2018-05-14T10:07:32-07:00 2017-06-30 990 2016-07-01 251490707 DuBois Regional Medical Center DUBO 8143756117 PO Box 447 100 Hospital Avenue DuBois PA 15801 John Sutika President 8143756107 2018-04-15 2016 2022-09-23 18:48:47Z Penn Highlands DuBois JOHN SUTIKA PO BOX 447 DUBOIS PA 15801 290599695 0 X www.phhealthcare.org X 1985 PA DuBois Regional Medical Center offers residents of West Central Pennsylvania a combination of advanced healthcare in a warm, friendly environment. DRMC is an oasis of clinical and technical excellence, with a focus on patient-centered care. 20 15 2397 206 327670 0 1327336 606190 266409651 283686494 3494000 2218389 1644135 3785329 272875122 290296402 0 0 0 0 140084001 147550277 0 0 0 123517430 133389532 263601431 280939809 9273691 9356593 244952958 262094511 73709818 76197290 171243140 185897221 DuBois Regional Medical Center offers residents of West Central Pennsylvania a rare combination of advanced healthcare in a warm, friendly environment. DRMC is an oasis of clinical and technical excellence, with a focus on patient-centered care. See Statement of Community Benefit. 0 0 247029445 0 290296406 DuBois Regional Medical Center provides a variety of comprehensive inpatient care and outpatient medical services to the residents of West Central Pennsylvania. The facility is licensed for 216 beds. In fiscal year 2017, DRMC serviced 9,592 inpatients with a total of 37,959 inpatient days and provided more than 746,930 outpatients visits. In addition to direct medical services, the hospital also provides other medical programs to the community outreach programs, clinics, support groups, education programs, health fairs and health screenings. 0 0 0 247029445 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 1 1 1 0 0 0 0 0 1 1 1 0 0 1 169 0 1 2397 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 20 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X X Brian S Kline CFO 8143756377 PO Box 447 100 Hospital Avenue DuBois PA 15801 JOSHUA B BENTON TRUSTEE 2 0 X 0 0 0 W JAY CHAMBERLIN TRUSTEE 2 0 X 0 0 0 DR JAMES DEVLIN TRUSTEE 2 0 X 0 0 0 RAYMOND E DONATI TRUSTEE 2 0 X 0 0 0 DR HAZEM F EL KASSAS TRUSTEE 2 0 X 0 0 0 SISTER LISA MARY MCCARTNEY TRUSTEE 2 0 X 0 0 0 SALLY MORAN TRUSTEE 2 0 X 0 0 0 SISTER MARGARET PARK TRUSTEE 2 0 X 0 0 0 DR GREGORY ROSCOE TRUSTEE 2 0 X 0 0 0 TODD STOLTZ TRUSTEE 2 0 X 0 0 0 ANTHONY VIGLIONE TRUSTEE 2 0 X 0 0 0 EDWARD V YAHNER TRUSTEE 2 0 X 0 0 0 WILLIAM YOUNG TRUSTEE 2 0 X 0 0 0 WILLIAM G CURLEY PHD TRUSTEE 2 0 X 0 0 0 JAMES D CURTIS TRUSTEE 2 0 X 0 0 0 RICHARD PFINGSTLER CHAIRMAN 5 0 X X 0 0 0 M TODD MILLER VICE CHAIRMAN 3 0 X X 0 0 0 LISA M ZOCCO TREASURER 3 0 X X 0 0 0 JOYCE R RAIRMAN SECRETARY 3 0 X X 0 0 0 STEVEN M FONTAINE PRESIDENT PENN HIGHLANDS HEALTHCARE 0 40 X 0 653436 101286 MARK A NORMAN COO PENN HIGHLANDS HEALTHCARE 0 40 X 0 215763 18028 JOHN S SUTIKA PRESIDENT 40 0 X 429728 0 62875 BRIAN S KLINE CFO 40 0 X 292489 0 30380 TRAVIS MILLINDER VP & COO PENN HIGHLANDS PHYSICIAN NETWORK 40 0 X 239188 0 37338 DR SANDEEP BANSAL PHYSICIAN 40 0 X 1199299 0 28923 DR RICHARD LATUSKA PHYSICIAN 40 0 X 1010998 0 28390 DR MOHANED HASSAN PHYSICIAN 40 0 X 951381 0 27914 DR GRAE SCHUSTER PHYSICIAN 40 X 797238 0 11914 DR DUSTIN McRAE PHYSICIAN 40 0 X 740879 0 28211 5661200 869199 375259 214 0 1 0 Associated Clinical Labs 1526 Peach Street Erie PA 16501 Lab Services 2168071 Allied Resources Medical Staffing 135 Dowlin Forge Road Exton PA 19341 Staffing Services 3796482 Apogee Medical Management 15059 N Scottsdale Road Suite 600 Scottsdale AZ 85254 Healthcare Staffing 3292779 Barton & Associates PO Box 417844 Boston MA 022417844 Staffing 959807 Synergy Surgicalists 678 Simmons Lane Bozeman MT 59715 Medical Staffing 2515539 35 0 0 0 0 394821 211369 0 606190 ANCILLARY OP AND PHYSICIAN 622000 488279345 488279345 0 0 R & B ANCILLARY IP 622000 183763998 183763998 0 0 OTHER PROGRAM REVENUE 622000 13468690 13468690 0 0 CONTRACTUAL ADJUSTMENTS 622000 -401825539 -401825539 0 0 0 0 0 0 283686494 2338697 0 0 2338697 0 0 0 0 0 0 0 0 995989 0 0 0 995989 0 995989 995989 0 0 10245 172740 8409 294884 1836 -122144 -120308 -120308 0 0 0 OTHER INCOME 622000 5185637 4857967 327670 0 EARNINGS FROM AFFILIATES 622000 -2629025 -2629025 0 0 RESTRICTED OPERATING