2014-05-08T15:39:16-05:00 2013-06-30 232932984 PARENTEBEARD LLC 20 STANWIX ST SUITE 800 PITTSBURGH PA 15222 990 2012-07-01 250967480 OHIO VALLEY GENERAL HOSPITAL OHIO 4127776547 25 HECKEL ROAD MCKEES ROCKS PA 15136 DAVID W SCOTT 4127776547 2014-04-23 1 BRIAN R LENART EA P00289136 4126976400 2012 2015-11-30 17:44:51Z DAVID W SCOTT 25 HECKEL ROAD MCKEES ROCKS PA 15136 70833412 0 X WWW.OHIOVALLEYHOSPITAL.ORG X 1906 PA TAX-EXEMPT HOSPITAL SYSTEM DEDICATED TO SERVING THE GREATER PITTSBURGH COMMUNITY. 12 12 704 115 0 0 210000 315651 64771260 65083645 1428256 1710493 907899 1338706 67317415 68448495 0 35841 0 0 27797246 29248704 0 0 0 40298936 38685865 68096182 67970410 -778767 478085 128854122 139305751 62079151 56917881 66774971 82387870 X OHIO VALLEY GENERAL HOSPITAL'S MISSION IS TO OUR COMMUNITY, TO PROVIDE PROGRAMS AND SERVICES TO IMPROVE THE QUALITY OF LIFE IN OUR COMMUNITY; TO OUR PATIENTS, TO PROVIDE PERSONALIZED HEALTH CARE SERVICE IN A FRIENDLY, CARING AND COST-EFFECTIVE MANNER WHILE CONTINUOUSLY IMPROVING QUALITY, SAFETY, COMFORT AND WELL-BEING; TO OUR EMPLOYEES, TO RECOGNIZE THAT PEOPLE ARE THE MOST VALUABLE RESOURCE IN PROVIDING SERVICE TO PATIENTS AND TO CULTIVATE AN ENVIRONMENT THAT ENCOURAGES AND DEVELOPS HUMAN POTENTIAL; TO OUR PHYSICIANS, TO PROVIDE COMPETENT EMPLOYEES, FACILITIES, EQUIPMENT, PROGRAMS AND FRIENDLY ENVIRONMENT DESIGNED TO MEET THE NEEDS OF PHYSICIANS AND PATIENTS; TO OUR STUDENTS, TO PROVIDE THE ENVIRONMENT FOR EDUCATING FUTURE HEALTH CARE PROFESSIONALS THROUGH A SOLID CLINICAL AND THEORETICAL BACKGROUND. 0 0 35898080 35841 59931605 THE HOSPITAL: SINCE ITS BEGINNING, OHIO VALLEY GENERAL HAS NURTURED A COMMITMENT TO PROVIDE THE COMMUNITY WITH A PERSONALIZED APPROACH TO HIGH QUALITY HEALTH CARE. THIS DEDICATION HAS ESTABLISHED THE FOUNDATION FOR THE HOSPITAL TO GROW AND MEET THE COMMUNITY'S HEALTH CARE NEEDS WITH EXPANDED SERVICES, NEW PROGRAMS, ADVANCED TECHNOLOGY AND EDUCATION. WITH ITS CLOSE PROXIMITY TO THE CITY OF PITTSBURGH, THE HOSPITAL HAS THE UNIQUE ADVANTAGE OF A MEDICAL STAFF WHOSE SPECIALISTS PRACTICE AT BOTH THE HOSPITAL AS WELL AS TERTIARY-CARE HOSPITALS LOCATED IN THE CITY. FOR OUR COMMUNITY WE PROVIDE PROGRAMS AND SERVICE TO IMPROVE THE QUALITY OF LIFE. PROGRAMS SUCH AS: DIABETES AWARENESS AND PREVENTION PROGRAMS, CPR AND FIRST AID CLASSES,5K COMMUNITY ANNUAL RACE, FREE BLOOD PRESSURE SCREENINGS, BLOOD SCREENINGS, LIFELINE, SENIORITY, VOLUNTEER SERVICES, KIDSHAPE, LIVING WELL WITH DIABETES CLASSES AND PERSONAL NUTRITION COACHING.FOR OUR PATIENTS, WE PROVIDE PERSONALIZED HEALTH CARE SERVICE IN A FRIENDLY, CARING AND COST-EFFECTIVE MANNER. SERVICES SUCH AS: ACUTE REHABILITATION UNIT, OCCUPATIONAL MEDICINE, CARDIAC REHABILITATION, CARDIOLOGY SERVICES, CRITICAL CARE, EMERGENCY DEPARTMENT, LABORATORY, MEDICAL/SURGICAL UNIT, NUCLEAR MEDICINE, PULMONARY REHABILITATION, RADIOLOGY, REHABILITATION SERVICES, RESPIRATORY, SLEEP LAB, SURGICAL, WILLOW BROOK GEROPSYCHIATRIC SERVICES, PAIN TREATMENT, WOUND HEALING AND PRIMARY CARE. FOR OUR STUDENTS WE PROVIDE THE ENVIRONMENT FOR THE EDUCATION OF FUTURE HEALTH CARE PROFESSIONALS THROUGH A SOLID CLINICAL AND THEORETICAL BACKGROUND. THE SCHOOL OF NURSING PROVIDES A THEORETICAL AND CLINICAL ENVIRONMENT WHERE PROSPECTIVE NURSES WILL BE CHALLENGED AND MOTIVATED TO ACHIEVE THEIR BEST. THE SCHOOL OF RADIOGRAPHY STRIVES TO MEET THE NEEDS OF THE COMMUNITIES IT SERVES BY OFFERING A PROGRAM THAT DEVELOPS COMPETENT AND PROFESSIONAL FUTURE RADIOLOGICAL TECHNOLOGISTS. THE HOSPITAL WAS ORGANIZED IN 1906 TO OWN AND OPERATE THE HOSPITAL AS NON-SECTARIAN INSTITUTION. THE HOSPITAL, ORIGINALLY KNOWN AS MCKEES ROCKS GENERAL HOSPITAL, WAS FOUNDED, BUILT, EQUIPPED AND FURNISHED IN 1900 BY DR. SAMUEL M. BLACK ON A SITE IN STOWE TOWNSHIP, PA, OVERLOOKING THE BOROUGH OF MCKEES ROCKS. IN 1901, THE SCHOOL OR NURSING WAS INAUGURATED WITH SIX STUDENTS ENROLLED IN A TWO-YEAR COURSE. THE HOSPITAL OPERATED IN THIS ORIGINAL FACILITY UNTIL IT WAS REPLACED BY THE HOSPITAL FACILITIES, WHICH OPENED NEARBY IN 1949.HISTORICAL PERSPECTIVE:UPON ITS OPENING IN 1949, THE HOSPITAL FACILITIES HAD A CAPACITY OF 130 BEDS AND 35 BASSINETS. SEVERAL FACILITY IMPROVEMENT AND EQUIPMENT ACQUISITION PROJECTS HAVE BEEN COMPLETED AND NEW PROGRAMS INITIATED SINCE THEN IN THE YEARS INDICATED: - 1963 EXPANSION OF THE HOSPITAL FACILITIES FEATURING THE ADDITION OF 21 NEW BEDS AND NEW OPERATING ROOMS, AND THE RELOCATION OF ANCILLARY DEPARTMENTS TO FACILITATE GROWTH OF OUTPATIENT SERVICES- 1978 ADDITION TO THE HOSPITAL FACILITIES FEATURING IMPROVEMENT TO OUTPATIENT AND ANCILLARY