2012-05-11T12:42:43-05:00 2011-06-30 CARBIS WALKER LLP 5700 CORPORATE DRIVE STE 650 PITTSBURGH PA 15237 990 2010-07-01 251494705 HIGHLANDS HOSPITAL HIGH 7246281500 401 EAST MURPHY AVENUE CONNELLSVILLE PA 15425 JOHN ANDURSKY CPA 7246281500 2012-05-03 1 JEFFREY J PETRELL CPA 4126356270 2012-05-03 2010 2016-02-24 21:20:13Z MICHELLE P CUNNINGHAM 401 EAST MURPHY AVENUE CONNELLSVILLE PA 15425 25203277 0 X WWW.HIGHLANDSHOSPITAL.ORG X 1985 PA THE HOSPITAL SERVES THE HEALTHCARE NEEDS OF THE COMMUNITY AND SURROUNDING AREAS 12 10 441 25 0 0 1013399 1098194 23892814 23598836 76856 16537 345821 476538 25328890 25190105 0 0 0 0 13699670 12911299 0 0 0 12300636 12609024 26000306 25520323 -671416 -330218 11083839 10908116 10048629 9417439 1035210 1490677 HIGHLANDS HOSPITAL IS COMMITTED TO PROVIDING HEALTH CARE TO THE COMMUNITY IN A COMPETENT, NURTURING, AND HEALING ENVIRONMENT. OUR STAFF WILL PROVIDE SUPPORT IN TIMES OF CRISIS AND FURNISH THE RESOURCES NECESSARY TO PROMOTE A HEALTHY LIFESTYLE. 0 0 21152541 23598836 THE HOSPITAL SERVED THE HEALTHCARE NEEDS OF THE COMMUNITY AND SURROUNDING AREAS WITH 2,543 ADMISSIONS, 11,943 PATIENT DAYS, 58,311 OUTPATIENT VISITS, AND 14,846 EMERGENCY ROOM VISITS. THE HOSPITAL PROVIDED A SIGNIFICANT AMOUNT OF HEALTHCARE TO THE INDIGENT AND LOW INCOME INDIVIDUALS REGARDLESS OF THE ABILITY TO PAY. 21152541 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 75 0 1 441 1 0 0 0 0 0 1 1 0 0 0 0 0 0 0 X 12 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 PA X JOHN ANDURSKY CPA 7246262359 401 EAST MURPHY AVENUE CONNELLSVILLE PA 15425 MICHELLE P CUNNINGHAM 40.00 X X 132927 0 16255 GERALD BROWELL 2.00 X X 0 0 0 BRUCE I JAYNES 2.00 X X 0 0 0 FLOYD C HUGGINS 2.00 X X 0 0 0 JOHN A FIESTA 2.00 X X 0 0 0 RICHARD A GRIMALDI DMD 2.00 X 0 0 0 ANNETTE GANASSI 2.00 X 0 0 0 KHALDON AL-SAADI MD 2.00 X 0 0 0 MICHAEL A JORDAN JR 2.00 X 0 0 0 DEANNA SHERBONDY 2.00 X 0 0 0 LAWRENCE KIEFER 2.00 X 0 0 0 PAUL MEANS DO 2.00 X 6000 0 0 JOHN S ANDURSKY 40.00 X 99237 0 15496 RONALD DELA CRUZ 40.00 X 187525 0 11157 LASZLO PETRAS 40.00 X 152623 0 4079 GINA CANADA 40.00 X 129647 0 3743 707959 0 50730 4 0 1 0 QUEST DIAGNOSTICS 2769 COLLECTION CENTER DR CHICAGO IL 60693 LABORATORY SERVICES 424439 BRADLEY ANESTHESIA PC RD 6 BOX 1162 MT PLEASANT PA 15666 ANESTHESIOLOGY SERVICES 400008 ANESTHESIOLOGY CONSULTSWPA PO BOX 293 MURRYSVILLE PA 15668 CRNA SERVICES 335000 EMERGENCY RESOURCE MGMT INC TWO HOT METAL STREET 2ND FLOOR PITTSBURGH PA 15203 EMERGENCY ROOM PHYSICIAN 331008 CPSI 6600 WALL STREET MOBILE AL 36695 COMPUTER SUPPORT AND APPLICATIONS 280505 11 22108 1076086 1098194 PATIENT REVENUE 900099 23598836 23598836 23598836 23400 23400 23400 23400 15574 963 15574 963 16537 16537 11180 22108 13172 -1992 -1992 MISCELLANEOUS REVENUE 900099 189678 189678 INVEST. IN OPEN MRI OF 900099 163030 163030 CAFETERIA & SNACK BAR 900099 79225 79225 23197 23197 455130 25190105 