2015-05-11T10:25:42-05:00 2014-06-30 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 1650 MARKET STREET SUITE 4500 PHILADELPHIA PA 19103 990 2013-07-01 240795411 EVANGELICAL COMMUNITY HOSPITAL EVAN 5705222741 ONE HOSPITAL DRIVE LEWISBURG PA 17837 JAMES STOPPER CFO 5705222741 2015-05-08 1 JULIUS C GREEN CPA JD P00350393 2159720701 2013 2016-02-25 16:41:14Z MICHAEL O'KEEFE ONE HOSPITAL DRIVE LEWISBURG PA 17837 206524730 0 X WWW.EVANHOSPITAL.COM X 1926 PA PROVIDE HEALTH CARE SERVICES TO THE PUBLIC AND TO BE THE COMMUNITY'S HEALTH CARE PROVIDER OF CHOICE. 17 14 1593 567 3774305 408613 2807525 2477137 141285558 162075899 4698335 5125488 5449885 5765700 154241303 175444224 81000 77100 0 0 71783728 75745702 0 0 509134 66364805 77728313 138229533 153551115 16011770 21893109 240301252 261612869 79638326 81614982 160662926 179997887 X WE WILL PROVIDE EXCEPTIONAL HEALTHCARE, ACCESSIBLE TO ALL, IN THE SAFEST AND MOST COMPASSIONATE ATMOSPHERE POSSIBLE. OUR VISION: WE WILL BE OUR COMMUNITY'S HEALTHCARE PROVIDER OF CHOICE BY PATIENTS, PHYSICIANS AND EMPLOYEES. 1 0 125652497 77100 162372261 MEETING THE HEALTHCARE NEEDS OF THE COMMUNITY IS AT THE HEART OF EVANGELICAL COMMUNITY HOSPITAL'S MISSION AS A NOT-FOR-PROFIT CHARITABLE ORGANIZATION. THE HOSPITAL'S RESOURCES PROVIDE FOR LONG-TERM INITIATIVES SUCH AS RECRUITMENT AND RETENTION OF OUTSTANDING MEDICAL PROFESSIONALS, ENHANCED TECHNOLOGIES AND NEW FACILITIES AND SERVICES.THE HOSPITAL IS LICENSED TO ACCOMMODATE 132 OVERNIGHT PATIENTS, 12 ACUTE REHABILITATION UNIT PATIENTS AND 18 NEWBORN BABIES. IT IS A NOT-FOR-PROFIT COMMUNITY HOSPITAL OFFERING A FULL CONTINUUM OF CARE. SERVICES RANGE FROM COMPREHENSIVE DIAGNOSTIC TESTS TO DELICATE MICROSURGERY AND FROM SPECIFIC TREATMENT PROGRAMS TO NUMEROUS OUTPATIENT SERVICES.IN ADDITION TO PROVIDING HOSPITAL-BASED MEDICAL SERVICES, EVANGELICAL PROVIDES A NUMBER OF COMMUNITY-BASED SERVICES DESIGNED TO IMPROVE THE HEALTH OF AREA RESIDENTS. MANY OF THE EMPLOYEES AND MEDICAL STAFF LEAD HEALTH EDUCATION AND SCREENINGS AS WELL AS SUPPORT GROUPS FOR INDIVIDUALS IN THE COMMUNITY LIVING WITH SERIOUS OR CHRONIC HEALTH CONDITIONS. WHETHER THROUGH CHARITABLE CARE, SUBSIDIZED HOSPITAL PROGRAMS AND SERVICES, OR COMMUNITY HEALTH EDUCATION, EVANGELICAL STRIVES TO RESPOND TO THE VALLEY'S MOST PRESSING HEALTH NEEDS. 