DEPARTMENTS, AND THE ADDITION OF ANOTHER 27 BEDS- 1987 INSTALLATION OF A CT SCANNER IN THE RADIOLOGY DEPARTMENT - 1988 OPENING OF THE MEDICAL OFFICE BUILDING - 1987 - 1992 EXTENSIVE RENOVATIONS TO VARIOUS PATIENT FLOORS, THE NUCLEAR MEDICINE DEPARTMENT AND THE MAIN ENTRANCE AND LOBBY- 1992 OPENING OF A 25,000 SQUARE-FOOT ADDITION TO THE SOUTH WING OF THE HOSPITAL FACILITIES WHICH PROVIDED SPACE FOR A CRITICAL CARE SUITE, CARDIOLOGY DEPARTMENT, RESPIRATORY THERAPY DEPARTMENT AND CARDIAC REHABILITATION UNIT. - 1992 OPENING OF THE WOUND CARE CENTER FOR THE SPECIALIZED TREATMENT OF CHRONIC WOUNDS, ONE OF THE FIRST PROGRAMS OF THIS TYPE IN WESTERN PENNSYLVANIA - 1994 EXTENSIVE RENOVATIONS TO THE HOSPITAL FACILITIES' SECOND FLOOR WHICH PROMOTED THE CONSOLIDATION OF OUTPATIENT REGISTRATION AND NUMEROUS OUTPATIENT PROGRAM IN A SINGLE LOCATION READILY ACCESSIBLE BY ELEVATED WALKWAY FROM THE MEDICAL OFFICE BUILDING, AND EXTENSIVE UPGRADES TO THE REHABILITATION SERVICES DEPARTMENT, THE LABORATORY AND THE RADIOLOGY DEPARTMENT. - 1997 COMPLETE REDESIGN OF THE EMERGENCY DEPARTMENT, INCLUDING THE INTERIOR PATIENT CARE AREAS, AS WELL AS THE EXTERIOR AMBULANCE AND AUTOMOBILE ACCESS ROADWAY. - 1999 CLOSURE OF THE HOSPITAL'S TRANSITIONAL (SUB-ACURE) CARE UNIT TO MAKE WAY FOR A 15-BED INPATIENT REHABILITATION UNIT, WHICH WAS SUBSEQUENTLY EXPANDED TO 16 BEDS. - 2001 ESTABLISHMENT OF A CARDIAC CATHETERIZATION LABORATORY (THE 'CATH LAB') WITH NEW EQUIPMENT. - 2001 OPENING OF THE HOSPITAL'S PAIN TREATMENT CENTER - 2003 OPENING OF THE HOSPITAL'S PULMONARY HEALTH CENTER - 2010 OPENING OF THE WILLOW BROOK GEROPSYCHIATRIC UNIT 1415663 1740618 THE RESIDENCE AT WILLOW HEIGHTS:THE RESIDENCE AT WILLOW HEIGHTS IS A UNIQUE RESIDENCE FOR INDEPENDENT SENIOR LIVING, WHERE SENIORS WILL FIND A VARIETY OF ACTIVITIES AND AMENITIES DESIGNED TO SUIT THEIR ACTIVE LIFESTYLES, ALL IN AN INVITING ATMOSPHERE OF COMFORT AND COMMUNITY. THE RESIDENTS ALSO ENJOY ENTERTAINING FAMILY AND FRIENDS, WHETHER IN THEIR OWN APARTMENT OR AT ONE OF THE MANY PARLORS, PATIOS OR ENTERTAINMENT AREAS SPECIFICALLY DESIGNED WITH FUN IN MIND. WITH A HOST OF ACTIVITIES, SOCIAL EVENTS, SERVICES AND AMENITIES, WILLOW HEIGHTS TRULY BRINGS NEW MEANING TO SENIOR LIVING. 2945143 3659490 THE RESIDENCE AT WILLOW LANE: THE RESIDENCE AT WILLOW LANE IS A CONTEMPORARY ASSISTED SENIOR LIVING AND MEMORY CARE COMMUNITY THAT COMBINES ALL THE COMFORTS OF HOME WITH THE ACTIVITY AND SECURITY OF A SMALL COMMUNITY OF PEOPLE WHO CARE. RESIDENTS ENJOY A WIDE VARIETY OF SOCIAL ACTIVITIES IN AN ELEGANT SETTING, SPECIALLY-PLANNED PROGRAMS, GOOD FOOD, FRIENDS AND LIVING ASSISTANCE TAILORED TO EACH RESIDENT'S PARTICULAR NEEDS. AT THE RESIDENCE AT WILLOW LANE, GOOD HEALTH COMES FIRST. WILLOW LANE PROVIDES THE SECURITY OF STAFF AVAILABLE 24 HOURS A DAY AND APARTMENTS WILL ALL THE COMFORTS OF HOME. 40258886 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 146 0 1 704 1 0 0 0 0 0 1 1 0 0 0 0 X 12 12 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X TADESSE TEFERA 4127776547 25 HECKEL ROAD MCKEES ROCKS PA 15136 X MARK R SCHOLL 1.00 2.00 X X 0 0 0 GENE M BATTISTELLA DO 1.00 2.00 X X 0 0 0 MARK S BRENNAN 1.00 2.00 X X 0 0 0 JOSEPH C CIRELLI 1.00 2.00 X X 0 0 0 JANE A DIXON 1.00 2.00 X 0 0 0 KURT R GINGRICH ESQ 1.00 2.00 X 0 0 0 ANTHONY F LISANTI 1.00 2.00 X 0 0 0 DANIEL B LONG 1.00 2.00 X 0 0 0 GARY G SAUER MD 1.00 2.00 X 0 0 0 VICTOR J THOMAS MD 1.00 2.00 X 0 0 0 ANGELO D LUPARIELLO MD 1.00 2.00 X 0 0 0 SN LEIBENSPERGER 1.00 2.00 X 0 0 0 DAVID W SCOTT 40.00 2.00 X 333412 0 89554 TADESSE TEFERA 40.00 2.00 X 142635 0 38312 PAULA LIGUS 40.00 X 101944 0 27382 VICTORIA MELL 40.00 X 112026 0 30090 HUWAIDA MANSOUR 40.00 X 196207 0 52701 THOMAS OSELLA 40.00 X 118177 0 31742 GETTE CHEROK 40.00 X 108303 0 29090 WILLIAM F PROVENZANO 0.00 0.00 X 117628 0 0 1230332 0 298871 10 1 1 0 CARDINAL HEALTH 1430 WAUKEGAN ROAD MCGAW PARK IL 60085 SUPPLIER 1860169 EMERGENCY RESOURCES MANAGEMENT INC PO BOX 371629 PITTSBURGH PA 15122 MEDICAL SERVICE PROVIDER 935439 PT UNLIMITED INC 1368 TIFFANY RIDGE DRIVE PITTSBURGH PA 15122 MEDICAL SERVICE PROVIDER 891761 REHABCARE GROUP INC PO BOX 502096 ST LOUIS MO 63101 MEDICAL SERVICE PROVIDER 848895 HEALOGICS WOUND CARE & HYPERBARIC 5220 BELFORT ROAD SUITE 130 JACKSONVILLE FL 32256 MEDICAL SERVICE PROVIDER 768548 64 60700 35840 200440 18671 315651 PATIENT REVENUE 621400 58922955 58922955 NURSING/ASSISTED LIVING 623000 6160690 6160690 65083645 979131 979131 836632 662286 174346 174346 174346 2355623 47049 1671293 17 684330 47032 731362 731362 117620 60700 51321 66299 