2020-07-06T09:05:40-05:00 2019-06-30 550486667 ARNETT CARBIS TOOTHMAN LLP 5700 CORPORATE DRIVE STE 650 PITTSBURGH PA 15237 990 2018-07-01 251441518 HERITAGE VALLEY HEALTH SYSTEMINC HERI 4127416600 1000 DUTCH RIDGE ROAD BEAVER PA 15009 ROBERT ROSENBERGER VICE-PRESIDENT, FINANCE 4127416600 2020-06-30 1 JEFFREY J PETRELL CPA P00138808 4126356270 2020-06-30 216.12.119.47 2020-06-30 09:52:07 ED P 2FCC53CBB48CF33582B79C602AC26854C347F8ED 3C3BA26E3B84C2B54F778FE225B7D70D68300C72 2018 2021-01-29 14:40:06Z ROBERT ROSENBERGER 720 BLACKBURN ROAD SEWICKLEY PA 15143 73014676 0 X WWW.HERITAGEVALLEY.ORG X 1996 PA SUPPORTING ORGANIZATION TO TAX-EXEMPT HOSPITALS (VALLEY MEDICAL FACILITIES, INC.) HELPING THE HOSPITALS TO FURTHER THEIR TAX-EXEMPT PURPOSES. 22 18 0 19 50769 -7938 0 0 8764366 7616808 3101092 8991579 0 39674000 11865458 56282387 0 0 0 0 1381371 1620156 0 0 0 6930004 6698958 8311375 8319114 3554083 47963273 55390087 97531912 17241045 11777297 38149042 85754615 SUPPORTING ORGANIZATION TO TAX-EXEMPT HOSPITALS (VALLEY MEDICAL FACILITIES, INC.) HELPING THE HOSPITALS TO FURTHER THEIR TAX-EXEMPT PURPOSES. 0 0 7204658 46643781 HERITAGE VALLEY HEALTH SYSTEM, INC. FORMED THE HERITAGE VALLEY HEALTHCARE NETWORK, LLC. (HVHN)IN FY 2017. THE PURPOSE OF THE HVHN IS TO FORM A CLINICALLY INTEGRATED PHYSICIAN HOSPITAL NETWORK WITH JOINT CONTRACTING AUTHORITY TO DEVELOP CARE PROTOCOLS AND OTHER CARE COORDINATION POLICIES USING EVIDENCE-BASED MEDICINE AND OTHER TECHNIQUES TO PROVIDE A MORE COST-EFFECTIVE HEALTH CARE PRODUCT WHILE MAINTAINING OR IMPROVING PHYSICIAN REIMBURSEMENT, USING EXISTING EXPERIENCE AND SUCCESS OF AFFILIATED PRIMARY CARE PRACTICES AS A FOUNDATION FROM WHICH TO BUILD. 596258 596258 HERITAGE VALLEY HEALTH SYSTEM, INC.'S SHARE OF REBATES FROM MATERIALS MANAGEMENT AND GROUP PURCHASING PROGRAMS UTILIZED BY VALLEY MEDICAL FACILITIES, INC., AND THE RELATED PHYSICIAN GROUPS WERE TRANSFERRED TO VALLEY MEDICAL FACILITIES, INC. AND THE RELATED PHYSICIAN GROUPS BASED ON THEIR USAGE OF MEDICAL RELATED SUPPLIES. THE GROUP PURCHASING PROGRAM IS DESIGNED TO REDUCE THE COST OF MEDICAL RELATED SUPPLIES PURCHASED BY THE HERITAGE VALLEY HEALTH SYSTEM ORGANIZATIONS. 7800916 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 25 0 0 1 1 0 0 0 0 0 0 0 0 0 X 22 18 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 1 1 PA X LINDA SCHAEFER 4127416600 420 ROUSER ROAD MOON TOWNSHIP PA 15108 NORMAN F MITRY PRESIDENT & CEO 2.00 64.75 X X 0 798313 38444 LYNN GEORGE PHD CHAIR 2.00 2.00 X X 0 0 0 SCOTT M ELSTE VICE-CHAIR 2.00 2.00 X X 0 0 0 JOAN MARSHALL ESQ SECRETARY 2.00 2.00 X X 0 