2011-05-16T09:32:46-05:00 2010-06-30 PARENTEBEARD LLC Suite 200 221 W PHILADELPHIA ST YORK PA 174012993 990 2009-07-01 251778644 PINNACLE HEALTH HOSPITALS PINN 7172318245 409 SOUTH SECOND ST PO BOX 8700 HARRISBURG PA 171058700 William H Pugh 7172318245 2011-05-13 1 Julius Green CPA 7178467000 2011-05-11 2009 2016-02-24 21:20:13Z William H Pugh 409 SOUTH SECOND ST PO BOX 8700 HARRISBURG PA 171058700 791853673 0 X WWW.PINNACLEHEALTH.ORG X 1996 PA INPATIENT AND OUTPATIENT non-profit HEALTHCARE SERVICES FOR CITIZENS OF THE local COMMUNITY 19 15 4544 532 4025753 0 12323223 6857923 537130580 552134240 -12152335 1334284 862508 -795480 538163976 559530967 0 0 250239731 261149682 0 0 280483556 284364093 530723287 545513775 7440689 14017192 535108496 629460924 358339823 437790572 176768673 191670352 PROVIDING BOTH INPATIENT AND OUTPATIENT HEALTHCARE SERVICES ON A NON-PROFIT BASIS FOR CITIZENS OF THE SURROUNDING COMMUNITY 0 0 451707970 532561811 Pinnacle Health Hospitals (Corp 200)Since the founding of Pinnacle Health Hospitals in 1996, its mission has been to provide quality medical treatment and health care for everyone in the community, regardless of their ability to pay. In the broad sense, this care includes social, educational and nutritional services which help people to learn better how to care for themselves. 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.In addition, a variety of health-related services and programs are provided to the community and are partially or fully subsidized by Pinnacle Health Hospitals.Finally, Pinnacle Health Hospitals provides or participates in a significant number of educational services and programs dedicated to the training of health professionals.The materials that follow describe some of the various patient services, community programs, and educational training provided by Pinnacle Health Hospitals.Community Health Improvement ServicesAs one of the largest providers of women's hospital services in the state of Pennsylvania, Pinnacle Health Hospitals offers a variety of clinical, education and support services to women in the greater Harrisburg area.Community Health EducationMammography Voucher Program (200-4301) provides a free mammography program for low income, at risk women.WomanCare Resource Centers (200-4301) offer a variety of opportunities to become better informed on health issues which affect women. These include classes, seminars, discussion groups, counseling sessions and a referral library. Membership is free to over 33,000 members.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. Kidshape is a pediatric weight management program offering education and support to children ages 6-14 and their families. Pinnacle Health has been approved as one of the KidShape facilitators, offering the free nine-week program to those families in need. (200-1076)Community health fairs.Consumer health information service provided by the LibraryCommunity 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 screening Body composition screening Prostate screening Podiatric screening Infant Development screenings Speech and hearing screenings Depression and anxiety screenings Lead Poison Bone Density Diabetes Education Nutrition Therapy Education programs Lead Poisoning Screenings Regional Cancer Center's (200-8007) 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 (200-0827) 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 (200-7187) 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. As described in the Hospital's Mission statement, Pinnacle Health System is committed to providing professional and community health education programs which will enhance the health status of the people we serve. Toward that end, Pinnacle Health Hospitals provided the following professional education programs: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. Auxilliary 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. (200-1101)Nurse/Family Partnership program (200-7021) - 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 renown, evidence based, nurse home visitation program that improvise the health, well-being and self sufficiency of low income, first time parents and their children. Children's Resource Center (200-0128) (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. 15120055 14271871 Pinnacle Health Emergency Department Services (Corp 205)Pinnacle 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 2010, Harrisburg Hospital Emergency Department had 56,926 billed patient visits and Community General Hospital had 34,118 billed patient visits. 