2018-04-25T16:07:05-05:00 2017-06-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2016-07-01 250984595 BROOKVILLE HOSPITAL % JULIANNE PEER BROO 8148491461 100 HOSPITAL ROAD BROOKVILLE PA 15825 JULIANNE PEER PRESIDENT 2018-03-01 true Brian D Todd P00422601 4178658701 167.68.126.162 43032920181155000007 2018-04-25 P 35B2FEF9FD89B74F90B63698513A1BB518488CA1 54C7A82FB991EFCC0C4292E6AF33D2EF9A8285F7 2016 2021-01-29 14:40:06Z PENN HIGHLANDS BROOKVILLE JULIANNE PEER 100 HOSPITAL ROAD BROOKVILLE PA 15825 30400432 false X WWW.PHHEALTHCARE.ORG X 1915 PA BROOKVILLE HOSPITAL IS A 35 BED CRITICAL ACCESS HOSPITAL THAT PROVIDES QUALITY HEALTHCARE SERVICES. OUTPATIENT SERVICES INCLUDE RADIOLOGY, LAB AND REHABILITATION. 9 5 259 25 0 0 416973 276984 28185611 30073102 20711 37508 84666 1283 28707961 30388877 6132 5229 0 0 15991336 16238304 0 0 0 12312949 14429140 28310417 30672673 397544 -283796 17942514 17432698 7378783 6916783 10563731 10515915 X TO PROVIDE QUALITY HEALTHCARE SERVICES TO THE COMMUNITIES THAT WE SERVE IN A COST-EFFECTIVE MANNER. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. false true 21205686 5229 23757751 BROOKVILLE HOSPITAL PROVIDES A WIDE VARIETY OF OUTPATIENT SERVICES TO THE COMMUNITY. WE HAVE A PHYSICIAN STAFFED 24 HOUR EMERGENCY DEPARTMENT THAT PROVIDED OVER 8,800 VISITS THIS YEAR AND 3 FAMILY PRACTICE CLINICS AND AN URGENT CARE CLINIC THAT HAD OVER 30,000 VISITS. WE ALSO PROVIDE OUTPATIENT PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY, GENERAL RADIOLOGY, CAT SCAN, MRI, PET, ULTRASOUND, NUCLEAR MEDICINE, CARDIOLOGY, LABORATORY SERVICES, PAIN CLINIC, AND OUTPATIENT PSYCH SERVICES. OUR SURGEONS PERFORMED 1,100 SURGERIES AND OUR HOME HEALTH AGENCY PROVIDED OVER 4,800 VISITS. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. 5636954 6315351 BROOKVILLE HOSPITAL IS A 35 BED HOSPITAL THAT PROVIDED INPATIENT SERVICES TO OVER 1,000 PATIENTS THIS YEAR. INPATIENT SERVICES INCLUDED TREATMENTS FOR BOTH MEDICAL AND SURGICAL PATIENTS. MANY OF OUR PATIENTS WERE TREATED IN THE GERO-PSYCHIATRIC UNIT OF THE HOSPITAL. THIS UNIT SPECIALIZES IN PSYCHIATRIC DISORDERS FOR PATIENTS OVER THE AGE OF 55. 26842640 true true false true false false false false false false true false false true true false true true false false false false false false true false true true false false true false false false false false false false true false false false false false true true true false false true 41 0 true 259 true false false false false false true true false false false false X 9 5 false false false false true true true true true false false true true true true true true true false false PA X JULIANNE PEER 8148491461 100 HOSPITAL ROAD BROOKVILLE PA 15825 X JUDITH A GROMLEY TREASURER 2.0 0.0 X X 0 0 0 GENE HOAK SECRETARY 2.0 0.0 X X 0 0 0 RONALD E KING CHAIRMAN 2.0 0.0 X X 0 0 0 SISTER MARGARET PARK DIRECTOR 1.0 0.0 X 0 0 0 JULIANNE PEER PRESIDENT 0.0 40.0 X X 0 163538 46336 WILLIAM YOUNG VICE CHAIRMAN 2.0 0.0 X X 0 0 0 JOHN SUTIKA DIRECTOR/DRMC PRESIDENT 2.0 40.0 X 0 450907 61771 STEVEN FONTAINE DIRECTOR/PHH CEO 2.0 40.0 X 0 626356 100546 KUMARESAN GANABATHI MEDICAL STAFF PRESIDENT 0.0 40.0 X 0 537923 25376 DAVID GIRARDI PHYSICIAN 37.5 0.0 X 462825 0 24112 TANIS PENDLETON PHYSICIAN 37.5 0.0 X 253853 0 4451 CYRIL GAMIS PHYSICIAN 37.5 0.0 X 162812 0 13576 ALAN CORNMAN PHARMACY 37.5 0.0 X 144222 0 22123 NICOLE WRIGHT CERTIFIED REGISTERED NURSE PRA 37.5 0.0 X 146168 0 13982 1169880 1778724 312273 7 false true false NORTHFORK REHABILITATION INC 445 FERGUSON ROAD BROOKVILLE PA 15825 PHYSICAL THERAPY 1043175 MEDICUS SURGERY LLC 22 ROULSTON RD WINDHAM NH 03087 STAFFING 414965 ASSOCIATED CLINICAL LABORATORIES 15832 COLLECTION CTR DR CHICAGO IL 60693 LABORATORY 313915 BROOKVILLE EMERGENCY GROUP PO BOX 82368 LAFAYETTE LA 70508 MEDICAL STAFFING 230674 ALLIED RESOURCES MEDICAL STAFFING 135 DOWLIN FORGE RD EXTON PA 19341 MEDICAL STAFFING 177559 5 12436 18702 245846 276984 NET PATIENT SERVICE REVENUE 621110 29299329 29299329 PHARMACY REVENUE 446110 493343 493343 MEALS TICKET 722210 64628 64628 OTHER REVENUE 900099 215802 215802 30073102 37925 37925 0 0 54577 54577 0 54577 54577 2783 3200 -417 -417 -417 7537 12436 8355 -818 -818 0 0 0 0 0 0 LOSS FROM EQUITY INVESTEES 900099 -52476 -52476 -52476 30388877 30073102 38791 X 3229 