2014-05-14T07:13:42-05:00 2013-06-30 232932984 PARENTEBEARD LLC SUITE 200 221 W PHILADELPHIA STREET YORK PA 174012993 990 2012-07-01 251778644 PINNACLE HEALTH HOSPITALS PINN 7172318245 409 SOUTH SECOND ST PO BOX 8700 HARRISBURG PA 171058700 WILLIAM H PUGH 7172318245 2014-05-13 1 JULIUS C GREEN CPA JD P00350393 7178467000 2012 2015-11-30 17:44:51Z WILLIAM H PUGH 409 SOUTH SECOND ST PO BOX 8700 HARRISBURG PA 171058700 931151154 0 X WWW.PINNACLEHEALTH.ORG X 1996 PA INPATIENT AND OUTPATIENT HEALTHCARE FOR CITIZENS OF THE LOCAL & SURROUNDING COMMUNITIES. 20 15 4916 412 3402930 0 4563329 10104993 685536106 712549245 4751454 10203668 2979262 898896 697830151 733756802 0 0 0 0 277613958 289037801 0 0 0 338070547 339159493 615684505 628197294 82145646 105559508 674650752 857817222 503128863 572120699 171521889 285696523 X PROVIDING BOTH INPATIENT AND OUTPATIENT HEALTHCARE SERVICES ON A NON-PROFIT BASIS FOR CITIZENS OF THE SURROUNDING COMMUNITY. 0 0 502907253 702407189 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 IS 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 SCREENINGBODY COMPOSITION SCREENINGPROSTATE SCREENINGINFANT DEVELOPMENT SCREENINGSSPEECH AND HEARING SCREENINGSDEPRESSION AND ANXIETY SCREENINGSBONE DENSITY SCREENINGSNUTRITION THERAPY EDUCATION PROGRAMSLEAD POISONING SCREENINGS PINNACLE HEALTH-FOX CHASE REGIONAL 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.TOXICOLOGY CENTER IS A NEEDED COMMUNITY SERVICE THAT PROVIDES SPECIALIZED CARE AND RELEVANT TREATMENT TO ADULTS AND ADOLESCENTS AS A RESULT OF OVERDOSE OR ACCIDENTAL POISONING. THE TOXICOLOGY CENTER FILLS A CRITICAL PUBLIC HEALTH GAP, IS A SIGNIFICANT RESOURCE TO THE REGION AND ACROSS THE STATE AND DEDICATED TO THE EMERGENT NEEDS OF UNINTENTIONAL INJURY AND OPERATES AT A LOSS. 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 OF 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. 14981097 10245079 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 TWO EMERGENCY DEPARTMENTS, (HARRISBURG HOSPITAL AND COMMUNITY GENERAL 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 2013, PINNACLE HEALTH HOSPITALS TREATED 119,775 PATIENTS IN ITS TWO EMERGENCY DEPARTMENTS THIS WAS AN INCREASE OF 11.3% OVER THE PRIOR YEAR AND WAS MADE POSSIBLE DUE TO THE COMPLETION OF THE EXPANSION OF THE EMERGENCY DEPARTMENT AT THE HARRISBURG HOSPITAL SITE. 517888350 1 1 0 0 0 0 0 0 0 0 1 0 0 0 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 1 0 0 0 0 1 1 1 1 0 0 1 X 239 0 1 4916 1 1 1 0 0 0 0 0 0 0 0 0 X 20 15 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 171058700 ROBERT L LYON 0.60 0.60 X 0 0 0 GEORGE F GRODE 0.70 0.70 X X 0 0 0 JOHN O CAMPBELL 0.50 0.50 X 0 0 0 FELIX GUTIERREZ MD 0.20 39.80 X 0 559968 26948 M RICHARD KLEIMAN 0.30 X 0 0 0 DEBORAH S MILLER 0.40 X 0 0 0 CLARENCE E ASBURY 0.60 X X 0 0 0 DENNIS WALSH 0.30 X 0 0 0 BONY R DAWOOD 0.50 X 0 0 0 GREGORY CAVOLI 0.20 X 0 0 0 STEVEN C KUSIC 0.60 X 0 0 0 KENNETH OKEN MD 0.60 X 0 0 0 MICHAEL L FERNANDEZ MD 0.30 X 0 0 0 JOHN C HICKEY 0.60 X 0 0 0 CAROLYN KREAMER PHD 0.30 X 0 0 0 MICHAEL A YOUNG 11.00 29.30 X X 0 1166902 24982 JOHN CAVANAUGH PHD 0.30 X 0 0 0 KEVIN KELLY MD 0.30 39.70 X 0 146608 13252 ROGER LEVIN MD 0.50 X 0 0 0 TINA NIXON 0.40 X 0 0 0 CYNTHIA TOLSMA 0.50 X 0 0 0 E GERALD WOODWARD MD 0.30 X 0 0 0 CHRISTOPHER P MARKLEY ESQ 