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BLUE MOUNTAIN HOSPITAL INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
BLUE MOUNTAIN HOSPITAL INC (EIN 24-0795436)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-15
IRS object ID
201401359349302140
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-05-15T11:52:06-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN232932984EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PARENTEBEARD LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11650 MARKET STREET SUITE 4500AddressLine1
CityPHILADELPHIACity
StatePAState
ZIP Code19103ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN240795436EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1GNADEN HUETTEN MEMORIAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlGNADNameControl
Phone6103771300Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1211 NORTH 12TH STREETAddressLine1
CityLEHIGHTONCity
StatePAState
ZIP Code182351195ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameANDREA ANDRAEName
TitleCFOTitle
Phone6103771300Phone
Date Signed2014-05-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJULIUS C GREEN CPA JDName
PTINP00350393PTIN
Phone2159720701Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonANDREA ANDRAENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1211 NORTH 12TH STREETAddressLine1
CityLEHIGHTONCity
StatePAState
ZIP Code182351195ZIPCode
FieldValueIRS element (for citing)
Gross Receipts65230727GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.BLMTN.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1947YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionOPERATES A 90 BED ACUTE CARE HOSP, A 91 BED SKILLED NURSING FACILITY & A HOME HEALTH CARE AGENCY.ActivityOrMissionDescription
Nbr Voting Members Governing Body17NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees911TotalNbrEmployees
Total Nbr Volunteers109TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year769724ContributionsGrantsPriorYear
Contributions Grants Current Year2021493ContributionsGrantsCurrentYear
Program Service Revenue Prior Year62451654ProgramServiceRevenuePriorYear
Program Service Revenue CY60537037ProgramServiceRevenueCY
Investment Income Prior Year226573InvestmentIncomePriorYear
Investment Income Current Year34652InvestmentIncomeCurrentYear
Other Revenue Prior Year523383OtherRevenuePriorYear
Other Revenue Current Year2454565OtherRevenueCurrentYear
Total Revenue Prior Year63971334TotalRevenuePriorYear
Total Revenue Current Year65047747TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year941342GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year32217975SalariesEtcPriorYear
Salaries Etc Current Year34641847SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year28065229OtherExpensePriorYear
Other Expenses Current Year28287887OtherExpensesCurrentYear
Total Expenses Prior Year61224546TotalExpensesPriorYear
Total Expenses Current Year62929734TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2746788RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2118013RevenuesLessExpensesCY
Total Assets BOY37902746TotalAssetsBOY
Total Assets EOY43142767TotalAssetsEOY
Total Liabilities BOY46659007TotalLiabilitiesBOY
Total Liabilities EOY43224320TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-8756261NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-81553NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionPROMOTE, MAINTAIN AND RESTORE THE GOOD HEALTH OF ALL THE PEOPLE IN THE COMMUNITIES WE SERVE THROUGH PARTNERSHIPS FOR EXCELLENCE IN HEALTHCARE SERVICE DELIVERY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense54312875Expense
Revenue62617573Revenue
DescriptionGNADEN HUETTEN MEMORIAL HOSPITAL (THE "HOSPITAL"), LOCATED IN LEHIGHTON, PENNSYLVANIA, IS A 90-BED, NOT-FOR-PROFIT GENERAL ACUTE CARE HOSPITAL SERVING THE RESIDENTS OF CARBON, SCHUYLKILL AND MONROE COUNTIES. THE HOSPITAL'S SERVICES PROVIDE BOTH INPATIENT AND OUTPATIENT CARE, INCLUDING HOME HEALTH CARE, MEDICAL/SURGICAL SERVICES, MENTAL HEALTH SERVICES AND ACUTE REHABILITATION SERVICES. THE HOSPITAL ALSO OFFERS A BROAD ARRAY OF ANCILLARY SERVICES SUCH AS RADIOLOGY, EMERGENCY, CARDIOLOGY AND REHABILITATION SERVICES.DURING THE PERIOD OF JULY 1, 2012 THROUGH JUNE 30, 2013, THE HOSPITAL HAD A TOTAL OF 3,551 ADMISSIONS AND 18,005 PATIENT DAYS. TOTAL OCCUPANCY FOR THE HOSPITAL WAS 55%. IN ADDITION, THERE WERE A TOTAL OF 19,340 EMERGENCY ROOM VISITS AND 19,005 HOME HEALTH CARE VISITS. IN ADDITION TO THE SERVICES PROVIDED AS INDICATED ABOVE, THE HOSPITAL ALSO PROVIDES LONG-TERM CARE SERVICES THROUGH AN ON-CAMPUS 91-BED SKILLED NURSING UNIT. DURING THE PERIOD OF JULY 1, 2012 THROUGH JUNE 30, 2013, THE SKILLED NURSING UNIT HAD 210 ADMISSIONS AND PATIENT DAYS OF APPROXIMATELY 32,000. TOTAL OCCUPANCY FOR THE SKILLED NURSING UNIT WAS 97%.Description
Total Program Service Expense54312875TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109643NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees911NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members17NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledPAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1ANDREA L ANDRAEBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6103777003TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1211 NORTH 12TH STREETAddressLine1
CityLEHIGHTONCity
StatePAState
ZIP Code18235ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
BARBARA GREEN
TREASURER1.003.00XX000
CONRAD BIEGE
DIRECTOR1.003.00X000
JAIME MENDES
DIRECTOR1.003.00X000
WILLIAM H FEGLEY JR
DIRECTOR1.003.00X000
PATRICK HANLEY DO
SECRETARY37.003.00XX11820802442
MICHAEL HARLEMAN
CHAIRMAN1.003.00XX000
WILLIAM MASON
DIRECTOR1.003.00X000
WILLIAM MARKSON MD
DIRECTOR1.003.00X000
SHELBA SCHEFFNER
DIRECTOR1.003.00X000
REV ROBERT VONFRISCH
DIRECTOR1.003.00X000
RICHARD ROTHFLEISCH MD
DIRECTOR1.003.00X000
STEVEN SERFASS
DIRECTOR1.003.00X000
WILLIAM KISSNER
DIRECTOR1.003.00X000
ROBERT GROB DO
DIRECTOR1.003.00X000
LOUIS SPORTELLI DC
VICE CHAIRMAN1.003.00XX000
PATRICK REILLY
DIRECTOR1.003.00X000
ANDREW E HARRIS
PRESIDENT/CEO15.0035.00XX488275022572
ANDREA ANDRAE
CFO15.0035.00X016864221174
DR HERBERT HOOVER
PHYSICIAN40.0047523909816X
DR MUHAMMAD RIFAI
PHYSICIAN40.00329169027690X
KATHLEEN R NOLL
PHYSICIAN40.00343269014936X
DAVID P RUSSO
PHYSICIAN40.00295916012898X
JAMES F MENAPACE
PHYSICIAN40.00273015026530X
WALTER J BELL
PHYSICIAN40.00263930026342X
FRANK R PENATER
PHYSICIAN40.00251185020489X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2838206TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs168642TotalReportableCompFrmRltdOrgs
Total Other Compensation184889TotalOtherCompensation
Number Individuals GT100 K34NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
REHAB CARE GROUP INC
PO BOX 502096ST LOUISMO63150ADMINISTER ACUTE REHAB PROGRAM1369795
SIEMENS MEDICAL SOLUTIONS
PO BOX 7777 W3580PHILADELPHIAPA19175IT SERVICES1343740
CARDIOLOGY ASSOCIATES
1241 BLAKESLEE BLVDLEHIGHTONPA18235ADMINISTER CARDIOLOGY PROGRAM1122460
MAHONING VALLEY ORTHOPEDICS
246 NORTH 6TH STREETLEHIGHTONPA18235ADMINISTER ORTHOPEDICS PROGRAM170000
PENN MEDICAL GROUP PC
2175 BLAKESLEE BLVD DRIVE WLEHIGHTONPA18235ADMINISTER MEDICAL PRACTICE168487
FieldValueIRS element (for citing)
Number Of Contractors GT100 K7NumberOfContractorsGT100K
Related Organizations1947885RelatedOrganizations
All Other Contributions73608AllOtherContributions
Total Contributions2021493TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SVC REVDescription
Business Code621990BusinessCode
Total Revenue Column60537037TotalRevenueColumn
Related Or Exempt Function Income60537037RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue60537037TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column32452TotalRevenueColumn
Exclusion$32,452ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real214489Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real182980Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real31509Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column31509TotalRevenueColumn
Exclusion$31,509ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other2200Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other2200Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column2200TotalRevenueColumn
Exclusion$2,200ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
MEANINGFUL USE62200018840111884011
CAFETERIA MEALS900099212869$212,869
INSURANCE PROCEEDS90009981064$81,064

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column245112TotalRevenueColumn
Related Or Exempt Function Income196525RelatedOrExemptFunctionIncome
Exclusion$48,587ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue2423056TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column65047747TotalRevenueColumn
Related Or Exempt Function Income62617573RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$408,681ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1275349Total
Program Services737913ProgramServices
Management And General537436ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total23436625Total
Program Services21049241ProgramServices
Management And General2387384ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2009811Total
Program Services1846616ProgramServices
Management And General163195ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total5561708Total