125652497 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 0 1 42 0 1 1593 1 1 1 0 0 0 0 1 1 0 0 0 0 X 17 14 1 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 PA X JAMES STOPPER CPA 5705222000 ONE HOSPITAL DRIVE LEWISBURG PA 17837 MICHAEL N O'KEEFE PRESIDENT/CEO (NON-VOTING) 40.00 1.00 X X 717281 0 98024 JOHN GRIFFITH DIRECTOR 1.00 0.10 X 0 0 0 TIM APPLE DIRECTOR 1.00 0.10 X 0 0 0 JULIE BARNA DMD VICE CHAIR 1.00 0.10 X X 0 0 0 MARTHA A BARRICK DIRECTOR 1.00 0.10 X 0 0 0 BROOKS GRONLUND DIRECTOR 1.00 0.10 X 0 0 0 ROBERT L GRONLUND DIRECTOR 1.00 0.10 X 0 0 0 ROGER S HADDON JR CHAIR 1.00 0.10 X X 0 0 0 AMANDA KESSLER DIRECTOR 1.00 0.10 X 0 0 0 JOHN MECKLEY ESQ DIRECTOR 1.00 0.10 X 0 0 0 FREDRIK B PAULSEN JR DIRECTOR 1.00 0.10 X 0 0 0 JANICE OMLOR DO DIRECTOR 1.00 0.10 X 0 0 0 W GALE REISH MD DIRECTOR 1.00 0.10 X 0 0 0 J DONALD STEELE JR DIRECTOR 1.00 0.10 X 0 0 0 JOHN E RICE MD DIRECTOR/PHYSICIAN 1.00 39.10 X 0 239100 24640 DENNIS SWANK DIRECTOR 1.00 0.10 X 0 0 0 HENRY A TRUSLOW IV DIRECTOR 1.00 0.10 X 0 0 0 P RONALD ZUG DIRECTOR/PHYSICIAN 1.00 39.10 X 0 121560 11849 TODD STEFAN MD EX-OFFICIO (NON-VOTING)/PHYSICIAN 1.00 39.10 X 0 466760 28836 SHARON L PEARCE EX-OFFICIO (NON-VOTING) 1.00 0.10 X 0 0 0 SARA G KIRKLAND DIRECTOR EMERITUS (NON-VOT 1.00 0.10 X 0 0 0 JOHN MATHIAS DIRECTOR EMERITUS (NON-VOT 1.00 0.10 X 0 0 0 JAMES G APPLE DIRECTOR EMERITUS (NON-VOT 1.00 0.10 X 0 0 0 NORMAN S RICH DIRECTOR EMERITUS (NON-VOT 1.00 0.10 X 0 0 0 KENDRA A AUCKER CHIEF OPERATING OFFICER 40.00 X 538882 0 49501 JAMES A STOPPER CHIEF FINANCIAL OFFICER 40.00 1.00 X 255235 0 35928 J LAWRENCE GINSBURG VP MEDICAL AFFAIRS 40.00 X 403163 0 72609 PAUL E TARVES VP OF NURSING 40.00 X 332707 0 40375 DALE E MOYER CHIEF INFORMATION OFFICER 40.00 X 282527 0 39939 MARK K KRAMMES CHIEF CRNA 40.00 X 238119 0 26918 SANDRA S WALKER NURSE ANESTHETIST 45.00 X 202336 0 8410 LORI K GOODLING NURSE ANESTHETIST 45.00 X 194819 0 9766 ROSEMARY S BURG NURSE ANESTHETIST 45.00 X 193433 0 14181 COLLEEN A FRITZ NURSE ANESTHETIST 45.00 X 189506 0 19348 3548008 827420 480324 12 0 1 0 THE QUANDEL GROUP INC 3003 NORTH FRONT ST SUITE 2-1 HARRISBURG PA 17110 CONSTRUCTION 4632451 DIVERSIFIED CLINICAL SERVICES PO BOX 636981 CINCINNATI OH 45263 MANAGEMENT SERVICES 319886 STANTEC ARCHITECTURE INC 13980 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 ARCHITECT 296553 DAVID M MAINES ASSOC INC 10 EXPANSION DR PO BOX 167 LEWISTOWN PA 17044 CONSTRUCTION 272264 EXECUTIVE HEALTH RESOURCES INC PO BOX 822688 PHILADELPHIA PA 191822688 CONSULTING SERVICES 214290 137 138337 5759 277035 2056006 2477137 ECH NET PATIENT SERVICE REV 621400 160765673 160765673 EASC NET PATIENT SERVICE REVENUE 621400 1310226 1310226 162075899 2413386 2413386 2187863 2374973 -187110 -187110 -187110 31306532 44161 28569167 69424 2737365 -25263 2712102 2712102 74929 138337 66942 7987 7987 LABORATORY SERVICES 621500 2332426 2332426 BILLING FEES FROM AFFILIATE 