2023-05-15T13:21:26-05:00 2022-06-30 FORVIS LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2021-07-01 250965579 TITUSVILLE AREA HOSPITAL % CORY JACKSON TITU 8148271851 406 WEST OAK STREET TITUSVILLE PA 16354 LEE CLINTON CEO 8148271851 2023-05-15 true JILL NEELY 999009999 Brian D Todd P00422601 4178658701 2 2021 2023-04-26 12:10:37Z LEE M CLINTON 406 WEST OAK STREET TITUSVILLE PA 16354 58557505 false X WWW.TITUSVILLEHOSPITAL.ORG X 1900 PA TAH IS A COMMUNITY BASED, ACUTE CARE, CRITICAL ACCESS HOSPITAL PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY SERVICES TO MORE THAN 30,000 PEOPLE IN 4 COUNTIES IN PA. 10 10 278 10 0 0 3918755 2791518 49586372 54906574 -43 73665 628461 742332 54133545 58514089 0 0 0 0 25272860 26871728 0 0 0 23895608 25579796 49168468 52451524 4965077 6062565 32246845 26664118 23064409 12277166 9182436 14386952 TITUSVILLE AREA HOSPITAL IS COMMITTED TO PROVIDING QUALITY HEALTHCARE SERVICES WITH AN EMPHASIS ON PERSONAL ATTENTION, COMPASSION AND RESPECT. false false 44219673 54906574 TITUSVILLE AREA HOSPITAL IS AN ACUTE CARE, CRITICAL ACCESS RURAL HOSPITAL WITH 795 ADMISSIONS, 4,624 PATIENT DAYS AND 74,476 OUTPATIENT VISITS. 44219673 true true false true false false false false false false true true false false true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true true false false true X 35 0 true 278 true false false false false false false false false false false false false X 10 10 true false false false true true true true true false false true true true true true true true true false PA X CORY JACKSON 8143335766 704 N MAIN ST MEADVILLE PA 16335 X MICHAEL DVORKIN PHYSICIAN 40.0 0.0 X 600612 0 11024 DWAIN ROGERS PHYSICIAN 40.0 0.0 X 395071 0 7258 LEE M CLINTON CEO/PRESIDENT 35.0 5.0 X 340458 0 13914 ROSE COLT PHYSICIAN 40.0 0.0 X 249032 0 7479 JAMES WILKENS PHYSICIAN 40.0 0.0 X 230934 0 10301 MARIA MUNOZ PHYSICIAN 40.0 0.0 X 225019 0 6779 CORY JACKSON MMC CONTROLLER/TREASURER 2.0 38.0 X 0 171835 12586 PATRICIA WALKER DIRECTOR 1.0 1.0 X 0 0 0 JOSEPH CARTER DIRECTOR 1.0 1.0 X 0 0 0 STEPHEN COLEMAN SECRETARY 1.0 1.0 X X 0 0 0 KENNETH WINGER DIRECTOR 1.0 2.0 X 0 0 0 JASON REAGLE CHAIRMAN 1.0 1.0 X X 0 0 0 SCOTT MCALLISTER MD DIRECTOR 1.0 1.0 X 0 0 0 MICHAEL R THOMSON DIRECTOR 1.0 1.0 X 0 0 0 BRIAN NAGEOTTE DIRECTOR END 09/21 1.0 2.0 X 0 0 0 MARK MEHLENBACHER DIRECTOR END 09/21 1.0 1.0 X 0 0 0 RICHARD CARR DIRECTOR 1.0 1.0 X 0 0 0 LARRY FLEDDERMAN VICE CHAIRMAN 1.0 2.0 X X 0 0 0 NICOLA FISHER DIRECTOR BEG 09/21 1.0 4.0 X 0 0 0 2041126 171835 69341 12 false true false OIL VALLEY INTERNAL MEDICINE ASSOCI 339 W SPRING ST TITUSVILLE PA 16354 MEDICAL PURCH SVCS 1821300 OIL VALLEY PHYSICAL THERAPY 228 E CENTRAL AVE TITUSVILLE PA 16354 PHYSICAL THERAPY 948541 EMCARE 7032 COLLECTION CENTER DR CHICAGO IL 60693 ER PHYSCIANS 828132 MAXIM HEALTHCARE 7227 LEE DEFOREST DRIVE COLUMBIA MD 21046 HEALTHCARE STAFFING 751329 ANETHESIA CONSULTANTS 1034 GROVE ST MEJADVILLE PA 16354 ANETHESIA SERVICES 690651 17 21987 2386471 383060 2791518 NET PATIENT SERVICE REVENUE 621990 51594673 51594673 PHARMACY REVENUE 446110 2481927 2481927 RHC REVENUE 621498 250120 250120 CAFETERIA REVENUE 811000 85697 85697 OTHER REVENUE 900099 494157 494157 