66299 NURSING ENTRANCE FEES 611600 244068 244068 MANAGEMENT SERVICE AGREEMENTS 900099 210421 210421 INVESTMENT FEES 900099 205623 205623 437949 4000 433949 1098061 68448495 65331713 0 2801131 X 35841 35841 624583 624583 22012791 13207803 8804988 2155895 1293550 862345 2276164 1365712 910452 2179271 1307575 871696 875022 525018 350004 261154 156694 104460 135632 81380 54252 44535 26721 17814 272237 272237 7685659 4611441 3074218 266958 160176 106782 990347 594214 396133 3456178 2073727 1382451 75486 45292 30194 1660442 996275 664167 4759613 2855796 1903817 588008 352808 235200 PATIENT SUPPLIES 10185226 6111195 4074031 0 BAD DEBT 5380635 3228413 2152222 0 MEDICAID ASSESSMENT 821399 492844 328555 0 EDUCATION & RECRUITING 514285 308574 205711 0 713049 427837 285212 67970410 40258886 27711524 0 4487 4487 2200379 3394261 5233853 5401945 919132 935633 729059 968049 121848882 64106452 60022836 57742430 46443298 53484388 13301078 17374558 128854122 139305751 26650427 22402468 289304 177315 25703677 25394437 8952483 8572483 483260 371178 62079151 56917881 X 66606527 78532803 168444 3855067 66774971 82387870 128854122 139305751 X 478085 4787306 10347508 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 44535 44535 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: GUYTON GROUP AND CRANMER CONSULTAINTS HAVE BEEN RETAINED TO LOBBY THE CONGRESS OF THE UNITED STATES AND THE VARIOUS FEDERAL AGENCIES ON BEHALF OF OHIO VALLEY GENERAL HOSPITAL. PURSUANT TO FEDERAL ETHICS RULES, BOTH GUYTON GROUP AND CRANMER CONSULTING MAINTAIN THE APPROPRIATE LOBBYING REGISTRATIONS WITH THE U.S. SENATE AND U.S. HOUSE COMMITTEES ON ETHICS ON BEHALF OF OHIO VALLEY GENERAL HOSPITAL. SPECIFICALLY, THESE GROUPS SEEK AND SECURE FUNDING, THROUGH CONGRESSIONALLY DIRECTED SPENDING INITIATIVES, FOR VARIOUS CAPITAL PROJECTS, TECHNOLOGICAL UPGRADES AND PROGRAMMATIC NEEDS AT THE HOSPITAL. OHIO VALLEY BELONGS TO THE HOSPITAL COUNCIL OF WESTERN PENNSYLVANIA AND THE HOSPITAL AND HEALTHSYSTEM ASSOCIATION OF PENNSYLVANIA. A PORTION OF THE ANNUAL DUES FOR THESE ORGANIZATIONS IS USED FOR LOBBYING FEDERAL AND STATE AGENCIES IN MATTERS OF HEALTH CARE REGULATORY ISSUES. 24010 24010 80218259 33910096 46308163 40351488 30196356 10155132 1255125 1255125 57742430 DEFERRED FINANCING COSTS 555023 DUE FROM AFFILIATES 16071653 ESTIMATED THIRD PARTY-PAYOR SETTLEMENTS 747882 17374558 DERIVATIVE FINANCIAL INSTRUMENTS 371178 371178 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE CORPORATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD IS MET. MANAGEMENT HAS DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2013 AND 2012. THE CORPORATION'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN OPERATING EXPENSES. THE CORPORATION'S FEDERAL INCOME TAX AND INFORMATIONAL RETURNS ARE NO LONGER SUBJECT TO EXAMINATION BY FEDERAL OR STATE TAXING AUTHORITIES FOR YEARS BEFORE 2009. 2013 GOLF FUND DRIVE 178320 60700 117620 45317 1149 4855 178320 60700 117620 45317 1149 4855 51321 66299 1 1 1 X 0 1 1 0 1 0 37115 37115 0.00060 3875296 2739406 1135890 0.01810 3912411 2739406 1173005 0.01870 33 4716 83337 4910 78427 0.00130 6 448793 400 448393 0.00720 4459962 3834589 625373 0.01000 10975 10975 0.00020 39 4716 5003067 3839899 1163168 0.01870 39 4716 8915478 6579305 2336173 0.03740 16478 16478 0.00030 5067 20 5047 0.00010 21545 20 21525 0.00040 1 1232624 0 13426710 12654959 771751 X 1 1 1 1 OHIO VALLEY GENERAL HOSPITAL

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X X X X OHIO VALLEY GENERAL HOSPITAL 1 1 X X X X X X X X 12 1 0 1 X X X X X X X X X X 1 0 1 1 150.000000000000 0 1 X X X X X X X 1 1 X X X X X X 1 X 1 X X X X X 1 X 1 0 7 THE RESIDENCE AT WILLOW LANE

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ASSISTED LIVING THE RESIDENCE AT WILLOW HEIGHTS

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INDEPENDENT LIVING HEALTH CENTER AT KENNEDY TOWNSHIP

KENMAWR PLAZA 500 PINE HOLLOW ROAD MCKEES ROCKS PA 15136

WOUND AND PAIN CLINIC HEALTH CENTER AT MT NEBO COMMONS

107 MOUNT NEBO POINT DRIVE PITTSBURGH PA 15237

WOUND AND PAIN CLINIC HEALTH CENTER AT CORAOPOLIS

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PROFESSIONAL SERVICES WILLOW BROOK

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GEROPSYCHIATRIC UNIT PATHWAYS MEMORY CARE UNIT