24.00 11.60 X 0 577350 29280 WILLIAM H PUGH 24.00 12.40 X 0 707232 23111 NANCY HAMMONDS 24.00 11.80 X 0 203233 42443 PHILIP GUARNESCHELLI 24.00 16.10 X 0 845342 33480 RICHARD SENECA EST 8.60 8.60 X 0 0 295433 EDWARD HILDREW 40.00 X 376252 0 41950 JULIAN GUTIERREZ 40.00 X 368264 0 15451 FRANK DITRAGLIA 40.00 X 468407 0 5000 R SCOTT RANKIN 40.00 X 375000 0 26636 CHRISTIAN CAICEDO 39.80 0.20 X 352830 0 32290 ROGER LONGENDERFERMD 0.00 X 0 313740 2082 1940753 4520375 612338 166 1 1 0 SIEMENS MEDICAL SOLUTIONS USA INC PO BOX 640401 PITTSBURGH PA 15264 SOFTWARE SUPPORT SVCS 16644671 SODEXO PO BOX 905374 CHARLOTTE NC 28290 FOOD SERVICES 16435411 CPTA INC 205 SOUTH FRONT STREET HARRISBURG PA 17104 TRANSPLANT SERVICES 2601193 MILTON HERSHEY MEDICAL CENTER 500 UNIVERSITY DR HERSHEY PA 17033 MEDICAL SERVICES 1946067 QUEST DIAGNOSTICS NICHOLS INSTITUTE 12436 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 LABORATORY SERVICES 1263146 53 28546 327921 3012631 6735895 10104993 PATIENT REVENUE, NET 621500 708236066 704852972 3383094 CONTRACTED MEDICAL SERVICES 621990 3296261 3296261 MEDICAL EDUCATION 900099 507153 507153 COMMUNITY PROGRAM INCOME 900099 168168 168168 MISC INPATIENT/OUTPATIENT 621990 92185 92185 249412 249412 712549245 7229202 7229202 8396113 10369770 -1973657 -1973657 19836 -1993493 189723801 275247 185214648 1809934 4509153 -1534687 2974466 2974466 HITECH REPORTING INCENTIVES 900099 1500000 1500000 VENDOR REBATE INCOME 900099 281414 281414 MSO CONTRACT FEES 900099 248909 248909 842230 842230 2872553 733756802 709166151 3402930 11082728 X 226565757 206086494 20479263 16058934 14375588 1683346 29646638 27127702 2518936 16766472 11927672 4838800 29562047 4645881 24916166 290801 144121 146680 17423 7957 9466 104912 104912 74346912 56176212 18170700 2401841 308637 2093204 7871509 4633740 3237769 6742786 4241150 2501636 37704164 22815047 14889117 426738 348295 78443 1199726 1008963 190763 15592330 11304996 4287334 41171797 33140544 8031253 6385456 4917199 1468257 MEDICAL SUPPLIES 113944307 113770305 174002 TEMP. RESTRICTED DONATI 796124 597093 199031 DUES AND SUBSCRIPTIONS 253320 103209 150111 SAFETY COMPLIANCE 16394 14464 1930 330906 193081 137825 628197294 517888350 110308944 0 5278 5134 713872 1043778 79245851 85037195 2521564 2390946 11552138 11425874 8606302 10525395 829563991 453386238 332161608 376177753 205205880 326855888 11110622 12289138 330269 1853669 23197368 30212452 674650752 857817222 166859872 143120451 144720 21823 274579531 404515661 43255812 13075340 18288928 11387424 503128863 572120699 X 144524071 253919159 8801077 12153612 18196741 19623752 171521889 285696523 674650752 857817222 X 105559508 4649073 3966053 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 12757949 12757949 465618536 248502001 217116535 15091492 8243088 6848404 235175981 172028794 63147187 100920033 24612355 76307678 376177753 ADVANCES FROM THIRD-PARTY PAYORS 3809400 DUE TO THIRD PARTY PAYORS 1837083 ACCRUED LONG-TERM SWAP CONTRACT 5740941 11387424 X 752636786 4649073 3966053 8615126 744021660 104912 -10369770 -10264858 733756802 638462152 10369770 10369770 628092382 104912 104912 628197294 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: 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: INTERCOMPANY TRANSFERS - UNRESTRICTED -28,989,237. CHANGE IN ADDITIONAL PENSION LIABILITY 34,439,880. INTERCOMPANY TRANSFERS - TEMP RESTRICTED -1,484,590. PART XI, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT INCOME FROM RESTRICTED ASSETS NET REALIZED GAIN/LOSS FROM SALE OF RESTRICTED INVESTMENTS RENTAL EXPENSES SHOWN NET OF RENTAL INCOME -10,369,770. UNRESTRICTED CONTRIBUTIONS FROM PINNACLE HEALTH FOUNDATION ADDITIONAL GAINS PERMANENT RESTRICTED FUNDS PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES SHOWN NET OF RENTAL INCOME 10,369,770. 