Program Services5045983ProgramServices
Management And General515725ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2358354Total
Program Services2127546ProgramServices
Management And General230808ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total204202Total
Management And General204202ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total101483Total
Management And General101483ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total5582Total
Program Services5582ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total6760481Total
Program Services4932049ProgramServices
Management And General1828432ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total196377Total
Program Services221ProgramServices
Management And General196156ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2209330Total
Program Services1797289ProgramServices
Management And General412041ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1061593Total
Program Services422589ProgramServices
Management And General639004ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1238735Total
Program Services1238735ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total140939Total
Program Services120524ProgramServices
Management And General20415ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total7412Total
Program Services4ProgramServices
Management And General7408ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total465230Total
Management And General465230ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2072701Total
Program Services2072701ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total1189811Total
Program Services1189811ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT EXPENSE57258965725896
MEDICAL SUPPLIES37834763782869607
DRUGS14564501456450
MA ASSESSMENT582024582024

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1086165Total
Program Services760856ProgramServices
Management And General325309ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total62929734Total
Program Services54312875ProgramServices
Management And General8616859ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1253BOY
EOY1253EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY115386BOY
EOY727694EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY6999663BOY
EOY7836359EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY816726BOY
EOY667511EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY586292BOY
EOY589774EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis63805363LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec46981306LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY15993088BOY
EOY16824057EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY2464314BOY
EOY3044567EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY10926024BOY
EOY13451552EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY37902746BOY
EOY43142767EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY7740641BOY
EOY10210729EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY9318551BOY
EOY8274594EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY240823BOY
EOY221224EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY29358992BOY
EOY24517773EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY46659007BOY
EOY43224320EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-8829861BOY
EOY-148460EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY73600BOY
EOY66907EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-8756261BOY
EOY-81553EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY37902746BOY
EOY43142767EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses2118013ReconcilationRevenueExpenses
Reconcilation Other Changes6556695ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations1GrantsOtherOrganizations
Grants Other Organizations$5,582GrantsOtherOrganizationsAmount
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities0OtherActivities
Total Lobbying Expenditures IIB5582TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationA PORTION OF THE DUES PAID TO THE HOSPITAL & HEALTHSYSTEM ASSOCIATION OF PENNSYLVANIA ($5,582) WAS DETERMINED TO BE FOR LOBBYING PURPOSES.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance73600BeginningOfYearBalance
Other Expenditures6693OtherExpenditures
End Of Year Balance66907EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance86624BeginningOfYearBalance
Other Expenditures13024OtherExpenditures
End Of Year Balance73600EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance84311BeginningOfYearBalance
Investment Earnings Or Losses15994InvestmentEarningsOrLosses
Other Expenditures12024OtherExpenditures
Administrative Expenses1657AdministrativeExpenses
End Of Year Balance86624EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance636097BeginningOfYearBalance
Contributions41098Contributions
Investment Earnings Or Losses-414InvestmentEarningsOrLosses
Other Expenditures592470OtherExpenditures
End Of Year Balance84311EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1022053BeginningOfYearBalance
Investment Earnings Or Losses-39694InvestmentEarningsOrLosses
Other Expenditures346262OtherExpenditures
End Of Year Balance636097EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis477770OtherCostOrOtherBasis
Book Value477770BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis26353457OtherCostOrOtherBasis
Depreciation17462822Depreciation
Book Value8890635BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis381903OtherCostOrOtherBasis
Depreciation344868Depreciation
Book Value37035BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis35148375OtherCostOrOtherBasis
Depreciation28308323Depreciation
Book Value6840052BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1443858OtherCostOrOtherBasis
Depreciation865293Depreciation
Book Value578565BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings16824057TotalOfBookValueLandBuildings

Other Assets OtherAssets (6 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM PALMERTON HOSPITAL6418348
BENEFICIAL INTEREST IN PERPETUAL TRUST66907
DEFERRED FINANCING COSTS, NET151278
PHYSICIAN INCOME GUARANTEES642093
THIRD PARTY RECEIVABLE703316
INSURANCE RECOVERIES RECEIVABLE5469610
FieldValueIRS element (for citing)
Total Book Value Other Assets13451552TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
OBLIGATIONS UNDER CAPITAL LEASES$1,489,712
BLUE CROSS WORKING CAPITAL ADVANCE$304,227
PENSION LIABILITY$16,327,460
ESTIMATED MEDICAL MALPRACTICE CLAIMS LIABILITY$6,313,203
DEFERRED GIFT ANNUITIES PAYABLE$83,171
FieldValueIRS element (for citing)
Total Of Amounts24517773TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt66061526TotRevenueEtcAuditedFinclStmt
Other Revenues830799OtherRevenues
Revenue Not Rptd F990830799RevenueNotRptdF990
Revenue Subtotal65230727RevenueSubtotal
Other Revenues Not Included-182980OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-182980RevenueNotRptdOnFinStmt
Total Revenue Per Form99065047747TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt57386818TotExpensesEtcAuditedFinclStmt
Other Expenses Included182980OtherExpensesIncluded
Expenses Not Rptd F990182980ExpensesNotRptdF990
Expenses Subtotal57203838ExpensesSubtotal
Other Expenses Not Included5725896OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt5725896ExpensesNotRptdOnFinStmt
Total Expenses Per Form99062929734TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:TERM ENDOWMENT FUNDS ARE USED FOR THE PURCHASE OF PLANT AND EQUIPMENT TO FURTHER THE MISSION OF THE ORGANIZATION.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:GNADEN HUETTEN MEMORIAL HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON ITS EXEMPT INCOME UNDER SECTION 501(A) OF THE CODE. THE HOSPITAL ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN THE FINANCIAL STATEMENTS USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. MANAGEMENT HAS DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD. THE HOSPITAL'S FEDERAL EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURNS FOR 2010, 2011, AND 2012 REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.
PART XI, LINE 2D - OTHER ADJUSTMENTS:PENSION LIABILITY ADJUSTMENT 6,563,388. VALUATION GAIN -6,693. BAD DEBT -5,725,896.
PART XI, LINE 4B - OTHER ADJUSTMENTS:RENTAL EXPENSES -182,980.
PART XII, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSES 182,980.
PART XII, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT 5,725,896.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care0AmountsBudgetedForCharityCare
Annual Community Benefit Report0AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense203449TotalCommunityBenefitExpense
Direct Offsetting Revenue99286DirectOffsettingRevenue
Net Community Benefit Expense104163NetCommunityBenefitExpense
Percent Of Total Expense0.00180PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense7698667TotalCommunityBenefitExpense
Direct Offsetting Revenue5578021DirectOffsettingRevenue
Net Community Benefit Expense2120646NetCommunityBenefitExpense
Percent Of Total Expense0.03710PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense7902116TotalCommunityBenefitExpense
Direct Offsetting Revenue5677307DirectOffsettingRevenue
Net Community Benefit Expense2224809NetCommunityBenefitExpense
Percent Of Total Expense0.03890PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense227912TotalCommunityBenefitExpense