REVENUE 622000 232728 232728 0 0 0 0 0 0 2789340 290296402 287023845 327670 2338697 2237807 741730 1496077 118914560 105872353 13042207 3267088 2875037 392051 14442334 12709254 1733080 8688488 7645869 1042619 12966144 11410207 1555937 224529 224529 21080096 18550484 2529612 948 834 114 980864 863160 117704 5302117 4665863 636254 4780255 4206624 573631 446618 393024 53594 531091 467360 63731 1375378 1210333 165045 14249609 12539656 1709953 3120343 2745902 374441 SUPPLIES 45904821 40396242 5508579 0 BAD DEBT 6428208 5656823 771385 0 MAINTENANCE CONTRACTS 2400842 2112741 288101 0 PURCHASED SERVICES 12097633 10645917 1451716 0 1500036 1320032 180004 0 280939809 247029445 33910364 0 39568281 24551314 27556988 26634130 3536024 3805097 251911683 163016654 90770135 88895029 58258320 89735405 25263210 28473536 244952958 262094511 25333306 28445211 2255759 2633481 42542107 40247498 1967001 2113435 1611645 2757665 73709818 76197290 X 169710949 184338445 1532191 1558776 0 0 171243140 185897221 244952958 262094511 X 9356593 4680271 0 0 0 617217 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 48818 327 34 0 0 0 49179 48784 0 34 0 0 0 48818 48750 0 34 0 0 0 48784 47469 1253 28 0 0 0 48750 41013 6401 55 0 0 0 47469 0 1 0 1 0 0 4614797 4614797 0 65002274 33735688 31266586 0 81905839 50634870 31270969 0 100388773 78646096 21742677 0 0 0 0 88895029 OTHER RECEIVABLES 14468650 INVENTORY 4464214 GOODWILL 703350 INVESTMENTS IN AFFILIATES 3903940 OTHER ASSETS 4933382 28473536 THIRD PARTY RATE ADJUSTMENT 2757665 2757665 Schedule D, Part V, Line 4 Endowment funds will be used to purchases of capital items used in patient care. 1 1 1 X 1 X 1 1 0 0 1657307 1657307 0.005 41200991 29906177 11294814 0.04 0 0 42858298 29906177 12952121 0.045 469339 469339 0.001 772600 772600 0.002 520518 520518 0.001 0 0 1762457 0 1762457 0.004 0 0 44620755 29906177 14714578 0.049 1 2507001 0 71360881 81895092 -10534211 X 1 1 1 1 DuBois Regional Medical Center 100 Hospital Avenue DuBois PA 15801 www.phhealthcare.org X X X DuBois Regional Medical Center 1 0 0 1 X X X X X X X X X 15 1 1 1 1 X www.phhealthcare.org 1 15 1 www.phhealthcare.org 0 0 1 X 200 300 X X X X 1 1 X X X X 1 X www.phhealthcare.org X www.phhealthcare.org X X X X X X 1 0 X X X 1 X 0 0 Schedule H, Part V, Section B, Line 5-DuBois Regional Medical Center Penn Highlands Healthcare hired the firm of Tripp Umbach to facilitate the preparation of the CHNA and collaborated with hospitals and outside organization in the surrounding region during the CHNA process including Alcohol and Drug Abuse services, Alcoholics Anonymous, Free Clinic of DuBois, Police departments, Chamber of Commerce, EMS services just to name a few. The process included public commentary, secondary data collection and analysis, stakeholder interviews, hand-distributed surveys, and a community health forum/retreat. The hospital worked with leaders within the healthcare systems as well as with several members outside of the system from various organizations and backgrounds. This list is included in the CHNA reports. Schedule H, Part V, Section B, Line 6a-DuBois Regional Medical Center Penn Highlands Elk, Penn Highlands Brookville, and Penn Highlands Clearfield which are all hospitals in the Penn Highlands Healthcare System. Schedule H, Part V, Section B, Line 6b-DuBois Regional Medical Center Penn Highlands Brookville, Penn Highlands Elk, and Penn Highlands Clearfield. Penn Highlands Healthcare also partnered with various local organizations in a collaborative manner during FY 2016 in order to carry out the intended goals and outcomes of our previous CHNA strategy. Schedule H, Part V, Section B, Line 11-DuBois Regional Medical Center The Hospital's CHNA gives a very detailed overview of the methods and activities that went into developing a strategic plan for accessing 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 this issue and the next steps to attain these goals. The report addresses the top five health needs of the community and focuses on those issues. Schedule H, Part I, Line 3c A discount of 40% is extended to uninsured patients not qualifying for charity care. A 60% discount is applied for patients with non-covered pharmacy expenses. Schedule H, Part I, Line 7 Actual amounts are used