3229 2000 2000 0 0 14727 14727 43788 43788 13307484 12420672 886812 231451 229827 1624 1976433 1845156 131277 664421 620289 44132 0 44504 44504 67816 67816 0 0 678 678 6414109 4466180 1947929 5451 5451 1295487 1021181 274306 0 0 567193 501043 66150 137530 61976 75554 0 33040 27739 5301 105365 88888 16477 0 992773 837751 155022 692783 617968 74815 MEDICAL SUPPLIES & DRUGS 2568061 2568061 BAD DEBT 1439285 1439285 LICENSES, DUES, SUBSCRIPTIONS 65065 47607 17458 30672673 26842640 3830033 0 898008 433217 5562296 1866220 0 0 3869348 3818253 4924 0 0 0 0 0 633087 625584 320145 268683 38815012 33964418 4879822 4850594 0 3794612 23473 23473 0 0 12494 0 1738917 1752062 17942514 17432698 2944864 3027702 0 0 0 0 3344066 3163680 0 0 0 0 447449 500532 0 0 642404 224869 7378783 6916783 X 10338587 10267072 32856 42402 192288 206441 10563731 10515915 17942514 17432698 X -283796 91619 144361 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 1800 1800 false SCHEDULE C, PART II-B, LINE 1(I) OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAYS DUES TO HOSPITAL COUNCIL OF WESTERN PENNSYLVANIA. A PORTION OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING. 205546 205546 8525031 7311342 1213689 204286 204286 27943083 26241419 1701664 1937066 207371 1729695 4850594 BEN INT IN PERPETUAL TRUST 206441 OTHER ASSETS 66214 DUE FROM AFFILIATES 1479407 1752062 0 EST AMT DUE TO THIRD PARTIES 172393 DUE TO BROOKCARE 52476 224869 29039342 91619 -1439285 -1347666 30387008 678 1191 1869 30388877 29241065 8355 8355 29232710 678 1439285 1439963 30672673 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 ON FORM 990, PART VIII, LINE 12: $(1,439,285) BAD DEBT EXPENSE SCHEDULE D, PART XI, LINE 4B OTHER REVENUE ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $( 8,355) SPECIAL EVENT EXPENSE 9,546 TEMPORARILY RESTRICTED CONTRIBUTIONS ------------ $ 1,191 SCHEDULE D, PART XII, LINE 2D OTHER EXPENSE ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25: $ 8,355 SPECIAL EVENT EXPENSE SCHEDULE D, PART XII, LINE 4B OTHER EXPENSE ON FORM 990, PART IX, LINE 25 BUT NOT ON LINE 1: $ 1,439,285 BAD DEBT EXPENSE 1 IN 100 19973 12436 7537 2700 1561 445 3275 374 0 19973 12436 7537 2700 1561 445 3275 374 8355 -818 true true X true X true X true true true false false 116797 116797 0.00420 3700181 1711524 1988657 0.07080 3816978 1711524 2105454 0.07500 2183 2183 0.00010 22000 4600 17400 0.00060 5229 5229 0.00020 29412 4600 24812 0.00090 3846390 1716124 2130266 0.07590 true 1439285 191425 10692220 10983687 -291467 X true false 1 1 BROOKVILLE HOSPITAL 100 HOSPITAL ROAD BROOKVILLE PA 15825 WWW.PHHEALTHCARE.ORG 28050101 X X X X BROOKVILLE HOSPITAL 1 false false true X X X X X X 14 true true false true X SEE PART V, SECTION C X true 14 true SEE PART V, SECTION C false true X 200. 300. X X X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X false X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY INPUT: THE CHNA ASSESSMENT CONDUCTED BY TRIPP UMBACH FOR BROOKVILLE HOSPITAL INCLUDED PRIMARY AND SECONDARY DATA COLLECTION, INTERVIEWS WITH COMMUNITY STAKEHOLDERS, FOCUS GROUPS WITH KEY AUDIENCES, AND A COMMUNITY PLANNING RETREAT. THE CHNA REPRESENTED A COMPREHENSIVE COMMUNITY-WIDE PROCESS WHERE BROOKVILLE HOSPITAL CONNECTED WITH A WIDE RANGE OF PUBLIC AND PRIVATE ORGANIZATIONS SUCH AS EDUCATIONAL INSTITUTIONS, HEALTH-RELATED PROFESSIONALS, LOCAL GOVERNMENT OFFICIALS, HUMAN SERVICE ORGANIZATIONS, AND FAITH-BASED ORGANIZATIONS TO EVALUATE THE COMMUNITY'S HEALTH AND SOCIAL NEEDS. SCHEDULE H, PART V, SECTION B, LINE 6A CHNA CONDUCTED WITH OTHER HOSPITAL FACILITIES: THE CHNA WAS CONDUCTED ALONG WITH DUBOIS REGIONAL MEDICAL CENTER, CLEARFIELD HOSPITAL, AND ELK REGIONAL HEALTH CENTER, RELATED ORGANIZATIONS. SCHEDULE H, PART V, SECTION B, LINE 7 WEBSITE WHERE CHNA IS AVAILABLE: https://www.phhealthcare.org/health-wellness/community-health-needs-assess ment SCHEDULE H, PART V, SECTION B, LINE 10A WEBSITE WHERE IMPLEMENTATION STRATEGY IS AVAILABLE: https://www.phhealthcare.org/health-wellness/community-health-needs-assess ment SCHEDULE H, PART V, SECTION B, LINE 11 ADDRESSING IDENTIFIED NEEDS: PENN HIGHLANDS BROOKVILLE, PENN HIGHLANDS DUBOIS, PENN HIGHLANDS CLEARFIELD AND PENN HIGHLANDS ELK ALSO PARTNERED WITH VARIOUS LOCAL ORGANIZATIONS IN A COLLABORATIVE MANNER