROUPS TO IDENTIFY HEALTH PROGRAMS AND RISK FACTORS IN THE SERVICE AREA. PINNACLEHEALTH ENGAGED THE BROADER COMMUNITY TO GATHER INPUT AND DOCUMENT COMMUNITY HEALTH NEEDS. THE FOLLOWING TOOLS WERE USED TO ASSESS THE COMMUNITY:COMMUNITY LEADER INTERVIEWSINTERVIEWS WITH FIFTY-EIGHT COMMUNITY LEADERS THROUGHOUT THE REGION WERE CONDUCTED TO GAIN AN UNDERSTANDING OF THE COMMUNITY'S HEALTH NEEDS FROM ORGANIZATIONS AND AGENCIES THAT HAVE A DEEP UNDERSTANDING OF THE POPULATIONS IN THE GREATEST NEED. THE COLLABORATIVE DEVELOPED A LIST OF COMMUNITY LEADERS TO INTERVIEW. INTERVIEWS WERE CONDUCTED WITH AN ARRAY OF DIRECTORS AND STAFF MEMBERS FROM COMMUNITY HEALTH CENTERS, MEMBERS FROM SOCIAL SERVICES ORGANIZATIONS, EDUCATIONAL LEADERS, RELIGIOUS GROUPS, AND ELECTED OFFICIALS. THE INFORMATION COLLECTED PROVIDED KNOWLEDGE ABOUT THE COMMUNITY'S HEALTH STATUS, RISK FACTORS, SERVICE UTILIZATION, AND COMMUNITY RESOURCE NEEDS, AS WELL AS GAPS AND SERVICE SUGGESTIONS.SECONDARY DATA COLLECTIONSECONDARY DATA WAS COLLECTED FROM MULTIPLE SOURCES, INCLUDING: COUNTY HEALTH RANKINGS, HEALTHY PEOPLE 2020, OFFICE OF APPLIED STUDIES, PENNSYLVANIA DEPARTMENT OF HEALTH, BUREAU OF HEALTH STATISTICS AND RESEARCH, PENNSYLVANIA OFFICE OF RURAL HEALTH, CAPITAL AREA COALITION ON HOMELESSNESS, THE CENTERS FOR DISEASE PREVENTION AND CONTROL (CDC), ETC. THE DATA RESOURCES WERE RELATED TO DISEASE PREVALENCE, SOCIO-ECONOMIC FACTORS, AND BEHAVIORAL HABITS. THE DATA WAS BENCHMARKED AGAINST STATE AND NATIONAL TRENDS.DATA WAS ALSO OBTAINED THROUGH TRUVEN HEALTH ANALYTICS (FORMERLY KNOWN AS THOMSON REUTERS) TO QUANTIFY THE SEVERITY OF HEALTH DISPARITIES FOR EVERY ZIP CODE IN THE NEEDS ASSESSMENT AREA BASED ON SPECIFIC BARRIERS TO HEALTHCARE ACCESS. FIVE PROMINENT SOCIO-ECONOMIC BARRIERS TO COMMUNITY HEALTH WERE IDENTIFIED: INCOME BARRIERS, CULTURAL/LANGUAGE BARRIERS, EDUCATIONAL BARRIERS, INSURANCE BARRIERS, AND HOUSING BARRIERS.HAND DISTRIBUTED SURVEYSA HAND-DISTRIBUTION METHODOLOGY WAS EMPLOYED TO DISSEMINATE SURVEYS TO INDIVIDUALS THROUGHOUT THE STUDY AREA. THE SURVEY WAS AVAILABLE IN BOTH ENGLISH AND IN SPANISH. THE ASSISTANCE OF LOCAL COMMUNITY ORGANIZATIONS WAS VITAL TO THE SURVEY DISTRIBUTION PROCESS. IN TOTAL, 1,279 SURVEYS WERE USED FOR ANALYSIS. OF THESE SURVEYS 1,175 WERE COLLECTED IN ENGLISH, AND 104 SURVEYS WERE COLLECTED IN SPANISH. FOCUS GROUPSNINE FOCUS GROUPS WERE FACILITATED WITHIN THE STUDY AREA WITH AT-RISK HEALTHCARE POPULATIONS. THE FOLLOWING TABLE LISTS THE TARGETED FOCUS GROUPS: 1. HIV/AIDS 2. HOMELESS 3. IMMIGRANT/DISENFRANCHISED 4. OBESE ADULTS/DIABETIC 5. RURAL UNDER-SERVED 6. SENIORS ON A FIXED-INCOME 7. SPANISH-SPEAKING ADULTS 8. VETERANS 9. WORKING-POOR COMMUNITY FORUMSA SERIES OF THREE COMMUNITY FORUMS WERE FACILITATED WITH COMMUNITY ORGANIZATION LEADERS, RELIGIOUS LEADERS, GOVERNMENT STAKEHOLDERS, AND OTHER KEY COMMUNITY LEADERS AT EACH OF THE SPONSORING HOSPITAL/HEALTH SYSTEM LOCATIONS. THE PURPOSE OF THE COMMUNITY FORUMS WAS TO PRESENT THE CHNA FINDINGS TO DATE AND TO RECEIVE INPUT WITH REGARD TO THE NEEDS AND CONCERNS OF THE COMMUNITY. WITH INPUT RECEIVED FROM FORUM PARTICIPANTS, COLLABORATIVE MEMBERS IDENTIFIED THE THREE TOP PRIORITY AREAS AS: HEALTHY LIFESTYLES, HEALTH EDUCATION, AND ACCESS TO AFFORDABLE HEALTHCARE. PINNACLE HEALTH HOSPITALS UTILIZES THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES' COMMUNITY HEALTH STATUS INDICATORS WHICH PROVIDES DATA THAT CAN BE COMPARED TO PEER COUNTIES ON A STATE AND NATIONAL LEVEL. IN ADDITION, HEALTHY PEOPLE 2020 IDENTIFIES NEARLY 600 OBJECTIVES WITH MORE THAN 1,300 MEASURES TO IMPROVE THE HEALTH OF ALL AMERICANS. TO MONITOR PROGRESS TOWARD ACHIEVING INDIVIDUAL OBJECTIVES, HEALTHY PEOPLE RELIES ON DATA SOURCES DERIVED FROM A NATIONAL CENSUS OF EVENTS LIKE THE NATIONAL VITAL STATISTICS SYSTEM AND NATIONALLY REPRESENTATIVE SAMPLE SURVEYS LIKE THE NATIONAL HEALTH INTERVIEW SURVEY. PINNACLEHEALTH HOSPITALS SEARCHES THE HEALTH INDICATORS WAREHOUSE FOR DATA RELATED TO HEALTHY PEOPLE 2020 OBJECTIVES DEVELOPED BY THE NATIONAL CENTER FOR HEALTH STATISTICS TO DEFINE PRIORITIES THAT ASSIST IN IMPROVING HEALTH IN THE COMMUNITY.PINNACLE HEALTH HOSPITALS USES DIRECT PATIENT FEEDBACK, OUTREACH EFFORTS, AND COMMUNITY BASED PARTNERSHIPS TO DETERMINE THE HEALTH CARE NEEDS IN CUMBERLAND, DAUPHIN, AND PERRY COUNTIES. THE PRIMARY DATA SOURCES FOR ASSESSING THE UNMET NEEDS OF THE COMMUNITY ARE DIRECT PATIENT CONTACT, QUESTIONNAIRES, AND OBSERVATION OF THE PATIENT POPULATION IN PINNACLE'S FOUR CAMPUSES (COMMUNITY, CUMBERLAND, HARRISBURG AND POLYCLINIC), FAMILY CARE PHYSICIAN PRACTICES, OUTPATIENT SURGERY AND IMAGING CENTERS. THROUGH VARIOUS OUTREACH PROGRAMS INCLUDING HEALTH FAIRS, SCREENINGS, LECTURES, AND EDUCATION SESSIONS, DATA IS COLLECTED AND INCLUDED IN ASSESSING THE OVERALL UNMET NEEDS OF THE COMMUNITY.AS A PART OF THE CHNA PROCESS, OUR TEAM GATHERED BOTH PRIMARY AND SECONDARY DATA. AS A PART OF THE PRIMARY DATA COLLECTION, WE CONDUCTED 58 PHONE INTERVIEWS WITH LOCAL COMMUNITY LEADERS. WITH THE HELP OF COMMUNITY