2016-05-11T12:01:36-05:00 2015-06-30 990 2014-07-01 232421970 Northeastern Pennsylvania Health Corp NORT 5705014000 700 E Broad St Hazleton PA 18201 Edward F O'Dea Exec VP & CFO 6104027501 2016-05-11 2014 2016-08-17 19:52:53Z Brian A Nester 700 E Broad St Hazleton PA 18201 202586539 0 X http://hazleton.lvhn.org/ X 1985 PA We heal, comfort and care for the people of our community by providing advanced and compassionate health care of superior quality and value, supported by education and clinical research. 14 10 899 5 757313 -116269 238186 252029 57596443 119840534 4743224 4613882 754546 1121268 63332399 125827713 25011 90738 0 0 26744887 54545510 0 0 0 28074914 54940094 54844812 109576342 8487587 16251371 144293845 151668170 69702131 62459224 74591714 89208946 X We heal, comfort and care for the people of our community by providing advanced and compassionate health care of superior quality and value, supported by education and clinical research. 1 0 92150647 90738 122529182 Lehigh Valley Hospital-Hazleton provides a full range of hospital inpatient, outpatient, therapeutic, diagnostic, imaging, maternity and rehabilitation care, as well as emergency room services to the residents of Greater Hazleton, regardless of race, religion, or economic status. See Schedule O for new projects done to enhance the quality and efficiency of our mission. View our community report at http://hazleton.lvhn.org/ 92150647 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 1 116 0 1 899 1 1 1 0 0 0 0 1 1 0 0 0 0 X 14 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 PA X X X The Organization 5705014972 700 E Broad St Hazleton PA 18201 Thomas L Kennedy Esquire Chair-Board of Trustee 0.00 X 0 0 0 Arvind Srinivasan MD Vice Chair-Board of Trustee 0.00 X 0 0 0 John R Madden PhD Member-Board of Trustee 0.00 X 0 0 0 Michael J Leib Member-Board of Trustee 0.00 X 0 0 0 Jill T Snyder DO Member-Board of Trustee 0.00 X 0 0 0 Philip J Benyo MD Member-Board of Trustee 0.50 40.00 X 0 488259 21850 Anthony P Veglia MD Member-Board of Trustee 0.00 X 0 0 0 Mark J Lobitz DO Member-Board of Trustee 0.00 X 0 0 0 Michael A Washinsky DO Member-Board of Trustee 1.00 X 0 233507 18581 Anthony Cusatis Member-Board of Trustee 0.00 X 0 0 0 Susan C Yee Member-Board of Trustee 0.00 X 0 0 0 Linda L Lapos MD Member-Board of Trustee 0.00 X 0 0 0 Terry Capuano Ex Officio LVHN Member Rep 0.30 60.00 X 0 797002 38761 John R Fletcher President, Ex Officio 44.00 16.00 X 374524 0 10339 William C Bauer Assistant Treasurer 44.00 16.00 X 265263 0 36472 Edward F O'Dea Treasurer 1.00 60.00 X 0 660544 42762 Jane Danish Secretary 29.00 11.00 X 101061 0 31017 Barbara A Forte Assistant Secretary 29.00 11.00 X 59336 0 3315 Michael Golden Chief Nursing Officer 44.00 16.00 X 197544 0 34583 Anthony Valente VP of Medical Affairs 22.00 8.00 X 212840 0 35096 Donald A Patten Physician 32.00 0.00 X 284393 0 36858 Joseph G Ciotola Physician 32.00 0.00 X 221356 0 36387 John P Amentler Physician 40.00 0.00 X 212716 0 8610 James D Edwards Former President 44.00 16.00 X 223637 0 29046 2152670 2179312 383677 30 1 1 0 Hazleton Anesthesia Services 10 Commerce Dr New Rochelle NY 10801 Anesthesia service 1872054 Philips Healthcare 22100 Bothell Everett Hwy Bothell WA 980218431 Biomedical equip maintenance Serv 760540 Laboratory Corp of America PO Box 12140 Burlington NC 27216 Laboratory service 702876 McKay Consulting Inc 8590 Business Park Dr Shreveport LA 71105 Consulting service 622675 Marval Medical 149 N Vine St Hazleton PA 18201 Hospitalist service 445104 26 906 212413 38710 636 252029 Outpatient Revenue 621990 62726730 61969417 757313 Inpatient Revenue 621990 55527884 55527884 EHR Revenue 621990 1585920 1585920 119840534 2127652 2127652 118181 0 118181 118181 118181 79229954 3326 76709056 37994 2520898 -34668 2486230 2486230 55132 906 11776 43356 43356 Cafeteria & Gift Shop Revenue 900099 496550 496550 MSA Revenue - HWC 541610 188331 188331 Equity in Affiliates 900003 58679 58679 216171 216171 959731 125827713 122529182 757313 2289189 90738 90738 1698556 564769 1133787 40687512 34391164 6296348 1075967 932154 143813 8029459 6904743 1124716 3054016 2583407 470609 250115 115 250000 180263 180263 14303 14303 6306 6306 124127 124127 6062668 5954607 108061 289825 3217 286608 2370170 1526135 844035 780445 457556 322889 2845105 2582624 262481 156927 124325 32602 43627 32336 11291 984711 984711 5455360 1922592 3532768 962042 556381 405661 Medical Supplies 11412538 11412538 Practice Support 9642425 9642425 Bad Debt Expense 8350897 8350897 Equipment Rental & Main 2026034 2026034 2982206 1911627 1070579 109576342 92150647 17425695 0 1777 1775 5126092 3779880 8486602 9125222 0 0 1956873 1760343 1032535 1040830 46720793 8391862 40297343 38328931 78116030 93432701 566533 202833 8710060 3995655 144293845 151668170 12404717 11467369 2481189 1125000 27415000 25765000 27401225 24101855 69702131 62459224 X 73851865 88447674 83201 118570 656648 642702 74591714 89208946 144293845 151668170 X 16251371 -3010631 1376492 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 38 0 1 6268 6306 0 Part II-B, Line 1: Item II-B, Line 1, Item i, represents indirect lobbying activities performed by hospital associations of which we are members. 