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MEMORY CARE RESIDENCE PART I, LINE 3C: OHIO VALLEY GENERAL HOSPITAL USES THE FEDERAL POVERTY GUIDELINES BASED AT 150% OF THE FPG TO DETERMINE ELIGIBILITY FOR THE OHIO VALLEY CARES PROGRAM FOR FREE CARE. WE DO NOT CURRENTLY OFFER DISCOUNTED CARE. PART I, LINE 7: THE HOSPITAL USED THE FISCAL YEAR 2013 MEDICARE COST REPORT TO CALCULATE THE COST TO CHARGE RATIO. THE EDUCATION DEPARTMENT DIRECT EXPENSES WERE DIVIDED BY THE TOTAL EDUCATION DEPARTMENT EXPENSES TO CALCULATE THE INDIRECT EXPENSE PERCENT FOR LINE 7(F).THE GENERAL SERVICES COST CENTER DIRECT EXPENSES WERE DIVIDED BY TOTAL EXPENSES OF THAT COST CENTER TO CALCULATE THE INDIRECT EXPENSES FOR LINE 7(E). PART I, L7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN A THAT WAS REMOVED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN SCHEDULE H, PART I, LINE 7, COLUMN (F) WAS $5,380,635. PART II: THE HOSPITAL HAS PROMOTED THE HEALTH OF THE COMMUNITY FOR OVER 100 YEARS. THE SCHOOLS OF NURSING AND RADIOLOGY HAVE BOTH SUPPLIED HEALTH CARE PROFESSIONALS FOR THE AREA AND HAVE BEEN THE SOURCE OF SATISFYING CAREERS FOR MANY IN THE COMMUNITY. PART III, LINE 4: ACCOUNTS RECEIVABLE 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 ESTIMATED BASED UPON A PERIODIC REVIEW OF THE ACCOUNTS RECEIVABLE AGING, PAYOR CLASSIFICATIONS, AND APPLICATION OF HISTORICAL WRITE-OFF PERCENTAGES.BAD DEBT EXPENSE IS LISTED ON THE STATEMENT OF OPERATIONS AS THE PROVISION FOR DOUBTFUL COLLECTIONS AND REPRESENTS THE AMOUNT WRITTEN OFF THAT PATIENTS COULD PAY BUT CHOOSE NOT TO PAY.THE FISCAL YEAR 2013 MEDICARE COST REPORT WAS USED TO CALCULATE THE COST-TO-CHARGE RATIO THAT WAS MULTIPLIED BY THE BAD DEBT EXPENSE AT CHARGES TO DETERMINE COST.BAD DEBT EXPENSE INCURRED BY THE HOSPITAL SHOULD BE CONSIDERED A BENEFIT FOR THOSE IN THE COMMUNITY WHO RECEIVE SERVICES. AS A NOT-FOR-PROFIT HOSPITAL, OHIO VALLEY SERVES ALL PATIENTS; THAT IS THE HOSPITAL'S MISSION AND IS WHAT DIFFERENTIATES OHIO VALLEY GENERAL HOSPITAL FROM FOR-PROFIT HOSPITALS.IF PATIENTS PAY A PORTION OF THEIR BALANCE, ANY REMAINING AMOUNT WOULD BE SENT OUT FOR COLLECTION (BAD DEBT) PER THE HOSPITAL'S NORMAL BAD DEBT PROCESS. PART III, LINE 8: 33 PERCENT OF OHIO VALLEY GENERAL HOSPITAL PATIENTS RECEIVE MEDICARE AND 45 PERCENT OF PATIENTS ARE COVERED BY MEDICARE MANAGED CARE INSURANCE GROUPS. THIS IS A DEMONSTRATED NEED OF THE COMMUNITY. MEDICARE'S PARTICIPATION AT OVGH MEETS A COMMUNITY BENEFIT OBJECTIVE, BECAUSE THE PATIENT POPULATION INCLUDES VULNERABLE AND UNDERSERVED MEDICARE PATIENTS. THERE IS NO SHORTFALL TO BE TREATED AS COMMUNITY BENEFIT FOR OUR CURRENT YEAR. THE AMOUNTS ABOVE WERE TAKEN DIRECTLY FROM THE MEDICARE COST REPORT. SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. PART III, LINE 9B: ALL PATIENTS PRESENTING WITH NO INSURANCE OR LIMITED COVERAGE ARE PROVIDED WITH THE GUIDELINES FOR THE OHIO VALLEY CARE PROGRAM. PATIENTS CAN QUALIFY FOR FREE CARE BASED ON THE INFORMATION THEY PROVIDE. IF A PATIENT IS PLACED INTO A BAD DEBT STATUS THEY MAY STILL ESTABLISH INDIGENCE AT ANY TIME AND BE COMPATIBLE WITH THE OHIO VALLEY CARE PROGRAM POLICY AND PROCEDURE GUIDELINES. DOCUMENTATION SUPPORTING THE DETERMINATION OF INDIGENCE WILL BE AVAILABLE UPON REQUEST. THE DOCUMENTATION WILL INCLUDE NOTES ON THE PATIENT'S ACCOUNT IN OUR PATIENT ACCOUNTING SYSTEM AND OTHER INFORMATION THAT CAN BE RETRIEVED AS NEEDED TO SUPPORT THE INDIGENCE STATUS OF THE PATIENT OR RESPONSIBLE PARTY.IF AN ACCOUNT QUALIFIES FOR INDIGENCE THE DEBT MAY BE DEEMED UNCOLLECTIBLE WITHOUT APPLYING ANY FURTHER COLLECTION EFFORTS. THERE WILL NOT BE ANY OTHER LEGAL SOURCE OF RESPONSIBILITY FOR PAYMENT. OHIO VALLEY GENERAL HOSPITAL PART V, SECTION B, LINE 3: OHIO VALLEY FORMED A STEERING COMMITTEE TO REVIEW PRIMARY AND SECONDARY DATA AND PRIORITIZED THE NEEDS AND ISSUES AS WELL AS REVIEW THE ACTION PLAN STRATEGIES. THE HOSPITAL ALSO CONDUCTED STAKEHOLDER INTERVIEWS.THE PRIMARY DATA COLLECTION PROCESS INCLUDED QUALITATIVE DATA FROM 11 STAKEHOLDER INTERVIEWS AND 231 SURVEYS DISTRIBUTED IN THE HOSPITAL AND COMMUNITY. INTERVIEWS CAPTURED PERSONAL PERSPECTIVES FROM COMMUNITY MEMBERS, PROVIDERS, AND LEADERS WITH INSIGHT AND EXPERTISE INTO THE HEALTH OF A SPECIFIC POPULATION GROUP OR ISSUE, A SPECIFIC COMMUNITY OR THE REGION OVERALL. OHIO VALLEY GENERAL HOSPITAL PART V, SECTION B, LINE 20D: THE HOSPITAL USES ITS USUAL AND CUSTOMARY CHARGES. THE HOSPITAL OFFERS A 20% DISCOUNT FOR PAYMENTS IN FULL AT TIME OF SERVICE OR WITHIN 30 DAYS OF SERVICE. OHIO VALLEY GENERAL HOSPITAL PART V, SECTION B, LINE 21: THE HOSPITAL OFFERS A 20% DISCOUNT FOR PAYMENTS IN FULL AT TIME OF SERVICE OR WITHIN 30 DAYS FROM DATE OF SERVICES. PART VI, LINE 2: THE 2012 - 2013 OHIO VALLEY GENERAL HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED TO IDENTIFY HEALTH ISSUES AND NEEDS AS WELL AS TO