2016-05-11T14:59:49-07:00 2015-06-30 990 2014-07-01 320345810 Penn Highlands Healthcare Inc PENN 8143756432 PO Box 447 Du Bois PA 15801 Raymond Graeca President / CEO 8143756430 2016-05-12 2014 2016-08-17 19:52:53Z Raymond Graeca PO Box 447 100 Hospital Ave Du Bois PA 15801 7421304 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 14 0 0 0 0 0 0 5845507 7421304 0 0 0 0 5845507 7421304 0 0 0 0 3080484 4433504 0 0 0 2527238 2508578 5607722 6942082 237785 479222 1585334 6289323 1308740 3413717 276594 2875606 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 5328058 7421304 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 5328058 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 1 0 0 1 X 23 0 1 0 0 0 0 0 0 0 0 0 0 0 X 16 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 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 Thomas G Gasbarre Chairman 2 0 X X 0 0 0 Rob O'Leary Vice-Chairman 2 0 X X 0 0 0 Scott Foradora Treasurer 2 0 X X 0 0 0 Dr Richard Bedger Secretary 2 0 X X 0 0 0 Dr Thomas Carnevale Trustee 1 0 X X 0 0 0 Dr Hazem ElKassas Trustee 1 0 X 0 0 0 Ronald King Trustee 1 0 X 0 0 0 Dr Carmine Marchioli Trustee 1 0 X 0 0 0 Dennis L Merrey Trustee 1 0 X 0 0 0 Edward Nasuti Trustee 1 0 X 0 0 0 Robert A Ordiway Trustee 1 0 X 0 0 0 Richard Pfingstler Trustee 1 0 X 0 0 0 Dr Gregory Roscoe Trustee 1 0 X 0 0 0 Jim Ryan Trustee 1 0 X 0 0 0 William Wood Trustee 1 0 X 0 0 0 Raymond A Graeca President and CEO 40 0 X X 0 649917 127183 David J McConnell Chief Financial Officer 40 0 X 0 337091 53842 Stephen Fontaine Chief Operating Officer 40.00 0 X 0 147154 28798 Gary Dugan Chief Medical Officer 40.00 0 X 0 373114 41723 0 1507276 251546 0 0 1 0 K & L GATES LLP 535 SMITHFIELD STREET HENRY W OLIVER BLDG PITTSBURGH PA 15222 LEGAL 105883 1 0 0 0 0 0 0 0 0 Management fees from related organaizations 541611 7421304 7421304 0 0 0 0 0 0 7421304 0 0 0 0 0 0 7421304 7421304 0 0 0 0 0 0 0 0 0 0 2064158 1671968 392190 0 0 0 0 0 1613873 1307237 306636 0 0 0 0 0 755473 611933 143540 0 0 0 0 0 0 0 0 0 255316 0 255316 0 33000 0 33000 0 0 0 0 0 0 0 0 0 0 0 312499 0 312499 0 1008588 1008588 0 10338 8374 1964 0 0 0 0 0 0 0 0 0 117699 95336 22363 0 39456 31959 7497 0 0 0 0 0 360 292 68 0 0 0 0 0 0 0 0 0 9069 7346 1723 0 121858 98705 23153 0 Dues 138059 111828 26231 0 Physician Recruitment 306124 247960 58164 0 156212 126532 29680 0 6942082 5328058 1614024 0 539640 1901513 0 3517330 0 0 777013 582041 0 0 0 0 0 0 0 0 193212 220825 75905 8291 75469 67614 0 0 0 0 0 0 0 0 0 0 1585334 6289323 1308740 1840744 0 0 0 0 0 0 0 0 0 0 0 1572973 0 0 0 1308740 3413717 X 0 0 0 0 276594 2875606 276594 2875606 1585334 6289323 X 479222 1970720 0 0 0 149070 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 DuBois Regional Medical 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 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, 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 appproves the recommendations. Schedule A, Part IV, Section E, Line 3b Control is exercised through the reserved powers of the bylaws. 0 0 0 0 0 0 0 0 0 0 0 0 75905 8291 67614 0 0 0 0 67614 X X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 Raymond A Graeca President and CEO 0 532248 0 117669 0 23084 0 107737 0 13862 0 794600 0 0 David J McConnell Chief Financial Officer 0 299231 0 37860 0 13164 0 28000 0 12678 0 390933 0 0 Stephen Fontaine Chief Operating Officer 0 108000 0 39154 0 18196 0 5400 0 5202 0 175952 0 0 Gary Dugan Chief Medical Officer 0 323871 0 49243 0 1516 0 26000 0 13607 0 414237 0 0 Schedule J, Part I, Line 1a Steve Fontaine, Chief Operating Officer, receives an annual housing allowance and reimbursement of health or social club dues or fees both 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 $79,837 into those plans. Raymond Graeca also received a 457 distribution in the amount of $165,778. Penn Highlands Clearfield deposited 18,000 into a 457 plan on behalf of Dave McConnell. Penn Highlands DuBois deposited $5,400 into a 457 plan on behalf of Steve Fontaine. Penn Highlands DuBois deposited $16,200 into a 457 plan on behalf of Gary Dugan. Oncology Hematology Asssociates of Pennsylvania Board Members of Penn Highlands Healthcare who provide service to Penn Highlands DuBois, subsidiary 674255 Payment for Medical Director Services 0 Dr Richard Bedger Secretary 25000 Payment from Penn Highlands Clearfield, a subsidiary of Penn Highlands Healthcare 0 Form 990, Part V, Line 2a Penn Highlands Healthcare, Inc. does not complete payroll or payroll taxes. All employees are paid by one of the affiliate organizations and Penn Highlands Healthcare reimburses the affiliate actual wages and benefits. Form 990, Part VI, Section B, Line 11b Penn Highlands Healthcare, Inc.'s Finance Committee reveiwed the 990 at the April 28, 2016 meeting. The Board of Directors reviewed the form at the May 2, 2016 meeting. 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 actuely aware of the heightened public scrutiny of executibe 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 XI, Line 9 There was a miscellaneous adjustment to fund balance for $149,070. 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) 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 1 1 Du Bois Medical Risk Retention Group 100 Hospital Ave Du Bois PA 15801 200324622 Insurance Service PA Du Bois Regional Medical Center C 1 1 Brookcare Inc 100 Hospital Rd Brookville PA 15825 251477768 Lease Office Space PA Brookville Hospital C 1 1 0 0 0 1 0 0 0 0 0 0 1 1 0 1 1 1 1 0 0 Du Bois Regional Medical Center k 117536 Fair market value - based on square footage Du Bois Regional Medical Center l 4417776 actual management service fees Clearfield Hospital l 1122537 actual management service fees Brookville Hospital l 460460 actual management service fees Elk Regional Health Center l 1557763 actual management service fees Du Bois Regional Medical Center o 2625985 actual wages paid to shared employees Clearfield Hospital o 606753 actual wages paid to shared employees Elk Regional Health Center o 335960 actual wages paid to shared employees