8410000 8410000 23534367 2411540 21122827 25063 1822 23241 13226905 5978500 7248405 1524458 1524458 38328931 SERP PROVISION 13048326 ACCRUED M/A SETTLEMENTS 9180348 PENSION PAYABLE - DC PLAN 664334 CAPITALIZED LEASES 124002 MALPRACTICE LIABILITY EST 785753 DUE FROM AFFILIATES 157904 MISCELLANEOUS LIABILITIES 141188 24101855 X Part X, Line 2: In 2014, the Organization adopted Financial Accounting Standards Board (FASB) Interpretation No. 48 "Accounting for Uncertainty in Income Taxes" ("FIN 48"). FIN 48 has become a part of ASC 740, FIN 48/ASC 740 establishes that the financial statement effects of a tax position taken or expected to be taken are to be recognized in the financial statements when it is more likely than not, based on technical merits, that the position will be sustained upon IRS examination, FIN 48 became effective for fiscal year 2014 for the Organization, upon becoming affiliated with Lehigh Valley Health Network. The Organization has analyzed tax positions taken on federal income tax returns for all open tax years for the taxable entities and has determined that as of June 30, 2015, there are no uncertain tax positions taken or expected to be taken that would require recognition in the financial statements. The Organization has analyzed specific criteria regarding the exempt 501(c)(3) status for the tax exempt entities and has determined that as of June 30, 2015, the Organization is compliant with the qualifications for exemption from Federal income tax. Golf Tournament 55768 636 55132 745 6788 1193 3050 Annual Giving Fund Drive 270 270 56038 906 55132 745 6788 1193 3050 11776 43356 1 1 1 X 1 X 1 1 0 1 1 3130500 0 3130500 0.03090 19952928 14099162 5853766 0.05780 23083428 14099162 8984266 0.08870 562688 157755 404933 0.00400 136617 16925 119692 0.00120 547887 0 547887 0.00540 90738 0 90738 0.00090 1337930 174680 1163250 0.01150 24421358 14273842 10147516 0.10020 249002 0 249002 0.00250 8475 0 8475 0.00010 1822 0 1822 0.00000 319076 0 319076 0.00320 578375 578375 0.00580 1 8350897 1176975 39471751 37846796 1624955 X 1 1 1 Beltway Health LP Medical Office Space Rental 0.43780 1 1 Northeastern Pennsylvania Health Corp 700 E Broad St Hazleton PA 18201 http://hazleton.lvhn.org/ 083701 X X X Northeastern Pennsylvania Health Corpora 1 0 0 1 X X X X X X X X X 13 1 0 1 1 X http://hazleton.lvhn.org X 1 13 0 1 0 1 X 200.000000000000 400.000000000000 X X 1 1 X X X X 1 X http://hazleton.lvhn.org X http://hazleton.lvhn.org X http://hazleton.lvhn.org X X X X 1 X 0 X X X X 1 X 0 0 Northeastern Pennsylvania Health Corporation Part V, Section B, Line 5: Tripp Upbach,a private healthcare consulting firm headquartered in Pittsburgh, Pennsylvania facilitated and managed a comprehensive community health needs assessment (CHNA) on behalf of Northeastern Pennsylvania Health Corporation, currently doing business as Lehigh Valley Hospital-Hazleton, resulting in the identification of community health needs. The assessment process included input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge and expertise of public health issues.A series of meetings were facilitated by the consultants and the CHNA oversight committee consisting of leadership from Lehigh Valley Hospital-Hazleton (LVH-H). The health of a community is largely related to the characterisitics of its residents. An individual's age, race, gender, education, and ethnicity often directly or indirectly impact health status and access to care. Tripp Upbach completed comprehensive analysis of health status and socio-economic environmental factors related to the health of residents of the hospital community from existing data sources such as state and county public health agencies, the Centers for Disease Control and Prevention (CDC), County Health Rankings, Thomson Reuters, Prevention Quality Indicators (PQI), Community Needs Index (CNI), U.S. Census, Pennsylvania Department of Health, Center for Rural Pennsylvania, and other data sources.Tripp Umbach worked closely with the CHNA oversight committee to identify leaders from organizations that have special knowledge and/or expertise in public and community health. Such persons were interviewed as part of the needs assessment planning process. A series of 13 interviews were completed with key stakeholders in the hospital community between January and April 2013.The consultant worked closely with the CHNA oversight committee to ensure that community members, including under-represented residents, were included in the needs assessment planning process via one focus group conducted by Tripp Umbach in the Lehigh Valley Hospital-Hazleton community in April 2013. Focus group audiences were defined by the CHNA oversight committee utilizing secondary data to identify health needs and deficits in target populations. The focus group audience included residents earning a low income that are Medicaid-ineligible, senior residents earning a low income, and Latino residents. Northeastern Pennsylvania Health Corporation Part V, Section B, Line 6a: The mission of the Lehigh Valley Hospital-Hazleton (LVH-H) Community Health Needs Assessment (CHNA) is to understand and plan for