541900 925020 925020 CAFETERIA AND VENDING MACHINE SAL 722210 585436 585436 2101941 296362 516859 1288720 5944823 175444224 162372261 3774305 6820521 77100 77100 3802428 3802428 54692729 47683442 6813394 195893 1541897 1481618 54192 6087 11623020 9608001 1975547 39472 4085628 3350888 720974 13766 369591 3249 365088 1254 101116 101116 763249 381752 381497 9281151 4201796 5020881 58474 504991 15743 489248 6060171 4287348 1759465 13358 4676058 938014 3715316 22728 2142917 2142917 157872 114865 39567 3440 237896 136374 92699 8823 2389484 2389484 10298793 10298793 841211 841211 MEDICAL SUPPLIES 23354364 23319187 35177 BAD DEBT EXPENSE 11001889 11001889 MA MODERNIZATION 1469120 1469120 LOSS ON DEBT REFINANCIN 1443953 1443953 2634487 1909706 578942 145839 153551115 125652497 27389484 509134 2150 2570 10485038 24058903 677515 449410 13146488 14319684 1427054 1370070 3394595 3525864 2316667 2613212 224138989 105407282 119199050 118731707 76981404 83686070 3675408 3205125 3175259 8995883 6474995 240301252 261612869 17935055 17369328 28492 48335000 45894698 1597158 594424 11771113 17728040 79638326 81614982 X 153886825 172260702 1368250 1863475 5407851 5873710 160662926 179997887 240301252 261612869 X 21893109 4345660 -6903808 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4590433 322276 635909 19298 79509 21600 5428211 3717474 700530 280387 22640 67350 17968 4590433 3351677 114280 341323 15894 60316 13596 3717474 2853652 380340 207310 16598 67522 5505 3351677 2701406 123011 102387 2000 66203 4949 2853652 0.62420 0.37580 0 0 7074428 7074428 108980922 33545451 75435471 2052671 512199 1540472 95583423 68816017 26767406 10447545 2533615 7913930 118731707 BLUE CROSS CURRENT FINANCING ADVANCE 3287199 ACCRUED POSTRETIREMENT BENEFIT COSTS 6312775 ESTIMATED MEDICAL MALPRACTICE CLAIMS LIABILITY 854816 CHARITABLE GIFT ANNUITIES PAYABLE 755163 DEFERRED COMPENSATION 1678275 CAPITAL LEASE OBLIGATION 2612323 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 2121618 DUE TO AFFILIATES 105871 17728040 X 172156400 4345660 -9705697 -5360037 177516437 369702 -2441915 -2072213 175444224 152821439 10641915 10641915 142179524 369702 11001889 11371591 153551115 PART V, LINE 4: ENDOWMENT FUNDS WILL BE USED TO SUPPORT VARIOUS HOSPITAL PROGRAMS SUCH AS FUNDING HELPLINE SERVICES, COMMUNITY HEALTH EDUCATION, HOSPICE SERVICES, PRE-HOSPITAL SERVICES, FAMILY PLACE (OB SERVICES), PROVIDE NURSING SCHOLARSHIPS AND TO PROVIDE FOOD, SERVICE, OR CARE FOR PEOPLE WHO DO NOT HAVE THE MEANS TO PAY FOR THE SERVICE. PART X, LINE 2: THE CORPORATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING 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. MANAGEMENT HAS DETERMINED THAT THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2014 OR 2013. THE HOSPITAL'S FEDERAL RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) AND THE FEDERAL EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURNS (FORM 990-T) FOR THE YEARS ENDING PRIOR TO JUNE 30, 2011 NO LONGER REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE ("IRS"). PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENT 33,439. VALUATION GAIN 402,348. POSTRETIREMENT BENEFIT LIABILITY ADJUSTMENT -666,975. PROVISION FOR BAD DEBT (NETTED ON F/S) -11,001,889. EQUITY TRANSFER FROM AFFILIATE 1,527,380. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -2,374,973. SPECIAL EVENTS EXPENSE -66,942. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 2,374,973. SPECIAL EVENTS EXPENSE 66,942. EQUITY TRANSFER TO AFFILIATE 8,200,000. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT (NETTED ON F/S) 11,001,889. 2014 GALA 131427 78705 52722 2658 13154 6500 19028 2013 GOLF TOURNAMENT 60829 43012 17817 9030 6403 5100 1 21010 16620 4390 1260 338 300 3171 213266 138337 74929 12948 19895 6800 27299 66942 7987 1 1 1 X 1 X 1 1 0 1 1 403 248217 0 248217 0.00170 18056 11906258 4977065 6929193 0.04860 329 54479 0 54479 0.00040 18788 12208954 4977065 7231889 0.05070 79 18593 723519 50629 672890 0.00470 11 62 150343 30000 120343 0.00080 3 739 17035 0 17035 0.00010 93 19394 890897 80629 810268 0.00560 93 38182 13099851 5057694 8042157 0.05630 5 50 4664 786 3878 0.00000 3 140 2349 2349 0.00000 11 190 24484 24484 0.00020 12 431 152173 152173 0.00110 31 811 183670 786 182884 0.00130 1 2373376 0 28534285 40244430 -11710145 X 1 1 1 1 EVANGELICAL COMMUNITY HOSPITAL ONE HOSPITAL DRIVE LEWISBURG PA 17837 X X X INPATIENT REHABILITATION, HOSPICE EVANGELICAL COMMUNITY HOSPITAL 1 1 X X X X X X X X X 12 1 1 1 X WWW.EVANHOSPITAL.COM/HEALTH-AND-WELLNESS X X X X X X X X X 0 0 1 1 100.000000000000 1 200.000000000000 1 X X 1 1 X X X X 1 X 0 X X X 1 X 0 0 EVANGELICAL COMMUNITY HOSPITAL PART V, SECTION B, LINE 3: IN 2012, EVANGELICAL COMMUNITY HOSPITAL PARTICIPATED IN A FIVE-COUNTY (SNYDER, UNION, MONTOUR, NORTHUMBERLAND AND COLUMBIA) COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) LED BY ACTION HEALTH. TRIPP UMBACH WAS SELECTED TO CONDUCT THE ASSESSMENT AND REPORT ON THE FINDINGS. THE ASSESSMENT CONSISTED OF INTERVIEWS WITH KEY COMMUNITY STAKEHOLDERS AND FOCUS GROUPS. FOCUS GROUP PARTICIPANTS FOR EVANGELICAL'S SERVICES AREA CONSISTED OF HEALTHCARE PROVIDERS, RESIDENTS FROM THE LATINO COMMUNITY AND UN/UNDER-INSURED RESIDENTS. KEY COMMUNITY STAKEHOLDER