2013-05-15T08:59:17-05:00 2012-06-30 232932984 PARENTEBEARD LLC SUITE 200 221 W PHILADELPHIA ST YORK PA 174012993 990 2011-07-01 251778644 PINNACLE HEALTH HOSPITALS PINN 7172318245 409 SOUTH SECOND ST PO BOX 8700 HARRISBURG PA 171058700 WILLIAM H PUGH 7172318245 2013-05-13 1 JULIUS GREEN CPA P00350393 7178467000 2011 2016-02-24 21:20:13Z WILLIAM H PUGH 409 SOUTH SECOND ST PO BOX 8700 HARRISBURG PA 171058700 812147714 0 X WWW.PINNACLEHEALTH.ORG X 1996 PA INPATIENT AND OUTPATIENT NON-PROFIT HEALTHCARE SERVICES FOR CITIZENS OF THE LOCAL COMMUNITY. 17 14 4533 461 3476976 0 6634714 4563329 602219557 685536106 4942988 4751454 -1027022 2979262 612770237 697830151 0 0 0 0 266807037 277613958 0 0 0 307799228 338070547 574606265 615684505 38163972 82145646 661811208 674650752 433311643 503128863 228499565 171521889 X PROVIDING BOTH INPATIENT AND OUTPATIENT HEALTHCARE SERVICES ON A NON-PROFIT BASIS FOR CITIZENS OF THE SURROUNDING COMMUNITY. 0 0 499958583 666948067 PINNACLE HEALTH HOSPITALS PINNACLE HEALTH HOSPITALS SUBSIDIZES THE COST OF TREATING PATIENTS WHO ARE UNINSURED, UNABLE TO PAY, OR ARE ON GOVERNMENT PROGRAMS WHERE REIMBURSEMENT IS LESS THAN THE COST OF PROVIDING THE SERVICE.AS AN ANCHOR INSTITUTION AND A LEADER IN OUR COMMUNITY, OUR ROLE HAS BEEN TO CARE FOR PATIENTS EVEN IN THESE DIFFICULT ECONOMIC TIMES. IN KEEPING WITH OUR TRADITION OF CARING FOR ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY, PINNACLE HEALTH IS A FORCE FOR STABILITY, STRENGTH, AND RELIABILITY FOR THOSE WE SERVE. IN ADDITION TO FINANCIAL SUPPORT, OUTREACH TO THE COMMUNITY IS CRUCIAL TO ACHIEVING OUR MISSION. THROUGH VOLUNTEERISM AND ENGAGEMENT, WE STRIVE TO BE A FORCE FOR HEALTH AND WELL-BEING. WE HELP THE UNDERSERVED, MENTOR STUDENTS, LEND EXPERTISE TO COMMUNITY ORGANIZATIONS, AND EDUCATE THE COMMUNITY ON DISEASE PREVENTION AND MANAGEMENT.COMMUNITY HEALTH IMPROVEMENT SERVICESAS ONE OF THE LARGEST PROVIDERS OF HEALTHCARE SERVICES IN THE STATE OF PENNSYLVANIA, PINNACLE HEALTH HOSPITALS OFFERS A VARIETY OF CLINICAL, EDUCATION AND SUPPORT SERVICES FOCUSED ON IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE.COMMUNITY HEALTH EDUCATIONDIABETES EDUCATION FOR DISPARATE POPULATIONS:TO PROVIDE CULTURALLY AND ECONOMICALLY APPROPRIATE EDUCATION THAT ENABLES PERSONS WITH DIABETES TO BETTER MANAGE THEIR DISEASE.KIDSHAPE:9 WEEK PEDIATRIC WEIGHT MANAGEMENT PROGRAM FOR KIDS AGE 6 - 14 YEARS OLD. KIDSHAPE TEACHES THE ENTIRE FAMILY HOW TO EAT MORE NUTRITIOUSLY, MAKE EXERCISE A FUN PART OF THE DAILY ROUTINE, FORM NEW HEALTHY HABITS, AND TO LIKE THEMSELVES, REGARDLESS OF SIZE. A TEAM OF HEALTH EXPERTS CONSISTING OF A REGISTERED DIETITIAN, A MENTAL HEALTH PROFESSIONAL, A PHYSICAL ACTIVITY EXPERT, AND A HEALTH EDUCATOR ADMINISTERS THE KIDSHAPE PROGRAM.ALL KIDSHAPE PROGRAMS ARE FAMILY-BASED. EACH PROGRAM INCORPORATES HANDS-ON ACTIVITIES TO EMPOWER YOUTH AND ADULTS TO EAT HEALTHY, MOVE MORE, AND FEEL GOOD.A VARIETY OF CHILDBIRTH EDUCATION PROGRAMS ARE OFFERED FOR NEW AND EXPECTANT PARENTS AND SIBLINGS INCLUDING INFANT CARE CLASSES. SUPPORT GROUPS ARE OFFERED FREE OF CHARGE TO HELP PEOPLE UNDERSTAND AND COPE WITH PARTICULAR PROBLEMS OR ILLNESSES. THEY INCLUDE DIABETES, BEREAVEMENT, CAREGIVER, TRANSPLANT, AND HEART DISEASE.CHILDREN'S HEALTH FAIR, CONFERENCES AND LECTURES PROVIDE INFORMATION ON HEALTHY LIFESTYLES AND HEALTH CAREER SESSIONS, YOUTH HEALTH SCREENINGS, YOUTH OBESITY PREVENTION, CHILD ABUSE AWARENESS/PREVENTION AND LITERACY PROGRAMS FOR CHILDREN. COMMUNITY HEALTH FAIRSCOMMUNITY LECTURES ON A VARIETY OF TOPICS, INCLUDING CARDIOVASCULAR HEALTH, AIDS, SPORTS MEDICINE, AND ETHICS.TOBACCO CESSATION EDUCATION IN CLINICS. HEALTH EDUCATION STORIES IN THE NEWSPAPER, ON TELEVISION, ON RADIO AND IN HOSPITAL NEWSLETTER.CLERGY IS AVAILABLE TO PATIENTS AND FAMILY MEMBERS TWENTY-FOUR HOURS A DAY. AS DESCRIBED IN THE HOSPITAL'S MISSION STATEMENT, PINNACLE HEALTH HOSPITALS IS COMMITTED TO PROVIDING COMMUNITY-BASED PROGRAMS AND SERVICES WHICH WILL ENHANCE THE HEALTH STATUS OF THE PEOPLE WE SERVE. TOWARD THAT END, PINNACLE HEALTH HOSPITALS PROVIDED THE FOLLOWING WELLNESS AND SCREENING PROGRAMS:SCREENINGS:CHOLESTEROL SCREENINGBODY COMPOSITION SCREENINGPROSTATE SCREENINGINFANT DEVELOPMENT SCREENINGSSPEECH AND HEARING SCREENINGSDEPRESSION AND ANXIETY SCREENINGSBONE DENSITYNUTRITION THERAPY EDUCATION PROGRAMSLEAD POISONING SCREENINGS PINNACLE HEALTH-FOX CHASE REGIONAL CANCER CENTER'S BOARD-CERTIFIED SURGEONS AND MEDICAL ONCOLOGISTS ATTACK ALL TYPES OF CANCER, SUPPORTED BY A TEAM OF PHARMACISTS, SOCIAL WORKERS, REHABILITATION AND PAIN MANAGEMENT SPECIALISTS EACH WITH A UNIQUE AWARENESS OF PATIENT NEEDS. HEART FAILURE CENTER WAS DEVELOPED IN AN EFFORT TO PROVIDE PATIENTS SUFFERING FROM HEART FAILURE AN ALTERNATIVE TO FREQUENT HOSPITALIZATIONS. OUR TEAM OF EXPERIENCED HEALTHCARE PROFESSIONALS ASSISTS YOU IN LEARNING THE SKILLS NEEDED TO HELP SELF-MANAGE YOUR CHRONIC ILLNESS.THE PINNACLE HEALTH WOUND AND HYPERBARIC CENTER WITH HYPERBARIC OXYGEN THERAPY CAPABILITIES IS DEVOTED TO THE TREATMENT, REHABILITATION AND PREVENTION OF CHRONIC WOUNDS. OUR CARING TEAM OF SPECIALTY PHYSICIANS, NURSES, PHYSICAL THERAPISTS AND NUTRITIONISTS CAN HELP ACCELERATE PATIENTS' HEALING, DECREASE DISCOMFORT, REDUCE COMPLICATIONS AND DECREASE RE-OCCURRENCE. SPINE INSTITUTE COMBINES THE EXPERTISE OF NEUROSURGEONS, ORTHOPEDIC SURGEONS, PHYSIATRISTS, NEUROLOGISTS, PAIN MANAGEMENT SPECIALISTS, NURSES, IMAGING SERVICES AND REHABILITATION SERVICES TO TARGET EVERY PATIENT'S PARTICULAR PROBLEM AND PROVIDE OPTIMAL TREATMENT. BUS PASSES OR TAXI FEES ARE PROVIDED TO PATIENTS AND FAMILIES MEETING THE ORGANIZATION'S FINANCIAL ASSISTANCE GUIDELINES TO ENHANCE PATIENT ACCESS TO CARE. RESIDENT PHYSICIAN TRAINING PROGRAMS FOR ORTHOPEDIC SURGERY, INTERNAL MEDICINE, GENERAL SURGERY, PODIATRY, AND FAMILY PRACTICE.FELLOWSHIP PROGRAMS FOR TOXICOLOGY, SPORTS MEDICINE, AND MATERNAL FETAL MEDICINE.CLINICAL SITE FOR MEDICAL STUDENTSCLINICAL SITE FOR NURSING STUDENTSCLINICAL SITE FOR DIETITIANSCLINICAL SITE FOR EMERGENCY MEDICAL PERSONNELCLINICAL SITE FOR PARAMEDIC STUDENTSCLINICAL SITE FOR RESPIRATORY THERAPY STUDENTSCLINICAL SITE FOR RADIOLOGY STUDENTS INTERNSHIPS FOR MEDICAL ASSISTANTS, SPEECH AND HEARING, PT/OT AND OTHER ALLIED HEALTH PROFESSIONAL TRAINING.SUPERVISION FOR PSYCHOLOGY STUDENTSCONTINUING EDUCATION FOR NURSES AND PHYSICIAN OFFICE STAFF AND FOR LOCAL COMMUNITY PROFESSIONALS SUCH AS SCHOOL NURSES.TOXICOLOGY CENTER IS A NEEDED COMMUNITY SERVICE THAT PROVIDES SPECIALIZED CARE AND RELEVANT TREATMENT TO ADULTS AND ADOLESCENTS AS A RESULT OF OVERDOSE OR ACCIDENTAL POISONING. THE TOXICOLOGY CENTER FILLS A CRITICAL PUBLIC HEALTH GAP, IS A SIGNIFICANT RESOURCE TO THE REGION AND ACROSS THE STATE AND DEDICATED TO THE EMERGENT NEEDS OF UNINTENTIONAL INJURY AND OPERATES AT A LOSS. AUXILIARY ERNEST R. MCDOWELL SCHOLARSHIP PROGRAMEQUIPMENT DONATIONSUNITED WAY FUNDRAISINGBAILEY HOUSE IS OUR HOME AWAY FROM HOME. IT PROVIDES FREE OVERNIGHT LODGING AND A COMFORTABLE, SUPPORTIVE, AND NURTURING ENVIRONMENT FOR FAMILIES FROM OUTSIDE OF THE HARRISBURG AREA.NURSE/FAMILY PARTNERSHIP PROGRAM WAS IMPLEMENTED BASED ON VERY HIGH TEEN BIRTH RATES AND A HIGH INCIDENCE OF WOMEN NOT RECEIVING PRENATAL CARE DURING THE FIRST TRIMESTER. THIS IS A NATIONALLY RENOWNED, EVIDENCE BASED, NURSE HOME VISITATION PROGRAM THAT IMPROVES THE HEALTH, WELL-BEING AND SELF SUFFICIENCY OF LOW INCOME, FIRST TIME PARENTS AND THEIR CHILDREN. CHILDREN'S RESOURCE CENTER(CRC) PROVIDES CARE AND COORDINATION TO CHILDREN SUSPECTED OF BEING ABUSED AND ENGAGES MULTIPLE DISCIPLINES TO DIAGNOSE, EVALUATE AND TREAT CHILDREN WHO ARE VICTIMS OF SEXUAL ABUSE. 