the current and future health needs of the residents of its community. The goal of the process is to identify the health needs of the communities served by LVH-H, while developing a deeper understanding of community needs and identifying community health priorities. Important to the success of the community needs assessment process is meaningful engagement and input from a broad cross-section of community based organizations, who were partners in the community health needs assessment. In conducting our CHNA, we took into account input from representatives of the community including Lehigh Valley Hospital-Hazleton, Freeland Senior Citizens Center, Buenas Nuevas Church, County Assistance Office-Hazleton District, Greater Hazleton Chamber of Commerce, Bureau of Aging-Hazleton and Freeland Centers, Rural Health Corp NEPA, Serento Gardens (Alcoholism and Drug Addiction Services), Greater Hazleton School District, Penn State University-Hazleton, the Central Susquehanna Intermediate Unit's Migrant Workers Education Program, Lehigh Valley Physician Group-Hazleton's Pediatric Office, United Way of Greater Hazleton, Northeast Counseling Services (Mental Health Services), Hazleton City Police Department, Commission on Economic Opportunity (C.E.O.), Hazleton Integration Project/Hazleton One Community Center, Luzerne County Community College-Hazleton Center, Anthracite Region Center for Independent Living (ARCIL) (Disability Services), Can Do Economic Development Organization, First Federal Foundation, Luzerne Foundation, Hazleton YWCA-YMCA, Catholic Social Services-Hazleton, State Senator John Yudichak-C.O.S, and Luzerne Schuylkill Workforce Investment Board. Northeastern Pennsylvania Health Corporation Part V, Section B, Line 7d: Our Community Health Needs Assessment is also available upon request. Northeastern Pennsylvania Health Corporation Part V, Section B, Line 18d: Billing activities include hospital sending four statements requesting payment, along with an SPO-1 letter which requests insurance information and includes information on applying for Medical Assistance, before any collection actions occur. The statements include information about the hospital's Financial Assistance Policy, soliciting the patient's participation in the Financial Assistance Program. Part V, Section B, Line 16 Financial Assistance Policy Website Availability Northeastern Pennsylvania Health Corpora Part V, Section B, line 16a website: http://hazleton.lvhn.org Northeastern Pennsylvania Health Corpora Part V, Section B, line 16b website: http://hazleton.lvhn.org Northeastern Pennsylvania Health Corpora Part V, Section B, line 16c website: http://hazleton.lvhn.org Part I, Line 3c: Lehigh Valley Hospital-Hazleton also uses an Asset Test to determine whether an individual is eligible for financial assistance. The only assets that are used for this test are cash balances in bank accounts. Part I, Line 6a: The Community Benefit Report is issued by Lehigh Valley Health Network - EIN 22-2458317, the parent company of Lehigh Valley Hospital-Hazleton. Part I, Line 7: The costing methodology is cost to charge ratio for programs with gross charges and direct costs for programs without gross charges. Part I, Line 7g: The subsidized health services of $547,887 includes the Telemedicine Services and the Hospitalist Program. These service expenses are not included in the Medical Assistance Shortfall or Uncompensated Charity Care value reported above. Part I, Ln 7 Col(f): The Bad Debt Expense included on Form 990, Part IX, Line 25(A) is $8,350,897. Part II, Community Building Activities: Our Community Building Activities include the following:Community Support includes Patient Advocates, Interpretation Services and Patient Satisfaction Surveys.Coalition Building includes activities related to Community Boards such as United Way and the YMCACommunity Health Improvement Advocacy includes employee time volunteering for the free clinic.Workforce Development includes recruitment costs, job shadowing and student clinical advisors. Part III, Line 2: Amounts reported as bad debt expense are reported net of applicable patient payments, insurance payments and contractual allowances as well as other hospital discounts for which the patient is deemed eligible. The ratio of costs-to-charges (RCC) is applied to the net amount to determine the bad debt expense. Part III, Line 3: Bad debt expense is calculated using the worksheet provided by IRS instructions. The bad debt expense attributable to patients eligible under our charity care policy was estimated using a sampling of accounts transferred to bad debts that were written off. We ran the patient information that we had through a third-party software package to determine estimated eligibility for charity care had the patient provided the information necessary to complete the charity care application. Part III, Line 4: The Organization records a provision for bad debts related to uninsured accounts net of the amounts generally billed (AGB) discount to record the net self-pay accounts receivable at the estimated amounts the Organization expects to collect. Coinsurances and deductibles within the third-party