PROVIDE CRITICAL INFORMATION TO DECISION-MAKERS AND OTHERS IN A POSITION TO MAKE A POSITIVE IMPACT ON THE HEALTH OF OUR REGION'S RESIDENTS. THE RESULTS ENABLED OHIO VALLEY GENERAL HOSPITAL AS WELL AS OTHER COMMUNITY AGENCIES AND PROVIDERS TO MORE STRATEGICALLY ESTABLISH PRIORITIES, DEVELOP INTERVENTIONS, AND DIRECT RESOURCES TO IMPROVE THE HEALTH OF THE PEOPLE LIVING IN ALLEGHENY COUNTY.TO ASSIST WITH THE CHNA PROCESS, OHIO VALLEY GENERAL HOSPITAL RETAINED STRATEGY SOLUTIONS, INC., A PLANNING AND RESEARCH FIRM WITH AN OFFICE IN PITTSBURGH, WHOSE MISSION IS TO CREATE HEALTY COMMUNITIES. THIS COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDED A DETAILED EXAMINATION OF THE FOLLOWING AREAS: * DEMOGRAPHICS & SOCIOECONOMIC INDICATORS * ACCESS TO QUALITY HEALTH CARE * CHRONIC DISEASE * HEALTHY ENVIRONMENT * HEALTHY MOTHERS, BABIES, & CHILDREN * INFECTIOUS DISEASE * MENTAL HEALTH & SUBSTANCE ABUSE * PHYSICAL ACTIVITY & NUTRITION * TOBACCO USE * INJURYTO GUIDE THIS ASSESSMENT, OHIO VALLEY GENERAL HOSPITAL FORMED A HOSPITAL STEERING COMMITTEE THAT CONSISTED OF HOSPITAL BOARD MEMBERS, COMMUNITY LEADERS WHO REPRESENTED THE BROAD INTEREST OF THE COMMUNITY INCLUDING THE INTERESTS OF MEDICALLY UNDERSERVED POPULATIONS, LOW-INCOME PERSONS, MINORITY GROUPS, AND THOSE WITH CHRONIC DISEASE NEEDS, INDIVIDUALS WITH EXPERTISE IN PUBLIC HEALTH, AND INTERNAL PROGRAM MANAGERS. THE STEERING COMMITTEES MET A TOTAL OF THREE TIMES BETWEEN NOVEMBER 2012 AND APRIL 2013 TO PROVIDE GUIDANCE ON THE VARIOUS COMPONENTS OF THE COMMUNITY HEALTH NEEDS ASSESSEMENT.CONSISTENT WITH IRS GUIDELINES AT THE TIME OF PUBLICATION, OHIO VALLEY GENERAL HOSPITAL DEFINED COMMUNITY BY GEOGRAPHIC LOCATION. MORE SPECIFICALLY, THE GEOGRAPHIC LOCATION OF THE PRIMARY SERVICE AREA ENCOMPASSES PORTIONS OF ALLEGHENY COUNTY AND INCLUDES OAKDALE, CARNEGIE, CORAOPOLIS, IMPERIAL, MCKEES ROACKS, CORLISS, CRAFTON, AND NEVILLE ISLAND. THIS ASSESSMENT COLLECTED DISEASE INCIDENCE AND PREVALENCE DATA AND INCLUDED PRIMARY DATA COLLECTION EFFORTS IN THE FORM OF A COMMUNITY SURVERY AND STAKEHOLDER INTERVIEWS.OHIO VALLEY GENERAL HOSPITAL IDENTIFIED EXISTING HEALTH CARE FACILITIES AND RESOURCES WITHIN THE COMMUNITY AVAILABLE TO RESPOND TO THE HEALTH NEEDS OF THE COMMUNITY. THE INFORMATION INCLUDED IN THE ASSET INVENTORY AND MAP IS A SUBSET OF THE INFORMATION MAINTAINED AND UTILIZED BY INTERNAL STAFF WHEN MAKING REFERRALS TO COMMUNITY RESOURCES.IN AN EFFORT TO EXAMINE THE HEALTH RELATED NEEDS OF THE RESIDENTS OF THE OHIO VALLEY GENERAL HOSPITAL SERVICE AREA AND TO MEET CURRENT IRS GUIDELINES AND REQUIREMENTS, THE CONSULTING TEAM EMPLOYED BOTH QUALITATIVE AND QUANTITATIVE DATA COLLECTION AND ANALYSIS METHODS. THE STEERING COMMITTEE MEMBERS AND CONSULTING TEAM MADE SIGNIFICANT EFFORTS TO ENSURE THAT THE ENTIRE PRIMARY SERVICE TERRITORY, ALL SOCIO-DEMOGRAPHIC GROUPS AND ALL POTENTIAL NEEDS, ISSUES AND UNDERREPRESENTED POPULATIONS WERE CONSIDERED IN THE ASSESSMENT.IN APRIL 2013, THE OHIO VALLEY GENERAL HOSPITAL STEERING COMMITTEE REVIEWED THE PRIMARY AND SECONDARY DATA COLLECTED THROUGH THE NEEDS ASSESSMENT PROCESS AND DISCUSSED NEEDS AND ISSUES PRESENT IN THE COMMUNITY. THE STEERING COMMITTEE PRIORITIZED THE NEEDS AND ISSUES IDENTIFIED THROUGHOUT THE ASSESSMENT IN ORDER TO IDENTIFY POTENTIAL INTERVENTION AND IMPLEMENTATION. DEBRA THOMPSON, PRESIDENT OF STRATEGY SOLUTIONS, INC. AND ROB COTTER, RESEARCH ANALYST PRESENTED THE DATA AND FACILITATED A PRIORITIZATION EXERCISE. FOR CRITERIA, INCLUDING THE ACCOUNTABLE ENTITY (HOSPITAL OR COMMUNITY), MAGNITUDE OF THE PROBLEM, IMPACT ON OTHER HEALTH OUTCOMES, CAPACITY (SYSTEMS AND RESOURCES TO IMPLEMENT SOLUTIONS), WERE USED TO EVALUATE IDENTIFIED NEEDS/ISSUES. STEERING COMMITTEE MEMBERS COMPLETED THE PRIORITIZATION EXERCISE USING THE OPTIONFINDER AUDIENCE RESPONSE POLLING TECHNOLOGY TO QUICKLY RATE AND RANK THE NEEDS AND ISSUES.FOLLOWING THE PRIORITIZATION SESSION AND BASED ON THE GREATEST NEEDS RELATED TO THE HEALTH SYSTEM'S MISSION, CURRENT CAPABILITIES AND FOCUS AREAS, OHIO VALLEY GENERAL HOSPITAL LEADERS AND STAFF INVOLVED IN THE CHNA PROCESS DETERMINED TOP PRIORITIES AND IDENTIFIED IMPLEMENTATION STRATEGIES TO MEET IDENTIFIED NEEDS. IMPLEMENTATION STRATEGIES FOCUS ON DIABETES, OBESITY, CARDIOVASCULAR DISEASES, EARLY SCREENINGS, AND HIGH BLOOD PRESSURE/HYPERTENSION. PART VI, LINE 3: THE CHARITY CARE POLICY (OHIO VALLEY CARES) AND FINANCIAL ASSISTANCE CONTACT INFORMATION IS AVAILABLE IN THE ADMISSION AREA, THE EMERGENCY ROOM, OUTPATIENT REGISTRATION AND OTHER AREAS OF THE ORGANIZATION IN WHICH PATIENT ARE LIKELY TO BE