BASED, GRASSROOTS ORGANIZATIONS, A HAND-DISTRIBUTED SURVEY WAS DISSEMINATED TO OUR MOST VULNERABLE POPULATIONS. AVAILABLE IN BOTH ENGLISH AND SPANISH, WE RECEIVED 1,279 COMPLETED SURVEYS. IN ADDITION, WE CONDUCTED (9) FOCUS GROUPS IN THE AREAS OF: HIV/AIDS; HOMELESS; IMMIGRANTS/DISENFRANCHISED; OBESE ADULTS/DIABETICS; RURAL UNDERSERVED: SENIORS ON FIXED INCOME; SPANISH SPEAKING ADULTS; VETERANS, AND WORKING POOR. LASTLY, THREE COMMUNITY FORUMS WERE HELD WELCOMING THE ENTIRE COMMUNITY TO REVIEW THE FINDINGS AND ADD COMMENTS OR ADDITIONAL CONCERNS. AFTER REVIEWING THIS DATA AND MAPPING EXISTING INTERNAL AND COMMUNITY BASED RESOURCES, PINNACLEHEALTH DEVELOPED THE FOLLOWING IMPLEMENTATION PLAN WITH EVIDENCE-BASED STRATEGIES. PINNACLEHEALTH'S CHNA IMPLEMENTATION PLAN (THE PLAN) DESCRIBES THE ASSESSMENT PROCESS, THE NEEDS IDENTIFIED, AND THE PRIORITIES CHOSEN TO INCLUDE: (1) HEALTHY LIFESTYLES WITH A FOCUS ON OBESITY AND PHYSICAL ACTIVITY/NUTRITION; (2) HEALTH EDUCATION IN THE AREAS OF DIABETES, HEART DISEASE AND CANCER ENSURING THAT THE EDUCATION IS CULTURALLY COMPETENT AND PRIMARILY FOCUSED ON SCHOOL AGED CHILDREN; AND (3) ACCESS TO CARE IN THE AREAS OF SPECIALTY CARE, PRIMARY CARE, DENTAL CARE, AND MENTAL HEALTH CARE. FOR EACH PRIORITY, THE PLAN DOCUMENTS PINNACLEHEALTH'S OBJECTIVES, GOALS, AND STRATEGIES FOR ADDRESSING THE COMMUNITY NEED. THE STRATEGIES ARE SUPPORTED BY SENIOR MANAGEMENT AND WILL BE SUSTAINED BY PINNACLEHEALTH STAFF, VOLUNTEERS, PARTNERSHIPS WITH COMMUNITY BASED ORGANIZATIONS INCLUDING PAYORS AND LOCAL FOUNDATIONS, AND FUNDING FROM THE PINNACLEHEALTH FOUNDATION WHEN APPROPRIATE. AS PINNACLEHEALTH LOOKS TOWARD THE FUTURE, WE ENSURE THAT OUR CORE VALUES OF QUALITY, ACCESS TO CARE AND COORDINATION OF CARE ARE AT THE CENTER OF ALL OF OUR ORGANIZATIONAL STRATEGIES. WE EMBRACE OUR COMMUNITY PARTNERS AND WORK COLLABORATIVELY WITH THEM TO STRENGTHEN THE SUPPORT SYSTEMS THAT WILL ALLOW OUR PATIENTS TO MAINTAIN POSITIVE HEALTH OUTCOMES. THE PINNACLEHEALTH SYSTEM PRESENTED THE RESULTS OF A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN SEPTEMBER 2012 AND DEVELOPED AN IMPLEMENTATION PLAN WITH STRATEGIES TO ADDRESS THE IDENTIFIED COMMUNITY HEALTH NEEDS. THE FINAL IMPLEMENTATION PLAN WAS REVIEWED BY THE MISSION EFFECTIVENESS AND STRATEGIC ISSUES COMMITTEE OF THE BOARD IN MAY 2013 AND APPROVED BY THE PINNACLEHEALTH BOARD OF DIRECTORS IN MAY 2013. THE FINAL APPROVED VERSION OF THE CHNA AND IMPLEMENTATION PLAN IS AVAILABLE TO THE PUBLIC ON THE WWW.PINNACLEHEALTH.ORG WEBSITE.IN ACCORDANCE WITH IRS GUIDELINES, PINNACLEHEALTH HOSPITALS WILL BEGIN THE NEXT COMMUNITY HEALTH NEEDS ASSESSMENT IN FALL 2014. PART VI, LINE 3: PATIENTS ARE INFORMED OF AVAILABLE ASSISTANCE IN NUMEROUS WAYS. SIGNAGE IS POSTED AND PAMPHLETS ARE AVAILABLE AT ALL THE REGISTRATION SITES INDICATING TO THE PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE. ALL UNINSURED PATIENTS WHO ARE SCHEDULED FOR HIGH DOLLAR TESTS AND SURGERIES ARE CONTACTED BY ONE OF THE HOSPITAL'S FINANCIAL COUNSELORS TO DISCUSS THE FINANCIAL ASSISTANCE OPTIONS AVAILABLE TO THEM. THE FINANCIAL ASSISTANCE POLICY IS ALSO DISCLOSED ON THE HOSPITAL WEBSITE, ALONG WITH THE APPLICATION, IN BOTH ENGLISH AND SPANISH. IN ADDITION, ALL INPATIENTS WHO ARE RESIDENTS OF PENNSYLVANIA ARE PROVIDED PERSONAL ASSISTANCE IN THE COMPLETION OF THE MEDICAL ASSISTANCE APPLICATION. AS PART OF THE DISCHARGE PROCESS IN THE EMERGENCY DEPARTMENT, ALL UNINSURED PATIENTS ARE SCREENED FOR CHARITY CARE ELIGIBILITY UNDER THE HOSPITAL POLICY. LASTLY, INFORMATION ABOUT FINANCIAL ASSISTANCE IS INCLUDED ON THE PATIENT BILLING STATEMENTS. PROGRAMS DISCUSSED INCLUDE THE PENNSYLVANIA STATE MEDICAID PROGRAM (MEDICAL ASSISTANCE), HOSPITAL CHARITY CARE PROGRAM, AND FUNDS AVAILABLE THROUGH HOSPITAL ENDOWMENT FUNDS. PART VI, LINE 4: PINNACLE HEALTH HOSPITALS' (PHH) PRIMARY SERVICE AREA (PSA) CONSISTS OF 53 CONTIGUOUS ZIP CODES IN PORTIONS OF 6 COUNTIES IN THE GREATER HARRISBURG AREA OF SOUTH CENTRAL PENNSYLVANIA. THE SIX COUNTIES INCLUDE DAUPHIN, CUMBERLAND, PERRY, YORK, LANCASTER AND LEBANON. THE COMMUNITY CAN BE DESCRIBED AS A MIX OF RURAL IN THE OUTLYING COUNTIES, SUBURBAN AND THE URBAN AREA OF THE CITY OF HARRISBURG. THE PSA ACCOUNTS FOR APPROXIMATELY 85 PERCENT OF THE OVERALL ACUTE PATIENT DISCHARGES OF THE HOSPITALS. PINNACLE HEALTH HOSPITALS COMPETES WITH THREE ACUTE CARE HOSPITALS AND 2 REHABILITATION HOSPITALS WITHIN THE PSA. ONE OF THE ACUTE CARE HOSPITALS IS A FOR-PROFIT HOSPITAL OWNED BY A LARGE PUBLICLY REGISTERED HEALTH CARE SYSTEM. THE SECOND COMPETITOR IS A MEDICAL ACADEMIC HOSPITAL AFFILIATED WITH A LARGE STATE FUNDED PUBLIC UNIVERSITY AND THE FINAL COMPETITOR IS A SMALLER, NON-TEACHING NOT-FOR-PROFIT HOSPITAL. THE FIRST REHABILITATION HOSPITAL IS OWNED AND OPERATED BY A LARGE PUBLICLY REGISTERED CORPORATION AND THE OTHER REHABILITATION HOSPITAL IS OPERATED BY THE MEDICAL ACADEMIC HOSPITAL OF THE LARGE STATE FUNDED PUBLIC UNIVERSITY ALREADY MENTIONED. THE PSA IN WHICH PHH SERVES HAS 12 CENSUS TRACTS WHICH HAVE BEEN IDENTIFIED BY