payer agreements are the patient's responsibility so the Organization includes these amounts in the self-pay accounts receivable and considers these amounts in its determination of the provision for bad debts based on historical collection experience.In instances where the Organization believes a patient has the ability to pay for services and, after appropriate collection effort, payment is not made, the amount of services not paid is written-off as bad debts. Amounts recorded as Provision for bad debts do not include charity care. The Provision for bad debts for the years ended ended June 30 2015 and 2014, was $5,739,000 and $5,445,755 respectively. Part III, Line 8: The source of the Medicare allowable costs relating to revenue received from Medicare is the FY '15 Medicare Cost Report. For the current fiscal year, there is no Medicare shortfall using only allowable costs; however, if all costs are considered, a shortfall would exist of $4.6 million. The entire shortfall should be treated as a community benefit. The hospital is providing the community a benefit in excess of Medicare payments. Part III, Line 9b: Financial Counseling staff assists patients in applying for Medicaid, CHIP, as well as financial assistance under our Financial Assistance Policy. Accounts that do not meet the eligibility requirements will be followed up in-house or referred to an external receivables follow up agency, and if not paid, referred to a collection agency, and, subsequently, transferred to bad debt status if the accounts remain unpaid. Part VI, Line 2: The objective of this assessment is to analyze traditional health-related indicators, as well as social, demographic, economic, and environmental factors. This project was developed and implemented to meet the individual project goals as defined by the project oversight committee, which included: (1) Assuring that community members, including under-represented residents and those with broad-based racial, ethnic, cultural and linguistic backgrounds are included in the needs assessment process. In addition, persons with special knowledge of, or expertise in public health; federal, tribal, regional, state or local health or other departments or agencies, with current data or other information relevant to the health needs of the community served by the hospital facility; and leaders, representatives or members of medically underserved, low-income and minority populations with chronic disease needs, in the community served by the hospital facility are included in the needs assessment process through data collection and key stakeholder interviews. (2) Obtaining statistically valid information on the health status and socio-economic and environmental factors related to the health of residents in the community and supplementing the general population survey data that is currently available. (3) Developing accurate comparisons to baseline health measures utilizing the most current validated data. (4) Developing a CHNA document as required by the Patient Protection and Affordable Care Act (PPACA). The assessment established the following priorities: (1) Improving access to affordable healthcare (2) Health education and communication (3) Behaviors that impact health. Part VI, Line 3: Consistent with the mission and values of Lehigh Valley Health Network, it is the policy to provide medical care to all individuals without regard to their ability to pay for services. The Patient Financial Assistance Program applies to uninsured and under-insured individuals who participate in the process to evaluate their ability to pay for LVH-H services.The Financial Counselors help patients complete the application for Financial Assistance. LVH-H follows the Federal Poverty Guidelines to evaluate eligibility. Patients whose family income falls below 200% of the Federal Poverty guideline will have their entire balance forgiven for their qualifying services at LVH-H. Patients with a family income below 400% of the Federal Poverty guidelines will have a portion of their balance forgiven for qualifying services at LVH-H.Patients often express financial concern or need by contacting LVH-H Patient Financial Services Department. The Counselor explains the programs available, Financial Assistance and support in applying for Medical Assistance or insurance through the Federal Health Insurance Exchange.Patients will be referred to the Financial Counselors who work with patients to apply for Pennsylvania Medical Assistance. The Financial Counselors are located onsite. The Financial Counselors visit patients in their inpatient rooms and in the Emergency Department (ED).Information regarding Financial Assistance is provided to patients via signage in the registration areas as well as the ED waiting room. Also, when the Financial Counselors assist patients in completing a Medicare uninsured and under-insured application, they also inform the patient about the Patient Financial Assistance Program. In addition, LVH-H advertises our Financial Assistance Program on our public website, as well as on all billing statements sent to out patients. Part VI, Line 4: Northeastern Pennsylvania Health Corp, d/b/a