0 0 ELISA DITOMMASO CPA TREASURER 2.00 2.00 X X 0 0 0 GR ORR III EMERITUS BOARD CHAIR 2.00 2.00 X 0 0 0 DENNIS PEGDEN PHD EMERITUS BOARD CHAIR 2.00 2.00 X 0 0 0 RICHARD KIM MD DIRECTOR 2.00 2.00 X 0 0 0 MICHAEL MALKOWSKI MD DIRECTOR 2.00 41.25 X 0 485200 29314 KEVIN FLANNERY DIRECTOR 2.00 2.00 X 0 0 0 THOMAS LEYDIG DIRECTOR 2.00 2.00 X 0 0 0 THOMAS ARBOGAST ESQ DIRECTOR 2.00 2.00 X 0 0 0 JEFFREY HEIN MD DIRECTOR 2.00 40.00 X 0 396820 29080 REBECCA POUNDS DDS DIRECTOR 2.00 2.00 X 0 0 0 BOB TERWILLIGER DIRECTOR 2.00 2.00 X 0 0 0 SUSAN PAONE DHA DIRECTOR 2.00 2.00 X 0 0 0 KAREN JEROME-ZAPADKA MD DIRECTOR 2.00 2.00 X 0 0 0 MARK BRENNAN DIRECTOR 2.00 2.00 X 0 0 0 MICHAEL DICLEMENTE DIRECTOR 2.00 2.00 X 0 0 0 DANA EDWARDS DIRECTOR 2.00 2.00 X 0 0 0 DAVID SCOTT DIRECTOR 2.00 2.00 X 0 0 0 SRIDHAR TAYUR DIRECTOR 2.00 2.00 X 0 0 0 BRYAN J RANDALL VICE-PRESIDENT, FINANCE & CFO 2.00 64.75 X 0 438281 35147 SHARON LOFTUS ESQ ASST. SECRETARY 2.00 40.00 X 0 310435 16155 0 2429049 148140 0 0 1 0 MARSHALL DENNEHEY WARNER 2000 WALNUT ST PHILADELPHIA PA 19103 LEGAL FEES 444790 DELOITTE ONE PPG PLACE SUITE 2600 PHILADELPHIA PA 15222 CONSULTANT 359293 JUNIPER ADVISORY LLC 191 N UPPER WACKER DRIVE CHICAGO IL 60606 CONSULTANT 264342 DICKIE MCCAMEY & CHILCOTE 2 PPG PLACE SUITE 400 PITTSBURGH PA 15222 LEGAL FEES 214401 WEBER GALLAGHER SIMPSON STAPLETON FIRES 4 PPG PLACE 5TH FLOOR PITTSBURGH PA 15222 LEGAL FEES 193758 6 SHARED SAVINGS REVENUE 900099 7566039 7566039 PARTNERSHIP INCOME 900099 50769 50769 7616808 5896588 5896588 19827280 16732289 3094991 3094991 3094991 INHERENT CONT. RELATED TO MEMBER 900099 39674000 39674000 39674000 56282387 47240039 50769 8991579 1302009 984101 317908 25845 19534 6311 201674 152431 49243 90628 68500 22128 18 18 113530 113530 5352 5352 HVHN LLC SHARED SAVINGS 5229585 5229585 OVH START UP COSTS 1143633 1143633 CONSULTING SERVICES 190788 68180 122608 MISCELLANEOUS EXPENSE 16052 16052 8319114 7800916 518198 0 5642470 4776236 3118849 3393004 2954109 565040 458840 8217974 350311 24624131 36798917 5223786 6686174 1215476 1215476 6508206 41173000 55390087 97531912 4838484 7248716 12402561 4528581 17241045 11777297 X 38149042 84255615 1499000 38149042 85754615 55390087 97531912 X 47963273 -1613164 -85969 1341433 X 0 1 X 1 1 1 X X 2 VALLEY MEDICAL FACILITIES INC 251801532 3 1 0 0 OHIO VALLEY HOSPITAL 250967480 3 1 0 0 2 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 X 1 1 PT IV SEC E LN 3A THE SOLE MEMBER OF VALLEY MEDICAL FACILITIES, HERITAGE VALLEY HEALTH SYSTEM, ACTING BY AND THROUGH ITS BOARD OF DIRECTORS HAVE EXCLUSIVE POWER TO: 1. ELECT ALL