DURING 2017 IN ORDER TO CARRY OUT THE INTENDED GOALS AND OUTCOMES OF OUR PREVIOUS CHNA STRATEGY. PENN HIGHLANDS BROOKVILLE LISTENS TO COMMUNITY CONCERNS, ANALYZES HEALTHCARE UTILIZATION AND COSTS, EXPLORES ACCESS ISSUES, COLLABORATES WITH AND DEVELOPS EFFECTIVE PROGRAMS TO IMPROVE THE HEALTH OF THOSE IN THIS PORTION OF WEST CENTRAL PENNSYLVANIA. BASED ON THE COMMUNITY HEALTH NEEDS ASSESSMENT FINDINGS AND THE PRIORITIZED NEEDS, THREE COMMUNITY NEEDS WILL BE ADDRESSED AND FURTHER EXPLORED. DESPITE MANY CHALLENGES FACING A RURAL, CRITICAL ACCESS HOSPITAL, PENN HIGHLANDS BROOKVILLE, IN COLLABORATION WITH OTHER PARTNERS IN OUR REGION, MADE STRIDES TO MEET MANY OF THE COMMUNITY NEEDS. OF THE IDENTIFIED CHNA AND PRIORITIZED HEALTH NEEDS, PENN HIGHLANDS BROOKVILLE FOCUSED ON THREE OF THE COMMUNITY REQUIREMENTS: -PROVIDER WORKFORCE -ACCESS TO CARE -DENTAL CARE PROVIDER WORKFORCE AND ACCESS TO CARE WHILE OUR STUDY NOTES THAT THOSE IN NEED OF HEALTHCARE OFTEN CITE THE LACK OF INSURANCE AS THE MAIN BARRIER, PENN HIGHLANDS BROOKVILLE TOOK ON THIS ISSUE IN ORDER TO ADDRESS THE PERCEPTION THAT THERE ARE NOT ENOUGH PROVIDERS TO SERVE COMMUNITY RESIDENTS. TACKLING THE LACK OF AVAILABLE PHYSICIANS AND ALLIED HEALTH PROFESSIONALS IN THE AREA WAS ALSO DONE TO HELP AND IMPROVE COMMUNITY RESIDENTS' ABILITY TO ACCESS AFFORDABLE HEALTHCARE SERVICES AND INFORMATION. ACCESS TO AFFORDABLE HEALTHCARE AND PREVENTIVE HEALTHCARE AND WELLNESS WERE IDENTIFIED AS DIRECT NEEDS FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT. DURING THE FISCAL YEAR, THE SYSTEM PHYSICIAN RECRUITERS USED THE FOLLOWING TOOLS TO ENGAGE POTENTIAL CANDIDATES: CONTINGENCY FIRMS; ADVERTISING JOB BOARDS (PRACTICE LINK, CAREER MD, JOURNAL OF FAMILY PRACTICE, HEALTHECAREERS); CAREER FAIRS (PITTSBURGH, GREENSBURG, PHILADELPHIA); COMMUNICATION WITH RESIDENCY PROGRAM DIRECTORS IN SURROUNDING STATES; AND COMMUNICATION WITH COLLEAGUES TO POOL CANDIDATES. PENN HIGHLANDS BROOKVILLE ALSO ENGAGED AN EMERGENCY MEDICINE PHYSICIAN STAFFING GROUP TO PROVIDE PHYSICIANS FOR ITS EMERGENCY DEPARTMENT. THE HOSPITAL HAS FOUR RURAL HEALTH CLINICS, INCLUDING LOCATIONS IN BROOKVILLE, MARIENVILLE, NEW BETHLEHEM AND MOSHANNON VALLEY. THERE ARE THREE PHYSICIANS AND FOUR ADVANCED PRACTICE PROVIDERS WORKING IN THOSE FOUR CLINICS. THE RECENT ADDITION OF THE FOURTH ALLIED HEALTH PROFESSIONAL ALSO INCREASED THE BROOKVILLE REGION'S ACCESS TO PRIMARY CARE. PENN HIGHLANDS BROOKVILLE WAS ALSO ABLE TO REESTABLISH ACCESS TO A FELLOWSHIP-TRAINED CARDIOLOGIST BY PARTNERING WITH DUBOIS REGIONAL CARDIOLOGY ASSOCIATES TO STAFF A LOCAL OFFICE AND PROVIDE CONSULTATIONS IN THE HOSPITAL TWO DAYS PER WEEK. THOSE SEEKING LOCAL ACCESS TO OUTPATIENT OBSTETRICAL AND GYNECOLOGICAL CARE ARE ALSO NOW ABLE TO SEE A PHYSICIAN IN BROOKVILLE THANKS TO THE ADDITION OF A NEW OFFICE OF PENN HIGHLANDS WOMEN'S CARE. IN ADDITION TO PLACING QUALIFIED PROVIDERS IN PRACTICES AROUND OUR SERVICE AREA, PENN HIGHLANDS BROOKVILLE IS WORKING ON A PLAN TO INCLUDE A QCARE PROGRAM IN THE REGION. THIS WILL FOCUS ON ACCESS AND AFFORDABILITY FOR THOSE SEEKING CARE FOR URGENT NEEDS THAT ARE NOT EMERGENCIES. IN 2016, PENN HIGHLANDS BROOKVILLE WORKED WITH LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE TO PROVIDE CLINICAL SETTINGS FOR MEDICAL STUDENTS TO GET HANDS-ON OPPORTUNITIES TO EXPAND THEIR MEDICAL EDUCATION. A GENERAL MEDICAL EDUCATION PROGRAM WILL BE PART OF A SYSTEM-WIDE INITIATIVE THAT WILL BRING MEDICAL RESIDENTS IN THE FIELDS OF FAMILY MEDICINE, INTERNAL MEDICINE AND EMERGENCY MEDICINE TO PENN HIGHLANDS BROOKVILLE IN 2017. ADDITIONAL PARTNERSHIPS WILL ALSO INCLUDE A PHYSICIAN ASSISTANT TRAINING PROGRAM WITH LOCK HAVEN UNIVERSITY AND AN EDUCATIONAL/TRAINING PROGRAM FOR MID-LEVEL PROVIDERS WITH THE UNIVERSITY OF PITTSBURGH MEDICAL CENTER. DENTAL CARE MANY AVENUES FOR EXPANDING ACCESS TO DENTAL CARE IN OUR COMMUNITIES WERE EXPLORED WITH PARTNERS THROUGHOUT OUR HEALTH SYSTEM. DISCUSSIONS WITH CURRENT PROVIDERS ABOUT PLANS FOR ADDITIONAL STAFFING, THE REVIEW OF A MOBILE DENTAL UNIT FOR THE REGION AND DISCUSSIONS WITH OTHER STAKE-HOLDERS TO GENERATE NEW OPTIONS FOR DENTAL CARE WERE ALL INCLUDED IN THE PROCESS. THIS PRIORITY PROVED VERY CHALLENGING. NO NEW PROVIDERS OR PARTNERS COULD BE IDENTIFIED FOR OUR REGION FOR ANY INITIATIVES