2018-05-10T14:57:43-05:00 2017-06-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2016-07-01 251010039 CLARION HOSPITAL % VINCENT LAMORELLA CLAR 8142261301 ONE HOSPITAL DRIVE CLARION PA 16214 VINCENT LAMORELLA CFO 2018-04-04 true Brian D Todd P00422601 4178658701 2016 2022-09-23 18:48:47Z VINCENT LAMORELLA ONE HOSPITAL DRIVE CLARION PA 16214 54169850 false X WWW.CLARIONHOSPITAL.ORG X 1951 PA CLARION HOSPITAL IS THE COMMUNITY'S DYNAMIC RESOURCE FOR QUALITY HEALTHCARE, CONTINUOUS EDUCATION, AND THE PROMOTION OF WELLNESS. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. 9 7 562 44 0 0 23625 34150 53642315 50755949 269697 295536 471707 415099 54407344 51500734 0 0 0 0 24678000 24499570 0 0 0 29329194 28785450 54007194 53285020 400150 -1784286 32991312 32598998 11023956 12783432 21967356 19815566 CLARION HOSPITAL IS THE COMMUNITY'S DYNAMIC RESOURCE FOR QUALITY HEALTHCARE, CONTINUOUS EDUCATION, AND THE PROMOTION OF WELLNESS. false false 33561472 38697252 CLARION HOSPITAL PROVIDED SERVICES TO 119,320 OUTPATIENTS AS WELL A 16,370 EMERGENCY ROOM VISITS. SERVICES INCLUDE, BUT ARE NOT LIMITED TO, RADIOLOGY SERVICES WHICH INCLUDE MRI, ULTRASOUND, CT, NUCLEAR MEDICINE AND X-RAY SERVICES, LABORATORY SERVICES, EKG AND PHYSICAL THERAPY SERVICES. THE ORGANIZATION ALSO OFFERS SAME-DAY SURGERY, GENETIC COUNSELING, DRUG AND ALCOHOL TESTING, AND OUTPATIENT PHYSICAL THERAPY AND REHABILITATION SERVICES. 8521879 9825948 CLARION HOSPITAL PROVIDED SERVICES TO 1,577 INPATIENTS FOR MEDICAL AND SURGICAL SERVICES AS WELL AS INTENSIVE CARE SERVICES. CLARION HOSPITAL ALSO PROVIDED OBSTETRIC CARE FOR 111 NEW MOTHERS AND BABIES. THE ORGANIZATION ALSO OFFERS AN INPATIENT REHABILITATION CENTER WHERE PATIENTS WHO HAVE SUFFERED MAJOR INJURIES OR TRAUMA CAN HAVE 24-HOUR NURSING CARE, ALONGSIDE INTENSIVE PHYSICAL, OCCUPATIONAL, AND/OR SPEECH THERAPY. 1111747 2232749 CLARION HOSPITAL PROVIDED 91 EDUCATION AND SCREENING OPPORTUNITIES FOR THE COMMUNITY ATTENDED BY 15,649 MEMBERS OF THE COMMUNITY. CLASSES ARE AVAILABLE FOR EXPECTANT MOTHERS, PEOPLE WITH DIABETES, AND WORKERS LOOKING FOR SAFER ENVIRONMENTS AS WELL AS SENIOR SERVICES. THE ORGANIZATION ALSO OFFERS CPR AND EMT TRAINING COURSES. 43195098 true true false true false false false false false false true true true true true false true false false false false false false false false false true true false false true false false false false false false false false false false false false false true true false false false true 58 0 true 562 true false false false false false false false false false false X 9 7 false true false false true true true true true false false true true true true true true false false false PA X VINCENT LAMORELLA 8142269500 ONE HOSPITAL DRIVE CLARION PA 16214 X VICTOR EWY CHAIRPERSON 3.0 0.0 X X 0 0 0 FRED PORT VICE CHAIRPERSON 1.0 1.0 X X 0 0 0 ARTHUR DORTORT TREASURER 2.0 17.0 X X 0 61850 808 DAVID BROOKER MEDICAL STAFF REP 1.0 0.0 X 0 0 0 THOMAS FREENOCK DIRECTOR 1.0 40.0 X 0 373918 3028 ERIC FUNK SECRETARY 1.0 0.0 X X 0 0 0 JAMES CARROLL DIRECTOR 1.0 0.0 X 0 0 0 JANICE SEMEYN DO PRESIDENT MEDICAL STAFF 1.0 0.0 X 0 0 0 MINDY GATESMAN DIRECTOR 1.0 0.0 X 0 0 0 VINCENT LAMORELLA CFO 40.0 5.0 X 0 0 0 BYRON QUINTON CEO 40.0 2.0 X 0 0 0 SHARON DOOLIN CRNA 40.0 0.0 X 173406 0 15349 WENDY STIVANSON CRNA 40.0 0.0 X 164737 0 22140 SETH MARTIN CRNA 40.0 0.0 X 156835 0 20641 THOMAS MORGO CRNA 40.0 0.0 X 163409 0 22073 WILLIAM SIMPSON DIRECTOR OF PHARMACY 40.0 0.0 X 138676 0 20837 797063 435768 104876 10 false true false CLARION REHABILITATION SERVICES 118 SUMMER DRIVE BLUFFTON SC 16346 PHYSICAL THERAPY 2166718 DJD ANESTHESIA ASSOCIATES 216 SYCAMORE DR SHIPPENVILLE PA 16544 PHYSICIAN 449815 SENECA PATHOLOGY ASSOCIATION PO BOX 310 SENECA PA 16346 PHYSICIAN 242068 VANTAGE MOBILE SERVICE 1305 SOUTH MAIN ST MEADVILLE PA 16335 MEDICAL COMPANY 134215 BKD PO BOX 1190 SPRINGFIELD MO 