2012-05-10T17:05:28-05:00 2011-06-30 PARENTEBEARD LLC 400 MARKET STREET WILLIAMSPORT PA 17701 990 2010-07-01 231352187 LEWISTOWN HOSPITAL LEWI 7172427650 400 HIGHLAND AVENUE LEWISTOWN PA 17044 RANDY TEWKSBURY 7172427650 2012-05-10 1 JULIUS C GREEN CPA JD 5703236023 2010 2016-02-24 21:20:13Z KAY HAMILTON 400 HIGHLAND AVENUE LEWISTOWN PA 17044 96850830 0 X WWW.LEWISTOWNHOSPITAL.ORG X 1905 PA TO PROVIDE PERSONAL, HIGH-QUALITY, ECONOMICAL HEALTHCARE FOR OUR COMMUNITIES. 15 12 1108 130 1632693 641042 1094863 181471 87817917 91424410 652451 726818 1791897 3494052 91357128 95826751 3328297 3496963 0 0 45693639 46778979 0 0 634566 40550095 43108767 89572031 93384709 1785097 2442042 87901083 90391492 64859043 55364995 23042040 35026497 TO PROVIDE PERSONAL, HIGH-QUALITY, ECONOMICAL HEALTHCARE FOR OUR COMMUNITIES. 0 0 88551355 3489463 92422167 PROVIDED INPATIENT, OUTPATIENT, WELLNESS, AND COMMUNITY SERVICES TO RESIDENTS OF LEWISTOWN, PA AND SURROUNDING COMMUNITIES. PROVIDED CARE, TO PATIENTS WHO MEET CERTAIN CRITERIA, WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. CHARGES FORGONE FOR SERVICES RENDERED AND SUPPLIES FURNISHED WERE APPROXIMATELY $4,318,000. 88551355 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 0 0 0 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 1 0 0 0 0 1 77 0 1 1108 1 1 1 0 0 0 0 1 1 0 0 0 0 X 15 12 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X RANDY TEWKSBURY CFO 7172427650 400 HIGHLAND AVENUE LEWISTOWN PA 17044 X KAY HAMILTON 36.00 X X 297474 0 42610 JEFFREY W ANDERSON 0.80 X 0 0 0 BRIAN D SCHELL 0.80 X X 0 0 0 DANA L PATTERSON 0.80 X X 0 0 0 FRANCIS EVANITSKY 0.80 X X 0 0 0 GURPREET S BHALLA MD 0.80 X 0 0 0 DONALD CHAPMAN 0.80 X 0 0 0 WILLIAM F HERKERT 0.80 X 0 0 0 CHARLES EVERHART JR MD 0.80 X 0 0 0 SHASHPAL K MALHOTRA MD 0.80 X 0 0 0 MARSHA A SOULT PHD 0.80 X X 0 0 0 DIANE SPOKUS PHD CHES 0.80 X 0 0 0 JON ZIMMERMAN 0.80 X 0 0 0 OKSANA DEARMENT 0.80 X 0 0 0 DANIEL REIFSNYDER 0.80 X 0 0 0 RANDY TEWKSBURY 36.00 X 166536 0 37753 KIRK E THOMAS 38.00 X 133077 0 19036 NANCY S REINKE 34.00 X 111752 0 16453 RONALD M COWAN 39.00 X 114515 0 16428 CHRISTINE W MATHEWS 40.00 X 121800 0 23635 NITIN V SHETH MD 40.00 X 607922 0 18137 DAVID M NELSON 40.00 X 203849 0 43102 RICHARD F STOMACKIN 40.00 X 145510 0 27315 LEWIS ALLSHOUSE III 40.00 X 120999 0 25066 ROBERT A MONTGOMERY 40.00 X 120417 0 34311 2143851 0 303846 13 0 1 0 CERNER CORPORATION 43 KENSICO DRIVE MT KISCO NY 105491009 MAINTENANCE/REMOTE HOSTING FOR CLINICAL 1663793 EPA 307 SOUTH EVERGREEN AVE WOODBURY NJ 08096 EMERGENCY DEPT. PHYSICIANS 840014 QUEST DIAGNOSTICS NICHOLS INSTITUTE 12436 COLLECTIONS CENTER DRIVE CHICAGO IL 606932436 DIAGNOSTIC LABORATORY TESTING SERVICES 723111 OPTIMAL IMX INC 2350 19TH STREET SOUTH STE 350 BIRMINGHAM AL 35209 DIAGNOSTIC IMAGE READING & RELATED SERVI 528508 MCKESSON PO BOX 98347 CHICAGO IL 606932436 FINANCIAL/CLINICAL SOFTWARE SUPPORT 496407 23 51937 4006 37296 88232 47838 181471 NET PATIENT SERVICE RE 621400 91424410 91424410 91424410 583507 583507 1000015 32840 889544 110471 32840 143311 143311 44466 51937 44181 285 285 6206 2506 3700 3700 128862 87848 41014 41014 LAB SERVICE REVENUE 621500 1607873 1607873 CAFETERIA REVENUE 722210 449381 449381 INTERCOMPANY REVENUE 900099 392540 392540 999259 605217 24820 369222 3449053 95826751 92422167 1632693 1590420 3472963 3472963 24000 24000 1171301 326753 844548 33679453 32392792 1114548 172113 3101712 2924269 162032 15411 6304746 6081523 190848 32375 2521767 2393285 116660 11822 105334 105334 87050 87050 14350 14350 4258 4258 7791907 6670352 933529 188026 299636 108311 12743 178582 14710605 14643678 37734 29193 71608 66912 4163 533 1824577 1657901 165035 1641 72968 45708 25672 1588 82608 69810 11991 807 1250279 1250279 5906467 5906467 157405 157405 FEDERAL INCOME TAXES 202770 202770 BAD DEBT EXPENSE 4745793 4745793 REPAIRS AND MAINTENANCE 4448799 4446049 2750 MA ASSESSMENT 891137 891137 MEMBERSHIP FEES 160481 88984 70409 1088 280735 186984 92364 1387 93384709 88551355 4198788 634566 1849 1820 11020406 13883416 8523804 8918281 1051551 714572 2205958 2118024 2459475 2540938 104162006 73628783 32933803 30533223 28379832 30178953 148000 690861 1176405 811404 87901083 90391492 34764584 26548913 21815000 21215000 2281296 1855672 5998163 5745410 64859043 55364995 X 22260436 34190991 272023 274698 509581 560808 23042040 35026497 87901083 90391492 X 2442042 9542415 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 14350 14350 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: A PORTION (25.82%) OF OUR ANNUAL DUES PAID TO THE HOSPITAL AND HEALTHSYSTEM ASSOCIATION OF PENNSYLVANIA (HAP) IS ATTRIBUTABLE TO LOBBYING EXPENSES. A PORTION (23.76%) OF OUR ANNUAL DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) IS ATTRIBUTABLE TO LOBBYING EXPENSES. 80371 91939 3266 1000 389 174187 69171 4750 7758 1000 308 80371 63766 4495 2070 1000 160 69171 1.00000 0 0 224654 224654 45822466 30039519 15782947 55944113 42300433 13643680 2170773 1288831 881942 30533223 OBLIGATIONS UNDER CAPITAL LEASE 2978971 DUE TO AFFILIATES 95014 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 1861252 BLUE CROSS CURRENT FINANCING ADVANCE 381800 ESTIMATED MEDICAL MALPRACTICE CLAIMS 428373 5745410 95826751 93384709 2442042 2050602 7491813 9542415 11984457 105499695 2050602 7491813 9542415 95957280 -130529 -130529 95826751 93515238 130529 130529 93384709 0 93384709 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE EARNINGS ON THE FRIENDS LEGACY ENDOWMENT FUND WILL BE USED SOLELY FOR THE PURPOSES OF CAPITAL AND BUILDING EXPENDITURES. NO EXPENDITURES CAN BE MADE UNTIL THE FUND REACHES $1,000,000 AND THEN ONLY THE EARNINGS FROM THE INVESTMENT CAN BE USED FOR THOSE PURPOSES. THE EARNINGS ON THE SCHOOL OF NURSING SCHOLARSHIP FUNDS ARE USED FOR SCHOLARSHIPS FOR LEWISTON HOSPITAL SCHOOL OF NURSING STUDENTS SELECTED BY THE SCHOLARSHIP COMMITTEE BASED ON ESTABLISHED CRITERIA. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE HOSPITAL 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 HAS BEEN MET. MANAGEMENT HAS DETERMINED THAT THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2011 AND 2010. PART XI, LINE 8 - OTHER ADJUSTMENTS: VALUATION LOSS 51,227. PENSION LIABILITY ADJUSTMENT 7,440,586. PART XII, LINE 2D - OTHER ADJUSTMENTS: VALUATION GAIN 51,227. PENSION LIABILITY ADJUSTMENT 7,440,586. PART XII, LINE 4B - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES -44,181. COST OF GOODS SOLD -87,848. GAMING EXPENSES -2,506. TRANSFERS FROM AFFILIATES NETTED ON FINANCIAL STATEMENTS 4,006. PART XIII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES 44,181. COST OF GOODS SOLD 87,848. RENTAL EXPENSES TRANSFERS FROM AFFILIATES NETTED ON FINANCIAL STATEMENTS -4,006. GAMING EXPENSES 2,506. GOLF TOURNAMENT 2011 55908 31836 24072 2710 6928 12864 10778 LEND-A-HAND EVENT 2011 27201 20101 7100 1353 7915 600 1033 83109 51937 31172 2710 8281 20779 600 11811 44181 -13009 1 1 1 X 0 1 1 1 0 1 1 1680131 1680131 0.01800 4472674 298210 4770884 0.05110 6152805 298210 6451015 0.06910 93052 93052 0.00100 39534 39534 0.00040 166 166 0.00000 132752 132752 0.00140 6285557 298210 6583767 0.07050 2387 2387 0.00000 29980 29980 0.00030 5845 5845 0.00010 2000 2000 0.00000 40212 40212 0.00040 1 1894611 26209774 27235024 -1025250 X 1 1 1 1 LEWISTOWN HOSPITAL