18305124 15211472 PINNACLE HEALTH EMERGENCY DEPARTMENT SERVICESPINNACLE HEALTH EMERGENCY DEPARTMENT SERVICES (PHEDS) IS A TAX EXEMPT, NON-PROFIT CORPORATION ENGAGED IN PROVIDING PROFESSIONAL SERVICES IN THE PINNACLE HEALTH EMERGENCY DEPARTMENT. EMERGENCY SERVICESTWENTY-FOUR HOUR MEDICAL EMERGENCY SERVICE IS PROVIDED IN TWO EMERGENCY DEPARTMENTS, (HARRISBURG HOSPITAL AND COMMUNITY GENERAL HOSPITAL) STAFFED BY PHYSICIANS AND NURSES SPECIALIZING IN EMERGENCY MEDICINE AND SUPPORT PERSONNEL. SERVICES ARE OPEN TO ALL PERSONS WITHOUT REGARD TO AGE, SEX, RACE, RELIGION, NATIONAL ORIGIN, HANDICAP OR ABILITY TO PAY.MEDICAL COVERAGE IS GIVEN FOR COMMUNITY SPORTING EVENTS.CPR TRAINING PROGRAMS ARE OFFERED TO COMMUNITY GROUPS AND ORGANIZATIONS.TWENTY-FOUR HOUR EMERGENCY MEDICAL COMMAND IS PROVIDED FOR THE TRI-COUNTY AREA.DURING FISCAL YEAR 2012, PINNACLE HEALTH HOSPITALS TREATED 107,616 PATIENTS IN ITS TWO EMERGENCY DEPARTMENTS THIS WAS AN INCREASE OF 5.3% OVER THE PRIOR YEAR AND WAS MADE POSSIBLE DUE TO THE COMPLETION OF THE EXPANSION OF THE EMERGENCY DEPARTMENT AT THE HARRISBURG HOSPITAL SITE. 518263707 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 0 0 1 X 234 0 1 4533 1 1 1 0 0 0 0 0 0 0 0 0 X 17 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X WILLIAM H PUGH CFO 7172318245 409 SOUTH SECOND ST HARRISBURG PA 171058700 X ROBERT L LYON 0.70 X X 0 0 0 GEORGE F GRODE 0.70 X X 0 0 0 JOHN O CAMPBELL 0.70 X 0 0 0 FELIX GUTIERREZ MD 0.30 X 0 351498 31401 M RICHARD KLEIMAN 0.30 X 0 0 0 DEBORAH S MILLER 0.50 X 0 0 0 LARRY L SOLLENBERGER MD 0.70 X 0 0 0 CLARENCE E ASBURY 0.70 X 0 0 0 DENNIS WALSH 0.20 X 0 0 0 BONY R DAWOOD 0.70 X 0 0 0 DENISE F HARR MD 0.20 X 0 0 0 GREGORY CAVOLI 0.20 X 0 0 0 DOUGLAS C DYER 0.20 X 0 0 0 STEVEN C KUSIC 0.60 X 0 0 0 KENNETH OKEN MD 0.40 X 0 0 0 MICHAEL L FERNANDEZ MD 0.30 X 0 0 0 JOHN C HICKEY 0.50 X 0 0 0 CAROLYN KREAMER PHD 0.40 X 0 0 0 MICHAEL A YOUNG 10.80 X X 0 535864 5167 CHRISTOPHER P MARKLEY ESQ 24.00 X 0 353696 47435 RICHARD C SENECA ESQ 40.00 X 278280 0 0 WILLIAM H PUGH 28.00 X 0 401411 45360 NANCY HAMMONDS 26.00 X 0 145331 35560 KIM KELLY 40.00 X 324203 0 34547 EDWARD HILDREW 40.00 X 359384 0 59485 JULIAN GUTIERREZ 40.00 X 343141 0 34291 JED SPRUCE SEITZINGER 40.00 X 324668 0 44681 JOHN GOLDMAN MD 40.00 X 323217 0 36331 ROGER LONGENDERFER MD 0.00 X 0 615873 254 1952893 2403673 374512 164 1 1 0 SIEMENS MEDICAL SOLUTIONS USA INC PO BOX 640401 PITTSBURGH PA 15264 SOFTWARE SUPPORT SVCS 16153271 SODEXO PO BOX 905374 CHARLOTTE NC 28290 FOOD SERVICES 14214370 CPTA INC 205 SOUTH FRONT STREET HARRISBURG PA 17104 TRANSPLANT SERVICES 2903598 QUANTUM IMAGING & THERAPEUTIC ASSOCIATES 629-D LOWTHER ROAD LEWISBERRY PA 17339 RADIOLOGY SERVICES 1338447 MILTON HERSHEY MEDICAL CENTER 500 UNIVERSITY DR HERSHEY PA 17033 MEDICAL SERVICES 1242746 55 24753 440530 3101884 996162 5457 4563329 PATIENT REVENUE, NET 621500 681014368 677565333 3449035 CONTRACTED MEDICAL SER 621990 3177481 3177481 MEDICAL EDUCATION 900099 488105 488105 MISC INPATIENT/OUTPATI 621990 255562 255562 TOXICOLOGY MEMBERSHIP 900099 144875 144875 455715 455715 685536106 789290 72468 716822 8558843 11341329 -2782486 -2782486 27941 -2810427 104011043 2927355 102445261 530973 1565782 2396382 3962164 3962164 HITECH REPORTING INCEN 900099 4451317 4451317 VENDOR REBATE INCOME 900099 310667 310667 CAFETERIA SALES 900099 221659 221659 778105 778105 5761748 697830151 682159539 3476976 7630307 278280 137916 140364 211307670 196709255 14598415 13929005 12456248 1472757 37196265 34030569 3165696 14902738 10563340 4339398 19143528 1468263 17675265 596141 295447 300694 26871 12272 14599 107876 107876 65929376 50373998 15555378 2078637 267105 1811532 30642594 27693811 2948783 6458342 4046272 2412070 36469754 21663230 14806524 412363 335259 77104 1122727 949765 172962 10801901 7603508 3198393 38166985 29016340 9150645 6341200 4884065 1457135 MEDICAL SUPPLIES 84894511 84894511 BAD DEBT EXPENSE 33862993 30476694 3386299 TEMP. RESTRICTED DONATI 647719 161930 485789 DUES AND SUBSCRIPTIONS 246432 109708 136724 120597 114201 6396 615684505 518263707 97420798 0 4704 5278 541276 713872 63659797 79245851 2639637 2521564 11419513 11552138 6531967 8606302 742593447 410431839 331894236 332161608 206320298 205205880 4875133 11110622 141669 330269 33782978 23197368 661811208 674650752 122941664 166859872 144720 279575398 274579531 19277133 43255812 11517448 18288928 433311643 503128863 X 194321459 144524071 15239834 8801077 18938272 18196741 228499565 171521889 661811208 674650752 X 82145646 -139123322 X X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 12756099 12756099 442670382 231456401 211213981 13947695 6909897 7037798 220944377 153063958 67880419 52274894 19001583 33273311 332161608 ADVANCES FROM THIRD-PARTY PAYORS 3809400 DUE TO THIRD PARTY PAYORS 5894811 ACCRUED LONG-TERM SWAP CONTRACT 8584717 18288928 697830151 615684505 82145646 -1529794 -137593528 -139123322 -56977676 706841694 -1064245 1772602 708357 706133337 48061 -8351247 -8303186 697830151 626869597 11341329 11341329 615528268 155937 300 156237 615684505 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE PINNACLE HEALTH SYSTEM EVALUATES UNCERTAIN TAX POSITIONS USING A TWO-STEP APPROACH FOR RECOGNIZING AND MEASURING TAX BENEFITS TAKEN OR EXPECTED TO BE TAKEN IN AN UNRELATED BUSINESS ACTIVITY TAX RETURN AND DISCLOSURES REGARDING UNCERTAINTIES IN TAX POSITIONS. NO ADJUSTMENTS TO THE CONSOLIDATED FINANCIAL STATEMENTS WERE REQUIRED AS A RESULT OF THIS EVALUATION. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN ADDITIONAL MINIMUM PENSION LIABILITY -48,689,926. FUND BALANCE TRANSFER - PINNACLE HEALTH SYSTEM -12,819,636. FUND BALANCE TRANSFER - PINNACLE HEALTH MEDICAL SERVICES -38,779,212. FUND BALANCE TRANSFER - PINNACLE HEALTH HOME CARE & HOSPICE -6,104,214. FUND BALANCE TRANSFER - COMMUNITY LIFE TEAM -3,152,963. FUND BALANCE TRANSFER - PINNACLE HEALTH FOUNDATION -193,142. FUND BALANCE TRANSFER - MEDICAL GROUP -3,017,057. FUND BALANCE TRANSFER - VENTURES 1,923,717. FUND BALANCE TRANSFER - PHCVI -27,439,192. HORIZON INVESTMENT VALUATION ADJUSTMENT 678,097. TOTAL TO SCHEDULE D, PART XI, LINE 8: -137,593,528. PART XII, LINE 2D - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTIONS 1,772,602. PART XII, LINE 4B - OTHER ADJUSTMENTS: RESTRICTED CONTRIBUTIONS 2,183,739. INVESTMENT INCOME FROM RESTRICTED ASSETS 99,458. NET REALIZED GAIN/LOSS FROM SALE OF RESTRICTED INVESTMENTS 81,916. RENTAL EXPENSES SHOWN NET OF RENTAL INCOME -11,341,329. UNRESTRICTED CONTRIBUTIONS FROM PINNACLE HEALTH FOUNDATION 445,688. ADDITIONAL GAINS PERMANENT RESTRICTED FUNDS 178,981. INSURANCE EXPENSE ADJUSTED FOR FOUNDATION CONTRIBUTIONS 300. PART XIII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES SHOWN NET OF RENTAL INCOME 11,341,329. TENANT MONTHLY INCOME RECLASSED FROM EXPENSES PART XIII, LINE 4B - OTHER ADJUSTMENTS: INSURANCE EXPENSE ADJUSTED FOR FOUNDATION CONTRIBUTIONS 300. 1 1 X 1 X 250.000000000000 1 X 1 1 1 0 1 1 7070650 7070650 0.01150 64776302 47015047 17761255 0.02880 71846952 47015047 24831905 0.04030 3604596 1215 3603381 0.00590 14814411 6672429 8141982 0.01320 3786339 3786339 0.00610 22205346 6673644 15531702 0.02520 94052298 53688691 40363607 0.06550 5950 39086 39086 0.00010 250 15000 15000 0.00000 50 87 87 0.00000 1850 1043 1043 0.00000 1317 2942 2942 0.00000 9417 58158 58158 0.00010 1 13222552 5080666 125941999 127610682 -1668683 X 1 1 1 WEST SHORE SURGERY CENTER LTD SURGICAL CARE - MEDICAL SERVICES 0.49000 0.00000 0.49000 2 SUSQUEHANNA VALLEY SURGERY CENTER SURGICAL CARE - MEDICAL SERVICES 0.50000 0.00000 0.50000 3 WALNUT BOTTOM RADIOLOGY LLC OUTPATIENT IMAGING SERVICES 0.50000 0.00000 0.50000 2 1 PINNACLE HEALTH HOSPITALS - HARRISBURG