Net Community Benefit Expense227912NetCommunityBenefitExpense
Percent Of Total Expense0.00400PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense9064TotalCommunityBenefitExpense
Net Community Benefit Expense9064NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense5096712TotalCommunityBenefitExpense
Direct Offsetting Revenue3926681DirectOffsettingRevenue
Net Community Benefit Expense1170031NetCommunityBenefitExpense
Percent Of Total Expense0.02050PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense5333688TotalCommunityBenefitExpense
Direct Offsetting Revenue3926681DirectOffsettingRevenue
Net Community Benefit Expense1407007NetCommunityBenefitExpense
Percent Of Total Expense0.02470PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense13235804TotalCommunityBenefitExpense
Direct Offsetting Revenue9603988DirectOffsettingRevenue
Net Community Benefit Expense3631816NetCommunityBenefitExpense
Percent Of Total Expense0.06360PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$1,834,635BadDebtExpenseAmount
Amount Attributable To183463AmountAttributableTo
Amount Reimbursed By Medicare17513994AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare18950139CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-1436145MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care0ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1GNADEN HUETTEN MEMORIAL HOSPITAL INCBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1211 NORTH 12TH STREETAddressLine1
CityLEHIGHTONCity
StatePAState
ZIP Code18235ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours
OtherSKILLED NURSING FACILITYOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1GNADEN HUETTEN MEMORIAL HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number2HospitalFacilityNumber
CHNA Conducted1CHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into Account1TakeIntoAccount
Other Facilities0OtherFacilities
CHNA Widely Available1CHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Adopt Implement StrategyXAdoptImplementStrategy
Include Operational PlansXIncludeOperationalPlans
Adopt BudgetXAdoptBudget
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs Addressed0AllNeedsAddressed
Organization Incur Excise Tax0OrganizationIncurExciseTax
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent400.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Medicaid MedicareXMedicaidMedicare
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 7G: WHILE WE ARE AWARE THAT EACH HOSPITAL IS REQUIRED TO STAND ALONE WITH REGARD TO THEIR COMMUNITY BENEFIT REPORTING, THE TWO HOSPITALS OF BLUE MOUNTAIN FUNCTION IN TANDEM TO DRIVE COMMUNITY BENEFIT STRATEGY. SUBSIDIZED HEALTH SERVICES INCLUDED UNDER SCHEDULE H FOR THE PALMERTON HOSPITAL ARE THE ADULT DAY SERVICES PROGRAM AND THE EMERGENCY DEPARTMENT. ADULT DAY SERVICES OF THE BLUE MOUNTAIN HEALTH SYSTEM OFFERS AN ALTERNATIVE TO NURSING CARE WHILE PROVIDING RESPITE FOR THOSE CARING FOR SOMEONE AT HOME. THE PROGRAM OFFERS A WARM, FRIENDLY ATMOSPHERE AND THE OPPORTUNITY FOR SENIORS TO DEVELOP FRIENDSHIPS WHILE PARTICIPATING IN ACTIVITIES THEY ENJOY. OUR EXPERIENCED STAFF INCLUDES REGISTERED NURSES, LICENSED PRACTICAL NURSES, CERTIFIED THERAPEUTIC RECREATION SPECIALISTS AND CERTIFIED NURSE AIDES. THE PALMERTON HOSPITAL PROVIDED SUBSIDIES OF APPROXIMATELY $334,000 TO THE ADULT DAY SERVICES CENTER DURING FY2013.THE EMERGENCY DEPARTMENT LOCATED AT PALMERTON HOSPITAL PROVIDES AROUND-THE-CLOCK EMERGENCY SERVICES TO THE SURROUNDING COMMUNITIES WITHIN CARBON COUNTY. CARE IS PROVIDED TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY OR THEIR INSURANCE STATUS. DURING FY2013, THE PALMERTON EMERGENCY DEPARTMENT SAW 11,395 PATIENTS WITH A SUBSIDIZED COST TO PROVIDE THESE SERVICES OF $883,000 OF WHICH $168,000 IS INCLUDED IN THE MEDICAID SHORTFALL.SUBSIDIZED HEALTH SERVICES INCLUDED UNDER SCHEDULE H FOR THE GNADEN HUETTEN MEMORIAL HOSPITAL ARE THE FAMILY PLANNING CLINIC AND THE EMERGENCY DEPARTMENT. THE NATIONAL FAMILY PLANNING PROGRAM, ALSO KNOWN AS TITLE X (TEN) OF THE PUBLIC HEALTH SERVICE ACT, WAS ESTABLISHED IN 1970 TO ENSURE THAT NO AMERICAN WOMAN WOULD BE DENIED ACCESS TO FAMILY PLANNING ASSISTANCE BECAUSE OF HER ECONOMIC CONDITION. FOR MORE THAN THREE DECADES, TITLE X HAS BEEN AN INTEGRAL COMPONENT OF OUR NATION'S PUBLIC HEALTH CARE SYSTEM, PROVIDING HIGH QUALITY FAMILY PLANNING SERVICES AND OTHER PREVENTIVE HEALTH CARE TO LOW-INCOME OR UNINSURED INDIVIDUALS WHO MAY OTHERWISE LACK ACCESS TO HEALTH CARE. MATERNAL AND FAMILY HEALTH SERVICES ADMINISTERS THE PROGRAM THROUGH A NETWORK OF DIRECT AND CONTRACT SERVICE PROVIDERS. IN ADDITION TO DIRECT SITES, THE NETWORK SYSTEM INCLUDES HOSPITALS, PLANNED PARENTHOOD AFFILIATES, COMMUNITY HEALTH CENTERS AND PHYSICIAN GROUPS. THE GNADEN HUETTEN MEMORIAL HOSPITAL PROVIDED SUBSIDIES OF APPROXIMATELY $60,000 TO OUR FAMILY PLANNING CLINIC DURING FY2013.THE EMERGENCY DEPARTMENT LOCATED AT GNADEN HUETTEN MEMORIAL HOSPITAL PROVIDES AROUND-THE-CLOCK EMERGENCY SERVICES TO THE SURROUNDING COMMUNITIES WITHIN CARBON COUNTY. CARE IS PROVIDED TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY OR THEIR INSURANCE STATUS. DURING FY2013, THE GNADEN HUETTEN MEMORIAL HOSPITAL EMERGENCY DEPARTMENT SAW 19,318 PATIENTS WITH A SUBSIDIZED COST TO PROVIDE THESE SERVICES OF $1,901,414 OF WHICH $791,444 IS INCLUDED IN THE MEDICAID SHORTFALL.
PART I, L7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25 COLUMN (A) BUT SUBTRACTED OUT FOR PURPOSES OF CALCULATING THE PERCENTAGE ON SCH H, PART I, LINE 7, COLUMN (F) IS $5,725,896.
PART II: COMMUNITY OUTREACH PROGRAMS-PROVIDES MORE THAN 2000 INFLUENZA VACCINES TO COMMUNITY RESIDENTS IN PARTNERSHIP WITH THE PA DEPARTMENT OF HEALTH AND THE CARBON COUNTY EMERGENCY MANAGEMENT AGENCY.-PARTICIPATES IN MORE THAN 25 COMMUNITY HEALTH FAIRS PROVIDING A VARIETY OF SCREENINGS EMS, L.B. MORRIS ELEMENTARY SCHOOL, THE VILLAGE AT PALMERTON, CARBON COUNTY FAIR, WEST END FAIR, PALMERTON COMMUNITY FESTIVAL, LEHIGHTON LIONESS AND LIONS CLUB, PALMERTON LIONS CLUB, PALMER ELEMENTARY SCHOOL, LEHIGHTON RECREATION SENIOR FAIR, REP. DOYLE HEFFLEY SENIOR FAIR, WEATHERLY SCHOOL DISTRICT WELLNESS FAIR, PLEASANT VALLEY ACADEMIC HEALTH FAIR, 24TH ANNUAL CHILDREN'S HEALTH FAIR, WEST END PHYSICAL THERAPY HEALTH FAIR.-HOSTS FIVE HEALTH SUPPORT GROUPS IN THE COMMUNITY: BREAST CANCER, WEIGHT LOSS/BARIATRIC SURGERY, ADULT DAY CAREGIVER, THE SUMMIT CAREGIVER, DIABETES AND OTHER SPECIALTY SUPPORT PROGRAMMING SUCH AS 6-WEEK BEREAVEMENT WORKSHOP.-BLUE MOUNTAIN HEALTH SYSTEM'S FAMILY PLANNING PROGRAM PROVIDES MEN, WOMEN AND TEENS WITH THE INFORMATION AND REPRODUCTIVE HEALTHCARE SERVICES THEY NEED TO STAY HEALTHY, PROVIDES FREE AND LOW-COST CONTRACEPTION, PREGNANCY TESTING, PELVIC EXAMS AND TESTING FOR SEXUALLY TRANSMITTED DISEASES.-OFFERS FREE DIAGNOSTIC MAMMOGRAMS AND ULTRASOUNDS TO WOMEN AND MEN WHO ARE UNDER OR NON-INSURED.-BMHS ADULT DAY CARE PROVIDES AN ALTERNATIVE TO NURSING CARE WHILE PROVIDING RESPITE FOR THOSE CARING FOR SOMEONE IN THEIR HOME.-PROVIDES A PHYSICIAN MEDICAL DIRECTOR FOR THE LOCAL ALS/BLS SERVICES IN THE SURROUNDING COMMUNITIES.-PROVIDES THE HEALTH SMILES, HAPPY KIDS DENTAL VAN, PROVIDES PREVENTATIVE AND RESTORATIVE DENTAL CARE TO UNDER AND NON-INSURED CHILDREN WITHIN CARBON COUNTY AND THE SURROUNDING AREAS.-HOSTS "LADIES NIGHT OUT", AN EDUCATIONAL EVENT FOR MORE THAN 200 PARTICIPANTS IN REGARDS TO AWARENESS ABOUT FEMALE CANCERS, ESPECIALLY BREAST CANCER.-SUPPORTS LOCAL COMMUNITY GROUPS, EX. AMERICAN CANCER SOCIETY TELETHON, RELAY FOR LIFE, LIGHT THE NIGHT, AMERICAN LUNG ASSOCIATION, AMERICAN HEART ASSOCIATION, AND ALZHEIMER'S ASSOCIATION.-VARIOUS STAFF MEMBERS PARTICIPATE IN LOCAL CIVIC ORGANIZATION SUCH AS CARBON COUNTY INTERAGENCY COUNCIL, CARBON COUNTY SAFE KIDS COALITION, AMERICAN CANCER SOCIETY, LEHIGHTON ROTARY, JIM THORPE ROTARY, LEHIGHTON LIONESS AND LIONS CLUBS, PALMERTON LIONS AND LIONESS CLUB, CARBON COUNTY CHAMBER OF COMMERCE AND PALMERTON CHAMBER OF COMMERCE.
PART III, LINE 4: ACCOUNTS RECEIVABLE, PATIENTS ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. THE ALLOWANCE FOR DOUBTFUL COLLECTIONS IS BASED UPON A PERIODIC REVIEW OF THE ACCOUNTS RECEIVABLE AGING, PAYOR CLASSIFICATIONS, AND APPLICATION OF HISTORICAL WRITE-OFF PERCENTAGES. THE TOTAL AMOUNT OF BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 WAS ESTIMATED BASED ON A PERCENTAGE OF TOTAL ADJUSTED PATIENT COST TO TOTAL ADJUSTED PATIENT CHARGES. THE TOTAL ADJUSTED PATIENT COSTS WAS CALCULATED AS FOLLOWS: TOTAL OPERATING EXPENSES AS REPORTED IN THE AUDITED FINANCIAL STATEMENTS LESS BAD DEBT EXPENSE, MEDICAID AND OTHER PROVIDER TAXES, NON PATIENT-CARE ACTIVITIES, AND NET COMMUNITY BENEFIT EXPENSE. TOTAL ADJUSTED OPERATING EXPENSES WERE APPROXIMATELY $56,015,000 FOR FY2013. TOTAL ADJUSTED PATIENT CHARGES WAS CALCULATED AS FOLLOWS: GROSS PATIENT CHARGES LESS GROSS CHARGES FOR COMMUNITY BENEFIT PROGRAMS. TOTAL ADJUSTED PATIENT CHARGES WERE APPROXIMATELY $156,335,000 FOR FY2013. MANAGEMENT DETERMINED APPROXIMATELY 10% OF THE TOTAL BAD DEBT EXPENSE REPORTED ON LINE 2 WAS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. MANAGEMENT CONSIDERED THIS TO BE REASONABLE BASED ON HISTORICAL ANALYSIS OF BAD DEBT EXPENSE.
PART III, LINE 8: NONE OF THE MEDICARE SHORTFALL REPORTED IN LINE 8 WAS TREATED AS A COMMUNITY BENEFIT. AMOUNTS REPORTED ON LINE 6 WERE OBTAINED FROM THE MEDICARE COST REPORT.