400 HIGHLAND AVENUE LEWISTOWN PA 17044

X X X NOT REQUIRED 1 PART I, LINE 3C: ELIGIBILITY FOR FREE CARE IS BASED ON FEDERAL POVERTY GUIDELINES. DISCOUNTS ARE AVAILABLE FOR PROMPT PAYMENT AND SELF PAY OVER CERTAIN DOLLAR LEVELS, REGARDLESS OF INCOME. PART I, L7 COL(F): BAD DEBT EXPENSE OF $4,745,793 WAS INCLUDED ON FORM 990, PART IX, LINE 25, BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN PART I LINE 7 COLUMN F. PART II: ECONOMIC DEVELOPMENT AND COMMUNITY BUILDING ACTIVITIES:MIFFLIN COUNTY INDUSTRIAL DEVELOPMENT CORPORATION - KAY HAMILTON, CEO, BOARD MEMBER THE MISSION OF THE MIFFLIN COUNTY INDUSTRIAL DEVELOPMENT CORPORATION IS TO PROMOTE THE GROWTH OF EMPLOYMENT AND INCOME IN MIFFLIN COUNTY BY USING TECHNICAL AND FINANCIAL RESOURCES FROM MCIDC AND FEDERAL, STATE, AND LOCAL AGENCIES AND INDIVIDUALS TO ENCOURAGE AND ASSIST BUSINESS AND INDUSTRIAL FORMATION, RETENTION, AND EXPANSION. MIFFLIN COUNTY PLANNING COMMISSION - KAY HAMILTON, CEO, MEMBER OF THE COMMISSIONTHE MISSION OF THE MIFFLIN COUNTY PLANNING COMMISSION IS TO PROVIDE STRATEGIC, COORDINATED, AND OBJECTIVE GUIDANCE AND OVERSIGHT TO THE GROWTH, PLANNING, AND DEVELOPMENT ACTIVITIES OF MIFFLIN COUNTY. IN DOING SO, IT IS THE GOAL OF THE COMMISSION TO ENSURE MIFFLIN COUNTY'S FUTURE IS CHARACTERIZED BY A HEALTHY ENVIRONMENT, ECONOMY, AND SOCIETY ACHIEVED THROUGH PROACTIVE PLANNING, CITIZEN REPRESENTATION, EFFECTIVE COMMUNICATION, AND THE PROVISION OF PROFESSIONAL SERVICES FROM THE MIFFLIN COUNTY PLANNING AND DEVELOPMENT DEPARTMENT.MIFFLIN JUNIATA CAREER TECH CENTER ADVISORY COMMITTEE - KAY HAMILTON, CEO, BOARD MEMBERTHE MIFFLIN JUNIATA CAREER AND TECHNOLOGY CENTER OFFERS VOCATIONAL-TECHNICAL EDUCATIONAL PROGRAMS FOR BOTH MIFFLIN AND JUNIATA COUNTY STUDENTS IN GRADES 10 - 12. PROGRAMS INCLUDE: HEALTH PROFESSIONS, ALLIED HEALTH SCIENCE, AGRICULTURE, CONSTRUCTION, CRIMINAL JUSTICE, ETC. MIFFLIN-JUNIATA PARTNERS ADVANCING TOMORROW'S HEALTH (MJ PATH) - KIRK THOMAS, VP OPERATIONS, BOARD CHAIRTHE MISSION OF THE MJ PATH GROUP IS TO PROMOTE THE HEALTH AND WELLNESS OF INDIVIDUALS AND THE COMMUNITIES OF MIFFLIN AND JUNIATA COUNTIES. THIS IS ACCOMPLISHED BY ENGAGING A BROAD SPECTRUM OF LOCAL COMMUNITY INDIVIDUALS AND ORGANIZATIONS WITH INTERESTS AND INFLUENCE ON LOCAL HEALTH STATUS BY WORKING TOGETHER TO PROMOTE EFFECTIVE HEALTH IMPROVEMENT STRATEGIES, INCLUDING PLANNING AND COORDINATION OF LOCAL RESOURCES. MEETINGS ARE HELD BI-MONTHLY. MIFFLIN-JUNIATA HEALTH CENTER - KIRK THOMAS, VP OPERATIONS, BOARD CHAIR THE MISSION OF THE MIFFLIN-JUNIATA HEALTH CENTER IS TO PROVIDE ACCESS TO PRIMARY AND PREVENTIVE HEALTH CARE SERVICES TO RESIDENTS OF ALL INCOME LEVELS WITHIN OUR SERVICE AREA, WITH SPECIAL EMPHASIS ON THE INDIGENT, THE UNINSURED, AND THE UNDERSERVED. THE HEALTH CENTER IS COLLABORATING WITH BROAD TOP MEDICAL CENTER, A FEDERALLY-QUALIFIED HEALTH CENTER, TO ESTABLISH AFFILIATE CLINICS IN MIFFLIN AND JUNIATA COUNTIES. AMISH HEALTH COUNCIL LIAISON - KIRK THOMAS, VP OPERATIONSAN INITIATIVE HAS BEEN IMPLEMENTED TO MEET THE HEALTH CARE NEEDS OF THE AMISH POPULATION IN MIFFLIN AND JUNIATA COUNTIES. TO ENCOURAGE ACCESS TO CARE, A DISCOUNT PAYMENT SCHEDULE HAS BEEN DEVELOPED. MIFFLIN-JUNIATA UNITED WAY - PHYLLIS MITCHELL, VP MARKETING & COMMUNITY AFFAIRS, BOARD MEMBERTHE MISSION OF THE MJ UNITED WAY IS TO IMPROVE PEOPLE'S LIVES BY MOBILIZING THE CARING POWER OF THE COMMUNITY. THE UNITED WAY SUPPORTS VARIOUS AGENCIES THROUGH FUNDING. THE COMMUNITY IMPACT FOCUS AREAS INCLUDE: BASIC NEEDS AND SELF SUFFICIENCY, COMMUNITY LIFE AND HEALTH, EDUCATION, AND SUCCESSFUL CHILDREN AND YOUTH. LEWISTOWN HOSPITAL EMPLOYEES AND MEDICAL-DENTAL STAFF CONTRIBUTE TO THE UNITED WAY FUND EACH YEAR TO SUPPORT THESE LOCAL COMMUNITY ORGANIZATIONS. JUNIATA VALLEY CHAMBER OF COMMERCE - PHYLLIS MITCHELL, BOARD MEMBERTHE JUNIATA VALLEY CHAMBER OF COMMERCE HELPS PROMOTE AND SUPPORT LOCAL BUSINESSES IN MIFFLIN AND JUNIATA COUNTIES. THE CHAMBER IS A RESPECTED SOURCE FOR INFORMATION ABOUT COMMUNITY BUSINESSES AND EVENTS IN THE AREA. EMERGENCY PREPAREDNESS COMMITTEE - COMMUNITY PLANNING IMITATIVETHE EMERGENCY PREPAREDNESS COMMITTEE IS ACTUALLY A SUB-COMMITTEE OF THE RISK MANAGEMENT & SAFETY COMMITTEE. THE PRIMARY FUNCTION WOULD BE TO ASSURE THE HOSPITAL IS PREPARED AS BEST AS POSSIBLE FOR ANY EMERGENCY SITUATION. WE WORK CLOSELY WITH BOTH THE MIFFLIN AND JUNIATA COUNTY EMERGENCY MANAGEMENT AGENCIES (EMA'S), AND EACH OF THEIR RESPECTIVE DIRECTORS SITS ON THE COMMITTEE IN AN EX-OFFICIO CAPACITY. THIS HELPS US IN DEVELOPING OUR PLANS AND DRILLS/EXERCISES SO WE ADDRESS CONCERNS OF EACH COUNTY AS IT RELATES TO THEIR HVA'S (HAZARDS VULNERABILITY ANALYSIS).IN ADDITION, WE COORDINATE AND WORK CLOSELY WITH THE SOUTH CENTRAL MOUNTAINS REGIONAL TASK FORCE (SCMRTF). THE REGION IS COMPRISED OF THE FOLLOWING COUNTIES: MIFFLIN, JUNIATA, SNYDER, HUNTINGDON, BLAIR, BEDFORD, FULTON, AND CENTRE. BY MEETING, PLANNING AND EXERCISING WITH THE HEALTH CARE PARTNERS, PRIMARILY HOSPITALS, IN THIS AREA, WE ARE ABLE TO DEVELOP PLANS AND CONTINGENCIES IN THE EVENT OF LOCAL, REGIONAL, STATE AND/OR NATIONAL INCIDENTS. BY KNOWING WHAT EACH OTHERS CAPABILITIES AND RESOURCES ARE IN ADVANCE, WE HOPE TO BE ABLE TO MAINTAIN OR RESTORE HEALTHCARE SERVICES AS QUICKLY AS POSSIBLE TO OUR AREAS. THIS IS ONE COMPONENT OF OUR COMMUNITY INTERACTION AND PLANNING FOR INCIDENTS WHICH COULD ADVERSELY AFFECT HEALTHCARE FOR OUR RESIDENTS, VISITORS AND PATIENTS. WE ALSO PLAN AT LEAST 2 EXTERNAL EXERCISES (DRILLS) WITHIN MIFFLIN AND/OR JUNIATA COUNTIES EACH YEAR. THIS INVOLVES NOT ONLY HOSPITAL ASSETS, BUT INCLUDES PERSONNEL AND EQUIPMENT FROM EMS, FIRE, LAW ENFORCEMENT, EMERGENCY