CLEARFIELD HOSPITAL: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
CLEARFIELD HOSPITAL (EIN 25-0979346)
Tax period
2020-07-01 to 2021-06-30
Filed
2022-05-16
IRS object ID
202221369349311602
Schema version
2020v4.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-05-16T14:37:29-05:00ReturnTs
Tax Period End2021-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1910 E ST LOUIS 200/PO BOX 1190AddressLine1Txt
CitySPRINGFIELDCityNm
State AbbreviationMOStateAbbreviationCd
ZIP658062523ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN250979346EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CLEARFIELD HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% ROBERT SPICHERInCareOfNm
Business Name ControlCLEABusinessNameControlTxt
Phone8147655341PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1809 TURNPIKE AVENUEAddressLine1Txt
CityCLEARFIELDCityNm
State AbbreviationPAStateAbbreviationCd
ZIP16830ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRHONDA HALSTEADPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone8147655341PhoneNum
Signature2022-05-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstRHONDAPersonFirstNm
Person LastHALSTEADPersonLastNm
FieldValueIRS element (for citing)
SSNXXX-XX-XXXXSSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBrian D ToddPreparerPersonNm
PTINP00422601PTIN
Phone4178658701PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1PENN HIGHLANDS CLEARFIELDBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerRHONDA HALSTEADPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1809 TURNPIKE AVENUEAddressLine1Txt
CityCLEARFIELDCityNm
State AbbreviationPAStateAbbreviationCd
ZIP16830ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$49,701,839GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PHHEALTHCARE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1901FormationYr
Legal Domicile StatePALegalDomicileStateCd
Activity Or MissionPENN HIGHLANDS CLEARFIELD EXISTS TO POSITIVELY IMPACT THE HEALTH STATUS OF THE REGION BY PROVIDING QUALITY HEALTHCARE COUPLED WITH QUALITY SERVICE.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee396TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$697,105PYContributionsGrantsAmt
CY Contributions Grants$3,962,385CYContributionsGrantsAmt
PY Program Service Revenue$39,852,043PYProgramServiceRevenueAmt
CY Program Service Revenue$43,902,444CYProgramServiceRevenueAmt
PY Investment Income$119,839PYInvestmentIncomeAmt
CY Investment Income$123,665CYInvestmentIncomeAmt
PY Other Revenue$1,098,861PYOtherRevenueAmt
CY Other Revenue$1,189,632CYOtherRevenueAmt
PY Total Revenue$41,767,848PYTotalRevenueAmt
CY Total Revenue$49,178,126CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$18,158,135PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$18,879,518CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$23,482,940PYOtherExpensesAmt
CY Other Expenses$24,439,678CYOtherExpensesAmt
PY Total Expenses$41,641,075PYTotalExpensesAmt
CY Total Expenses$43,319,196CYTotalExpensesAmt
PY Revenues Less Expenses$126,773PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$5,858,930CYRevenuesLessExpensesAmt
Total Assets BOY$54,721,848TotalAssetsBOYAmt
Total Assets EOY$57,734,677TotalAssetsEOYAmt
Total Liabilities BOY$37,206,388TotalLiabilitiesBOYAmt
Total Liabilities EOY$34,102,027TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$17,515,460NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$23,632,650NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE THE COMMUNITY WITH EXCEPTIONAL CARE THROUGH OUR COMMUNITY-BASED HEALTH SYSTEM WHILE MAINTAINING A REVERENCE FOR LIFE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$40,797,616ExpenseAmt
Revenue$43,902,444RevenueAmt
DescAS A PART OF PENN HIGHLANDS HEALTHCARE, PENN HIGHLANDS CLEARFIELD CONTINUES ITS RICH TRADITION OF PROVIDING EXCELLENT CARE TO THE COMMUNITIES IT SERVES. IT CONTINUES TO EXPAND AND CREATE ACCESS TO A LARGE NUMBER OF MEDICAL, SURGICAL AND SUPPORT SERVICES. ITS AWARD-WINNING HOME HEALTH CARE SERVES A LARGE GEOGRAPHIC REGION. PENN HIGHLANDS CLEARFIELD CONSISTS OF AN ACTIVE EMERGENCY DEPARTMENT, MEDICAL-SURGICAL UNITS, BEHAVIORAL HEALTH SERVICES, CARDIAC DIAGNOSTIC SERVICES, REHABILITATION SERVICES, CARDIAC REHAB, CHEMOTHERAPY, IMAGING SERVICES, LABORATORY SERVICES, NUTRITION COUNSELING, PULMONARY REHABILITATION, SURGICAL SERVICES, WOUND CARE AND A SWING-BED PROGRAM.Desc
Total Program Service Expenses$40,797,616TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (true)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesYes (true)ForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document34IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee396EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (true)DelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (true)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldPAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonROBERT SPICHERPersonNm
Phone8143756136PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 HOSPITAL AVENUEAddressLine1Txt
CityDUBOISCityNm
State AbbreviationPAStateAbbreviationCd
ZIP15801ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
RYAN BISBEY MD
BOARD MEMBER1.040.0Yes (X)$0$535,051$34,301
THOMAS CARNEVALE
CHAIRMAN1.040.0Yes (X)$0$448,718$16,986Yes (X)
KEVIN TYLER DO
PRESIDENT OF MEDICAL STAFF1.040.0Yes (X)$0$337,778$31,755Yes (X)
BRIAN KLINE
CHIEF FINANCIAL OFFICER2.040.0$0$337,274$7,093Yes (X)
ROBERT M EDWARDS JR
BOARD MEMBER1.040.0Yes (X)$0$313,000$27,370
RHONDA HALSTEAD
PRESIDENT40.00.0Yes (X)$291,348$0$18,104Yes (X)
DONALD E CONRAD DO
BOARD MEMBER1.040.0Yes (X)$0$202,573$11,632
THOMAS L YEAGER
PHARMACIST40.00.0$134,163$0$24,480Yes (X)
MICHEAL T ALLMAN
PHARMACIST40.00.0$116,298$0$18,211Yes (X)
KENNETH J SHURER
PHARMACIST40.00.0$121,019$0$7,236Yes (X)
RUBY MAINES
HOME HEALTH RN40.00.0$101,913$0$7,236Yes (X)
BROCKTON SHAFFER
BOARD MEMBER1.00.0Yes (X)$0$0$0
DARLENE ARDARY PHD
BOARD MEMBER1.00.0Yes (X)$0$0$0
KATHLEEN GILLESPIE
SECRETARY/TREASURER1.00.0Yes (X)$0$0$0Yes (X)
BRIAN WINGARD
VICE CHAIRMAN1.00.0Yes (X)$0$0$0Yes (X)
DEREK WALKER
BOARD MEMBER1.00.0Yes (X)$0$0$0
DAVID M CURULLA
BOARD MEMBER1.040.0Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$764,741TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,174,394TotReportableCompRltdOrgAmt
Total Other Compensation$204,404TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K5IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
AMN HEALTHCARE
12400 HIGH BLUFF DRSAN DIEGOCA92130STAFFING SERVICES$409,884
ASSOCIATED CLINICAL LABORATORIES
1526 PEACH STREETERIEPA16501LAB SERVICES$731,169
CLEARFIELD COUNTY INVESTIGATORS
624 ARROWHEAD WAYCLEARFIELDPA16830SECURITY SERVICES$172,943
GE HEALTHCARE
3000 N GRANDVIEW BLVDWAUKESHAWI53188MEDICAL SERVICES$197,077
APOGEE MANAGEMENT
15059 N SCOTTSDALE RDSCOTTSDALEAZ85254HOSPITALIST STAFFING$478,114
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K7CntrctRcvdGreaterThan100KCnt
Government Grants$3,662,569GovernmentGrantsAmt
All Other Contributions$299,816AllOtherContributionsAmt
Total Contributions$3,962,385TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE621990$42,696,463$42,696,463
OTHER REVENUE621990$1,044,292$1,044,292
CAFETERIA722514$88,785$88,785
PHARMACY446110$72,904$72,904
FieldValueIRS element (for citing)
Total Program Service Revenue$43,902,444TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$110,251TotalRevenueColumnAmt
Exclusion$110,251ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$918,143RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$518,016RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$400,127RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$400,127TotalRevenueColumnAmt
Exclusion$400,127ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$13,414OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$13,414OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$13,414TotalRevenueColumnAmt
Exclusion$13,414ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$794GrossSalesOfInventoryAmt