Lehigh Valley Hospital-Hazleton (LVH-H) is a Pennsylvania not-for-profit corporation exempt from federal income taxes as a corporation described in Section 501(c)(3) of the Internal Revenue Code.The primary service area of LVH-H consists of Luzerne, Schuykill and Carbon counties.During the fiscal year 2015, 85.7% and 7.6% of the discharges from LVH-H were residents of the primary service and secondary service area, respectively. During the fiscal year 2015, 6.7% of the discharges from LVH-H were residents outside the primary and secondary areas. Part VI, Line 5: Lehigh Valley Hospital-Hazleton qualifies as an Institure of Purely Public Charity in Pennsylvania. This regulation is referred to as Act 55. To be considered a purely public charity, nonprofits must:(1) advance a charitable purpose;(2) donate or render gratuitously a substantial portion of its services;(3) benefit a substantial and indefinite class of persons who are legitimate subjects of charity;(4) relieve the government of some burden; and(5) operate entirely free from private profit motive.LVH-H is required to reapply for this charitable status every five years and currently qualifies through July 31, 2018. Part VI, Line 6: The mission of the Lehigh Valley Hospital-Hazleton (LVH-H) Community Health Needs Assessment (CHNA) is to understand and plan for the current and future health needs of the residents of its community. The goal of the process is to identify the health needs of the communities served by LVH-H, while developing a deeper understanding of community needs and identifying community health priorities. The assessment established the following priorities: (1) Improving access to affordable healthcare (2) Health education and communication (3) Behaviors that impact health. Our first objective was to improve access and the health of the community we serve through financial support of a free clinic. Financial support was provided and an Executive Director was hired. The clinic opened on 01/22/2015. Our second objective was to improve the health of the community we serve through education and outreach. Health programs continue to be offered through the Occupational Medicine, nursing and various other clinical departments. These included both educational programs as well as health fairs. Specific health programs were offered in cooperation with the Manufacturers Association of Eastern Pennsylvania to include ergonomics and OSHA guideline training. OSHA partnered in the program. As of 06/30/14, 19 health fairs and programs were held. These programs reached 1,331 participants, 387 health screenings were conducted as a result of the health fairs. Program information was distributed to 277 corporate clients. An additional 3 expanded health fairs were requested and conducted at three corporate partners. Our third objective was to improve access and the health of the community we serve by offering non-traditional hours. Our physician practice, Lehigh Valley Physician Group-Hazleton (LVPG-H) opened an urgent care center (ExpressCare) in July 2014. Hours are Monday through Friday: 8AM to 8PM and Weekends and Holidays: 10AM to 6PM. Evaluation will continue to add additional locations. Our fourth objective was to implement programs that positively affect behaviors that impact health. Several programs were offered in addition to health fairs. Programs included Breast Health, Prostate screening, education in the changes in the Pennsylvania Medicaid insurance products for residents, as well as health education at the Hazleton Integration Program (HIP). Leadership had several meetings with the HIP leadership to understand needs. Financial support was provided and quarterly health programs were established to begin in 2015. Part III, Section B. Medicare, Line 8 Medicare program costs included in the annual LVHN Community Benefit Report not included or allowable in the Medicare Cost Report totaled $9,001,301. The costs of Medicare Managed Care, included in this amount is $2,562,845. The remaining $6,438,456 of costs not included in the Medicare Cost Report consists primarily of LVPG-H practice subsidies, Physician costs in excess of allowable amounts, and other Medicare disallowable costs. 0 American Cancer Society PO Box 2306 Hazleton PA 18201 131788491 501(c)(3) 12500 To continue the mission of the American Cancer Society to eliminate cancer as a major health problem American Heart Association 10900-B Stonelake Blvd Suite 320 Austin TX 78759 135613797 501(c)(3) 5000 To continue the mission of the American Heart Association to advance the health of communities Downtown Hazleton Alliance for Progress 20 W Broad St Hazleton PA 18201 464210453 501(c)(3) 30000 To continue the mission to revitalize the downtown Hazleton area Minsi Trails Council PO Box 20624 Lehigh Valley PA 180020624 231708585 501(c)(3) 7500 To continue the mission of the Boy Scouts of America Mountain Council on Governments 20 W Broad St Hazleton PA 18201 233054092 501(c)(3) 5000 To continue the mission to study community challenges The Wiltsie Center 1 S CHURCH ST SUITE 200 HAZLETON PA 18201 501(c)(3) 5000 To support the performing arts center in our community. 