MEMBERS TO VALLEY MEDICAL FACILITIES' BOARD OF DIRECTORS, WITH RIGHT TO REVOKE THE ELECTED DIRECTORS, WITH OR WITHOUT CAUSE; 2. AMEND OR APPROVE AMENDMENTS TO VALLEY MEDICAL FACILITIES' ARTICLES OF INCORPORATION OR BYLAWS; 3. APPROVE ANY VOLUNTARY DISSOLUTION, MERGER OR CONSOLIDATION OF VALLEY MEDICAL FACILITIES; 4. APPROVE THE CREATION OR ACQUISITION OF ANY SUBSIDIARY OR AFFILIATE; AND 5. APPOINT AND REMOVE THE PRESIDENT OF VALLEY MEDICAL FACILITIES. THE SOLE MEMBER OF OHIO VALLEY HOSPITAL, HERITAGE VALLEY HEALTH SYSTEM, ACTING BY AND THROUGH ITS BOARD OF DIRECTORS HAVE EXCLUSIVE POWER TO: (A) TO RATIFY THE APPOINTMENT OF THE DIRECTORS OF THE HOSPITAL WHO ARE OVH BOARD APPOINTEES FOLLOWING NOMINATION AND APPROVAL BY THE BOARD OF DIRECTORS, AND TO APPOINT THE DIRECTORS OF THE HOSPITAL WHO ARE SOLE MEMBER APPOINTEES; (B) (I) SUBJECT TO CONSULTATION BETWEEN THE BOARD CHAIRS OF THE SOLE MEMBER AND THE HOSPITAL, TO REMOVE ANY OF THE DIRECTORS OF THE HOSPITAL WHO ARE OVH BOARD APPOINTEES, AND TO RATIFY THE APPOINTMENT OF REPLACEMENT OVH BOARD APPOINTEES NOMINATED AND APPROVED BY THE BOARD OF DIRECTORS FOR THE UNEXPIRED PORTION OF THEIR TERM(S); AND (II) TO REMOVE AND REPLACE ANY DIRECTORS OF THE HOSPITAL WHO ARE SOLE MEMBER APPOINTEES; (C) TO RATIFY THE ELECTION, RE-ELECTION AND REMOVAL OF ALL OFFICERS, INCLUDING THE PRESIDENT/CEO OF THE HOSPITAL; (D) TO APPROVE THE AMENDMENT, REVISION OR RESTATEMENT OF THE HOSPITAL'S ARTICLES OF INCORPORATION AND THESE BYLAWS; (E) TO APPROVE THE ADOPTION OF OR ANY CHANGE IN THE MISSION, PURPOSE, PHILOSOPHY OR OBJECTIVES OF THE HOSPITAL; (F) TO APPROVE ANY CHANGE IN THE GENERAL STRUCTURE OF THE HOSPITAL AS A VOLUNTARY, NONPROFIT CORPORATION; (G) TO APPROVE ANY (I) TRANSACTION AUTHORIZED BY THE PENNSYLVANIA ENTITY TRANSACTIONS LAW, 15 PA. CSA 311, ET SEQ., INVOLVING THE HOSPITAL, OR (II) SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE HOSPITAL; (H) TO APPROVE THE VOLUNTARY DISSOLUTION, WINDING UP OR TERMINATION OF THE HOSPITAL; (I) TO APPROVE THE STRATEGIC PLAN, CAPITAL PLAN AND OPERATING BUDGET OF THE HOSPITAL; (J) TO APPROVE THE INCURRENCE OF ANY UNPLANNED OR UNBUDGETED COMMITMENTS BY THE HOSPITAL IN EXCESS OF $250,000; (K) TO RE-APPROVE THE HOSPITAL ENTERING INTO ANY BUDGETED ITEMS OR AGREEMENTS THAT HAVE A TOTAL VALUE OR DOLLAR COMMITMENT AMOUNT GREATER THAN$1,000,000; (L) TO APPROVE INVESTMENT POLICIES OF THE HOSPITAL; (M) TO APPROVE THE CLOSURE OR RELOCATION OF A LICENSED HEALTHCARE FACILITY OR AN EXISTING LINE OF BUSINESS OF THE HOSPITAL AND/OR ITS SUBSIDIARIES; (N) TO APPROVE THE FORMATION OF, DISSOLUTION OF, OR