Cost Of Goods Sold$5,697CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$4,903TotalRevenueColumnAmt
Exclusion-$4,903ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescEquity InvesteeDesc
Business900099BusinessCd
Total Revenue Column$794,408TotalRevenueColumnAmt
Exclusion$794,408ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$794,408OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$49,178,126TotalRevenueColumnAmt
Related Or Exempt Func Income$43,902,444RelatedOrExemptFuncIncomeAmt
Exclusion$1,313,297ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$309,452TotalAmt
Management And General$309,452ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$14,445,794TotalAmt
Program Services$14,393,093ProgramServicesAmt
Management And General$52,701ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$344,257TotalAmt
Program Services$330,647ProgramServicesAmt
Management And General$13,610ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,673,574TotalAmt
Program Services$2,478,225ProgramServicesAmt
Management And General$195,349ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,106,441TotalAmt
Program Services$1,023,688ProgramServicesAmt
Management And General$82,753ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$5,319,029TotalAmt
Program Services$5,319,029ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$23,625TotalAmt
Management And General$23,625ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$13,698TotalAmt
Management And General$13,698ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,989,584TotalAmt
Program Services$5,068,564ProgramServicesAmt
Management And General$921,020ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$23,724TotalAmt
Program Services$1,369ProgramServicesAmt
Management And General$22,355ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,446,256TotalAmt
Program Services$1,035,724ProgramServicesAmt
Management And General$410,532ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$799,412TotalAmt
Program Services$706,956ProgramServicesAmt
Management And General$92,456ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$27,844TotalAmt
Program Services$26,912ProgramServicesAmt
Management And General$932ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$9,323TotalAmt
Program Services$9,323ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$464,331TotalAmt
Program Services$429,603ProgramServicesAmt
Management And General$34,728ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,481,598TotalAmt
Program Services$2,295,995ProgramServicesAmt
Management And General$185,603ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,527,915TotalAmt
Program Services$1,399,786ProgramServicesAmt
Management And General$128,129ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES & DRUGS$5,904,241$5,904,241
REPAIRS AND MAINTENANCE$390,140$370,237$19,903
LICENSES, DUES, SUBSCRIPTIONS$18,958$4,224$14,734

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$43,319,196TotalAmt
Program Services$40,797,616ProgramServicesAmt
Management And General$2,521,580ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$172,954BOYAmt
EOY$505,896EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$16,139,632BOYAmt
EOY$16,240,427EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$20,000BOYAmt
EOY$10,000EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,136,466BOYAmt
EOY$4,681,000EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$336,709BOYAmt
EOY$315,461EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$175,012BOYAmt
EOY$81,523EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$45,383,472LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$24,526,152LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$19,925,319BOYAmt
EOY$20,857,320EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$6,988,485BOYAmt
EOY$7,720,623EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$4,037,652BOYAmt
EOY$4,106,706EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$5,000BOYAmt
EOY$5,000EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$638,587BOYAmt
EOY$364,927EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$3,146,032BOYAmt
EOY$2,845,794EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$54,721,848BOYAmt
EOY$57,734,677EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$6,820,091BOYAmt
EOY$6,765,181EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$4,536,695BOYAmt
EOY$9,860EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$14,230,747BOYAmt
EOY$13,949,946EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$114,644BOYAmt
EOY$1,238,021EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$11,504,211BOYAmt
EOY$12,139,019EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$37,206,388BOYAmt
EOY$34,102,027EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$15,730,055BOYAmt
EOY$21,631,495EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,785,405BOYAmt
EOY$2,001,155EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$17,515,460BOYAmt
EOY$23,632,650EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$54,721,848BOYAmt
EOY$57,734,677EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$5,858,930ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$427,605NetUnrlzdGainsLossesInvstAmt
Prior Period Adjustments-$173,345PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$4,000OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteefalseAuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$291,303BeginningYearBalanceAmt
Investment Earnings Or Losses$67,015InvestmentEarningsOrLossesAmt
Administrative Expenses$1,744AdministrativeExpensesAmt
End Year Balance$356,574EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$277,096BeginningYearBalanceAmt
Investment Earnings Or Losses$15,605InvestmentEarningsOrLossesAmt
Administrative Expenses$1,398AdministrativeExpensesAmt
End Year Balance$291,303EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$262,377BeginningYearBalanceAmt
Investment Earnings Or Losses$15,844InvestmentEarningsOrLossesAmt
Administrative Expenses$1,125AdministrativeExpensesAmt
End Year Balance$277,096EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$264,223BeginningYearBalanceAmt
Investment Earnings Or Losses-$235InvestmentEarningsOrLossesAmt
Administrative Expenses$1,611AdministrativeExpensesAmt
End Year Balance$262,377EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$239,593BeginningYearBalanceAmt
Investment Earnings Or Losses$26,045InvestmentEarningsOrLossesAmt
Administrative Expenses$1,415AdministrativeExpensesAmt
End Year Balance$264,223EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY1.00000BoardDesignatedBalanceEOYPct
Endowments Held Unrelated OrgYes (true)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$987,690OtherCostOrOtherBasisAmt
Book Value$987,690BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$19,470,650OtherCostOrOtherBasisAmt
Depreciation$7,874,783DepreciationAmt
Book Value$11,595,867BookValueAmt
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$21,249,425OtherCostOrOtherBasisAmt
Depreciation$15,794,098DepreciationAmt
Book Value$5,455,327BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$3,675,707OtherCostOrOtherBasisAmt
Depreciation$857,271DepreciationAmt
Book Value$2,818,436BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$20,857,320TotalBookValueLandBuildingsAmt
Financial DerivativesFinancialDerivativesGrp
Closely Held Equity InterestsCloselyHeldEquityInterestsGrp
Total Book Value Securities$0TotalBookValueSecuritiesAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
Due to Third Party$1,147,333
Deferred Compensation Liab$982,826
Due to Affiliate$6,234,297
Contract Liabilities$3,774,563
FieldValueIRS element (for citing)
Total Liability$12,139,019TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART V, LINE 4ENDOWMENT FUNDS: INTENDED USES OF ENDOWMENT FUNDS ARE DIRECTED BY THE BOARD OF CLEARFIELD HOSPITAL AND FOR THE GOOD OF CLEARFIELD HOSPITAL IN CONTINUING THE CHARITABLE AND NON-PROFIT ACTIVITIES OF CLEARFIELD HOSPITAL.