THE U.S. HEALTH RESOURCES AND SERVICES ADMINISTRATION AS MEDICALLY UNDERSERVED AREAS (MUAS). IN ADDITION, IMMEDIATELY ADJACENT TO THE WEST OF THE PSA ARE AN ADDITIONAL 5 MINOR CIVIL DIVISIONS WHICH HAVE BEEN IDENTIFIED AS MUAS. PHH IS A SIGNIFICANT PROVIDER OF HEALTHCARE SERVICES TO PATIENTS IN THE AREAS ADJACENT TO ITS PSA. PHH IS THE PRIMARY PROVIDER FOR THE 49,000 PEOPLE LIVING IN THE CITY OF HARRISBURG. THE EMERGENCY DEPARTMENT (ED) OF THE HOSPITAL IS THE FIRST OPTION FOR A LARGE MAJORITY OF THE CITY RESIDENTS. IN ADDITION, THE HOSPITAL AND RELATED ORGANIZATIONS OPERATE ADULT, CHILDREN, WOMAN AND TEEN PRIMARY CARE CLINICS THAT MAINLY SERVE THE CITY'S MEDICAID AND UNINSURED POPULATION. NEARLY 75% OF THE HARRISBURG CITY POPULATION IS MINORITY, COMPARED TO 30% OF THE COUNTY POPULATION. AFRICAN-AMERICANS/BLACKS COMPRISE 52.4% OF HARRISBURG'S POPULATION AND HISPANICS/LATINOS MAKE UP 18% OF THE CITY'S POPULATION, COMPARED TO 18.6% AFRICAN-AMERICANS/BLACKS AND 7.5% HISPANICS/LATINOS IN DAUPHIN COUNTY AS A WHOLE. NEARLY 17% OF HARRISBURG CITY RESIDENTS SPEAK A LANGUAGE OTHER THAN ENGLISH IN THE HOME, COMPARED TO 10% OF COUNTY RESIDENTS. FULLY 31.6% OF CITY RESIDENTS HAVE INCOME BELOW THE POVERTY LEVEL, WHILE ONLY 12.3% OF COUNTY RESIDENTS HAVE INCOME BELOW POVERTY. WHILE THE CITY REPRESENTS 18% OF THE COUNTY POPULATION, IT IS HOME TO 45% OF THOSE WITH INCOMES AT OR BELOW THE FEDERAL POVERTY LEVEL (FPL). NEARLY 26% OF HARRISBURG CITY RESIDENTS RECEIVED FOOD STAMPS/SNAP BENEFITS AT SOME POINT IN THE PAST YEAR, COMPARED TO 9.1% IN THE COUNTY AS A WHOLE.COUNTY HEALTH RAKINGS FOR 2013 SHOWED THAT 12% OF DAUPHIN COUNTY RESIDENTS HAD NO HEALTH INSURANCE. ALTHOUGH INSURANCE COVERAGE RATES FOR MOST OF THE COUNTRY INCREASED BECAUSE OF THE AFFORDABLE CARE ACT'S PROVISIONS EXTENDING PARENT'S INSURANCE TO 18-TO-26-YEAR-OLDS, AN INCREASE IN COVERAGE RATES WAS NOT VISIBLE IN DAUPHIN COUNTY.PINNACLEHEALTH WORKS IN COLLABORATION WITH OUR LOCAL FEDERALLY QUALIFIED HEALTH CENTER (FQHC), HAMILTON HEALTH CENTER, WHICH IS LOCATED IN THE HEART OF THE HARRISBURG HIGH-NEED AREA. ZIP CODE ANALYSIS CONDUCTED BY PINNACLE SHOWED THAT THIS SAME POPULATION USES PINNACLEHEALTH AS THEIR PRIMARY HOSPITAL INCLUDING THE EMERGENCY DEPARTMENT. IN 2013, 81% OF THOSE SERVED HAD INCOME AT OR BELOW THE FEDERAL POVERTY LEVEL (FPL) AND 99% HAD INCOME AT OR BELOW 200% OF THE FPL. MORE THAN A THIRD OF THOSE SERVED (34.5%) BY HAMILTON DID NOT HAVE INSURANCE COVERAGE. THIS IS SUBSTANTIALLY HIGHER THAN FQHCS IN THE STATE AS A WHOLE, WHERE 26.9% OF PATIENTS SERVED HAD NO INSURANCE. PHH IS ALSO THE MAJOR PROVIDER OF HEALTH CARE SERVICES FOR ALL OF DAUPHIN COUNTY, WHERE THE CITY OF HARRISBURG IS LOCATED, AND ACCORDING TO "COUNTY HEALTH RANKINGS," DAUPHIN COUNTY RANKS 38TH OUT OF A TOTAL OF 67 PENNSYLVANIA COUNTIES IN AN ASSESSMENT OF THE OVERALL HEALTH OF EACH COUNTY. THE PA DEPARTMENT OF HEALTH (DOH) REPORTS THAT DAUPHIN COUNTY RANKS ABOVE THE STATE OF PA AS A WHOLE IN THE FOLLOWING CATEGORIES: LOW BIRTH WEIGHT, BIRTHS TO MOTHERS UNDER THE AGE OF 18, MOTHERS RECEIVING NO PRENATAL CARE IN THE FIRST TRIMESTER, BREAST CANCER INCIDENCE, HEART DISEASE AND DIABETES. PART VI, LINE 5: PINNACLE HEALTH HOSPITALS MAINTAINS AN ACTIVE ROLE IN THE COMMUNITY IN WHICH IT SERVES. THE ROLE IS REFLECTIVE IN ITS BOARD OF DIRECTORS WHOSE COMPOSITION IS GREATER THAN 80 PERCENT INDEPENDENT COMMUNITY BASED LEADERS. PHH HAS AN OPEN MEDICAL STAFF. PHH PROVIDES TRAINING FOR BOTH MEDICAL STUDENTS AND RESIDENTS IN A NUMBER OF SPECIALTIES. PINNACLE HEALTH HOSPITALS HAS ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) ACCREDITED RESIDENCY PROGRAMS AS WELL AS AMERICAN OSTEOPATHIC ASSOCIATION (AOA) ACCREDITED TEACHING PROGRAMS. PHH USES ITS SURPLUS FUNDS TO RENOVATE AND EXPAND PATIENT CARE AREAS IN ADDITION TO PROVIDING PATIENT SERVICES WHICH MAY NOT BE CURRENTLY AVAILABLE IN THE COMMUNITY.PINNACLEHEALTH HOSPITALS RECOGNIZES THAT THE HEALTH OF THE COMMUNITY GOES BEYOND THAT OF THE PHYSICAL HEALTH OF ITS MEMBERS. TAKING A HOLISTIC APPROACH TO ADDRESSING THE HEALTH NEEDS OF THE COMMUNITY, PINNACLEHEALTH SUPPORTS A PLETHORA OF COMMUNITY-WIDE INITIATIVES THAT ADDRESS SOCIO-ECONOMIC BARRIERS TO IMPROVED HEALTH. STAFF WORK CLOSELY WITH THE CAPITAL AREA COALITION ON HOMELESSNESS AND HOLD SEATS ON BROAD-BASED INITIATIVES SUCH AS PROJECT HOMELESS CONNECT, AN EVENT THAT TARGETS THE HARDEST-TO-REACH MEN, WOMEN, TEENS, AND CHILDREN WHO ARE IN SHELTERS, ABOUT TO LEAVE SHELTERS, OR LIVING ON THE STREET. IN SEPTEMBER 2013, THIS EVENT HELPED MORE THAN THREE HUNDRED INDIVIDUALS MOVE FROM CRISIS TO MEANINGFUL AND LASTING SUCCESS. PINNACLE STAFF ALSO HAS A LEAD ROLE IN THE COMPASSIONATE CLOSURES PROGRAM TO ASSIST INDIGENT FAMILIES WITH NO FINANCIAL RESOURCES TO RESPECTFULLY MEMORIALIZE, CREMATE OR BURY THEIR LOVED ONES. A BROAD COMMUNITY PARTNERSHIP HAS COME TOGETHER TO ADDRESS THIS NEED AND THE PARTNERS ARE: THE VNA OF CENTRAL PENNSYLVANIA AND CROSSINGS HOSPICE, THE HISPANIC COMMUNITY CENTER, THE INTERNATIONAL SERVICE CENTER, THE PENNSYLVANIA