THE MAKING OF INVESTMENTS IN SUBSIDIARY CORPORATIONS, PARTNERSHIPS AND JOINT VENTURES; (O) TO APPROVE THE TAKING OF ANY ACTION WHICH WOULD ENDANGER THE NONPROFIT STATUS OF THE HOSPITAL OR THE TAX EXEMPT STATUS OF THE SOLE MEMBER; AND (P) TO GIVE SUCH OTHER APPROVALS AND TAKE SUCH OTHER ACTIONS AS ARE SPECIFICALLY RESERVED TO MEMBERS OF PENNSYLVANIA NONPROFIT CORPORATIONS UNDER THE NONPROFIT CORPORATION LAW. PT IV SEC E LN 3B THE SOLE MEMBER OF VALLEY MEDICAL FACILITIES, HERITAGE VALLEY HEALTH SYSTEM, ACTING BY AND THROUGH ITS BOARD OF DIRECTORS HAVE EXCLUSIVE POWER TO: 1. ELECT ALL MEMBERS TO VALLEY MEDICAL FACILITIES' BOARD OF DIRECTORS, WITH RIGHT TO REVOKE THE ELECTED DIRECTORS, WITH OR WITHOUT CAUSE; 2. AMEND OR APPROVE AMENDMENTS TO VALLEY MEDICAL FACILITIES' ARTICLES OF INCORPORATION OR BYLAWS; 3. APPROVE ANY VOLUNTARY DISSOLUTION, MERGER OR CONSOLIDATION OF VALLEY MEDICAL FACILITIES; 4. APPROVE THE CREATION OR ACQUISITION OF ANY SUBSIDIARY OR AFFILIATE; AND 5. APPOINT AND REMOVE THE PRESIDENT OF VALLEY MEDICAL FACILITIES. THE SOLE MEMBER OF OHIO VALLEY HOSPITAL, HERITAGE VALLEY HEALTH SYSTEM, ACTING BY AND THROUGH ITS BOARD OF DIRECTORS HAVE EXCLUSIVE POWER TO: (A) TO RATIFY THE APPOINTMENT OF THE DIRECTORS OF THE HOSPITAL WHO ARE OVH BOARD APPOINTEES FOLLOWING NOMINATION AND APPROVAL BY THE BOARD OF DIRECTORS, AND TO APPOINT THE DIRECTORS OF THE HOSPITAL WHO ARE SOLE MEMBER APPOINTEES; (B) (I) SUBJECT TO CONSULTATION BETWEEN THE BOARD CHAIRS OF THE SOLE MEMBER AND THE HOSPITAL, TO REMOVE ANY OF THE DIRECTORS OF THE HOSPITAL WHO ARE OVH BOARD APPOINTEES, AND TO RATIFY THE APPOINTMENT OF REPLACEMENT OVH BOARD APPOINTEES NOMINATED AND APPROVED BY THE BOARD OF DIRECTORS FOR THE UNEXPIRED PORTION OF THEIR TERM(S); AND (II) TO REMOVE AND REPLACE ANY DIRECTORS OF THE HOSPITAL WHO ARE SOLE MEMBER APPOINTEES; (C) TO RATIFY THE ELECTION, RE-ELECTION AND REMOVAL OF ALL OFFICERS, INCLUDING THE PRESIDENT/CEO OF THE HOSPITAL; (D) TO APPROVE THE AMENDMENT, REVISION OR RESTATEMENT OF THE HOSPITAL'S ARTICLES OF INCORPORATION AND THESE BYLAWS; (E) TO APPROVE THE ADOPTION OF OR ANY CHANGE IN THE MISSION, PURPOSE, PHILOSOPHY OR OBJECTIVES OF THE HOSPITAL; (F) TO APPROVE ANY CHANGE IN THE GENERAL STRUCTURE OF THE HOSPITAL AS A VOLUNTARY, NONPROFIT CORPORATION; (G) TO APPROVE ANY (I) TRANSACTION AUTHORIZED BY THE PENNSYLVANIA ENTITY TRANSACTIONS LAW, 15 PA. CSA 311, ET SEQ., INVOLVING THE HOSPITAL, OR (II) SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE HOSPITAL; (H) TO APPROVE THE VOLUNTARY DISSOLUTION, WINDING UP OR TERMINATION OF THE HOSPITAL; (I) TO APPROVE