MANAGEMENT, AND SEVEN MOUNTAINS EMS REGION, TO PRACTICE WHAT COULD OCCUR IN A VARIETY OF DIFFERENT SITUATIONS SUCH AS MAJOR FIRES, BUILDING COLLAPSES, BUS ACCIDENTS, OR TERRORIST TYPES OF ATTACKS.THE COMMITTEE IS COMPRISED OF: HOSPITAL RISK MANAGER (CHAIR), PCD'S FROM THE ED AND ICCU, VP OF NURSING, VP OF COMMUNITY RELATIONS, MANAGER OF EMPLOYEE HEALTH, STAFF MEMBERS FROM THE ED, SECURITY, AND THE LAB, DIRECTOR OF QUALITY IMPROVEMENT, COMMUNICATIONS SUPERVISOR, SENIOR FINANCIAL ACCOUNTANT, AND OTHERS. WE MEET MONTHLY AND REVIEW ANY & ALL ITEMS RELATED TO EMERGENCY PREPAREDNESS AND CONTINUITY OF OPERATIONS DURING AN EMERGENCY INCIDENT. WE ALSO REVIEW INCIDENTS WHICH MAY HAVE OCCURRED, EVALUATE INTERNAL/EXTERNAL COMMUNICATIONS AS NECESSARY, DISCUSS DISSEMINATION OF PUBLIC INFORMATION DURING INCIDENTS, AND APPROVE EXPENDITURES OF THE ASPR/OPHP (ASSISTANT SECRETARY OF PREPAREDNESS RESPONSE/OFFICE OF PUBLIC HEALTH PREPAREDNESS) ANNUAL GRANTS.INTERNSHIP PROGRAMS FOR VARIOUS DEPARTMENTSTHE HOSPITAL WORKS WITH MANY DIFFERENT ORGANIZATIONS SUCH AS SECONDARY EDUCATION INSTITUTIONS, AND MEDICAL SCHOOLS, TO PROVIDE JOB SHADOWING AND TRAINING INTERNSHIPS FOR PARTICIPANTS. MANY DIFFERENT DEPARTMENTS WORK WITH INTERNS TO PROVIDE A VALUABLE WORK EXPERIENCE. IN FY2011, WE HELD TWO DAYS OF JOB SHADOWING WITH PARTICIPATION FROM APPROXIMATELY 15 DIFFERENT DEPARTMENTS ACROSS THE ORGANIZATION SHADOWING APPROXIMATELY 45 INDIVIDUALS INTERESTED IN CAREERS IN THE HEALTH CARE FIELD. THIS IS A VALUABLE SERVICE TO THE EDUCATIONAL INSTITUTIONS OF THE COMMUNITY AS THE STUDENTS ARE ABLE TO EXPERIENCE FIRSTHAND WHAT THESE TYPES OF CAREERS HAVE TO OFFER, SOMETHING THAT A CLASSROOM SETTING COULD NOT PROVIDE. THIS PROGRAM IS OF NO COST TO THE EDUCATIONAL INSTITUTIONS AND IT IS AN EXCELLENT WAY FOR STUDENTS TO MAKE INFORMED CAREER CHOICES ULTIMATELY RESULTING IN A STRONGER WORKFORCE FOR THE COMMUNITY.EXPERIENCE WORKS PROGRAM SPONSOR.EXPERIENCE WORKS (FORMERLY GREEN THUMB) IS A FEDERAL EMPLOYMENT PROGRAM THAT IS FOCUSED ON MEETING THE TRAINING AND EMPLOYMENT NEEDS OF A RAPIDLY GROWING OLDER POPULATION. LEWISTOWN HOSPITAL IS A TRAINING AGENCY FOR EXPERIENCE WORKS INDIVIDUALS. CURRENTLY TWO EXPERIENCED WORKS PARTICIPANTS ARE WORKING AT THE HOSPITALLEWISTOWN HOSPITAL SCHOOL OF NURSINGMANY RURAL AREAS FACE SEVERE SHORTAGES OF NURSES. NO MEDICAL CENTER CAN WORK PROPERLY WITHOUT ENOUGH GOOD NURSES, AND LEWISTOWN HOSPITAL IS NO EXCEPTION. THE HOSPITAL HAD DIFFICULTY HIRING AND KEEPING RNS FOR YEARS. SO DID OTHER FACILITIES IN THE REGION, SUCH AS NURSING HOMES AND DOCTORS' OFFICES . IN RESPONSE TO THIS SHORTAGE OF NURSES, LEWISTOWN HOSPITAL APPEALED TO THE STATE BOARD OF NURSING TO OPEN ITS CURRENT SCHOOL OF NURSING. IN MAY 2005, THE PENNSYLVANIA STATE BOARD OF NURSING GRANTED INITIAL APPROVAL TO THE LEWISTOWN HOSPITAL TO ADMIT TWENTY-FIVE STUDENTS TO EACH OF TWO CLASSES. THE PENNSYLVANIA STATE BOARD EDUCATION ADVISORS REVIEWED THE PROGRAM IN OCTOBER 2007 AFTER THE FIRST CLASS GRADUATED, AND FULL APPROVAL WAS GRANTED TO THE PROGRAM IN DECEMBER 2007. PART III, LINE 4: ACCOUNTS RECEIVABLE, PATIENTS ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. THE ALLOWANCE FOR DOUBTFUL COLLECTIONS IS ESTIMATED BASED UPON A PERIODIC REVIEW OF THE ACCOUNTS RECEIVABLE AGING, PAYOR CLASSIFICATIONS, AND APPLICATION OF HISTORICAL WRITE-OFF PERCENTAGES.THE COST-TO CHARGE RATIO WAS CALCULATED USING TOTAL COSTS AND TOTAL PATIENT CHARGES. THE MEDICARE STEPDOWN METHODOLOGY WAS USED BUT INCLUDED ALL EXPENSES, NET OF RELATED OTHER INCOME. THE TOTAL EXPENSES TIED TO THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THE HOSPITAL CONTINUES TO PROVIDE CARE TO ALL PRESENTING AND ADMITTED PATIENTS, REGARDLESS OF ABILITY OR PAY. NOTWITHSTANDING THE COSTS TO PROVIDE CARE, RECEIVING "LESS" THAN WHAT IT COSTS TO PROVIDE ADEQUATE CARE TO MEDICARE COVERED LIVES DOES THE HOSPITAL A DISSERVICE. THIS SHORTFALL SHOULD COUNT AS A COMMUNITY BENEFIT. OUR SERVICE AREA INCLUDES MANY MEDICARE RECIPIENTS THAT ARE ALSO DUALLY ELIGIBLE FOR MEDICAL ASSISTANCE, WHICH DENOTES SOME TYPE OF FINANCIAL NEED.MEDICARE COST-TO-CHARGE RATIOS FROM THE MEDICARE COST REPORT ARE USED TO DETERMINE THE COST OF THE PROGRAMS. PART III, LINE 9B: PER OUR CURRENT POLICIES, THE ONLY WAY WE ARE GUARANTEED TO KNOW IF SOMEONE IS INDIGENT IS IF THEY COMPLETE A CHARITY CARE APPLICATION. THERE IS A PROVISION IN THE COMMUNITY CARE POLICY (OUR CHARITY CARE POLICY) - THAT ONCE COMPLETED, A CHARITY CARE THE APPLICATION IS VALID FOR 6 MONTHS. THEREFORE IF ANOTHER DEBT IS INCURRED DURING THAT WINDOW, WE KNOW THEY MEET THE REQUIREMENTS AND WE EXTEND THE TERMS OF FINANCIAL ASSISTANCE/CHARITY CARE TO THAT PATIENT. CONTINUATION OF DESCRIPTION OF COMMUNITY BUILDING ACTIVITIES (PART II):THE SCHOOL OF NURSING HAS A FULL-TIME PROGRAM, WHICH TAKES TWO YEARS TO COMPLETE AND IS A TOTAL OF 102 CREDIT UNITS. STUDENTS MAY ALSO OPT FOR PART-TIME, AND THEY CAN CHOOSE A THREE- OR FOUR-YEAR OPTION. IN ADDITION, THE PROGRAM OFFERS AN LPN TO RN PROGRAM, AND IT COULD TAKE AS LITTLE AS FOUR SEMESTERS (14 MONTHS) TO COMPLETE. THE MISSION OF THE LEWISTOWN HOSPITAL SCHOOL OF NURSING IS TO PROVIDE QUALITY NURSING EDUCATION TO A DIVERSE GROUP OF STUDENTS IN A MANNER THAT ENABLES THE GRADUATES TO BECOME LEADERS IN PROVIDING COMPETENT AND SAFE CARE IN A VARIETY OF SETTINGS IN ORDER TO MEET THE CONTINUALLY CHANGING HEALTHCARE NEEDS OF THE HOSPITAL'S AND SCHOOL'S COMMUNITY.BESIDES EASING THE NURSING SHORTAGE, THE SCHOOL ALSO BOLSTERS LOCAL EMPLOYMENT AND WORKFORCE TRAINING. OUR AREA HAS SUFFERED BADLY IN THE RECENT RECESSION. A FIRST-CLASS NURSING SCHOOL PROVIDES RETRAINING FOR MANY. STUDENTS CAN MOVE INTO A CAREER THAT OFFERS REAL JOB OPPORTUNITIES. NURSES ALSO FIND THAT THEIR WORK IS WELL PAID, STABLE, AND PERSONALLY REWARDING. THE SCHOOL'S COMMUNITY FOCUS IS SHOWN IN NURSES' CAREER CHOICES. SEVENTY-FIVE PERCENT CHOOSE TO WORK IN THE LEWISTOWN AREA. IT IS NOT JUST LEWISTOWN HOSPITAL FILLING GAPS IN NURSING STAFF. LOCAL NURSING HOMES HAVE HIRED GRADUATES AS WELL. YEAR BY YEAR THE NURSE AVAILABILITY IN THE AREA HAS CONTINUED TO IMPROVE. SURVEYS THAT GO OUT TO EMPLOYERS A YEAR INTO THE NURSES' WORK HAVE SHOWN VERY POSITIVE RESPONSES. THE WHOLE COMMUNITY HAS BENEFITTED FROM THE LEWISTOWN HOSPITAL SCHOOL OF NURSING. FREE HEALTH EDUCATION WORKSHOPS, SUPPORT GROUPS, AND SEMINARSTHROUGH THE HOSPITAL'S SPEAKER BUREAU PROGRAM, A WIDE VARIETY OF PROGRAMS ARE OFFERED TO THE COMMUNITY FREE OF CHARGE AND