54906574 0 0 0 129223 40197 89026 0 89026 89026 76884 3219 73665 73665 73665 0 0 0 0 0 0 0 0 0 INCOME FROM EQUITY INVESTEE 900099 653306 653306 653306 58514089 54906574 815997 X 0 0 0 0 354372 354372 0 20916243 17459210 3457033 473102 420779 52323 3658181 3089241 568940 1469830 1181074 288756 486610 486610 1125 1125 151858 151858 0 0 0 11400356 9972159 1428197 105062 105062 469803 262465 207338 0 0 2019632 2019632 67056 49533 17523 0 25084 21033 4051 79 79 0 1675925 1340740 335185 1418213 1366925 51288 MEDICAL SUPPLIES & DRUGS 7167093 6661018 506075 MISCELLANEOUS EXPENSE 460576 206657 253919 LICENSES, DUES, SUBSCRIPTIONS 131324 64066 67258 52451524 44219673 8231851 0 4720647 851366 3725 3391 0 0 3731413 2870183 0 0 0 0 0 0 1016159 1004910 542227 848478 44662730 32355113 12663393 12307617 5684462 4772364 3067795 3220895 0 0 20980 82940 796044 701974 32246845 26664118 4751030 3275065 0 0 915208 437967 0 0 0 0 0 0 9434 0 0 0 17388737 8564134 23064409 12277166 X 4870899 10886733 4311537 3500219 9182436 14386952 32246845 26664118 X 6062565 -205322 -652727 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 9618 9618 false SCHEDULE C, PART II-B, LINE 1(I) OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAYS DUES TO THE AMERICAN HOSPITAL ASSOCIATION, OF WHICH $9,816 IS ATTRIBUTABLE TO LOBBYING. 0 797350 797350 0 14637308 11298721 3338587 0 2859597 202992 2656605 0 24943432 20241182 4702250 0 1425043 612218 812825 12307617 INVESTMENT - VANTAGE 107656 F INVESTMENT - CHART 3113239 C 3220895 0 DUE TO AFFILIATES 6103910 EST AMOUNTS TO 3RD PARTY 1533237 CONTRACT LIABILITIES 844047 OPERATING LEASE LIABILITY 82940 8564134 58348964 -205322 -205322 58554286 -40197 -40197 58514089 52491721 40197 40197 52451524 52451524 SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITION: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ ( 40,197) RENTAL EXPENSES SCHEDULE D, PART XII, LINE 2D AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25: $ 40,197 RENTAL EXPENSES true true X true X true X true true true false true true 275715 275415 0.00530 9655597 12556407 -2900810 9931312 12556407 -2625395 0.00530 13210984 6943234 6267750 0.11950 17107 17107 0.00030 13228091 6943234 6284857 0.11980 23159403 19499641 3659462 0.12510 false 1559805 372088 10117020 9582343 534677 X true false 1 1 TITUSVILLE AREA HOSPITAL 406 WEST OAK STREET TITUSVILLE PA 16354 WWW.TITUSVILLEHOSPITAL.ORG 200901 X X X X TITUSVILLE AREA HOSPITAL 1 false false true X X X X X X X X X 22 true true true true X SEE PART V, SECTION C X SEE PART V, SECTION C X true 22 true SEE PART V, SECTION C false true X 200. 300. X X X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY INPUT: THE RESEARCH PROCESS INCLUDED A WIDE BASED SURVEY OF THE POPULATION. THE SURVEY INCLUDED INPUT FROM UNDERREPRESENTED GROUPS IN PUBLIC HOUSING. ELECTRONIC SURVEYS WERE COMPLETED. A GOOD DIVERSITY OF RESPONSE WAS REALIZED. SCHEDULE H, PART V, SECTION B, LINE 6A OTHER HOSPITAL FACILITIES: THE CHNA REPORT WAS CONDUCTED WITH MEADVILLE MEDICAL CENTER, AN AFFILIATED ENTITY. SCHEDULE H, PART V, SECTION B, LINE 6B OTHER ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES: THE CHNA REPORT WAS CONDUCTED WITH ALLEGHENY COLLEGE AND