FUNERAL DIRECTORS ASSOCIATION, PINNACLEHEALTH SYSTEM, THE SALVATION ARMY, THE UNITED WAY OF THE CAPITAL REGION, DAUPHIN COUNTY COMMISSIONERS AND CORONER'S OFFICE, CUMBERLAND COUNTY COMMISSIONERS AND CORONER'S OFFICE, THE FOUNDATION FOR ENHANCING COMMUNITIES AND THE PA DEPARTMENT OF PUBLIC WELFARE. THE MISSION OF THE PARTNERS IS TO OFFER A MEASURE OF COMPASSIONATE CARE BLENDED WITH DIGNITY AND RESPECT FOR OUR INDIGENT FAMILIES LIVING IN DAUPHIN OR CUMBERLAND COUNTIES WHO HAVE LOST LOVED ONES. SEVERAL MAJOR CONSTRUCTION PROJECTS WERE COMPLETED IN FISCAL YEAR 2014 INCLUDING CONSTRUCTION OF A NEW 108 BED ACUTE CARE HOSPITAL ON THE FREDRICKSEN CAMPUS AT A COST OF $114.4 MILLION; EXPANSION AND RENOVATION FROM SEMI-PRIVATE TO MOSTLY PRIVATE ROOMS AT COMMUNITY GENERAL HOSPITAL WITH AN EXPECTED COST OF $25.0 MILLION; RENOVATIONS AND NEW CONSTRUCTION AT HARRISBURG HOSPITAL TO INCLUDE NEW HEART CATH AND ELECTROPHYSIOLOGY LABS AND A CARDIOTHORACIC INTENSIVE CARE UNIT; AND PATIENT ROOM UPGRADES TO MOSTLY PRIVATE ROOMS WITH COSTS ESTIMATED AT $34.0 MILLION; AND CONSTRUCTION OF A NEW CANCER CENTER LOCATED ON THE WEST SHORE FREDRICKSEN CAMPUS WITH A COST OF $20.6 MILLION. THE NEW WEST SHORE HOSPITAL BEGAN OPERATIONS ON MAY 19, 2014 FOLLOWED BY THE OPENING OF THE WEST SHORE CANCER CENTER IN AUGUST 2014.ADDITIONAL PROJECTS INCLUDE MODERNIZING AND UPDATING EXISTING LOCATIONS WITHIN THE PHH SERVICE AREA TO MEET THE PATIENT NEEDS IN THE COMMUNITY WE SERVE AND EXPANDING THE UTILIZATION OF ELECTRONIC MEDICAL RECORDS BOTH WITHIN PINNACLE HEALTH SYSTEM AS WELL AS WITHIN THE COMMUNITY-BASED PHYSICIAN PRACTICES OF OUR AREA. AS ONE OF THE LEADING HOSPITALS IN SOUTH CENTRAL PENNSYLVANIA, PINNACLE HEALTH HOSPITALS STRIVES TO STRENGTHEN ACCESS TO CARE AS WE PROVIDE A CONTINUUM OF COMMUNITY-BASED SERVICES THAT EXTEND BEYOND THE ROLE OF AN ACUTE CARE HOSPITAL - FROM IN-HOME PRENATAL CARE FOR FIRST TIME MOTHERS TO A LEAD AGENCY ON A REGIONAL DISASTER PREPAREDNESS TASK FORCE. TO BRING FOCUS TO OUR MISSION, PINNACLE HEALTH HOSPITALS IS COMMITTED TO SIX STRATEGIC PILLARS: COMMITMENT TO PEOPLE, SERVICE, QUALITY, GROWTH, COMMUNITY, AND FINANCE. GUIDED BY THESE PILLARS, THE SIX INITIATIVES HIGHLIGHTED BELOW ARE KEY EXAMPLES OF OUR COMMITMENT TO BEING A TRUSTED PLACE FOR OUR COMMUNITY TO GO FOR ACCESS TO PUBLIC HEALTH SERVICES AND INFORMATION: -NURSE FAMILY PARTNERSHIP (NFP) - WITH A FOCUS ON PEOPLE AND A DESIRE TO MAKE THE HEALTHCARE SYSTEM EASIER TO NAVIGATE, WE OFFER THIS VOLUNTARY PREVENTION PROGRAM THAT PROVIDES NURSE HOME VISITATION SERVICES TO LOW INCOME, FIRST-TIME MOTHERS. THIS NATIONALLY RENOWNED, EVIDENCE-BASED COMMUNITY HEALTH CURRICULUM TRANSFORMS THE LIVES OF VULNERABLE FAMILIES.-CERTIFIED APPLICATION COUNSELORS (CAC) DURING THE LAUNCH OF THE INSURANCE MARKETPLACE IN FALL 2013, PINNACLEHHEALTH HOSPITALS DEDICATED TWO STAFF TO THE OPEN ENROLLMENT PROCESS AND SUPPORTED THEIR ROLES AS CERTIFIED APPLICATION COUNSELORS. PINNACLEHEALTH CACS WERE POSITIONED IN OUR HEALTH CLINICS WHERE MANY UNINSURED AND VULNERABLE MEMBERS OF OUR COMMUNITY VISIT OUR HEALTHSYSTEM FOR SERVICES. THE CACS HELPED PEOPLE UNDERSTAND, APPLY, AND ENROLL FOR HEALTH COVERAGE THROUGH THE MARKETPLACE. THE CACS COMPLETED REQUIRED TRAINING, AND COMPLIED WITH PRIVACY AND SECURITY LAWS, AND OTHER PROGRAM STANDARDS. -BRIDGES TO CARE - NEARLY 1,000 CHILDREN AND MORE THAN 6,700 ADULTS IN THE CITY OF HARRISBURG ARE NOT RECEIVING ADEQUATE HEALTH CARE OR DO NOT HAVE HEALTH INSURANCE. TO ADDRESS THIS GAP IN CARE AND COVERAGE, CAPITAL BLUECROSS, HAMILTON HEALTH CENTER AND PINNACLEHEALTH HAVE PARTNERED WITH DAUPHIN COUNTY ON THIS PROGRAM, WHICH CONNECTS PEOPLE TO MUCH-NEEDED HEALTH CARE.LAUNCHED IN APRIL 2013, THE PROGRAM'S MISSION IS TO IDENTIFY, ENROLL AND COORDINATE HEALTH CARE SERVICES FOR HARRISBURG AREA CHILDREN UP TO AGE 19 WHO ARE UNINSURED OR MEDICALLY UNDERSERVED. THE PROGRAM ALSO PROVIDES FAMILY-CENTERED SUPPORT TO PARENTS OR GUARDIANS OF THESE CHILDREN. -DAUPHIN COUNTY HEALTH IMPROVEMENT PARTNERSHIP (DCHIP) - WITH A FOCUS ON CREATING A COHESIVE SYSTEM OF PUBLIC HEALTH SERVICES, WE CONVENE A TEAM OF MULTI-SECTOR, COMMUNITY-BASED PARTNERS FROM HEALTHCARE, HUMAN SERVICE, GOVERNMENT, EDUCATION, FAITH AND PAYOR COMMUNITIES. MEMBERS ARE COMMITTED TO WORKING COLLABORATIVELY TO IMPROVE HEALTH, REDUCE DISPARITIES, AND ADDRESS THE QUALITY OF LIFE OF COMMUNITY RESIDENTS.-RESOURCE EDUCATION AND COMPREHENSIVE CARE FOR HIV (REACCH) PROGRAM - WITH A FOCUS ON ACCESS TO QUALITY CARE FOR VULNERABLE MEMBERS OF THE COMMUNITY WE EMPHASIZE TREATMENT AND PREVENTION OF THE SPREAD OF HIV FOR WOMEN AND CHILDREN. REACCH INCLUDES DIAGNOSTIC, THERAPEUTIC AND SUPPORTIVE SERVICES SUCH AS EDUCATION ABOUT HIV DISEASE AND TRANSMISSION, AS WELL AS TREATMENT RECOMMENDATIONS AND HOW TO ACCESS THEM.