SCHEDULE D, PART X, LINE 2UNCERTAIN TAX POSITIONS: 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 F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp

FieldValueIRS element (for citing)
RegionCentral America and the CaribbeanRegionTxt
Offices0OfficesCnt
Employee0EmployeeCnt
Type Of Activities ConductedInvestmentsTypeOfActivitiesConductedTxt
Region Total Expenditures$102,907RegionTotalExpendituresAmt
FieldValueIRS element (for citing)
Subtotal Offices0SubtotalOfficesCnt
Subtotal Employees0SubtotalEmployeesCnt
Total Office0TotalOfficeCnt
Total Employee0TotalEmployeeCnt
Subtotal Spent$102,907SubtotalSpentAmt
Total Spent$102,907TotalSpentAmt
Transfer To Foreign CorpfalseTransferToForeignCorpInd
Interest In Foreign TrustfalseInterestInForeignTrustInd
Foreign Corp OwnershipfalseForeignCorpOwnershipInd
Passive Foreign Investmest CofalsePassiveForeignInvestmestCoInd
Foreign PartnershipfalseForeignPartnershipInd
Boycott CountriesfalseBoycottCountriesInd

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$54,505TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$54,505NetCommunityBenefitExpnsAmt
Total Expense0.00120TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,604,863TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,703,240DirectOffsettingRevenueAmt

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,659,368TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,703,240DirectOffsettingRevenueAmt
Net Community Benefit Expns$54,505NetCommunityBenefitExpnsAmt
Total Expense0.00120TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,659,368TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,703,240DirectOffsettingRevenueAmt
Net Community Benefit Expns$54,505NetCommunityBenefitExpnsAmt
Total Expense0.00120TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$2,539,251BadDebtExpenseAmt
Bad Debt Expense Attributable$253,925BadDebtExpenseAttributableAmt
Reimbursed By Medicare$10,959,995ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$10,837,146CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$122,849MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PENN HIGHLANDS CLEARFIELDBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1809 TURNPIKE AVENUEAddressLine1Txt
CityCLEARFIELDCityNm
State AbbreviationPAStateAbbreviationCd
ZIP16830ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.PHHEALTHCARE.ORGWebsiteAddressTxt
State License291301StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1PENN HIGHLANDS CLEARFIELDBusinessNameLine1Txt
FieldValueIRS element (for citing)
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted20CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART V, SECTION COwnWebsiteURLTxt
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt21ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSEE PART V, SECTION CStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.FPGFamilyIncmLmtDscntCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART V, SECTION CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART V, SECTION CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART V, SECTION CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 5COMMUNITY INPUT: PENN HIGHLANDS AND THE ASSOCIATED HOSPITALS HIRED THE FIRM TRIPP UMBACH TO FACILITATE THE PREPARATION OF THE CHNA AND COLLABORATED WITH HOSPITALS AND OUTSIDE ORGANIZATIONS IN THE SURROUNDING REGION. DURING THE CHNA PROCESS, COMMUNITY INPUT WAS SOUGHT FROM A VARIETY OF COMMUNITY MEMBERS AND ORGANIZATIONS, INCLUDING INPUT FROM ALCOHOL AND DRUG ABUSE SERVICES, ALCOHOLICS ANONYMOUS, FREE CLINIC OF DUBOIS, POLICE DEPARTMENTS, CHAMBER OF COMMERCE AND EMS SERVICES TO JUST NAME A FEW. THE PROCESS INCLUDED PUBLIC COMMENTARY, SECONDARY DATA COLLECTION AND ANALYSIS, STAKEHOLDER INTERVIEWS, HAND-DISTRIBUTED SURVEYS AND COMMUNITY HEALTH FORUM/RETREAT. THE HOSPITAL WORKED WITH LEADERS WITHIN THE HEALTHCARE SYSTEM AS WELL AS WITH SEVERAL MEMBERS OUTSIDE OF THE SYSTEM FROM VARIOUS ORGANIZATIONS AND BACKGROUNDS. THIS LIST IS INCLUDED IN THE CHNA REPORT.
SCHEDULE H, PART V, SECTION B, LINE 6ACHNA CONDUCTED WITH OTHER HOSPITAL FACILITIES: PENN HIGHLANDS DUBOIS, PENN HIGHLANDS BROOKVILLE, PENN HIGHLANDS ELK, PENN HIGHLANDS TYRONE AND PENN HIGHLANDS HUNTINGDON WHICH ARE ALL PART OF THE PENN HIGHLANDS HEALTHCARE SYSTEM.