THAT WERE REVIEWED. MUCH TIME WAS DEVOTED TO STUDYING HOW MOBILE DENTAL UNITS WORK IN RURAL COMMUNITIES AND DEMONSTRATIONS OF MOBILE UNITS WERE CONDUCTED. FOLLOWING EXTENSIVE REVIEW AND DISCUSSION, OFFICIALS DETERMINED THAT PURCHASING A MOBILE UNIT WAS NOT FEASIBLE FOR OUR SYSTEM. THE TWO MAJOR FACTORS INCLUDED COST AND THE LACK OF A QUALIFIED PROVIDER TO RUN THE UNIT. EACH OF THE HEALTH NEEDS IDENTIFIED WITHIN THE CHNA ARE IMPORTANT AND ARE BEING ADDRESSED TO SOME DEGREE BY ORGANIZATIONS, PROGRAMS/INITIATIVES OPERATED BY REGIONAL AND LOCAL COMMUNITY-BASED ORGANIZATIONS OR BY BROOKVILLE HOSPITAL AND/OR DRMC. THROUGH ANALYSIS AND DISCUSSIONS RESULTING FROM A WORK SESSION HELD WITH REPRESENTATIVES FROM BROOKVILLE HOSPITAL AND DRMC, THE FOLLOWING NEEDS IDENTIFIED IN THE CHNA THAT WILL NOT BE ADDRESSED ARE: 1. ACCESSING HEALTH INFORMATION / LACK OF ACCESS (BRIDGING GAP BETWEEN SERVICE PROVIDERS AND END-USERS) 2. DRUG/ALCOHOL PREVENTION 3. HEALTH EDUCATION AND COMMUNICATION A SITE WAS IDENTIFIED FOR A QCARE IN BROOKVILLE THAT WILL INCREASE ACCESS TO CARE. RENOVATIONS TO THE SITE WILL BEGIN IN 2018. THE GME STUDENTS STARTING SEEING PATIENTS IN THE BROOKVILLE RHC IN 2017 AND RN STUDENTS FROM CLARION UNIVERSITY STARTED DOING ROTATIONS AT PHB IN 2017. SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, 16C FINANCIAL ASSISTANCE POLICY: https://www.phhealthcare.org/patients-visitors/financial-assistance-policy SCHEDULE H, PART V, SECTION B, LINE 16G DURING THE ORGANIZATION'S EVALUATION OF LANGUAGE POPULATIONS, THERE WERE NO POPULATIONS THAT MET THE 5% OR 1,000 PERSON THRESHOLD TO REQUIRE LEP TRANSLATIONS TO BE POSTED ON THE ORGANIZATION'S WEBSITE. THE POLICY, APPLICATION FORM AND PLAIN LANGUAGE SUMMARY OF THE POLICY WILL BE AVAILABLE IN ENGLISH WHICH CONSTITUTES MORE THAN 95% OF THE RESIDENTS IN THE COMMUNITY. FOR THOSE INDIVIDUALS SPEAKING LANGUAGES OTHER THAN THOSE FOR WHICH THE FINANCIAL ASSISTANCE GUIDELINES ARE PRINTED, INTERPRETERS ARE MADE AVAILABLE TO CLEARLY COMMUNICATE THE POLICY AND PROVIDE ASSISTANCE IN COMPLETING THE NECESSARY FORMS. 6 PHYSICAL THERAPY BUILDING 88 INDUSTRIAL PARK RD BROOKVILLE PA 15825 PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY CHARLES PROFESSIONAL BUILDING 240 ALLEGHENY BLVD BROOKVILLE PA 15825 PHYSICIAN OFFICES, HOME HEALTH DAVID L MILLER MEDICAL CENTER BROOKVILLE STREET FAIRMOUNT PA 16224 RADIOLOGY, LAB, PHYSICAL AND OCCUPATIONAL THERAPY, AND RURAL HEALTH CLINIC ALLEGHENY HEALTH CENTER 22 INDUSTRIAL PARK RD BROOKVILLE PA 15825 RURAL HEALTH CLINIC MARIENVILLE FAMILY HEALTH 125 CHESTNUT ST MARIENVILLE PA 16239 RURAL HEALTH CLINIC MOSHANNON VALLEY RURAL HEALTH CENTER 271 RAILROAD STREET PHILIPSBURG PA 16866 RURAL HEALTH CLINIC 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 OF IX, LINE 25 OF THE FORM 990, WAS REDUCED BY BAD DEBT EXPENSE OF $ 1,439,285. SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY: THE COST TO CHARGE RATIO COMPUTED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATIONS OF IRS WORKSHEETS 1 AND 3. SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT EXPENSE: THE ORGANIZATION CALCULATED BAD DEBT USING THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS PER THE AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION A, LINE 3 BAD DEBT EXPENSE 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 U.S. CENSUS BUREAU. THE MOST RECENT US CENSUS BUREAU INDICATES THAT 13.3 PERCENT OF JEFFERSON 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 DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE SYSTEM ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL 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 DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL 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 SYSTEM RECORDS A SIGNIFICANT 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 DOUBTFUL 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: A CHARITY CARE APPLICATION IS GOOD FOR SIX MONTHS ONCE APPROVED. ALSO PATIENTS ARE SENT THREE STATEMENTS BEFORE BEING SENT TO COLLECTION AGENCY, SO THEY HAVE TIME TO CONTACT THE BILLING OFFICE FOR CHARITY CARE. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: The hospital collects data on an ongoing basis regarding patients who travel to outlying areas for services not offered by Penn Highlands Brookville. 