VARIOUS LOCAL COMMUNITY PARTNERS. SCHEDULE H, PART V, SECTION B, LINE 7A HOSPITAL FACILITY'S WEBSITE: HTTPS://WWW.TITUSVILLEHOSPITAL.ORG/PATIENT-VISITORS/COMMUNITY-HEALTH-NEEDS -ASSESSMENT.ASPX SCHEDULE H, PART V, SECTION B, LINE 7B OTHER WEBSITE: HTTPS://WWW.MMCHS.ORG/PATIENT-VISITORS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. ASPX SCHEDULE H, PART V, SECTION B, LINE 10 IMPLEMENTATION STRATEGY WEBSITE: HTTPS://WWW.TITUSVILLEHOSPITAL.ORG/PATIENT-VISITORS/COMMUNITY-HEALTH-NEEDS -ASSESSMENT.ASPX SCHEDULE H, PART V, SECTION B, LINE 11 ADDRESSING IDENTIFIED NEEDS: IN RESPONSE TO THE RESULTS OF TITUSVILLE AREA HOSPITAL'S (TAH) MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT, THE ORGANIZATION ADOPTED AN IMPLEMENTATION STRATEGY. THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) CONDUCTED IN COLLABORATION BETWEEN MEADVILLE MEDICAL CENTER, TITUSVILLE AREA HOSPITAL AND ALLEGHENY COLLEGE LOOKED AT DATA COLLECTED FROM MORE THAN 1,100 ADULT PARTICIPANTS FROM ACROSS CRAWFORD COUNTY. ONLINE SURVEYS SHOWED A NEED TO SUPPORT COMMUNITY MEMBERS IN LEADING A HEALTHIER LIFESTYLE. INTERNAL DATA AND SURVEY DATA ALIGNED TO IDENTIFY LONGER THAN ACCEPTABLE WAIT TIMES FOR CERTAIN HEALTHCARE SERVICES. 7.1% OF RESPONDENTS STATED THEY DID NOT ACCESS MEDICAL CARE WHEN THEY NEEDED IT BECAUSE WAIT TIMES WERE TOO LONG AND WAIT TIMES OF UP TO MANY MONTHS FOR A NEXT AVAILABLE APPOINTMENT IN CERTAIN OFFICES MAKES THIS A PRIORITY FOCUS. COST OF HEALTHCARE, ALONG WITH NATIONWIDE ECONOMIC CONDITIONS, IS A CONCERN. TAH REMAINS A LOW-COST HEALTHCARE PROVIDER IN THE REGION, ACCORDING TO THE PENNSYLVANIA HEALTH CARE COST CONTAINMENT COUNCIL, HOWEVER WITH RISING INSURANCE DEDUCTIBLES, CO-PAYS AND INCREASING LABOR AND SUPPLY COST MANAGING OPERATIONAL EXPENSES IS A PRIORITY. IN THE 2016 CHNA, 73% OF ALL RESPONDENTS SAID THEY HAD AN ANNUAL CHECKUP IN THE PRIOR YEAR WHILE IN 2022 80% HAVE RECEIVED A CHECK-UP IN THE PRIOR YEAR. DURING THE 2019 CHNA THERE WAS A DECREASE OF 14% AMONG RESPONDENTS WHO STATED THEY HAD A PRIMARY CARE PHYSICIAN. THE GOAL IS TO CONNECT INDIVIDUALS WITH A CONSISTENT CARE PROVIDER, BUT OUR HOPE IS THE MOST RECENT DATA SHOWS THERE HAS BEEN A POSITIVE IMPROVEMENT IN INDIVIDUALS GETTING ROUTINE SCREENINGS. IN THE 2016 CHNA 14% OF RESPONDENTS SAID THEY USED TOBACCO, IN 2019 35% REPORTED SMOKING (CURRENT AND FORMER) AND IN 2022 9.2% REPORTED USING TOBACCO. THIS DECREASE REFLECTS POSITIVE OUTCOMES FROM PRIOR STRATEGIES WHICH WILL CONTINUE INTO THE FUTURE. THE MOST IMPORTANT HEALTH ISSUE IN OUR COMMUNITY, SELECTED BY 63% OF RESPONDENTS, IS MENTAL HEALTH. INCREASING ACCESS TO BEHAVIORAL HEALTH SERVICES BY ADDING ADDITIONAL PROVIDERS AND CONNECTING WITH INDIVIDUALS IN REMOTE AREAS OF THE COUNTY IS CRITICAL. PEDIATRIC COUNSELORS AND SUPPORT SERVICES ACROSS THE COUNTY AND IN THE SCHOOLS NEEDS TO BECOME A COMMUNITY-WIDE PRIORITY. SCHEDULE H, PART V, SECTION B, LINES 16A, 16B & 16C FAP, FAP APPLICATION, AND PLS WEBSITE: HTTPS://WWW.TITUSVILLEHOSPITAL.ORG/PATIENT-VISITORS/BILLING-INSURANCE/ FINANCIAL-ASSISTANCE.ASPX 7 CONNEAUT VALLEY HEALTH CENTER 906 WASHINGTON ST CONNEAUTVILLE PA 16406 FAMILY MEDICINE CAMBRIDGE SPRINGS HEALTH CENTER 118 RAILROAD ST CAMBRIDGE PA 