65801 AUDIT/TAX/CONSULTING 110645 11 26307 7843 34150 PATIENT REVENUE 900099 49885952 49885952 AMBULANCE 621910 185930 185930 EHR INCENTIVE 900099 45002 45002 CAFETERIA 722210 431315 431315 DAYCARE 624410 167319 167319 40431 40431 50755949 191404 191404 0 0 103262 61119 42143 0 42143 42143 2593620 118509 2540202 67795 53418 50714 104132 104132 0 0 0 0 0 0 0 0 0 GAIN ON EQUITY INVESTEE 900099 372956 372956 372956 51500734 50755949 710635 X 0 0 0 0 0 0 18977140 16332604 2644536 818000 704009 113991 3318380 2855951 462429 1386050 1192899 193151 895421 895421 44421 44421 102045 102045 0 0 54688 54688 7905558 6222066 1683492 266190 217 265973 2535289 1617297 917992 591267 591267 0 1519257 599836 919421 85525 77306 8219 0 70167 58575 11592 203812 163933 39879 0 2010589 1617182 393407 639109 467448 171661 MEDICAL SUPPLIES & DRUGS 9621825 9621825 BAD DEBT 1432305 1432305 RECRUITING & RETENTION 449667 449667 MISCELLANEOUS 222978 168064 54914 135337 63581 71756 53285020 43195098 10089922 0 7838 7951 1950230 1495814 0 0 4863281 4583338 0 0 0 0 0 0 1025927 1156995 841879 667899 63659981 53750571 11333889 9909410 8656336 8241796 1797284 1953216 2024736 1738546 0 0 489912 2844033 32991312 32598998 5107898 7995341 0 0 0 0 0 0 0 0 0 0 5038305 3995107 0 0 877753 792984 11023956 12783432 X 21330166 19413037 461627 216661 175563 185868 21967356 19815566 32991312 32598998 X -1784286 591883 -959387 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true false true 4881 4881 false SCHEDULE C, PART II-B, LINE 1 (G) DIRECT CONTACT: MANAGEMENT OCCASIONALLY HAS DIRECT CONTACT WITH LEGISLATORS AT CHAMBER FUNCTIONS AND OTHER LOCAL EVENTS, AS WELL AS BREAKFAST WITH A CONGRESSMAN'S STAFFER. THE AMOUNT OF TIME SPENT IS INSIGNIFICANT AND ANY DOLLAR AMOUNT ALLOCATED TO THIS ACTIVITY IS NEGLIGIBLE. SCHEDULE C, PART II-B, LINE 1 (I) OTHER LOBBYING ACTIVITIES: A PORTION OF DUES PAID IN FISCAL YEAR 2017 TO THE AHA, HAP, AND HCWP WERE ATTRIBUTABLE TO LOBBYING, TOTALING $4,881. 410420 410420 26551054 21286230 5264824 613663 427051 186612 33989493 30047190 3942303 2095351 1990100 105251 9909410 INVEST INT IN CHART 1953216 C 1953216 CLOSELY HELD EQUITY INTERESTS 1738546 C 1738546 OTHER RECEIVABLES 2118533 INT IN PERPETUAL TRUST 185868 DUE FROM AFFILIATES 539632 2844033 0 EST AMT DUE TO THIRD PRTY 792984 792984 49996705 591883 -2157031 -1565148 51561853 -61119 -61119 51500734 51913834 61119 61119 51852715 1432305 1432305 53285020 SCHEDULE D, PART X, LINE 2 UNCERTAIN 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 D, PART XI, LINE 2D OTHER REVENUE ON LINE 1, BUT NOT FORM 990, PART VIII, LINE 12: $ (895,002) TRANSFER TO AFFILIATES 170,276 CHANGE IN INT IN NET ASSETS OF CLARION HOSPITAL FDN (1,432,305) PROVISION FOR UNCOLLECTIBLE ACCOUNTS ------------- $(2,157,031) TOTAL SCHEDULE D, PART XI, LINE 4B OTHER REVENUE ON FORM 990, PART VIII, LINE 12 BUT NOT LINE 1: $ (61,119) RENTAL EXPENSES SCHEDULE D, PART XII, LINE 2D OTHER EXPENSES ON LINE 1, BUT NOT FORM 990, PART IX, LINE 25: $ 61,119 RENTAL EXPENSES SCHEDULE D, PART XII, LINE 4B OTHER EXPENSES ON FORM 990, PART IX, LINE 25, BUT NOT LINE 1: $ 1,432,305 PROVISION FOR UNCOLLECTIBLE ACCOUNTS true true X true X true X false true true false false 125142 125142 0.00240 7249311 3731410 3517901 0.06780 7374453 3731410 3643043 0.07020 24580 24580 0.00050 1071823 799047 272776 0.00530 3541532 2064195 1477337 0.02850 4637935 2863242 1774693 0.03430 12012388 6594652 5417736 0.10450 true 1432305 217710 16569208 16196892 372316 X true true 1 1 CLARION HOSPITAL ONE HOSPITAL DRIVE CLARION PA 16214 WWW.CLARIONHOSPITAL.ORG 297801 X X X X CLARION HOSPITAL 1 false false true X X X X X X X X X 15 true true true true X SEE PART V, SECTION C X true 15 true SEE PART V, SECTION C false true X 100 250. true true X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X true X false X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY INPUT: TO GUIDE THIS ASSESSMENT, THE HOSPITAL LEADERSHIP TEAM FORMED A STEERING COMMITTEE IN THEIR LOCAL SERVICE AREA THAT CONSISTED OF HOSPITAL AND COMMUNITY LEADERS WHO REPRESENTED THE BROAD INTERESTS OF THEIR LOCAL REGION. THESE INCLUDED REPRESENTATIVES WHO UNDERSTOOD THE NEEDS AND ISSUES RELATED TO VARIOUS UNDERREPRESENTED GROUPS INCLUDING MEDICALLY UNDERSERVED POPULATIONS, LOW-INCOME PERSONS, MINORITY GROUPS, AND THOSE WITH CHRONIC DISEASE NEEDS, INDIVIDUALS WITH EXPERTISE IN PUBLIC HEALTH, AND INTERNAL PROGRAM MANAGERS. THIS OUTSIDE INDIVIDUALS INCLUDED A REPRESENTATIVES FROM THE PA STATE HEALTH DEPARTMENT, CLARION COUNTY BEHAVIORAL HEALTH, YMCA, STATE SENATORS OFFICE, PA 5TH CONGRESSIONAL DISTRICT, A SCHOOL SUPERINTENDENT, AND OTHERS. THE CLARION HOSPITAL STEERING COMMITTEE MET THREE TIMES BETWEEN APRIL 2015 AND MAY 2015 TO PROVIDE GUIDANCE ON THE VARIOUS COMPONENTS OF THE CHNA. SCHEDULE H, PART V, SECTION B, LINE 6A OTHER HOSPITAL FACILITIES: - INDIANA REGIONAL MEDICAL CENTER - PUNXSUTAWNEY AREA HOSPITAL SCHEDULE H, PART V, SECTION B, LINE 6B OTHER ORGANIZATIONS: - CLARION AREA SCHOOL DISTRICT SUPERINTENDENT - CHILDREN AND YOUTH SERVICES/HUMAN SERVICES, CLARION COUNTY - PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE - SERVICE AND ACCESS MANAGEMENT, CLARION COUNTY - CLARION COUNTY PRISON - OFFICE OF VETERANS AFFAIRS, CLARION COUNTY - CLARION MINISTERIUM SCHEDULE H, PART V, SECTION B, LINES 7A & 10 CHNA AND IMPLEMENTATION STRATEGY WEBSITE: HTTP://WWW.CLARIONHOSPITAL.ORG/COMMUNITY_EDUCATION/COMMUNITY_HEALTH _NEEDS_ASSESSMENT.ASPX SCHEDULE H, PART V, SECTION B, LINE 11 ADDRESSING SIGNIFICANT NEEDS: INDIVIDUALS WITH EXPERTISE IN THE FOLLOWING DISCIPLINES AND/OR ORGANIZATIONAL AFFILIATIONS: - CLARION AREA SCHOOL DISTRICT SUPERINTENDENT - CHILDREN AND YOUTH SERVICES/HUMAN SERVICES, CLARION COUNTY - PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE - SERVICE AND ACCESS MANAGEMENT, CLARION COUNTY - CLARION COUNTY PRISON - OFFICE OF VETERANS AFFAIRS, CLARION COUNTY - CLARION MINISTERIUM IN MARCH 2015, CLARION HOSPITAL CONDUCTED A 2-YEAR EVALUATION OF ITS CHNA IMPLEMENTATION STRATEGIES FROM THE 2013 ASSESSMENT. CLARION HOSPITAL IS CONDUCTING ITS CHNA A YEAR EARLY, IN ORDER TO WORK COLLABORATIVELY WITH THE OTHER PMCN HOSPITALS AND CONDUCT THEIR ASSESSMENT ON THE SAME SCHEDULE. THE 2013 CLARION CHNA IDENTIFIED 3 GOALS THAT INCLUDED IMPLEMENTING A WORKPLACE WELLNESS PROGRAM, REDUCING CHILDHOOD OBESITY AND IMPACTING THE DIABETES EPIDEMIC. WITHIN THE SHORT TIME FRAME, IT IS IMPOSSIBLE TO DETERMINE IF THE IMPLEMENTATION STRATEGIES IMPACTED ANY OF THE COUNTY-WIDE INDICATORS, AS MOST OF THE OUTCOMES MEASURES FOR THE FIRST TWO YEARS WERE PROCESS MEASURES, ALTHOUGH THE HOSPITAL HAS MADE PROGRESS TOWARD ACCOMPLISHING ITS FIRST TWO GOALS. THE THIRD GOAL, IMPACTING DIABETES, WAS NOT SCHEDULED FOR IMPLEMENTATION UNTIL THIS UPCOMING YEAR AND WILL BE A FOCUS AREA IN THE UPDATED IMPLEMENTATION STRATEGY. THE CHNA IMPLEMENTATION STRATEGY/ACTION PLAN GOT OFF TO A SLOW START AND DID NOT MEET THE INITIAL MILESTONE/DEADLINES OUTLINED IN IMPLEMENTATION STRATEGY. IN THE ORIGINAL ACTION PLAN, A COORDINATOR WAS DESIGNATED TO BE APPOINTED BY SEPTEMBER 2013. BRIDGET THORNTON WAS APPOINTED AS CHNA COORDINATOR IN JUNE 2014. WHILE THIS DELAYED THE ACCOMPLISHMENTS OF THE MILESTONES IN THE PLAN, BRIDGET MADE GREAT PROGRESS SINCE COMING ON BOARD AND BEGAN IMPLEMENTATION OF THE EMPLOYEE WELLNESS PROGRAM IN JANUARY 2015, ONLY FOUR MONTHS BEHIND THE ORIGINAL SCHEDULE. DURING HER SHORT TENURE, BRIDGET BENCHMARKED BEST PRACTICES IN EMPLOYEE WELLNESS PROGRAMS, IDENTIFIED AND OUTREACHED TO INTERNAL RESOURCES AND PROFESSIONALS WHO SHOULD BE INVOLVED IN THE PROGRAM, CONDUCTED AN EMPLOYEE SURVEY THAT ACHIEVED OVER 200 RESPONSES, CONDUCTED SITE VISITS WITH TWO OTHER EMPLOYEE WELLNESS PROGRAMS TO UNDERSTAND HOW THOSE PROGRAMS WORK, AND