INTERVIEWS CONSISTED OF LEADERS FROM ORGANIZATIONS SUCH AS AGENCY ON AGING, PA DEPARTMENT OF HEALTH, AMERICAN CANCER SOCIETY, FAITH-BASED ORGANIZATIONS, LOCAL SCHOOLS AND UNIVERSITIES, BUSINESSES AND NONPROFIT ORGANIZATIONS. EVANGELICAL COMMUNITY HOSPITAL PART V, SECTION B, LINE 4: IN 2012, EVANGELICAL COMMUNITY HOSPITAL PARTICIPATED IN A FIVE-COUNTY (SNYDER, UNION, MONTOUR, NORTHUMBERLAND AND COLUMBIA) COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE ASSESSMENT PROCESS WAS LED BY ACTION HEALTH, AN ORGANIZATION THAT FOSTERS COLLABORATION BETWEEN HOSPITALS AND LOCAL EDUCATIONAL INSTITUTIONS FOR THE PURPOSE OF MEETING THE HEALTH NEEDS OF THE COMMUNITY. THE OTHER FACILITIES THAT WERE INVOLVED WERE GEISINGER, GEISINGER-SHAMOKIN AREA COMMUNITY HOSPITAL, BLOOMSBURG HOSPITAL AND BLOOMSBURG UNIVERSITY. EVANGELICAL COMMUNITY HOSPITAL PART V, SECTION B, LINE 7: THE THIRD AND FINAL MOST PRESSING NEED IDENTIFIED THROUGH THE 2012 CHNA WAS THE NEED FOR ADEQUATE PUBLIC TRANSPORTATION - THIS HAS NOT BEEN FULLY ADDRESSED BY THE HOSPITAL.THE ISSUE OF ENSURING ADEQUATE PUBLIC TRANSPORTATION FOR VALLEY RESIDENTS IS A CONCERN FOR THE HOSPITAL. IN RESPONSE TO THIS IDENTIFIED NEED, HOSPITAL ADMINISTRATION HAS PROVIDED TIME DURING BUSINESS HOURS FOR A MEMBER OF THE COMMUNITY BENEFIT COMMITTEE TO SERVE ON THE REGIONAL NORTH CENTRAL PA PUBLIC TRANSPORTATION TASK FORCE. IN ADDITION, KEY PERSONNEL IN SOCIAL SERVICES, CASE MANAGEMENT AND THE EMERGENCY DEPARTMENT ARE WORKING TOGETHER TO ADDRESS TRANSPORTATION ISSUES AS THEY RELATE TO PATIENTS WHO COME TO THE HOSPITAL FOR EMERGENT OR SCHEDULED CARE, BUT ARE UNABLE TO RETURN HOME DUE TO THE LACK OF TRANSPORTATION. A SPECIAL FUND HAS BEEN ESTABLISHED FOR THIS PURPOSE MAKING TAXI-FARE AVAILABLE TO THESE PATIENTS WHEN NEEDED. REPRESENTATIVES OF THE HOSPITAL WILL CONTINUE TO ADVOCATE AND SUPPORT EFFORTS IN OUR COMMUNITY TO ADDRESS AND SOLVE THE MOST URGENT TRANSPORTATION NEEDS IN THE VALLEY, ESPECIALLY AS THEY RELATE TO THOSE WHO HAVE DIFFICULTY ACCESSING HEALTHCARE DUE TO LACK OF TRANSPORTATION. HOWEVER, A SPECIAL SUBCOMMITTEE OF THE COMMUNITY BENEFITS COMMITTEE WILL NOT BE DEVELOPED AND STAFFED FOR THE PURPOSE OF ADDRESSING TRANSPORTATION NEEDS. EVANGELICAL COMMUNITY HOSPITAL PART V, SECTION B, LINE 12I: MEDICAL ASSISTANCE DENIAL EVANGELICAL COMMUNITY HOSPITAL PART V, SECTION B, LINE 14G: POLICY IS PRESENTED TO PATIENTS BY HRSI WHEN WORKING WITH PATIENTS ON MEDICAL ASSISTANCE APPLICATIONS. HRSI IS A THIRD PARTY USED BY EVANGELICAL COMMUNITY HOSPITAL TO WORK WITH PATIENTS FOR OBTAINING FINANCIAL ASSISTANCE. EVANGELICAL COMMUNITY HOSPITAL PART V, SECTION B, LINE 20D: PATIENTS ARE CHARGED THE FULL AMOUNT AND THEN CHARITY CARE DISCOUNT IS APPLIED AS AN ADJUSTMENT. 