2017-05-12T12:53:21-07:00 2016-06-30 990 2015-07-01 320345810 Penn Highlands Healthcare Inc PENN 8143756432 PO Box 447 Du Bois PA 15801 David McConnell Chief Financial Officer 8143756430 2017-05-15 2015 2021-01-29 14:40:06Z Steven Fontaine PO Box 447 DuBois PA 15801 14537522 0 X www.phhealthcare.org X 2011 PA Penn Highlands Healthcare is a community based and controlled health care system that exists to improve regional acess to a wide array of premier primary care and advanced health services while supporting a reverance for life and the worth and dignity of each individual. 16 9 0 15 0 0 0 0 7421304 14405397 0 0 0 0 7421304 14405397 0 0 0 0 4433504 11679169 0 0 0 2508578 3490567 6942082 15169736 479222 -764339 6289323 4467511 3413717 4863951 2875606 -396440 Our community based and controlled health care system exists to improve regional access to a wide array of premier primary care and advanced health services while supporting a reverance for life and the worth and dignity of each individual. 0 0 11622074 14403877 Penn Highlands Healthcare was formed in conjunction with the affiliation of DuBois Regional Medcial Center and its affiliated entities (including Brookville hospital), Clearfield Hospital and its affiliated entities and Elk Regional Hospital and its affiliated entities. The purpose for the affiliation is to ensure the accessibility of health care services in the Clearfield, DuBois, Elk and Brookville areas, enhance access to high-quality patient care facilities for patients and medical staffs of the hospitals, offer a broader range of services and create cost efficiencies in the delivery of health care services to the community. Penn Highlands Healthcare exercises a substantial degree of direction over the policies, programs and activities of the supported organizations and the other subsidiaries, including overseeing and implementing a system-wide conflict of interest policy and pastoral care program. 0 0 0 11622074 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 1 1 0 0 1 24 0 1 0 0 0 0 0 0 0 X 16 9 0 0 0 0 0 0 0 1 1 1 0 1 1 1 1 1 1 1 1 0 PA X Du Bois Regional Medical Center c/o Brian Kline 8143756377 PO Box 447 100 Hospital Ave Du Bois PA 15801 X Thomas G Gasbarre Trustee 1 X 0 0 0 Rob O'Leary Chairman 2 X X 0 0 0 Scott Foradora Treasurer 2 X X 0 0 0 Dr Richard Bedger Secretary 2 40 X X 0 25000 0 Dr Thomas Carnevale Trustee 1 40 X 0 350000 0 Dr Hazem ElKassas Trustee 1 X 0 0 0 Ronald King Vice-Chair 2 X X 0 0 0 Dr Carmine Marchioli Trustee 1 X 0 0 0 Edward Nasuti Trustee 1 X 0 0 0 Robert A Ordiway Trustee 1 X 0 0 0 Richard Pfingstler Trustee 1 X 0 0 0 Dr Gregory Roscoe Trustee 1 X 0 0 0 Jim Ryan Trustee 1 X 0 0 0 William Wood Trustee 1 X 0 0 0 David Lezzer Trustee 1 X 0 0 0 Raymond A Graeca President and CEO 40 X 692298 0 111549 David J McConnell Chief Financial Officer 40 X 392649 0 29378 Steven Fontaine Chief Operating Officer 40 X 406308 0 39549 Dr Gary Dugan PHH Chief Medical Officer 40 X 379950 0 43569 Robert McKee VP Chief HR Officer 40 X 256886 0 34868 Cloyd Geedey VP Supply Chain Management 40 X 155000 0 17169 2283091 375000 276082 5 0 1 0 Baldwin Law Group 210 West Pennsylvania Ave Suite 220 Baltimore MD 21204 Legal Services 185073 BKD LLP 910 E St Louis St PO Box 1190 Springfield MO 658011190 Audit Services 277845 2 0 Management Services 541611 14403877 14403877 0 0 1520 1520 0 0 14405397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132125 132125 0 0 0 0 14405397 14405397 0 0 2743851 2222519 521332 6788176 5498423 1289753 2147142 1739185 407957 358091 290054 68037 380848 380848 911001 241490 669511 734190 734190 10879 8812 2067 120745 97803 22942 71061 57559 13502 20142 16315 3827 137638 111487 26151 745972 604237 141735 15169736 11622074 3547662 0 5418843 3417876 0 582041 854688 0 0 0 0 220825 142431 75709 23193 67614 52516 0 0 0 0 0 6289323 4467511 1840744 3179237 0 0 0 0 0 1572973 278221 0 1406493 3413717 4863951 X 0 0 0 0 2875606 -396440 2875606 -396440 6289323 4467511 X -764339 0 0 0 -1932380 -575327 X 0 1 X 1 0 X X X 4 DuBois Regional Medical Center 251490707 3 1 0 0 Clearfield Hospital 250979346 3 1 0 0 Brookville Hospital 250984595 3 1 0 0 Elk Regional Health Center 250585280 3 1 0 0 4 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 X X 1 1 1 1 Schedule A, Part IV, Section E, Line 2a Penn Highlands Healthcare Inc provided