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        <FormAndLineReferenceDesc>FORM 990 - ORGANIZATION'S MISSION</FormAndLineReferenceDesc>
        <ExplanationTxt>PROVIDER OF HEALTH CARE SERVICES TO THE GENERAL POPULATION TARGETING UNINSURED, LOW-INCOME AND MEDICAL ASSISTANCE INDIVIDUALS. KEYSTONE, FOUNDED IN 1986, IS A PUBLIC NOT-FOR PROFIT ORGANIZATION THAT OFFERS HEALTH CARE AND WHEN NEEDED SOCIAL SERVICES TO UNDERSERVED AND VULNERABLE POPULATIONS AS WELL AS TO THE ENTIRE COMMUNITY POPULATION OF FRANKLIN COUNTY. KEYSTONE IS DESIGNATED BY THE FEDERAL GOVERNMENT AS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC). BECAUSE OF THIS DESIGNATION KEYSTONE RECEIVES FEDERAL GRANTS AND A PROSPECTIVE PAYMENT RATE REIMBURSEMENT FROM MEDICAID AND MEDICARE FOR PROVIDING SERVICES TO THOSE ELIGIBLE PATIENTS AND TO UNDERSERVED POPULATIONS. KEYSTONE HEALTH IS IDENTIFIED AS AN ESSENTIAL COMMUNITY PROVIDER BY THE AFFORDABLE CARE ACT. AT PRESENT, KEYSTONE HEALTH OPERATES SEVENTEEN PRIMARY CARE AND SUPPLEMENTAL PRACTICES IN CHAMBERSBURG, PENNSYLVANIA. KEYSTONE ALSO OPERATES A DENTAL PRACTICE IN MONT ALTO, A SPEECH AND OCCUPATIONAL THERAPY PRACTICE AT THE WINEBRENNER CAMPUS IN SCOTLAND AND A PEDIATRIC PRACTICE IN WAYNESBORO. SERVICES ARE PROVIDED IN CHAMBERSBURG AT THE 820 FIFTH AVENUE SITE AND INCLUDE: FAMILY PRACTICE, AUDIOLOGY AND SPEECH, BEHAVIORAL HEALTH; CRISIS INTERVENTION IS PROVIDED AT THE CHAMBERSBURG HOSPITAL; CARDIOLOGY IS PROVIDED AT 22 ST. PAUL DRIVE, SUITE 201; DENTAL IS PROVIDED AT 761 FIFTH AVENUE CHAMBERSBURG AND 6155 ANTHONY HIGHWAY, SUITE C, WAYNESBORO, PA. SERVICES ARE PROVIDED AT THE 830 FIFTH AVENUE COCHRAN BUILDING AND INCLUDE: URGENT CARE, PEDIATRICS, WOMEN'S CARE, INFECTIOUS DISEASE, INTERNAL MEDICINE,AND HIV/STD. ALSO LOCATED IN THE COCHRAN BUILDING IS THE KEYSTONE PHARMACY WHICH CONTRACTS WITH 14 OTHER PHARMACIES THROUGHOUT FRANKLIN COUNTY FOR A SPECIAL DISCOUNTED PROGRAM (340B) FOR OUR NEEDY PATIENTS. KEYSTONE PROVIDES STD AND FAMILY PLANNING OUTREACH SERVICES AT 51 SOUTH MAIN STREET AND 455 LINCOLN WAY WEST. KEYSTONE ALSO MANAGES THE STATE MIGRANT AND SEASONAL FARM WORKER PROGRAM WITH KEYSTONE OPERATED SITES IN ERIE, MERCER, CRAWFORD, WARREN, SOMERSET, FULTON, NORTHUMBERLAND, SNYDER, UNION, COLUMBIA, CARBON, MONTOUR, LUZERNE, LANCASTER, BERKS, SCHUYLKILL, LEHIGH, CHESTER, CUMBERLAND, FRANKLIN AND ADAMS. THE STRENGTH OF THE KEYSTONE NETWORK IS THAT ALL SERVICES ARE PROVIDED IN A MISSION-DRIVEN ENVIRONMENT FOCUSING ON ACCESSIBLE, AFFORDABLE, CULTURALLY APPROPRIATE, QUALITY AND COMPASSIONATE CARE OFFERED TO ANYONE AND EVERYONE REGARDLESS OF ABILITY TO PAY, ETHNIC BACKGROUND OR DISEASE. DURING 2016, KEYSTONE TREATED 49,336 INDIVIDUALS THROUGH 210,083 