SCHEDULE H, PART V, SECTION B, LINE 7ACHNA REPORT URL: WWW.PHHEALTHCARE.ORG/HEALTH-WELLNESS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
SCHEDULE H, PART V, SECTION B, LINE 10AIMPLEMENTATION STRATEGY URL: HTTPS://WWW.PHHEALTHCARE.ORG/HEALTH-WELLNESS/COMMUNITY-HEALTH-NEEDS-ASSESS MENT
SCHEDULE H, PART V, SECTION B, LINE 11ADDRESSING IDENTIFIED NEEDS: THE HOSPITAL'S CHNA GIVES A VERY DETAILED OVERVIEW OF THE METHODS AND ACTIVITIES THAT WENT INTO DEVELOPING A STRATEGIC PLAN FOR ASSESSING THE NEEDS OF THE COMMUNITY AND CHOOSING WHAT THE MOST IMPORTANT AND ATTAINABLE GOALS WOULD BE. THESE NEEDS ARE PRESENTED IN THE CHNA WITH A DETAILED EXPLANATION OF THE ISSUES, HOW THIS INFORMATION WAS GATHERED, INCLUDING PRIMARY AND SECONDARY DATA, WHAT THE GOALS ARE TO DEAL WITH THE ISSUES AND THE NEXT STEPS TO TAKE TO ATTAIN THESE GOALS. THE REPORT ADDRESSES THE TOP FIVE HEALTH NEEDS OF THE COMMUNITY AND FOCUSES ON THOSE ISSUES. THE IMPLEMENTATION PLAN ONLINE INCLUDES DETAIL OF ANNUAL ACTIVITIES.
SCHEDULE H, PART V, SECTION B, LINE 16A, B, AND CFAP, FAP APPLICATION, PLAIN LANGUAGE SUMMARY URL: HTTPS://WWW.PHHEALTHCARE.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE-POLICY
SCHEDULE H, PART V, SECTION B, LINE 20EOTHER EFFORTS: THE BILLING STATEMENT STATES THAT THERE IS A FAP AVAILABLE AND GIVES INFORMATION ON HOW TO CONTACT SOMEONE FOR THE APPLICATION.

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART I, LINE 7, COLUMN FPERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25 OF THE FORM 990.
SCHEDULE H, PART I, LINE 7COSTING METHODOLOGY: THE COST TO CHARGE RATIO COMPUTED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATIONS ON IRS WORKSHEETS 1 AND 3.
SCHEDULE H, PART III, SECTION A, LINE 2BAD 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 HOSPITAL DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'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, 2021. 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 3BAD DEBT ATTRIBUTABLE TO CHARITY CARE: HISTORICALLY THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO CHARITY IS ABOUT 10% OF BAD DEBT EXPENSE.
SCHEDULE H, PART III, SECTION A, LINE 4BAD DEBT EXPENSE FOOTNOTE: THE AUDIT FOOTNOTE ADDRESSING BAD DEBT EXPENSE AND PATIENT ACCOUNTS RECEIVABLE IS FOUND ON PAGE 13 OF THE AUDITED FINANCIAL STATEMENTS UNDER NOTE 1, SUBTITLED "PATIENT ACCOUNTS RECEIVABLE."
SCHEDULE H, PART III, SECTION C, LINE 9BCOLLECTION POLICY: THE ACTIONS THAT PHH/PHPN MAY TAKE WITH REGARD TO THE NON-PAYMENT BY AN INDIVIDUAL WHO IS ABLE TO PAY FOR SERVICES, INCLUDING COLLECTION ACTIONS AND POSSIBLE REPORTING TO CREDIT AGENCIES ARE CONTAINED IN PHH/PHPN'S BILLING AND COLLECTION POLICY. FOR INDIVIDUALS WHO QUALIFY FOR FAP AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED MEDICAL BILLS, PHH/PHPN WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTIONS AGENCIES. PHH/PHPN WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS(ECA) SUCH AS LAWSUITS, LIENS ON RESIDENCES OR OTHER SIMILAR LEGAL ACTIONS FOR ANY INDIVIDUAL WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FAP. REASONABLE EFFORTS SHALL INCLUDE: A) NOTIFYING THE INDIVIDUAL OF THE FAP UPON ADMISSION, IN WRITTEN AND ORAL COMMUNICATIONS WITH THE INDIVIDUAL REGARDING THEIR BILL AND INCLUDING INFORMATION ON THE FAP ON STATEMENTS; B) WRITTEN DOCUMENTATION THAT PHH/PHPN HAS ATTEMPTED TO OFFER THE INDIVIDUAL THE OPPORTUNITY TO APPLY FOR FINANCIAL ASSISTANCE PURSUANT TO THIS POLICY AND THAT THE INDIVIDUAL HAS NOT COMPLIED WITH THE APPLICATION REQUIREMENTS; C) VALIDATING THAT THE INDIVIDUAL OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD-PARTY PAYMENTS HAVE BEEN IDENTIFIED AND BILLED BY PHH/PHPN; D) DOCUMENTATION THAT THE INDIVIDUAL HAS BEEN OFFERED A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN.
SCHEDULE H, PART VI, LINE 2NEEDS ASSESSMENT: PENN HIGHLANDS CLEARFIELD PARTICIPATED IN A COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED BY TRIPP UMBACH.
SCHEDULE H, PART VI, LINE 3PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: THE HOSPITAL NOTIFIED INDIVIDUALS OF THE FINANCIAL ASSISTANCE POLICY ON ADMISSION AND PRIOR TO DISCHARGE. THE HOSPITAL ALSO NOTIFIES INDIVIDUALS OF OUR FINANCIAL ASSISTANCE POLICY WHEN DISCUSSING BILLING MATTER'S WITH THE PATIENT.
SCHEDULE H, PART VI, LINE 4COMMUNITY INFORMATION: CLEARFIELD HOSPITAL SERVES SEVERAL COUNTIES IN WESTERN AND CENTRAL PA. OUR CORE POPULATION HAS MEDICARE OR MEDICAID. PENN HIGHLANDS CLEARFIELD IS DESIGNATED AS A MEDICARE DEPENDENT HOSPITAL.
