2017-05-12T14:10:39-05:00 2016-06-30 550486667 ARNETT CARBIS TOOTHMAN LLP 5700 CORPORATE DRIVE STE 650 PITTSBURGH PA 15237 990 2015-07-01 250965598 WARREN GENERAL HOSPITAL WARR 8147234973 TWO CRESCENT PARK WEST WARREN PA 16365 JULIE JACOBS CFO 8147234973 2017-05-11 1 JEFFREY J PETRELL CPA P00138808 4126356270 2017-05-04 2015 2021-01-29 14:40:06Z RICHARD L ALLEN TWO CRESCENT PARK WEST WARREN PA 16365 70731421 0 X WWW.WGH.ORG X 1898 PA TO PROVIDE HEALTH CARE SERVICES TO THE PUBLIC INCLUDING INPATIENT ACUTE CARE, PSYCHIATRIC CARE, 24-HR ER CARE, AND OTHER OUTPATIENT SERVICES TO WARREN AND SURROUNDING COUNTIES. 11 7 647 140 0 0 391851 266411 72527042 69075752 1987668 -108716 2373980 1129133 77280541 70362580 0 0 0 0 35413863 34184741 0 0 62652 45785869 38005369 81199732 72190110 -3919191 -1827530 56093272 51946132 36600866 42960242 19492406 8985890 WARREN GENERAL HOSPITAL'S MISSION IS TO PROVIDE COMMUNITY HEALTHCARE WITH QUALITY AND COMPASSION. WE STRIVE TO IMPROVE THE COMMUNITY'S HEALTH, LEAD A VISION FOR THE HEALTHCARE FUTURE, AND MAINTAIN FISCAL VIABILITY WHILE PROVIDING CORE HEALTHCARE SERVICES. 0 0 56839080 69296162 THE WARREN GENERAL HOSPITAL (WGH) IS A NON-PROFIT ACUTE CARE HOSPITAL. WGH PROVIDES HEALTHCARE SERVICES TO THE PUBLIC. THESE SERVICES INCLUDE: INPATIENT ACUTE CARE AND PSYCHIATRIC CARE, 24 HOUR EMERGENCY ROOM, OUTPATIENT HOME CARE AND OTHER OUTPATIENT CARE FOR RESIDENTS OF WARREN COUNTY AND SURROUNDING AREAS. IN ADDITION, THE HOSPITAL OFFERS AN OUTPATIENT CANCER CARE CENTER TO RELIEVE THE NEED FOR RESIDENTS TO TRAVEL DURING THESE MOST DIFFICULT TIMES. THE HOSPITAL ALSO OPERATES TWO OUTPATIENT DENTAL CLINICS FOR THOSE UNDER/UNINSURED RESIDENTS IN NEED OF DENTAL SERVICES. 56839080 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 0 0 0 1 40 0 647 1 0 0 0 0 0 0 0 0 X 11 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 PA X JULIE JACOBS 8147233300 TWO CRESCENT PARK WARREN PA 16365 CARMEN N FERRANTO PRESIDENT 1.00 X X 0 0 0 TIMOTHY R BEVEVINO ESQ SECRETARY 1.00 X X 0 0 0 LISA HAGBERG TREASURER 1.00 X X 0 0 0 VIJAYA K AGARWALA MD BOARD MEMBER 1.00 X 416333 0 51223 GLENN FEGLEY BOARD MEMBER 1.00 X 0 0 0 GARY L MCAFOOS MD BOARD MEMBER 1.00 X 0 0 0 DAVID M MCCONNELL JR MD BOARD MEMBER 1.00 X 0 0 0 JULIA W MCTAVISH BOARD MEMBER 1.00 X 0 0 0 TIMOTHY STANTON MD BOARD MEMBER 1.00 X 237237 0 30570 MASON TOOTELL MD BOARD MEMBER 1.00 X 207970 0 28192 THAD TURNER BOARD MEMBER 1.00 X 0 0 0 RICHARD L ALLEN CEO 40.00 1.00 X 344043 0 36522 JULIE D JACOBS CFO 40.00 1.00 X 135127 0 13286 RANDY CALIFORNIA CHIEF OPERATING OFFICER 40.00 X 239071 0 29680 DAVID J THOMAS MD PHYSICIAN 40.00 X 578695 0 34522 TREVOR M OLSEN MD PHYSICIAN 40.00 X 597223 0 45231 ANNE RASSIGA MD PHYSICIAN 40.00 X 473564 