111 SOUTH FRONT STREET HARRISBURG PA 17101

X X X X X 2 PINNACLE HEALTH HOSPITALS - CGOH

4300 LONDONDERRY ROAD HARRISBURG PA 17109

X X X X X PINNACLE HEALTH HOSPITALS - HARRISBURG 1 1 1 250.000000000000 1 400.000000000000 1 X X 1 1 X X X X X 1 0 1 X 0 0 PINNACLE HEALTH HOSPITALS - CGOH 2 1 1 250.000000000000 1 400.000000000000 1 X X 1 1 X X X X X 1 0 1 X 0 0 7 HORIZON HEALTH CARE SERVICES LLP

607 N DUKE STREET LANCASTER PA 17602

IN-HOME DRUG INFUSION THERAPY PINNACLE HEALTH EMERGENCY DEPARTMENT SER

111 SOUTH FRONT STREET HARRISBURG PA 17101

EMERGENCY MEDICAL SERVICES SUSQUEHANNA VALLEY SURGERY CENTER LLC

4310 LONDONDERRY ROAD SUITE 1 HARRISBURG PA 17109

SURGICAL CARE - MEDICAL SERVICES WEST SHORE SURGERY CENTER LTD

2015 TECHNOLOGY PARKWAY MECHANICSBURG PA 17050

SURGICAL CARE - MEDICAL SERVICES CONCENTRA OCCUPATIONAL HEALTHCARE HARRIS

495 OLD CONNECTICUT PATH SUITE 220 FRAMINGHAM MA 01701

URGENT CARE CENTER - MEDICAL SERVICES WALNUT BOTTOM RADIOLOGY LLC

850 WALNUT BOTTOM ROAD CARLISLE PA 17013

OUTPATIENT RADIOLOGY AND IMAGING SERVICES VNA COMMUNITY CARE SERVICES

1811 OLDE HOMESTEAD LANE PO BOX 10788 LANCASTER PA 17604

HOME HEALTH CARE PROVIDER PART I, LINE 6A: THE COMMUNITY BENEFIT REPORT IS PREPARED BY PINNACLE HEALTH SYSTEM, THE PARENT ORGANIZATION. PART I, LINE 7: THE COSTS OF CHARITY CARE AND UNREIMBURSED MEDICAID COSTS ARE CALCULATED BY THE HOSPITAL'S COST ACCOUNTING SYSTEM FOR EACH OF THE INDIVIDUAL SERVICES PROVIDED TO THE PATIENT. IT UTILIZES HOSPITAL EXPENSES FROM THE GENERAL LEDGER AND REVENUE DETAILS FROM THE PATIENT ACCOUNTING SYSTEM. EACH DEPARTMENT WITHIN THE HOSPITAL IS CLASSIFIED AS EITHER INDIRECT (OVERHEAD) OR DIRECT (PATIENT CARE AREAS). EXPENSES ARE CLASSIFIED AS FIXED OR VARIABLE AS THEY RELATE TO PATIENT VOLUME. LOGICAL STATISTICS ARE USED TO ALLOCATE OVERHEAD EXPENSES TO THE PATIENT CARE DEPARTMENTS. USING EITHER A RATIO OF COST-TO-CHARGE OR RVUS (RELATIVE VALUE UNITS), THE DIRECT AND INDIRECT COSTS FOR EACH DEPARTMENT ARE ALLOCATED TO THE SERVICES THEY PROVIDE. PART I, L7 COL(F): THE AMOUNT OF BAD DEBT INCLUDED IN FORM 990, PART IX, LINE 25 AND NOT INCLUDED FOR THE PURPOSES OF CALCULATING THE APPLICABLE PERCENTAGES OF SCHEDULE H IS $33,862,993. PART II: WITH A FOCUS ON PROVIDING LEADERSHIP IN IMPROVING THE OVERALL HEALTH OF OUR COMMUNITY, PINNACLE HEALTH HOSPITALS VALUES RELATIONSHIPS WITH COMMUNITY PARTNERS AND THE ASSETS THEY BRING TO ANY COLLABORATIVE EFFORTS. PINNACLE HEALTH HOSPITALS HELPED CREATE THE DAUPHIN COUNTY HEALTH IMPROVEMENT PARTNERSHIP (DCHIP) COMPRISED OF REGIONAL HEALTH AND HUMAN SERVICE PROVIDERS, PAYORS, COUNTY GOVERNMENT, BUSINESSES AND EDUCATION. PHH HAS WORKED COLLABORATIVELY WITH PHYSICIANS, HEALTH AND HUMAN SERVICE ORGANIZATIONS FOR MANY YEARS TO MAXIMIZE COMMUNITY CAPACITY, PROVIDE NECESSARY SERVICES TO THE COMMUNITY AND REDUCE DUPLICATION OF SERVICES. PHH SERVES IN A CONVENING ROLE TO STRENGTHEN COMMUNITY ASSETS THROUGH REFERRAL NETWORKS AND PARTNERSHIPS; SUCH INITIATIVES INCLUDE THE PHARMACY VOUCHER PROGRAM WITH THE HARRISBURG PHARMACY, AND WITH THE LOCAL SCHOOL SYSTEM TO PROMOTE HEALTH AWARENESS AND PHYSICAL ACTIVITY AMONG CHILDREN. THE PROGRAM INCLUDES A PREMIUM SYSTEM TO ENCOURAGE STUDENTS TO ADOPT AND MAINTAIN A HEALTHIER LIFESTYLE AND OFFERS OPPORTUNITY FOR FAMILIES TO PARTICIPATE IN CLASSES TOGETHER TO LEARN ABOUT HEALTHY COOKING AND PHYSICAL ACTIVITY. OUR JOINT VENTURES WITH REGIONAL PHYSICIAN SPECIALTY GROUPS AND RADIOLOGICAL SERVICES ARE NUMEROUS. BASED ON IDENTIFIED COMMUNITY NEEDS AND VULNERABLE POPULATIONS, CONTINUOUS AND FREE PUBLIC PROGRAMS ARE TARGETED AT VARIOUS LOCATIONS THROUGHOUT THE COMMUNITY AND INTO AREAS OF LIMITED ACCESS TO SPECIALTY SERVICES. THESE PROGRAMS ARE INTENDED TO INFORM AND CHANGE THE HEALTH HABITS OF PARTICIPANTS THROUGH SUCH TOPIC AREAS AS DIABETES, HEART DISEASE, SEXUALLY TRANSMITTED DISEASE PREVENTION, CANCER, ACCESSING HEALTHCARE, BEHAVIORAL HEALTH, SMOKING CESSATION AND NUTRITION. EXAMPLES OF PINNACLEHEALTH'S LEADERSHIP IN BUILDING COMMUNITY CAPACITY ARE:CONGREGATIONAL HEALTH NETWORK (CHN)PINNACLEHEALTH SYSTEM KNOWS THAT 70% OF OUR PATIENTS BELONG TO A CONGREGATION IN CENTRAL PENNSYLVANIA. THE CHN IS A PARTNERSHIP BETWEEN CONGREGATIONS, THE HEALTHCARE SYSTEM AND THE COMMUNITY. BY NETWORKING WITH THESE PARTNERS, THE CHN WORKS TO IMPROVE THE HEALTH OF ALL IN OUR REGION. CONGREGATIONS PARTNER WITH PINNACLEHEALTH SYSTEM AND OTHERS TO PROVIDE A NETWORK OF HEALTH SUPPORT. AS A MEMBER OF CONGREGATION, AND AS A MEMBER OF THE CONGREGATIONAL HEALTH NETWORK (CHN), INDIVIDUALS HAVE ACCESS TO A WEALTH OF SUPPORT ON ISSUES SUCH AS PREVENTIVE MEDICINE AND FOLLOW-UP CARE. THE CHN WORKS WITH CONGREGATIONS TO EDUCATE AND PROVIDE A SUPPORTIVE NETWORK TO HELP INDIVIDUAL MEMBERS NAVIGATE THE HEALTH SYSTEM. TRAINED LEADERS AT LOCAL CONGREGATIONS AND AT PINNACLEHEALTH SYSTEM CAN HELP: ** PROVIDE ACCESS TO QUALITY HEALTH CARE AND HELP GUIDE INDIVIDUALS THROUGH THE HEALTHCARE SYSTEM. ** PROVIDE ADVOCACY TO EMPOWER CONGREGANTS IN HEALTHCARE DECISION MAKING. ** CONNECT FAITH COMMUNITIES TO A NETWORK OF SUPPORT FOLLOWING ILLNESS, INJURY, AND HOSPITALIZATION. ** CONNECT PEOPLE WITH EDUCATION AND SERVICES THAT WILL ENABLE THEM TO MAINTAIN OPTIMAL LEVELS OF HEALTH AND WELLBEING.KEYSTONE COMMUNITY CARE CONTINUUM (KCCC) IN 2009, PINNACLEHEALTH LAUNCHED THE KEYSTONE COMMUNITY CARE CONTINUUM (KCCC), A COLLABORATION BETWEEN PINNACLEHEALTH AND FIVE COMMUNITY CLINICS TO IMPROVE ACCESS TO AND INTEGRATION OF CARE FOR OUR REGION'S NEEDIEST POPULATIONS. THIS INNOVATIVE PROGRAM REQUIRES THE COLLABORATION AND COOPERATION OF NUMEROUS ENTITIES BOTH INTERNAL AND EXTERNAL TO PINNACLEHEALTH TO ESTABLISH THE INFRASTRUCTURE TO SUPPORT THE IMPLEMENTATION OF PINNACLEHEALTH'S HEALTH INFORMATION EXCHANGE (HIE) TO COMMUNICATE CARE, DIAGNOSTIC NEEDS AND RESULTS AMONG THE CONTINUUM OF HEALTHCARE PROVIDERS.TO DATE, THE CONTINUUM PROJECT HAS SERVED 134 (43 PATIENTS 1ST QUARTER, 29 PATIENTS 2ND QUARTER, AND 62 PATIENTS THE 3RD QUARTER) PATIENTS AT THE HOPE WITHIN CLINIC AND BETHESDA MISSION, AND DISBURSED OVER $46,519.00 IN FREE CARE FUNDS TO PATIENTS. BASED ON THE ANALYSIS TO DATE AND PINNACLEHEALTH SYSTEM GOALS, THE FOLLOWING OUTCOMES HAVE BEEN ESTABLISHED FOR THE KCCC PROJECT:** DECREASE READMISSIONS WITHIN THIRTY DAYS FOR COMMUNITY HEALTH CENTER PATIENTS FROM 23% TO 20% IN EIGHTEEN MONTHS.