VISITS. THE KEYSTONE SYSTEM WIDE PATIENT MIX WAS AS FOLLOWS: 42.7% MEDICAID PATIENTS, 9.8% MEDICARE PATIENTS, 7.6% UNINSURED PATIENTS AND 39.9% PRIVATE INSURANCE PATIENTS. THE LOW-INCOME POPULATION AND THE MIGRANT FARMWORKER POPULATION OF FRANKLIN COUNTY ARE DECLARED A HEALTH PROFESSIONAL SHORTAGE POPULATIONS (HPSP). IN ADDITION THE BOROUGH OF CHAMBERSBURG IS DECLARED A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) AND FANNETT AND METAL TOWNSHIPS ARE DECLARED A MEDICALLY UNDERSERVED AREA (MUA). FRANKLIN COUNTY ALSO HAS A MEDICAL, DENTAL AND MENTAL HEALTH HPSA (HEALTH PROFESSIONAL SHORTAGE AREA) DESIGNATION. KEYSTONE DENTAL IS THE ONLY DENTAL PRACTICE IN FOUR COUNTIES THAT ROUTINELY PROVIDES DENTAL CARE TO LOW-INCOME, MEDICAL ASSISTANCE CLIENTS, AND UNINSURED CLIENTS. KEYSTONE PROVIDES A SLIDING FEE WITH DISCOUNTED RATES FOR THOSE WHO QUALIFY FOR THE PROGRAM. IF IT WERE NOT FOR KEYSTONE DENTAL THESE POPULATIONS WOULD HAVE LITERALLY NO ACCESS TO DENTAL CARE. ONE OF THE GREATEST HEALTH CARE ACCESS BARRIERS FOR FRANKLIN COUNTY RESIDENTS IS FINANCIAL. LOW-INCOME AND UNINSURED INDIVIDUALS REQUIRE A SOURCE OF REGULAR, CONTINUOUS PRIMARY AND PREVENTIVE CARE IN ORDER TO YIELD BETTER HEALTH OUTCOMES AND MINIMIZE HEALTH DISPARITIES. IN ORDER TO ASSURE THAT THE RESIDENTS OF OUR COMMUNITY THAT ARE POOR OR FINANCIALLY NEEDY RECEIVE CARE, KEYSTONE HAS A SYSTEM IN PLACE TO DETERMINE ELIGIBILITY FOR PATIENT DISCOUNTS ADJUSTED ON THE BASIS OF THE PATIENT'S ABILITY TO PAY. THIS SYSTEM PROVIDES FOR FULL DISCOUNTS TO INDIVIDUALS AND FAMILIES WITH ANNUAL INCOMES AT OR BELOW THE POVERTY GUIDELINES (ONLY A NOMINAL FEE IS CHARGED) AND FOR THOSE WITH INCOMES BETWEEN 101% AND 200% OF POVERTY FEES ARE CHARGED IN ACCORDANCE WITH A SLIDING FEE DISCOUNT POLICY BASED ON FAMILY SIZE AND INCOME. MANY CLIENTS DO NOT QUALIFY FOR THE SLIDING FEE BUT STILL DO NOT EARN ENOUGH MONEY TO BE ABLE TO PAY FOR THEIR CARE IN A TIMELY WAY. THESE PATIENTS ARE PLACED ON A PAYMENT PLAN. MANY OF KEYSTONE'S CLIENTS ARE UTILIZING THE PAYMENT PLAN. ANOTHER BARRIER TO HEALTH CARE ACCESS IS LANGUAGE AND CULTURE. ONE IN 18 CLIENTS DOES NOT HAVE ENGLISH AS A PRIMARY LANGUAGE. ALL SERVICES PROVIDED BY KEYSTONE ARE CULTURALLY AND LINGUISTICALLY APPROPRIATE. THROUGH KEYSTONE PROVIDERS AND TRANSLATORS AND ACCESS TO A LANGUAGE LINE, WE ARE FORTUNATE TO HAVE INDIVIDUALS WHO CAN PROVIDE SERVICES TO EVERY PATIENT THAT IS WITHIN THE KEYSTONE SYSTEM INCLUDING THE DEAF. KEYSTONE OFFERS ACCESSIBLE HOURS OF SERVICE INCLUDING A WALK IN PROGRAM FROM 8 AM TO 7 PM MONDAY THROUGH FRIDAY AT PEDIATRICS AND 7 AM TO 8 PM COVERAGE DAILY AT OUR URGENT CARE CENTER. KEYSTONE PARTICIPATES IN THE FEDERAL 340B DRUG DISCOUNT PROGRAM. THROUGH THIS PROGRAM, KEYSTONE CAN PURCHASE PHARMACEUTICALS AT REDUCED PRICES AND PASS THE SAVINGS ON TO ITS PATIENTS. THIS GIVES KEYSTONE'S UNINSURED PATIENTS ACCESS TO SIGNIFICANT DISCOUNTS ON THEIR PRESCRIPTION MEDICATIONS. WHILE THIS PROGRAM IS OPEN TO ANY KEYSTONE PATIENT, THOSE WHO BENEFIT THE MOST ARE THE UNINSURED WHO CAN APPLY THEIR SLIDING FEE DISCOUNT TO THE ALREADY REDUCED 340B PROGRAM DISCOUNTS. 