THEY TARGET SPECIFIC MEDICAL CONDITIONS OR TOPICS SUCH AS CANCER AND DIABETES. FOR CANCER, THERE IS THE CANCER CARE SUPPORT GROUP AND THE PA CANCER EDUCATION NETWORK SESSIONS. FOR DIABETES, THERE IS A DIABETES SUPPORT GROUP AND THERE ARE ALSO EDUCATIONAL CLASSES (WITH ENROLLMENT FEES) OFFERED THROUGHOUT THE YEAR. FREE HEALTH SCREENINGSVARIOUS DEPARTMENTS OFFER HEALTH SCREENINGS AT LOCAL COMMUNITY EVENTS OR DURING A SPONSORED BUSINESS HEALTH FAIR. SCREENINGS INCLUDE: BONE DENSITY, BLOOD PRESSURE, CHOLESTEROL, BLOOD SUGAR, LUNG FUNCTION, DEPRESSION, AND SKIN CANCER. FREE CHILD SAFETY SEAT INSPECTIONSTHE FAMILY PLACE (MATERNITY CENTER) OFFERS QUARTERLY CHILD SAFETY SEAT INSPECTIONS AT THE HOSPITAL. FOR FAMILIES THAT DO NOT HAVE A SAFE CAR RESTRAINT FOR THEIR CHILDREN 0-8 YEARS OF AGE, THE HOSPITAL PROVIDES A NEW AND APPROPRIATE CHILD SAFETY SEAT. FLU SHOTSLEWISTOWN HOSPITAL, IN PARTNERSHIP WITH OTHER COMMUNITY ORGANIZATIONS, PROVIDES FLU SHOTS AT NO CHARGE TO PEOPLE AT HIGH RISK FOR CONTRACTING THE FLU.DENTAL HEALTH PRESENTATIONSLEWISTOWN HOSPITAL, IN PARTNERSHIP WITH UNITED WAY OF MIFFLIN-JUNIATA, ASSISTED WITH DENTAL PRESENTATIONS TO OVER 80 GROUPS OF CHILDREN WHICH INCLUDED: PRE-SCHOOLS, DAY CARE CENTERS, HEAD START PROGRAMS, AND KINDERGARTEN CLASSES. LEWIE B. HEALTHY PROGRAMLEWISTOWN HOSPITAL DEVELOPED A MASCOT ALONG HEALTH EDUCATIONAL MODULES GEARED FOR CHILDREN BETWEEN THE AGES OF 4 AND 8 YEARS OF AGE. THE PURPOSE OF THE PROGRAM IS TO PROMOTE HEALTHY LIFESTYLE CHOICES FOR YOUNG CHILDREN.QUICK ER CARE PROGRAMQUICK ER CARE, A NEW SERVICE INTRODUCED IN DECEMBER 2008, PROVIDES SEPARATE RESOURCES FOR NON-EMERGENCY CASES IN THE ER. THESE RESOURCES INCLUDE THREE ADDITIONAL PATIENT EXAMINATION ROOMS AND STAFF DEDICATED TO HANDLING THESE CASES. THESE ADDITIONAL RESOURCES PROVIDE ANOTHER PATH FOR PATIENTS TO BE TREATED.PEOPLE WHO NORMALLY HAVE TO WAIT FOR LONG PERIODS OF TIME IN THE ER, ARE USUALLY NOT THE SEVERE CASES. QUICK ER CARE REDUCES THE WAIT TIME FOR PATIENTS WHO COME TO THE ER BECAUSE THEY CAN'T GET AN APPOINTMENT OR DON'T HAVE AN ESTABLISHED PHYSICIAN RELATIONSHIP. QUICK ER CARE IS AVAILABLE AT LEWISTOWN HOSPITAL 7 DAYS A WEEK FROM 10:00AM - 8:00PM. QUICK ER CARE HAS A FULL-TIME PHYSICIAN ASSISTANT AND REGISTERED NURSE WHO PROVIDE MEDICAL SCREENING AND TREATMENT FOR PATIENTS WHO HAVE LESS URGENT CONDITIONS SUCH AS POTENTIAL FRACTURES, SPRAINS, MILD RASHES AND LOW GRADE FEVERS. BEFORE BEING ADMITTED TO QUICK ER CARE, ALL PATIENTS WILL BE TRIAGED AND ASSESSED BY A REGISTERED NURSE TO ENSURE THAT THEY ARE CANDIDATES FOR QUICK CARE. TELESTROKE PROGRAMLEWISTOWN HOSPITAL, COLLABORATING WITH GEISINGER HEALTH SYSTEM, HAS EXPANDED ITS STROKE SERVICES TO PROVIDE ADVANCED CARE FOR PATIENTS IN THE LEWISTOWN AREA. THROUGH A NEW TELEMEDICINE PROGRAM, THE EXPERTISE OF GEISINGER'S STROKE SPECIALISTS IS NOW AVAILABLE TO LEWISTOWN HOSPITAL EMERGENCY DEPARTMENT PHYSICIANS 24 HOURS A DAY, SEVEN DAYS A WEEK. A SECURE VIDEO MONITORING SYSTEM (POLYCOM MACHINE) PROVIDES A REAL-TIME LINK BETWEEN GEISINGER'S STROKE-TRAINED NEUROLOGISTS AND LEWISTOWN'S EMERGENCY DEPARTMENT. STROKE PATIENTS NOW RECEIVE ADVANCED TREATMENT FROM GEISINGER SPECIALISTS IN COLLABORATION WITH LEWISTOWN EMERGENCY PHYSICIANS. STROKE IS THE THIRD LEADING CAUSE OF DEATH IN THE UNITED STATES. AS THE POPULATION CONTINUES TO AGE, STROKES ARE LIKELY TO INCREASE. THE AMERICAN HEART ASSOCIATION AND THE AMERICAN COLLEGE OF EMERGENCY PHYSICIANS SAY THAT AGGRESSIVELY TREATING STROKE IN ITS EARLY STAGES SIGNIFICANTLY IMPROVES A PERSON'S CHANCE FOR A FULL RECOVERY.GEISINGER SPECIALISTS EVALUATE THE PATIENT, REVIEW BRAIN SCANS AND WORK WITH LEWISTOWN EMERGENCY DEPARTMENT PHYSICIANS AND STAFF TO PROVIDE THE BEST ACUTE STROKE CARE. TELECONFERENCING EQUIPMENT IS BROUGHT TO THE PATIENT'S BEDSIDE, ALLOWING GEISINGER STAFF TO ASSESS THE PATIENT, AND SPEAK DIRECTLY TO THE LEWISTOWN PHYSICIAN, PATIENT AND PATIENT'S FAMILY. SPONSORSHIPS FOR ORGANIZATIONS/COMMUNITY ACTIVITIES THAT PROMOTE HEALTH - THE HOSPITAL HAS A FOR-PROFIT SISTER ORGANIZATION, HEALTH ENTERPRISES, INC. THAT PROVIDED OVER $14,000 IN SPONSORSHIPS IN FY 2011 TO SUPPORT TO FOLLOWING HEALTH RELATED COMMUNITY ORGANIZATIONS AND ACTIVITIES. PART VI, LINE 2: QUARTERLY ADVISORY GROUPS:THE PATIENT SATISFACTION ADVISORY GROUP PURPOSE IS TO PROVIDE FEEDBACK REGARDING THE HOSPITAL'S PATIENT SATISFACTION EFFORTS. THE COMMITTEE IS COMPOSED OF FORMER AND CURRENT PATIENTS, AS WELL AS COMMUNITY MEMBERS. MEMBERS GIVE INSIGHT INTO WHAT THE COMMUNITY IS SAYING ABOUT THE HOSPITAL AND SUGGESTIONS FOR CHANGES TO MAKE THE HOSPITAL EXPERIENCE MORE PATIENT-FOCUSED.THE MARKETING ADVISORY COMMITTEE'S PURPOSE IS TO PROVIDE GUIDANCE FOR THE HOSPITAL'S MARKETING AND OUTREACH EFFORTS. FOCUS GROUP INTERVIEWS:THE HOSPITAL ENGAGED THE MELIOR GROUP TO CONDUCT INTERNAL AND EXTERNAL FOCUS GROUPS. THE OBJECTIVES OF THE RESEARCH WERE TO LEARN HOW LEWISTOWN HOSPITAL IS PERCEIVED; WHAT MAKES IT A HOSPITAL OF CHOICE OR NOT; WHAT ARE EXPERIENCES LIKE WITH THE HOSPITAL; AND WHAT SERVICES AND SPECIALTIES IT SHOULD FOCUS ON IN THE FUTURE. MEDICAL STAFF SURVEYS:THE PRIMARY OBJECTIVE OF THE MEDICAL STAFF ASSESSMENT PROCESS WAS TO CREATE A MEDICAL STAFF DEVELOPMENT PLAN FOR LEWISTOWN HOSPITAL THAT PROJECTS THE NEEDS FOR PHYSICIANS OVER THE NEXT SEVERAL YEARS, BY SPECIALTY, IN THE HOSPITAL'S PRIMARY AND SECONDARY SERVICE AREAS. IN ADDITION, THE SURVEY WAS USED TO CREATE A PHYSICIAN RECRUITMENT STRATEGY FOR THE HOSPITAL AND MEMBERS OF THE MEDICAL STAFF.UTILIZATION STATISTICS AND ANALYSIS:DECISION SUPPORT SOFTWARE WITHIN THE HOSPITAL'S FINANCE DEPARTMENT PROVIDES HISTORICAL AND CURRENT DATA ON THE UTILIZATION OF INPATIENT AND OUTPATIENT SERVICES. STATE HEALTH IMPROVEMENT PLAN PARTNERSHIP (SHIP) DATA:LEWISTOWN HOSPITAL IS A KEY MEMBER OF THE LOCAL SHIP (MIFFLIN -JUNIATA PARTNERS ADVANCING TOMORROW'S HEALTH). THE PURPOSE OF THIS GROUP IS TO SUPPORT THE HEALTH PLANNING INITIATIVES FROM THE PENNSYLVANIA DEPARTMENT OF HEALTH. THIS IS ACCOMPLISHED BY ENGAGING A BROAD SPECTRUM OF LOCAL COMMUNITY INDIVIDUALS AND ORGANIZATIONS WITH INTERESTS AND INFLUENCE ON LOCAL HEALTH STATUS BY WORKING TOGETHER TO PROMOTE EFFECTIVE HEALTH IMPROVEMENT STRATEGIES, INCLUDING PLANNING AND COORDINATION OF LOCAL RESOURCES. MEETINGS ARE HELD BI-MONTHLY. PA DEPARTMENT OF HEALTH STATISTICS:THE PA DEPARTMENT OF HEALTH WEBSITE PROVIDES A WEALTH OF HEALTH STATISTICS AND DATA FOR EACH COUNTY. THIS INCLUDES THE FOLLOWING:RATES FOR BIRTH, DEATH, CANCER, AND