** DECREASE PERCENT OF COMMUNITY HEALTH CENTER PATIENTS WITH ACUITY LEVELS OF 4 OR 5 IN THE ED FROM 55% TO 50% IN EIGHTEEN MONTHS. THIS TRANSFORMATION FROM A TRADITIONAL INPATIENT BASED HEALTH CARE MODEL TO A COLLABORATIVE, PATIENT CENTERED MEDICAL HOME MODEL FACILITATES A PARTNERSHIP BETWEEN INDIVIDUAL PATIENTS, PHYSICIANS, CLINICS AND THE COMMUNITY-BASED PATIENT SUPPORT SYSTEM. PATIENT CARE WILL BE FACILITATED BY THE COMMUNITY HEALTH NAVIGATION TEAM USING RELATIONSHIPS WITH COMMUNITY BASED ORGANIZATIONS, AND A HEALTH INFORMATION EXCHANGE TO ASSURE THAT PATIENTS GET THE INDICATED CARE WHEN AND WHERE THEY NEED AND WANT IT IN A CULTURALLY AND LINGUISTICALLY APPROPRIATE MANNER. AS A TRUSTED PLACE FOR OUR COMMUNITY TO GO FOR ACCESS TO PUBLIC HEALTH SERVICES AND INFORMATION, OUR PHH STAFF OF PROFESSIONALS MEETS THE NEEDS OF A DIVERSE POPULATION WITH CULTURAL AWARENESS AND SENSITIVITY. THE CHILDREN'S RESOURCE CENTER (CRC) PARTNERS WITH LAW ENFORCEMENT, DISTRICT ATTORNEY'S OFFICES, SOCIAL SERVICES, PSYCHOLOGICAL SUPPORT SERVICES, CRISIS INTERVENTION, AND CHILD PROTECTION SERVICES TO PROVIDE EFFICIENT, QUALITY CARE IN A SAFE, CHILD-FRIENDLY ENVIRONMENT FOR CHILDREN SUSPECTED OF HAVING BEEN ABUSED OR NEGLECTED. THROUGH ONGOING TRAINING AND EDUCATION IN THE COMMUNITY, THE CRC HAS SEEN AN INCREASE IN PARTICIPATION WITH PARTNER AGENCIES IN AN EVER-WIDENING GEOGRAPHIC SERVICE AREA. IN 2012, 845 CHILDREN WERE SERVED ACROSS 24 COUNTIES IN THE CENTRAL PENNSYLVANIA REGION. WE SERVED APPROXIMATELY 500 NON-OFFENDING CAREGIVERS MAKING OUR TOTAL NUMBERS 1345 FOR THE YEAR. OUR MAIN SERVICE AREAS ARE DAUPHIN, CUMBERLAND, PERRY, LEBANON, SCHUYLKILL, MIFFLIN, AND JUNIATA COUNTIES.OVER THIS PAST YEAR, THE PINNACLEHEALTH CHILDHOOD LEAD PREVENTION PROGRAM SCREENED 6183 CHILDREN FOR LEAD POISONING OF WHICH 300 OF THESE CHILDREN WERE DETERMINED TO BE LEAD POISONED. THAT RESULT CALCULATES TO APPROXIMATELY 6% OF THE TOTAL NUMBER TESTED. IF PINNACLEHEALTH DID NOT TEST THESE CHILDREN AT HEAD STARTS, WIC'S, DAY CARES, AND HOME VISITS, THAT WOULD EQUATE TO 300 CHILDREN WHO WOULD MOST LIKELY GO UNDETECTED FOR LEAD POISONING. APPROXIMATELY 90% OF ALL THE CHILDREN WE TEST FOR LEAD ARE MEDICAL ASSISTANCE RECIPIENTS. PINNACLEHEALTH SERVES THE HIV/AIDS POPULATION THROUGH PINNACLE'S RESOURCE EDUCATION AND COMPREHENSIVE CARE FOR HIV (REACCH) CLINIC, IN CALENDAR YEAR 2012, 93% OF 465 CLIENTS WHO RECEIVED A RYAN WHITE PART B OR PART C SERVICE FROM REACCH WERE FROM DAUPHIN, CUMBERLAND, AND PERRY COUNTIES. REACCH HAS A HISTORY IN WORKING WITH PATIENTS OF RACIAL AND SOCIOECONOMIC DIVERSITY. PER 2012 REACCH DEMOGRAPHICS, 42% OF PATIENTS IDENTIFIED AS BLACK, AND 56% IDENTIFIED AS WHITE. PATIENTS WHO IDENTIFY AS HISPANIC (CAN INCLUDE OTHER DEMOGRAPHIC CATEGORIES) COMPRISED 10% OF THE REACCH POPULATION. IN ITS FIFTEEN YEARS IN EXISTENCE, REACCH HAS SUCCESSFULLY ACHIEIVED ZERO PERINATAL TRANSMISSIONS IN 88 PREGNANCIES. REACCH IS LOCATED IN WHAT IS CONSIDERED PART OF THE 'SOUTHCENTRAL' REGION OF PENNSYLVANIA IN THE PA DOH EPIDEMIOLOGICAL LITERATURE. THE SOUTHCENTRAL REGION'S HIV PREVALENCE RATE IS 173.26 PERSONS PER 100,000; SECOND ONLY IN THE STATE TO THE TWO REGIONS SURROUNDING PHILADELPHIA. IN THE STATEWIDE COORDINATED STATEMENT OF NEED FOR THE STATE OF PENNSYLVANIA (REACCH PERSONNEL CONTRIBUTED TO AUTHORSHIP), AN ESTIMATE IS GIVEN BY THE STATE EPIDEMIOLOGIST THAT 30% OF AN (ESTIMATED 960) PERSONS LIVING WITH HIV IN THE SOUTHCENTRAL REGION ARE NOT IN MEDICAL CARE. FOR A SENSE OF SCALE, IN 2011, THERE WERE 1,352 IDENTIFIED PEOPLE LIVING WITH HIV IN DAUPHIN, CUMBERLAND, AND PERRY COUNTIES. WITH 405 POTENTIAL PERSONS LIVING WITH HIV WHO ARE NOT YET DIAGNOSED (30% OF 1,352); REACCH RECOGNIZES THAT MEDICAL CARE CONTINUES TO BE A NECESSITY IN OUR REGION. PART III, LINE 4: THE FINANCIAL STATEMENTS DO NOT HAVE A SPECIFIC NOTE ON BAD DEBT EXPENSE; RATHER THE FINANCIAL STATEMENTS EVALUATE BAD DEBTS BASED ON ITS ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE FOOTNOTE RELATED TO THE ALLOWANCE IS SUMMARIZED AS FOLLOWS: "PATIENT RECEIVABLES ARE RECORDED AT THEIR ESTIMATED NET REALIZABLE VALUE. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS ESTIMATED BASED UPON HISTORICAL COLLECTION RATES."THE BAD DEBT EXPENSE ON FORM 990, PART III, LINE 2 WAS CALCULATED BY TAKING THE AMOUNT WRITTEN OFF TO BAD DEBT FOR EACH ACCOUNT AND CONVERTING IT TO CHARGES BY APPROPRIATELY ADJUSTING THE AMOUNT BY THE PAYOR REIMBURSEMENT PERCENTAGE FOR THAT ACCOUNT. THEN, THE COST/CHARGE RATIO FOR EACH SPECIFIC ACCOUNT, UTILIZING THE COSTS FROM THE HOSPITAL COST ACCOUNTING SYSTEM (DESCRIBED IN DETAIL ABOVE), WAS APPLIED TO THIS CALCULATED PORTION OF THE TOTAL CHARGES. FOR THE PORTION OF BAD DEBT EXPENSE THAT IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY, THE HOSPITAL UTILIZES DATA PROVIDED BY MEDEANALYTICS, A THIRD PARTY INDEPENDENT COMPANY, ON THE PATIENT'S ESTIMATED INCOME WHICH IS DERIVED BY NORMALIZING DATA FROM MULTIPLE, DISPARATE SOURCES TO DETERMINE WHICH OF THE BAD DEBT ACCOUNTS COULD HAVE BEEN ELIGIBLE FOR CHARITY CARE BUT THE PATIENT HAD NOT APPLIED. THIS PATIENT FINANCIAL DATA HAS BEEN FOUND TO BE REASONABLY ACCURATE BASED ON COMPARISONS TO THE PATIENTS' ACTUAL INCOME PER SUPPORTING DOCUMENTATION PROVIDED FOR THOSE THAT HAVE APPLIED FOR CHARITY CARE. AN OVERALL COST TO CHARGE RATIO WAS THEN APPLIED TO THIS AMOUNT TO ARRIVE AT AN EXPENSE FIGURE. PART III, LINE 8: THE MEDICARE COSTS WERE DETERMINED BASED ON THE HOSPITALS' COST ACCOUNTING SYSTEM ALLOCATION OF COSTS BASED ON THE SERVICES RENDERED. PART III, LINE 9B: PATIENTS ARE NOTIFIED OF OUR CHARITY CARE POLICY IN A VARIETY OF WAYS. THERE ARE POSTERS INFORMING PATIENTS OF OUR CHARITY CARE POLICY AND PAMPHLETS OUTLINING THE APPLICATION PROCESS AT ALL THE REGISTRATION SITES. ALL OUR PATIENT ACCOUNT STATEMENTS CONTAIN LANGUAGE THAT INDICATES THERE IS FINANCIAL AID AVAILABLE FOR QUALIFYING INDIVIDUALS. IN ADDITION, THE POLICY AND APPLICATION ARE POSTED ON THE HOSPITAL WEBSITE IN BOTH ENGLISH AND SPANISH. PATIENTS THAT APPLY FOR FINANCIAL ASSISTANCE AND PROVIDE ALL THE NECESSARY DOCUMENTATION REQUIREMENTS ARE NOTIFIED WITHIN TWO WEEKS OF THE HOSPITALS' DECISION. WHEN THE APPROVAL IS DETERMINED, THE APPROPRIATE DISCOUNT IS POSTED TO THE PATIENT'S ACCOUNT IMMEDIATELY. THE FINANCIAL ASSISTANCE DISCOUNT WILL BE APPLIED TO SERVICES FOR THE PREVIOUS EIGHTEEN MONTHS AND SUBSEQUENT SIX MONTHS. APPLICANTS APPROVED FOR ONLY PARTIAL DISCOUNT WILL BE REQUIRED TO MAKE REASONABLE PAYMENT ARRANGEMENTS ON THEIR BALANCE IN ACCORDANCE TO THE HOSPITAL'S CREDIT AND COLLECTION POLICY. THIS POLICY DOES PERMIT THE USE OF BOTH INTERNAL COLLECTION STAFF AND EXTERNAL COLLECTION AGENCIES WHO WILL ENGAGE IN STANDARD ACCEPTABLE BUSINESS PRACTICES WHICH INCLUDE PHONE CALLS, MAILINGS AND THE REPORTING OF ITS UNPAID DEBT TO THE CREDIT REPORTING AGENCIES; BUT UNDER NO CIRCUMSTANCES WILL THE HOSPITALS OR ITS CONTRACTED COLLECTION AGENCY ADOPT "EXTRAORDINARY COLLECTION ACTIONS" THAT ENTAIL LEGAL COURSE OF ACTION OR JUDICIAL PROCESS SUCH AS LAWSUITS OR LIENS. PART VI, LINE 2: AS A CO-SPONSOR OF THE 2007 COMMUNITY NEEDS ASSESSMENT CONDUCTED BY THE DREXEL UNIVERSITY SCHOOL OF PUBLIC HEALTH, PINNACLEHEALTH HOSPITALS USES EVIDENCE-BASED FINDINGS TO OUTLINE COMMUNITY HEALTH IMPROVEMENT STRATEGIES. THIS "POINT-IN-TIME" STUDY NOTED, "THE HEALTH STATUS OF DAUPHIN COUNTY'S RESIDENTS IS POOR AND RANKS AMONG THE FIVE WORST IN PENNSYLVANIA FOR HIV/AIDS, SEXUALLY TRANSMITTED DISEASES, AND LOW BIRTH WEIGHT." SPECIFICALLY, SEVEN KEY NEEDS FOR ENHANCING PUBLIC HEALTH AND IMPROVING ACCESS TO PERSONAL HEALTH SERVICES WERE CITED: MATERNAL AND CHILD HEALTH; SEXUALLY TRANSMITTED DISEASES AND