1 1 X 1 X 250.000000000000 1 X 1 1 1 0 1 1 7893646 7893646 0.01260 66634498 47530111 19104387 0.03040 74528144 47530111 26998033 0.04300 4040272 14440 4025832 0.00640 15295990 7087893 8208097 0.01310 4445774 4445774 0.00710 23782036 7102333 16679703 0.02660 98310180 54632444 43677736 0.06960 12182 44178 44178 0.00010 450 12444 12444 0.00000 1250 1149 1149 0.00000 107 9865 9865 0.00000 13989 67636 67636 0.00010 1 14197757 4645239 130528586 127838514 2690072 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 2 1 PINNACLE HEALTH HOSPITALS - HARRISBURG

111 SOUTH FRONT STREET HARRISBURG PA 17101

WWW.PINNACLEHEALTH.ORG X X X X X 2 PINNACLE HEALTH HOSPITALS - CGOH

4300 LONDONDERRY ROAD HARRISBURG PA 17109

WWW.PINNACLEHEALTH.ORG X X X X X PINNACLE HEALTH HOSPITALS - HARRISBURG 1 1 X X X X X X X X 12 1 1 1 X 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 X 1 X 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 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 X 1 X X X X X 1 X 0 0 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, L7 COL(F): BAD DEBT EXPENSE OF $36,165,106 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: 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:CONGREGATIONAL HEALTH NETWORK (CHN)PINNACLEHEALTH SYSTEM KNOWS THAT 70% OF OUR PATIENTS BELONG TO A CONGREGATION IN CENTRAL PENNSYLVANIA. THE CHN IS A PARTNERSHIP BETWEEN CONGREGATIONS, THE HEALTHCARE SYSTEM AND THE COMMUNITY. BY NETWORKING WITH THESE PARTNERS, THE CHN WORKS TO IMPROVE THE HEALTH OF ALL IN OUR REGION. CONGREGATIONS PARTNER WITH PINNACLEHEALTH SYSTEM AND OTHERS TO PROVIDE A NETWORK OF HEALTH SUPPORT. AS A MEMBER OF A CONGREGATION, AND AS A MEMBER OF THE CONGREGATIONAL HEALTH NETWORK (CHN), INDIVIDUALS HAVE ACCESS TO A WEALTH OF SUPPORT ON ISSUES SUCH AS PREVENTIVE MEDICINE AND FOLLOW-UP CARE. THE CHN 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) IN 2009, PINNACLEHEALTH LAUNCHED THE KEYSTONE COMMUNITY CARE CONTINUUM (KCCC), A COLLABORATION BETWEEN PINNACLEHEALTH AND 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 $75,000 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 WILL BE 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 2013, 782 CHILDREN WERE SERVED ACROSS 25 COUNTIES IN THE CENTRAL PENNSYLVANIA REGION. WE SERVED APPROXIMATELY 450 NON-OFFENDING CAREGIVERS. OUR MAIN SERVICE AREAS ARE DAUPHIN, CUMBERLAND, PERRY, LEBANON, SCHUYLKILL, MIFFLIN, AND JUNIATA COUNTIES.OVER THIS PAST YEAR, THE PINNACLEHEALTH CHILDHOOD LEAD PREVENTION PROGRAM SCREENED 5271 CHILDREN FOR LEAD POISONING OF WHICH 209 OF THESE CHILDREN WERE DETERMINED TO BE LEAD POISONED. THAT RESULT CALCULATES TO APPROXIMATELY 4% OF THE TOTAL NUMBER TESTED. IF PINNACLEHEALTH DID NOT TEST THESE CHILDREN AT HEAD STARTS, WIC'S, DAY CARES, AND HOME VISITS, THAT WOULD EQUATE TO 209 CHILDREN