PART V, SECTION B, LINE 3: THE CHNA INCLUDED THREE SEPARATE DATA COLLECTION STRATEGIES: AN ANALYSIS OF EXISTING SECONDARY DATA AND EXISTING COMMUNITY HEALTH MEASURES; A FOCUS GROUP CONDUCTED ON NOVEMBER 15, 2012 DURING A REGULARLY SCHEDULED MEETING OF THE CARBON COUNTY INTERAGENCY COUNCIL; AND KEY INFORMANT SURVEYS AND INTERVIEWS. IN-HOUSE AT BMHS, A COMMUNITY BENEFIT PLAN STEERING COMMITTEE WAS FORMED AND PROVIDED INPUT PRIOR TO THE NEEDS ASSESSMENT. THE COMMITTEE WAS COMPOSED OF SENIOR MANAGEMENT AND DEPARTMENT HEADS WITHIN THE HEALTH SYSTEM. THE CARBON COUNTY INTERAGENCY COUNCIL IS COMPOSED OF LEADERSHIP FROM NUMEROUS AGENCIES AND ORGANIZATIONS, REPRESENTING MATERNAL AND CHILD HEALTH, ELDER CARE, BEHAVIORAL HEALTH, COUNTY INFRASTRUCTURE, HEALTHCARE PROVIDERS AND SOCIAL SERVICES. THE FOCUS GROUP WAS CONDUCTED WITH THESE MEMBERS. ADDITIONALLY, A REPORT ON THE FINDINGS WAS GIVEN AT THE MARCH 21, 2013 MEETING. KEY INFORMANTS FROM THE FOLLOWING COMMUNITY WORKPLACES/ PROFESSIONAL FIELDS WERE SURVEYED: FAMILY PRACTICE, COUNTY SCHOOL DISTRICTS, A COMMUNITY COLLEGE, DEPARTMENT OF HEALTH, AND AN INTERMEDIATE UNIT.GNADEN HUETTEN MEMORIAL HOSPITAL, INC.
PART V, SECTION B, LINE 7: THE COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED HEALTH PROBLEMS OUR COMMUNITIES FACE AND BARRIERS THAT KEEP RESIDENTS OF OUR COMMUNITIES FROM BEING HEALTHY. THE PRIORITY AREAS OF NEEDS WERE CLEARLY IDENTIFIED THROUGHOUT THE SURVEY TO BE: DRUG, ALCOHOL, AND TOBACCO USE, MENTAL HEALTH, OBESITY, DENTAL NEEDS, AND CHRONIC ILLNESSES. THESE NEEDS ARE CURRENTLY BEING ADDRESSES AS PART OF THE IMPLEMENTATION PLAN. FURTHER IN THE PLAN TO ADDRESS THESE NEEDS, WE ARE ASSISTING WITH LOWERING THE FOLLOWING BARRIERS: LACK OF HEALTH CARE INSURANCE OR UNDERINSURANCE, ACCESS TO COMMUNITY SERVICES, LACK OF PREVENTION SERVICES AND/OR EDUCATION, POOR DIET, AND DENIAL BY PARENTS REGARDING CHILDREN'S ISSUES. THE HOSPITAL CONTINUES TO WORK ACROSS MANY OF THE OTHER IDENTIFIED NEEDS. AS THE NEEDS THAT WERE IDENTIFIED ARE NOT MUTUALLY EXCLUSIVE FROM ONE ANOTHER, IT IS THE HOSPITAL'S HOPE THAT BY ADEQUATELY ADDRESSING THE ABOVE NEEDS AND BARRIERS, THE OTHER NEEDS AND BARRIERS WILL BE INDRECTLY IMPACTED AS WELL. THE NEEDS THAT WERE IDENTIFIED BUT ARE NOT CURRENTLY BEING ADDRESSED ARE: SPECIALTY SERVICES, DOCTORS THAT ACCEPT MA, AND NEEDS NOT MET AT HOME (ELEMENTARY LEVEL-MEDICAL CARE). THE BARRIERS THAT ARE NOT CURRENTLY BEING ADDRESSED ARE: CULTURAL HABITS, ACCESS TO JOBS, POVERTY, AND LACK OF SUPPORT SYSTEMS.GNADEN HUETTEN MEMORIAL HOSPITAL, INC.
PART V, SECTION B, LINE 20D: THE AMOUNTS CHARGED WERE IN ACCORDANCE WITH THE HOSPITAL'S OVERALL FINANCIAL ASSISTANCE POLICY.GNADEN HUETTEN MEMORIAL HOSPITAL, INC.
PART VI, LINE 2: THE HOSPITALS OF THE BLUE MOUNTAIN HEALTH SYSTEM CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT, AUGUST 2012 - JANUARY 2013 AND DEVELOPED AN IMPLEMENTATION PLAN WITH STRATEGIES TO ADDRESS IDENTIFIED COMMUNITY HEALTH NEEDS. THE PROCESS, CONDUCTED BY EASTCENTRAL PA AREA HEALTH EDUCATION CENTER (ECPA AHEC), USED PRIMARY AND SECONDARY SURVEY DATA, KEY INFORMANT SURVEYS AND INTERVIEWS, AND A FOCUS GROUP TO IDENTIFY AND PRIORITIZE HEALTH PROBLEMS AND RISK FACTORS IN THE CARBON COUNTY SERVICE AREA. AFTER ANALYZING THIS DATA AND MAPPING EXISTING INTERNAL AND COMMUNITY BASED RESOURCES, BMHS DEVELOPED AN IMPLEMENTATION PLAN WITH EVIDENCE BASED STRATEGIES. THE IMPLEMENTATION PLAN WAS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS AT THE ANNUAL STRATEGIC PLANNING RETREAT ON JULY 20, 2013. THE FINAL APPROVED VERSION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN IS AVAILABLE TO THE PUBLIC ON THE HEALTH SYSTEM'S WEBSITE. WITH THE COLLABORATION AFFORDED BY BMHS LEADERSHIP AND KEY COMMUNITY PARTNERS, THE GOALS, OBJECTIVES AND OUTCOME MEASURES DEFINED FOR THE IMPLEMENTATION PLAN WILL REVIEWED ON AN ANNUAL BASIS FOR THE IMPROVEMENT AND POSITIVE IMPACT OF THE IDENTIFIED/PERCEIVED HEALTH NEEDS OF THE COMMUNITY.POST-ASSESSMENT MEETINGS WERE HELD WITH BOTH THE BLUE MOUNTAIN HEALTH SYSTEM'S COMMUNITY BENEFIT PLAN STEERING COMMITTEE AND THE CARBON COUNTY INTERAGENCY COUNCIL TO REPORT THE FINDINGS AND GAIN FURTHER INPUT AND ASSISTANCE WITH THE PRIORITIZATION OF HEALTH NEEDSIDENTIFIED, PRIORITIZED/RANKED COMMUNITY HEALTH NEEDSO DRUG, ALCOHOL AND TOBACCO USE (ACROSS ALL AGES)O MENTAL HEALTHO OBESITY (INCLUDING CHILDREN)O DENTAL NEEDSO CHRONIC ILLNESSES, ESPECIALLY CARDIAC AND PULMONARY DISEASE, DIABETES, HYPERTENSION, CANCER AND STROKE.BARRIERS TO GOOD HEALTH O LACK OF HEALTH INSURANCE OR UNDERINSURANCE.O BARRIERS TO ACCESS TO COMMUNITY SERVICESO LACK OF PREVENTION SERVICES AND/OR EDUCATIONO POOR DIETO DENIAL BY PARENTS REGARDING CHILDREN'S HEALTH ISSUES
PART VI, LINE 3: IN ACCORDANCE WITH PENNSYLVANIA STATE REPORTING REQUIREMENTS, THE BLUE MOUNTAIN HEALTH SYSTEM'S CHARITY CARE EXPENSE IS REPORTED BASED UPON COSTS VERSUS CHARGES. CHARITY CARE INCLUDES THE HEALTH SYSTEM'S TRADITIONAL INPATIENT AND EMERGENCY SERVICES, AS WELL AS THE CARE PROVIDED AS PART OF EXTERNAL EDUCATIONAL PROGRAMS AND SERVICES SUCH AS THROUGH OUR FAMILY PLANNING PROGRAM.MORE PEOPLE WERE SERVED THROUGH THE HOSPITAL'S CHARITABLE CARE AND FINANCIAL ASSISTANCE PROGRAMS IN VIRTUALLY ALL CATEGORIES, AS FOLLOWS:- GNADEN HUETTEN MEMORIAL HOSPITAL CHARITABLE CARE PATIENTS- PALMERTON HOSPITAL CHARITABLE CARE PATIENTS- BLUE MOUNTAIN HEALTH SYSTEM'S "HEALTHY SMILES, HAPPY KIDS" DENTAL VAN - 1,417 SERVED IN FY 2012SIGNAGE IS VISIBLE IN ALL BLUE MOUNTAIN HEALTH SYSTEM POINTS OF REGISTRATION IN ORDER TO CREATE AWARENESS OF THE FINANCIAL ASSISTANCE PROGRAM. AT A MINIMUM, SIGNAGE IS POSTED IN ALL PATIENT INTAKE AREAS, INCLUDING, BUT NOT LIMITED TO, EMERGENCY DEPARTMENT, AND THE ADMISSION/PATIENT REGISTRATION AREA.IN RECENT YEARS, THE HEALTH SYSTEM HAS EXPANDED THE NUMBER OF FINANCIAL COUNSELORS AVAILABLE TO ASSIST PATIENTS. A KEY GOAL IS TO IDENTIFY COMMUNITY MEMBERS IN NEED SOONER. COUNSELORS PROACTIVELY SEEK OUT PATIENTS PRIOR TO TREATMENT IN AN EFFORT TO CONNECT THEM WITH PUBLIC INSURANCE PROGRAMS AS APPROPRIATE OR TO ENCOURAGE THEM TO COMPLETE AN ASSISTANCE APPLICATION. THE RESULT IS MORE CHARITY CARE AND LESS REPORTED AS BAD DEBT; MOST IMPORTANTLY, COMMUNITY MEMBERS ARE PROVIDED WITH THE SUPPORT TO ACCESS THE MEDICAL CARE THEY NEED.