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. PH Brookville routinely sends patient satisfaction surveys to those receiving medical services. These surveys allow patients to offer suggestions regarding how the hospital could better serve patients and the community as a whole. PH Brookville 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 education. This knowledge allows the hospital to remain updated on the latest medical news and techniques in order to offer patients the highest and most innovative levels of care. Penn Highlands hired an outside firm to assist with conducting a Community Health Needs Assessment. The contractor gathered secondary data in Jefferson 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 PH Brookville which has been posted on the hospitals website. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: INFORMATION IS POSTED AT REGISTRATION AREA AND IN WAITING AREAS. SELF PAY PATIENTS ARE GIVEN INFORMATION WITH THE FIRST BILL. THE CARE MANAGEMENT DEPARTMENT WORKS WITH ALL INPATIENTS AND WITH OUTPATIENTS AS NEEDED/REQUESTED. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: BROOKVILLE HOSPITAL SERVES BROOKVILLE AND THE SURROUNDING COMMUNITIES. THE SERVICE AREA EXTENDS NORTH TO MARIENVILLE AND SOUTH TO NEW BETHLEHEM, AND INCLUDES JEFFERSON COUNTY, FOREST COUNTY AND CLARION COUNTY. THIS SERVICE AREA IS IN A RURAL PART OF WESTERN PENNSYLVANIA, WITH MANY RESIDENTS LIVING BELOW OR WELL BELOW THE NATIONAL AND STATE INCOME AVERAGE. ACCORDING TO THE US CENSUS BUREAU'S MOST RECENT DATA, APPROXIMATELY 15 PERCENT OF INDIVIDUALS LIVING IN THIS AREA WERE CONSIDERED TO LIVE IN POVERTY. THE MEDIAN HOUSEHOLD INCOME IN THE SERVICE AREA IS APPROXIMATELY $38,500. FROM THE RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT, THE SERVICE AREA INCLUDES 22% OF UNINSURED ADULTS, 7.8% OF CHILDREN WHO ARE UNINSURED. UNEMPLOYMENT RATES FOR CLEARFIELD AND JEFFERSON COUNTY WERE JUST OVER 8%. THE MEDIAN AGE OF THE POPULATION IS ABOUT 42, WITH ABOUT 18% 65 AND OVER. CLEARFIELD COUNTY HAS A 45.9% URBAN POPULATION, WHILE JEFFERSON HAS A 33.8% URBAN POPULATION. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: BROOKVILLE HOSPITAL PARTICIPATES IN AND PROVIDES MANY HEALTH FAIR AND COUNSELING OPPORTUNITIES THROUGHOUT THE YEAR, INCLUDING THOSE ASSOCIATED WITH MENTAL HEALTH, DIABETES, NUTRITION AND WEIGHT MANAGEMENT. ALSO, THE ORGANIZATION WORKS TO PROMOTE LEARNING THROUGH THE MEDICAL EXPLORERS PROGRAM AND LOCAL CAREER DAYS. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: BROOKVILLE HOSPITAL IS A SUBSIDIARY OF DUBOIS REGIONAL MEDICAL CENTER (DRMC). DRMC HAS AN AFFILIATION AGREEMENT WITH CLEARFIELD HOSPITAL, CREATING PENN HIGHLANDS HEALTHCARE, WHICH BECAME THE PARENT AND SOLE MEMBER OF DRMC AND CLEARFIELD. false true false false false false false true false JULIANNE PEER PRESIDENT 0 143458 0 17962 0 2118 14727 14727 0 16882 14727 195147 0 0 DAVID GIRARDI PHYSICIAN 462800 0 0 0 25 0 7758 0 16354 0 486937 0 0 0 TANIS PENDLETON PHYSICIAN 242776 0 0 0 11077 0 0 0 4451 0 258304 0 0 0 CYRIL GAMIS PHYSICIAN 162812 0 0 0 0 0 0 0 13576 0 176388 0 0 0 ALAN CORNMAN PHARMACY 141222 0 0 0 3000 0 5769 0 16354 0 166345 0 0 0 NICOLE WRIGHT CERTIFIED REGISTERED NURSE PRA 146140 0 0 0 28 0 704 0 13278 0 160150 0 0 0 JOHN SUTIKA DIRECTOR/DRMC PRESIDENT 0 342892 0 106986 0 1029 0 44889 0 16882 0 512678 0 0 STEVEN FONTAINE DIRECTOR/PHH CEO 0 503005 0 122688 0 663 0 84192 0 16354 0 726902 0 0 KUMARESAN GANABATHI MEDICAL STAFF PRESIDENT 0 518000 0 0 0 19923 0 10600 0 14776 0 563299 0 0 SCHEDULE J, PART I, LINE 3 CEO COMPENSATION DETERMINATION: PENN HIGHLANDS HEALTHCARE (PHH), A RELATED ORGANIZATION, COMPLETES THE REVIEW OF THE CEO'S COMPENSATION, USING THE FOLLOWING METHODS: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE -WRITTEN EMPLOYMENT CONTRACT SCHEDULE J, PART I, LINE 4B NONQUALIFIED RETIREMENT PLAN: PENN HIGHLANDS DUBOIS EMPLOYEES WHO PARTICIPATED IN A 457(F) PLAN: JOHN SUTIKA 2016 CONTRIBUTIONS $16,289 STEVEN FONTAINE 2016 CONTRIBUTIONS $55,535 SCHEDULE J, PART I, LINE 7 A PORTION OF JULIANNE PEER, STEVEN FONTAINE, AND JOHN SUTIKA'S BONUSES WERE BASED ON BOARD DISCRETION, WHILE THE MAJORITY WAS BASED ON FORMULAS USING INFORMATION BASED ON FINANCE, GROWTH, QUALITY/SAFETY, PEOPLE, AND SERVICE. 