SCHEDULE H, PART VI, LINE 5PROMOTION OF COMMUNITY HEALTH: CLEARFIELD HOSPITAL, DBA PENN HIGHLANDS CLEARFIELD, IS VITAL TO THE COMMUNITIES IT HAS SERVED FOR MORE THAN 100 YEARS. LOCATED IN NORTHWEST CENTRAL PENNSYLVANIA, IT PROVIDES HEALTHCARE ACCESS TO A POPULATION THAT WOULD HAVE TO TRAVEL MORE THAN 20-45 MILES OR NOT RECEIVE CARE AT ALL IF IT DIDN'T EXIST. IT PROVIDES MEDICAL, SURGICAL AND SUPPORT SERVICES, INCLUDING: EMERGENCY SERVICES, A TELEMETRY UNIT, SURGICAL SUITES, CARDIOPULMONARY, CARDIAC REHABILITATION, A WOUND CLINIC, NUCLEAR MEDICINE, CT, MRI, PET SCANNING, LABORATORY SERVICES, AND OCCUPATIONAL, SPEECH AND PHYSICAL THERAPY. PH CLEARFIELD TREATS ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. PATIENTS ARE GIVEN PAYMENT OPTIONS FOR ALL LEVELS OF FINANCIAL NEEDS. THEY MAY BE DIRECTED TO PROGRAMS THAT THEY QUALIFY FOR, SUCH AS MEDICARE, MEDICAID OR VETERANS SERVICES, OR THEY MAY QUALIFY FOR THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM THAT GIVES DISCOUNTS UP TO 100 PERCENT. OUTSIDE OF THE HOSPITAL, EMPLOYEES ATTEND EVENTS TO PROVIDE INFORMATION ON HEALTH AND SAFETY TO THE COMMUNITY. PH CLEARFIELD IS A VALUABLE ASSET, AND WITH THE GUIDANCE OF COMMUNITY LEADERS, HOSPITAL LEADERS AND STAFF, IT WILL REMAIN SO FOR YEARS TO COME.
SCHEDULE H, PART VI, LINE 6AFFILIATED HEALTH CARE SYSTEM: PENN HIGHLANDS HEALTHCARE (PHH, SYSTEM) IS A NOT-FOR-PROFIT CORPORATION ORGANIZED TO COORDINATE AND MANAGE THE INTEGRATION OF THE DELIVERY OF HEALTHCARE SERVICES TO THE NORTH CENTRAL PENNSYLVANIA AREA. PENN HIGHLANDS HEALTHCARE INCLUDES PENN HIGHLANDS NATURAL THERAPIES, LLC AND PENN HIGHLANDS APOTHECARY, INC. THESE COMPANIES WERE FORMED IN 2017 WITH NO ACTIVITY IN THE FISCAL YEAR. DUBOIS REGIONAL MEDICAL CENTER (DRMC) PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES TO RESIDENTS IN DUBOIS, PENNSYLVANIA, AND SURROUNDING AREAS. DUBOIS INCLUDES BROOKVILLE HOSPITAL (BROOKVILLE), A CRITICAL ACCESS HOSPITAL IN BROOKVILLE, PENNSYLVANIA. BROOKVILLE EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES. BROOKVILLE INCLUDES BROOKCARE, A CORPORATION WHOSE PRIMARY BUSINESS IS TO RENT OFFICE SPACE TO PHYSICIANS AND VARIOUS DEPARTMENTS OF BROOKVILLE HOSPITAL. BROOKVILLE ALSO INCLUDES JEFFCO HEALTH SERVICES. JEFFCO HEALTH SERVICES IS A SKILLED NURSING AND REHABILITATION FACILITY IN BROOKVILLE, PA. DUBOIS INCLUDES DUBOIS MEDICAL RISK RETENTION GROUP (DMRRG). DMRRG PROVIDES LIABILITY INSURANCE TO THE DUBOIS COMPANIES. DUBOIS IS THE SOLE MEMBER OF THE CLASS A VOTING AND PARTICIPATING CERTIFICATES OF DMRRG. DUBOIS INCLUDES DUBOIS REGIONAL MEDICAL GROUP (DRMG). DRMG PROVIDES PRIMARY CARE AND SPECIALTY PHYSICIAN SERVICES. ELK REGIONAL HEALTH CENTER (ELK) PROVIDES PRIMARY ACUTE CARE MEDICAL SERVICES AT TWO CAMPUSES, THE ST. MARYS HEALTH CENTER IN ST. MARYS, PENNSYLVANIA, AND THE RIDGWAY HEALTH CENTER IN RIDGWAY, PENNSYLVANIA. ELK INCLUDES THE COMMUNITY NURSES ENTITIES AND HELPMATES. JC BLAIR MEMORIAL HOSPITAL IS A NON-PROFIT COMMUNITY HOSPITAL LOCATED IN HUNTINGDON, PA. JC BLAIR HOSPITAL INCLUDES JC BLAIR MEMORIAL HOSPITAL FOUNDATION. PENN HIGHLANDS TYRONE IS A NON-PROFIT HOSPITAL LOCATED IN TYRONE, PA. TYRONE HOSPITAL INCLUDES TYRONE REGIONAL HEALTH NETWORK FOUNDATION.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
RHONDA HALSTEAD
PRESIDENT$252,070$0$39,278$0$0$0$13,119$0$4,985$0$309,452$0
KEVIN TYLER DO
PRESIDENT OF MEDICAL STAFF$0$337,778$0$0$0$0$0$15,200$0$16,555$0$369,533$0$0
BRIAN KLINE
CHIEF FINANCIAL OFFICER$0$297,402$0$39,872$0$0$0$0$0$7,093$0$344,367$0$0
THOMAS CARNEVALE
CHAIRMAN$0$442,193$0$6,525$0$0$0$0$0$16,986$0$465,704$0$0
RYAN BISBEY MD
BOARD MEMBER$0$535,051$0$0$0$0$0$12,535$0$21,766$0$569,352$0$0
THOMAS L YEAGER
PHARMACIST$129,012$0$0$0$5,151$0$7,539$0$16,941$0$158,643$0$0$0
DONALD E CONRAD DO
BOARD MEMBER$0$197,073$0$5,500$0$0$0$9,240$0$2,392$0$214,205$0$0
ROBERT M EDWARDS JR
BOARD MEMBER$0$298,000$0$15,000$0$0$0$14,085$0$13,285$0$340,370$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART I, LINE 3FormAndLineReferenceDesc
ExplanationCEO COMPENSATION: PENN HIGHLANDS HEALTHCARE, INC. (PHH), A RELATED ORGANIZATION, DETERMINES THE COMPENSATION OF THE CEO. PHH USES THE FOLLOWING METHODS TO DETERMINE THE COMPENSATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY BOARD OR COMPENSATION COMMITTEE.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2BUSINESS RELATIONSHIP: KEVIN TYLER, DO, THOMAS CARNEVALE, MD, ROBERT STEWARD, JR, MD, RYAN BISBEY, MD, BRIAN KLINE, AND RHONDA HALSTEAD SHARE A BUSINESS RELATIONSHIP THROUGH THEIR EMPLOYMENT WITH A RELATED ORGANIZATION, PENN HIGHLANDS DUBOIS.