6 X X X X X 1 1 0 0 0 0 0 0 0 Philip J Benyo MD Member-Board of Trustee 0 478042 0 0 0 10217 0 0 0 21850 0 510109 0 0 Michael A Washinsky DO Member-Board of Trustee 0 233507 0 0 0 0 0 0 0 18581 0 252088 0 0 Terry Capuano Ex Officio LVHN Member Rep 0 534571 0 159451 0 102980 0 0 0 38761 0 835763 0 0 John R Fletcher President, Ex Officio 300624 0 60000 0 13900 0 0 0 10339 0 384863 0 0 0 William C Bauer Assistant Treasurer 229870 0 35393 0 0 0 0 0 36472 0 301735 0 0 0 Edward F O'Dea Treasurer 0 465134 0 113322 0 82088 0 0 0 42762 0 703306 0 0 Michael Golden Chief Nursing Officer 175051 0 22493 0 0 0 0 0 34583 0 232127 0 0 0 Anthony Valente VP of Medical Affairs 188598 0 24242 0 0 0 0 0 35096 0 247936 0 0 0 Donald A Patten Physician 276221 0 0 0 8172 0 0 0 36858 0 321251 0 0 0 Joseph G Ciotola Physician 221356 0 0 0 0 0 0 0 36387 0 257743 0 0 0 John P Amentler Physician 212716 0 0 0 0 0 0 0 8610 0 221326 0 0 0 James D Edwards Former President 53530 0 120000 0 50107 0 0 0 29046 0 252683 0 0 0 Susan C Yee - Trustee Partnership in 94 Brodhead Associates - Trustee of LVHN/LVH/LVHM/LVHH/HWC 123964 94 Brodhead Associates leases office space to LVPG at fair market value. 0 Form 990, Part III, line 2 Northeastern Pennsylvania Health Corporation, d/b/a Lehigh Valley Hospital-Hazleton continues to pursue opportunities to provide and/or enhance quality services for the community we serve. We continued development and implementation of the Electronic Medical Record (EMR) system to meet Meaningful Use requirements; continued to fulfill commitment to a three-year financial pledge to support a community-based organization's development of a free clinic for the uninsured; continued implementation of our Community Health Needs Assessment plan based on community needs; continued implementation of our strategic plan to recruiting orthopedic and oncology specialists to begin the development of comprehensive orthopedic and oncology programs in our service area; recruited 11 physicians and advance care practitioners to the medical staff to meet the growing health needs of our community; developed and internet-based patient health portal; began a medical staff development plan to support and further the mission of the hospital; made application for Level IV Trauma Center designation; continued extensive work to implement ICD-10 coding; began planning for the development of a health center in Mountain Top, PA to open in March 2016, including physician practices and outpatient diagnostic testing services; started a Veterans Health Initiative to better serve the basic health needs of area veterans. Form 990, Part VI, Section A, line 6 The Organization's sole corporate member is Lehigh Valley Health Network, Inc. Form 990, Part VI, Section A, line 7a The Organization's sole corporate member, Lehigh Valley Health Network, Inc., has the power to elect, appoint, approve, or reject members of the Organization's governing body. Form 990, Part VI, Section A, line 7b The Organization's sole corporate member, Lehigh Valley Health Network, Inc., has the power to approve or reject certain major operating decisions made by the Organization's governing body. Form 990, Part VI, Section B, line 11 The process to review the 990's includes: Draft 1 of the returns is reviewed in detail with a focus on accuracy, completeness, and perspective by the LVHN Vice-President, Finance-Controller and the LVHN Corporate Legal Counsel. Draft 2 of the returns is reviewed by the Executive Vice President & Chief Financial Officer. All Compensation disclosures are reviewed by the Director - Compensation - Human Resources. Draft 3 of the returns is reviewed together with the President & CEO, the Executive Vice President & Chief Financial Officer, the Vice-President, Finance-Controller and the Director-Tax. Final returns are reviewed with the LVHN Board Leadership Group (the Board Chair and three Vice Chairs). Copies of all 990's are provided to the full Board prior to filing. Form 990, Part VI, Section B, line 12c In January 2016, LVHN implemented an electronic tool designed to send notifications and track disclosures reported on Conflict of Interest Questionnaires. The Network also expanded the scope of the Conflict of Interest or Commitment Policy, such that additional colleagues are now required to complete a questionnaire each year. Prior to January, the VP, Internal Audit and Compliance Services issued a notice to Board Members and members of the Senior Management Council when it was time for them to submit their conflict of interest questionnaires. The VP also instructed members of the Senior Management Council to identify and request completed conflict of interest questionnaires from individuals who had potential conflicts of interest and to provide her with the identity of those individuals. Compliance Services tracked completion of the questionnaires. All physicians on LVHN's medical staff are also required to complete a conflict of interest questionnaire annually. Medical Staff Services monitors this process to ensure that all physicians comply. Potential conflicts are managed by the LVHN Conflict of Interest Committee and/or by the Board of Trustees, depending on whose