OTHER VITAL STATISTICSBEHAVIORAL RISK AND INJURY STATISTICSCOMMUNICABLE DISEASESHEALTH FACILITIESSCHOOL HEALTH PA DEPARTMENT OF HEALTH BEHAVIORAL RISK FACTOR SURVEY:THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) IS AN ANNUAL TELEPHONE SURVEY IMPLEMENTED NATIONWIDE UNDER A GRANT FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION. SINCE 1989, THE PENNSYLVANIA DEPARTMENT OF HEALTH HAS RELEASED ANNUAL REPORTS USING BRFSS DATA ON VARIOUS HEALTH RISK BEHAVIORS, SUCH AS SMOKING, DRINKING, SEAT BELT USAGE AND HEALTH STATUS.MIFFLIN-JUNIATA HUMAN SERVICES NEEDS ASSESSMENT - FROM MIFFLIN COUNTY COMMISSIONERS OFFICETHE MIFFLIN-JUNIATA COUNTY HUMAN NEEDS ASSESSMENT PROJECT BEGAN IN 2004 TO IDENTIFY CRITICAL AREAS WHERE THE ASSISTANCE OF THE HUMAN SERVICES DEPARTMENT WOULD BE MOST BENEFICIAL FOR INDIVIDUALS, FAMILIES AND THE COMMUNITY. THE HUMAN SERVICES DEPARTMENT COLLABORATED WITH PENN STATE UNIVERSITY TO CONDUCT A NEEDS ASSESSMENT IN BOTH JUNIATA AND MIFFLIN COUNTIES. THE ASSESSMENT WAS HELPFUL IN DETERMINING WHAT THE HIGHEST HUMAN SERVICE NEEDS WERE FOR THE TWO COUNTIES.IN LATE 2011, LEWISTOWN HOSPITAL BEGAN WORKING WITH MIFFLIN-JUNIATA HUMAN SERVICES DEPARTMENT, UNITED WAY OF MIFFLIN-JUNIATA AND PENN STATE EXTENSION SERVICE TO DEVELOP AND CONDUCT AN UPDATED COMMUNITY HUMAN SERVICES NEEDS ASSESSMENT. FOR LEWISTOWN HOSPITAL, THIS ASSESSMENT WILL BE ONE TOOL USED TO DETERMINE WHAT PRIORITY SHOULD BE GIVEN TO SPECIFIC HEALTH CARE NEEDS WITHIN OUR COMMUNITY AND TO IMPLEMENT A STRATEGY TO ADDRESS THOSE IDENTIFIED HEALTH CARE NEEDS. THE ASSESSMENT PROCESS WILL CONTINUE THROUGH 2012. HOW IS ALL OF THE ABOVE INFORMATION PULLED TOGETHER AND UTILIZED?VARIOUS HOSPITAL STAFF MEMBERS ASSIST WITH THE DATA COLLECTION. PRIMARY AND SECONDARY DATA IS ORGANIZED INTO COMPUTER FILES TO MAKE THE INFORMATION EASIER TO USE AND ANALYZE. ONCE THE HOSPITAL HAS THE PRIMARY AND SECONDARY DATA COLLECTED AND IN HAND, THE SENIOR TEAM SPENDS TIME ANALYZING THE DATA TO DISCERN PATTERNS AND THEMES. ASSESSMENT DATA FINDINGS ARE SHARED WITH A VARIETY OF GROUPS INTERNALLY AND EXTERNALLY (MANAGEMENT STAFF, MEDICAL-DENTAL STAFF, BOARD OF TRUSTEES, COMMUNITY ORGANIZATIONS).SINCE SUFFICIENT RESOURCES ARE NOT AVAILABLE TO ADDRESS ALL THE HEALTH CONCERNS IDENTIFIED IN THE ASSESSMENTS, CHOICES MUST BE MADE ABOUT WHICH ISSUES ARE DESIGNATED AS PRIORITIES FOR ACTION IN THE SHORT TO INTERMEDIATE TERM (ONE TO THREE YEARS). IN GENERAL, THE HOSPITAL AIMS FOR TWO TO THREE PRIORITIES.THE HOSPITAL COLLABORATES WITH OTHER COMMUNITY STAKEHOLDERS TO GAIN A GREATER COMMITMENT TO ACTION. A CONSENSUS IS REACHED WITH INPUT FROM HOSPITAL STAFF, MEDICAL STAFF, THE BOARD OF TRUSTEES, AND COMMUNITY MEMBERS. CRITERIA THAT ARE USED TO IDENTIFY THE MOST SIGNIFICANT HEALTH ISSUES INCLUDE:THE MAGNITUDE OF THE PROBLEMTHE SEVERITY OF THE PROBLEMA HIGH NEED AMONG VULNERABLE POPULATIONSCRITERIA THAT ARE USED TO EVALUATE WHICH HEALTH ISSUES THE HOSPITAL SHOULD PRIORITIZE INCLUDE:THE HOSPITAL'S CAPACITY TO ACT ON THE ISSUE, INCLUDING ECONOMIC, SOCIAL, AND CULTURAL CONSIDERATIONS.THE FEASIBILITY OF HAVING A MEASURABLE IMPACT ON THE ISSUECOMMUNITY RESOURCES ALREADY FOCUSED ON THE ISSUEWHETHER THE ISSUE IS A ROOT CAUSE OF OTHER PROBLEMS (THEREBY POSSIBLY AFFECTING MULTIPLE ISSUES)WHEN THE ISSUES HAVE BEEN PRIORITIZED, THE SENIOR TEAM AND BOARD OF TRUSTEES DISCUSS THE PRIORITIZED LIST AND ASK FOR ADDITIONAL INPUT AND VALIDATION. WHEN A FINAL DECISION IS MADE, A PLAN IS PUT INTO PLACE TO ADDRESS THE PRIORITIES AND IMPROVE COMMUNITY HEALTH. SPECIFIC GOALS HELP FOCUS THE SPECIFIC INTERVENTIONS AND PROVIDE A METHOD FOR VALUING EACH OPTION. PART VI, LINE 3: LEWISTOWN HOSPITAL PRODUCES DAILY REPORTS FOR HIGH TICKET SERVICES THAT IDENTIFY PATIENTS THAT ARE POTENTIALLY UNINSURED. WE CONTRACT WITH A THIRD PARTY THAT EMPLOYS A REPRESENTATIVE ON SITE AT THE HOSPITAL THAT WILL TAKE THE REPORT OF UNINSURED PATIENTS. THE REPRESENTATIVE WILL ATTEMPT TO PERSONALLY VISIT EACH PATIENT WHILE THEY ARE STILL AT THE HOSPITAL TO OUTLINE POSSIBLE OPTIONS. THE PRIMARY OPTION IS USUALLY MAKING APPLICATION FOR MEDICAL ASSISTANCE. THE REPRESENTATIVE IS HIGHLY EXPERIENCED IN THE MEDICAL ASSISTANCE APPLICATION PROCESS AND WILL ASSIST THE PATIENT IN COMPLETING THE APPLICATION PROCESS. THIS INCLUDES COMPLETING THE PAPERWORK, COPYING DOCUMENTS AND EVEN WILL REPRESENT THE PATIENT AT THE FACE TO FACE INTERVIEW AT THE COUNTY OFFICE IF NECESSARY. POST DISCHARGE ALL PATIENTS INDICATING THAT THEY ARE UNINSURED WILL RECEIVE A LETTER OFFERING A PROMPT PAY DISCOUNT. THERE ARE CONTACT PHONE NUMBERS ON THE LETTER SHOULD THE PATIENT HAVE ANY QUESTIONS CONCERNING OUR DISCOUNT PROGRAM. TELEPHONE CALLS ARE MADE TO PATIENTS IN AN ATTEMPT TO EXPLAIN OUR DISCOUNT POLICY, THE FACT THAT WE ACCEPT INTEREST FREE TIME PAYMENTS, WE ENCOURAGE PATIENTS TO MAKE APPLICATION FOR MEDICAL ASSISTANCE AND BLUECHIP AND IF WE DETERMINE THAT THERE TRULY IS AN INDIGENT SITUATION WHERE THERE ARE NO OTHER ALTERNATIVES WE DO OFFER A CHARITY PROGRAM WHEREBY PATIENTS MAY QUALIFY FOR FREE CARE.IN OUR PATIENT INFORMATION GUIDE, THERE IS WORDING THAT TELLS PATIENTS ABOUT FINANCIAL ASSISTANCE, OUR WEBSITE OFFERS INFORMATION REGARDING FINANCIAL ASSISTANCE, AND WE ALSO MAKE CHARITY CARE APPLICATIONS AVAILABLE AT REGISTRATION POINTS. WE ALSO HAVE TRANSLATORS AVAILABLE IF THE NEED ARISES. PART VI, LINE 4: OUR SERVICE AREA IS COMPRISED OF MIFFLIN COUNTY, JUNIATA COUNTY, AND PARTS OF HUNTINGDON AND SNYDER COUNTIES. THIS RURAL AREA CONTAINS SOME 145,000 PEOPLE SPREAD OVER MORE THAN 2,500 SQUARE MILES OF RUGGED TERRAIN LOCATED IN THE HEART OF THE APPALACHIAN MOUNTAINS IN CENTRAL PENNSYLVANIA. THE AVERAGE POPULATION DENSITY IS APPROXIMATELY 60 PERSONS PER SQUARE MILE. THE JUNIATA RIVER RUNS ALONG THE VERDANT VALLEYS AND SLICES THROUGH NARROW MOUNTAIN PASSES TO CONNECT OUR RESIDENTS TOGETHER, WHICH IS WHY OUR AREA IS CALLED THE JUNIATA VALLEY.TRANSPORTATION BARRIERS PLAY A MAJOR ROLE IN ACCESS TO HEALTH CARE IN OUR REGION. THESE NATURAL BARRIERS INCLUDE NARROW ROADS THAT EITHER MEANDER ALONG STREAMS AND CREEKS OR CROSSOVER THE MOUNTAIN RANGES THAT TRAVERSE OUR APPALACHIAN RIDGE REGION. THESE BARRIERS ARE EVEN MORE DAUNTING GIVEN HAZARDOUS WINTER DRIVING CONDITIONS CAUSED BY SNOW OR ICE COVERED ROADS. LOW-INCOME AND SENIOR CITIZENS ALSO FACE TRANSPORTATION ISSUES, AS THERE IS NO PUBLIC TRANSPORTATION IN OUR SERVICE AREA. SENIOR CITIZENS AND MEDICAID-ELIGIBLE PERSONS CAN USE THE CARS VAN SYSTEM FOR