PRESENT. INTERPRETATION SERVICES ARE AVAILABLE FOR NON-ENGLISH SPEAKING INDIVIDUALS.OHIO VALLEY GENERAL HOSPITAL (OVGH) PROVIDES FINANCIAL COUNSELING TO THOSE IN NEED. OUR POLICY FOR THE PURPOSE OF PROVIDING INPATIENT AND/OR OUTPATIENT SERVICES TO THE INDIGENT STATES:THE FINANCIAL COUNSELOR WILL IDENTIFY PATIENTS AND/OR GUARANTORS THAT MAY QUALIFY FOR CHARITY CARE RELIEF IN ADDITION TO DISCUSSING THE ALTERNATIVE OF PUBLIC ASSISTANCE.THERE ARE TWO (2) OUTSIDE VENDORS THAT ARE AVAILABLE TO ASSIST PATIENTS IN THE APPLICATION PROCESS FOR PUBLIC ASSISTANCE.THE FINANCIAL COUNSELOR WILL CONDUCT A PRIVATE INTERVIEW WITH THE PATIENT AND/OR GUARANTOR AND DISCUSS THE CHARITY ALTERNATIVE AND PARAMETERS. THE FINANCIAL COUNSELOR WILL DISTRIBUTE THE CHARITY CARE APPLICATION AND ASSIST IN ITS COMPLETION AS NECESSARY. THEY WILL FURTHER REQUEST:1. THE MOST RECENT IRS TAX RETURN AND W-2 PROOF OF NON-FILING STATUS2. COPIES OF THE APPLICANTS MOST RECENT PAY STUBS, IF APPROPRIATE3. DENIAL NOTICE RECEIVED FROM MEDICAL ASSISTANCE, IF APPROPRIATETHE FINANCIAL COUNSELOR WILL REFER THE COMPLETED CHARITY CARE APPLICATION AND ANY/ALL ATTACHMENTS TO THE DIRECTOR OF PATIENT FINANCIAL SERVICES FOR REVIEW AND PROCESSING OF THE REQUEST. THE FINANCIAL COUNSELOR WILL ENTER COMMENTS THAT CONVEY ANY AND ALL ACTIONS TAKEN IN THE NOTES FEATURE OF THE HOSPITAL PATIENT ACCOUNTING SYSTEM. THE DIRECTOR OF PATIENT FINANCIAL SERVICES WILL DETERMINE THE CHARITY CARE ELIGIBILITY BASED ON FEDERAL POVERTY GUIDELINES AND:1. INCOME LEVEL2. FAMILY SIZEAN ALTERNATIVE METHOD IS TO HAVE ALL SELF PAY ACCOUNTS AND BALANCES AFTER INSURANCE PROCESSED THROUGH A PRESUMPTIVE CHARITY CARE ANALYSIS TOOL TO DETERMINE ELIGIBILITY BASED ON OVGH GUIDELINES OR IN ACCORDANCE WITH FORM 990 SCHEDULE H LANGUAGE. PART VI, LINE 4: OVGH IS PART OF THE HIGHLY COMPETITIVE PITTSBURGH, PENNSYLVANIA HEALTH CARE ENVIRONMENT. MANY OF THE HOSPITALS ARE INTERNATIONALLY RECOGNIZED. OVGH SERVES A MIX OF FIFTEEN SMALL, URBAN AND SUBURBAN COMMUNITIES IN ITS PRIMARY SERVICE AREA. SMALL MANUFACTURING AND OTHER BUSINESSES HAVE REPLACED THE LARGE STEEL MILLS. OVGH IS LOCATED IN MCKEES ROCKS, PENNSYLVANIA WHICH IS ITS PRIMARY SERVICE AREA. OVGH ALSO SERVES SURROUNDING COMMUNITIES WHICH INCLUDE: KENNEDY TWP, ROBINSON TOWNSHIP, MOON TOWNSHIP, CRAFTON, CORLISS, NORTH FAYETTE, MCDONALD, CORAOPOLIS, SEWICKLEY, BELLEVUE, AVONWORTH, AND OHIO TOWNSHIP. THE COMMUNITIES MENTIONED ABOVE PROVIDE A LARGE CROSS SECTION OF SOCIO-ECONOMIC CLASSES AND A WIDE RANGE OF ETHNIC AND CULTURAL DIVERSITY AS WELL.THE TOTAL POPULATION IN THE OHIO VALLEY GENERAL HOSPITAL SERVICE AREA AS OF THE 2010 CENSUS IS APPROXIMATELY 128,929 PEOPLE. OVERALL, THE SERVICE REGION'S POPULATION REMAINED STABLE OVER THE LAST TEN YEARS SINCE THE 2000 CENSUS, ALTHOUGH THE POPULATION IS EXPECTED TO INCREASE SLIGHTLY OVER THE NEXT SEVERAL YEARS.IN ALLEGHENY COUNTY, 12% OF ADULTS AGED 18 - 64 HAVE NO HEALTH INSURANCE, WHICH IS LOWER THAN STATE AND NATIONAL AVERAGES. UNEMPLOYMENT RATES INCREASED FOR BOTH ALLEGHENY COUNTY AND THE STATE BETWEEN 2010 AND 2012, WHILE THE NUMBER OF CHILDREN LIVING IN POVERTY HAS REMAINED FAIRLY CONSISTENT.OBESITY FIGURES IN THE AREA ARE COMPARABLE TO THE STATE AND NATION. IN ALLEGHENY COUNTY, 35% OF ADULTS ARE CONSIDERED TO BE OVERWEIGHT, WHILE 28% ARE CONSIDERED OBESE, WHICH IS UNDER THE HEALTHY PEOPLE 2020 GOAL OF 30.6%. IN ALLEGHENY COUNTY, 9% OF ADULTS HAVE BEEN TOLD THEY HAVE DIABETES, WHICH IS COMPARABLE TO STATE AND NATIONAL RATE.OVGH RETAINS MEMBERSHIP IN MANY COMMUNITY BASED ORGANIZATIONS SUCH AS THE MCKEES ROCKS ROTARY, FOR (FOCUS ON RENEWAL), THE WESTERN AREA YMCA, THE PARKWAY WEST ROTARY, AND THE AIRPORT AREA CHAMBER OF COMMERCE TO NAME A FEW.OVGH PROVIDES MANY PROGRAMS AS COMMUNITY OUTREACH RESOURCES TO PROACTIVELY PROMOTE HEALTHY LIFESTYLES. BY TAKING A PROACTIVE APPROACH TO HEALTHY LIFESTYLES, OVGH NOT ONLY PROVIDES MUCH NEEDED SERVICES TO ITS COMMUNITIES BUT IT ALSO ALLOWS US TO INTERACT WITH ITS CONSTITUENTS AND ASSESS WHAT THEIR NEEDS ARE ON AN ONGOING BASIS. SOME OF THE SERVICES PROVIDED SOLELY BY OVGH ARE: AN EMERGENCY DEPARTMENT OPEN TO ALL PERSONS REGARDLESS OF RACE, COLOR, SEX OR CREED, OR ABILITY TO PAY. OPERATES AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS, DIABETIC EDUCATION AND TRAINING, SAFE HAVEN, ORTHOPEDIC EDUCATION PROGRAMS, CONTINUOUS EDUCATION PROGRAMS FOR EMT'S AND PARAMEDICS, INDEPENDENT, ASSISTED AND MEMORY CARE UNITS, CARDIAC REHAB AND OCCUPATIONAL REHAB AND MEDICINE. ADDITIONALLY, OVGH RUNS A SCHOOL OF NURSING THAT IS A 20 MONTH DIPLOMA PROGRAM FOR RN