FORM 990, PART VI, SECTION A, LINE 3DELEGATION OF MANAGEMENT DUTIES: PENN HIGHLANDS HEALTHCARE, PENN HIGHLANDS CLEARFIELD'S RELATED TAX-EXEMPT PARENT ORGANIZATION, PROVIDES ADMINISTRATIVE SERVICES INCLUDING MANAGEMENT DUTIES.
FORM 990, PART VI, SECTION A, LINES 6, 7A, AND 7BMEMBERS: PENN HIGHLANDS HEALTHCARE (PHH) HOLDS CERTAIN POWERS, INCLUDING THE APPROVAL OF THE ELECTION AND REMOVAL OF OFFICERS AND DIRECTORS AND APPROVAL OF ANY AND ALL AMENDMENTS TO THE BYLAWS OR OTHER ORGANIZATIONAL/GOVERNANCE DOCUMENTS. PENN HIGHLANDS HEALTHCARE (PHH) SHALL HAVE THE FOLLOWING POWERS WITH RESPECT TO THE ELECTION AND REMOVAL OF DIRECTORS OF THIS CORPORATION. NOMINATION AND ELECTION OF DIRECTORS: PRIOR TO THE END OF PHH'S FISCAL YEAR, THE PHH BOARD WILL MEET TO ELECT DIRECTORS TO FILL OPEN DIRECTOR POSITIONS, OTHER THAN EX-OFFICIO POSITIONS. AT LEAST SIXTY (60) DAYS IN ADVANCE OF THIS MEETING, PENN HIGHLANDS CLEARFIELD SHALL PROVIDE TO PHH'S GOVERNANCE/NOMINATING COMMITTEE (THE PHH GOVERNANCE/NOMINATING COMMITTEE) A LIST OF ONE OR MORE CANDIDATES (THE NUMBER OF CANDIDATES TO BE DETERMINED IN THE PHH GOVERNANCE/NOMINATING COMMITTEE'S DISCRETION) WHOM IT HAS APPROVED FOR EACH EXPIRING DIRECTOR POSITION (OTHER THAN EX OFFICIO POSITIONS). THE LIST OF CANDIDATES SHALL HAVE BEEN DEVELOPED IN CONSULTATION WITH THE BOARD OF PENN HIGHLANDS CLEARFIELD. THE PHH GOVERNANCE/NOMINATING COMMITTEE SHALL REVIEW EACH CANDIDATE IN ACCORDANCE WITH THE PHH BYLAWS, THE CRITERIA, IF ANY, SET FORTH IN THIS ORGANIZATION'S BYLAWS OR POLICIES FOR WHICH SAID CANDIDATE IS BEING CONSIDERED FOR BOARD SERVICE, AND THE POLICIES AND RULES OF PHH, INCLUDING, WITHOUT LIMITATION, THE CONFLICT OF INTEREST POLICY (ALL OF WHICH SHALL BE REFERRED TO COLLECTIVELY HEREIN AS THE ELIGIBILITY CRITERIA) AND DEVELOP A LIST OF ONE OR MORE CANDIDATES FOR EACH OPEN POSITION (THE NUMBER OF CANDIDATES TO BE DETERMINED IN THE PHH GOVERNANCE/NOMINATING COMMITTEE'S DISCRETION). ONCE THE SLATE OF CANDIDATES FOR EACH OPEN DIRECTOR POSITION IS NOMINATED BY THE PHH GOVERNANCE/NOMINATING COMMITTEE, THE BOARD OF PENN HIGHLANDS CLEARFIELD SHALL SUBMIT SUCH SLATE OF CANDIDATES TO THE PHH BOARD FOR ELECTION. THE PHH BOARD MAY ELECT BY A VOTE OF THE MAJORITY OR REFUSE TO ELECT EACH CANDIDATE SUBMITTED BY THE BOARD OF PENN HIGHLANDS CLEARFIELD AND MAY NOT ELECT ANY CANDIDATE NOT SUBMITTED BY THE BOARD OF PENN HIGHLANDS CLEARFIELD AND NOMINATED BY THE PHH GOVERNANCE/NOMINATING COMMITTEE. IN THE EVENT THE PHH BOARD FAILS TO ELECT A CANDIDATE NOMINATED AS DESCRIBED ABOVE, THEN (I) PHH WILL NOTIFY THIS CORPORATION; AND (II) THE PROCESS DESCRIBED ABOVE SHALL CONTINUE UNTIL ALL OPEN BOARD POSITIONS OF PENN HIGHLANDS CLEARFIELD HAVE BEEN FILLED. UNLESS OTHERWISE SPECIFIED AT THE TIME OF ELECTION, NEW DIRECTORS SHALL BE INSTALLED AT THE FIRST MEETING OF THE BOARD OF DIRECTORS OF PENN HIGHLANDS CLEARFIELD FOLLOWING THEIR ELECTION. REMOVAL: WITH RESPECT TO ANY DIRECTOR OF PENN HIGHLANDS CLEARFIELD, THE BOARD OF PHH HAS THE POWER TO REMOVE SUCH DIRECTOR AT ANY TIME WITH OR WITHOUT CAUSE. VACANCIES: IN THE EVENT THAT PENN HIGHLANDS CLEARFIELD DESIRES TO FILL A VACANCY OCCURRING ON ITS BOARD, THE PHH GOVERNANCE/NOMINATING COMMITTEE AND THE BOARD OF PHH, AT THE REQUEST OF PENN HIGHLANDS CLEARFIELD, SHALL ACT TO FILL SUCH VACANCY. BYLAWS: SUBJECT TO THE APPROVAL OF PHH AS SET FORTH IN THE BYLAWS, THE ARTICLES AND THESE BYLAWS MAY BE ALTERED, AMENDED, OR REPEALED AND NEW ARTICLES OR BYLAWS MAY BE ADOPTED BY THE AFFIRMATIVE VOTE OF TWO-THIRDS (2/3) OF THE BOARD. WRITTEN NOTICE OF THE INTENT TO AMEND THE ARTICLES OR THESE BYLAWS AND A DRAFT OF THE PROPOSED CHANGE SHALL BE SENT TO ALL DIRECTORS, BY THE SECRETARY, AT LEAST FIVE (5) DAYS PRIOR TO ANY MEETING AT WHICH AMENDMENT OF THE ARTICLES OR THESE BYLAWS IS INTENDED.