0 LINDA GRINDER SISTER OF RON KING 43788 EMPLOYEE OF HOSPITAL false FORM 990, PART III, LINE 1 ORGANIZATION'S MISSION: MISSION STATEMENT OUR MISSION IS TO PROVIDE QUALITY HEALTHCARE SERVICES TO THE COMMUNITIES THAT WE SERVE IN A COST EFFECTIVE MANNER. VISION STATEMENT OUR VISION IS TO BE THE PROVIDER OF CHOICE IN PROMOTING HEALTHCARE FOR THE COMMUNITIES THAT WE SERVE. VALUE STATEMENT -SERVICE EXCELLENCE THAT IS RESPONSIVE TO THE NEEDS OF THOSE WE SERVE. -DIGNITY & COMPASSION IN CARING FOR PATIENTS AND THEIR FAMILIES. -RESPECT TREATING EACH OTHER WITH FAIRNESS, HONESTY, AND TRUST. -TEAMWORK CHARACTERIZED BY UNITY OF PURPOSE, FLEXIBILITY AND EMPOWERMENT OF PEOPLE. -PLANNING BUILDING ON THE PAST AND ANTICIPATING THE FUTURE TO MEET OUR GOALS. -FINANCIAL HEALTH TO ENSURE THE CONTINUATION OF OUR MISSION. -ACTIVE PARTICIPATION BY PATIENTS AND FAMILIES IN THEIR HEALTHCARE. FORM 990, PART III, LINE 3 SIGNIFICANT CHANGE IN PROGRAM SERVICES: BROOKVILLE HOSPITAL TRANSFERRED ITS HOME HEALTH PROGRAM TO COMMUNITY NURSES, INC, A RELATED PARTY, IN JUNE 2017. FORM 990, PART III, LINE 4A PROGRAM SERVICE: BROOKVILLE HOSPITAL ESTIMATED VALUE OF FREE CARE, COMMUNITY SERVICE, CHARITABLE CONTRIBUTIONS, AND PROFESSIONAL AND COMMUNITY EDUCATION. UNCOMPENSATED CHARITY CARE UNCOMPENSATED CHARITY CARE CHARGES WRITTEN OFF WERE $293,755. THE TOTAL DOES NOT INCLUDE BAD DEBT. THE HOSPITAL'S DETERMINATION OF INABILITY TO PAY DIFFERENTIATES CHARITY CARE FROM BAD DEBT, WHICH IS DETERMINED BY ABILITY TO PAY BUT UNWILLINGNESS TO DO SO. BAD DEBT THE HOSPITAL'S BAD DEBT AMOUNT WRITTEN OFF WAS $1,439,285 IN FY 2017. CHARITY CARE SERVICE THE HOSPITAL OWNS AND OPERATES THE ALLEGHENY, NEW BETHLEHEM, AND MARIENVILLE HEALTH CENTERS. THESE ARE RURAL HEALTH CLINICS THAT ARE AVAILABLE TO THE COMMUNITY. CHARITY CARE IS OFFERED TO PATIENTS OF THESE CLINICS. COMMUNITY VOLUNTEER ASSISTANCE APPROXIMATELY 25 ACTIVE HOSPITAL VOLUNTEERS ASSISTED WITH THE PROVISION OF SERVICES BY THE HOSPITAL. THE AUXILIARY HAS ABOUT 28 MEMBERS THAT HOLD FUND RAISING EVENTS THROUGHOUT THE YEAR. THE FUNDS FROM THESE EVENTS ARE GIVEN BACK TO THE HOSPITAL FOR VARIOUS PROJECTS. PASTORAL CARE THE HOSPITAL HAS VOLUNTEER PASTORS THAT PERFORM MINISTRY TO THE HOSPITAL'S PATIENTS, PATIENTS' FAMILIES, AND STAFF. THIS SERVICE IS AVAILABLE 24 HOURS A DAY/7 DAYS A WEEK. PATIENT COMMENT SURVEYS THE HOSPITAL DISTRIBUTES SURVEYS TO INPATIENT, OUTPATIENTS, AMBULATORY SURGERY, EMERGENCY ROOM, AND HOME CARE PATIENTS TO ASSESS THE NEEDS OF THE PATIENTS IN OUR COMMUNITY REGARDING CARE AND OPPORTUNITIES TO IMPROVE THAT CARE. RESULTS ARE RECEIVED QUARTERLY AND COMPARED TO PRIOR RESULTS. TIME IS SPENT BY HOSPITAL STAFF I EVALUATING RESULTS, WITH DEPARTMENTAL AND CONSUMER FOLLOW-UP AND WORK PROCESS REDESIGN TO IMPROVE CARE AND SATISFACTION. FOREIGN LANGUAGE & SIGN LANGUAGE INTERPRETING SERVICE THE HOSPITAL PROVIDES INTERPRETING SERVICES AT NO CHARGE TO FOREIGN LANGUAGE AND SIGN LANGUAGE SPEAKING PATIENTS AND PATIENT FAMILY MEMBERS. THESE SERVICES ARE PERFORMED ON AN ON-CALL BASIS. HOSPITAL EMPLOYEES WHO SPEAK A FOREIGN LANGUAGE OR ARE TRAINED IN SIGN LANGUAGE CAN BE USED TO TRANSLATE. THE HOSPITAL ALSO SUBSCRIBES TO AN ON-LINE INTERPRETING SERVICE, LANGUAGE LINE SERVICES. COMMUNITY EDUCATION / PUBLIC AFFAIRS ACTIVITIES IN OUR ROLES AS A LEADING PROVIDER OF HEALTH AND HEALTH-RELATED SERVICES TO JEFFERSON AND SURROUNDING COUNTIES, BROOKVILLE HOSPITAL RECOGNIZES OUR RESPONSIBILITY TO HELP THE PEOPLE OF OUR SERVICE AREA ACHIEVE AND MAINTAIN OPTIMUM HEALTH STATUS. THE ADMINISTRATION AND EDUCATION DEPARTMENT AND THE HEALTHY COMMUNITY COMMITTEE, OFFERS A SERIES OF PROGRAMS THROUGHOUT THE YEAR TO ACHIEVE THIS ROLE. BROOKVILLE HOSPITAL'S EDUCATIONAL EFFORTS ARE HEALTH-RELATED TO HELP FULFILL OUR MISSION OF HELPING PEOPLE IN OUR SERVICE AREA ACHIEVE AND MAINTAIN OPTIMUM HEALTH STATUS. EFFORTS IN THIS AREA INCLUDE FREE COMMUNITY HEALTH AND PATIENT EDUCATION PUBLICATIONS, MATERIALS TO PROMOTE HEALTH-RELATED ACTIVITIES, A PHYSICIAN REFERRAL LINE, AND PARTICIPATION IN LOCAL HEALTH FAIRS. PATIENT SUPPORT AND EDUCATION NUTRITIONAL COUNSELING A REGISTERED DIETITIAN IS AVAILABLE TO MEET WITH PATIENTS AND FAMILIES TO ASSESS NUTRITIONAL NEEDS AND DETERMINE APPROPRIATE NUTRITIONAL GOALS AND STRATEGIES. IN