16403 FAMILY MEDICINE CONNEAUT LAKE HEALTH CENTER 10926 PA-18 CONNEAUT LAKE PA 16316 FAMILY MEDICINE MEADVILLE COMMUNITY HEALTH 747 TERRACE ST MEADVILLE PA 16335 FAMILY MEDICINE SAEGERTOWN MEDICAL ASSOCIATES 707 ERIE ST SAEGERTOWN PA 16443 FAMILY MEDICINE VALLEY DENTAL CENTER 906 WASHINGTON STREET CONNEAUTVILLE PA 16406 DENTAL SERVICES ALDEN PRIMARY CARE 640 ALDEN ST MEADVILLE PA 16335 FAMILY MEDICINE SCHEDULE H, PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR USED EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25 OF THE FORM 990. SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1, 3 AND 6. SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT EXPENSE: THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HEALTH SYSTEM DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HEALTH SYSTEM'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2022. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2. SCHEDULE H, PART III, SECTION A, LINE 3 BAD DEBT EXPENSE ATTRIBUTABLE TO FAP-ELIGIBLE PATIENTS: BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING POVERTY LIMIT DEMOGRAPHIC INFORMATION OBTAINED THROUGH THE US CENSUS BUREAU. THIS AMOUNT EXPENSED BY THE ORGANIZATION IS ATTRIBUTABLE TO LOW INCOME INDIVIDUALS IN THEIR TARGET COMMUNITY AND IS CONSIDERED A COMMUNITY BENEFIT. SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT EXPENSE FOOTNOTE: THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE. THAT NOTE CAN BE FOUND ON PAGE 14 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION B, LINE 8 COSTING SOURCE: MEDICARE DATA COMPUTED USING THE MEDICARE COST REPORT FILED WITH CMS WAS UTILIZED FOR THE COMPUTATIONS IN PART III, SECTION B. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: TITUSVILLE AREA HOSPITAL COMPLETES A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT ON A REGULAR BASIS TO DETERMINE HEALTH CARE NEEDS. THE MOST RECENT ASSESSMENT WAS COMPLETED IN 2022. TITUSVILLE AREA HOSPITAL WORKS WITH MANY COMMUNITY PARTNERS INCLUDING HEALTH AND HUMAN SERVICE PROVIDERS, EDUCATION, GOVERNMENT, FAITH, LAW ENFORCEMENT, AND OTHER INTERESTED PARTIES IN COMPLETING THE ASSESSMENT OF THE COMMUNITY HEALTH NEEDS. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: THE CHARITY CARE POLICY IS POSTED IN ADMISSIONS AND EMERGENCY ROOM AREAS. COPIES OF THE CHARITY CARE POLICY ARE AVAILABLE IN ADMISSIONS AREA AND EMERGENCY ROOM AREAS. IF A PERSON IS ADMITTED WITH NO INSURANCE THEY ARE VISITED BY A FINANCIAL AID COUNSELOR AND MADE AWARE OF THEIR OPTIONS. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: TITUSVILLE AREA HOSPITAL SERVES RESIDENTS OF CRAWFORD, FOREST, WARREN, AND VENANGO COUNTIES IN PENNSYLVANIA. THE MAIN SERVICE AREA IS CRAWFORD COUNTY. CRAWFORD COUNTY IS A RURAL AREA WITH A POPULATION OF APPROXIMATELY 83,938. THE 2020 ESTIMATED MEDIAN HOUSEHOLD INCOME WAS $51,919, WHICH IS WELL BELOW THE PENNSYLVANIA ESTIMATED HOUSEHOLD INCOME OF $63,627. APPROXIMATELY 12.5% OF RESIDENTS LIVE IN POVERTY. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: OUR STAFF IS COMMITTED TO THE CARE AND IMPROVEMENT OF LIFE. IN RECOGNITION OF THIS COMMITMENT, WE STRIVE TO DELIVER HIGH-QUALITY AND COST-EFFECTIVE HEALTHCARE WITH AN EMPHASIS ON COMPASSION, PERSONAL ATTENTION AND RESPECT. WE BELIEVE IN THE FOLLOWING VALUES: -WE WILL MEET OR EXCEED COMMUNITY STANDARDS FOR CARE EXPECTATIONS OF PATIENTS AND FAMILIES. -WE WILL MAINTAIN A POSITIVE AND FULFILLING WORKING ATMOSPHERE THAT BOTH MOTIVATES AND ALLOWS CAREGIVERS AND SUPPORT STAFF TO GIVE THEIR BEST. -WE WILL ENSURE THAT THE ORGANIZATION IS ADEQUATELY COMPENSATED FOR SERVICES PROVIDED, THEREBY MAINTAINING VIABILITY AS A CRITICAL REGIONAL HEALTHCARE AND ECONOMIC ASSET. -OUR VISION IS TO PROVIDE ACCESS TO HIGH QUALITY HEALTHCARE SERVICES ENHANCED BY HIGH TECHNOLOGY APPROPRIATE TO COMMUNITY NEED. -WE WILL MAINTAIN A HIGHLY QUALIFIED MEDICAL AND SUPPORT STAFF IN A POSITIVE WORKING ENVIRONMENT FOCUSED ON EXCELLENCE. A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS RESIDING IN PRIMARY SERVICE AREA AND ARE NOT EMPLOYEES OR CONTRACTORS OF THE ORGANIZATION OR FAMILY MEMBERS. THE ORGANIZATION USES SURPLUS FUNDS TO PROVIDE THE LATEST IN TECHNOLOGY TO IMPROVE PATIENT CARE. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: MEADVILLE MEDICAL CENTER (MMC) IS A CORPORATE MEMBER ALONG WITH TITUSVILLE AREA HEALTH CENTER. AS OF THE DATE OF ACQUISITION, MMC HAS DIRECT AUTHORITY OVER THE STRATEGIC, FINANCIAL, AND OPERATIONAL DIRECTION OF TITUSVILLE AREA HEALTH CENTER, INC. AND AFFILIATES. TITUSVILLE AREA HEALTH CENTER, INC. AND AFFILIATES (HEALTH CENTER) CONSISTS OF TITUSVILLE AREA HEALTH CENTER, INC. (PARENT), TITUSVILLE AREA HOSPITAL (HOSPITAL), THE TITUSVILLE AREA HEALTH CENTER FOUNDATION (FOUNDATION) AND TITUSVILLE AREA HEALTH SERVICES, INC. (HEALTH SERVICES). THE HOSPITAL PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES TO PATIENTS IN TITUSVILLE, PENNSYLVANIA, AND THE SURROUNDING AREA. THE FOUNDATION WAS ESTABLISHED TO RECEIVE, ADMINISTER AND DISTRIBUTE FUNDS AND PROPERTY FOR THE BENEFIT AND SUPPORT OF THE HEALTH CENTER AND AFFILIATES. HEALTH SERVICES OPERATES SEPARATELY FROM THE HOSPITAL OFFERING MULTISPECIALTY FAMILY MEDICINE PEDIATRICS TO PATIENTS IN TITUSVILLE, PENNSYLVANIA, AND THE SURROUNDING AREA. X X X false false false false false true false true false CORY JACKSON MMC CONTROLLER/TREASURER 0 159049 0 12478 0 308 0 7014 0 5572 0 184421 0 0 LEE M CLINTON CEO/PRESIDENT 282762 0 57413 0 283 0 11600 0 2314 0 354372 0 0 0 DWAIN ROGERS PHYSICIAN 393781 0 0 0 1290 0 0 0 7258 0 402329 0 0 0 MICHAEL DVORKIN PHYSICIAN 576802 0 20000 0 3810 0 7250 0 3774 0 611636 0 0 0 MARIA MUNOZ PHYSICIAN 195081 0 27958 0 1980 0 4745 0 2034 0 231798 0 0 0 JAMES WILKENS PHYSICIAN 228954 0 0 0 1980 0 5714 0 4587 0 241235 0 0 0 ROSE COLT PHYSICIAN 248792 0 0 0 240 0 6251 0 1228 0 256511 0 0 0 SCHEDULE J, PART I, LINE 6A CONTINGENT COMPENSATION: THE ORGANIZATION PAYS AN INCENTIVE TO ITS OFFICERS, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES THAT ARE CONTINGENT ON A POSITIVE TOTAL MARGIN OF THE ORGANIZATION. SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS: PHYSICIANS RECEIVE A BONUS BASED ON RVU (RELATED VALUE UNITS), WHICH IS A MEASUREMENT SET BY MEDICARE. FORM 990, PART V, LINES 1A, 2A, & 2B AND PART IX, LINES 5-10 REPORTING AGENT: MEADVILLE MEDICAL CENTER (EIN: 25-1512436), A RELATED ORGANIZATION, FILES ALL INFORMATIONAL RETURNS