0 61946 NIAZ AHMED MD PHYSICIAN 40.00 X 458951 0 55275 MARK LONDON MD PHYSICIAN 40.00 X 611732 0 34240 4299946 0 420687 38 0 1 0 ASSOCIATED CLINICAL LABS 1526 PEACH STREET ERIE PA 16501 LABORATORY SERVICES 1266937 GROUP MEDICAL SERVICES CORP PO BOX 68 WARREN PA 16365 PURCHASED SERVICES 757079 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 75397 PURCHASED MEDICAL SERVICES 643164 KING'S MEDICAL COMPANY 1920A GEORGETOWN ROAD HUDSON OH 44236 PURCHASED MEDICAL SERVICES (MRI) 511025 DEERFIELD PROFESSIONAL ASSOCIATES 514 WEST THIRD AVENUE WARREN PA 16365 PURCHASED MEDICAL SERVICES 431351 15 4535 261876 266411 PATIENT SERVICE REVENUE 623990 67941792 67941792 HOME HEALTH SERVICES 621610 1133960 1133960 69075752 244907 244907 353623 -353623 -353623 -353623 71120 4535 15218 55902 55902 VANTAGE/DEERFIELD/CHART 900099 836950 836950 CAFETERIA REVENUE 900099 220410 220410 OTHER REVENUE 900099 15871 15871 1073231 70362580 69296162 0 800007 X 1769254 1769254 22282637 16463824 5799655 19158 2767784 1909627 855935 2222 5372103 3837198 1530440 4465 1992963 1375041 616322 1600 92300 92300 88407 88407 15112232 13141386 1970846 701797 375024 294221 32552 1440636 1440636 401541 138572 262680 289 258495 258495 3463270 3463270 1068975 1068975 MEDICAL SUPPLIES 11685771 11685771 REPAIRS & MAINTENANCE 1833498 1170954 662544 LICENSES AND FEES 1358788 148529 1210221 38 EQUIPMENT RENTALS AND L 221028 220878 150 278631 140900 135403 2328 72190110 56839080 15288378 62652 515086 969331 334252 129486 8335216 8849083 101189 0 1463312 1618551 523539 704935 83493884 63637185 22409994 19856699 16709174 9724109 5701510 10093938 56093272 51946132 12479180 10255424 12235 94019 3805175 3658966 2078000 2878000 18226276 26073833 36600866 42960242 X 9864116 -600903 4518132 4732371 5110158 4854422 19492406 8985890 56093272 51946132 X -1827530 322858 -1350637 -7651207 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5892957 4510 -43069 240893 5613505 11127993 21266 135091 5391393 5892957 9106171 1001118 1291010 256830 13476 11127993 9948456 99909 959373 1888832 12735 9106171 8391676 2342897 -195755 577004 13358 9948456 0.02000 0.86490 0.11510 1 0 674941 674941 43778315 33670846 10107469 3170366 3170366 35830086 29966339 5863747 40176 40176 19856699 DUE FROM AFFILIATES 15404 OTHER ASSETS 641178 ESTIMATED INSURANCE RECOVERIES 1042000 DEFERRED FINANCING COSTS 34860 BENEFICIAL INTEREST IN TRUSTS 5004264 INTEREST IN NET ASSETS OF COMMUNITY FOUNDATION OF WARREN 112770 ASSETS LIMITED AS TO USE 3071938 ESTIMATED AMOUNTS DUE FROM THIRD PARTY PAYORS 171524 10093938 ACCRUED POST RETIREMENT BENEFIT 312862 ACCURED PENSION COSTS 22661139 ESTIMATED INSURANCE COSTS 1266000 DEFERRED COMPENSATION 1833832 26073833 X PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AND IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN MADE. THE HOSPITAL FOLLOWS THE GUIDANCE FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S CONSOLIDATED FINANCIAL STATEMENTS THAT PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. THE GUIDANCE ALSO ADDRESSES DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, AND DISCLOSURE. THE HOSPITAL'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN MATERIALS, SUPPLIES, AND SERVICES EXPENSES. THERE WERE NO INTEREST OR PENALTIES RECOGNIZED ON THE CONSOLIDATED STATEMENT OF OPERATIONS AS A RESULT OF THIS GUIDANCE. GENERALLY, TAX RETURNS FOR YEARS ENDED JUNE 30, 2013, AND THEREAFTER REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. HOSPITAL BALL 7975 4535 3440 3421 19 39 GOLF OUTING 67680 67680 330 9800 1609 75655 4535 71120 330 9800 3421 19 1648 15218 55902 1 1 X 1 X 1 X 1 1 1 0 0 85462 85462 0.00120 8732136 5535012 3197124 0.04430 8817598 5535012 3282586 0.04550 49960 49960 0.00070 1153156 512129 641027 0.00890 6454 6454 0.00010 1209570 512129 697441 0.00970 10027168 6047141 3980027 0.05520 38402 38402 0.00050 325346 325346 0.00450 363748 363748 0.00500 1 1510532 151053 17941094 26272230 -8331136 X 1 1 1 PINEGROVE AMBULATORY OUTPATIENT AMBULATORY SURGERY 0.35000 0.11000 0.54000 2 MEDIPAR ASSOCIATES REAL ESTATE FOR MEDICAL BLDG 0.86000 0.14000 1 1 WARREN GENERAL HOSPITAL TWO CRESCENT PARK WEST WARREN PA 16365 WWW.WGH.ORG X X X WARREN GENERAL HOSPITAL 1 0 0 1 X X X X X X X X X 13 1 0 0 1 X WWW.WGH.ORG X X 1 13 1 WWW.WGH.ORG 0 0 1 X 200.000000000000 200.000000000000 X X X X 1 1 X X X 1 X WWW.WGH.ORG X WWW.WGH.ORG X X X X X 1 X 0 X X X X X 1 X X 0 0 WARREN GENERAL HOSPITAL PART V, SECTION B, LINE 5: DEMOGRAPHIC INFORMATION, SECONDARY DATA STATISTICS, AND RESULTS OF PHYSICIAN SURVEY WERE PROVIDED TO THE GROUP IN THE FORM OF A POWER POINT PRESENTATION. THE GROUP WAS ASKED TO PROVIDE OPINION ON THE #1 CONCERN WARREN COUNTY POPULATION IS FACING PRE AND POST PRESENTATION. THE PERSONS THE HOSPITAL CONSULTED WITH WERE AS FOLLOWS:NUTRITION EDUCATION ADVISOR FROM PENN STATE NUTRITION LINK - CAROL WILCOXSENIOR INCOME DEVELOPMENT REP FROM AMERICAN CANCER SOCIETY/WARREN COUNTY - MARIE COSTELLOEXECUTIVE DIRECTOR FROM WARREN COUNTY HOUSING AUTHORITY - TONYA MITCHELL-WESTRNC FROM PA DEPT OF HEALTH/WARREN COUNTY - BARBARA WHITEEXECUTIVE DIRECTOR OF EXPERIENCE INC./AREA AGENCY ON AGING - FARLEY WRIGHTWARREN COUNTY SHERIFF - WILLIAM GARDNERPOLICE LIEUTENANT FROM WARREN POLICE DEPT - JAMES JORDANWGH DIRECTOR OF MARKETING AND DEVELOPMENT - GEORGE LILJAPSYCHIATRIST FROM DEERFIELD BEHAVIORAL HEALTH - MARK BEUGER, MDVP OF PROGRAM EVALUATION FROM BEACON LIGHT BEHAVIORAL HEALTH - BECKY JENSENWGH DIABETES EDUCATOR - NANCY