2016 YEAR HIGHLIGHTS: KEYSTONE PEDIATRICS BEGAN PROVIDING EXCLUSIVE INPATIENT HOSPITALIST CARE TO ALL CHILDREN ADMITTED TO CHAMBERSBURG HOSPITAL. ADDITIONALLY, KEYSTONE PEDIATRICS BEGAN OPERATING A PEDIATRIC PRACTICE IN WAYNESBORO AND PROVIDING INPATIENT PEDIATRIC COVERAGE TO ALL CHILDREN ADMITTED TO THE WAYNESBORO HOSPITAL. KEYSTONE INFECTIOUS DISEASE IS NOW A SEPARATE PRACTICE FROM KEYSTONE INTERNAL MEDICINE. KEYSTONE INFECTIOUS DISEASE PROVIDES EXCLUSIVE INPATIENT CARE TO ALL INFECTIOUS DISEASE PATIENTS IN BOTH CHAMBERSBURG HOSPITAL AND WAYNESBORO HOSPITAL. KEYSTONE BEHAVIORAL HEALTH IS NOW PROVIDING SERVICES TO OVER THE RAINBOW CHILDREN AND FAMILIES AT THE REQUEST OF THE DISTRICT ATTORNEY. KEYSTONE ACQUIRED EDLANTIS AND IS NOW OPERATING AS THE KEYSTONE PEDIATRIC THERAPIES (KPT) SERVICE. THIS SERVICE INCLUDES SPEECH, OCCUPATIONAL AND AUDIOLOGY SERVICES. THE SITE FOR KPT IS THE FORMER SCOTLAND SCHOOL FOR VETERAN CHILDREN. KEYSTONE WAS GRANTED APPROVAL AND DOLLARS TO INITIATE AN S-BIRT (SCREENING, BRIEF INTERVENTION AND TREATMENT) BEHAVIORAL HEALTH PROGRAM. ALL PATIENTS ARE BEING SCREENED FOR DRUG AND ALCOHOL USAGE ISSUES. THROUGH A MILLION DOLLAR GRANT, KEYSTONE DENTAL EXPANDED AND RENOVATED ITS OFFICE TO ACCOMMODATE ADDITIONAL PROVIDERS, ONE OF WHICH IS A PEDIATRIC DENTIST. FRANKLIN COUNTY HAS HAD NO PUBLIC TRANSPORTATION SINCE THE CLOSING OF THE TRANSIT AUTHORITY YEARS AGO. TRANSPORTATION OR LACK THEREOF IS A HUGE BARRIER TO GOOD OUTCOMES IN HEALTH CARE. RABBIT TRANSIT CAME TO FRANKLIN COUNTY IN EARLY 2016. THE CEO OF KEYSTONE HAS BEEN INSTRUMENTAL IN BRINGING THIS SERVICE TO OUR COMMUNITY. SHE ASSISTED IN THE GRANT WRITING OF A GRANT THAT INITIATED THE FEASIBILITY STUDY AND OPENED THE DOOR FOR THIS SERVICE TO COME TO FRANKLIN COUNTY. KEYSTONE OPENED A NEW HIV/AIDS, STD, HEALTHY WOMEN, OUTREACH AND ENROLLMENT SITE AT 455 LINCOLN WAY WEST THIS YEAR. THE CLINIC OFFERS SERVICES MONDAY THROUGH FRIDAY AND A PROVIDER IS PRESENT AT THIS SITE DURING OPERATING HOURS. KEYSTONE UNDERWENT ITS TRIANNUAL JOINT COMMISSION SURVEY DURING THE SUMMER AND RECEIVED FULL ACCREDITATION FROM THE AMBULATORY CARE DIVISION. KEYSTONE OPENED ITS FIRST SCHOOL BASED HEALTH CLINIC AT CHAMBERSBURG AREA SENIOR HIGH SCHOOL WITH HOURS FROM 8 AM UNTIL NOON MONDAY THROUGH FRIDAY. KEYSTONE HEALTH HAS STAYED TRUE TO ITS MISSION FOR OVER 31 YEARS OF PROVIDING SERVICES TO ANYONE AND EVERYONE IN THE COMMUNITY WHILE TARGETING THE POOR AND LESS FORTUNATE, VULNERABLE POPULATIONS. RECOGNIZED BY BOTH THE FEDERAL GOVERNMENT AND THE PA. STATE GOVERNMENT AS AN ESSENTIAL COMMUNITY PROVIDER, KEYSTONE WILL CONTINUE TO PROVIDE HIGH QUALITY, LOW COST AND ACCESSIBLE, COMPASSIONATE HEALTH CARE TO OUR COMMUNITY.</ExplanationTxt>