AND EMPLOYMENT TAX RETURNS ON BEHALF OF TITUSVILLE AREA HOSPITAL. THE NUMBER OF 1099'S AND W2'S FILED FOR THE HOSPITAL HAS BEEN REPORTED ON LINES 1A AND 2A, RESPECTIVELY. THESE AMOUNTS ARE INCLUDED IN THE FORM 1096 AND FORM W-3 FILED BY MMC. THE AMOUNT OF SALARIES, PENSIONS, PAYROLL TAXES, AND EMPLOYEE BENEFITS REPORTED ON PART IX, LINES 5-10 HAVE BEEN ALLOCATED TO THE HOSPITAL BASED ON THE EMPLOYEES THAT WORK DIRECTLY FOR THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 2 FAMILY/BUSINESS RELATIONSHIPS: STEPHEN COLEMAN HAS A BUSINESS RELATIONSHIP WITH RICHARD CARR AND JASON REAGLE. CORY JACKSON, CONTROLLER, IS COMPENSATED BY MEADVILLE MEDICAL CENTER, A RELATED ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS: TITUSVILLE AREA HOSPITAL HAS TWO CLASSES OF MEMBERSHIP. CORPORATE MEMBERSHIP CONSISTS OF ONE MEMBER, TITUSVILLE AREA HEALTH CENTER. COMMUNITY MEMBERSHIP SHALL CONSIST OF FORMER HOLDERS OF SHARES OF THE CORPORATION WHO ELECT TO CONTINUE AS SUCH MEMBERS AND OTHER PERSONS WHO ELECT TO BECOME SUCH MEMBERS OF THE CORPORATION. COMMUNITY MEMBERS SHALL NOT BE ENTITLED TO VOTE ON ANY MATTERS RESPECTING THE ACTIONS OR GOVERNANCE OF THE CORPORATION, SUCH ENTITLEMENT HAVING BEEN RESERVED SOLELY UNTO THE CORPORATION'S CORPORATE MEMBER, AND SHALL HAVE NO INTEREST IN THE PROPERTY, ASSETS OR BUSINESS OF THE CORPORATION. MEADVILLE MEDICAL CENTER IS A CORPORATE MEMBER ALONG WITH TITUSVILLE AREA HEALTH CENTER. FORM 990, PART VI, SECTION A, LINE 7A POWER TO ELECT MEMBERS OR STOCKHOLDERS: A MAJORITY OF THE DIRECTORS SHALL BE APPOINTED BY THE BOARD OF DIRECTORS OF THE CORPORATE MEMBER (TITUSVILLE AREA HEALTH CENTER, INC). MEADVILLE MEDICAL CENTER (MMC) SHALL APPOINT THE MMC BOARD APPOINTEE TO SERVE ON THE BOARD. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF GOVERNING BODY SUBJECT TO APPROVAL BY MEMBERS OR STOCKHOLDERS: THE FOLLOWING POWERS ARE RESERVED UNTO MEADVILLE MEDICAL CENTER (MMC): A) NOMINATE AND ELECT THE MMC BOARD APPOINTEE, AND REMOVE SAID APPOINTEE AT ANY TIME, WITH OR WITHOUT CAUSE; B) APPROVE OR DISAPPROVE IN WHOLE OR IN PART THE CORPORATION'S BUDGET AND AMENDMENTS THERETO; C) APPROVE OR DISAPPROVE PROJECTS OR EXPENDITURES WHICH ARE NOT IN THE BUDGET OR WHICH ARE VARIANCES THERETO INCLUDING THE AUTHORITY TO ESTABLISH A DOLLAR THRESHOLD BELOW WHICH THE CORPORATION WILL NOT NEED TO OBTAIN APPROVAL FROM MMC; D) APPROVE OR DISAPPROVE ALL LONG RANGE PLANS OF THE CORPORATION; E) APPROVE OR DISAPPROVE ALL AFFILIATIONS, MERGERS AND OTHER TRANSACTIONS BY THE CORPORATION NOT IN THE ORDINARY COURSE OF BUSINESS; F) APPROVE OR DISAPPROVE ALL AMENDMENTS TO THE CORPORATION'S ARTICLES OF INCORPORATION AND BYLAWS; G) DIRECT THE CORPORATION TO MAKE CHANGES IN ITS ARTICLES OF INCORPORATION OR BYLAWS AND IN THE ABSENCE OF SUCH ACTION BY THE CORPORATION, OR A RECOMMENDATION BY TITUSVILLE AREA HEALTH CENTER, INC. (TAHC), TO DIRECTLY AMEND ITS ARTICLES OF INCORPORATION AND/OR BYLAWS ON ITS OWN MOTION; H) APPROVE OR DISAPPROVE ALL FINANCINGS OF INDEBTEDNESS BY THE CORPORATION FOR WHICH THE OBLIGATION TO REPAY EXCEEDS (I) A TERM OF TWELVE MONTHS OR (II) AN AGGREGATE DOLLAR THRESHOLD SET BY THE BOARD OF DIRECTORS OF MMC FROM TIME TO TIME, AND; I) EXERCISE