-EAT SMART, PLAY SMART - WITH A FOCUS ON LONG RANGE SUSTAINABLE GROWTH WITHIN OUR COMMUNITIES, IT IS EVIDENT THAT THE HEALTH OF OUR CHILDREN IS A FOCAL POINT. A MULTI-STEP, LONG-TERM APPROACH TO PARTNERING WITH SCHOOLS, BUSINESSES, AND PAYORS TO EDUCATE STUDENTS AND FAMILIES ON HEALTHY FOOD CHOICES AND PHYSICAL ACTIVITY ALTERNATIVES ENSURES SUSTAINABLE BEHAVIOR CHANGE. -EMERGENCY MANAGEMENT PLAN-SOUTH CENTRAL TASK FORCE - WITH A FOCUS ON PROVIDING LEADERSHIP IN IMPROVING THE OVERALL HEALTH OF OUR COMMUNITY, OUR EMERGENCY MANAGEMENT TEAM CREATES AN ENVIRONMENT THAT SUPPORTS ACCESSIBILITY AND CONSIDERATION OF BASIC FAMILY NEEDS INCLUDING SAFETY. THE TASK FORCE COLLABORATES AND COORDINATES BOTH PUBLIC AND PRIVATE SECTOR RESOURCES FOR REGIONAL SOLUTIONS THAT PROVIDE SUPPORT TO COMMUNITIES WHEN EVENTS EXCEED THEIR CAPABILITIES.-SMILES - IN JANUARY 2013, PINNACLEHEALTH STARTED WORKING IN PARTNERSHIP WITH MEMBERS OF THE HARRISBURG AREA DENTAL SOCIETY TO PROVIDE ACCESS TO DENTAL SERVICES FOR UNINSURED AND UNDERINSURED PATIENTS WITH URGENT DENTAL NEEDS. A NETWORK OF MORE THAN FIFTY VOLUNTEER DENTISTS SPAN THE EAST AND WEST SHORES OF HARRISBURG. ONCE IT IS DETERMINED THAT A PATIENT HAS AN URGENT DENTAL NEED, HE/SHE CAN BE REFERRED TO SMILES USING THE FOLLOWING REFERRAL PROCESS. PINNACLEHEALTH'S DENTAL ACCESS COORDINATOR WILL WORK WITH THE PATIENT AND DENTIST TO SET UP AN APPOINTMENT TO ALLEVIATE THE URGENT NEED. IN 2012, PINNACLE REFERRED CLOSE TO 100 PATIENTS TO VOLUNTEER DENTISTS FOR URGENT DENTAL NEEDS.-FAITH COMMUNITY CONNECTION - A CONGREGATIONAL HEALTH NETWORK DEVELOPED AS A PATIENT NAVIGATION MODEL THAT LINKS BODY, MIND, SPIRIT AND COMMUNITY TO ADDRESS CHRONIC DISEASES THAT SUPPORTS OUTCOME BASED PLANNING, CARE COORDINATION AND FOLLOW UP OF CARE. PART VI, LINE 6: PINNACLE HEALTH HOSPITALS IS PART OF THE PINNACLE HEALTH SYSTEM, A FULLY INTEGRATED, AFFILIATED HEALTH CARE SYSTEM. THE SYSTEM IS COMPRISED OF NINE WHOLLY OWNED ENTITIES AS WELL AS A VARIETY OF AFFILIATED JOINT VENTURES. THE ORGANIZATION'S MISSION IS TO MAINTAIN AND IMPROVE THE HEALTH AND QUALITY OF LIFE FOR EVERYONE IN CENTRAL PENNSYLVANIA. PINNACLE HEALTH SYSTEM IS ENGAGED IN AND CONDUCTS CHARITABLE, EDUCATIONAL, AND SCIENTIFIC ACTIVITIES THROUGH THE SUPPORT AND BENEFIT OF PINNACLE HEALTH FOUNDATION, AND PROVIDES MANAGEMENT AND CONSULTATIVE SERVICES TO AFFILIATED ENTITIES. PINNACLE HEALTH FOUNDATION ENGAGES IN INVESTMENT AND FUNDRAISING ACTIVITIES FOR THE BENEFIT OF THE RELATED ORGANIZATIONS. PINNACLE HEALTH MEDICAL SERVICES IS PRIMARILY ENGAGED IN THE PROVISION OF PHYSICIAN SERVICES TO SUPPORT AND ENHANCE THE SERVICES WITHIN PINNACLE HEALTH HOSPITALS AND PINNACLE HEALTH SYSTEM. THE PINNACLE HEALTH CARDIOVASCULAR INSTITUTE IS ENGAGED IN PROVIDING COMPREHENSIVE CARDIAC CARE, INCLUDING LEADING EDGE TECHNOLOGICAL ADVANCES IN ORDER TO PROVIDE THE BEST CLINICAL OUTCOMES TO THE COMMUNITY. THE COMMUNITY LIFE TEAM IS ENGAGED IN PROVIDING COMMUNITY BASED, EFFICIENT AND COST EFFECTIVE MEDICAL TRANSPORT SERVICES, PRE-HOSPITAL EMERGENCY MEDICAL SERVICES FOR THE RESIDENTS AND COMMUNITIES OF THE CENTRAL PENNSYLVANIA REGION.PINNACLE HEALTH VENTURES, INC. WAS FORMED AS A RESULT OF THE ACQUISITION OF 100% OF THE STOCK OF TRISTAN ASSOCIATES ON MARCH 1, 2012 AND IS THE SOLE SHAREHOLDER OF PINNACLE HEALTH IMAGING (PHI). PHI LEASES EQUIPMENT AND SERVICES TO PINNACLE HEALTH HOSPITALS. UNITED HEALTH RISK IS A WHOLLY-OWNED, FOR PROFIT, OFFSHORE CAPTIVE INSURANCE COMPANY AND UNITED CENTRAL PENNSYLVANIA RECIPROCAL RISK RETENTION GROUP IS A WHOLLY-OWNED, FOR PROFIT, VERMONT CAPTIVE INSURANCE COMPANY. BOTH INSURANCE ENTITIES OPERATE FOR THE BENEIFIT OF PINNACLE HEALTH SYSTEM.RIVER HEALTH ACO IS AN ACCOUNTABLE CARE ORGANIZATION DEDICATED TO IMPROVING THE COST, QUALITY, ACCESS, AND PATIENT EXPERIENCE TO CARE FOR A MEDICARE POPULATION IN CENTRAL PENNSYLVANIA. PINNACLE HEALTH SYSTEM IS A 70% MAJORITY PARTNER IN THIS ENTITY.THE PINNACLE HEALTH SYSTEM AND ITS AFFILIATES ARE ACTIVELY INVOLVED IN THE CENTRAL PENNSYLVANIA REGION THROUGH VARIOUS CHARITY AND COMMUNITY BENEFIT ACTIVITIES. THE OTHER ENTITIES WITHIN THE SYSTEM, NOT INCLUDING THE HOSPITAL, PROVIDED $349,714 OF CHARITY CARE RECORDED AT CHARGES. THE SYSTEM ENTITIES ARE ALSO ACTIVELY ENGAGED IN A VARIETY OF COMMUNITY BENEFIT ACTIVITIES. THE FOLLOWING LISTS THE VARIETY OF COMMUNITY BENEFITS PERFORMED WITHIN THE SYSTEM, THAT HAD THEY BEEN PERFORMED AT THE HOSPITAL LEVEL, WOULD HAVE BEEN INCLUDABLE ON SCHEDULE H. -PINNACLE HEALTH SYSTEM - $1,096,183 IN COMMUNITY HEALTH IMPROVEMENT SERVICES, HEALTH PROFESSIONS EDUCATION, COMMUNITY BENEFIT OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS. -PINNACLE HEALTH MEDICAL SERVICES - $892,302 IN COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BASED CLINICAL SERVICES AND HEALTH CARE SUPPORT SERVICES -COMMUNITY LIFE TEAM - $83,880 IN SUBSIDIZED HEALTH SERVICES-PINNACLE HEALTH FOUNDATION - $775,891 IN COMMUNITY BENEFIT OPERATIONS AND FINANCIAL CONTRIBUTIONS.WERE THE ABOVE COMMUNITY BENEFIT EXPENSES OF $3.2 MILLION INCLUDED IN THE HOSPITAL COMMUNITY BENEFIT EXPENSES OF $46.7 MILLION, THE PERCENTAGE OF COMMUNITY BENEFIT EXPENSE TO TOTAL EXPENSE WOULD HAVE BEEN 7.51%. PART VI, LINE 7, REPORTS FILED WITH STATES PA X X 1 1 0 1 0 0 0 0 0 1 0 FELIX GUTIERREZ MD DIRECTOR 