to calculate these figures. Schedule H, Part III, Section A, Line 4 Bad debt is estimated based on applying pre-established percentages to each payor balance in the organization accounts receivable. Self-pay balance percentages are applied based on the accounts receivable aging. The percentages are based on historical bad debt information and assistance from the organization's financial auditors. Schedule H, Part III, Section B, Line 8 Medicare total revenue received and allowable costs are calculated using various lines from the Medicare cost report, For the professional component revenue, internal reports are used. The professional cost is calculated using the non-allowable physician costs from the cost report multiplied by the percentage of Medicare PCs to total PCs. Schedule H, Part III, Section C, Line 9b The hospital offers free and discounted charity care to those patients who qualify. A patient with family income at or below 200% of Schedule A of the poverty guidelines, or below this level due to medical indigency, is eligible to receive free medical services. Discounted services are offered to patients with a family income between 201% and 300% of Schedule A of the poverty guidelines. Schedule H, Part VI, Line 2 The hospital collects data on an ongoing basis regarding patients who travel to outlying areas for services not offered by DRMC. Based on this data, services are added and improved upon in order to serve the needs of the community as effectively and efficiently as possible. DRMC routinely sends patient satisfaction surveys to those receiving medical services. These surveys allow patients to offer suggestions regarding how the hospital could better serve them as patients and the community as a whole. DRMC offers a variety of education programs that allow employees to interact on a one-on-one basis with the residents of the community as a whole. In addition, the medical staff of the hospital consistently participates in research and continuing medical education. This knowledge allows the hospital to remain updated n the latest medical news and techniques in order to offer patients the highest and most innovative levels of care. DRMC hired an outside firm to assist with conduction a Community Health Needs Assessment. The contractor gathered secondary data in Clearfield and surrounding counties, conducted various focus groups with key audiences and users of healthcare and social services to identify areas for perspective improvement within the community. The contractor has developed a master plan of initiatives for DRMC which has been posted on the hospital's website. Schedule H, Part VI, Line 3 DRMC posts a Notice of Charity Care at all points of registration, including all employed physician practices. The notice includes a statement as to the availability of charity care and how to apply. DRMC employs a Financial Counselor who meets individually with all inpatients admitted to the facility who indicate no health care coverage. The Financial Counselor interviews the patient, and, if appropriate, discusses and educates the patient relative to Medical Assistance, Blue Chip and the hospital's charity program. The Financial Counselor competes and assists the patients with the necessary applications and follow-thru with the physician and the assigned County Board of Assistance casework. The Financial Counselor also contact other patients with large dollar account balances to discuss and educate the patient's need for financial assistance. Additionally, DRMC employs a credit collections staff who also contacts, educates and offers assistance to other patients with financial need to help with health care costs. Schedule H, Part VI, Line 4 DRMC's 216 licensed beds are housed in two facilities in DuBois, a small town in West Central Pennsylvania. The combine tradition of providing high quality, compassionate care began with its predecessors, DuBois Hospital and Maple Avenue Hospital in 1897. In 1985, the two organizations joined to create Dubois Regional Medical Center, and, since then, the medical center as grown for the benefit of the entire community. DRMC West houses acute inpatient care and a full range of ancillary services. DRMC East is the sight of the Behavioral Health