466828025 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 0 0 4544 1 1 1 0 0 0 0 0 0 0 0 19 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 PA X William H Pugh 7172318245 409 SOUTH SECOND ST HARRISBURG PA 171058700 Robert L LYON 1.80 X X 0 0 0 ROGER LONGENDERFER MD 8.70 X X 0 687286 276616 Cynthia T Tolsma 0.20 X X 0 0 0 EDNA V BAEHRE PHD 0.50 X 0 0 0 Theodore Bernstein 1.30 X 0 0 0 JOHN O CAMPBELL 1.60 X 0 0 0 Gregory Cavoli 0.50 X 0 0 0 Susan S Cohen 1.00 X 0 0 0 Paul J Creary MD 1.00 X 0 0 0 Bony R Dawood 1.60 X 0 0 0 George F Grode 3.10 X 0 0 0 Felix Gutierrez MD 0.90 X 0 0 0 Denise F Harr MD 1.00 X 0 0 0 Mark Kimmel Esq 0.40 X 0 0 0 M Richard Kleiman 1.20 X 0 0 0 Deborah S Miller 1.40 X 0 0 0 Douglas A Neidich 0.50 X 0 0 0 Larry L Sollenberger MD 1.50 X 0 0 0 Dennis Walsh 0.60 X 0 0 0 Clarence E Asbury 2.30 X 0 0 0 Paul A Kunkel MD 0.10 X 0 0 0 William H Pugh 28.20 X 0 348480 42998 CHRISTOPHER P MARKLEY ESQ 22.00 X 0 331390 48198 RICHARD C SENECA ESQ 34.00 X 259935 0 0 KIM KELLY 40.00 X 488023 0 32068 Wendy Biedrzycki 40.00 X 327747 0 23256 Edward Hildrew 40.00 X 354332 0 58160 John Goldman 40.00 X 291575 0 34881 Julian Gutierrez 40.00 X 289720 0 41749 E Danfield-surviving sps 0.00 X 61929 0 0 E Fletcher-surviving sps 0.00 X 16143 0 0 Jesse A Weigel 0.00 X 27963 0 0 2117367 1367156 557926 131 1 1 0 Siemens Medical Solutions USA Inc PO Box 640401 Pittsburgh PA 15264 software support svcs 15416728 SODEXO PO Box 905374 Charlotte NC 28290 Food services 13830200 CPTA Inc 205 South Front Street harrisburg PA 17104 Transplant services 3191409 Up to Date Laundry Inc 1221 Desoto Road Baltimore MD 21223 Laundry services 1302746 Quest Diagnostics Nichols Institute 12436 Collections Center Drive Chicago IL 60693 diagnostic laboratory services 1153338 44 18000 532342 4677428 1630153 6857923 Patient Revenue, net 621500 547522475 543521245 4001230 contracted medical ser 621500 3018848 3018848 misc inpatient/outpati 621500 464215 464215 medical education 900099 342073 342073 Toxicology membership 900099 163050 163050 623579 623579 552134240 1258976 -1299328 2558304 7714361 9341040 -1626679 -1626679 24523 -1651202 223039315 17659 222414872 566794 624443 -549135 75308 75308 Miscellaneous Income 900099 494912 494912 Cafeteria Sales 900099 131666 131666 Parking Fees 900099 114527 114527 90094 90094 831199 559530967 546833682 4025753 1813609 265318 131492 133826 192873609 177041720 15831889 21887577 19748990 2138587 31800828 28926045 2874783 14322350 10175486 4146864 14115196 83280 14031916 54118 26821 27297 114907 52478 62429 95983 95983 54352466 40403017 13949449 1398333 179686 1218647 109877606 107357186 2520420 4473714 2761565 1712149 20838043 15371068 5466975 356294 288600 67694 942875 797416 145459 10482681 7525780 2956901 31234398 24645394 6589004 5062157 3897839 1164318 Bad Debts Expense 30018766 27016889 3001877 Temp. Restricted Donati 533293 133323 399970 Dues and Subscriptions 243229 110299 132930 Miscellaneous Expense 170034 153651 16383 545513775 466828025 78685750 0 5834 4704 803600 918392 62835194 56411226 4267522 2747263 11917900 11860354 6221045 6879061 763785898 468456950 274534601 295328948 144915461 222168206 6313933 6157458 23293406 26985312 535108496 629460924 146474989 153858256 447530 264008 187536946 253250368 9485440 11935494 14394918 18482446 358339823 437790572 X 150490279 161192189 11375319 14372294 14903075 16105869 176768673 191670352 535108496 629460924 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 12053845 12053845 372305007 199697651 172607356 10813748 4505374 6308374 308535125 253655608 54879517 60078173 10598317 49479856 295328948 Advances from Third-Party Payors 3809400 Due to third party payors 9070476 Accrued Long-Term Swap Contract 5602570 18482446 559530967 545513775 14017192 11609026 -10724539 884487 14901679 574445118 8411078 1423968 9835046 564610072 -5079105 -5079105 559530967 554757793 9341040 9341040 545416753 97022 97022 545513775 Part X: Description of Uncertain Tax Positions Under FIN 48: 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: 723547. Fund balance transfer - Pinnacle health System: 33933532. Fund balance transfer - Pinnacle Health Medical Services: -31127135. Fund Balance transfer - Pinnacle Health Home Care & Hospice: -11810893. Fund Balance Transfer - Community Life Team: -2218209. Fund Balance Transfer - Pinnacle Health Foundation: -225381. Part XII, Line 2d - Other Adjustments: Net Assets Released from Restrictions: 1425007. Investment fees reported net of investment income: -1039. Part XII, Line 4b - Other Adjustments: Restricted Contributions: 4266815. Investment income from restricted assets: 26065. Net realized losses from sale of restricted investments: -563287. rental expenses shown net of rental income: -9341040. Unrestricted contributions from Pinnacle Health Foundation: 532342. Part XIII, Line 2d - Other Adjustments: rental expenses shown net of rental income: 9341040. 1 1 X 1 X 250.000000000000 1 X 1 1 1 0 1 1 4905299 0 4905299 0.00950 58093699 39663691 18430008 0.03580 0 0 62998998 39663691 23335307 0.04530 2261213 280 2260933 0.00440 13425882 5466589 7959293 0.01540 29274 0 29274 0.00010 0 0 3611946 0 3611946 0.00700 19328315 5466869 13861446 0.02690 82327313 45130560 37196753 0.07220 71813 0 71813 0.00010 196 0 196 0.00000 22298 0 22298 0.00000 94307 94307 0.00010 1 12796705 4172467 113773577 111571221 2202356 X 1 1 West Shore Surgery Center Ltd Surgical Care - Medical Services 0.49000 0.00000 0.49000 Susquehanna Valley Surgery Center Surgical Care - Medical Services 0.50000 0.00000 0.50000 Pinnacle Health Hospitals - Harrisburg