MAGUEADMINISTRATOR OF THE ROUSE HOME - CINDY WALTERSSUPERINTENDENT OF WARREN COUNTY SCHOOL DISTRICT - BRANDON HUFFNAGELOFFICE MANAGER AND PROGRAM DEVELOPMENT SPECIALIST AT DEERFIELD BEHAVIORAL HEALTH - SUSAN TECONCHUKWGH DIRECTOR OF PATIENT & PUBLIC RELATIONS - HOLLI SUMMERVILLECOO OF WARREN MEDICAL GROUP - KAREN COOMBSEXECUTIVE DIRECTOR OF THE WARREN COUNTY YMCA - THAD TURNERWARREN GENERAL HOSPITAL ALCOHOL/DRUG COUNSELOR - JESSICA UBER WARREN GENERAL HOSPITAL PART V, SECTION B, LINE 7D: THE CHNA WAS AVAILABLE ON THE HOSPITAL'S WEBSITE - WWW.WGH.ORG - WAS AVAILABLE IN PAPER COPY FOR PUBLIC INSPECTION AT THE HOSPITAL, AND INFORMATION ON HOW TO ACCESS THE CHNA WAS PUBLISHED ON THE WGH QUARTERLY NEWSLETTER. WARREN GENERAL HOSPITAL PART V, SECTION B, LINE 11: THE HOSPITAL CONDUCTS ANNUAL STRATEGIC PLANNING SESSIONS WHICH INCLUDES A FOCUS ON COMMUNITY HEALTH NEEDS. THE HOSPITAL USES METRICS AND PLANS SERVICE NEEDS ACCORDINGLY. THIS PROCESS IS INTERACTIVE AND HAS RESULTED IN THE EXPANSION OF DENTAL SERVICES IN 2010 AS ONE EXAMPLE. WE ALSO DRIVE OUR PHYSICIAN RECRUITING PLAN FROM THIS PROCESS. WARREN GENERAL HOSPITAL PART V, SECTION B, LINE 16I: A FINANCIAL ASSISTANCE COUNSELOR IS AVAILABLE TO SPEAK WITH ELIGIBLE INDIVIDUALS REGARDING OUR FAP. WARREN GENERAL HOSPITAL PART V, SECTION B, LINE 20E: THE HOSPITAL EMPLOYS A FINANCIAL COUNSELOR WHO SPEAKS WITH ELIGIBLE INDIVIDUALS REGARDING OUR FINANCIAL ASSISTANCE POLICY. SHE ASSISTS INDIVIDUALS IN APPLYING FOR OUR STATE MEDICAL ASSISTANCE PROGRAM. WARREN GENERAL HOSPITAL PART V, SECTION B, LINE 22D: WARREN GENERAL HOSPITAL USES THE LOOK-BACK METHOD TO CALCULATE AMOUNTS GENERALLY BILLED. PART I, LINE 7: A COST-TO-CHARGE RATIO CALCULATED FROM WORKSHEET 2, RATIO OF PATIENT CARE COSTS-TO-CHARGES IS THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNTS REPORTED ON PART I, LINE 7. PART II, COMMUNITY BUILDING ACTIVITIES: THE HOSPITAL SPENT $325,346 ON THE DIRECT EXPENSE OF RECRUITING PHYSICIANS ITS RURAL MARKET DURING FISCAL YEAR 2016.THE DIRECT HEALTH BENEFITS AND INDIRECT ECONOMIC BENEFITS OF OUR EMPLOYMENT AND SPENDING ARE SUBSTANTIAL. OUR TRADE ASSOCIATION ESTIMATES THAT THE ECONOMIC IMPACT (DIRECT SPENDING OF THE HOSPITAL PLUS INDIRECT BENEFITS ON OUR COMMUNITY) IS OVER $100 MILLION DOLLARS. PART III, LINE 2: PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTABLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. THE ALLOWANCE FOR DOUBTFUL COLLECTIONS IS ESTIMATED BASED UPON PERIODIC REVIEW OF THE ACCOUNTS RECEIVABLE AGING, PAYOR CLASSIFICATIONS, AND APPLICATION OF HISTORICAL WRITE-OFF PERCENTAGES. PART III, LINE 3: THE HOSPITAL CALCULATED AN OVERALL COST TO CHARGE RATIO USING GROSS CHARGES AND TOTAL OPERATING COSTS LESS BAD DEBT EXPENSE. THE