0 398423 0 100787 0 15103 0 26400 0 27222 0 567935 0 0 MICHAEL A YOUNG PRESIDENT/CEO 0 729377 0 361078 0 148292 0 12750 0 12824 0 1264321 0 0 KEVIN KELLY MD DIRECTOR 0 142501 0 21493 0 77295 0 14179 0 8616 0 264084 0 0 CHRISTOPHER P MARKLEY ESQ SEC'Y/SR VP STAT SVCC/GEN COUNSEL 0 306071 0 112249 0 57694 0 15200 0 14749 0 505963 0 0 WILLIAM H PUGH TREASURER/SR VP CORP FIN/CFO 0 487274 0 190935 0 71754 0 15200 0 7890 0 773053 0 0 NANCY HAMMONDS ASST. TREASURER/CFO 0 157488 0 51358 0 17944 0 24950 0 16038 0 267778 0 0 PHILIP GUARNESCHELLI SR VICE PRESIDENT/COO 0 458225 0 171873 0 127949 0 15300 0 19318 0 792665 0 0 JOHN DELORENZO ASSISTANT SECRETARY 0 142077 0 12782 0 0 0 602 0 17267 0 172728 0 0 EDWARD HILDREW ED PHYSICIAN 247411 0 81390 0 1337 0 35700 0 7436 0 373274 0 0 0 FRANK DITRAGLIA ED PHYSICIAN 454200 0 0 0 0 0 5100 0 0 0 459300 0 0 0 R SCOTT RANKIN ED PHYSICIAN 247411 0 231282 0 1398 0 15300 0 12500 0 507891 0 0 0 HARRY MATTA ER PHYSICIAN 247411 0 21849 0 156728 0 37350 0 16950 0 480288 0 0 0 JED SPRUCE SEITZINGER ER PHYSICIAN 266947 0 101998 0 0 0 15300 0 18449 0 402694 0 0 0 PART I, LINE 1A THE ORGANIZATION PAYS FOR THE CEO'S CLUB DUES, WHICH ARE REPORTABLE AS TAXABLE COMPENSATION FOR THE CEO. THE CEO'S SPOUSE ACCOMPANIED THE CEO ON INFREQUENT TRIPS WHERE THE PRESENCE OF THE SPOUSE WAS EXPECTED. RELATED COSTS WERE MINIMAL AND WERE NOT INCLUDED IN THE CEO'S COMPENSATION. PART I, LINE 1B THERE IS A WRITTEN POLICY REGARDING THE PAYMENT OF CLUB DUES, HOWEVER, THERE IS NO WRITTEN POLICY REGARDING COMPANION TRAVEL. THE INFREQUENCY OF THE TRAVEL AND THE DE MINIMIS COSTS ASSOCIATED WITH THE ACTIVITY WERE DEEMED NOT TO RISE TO THE LEVEL WHERE A WRITTEN POLICY WAS CONSIDERED NECESSARY. PART I, LINE 3 PINNACLE HEALTH HOSPITALS RELIES ON PINNACLE HEALTH SYSTEM, A RELATED ORGANIZATION, TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO. METHODS USED TO ESTABLISH COMPENSATION BY THE RELATED ORGANIZATION INCLUDE: * COMPENSATION COMMITTEE * INDEPENDENT COMPENSATION CONSULTANT * COMPENSATION SURVEY OR STUDY * APPROVAL BY THE COMPENSATION COMMITTEE OF THE BOARD PART I, LINE 4B DR. FELIX GUTIERREZ IS A MEMBER OF THE BOARD OF DIRECTORS AND IS EMPLOYED AS A CARDIOLOGIST IN A RELATED ENTITY. HE WAS COVERED BY A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN IN CALENDAR YEAR 2013 AT A TOTAL COST OF $16,200. MICHAEL YOUNG PARTICIPATES IN A SPLIT INTEREST LIFE INSURANCE POLICY WHEREBY THE ORGANIZATION PAYS THE PREMIUMS AND MR. YOUNG REPORTS THE PREMIUMS AS OTHER REPORTABLE COMPENSATION. UPON MR. YOUNG'S DEATH, THE ORGANIZATION WILL RECOVER ITS PREMIUMS BEFORE ANY PROCEEDS ARE RELEASED TO THE BENEFICIARIES. PART I, LINE 7 THE COMPENSATION COMMITTEE OF THE BOARD WITH ASSISTANCE FROM AN INDEPENDENT OUTSIDE ADVISOR ESTABLISHES A COMPENSATION PHILOSOPHY TO COMPENSATE LEADERS OF THE ORGANIZATION AT THE MARKET MEDIAN WITH AN INCENTIVE OPPORTUNITY TO REACH THE 75TH PERECENTILE OF THE MARKET FOR THEIR POSITION. THE INCENTIVE OPPORTUNITY IS DIVIDED BETWEEN PERSONAL GOALS AND SYSTEM LEVEL GOALS. ALL GOALS ARE MEASURABLE AND ARE DESIGNED TO IMPROVE QUALITY OF CARE, PATIENT SAFETY, PATIENT EXPERIENCE, AND MANAGEMENT OF RESOURCES. PERFORMANCE IS REWARDED AT THREE LEVELS; THRESHOLD (IMPROVEMENT OVER THE BASELINE), TARGET (SIGNIFICANT IMPROVEMENT OVER THE PRIOR YEAR) AND OPTIMUM (STRETCH). A DAUPHIN COUNTY GENERAL AUTHORITY 232336949 23825ECL6 2009-06-24 187538449 REFUND SERIES 2004, 2005 & 2007, SWAP TERMINATION, CAPITAL PROJECTS 0 0 0 B DAUPHIN COUNTY GENERAL AUTHORITY 232336949 23825ECY8 2011-06-28 100000000 REFUND 2009B NOTES AND CAPITAL PROJECTS 0 0 0 C DAUPHIN COUNTY GENERAL AUTHORITY 232336949 23825EDB7 2012-08-07 135249990 CAPITAL PROJECTS 0 0 0 A 19641212 187538449 14590708 2962259 6775515 168307000 2009 1 0 1 1 B 4175000 100000000 279272 27640702 70000000 2012 1 0 1 1 C 135249990 10851923 1512711 122255668 668893 2014 0 0 0 1 A 0 0 1 1 0 0.00000 0.00680 0.00680 0 0 1 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 1 0 0 0 1 C 0 0 0 1 0 0 0 0 1 A 1 B 1 C 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: DAUPHIN COUNTY GENERAL AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 06/24/2014 ISSUER NAME: DAUPHIN COUNTY GENERAL AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 07/01/2013 ISSUER NAME: DAUPHIN COUNTY GENERAL AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 09/30/2014 FORM 990, PART III, LINE 2 UTILIZING PROCEEDS FROM THE SERIES A REVENUE BONDS OF 2012, PINNACLEHEALTH HOSPITAL UNDERTOOK A PROJECT CONSISTING OF THE CONSTRUCTION, EQUIPPING, AND DEVELOPMENT OF A NEW APPROXIMATELY 200,000 SQUARE FOOT, 108 BED PRIVATE ROOM ACUTE CARE HOSPITAL ON THE FREDRICKSON CAMPUS LOCATED IN HAMPDEN TOWNSHIP PENNSYLVANIA. KNOWN AS THE WEST SHORE HOSPITAL, THIS FACILITY WAS COMPLETED AND OPENED IN MAY 2014 PROVIDING CONVENIENT ACCESS TO HEALTHCARE FOR THE RESIDENTS IN AND AROUND CUMBERLAND AND PERRY COUNTIES. FORM 990, PART V, LINE 1: PINNACLE HEALTH SYSTEM, THE PARENT ENTITY OF A GROUP OF TAX-EXEMPT ORGANIZATIONS, IS THE COMMON REPORTING AGENT FOR THE GROUP AND FILES ALL 1099 FORMS FOR PINNACLE HEALTH HOSPITALS. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS PINNACLE HEALTH SYSTEM, A NONPROFIT CORPORATION (EIN 25-1778658). FORM 990, PART VI, SECTION A, LINE 7A AS SOLE MEMBER OF THE ORGANIZATION, PINNACLE HEALTH SYSTEM SHALL ELECT THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING POWERS ARE RESERVED TO THE SOLE MEMBER, PINNACLE HEALTH SYSTEM: TO APPROVE AND AUTHORIZE: ANNUAL OPERATING AND CAPITAL BUDGETS STRATEGIC PLANS BORROWINGS OR EXTENSIONS OF CREDIT EQUAL TO OR GREATER THAN ONE MILLION DOLLARS VOLUNTARY DISSOLUTION, MERGER, OR CONSOLIDATION THE SALE, PLEDGING, LEASING OR TRANSFER OF ASSETS IN EXCESS OF $500,000 THE CREATION OR ACQUISITION OF ANY SUBSIDIARY OR AFFILIATE ADDITION OR DELETION OF CLINICAL CENTERS OF EMPHASIS ANY CONTRACT WITH AN UNRELATED PARTY FOR MANAGEMENT OF SUBSTANTIALLY ALL ACTIVITIES INVESTMENT POLICIES UNBUDGETED CAPITAL EXPENDITURES TO SELECT THE CERTIFIED PUBLIC ACCOUNTANTS TO ESTABLISH AN OBLIGATED GROUP FOR FINANCING PURPOSES TO ADOPT EMPLOYEE BENEFIT PLANS FORM 990, PART VI, SECTION B, LINE 11 THE AUTHORITY AND RESPONSIBILITY FOR REVIEW OF THE FORM 990 FOR PINNACLE HEALTH SYSTEM AND SUBSIDIARIES IS DELEGATED TO THE FINANCE AND AUDIT COMMITTEE OF THE PINNACLE HEALTH SYSTEM BOARD. IN ORDER TO ACCOMPLISH THIS, ALL MEMBERS OF THE FINANCE AND AUDIT COMMITTEE ARE PROVIDED WITH A REASONABLE OPPORTUNITY TO REVIEW AND COMMENT TO EXECUTIVE LEADERSHIP ON THE IRS FORMS 990 OF THE PINNACLE HEALTH SYSTEM AND ITS SUBSIDIARIES, INCLUDING PINNACLE HEALTH HOSPITALS, PINNACLE HEALTH MEDICAL SERVICES, PINNACLE HEALTH FOUNDATION, AND COMMUNITY LIFE TEAM BEFORE THE RETURNS ARE FILED WITH THE INTERNAL REVENUE SERVICE. IN ADDITION, EACH MEMBER OF EACH RESPECTIVE BOARD OF DIRECTORS WILL BE GIVEN ACCESS TO VIEW THEIR INDIVIDUAL FORM 990 VIA A SHARED, PASSWORD-PROTECTED WEBSITE. FORM 990, PART VI, SECTION B, LINE 12C IN THE PERFORMANCE OF THEIR DUTIES TO PINNACLE HEALTH SYSTEM AND SUBSIDIARIES (COLLECTIVELY REFERRED TO AS "PHS"), COVERED PERSONS SHALL SEEK TO ACT IN THE BEST INTERESTS OF PHS, AND SHALL EXERCISE GOOD FAITH, LOYALTY, DILIGENCE AND HONESTY. A COVERED PERSON IS ANY INDIVIDUAL WHO SERVES IN A FIDUCIARY CAPACITY TO, OR WHO HAS LEGAL AUTHORITY TO REPRESENT OR OBLIGATE, THE PINNACLE HEALTH SYSTEM OR ANY OF ITS AFFILIATED ORGANIZATIONS INCLUDING, BUT NOT LIMITED TO, DIRECTORS, OFFICERS, EMPLOYEES, AND AGENTS. COVERED PERSONS ALSO INCLUDE A) IMMEDIATE FAMILIES (SPOUSES, CHILDREN, SIBLINGS, PARENTS, OR SPOUSE'S PARENTS), B) ANY ORGANIZATION IN WHICH THEY OR THEIR IMMEDIATE FAMILIES DIRECTLY OR INDIRECTLY I) HAVE A MATERIAL FINANCIAL OR BENEFICIAL INTEREST, OR II) SERVE AS A DIRECTOR, OFFICER, EMPLOYEE, AGENT, ATTORNEY OR SIMILAR CAPACITY. A COVERED PERSON SHALL DISCLOSE ANY BUSINESS OR PERSONAL INTERESTS OR RELATIONSHIPS WHICH MAY BE IN CONFLICT WITH THE INTERESTS OF PHS, INCLUDING, BUT NOT LIMITED TO (A) ENGAGING IN OR SEEKING TO BE ENGAGED IN (I) THE DELIVERY OF HEALTH CARE SERVICES OR (II) THE DELIVERY OF GOODS OR SERVICES TO PHS, OR (B) ANY TRANSACTION OR ARRANGEMENT WITH PHS WHICH WOULD RESULT IN BENEFIT TO COVERED PERSONS. THE GOVERNANCE COMMITTEE OF THE PHS BOARD REVIEWS ALL CONFLICT OF INTEREST STATEMENTS AND DETERMINES WHETHER EACH DIRECTOR ON THE BOARD IS INDEPENDENT. COVERED PERSONS WHO ARE DIRECTORS MUST COMPLY WITH THE PINNACLE HEALTH SYSTEM GUIDELINES FOR DETERMINING DIRECTOR INDEPENDENCE AND APPLYING DIRECTOR INDEPENDENCE REQUIREMENTS. COVERED PERSONS WITH A CONFLICT OF INTEREST SHALL NOT VOTE ON THE MATTER, AND THE PHS BOARD OR COMMITTEE MUST APPROVE, AUTHORIZE, OR RATIFY THE TRANSACTION OR ARRANGEMENT BY A MAJORITY VOTE OF THE NON-INTERESTED DIRECTORS OR COMMITTEE MEMBERS PRESENT AT A MEETING THAT HAS A QUORUM. VIOLATIONS OF THIS STATEMENT OF POLICY MAY SUBJECT COVERED PERSONS TO APPROPRIATE SANCTIONS, INCLUDING REMOVAL FROM THEIR POSITIONS WITH PHS. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE OF THE PINNACLE HEALTH SYSTEM ("PHS") BOARD OF DIRECTORS HAS THE AUTHORITY TO DEVELOP AND MAINTAIN EXECUTIVE AND PHYSICIAN COMPENSATION TO BE APPROVED BY THE PINNACLE HEALTH SYSTEM BOARD. THE COMPENSATION COMMITTEE WILL FOLLOW A DILIGENT PROCESS THAT MEETS REGULATORY REQUIREMENTS FOR A REBUTTABLE PRESUMPTION OF REASONABLENESS AND PROMOTES EFFECTIVE GOVERNANCE OF EXECUTIVE COMPENSATION, CONSISTENT WITH THE PHS COMPENSATION PHILOSOPHY. 1. FOLLOW A PROCESS THAT ESTABLISHES AND MAINTAINS A REBUTTABLE PRESUMPTION OF REASONABLENESS FOR ALL EXECUTIVES AND PHYSICIANS POTENTIALLY SUBJECT TO INTERMEDIATE SANCTIONS. 2. PREPARE MINUTES FOR EACH MEETING TO RECORD THE TERMS OF THE COMMITTEE'S DECISIONS AND THE PROCESS FOLLOWED IN REACHING THOSE DECISIONS. THESE MINUTES MUST INCLUDE INDICATIONS THAT THE COMMITTEE IS FOLLOWING GOOD PRACTICES IN DEALING WITH CONFLICTS OF INTEREST AND IN OBTAINING AND RELYING ON APPROPRIATE COMPARABILITY DATA ON TOTAL COMPENSATION. 3. SELECT AND DIRECTLY ENGAGE AND SUPERVISE ANY CONSULTANT HIRED BY PHS TO ADVISE THE COMMITTEE ON EXECUTIVE AND PHYSICIAN COMPENSATION. 