1 EVANGELICAL AMBULATORY SURGICAL CENTER 210 JPM ROAD SUITE 100 LEWISBURG PA 17837 OUTPATIENT SURGICAL CENTER PART I, LINE 6A: THE COMMUNITY BENEFIT REPORT IS AVAILABLE ON THE HOSPITAL'S WEBSITE OR UPON REQUEST. PART I, LINE 7: THE HOSPITAL USED THE COST-TO-CHARGE RATIO TO DETERMINE THE AMOUNTS INCLUDED IN LINE 7. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $11,001,889. PART II, COMMUNITY BUILDING ACTIVITIES: AS A COMMUNITY AND HEALTH RESOURCE FOR MORE THAN 88 YEARS, EVANGELICAL COMMUNITY HOSPITAL HAS CONTINUALLY DEMONSTRATED ITS COMMITMENT TO THE CENTRAL SUSQUEHANNA VALLEY BY TAKING CARE OF PATIENTS NEEDING TREATMENT, AND BY ITS OUTREACH TO THE COMMUNITY. BEYOND THE DAILY CARE OF PATIENTS, THE HOSPITAL EXTENDS ITS REACH TO PROVIDE PREVENTION AND WELLNESS EDUCATION TO RESIDENTS OF THE VALLEY. OUTREACH INCLUDES CHARITY-CARE FOR THOSE WHO CANNOT AFFORD MEDICAL TREATMENT, HEALTH SCREENINGS TARGETING THE UN/UNDER-INSURED, HEALTH EDUCATION FOCUSING ON HEALTHY LIFESTYLE CHANGES, CHILD SAFETY SEAT INSPECTIONS, SCHOOL AGED HEALTH INITIATIVES, AND LECTURES ON HEALTH CONCERNS AND TOPICS. MANY OF THESE PROGRAMS ARE PROVIDED AT MINIMAL OR NO COST, AND ARE SUBSIDIZED USING HOSPITAL RESOURCES.COMMUNITY BENEFIT. THE COMMUNITY BENEFIT COMMITTEE OF THE HOSPITAL CONTINUES TO FOCUS ON DEVELOPING NEW WAYS OF IDENTIFYING AND ADDRESSING HEALTH NEEDS IN OUR REGION. THE HOSPITAL UTILIZES THE INTERNAL DOCUMENTATION PROCESS DEVELOPED TO CAPTURE COMMUNITY BENEFIT OUTREACH DELIVERED BY THE MAJORITY OF ITS EMPLOYEES. THE COMMITTEE CONSISTS OF MEMBERS FROM THE HOSPITAL'S BOARD OF DIRECTORS, EXECUTIVE OPERATING TEAM, MANAGEMENT STAFF, AS WELL AS FRONT-LINE CLINICAL AND ADMINISTRATIVE EMPLOYEES. THE COMMUNITY BENEFIT COMMITTEE WORKS COOPERATIVELY WITH DEPARTMENTS OF THE HOSPITAL AND OTHER ORGANIZATIONS IN THE COMMUNITY TO ADDRESS UNMET NEEDS. CANCER AWARENESS AND EDUCATION IS EXTREMELY IMPORTANT. THE FOLLOWING PROGRAMS WERE OFFERED IN FY14; THE CORRESPONDING NUMBER BESIDE THE PROGRAM DOCUMENTS THE NUMBER OF PEOPLE SERVED.PROGRAM INDIVIDUALS SERVEDLOOK GOOD, FEEL BETTER 1-2 WOMEN MONTHLYCANCER SUPPORT GROUP 5-6 PER MEETINGHOSPITAL'S EMPLOYEE HEALTH FAIR (EDUCATION ON BREAST CANCER AWARENESS, SMOKING CESSATION, EARLY DETECTION AND PREVENTATIVE HEALTH ACTIVITIES.) 