DEVELOPED A LOGIC MODEL WITH OUTCOMES AND IMPACT MEASUREMENTS FOR THE EMPLOYEE WELLNESS PROGRAM, AS WELL AS THE OVERALL IMPLEMENTATION STRATEGY. THE INITIAL IMPLEMENTATION STRATEGY/ACTION PLAN INCLUDED ONLY PROCESS MEASURES AND LACKED TRUE OUTCOMES AND IMPACT MEASUREMENTS. THE CHNA IMPLEMENTATION STRATEGY WAS REVISED TO INCLUDE ASSISTANCE FROM THE INFORMATION SYSTEMS DEPARTMENT TO DEVELOP METHODS TO TRACK PATIENTS AS WELL AS REPORT THE RESULTS (PRE AND POST WHERE POSSIBLE AND OVER TIME) FOR THOSE WHO PARTICIPATE IN THE EMPLOYEE WELLNESS PROGRAM AS WELL AS IN VARIOUS SCREENING AND INTERVENTION ACTIVITIES. BECAUSE THE HOSPITAL AND PHYSICIAN PRACTICES HAVE EMRS, THIS IS POSSIBLE, BUT WILL TAKE SOME TIME TO DEVELOP THE REPORTING SYSTEMS. REGARDING CLARION'S GOAL OF REDUCING CHILDHOOD OBESITY, THE HOSPITAL HAS MET WITH THE CLARION COUNTY YMCA TO FORM A PARTNERSHIP THAT WOULD EXPAND THEIR CURRENT "FUN N' FIT CLUB" CURRICULUM, ADDRESS THE ISSUE OF TRANSPORTATION TO ENSURE THAT CHILDREN CAN ATTEND THE "FUN 'N FIT CLUB." IN ADDITION, MEETINGS WERE HELD WITH VARIOUS LEADERS IN THE BUSINESS/INDUSTRY SECTOR OF THE COMMUNITY. WORK-SITE WELLNESS PROGRAMS WERE INTRODUCED WITH THE EXPECTATION OF THE HOSPITAL INITIATING THESE IN THE COMMUNITY IN 2017. DURING THE EVALUATION PROCESS, THE TEAM ALSO RECOGNIZED THAT THE HOSPITAL CURRENTLY CONDUCTS A NUMBER OF COMMUNITY BENEFIT EDUCATION AND SCREENING PROGRAMS THAT ARE DESIGNED TO IMPROVE COMMUNITY HEALTH, BUT THAT WERE NOT INCLUDED IN THE ORIGINAL IMPLEMENTATION STRATEGY. THE IMPLEMENTATION STRATEGY WAS REVISED TO INCLUDE THESE ACTIVITIES AS WELL AS THEIR ACCOMPANYING OUTCOMES AND IMPACTS. SHORT TERM OUTCOMES FROM THE INTERVENTION ACTIVITIES CONDUCTED TO DATE INCLUDE: - TEDDY BEAR CLINIC - SENIOR WELLNESS EXPO SCHEDULE H, PART V, SECTION B, LINES 16 A, 16B, & 16C FAP, PLS, AND APPLICATION WEBSITE: HTTP://WWW.CLARIONHOSPITAL.ORG/BILL_PAY/FINANCIAL_ASSISTANCE.ASPX SCHEDULE H, PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25, OF THE FORM 990 WAS REDUCED BY BAD DEBT EXPENSE OF $1,432,305. SCHEDULE H, PART I, LINE 7 COST TO CHARGE RATIO: THE COST TO CHARGE RATIO COMPUTED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATIONS ON IRS WORKSHEETS 1 & 3. WORKSHEET 6 USED COST ACCOUNTING DATA. SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT EXPENSE: BAD DEBT EXPENSE ON LINE 2 WAS CALCULATED USING THE AMOUNT OF BAD DEBT REPORTED ON THE AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION A, LINE 3 BAD DEBT ATTRIBUTABLE TO CHARITY CARE: BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING POVERTY LIMIT DEMOGRAPHIC INFORMATION OBTAINED THROUGH THE US CENSUS BUREAU. USING 2012-2016 DATA, 15.2 PERCENT OF CLARION COUNTY WAS CONSIDERED TO LIVE IN POVERTY. SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT EXPENSE FOOTNOTE: THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. SCHEDULE H, PART III, SECTION B, LINE 8 COMMUNITY BENEFIT: SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. SCHEDULE H, PART III, SECTION C, LINE 9B COLLECTION POLICY: THE NEED FOR CHARITY CARE IS ADDRESSED AS SOON AS A PATIENT INDICATES A FINANCIAL HARDSHIP. GENERALLY, THIS OCCURS AT THE TIME OF SERVICE OR UPON THE INITIAL BILLING. A PATIENT WILL HAVE 90 DAYS FROM THE DATE OF FIRST STATEMENT TO APPLY FOR FINANCIAL ASSISTANCE UNDER THE CHARITY CARE POLICY. ACCOUNTS CURRENTLY IN COLLECTION WILL NOT BE APPROVED UNDER THE CHARITY CARE PROGRAM. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: CLARION HOSPITAL IS GOVERNED BY A BOARD OF VOLUNTEER DIRECTORS WHO REPRESENT THE COMMUNITY WE SERVE. THROUGH THEIR INPUT AND OCCASIONAL COMMUNITY SURVEYS, CLARION HOSPITAL ASSESSES THE HEALTH CARE NEEDS OF ITS SERVICE AREA. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: MEDICAID APPLICATIONS ARE GIVEN TO SELF PAY PATIENTS IN EMERGENCY ROOM AND INPATIENT. THE HOSPITAL FINANCIAL POLICY AND BUSINESS OFFICE CONTACT INFORMATION ARE AVAILABLE AT REGISTRATION DESKS. FREE CARE GUIDELINES ARE PRINTED ON REVERSE SIDE OF PATIENT STATEMENTS. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: CLARION HOSPITAL SERVES CLARION COUNTY AND PARTS OF THE SURROUNDING COUNTIES, INCLUDING VENANGO, FOREST, JEFFERSON, AND ARMSTRONG. OUR SERVICE AREA IS IN A RURAL PART OF WESTERN PENNSYLVANIA, WITH MANY LIVING BELOW OR WELL BELOW THE NATIONAL AND STATE INCOME AVERAGE. ACCORDING TO US CENSUS BUREAU DATA, THE MEDIAN HOUSEHOLD INCOME FOR THE AREA IS APPROXIMATELY $41,500. THE ESTIMATED POPULATION OF CLARION COUNTY WAS 39,479. AS OF THE CENSUS OF 2000, THERE WERE 6,185 PEOPLE, 2,000 HOUSEHOLDS, AND 718 FAMILIES RESIDING IN THE BOROUGH ALONE. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: THE AMERICAN DIABETES ASSOCIATION ESTIMATES THAT NEARLY 26 MILLION ADULTS AND CHILDREN HAVE DIABETES. AT LEAST 7 MILLION PEOPLE DON'T KNOW THIS YET. EDUCATION IS THE BEST WAY TO PREVENT PRE-DIABETES, ADVANCEMENT TO DIABETES, AS WELL AS HELPING THOSE DIAGNOSED WITH DIABETES TO MANAGE THEIR DISEASE AND PREVENT COMPLICATIONS. THE DIABETIC EDUCATION PROGRAM AT CLARION HOSPITAL IS DEDICATED TO EDUCATION OF INDIVIDUALS WHO HAVE DIABETES. WE SEE PEOPLE WHO ARE NEWLY DIAGNOSED, OR WHO HAVE BEEN MANAGING THEIR DIABETES FOR SOME TIME. WE SPECIALIZE IN EDUCATION RELATED TO TYPE I (INSULIN-DEPENDENT), TYPE II (THOSE WHO CAN MANAGE WITH MEDICATIONS), AND PRE-DIABETES, WHOSE BLOOD SUGARS ARE HIGH AND WHO ARE AT RISK. OUR PROGRAM TEACHES DIABETICS AND THEIR LOVED ONES ABOUT THE DISEASE PROCESS, GLUCOSE MONITORING, MEDICATION MANAGEMENT, LIFESTYLE CHANGES, EXERCISE, NUTRITIONAL MANAGEMENT, AND SICK DAY GUIDELINES. WE CAN MEET WITH PATIENTS INDIVIDUALLY OR IN A CLASSROOM ENVIRONMENT. CLARION HOSPITAL ALSO PROVIDES CLASSES ON CPR AND AED, WITH OR WITHOUT FIRST AID. THESE COURSES ARE OFFERED SEVERAL TIMES A YEAR AND ARE TAUGHT BY CLARION HOSPITAL PARAMEDICS. ADDITIONALLY, THE CLARION HOSPITAL FOUNDATION AWARDS SCHOLARSHIPS TO CLARION COUNTY STUDENTS PURSUING CAREERS IN HEALTH CARE. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: CLARION HOSPITAL IS AN AFFILIATE OF CLARION HEALTHCARE SYSTEM, INC. CLARION HEALTHCARE SYSTEM, INC. EXISTS TO SUPPORT THE HOSPITAL MISSION AND TO PROVIDE A VITAL LINK BETWEEN THE HOSPITAL SYSTEM AND THE SURROUNDING COMMUNITY. THROUGH THE PROCESSES OF STRATEGIC AND FINANCIAL DEVELOPMENT, THE HEALTH SYSTEM WILL ENHANCE THE PUBLIC'S AWARENESS OF HEALTH CARE AND THE HOSPITAL'S SERVICES; SECURE CHARITABLE GIFTS; INCREASE ITS CURRENT PERMANENTLY RESTRICTED FUNDS TO GENERATE A PERMANENT SOURCE OF INVESTMENT INCOME; AND REGULARLY DISTRIBUTE FINANCIAL ASSISTANCE TO THE SURROUNDING COMMUNITY AND THE HOSPITAL TO ENHANCE HEALTH CARE EDUCATION, TECHNICAL RESOURCES AND QUALITY PATIENT CARE. BY THESE ACTIVITIES, THE SYSTEM WILL SERVE TO LEAD THE WAY FOR THE SURROUNDING COMMUNITY'S HEALTH CARE STABILITY AND GROWTH IN THE TWENTY-FIRST CENTURY. X X X false false false false false false false false false THOMAS FREENOCK DIRECTOR 0 372242 0 236 0 1440 0 2650 0 378 0 376946 0 0 SHARON DOOLIN CRNA 173406 0 0 0 0 0 8670 0 6679 0 188755 0 0 0 WENDY STIVANSON CRNA 164737 0 0 0 0 0 8237 0 13903 0 186877 0 0 0 SETH MARTIN CRNA 156835 0 0 0 0 0 7842 0 12799 0 177476 0 0 0 THOMAS MORGO CRNA 163409 0 0 0 0 0 8170 0 13903 0 185482 0 0 0 WILLIAM SIMPSON DIRECTOR OF PHARMACY 138676 0 0 0 0 0 6934 0 13903 0 159513 0 0 0 SCHEDULE J, PART I, LINE 3 COMPENSATION OF ORGANIZATION'S CEO: CLARION HOSPITAL CONTRACTED WITH QUORUM HEALTH RESOURCES, AN UNRELATED MANAGEMENT COMPANY, FOR THE SERVICES OF BYRON QUINTON, CEO, AND VINCENT LAMORELLA, CFO. AMOUNTS PAID TO QUORUM HEALTH RESOURCES ARE REPORTED IN FORM 990, PART VII, SECTION B, AND ARE FOR SERVICES PROVIDED BY THE COMPANY. NO COMPENSATION WAS REPORTED FOR EITHER INDIVIDUAL ON FORM 990, PART VII OR SCHEDULE J, PART