Management services, HR services, Payroll services, IT services, Development, Recruitment, Compliance, Supply Chain, Advertising and other services to the hospitals in the Penn Highlands Healthcare system including Penn Highlands DuBois, Penn Highlands Elk, Penn Highlands Clearfield and Penn Highlands Brookville. Each individual hospital would have needed to pay for these costs if the parent company didn't provide them. Schedule A, Part IV, Section E, Line 2b Penn Highlands Healthcare Inc provided HR services, Payroll services, IT services, Development, Recruitment, compliance, Supply Chain and Advertising to DuBois Regional Medical center, Elk Regional Health Center, Elk Regional Health Center, Clearfield Hospital and Brookville Hospital. Each individual hospital would have needed to pay for these costs if the parent company didn't provide them. Schedule A, Part IV, Section E, Line 3a The supported organizations recommend officers and directors to the parent corporation and the parent corporation reviews and approves the recommendations. Schedule A, Part IV, Section E, Line 3b Control is exercised through the reserved powers of the bylaws. The reserved powers in the bylaws include but are not limited to approving all fundamental transactions of a System Subsidiary, including amendments of the bylaws or other organizational/governance documents, all strategic plans, all capital, operating and cash flow budgets, all quality plans, any changes proposed that could affect the not-for-profit, tax-exempt status of this Corporation or any System Subsidiary, any change in mission or direction of a Subsidiary, including, without limitation, any decision to add or discontinue a line of service or add or discontinue any of the clinical services. The entity oversees all transactions for the purchase of assets with a current fair market value in excess of $500,000 and the entering into any contract, mortgage or any other unbudgeted operating expenditure in excess of $500,000. Reserved powers also include the nomination and election of certain system subsidiary directors and certain system subsidiary officers and other system-wide items including selection of the independent auditor and legal counsel, establishment of the charitable care policy, reallocation of income and/or capital among the system subsidiaries, the addition of new system subsidiaries and the establishment and implementation of system-wide programs, policies and initiatives. 0 0 0 0 0 0 0 0 0 0 0 0 75709 23193 52516 0 0 0 0 52516 Interest Rate Swap Agreement 1406493 1406493 Penn Highlands Healthcare Golf Tournament 132125 96828 35297 0 12906 9064 12270 0 1057 0 0 132125 96828 35297 0 12906 9064 12270 0 1057 35297 0 X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 Raymond A Graeca President and CEO 0 559163 0 115150 0 17984 0 94474 0 17075 0 803846 0 0 Steven Fontaine Chief Operating Officer 0 333546 0 62836 0 9925 0 21642 0 17907 0 445856 0 Robert McKee VP Chief HR Officer 0 221829 0 35057 0 0 0 19983 0 14884 0 291753 0 0 Dr Gary Dugan PHH Chief Medical Officer 0 340000 0 39950 0 0 0 27600 0 15969 0 423519 0 Cloyd Geedey VP Supply Chain Management 0 150000 0 0 0 5000 0 1200 0 15969 0 172169 0 0 David J McConnell Chief Financial Officer 0 334000 0 49056 0 9593 0 16700 0 12678 0 422027 0 0 Schedule J, Part I, Line 1a Steven Fontaine, CEO, receives an annual flexible benefit allowance. The expenses available for reimbursement under this allowance are: automobile allowance and auto expenses; supplemental LTD premiums; premiums on term life insurance coverage, health club memberships, and tax/financial planning, all of which are reported as fully taxable compensation on the W-2. Schedule J, Part I, Line 4 Raymond Graeca participated in 457B and 457F plans and Penn Highlands DuBois deposited $83,874 into those plans. Penn Highlands Clearfield deposited $16,700 into a 457 plan on behalf of Dave McConnell. Penn Highlands DuBois deposited $16,686 into a 457 Plan on behalf of Steve Fontaine and 17,000 on behalf of Gary Dugan. A HOSPITAL AUTHORITY OF THE CITY OF DUBOIS 251718944 000000000 2014-06-26 90000000 REFINANCING AND PURCHASE OF CAPITAL ITEMS 0 0 0 A 8608750 0 90000000 0 0 0 0 0 0 0 0 0 1 0 0 1 A 0 0 0 0 0 0 0 1 A 0 1 0 0 1 0 0 0 0 A 0 Schedule K, Part I-06/26/2014 90,000,000 HOSPITAL AUTHORITY OF THE CITY OF DUBOIS