TRANSPORTATION TO REGULARLY SCHEDULED APPOINTMENTS WITH A WEEKS' NOTICE BUT NOT FOR URGENT OR EMERGENCY CARE. LOW INCOME CITIZENS HAVE NO ACCESS TO ANY PUBLIC TRANSPORTATION AT ALL IN OUR COMMUNITY. IF A TRIP TO A SPECIALIST IS REQUIRED THE MAJOR SUPPORT HOSPITALS ARE OVER ONE AND HALF HOURS DRIVE AWAY (IN THE SUMMER).THE POPULATION OF OUR TOTAL SERVICE AREA IS JUST ABOUT 145,000 PERSONS BASED ON 2000 US CENSUS DATA. MIFFLIN COUNTY HAS A RELATIVELY FLAT GROWTH RATE AND HAS NOT GROWN SIGNIFICANTLY IN POPULATION SINCE THE 1950 CENSUS WHEN OVERALL POPULATION WAS ABOUT 46,000 PEOPLE. JUNIATA COUNTY, ON THE OTHER HAND, HAS SEEN SIGNIFICANT GROWTH WITH A 10.6% INCREASE IN POPULATION FROM 1990 TO 2000. IT IS BELIEVED THAT THIS GROWTH IS MOSTLY COMING FROM PEOPLE WHO WORK IN THE NEARBY HARRISBURG AREA WHO ARE LOOKING FOR A LOWER COST OF LIVING. WITH THE RECENT COMPLETION OF A NEW FOUR-LANE HIGHWAY NORTH OF HARRISBURG, THE COMMUTE TO HARRISBURG HAS BECOME MORE CONVENIENT RESULTING IN AN INCREASE IN JUNIATA COUNTY'S POPULATION AS PEOPLE MOVE FURTHER AWAY FROM THE URBAN AREAS TO LIVE IN THE COUNTRY. HIGHER GROWTH IN FULTON COUNTY IS EXPLAINED BY MIGRATION FROM MARYLAND AS PEOPLE TRY TO MOVE AWAY FROM HIGHER HOUSING COSTS IN MARYLAND. HUNTINGDON COUNTY'S GROWTH IS MOSTLY OCCURRING IN THE NORTHERN PORTION OF THE COUNTY THAT IS CLOSE ENOUGH TO STATE COLLEGE TO ALLOW RESIDENTS TO COMMUTE TO PENN STATE UNIVERSITY. THESE GROWTH RATES ARE STILL VERY LOW WHEN COMPARED TO A NATIONAL GROWTH RATE OF OVER 13 %.OTHER IMPORTANT DEMOGRAPHIC STATISTICS ARE OUTLINED IN THE CHART BELOW.STATISTICS: MIFFLIN COUNTY(MC), JUNIATA COUNTY(JC), PENNSYLVANIA(PA)POPULATION: 46,682(MC), 24,636(JC), 12,702,379(PA)POPULATION LESS THAN 18 YEARS OF AGE: 23.1%(MC), 24%(JC), 22%(PA)AGE 65 AND UP: 8.5%(MC), 16.8%(JC), 15.4%(PA)PERCENTAGE OF POPULATION BELOW THE POVERTY LEVEL (2009): 15.1%(JC), 10.4%(MC), 12.5% (PA)POVERTY RATE FOR CHILDREN UNDER AGE 18 (2009): 24.9%(JC), 17.1%(MC), 17.1%(PA)MEDIAN HOUSEHOLD INCOME: $38,310(JC), $43,604(MC), $49,501(PA)UNINSURED ADULTS (2009): 13.9%(JC), 16.6%(MC), 12.8%(PA)MIFFLIN COUNTY'S 65 AND OVER AGE GROUP IS 18.5 PERCENT (2009), WHILE JUNIATA COUNTY'S IS 16.8%, HUNTINGDON COUNTY'S, 16% AND FULTON COUNTY'S 16.7%. THE PENNSYLVANIA AVERAGE FOR THIS STATISTIC IS ON 15.4%. BOTH MIFFLIN AND JUNIATA COUNTIES HAVE HIGHER PERCENTAGES OF PERSONS LESS THAN 18 YEARS OF AGE, 23.1% AND 24% RESPECTIVELY, THAN THE PA AVERAGE OF 22%. BOTH OF THESE GROUPS REQUIRE MORE HEALTH CARE RESOURCES THAN OTHER AGE GROUPS IN OUR COMMUNITY. MIFFLIN COUNTY HAS 15.1% OF THE POPULATION WITH INCOME BELOW THE POVERTY LINE AND 24.9% OF CHILDREN UNDER 18 LIVING IN POVERTY. JUNIATA COUNTY HAS 10.4% OF THE POPULATION WITH INCOME BELOW THE POVERTY LINE, WHILE HUNTINGDON AND SNYDER COUNTIES ARE 13% AND 14% RESPECTIVELY. PER CAPITA PERSONAL INCOME (2009) FOR THE FOUR MAIN COUNTIES IN OUR SERVICE AREA ARE AS FOLLOWS: MIFFLIN $28.3K, JUNIATA $30.3K, HUNTINGDON $27.6K, AND SNYDER $30.8K. THE PERCENTAGES OF THE POPULATIONS WHO ARE UNINSURED (IN THE 18-64 AGE RANGE) FOR THOSE COUNTIES ARE AS FOLLOWS: MIFFLIN 19%, JUNIATA 19%, HUNTINGDON 19%, AND SNYDER 16%. DURING THE FISCAL YEAR 2011, APPROXIMATELY 14% OF OUR PATIENT POPULATION WAS MEDICAL ASSISTANCE, WHILE ANOTHER 3.5% WERE SELF PAY.THERE IS ONE OTHER HOSPITAL LOCATED WITHIN THE SERVICE AREA DESCRIBED ABOVE, JC BLAIR MEMORIAL HOSPITAL IN HUNTINGDON, PA. THERE ARE ALSO SEVERAL OTHER HOSPITALS LOCATED IN AREAS SURROUNDING OUR SERVICE AREA. THESE INCLUDE MT. NITTANY MEDICAL CENTER IN STATE COLLEGE, PA; GEISINGER MEDICAL CENTER IN DANVILLE, PA; HOLY SPIRIT HOSPITAL IN CAMP HILL, PA; THE PENN STATE MILTON S. HERSHEY MEDICAL CENTER IN HERSHEY, PA; AND SEVERAL CAMPUSES OF PINNACLE HEALTH IN THE HARRISBURG, PA AREA.THERE ARE ALSO SEVERAL FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS WITHIN OUR SERVICE AREA. THERE ARE TWO LOCATED IN MIFFLIN COUNTY, ONE IN JUNIATA COUNTY, AND FOUR IN HUNTINGDON COUNTY.THE ADULT BEHAVIORAL HEALTH RISK FACTORS SURVEY (2006-2008) SHOWS THE FOLLOWING STATISTICS FOR THE POPULATION LIVING IN MIFFLIN AND JUNIATA COUNTIES:RISK FACTORS : PERCENTFAIR OR POOR GENERAL HEALTH: 20%OBESE: 29%OVERWEIGHT (INCLUDES OBESE): 66%EVER TOLD THEY HAD DIABETES: 12%CURRENTLY HAS ASTHMA: 10%CURRENT SMOKER: 26%FOR MIFFLIN AND JUNIATA COUNTIES, THE HEALTH PROFILE 2011 FROM THE PA DEPARTMENT OF HEALTH SHOW THE MAJOR CAUSES OF DEATH ARE DISEASES OF THE HEART, CANCER, STROKE, AND CHRONIC LOWER RESPIRATORY DISEASES. PROSTATE CANCER RANKS AS NUMBER ONE FOR THE HIGHEST INCIDENCE OF CANCER, FOLLOWED BY FEMALE BREAST CANCER. RANKING THIRD AND FOURTH ON THE LIST ARE LUNG CANCER AND COLON CANCER. PART VI, LINE 6: ALL OF THE ORGANIZATION'S BOARD MEMBERS RESIDE WITHIN THE ORGANIZATION'S PRIMARY SERVICE AREA. KAY HAMILTON, THE PRESIDENT, IS THE ONLY EMPLOYEE ON THE BOARD AND NONE OF THE BOARD MEMBERS ARE FAMILY MEMBERS OF EMPLOYEES WITHIN THE ORGANIZATION. DR. CHARLES EVERHART, JR, MD, BOARD MEMBER OWNS ENDOSCOPY CENTER OF PA, WHICH PROVIDES ENDOSCOPY SERVICES TO LEWISTOWN HOSPITAL; FRANCIS EVANITSKY , TREASURER OF THE BOARD IS FORMER PRESIDENT OF JUNIATA VALLEY BANK WHICH DOES PROVIDE BANKING SERVICES FOR LH. THE ORGANIZATION EXTENDS STAFF PRIVILEGES TO ALL QUALIFIED PHYSISIANS IN THE AREA.ANNUALLY DURING THE BUDGET PROCESS, A CASH FORECAST IS PREPARED TO DETERMINE THE AMOUNT OF CASH AVAILABLE FOR CAPITAL PURCHASES. CAPITAL REQUESTS ARE MADE BY MANAGEMENT OF THE ORGANIZATION DURING THE BUDGET PROCESS AS WELL. REQUESTS ARE REVIEWED AND APPROVED BY THE MEDICAL EXECUTIVE COMMITTEE ONCE ALL OF THE REQUESTS ARE COMPLETE. THE AMOUNT DETERMINED TO BE AVAILABLE AND APPROVED IS SET ASIDE INTO A FUNDED DEPRECIATION ACCOUNT IN WEEKLY INSTALLMENTS OVER THE COURSE OF THE FISCAL YEAR. LEWISTOWN HOSPITAL IS WHOLLY DEDICATED TO THE LIVES, HEALTH AND WELL-BEING OF THE INDIVIDUALS IN OUR COMMUNITY. ENSURING THAT ADEQUATE CAPITAL EQUIPMENT IS AVAILABLE TO PROVIDE THE BEST TREATMENT POSSIBLE FOR OUR PATIENTS IS AN EXAMPLE OF THAT DEDICATION. PART VI, LINE 7: WHILE NOT PART OF A HEALTH SYSTEM PER SE, LEWISTOWN HOSPITAL IS A PART OF THE LEWISTOWN HEALTHCARE FOUNDATION NETWORK OF RELATED ORGANIZATIONS. THE ROLE OF THE HOSPITAL AND ITS AFFILIATED ORGANIZATIONS ARE AS FOLLOWS:LEWISTOWN HOSPITAL:LEWISTOWN HOSPITAL IS A 123-BED ACUTE CARE COMMUNITY HOSPITAL SERVING THE RESIDENTS OF MIFFLIN AND JUNIATA COUNTIES AND MEMBERS OF THE SURROUNDING COUNTIES OF SNYDER, AND HUNTINGDON. ESTABLISHED