HIV/AIDS; EMERGENCY PREPAREDNESS; MEDICAL CARE AND SERVICES; DENTAL CARE; CHRONIC DISEASE PREVENTION AND MANAGEMENT; AND BEHAVIORAL HEALTH. THE STUDY ALSO IDENTIFIED THE LACK OF A SINGLE, WELL-KNOWN AND ACCEPTED PLACE FOR DAUPHIN COUNTY RESIDENTS TO GO FOR PUBLIC HEALTH SERVICES AND INFORMATION. PINNACLEHEALTH HOSPITALS HAVE USED THE RESULTS OF THIS STUDY TO DEVELOP A COMMUNITY HEALTH STRATEGY THAT IS BROAD IN SCOPE AND FOCUSED ON OUTCOMES THAT MEET THE SPECIFIC NEEDS OF A DIVERSE POPULATION.PINNACLEHEALTH HOSPITALS (PHH) ACCESSES VARIOUS STATE AND NATIONAL SOURCES FOR SECONDARY DATA, INCLUDING THE PENNSYLVANIA DEPARTMENT OF HEALTH EPIQMS SYSTEM (EPIDEMIOLOGIC QUERY AND MAPPING SYSTEM), AN INTERACTIVE HEALTH STATISTICS WEB TOOL WHERE YOU CAN CREATE CUSTOMIZED DATA TABLES, CHARTS, MAPS, AND COUNTY ASSESSMENTS/PROFILES FOR THE FOLLOWING DATASETS: -BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS)-BIRTHS-CANCER INCIDENCE -COMMUNICABLE DISEASES (OTHER THAN STDS) -DEATHS -EMERGENCY MEDICAL SERVICES -ENVIRONMENTAL PUBLIC HEALTH TRACKING NETWORK (EPHTN) -INFANT DEATHS -POPULATION -SEXUALLY TRANSMITTED DISEASES (STDS) -TEEN PREGNANCIES (REPORTED)PINNACLE HEALTH HOSPITALS UTILIZES THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES' COMMUNITY HEALTH STATUS INDICATORS WHICH PROVIDES DATA THAT CAN BE COMPARED TO PEER COUNTIES ON A STATE AND NATIONAL LEVEL. IN ADDITION, HEALTHY PEOPLE 2020 IDENTIFIES NEARLY 600 OBJECTIVES WITH MORE THAN 1,300 MEASURES TO IMPROVE THE HEALTH OF ALL AMERICANS. TO MONITOR PROGRESS TOWARD ACHIEVING INDIVIDUAL OBJECTIVES, HEALTHY PEOPLE RELIES ON DATA SOURCES DERIVED FROM A NATIONAL CENSUS OF EVENTS LIKE THE NATIONAL VITAL STATISTICS SYSTEM AND NATIONALLY REPRESENTATIVE SAMPLE SURVEYS LIKE THE NATIONAL HEALTH INTERVIEW SURVEY. PINNACLEHEALTH HOSPITALS SEARCHES THE HEALTH INDICATORS WAREHOUSE FOR DATA RELATED TO HEALTHY PEOPLE 2020 OBJECTIVES DEVELOPED BY THE NATIONAL CENTER FOR HEALTH STATISTICS TO DEFINE PRIORITIES TO ASSIST IN IMPROVING HEALTH IN THE COMMUNITY. PINNACLE HEALTH HOSPITALS USES DIRECT PATIENT FEEDBACK, OUTREACH EFFORTS, AND COMMUNITY BASED PARTNERSHIPS TO DETERMINE THE HEALTH CARE NEEDS IN CUMBERLAND, DAUPHIN, AND PERRY COUNTIES. THE PRIMARY DATA SOURCES FOR ASSESSING THE UNMET NEEDS OF THE COMMUNITY ARE DIRECT PATIENT CONTACT, QUESTIONNAIRES, AND OBSERVATION OF THE PATIENT POPULATION IN PINNACLE'S FOUR CAMPUSES (COMMUNITY, CUMBERLAND, HARRISBURG AND POLYCLINIC), FAMILYCARE PHYSICIAN PRACTICES, HOME HEALTH AND HOSPICE SERVICES, OUTPATIENT SURGERY AND IMAGING CENTERS. THROUGH VARIOUS OUTREACH PROGRAMS INCLUDING HEALTH FAIRS, SCREENINGS, LECTURES, AND EDUCATION SESSIONS, DATA IS COLLECTED AND INCLUDED IN ASSESSING THE OVERALL UNMET NEEDS OF THE COMMUNITY.AN UPDATED COMMUNITY HEALTH NEEDS ASSESSMENT IS BEING DEVELOPED DURING FISCAL YEAR 2013 IN COORDINATION WITH TWO HOSPITALS LOCATED WITHIN PINNACLEHEALTH HOSPITAL'S MAJOR SERVICE AREA. PART VI, LINE 3: PATIENTS ARE INFORMED OF AVAILABLE ASSISTANCE IN NUMEROUS WAYS. SIGNAGE IS POSTED AND PAMPHLETS ARE AVAILABLE AT ALL THE REGISTRATION SITES INDICATING TO THE PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE. ALL UN-INSURED PATIENTS WHO ARE SCHEDULED FOR HIGH DOLLAR TESTS AND SURGERIES ARE CONTACTED BY ONE OF THE HOSPITALS FINANCIAL COUNSELORS TO DISCUSS THE FINANCIAL ASSISTANCE OPTIONS AVAILABLE TO THEM. THE FINANCIAL ASSISTANCE POLICY IS ALSO DISCLOSED ON THE HOSPITAL WEBSITE, ALONG WITH THE APPLICATION, IN BOTH ENGLISH AND SPANISH. IN ADDITION, ALL INPATIENTS WHO ARE RESIDENTS OF PENNSYLVANIA ARE PROVIDED PERSONAL ASSISTANCE IN THE COMPLETION OF THE MEDICAL ASSISTANCE APPLICATION. AS PART OF THE DISCHARGE PROCESS IN THE EMERGENCY DEPARTMENT, ALL UNINSURED PATIENTS ARE SCREENED FOR CHARITY CARE ELIGIBILITY UNDER THE HOSPITAL POLICY. LASTLY, INFORMATION ABOUT FINANCIAL ASSISTANCE IS INCLUDED ON THE PATIENT BILLING STATEMENTS. PROGRAMS DISCUSSED INCLUDE THE PENNSYLVANIA STATE MEDICAID PROGRAM (MEDICAL ASSISTANCE), HOSPITAL CHARITY CARE PROGRAM, AND FUNDS AVAILABLE THROUGH HOSPITAL ENDOWMENT FUNDS. PART VI, LINE 4: PINNACLE HEALTH HOSPITALS' (PHH) PRIMARY SERVICE AREA (PSA) CONSISTS OF 53 CONTIGUOUS ZIP CODES IN PORTIONS OF 6 COUNTIES IN THE GREATER HARRISBURG AREA OF SOUTH CENTRAL PENNSYLVANIA. THE SIX COUNTIES INCLUDE DAUPHIN, CUMBERLAND, PERRY, YORK, LANCASTER AND LEBANON. THE COMMUNITY CAN BE DESCRIBED AS A MIX OF RURAL IN THE OUTLYING COUNTIES, SUBURBAN AND THE URBAN AREA OF THE CITY OF HARRISBURG. THE PSA ACCOUNTS FOR APPROXIMATELY 85 PERCENT OF THE OVERALL ACUTE PATIENT DISCHARGES OF THE HOSPITALS. PINNACLE HEALTH HOSPITALS COMPETES WITH THREE ACUTE CARE HOSPITALS AND 2 REHABILITATION HOSPITALS WITHIN THE PSA. ONE OF THE ACUTE CARE HOSPITALS IS A FOR PROFIT HOSPITAL OWNED BY A LARGE PUBLICLY REGISTERED HEALTH CARE SYSTEM. THE SECOND COMPETITOR IS A MEDICAL ACADEMIC HOSPITAL AFFILIATED WITH A LARGE STATE FUNDED PUBLIC UNIVERSITY AND THE FINAL COMPETITOR IS A SMALLER, NON-TEACHING NOT-FOR-PROFIT HOSPITAL. THE FIRST REHABILITATION HOSPITAL IS OWNED AND OPERATED BY A LARGE PUBLICLY REGISTERED CORPORATION AND THE OTHER REHABILITATION HOSPITAL IS OPERATED BY THE MEDICAL ACADEMIC HOSPITAL OF THE LARGE STATE FUNDED PUBLIC UNIVERSITY ALREADY MENTIONED. THE PSA IN WHICH PHH SERVES HAS 12 CENSUS TRACTS WHICH HAVE BEEN IDENTIFIED BY THE U.S. HEALTH RESOURCES AND SERVICES ADMINISTRATION AS MEDICALLY UNDERSERVED AREAS (MUAS). IN ADDITION, IMMEDIATELY ADJACENT TO THE WEST OF THE PSA ARE AN ADDITIONAL 5 MINOR CIVIL DIVISIONS WHICH HAVE BEEN IDENTIFIED AS MUAS. PHH IS A SIGNIFICANT PROVIDER OF HEALTHCARE SERVICES TO PATIENTS IN THE AREAS ADJACENT TO ITS PSA. PHH IS THE PRIMARY PROVIDER FOR THE 49,000 PEOPLE LIVING IN THE CITY OF HARRISBURG. THE EMERGENCY DEPARTMENT (ED) OF THE HOSPITAL IS THE FIRST OPTION FOR A LARGE MAJORITY OF THE CITY RESIDENTS. IN ADDITION, THE HOSPITAL AND RELATED ORGANIZATIONS OPERATE ADULT, CHILDREN, WOMAN AND TEEN PRIMARY CARE CLINICS THAT MAINLY SERVE THE CITY'S MEDICAID AND UNINSURED POPULATION. OTHER DEMOGRAPHIC STATISTICS OF HARRISBURG INCLUDE 27.5 PERCENT OF THE POPULATION IS UNDER THE AGE OF 18, 41.6 PERCENT HAVE HOUSEHOLD INCOMES OF LESS THAN $25,000, 45 PERCENT OF CHILDREN LIVE BELOW THE FEDERAL POVERTY LINE, 77 PERCENT OF THE POPULATION IS COMPRISED OF ETHNICALLY DIVERSE MINORITY POPULATIONS AND FINALLY 22 PERCENT OF THE POPULATION IS ESTIMATED TO HAVE NO HEALTH INSURANCE AND 29 PERCENT HAVE MEDICAID INSURANCE. THE HOSPITAL'S MARKET SHARE OF THE CITY OF HARRISBURG'S MEDICAID POPULATION IS APPROXIMATELY 77.5 PERCENT. PHH IS ALSO THE MAJOR PROVIDER OF HEALTH CARE SERVICES FOR ALL OF DAUPHIN COUNTY, WHERE THE CITY OF HARRISBURG IS LOCATED, AND ACCORDING TO "COUNTY HEALTH RANKINGS," DAUPHIN COUNTY RANKS 38TH OUT OF A TOTAL OF 67 PENNSYLVANIA COUNTIES IN AN ASSESSMENT OF THE OVERALL HEALTH OF EACH COUNTY. THE PA DEPARTMENT OF HEALTH (DOH) REPORTS THAT DAUPHIN COUNTY RANKS ABOVE THE STATE OF PA AS A WHOLE IN THE FOLLOWING CATEGORIES: LOW BIRTH WEIGHT, BIRTHS TO MOTHERS UNDER