FORM 990, PART VI, SECTION B, LINE 11BFORM 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT AND MANAGEMENT OF THE ORGANIZATION. THE DRAFT FORM 990 IS REVIEWED BY THE CFO AND THE ACCOUNTING MANAGER. AFTER ALL SUGGESTED CHANGES FROM THE CFO AND THE ACCOUNTING MANAGER ARE MADE, THE UPDATED DRAFT FORM 990 IS PROVIDED FOR REVIEW TO THE FULL BOARD.
FORM 990, PART VI, SECTION B, LINE 12CMONITORING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY: PENN HIGHLANDS HEALTHCARE, INC. (PHH), MAINTAINS A CONFLICT OF INTEREST POLICY WHICH APPLIES TO ALL SUBSIDIARIES. THE CONFLICT OF INTEREST POLICY APPLIES TO BOARD MEMBERS, OFFICERS, EXECUTIVE EMPLOYEES, AND ANY OTHER MANAGER OR SUPERVISOR EXERCISING SUBSTANTIAL INFLUENCE OVER OPERATIONS. EACH COVERED PERSON WILL PROMPTLY AND FULLY DISCLOSE ALL MATERIAL FACTS OF EVERY ACTUAL OR POTENTIAL DUAL INTEREST EXISTING AT THE TIME WHEN HE/SHE BECOMES A COVERED PERSON, AND ANNUALLY THROUGH EACH PHH SYSTEM ENTITY'S DISCLOSURE STATEMENT, WHICH REQUESTS DISCLOSURE OF RELATIONSHIPS, INVESTMENTS, AND TRANSACTIONS THAT MAY LEAD TO AN ACTUAL CONFLICT OF INTEREST. ALL COMPLETED DISCLOSURE STATEMENTS WILL BE PROVIDED TO THE PHH GOVERNANCE/NOMINATING COMMITTEE. THIS COMMITTEE, IN CONSULTATION WITH THE CHAIRPERSON OR VICE CHAIRPERSON OF EACH PHH SYSTEM ENTITY'S BOARD, SHALL EVALUATE THE COMPLETED DISCLOSURE STATEMENTS AND DETERMINE IF THERE ARE ANY CONFLICTS THAT ARE SO PERVASIVE AS TO RENDER ANY COVERED PERSON INELIGIBLE FOR SERVICE. THE CHAIRPERSON OF EACH PHH SYSTEM ENTITY'S BOARD WILL DISCLOSE TO THE FULL BOARD OF SAID PHH SYSTEM ENTITY ALL DUAL INTERESTS REPORTED TO HIM OR HER UNDER THE POLICY AND WILL ALSO MAKE THE DISCLOSURE STATEMENTS OF ALL COVERED PERSONS AVAILABLE TO DIRECTORS AT ANY TIME DURING THE YEAR. IF A POTENTIAL DUAL INTEREST ARISES AS A RESULT OF A CONTEMPLATED PHH SYSTEM ENTITY BOARD (OR COMMITTEE) ACTION, THE CHAIRPERSON OF SAID PHH SYSTEM ENTITY'S BOARD OR THE INTERESTED PERSON SHALL, OR ANY OTHER DIRECTOR MAY, RAISE THE QUESTION OF THE INTERESTED PERSON'S DUAL INTEREST. THE DISINTERESTED MEMBERS OF THE PHH SYSTEM ENTITY'S BOARD (OR COMMITTEE) WILL EVALUATE THE DISCLOSURES AND THE MATERIAL FACTS RELATING TO THE TRANSACTION, ARRANGEMENT, OR POLICY GIVING RISE TO THE DUAL INTEREST TO DETERMINE WHETHER THEY INVOLVE ACTUAL CONFLICTS OF INTEREST AND MAY ATTEMPT TO DEVELOP ALTERNATIVES TO REMOVE THE CONFLICT FROM THE TRANSACTION, ARRANGEMENT, OR POLICY. A COVERED PERSON WHO HAS A DUAL INTEREST SHALL NOT BE PRESENT FOR OR SHALL LEAVE ANY PORTION OF A MEETING AT WHICH A PHH SYSTEM ENTITY'S BOARD (OR COMMITTEE) IS VOTING TO DETERMINE WHETHER A CONFLICT EXISTS, BUT MAY BE PRESENT PRIOR TO THE VOTE TO MAKE A PRESENTATION TO SAID BOARD (OR COMMITTEE), TO DISCLOSE ADDITIONAL FACTS, OR TO RESPOND TO QUESTIONS. IF A PHH SYSTEM ENTITY'S BOARD (OR COMMITTEE DETERMINES THAT AN ACTUAL CONFLICT OF INTEREST EXISTS, THE INTERESTED PERSON SHALL BE SO ADVISED AND THE CHAIRPERSON OF A PHH SYSTEM ENTITY'S BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE OR DIRECT MANAGEMENT TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, IF THIS HAS NOT ALREADY BEEN DONE. ANY INTERESTED PERSON WHO HAS AN ACTUAL CONFLICT OF INTEREST WITH RESPECT TO THE TRANSACTION OR ARRANGEMENT DOES NOT PARTICIPATE IN AND IS NOT PRESENT FOR THE VOTE REGARDING ANY SUCH TRANSACTION OR ARRANGEMENT. IF AN INDIVIDUAL WHOSE COMPANY OR EMPLOYER HAS A BUSINESS RELATIONSHIP WITH A PHH SYSTEM ENTITY, BUT THE INDIVIDUAL DOES NOT HAVE AN ACTUAL CONFLICT OF INTEREST WITH RESPECT TO THIS BUSINESS RELATIONSHIP, THE INDIVIDUAL MAY NONETHELESS VOLUNTARILY RECUSE HIM/HERSELF FROM VOTING ON ANY MATTERS RELATED TO THE RELATIONSHIP.