200 EMPLOYEES AND FAMILY MEMBERSCOUPLES RETREAT 3 COUPLES (6 PARTICIPANTS)I CAN COPE SURVIVOR PROGRAM 10 PARTICIPANTSCOPING WITH THE HOLIDAYS PROGRAM 21 PARTICIPANTSFREE SKIN CANCER SCREENINGS 44 PARTICIPANTSCOMMUNITY EVENT TO SUPPORT BREAST CANCER 320 PARTICIPANTSLIFE AFTER LOSS BEREAVEMENT SUPPORT GROUP PARTICIPANTSOTHER HEALTH EDUCATION AND PREVENTION ACTIVITIES INCLUDE:PROGRAM INDIVIDUALS SERVEDMONTHLY SUPPORT GROUPS 1493 PARTICIPANTSFREE HEART HEALTH SCREENINGS 44 PARTICIPANTSCOMPREHENSIVE BLOOD SCREENINGS 723 PARTICIPANTSMEN'S HEALTH SCREEN 42 PARTICIPANTSWOMEN'S HEALTH SCREEN 92 PARTICIPANTS PART III, LINE 2: THE COSTING METHODOLOGY USED IN DETERMINING BAD DEBT EXPENSE AT COST IS BAD DEBT EXPENSE TIMES THE COST TO CHARGE RATIO. IN DETERMINING BAD DEBT EXPENSE, PATIENT LIABILITIES ARE NET OF THIRD-PARTY PAYMENTS AND ANY PATIENT PAYMENTS. PART III, LINE 3: WE BELIEVE THAT A PORTION OF OUR BAD DEBTS RESULTS FROM SERVICES PROVIDED TO PATIENTS WHO MEET THE CHARITY CARE GUIDELINES BUT WERE UNABLE OR UNWILLING TO PROVIDE THE APPROPRIATE DOCUMENTATION TO ALLOW THAT CLASSIFICATION. EVANGELICAL COMMUNITY HOSPITAL PROVIDES CARE TO ALL PATIENTS WHO NEED IT, REGARDLESS OF THEIR ABILITY TO PAY. THIS IS PART OF THE HOSPITAL'S MISSION. PART III, LINE 4: ACCOUNTS RECEIVABLE- PATIENTS ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. THE ALLOWANCE FOR DOUBTFUL COLLECTIONS ARE ESTIMATED BASED UPON A PERIODIC REVIEW OF THE ACCOUNTS RECEIVABLE AGING, PAYOR CLASSIFICATIONS AND APPLICATION OF HISTORICAL WRITE-OFF PERCENTAGES. PART III, LINE 8: THE HOSPITAL CONTINUES TO PROVIDE CARE TO ALL PRESENTING AND ADMITTED PATIENTS, REGARDLESS OF ABILITY OR PAY. NOTWITHSTANDING THE COSTS TO PROVIDE CARE, RECEIVING "LESS" THAN WHAT IT COSTS TO PROVIDE ADEQUATE CARE TO MEDICARE COVERED LIVES DOES THE HOSPITAL A DISSERVICE. THIS SHORTFALL SHOULD COUNT AS A COMMUNITY BENEFIT. THE HOSPITAL USES THE COST-TO-CHARGE RATIO TO DETERMINE THE MEDICARE ALLOWABLE COSTS. PART III, LINE 9B: IN ACCORDANCE WITH THE COLLECTION POLICY, BAD DEBT ACCOUNTS WILL BE ELIGIBLE FOR A CHARITY CARE DISCOUNT IF THE PATIENT MEETS CHARITY CARE POLICY GUIDELINES. THE PATIENT WILL NEED TO SUPPLY INCOME INFORMATION IN ORDER TO DETERMINE ELIGIBILITY FOR CHARITY CARE PER POLICY. ALSO SEE RESPONSES TO PART III SECTION A ABOVE. PART VI, LINE 2: IN 2012, EVANGELICAL COMMUNITY HOSPITAL PARTICIPATED IN A FIVE-COUNTY (SNYDER, UNION, MONTOUR, NORTHUMBERLAND AND COLUMBIA) COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE ASSESSMENT PROCESS WAS LED BY ACTION HEALTH, AN ORGANIZATION THAT FOSTERS COLLABORATION BETWEEN HOSPITALS AND LOCAL EDUCATIONAL INSTITUTIONS FOR THE PURPOSE OF MEETING THE HEALTH NEEDS OF THE COMMUNITY. DURING THIS REPORTING PERIOD, EVANGELICAL HAS DEVELOPED NEW AND ENHANCED EXISTING PROGRAMMING AS WELL AS COLLABORATED WITH EXTERNAL ORGANIZATIONS