unit. In addition, DRMC offers access to primary and specialty care health centers in several communities. As one of the largest private employers in Clearfield County, DRMC is a significant part of the area's economy. We take pride in the role we play in shaping the quality of life for residents of the communities we serve. We also believe that the population we serve is both very proud and grateful to have DRMC as their primary health care provider. Schedule H, Part VI, Line 5 DuBois Regional Medical Center offers residents of West Central Pennsylvania the combination of advanced healthcare in a warm, friendly environment. Widely recognized as one of the leading health centers of its kind in the Commonwealth, DRMC is an oasis of clinical and technical excellence, with a focus on patient-centered care. Our combined vision is to be positioned as the premier provider of comprehensive, quality services to our broad region. Providing inpatient and outpatient hospital care represents the largest portion of these services. DRMC's mission in maintaining these services is accomplished by providing assess to healthcare services for all, including individuals who are unable to pay for such services. DRMC has a tradition of serving the poor and under-privileged of the area by providing care programs and services to enhance their quality of life. Beyond the inpatient and outpatient hospital care, there are many other ways in which DRMC and our employees serve our community every day. In addition to giving to organizations, they provide information on health and safety to the community. They provide direct patient care on volunteer basis at the local DuBois Free Clinic. The clinic was established for low-income people who could not afford health insurance. The success and reputation of DRMC is a direct result of the dedicated efforts of our Board of Directors, Administration, Physicians and Staff. With the continued support of the DRMC family and the communities we serve, DRMC will remain a valuable resource to our area. Schedule H, Part VI, Line 7 Pennsylvania X 1 1 X X X X X 0 1 0 0 0 1 0 0 0 JOHN S SUTIKA PRESIDENT 342892 0 64622 0 22213 0 44889 0 17987 0 492603 0 0 0 STEVEN M FONTAINE PRESIDENT PENN HIGHLANDS HEALTHCARE 0 503005 0 122688 0 27743 0 84192 0 17094 0 754722 0 0 BRIAN S KLINE CFO 256000 0 36489 0 0 0 23400 0 6980 0 322869 0 0 0 TRAVIS MILLINDER VP & COO PENN HIGHLANDS PHYSICIAN NETWORK 215000 0 24188 0 0 0 19350 0 17988 0 276526 0 0 0 DR SANDEEP BANSAL PHYSICIAN 474904 0 635645 0 88750 0 10600 0 18323 0 1228222 0 0 0 DR RICHARD LATUSKA PHYSICIAN 600000 0 387448 0 23550 0 10600 0 17790 0 1039388 0 0 0 DR MOHANED HASSAN PHYSICIAN 532923 0 410125 0 8333 0 10600 0 17314 0 979295 0 0 0 DR GRAE SCHUSTER PHYSICIAN 550000 0 234713 0 12525 0 0 0 11914 0 809152 0 0 0 DR DUSTIN McRAE PHYSICIAN 578830 0 109624 0 52425 0 10600 0 17611 0 769090 0 0 0 MARK A NORMAN COO PENN HIGHLANDS HEALTHCARE 158654 0 32846 0 24263 0 7933 0 10095 0 233791 0 0 0 Schedule J, Part I, Line 1a As part of some employment contracts, memberships to the local Country Club and/or the YMCA are offered. Schedule J, Part I, Line 4 John Sutika - $18,000 Steve Fontaine - $18,000 Brian Kline - $12,800 Janice Hamscher - $10,410 Travis Millinder - $10,750 Russell Cameron - $18,000 Rose Campbell - $3,243 Mark Norman - $7,933 Schedule J, Part I, Line 6 Members of the management team are eligible for an incentive bonus each year based on predetermined criteria. Such criteria includes multiple factors such as meeting strategic and other performance metrics including growth of services, new services, customer satisfaction, financial performance, quality improvements, among other goals. Michelle Sutika Bennett Relative of officer 133938 Compensation 0 Linda McKee Relative of Board Member 10450 Compensation 0 Kristie Yount Relative of Board Member 92004 Compensation 0 Douglas Dale Relative of Board Member 34850 Compensation 0 Lauren Dale Hospodar Relative of Board Member 62086 Compensation 0 Megan Devlin Bussard Relative of Board Member 111584 Relative of Board Member 0 Tricia Brigger Relative of Board Member 84315 Compensation 0 Ann Curtis Relative of Board Member 31612 Compensation 0 Julianne Hassan Relative of Board Member 67869 