WHO WOULD MOST LIKELY GO UNDETECTED FOR LEAD POISONING. APPROXIMATELY 90% OF ALL THE CHILDREN WE TEST FOR LEAD ARE MEDICAL ASSISTANCE RECIPIENTS. WE ALSO TESTED 270 PREGNANT WOMEN FOR LEAD POISONING.PINNACLEHEALTH SERVES THE HIV/AIDS POPULATION THROUGH PINNACLE'S RESOURCE EDUCATION AND COMPREHENSIVE CARE FOR HIV (REACCH) CLINIC. IN CALENDAR YEAR 2013, 96% OF 482 CLIENTS WHO RECEIVED A RYAN WHITE PART B OR PART C SERVICE FROM REACCH WERE FROM DAUPHIN, CUMBERLAND, AND PERRY COUNTIES. REACCH HAS A HISTORY OF WORKING WITH PATIENTS OF RACIAL AND SOCIOECONOMIC DIVERSITY. PER 2013 REACCH DEMOGRAPHICS, 46% OF PATIENTS SELF-IDENTIFIED AS AFRICAN-AMERICAN, AND 42% SELF-IDENTIFIED AS CAUCASIAN. PATIENTS WHO SELF-IDENTIFIED AS HISPANIC COMPRISED 11% OF THE REACCH POPULATION AND 1% HAVE SELF-IDENTIFIED AS "OTHER". IN ADDITION, OVER 50% OF CLIENTS WERE COVERED EITHER BY MEDICAID OR MEDICARE, AND 20% OF CLIENTS HAD NO PRIVATE INSURANCE. AS PART OF ITS MISSION, REACCH WORKS TO ENSURE THERE ARE NO BARRIERS (FINANCIAL OR OTHERWISE) TO OBTAINING CARE. REACHH INTRODUCED HIV TESTING FOR HIGH RISK POPULATIONS IN DAUPHIN COUNTY IN 2013 IN RESPONSE THE COUNTY'S HIGH HIV PREVALENCE RATE (SECOND ONLY IN THE STATE TO THE TWO REGIONS SURROUNDING PHILADELPHIA) AND IN RESPONSE TO THE IDENTIFIED NEED TO FACILITATE ROUTINE SCREENING FOR COMMUNITY MEMBERS WHO HAVE NO PRIMARY CARE PROVIDER OR LACK INSURANCE. A NEW MEDICAL CASE MANAGEMENT SYSTEM WAS ADDED IN 2013 TO COACH CLIENTS IN GOAL-SETTING AND FACILITATE INSURANCE AND CHARITY CARE APPLICATIONS TO ENHANCE THE PROGRAM'S MISSION. AT THE END OF 2013, 87% OF REACHH CLIENTS HAD AN UNDETECTABLE AMOUNT OF HIV VIRUS IN THEIR BLOOD, WHICH ALLOWS THOSE CLIENTS TO HAVE A HEALTHIER LIFE, AND DECREASES THE CHANCES OF SHARING HIV WITH OTHERS. 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 DATA 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. PINNACLE HEALTH HOSPITALS - HARRISBURG PART V, SECTION B, LINE 4: HERSHEY HOSPITAL MEDICAL CENTERHOLY SPIRIT HOSPITAL PINNACLE HEALTH HOSPITALS - CGOH PART V, SECTION B, LINE 4: HERSHEY HOSPITAL/MEDICAL CENTERHOLY SPIRIT HOSPITAL PINNACLE HEALTH HOSPITALS - HARRISBURG PART V, SECTION B, LINE 5C: COMMUNITY EVENTS PINNACLE HEALTH HOSPITALS - CGOH PART V, SECTION B, LINE 5C: 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. 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 QUANTIFIED: 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: LOCATION OF THE EVENT: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 IN REGARDS 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.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 PINNACLEHEALTHS 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. THISTHE 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. 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 UN-INSURED 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.AMERICAN COMMUNITY SURVEY DATA FOR 2011 SHOWED THAT THE 10.3% 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 2012, 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.SEVERAL MAJOR CONSTRUCTION PROJECTS BEGAN IN FISCAL YEAR 2013 INCLUDING CONSTRUCTION OF A NEW 108 BED ACUTE CARE HOSPITAL ON THE FREDRICKSEN CAMPUS AT A PLANNED COST OF $114.0 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 A NEW HEART CATH AND ELECTROPHYSIOLOGY LABS AND CARDIOTHORACIC INTENSIVE CARE UNIT; AND PATIENT ROOM UPGRADES TO MOSTLY PRIVATE ROOMS WITH COST ESTIMATED AT $34.0 MILLION; AND CONSTRUCTION A NEW CANCER CENTER LOCATED ON THE WEST SHORE FREDRICKSEN CAMPUS WITH A COST OF $20.6 MILLION. THE NEW WEST SHORE HOSPITAL IS SLATED TO BEGIN OPERATIONS 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.