THE STRATEGIC PLAN, CAPITAL PLAN AND OPERATING BUDGET OF THE HOSPITAL; (J) TO APPROVE THE INCURRENCE OF ANY UNPLANNED OR UNBUDGETED COMMITMENTS BY THE HOSPITAL IN EXCESS OF $250,000; (K) TO RE-APPROVE THE HOSPITAL ENTERING INTO ANY BUDGETED ITEMS OR AGREEMENTS THAT HAVE A TOTAL VALUE OR DOLLAR COMMITMENT AMOUNT GREATER THAN$1,000,000; (L) TO APPROVE INVESTMENT POLICIES OF THE HOSPITAL; (M) TO APPROVE THE CLOSURE OR RELOCATION OF A LICENSED HEALTHCARE FACILITY OR AN EXISTING LINE OF BUSINESS OF THE HOSPITAL AND/OR ITS SUBSIDIARIES; (N) TO APPROVE THE FORMATION OF, DISSOLUTION OF, OR THE MAKING OF INVESTMENTS IN SUBSIDIARY CORPORATIONS, PARTNERSHIPS AND JOINT VENTURES; (O) TO APPROVE THE TAKING OF ANY ACTION WHICH WOULD ENDANGER THE NONPROFIT STATUS OF THE HOSPITAL OR THE TAX EXEMPT STATUS OF THE SOLE MEMBER; AND (P) TO GIVE SUCH OTHER APPROVALS AND TAKE SUCH OTHER ACTIONS AS ARE SPECIFICALLY RESERVED TO MEMBERS OF PENNSYLVANIA NONPROFIT CORPORATIONS UNDER THE NONPROFIT CORPORATION LAW. 0 INVESTMENT IN SUBSIDIARIES 36699071 F ALTERNATIVE INVESTMENTS 50142 C COMMON TRUST 49704 C 36798917 EQUITY INTEREST IN PREMIER, INC. 6686174 F 6686174 ACQUISITION COSTS 41173000 41173000 AFFILIATES PAYABLE 4528581 4528581 X PART X, LINE 2: HERITAGE VALLEY HEALTH SYSTEM QUALIFIES AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE SERVICE CODE AND, THEREFORE, IS EXEMPT FROM INCOME TAX ON RELATED INCOME PURSUANT TO SECTION 501 (A) OF THE CODE. HERITAGE VALLEY HEALTH SYSTEM DOES NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF JUNE 30, 2019 AND 2018. CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, 0 0 INVESTMENTS 213997 0 0 0 0 0 0 213997 0 213997 0 0 1 1 1 0 PT 1 LINE 2 HERITAGE VALLEY HEALTH SYSTEM DOES NOT MAKE ANY GRANTS OUTSIDE OF THE UNITED STATES. 0 1 0 0 0 0 0 0 0 NORMAN F MITRY PRESIDENT & CEO 0 679743 0 67020 0 51550 0 23466 0 14978 0 836757 0 0 MICHAEL MALKOWSKI MD DIRECTOR 0 485000 0 0 0 200 0 11000 0 18314 0 514514 0 0 JEFFREY HEIN MD DIRECTOR 0 212500 0 183820 0 500 0 11000 0 18080 0 425900 0 0 BRYAN J RANDALL VICE-PRESIDENT, FINANCE & CFO 0 379846 0 32962 0 25473 0 17966 0 17181 0 473428 0 0 SHARON LOFTUS ESQ ASST. SECRETARY 0 275001 0 18884 0 16550 0 15216 0 939 0 326590 0 0 PART I, LINE 3 HERITAGE VALLEY HEALTH SYSTEM'S BOARD OF DIRECTORS HAS APPOINTED AN EXECUTIVE COMPENSATION COMMITTEE TO REVIEW THE SALARIES FOR THE ORGANIZATION'S CEO AND OTHER SENIOR MANAGEMENT OFFICIALS. AS PART OF THE REVIEW, THE EXECUTIVE COMPENSATION COMMITTEE ENGAGED AN OUTSIDE CONSULTING FIRM TO REVIEW THE BASE SALARIES OF THE SENIOR MANAGEMENT TEAM INCLUDING