SUCH OTHER POWERS OR PERFORM SUCH OTHER TASKS AS ARE RESERVED TO OR REQUIRED OF MMC. THE FOLLOWING POWERS ARE RESERVED UNTO TITUSVILLE AREA HEALTH CENTER, INC. (TAHC): A) NOMINATE AND ELECT THE REMAINING APPOINTEES TO THE BOARD OF DIRECTORS OF THE CORPORATION AND THE OFFICERS OF THE CORPORATION AND REMOVE SUCH DIRECTORS AND OFFICERS AT ANY TIME, WITH OR WITHOUT CAUSE; B) APPROVE OR DISAPPROVE ANY CHANGE IN THE NUMBER OF DIRECTORS; C) RECOMMEND TO MMC THE APPROVAL OR DISAPPROVAL IN WHOLE OR IN PART OF THE CORPORATION'S BUDGET AND AMENDMENTS THERETO; D) RECOMMEND TO MMC THE APPROVAL OR DISAPPROVAL OF PROJECTS OR EXPENDITURES WHICH ARE NOT IN THE BUDGET OR WHICH ARE VARIANCES THERETO INCLUDING RECOMMENDATION OF A DOLLAR THRESHOLD BELOW WHICH THE CORPORATION WILL NOT NEED TO OBTAIN APPROVAL FROM MMC; E) RECOMMEND TO MMC THE APPROVAL OR DISAPPROVAL OF ALL LONG RANGE PLANS OF THE CORPORATION; F) RECOMMEND TO MMC THE APPROVAL OR DISAPPROVAL OF ALL AFFILIATIONS, MERGERS, AND OTHER TRANSACTIONS BY THE CORPORATION NOT IN THE ORDINARY COURSE OF BUSINESS; G) RECOMMEND TO MMC THE APPROVAL OR DISAPPROVAL OF ALL AMENDMENTS TO THE CORPORATION'S ARTICLES OF INCORPORATION AND BYLAWS; H) RECOMMEND TO MMC THE APPROVAL OR DISAPPROVAL OF ALL FINANCINGS OR INDEBTEDNESS BY THE CORPORATION FOR WHICH THE OBLIGATION TO REPAY EXCEEDS (I) A TERM OF TWELVE MONTHS OR (II) AN AGGREGATE DOLLAR THRESHOLD SET BY THE BOARD OF DIRECTORS OF MMC FROM TIME TO TIME, AND; I) EXERCISE SUCH OTHER POWERS OR PERFORM SUCH OTHER TASKS AS ARE RESERVED TO OR REQUIRED OF TAHC. FORM 990, PART VI, SECTION B, LINE 11B 990 REVIEW PROCEDURES: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE RETURN IS COMPLETED IN DRAFT FORM AND REVIEWED BY MANAGEMENT OF THE ORGANIZATION. THE COMPLETED 990 IS MADE AVAILABLE TO BOARD MEMBERS FOR REVIEW AND QUESTIONS PRIOR TO SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: TITUSVILLE AREA HOSPITAL ANNUALLY REQUIRES ITS BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES TO FILL OUT A CONFLICTS OF INTEREST FORM DURING BOARD MEETINGS. ANY CONFLICT OF INTEREST IS REVIEWED BY THE BOARD OF DIRECTORS. IF AN INTERESTED PARTY HAS A CONFLICT, HE OR SHE RECUSES THEMSELVES FROM VOTING. FORM 990, PART VI, SECTION B, LINE 15A & 15B REVIEW OF CEO AND OTHER OFFICER COMPENSATION: AN INDEPENDENT CONSULTING FIRM, MERCER, PERFORMED THE MOST RECENT COMPENSATION REVIEW IN JUNE 2022. THEY COMPILED THE SALARY ADMINISTRATION AND PERFORMANCE MANAGEMENT GUIDELINES WHICH THE HOSPITAL UTILIZES ANY TIME A NEW POSITION IS CREATED OR AN EXISTING POSITION'S DESCRIPTION CHANGES. A JOB FACTOR WORKSHEET IS COMPLETED WHICH EVALUATES 6 AREAS BASED ON A POINT SYSTEM. THE SIX AREAS ARE LISTED BELOW: 1.) EDUCATION 2.) EXPERIENCE 3.) CONTACTS 4.) GUIDELINES 5.) BUDGET ACCOUNTABILITY 6.) SUPERVISORY/ACCOUNTABILITY THE TOTAL POINTS ARE USED TO ARRIVE AT A PAY GRADE ON THE SALARY ADMINISTRATION POLICY MANAGEMENT PAY SCALE. THE MANAGEMENT PAY SCALE IS REVIEWED ANNUALLY, AND UPDATED IF NECESSARY, BASED ON THE HOSPITAL COUNCIL OF WESTERN PENNSYLVANIA SURVEYS, WHICH PROVIDES COMPARABLE DATA OF OTHER HOSPITALS IN THE AREA. THE DELIBERATIONS AND DECISIONS OF THE COMPENSATION COMMITTEE ARE DOCUMENTED IN