HOSPITAL THEN REDUCED ITS BAD DEBT EXPENSE TO COST USING THIS COST TO CHARGE RATIO. THE ESTIMATE OF THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY IS 10% OF THE BAD DEBT AT COST. PART III, LINE 4: ESTIMATES OF ALLOWANCE FOR ADJUSTMENTS INCLUDED IN NET PATIENT SERVICE REVENUE ARE DESCRIBED IN NOTES 1 AND 2. PART III, LINE 8: THE HOSPITAL'S LARGEST GOVERNMENTAL PAYER IS THE FEDERAL MEDICARE PROGRAM. THE HOSPITAL'S COSTS ARE GREATER THAN PROGRAM REIMBURSEMENTS. IT IS CLEARLY A COMMUNITY BENEFIT FOR THE HOSPITAL TO PROVIDE RURAL ACCESS TO MEDICARE BENEFICIARIES IN TERMS OF TIME, DISTANCE, AND WEATHER CONDITIONS ISSUES. THE ALLOWABLE COSTS ARE OBTAINED FROM THE FISCAL YEAR MEDICARE COST REPORT FOR EACH OF THE HOSPITAL AREAS (INPATIENT, OUTPATIENT, ETC.). PART III, LINE 9B: THE HOSPITAL CONTRACTS WITH A RECEIVABLES MANAGEMENT COMPANY TO HANDLE THE SELF-PAY ACCOUNTS RECEIVABLE FROM DAY 1 TO 120. AT DAY 61, THE RECEIVABLES MANAGEMENT COMPANY RUNS A PUBLIC DATA SEARCH ON THE INDIVIDUALS WITH OUTSTANDING ACCOUNTS AS PART OF A REQUIREMENT FOR 501(R). THE PUBLIC DATA SEARCH REPORT IS GIVEN TO OUR FINANCIAL COUNSELOR WHO FOLLOWS UP WITH THAT PATIENT IN AN EFFORT TO CHECK CHARITY ELIGIBILITY OR STATE MEDICAL ASSISTANCE PROGRAM. AFTER DAY 120 THE ACCOUNTS ARE SENT TO A COLLECTIONS AGENCY WHO AT THAT POINT REPORTS THE INDIVIDUALS TO A CREDIT AGENCY. AT DAY 366, ANY OUTSTANDING ACCOUNTS ARE SENT TO A SECOND COLLECTION AGENCY. A FINANCIAL COUNSELOR IS AVAILABLE AS WELL TO ASSIST THE INDIVIDUALS AT ANY POINT IN THE PROCESS WITH OUR FINANCIAL ASSISTANCE POLICY. PART VI, LINE 2: THE HOSPITAL CONDUCTS ANNUAL STRATEGIC PLANNING SESSIONS AND ONE FOCUS IS THE HEALTH NEEDS OF THE COMMUNITY. PART VI, LINE 3: THE HOSPITAL DEPLOYS MANY METHODS TO DETERMINE WHICH PATIENTS MIGHT BE ELIGIBLE FOR CHARITY CARE OR GOVERNMENT FINANCIAL ASSISTANCE INCLUDING ITS WEBSITE, NOTICES ON PATIENT STATEMENTS, NOTICES ON THE HOSPITAL, AND THE EMPLOYMENT OF A FINANCIAL COUNSELOR. PART VI, LINE 4: WARREN COUNTY HAS A POPULATION OF APPROXIMATELY 40,000. THE COUNTY IS A LARGE GEOGRAPHIC SIZE WITH MANY RURAL AND SMALL COMMUNITIES.WARREN COUNTY RANKS 13TH OF 67 COUNTIES IN PENNSYLVANIA IN TERMS OF OVERALL HEALTH OUTCOMES.WARREN COUNTY RANKS 48TH OF 67 COUNTIES IN PENNSYLVANIA IN TERMS OF HEALTH FACTORS17.5% OF THE POPULATION IS +65 - STATE AVERAGE 15.2%27% ADULT POPULATION SMOKES - STATE AVERAGE 23%28% ADULT OBESITY - STATE AVERAGE 28%16% POOR HEALTH - STATE AVERAGE 14%12% UNINSURED ADULTS - STATE AVERAGE 12% PART VI, LINE 5: WE HAVE AN OPEN MEDICAL STAFF, A DIVERSE COMMUNITY BOARD, AND ALL OF OUR SURPLUS IS USED TO SUSTAIN AND REINVEST IN OUR PLANT AND FUND BALANCE TO ASSURE LONG TERM VIABILITY AND ACCESS IN OUR COMMUNITY. X X X 0 