23598836 0 493075 263915 263915 9804254 8156005 1648249 415653 341640 74013 1697400 1401316 296084 730077 593291 136786 127286 127286 74742 74742 62147 62147 140314 61315 78999 248419 248419 858882 821360 37522 12605 12605 72221 54166 18055 997123 747842 249281 396904 297678 99226 PURCHASED SERVICES 2471459 2300775 170684 BAD DEBT 2373113 1779835 593278 MEDICAL SUPPLIES 2231924 2231924 PHYSICIAN FEES 1213609 1213609 EQUIPMENT RENTAL & MAIN 466176 432201 33975 862100 706979 155121 25520323 21152541 4367782 0 448906 657710 291761 3116399 2923276 151483 159135 123815 118050 22185276 17654156 4380026 4531120 2205500 2364665 121500 0 398609 11083839 10908116 8837901 3342341 630728 632876 580000 5442222 10048629 9417439 X -54324 555956 717130 562317 372404 372404 1035210 1490677 11083839 10908116 X -330218 785685 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 197199 197199 9393305 7730256 1663049 135150 26673 108477 11859157 9701650 2157507 600465 195577 404888 4531120 INVESTMENT IN JOINT VENTURE 476575 F ASSETS LIMITED AS TO USE 1888090 F 2364665 LINE OF CREDIT 880000 ACCRUED PENSION COSTS 4555183 CASH OVERDRAFT 7039 5442222 25190105 25520323 -330218 174757 610928 785685 455467 25017177 174757 13172 187929 24829248 360857 360857 25190105 25533495 13172 13172 25520323 0 25520323 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE HOSPITAL FOLLOWS THE GUIDANCE FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S FINANCIAL STATEMENTS THAT PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. THE GUIDANCE ALSO ADDRESSES DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, AND DISCLOSURE. MANAGEMENT HAS DETERMINED THAT THIS GUIDANCE HAD NO MATERIAL EFFECT ON THE FINANCIAL STATEMENTS. THE HOSPITAL'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN GENERAL AND ADMINISTRATIVE EXPENSES. THERE WERE NO INTEREST OR PENALTIES RECOGNIZED ON THE STATEMENTS OF OPERATIONS AS A RESULT OF THIS GUIDANCE. GENERALLY, TAX RETURNS FOR YEARS ENDED JUNE 30, 2008, AND THEREAFTER REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. PART XI, LINE 8 - OTHER ADJUSTMENTS: ACCUMULATED LIABILITY FOR PENSION BENEFITS 765,741. TEMPORARILY RESTRICTED CONTRIBUTIONS 208,173. NET ASSETS RELEASED FROM RESTRICTIONS -362,986. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 13,172. PART XII, LINE 4B - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTIONS USED FOR CAPITAL EXPENDITURES 360,857. PART XIII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 13,172. GOLF OUTING 33288 22108 11180 250 3358 9140 424 33288 22108 11180 250 3358 9140 424 13172 -1992 1 1 1 X 1 X 1 1 1 0 0 143030 143030 0.00620 5898596 5777002 121594 0.00530 6041626 5777002 264624 0.01150 184634 169070 15564 0.00070 3887942 3696550 191392 0.00830 81459 81459 4154035 3947079 206956 0.00900 10195661 9724081 471580 0.02050 0 983842 248747 4507281 6464182 -1956901 X 1 1 1 1 HIGHLANDS HOSPITAL