111 South Front Street Harrisburg PA 17101

X X X X X Pinnacle health Hospitals - Community

4300 Londonderry Road Harrisburg PA 17109

X X X X X 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, Line 7g: The subsidized health services include costs associated with the expanded Emergency Room services during Fiscal Year 2010 to respond to the H1N1 Flu Pandemic to meet the needs of the community for testing and response. The subsidized services also include prescription medications that were provided at no or very little cost to inpatients that otherwise would not have been able to obtain the medications. Part I, Line 7f: 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 $30,018,766. 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 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. The entire amount should be treated as community benefit as this shortfall must be supplemented by the community through higher charges and payor rates. 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 at all the registration sites. In addition, the patient account statements contain language that indicates there is financial aid available for qualifying individuals. Furthermore, the Hospital contracts with a third party, MedeAnalytics, to review patient data to determine if certain patient accounts may qualify for charity care. Once the data is reviewed and the patient account indicates it may be possible for charity care, the patient may be contacted in writing of the policy and provided an application. Not all patients receive an application as it is a case by case basis depending on each patient's financial situation. Once the patient returns to the Hospital a completed application, along with supporting documentation, the Hospital will review the data and provide a determination within two weeks. If approved, the discount is applied to all open accounts and is effective for six months from the date of approval. Patients provided partial financial aid discounts are expected to make reasonable payment arrangements. Part VI, Line 2: As a co-sponsor of the 2007 Community Needs Assessment conducted by the Drexel University School of Public Health, Pinnacle Health 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. Pinnacle Health Hospitals has 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.Pinnacle Health Hospitals 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. Pinnacle searches the Health Indicators Warehouse for data related to Healthy People 2020 objectives developed by the National Center for Health Statistics. 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. Part VI, Line 3: Patients are informed of available assistance in numerous ways. Signage is posted 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 our financial counselors to discuss the financial assistance options available to them. 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 the hospital endowment. 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 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 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 population. Other demographic statistics of Harrisburg include 27.9 percent of the population is under the age of 18, 39.4 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 81.9 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 47th out of a total of 67 Pennsylvania Counties in an assessment of the overall health of each county. The PA department of health 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, breast cancer incidence, lung cancer incidence, heart disease and stroke. Part VI, Line 5: Pinnacle Health Hospitals' long standing relationship with the local community positions us as a leader at improving the community's overall well-being. We actively support the United Way of the Capital Region and our Senior Leadership leads a charge to incrementally increase employee giving and financial support. We work collaboratively with the Harrisburg Chamber of Commerce to improve the economic development of the community including the Harrisburg Downtown Improvement District and Team Pennsylvania Foundation to help build and retain a qualified workforce in Pennsylvania. The Pinnacle Health Foundation granted the Latino Hispanic American Community Center a computer to allow clients to access the internet to apply for public assistance programs including job placement and health insurance. As previously noted, Pinnacle Health co-sponsored the 2007 Community Needs Assessment conducted by the Drexel University School of Public Health, to provide the community evidence-based findings to outline community health improvement strategies. Additionally Pinnacle Health Hospitals supports the Institute for Cultural Partnerships to facilitate opportunities for understanding among diverse cultures and communities. Pinnacle Health Hospitals' staff collaborates with traditional health care focused organizations including the American Health Association, American Lung Association, American Cancer Society, American Diabetes, YMCA, and Central Pennsylvania Food Bank to provide resources and expertise.