II. IN ESTABLISHING THE COMPENSATION OF THE CEO, QUORUM HEALTH RESOURCES USED A COMPENSATION COMMITTEE, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART I, LINE 1 ORGANIZATION'S MISSION: CLARION HOSPITAL, AS THE COMMUNITY'S RESOURCE FOR THE DELIVERY OF QUALITY-BASED HEALTHCARE, IS COMMITTED TO PROVIDE EMERGENT, ACUTE, TRANSITIONAL, AND LONG-TERM MEDICAL SERVICES FOR THE RESIDENTS OF CLARION COUNTY AND ITS SURROUNDING COMMUNITIES. PURPOSE: CLARION HOSPITAL EXISTS TO PROVIDE COMPREHENSIVE, QUALITY HEALTH CARE, APPROPRIATE TO THE NEEDS OF OUR COMMUNITY, IN A COMPASSIONATE AND EMPATHETIC MANNER. THE HOSPITAL ACKNOWLEDGES THE IMPORTANCE OF PREVENTIVE MEDICINE AND FOCUSES ON THE PROMOTION OF A HEALTHY LIFESTYLE FOR ALL. EVERY DEPARTMENT WITHIN CLARION HOSPITAL CONTRIBUTES AN INVALUABLE SERVICE TOWARD THE PROVISION OF QUALITY HEALTH CARE FROM THE ORGANIZATION AS A WHOLE. EACH DEPARTMENT EXISTS FOR A SPECIFIC PURPOSE, YET NO DEPARTMENT EXISTS SOLELY ON ITS OWN. WE ARE ALL INTER-DEPENDENT UPON EACH OTHER. VALUES: *WE BELIEVE IN BEING CUSTOMER FOCUSED. *WE BELIEVE IN COMPETENCY. *WE BELIEVE IN HONESTY. *WE BELIEVE IN CARING. *WE BELIEVE IN COMMITMENT. *WE BELIEVE IN BEING TEAM PLAYERS. *WE BELIEVE IN DEMONSTRATING PROFESSIONALISM. *WE BELIEVE IN THE PRESERVATION OF DIGNITY FOR THOSE WE SERVE. *WE BELIEVE IN MAINTAINING CONFIDENTIALITY. *WE BELIEVE IN EDUCATION AND CONTINUAL LEARNING. *WE BELIEVE IN CONTINUAL IMPROVEMENT. *WE BELIEVE IN DEMONSTRATING MUTUAL RESPECT FOR OUR CO-WORKERS. VISION: CLARION HOSPITAL ENDEAVORS TO EXCEED THE COMMUNITY'S HEALTHCARE EXPECTATIONS THROUGH THE IMPLEMENTATION OF CONTINUOUS QUALITY IMPROVEMENTS, BY REASSESSING THE COMMUNITY'S EVOLVING NEEDS, BY DEVELOPING INNOVATIVE FAMILY-ORIENTED HEALTHCARE SERVICES, AND BY PROVIDING EDUCATIONAL PROGRAMS FOR OUR FUTURE HEALTHCARE PROVIDERS. FORM 990, PART I, LINE 6 NUMBER OF VOLUNTEERS: VOLUNTEER SERVICES OF CLARION HOSPITAL CONSISTS OF APPROXIMATELY 35 VOLUNTEERS WHO WORK WITHIN 25 VARIOUS DEPARTMENTS ASSISTING EMPLOYEES, PATIENTS, AND STAFF TO DELIVER QUALITY BASED HEALTHCARE. IN ADDITION, THE MEMBERS OF THE BOARD OF DIRECTORS WHO SERVED DURING THE YEAR ARE CONSIDERED VOLUNTEERS, FOR A TOTAL OF 44. FORM 990, PART VI, SECTION A, LINE 3 MANAGEMENT DUTIES: CLARION HOSPITAL HAS A MANAGEMENT CONTRACT WITH QUORUM HEALTH RESOURCES TO PROVIDE MANAGEMENT SERVICES. IN ADDITION, QUORUM HEALTH RESOURCES PROVIDES COMPENSATION FOR THE HOSPITAL'S CEO AND CFO. THE HOSPITAL REIMBURSES QUORUM HEALTH RESOURCES WITH MONTHLY MANAGEMENT FEES FOR THE COMPENSATION PAID AND OTHER SERVICES PROVIDED. FORM 990, PART VI, SECTION A, LINE 6, 7A, & 7B MEMBERS OF THE ORGANIZATION: THE BOARD OF CLARION HOSPITAL SHALL CONSIST OF NINE (9) MEMBERS AND SHALL BE APPOINTED BY THE BOARD OF DIRECTORS OF CLARION HEALTHCARE SYSTEM, INC. IN ACCORDANCE WITH HOSPITAL BYLAWS. THE BOARD MEMBERS SHALL BE THE SAME PERSONS WHO SERVE AS THE EXECUTIVE COMMITTEE OF CLARION HEALTHCARE SYSTEM, INC. WHICH INCLUDE THE CHAIRPERSON, VICE CHAIRPERSON, SECRETARY, TREASURER, FORMER CHAIRPERSON (IF APPLICABLE), PRESIDENT AND CEO (NON-VOTING), CHIEF OF STAFF (WITH VOTING RIGHTS), ONE MEDICAL STAFF REPRESENTATIVE, AND ANY OTHER DIRECTORS SELECTED BY THE CHAIRPERSON. BYLAWS MAY ONLY BE AMENDED OR REPEALED AND NEW BYLAWS ADOPTED BY THE BOARD OF DIRECTORS OF CLARION HEALTHCARE SYSTEM, INC., SUBJECT TO APPROVAL OF PMCN AS SET FORTH IN THE BYLAWS OF CLARION HEALTHCARE SYSTEM, INC. AS A RESULT OF THE SYSTEM'S AFFILIATION AGREEMENT WITH PENNSYLVANIA MOUNTAIN CARE NETWORK (PMCN), PMCN HAS CERTAIN RESERVED POWERS OVER CLARION HEALTHCARE SYSTEM AND ITS SUBSIDIARIES, CLARION HOSPITAL AND HEALTH SERVICES OF CLARION. FORM 990, PART VI, SECTION B, LINE 11B FORM 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 OF THE ORGANIZATION. PRIOR TO FILING, A DRAFT OF THE RETURN IS REVIEWED BY THE CFO IN DETAIL. A FINAL DRAFT