1 0 0 0 0 0 0 0 VIJAYA K AGARWALA MD BOARD MEMBER 416333 0 0 0 0 0 35626 0 15597 0 467556 0 0 0 TIMOTHY STANTON MD BOARD MEMBER 9446 0 0 0 227791 0 14973 0 15597 0 267807 0 0 0 MASON TOOTELL MD BOARD MEMBER 200078 0 0 0 7892 0 12595 0 15597 0 236162 0 0 0 RICHARD L ALLEN CEO 309683 0 31500 0 2860 0 20925 0 15597 0 380565 0 0 0 RANDY CALIFORNIA CHIEF OPERATING OFFICER 211381 0 26400 0 1290 0 14083 0 15597 0 268751 0 0 0 DAVID J THOMAS MD PHYSICIAN 453408 0 72590 0 52697 0 18925 0 15597 0 613217 0 0 0 TREVOR M OLSEN MD PHYSICIAN 549566 0 0 0 47657 0 29639 0 15592 0 642454 0 0 0 ANNE RASSIGA MD PHYSICIAN 473564 0 0 0 0 0 56644 0 5302 0 535510 0 0 0 NIAZ AHMED MD PHYSICIAN 458951 0 0 0 0 0 39678 0 15597 0 514226 0 0 0 MARK LONDON MD PHYSICIAN 380837 0 198082 0 32813 0 18643 0 15597 0 645972 0 0 0 PART I, LINE 4B THE FOLLOWING EMPLOYEES PARTICIPATE IN A 457(F) PLAN: VIJAYA K. AGARWALA $16,667 RICHARD ALLEN $9,000 TREVOR OLSEN $10,714 ANNE RASSIGA $37,500 NIAZ AHMED $20,000 JODI BEVEVINO FAMILY MEMBER OF TIMOTHY R. BEVEVINO, BOARD MEMBER 159635 EMPLOYEE OF WARREN GENERAL HOSPITAL 0 SWANSON BEVEVINO & GILFORD ENTITY MORE THAN 35% OWNED BY TIMOTHY R. BEVEVINO, BOARD MEMBER 135930 LEGAL SERVICES 0 FORM 990, PART VI, SECTION A, LINE 6 CARE CORPORATION OF WARREN IS THE SOLE CORPORATE MEMBER OF WARREN GENERAL HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A CARE CORPORATION OF WARREN, THE PARENT COMPANY, APPOINTS THREE OF THE MEMBERS OF THE WARREN GENERAL HOSPITAL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B SPECIFIC DECISIONS OF THE BOARD OF DIRECTORS ARE SUBJECT TO APPROVAL BY THE BOARD OF DIRECTORS OF CARE CORPORATION OF WARREN, THE PARENT COMPANY. FORM 990, PART VI, SECTION B, LINE 11 WARREN GENERAL HOSPITAL HAS A CPA FIRM PREPARE ITS FORM 990. THE RETURN IS COMPLETED IN DRAFT FORM AND REVIEWED BY MANAGEMENT OF THE ORGANIZATION. THE FORM 990 IS THEN PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR THE DIRECTORS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST POLICY AND DISCLOSE ANY BUSINESS OR FAMILY RELATIONSHIPS WHICH MAY CREATE A CONFLICT. EACH BOARD OF DIRECTOR AGREES TO REFRAIN FROM VOTING ON ANY ITEM IN WHICH A CONFLICT MAY EXIST. ANNUALLY, THE CORPORATE COMPLIANCE OFFICER REVIEWS THE POLICY AND AUDITS THE SIGNATURES. FORM 990, PART VI, SECTION B, LINE 15 THE HOSPITAL PARTICIPATES IN THE YAFFEE AND COMPANY HOSPITAL ASSOCIATION OF PENNSYLVANIA COUNCIL OF SMALL HOSPITALS EXECUTIVE COMPENSATION SURVEY. THIS INSTRUMENT SURVEYS HOSPITALS OF LIKE SIZE AND WITHIN OUR GEOGRAPHY. THE HOSPITAL BOARD CHOSE THIS INSTRUMENT DUE TO ITS RELEVANCY TO THE HOSPITAL'S MARKET. THE SURVEY DATA IS USED BY THE HOSPITAL BOARD OF DIRECTORS COMPENSATION COMMITTEE FOR COMPARISONS OF