ADDITION, CLASSES ARE OFFERED THROUGHOUT THE YEAR TO THE COMMUNITY ON HEALTHY COOKING, LOW FAT DIET, DIABETES, CARDIOVASCULAR HEALTH. MAMMOGRAMS IN COOPERATION WITH AREA PHYSICIANS, THE HOSPITAL PROVIDES REDUCED FEE MAMMOGRAMS WITH INTERPRETATIONS ON AN ANNUAL BASIS FOR HIGH RISK WOMEN WHO ARE LOW INCOME AND GENERALLY UNINSURED. COMMUNITY CLASSES THE HOSPITAL OFFERS A VARIETY OF COMMUNITY EDUCATION CLASSES THAT INCLUDES CPR, DIABETES EDUCATION, AND A NEW WAY OF LIFE. PATIENT EDUCATION PUBLICATIONS INCLUDES A VARIETY OF PUBLICATIONS SUCH AS THE PATIENT VISITOR GUIDE, THE PATIENT RIGHTS & RESPONSIBILITIES BOOKLET, ADVANCE DIRECTIVES, ETC. MATERIALS TO PROMOTE HEALTH-RELATED ACTIVITIES MATERIALS INCLUDE PROMOTING A VARIETY OF ACTIVITIES INCLUDING HEALTH SCREENING ADS, CANCER ASSESSMENT AND BREAST HEALTH AWARENESS MATERIALS, AND DIABETES EDUCATION CLASSES. VOLUNTARISM BROOKVILLE HOSPITAL'S WORK FORCE, ONE OF THE LARGEST IN THE REGION, IS COMPRISED OF MANY INDIVIDUALS WHO ENGAGE IN PERSONAL COMMUNITY SERVICE. THESE INDIVIDUALS GIVE OF THEIR TIME, TALENT, AND RESOURCES TO MAKE OUR COMMUNITY A BETTER PLACE TO LIVE AND WORK. PHYSICIANS AND EMPLOYEES VOLUNTEER THEIR TIME INDIVIDUALLY, BENEFITING COMMUNITY ORGANIZATIONS AND CAUSES. DURING THE YEAR. EMPLOYEES SPEND TIME PROVIDING CARE, EDUCATING THE COMMUNITY, AND SERVING ON BOARDS OF SOCIAL SERVICE AGENCIES. EMPLOYEES VOLUNTEER THEIR TIME FOR ADOPT A HIGHWAY, MARCH OF DIMES WALK AMERICA, THE M/S WALK, AND SIT ON VARIOUS COMMUNITY BOARDS. CONTRIBUTIONS EACH YEAR, BROOKVILLE HOSPITAL RECEIVES REQUESTS FOR FINANCIAL SUPPORT FROM NUMEROUS ORGANIZATIONS PROVIDING VALUABLE SERVICES TO OUR COMMUNITY. WHILE WE ARE A NOT-FOR-PROFIT ORGANIZATION, WE DO PROVIDE SUPPORT ON A LIMITED BASIS. INFECTION CONTROL COMMUNITY SERVICE THE INFECTION CONTROL DEPARTMENT SHARES POLICIES, PROCEDURES, AND EXPERTISE WITH OTHER HOSPITALS, NURSING HOMES, AND HEALTH CARE PROVIDERS IN SOLVING INFECTION-RELATED PROBLEMS, HELPING TO DEVELOP PROGRAMS, ETC., AS REQUESTED. THE INFECTION CONTROL DEPARTMENT ALSO PROVIDES FOLLOW-UP TO BLOOD/BODY FLUID EXPOSURES EXPERIENCED BY HOSPITAL PERSONNEL. FOLLOW-UP IS GENERALLY COMPLICATED AND INVOLVES BLOOD WORK FOR EMPLOYEES AND PATIENTS AND COUNSELING AS PROVIDED AFTER EACH EXPOSURE. INFECTION CONTROL COMMUNICATE REGULARLY WITH ALL AREA HEALTH BUREAUS REPORTING COMMUNICABLE DISEASES, THUS AFFORDING CONTINUITY OF FOLLOW-UP INVESTIGATION FOR POTENTIALLY EXPOSED PATIENTS AND STAFF. COMMUNITY EDUCATION WE WORK WITH HIGH SCHOOL STUDENTS TO EDUCATE THEM ABOUT HEALTHCARE CAREERS THROUGH JOB FAIRS AT THE SCHOOL AND BY OFFERING JOB SHADOWING OPPORTUNITIES IN BOTH CLINICAL AND NON-CLINICAL AREAS. FORM 990, PART IV, LINE 24A TAX EXEMPT BOND ISSUE: A REFINANCING BOND ISSUE WAS NEGOTIATED BY THE PARENT COMPANY OF BROOKVILLE HOSPITAL, PENN HIGHLANDS HEALTHCARE, INC., TO BENEFIT THE HOSPITALS WITHIN THE PENN HIGHLANDS SYSTEM. PENN HIGHLANDS HEALTHCARE, INC. REPORTED THIS BOND ISSUE ON SCHEDULE K OF ITS FORM 990. PENN HIGHLANDS HEALTHCARE, INC. DOES NOT CARRY THIS LIABILITY ON ITS BALANCE SHEET. RATHER, BROOKVILLE HOSPITAL IS LEGALLY RESPONSIBLE FOR ITS PORTION OF THE LIABILITY AND THUS, REPORTS ITS SHARE ON ITS BALANCE SHEET. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS/STOCKHOLDERS: DUBOIS REGIONAL MEDICAL CENTER (DRMC) IS THE SOLE MEMBER OF BROOKVILLE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A ELECTION OF DIRECTORS: AS THE SOLE MEMBER OF BROOKVILLE HOSPITAL, DRMC'S RESERVED POWERS INCLUDE THE RIGHT TO ELECT THE BOARD OF DIRECTORS OF BROOKVILLE HOSPITAL. CANDIDATES ARE SUBMITTED TO DRMC THROUGH A NOMINATING PROCESS THAT INVOLVES THE APPROVAL OF BROOKVILLE HOSPITAL'S BOARD. AS THE OTHER BODY OF DRMC, PHH HAS THE AUTHORITY TO APPROVE DRMC'S ELECTION OF BROOKVILLE HOSPITAL'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B DECISION APPROVALS: AS THE SOLE MEMBER OF BROOKVILLE HOSPITAL, DRMC'S RESERVED POWERS INCLUDE: -APPROVAL OF ALL FUNDAMENTAL TRANSACTIONS; -APPROVAL OF ALL STRATEGIC PLANS, BUDGETS, AND FEASIBILITY PLANS; -APPROVAL OF THE INCURRENCE, RE-FINANCING OR PREPAYMENT OF ALL INDEBTEDNESS IN EXCESS OF $10,000; -WITH SOME EXCEPTIONS, THE APPROVAL OF THE SECURING OF ANY ENCUMBRANCE OF ASSETS; -WITH SOME EXCEPTIONS, APPROVAL OF THE MAKING OF ANY CAPITAL