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        <FormAndLineReferenceDesc>FORM 990, PAGE 2, PART III, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>KEYSTONE PEDIATRIC THERAPIES, KEYSTONE COMMUNITY OUTREACH, KEYSTONE INFECTIOUS DISEASE, KEYSTONE PEDIATRICS SCHOOL, AND KEYSTONE PEDIATRICS WAYNESBORO WERE SERVICES AND SITES ADDED DURING 2016.</ExplanationTxt>
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        <FormAndLineReferenceDesc>FORM 990, PAGE 2, PART III, LINE 4D</FormAndLineReferenceDesc>
        <ExplanationTxt>PROVIDER OF CARDIOLOGY, DENTAL, BEHAVIORAL HEALTH, INTERNAL MEDICINE, PHARMACY SERVICES, AND HIV SERVICES TO THE GENERAL POPULATION TARGETING LOW INCOME MEDICARE AND MEDICAL ASSISTANCE INDIVIDUALS. IN ADDITION, WE ARE A PROVIDER OF HEALTH CARE SERVICES TO THE MIGRANT WORKER POPULATION OF THE COMMONWEALTH OF PENNSYLVANIA.</ExplanationTxt>
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        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION PROVIDED A COPY OF THE FEDERAL FORM 990 TO THE BOARD OF DIRECTORS PRIOR TO THE FILING OF THE FORM 990.</ExplanationTxt>
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        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>CONFLICT OF INTEREST POLICY IS REVIEWED AT ANNUAL EMPLOYEE EVALUATIONS AND ANNUALLY WITH THE BOARD OF DIRECTORS' SELF-EVALUATIONS.</ExplanationTxt>
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        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS MEETS IN A CLOSED SESSION TO DISCUSS THE COMPENSATION AND PERFORMANCE OF THE CEO.</ExplanationTxt>
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        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COMPENSATION OF ALL OFFICERS AND KEY EMPLOYEES IS REVIEWED WITH THE CEO AS PART OF THE ANNUAL EVALUATION PROCESS. GUIDELINES CONCERNING SALARY ADJUSTMENTS ARE REVIEWED ANNUALLY AS PART OF THE BUDGETING PROCESS. THE BUDGET SUBMISSION IS SUBSEQUENTLY REVIEWED BY THE FINANCE COMMITTEE AND APPROVED BY THE ORGANIZATION'S BOARD OF DIRECTORS.</ExplanationTxt>
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        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE GOVERNING DOCUMENTS ARE MADE AVAILABLE TO REVIEW UPON REQUEST.</ExplanationTxt>
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