IN 1905, THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, WELLNESS AND COMMUNITY SERVICES WHILE EMPLOYING OVER 1,000 FULL-TIME AND PART-TIME EMPLOYEES AND PROVIDING A MEDICAL STAFF CONSISTING OF 128 PHYSICIANS AND ALLIED HEALTH PRACTITIONERS REPRESENTING SPECIALTIES RANGING FROM FAMILY MEDICINE, INTERNAL MEDICINE, AND CARDIOLOGY TO INFECTIOUS DISEASE AND GENERAL/CARDIOVASCULAR SURGERY.THE MISSION OF LEWISTOWN HOSPITAL IS TO PROVIDE PERSONAL, HIGH-QUALITY ECONOMICAL HEALTHCARE FOR OUR COMMUNITIES.FAMILY HEALTH ASSOCIATES OF LEWISTOWN HOSPITAL (FHA):FHA, A PENNSYLVANIA NON-PROFIT CORPORATION, IS A MULTI-SPECIALTY PHYSICIAN/PRACTITIONER GROUP LOCATED IN CENTRAL PENNSYLVANIA. OUR PHYSICIANS ARE BOARD-CERTIFIED OR BOARD ELIGIBLE IN PRIMARY CARE AS WELL AS MANY SPECIALTY AREAS INCLUDING GENERAL SURGERY, PULMONARY MEDICINE, SLEEP MEDICINE, AND WEIGHT LOSS AND NUTRITION. WE ARE DEDICATED TO OUR MISSION OF PROVIDING PERSONAL, HIGH QUALITY, ECONOMICAL HEALTH CARE THAT MEETS THE NEEDS OF OUR COMMUNITIES.LEWISTOWN AMBULATORY CARE CORPORATION (LACC):LACC IS A PENNSYLVANIA NON-PROFIT ORGANIZATION THAT IS MAINLY A REAL ESTATE HOLDING COMPANY THAT OWNS AND/OR MANAGES THE NON-HOSPITAL REAL ESTATE ASSETS INCLUDING A MEDICAL OFFICE BUILDING THAT IS ATTACHED TO THE HOSPITAL. LACC ALSO MANAGES THE MEDIC 29 ADVANCED LIFE SUPPORT SERVICES (ALS). THE MEDIC 29 ALS SQUADS PROVIDE ALS SERVICE TO THE PEOPLE IN MIFFLIN AND JUNIATA COUNTIES, AS WELL AS TO PEOPLE IN PARTS OF HUNTINGDON, SNYDER, AND OCCASIONALLY PERRY COUNTIES. EMERGENCY MEDICAL TECHNICIANS - PARAMEDICS, OR PARAMEDICS FOR SHORT, STAFF THESE ALS SQUADS TWENTY-FOUR HOURS A DAY, SEVEN DAYS A WEEK. ALS SQUADS AUGMENT THE STAFF OF THE EXISTING BASIC LIFE SUPPORT (BLS) AMBULANCE TEAMS THAT OPERATE IN OUR AREAS. DURING AN EMERGENCY CALL, THE ALS SQUAD IS DISPATCHED, ALONG WITH THE BLS AMBULANCE, AND MEETS THE BLS AMBULANCE ON SCENE OR EN ROUTE TO THE HOSPITAL. THE PARAMEDIC TAKES HIS/HER EQUIPMENT AND JOINS THE BLS CREW IN THEIR AMBULANCE AND PROVIDES ALS CARE TO THE PATIENT WHILE EN ROUTE TO THE HOSPITAL. THIS ENSURES THAT YOU RECEIVE THE BEST POSSIBLE CARE AS SOON AS POSSIBLE. MEDIC 29 PRIMARILY TRANSPORTS PATIENTS TO LEWISTOWN HOSPITAL, BUT WILL ALSO TRANSPORT TO OTHER HOSPITALS BASED ON THE PATIENT'S NEEDS AND PREFERENCES. MEDIC 29 WAS ORIGINALLY PLACED IN SERVICE IN 1989 AS THE FIRST ALS PROVIDER IN THE AREA AND WAS RESPONSIBLE FOR PROVIDING ALS SERVICE TO MIFFLIN AND JUNIATA COUNTIES AND PARTS OF HUNTINGDON AND SNYDER COUNTIES. OVER THE YEARS, THE NEEDS OF THE COMMUNITY HAVE INCREASED AND MEDIC 29 HAS GROWN TO MEET THESE NEEDS BY PROVIDING FASTER ACCESS TO ALS CARE. IN 1992, MEDIC 29 INCREASED STAFF TO PROVIDE A SECOND ALS SQUAD BASED IN JUNIATA COUNTY. THE JUNIATA COUNTY PARAMEDIC SQUAD BROUGHT MUCH NEEDED ALS CARE FIFTEEN MINUTES CLOSER TO RESIDENTS IN JUNIATA COUNTY.HEALTH ENTERPRISES, INC. (HEI):HEI, A PENNSYLVANIA FOR-PROFIT ENTITY, THE ONLY ONE WITHIN THE LEWISTOWN HEALTHCARE FOUNDATION. THE MAIN PURPOSE OF HEI IS THE OPERATION OF OUR FOUR TOTAL LIFE CARE PHARMACIES (TLC PHARMACY). WE HAVE TAKEN THE ROAD LESS TRAVELED, LITERALLY, IN DETERMINING OUR SERVICE SITES. NOTICE THAT THEY ARE LOCATED IN THE MORE RURAL AREAS THROUGHOUT THE JUNIATA VALLEY TO PROVIDE CONVENIENCE AND CLOSE PROXIMITY TO OUR PHYSICIAN PRACTICES IN FAMILY HEALTH ASSOCIATES. LEWISTOWN HEALTHCARE FOUNDATION (LHF):LHF, IS A PENNSYLVANIA NON-PROFIT MEMBERSHIP CORPORATION. LEWISTOWN HOSPITAL IMPLEMENTED A CORPORATE REORGANIZATION PLAN IN 1985, ESTABLISHING LHF AS THE PARENT COMPANY OF WHICH LEWISTOWN HOSPITAL IS ONE OF ITS SUBSIDIARIES. LEWISTOWN HOSPITAL:85% OF COMMUNITY BENEFIT ACTIVITIES ARE CONTRIBUTED THROUGH LEWISTOWN HOSPITAL.FHA:FHA STAFF PARTICIPATES IN COMMUNITY HEALTH FAIRS AND SCREENINGS. SEVERAL PHYSICIANS ALSO PARTICIPATE IN MENTORSHIP PROGRAMS FOR INTERNS AND RESIDENTS. 8% OF COMMUNITY BENEFIT ACTIVITIES ARE CONTRIBUTED THROUGH FHA.LAC:THE DIRECTOR OF MEDIC 29 VOLUNTEERS MANY HOURS IN SERVICE TO SEVERAL DIFFERENT COMMUNITY ORGANIZATIONS INCLUDING:JUNIATA COUNTY AMBULANCE ASSOCIATION - 7 HOURS MIFFLIN COUNTY ALERT & ADVISORY COUNCIL - 6 HOURSLEPC - 3 HOURSEMS ASSOCIATION - 6 HOURSPA EMERGENCY HEALTH SERVICE COUNCIL - 5 HOURSIN ADDITION, THE DIRECTOR PARTICIPATES IN SEVERAL COMMUNITY HEALTH SCREENINGS. 2% OF COMMUNITY BENEFIT ACTIVITIES ARE CONTRIBUTED THROUGH MEDIC 29.HEI:MANY OF OUR SPONSORSHIPS AND CONTRIBUTIONS COME FROM HEI. IN 2011, AT TOTAL OF $17,335 WAS MADE TO THE FOLLOWING COMMUNITY ORGANIZATIONS:LEWISTOWN ROTARY4STEPUNITED WAY OF MIFFLIN-JUNIATAMIFFLIN JUNIATA PARTNERSHIPS RC & DMIFFLIN JUNIATA ARTS COUNCILJUNIATA COUNTY BUSINESS & PROFESSIONAL WOMENEXPERIENCE WORKS OF PAJUNIATA RIVER VALLEY VISITORS BUREAUPA ASSOCIATION OF HEALTHCARE AUXILIARIESMIFFLIN COUNTY YOUTH BASEBALL LEAGUEBIG BROTHERS BIG SISTERSAMERICAN RED CROSS OF SUSQUEHANNA VALLEYAMERICAN CANCER SOCIETYLEWISTOWN COUNTRY CLUBJUNIATA RIVER FESTJUNIATA VALLEY COUNCIL BOY SCOUTS ASSOCIATIONVNA - CENTRE HOME CARE5% OF COMMUNITY BENEFIT ACTIVITIES ARE CONTRIBUTED THROUGH HEI. REPORTS FILED WITH STATES PART VI, LINE 7 PA 1 LEWISTOWN HEALTHCARE FOUNDATION 400 HIGHLAND AVENUE LEWISTOWN PA 17044 232344363 501(C)(3) 3472963 CASH N/A NET ASSET TRANSFER TO FUND OPERATIONS OF RELATED ENTITY - FAMILY HEALTH ASSOCIATES OF LEWISTOWN HOSPITAL 1 EDUCATIONAL SCHOLARSHIPS 21 24000 CASH N/A PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: FUNDS WERE PROVIDED TO A RELATED ORGANIZATION UNDER COMMON MANAGEMENT TO SUPPORT OPERATIONS. THE PARTNERS IN EDUCATION SCHOLARSHIP IS A SCHOLARSHIP PROGRAM FOR EMPLOYEES OF LEWISTOWN HOSPITAL OR AN AFFILIATE WHO IS PURSUING A DIPLOMA, ASSOCIATES, BACHELORS, OR MASTERS DEGREE IN A HEALTH CARE RELATED FIELD. THE FUNDING FOR THIS IS MADE POSSIBLE THROUGH NET PROCEEDS FROM THE HOSPITAL GIFT SHOP. APPLICANTS MUST MEET CERTAIN CRITERIA AND MINIMUM TWO-PAGE ESSAY. THE APPLICATIONS AND ESSAYS ARE REVIEWED BY THE SCHOLARSHIP COMMITTEE WHICH IS COMPRISED OF 3 DIRECTOR LEVEL EMPLOYEES OF THE HOSPITAL. FINALISTS ARE AWARDED $1,000 EACH BY JUNE 1 OF EACH YEAR. THE SOPHIE SNOOK SCHOLARSHIP PROGRAM IS A SCHOLARSHIP PROGRAM IN MEMORY OF SOPHIE SNOOK, THE FIRST GRADUATE OF LEWISTOWN HOSPITAL SCHOOL OF NURSING. APPLICANTS MUST BE EITHER A FULL, PART-TIME, OR RELIEF EMPLOYEE FROM ANY OF THE HOSPITAL WHO IS PURSUING A SECONDARY DIPLOMA, CERTIFICATE OR DEGREE RELATING TO PATIENT CARE, OR A STUDENT WHO HAS BEEN ACCEPTED INTO THE LEWISTOWN HOSPITAL