THE COMMITTEE MINUTES FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS: TITUSVILLE AREA HOSPITAL MAKES ITS FORM 990 AND FORM 1023 AVAILABLE TO THE PUBLIC UPON REQUEST. AT THIS TIME, TITUSVILLE AREA HOSPITAL DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC. FORM 990, PART VII, SECTION A, LINE 7 BOARD MEMBER COMPENSATION: CORY JACKSON IS THE CONTROLLER FOR RELATED ORGANIZATION MEADVILLE MEDICAL CENTER (MMC). HE IS THE ACTING BOARD TREASURER FOR TITUSVILLE AREA HOSPITAL. HE DOES NOT HAVE VOTING POWER. HIS COMPENSATION LISTED IS BEING SHOWN AS FROM A RELATED ORGANIZATION AS HE IS PAID BY MMC FOR HIS POSITION AS CONTROLLER. HE IS NOT COMPENSATED FOR HIS ROLE AS BOARD TREASURER. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: $ (811,318) CHANGE IN BENEFICIAL INTEREST 158,591 TRANSFER FROM SUBSIDIARIES ----------- $ (652,727) FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES - MEDICAL TOTAL FEES:7331221 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES - NONMEDICA TOTAL FEES:2391695 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN FEES TOTAL FEES:907974 FORM 990 PART IX LINE 11G DESCRIPTION:ASSOC. CLINICAL LABS TOTAL FEES:435666 FORM 990 PART IX LINE 11G DESCRIPTION:COLLECTION FEES TOTAL FEES:213972 FORM 990 PART IX LINE 11G DESCRIPTION:LAB OTHER TOTAL FEES:119828 TITUSVILLE AREA HEALTH CENTER INC 406 WEST OAK STREET TITUSVILLE PA 16354 251517855 HOLDING CO PA 501(C)(3) 7 MMC false TITUSVILLE HEALTH SERVICES INC 406 WEST OAK STREET TITUSVILLE PA 16354 251517865 COMM HLT CLNC PA 501(C)(3) 3 TAHC false TITUSVILLE AREA HEALTH CENTER FOUNDATION 406 WEST OAK STREET TITUSVILLE PA 16354 251517854 SUPPORT PA 501(C)(3) 12 A I TAHC false MEADVILLE MEDICAL CENTER 1034 GROVE STREET MEADVILLE PA 16335 251512436 HOSPITAL PA 501(C)(3) 3 NA false MEADVILLE MEDICAL CENTER FOUNDATION 1034 GROVE STREET MEADVILLE PA 16335 251681342 SUPPORT PA 501(C)(3) 7 MMC false HOSPICE OF CRAWFORD COUNTY INC 1034 GROVE STREET MEADVILLE PA 16335 251480565 HOSPICE PA 501(C)(3) 7 MMC false CONNEAUT VALLEY HEALTH CENTER 1034 GROVE STREET MEADVILLE PA 16335 251490887 HEALTH CENTER PA 501(C)(3) 3 MMC false MEADVILLE PHYSICIANS SERVICES 751 LIBERTY STREET MEADVILLE PA 16335 251602133 PHYS. OFFICES PA 501(C)(3) 10 MMC false COMMUNITY HEALTH SERVICES INC 1034 GROVE STREET MEADVILLE PA 16335 251490886 PHYS. OFFICES PA 501(C)(3) 10 MMC false MEADVILLE MEDICAL CENTER AUXILIARY 751 LIBERTY STREET MEADVILLE PA 16335 251512834 SUPPORT PA 501(C)(3) 12A I MMC false FRENCH CREEK INTERNAL MEDICINE 751 LIBERTY STREET MEADVILLE PA 16335 471870077 PHYS. OFFICES PA 501(C)(3) 10 MPS false PERPETUAL TRUST TRUST PA TAH TRUST 2932 69854 1.00000 true PERPETUAL TRUST TRUST PA TAH TRUST 11633 277143 1.00000 true PERPETUAL TRUST TRUST PA TAH TRUST 1204 28690 1.00000 true HOME CARE CONNECTIONS INC 751 LIBERTY STREET MEADVILLE PA 16335 251605314 HOLDING COMPANY PA MMC C CORP false MEADVILLE HOUSING CORPORATION 934 B STREET MEADVILLE PA 16335 250657800 HOUSING PA MMC C CORP false CHARITABLE TRUST 256196092 TRUST PA MMC TRUST false CHARITABLE TRUST 066031521 TRUST PA MMC TRUST false false false true false true false false false false true false false true true true false true false true