4. PERIODICALLY EVALUATE THE APPROPRIATENESS OF THIS CHARTER AND THE EFFECTIVENESS OF THE PROCESS THE COMMITTEE USES IN GOVERNING EXECUTIVE AND PHYSICIAN COMPENSATION AND REPORT THIS EVALUATION TO THE BOARD. 5. PROVIDE THE BOARD WITH AN ANNUAL REPORT ON THE COMMITTEE'S ACTIONS. 6. MONITOR CHANGES IN LAWS AND REGULATIONS PERTAINING TO EXECUTIVE COMPENSATION AND BENEFITS TO SEE THAT PHS COMPLIES WITH THEM. 7. SEEK OUTSIDE REVIEW OF COMMITTEE OPERATIONS TO ENSURE COMPLIANCE WITH THE IRS REBUTTABLE PRESUMPTION OF REASONABLENESS. 8. REVIEW ACTUAL EXECUTIVE COMPENSATION AND BENEFITS PROVIDED TO CONFIRM CONSISTENCY WITH COMPENSATION AND BENEFITS APPROVED BY THE COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE FOR PUBLIC INSPECTION. THE ORGANIZATION INCLUDES A COPY OF ITS FINANCIAL STATEMENTS WITH THE STATE REGISTRATION FILED WITH THE PENNSYLVANIA DEPARTMENT OF STATE, BUREAU OF CHARITABLE ORGANIZATIONS. THESE DOCUMENTS ARE A MATTER OF PUBLIC RECORD AND CAN BE VIEWED AT THE BUREAU OFFICE. FORM 990, PART IX, LINE 11G PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 2,654,023. MANAGEMENT AND GENERAL EXPENSES 1,307,205. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,961,228. OUTSOURCING: PROGRAM SERVICE EXPENSES 25,282,517. MANAGEMENT AND GENERAL EXPENSES 5,930,467. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 31,212,984. CLEANING SERVICES: PROGRAM SERVICE EXPENSES 6,820,232. MANAGEMENT AND GENERAL EXPENSES 1,497,124. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,317,356. LAB FEES: PROGRAM SERVICE EXPENSES 3,256,765. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,256,765. RESIDENT ROTATION: PROGRAM SERVICE EXPENSES 1,201,526. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,201,526. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 20,342,331. MANAGEMENT AND GENERAL EXPENSES 7,564,872. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 27,907,203. FORM 990, PART XI, LINE 9: PENSION SETTLEMENT LOSS -44,913,170. CHANGE IN ADDITIONAL MINIMUM PENSION LIABILITY 43,913,212. FINANCING FRAMEWORK TRANSFERS -22,503,724. INTERCOMPANY TRANFERS - TEMP RESTRICTED 2,230,340. PINNACLE HEALTH EMERGENCY DEPARTMENT SERVICES LLC 409 SOUTH SECOND STREET PO BOX 8700 HARRISBURG PA 17105 861057582 MEDICAL EMERGENCY SERVICES PA -6912825 1656180 PINNACLE HEALTH HOSPITALS PINNACLE HEALTH HOSPITALISTS SERVICES LLC 409 SOUTH SECOND STREET PO BOX 8700 HARRISBURG PA 17105 HOSPITALISTS SERVICES PA 4814076 1085978 PINNACLE HEALTH HOSPITALS PINNACLE HEALTH SYSTEM 409 SOUTH SECOND STREET PO BOX 8700 HARRISBURG PA 171058700 251778658 MANAGEMENT AND CONSULTATIVE SERVICES FOR RELATED EXEMPT ORGS PA 501(C)(3) LINE 11C, III-FI N/A 0 PINNACLE HEALTH MEDICAL SERVICES 409 SOUTH SECOND STREET PO BOX 8700 HARRISBURG PA 171058700 251709054 PHYSICIAN SERVICES PA 501(C)(3) LINE 3 PINNACLE HEALTH SYSTEM 0 PINNACLE HEALTH FOUNDATION 409 SOUTH SECOND STREET PO BOX 8700 HARRISBURG PA 171058700 222691718 INVESTMENT AND FUNDRAISING ACTIVITIES FOR RELATED TAX-EXEMPT ORGANIZATIONS PA 501(C)(3) LINE 11B, II PINNACLE HEALTH SYSTEM 0 COMMUNITY LIFE TEAM 409 SOUTH SECOND STREET PO BOX 8700 HARRISBURG PA 171058700 231890444 COMMUNITY EMERGENCY MANAGEMENT SERVICE AND MEDICAL TRANSPORT PROVIDER PA 501(C)(3) LINE 9 PINNACLE HEALTH SYSTEM 0 WEST SHORE SURGERY CENTER LTD 409 SOUTH SECOND STREET PO BOX 8700 HARRISBURG PA 171058700 251821415 SURGICAL CARE - MEDICAL SERVICES PA SEE PART VII - SUPPLEMENTAL INFORMATION RELATED 1117416 1101889 0 0 0.49000 RIVER HEALTH ACO LLC 409 SOUTH SECOND STREET PO BOX 8700 HARRISBURG PA 171058700 462567488 MEDICAL SERVICES PA N/A SUSQUEHANNA VALLEY SURGICAL CENTER 409 SOUTH SECOND STREET PO BOX 8700 HARRISBURG PA 171058700 251847818 SURGICAL CARE - MEDICAL SERVICES PA N/A UNITED CENTRAL PA RISK RETENTION GROUP 76 ST PAUL STREET SUITE 500 BULINGTON VT 054014477 134224033 CAPTIVE INSURANCE VT N/A C 0 UNITED HEALTH RISK LTD PO BOX 2450 HAMILTON HM JX BD CAPTIVE INSURANCE BD N/A C 0 PINNACLE HEALTH CARDIOVASCULAR INSTITUTE PO BOX 8700 HARRISBURG PA 17105 320321362 PHYSICIAN SERVICES PA N/A C 0 PINNACLE HEALTH MEDICAL GROUP PO BOX 8700 HARRISBURG PA 17105 800771040 PHYSICIAN SERVICES PA N/A C 0 PINNACLE HEALTH VENTURES INC PO BOX 8700 HARRISBURG PA 17105 611677624 HOLDING COMPANY PA N/A C 0 PINNACLE HEALTH IMAGING INC PO BOX 8700 HARRISBURG PA 17105 231718571 IMAGING SERVICES PA N/A C 0 1 1 1 1 0 0 0 0 0 1 0 1 1 1 1 1 1 1 1 WEST SHORE SURGERY CENTER LTD A 552532 FMV WEST SHORE SURGERY CENTER LTD R 749372 FMV FORM 990, SCHEDULE R, PART III WEST SHORE SURGERY CENTER IS OWNED BY THE FOLLOWING RELATED ENTITIES: PINNACLE HEALTH HOSPITALS - 49% PINNACLE HEALTH MEDICAL SERVICES - 2% THE REMAINING 49% IS OWNED BY A NUMBER OF INDIVIDUAL PHYSICIANS. PINNACLE HEALTH HOSPITALS' 49% OWNERSHIP PERCENTAGE DOES NOT RESULT IN ANY DIRECT CONTROLLING ENTITY; HOWEVER, COMBINED WITH THE OWNERSHIP PERCENTAGE OF PINNACLE HEALTH MEDICAL SERVICES, A RELATED ENTITY, THERE IS MORE THAN 50% CONTROL AMONG THE RELATED GROUP.