2011-05-12T14:14:22-05:00 2010-06-30 Carbis Walker LLP 5700 Corporate Drive Ste 650 Pittsburgh PA 15237 990 2009-07-01 251494705 Highlands Hospital HIGH 7246281500 401 East Murphy Avenue Connellsville PA 15425 officer 7246281500 2011-05-09 1 Jeffrey J Petrell CPA 4126356270 2009 2016-02-24 21:20:13Z Michelle P Cunningham 401 East Murphy Avenue Connellsville PA 15425 25355795 0 X www.highlandshospital.org X 1985 PA The Hospital serves the healthcare needs of the community and surrounding areas 12 10 448 6 0 0 500162 1013399 24967145 23892814 -203912 76856 603006 345821 25866401 25328890 0 0 13782137 13699670 0 0 12897544 12300636 26679681 26000306 -813280 -671416 10843397 11083839 10288531 10048629 554866 1035210 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 21766684 23892814 The Hospital served the healthcare needs of the community and surrounding areas with 2,636 admissions, 11,820 patient days, 58,322 outpatient visits, and 14,878 emergency room visits. The hospital provided a significant amount of healthcare to the indigent and low income individuals regardless of the ability to pay. 21766684 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 79 0 448 1 0 0 0 0 0 1 1 0 0 0 0 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 128621 0 37245 John S Andursky 40.00 X 97771 0 22621 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 RONALD DELA CRUZ 40.00 X 232090 0 11034 LASZLO PETRAS 40.00 X 145871 0 5849 Gina Canada 40.00 X 117464 0 11648 727817 0 88397 4 0 1 0 cpsi 6600 wall street Mobile AL 36695 computer support and applications 515827 bradley anesthesia pc RD 6 BOX 1162 MT PLEASANT PA 15666 anesthesiology services 400008 quest diagnostics 2769 COLLECTION CENTER DR CHICAGO IL 60693 laboratory services 336849 anesthesiology consultswpa PO Box 293 MURRYSVILLE PA 15668 crna services 335000 LARRY STEPT MD 139 YORKSHIRE DRIVE PITTSBURGH PA 15208 emergency room physician 191840 11 1013399 1013399 Patient Revenue 900099 23892814 23892814 23892814 23400 23400 23400 23400 76480 376 76480 376 76856 76856 43403 26905 16498 16498 Invest. in Open MRI of 900099 98409 98409 Miscellaneous Revenue 900099 96906 96906 Cafeteria & Snack Bar 900099 84795 84795 25813 25813 305923 25328890 23892814 0 422677 286258 286258 10088691 8459967 1628724 683500 587127 96373 1891459 1573839 317620 749762 614922 134840 117366 117366 91139 91139 130946 65672 65274 228664 228664 910471 871372 39099 10808 10808 64805 48604 16201 907509 680632 226877 426969 320227 106742 MEDICAL SUPPLIES 2343866 2343866 PURCHASED SERVICES 2316621 2240941 75680 BAD DEBT 2005629 1504222 501407 PHYSICIAN FEES 1355615 1355615 EQUIPMENT RENTAL & MAIN 453056 408838 44218 937172 680032 257140 26000306 21766684 4233622 0 1978 448906 973316 657710 3277999 3116399 163279 151483 111080 123815 21050560 16670534 4151760 4380026 1563985 2205500 600000 10843397 11083839 9364257 8837901 324274 630728 600000 580000 10288531 10048629 X -455973 -54324 638435 717130 372404 372404 554866 1035210 10843397 11083839 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 197010 197010 9219388 7669797 1549591 135150 19539 115611 11450826 8961801 2489025 48186 19397 28789 4380026 INVESTMENT IN JOINT VENTURE 464764 F ASSETS LIMITED AS TO USE 1740736 F 2205500 Line of Credit 580000 580000 25328890 26000306 -671416 68259 1083501 1151760 480344 25424054 68259 26905 95164 25328890 0 25328890 26027211 26905 26905 26000306 0 26000306 Part X: Description of Uncertain Tax Positions Under FIN 48: THE ORGANIZATION FOLLOWS THE PROVISIONS OF FINANCIAL ACCOUNTING STANDARDS BOARD ("FASB") INTERPRETATION NO. 48, "ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES - AN INTERPRETATION OF FASB STATEMENT NO. 109" ("FIN 48"). FIN 48 CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN THE ORGANIZATION'S FINANCIAL STATEMENT AND 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 IS MET. THE STANDARD ALSO PROVIDES GUIDANCE ON THE DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, AND DISCLOSURE. MANAGEMENT HAS DETERMINED THAT THE ADOPTION OF FIN 48 DID NOT HAVE A MATERIAL EFFECT ON THE CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN OPERATING EXPENESE. THERE WERE NO INTEREST OR PENALTIES RECOGNIZED ON THE CONSOLIDATED FINANCIAL STATEMENTS OF OPERATIONS AS A RESULT OF THE ADOPTION OF FIN 48. Part XI, Line 8 - Other Adjustments: accumulated liability for pension benefits: 1004806. temporarily restricted contributions: 252914. NET ASSETS RELEASED FROM RESTRICTIONS: -174219. Part XII, Line 2d - Other Adjustments: Fundraising Expenses: 26905. Part XIII, Line 2d - Other Adjustments: Fundraising Expenses: 26905. Golf Outing 26616 26616 250 1768 8929 1146 405 5K Race 16787 16787 14407 43403 43403 250 1768 8929 1146 14812 26905 16498 1 1 1 X 1 X 1 1 1 0 0 106169 106169 0.00440 5733442 3878397 1855045 0.07730 5839611 3878397 1961214 0.08170 209665 188313 21352 0.00090 3354987 3134952 220035 0.00920 26544 26544 3591196 3349809 241387 0.01010 9430807 7228206 2202601 0.09180 0 2005629 500000 4448239 4453243 -5004 X 1 1 Highlands Hospital

401 E Murphy Ave Connellsville PA 15425

X X X 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 2010. Part I, Line 7f: The Bad debt expense of 2,005,629 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 few years, 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 Michelle P Cunningham 128621 0 0 0 0 0 23456 0 13789 0 165866 0 0 0 RONALD DELA CRUZ 232090 0 0 0 0 0 0 0 11034 0 243124 0 0 0 LASZLO PETRAS 145871 0 0 0 0 0 0 0 5849 0 151720 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. FORM 990, PART XI, 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.