COMPENSATION AND BENEFITS FOR THE CEO AND OTHER TOP MANAGEMENT OFFICIALS. THE COMPENSATION COMMITTEE REPORTS ITS FINDINGS AND MAKES RECOMMENDATIONS TO THE FULL BOARD OF DIRECTORS FOR THEIR REVIEW, DELIBERATION, AND APPROVAL OR MODIFICATION. THE HOSPITAL BOARD OF DIRECTORS ALSO APPOINTED A COMMITTEE CALLED THE MANAGEMENT TRANSACTION AND AUDIT COMMITTEE TO REVIEW ALL TRANSACTIONS BETWEEN THE HOSPITAL AND PHYSICIANS. THIS BODY REVIEWS SEVERAL PHYSICIAN COMPENSATION SURVEYS (SUCH AS THE MEDICAL GROUP MANAGEMENT ASSOCIATION SURVEY AND THE MERRITT HAWKINS SURVEY) TO ESTABLISH COMPARISONS FOR PHYSICIAN COMPENSATION. FORM 990, PART VI, SECTION C, LINE 18 WARREN GENERAL HOSPITAL MAKES ITS FORM 990 AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 EACH YEAR A COMBINED CORPORATE MEETING IS HELD IN WHICH THE PUBLIC IS WELCOME TO ATTEND. IN ADDITION, DOCUMENTS WILL BE MADE AVAILABLE TO THE PUBLIC IF THEY ARE REQUESTED IN PERSON OR IN WRITING. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 13,141,386. MANAGEMENT AND GENERAL EXPENSES 1,970,846. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,112,232. FORM 990, PART XI, LINE 9: CHANGE IN DEFINED BENEFIT PENSION PLAN GAINS/LOSSES & PRIOR SERVICE COSTS -7,629,197. CHANGE IN DEFINED BENEFIT POST RETIREMENT PLAN GAINS AND LOSSES 11,985. TRANSFERS TO AFFILIATE 226,428. TEMP. RESTRICTED NET ASSETS INVESTMENT RETURN -4,687. PERM. RESTRICTED NET ASSETS CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUS -255,736. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. PART VI, SECTION B, LINE 16: THE HOSPITAL BOARD OF DIRECTORS MUST ULTIMATELY APPROVE ANY INVESTMENTS IN ANY JOINT VENTURE OR SIMILAR ARRANGEMENT. AS AN ADDITIONAL STEP, THE HOSPITAL BOARD OF DIRECTORS APPOINTED A COMMITTEE CALLED THE MANAGEMENT TRANSACTION & AUDIT COMMITTEE THAT REVIEWS ALL TRANSACTIONS BETWEEN THE HOSPITAL AND PHYSICIANS. AS PART OF ITS GOVERNANCE AND OVERSIGHT ROLE, THE FULL HOSPITAL BOARD ALSO SUBJECTS ANY JOINT VENTURE ARRANGEMENTS TO LEGAL REVIEW PRIOR TO ANY INVESTMENT BY THE HOSPITAL. CARE CORPORATION OF WARREN 2 CRESCENT PARK WEST WARREN PA 16365 251512016 PARENT CORP PA 501(C)(3) LINE 11C, III-FI N/A 0 GENERAL CARE SERVICES INC 2 CRESCENT PARK WEST WARREN PA 16365 251512020 HOSPICE SERVICES PA 501(C)(3) LINE 9 CARE CORPORATION OF WARREN 0 MEDIPAR ASSOCIATES 103 WEST ST CLAIR ST WARREN PA 16365 251361787 REAL ESTATE PA WARREN GENERAL HOSPITAL RELATED -11965 256873 0 0 0.82890 GROUP MEDICAL SERVICES CORP 2 CRESCENT PARK WEST WARREN PA 16365 232803659 HEALTH CARE SVCS PA CARE CORPORATION OF WAREEN C 0 WEST ST CLAIR INC 103 WEST ST CLAIR ST WARREN PA 16365 251601073 REAL ESTATE PA WARREN GENERAL HOSPITAL C 1134 135830 0.82500 1 0 0 0 1 0 0 0 0 0 1 0 1 0 1 1 0 1 0 0