THE AGE OF 18, MOTHERS RECEIVING NO PRENATAL CARE IN THE FIRST TRIMESTER, BREAST CANCER INCIDENCE, HEART DISEASE AND DIABETES. PART VI, LINE 5: PINNACLE HEALTH HOSPITALS MAINTAINS AN ACTIVE ROLE IN THE COMMUNITY IN WHICH IT SERVES. THE ROLE IS REFLECTIVE IN ITS BOARD OF DIRECTORS WHOSE COMPOSITION IS GREATER THAN 80 PERCENT INDEPENDENT COMMUNITY BASED LEADERS. PHH HAS AN OPEN MEDICAL STAFF. PHH PROVIDES TRAINING FOR BOTH MEDICAL STUDENTS AND RESIDENTS IN A NUMBER OF SPECIALTIES. PINNACLE HEALTH HOSPITALS HAS ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) ACCREDITED RESIDENCY PROGRAMS AS WELL AS AMERICAN OSTEOPATHIC ASSOCIATION (AOA) ACCREDITED TEACHING PROGRAMS. PHH USES ITS SURPLUS FUNDS TO RENOVATE AND EXPAND PATIENT CARE AREAS IN ADDITION TO PROVIDING PATIENT SERVICES WHICH MAY NOT BE CURRENTLY AVAILABLE IN THE COMMUNITY. RECENT PROJECTS INCLUDE A $34 MILLION PROJECT TO RENOVATE AND EXPAND THE EMERGENCY DEPARTMENT AT THE HARRISBURG HOSPITAL DUE TO THE IMPORTANCE OF THIS AREA IN THE HARRISBURG COMMUNITY, AND A GREATER THAN $32 MILLION DOLLAR PROJECT TO CREATE EXPANDED ONCOLOGY SERVICES TO THE GREATER HARRISBURG COMMUNITY. ADDITIONAL PROJECTS INCLUDE MODERNIZING AND UPDATING EXISTING LOCATIONS WITHIN THE PHH SERVICE AREA TO MEET THE PATIENT NEEDS IN THE COMMUNITY WE SERVE AND EXPANDING THE UTILIZATION OF ELECTRONIC MEDICAL RECORDS BOTH WITHIN PINNACLE HEALTH SYSTEM AS WELL AS WITHIN THE COMMUNITY BASED PHYSICIAN PRACTICES OF OUR AREA. AS ONE OF THE LEADING HOSPITALS IN SOUTH CENTRAL PENNSYLVANIA, PINNACLE HEALTH HOSPITALS STRIVES TO STRENGTHEN ACCESS TO CARE AS WE PROVIDE A CONTINUUM OF COMMUNITY BASED SERVICES THAT EXTEND BEYOND THE ROLE OF AN ACUTE CARE HOSPITAL - FROM IN HOME PRENATAL CARE FOR FIRST TIME MOTHERS TO A LEAD AGENCY ON A REGIONAL DISASTER PREPAREDNESS TASK FORCE. TO BRING FOCUS TO OUR MISSION, PINNACLE HEALTH HOSPITALS IS COMMITTED TO SIX STRATEGIC PILLARS: COMMITMENT TO PEOPLE, SERVICE, QUALITY, GROWTH, COMMUNITY, AND FINANCE. GUIDED BY THESE PILLARS, THE FIVE INITIATIVES HIGHLIGHTED BELOW ARE KEY EXAMPLES OF OUR COMMITMENT TO BEING A TRUSTED PLACE FOR OUR COMMUNITY TO GO FOR ACCESS TO PUBLIC HEALTH SERVICES AND INFORMATION: -NURSE FAMILY PARTNERSHIP (NFP) - WITH A FOCUS ON PEOPLE AND A DESIRE TO MAKE THE HEALTHCARE SYSTEM EASIER TO NAVIGATE, WE OFFER THIS VOLUNTARY PREVENTION PROGRAM THAT PROVIDES NURSE HOME VISITATION SERVICES TO LOW INCOME, FIRST-TIME MOTHERS. THIS NATIONALLY RENOWNED, EVIDENCE-BASED COMMUNITY HEALTH CURRICULUM TRANSFORMS THE LIVES OF VULNERABLE FAMILIES.-DAUPHIN COUNTY HEALTH IMPROVEMENT PARTNERSHIP (DCHIP) - WITH A FOCUS ON CREATING A COHESIVE SYSTEM OF PUBLIC HEALTH SERVICES, WE CONVENE A TEAM OF MULTI-SECTOR, COMMUNITY BASED PARTNERS FROM HEALTHCARE, HUMAN SERVICE, GOVERNMENT, EDUCATION, FAITH AND PAYOR COMMUNITIES. MEMBERS ARE COMMITTED TO WORKING COLLABORATIVELY TO IMPROVE HEALTH, REDUCE DISPARITIES, AND ADDRESS THE QUALITY OF LIFE OF COMMUNITY RESIDENTS.-RESOURCE EDUCATION AND COMPREHENSIVE CARE FOR HIV (REACCH) PROGRAM - WITH A FOCUS ON ACCESS TO QUALITY CARE FOR VULNERABLE MEMBERS OF THE COMMUNITY WE EMPHASIZE TREATMENT AND PREVENTION OF THE SPREAD OF HIV FOR WOMEN AND CHILDREN. REACCH INCLUDES DIAGNOSTIC, THERAPEUTIC AND SUPPORTIVE SERVICES SUCH AS EDUCATION ABOUT HIV DISEASE AND TRANSMISSION, AS WELL AS TREATMENT RECOMMENDATIONS AND HOW TO ACCESS THEM.-EAT SMART, PLAY SMART - WITH A FOCUS ON LONG RANGE SUSTAINABLE GROWTH WITHIN OUR COMMUNITIES, IT IS EVIDENT THAT THE HEALTH OF OUR CHILDREN IS A FOCAL POINT. A MULTI STEP, LONG TERM APPROACH TO PARTNERING WITH SCHOOLS, BUSINESSES, AND PAYORS TO EDUCATE STUDENTS AND FAMILIES ON HEALTHY FOOD CHOICES AND PHYSICAL ACTIVITY ALTERNATIVES ENSURES SUSTAINABLE BEHAVIOR CHANGE. -EMERGENCY MANAGEMENT PLAN-SOUTH CENTRAL TASK FORCE - WITH A FOCUS ON PROVIDING LEADERSHIP IN IMPROVING THE OVERALL HEALTH OF OUR COMMUNITY, OUR EMERGENCY MANAGEMENT TEAM CREATES AN ENVIRONMENT THAT SUPPORTS ACCESSIBILITY AND CONSIDERATION OF BASIC FAMILY NEEDS INCLUDING SAFETY. THE TASK FORCE COLLABORATES AND COORDINATES BOTH PUBLIC AND PRIVATE SECTOR RESOURCES FOR REGIONAL SOLUTIONS THAT PROVIDE SUPPORT TO COMMUNITIES WHEN EVENTS EXCEED THEIR CAPABILITIES. PART VI, LINE 6: PINNACLE HEALTH HOSPITALS IS PART OF THE PINNACLE HEALTH SYSTEM, A FULLY INTEGRATED, AFFILIATED HEALTH CARE SYSTEM. THE SYSTEM IS COMPRISED OF SEVEN WHOLLY OWNED ENTITIES AS WELL AS A VARIETY OF AFFILIATED JOINT VENTURES. THE ORGANIZATION'S MISSION IS TO MAINTAIN AND IMPROVE THE HEALTH AND QUALITY OF LIFE FOR EVERYONE IN CENTRAL PENNSYLVANIA. PINNACLE HEALTH SYSTEM IS ENGAGED IN AND CONDUCTS CHARITABLE, EDUCATIONAL, AND SCIENTIFIC ACTIVITIES THROUGH THE SUPPORT AND BENEFIT OF PINNACLE HEALTH FOUNDATION, AND PROVIDES MANAGEMENT AND CONSULTATIVE SERVICES TO AFFILIATED ENTITIES. PINNACLE HEALTH FOUNDATION ENGAGES IN INVESTMENT AND FUNDRAISING ACTIVITIES FOR THE BENEFIT OF THE RELATED ORGANIZATIONS. PINNACLE HEALTH MEDICAL SERVICES AND PINNACLE HEALTH MEDICAL GROUP ARE PRIMARILY ENGAGED IN THE PROVISION OF PHYSICIAN SERVICES TO SUPPORT AND ENHANCE THE SERVICES WITHIN PINNACLE HEALTH HOSPITALS AND PINNACLE HEALTH SYSTEM. THE PINNACLE HEALTH CARDIOVASCULAR INSTITUTE IS ENGAGED IN PROVIDING COMPREHENSIVE CARDIAC CARE, INCLUDING LEADING EDGE TECHNOLOGICAL ADVANCES IN ORDER TO PROVIDE THE BEST CLINICAL OUTCOMES TO THE COMMUNITY. THE COMMUNITY LIFE TEAM IS ENGAGED IN PROVIDING COMMUNITY BASED, EFFICIENT AND COST EFFECTIVE MEDICAL TRANSPORT SERVICES, PRE-HOSPITAL EMERGENCY MEDICAL SERVICES FOR THE RESIDENTS AND COMMUNITIES OF THE CENTRAL PENNSYLVANIA REGION. THE PINNACLE HEALTH SYSTEM AND ITS AFFILIATES ARE ACTIVELY INVOLVED IN THE CENTRAL PENNSYLVANIA REGION THROUGH VARIOUS CHARITY AND COMMUNITY BENEFIT ACTIVITIES. THE OTHER ENTITIES WITHIN THE SYSTEM, NOT INCLUDING THE HOSPITAL, PROVIDED $455,731 OF CHARITY CARE RECORDED AT CHARGES. THE SYSTEM ENTITIES ARE ALSO ACTIVELY ENGAGED IN A VARIETY OF COMMUNITY BENEFIT ACTIVITIES. THE FOLLOWING LISTS THE VARIETY OF COMMUNITY BENEFITS PERFORMED WITHIN THE SYSTEM, THAT HAD THEY BEEN PERFORMED AT THE HOSPITAL LEVEL, WOULD HAVE BEEN INCLUDABLE ON SCHEDULE H. -PINNACLE HEALTH SYSTEM - $1,454,883 IN COMMUNITY HEALTH IMPROVEMENT SERVICES, HEALTH PROFESSIONS EDUCATION, COMMUNITY BENEFIT OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS-PINNACLE HEALTH MEDICAL SERVICES - $684,394 IN COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BASED CLINICAL SERVICES AND HEALTH CARE SUPPORT SERVICES-COMMUNITY LIFE TEAM - $175,818 IN SUBSIDIZED HEALTH SERVICES-PINNACLE HEALTH FOUNDATION - $434,568 IN COMMUNITY BENEFIT OPERATIONS AND FINANCIAL CONTRIBUTIONS. THE ABOVE COMMUNITY BENEFIT ACTIVITIES WOULD HAVE CONTRIBUTED AN ADDITIONAL 0.46% OF BENEFIT PROVIDED TO THE CENTRAL PENNSYLVANIA COMMUNITY HAD THEY BEEN REPORTABLE BY THE PINNACLE HEALTH HOSPITALS. OTHER COMMUNITY BENEFIT ACTIVITIES PROVIDED BY PINNACLE HEALTH SYSTEM WHICH ARE NOT DESCRIBED ABOVE ARE URBAN BASED CLINICS SERVING MOSTLY LOW INCOME, UNDERINSURED PATIENTS, URGENT