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. 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. 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.Recently, Pinnacle Health Hospitals initiated the creation of a jointly owned psychiatric hospital in collaboration with Hershey Medical Center. This venture was pursued due to growing community needs for psychiatric services and closing of the state-operated psychiatric hospital.As a trusted place for our community to go for access to public health services and information, our staff of professionals meets the needs of a diverse population with cultural awareness and sensitivity. In 2009, the Children's Resource Center evaluated 877 children in the region for child abuse which is an increase over prior years. More than 5,000 children were screened for lead poisoning with 13% confirmations of poisoning. Since the inception of the lead poisoning screening program in 2004, we have assisted more than 872 patients with medication assistance, with a growing number being served each year. More than 450 active HIV positive patients are served by Pinnacle Health Hospitals while the numbers continue to grow by 13% each year. These initiatives are part of over $62 million of uncompensated care, charity care and community benefits provided by Pinnacle Health Hospitals to those in need in Central Pennsylvania.Many of the community needs are initially addressed through the emergency departments of Pinnacle Health Hospitals where more than 90,000 patients are seen each year. In addition, women and children's clinics are provided for those without insurance or with minimal ability to pay. In 2008, 16,700 visits were provided through the Women's Outpatient Health Center and 18,743 were provided through the Children and Teen Center.Although in its infancy stages, Pinnacle is convening a network of health centers to broaden its reach to the underserved populations. The Keystone Community Care Continuum includes four Community Health Centers working collaboratively with Pinnacle Health Hospitals' leadership to develop information technology to improve access to and integration of care for our regions most needy populations. The three main goals are to increase access to care, build capacity and performance of community clinics, and enhance coordination of care between Pinnacle Health Hospitals and community clinics. Part VI, Line 6: 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. Currently more than 85% of the medical staff of the Hospital is community based. Other community based medical staff which serve at the hospital include nurse practitioners, physician assistants, psychologists and nurse midwives. The hospital also provides training for both medical students and residents in a number of specialties. The Hospital has two ACGME accredited residency programs as well as four AOA accredited teaching programs. The Hospital uses its surplus funds to renovate and expand patient care areas included to provide patient services which may not be currently available in the community. Recent projects include a $28 million project to renovate and expand the Emergency Department at the Harrisburg Hospital due to the importance of this area in the Harrisburg community, a greater than $28 million dollar project to create expanded oncology services to the greater Harrisburg community and additional expansion and renovation to existing sites within the Hospital campuses to ensure the Hospital is meeting the needs of the community we serve. 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.-Improving the Health of Our Youth Program - 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 7: Pinnacle Health Hospitals is part of the Pinnacle Health System, a fully integrated, affiliated health care system. The system is comprised of six 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 Homecare is dedicated to providing high quality, holistic home care services to homebound individuals of all ages with intermittent skilled needs. Pinnacle Health Hospice is dedicated to providing comprehensive, individualized, quality care to terminally ill adults, children and their families regardless of personal or financial circumstances. Pinnacle Health Medical Services is primarily engaged in the provision of physician services to support and enhance the services within Pinnacle Health Hospitals and Pinnacle Health System. 