PART VI, LINE 4: THE MEDIAN INCOME OF HOUSEHOLDS IN CARBON COUNTY WAS $47,283. 74 PERCENT OF THE HOUSEHOLDS RECEIVED EARNINGS AND 25 PERCENT RECEIVED RETIREMENT INCOME OTHER THAN SOCIAL SECURITY. THIRTY-NINE PERCENT OF THE HOUSEHOLDS RECEIVED SOCIAL SECURITY. THE AVERAGE INCOME FROM SOCIAL SECURITY WAS $15,428.ACCORDING TO THE BUREAU OF LABOR STATISTICS, CARBON COUNTY SHOWS A RELATIVELY HIGH RATE OF UNEMPLOYMENT- 10.2 PERCENT- COMPARED TO THE MID-ATLANTIC REGION AND THE NATION AS A WHOLE.THE CARBON COUNTY CHILD & FAMILY COLLABORATIVE'S 2009-10 "STATE OF THE CHILD & FAMILY IN CARBON COUNTY" REPORT STATES THAT THE AREA'S CHILDREN ARE AT MODERATE-HIGH RISK OF SCHOOL FAILURE DUE TO THE FOLLOWING FACTORS: 42.3 PERCENT LIVE IN HOUSEHOLDS EARNING LESS THAN 200 PERCENT OF POVERTY; 10.8 PERCENT LIVE IN FAMILIES WHOSE MOTHER EARNED LESS THAN A HIGH SCHOOL DIPLOMA; AND 11 PERCENT OF CHILDREN UNDER THE AGE OF 5 LIVING BELOW POVERTY LEVEL ARE OF A SINGLE MOTHER HOUSEHOL. FURTHERMORE, ACCORDING TO A 2010 DRUG AND ALCOHOL SURVEY, 27 OUR OF 3,000 6TH TO 11TH GRADERS IN CARBON COUNTY HAD ALCOHOL WITHIN THE LAST 30 DAYS, WITH 20 PERCENT HAVING BEEN GIVEN TO THEM BY PARENTS OR FAMILY MEMBERS.OVERALL, CARBON COUNTY RANKS 49TH (OF 67 COUNTIES) IN HEALTH OUTCOMES RELATED TO MORTALITY, MORBIDITY, HEALTH BEHAVIORS, CLINICAL CARE, SOCIAL AND ECONOMIC FACTORS AND PHYSICAL ENVIRONMENT. OF PARTICULAR INTEREST IS THE CATEGORY OF HEALTH BEHAVIORS (TOBACCO USE, OBESITY, PHYSICAL INACTIVITY, EXCESSIVE DRINKING, MOTRO VEHICLE CRASH DEATH RATE, SEXUALLY TRANSMITTED INFECTIONS AND TEEN BIRTH RATE) WHERE THE COUNTY RANKS 63/37. A MEASURE OF ACCESS TO CARE RELATES TO THE PRIMARY CARE PROVIDER RATE, OR THE POPULATION TO PRIMARY PHYSICIAN RATIO. THE NATIONAL BENCHMARK FOR POPULATION TO PRIMARY PHYSICIAN RATIO IS 631:1. IN PENNSYLVANIA, THAT RATIO IS 838:1, AND IN CARBON COUNTY THE RAIOS IS 2121:1, ALMOST THREE TIMES THE RATIO OF THE STATE AS A WHOLE.
PART VI, LINE 5: THE MEDICAL STAFF OF THE BLUE MOUNTAIN HEALTH SYSTEM IS AN OPEN MEDICAL STAFF ALLOWING SUBMISSIONS FOR PRIVILEGES AND CREDENTIALING FROM ANY INTERESTED PHYSICIAN OR SURGEON. THE BOARD OF DIRECTORS IS COMPRISED OF 17 INDIVIDUALS FROM VARIOUS COMMUNITY ORGANIZATIONS SUCH AS FINANCIAL INSTITUTIONS, TELECOMMUNICATION, RECREATION, AND REPRESENTATION FROM THE MEDICAL STAFF. OF THE 17 MEMBERS OF THE BOARD OF DIRECTORS, 13 RESIDE IMMEDIATELY WITHIN THE PRIMARY SERVICE AREA OF THE HEALTH SYSTEM. ALL OF THE BOARD MEMBERS ARE INDEPENDENT, WITH THE EXCEPTION OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, WHO IS EMPLOYED DIRECTLY BY THE HEALTH SYSTEM.BLUE MOUNTAIN HEALTH EDUCATION PROGRAMMING-PROVIDES MORE THAN 30 EDUCATIONAL PROGRAMS AND SCREENINGS NATIONAL CHOLESTEROL MONTH DINNER & LECTURE PROGRAM, WEIGHT LOSS SURGERY, AARP DRIVING CLASS, LUNG CANCER EDUCATION, DIABETES EDUCATION, STRESS/STROKE SCREENINGS, CARBON COUNTY DOMESTIC VIOLENCE, FAMILY CAREGIVER TRAINING NIGHT, CARBON COUNTY DRUG & ALCOHOL PROGRAM; LOOK GOOD... FEEL BETTER WITH AMERICAN CANCER SOCIETY; NEW TO MEDICARE CO-SPONSORED WITH CARBON COUNTY AREA AGENCY ON AGING; HEART HEALTH FAIR; AMERICAN HEART MONTH LUNCH 'N LEARN; LET'S TALK ABOUT WOUND CARE AND ADULT DAY SERVICE; CARBON COUNTY SAFE KIDS AND SENATOR YUDICHAK COMMUNITY SAFETY DAY; PANTHER VALLEY CAREER DAY; SAFE KIDS CAR SEAT CHECK; MENTAL HEALTH DEPRESSION OUTREACH ASSESSMENTS.-SERVES AS A MEDICAL TRAINING/CLINICAL EDUCATION SITE FOR AREA COLLEGES AND SCHOOLS SUCH AS CEDAR CREST COLLEGE, WILKES UNIVERSITY, KING'S COLLEGE, KUTZTOWN UNIVERSITY, DESALES UNIVERSITY, MARYWOOD UNIVERSITY, UNIVERSITY OF SCRANTON, LEHIGH CARBON COMMUNITY COLLEGE, LINCOLN TECHNICAL INSTITUTE, NORTHAMPTON AREA COMMUNITY COLLEGE, PENNSYLVANIA STATE UNIVERSITY, JOHNSON SCHOOL OF TECHNOLOGY AND PENNSYLVANIA COLLEGE OF OSTEOPATHIC MEDICINE.-PROVIDE CPR/BLS/ACLS/PALS TRAINING TO COMMUNITY ORGANIZATIONS SUCH AS AMBULANCE/EMS, FIRE, POLICE, TEACHERS.-PROVIDES "BLUE MOUNTAIN VIEWS" A COMMUNITY NEWSLETTER AND "HEALTH IMAGES" A HEALTH SYSTEM HOSTED TELEVISION PROGRAM FEATURING A VARIETY OF HEALTH AND WELLNESS INFORMATION AND EDUCATION.-HOSTS NEW SEASONS, A PROGRAM FOR ADULTS AGE 65 AND OLDER THAT OFFERS EXERCISE AND WELLNESS PROGRAMS SUCH AS YOGA AND LOW-IMPACT AEROBICS, NEW SEASONS HEARING AID BATTERY BANK, AND THE NEW SEASONS ANNUAL HEALTH & INFORMATION FAIR
PART VI, LINE 6: THE HOSPITALS OF THE BLUE MOUNTAIN HEALTH SYSTEM ARE REGIONAL PROVIDERS OF HEALTH CARE SERVICES TO THE PEOPLE LIVING IN CARBON COUNTY AND PARTS OF MONROE, LEHIGH, NORTHAMPTON AND SCHUYLKILL COUNTIES. BLUE MOUNTAIN HEALTH SYSTEM INCLUDES PALMERTON HOSPITAL, A 70-BED COMMUNITY HOSPITAL LOCATED IN PALMERTON; GNADEN HUETTEN MEMORIAL HOSPITAL, A 90-BED COMMUNITY HOSPITAL; THE SUMMIT AT BLUE MOUNTAIN, A 91-BED NURSING AND REHABILITATION CENTER, BOTH LOCATED IN LEHIGHTON AND AN ADULT DAY SERVICE CENTER IN PALMERTON. COMBINED, THESE FACILITIES HAVE BEEN SERVING THE FAMILIES OF OUR AREA FOR MORE THAN 150 YEARS. THE HOSPITALS OF THE BLUE MOUNTAIN HEALTH SYSTEM ARE FULLY ACCREDITED BY THE JOINT COMMISSION. DIAGNOSTIC OUTPATIENT SERVICES, INCLUDING ACUTE REHABILIATION, MAMMOGRAPHY, ULTRASOUND, CARDIAC REHABILITATION AND THE CLINICAL LABORATORY ARE ALSO ACCREDITED BY THEIR RESPECTIVE NATIONAL PROFESSIONAL ORGANIZATIONS.