interest(s) pose the conflict and the nature of the conflict. Form 990, Part VI, Section B, line 15 LEHIGH VALLEY HEALTH NETWORK 2015 Executive Compensation Review In compliance with the rebuttable presumption of reasonableness process outlined in the Intermediate Sanctions regulations (issued under Section 4958 of the Internal Revenue Code); Sullivan Cotter and Associates, Inc. (Sullivan Cotter) qualifies as an independent executive compensation expert, specializing in the health care industry. Sullivan Cotter provides advice to the Lehigh Valley Health Network Executive Compensation Committee of the Board of Trustees to support its attainment of the rebuttable presumption of reasonableness under the Intermediate Sanctions regulations. They also support the committee in ensuring that the LVHN executive compensation program is competitive and aligned with the organization's executive compensation philosophy. Chief Executive Officer Total Compensation Review: Program Analysis: Analyze the market position of total compensation (base salary, incentive, benefits, and perquisites) for LVHN's President and Chief Executive Officer (CEO) in relation to CEO market data obtained for a defined peer group of comparable health systems. This includes the preparation of tally sheets for the President and CEO as well as an analysis of Form 990 compensation data. They assess the alignment of the President and CEO's compensation with LVHN's compensation philosophy and note the implications of the review. Sullivan Cotter's analyses and findings are summarized in a report to the Committee that provides a reasonableness opinion for the Intermediate Sanctions compliance. The report was provided by Sullivan Cotter at the August 17, 2015 Executive Compensation Committee Meeting. Senior Management Council (SMC) Total Compensation Review: Program Analysis: Analyze the market position of total compensation (salaries, incentives, benefits, and perquisites) for LVHN's SMC executives and Clinical Chairs (approximately 30 total positions) in relation to comparable positions in peer organizations. This includes the preparation of tally sheets for each individual. Sullivan Cotter's analyses and findings are summarized in a report to the Committee that also provides an opinion of reasonableness for Intermediate Sanctions compliance. . The report was provided by Sullivan Cotter at the August 17, 2015 Executive Compensation Committee Meeting. Summary of Methodology To conduct this analysis, Sullivan Cotter: Collected background information regarding LVHN's operations, structure, size and scope, as well as each position's duties. Compiled market data for SMC executives consistent with the Executive Compensation Philosophy approved by the Committee during its September 16, 2014 meeting: o The market data used for LVHN system executives in this assessment are an equally weighted blend of (1) a peer group of 33 not-for-profit health systems located in the Northeast region (excluding New York City) with net operating revenues between $1.0 billion and $4.3 billion (average of $1.8 billion), and (2) national data reflecting organizations of similar scope and size to LVHN. National data are used where peer group data are not available. o Peer group and national market data were abstracted from Sullivan Cotter's 2014 Survey of Manager and Executive Compensation in Hospitals and Health Systems, as well as other published compensation surveys reflecting pay at comparably sized organizations, which included national hospitals and national medical groups. o Sullivan Cotter notes that no market data are provided for the SVP, Medical Services as the responsibilities of that position are unique, so no benchmark data are available. They recommend that the Committee assess the compensation for that position based on internal equity considerations. Compiled market data for the LVHN clinical chairs prepared by the Association of American Medical Colleges (AAMC) for the chairs of clinical departments in medical schools, LVHN's traditional comparator group for these jobs. Adjusted the market data to an effective date of January 1, 2016 at an annualized rate of 3.0% based on salary increase trends. Compared each component of LVHN's benefit program against typical market benefit practices in health systems and hospitals based on multiple published surveys, supplemented by Sullivan Cotter's proprietary data and experience. Developed market total compensation data by combining market TCC with typical market benefit costs. Compared LVHN's TC to market rates and assessed overall positioning. For physician executives having both clinical and administrative roles, relevant market data were collected based on FTE allocation. o Sullivan Cotter has not completed an assessment of the physician's productivity or the Fair Market Value (FMV) of their clinical compensation, as LVHN has advised that such amounts are appropriate and within FMV. Sullivan Cotter used the following methodology to assess the competitiveness and reasonableness of LVHN's executive total compensation levels: Collected background information regarding LVHN's operations, structure, size and scope. Collected