AND A 24 MONTH CERTIFICATE PROGRAM FOR RADIOLOGIC TECHNOLOGY. PART VI, LINE 5: THE HOSPITAL PROMOTES THE HEALTH OF THE COMMUNITY BY IDENTIFYING, CONSTRUCTING FACILITIES AND STARTING NEW PROGRAMS, SUCH AS MEMORY CARE AND GEROPSYCH THAT WILL HELP THE COMMUNITY AND IMPROVE PATIENT CARE. THE HOSPITAL EXTENDS MEDICAL PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY.FIFTY-FOUR PERCENT OF THE MEMBERS OF THE BOARD OF DIRECTORS LIVE IN THE HOSPITAL'S PRIMARY SERVICE AREA. THE HOSPITAL'S EMERGENCY DEPARTMENT IS OPEN 24 HOURS PER DAY. PAIN AND WOUND CARE DEPARMENTS SERVE THE COMMUNITY IN TWO SITES OFF THE HOSPITAL CAMPUS.THERE ARE NO BOARD MEMBERS THAT ARE EMPLOYEES AND NO BOARD MEMBER'S FAMILY MEMBERS THAT ARE ON THE BOARD OR ARE EMPLOYEES.THE HOSPITAL CEO, CFO, DON, HR DIRECTOR AND DIRECTOR OF OUTPATIENT PHYSICIAN SERVICES RECOMMEND TO THE BOARD IMPROVEMENTS IN PATIENT CARE. FOR EXAMPLE, THE ORTHOPEDIC CENTER. ANY 'SURPLUS' FUNDS ARE USED FOR PATIENT CARE ENHANCEMENTS, EXEMPLIFIED BY ALL OF THE CONSTRUCTION THAT HAS BEEN UNDERTAKEN IN RECENT YEARS. PART VI, LINE 6: OHIO VALLEY GENERAL HOSPITAL IS A FREE-STANDING, INDEPENDENT, NOT-FOR-PROFIT ACUTE CARE HOSPITAL. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES. THE HOSPITAL ALSO OPERATES THE RESIDENCE AT WILLOW LANE, AN 84-BED ASSISTED LIVING FACILITY, THE RESIDENCE AT WILLOW HEIGHTS, A 65-BED INDEPENDENT LIVING FACILITY, WILLOW BROOK, A 21-BED GEROPSYCHIATRIC UNIT, PATHWAYS, A 16-BED MEMORY CARE UNIT, AND A 16-BED ACUTE REHABILITATION UNIT ON ITS CAMPUS. IN ADDITION, THE HOSPITAL CONTROLS OHIO VALLEY MEDICAL SERVICES, INC., AND OHIO VALLEY PROFESSIONAL SERVICES, INC. WHOSE PRINCIPAL PURPOSES ARE TO PROVIDE VARIOUS HEALTHCARE SERVICES TO PATIENTS OF THE HOSPITAL. FORM 990, PART VI, LINE 7: PENNSYLVANIA 1 THE RESIDENCE AT WILLOW LANE 30 HECKEL ROAD MCKEES ROCKS PA 15136 250967480 501(C)(3) 29392 GENERAL PURPOSE PATHWAYS MEMORY CARE 30 HECKEL ROAD MCKEES ROCKS PA 15136 250967480 501(C)(3) 6449 GENERAL PURPOSE 2 X X X 1 0 0 0 0 0 0 0 0 DAVID W SCOTT 333412 0 0 0 0 0 0 0 89554 0 422966 0 0 0 TADESSE TEFERA 142635 0 0 0 0 0 0 0 38312 0 180947 0 0 0 HUWAIDA MANSOUR 196207 0 0 0 0 0 0 0 52701 0 248908 0 0 0 WILLIAM F PROVENZANO 117628 0 0 0 0 0 0 0 0 0 117628 0 0 0 A ALLEGHENY COUNTY HOSPITAL DEVELOPMENT AUTHORITY 251327925 01728AZG4 2003-05-29 9319477 CAPITAL IMPROVEMENTS & EQUIPMENT FOR SCHOOL OF NURSING 0 0 0 B ALLEGHENY COUNTY HOSPITAL DEVELOPMENT AUTHORITY 251327925 01728AB88 2005-04-21 23500623 CONSTRUCTION OF MED SURG & OB GYN WING 0 0 0 A 9145000 159428 8985572 2003 0 0 1 1 B 23870000 1004091 376938 23493062 2008 0 0 1 1 A 0 0 0 0 1 0 0 B 0 0 0 0 1 0 0 A 0 0 0 1 0 0 0 0 0 B 0 0 0 1 0 0 0 0 0 A 0 FORM 990, SCHEDULE K, PART V OHIO VALLEY GENERAL HOSPITAL'S BOND ISSUANCES ARE MANAGED BY US BANK. AS TRUSTEE US BANK MONITORS AND REPORTS THE DEBT SERVICE REQUIREMENTS FOR EXPECTED INTEREST AND REDEMPTION REQUIREMENTS FOR OUR INDENTURES (BOND HOLDERS). THE BOND PROCEEDS HAVE BEEN USED FOR THEIR INTENDED PURPOSE AND ANY INVESTMENT INCOME IS MAINTAINED IN RESERVE FOR DEBT SERVICE ACTIVITIES. THEREFORE OHIO VALLEY AT THIS TIME HAS NOT CREATED A WRITTEN POLICY. FORM 990, PART VI, SECTION A, LINE 3 REHABCARE GROUP INC. HAS BEEN CONTRACTED TO MANAGE THE ACUTE REHAB UNIT OF THE HOSPITAL. TELECARE CORPORATION HAS BEEN CONTRACTED TO MANAGE THE HOSPITALS GERIATRIC PSYCHIATRIC UNIT OF THE HOSPITAL. NATIONAL HEALING HAS BEEN CONTRACTED TO MANAGE THE HOSPITAL'S WOUND HEALING FACILITIES. ALL THREE GROUPS RESPONSIBILITIES INCLUDE DEPARTMENTAL BUDGETING, STAFFING, OFFICE MANAGEMENT, AS WELL AS PATIENT SCHEDULING, CARE, AND BILLING FOR THE FACILITY. FORM 990, PART VI, SECTION B, LINE 11 A DRAFT OF THE FORM 990 IS PRESENTED TO THE FINANCE COMMITTEE FOR ITS PRELIMINARY APPROVAL AND THEN TO THE BOARD OF DIRECTORS FOR FINAL APPROVAL BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE (IRS). THE BOARD OF DIRECTORS APPROVES THE FINAL DRAFT OF THE FORM 990 BEFORE IT IS FILED WITH IRS. FORM 990, PART VI, SECTION B, LINE 12C EVERY YEAR THE SECRETARY OF THE BOARD OF DIRECTORS OF OHIO VALLEY GENERAL HOSPITAL ("OVGH") DISTRIBUTES TO THE BOARD OF DIRECTORS AND HOSPITAL MANAGEMENT THE CONFLICT OF INTEREST POLICY. EACH RECIPIENT MUST LIST ANY POSSIBLE CONFLICT, SIGN AND RETURN THE CONFLICT STATEMENT. INCLUDED IN THE POLICY IS SPECIFIC LANGUAGE REGARDING THE CONDUCT OF THE INDIVIDUAL WITH THE POTENTIAL CONFLICT. EACH DISCLOSURE STATEMENT IS REVIEWED BY THE SECRETARY OF THE BOARD, WHO REPORTS THE FINDINGS TO THE FULL BOARD. A LIST OF ANNUAL PAYMENTS MADE TO THE DISCLOSED ENTITIES IS MAINTAINED BY THE HOSPITAL'S PRESIDENT'S OFFICE. FORM 990, PART VI, SECTION B, LINE 15 THE HOSPITAL UTILIZES THE HOSPITAL COUNCIL OF WESTERN PA'S SALARY SURVEY IN DETERMING COMPENSATION FOR OFFICERS AND KEY EMPLOYEES TO ENSURE COMPENSATION DOES NOT EXCEED FAIR MARKET VALUE. THE OFFICERS OF THE BOARD OF DIRECTORS APPROVES ALL SALARY INCREASES FOR THE CEO, COO, AND CFO. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII: IN THE INTEREST OF FULL DISCLOSURE AND TRANSPARENCY, THE FOLLOWING LISTING REPRESENTS THE OFFICERS AND HIGHEST COMPENSATED EMPLOYEES OF THE FOLLOWING OHIO VALLEY GENERAL HOSPITAL AFFILIATED ENTITIES: THE HIGHEST COMPENSATED EMPLOYEES, DIRECTORS AND OFFICERS FOR THE OHIO VALLEY ANETHESIA PAIN MANAGEMENT, INC.: DR. DAVID PROVENZANO SALARY $556,149 BENEFITS $149,382 THE HIGHEST COMPENSATED EMPLOYEES OTHER THAN DIRECTORS AND OFFICERS FOR THE OHIO VALLEY PROFESSIONAL SERVICES, INC.: DR. VIDHU SHARMA SALARY $232,377 BENEFITS $62,416 DR. SAMINA NASEER SALARY $157,770 BENEFITS $42,377 THE HIGHEST COMPENSATED EMPLOYEES, DIRECTORS AND OFFICERS FOR THE OHIO VALLEY ANESTHESIA SERVICES, INC.: DR. THOMAS BIJO SALARY $355,523 BENEFITS $95,493 THE HIGHEST COMPENSATED EMPLOYEES OTHER THAN DIRECTORS AND OFFICERS FOR THE OHIO VALLEY MEDICAL SERVICES, INC.: DR. HANNAH HELIGER SALARY $310,537 BENEFITS $83,410 DR. CHRIS BARTON HAYES SALARY $326,883 BENEFITS $87,801 DR. LAJENNEPHER ZEVALA SALARY $142,063 BENEFITS $38,158 DR. DANA DELLAPIAZZA SALARY $131,696 BENEFITS $35,374 DR. FNU KAILASH SALARY $291,197 BENEFITS $78,216 OTHER FEES FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,269,801. MANAGEMENT AND GENERAL EXPENSES 846,513. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,116,314. TEMPORARY HELP: PROGRAM SERVICE EXPENSES 66,557. MANAGEMENT AND GENERAL EXPENSES 44,370. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 110,927. CONSULTING FEES: PROGRAM SERVICE EXPENSES 159,722. MANAGEMENT AND GENERAL EXPENSES 106,478. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 266,200. CONTRACT AGREEMENTS: PROGRAM SERVICE EXPENSES 2,243,309. MANAGEMENT AND GENERAL EXPENSES 1,495,503. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,738,812. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 872,052. MANAGEMENT AND GENERAL EXPENSES 581,354. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,453,406. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: PENSION LIABILITY ADJUSTMENT 6,466,033. CHANGE IN FAIR VALUE OF DERIVATIVE 112,081. TRANSFER OF NET ASSETS FROM OHIO VALLEY GENERAL HOSPITAL FOUNDATION 3,769,394. COMMITTEE THAT ASSUMES RESPONSIBILITY OF THE AUDIT FORM 990, PART XII, LINE 2C THIS ORGANIZATION DOES HAVE A COMMITTEE THAT ASSUMES THE RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS & THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THE ORGANIZATION DID NOT CHANGE THIS OVERSIGHT PROCESS OR ITS SELECTION PROCESS FROM THE PREVIOUS YEAR. OVGH PROFESSIONAL LIABILITY SELF INSURANCE 25 HECKEL ROAD MCKEES ROCK PA 15136 251619844 PROVIDES MALPRACTICE INSURANCE TO THE HOSPITAL PA 501(C)(3) LINE 11A, I OHIO VALLEY GENERAL HOSPITAL 1 OVGH WORKER COMPENSATION SELF INSURANCE TRUST 25 HECKEL ROAD MCKEES ROCK PA 15136 251619842 FOR THE HOSPITAL TO COVER ITS WORKERS COMPENSATION CLAIMS PA 501(C)(3) LINE 11A, I OHIO VALLEY GENERAL HOSPITAL 1 PITTSBURGH'S OHIO VALLEY GENERAL HOSPITAL FOUNDATION 25 HECKEL ROAD MCKEES ROCK PA 15136 251792662 TO PROVIDE SUPPORT TO OHIO VALLEY GENERAL HOSPITAL PA 501(C)(3) LINE 11A, I OHIO VALLEY GENERAL HOSPITAL 1 OHIO VALLEY MEDICAL SERVICES INC 25 HECKEL ROAD MCKEES ROCK PA 15136 205830183 PROVIDES SURGERY AND ANESTHESIA SERVICES TO PATIENTS PA OHIO VALLEY GENERAL HOSPITAL C -655137 853286 1.00000 1 OHIO VALLEY ANESTHESIA PAIN MANAGEMENT INC 25 HECKEL ROAD MCKEES ROCK PA 15136 205696032 PROVIDES PAIN MANAGMENT SERVICES TO PATIENTS PA OHIO VALLEY GENERAL HOSPITAL C -1213428 13936 1.00000 1 OHIO VALLEY PROFESSIONAL SERVICES INC 25 HECKEL ROAD MCKEES ROCK PA 15136 205689859 EXTENSION OF THE HOSPITAL TO PROVIDE HEALTH SERVICES TO THE COMMUNITY PA OHIO VALLEY GENERAL HOSPITAL C -580344 560315 1.00000 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 PITTSBURGH'S OHIO VALLEY GENERAL HOSPITAL FOUNDATION C 3746742 FMV OHIO VALLEY ANESTHESIA PAIN MANAGEMENT INC R -1772734 COST OHIO VALLEY PROFESSIONAL SERVICES INC R -1476246 COST OHIO VALLEY MEDICAL SERVICES INC R -2155998 COST OHIO VALLEY ANESTHESIA PAIN MANAGEMENT INC S 346067 COST OHIO VALLEY PROFESSIONAL SERVICES INC S 634208 COST OHIO VALLEY MEDICAL SERVICES INC S 1429087 COST