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 $121,129 of charity care. 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 - $858,404 in Community Health Improvement Services, Health Professions Education, Community Benefit Operations and Cash and In-kind contributions-Pinnacle Health Medical Services - $672,395 in Community Health Improvement Services-Pinnacle Health Home Care & Hospice - $226,000 in Subsidized health services-Pinnacle Health Foundation - $11,791 in Community Benefit OperationsThe above community benefit activities would have contributed an additional 0.34% of benefit provided to the central Pennsylvania community had they been reportable by the Pinnacle Health Hospital. 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 procedures and a bereavement camp for children and teens. PA X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 ROGER LONGENDERFER MD 0 574336 0 86636 0 26314 0 223989 0 52627 0 963902 0 0 William H Pugh 0 298589 0 35726 0 14165 0 13627 0 29371 0 391478 0 0 CHRISTOPHER P MARKLEY ESQ 0 267132 0 29268 0 34990 0 14833 0 33365 0 379588 0 0 RICHARD C SENECA ESQ 259935 0 0 0 0 0 0 0 0 0 259935 0 0 0 KIM KELLY 483583 0 0 0 4440 0 14846 0 17222 0 520091 0 0 0 Wendy Biedrzycki 327747 0 0 0 0 0 11364 0 11892 0 351003 0 0 0 Edward Hildrew 236199 0 11463 0 106670 0 33246 0 24914 0 412492 0 0 0 John Goldman 204765 0 62210 0 24600 0 12308 0 22573 0 326456 0 0 0 Julian Gutierrez 185734 0 9425 0 94561 0 14730 0 27019 0 331469 0 0 0 E Danfield-surviving sps 61929 0 0 0 0 0 0 0 0 0 61929 0 0 0 E Fletcher-surviving sps 16143 0 0 0 0 0 0 0 0 0 16143 0 0 0 Jesse A Weigel 27963 0 0 0 0 0 0 0 0 0 27963 0 0 0 Part I, Line 1a Roger Longenderfer, M.D., President and CEO, received a reimbursement for personal financial services. The reimbursement was included in his taxable compensation. Part I, Line 4a Roger Longenderfer, M.D., President and CEO was covered by a 457(f) Supplemental Retirement Agreement (SERP) which was not funded in the current year. Dauphin County General Authority 232336949 23825ECL6 2009-06-24 187538449 refund Series 2004, 2005 & 2007, SWAP termination, capital projects 0 0 Dauphin County General Authority 232336949 23825ecx0 2009-08-31 70000000 Capital projects 0 0 187538449 9493675 168307000 2962259 6775515 2009 1 0 1 1 70000000 16184997 536506 53278497 0 0 0 1 0 0 0 0 1 0.00000 0.02060 0.02060 1 0 0 0 0 1 0.00000 0.00780 0.00780 1 0 0 1 Citigroup 30.000000000000 0 0 0 0 1 0 0 0 0 Denise F Harr MD Partner with Heritage Medical Group Board Director 450000 See Sch O - Contract termination related to Hospitalist coverage agreement with medical group in which Dr. Harr is a Partner. Payment was made to the group, not Dr. Harr directly. 0 Felix Gutierrez MD President of Moffitt Heart & Vascular Group Board Director 360217 See Sch O - Cardiology services agreement with medical group in which Dr. Gutierrez is an owner. Payment was made to the group, not Dr. Gutierrez directly. 0 0 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 Form 990's 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 interest 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's 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. Roger Longenderfer, M.D. William H. Pugh Richard C. Seneca, Esq. Form 990, Part XI, Line 2C: Pinncale 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 LLC 409 SOUTH SECOND STREET PO BOX 8700 HARRISBURG PA 17105 861057582 Medical Emergency Services PA 14271871 1533802 N/A pinnacle health cumberland condominium association 409 SOUTH SECOND STREET PO BOX 8700 hARRISBURG PA 171058700 208977427 Condominium Association PA 0 6251 N/A Pinnacle health System 409 South Second Street PO Box 8700 Harrisburg PA 171058700 251778658 management and consultative services for related entities PA 501(c)(3) Line 11c, III-FI N/A Pinnacle health Medical Services 409 South Second Street PO Box 8700 harrisburg PA 171058700 251709054 Physician services PA 501(c)(3) Line 3 N/A 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 N/A Community Life TEam 409 South Second Street PO Box 8700 harrisburg PA 171058700 231890444 Medical transport services PA 501(c)(3) Line 9 N/A Pinnacle health HomeCare & Hospice 409 South Second Street PO Box 8700 harrisburg PA 171058700 232024121 skilled homecare services and services to terminally ill PA 501(c)(3) Line 3 N/A West Shore Surgery Center Ltd 409 South Second Street PO Box 8700 harrisburg PA 171058700 251821415 surgical care - medical services PA N/A related 1071101 1313787 0 0 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 HM 2450 Hamilton HM JX BD captive insurance BD 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 627144 west shore surgery center Ltd Q 270102 Pinnacle Health Home Care & Hospice A 155861 Pinnacle Health Home Care & Hospice Q 160008