BLUE MOUNTAIN HEALTH SYSTEM HAS ADOPTED THE FOLLOWING IMPLEMENTATION DETAILS TO SUPPORT ITS COMMUNITY HEALTH NEEDS ASSESSMENT. DRUG, ALCOHOL, AND TOBACCO USEGOAL: PRECLUDE OR REDUCE THE NEGATIVE IMPACT OF ALCOHOL, TOBACCO AND OTHER DRUG (ATOD) USE ON THE RESIDENTS OF CARBON COUNTY AND SURROUNDING COMMUNITIES.OBJECTIVE: IMPROVE THE HEALTH SYSTEMS CAPACITY TO EFFECTIVELY ADDRESS ATOD ISSUES STRATEGY 1: CREATE A COMPREHENSIVE ATOD INTERNAL AND EXTERNAL PREVENTION, INTERVENTION AND TREATMENT PLAN FOR THE BLUE MOUNTAIN HEALTH SYSTEM (BMHS) ACTION STEPS AND METRICS:-IDENTIFY KEY PERSONNEL AND CREATE A SYSTEM WIDE ATOD TASK FORCE. EVIDENCED BY THE CREATION OF THE TASK FORCE INVITATION LIST BY SR. MGT. AND HUMAN RESOURCES.-CONVENE TASK FORCE MEETINGS AND BEGIN THE ATOD STRATEGIC PLANNING PROCESS.EVIDENCED BY THE TASK FORCE MEETING MINUTES AND ULTIMATELY THE ATOD PLAN.- DISSEMINATE THE PLAN, SEEK LEADERSHIP APPROVAL AND BEGIN THE IMPLEMENTATION OF THE STRATEGIES CONTAINED THEREIN. EVIDENCED BY THE ADOPTION OF THE ATOD PLAN BY THE BOD AND THE ROLL OUT OF INITIAL PROJECTS/PROGRAMS CONTAINED IN THE PLAN.STRATEGY 2: EDUCATE AND TRAIN BMHS PERSONNEL ON THE LOCAL ATOD PROBLEM AND BUILD ATOD ASSESSMENT, INTERVENTION AND REFERRAL CAPACITIES SYSTEM WIDE ACTION STEPS AND METRICS:-DEVELOP BASIC ATOD 101 CURRICULUM TO TRAIN STAFF. EVIDENCED BY THE PRESENCE AND ROLL OUT OF AN ATOD COMPETENCY FOR BMHS STAFF -PARTNER WITH CMP D&A AND OTHERS TO SECURE TRAINING ON THE PA CLIENT PLACEMENT CRITERIA (PCPC). TRACK THE NUMBER OF PCPC TRAINED STAFF ADDED TO THE STAFF COMPLIMENT OVER THE NEXT THREE YEARS. -PARTNER WITH CMP D&A AND OTHERS TO SECURE SPECIALIZED ATOD TRAINING AND/OR MATERIALS. DOCUMENTATION OF AT LEAST ONE SPECIAL ATOD TRAINING EVENT SPONSORED OR SUPPORTED BY BMHS.OBJECTIVE 2: INCREASE THE NUMBER OF HEALTHCARE PROVIDERS WHO DO BRIEF INTERVENTIONS WITH THEIR PATIENTS WHO USE TOBACCO AND WHO ARE AWARE OF LOCAL CESSATION RESOURCES AND HOW TO REFER TO THOSE SERVICESSTRATEGY: EDUCATE PROVIDERS REGARDING HOW TO DO A BRIEF INTERVENTION WITH PATIENTS WHO USE TOBACCO AND ARRAY OF SERVICES AVAILABLE TO SUPPORT TOBACCO USERS WHO ARE READY TO QUITACTION STEP AND METRICS: WORK WITH TOBACCO FREE NORTHEAST AND EASTCENTRAL AHEC TO SCHEDULE BRIEF INTERVENTION TRAININGS FOR HEALTH CARE PROVIDERS. INCLUDE INFORMATION ON LOCAL CESSATION SERVICES AVAILABLE; QUITLINE AND HOW TO ACCESS; FAX TO QUIT AND HOW IT IS UTILIZED; AND PHARMACOTHERAPY OPTIONS. SCHEDULE A MINIMUM OF THREE TRAININGS EACH YEAR AT VARIOUS TIMES AND LOCATIONS CONVENIENT FOR PROVIDERS TO ATTEND AND EACH HOSPITAL DEPARTMENT AND OUTPATIENT OFFICE WILL BE REQUIRED TO HAVE AT LEAST ONE STAFF MEMBER ATTEND A TRAINING.MENTAL HEALTHGOAL: IMPROVE THE MENTAL HEALTH OF THE RESIDENTS OF CARBON COUNTY AND ITS SURROUNDING COMMUNITIES BY REMOVING OBSTACLES (REAL OR PERCEIVED) THAT PREVENT ACCESS TO PREVENTION, INTERVENTION AND TREATMENT SERVICES.OBJECTIVE 1: EXPAND THE CONTINUUM OF CARE FOR RESIDENTS WHO ARE SEEKING TREATMENT FOR BEHAVIORAL HEALTH CARE SERVICES STRATEGY: ADD AN OUTPATIENT LEVEL OF CARE (LOC) TO THE EXISTING BMHS CONTINUUM OF CARE. ACTION STEP AND METRIC: RECRUIT ONE ADDITIONAL PSYCHIATRIST OVER THE NEXT THREE YEARS. EVIDENCED BY THE HIRING OF THE PHYSICIAN WHO WILL STAFF THE OP LOC.OBJECTIVE 2: PROVIDE COMMUNITY EDUCATION OR SUPPORT PROGRAMS OR SERVICES TO THE COMMUNITY FREE OF CHARGE.STRATEGY: PROVIDE SPACE FOR MEETINGS AND/OR ASSIGN STAFF TO FACILITATE OR CONSULT WITH COMMUNITY GROUPS/ORGANIZATIONS IN AN EFFORT TO PROVIDE EDUCATION AND SUPPORT SERVICES FOR INDIVIDUALS OR FAMILY MEMBERS WHO ARE AFFECTED BY MENTAL ILLNESS. ACTION STEPS AND METRICS:-CONTINUE TO SUPPLY MEETING SPACE AND SUPPORT FOR THE "SURVIVORS OF SUICIDE" SUPPORT GROUPS. EVIDENCED BY "SURVIVORS OF SUICIDE" GROUPS HELD AT GHMH CAMPUS.-CONTINUE TO SUPPLY STAFF AND OTHER RESOURCES TO CONDUCT COMMUNITY BASED "DEPRESSION SCREENINGS" AS SCHEDULED. EVIDENCED BY "DEPRESSION SCREENING" SESSIONS HELD AT VARIOUS LOCATIONS AROUND THE COUNTY. -CONTINUE TO SUPPLY, ON AN AD HOC BASIS, STAFF AND RESOURCES NEEDED TO CONDUCT OTHER TYPES OF INTERVENTION PROGRAMS OR SERVICES AS IDENTIFIED. EVIDENCED BY OTHER EDUCATIONAL OR SUPPORT GROUPS BEING HELD ANNUALLY.OBJECTIVE 3: REMOVE FINANCIAL OBSTACLES WHENEVER POSSIBLE AND EVALUATE ALL CONSUMERS FOR ADMISSIONS TO ALL LEVELS OF SERVICE REGARDLESS OF THEIR ABILITY TO PAYSTRATEGY: OFFER FINANCIAL COUNSELING TO ALL CLIENTS WITH MENTAL HEALTH ISSUES AND WHEN POSSIBLE PROVIDE FULL OR PARTIAL REDUCTIONS IN CHARGES FOR THESE SERVICES. ACTION STEPS AND METRICS:-OFFER FINANCIAL COUNSELING TO ALL NON OR UNDERINSURED PATIENTS TO DETERMINE IF THERE ARE OTHER PAYERS WHO CAN BE ACCESSED OR TO ESTABLISH A PAYMENT PLANS OPTION IF APPROPRIATE. EVIDENCED BY DOCUMENTATION OF REFERRALS TO FINANCIAL COUNSELING BY THE FINANCE OFFICE. -ASSIST PATIENTS IN THE APPLICATION PROCESS FOR BOTH MEDICAID AND FINANCIAL ASSISTANCE. EVIDENCED BY DOCUMENTATION OF MEDICAID APPLICATIONS AND APPLICATION FOR PATIENT FINANCIAL ASSISTANCE.-GRANT FINANCIAL ASSISTANCE TO CERTAIN NON-EMERGENT, UNINSURED PATIENTS IDENTIFIED BY THE CRISIS WORKERS. EVIDENCED BY NON-INSURED REGISTRATIONS INTO OUR ACUTE PARTIAL HOSPITALIZATION PROGRAM.DENTAL HEALTHGOAL: CONTINUE TO PROVIDE DENTAL HEALTH SERVICES FOR UNINSURED AND UNDERINSURED CHILDREN IN CARBON COUNTY AND ITS SURROUNDING COMMUNITIES.OBJECTIVE 1: IMPROVE THE DENTAL HEALTH FOR LOW INCOME CHILDREN BY PROVIDING THEM WITH A MOBILE DENTAL HOME.STRATEGY: DEPLOY THE BMHS HEALTHY SMILES HAPPY KIDS MOBILE DENTAL VAN TO THE FIVE CARBON COUNTY SCHOOL DISTRICTS, THE TAMAQUA AREA SCHOOL DISTRICT AND THE CARBON & SCHUYLKILL COUNTY HEAD START PROGRAMS.ACTION STEPS AND METRICS:-PROVIDE ANNUAL DEPT. OF HEALTH (DOH) MANDATED DENTAL EXAMS TO ALL GRADE LEVEL APPROPRIATE STUDENTS AS REQUESTED BY THE SCHOOL DISTRICT. TRACK AND REPORT THE TOTAL # OF CHILDREN ACCESSING A DOH MANDATED EXAM ON THE HSHK DENTAL VAN.-PROVIDE BI-ANNUAL CHECK-UPS, CLEANINGS, AND WHEN NECESSARY RESTORATION SERVICES. TRACK AND REPORT THE TOTAL NUMBER OF CHILDREN BY SERVICE PROVIDED. -PROVIDE REFERRAL SERVICES TO PEDIATRIC SPECIALIST OR HIGHER LEVEL OF CARE WHEN CLEANING OR RESTORATION CAN NOT BE ACCOMPLISHED ON THE VAN. TRACK AND REPORT THE TOTAL NUMBER OF CHILDREN WHO WERE REFERRED TO A OTHER LEVELS OF CARE. OBJECTIVE 2: ENSURE THE FUTURE SUSTAINABILITY OF THE HSHK DENTAL VAN. STRATEGY: HOLD MEETINGS AND ENGAGE THE CARBON COUNTY CORPORATE COMMUNITY, COMMUNITY GROUPS AND OTHER INDIVIDUALS WITH WEALTH IN ANNUALLY FUNDRAISING EFFORTS.ACTION STEPS AND METRICS: -IDENTIFY KEY PARTNERS TO BE INVITED TO THE TABLE AND HOLD MEETINGS. EVIDENCED BY THE MINUTES OF THESE SPECIAL MEETINGS.