IS THEN PRESENTED TO THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS AND THE FULL BOARD FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY: CLARION HOSPITAL, INC. BOARD MEMBERS ARE ASKED TO COMPLETE A CONFLICT OF INTEREST FORM ON AN ANNUAL BASIS. IF A CONFLICT ARISES, THE BOARD MEMBER WITH A CONFLICT ABSTAINS FROM VOTING ON ANY MATTER RELATED TO THE CONFLICT. POLICY: MEMBERS OF THE GOVERNING BODY SHALL NOT MAINTAIN SUBSTANTIAL PERSONAL OR BUSINESS INTERESTS WHICH CONFLICT WITH THOSE OF THE HOSPITAL. PROCEDURES: ALL GOVERNING BODY MEMBERS SHALL EXECUTE A CONFLICT OF INTEREST STATEMENT. MEMBERS OF THE GOVERNING BODY SHALL NOT ENGAGE IN THE FOLLOWING FORMS OF SELF DEALINGS: A) THE SALE, EXCHANGE, OR LEASING OF PROPERTY OR SERVICES BETWEEN THE HOSPITAL AND A GOVERNING BOARD MEMBER, HIS EMPLOYER, OR AN ORGANIZATION SUBSTANTIALLY CONTROLLED BY HIM ON A BASIS LESS FAVORABLE TO THE HOSPITAL THAN THAT ON WHICH SUCH PROPERTY OR SERVICE IS MADE AVAILABLE TO THE GENERAL PUBLIC. B) FURNISHING OF GOODS, SERVICES, OR FACILITIES BY THE HOSPITAL TO A GOVERNING BOARD MEMBER, UNLESS SUCH FURNISHING IS MADE ON A BASIS NOT MORE FAVORABLE THAN THAT ON WHICH SUCH GOODS, SERVICES, OR FACILITIES ARE MADE AVAILABLE TO THE GENERAL PUBLIC OR EMPLOYEES OF THE HOSPITAL. C) ANY TRANSFER TO OR USE BY OR FOR THE BENEFIT OF A GOVERNING BOARD MEMBER OF THE INCOME OR ASSETS OF THE HOSPITAL EXCEPT BY PURCHASE FOR FAIR MARKET VALUE. ANY DIRECTOR, OFFICER, EMPLOYEE, OR COMMITTEE MEMBER HAVING AN INTEREST IN A CONTRACT OR OTHER TRANSACTION PRESENTED TO THE BOARD OF DIRECTORS OR A COMMITTEE THEREOF FOR AUTHORIZATION, APPROVAL OR RATIFICATION SHALL GIVE PROMPT, FULL AND FRANK DISCLOSURE OF HIS INTEREST TO THE BOARD OR COMMITTEE PRIOR TO ITS ACTING ON SUCH CONTRACT OR TRANSACTION. THE BODY TO WHICH SUCH DISCLOSURE IS MADE SHALL THEREUPON DETERMINE, BY MAJORITY VOTE, WHETHER THE DISCLOSURE SHOWS THAT A CONFLICT OF INTEREST EXISTS OR CAN REASONABLY BE CONSTRUED TO EXIST. IF A CONFLICT IS DEEMED TO EXIST, SUCH PERSON SHALL NOT VOTE ON, NOR USE HIS PERSONAL INFLUENCE ON, NOR PARTICIPATE (OTHER THAN TO PRESENT FACTS) IN THE DISCUSSIONS OR DELIBERATIONS WITH RESPECT TO SUCH CONTRACT OR TRANSACTION. SUCH PERSON MAY NOT BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM AT ANY MEETING WHERE THE CONTRACT OR TRANSACTION IS UNDER DISCUSSION OR IS BEING VOTED UPON. THE MINUTES OF THE MEETING SHALL REFLECT THE DISCLOSURE MADE, THE VOTE THEREON AND, WHERE APPLICABLE, THE ABSTENTION FROM VOTING AND PARTICIPATING, AND WHETHER A QUORUM WAS PRESENT. FORM 990, PART VI, SECTION B, LINE 15A & 15B COMPENSATION REVIEW POLICY: CLARION HOSPITAL CONTRACTED WITH QUORUM HEALTH RESOURCES, AN UNRELATED MANAGEMENT COMPANY, FOR THE SERVICES OF BYRON QUINTON, CEO, AND VINCENT LAMORELLA, CFO. AMOUNTS PAID TO QUORUM HEALTH RESOURCES ARE REPORTED IN FORM 990, PART VII, SECTION B, AND ARE FOR SERVICES PROVIDED BY THE INDIVIDUALS AS WELL AS OTHER SERVICES PROVIDED BY THE COMPANY. NO COMPENSATION WAS REPORTED FOR EITHER INDIVIDUAL ON FORM 990, PART VII OR SCHEDULE J, PART II. ALTHOUGH THE ORGANIZATION DID NOT DIRECTLY PAY THE COMPENSATION OF THE CEO OR CFO DURING THE YEAR, THE ORGANIZATION DOES HAVE A COMPENSATION REVIEW POLICY IN PLACE. IT SHALL BE THE POLICY OF THE BOARD OF DIRECTORS TO ESTABLISH AND MAINTAIN AN EXECUTIVE COMPENSATION PROGRAM FOR THE PRESIDENT/CEO AND CHIEF FINANCIAL OFFICER WHICH: (1) ENABLES THE BOARD TO ATTRACT AND RETAIN THE EXECUTIVES NEEDED TO EFFECTIVELY CARRY OUT THE MISSION OF THE ORGANIZATION AND THE POLICIES OF THE BOARD. (2) RESPONDS TO MARKET TRENDS. (3) REFLECTS THE VALUE OF THE FUNCTIONAL DEMANDS OF EXECUTIVE WORK. (4) REWARDS PERFORMANCE RESULTS. (5) IS BASED ON FACTORS THAT PROVIDE FOR JUST AND REASONABLE COMPENSATION. COMPENSATION ACTIONS APPROVED BY THE BOARD OF DIRECTORS MUST BE DOCUMENTED, AND SUCH DOCUMENTATION SHALL INCLUDE THE BASES