CARE CENTERS THROUGHOUT THE SERVICE AREA, SEVERAL JOINT VENTURES WITH PHYSICIANS FOR AMBULATORY SURGERY AND IMAGING SERVICES. REPORTS FILED WITH STATES PART VI, LINE 7 PA X 1 1 1 1 0 0 0 0 0 1 0 FELIX GUTIERREZ MD 0 301509 0 36891 0 13098 0 22774 0 8627 0 382899 0 0 MICHAEL A YOUNG 0 310826 0 146255 0 78783 0 0 0 5167 0 541031 0 0 CHRISTOPHER P MARKLEY ESQ 0 279185 0 46200 0 28311 0 14803 0 32632 0 401131 0 0 RICHARD C SENECA ESQ 278280 0 0 0 0 0 0 0 0 0 278280 0 0 0 WILLIAM H PUGH 0 339233 0 47600 0 14578 0 14700 0 30660 0 446771 0 0 NANCY HAMMONDS 0 127097 0 12400 0 5834 0 20947 0 14613 0 180891 0 0 KIM KELLY 323945 0 0 0 258 0 14806 0 19741 0 358750 0 0 0 EDWARD HILDREW 230587 0 15701 0 113096 0 34406 0 25079 0 418869 0 0 0 JULIAN GUTIERREZ 197011 0 13497 0 132633 0 14778 0 19513 0 377432 0 0 0 JED SPRUCE SEITZINGER 230693 0 9365 0 84610 0 14803 0 29878 0 369349 0 0 0 JOHN GOLDMAN MD 288279 0 8000 0 26938 0 12248 0 24083 0 359548 0 0 0 ROGER LONGENDERFER MD 0 592010 0 17760 0 6103 0 103 0 151 0 616127 0 0 PART I, LINE 1A ROGER LONGENDERFER, M.D., A FORMER PRESIDENT AND CEO, RECEIVED A REIMBURSEMENT FOR PERSONAL FINANCIAL SERVICES. THE REIMBURSEMENT WAS INCLUDED IN HIS TAXABLE COMPENSATION. PART I, LINE 3 PINNACLE HEALTH HOSPITALS RELIES ON PINNACLE HEALTH SYSTEM, A RELATED ORGANIZATION, TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO. METHODS USED TO ESTABLISH COMPENSATION BY THE RELATED ORGANIZATION INCLUDE: * COMPENSATION COMMITTEE * INDEPENDENT COMPENSATION CONSULTANT * WRITTEN EMPLOYMENT CONTRACT * COMPENSATION SURVEY OR STUDY * APPROVAL BY THE COMPENSATION COMMITTEE OF THE BOARD PART I, LINES 4A-B ROGER LONGENDERFER, M.D., A FORMER PRESIDENT AND CEO, WAS PAID SEVERANCE IN THE FORM OF SALARY AND BENEFITS TOTALING $616,127 IN 2011 AS PART OF HIS RETIREMENT PACKAGE. DR FELIX GUTIERREZ IS A MEMBER OF THE BOARD OF DIRECTORS AND IS EMPLOYED AS A CARDIOLOGIST IN A RELATED ENTITY. HE WAS COVERED BY A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN IN CALENDAR YEAR 2011 AT A TOTAL COST OF $12,323. PART I, LINE 7 THE COMPENSATION COMMITTEE OF THE BOARD WITH ASSISTANCE FROM AN INDEPENDENT OUTSIDE ADVISOR ESTABLISHES A COMPENSATION PHILOSOPHY TO COMPENSATE LEADERS OF THE ORGANIZATION AT THE MARKET MEDIAN WITH AN INCENTIVE OPPORTUNITY TO REACH THE 75TH PERECENTILE OF THE MARKET FOR THEIR POSITION. THE INCENTIVE OPPORTUNITY IS DIVIDED BETWEEN PERSONAL GOALS AND SYSTEM LEVEL GOALS. ALL GOALS ARE MEASURABLE AND ARE DESIGNED TO IMPROVE QUALITY OF CARE, PATIENT SAFETY, PATIENT EXPERIENCE, AND MANAGEMENT OF RESOURCES. PERFORMANCE IS REWARDED AT THREE LEVELS; THRESHOLD (IMPROVEMENT OVER THE BASELINE) , TARGET (SIGNIFICANT IMPROVEMENT OVER THE PRIOR YEAR) AND OPTIMUM (STRETCH). DAUPHIN COUNTY GENERAL AUTHORITY 232336949 23825ECL6 2009-06-24 187538449 REFUND SERIES 2004, 2005 & 2007, SWAP TERMINATION, CAPITAL PROJECTS 0 0 0 DAUPHIN COUNTY GENERAL AUTHORITY 232336949 23825ECY8 2011-06-28 100000000 REFUND 2009B NOTES AND CAPITAL PROJECTS 0 0 0 11665000 187538449 9493675 168307000 2962259 6775515 2009 1 0 1 1 1250000 100000000 70000000 279272 27640702 2080026 2012 1 0 0 1 0 0 1 1 0 0.00410 0.00410 1 0 0 1 1 0 0.00000 0.00000 1 0 0 1 CITIGROUP 30.000000000000 0 0 0 0 0 0 1 0 0 0 0 RIVERSIDE DIRECTOR FELIX GUTIERREZ, MD IS A PARTNER IN RIVERSIDE 710980 SEE PART V - RENTAL OF PHYSICIAN OFFICE SPACE. 0 M&T BANK DIRECTOR JOHN CAMPBELL IS ADMINISTRATIVE VP OF PERSONAL TRUST WITH M&T BANK 132548 SEE PART V - INVESTMENT MANAGMENT SERVICES PROVIDED BY M&T BANK 0 FORM 990, PART V, LINE 1: PINNACLE HEALTH SYSTEM, THE PARENT ENTITY OF A GROUP OF TAX-EXEMPT ORGANIZATIONS, IS THE COMMON REPORTING AGENT FOR THE GROUP AND FILES ALL 1099 FORMS FOR PINNACLE HEALTH HOSPITALS. FORM 990, PART VI, SECTION B, LINE 11 THE AUTHORITY AND RESPONSIBILITY FOR REVIEW OF THE FORM 990 FOR PINNACLE HEALTH SYSTEM AND SUBSIDIARIES IS DELEGATED TO THE FINANCE AND AUDIT COMMITTEE OF THE PINNACLE HEALTH SYSTEM BOARD. IN ORDER TO ACCOMPLISH THIS, ALL MEMBERS OF THE FINANCE AND AUDIT COMMITTEE ARE PROVIDED WITH A REASONABLE OPPORTUNITY TO REVIEW AND COMMENT TO EXECUTIVE LEADERSHIP ON THE IRS FORMS 990 OF THE PINNACLE HEALTH SYSTEM AND ITS SUBSIDIARIES, INCLUDING PINNACLE HEALTH HOSPITALS, PINNACLE HEALTH MEDICAL SERVICES, PINNACLE HEALTH FOUNDATION, PINNACLE HEALTH HOME CARE & HOSPICE AND COMMUNITY LIFE TEAM BEFORE THEY ARE FILED WITH THE INTERNAL REVENUE SERVICE. IN ADDITION, EACH MEMBER OF EACH RESPECTIVE BOARD OF DIRECTORS WILL BE GIVEN ACCESS TO VIEW THEIR INDIVIDUAL FORM 990 VIA A SHARED, PASSWORD-PROTECTED WEBSITE. FORM 990, PART VI, SECTION B, LINE 12C IN THE PERFORMANCE OF THEIR DUTIES TO PINNACLE HEALTH SYSTEM AND SUBSIDIARIES (COLLECTIVELY REFERRED TO AS "PHS"), COVERED PERSONS SHALL SEEK TO ACT IN THE BEST INTERESTS OF PHS, AND SHALL EXERCISE GOOD FAITH, LOYALTY, DILIGENCE AND HONESTY. A COVERED PERSON IS ANY INDIVIDUAL WHO SERVES IN A FIDUCIARY CAPACITY TO, OR WHO HAS LEGAL AUTHORITY TO REPRESENT OR OBLIGATE, THE PINNACLE HEALTH SYSTEM OR ANY OF ITS AFFILIATED ORGANIZATIONS INCLUDING, BUT NOT LIMITED TO, DIRECTORS, OFFICERS, EMPLOYEES, AND AGENTS. COVERED PERSONS ALSO INCLUDE A) IMMEDIATE FAMILIES (SPOUSES, CHILDREN, SIBLINGS, PARENTS, OR SPOUSE'S PARENTS), B) ANY ORGANIZATION IN WHICH THEY OR THEIR IMMEDIATE FAMILIES DIRECTLY OR INDIRECTLY I) HAVE A MATERIAL FINANCIAL OR BENEFICIAL INTEREST, OR II) SERVE AS A DIRECTOR, OFFICER, EMPLOYEE, AGENT, ATTORNEY OR SIMILAR CAPACITY. A COVERED PERSON SHALL DISCLOSE ANY BUSINESS OR PERSONAL INTERESTS OR RELATIONSHIPS WHICH MAY BE IN CONFLICT WITH THE INTERESTS OF PHS, INCLUDING, BUT NOT LIMITED TO (A) ENGAGING IN OR SEEKING TO BE ENGAGED IN (I) THE DELIVERY OF HEALTH CARE SERVICES OR (II) THE DELIVERY OF GOODS OR SERVICES TO PHS, OR (B) ANY TRANSACTION OR ARRANGEMENT WITH PHS WHICH WOULD RESULT IN BENEFIT TO COVERED PERSONS. THE GOVERNANCE COMMITTEE OF THE PHS BOARD REVIEWS ALL CONFLICT OF INTEREST STATEMENTS AND DETERMINES WHETHER EACH DIRECTOR ON THE BOARD IS INDEPENDENT. COVERED PERSONS WHO ARE DIRECTORS MUST COMPLY WITH THE PINNACLE HEALTH SYSTEM GUIDELINES FOR DETERMINING DIRECTOR INDEPENDENCE AND APPLYING DIRECTOR INDEPENDENCE REQUIREMENTS. COVERED PERSONS WITH A CONFLICT OF INTEREST SHALL NOT VOTE ON THE MATTER, AND THE PHS BOARD OR COMMITTEE MUST APPROVE, AUTHORIZE, OR RATIFY THE TRANSACTION OR ARRANGEMENT BY A MAJORITY VOTE OF THE NON-INTERESTED DIRECTORS OR COMMITTEE MEMBERS PRESENT AT A MEETING THAT HAS A QUORUM. VIOLATIONS OF THIS STATEMENT OF POLICY MAY SUBJECT COVERED PERSONS TO APPROPRIATE SANCTIONS, INCLUDING REMOVAL FROM THEIR POSITIONS WITH PHS. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE OF THE PINNACLE HEALTH SYSTEM ("PHS") BOARD OF DIRECTORS HAS THE AUTHORITY TO DEVELOP AND MAINTAIN EXECUTIVE AND PHYSICIAN COMPENSATION TO BE APPROVED BY THE PINNACLE HEALTH SYSTEM BOARD. THE COMPENSATION COMMITTEE WILL FOLLOW A DILIGENT PROCESS THAT MEETS REGULATORY REQUIREMENTS FOR A REBUTTABLE PRESUMPTION OF REASONABLENESS AND PROMOTES EFFECTIVE GOVERNANCE OF EXECUTIVE COMPENSATION, CONSISTENT WITH THE PHS COMPENSATION PHILOSOPHY. 