The refinancing bond issue was negotiated by the parent company, Penn Highlands Healthcare, Inc. to benefit the hospitals within the Penn Highlands system. These related parties are: Penn Highlands DuBois, Penn Highlands Elk, Penn Highlands Brookville and Penn Highlands Clearfield. Penn Highlands Healthcare, Inc., does not carry this liability on the balance sheet. Each hospital is legally responsible for its portion of the liability and thus, reports this on its balance sheet. Dr Thomas Carnevale Employee of Penn Highlands DuBois 350000 Physician Services 0 Dr Gregory Roscoe Trustee 100270 Lease of Office Space from Trustee 0 William Nasuti Brother of a Board Member 32674 Wages 0 Oncology Hematology Assoc of PA Owned by Dr. Elkassas and Dr. Marchioli Trustees 658790 Payment for on-call and medical director services 0 Schedule L, Part IV Dr. C. Marchioli and Dr. H. El Kassas are owners of Oncology Hematology Associates of Northern Pennsylvania, PC. Form 990, Part VI, Section A, Line 9 Dr. Carmine Marchioli and Dr. Hazem ElKassas, Trustees on the Board of Directors, are the owners of Oncology Hematology Associates of Pennsylvania. Payments are made by PH DuBois, a related entity, to this business for on-call and medical director services. Form 990, Part VI, Section B, Line 11b Penn Highlands Healthcare, Inc.'s Finance Committee and the Board of Directors reviewed the 990 at the regularly schedule April meetings. Form 990, Part VI, Section B, Line 12c A system-wide Conflict of Interest Policy and Healthcare Disclosure Statement is sent to each Board Member in July. All documents are required to be returned, reviewed and filed. Form 990, Part VI, Section B, Line 15 The Penn Highlands Healthcare Executive Compensation Committee consults with the healthcare consulting firm, Yaffee & Company to obtain comparable data to make recommendations to the Board of Directors regarding executive compensation. The Penn Highlands Healthcare Board of Directors is acutely aware of the heightened public scrutiny of executive compensation and the need to consider regulatory compliance when setting executive pay. Form 990, Part VI, Section C, Line 19 The organization's governing documents, conflict of interest policy and financial statements are available to the public upon request. Form 990, Part VII, Section A, Line 1a Officers are paid via payroll through DuBois Regional Medical Center (25-1490707) and Clearfield Hospital (25-0979346). These wages are reported as W-2 income through these organizations and billed to Penn Highlands Healthcare Inc. Form 990, Part XI, Line 9 Interest Rate Swap Du Bois Regional Medical Center PO Box 447 100 Hospital Ave Du Bois PA 15801 251490707 Hospital PA 501(c)(3) 3 Penn Highlands Healthcare Inc 1 Brookville Hospital 100 Hospital Rd Brookville PA 15825 250984595 Hospital PA 501(c)(3) 3 Du Bois Regional Medical Center 1 Clearfield Hospital 809 Turnpike Dr Clearfield PA 16830 250979346 Hospital PA 501(c)(3) 3 Penn Highlands Healthcare Inc 1 Elk Regional Health Center 763 Johnsonburg Rd St Marys PA 15857 250585280 Hospital PA 501(c)(3) 3 Penn Highlands Healthcare Inc 1 Clear-Med Provider Corporation PO Box 1260 Clearfield PA 16830 251657668 Outpatient Physician PA 501(c)(3) 3 Clearfield Hospital 1 DRMC Auxiliary 100 Hospital Ave PO Box 447 Du Bois PA 15801 251531359 Support Du Bois Regional Medical Center PA 501(c)(3) 11 N/A 1 DRMC Employee Benefits Plan Trust 100 Hospital Ave Du Bois PA 15801 256332829 DuBois Regional Medical Center's Employee Benefits PA 501(c)(3) 3 Du Bois Regional Medical Center 1 Du Bois Regional Medical Group 100 Hospital Ave Du Bois PA 15801 251856569 Medical practices PA Du Bois Regional Medical Center C 0 Du Bois Medical Risk Retention Group 100 Hospital Ave Du Bois PA 15801 200324622 Insurance Service PA Du Bois Regional Medical Center C 0 Brookcare Inc 100 Hospital Rd Brookville PA 15825 251477768 Lease Office Space PA Brookville Hospital C 0 0 0 0 1 0 0 0 0 0 0 1 1 0 1 1 1 1 0 0 Brookville Hospital l 945228 Cost Clearfield Hospital l 1586036 Cost Du Bois Regional Medical Center l 9378189 Cost Elk Regional Health Center l 2494424 Cost Brookville Hospital o 109831 Cost Clearfield Hospital o 1275348 Cost Du Bois Regional Medical Center k 120745 Cost Du Bois Regional Medical Center o 8518982 Cost Elk Regional Health Center o 1754623 Cost