OF EACH COMMITTEE'S ACTIONS AND THE NAMES OF THE COMMITTEE MEMBERS INVOLVED IN THE ACTIONS. THE DOCUMENTED PROCESS FOR DETERMINING EXECUTIVE COMPENSATION SHALL INCLUDE: (1) TERMS OF THE COMPENSATION ARRANGEMENTS. (2) APPROVAL DATE. (3) NAMES OF BOARD MEMBERS WHO APPROVED THE COMPENSATION DECISIONS. (4) DATA USED IN THE COMPENSATION DECISION. (5) DISCLOSURES OF CONFLICT OF INTEREST, IF ANY. (6) ANNUAL REVIEW OF COMPENSATION RECORDS. THE BOARD OF DIRECTORS AUTHORIZES THE HUMAN RESOURCE COMMITTEE TO REVIEW AND RECOMMEND COMPENSATION DECISIONS FOR THE PRESIDENT/CEO. THE BOARD OF DIRECTORS AUTHORIZES THE FINANCE COMMITTEE TO REVIEW AND RECOMMEND COMPENSATION DECISIONS FOR THE CHIEF FINANCIAL OFFICER. SUCH RECOMMENDATIONS ARE REPORTED TO AND ACTED UPON BY THE FULL BOARD OF DIRECTORS. GUIDELINES FOR DETERMINING PROPOSED COMPENSATION FOR THE PRESIDENT/CEO AND THE CHIEF FINANCIAL OFFICER: (A) A REVIEW AND APPROVAL OF THE OFFICER'S COMPENSATION SHALL OCCUR INITIALLY UPON HIRE OF THE OFFICER AND WHENEVER THE OFFICER'S COMPENSATION IS MODIFIED. (B) ANNUALLY, THE HUMAN RESOURCE COMMITTEE OF THE BOARD OF DIRECTORS SHALL ESTABLISH PERFORMANCE STANDARDS FOR THE PRESIDENT/CEO WHICH SHALL BE USED IN DETERMINING COMPENSATION ACTIONS. THE HUMAN RESOURCE COMMITTEE SHALL HAVE THE AUTHORITY TO REVIEW THE PERFORMANCE OF THE PRESIDENT/CEO AND RECOMMEND A COMPENSATION ADJUSTMENT, IF WARRANTED IN THE JUDGMENT OF THE COMMITTEE. (C) ANNUALLY, THE PRESIDENT/CEO SHALL ESTABLISH PERFORMANCE STANDARDS FOR THE CHIEF FINANCIAL OFFICER WHICH SHALL BE USED IN DETERMINING COMPENSATION ACTIONS. THE PRESIDENT/CEO SHALL HAVE THE AUTHORITY TO REVIEW THE PERFORMANCE OF THE CHIEF FINANCIAL OFFICER AND PROPOSE A COMPENSATION ADJUSTMENT, IF WARRANTED IN THE JUDGMENT OF THE PRESIDENT/CEO, TO THE FINANCE COMMITTEE. (D) INFORMATION GATHERED AND USED IN COMPENSATION ACTIONS SHALL INCLUDE: 1. COMPENSATION PAID BY SIMILAR ORGANIZATIONS. 2. QHR WILL PROVIDE COMPENSATION COMPARABILITY DATA FOR THE POSITION COMPILED BY INDEPENDENT ORGANIZATIONS. THE DATA MAY BE BASED ON INDUSTRY SURVEYS, EXPERT COMPENSATION STUDIES, OR OTHER COMPARABLE DATA. 3. REFERENCE TO FUNCTIONALLY COMPARABLE POSITIONS. 4. THE AVAILABILITY OF SIMILAR SERVICES IN THE GEOGRAPHIC SERVICE AREA. COMPENSATION WAS LAST REVIEWED, USING THE ABOVE METHOD, IN FEBRUARY 2011. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE BY WRITTEN REQUEST FOR A LEGITIMATE BUSINESS PURPOSE, AS DETERMINED BY TOP MANAGEMENT. REQUESTED DOCUMENTS WILL BE MAILED TO THE REQUESTOR. FORM 990, PART VII, SECTION A COMPENSATION OF BOARD MEMBERS: ARTHUR DORTORT, TREASURER, AND THOMAS FREENOCK, DIRECTOR, ARE COMPENSATED BY HEALTH SERVICES OF CLARION, A RELATED ORGANIZATION, FOR SERVICES AS EMPLOYEES OF THAT ORGANIZATION. NEITHER INDIVIDUAL RECEIVED ANY COMPENSATION FOR SERVICES AS A MEMBER OF THE BOARD OF DIRECTORS OF CLARION HOSPITAL. FORM 990, PART IX, LINE 11G OTHER FEES FOR SERVICES: $2,851,122 MEDICAL PURCHASED SERVICES 2,227,937 REHAB PURCHASED SERVICES 2,089,491 OTHER PURCHASED SERVICES 526,449 PHYSICIAN FEES 210,559 COLLECTION AGENCY FEES ----------- $7,905,558 FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: $ (895,002) TRANSFER TO AFFILIATES (74,690) CHANGE IN INT IN NET ASSETS OF CLARION HOSPITAL FDN 10,305 CHANGE IN INT IN TRUST ------------- $ (959,387) HEALTH SERVICES OF CLARION ONE HOSPITAL DRIVE CLARION PA 16214 753126134 PHYSICIAN GRP PA 501(C)(3) 3 CLARION HS false CLARION HEALTHCARE SYSTEM INC ONE HOSPITAL DRIVE CLARION PA 16214 251534023 HOLDING CO PA 501(C)(3) 12A I NA false CLARION HOSPITAL SELF-INS TRUST FUND ONE HOSPITAL DRIVE CLARION PA 16214 251766602 SELF-INS PA 501(C)(3) 12A I HOSPITAL true CLARION DEVELOPMENT CORPORATION 24 DOCTORS LANE CLARION PA 16214 251516298 PHARMACY PA NA C CORP false false false true true false false false false false true true false false true true true true true false