SCHOOL OF NURSING. APPLICANTS MUST MEET CERTAIN OTHER AND WRITE A MINIMUM TWO-PAGE ESSAGE. THE APPLICATIONS AND ESSAYS ARE REVIEWED BY THE SHOLARSHIP COMMITTEE WHICH IS COMPRISED OF MEMBERS OF THE FRIENDS OF LEWISTOWN HOSPITAL, FORMERLY THE LEWISTOWN HOSPITAL AUXILIARY. THE RECIPIENTS BY JULY 1 OF EACH YEAR. PROCEEDS TO FUND THE PROGRAM COME FROM THE FUNDRAISING ACTIVITIES OF THE FRIENDS OF LEWISTOWN HOSPITAL. SCHOLARSHIPS WILL BE OFFERED TO ENROLLED STUDENTS AT THE LEWISTOWN HOSPITAL SCHOOL OF NURSING TO OFFER FINANCIAL STUDENT SCHOLARSHIPS. TO BE ELIGIBLE, STUDENTS MUST HAVE A GPA OF 3.0 OR HIGHER, PROVE FINANCIAL NEED, SHOW ACADEMIC PROGRESSION, AND BE TAKING 6 CREDITS OR MORE. THEY MUST COMPLETE AN APPLICATION AND MEET ANY OTHER CRITERIA SPECIFIED BY THE GRANT DONORS. A SCHOLARSHIP COMMITTEE COMPRISED OF AT LEAST ONE MEMBER OF THE SCHOOL OF NURSING, ONE MEMBER OF THE FINACE DEPARTMENT, ONE MEMBER FROM THE LEWISTOWN HOSPITAL HR DEPARTMENT, AND ONE COMMUNITY MEMBER. THE COMMITTEE MEETS ON AT LEAST ANNUAL BASIS TO REVIEW APPLICATIONS. STUDENTS WHO ARE AWARDED MONIES WILL BE NOTIFIED VIA MAIL. X 1 1 X X X X X 0 0 0 0 0 0 0 0 0 KAY HAMILTON 269116 0 25000 0 3358 0 34545 0 8065 0 340084 0 0 0 RANDY TEWKSBURY 166020 0 0 0 516 0 23900 0 13853 0 204289 0 0 0 KIRK E THOMAS 132827 0 0 0 250 0 19036 0 0 0 152113 0 0 0 NITIN V SHETH MD 383264 0 224400 0 258 0 0 0 18137 0 626059 0 0 0 DAVID M NELSON 198638 0 5000 0 211 0 29118 0 13984 0 246951 0 0 0 RICHARD F STOMACKIN 144281 0 0 0 1229 0 20546 0 6769 0 172825 0 0 0 ROBERT A MONTGOMERY 120337 0 0 0 80 0 17470 0 16841 0 154728 0 0 0 PART I, LINE 1A AN AUTOMOBILE WAS LEASED FOR THE PRESIDENT AND CEO, KAY HAMILTON. THE VALUE OF THE LEASE PAYMENTS WERE RECORDED AS INCOME ON HER 2010 FORM W-2. THE AMOUNT WAS GROSSED UP FOR THE EMPLOYER SHARE OF FICA TAXES. THE TOTAL AMOUNT ADDED TO HER 2010 W-2 WAS $1,834.26. THIS ENDED MID-WAY THROUGH TAX YEAR 2010. LEWISTOWN HOSPITAL NO LONGER LEASES A CAR FOR KAY, BUT INSTEAD PROVIDES AN EXTRA ALLOWANCE IN HER SALARY. MIFFLIN COUNTY HOSPITAL AUTHORITY 231352187 598520CE2 2007-06-13 21723377 REFUNDING ON AN ADVANCE BASIS A PORTION ($19,775,000) OF SERIES 2000 BONDS 0 0 0 21723377 1722381 19561939 434468 4589 0 1 1 1 0 0 0 0 0 0 GAYLE COWAN DIRECTOR/MANAGER OF THE EDUCATION DEPARTMENT, WIFE OF RONALD COWAN, CIO 80247 WAGES AND BENEFITS PAID TO GAYLE COWAN 0 CHARLES EVERHART JR MD BOARD DIRECTOR 153564 MONTHLY ENDOSCOPY SERVICES PROVIDED TO LH BY THE ENDOSCOPY CENTER OF PA. CHARLES EVERHART JR. HAS AN 80% OWNERSHIP INTEREST IN THE ENDOSCOPY CENTER. 0 GURPREET S BHALLA MD BOARD MEMBER/PROPRIETOR OF PENN ANESTHESIA 280000 CONTRACTUAL AGREEMENT WITH LH TO PROVIDE ANESTHESIA SERVICES TO THE HOSPITAL 0 X MEDICAL EQUIPMENT 19 47838 FMV OF INVOICE 0 0 0 FORM 990, PART VI, SECTION A, LINE 4 LEWISTOWN HOSPTIAL BYLAWS SECTION 7.1.3 "A MEDICAL STAFF MEMBER WHOSE APPOINTMENT HAS NOT BEEN RENEWED OR WHOSE CLINICAL PRIVILEGES ARE REDUCED, ALTERED OR SUSPENDED WILL BE ENTITLED TO A HEARING AND APPEAL." PREVIOUSLY A MEDICAL STAFF MEMBER WAS ONLY ENTITLED TO APPEAL. LEWISTOWN HOSPITAL BYLAWS SECTION 7.3: THIS SECTION WAS ALTERED, ACCORDING TO THE JOINT COMMISSION'S MEDICAL STAFF STANDARD 01.01.01, TO NO LONGER ALLOW THE HOSPITAL THE RIGHT TO UNILATERALLY AMEND THE HOSPITAL'S MEDICAL STAFF BYLAWS AS WAS ALLOWED HISTORICALLY. FORM 990, PART VI, SECTION B, LINE 11 A FINAL DRAFT REVIEWED BY THREE LEVELS OF FINANCE STAFF WILL BE PRESENTED TO THE BOARD FOR REVIEW PRIOR TO BEING FILED. THE BOARD WILL REVIEW PRIOR TO MEETING AT A REGULARLY SCHEDULED MEETING AND DEVELOP QUESTIONS TO BE ASKED AT THE MEETING. ANY QUESTIONS SUBMITTED BY THE BOARD WILL BE RESEARCHED WITH THE PREPARER AND FINAL RESOLUTION WILL BE COMMUNICATED BACK TO THE BOARD BY THE FINANCE STAFF. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY CONFLICT OF INTEREST STATEMENTS ARE COMPLETED BY ALL BOARD MEMBERS AND KEY EMPLOYEES. THESE STATEMENTS ARE REVIEWED BY THE CHAIR OF THE LEWISTOWN HEALTHCARE FOUNDATION (PARENT COMPANY) BOARD. THE CHAIR PERSON'S CONFLICT OF INTEREST STATEMENT IS REVIEWED BY THE VICE CHAIR OF THE FOUNDATION BOARD. ANY LISTED CONFLICTS ARE BROUGHT FORTH TO THE ENTIRE BOARD FOR REVIEW AND RESOLUTION IF NECESSARY. FORM 990, PART VI, SECTION B, LINE 15 THE SENIOR EXECUTIVE STAFF INCLUDES THE CEO AND OTHER KEY EMPLOYEES. THE SENIOR EXECUTIVE STAFF HAS THEIR SALARIES, RESPONSIBILITIES ANALYZED BY AN OUTSIDE CONSULTANT SPECIALIZING IN THE EXECUTIVE COMPENSATION AREA. RECOMMENDATIONS BASED ON THE ANALYSIS ARE THEN BROUGHT TO THE BOARD. THE BOARD DETERMINES ACTUAL INCREASES BASED ON THE RECOMMENDATIONS AND FINANCES OF THE HOSPITAL. THIS ANNUAL REVIEW AND APPROVAL PROCESS IS DOCUMENTED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 AN ANNUAL REPORT IS AVAILABLE TO THE PUBLIC VIA THE ORGANIZATION'S WEBSITE. THIS REPORT SHOWS THE ANNUAL CONSOLIDATED STATEMENT OF OPERATIONS AND A CONSOLIDATED BALANCE SHEET. IT ALSO SHOWS ANNUAL OPERATING STATISTICS AND LISTS THE NAMES OF BOARD MEMBERS, SENIOR EXECUTIVE STAFF, AND THE MEMBERS OF THE MEDICAL EXECUTIVE COMMITTEE. CURRENTLY, THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. THIS INFORMATION IS CONSIDERED PROPRIETARY AND IS NOT LEGALLY REQUIRED TO BE MADE AVAILABLE TO THE GENERAL PUBLIC. FORM 990, PART VII, SECTION A: AVERAGE HOURS PER WEEK FOR LEWISTOWN HOSPITAL AND RELATED ORGANIZATIONS ARE AS FOLLOWS: KAY HAMILTON - 40 HOURS RANDY TEWKSBURY - 40 HOURS KIRK THOMAS - 42 HOURS NANCY REINKE - 40 HOURS RONALD COWAN - 40 HOUR ALL BOARD DIRECTORS - 1 HOUR CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 2,050,602. VALUATION LOSS 51,227. PENSION LIABILITY ADJUSTMENT 7,440,586. TOTAL TO FORM 990, PART XI, LINE 5: 9,542,415. LEWISTOWN AMBULATORY CARE CORPORATION 400 HIGHLAND AVENUE LEWISTOWN PA 17044 232344362 TO DEVELOP AND RENT REAL ESTATE TO ITS AFFILIATES PA 501(C)(3) 11B LEWISTOWN HEALTHCARE FOUNDATION 0 LEWISTOWN HEALTHCARE FOUNDATION 400 HIGHLAND AVENUE LEWISTOWN PA 17044 232344363 TO CONDUCT FUNDRAISING AND GRANT-MAKING ACTIVITIES TO BENEFIT RELATED ORGS. PA 501(C)(3) 11B N/A 0 FAMILY HEALTH ASSOCIATES OF LEWISTOWN HOSPITAL 400 HIGHLAND AVENUE LEWISTOWN PA 17044 251651582 TO EMPLOY PRIMARY CARE PHYSICIANS AND PROVIDE HEALTHCARE SERVICES PA 501(C)(3) 11B LEWISTOWN HEALTHCARE FOUNDATION 0 HEALTH ENTERPRISES INC 400 HIGHLAND AVENUE LEWISTOWN PA 17044 232353212 HEALTHCARE PA LEWISTOWN HEALTHCARE FOUNDATION C 0 1 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1