EXPENDITURES OR ANY CAPITAL ADDITIONS OR IMPROVEMENTS GREATER THAN $10,000; -APPROVAL OF ANY AND ALL AMENDMENTS OF THE ARTICLES AND/OR BYLAWS; -APPROVAL OF ANY CHANGE IN MISSION OR DIRECTION; -APPROVAL OF THE ESTABLISHMENT OF, OR TERMINATION OR WITHDRAWAL FROM, ANY SUBSIDIARY, JOINT VENTURE, OR OTHER PARTNERSHIP OR SHARED GOVERNANCE ARRANGEMENT; -APPROVAL OF AGREEMENTS OF $50,000 OR MORE; AND -APPROVAL OF THIRD PARTY PAYOR AGREEMENTS, COLLECTIVE BARGAINING AGREEMENTS AND AGREEMENTS BETWEEN BROOKVILLE HOSPITAL AND DRMC. AS THE OTHER BODY OF DRMC, PHH HAS THE POWER TO REVIEW AND APPROVE ANY ACTION TAKEN BY DRMC IN EXERCISING THE RESERVED POWERS LISTED ABOVE. FORM 990, PART VI, SECTION B, LINE 11B 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. THE FORM 990 IS REVIEWED BY THE CEO PRIOR TO BEING FILED. IN ADDITION, THE BOARD REVIEWS AND APPROVES THE FORM 990 BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY: THE CONFLICT OF INTEREST STATEMENTS ARE REVIEWED BY THE CEO. ANY BOARD MEMBER WITH A CONFLICT OR POTENTIAL CONFLICT WOULD ABSTAIN FROM VOTING ON ANY MATTER RELATED TO THAT CONFLICT. ADDITIONALLY, THE BOARD MEMBERS ARE GIVEN A QUESTIONNAIRE TO COMPLETE TO ASSIST THE ORGANIZATION IN PROPERLY ANSWERING THE QUESTIONS FOR THE NEW FORM 990. CORPORATE OFFICERS AND KEY EMPLOYEES ARE ALSO REQUIRED TO ANNUALLY DISCLOSE CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A CEO COMPENSATION REVIEW: PHH COMPLETES A REVIEW OF EXECUTIVE SALARIES USING AN INDEPENDENT CONSULTANT AND A COMPENSATION COMMITTEE. THE INDEPENDENT CONSULTANT USES COMPARABILITY DATA IN THE REVIEW AND THE DECISION IS DOCUMENTED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: THE FINANCIAL SUMMARY AND ANNUAL REPORT CAN ALSO BE REVIEWED IN THE HOSPITAL ADMINISTRATIVE OFFICES. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART VII DIRECTOR COMPENSATION: NO DIRECTORS RECEIVE COMPENSATION FOR THEIR ROLES AS DIRECTORS. JULIANNE PEER, JOHN SUTIKA, KUMARESAN GANABATHI AND STEVEN FONTAINE RECEIVE COMPENSATION FROM RELATED ORGANIZATIONS FOR THEIR ROLES AS MANAGEMENT AND/OR PHYSICIANS. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: $130,208 TRANSFER FROM AFFILIATES 14,153 CHANGE IN BENEFICIAL INTEREST IN TRUST --------- $144,361 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:4409048 FORM 990 PART IX LINE 11G DESCRIPTION:OUTSIDE SERVICES TOTAL FEES:1195833 FORM 990 PART IX LINE 11G DESCRIPTION:MAINTENANCE CONTRACTS TOTAL FEES:728199 FORM 990 PART IX LINE 11G DESCRIPTION:SERVICE CONTRACTS TOTAL FEES:81029 PENN HIGHLANDS HEALTHCARE 100 HOSPITAL AVENUE DUBOIS PA 15801 320345810 MGMT SERVICES PA 501(C)(3) 12 C III-FI NA false DUBOIS REGIONAL MEDICAL CENTER 100 HOSPITAL AVENUE DUBOIS PA 15801 251490707 HEALTHCARE PA 501(C)(3) 3 PHH false ELCO HOUSING 759 JOHNSONBURG ROAD ST MARYS PA 15857 251639115 HOUSING PA 501(C)(3) 7 PHH false ELK REGIONAL PROFESSIONAL GROUP INC 763 JOHNSONBURG ROAD ST MARYS PA 15857 251875183 HEALTH CARE PA 501(C)(3) 3 PHH false COMMUNITY NURSES HOME SUPPORT SERVICES 757 JOHNSONBURG ROAD STE 200 ST MARYS PA 15857 251623601 HEALTH CARE PA 501(C)(3) 10 CNI false COMMUNITY NURSES INC 757 JOHNSONBURG ROAD STE 200 ST MARYS PA 15857 251623598 HEALTH CARE PA 501(C)(3) 7 PHH false COMMUNITY NURSES HOME HEALTH AND HOSPICE 757 JOHNSONBURG ROAD STE 200 ST MARYS PA 15857 250996070 HEALTH CARE PA 501(C)(3) 10 CNI false CLEARFIELD HOSPITAL 809 TURNPIKE DR CLEARFIELD PA 16830 250979346 HOSPITAL PA 501(C)(3) 3 PHH false ELK REGIONAL HEALTH CENTER 763 JOHNSONBURG ROAD ST MARYS PA 15857 250585280 HOSPITAL PA 501(C)(3) 3 PHH false NATHANIEL D YINGLING CANCER CENTER 815 DOCTORS DR CLEARFIELD PA 16830 205114093 RADIATION ONC PA 501(C)(3) 3 PHH false CLEAR-MED PROVIDER CORPORATION PO BOX 1260 CLEARFIELD PA 16830 251657668 OUTPAT. PHYS. PA 501(C)(3) 3 PHH false DRMC EMPLOYEE BENEFITS PLAN TRUST 100 HOSPITAL AVE DUBOIS PA 15801 256332829 DRMC EMP BENE PA 501(C)(9) PHH false BROOKCARE II INC 100 HOSPITAL ROAD BROOKVILLE PA 15825 271573910 OFFICE SPACE PA BROOKVILLE C CORP 220338 892701 1.00000 true CHARITABLE TRUST 100 HOSPTIAL RD BROOKVILLE PA 15825 256171730 TRUST PA BROOKVILLE TRUST 206507 1.00000 true false false true false false false false false true true true false true true true true true false true BROOKCARE II INC K 79208 FMV