-DEVELOP A COMMUNITY DRIVEN FUNDRAISING PLAN TO NET THE VAN AN ADDITIONAL OPERATING REVENUES. EVIDENCED BY THE PRESENCE OF A PLAN AND ADDITIONAL FUNDS RAISED.CHRONIC ILLNESSGOAL 1: TO IMPROVE THE HEALTH OF CARBON COUNTY AND ITS SURROUNDING COMMUNITIES BY CREATING A COMPREHENSIVE MENU OF SERVICES DESIGNED TO PRECLUDE OR REDUCE THE INCIDENCE OF CHRONIC DISEASE OR ILLNESSES.OBJECTIVE 1: PROVIDE EDUCATION, SCREENING AND COMMUNITY SUPPORT SERVICES THAT ADDRESS VARIOUS CHRONIC DISEASES AND ILLNESSES THAT AFFECT THE BMHS SERVICE AREA. STRATEGY 1: EDUCATE THE COMMUNITY BY PROVIDING ACCESS TO THE LATEST MEDICAL INFORMATION ON CHRONIC DISEASES AND ILLNESSES BY PROVIDING THEM WITH ACCESS TO LECTURES AND EDUCATIONAL MATERIALS ON THE PREVENTION, EARLY DETECTION AND TREATMENTS AVAILABLE. ACTION STEPS AND METRICS:-OBESITY-PROMOTE HEALTHY LIFESTYLE FROM CHILDHOOD THROUGH OLD AGE THROUGH EDUCATION OF ASSOCIATED RISK FACTORS, ADOPTION OF HEALTHY EATING HABITS, AND BENEFITS OF EXERCISE. -DIABETES-PROMOTE SELF MANAGEMENT OF DIABETES THROUGH EDUCATION TO PROMOTE HEALTHY EATING AND PHYSICAL ACTIVITY, UNDERSTANDING OF HYPOGLYCEMIC MEDICATIONS, AND KNOWLEDGE OF COMPLICATIONS ASSOCIATED WITH DIABETES.-HEART DISEASE-PROVIDE EDUCATION TO THE COMMUNITY ON THE PREVENTION OF HEART DISEASE, AND PROMOTION OF A HEALTHY LIFESTYLE THROUGH FREE BP AND CHOLESTEROL SCREENINGS AT HEALTH FAIRS, SENIOR CENTERS, SHOPPING MALLS.-METRIC IS TO RECORD THE TYPES OF LECTURES, THE NUMBER OF LECTURES, THE NUMBER OF PERSONS AND BASIC DEMOGRAPHICS OF THOSE WHO ATTEND EDUCATIONAL OFFERINGS.STRATEGY 2: PROVIDE ACCESS TO THE ALL TYPES OF SCREENING AND INTERVENTIONAL SUPPORT SERVICES THAT WILL ASSIST INDIVIDUALS IN DETERMINING THEIR LEVEL OF RISK AND READINESS TO CHANGE AT RISK BEHAVIORS.IMPLEMENTATION PLANPART VI
ACTION STEPS AND METRICS:-PARTICIPATE IN AND/OR SPONSOR EVENTS THAT PROMOTE WELLNESS: ANNUAL GREAT AMERICAN SMOKE OUT, THE BMHS 5K RUNS AND LOCAL CANCER "RELAY FOR LIFE" EVENTS. -PROVIDE BLOOD PRESSURE, GLUCOSE, CHOLESTEROL AND BODY MASS INDEX SCREENINGS AT VARIOUS COMMUNITY HEALTH FAIRS AS WELL AS PROVIDE HOSPITAL BASED DIABETIC EDUCATION AND BARIATRIC SUPPORT GROUPS SERVICES TO THOSE MOST AT RISK.-PROVIDE FREE PHENOMENA AND INFLUENZA INOCULATION CLINICS AT VARIOUS LOCATIONS ACROSS THE COUNTY FOR THE UN AND UNDER INSURED AS WELL AS OLDER ADULTS AND OTHER AT RISK GROUPS.-METRIC IS TO RECORD THE NUMBER OF SCREENING EVENTS, IMMUNIZATION CLINICS OR CHRONIC DISEASE SUPPORT GROUPS HELD, AS WELL AS THE NUMBER OF PERSONS AND BASIC DEMOGRAPHICS OF THOSE WHO PARTICIPATED.OBJECTIVE 2: IMPROVE THE HEALTH OF NON OR UNDER INSURED WOMEN RESIDENTS OF CARBON COUNTY AND ITS SURROUNDING COMMUNITIES BY PROVIDING THEM WITH A COMPREHENSIVE CANCER EDUCATION, PREVENTION, EARLY INTERVENTION, SUPPORT AND ADVOCACY PROGRAMS.STRATEGY 1: PROVIDE WOMEN FROM THE BMHS SERVICE AREA WITH UP-TO-DATE INFORMATION ABOUT WOMEN'S CANCER PREVENTION, EARLY DETECTION, ADVOCACY, AND SUPPORT SERVICES.ACTION STEPS AND METRICS:-USE THE "PINK PACK PAL" PROJECT TO PROVIDE NO WOMEN WITH CALENDAR STICKERS & OTHER EDUCATIONAL MATERIALS ON SELF BREAST EXAM. EVIDENCED BY 2500 PAL PACKS CREATED AND DISTRIBUTED THROUGHOUT THE BMHS SERVICE AREA.-PROVIDE THROUGHOUT THE YEAR UP-TO-DATE INFORMATION/EDUCATION PROGRAMS ON WOMEN'S CANCER ISSUES IN VARIOUS SM. AND LG. GROUP FORMATS. EVIDENCED BY THE NUMBER OF ED. GROUPS PROVIDED AND TRACKED BY THE BMHS COMMUNITY EDUCATION SPECIALIST.-HOLD ANNUAL LADIES NIGHT OUT CANCER INFORMATION/NETWORKING EVENT. EVIDENCED BY THE DOCUMENTATION OF WOMEN ATTENDING THE LADIES NIGHT OUT PROGRAM.STRATEGY 2: AUTHORIZE SCREENING MAMMOGRAMS AND DIAGNOSTIC ULTRASOUND STUDIES FOR NO LESS THAN 65 NON OR UNDER INSURED WOMEN THROUGH THE EXISTING "VOUCHER PROGRAM" ADMINISTERED BY THE BMHS IMAGING DEPARTMENT. ACTION STEPS AND METRICS:-SUBMIT GRANT APPLICATIONS TO HELP DEFRAY COST ABSORBED BY BMHS AND FOUNDATION RADIOLOGY. EVIDENCED BY OCTOBER 2013 GRANT SUBMISSION TO VARIOUS FUNDING SOURCES.-DETERMINE THE NUMBER OF FREE MAMMOGRAMS AND ULTRASOUND STUDIES THAT CAN BE PROVIDED ANNUALLY. EVIDENCED BY NUMBER OF WOMEN RECEIVING THE FREE MAMMOGRAM OR ULTRASOUND SERVICE ANNUALLY.GOAL 2: IMPROVE THE HEALTH OF THE NON OR UNDERINSURED RESIDENTS OF CARBON COUNTY AND ITS SURROUNDING COMMUNITIES WHO HAVE CHRONIC ILLNESSES BY INCREASING THEIR ACCESS TO PRIMARY & SPECIALTY CARE PHYSICIANS THAT ACCEPT MEDICARE AND MEDICAID.OBJECTIVE: INCREASE ACCESS TO PRIMARY & SPECIALTY CARE PHYSICIANS IN THE BMHS SERVICE AREA.STRATEGY 1: ACTIVELY RECRUIT AND PLACE PRIMARY AND SPECIALTY CARE PHYSICIANS IN BMHS SERVICE AREA.ACTION STEPS AND METRICS: -IDENTIFY SERVICE AREA LOCATIONS THAT HAVE A SHORTAGE OF PRIMARY CARE PHYSICIANS. COMPLETE MARKET ANALYSIS BASED UPON POPULATION TO IDENTIFY THE LOCATION FOR ADDITIONAL PRIMARY AND SPECIALTY CARE PHYSICIANS.-HIRE RECRUITMENT FIRMS TO ASSIST IN SOURCING CANDIDATES. BMHS WILL HIRE CONTINGENCY AND RETAINED SEARCH FIRMS TO ASSIST IN RECRUITMENT.-INTERVIEW QUALIFIED CANDIDATES AND OFFER EMPLOYMENT TO ACCEPTABLE PHYSICIANS. BMHS WILL DOCUMENT THE NUMBER OF RESUMES RECEIVED, CANDIDATES INTERVIEWED, OFFERS MADE AND NUMBER OF ACCEPTANCES.STRATEGY 2: CONTINUE TO SUPPORT THE EAST CENTRAL AREA HEALTH EDUCATION CENTER AND THEIR MISSION TO PROMOTE PRIMARY AND FAMILY MEDICINE IN RURAL COMMUNITIES AS A VIABLE CAREER CHOOSE FOR MEDICAL STUDENTS IN THEIR CHARGE.ACTION STEPS AND METRICS:-PROVIDE ECAHEC WITH ACCESS TO THE HEALTH SYSTEM'S "PALMERTON HOUSE" TO BE USE FOR MEDICAL STUDENT RENT FREE HOUSING DURING THEIR RURAL MEDICINE ROTATIONS. EVIDENCED BY THE SIGNED FACILITY USE AGREEMENT.-PROVIDE SUPPORT FOR THE ECAHEC MISSION BY ENCOURAGING HEALTH SYSTEM EMPLOYEES TO BECOME ACTIVE MEMBERS OF THEIR BOD. EVIDENCED BY SENIOR MANAGEMENT PARTICIPATION AS BOARD MEMBERS.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
ANDREW E HARRIS
PRESIDENT/CEO3520170122500013758000225720510847000
ANDREA ANDRAE
CFO01424410262010000021174018981600
DR HERBERT HOOVER
PHYSICIAN475239000000098160485055000
DR MUHAMMAD RIFAI
PHYSICIAN3291690000000276900356859000
KATHLEEN R NOLL
PHYSICIAN3432690000000149360358205000
DAVID P RUSSO
PHYSICIAN2959160000000128980308814000
JAMES F MENAPACE
PHYSICIAN2730150000000265300299545000
WALTER J BELL
PHYSICIAN2639300000000263420290272000
FRANK R PENATER
PHYSICIAN2511850000000204890271674000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 1ATHE ORGANIZATION INCLUDED $1,168 OF CLUB DUES IN PRESIDENT/CEO ANDREW HARRIS' REPORTABLE INCOME IN HIS 2012 W-2. THIS AMOUNT WAS INCLUDED AS TAXABLE INCOME FOR MR. HARRIS.