401 E MURPHY AVE CONNELLSVILLE PA 15425

X X X HIGHLANDS HOSPITAL 1 5 HIGHLANDS HOSPITAL DIABETES CENTER

1032 MORRELL AVE CONNELLSVILLE PA 15425

EDUCATION OF DIABETICS HIGHLANDS HEALTHSTOP

109 CROSSROADS ROAD SCOTTDALE PA 15683

BLOOD DRAW STATION HIGHLANDS HEALTHSTOP

201 N PITTSBURGH ST CONNELLSVILLE PA 15425

BLOOD DRAW STATION HIGHLANDS HEALTHSTOP

814 VANDERBILT ROAD CONNELLSVILLE PA 15425

BLOOD DRAW STATION CHILD DEVELOPMENT DISORDERS DIAGNOSTIC C

413 EAST GIBSON AVE CONNELLSVILLE PA 15425

DIAGNOSE AUTISTIC DISORDERS IN CHILDREN PART I, LINE 7: A COST-TO-CHARGE RATIO CALCULATED FROM WORKSHEET 2, RATIO OF PATIENT CARE COSTS-TO-CHARGES IS THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNTS REPORTED ON PART I, LINE 7. PART I, LINE 7G: THE EMERGENCY DEPARTMENT OPERATED AT A LOSS DURING FISCAL YEAR 2011. PART I, L7 COL(F): THE BAD DEBT EXPENSE OF 2,373,113 INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN A WAS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE OF TOTAL EXPENSES. PART III, LINE 4: HIGHLANDS HOSPITAL'S FINANCIAL STATEMENTS DO NOT INCLUDE A BAD DEBT FOOTNOTE. THE BAD DEBT EXPENSE CONSISTS OF THE PORTION OF SELF-PAY BALANCES THAT IS SENT TO COLLECTIONS AND THE RESERVED AMOUNTS BASED ON AGING OF SELF-PAY ACCOUNTS RECEIVABLE.A COST-TO-CHARGE RATIO CALCULATED FROM WORKSHEET 2, RATIO OF PATIENT CARE COSTS-TO-CHARGES IS THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNTS REPORTED ON LINES 2 AND 3 OF PART III. PART III, LINE 8: A COST-TO-CHARGE RATIO CALCULATED FROM WORKSHEET 2, RATIO OF PATIENT CARE COSTS-TO-CHARGES IS THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNTS REPORTED ON PART III, LINE 6. PART III, LINE 9B: PATIENTS ARE NOT BILLED ONCE THEY ARE DETERMINED TO QUALIFY FOR CHARITY CARE. PART VI, LINE 2: HIGHLANDS HOSPITAL DOES NOT CURRENTLY HAVE A FORMALIZED METHOD TO ASSESS THE COMMUNITY FOR ITS HEALTH NEEDS. IN THE NEXT YEAR, THE ORGANIZATION PLANS TO LAUNCH A MORE FORMALIZED PROCESS TO ASSESS OUR COMMUNITY NEEDS. PART VI, LINE 3: HOSPITAL STAFF PROVIDE CHARITY CARE INFORMATION TO PATIENTS UPON REGISTRATION AND INFORMATION IS INCLUDED IN ADMISSIONS PACKETS. PART VI, LINE 4: THE DEMOGRAPHICS OF THE COMMUNITY INCLUDES A HIGH PERCENTAGE OF ELDERLY AND LOW INCOME HOUSEHOLDS. MANY OF THESE RESIDENTS ARE UNINSURED AND UNDERINSURED RESULTING IN A HIGH PERCENTAGE OF UNCOMPENSATED CARE. THE POPULATION, ALSO, HAS A HIGH VOLUME OF CHRONIC ILLNESSES SUCH AS CORONARY DISEASE, DIABETES AND PULMONARY DISEASE. PART VI, LINE 6: THE GOVERNING BOARD IS MADE UP OF INDIVIDUALS WHO LIVE AND/OR WORK IN THE COMMUNITY WHO VOLUNTEER THEIR TIME AND SERVICES TO ASSIST IN THE GOVERNANCE OF THE ORGANIZATION. MEDICAL STAFF IS OPEN TO ALL QUALIFIED PHYSICIANS WHO EXPRESS AN INTEREST TO JOIN. THE MEDICAL STAFF OPERATES INDEPENDENTLY OF THE ADMINISTRATIVE MANAGEMENT OF THE ORGANIZATION. THE ORGANIZATION CURRENTLY LACKS SURPLUS FUNDS. IT UTILIZES GRANTS AND CONTRIBUTIONS FOR THE ADVANCEMENT OF SERVICES AND IMPROVEMENTS. X X X X 0 0 0 0 0 0 0 0 0 RONALD DELA CRUZ 187525 0 0 0 0 0 0 0 11157 0 198682 0 0 0 LASZLO PETRAS 152623 0 0 0 0 0 0 0 4079 0 156702 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 HIGHLANDS HOSPITAL HAS A CPA FIRM PREPARE ITS FORM 990. THE RETURN IS COMPLETED IN DRAFT FORM AND REVIEWED BY THE TREASURER. THE RETURN IS THEN FINALIZED AND THE BOARD IS PROVIDED A COPY OF THE FORM 990 TO REVIEW BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C HIGHLANDS HOSPITAL ANNUALLY REQUIRES ITS BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES TO FILL OUT A CONFLICTS OF INTEREST FORM. DURING BOARD MEETINGS, IF AN INTERESTED PARTY HAS A CONFLICT, HE OR SHE RECUSES THEMSELVES FROM VOTING. FORM 990, PART VI, SECTION B, LINE 15 HIGHLANDS HOSPITAL'S BOARD OF DIRECTORS ANNUALLY REVIEWS AND APPROVES THE COMPENSATION OF THEIR ORGANIZATION'S TOP MANAGEMENT AND KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 18 HIGHLANDS HOSPITAL MAKES ITS FORM 990 AND FORM 1023 AVAILABLE TO THE PUBLIC. FORM 990, PART VI, SECTION C, LINE 19 AT THIS TIME, HIGHLANDS HOSPITAL DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 174,757. ACCUMULATED LIABILITY FOR PENSION BENEFITS 765,741. TEMPORARILY RESTRICTED CONTRIBUTIONS 208,173. NET ASSETS RELEASED FROM RESTRICTIONS -362,986. TOTAL TO FORM 990, PART XI, LINE 5: 785,685. FORM 990, PART XII, LINE 2C: THE ORGANIZATION'S BOARD OF DIRECTORS ASSUME RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT. THE PROCESS IS CONSISTENT WITH PRIOR YEARS AND HAS NOT CHANGED. FORM 990, PART VI, LINE 16B WHEN HIGHLANDS HOSPITAL CONTEMPLATES ENTERING INTO A JOINT VENTURE WITH FOR PROFIT ORGANIZATIONS, IT ENGAGES LEGAL COUNSEL AND TAX COUNSEL TO ENSURE THAT THE TAX EXEMPT STATUS OF THE HOSPITAL IS SAFEGUARDED.