information on each Senior Management Council (SMC) member's current compensation. o Data collected include base salaries, annual incentive opportunity levels (target and Maximum), actual annual incentive payout amounts, annual costs of all standard and supplemental benefits and annual cost and description of executive perquisites. Reviewed job descriptions and organizational charts to identify each position's functional responsibilities and reporting relationships. o Selected the appropriate benchmark position match for each position and applied premiums/discounts to the market data in instances where LVHN's job duties differ materially from benchmark position matches. ? Position matches and market adjustments were reviewed with LVHN's Senior Vice President, Human Resources and Compensation staff. o LVHN's projected FY2015 net revenues and physician FTE's were used as the scope size for each entity. Form 990, Part VI, Section C, line 18 Another's website-Guidestar. Upon request-hard copies with senior management and marketing. Form 990, Part VI, Section C, line 19 The Organization makes its financial statements available to the public through its Annual Report to the community. The Annual Report is distributed to all attendees at the Organization's annual public meeting. In addition, it is distributed via mail to members of the community. The organization's governing documents and conflicts of interest policy are not available to the public. Form 990, Part XI, line 9: Minimum pension liability 1,763,278. Loss on impairment -184,335. Minority interest - HSA 511,338. Change in temporarily & permanently restricted assets 21,423. Transfers from affiliates -735,212. Form 990, Part XI, Line 2c The Audit Committee of the Board of Trustees assumes responsibility for oversight of the audit and selection of an independent auditor. Form 990, Part VI, Section A, Line 6 Lehigh Valley Health Network, a PA non-profit corporation is Northeastern Pennsylvania Health Corporation's sole member. There are no stockholders. Form 990, Part VI, Section A, Line 7a Lehigh Valley Health Network, the sole member, appoints the directors. Form 990, Part VI, Section A, Line 7b Lehigh Valley Health Network, the sole member, makes and ratifies the decisions as specified in Northeastern Pennsylvania Health Corporation's bylaws. Lehigh Valley Health Network 1200 S Cedar Crest Blvd Allentown PA 181036202 222458317 Parent Company PA 501(c)(3) Line 3 N/A 0 Lehigh Valley Hospital 2100 Mack Blvd Allentown PA 181035622 231689692 Health Care Organization PA 501(c)(3) Line 3 Lehigh Valley Health Network 0 Lehigh Valley Hospital-Muhlenberg 1200 S Cedar Crest Blvd Allentown PA 181036202 232367707 Health Care Organization PA 501(c)(3) Line 3 Lehigh Valley Health Network 0 Lehigh Valley Physician Group 1200 S Cedar Crest Blvd Allentown PA 181036202 232700908 Physician Practice Organization PA 501(c)(3) Line 3 Lehigh Valley Health Network 0 Muhlenberg Realty Corporation 1200 S Cedar Crest Blvd Allentown PA 181036202 232245513 Real Estate Rentals PA 501(c)(3) Line 3 Lehigh Valley Health Network 0 Lehigh Valley Health Network Realty Holding Co 1200 S Cedar Crest Blvd Allentown PA 181036202 232586770 Real Estate Holding Co PA 501(c)(2) Lehigh Valley Health Network 0 Hazleton Professional Services 700 E Broad St Hazleton PA 182016835 205880364 Physician Practice Organization PA 501(c)(3) Line 3 Lehigh Valley Physician Group 0 Hazleton Surgical Alliance 700 E Broad St Hazleton PA 182016835 202038456 Surgical Services PA 501(c)(3) Line 3 Northeastern Pennsylvania Health Corp 0 Hazleton Health & Wellness Center 700 E Broad St Hazleton PA 182016835 232580968 Staffing Services PA 501(c)(3) Line 11a, I Northeastern Pennsylvania Health Corp 0 LVHN Reciprocal Risk Retention Group 151 Meeting Street Suite 310 Charleston SC 294012238 200037118 Insurance PA N/A Health Network Laboratories LLC 794 Roble Rd Allentown PA 181099110 232932802 Laboratory Services PA N/A Health Network Laboratories LP 794 Roble Rd Allentown PA 181099110 232948774 Laboratory Services PA N/A Lehigh Magnetic Imaging Center 1230 S Cedar Crest Blvd Allentown PA 18103 232429007 Imaging Center PA N/A Lehigh Valley Imaging LLC 1200 Cedar Crest Blvd Allentown PA 181036202 464551937 Imaging Services PA N/A Hazleton Surgery Center LLC 17480 Dallas Pkwy Ste 210 Dallas TX 752877304 201232531 Surgical Services PA N/A Lehigh Valley Health Services Inc 2100 Mack Blvd Allentown PA 181035622 232263665 Health Care Related Services PA N/A C 0 Lehigh Valley Anesthesia Services PC 2100 Mack Blvd Allentown PA 181035622 233096124 Anesthesia Services PA N/A C 0 Westgate Professional Center Inc 2100 Mack Blvd Allentown PA 181035622 231657333 Real Estate Rentals PA N/A C 0 Lehigh Valley Physician Hospital Organization Inc 2100 Mack Blvd Allentown PA 181035622 232750430 Health Care related Services PA N/A C 0 Hazleton Saint Joseph Medical Office Building Inc 700 E Broad St Hazleton PA 182016835 232500981 Medical Office Rental PA Northeastern Pennsylvania Health Corp C -6108 117722 1.00000 0 0 0 0 1 0 0 0 0 0 1 1 1 1 1 1 1 1 1 1 Hazleton Saint Joseph Medical Office Building Inc K 10455 Actual rent amount