PART I, LINE 7THE BONUS PROGRAM AT THE BLUE MOUNTAIN HEALTH SYSTEM IS BASED ON FIVE DEFINED PILLARS OF SUCCESS. THESE 5 PILLARS INCLUDE FINANCE, QUALITY, SERVICE, PEOPLE AND GROWTH. ALL EMPLOYEES OF THE HEALTH SYSTEM PARTICIPATE IN THE BONUS PROGRAM. THE BONUS PAYMENT IS DETERMINED BASED ON SPECIFIED CRITERIA FOR EACH OF THE 5 PILLARS INDICATED ABOVE ON A FISCAL YEAR BASIS. THE CRITERIA IS PREDETERMINED AND HAS BEEN ESTABLISHED BY SENIOR MANAGEMENT AND APPROVED BY THE BOARD OF DIRECTORS OF THE BLUE MOUNTAIN HEALTH SYSTEM. DURING THE 2013 FISCAL YEAR, ALL EMPLOYEES RECEIVED A BONUS AS THE SYSTEM SUCCESSFULLY MET CERTAIN CRITERIA OF THE 5 PILLARS OF SUCCESS. THE BONUSES ARE REPORTED ON THEIR 2012 W-2S.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1CARBON COUNTY HOSPITAL AUTHORITYBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN232280834IssuerEIN
CUSIP Number140868EN6CUSIPNumber
Date Issued2012-02-23DateIssued
Issue Price6306819IssuePrice
Description Of PurposeCURRENT REFUNDING OF THE 1999 REVENUE BONDSDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Total Proceeds6000000TotalProceeds
Amount In Reserve Fund1341565AmountInReserveFund
Issuance Costs From Proceeds126068IssuanceCostsFromProceeds
Credit Enhancement41940CreditEnhancement
Other Spent Proceeds6138811OtherSpentProceeds
Year Of Subst Completion2012YearOfSubstCompletion
Current Refunding1CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty1MngmentCntrctBondFinancdPrprty
Engage Bond Counsel Contracts1EngageBondCounselContracts
Any Research Agreements0AnyResearchAgreements
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Bond Iss Meet Prvt Security Pay Test0BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop0ChangeInUseBondFinancedProp
Non Qualified Bond Remed Procdrs0NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiled
Rebate Not Due Yet0RebateNotDueYet
Exception To Rebate0ExceptionToRebate
No Rebate Due1NoRebateDue
Variable Rate Issue1VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Written Proc To Monitor Reqs0WrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Proc To Undertk Corrective Action0ProcToUndertkCorrectiveAction

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierPART III LINE 9, PART IV LINE 7 AND PART VIdentifier
ExplanationWHILE THE HOSPITAL DOES NOT HAVE FORMAL WRITTEN PROCEDURES, THEY WORK CONTINOUSLY WITH A BOND CONSULTANT TO ENSURE THEY ARE IN COMPLIANCE. THE HOSPITAL IS CONSIDERING WRITTEN PROCEDURES FOR A FUTURE YEAR.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11THE BLUE MOUNTAIN HEALTH SYSTEM (BMHS) STAFF COMMUNICATED TO THE FINANCE COMMITTEE OF THE BOARD THAT THE FORMS 990 WERE PREPARED BY PARENTEBEARD LLC AS WELL AS COMMUNICATING THE GENERAL TYPES OF INFORMATION CONTAINED IN THE FILING. THE BOARD IS PROVIDED THE DETAILS TO ACCESS TEH 990 THROUGH A SECURED BOARD "PORTAL" PRIOR TO ISSUANCE.
FORM 990, PART VI, SECTION B, LINE 12CTHE CONFLICT STATEMENT MUST BE SIGNED OFF ON AN ANNUAL BASIS BY ALL GOVERNING BODY MEMBERS, OFFICERS, AND KEY EMPLOYEES. THIS PROCESS IS MONITORED BY THE ADMINISTRATIVE ASSISTANT TO THE PRESIDENT/CEO. A CONFLICT WOULD BE ANY DIRECT OR INDIRECT FINANCIAL INTEREST. ANY CONFLICTS NOTED WOULD BE COMMUNICATED TO THE COMPLIANCE COMMITTEE. THERE WERE NO CONFLICTS DISCLOSED THIS YEAR.
FORM 990, PART VI, SECTION B, LINE 15SENIOR MANAGEMENT SALARIES ARE DETERMINED BY THE EXECUTIVE COMMITTEE USING MARKET VALUES OBTAINED. HUMAN RESOURCES PARTICIPATE IN VARIOUS SALARY SURVEYS TO DETERMINE THE CORRECT SALARY RANGE. THE APPALACHIAN HOSPITAL HUMAN RESOURCE SOCIETY CONDUCTS AN ANNUAL SALARY SURVEY FOR ALL POSITIONS. IN ADDITION, THE HOSPITAL ASSOCIATION OF PENNSYLVANIA CONDUCTS AN ANNUAL SURVEY WITH YAFFE ASSOCIATES FOR SENIOR MANAGEMENT EMPLOYEES. THE MARKET DATA IS ANALYZED BY HUMAN RESOURCES AND THE GOAL IS TO PAY AT THE 50 PERCENTILE. SALARIES OF OTHER EMPLOYEES ARE RECOMMENDED BY HUMAN RESOURCES AND APPROVED BY THE PRESIDENT AND CEO. THE EXECUTIVE COMMITTEE OF THE BOARD SERVES AS THE COMPENSATION COMMITTEE AND APPROVES RECOMMENDATIONS FOR SALARY INCREASES. THE EXECUTIVE COMMITTEE APPROVES INCREASES FOR THE CEO. REVIEW AND APPROVAL PROCESS IS DOCUMENTED. SENIOR MANAGEMENT HAS RECEIVED THE SAME GENERAL INCREASES AS THE STAFF EMPLOYEES RECEIVED.
FORM 990, PART VI, SECTION C, LINE 19FORM 990, PART VI, SECTION C, LINE 19: UPON REQUEST, THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND/OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
FORM 990, PART IX, LINE 11GPURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,079,184. MANAGEMENT AND GENERAL EXPENSES 451,683. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,530,867. OUTSIDE PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 566,981. MANAGEMENT AND GENERAL EXPENSES 1,350,154. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,917,135. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 1,285,884. MANAGEMENT AND GENERAL EXPENSES 26,595. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,312,479.OTHER FEES
FORM 990, PART XI, LINE 9:PENSION LIABILITY ADJUSTMENT 6,563,388. VALUATION LOSS -6,693.CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
BLUE MOUNTAIN HEALTH SYSTEM INC
211 NORTH 12TH STREETLEHIGHTONPA182351195201311316MAINTAINS AN INTEGRATED HEALTH CARE SYSTEM.PA501(C)(3)11AN/A0
CMS MEDICAL CARE CORPORATION
211 NORTH 12TH STREETLEHIGHTONPA182351195232473899OWNS AND OPERATES AMBULATORY CARE CENTERS IN VARIOUS COMMUNITIESPA501(C)(3)31GNADEN HUETTEN MEMORIAL HOSPITAL
THE PALMERTON HOSPITAL
135 LAFAYETTE AVENUEPALMERTONPA18071235562316OPERATES AN ACUTE CARE HOSP, PROVIDNG INPATIENT, OUTPATIENT & EMERGENCY CAREPA501(C)(3)30BLUE MOUNTAIN HEALTH SYSTEM INC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1CMS MEDICAL CARE CORPORATIONBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeOTransactionType
Amount Involved6478132AmountInvolved
Method Of Amt DeterminationCASHMethodOfAmtDetermination