-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. 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 AND PINNACLE HEALTH MEDICAL GROUP ARE 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.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 $721,104 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 - $1,016,734 IN COMMUNITY HEALTH IMPROVEMENT SERVICES, HEALTH PROFESSIONS EDUCATION, COMMUNITY BENEFIT OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS. -PINNACLE HEALTH MEDICAL SERVICES - $1,061,134 IN COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BASED CLINICAL SERVICES AND HEALTH CARE SUPPORT SERVICES -COMMUNITY LIFE TEAM - $132,051 IN SUBSIDIZED HEALTH SERVICES-PINNACLE HEALTH FOUNDATION - $442,865 IN COMMUNITY BENEFIT OPERATIONS AND FINANCIAL CONTRIBUTIONS.WERE THE ABOVE COMMUNITY BENEFIT EXPENSES OF $3.3 MILLION INCLUDED IN THE HOSPITAL COMMUNITY BENEFIT EXPENSES OF $43.7 MILLION, THE PERCENTAGE OF COMMUNITY BENEFIT EXPENSE TO TOTAL EXPENSE WOULD HAVE BEEN 7.48%. REPORTS FILED WITH STATES PART VI, LINE 7 PA 1 1 0 0 0 0 0 1 0 FELIX GUTIERREZ MD 0 436606 0 120671 0 2691 0 15000 0 11948 0 586916 0 0 MICHAEL A YOUNG 0 676761 0 286446 0 203695 0 10623 0 14359 0 1191884 0 0 KEVIN KELLY MD 0 121255 0 0 0 25353 0 8550 0 4702 0 159860 0 0 CHRISTOPHER P MARKLEY ESQ 0 290096 0 84427 0 202827 0 15045 0 14235 0 606630 0 137480 WILLIAM H PUGH 0 459606 0 141324 0 106302 0 15000 0 8111 0 730343 0 45775 NANCY HAMMONDS 0 145942 0 35829 0 21462 0 24037 0 18406 0 245676 0 0 PHILIP GUARNESCHELLI 0 443532 0 134991 0 266819 0 15045 0 18435 0 878822 0 161203 EDWARD HILDREW 238902 0 22559 0 114791 0 35000 0 6950 0 418202 0 0 0 JULIAN GUTIERREZ 201755 0 4610 0 161899 0 15000 0 451 0 383715 0 0 0 FRANK DITRAGLIA 0 0 157 0 468250 0 5000 0 0 0 473407 0 0 0 R SCOTT RANKIN 235102 0 17206 0 122692 0 15000 0 11636 0 401636 0 0 0 CHRISTIAN CAICEDO 272653 0 46038 0 34139 0 15000 0 17290 0 385120 0 0 0 ROGER LONGENDERFERMD 0 308439 0 5086 0 215 0 0 0 2082 0 315822 0 0 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, LINES 4A-B ROGER LONGENDERFER, M.D., A FORMER PRESIDENT AND CEO, WAS PAID SEVERANCE IN THE FORM OF SALARY AND BENEFITS TOTALING $315,821 IN 2012 AS PART OF HIS RETIREMENT PACKAGE. WILLIAM PUGH, PHILIP GUARNESCHELLI, AND CHRISTOPHER MARKLEY RECEIVED AS TAXABLE COMPENSATION INCOME FROM A NONQUALIFIED PLAN THAT HAD BEEN DEFERRED IN PRIOR YEARS. 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 2012 AT A TOTAL COST OF $15,000. 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). SUPPLEMENTAL INFORMATION PART III NOTE THAT NANCY HAMMONDS WAS "GRANDFATHERED" IN WITH A GROUP OF EMPLOYEES FOR WHOM IT WAS DETERMINED THAT THE CHANGE TO A NEW DEFINED CONTRIBUTION PLAN WOULD NOT MAKE THEM "WHOLE" DUE TO THEIR LENGTH OF SERVICE. IT WAS DETERMINED THAT THESE EMPLOYEES SHOULD RECEIVE AN ADDITIONAL BENEFIT TO ADJUST FOR THE ADVERSE CONSEQUENCE TO THEM OF THE NEW PLAN. 