Compensation 0 Mark Stoltz Relative of Board Member 62297 Compensation 0 Cody Millinder Relative of Board Member 50643 Compensation 0 Kylee Millinder Relative of Board Member 41412 Compensation 0 Oncology Hematology Associates Owned by a Board Member 706371 Medical Services 0 William Nasuti Relative of a Board Member 41650 Compensation 0 Dr Gregory Roscoe Board Member 109603 Lease of Office Space from Trustee 0 Dr James Devlin Board Member 50750 Stipends and Medical Director Payments 0 Andrew Sutika Relative of Board Member 23702 Wages 0 Form 990, Part VI, Section A, Line 7a Effective October 1, 2011, Penn Highlands Healthcare became the Corporation governing DRMC. It holds certain reserved powers over DRMC, including the power to elect the directors of DRMC (other than ex-officio directors) from a panel of individuals submitted to PHH by DRMC's board and nominated by PH's Governance/Nominating Committee. The Sisters of Mercy have a right to nominate up to three of its sisters to sit on the DRMC Board of Directors (subject to certain restrictions). PHH also have the power to remove directors. Form 990, Part VI, Section B, Line 11b DRMC will be submitting the Form 990 to meet the May 15th deadline for filing. The complete Form 990 will be provided to the Finance Committee and Board of Directors at the May 2018 meetings. At that time, the committees will review the Form 990 and have the opportunity to discuss any information contained within the document. Form 990, Part VI, Section B, Line 12c Yearly, Board members are required to complete a new conflict of interest statement. At any time, any board member may question a possible conflict of interest and a thorough review would then be completed. Form 990, Part VI, Section B, Line 15 And independent firm is hired to compare review, and recommend all senior officers' compensation. The Board of Directors provides the final approval. Form 990, Part VI, Section C, Line 18 A copy of the Form 990 tax return is located in the administrative offices of DuBois Regional Medical Center. It is available for public inspection at any time upon request. Form 990, Part VI, Section C, Line 19 The conflict of interest statement and other governing documents are available to the public at the public's request. They are located in a "Public Binder" in the administrative offices of DRMC. Form 990, Part XI, Line 9 MISCELLANEOUS NET ASSET ADJUSTMENT Brookville Hospital 100 Hospital Road Brookville PA 15825 250984595 Hospital PA 501 (c) (3) 3 Penn Highlands Healthcare 1 Clearfield Hospital 809 Turnpike Avenue Clearfield PA 16830 250979346 Hospital PA 501 (c) (3) 3 Penn Highlands Healthcare 1 Penn Highlands Healthcare 100 Hospital Avenue DuBois PA 15801 320345810 Hospital Mgmt Services PA 501 (c) (3) 11c N/A 0 Elk Regional Health Center 763 Johnsonburg Road St Marys PA 15857 250585230 Hospital PA 501 (c) (3) 3 Penn Highlands Healthcare 1 DuBois Regional Medical Group PO Box 447 DuBois PA 15801 251856569 Pediatric Services PA N/A C -2944127 1814341 1 0 DuBois Medical Risk Retention Group PO Box 447 DuBois PA 15801 200324622 Insurance Services PA N/A C 300162 12725645 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 DuBois Medical Risk Retention Group m 947855 Cost Brookville Hospital q 5232779 Actual Wages paid to employees Brookville Hospital l 328475 Cost Brookville Hospital q 253706 Cost Brookville Hospital j 55567 Cost Clearfield Hospital q 2324064 Wages paid to employees Clearfield Hospital q 421880 Cost Clearfield Hospital j 8307 Cost Clearfield Hospital l 214102 Cost Elk Regional Health Center q 3149988 Wages paid to employee Elk Regional Health Center q 130084 Cost Elk Regional Health Center j 55673 Cost Elk Regional Health Center k 541250 Cost Elk Regional Health Center p 134930 Cost Elk Regional Health Center p 127163 Wages paid to employees Brookville Hospital k 37074 Cost Clearfield Hospital p 621906 Wages paid to employees Clearfield Hospital p 80425 Cost Penn Highlands Healthcare m 11883365 Cost Penn Highlands Healthcare q 10830370 Wages paid to employees Penn Highlands Healthcare q 59614 Cost Penn Highlands Healthcare j 143475 Cost DuBois Regional Medical Group j 360746 Cost DuBois Regional Medical Group q 10676120 Wages paid to employees