THE CEO IN COMPARISON TO THE MARKET TO ENSURE REASONABLENESS OF COMPENSATION. MARKET ADJUSTMENTS WERE MADE ACCORDINGLY IN INSTANCES WHERE DATA SUPPORTED SUCH CHANGES FOR THIS PERIOD. BONUSES WERE PAID IN ACCORDANCE WITH AN INCENTIVE COMPENSATION PLAN WHICH WAS DEVELOPED AND APPROVED BY THE BOARD OF DIRECTORS SEVERAL YEARS AGO. PART I, LINE 4B THE FOLLOWING EMPLOYEES PARTICIPATED IN THE 457(F) RETIREMENT PLAN - BRYAN RANDALL - $3,100 FORM 990, PART VI, SECTION B, LINE 11B A DRAFT OF THE COMPLETED FORM 990 AND ALL ASSOCIATED FORMS IS MADE AVAILABLE ELECTRONICALLY TO ALL BOARD OF DIRECTORS MEMBERS AND SENIOR MANAGEMENT FOR REVIEW AND COMMENT PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE (IRS). THE BOARD OF DIRECTORS HAS DELEGATED THE RESPONSIBILITY OF REVIEW AND APPROVAL OF THE FORM 990 TO THE FINANCE COMMITTEE OF THE BOARD, WHICH MEETS, REVIEWS, AND APPROVES THE FORM 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C CERTAIN NON-MERIT EMPLOYEES WITH JOB RESPONSIBILITIES THAT PROVIDE AN OPPORTUNITY TO INFLUENCE BUSINESS DECISIONS ARE REQUIRED TO SIGN THE CONFLICT OF INTEREST FORM ANNUALLY. THESE CONFLICT OF INTEREST STATEMENTS ARE REVIEWED ANNUALLY BY THE DEPARTMENT DIRECTOR AND SYSTEM DIRECTOR FOR CORPORATE COMPLIANCE TO DETERMINE IF A CONFLICT EXISTS. ANY POTENTIAL CONFLICTS ARE REFERRED TO THE APPROPRIATE VICE PRESIDENT AND HUMAN RESOURCES TO CONFIRM AND RESOLVE THE CONFLICT. FOR MERIT EMPLOYEES, CONFLICT OF INTEREST STATEMENTS ARE REVIEWED ANNUALLY BY THE DEPARTMENT MANAGER, VICE PRESIDENT OR CEO. ANY POTENTIAL CONFLICTS ARE MANAGED BY THE CEO. OTHER POTENTIALLY INTERESTED PARTIES, SUCH AS BOARD MEMBERS, OFFICERS AND HIGHLY COMPENSATED EMPLOYEES SIGN A STATEMENT ANNUALLY WHICH AFFIRMS SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX EXEMPT PURPOSES. THE CHAIRPERSON OF THE BOARD REVIEWS ANNUALLY A SUMMARY OF THE DISCLOSURE STATEMENTS SO THAT THE BOARD MEMBERS ARE FAMILIAR WITH POTENTIAL CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15 HERITAGE VALLEY HEALTH SYSTEM'S BOARD OF DIRECTORS HAS APPOINTED AN EXECUTIVE COMPENSATION COMMITTEE TO REVIEW THE SALARIES FOR THE ORGANIZATION'S CEO AND OTHER SENIOR MANAGEMENT OFFICIALS. AS PART OF THE REVIEW, THE EXECUTIVE COMPENSATION COMMITTEE ENGAGED AN OUTSIDE CONSULTING FIRM TO REVIEW THE BASE SALARIES OF THE SENIOR MANAGEMENT TEAM INCLUDING THE CEO IN COMPARISON TO THE MARKET TO ENSURE REASONABLENESS OF COMPENSATION. MARKET ADJUSTMENTS WERE MADE ACCORDINGLY IN INSTANCES WHERE DATA SUPPORTED SUCH CHANGES FOR THIS PERIOD. BONUSES WERE PAID IN ACCORDANCE WITH AN INCENTIVE COMPENSATION PLAN WHICH WAS DEVELOPED AND APPROVED BY THE BOARD OF DIRECTORS SEVERAL YEARS AGO. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION PUBLISHES CONDENSED FINANCIAL STATEMENTS FOR PUBLIC USE ON ITS WEBSITE WWW.HERITAGEVALLEY.ORG. GOVERNING DOCUMENTS AND POLICIES, INCLUDING CONFLICTS OF INTEREST, ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: EQUITY TRANSFER -157,567. CHANGE IN TEMPORARILY RESTRICTED NET ASSETS 1,499,000. PART VI LINE 16B THE ORGANIZATION PARTICIPATES IN A NUMBER OF JOINT VENTURES. IN ORDER FOR AN ORGANIZATION TO BE EXCLUSIVELY OPERATED FOR CHARITABLE PURPOSES, AN ORGANIZATION CANNOT DEDICATE A SUBSTANTIAL AMOUNT OF ITS RESOURCES TO AN UNRELATED ACTIVITY. WITH HOSPITAL-AFFILIATED JOINT VENTURES, THE IRS IS CONCERNED ABOUT WHETHER ORGANIZATIONS CAN ADEQUATELY UPHOLD THEIR CHARITABLE MISSION AND PROTECT THEIR CHARITABLE ASSETS UNDER THE TERMS OF THE AGREEMENT AND WHETHER ANY CO-VENTURES IMPERMISSIBLY BENEFIT FROM THE ARRANGEMENT. IN ADDITION TO ANY OTHER DUE DILIGENCE ACTIONS TAKEN REGARDING EACH JOINT VENTURE ARRANGEMENT, AN OUTSIDE TAX CONSULTANT HAS BEEN CONSULTED TO ASSIST THE ORGANIZATION IN EVALUATING THAT THE ARRANGEMENT WILL NOT JEOPARDIZE THE ORGANIZATION'S EXEMPT STATUS BECAUSE OF THE POTENTIAL AMOUNT OF TIME AND EFFORT THAT WILL BE DEVOTED TO THE VENTURES' UNRELATED BUSINESS ACTIVITIES. THE ORGANIZATION DOES NOT BELIEVE THAT ITS JOINT VENTURE ACTIVITIES JEOPARDIZE THE ORGANIZATION'S TAX EXEMPT STATUS. HERITAGE VALLEY INSURANCE COMPANY PO BOX 1051 GT GRAND CAYMEN CJ 251441518 PROFESSIONAL LIABILITY CAPTIVE CJ 5334303 20629264 HERITAGE VALLEY HEALTH SYSTEM INC HERITAGE VALLEY HEALTHCARE NETWORK LLC 1000 DUTCH RIDGE ROAD BEAVER PA 15009 814233618 CLINICAL INTEGRATED NETWORK PA 7581887 7818934 HERITAGE VALLEY HEALTH SYSTEM INC HERITAGE VALLEY HEALTHCARE NETWORK ACO LLC 1000 DUTCH RIDGE ROAD BEAVER PA 15009 821646033 CLINICAL INTEGRATED NETWORK PA 0 0 HERITAGE VALLEY HEALTH SYSTEM INC VALLEY MEDICAL FACILITIES INC 720 BLACKBURN ROAD SEWICKLEY PA 15143 251801532 HOSPITALS PA 501(C)(3) 3 HERITAGE VALLEY HEALTH SYSTEM INC 1 WORKERS COMPENSATION TRUST FUND 420 ROUSER RD MOON TOWNSHIP PA 15108 251463381 WORKERS COMPENSATION PA 501(C)(3) 11C VALLEY MEDICAL FACILITIES INC 0 HOSPITALITY SHOP OF SEWICKLEY VALLEY HOSPITAL 720 BLACKBURN ROAD SEWICKLEY PA 15143 251012989 FUNDRAISING PA 501(C)(3) 11C HERITAGE VALLEY HEALTH SYSTEM INC 1 THE MEDICAL CENTER AUXILIARY 1000 DUTCH RIDGE ROAD BEAVER PA 15009 251383145 FUNDRAISING PA 501(C)(3) 11C HERITAGE VALLEY HEALTH SYSTEM INC 1 HERITAGE VALLEY HEALTH SYSTEM FOUNDATION 420 ROUSER RD MOON