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 15558000 187538449 9493675 168307000 2962259 6775515 2009 1 0 1 1 B 2670000 100000000 70000000 279272 27640702 2012 1 0 1 1 C 135249990 10851923 1512711 44562840 78361721 2014 0 0 0 1 A 0 0 1 1 0 0.00000 0.00390 0.00390 0 0 0 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 0 C 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 0 B 0 1 0 0 1 0 0 0 0 C 0 1 0 0 0 0 0 0 0 A 0 B 0 C 0 SCHEDULE K PART IV, ARBITRAGE, LINE 2C DATE REBATE COMPUTATION PERFORMED ISSUER NAME: DAUPHIN COUNTY GENERAL AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 07/15/2013 SCHEDULE K, PART III, LINE 9, PART IV, LINE 7, AND PART V: POST-BOND ISSUANCE POLICIES THE ORGANIZATION TAKES GREAT CARE AND PRUDENCE IN MONITORING ITS TAX EXEMPT BOND USES. IT IS EVALUATING ITS POLICIES TO ENSURE ALL NECESSARY PROCEDURES ARE DOCUMENTED AS FORMAL POLICY AND WILL UPDATE ITS POST-ISSUANCE COMPLIANCE POLICIES AS NECESSARY. FELIX GUTIERREZ MD DIRECTOR FELIX GUTIERREZ, MD IS A PARTNER IN RIVERSIDE CARDIOLOGY 536754 SEE PART V - RENTAL OF PHYSICIAN OFFICE SPACE. 0 JOHN CAMPBELL DIRECTOR JOHN CAMPBELL IS ADMINISTRATIVE VP OF PERSONAL TRUST WITH M&T BANK 135773 SEE PART V - INVESTMENT MANAGMENT SERVICES PROVIDED BY M&T BANK 0 BONY DAWOOD DIRECTOR AND OWNER, DAWOOD ENGINEERING THE ORGANIZATION PROVIDED ENGINEERING SERVICES TO A RELATED ORGANIZATION. THE AMOUNT WAS $323,941 AND ALL TRANSACTIONS WERE AT ARM'S LENGTH. 0 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 MGT 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. OTHER FEES FORM 990, PART IX, LINE 11G PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 4,776,119. MANAGEMENT AND GENERAL EXPENSES 744,129. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,520,248. OUTSOURCING: PROGRAM SERVICE EXPENSES 23,939,805. MANAGEMENT AND GENERAL EXPENSES 6,882,655. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 30,822,460. CLEANING SERVICES: PROGRAM SERVICE EXPENSES 1,497,870. MANAGEMENT AND GENERAL EXPENSES 6,846,808. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,344,678. LAB FEES: PROGRAM SERVICE EXPENSES 4,010,830. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,010,830. RESIDENT ROTATION: PROGRAM SERVICE EXPENSES 1,292,720. MANAGEMENT AND GENERAL EXPENSES 776. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,293,496. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 20,658,868. MANAGEMENT AND GENERAL EXPENSES 3,696,332. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 24,355,200. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN ADDITIONAL MINIMUM PENSION LIABILITY 34,439,880. INTERCOMPANY TRANFERS - UNRESTRICTED -28,989,237. INTERCOMPANY TRANFERS - TEMP RESTRICTED -1,484,590. PINNACLE HEALTH EMERGENCY DEPARTMENT SERVICES LLC 409 SOUTH SECOND STREET PO BOX 8700 HARRISBURG PA 17105 861057582 MEDICAL EMERGENCY SERVICES PA -5368838 1718798 N/A 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 1440995 1376951 0 0 0.49000 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 CARDIOLOGY PRACTICE INC PO BOX 8700 HARRISBURG PA 17105 800658616 PHYSICIAN 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 505467 FMV WEST SHORE SURGERY CENTER LTD R 914467 FMV IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIP: 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.