1. FOLLOW A PROCESS THAT ESTABLISHES AND MAINTAINS A REBUTTABLE PRESUMPTION OF REASONABLENESS FOR ALL EXECUTIVES AND PHYSICIANS POTENTIALLY SUBJECT TO INTERMEDIATE SANCTIONS. 2. PREPARE MINUTES FOR EACH MEETING TO RECORD THE TERMS OF THE COMMITTEE'S DECISIONS AND THE PROCESS FOLLOWED IN REACHING THOSE DECISIONS. THESE MINUTES MUST INCLUDE INDICATIONS THAT THE COMMITTEE IS FOLLOWING GOOD PRACTICES IN DEALING WITH CONFLICTS OF INTEREST AND IN OBTAINING AND RELYING ON APPROPRIATE COMPARABILITY DATA ON TOTAL COMPENSATION. 3. SELECT AND DIRECTLY ENGAGE AND SUPERVISE ANY CONSULTANT HIRED BY PHS TO ADVISE THE COMMITTEE ON EXECUTIVE AND PHYSICIAN COMPENSATION. 4. PERIODICALLY EVALUATE THE APPROPRIATENESS OF THIS CHARTER AND THE EFFECTIVENESS OF THE PROCESS THE COMMITTEE USES IN GOVERNING EXECUTIVE AND PHYSICIAN COMPENSATION AND REPORT THIS EVALUATION TO THE BOARD. 5. PROVIDE THE BOARD WITH AN ANNUAL REPORT ON THE COMMITTEE'S ACTIONS. 6. MONITOR CHANGES IN LAWS AND REGULATIONS PERTAINING TO EXECUTIVE COMPENSATION AND BENEFITS TO SEE THAT PHS COMPLIES WITH THEM. 7. SEEK OUTSIDE REVIEW OF COMMITTEE OPERATIONS TO ENSURE COMPLIANCE WITH THE IRS REBUTTABLE PRESUMPTION OF REASONABLENESS. 8. REVIEW ACTUAL EXECUTIVE COMPENSATION AND BENEFITS PROVIDED TO CONFIRM CONSISTENCY WITH COMPENSATION AND BENEFITS APPROVED BY THE COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE FOR PUBLIC INSPECTION AS THIS IS NOT REQUIRED BY FEDERAL OR STATE LAW. THE ORGANIZATION INCLUDES A COPY OF ITS FINANCIAL STATEMENTS WITH THE STATE REGISTRATION FILED WITH THE PENNSYLVANIA DEPARTMENT OF STATE, BUREAU OF CHARITABLE ORGANIZATIONS. THESE DOCUMENTS ARE A MATTER OF PUBLIC RECORD AND CAN BE VIEWED AT THE BUREAU OFFICE. FORM 990, PART VII, SECTION A: THE FOLLOWING OFFICERS AND DIRECTORS HAVE WORKED AN AVERAGE OF 40 HOURS PER WEEK BETWEEN PINNACLE HEALTH HOSPITALS AND ALL RELATED ORGANIZATIONS OF PINNACLE HEALTH SYSTEM, THE PARENT COMPANY: CHRISTOPHER P. MARKLEY, ESQ. PHILIP GUARNESCHELLI WILLIAM H. PUGH RICHARD C. SENECA, ESQ. THE FOLLOWING DIRECTORS ARE ALSO DIRECTORS OF PINNACLE HEALTH SYSTEM, THE PARENT ORGANIZATION: ROBERT L. LYON GEORGE F. GRODE JOHN O. CAMPBELL SUSAN S. COHEN FELIX GUTIERREZ, MD M. RICHARD KLEIMAN DEBORAH S. MILLER DOUGLAS A. NEIDICH LARRY L. SOLLENBERGER, MD CLARENCE E. ASBURY DENNIS WALSH BONY R. DAWOOD DENISE F. HARR, MD GREGORY CAVOLI MARK KIMMEL, ESQ. DOUGLAS C. DYER STEVEN C. KUSIC KENNETH OKEN, MD MICHAEL L. FERNANDEZ, MD DIRECTOR M. RICHARD KLEIMAN IS ALSO A DIRECTOR OF PINNACLE HEALTH FOUNDATION, A RELATED ORGANIZATION. DIRECTOR DEBORAH S. MILLER IS ALSO A DIRECTOR OF PINNACLE HEALTH MEDICAL SERVICES AND PINNACLE HEALTH HOME CARE & HOSPICE, BOTH OF WHICH ARE RELATED ORGANIZATIONS. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -1,529,794. CHANGE IN ADDITIONAL MINIMUM PENSION LIABILITY -48,689,926. FUND BALANCE TRANSFER - PINNACLE HEALTH SYSTEM -12,819,636. FUND BALANCE TRANSFER - PINNACLE HEALTH MEDICAL SERVICES -38,779,212. FUND BALANCE TRANSFER - PINNACLE HEALTH HOME CARE & HOSPICE -6,104,214. FUND BALANCE TRANSFER - COMMUNITY LIFE TEAM -3,152,963. FUND BALANCE TRANSFER - PINNACLE HEALTH FOUNDATION -193,142. FUND BALANCE TRANSFER - MEDICAL GROUP -3,017,057. FUND BALANCE TRANSFER - VENTURES 1,923,717. FUND BALANCE TRANSFER - PHCVI -27,439,192. HORIZON INVESTMENT VALUATION ADJUSTMENT 678,097. TOTAL TO FORM 990, PART XI, LINE 5: -139,123,322. FORM 990, PART XII, LINE 2C: PINNACLE HEALTH HOSPITALS WAS INCLUDED IN THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND SUPPLEMENTAL DATA FOR PINNACLE HEALTH SYSTEM AND ITS SUBSIDIARIES. THE FINANCE AND AUDIT COMMITTEE OF THE PINNACLE HEALTH SYSTEM BOARD ASSUMES THE RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT AND THE SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED DURING THE TAX YEAR. PINNACLE HEALTH EMERGENCY DEPARTMENT SERVICES LLC 409 SOUTH SECOND STREET PO BOX 8700 HARRISBURG PA 17105 861057582 MEDICAL EMERGENCY SERVICES PA 15233228 1566208 N/A PINNACLE HEALTH CUMBERLAND CONDOMINIUM ASSOCIATION 409 SOUTH SECOND STREET PO BOX 8700 HARRISBURG PA 171058700 208977427 CONDOMINIUM ASSOCIATION PA 0 0 N/A PINNACLE HEALTH SYSTEM 409 SOUTH SECOND STREET PO BOX 8700 HARRISBURG PA 171058700 251778658 MANAGEMENT AND CONSULTATIVE SERVICES FOR RELATED EXEMPT ORGS PA 501(C)(3) LINE 11C, III-FI N/A 0 PINNACLE HEALTH MEDICAL SERVICES 409 SOUTH SECOND STREET PO BOX 8700 HARRISBURG PA 171058700 251709054 PHYSICIAN SERVICES PA 501(C)(3) LINE 3 PINNACLE HEALTH SYSTEM 0 PINNACLE HEALTH FOUNDATION 409 SOUTH SECOND STREET PO BOX 8700 HARRISBURG PA 171058700 222691718 INVESTMENT AND FUNDRAISING ACTIVITIES FOR RELATED TAX-EXEMPT ORGANIZATIONS PA 501(C)(3) LINE 11B, II PINNACLE HEALTH SYSTEM 0 COMMUNITY LIFE TEAM 409 SOUTH SECOND STREET PO BOX 8700 HARRISBURG PA 171058700 231890444 COMMUNITY EMERGENCY MANAGEMENT SERVICE AND MEDICAL TRANSPORT PROVIDER PA 501(C)(3) LINE 9 PINNACLE HEALTH SYSTEM 0 PINNACLE HEALTH HOME CARE & HOSPICE 409 SOUTH SECOND STREET PO BOX 8700 HARRISBURG PA 171058700 232024121 SKILLED HOMECARE SERVICES AND SERVICES TO THE TERMINALLY ILL PA 501(C)(3) LINE 3 PINNACLE HEALTH HOSPITALS 1 WEST SHORE SURGERY CENTER LTD 409 SOUTH SECOND STREET PO BOX 8700 HARRISBURG PA 171058700 251821415 SURGICAL CARE - MEDICAL SERVICES PA SEE PART VII - SUPPLEMENTAL INFORMATION RELATED 1080523 1138415 0 0 0.49000 UNITED CENTRAL PA RISK RETENTION GROUP 76 ST PAUL STREET SUITE 500 BULINGTON VT 054014477 134224033 CAPTIVE INSURANCE VT N/A C UNITED HEALTH RISK LTD PO BOX 2450 HAMILTON HM JX BD CAPTIVE INSURANCE BD N/A C PINNACLE HEALTH CARDIOVASCULAR INSTITUTE PO BOX 8700 HARRISBURG PA 17105 320321362 PHYSICIAN SERVICES PA N/A C CARDIOLOGY PRACTICE INC PO BOX 8700 HARRISBURG PA 17105 800658616 PHYSICIAN SERVICES PA N/A C PINNACLE HEALTH MEDICAL GROUP PO BOX 8700 HARRISBURG PA 17105 800771040 PHYSICIAN SERVICES PA N/A C PINNACLE HEALTH VENTURES INC PO BOX 8700 HARRISBURG PA 17105 611677624 HOLDING COMPANY PA N/A C PINNACLE HEALTH IMAGING INC PO BOX 8700 HARRISBURG PA 17105 231718571 RADIOLOGY SERVICES PA N/A C 1 1 1 1 0 0 0 0 1 0 1 1 1 1 1 1 1 1 WEST SHORE SURGERY CENTER LTD A 651345 FMV WEST SHORE SURGERY CENTER LTD Q 832642 FMV PINNACLE HEALTH HOME CARE & HOSPICE A 82677 FMV PINNACLE HEALTH HOME CARE & HOSPICE Q 80007 FMV PINNACLE HEALTH HOME CARE & HOSPICE B 6253929 FMV PINNACLE HEALTH HOME CARE & HOSPICE C 149715 FMV IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIP: FORM 990, SCHEDULE R, PART III WEST SHORE SURGERY CENTER IS OWNED BY THE FOLLOWING RELATED ENTITIES: PINNACLE HEALTH HOSPITALS - 49% PINNACLE HEALTH MEDICAL SERVICES - 2% THE REMAINING 49% IS OWNED BY A NUMBER OF INDIVIDUAL PHYSICIANS. PINNACLE HEALTH HOSPITALS' 49% OWNERSHIP PERCENTAGE DOES NOT RESULT IN ANY DIRECT CONTROLLING ENTITY; HOWEVER, COMBINED WITH THE OWNERSHIP PERCENTAGE OF PINNACLE HEALTH MEDICAL SERVICES, A RELATED ENTITY, THERE IS MORE THAN 50% CONTROL AMONG THE RELATED GROUP.