TOWNSHIP PA 15108 251801534 FUNDRAISING PA 501(C)(3) 11C HERITAGE VALLEY HEALTH SYSTEM INC 1 OHIO VALLEY HOSPITAL 25 HECKEL ROAD MCKEES ROCK PA 15136 250967480 HOSPITAL PA 501(C)(3) 3 HERITAGE VALLEY HEALTH SYSTEM INC 1 OVH PROFESSIONAL LIABILITY SELF-INSURANCE 25 HECKEL ROAD MCKEES ROCK PA 15136 251619844 MALPRACTICE INSURANCE PA 501(C)(3) 12B, II OHIO VALLEY HOSPITAL 0 OVH WORKER COMPENSATION SELF-INSURANCE TRUST 25 HECKEL ROAD MCKEES ROCK PA 15136 251619842 WORKERS COMPENSATION PA 501(C)(3) 12B, II OHIO VALLEY HOSPITAL 0 CONSOLIDATED SUPPLY CHAIN SERVICES LLC 420 ROUSER ROAD MOON TOWNSHIP PA 15108 271055405 GROUP PURCHASING PA HERITAGE VALLEY HEALTH SYSTEM INC RELATED 3869 590593 0 1 0.70000 EDGEWORTH COMMONS GROUP LLC 725 CHERRINGTON PARKWAY STE 200 MOON TOWNSHIP PA 15108 020713415 SURGERY CENTER PA HERITAGE VALLEY HEALTH SYSTEM INC RELATED 131051 1276125 0 0 0.51000 BEAVER VALLEY AMBULATORY SURGERY CENTER LLC 1030 BEANER HOLLOW ROAD BEAVER PA 15009 822918272 SURGERY CENTER PA HERITAGE VALLEY HEALTH SYSTEM INC RELATED -29598 3423757 0 0 0.51000 HERITAGE VALLEY MULTISPECIALTY GROUP INC 420 ROUSER ROAD MOON TOWNSHIP PA 15108 251775949 PHYSICIAN PRACTICE PA HERITAGE VALLEY HEALTH SYSTEM INC C -6913888 28585460 1.00000 1 TRI-STATE OBSTETRICS & GYNECOLOGY 420 ROUSER ROAD MOON TOWNSHIP PA 15108 251776052 PHYSICIAN PRACTICE PA HERITAGE VALLEY HEALTH SYSTEM INC C -153910 1016165 1.00000 1 HERITAGE VALLEY PEDIATRICS INC 420 ROUSER ROAD MOON TOWNSHIP PA 15108 251775950 PHYSICIAN PRACTICE PA HERITAGE VALLEY HEALTH SYSTEM INC C 1578834 1.00000 1 TRI-STATE GYNECOLOGY INC 420 ROUSER ROAD MOON TOWNSHIP PA 15108 841647473 PHYSICIAN PRACTICE PA HERITAGE VALLEY HEALTH SYSTEM INC C 1.00000 1 OHIO VALLEY MEDICAL SERVICES INC 420 ROUSER ROAD MOON TOWNSHIP PA 15108 205830183 ANESTHESIA SERVICES PA N/A C 0 OHIO VALLEY ANESTHESIA PAIN MANAGEMENT INC 420 ROUSER ROAD MOON TOWNSHIP PA 15108 205690632 PAIN MANAGEMENT SERVICES PA N/A C 0 OHIO VALLEY PROFESSIONAL SERVICES INC 420 ROUSER ROAD MOON TOWNSHIP PA 15108 205689859 HEALTH SERVICES PA N/A C 0 EMBROOKE INCORPORATED 420 ROUSER ROAD MOON TOWNSHIP PA 15108 300008536 AMBULANCE SERVICES PA N/A C 0 KBS ANESTHESIA INC 420 ROUSER ROAD MOON TOWNSHIP PA 15108 834184731 PROVIDES MEDICAL SERVICES PA HERITAGE VALLEY HEALTH SYSTEM INC C 1.00000 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 HERITAGE VALLEY MULTISPECIALTY GROUP INC R 258462 FAIR MARKET VALUE BEAVER VALLEY AMBULATORY SURGERY CENTER LLC R 1263272 FAIR MARKET VALUE OHIO VALLEY HOSPITAL R 7848023 FAIR MARKET VALUE VALLEY MEDICAL FACILITIES INC R 1456289 FAIR MARKET VALUE