FORM 990, PART VI, SECTION B, LINES 15A & 15BCOMPENSATION DETERMINATION: PENN HIGHLANDS HEALTHCARE, INC. (PHH) PERFORMS THE COMPENSATION REVIEW FOR THE PHH EXECUTIVES, INCLUDING THE CEO OF PH CLEARFIELD. AN INDEPENDENT COMPENSATION CONSULTANT, YAFFE AND COMPANY, IS CONTRACTED TO COMPLETE AN ANNUAL COMPENSATION REVIEW. INCLUDED IN THIS REVIEW IS COMPARATIVE DATA. THE PHH BOARD REVIEWS AND APPROVES THE COMPENSATION.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENT AVAILABILITY: THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART VII, SECTION ABOARD MEMBER COMPENSATION: NO DIRECTORS RECEIVE ANY COMPENSATION FOR THEIR DIRECTOR DUTIES. RHONDA HALSTEAD WAS COMPENSATED FOR HER DUTIES AS PRESIDENT OF PENN HIGHLANDS CLEARFIELD. KEVIN TYLER, DO, THOMAS CARNEVALE, MD, RYAN BISBEY, MD, AND ROBERT STEWARD, JR, MD, ARE COMPENSATED BY A RELATED ORGANIZATION FOR THEIR DUTIES AS PHYSICIANS.
FORM 990, PART XI, LINE 9OTHER CHANGES IN NET ASSETS: $ 4,000 TRANSFER FROM AFFILIATE
FORM 990 PART IX LINE 11GDESCRIPTION:PROFESSIONAL FEES TOTAL FEES:1863611
FORM 990 PART IX LINE 11GDESCRIPTION:LAB SERVICES TOTAL FEES:1189746
FORM 990 PART IX LINE 11GDESCRIPTION:OUTSIDE SERVICES TOTAL FEES:1481456
FORM 990 PART IX LINE 11GDESCRIPTION:CONTRACT LABOR TOTAL FEES:842839
FORM 990 PART IX LINE 11GDESCRIPTION:MAINTENANCE CONTRACTS TOTAL FEES:600501
FORM 990 PART IX LINE 11GDESCRIPTION:CONSULTING SERVICES TOTAL FEES:11431

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (18 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
PENN HIGHLANDS HEALTHCARE
PO BOX 447DUBOISPA15801320345810MGMT SERVICESPA501(C)(3)12 C III-FINAfalse
CLEAR-MED CORPORATION
809 TURNPIKE AVENUECLEARFIELDPA16830251657668OUTPAT. PHYSPA501(C)(3)3PHHfalse
ELCO HOUSING
763 JOHNSONBURG ROADST MARYSPA15857251639115HOUSINGPA501(C)(3)12 A IPHHfalse
ELK REGIONAL PROFESSIONAL GROUP INC
757 JOHNSONBURG ROAD STE 200ST MARYSPA15857251875183HEALTHCAREPA501(C)(3)10PHHfalse
COMMUNITY NURSES HOME HEALTH AND HOSPICE
757 JOHNSONBURG ROAD STE 200ST MARYSPA15857250996070HEALTHCAREPA501(C)(3)10CNIfalse
COMMUNITY NURSES HOME SUPPORT SERVICES
757 JOHNSONBURG ROAD STE 200ST MARYSPA15857251623601HEALTHCAREPA501(C)(3)10CNIfalse
COMMUNITY NURSES INC
757 JOHNSONBURG ROAD STE 200ST MARYSPA15857251623598HEALTHCAREPA501(C)(3)7PHHfalse
DUBOIS REGIONAL MEDICAL CENTER
100 HOSPITAL AVENUEDUBOISPA15801251490707HOSPITALPA501(C)(3)PHHfalse
BROOKVILLE HOSPITAL
100 HOSPITAL ROADBROOKVILLEPA15825250984595HOSPITALPA501(C)(3)DRMCfalse
DRMC EMPLOYEE BENEFITS PLAN TRUST
100 HOSPITAL AVEDUBOISPA15810256332829DRMC EMP BENEPA501(C)(9)DRMCfalse
ELK REGIONAL HEALTH CENTER
763 JOHNSONBURG ROADST MARYSPA15857250585280HOSPITALPA501(C)(3)PHHfalse
JC BLAIR MEMORIAL HOSPITAL
1225 WARM SPRINGS AVENUEHUNTINGDONPA16652231352159ACUTE HOSPITAPA501(C)(3)PHHfalse
JEFFCO HEALTH SERVICES INC
417 ROUTE 28BROOKVILLEPA15825251505478HEALTH CAREPA501(C)(3)10BROOKVILLEfalse
JC BLAIR MEMORIAL HOSPITAL FOUNDATION
935 14TH STREETHUNTINGDONPA16652251881377SUPPORT HOSPPA501(C)(3)12A IPHHfalse
DRMC WORKERS COMPENSATION TRUST
PO BOX 447DUBOISPA15801251741497SUPPORTPA501(C)(3)12 B IIDRMCfalse
PENN HIGHLANDS TYRONE
187 HOSPITAL DRIVETYRONEPA16686231440116HOSPITALPA501(C)(3)PHHfalse
HELPMATES INC
250 WEST MAIN STREETRIDGWAYPA15853251555968HEALTH CAREPA501(C)(3)10CNIfalse
TYRONE REGIONAL HEALTH NETWORK FOUNDATIO
187 HOSPITAL DRIVETYRONEPA16686814504606SUPPORTPA501(C)(3)12 A IPH TYRONEfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1CLEARFIELD MEDICAL ASSOCIATES LPBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1807 TURNPIKE AVENUEAddressLine1Txt
CityCLEARFIELDCityNm
State AbbreviationPAStateAbbreviationCd
ZIP16830ZIPCd
FieldValueIRS element (for citing)
EIN251369635EIN
Primary ActivitiesPHYSICIAN OFFICESPrimaryActivitiesTxt
Legal Domicile StatePALegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1CLEARFIELD HOSPBusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeEXCLUDEDPredominantIncomeTypeTxt
Share Of Total Income$2,746ShareOfTotalIncomeAmt
Share Of EOY Assets$812,387ShareOfEOYAssetsAmt
Disproportionate AllocationsfalseDisproportionateAllocationsInd
General Or Managing PartnerYes (true)GeneralOrManagingPartnerInd
Ownership0.80000OwnershipPct

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationInd
CHARITABLE TRUST #1
PO BOX 171CLEARFIELDPA16830256019042INVESTMENTSPACLEARFIELD HOSPTRUST$4,794$864,4331.00000Yes (true)
CHARITABLE TRUST #2
PO BOX 171CLEARFIELDPA16830256019043INVESTMENTPACLEARFIELD HOSPTRUST$631$84,2331.00000Yes (true)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (true)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (true)LoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.