TO PROVIDE EDUCATIONAL AND SCREENING OPPORTUNITIES THAT MEET THE IDENTIFIED NEEDS AS PRESENTED IN OUR CURRENT ASSESSMENT. IN JUNE 2013 THE HOSPITAL'S BOARD OF DIRECTORS APPROVED OUR CURRENT IMPLEMENTATION PLAN. THIS PLAN PROVIDED A ROADMAP FOR OUR HOSPITAL TO MEET SPECIFIC NEEDS WITHIN OUR FOUR COUNTY SERVICE AREA. BELOW ARE THE THREE KEY IDENTIFIED NEEDS, THE HOSPITAL'S RESPONSE ACCORDING TO OUR IMPLEMENTATION PLAN AND OUR ACCOMPLISHMENTS AS WELL AS WHAT IS IN PROCESS.1.) IMPROVING ACCESS TO HEALTHCARE FOR UN/UNDER INSURED RESIDENTS - NEED FOR INCREASED ACCESS TO AFFORDABLE HEALTH INSURANCE AND INCREASED NUMBER OF HEALTHCARE PROVIDERS IN GENERAL AND SPECIFICALLY, HEALTHCARE PROVIDERS THAT WILL ACCEPT STATE FUNDED MEDICAL INSURANCE.A) CONTINUE TO OFFER A VARIETY OF HEALTH SCREENING PROGRAMS FOR THE COMMUNITY AT MINIMAL OR NO COST. CURRENTLY THE HOSPITAL OFFERS SEVERAL HEALTH SCREENINGS THROUGHOUT OUR SERVICE AREA. WE FOCUS ON LOW OR NO COST AND TARGET THOSE THAT ARE UN OR UNDER INSURED. PROGRESS: COLLABORATIVE EFFORTS WITH THE DEPARTMENT OF HEALTH, AREA AGENCY ON AGING AND A COMMUNITY CLINIC, A FREE, HIGH QUALITY HEALTHCARE CLINIC FOR THE UNINSURED, HAVE PROVEN TO BE SUCCESSFUL AND IN HIGH DEMAND. WE CONTINUE TO OFFER MULTIPLE HEALTH SCREENS MONTHLY.B) COLLABORATE WITH THE HOSPITAL'S EMPLOYED PHYSICIAN NETWORK, THE EVANGELICAL MEDICAL SERVICE ORGANIZATION (EMSO), FAMILY PRACTICE CENTERS AND EVANGELICAL'S HOSPITALISTS TO DEVELOP AND DEPLOY THE "YOUR WELLNESS PRESCRIPTION PAD". PROGRESS: WE HAVE DEVELOPED A PRESCRIPTION PAD AS WELL AS AN ELECTRONIC VERSION FOR PROVIDERS TO PRESCRIBE THROUGH OUR EHR. C) DEVELOP A COMMUNITY HEALTH COALITION. PROGRESS: OUR COMMUNITY HEALTH COALITION HAS BEEN MEETING FOR TWO YEARS. DURING THIS TIME THE COALITION HAS DEVELOPED COLLABORATIONS AND RELATIONSHIPS THAT HAVE STRENGTHENED OUR COMMUNITY EFFORTS TO MEET THE IDENTIFIED NEEDS OF OUR SERVICE AREA. D) EXPAND THE OUTREACH OF THE HOSPITAL'S "FREE OR REDUCED FEE MAMMOGRAPHY PROGRAM" TO REACH HIGH RISK WOMEN (E.G., MINORITY POPULATIONS, AMISH AND MENNONITES, AND THOSE WITHOUT INSURANCE). PROGRESS: THIS PROGRAM CONTINUES TO GROW. NOT ONLY CAN WE PROVIDE FREE MAMMOGRAMS BUT FUNDING HAS BEEN SECURED TO ASSIST WITH RECOMMENDED DIAGNOSTIC FOLLOW UPS. E) DEVELOP AND EXPAND A NEW SURVIVORSHIP ASSISTANCE PROGRAM FOR CANCER SURVIVORS. PROGRESS: OUR SURVIVORSHIP PROGRAM HAS GROWN INTO A STRONG AND STABLE PROGRAM. WE CURRENTLY OFFER AN ASSISTANCE PROGRAM FOR PATIENTS NEEDING ADDITIONAL SUPPORT IN AREAS SUCH AS FINANCIAL AND EMOTIONAL SUPPORT. WE HAVE ALSO DEVELOPED A "COUPLES RETREAT". THIS PROGRAM ALLOWS THE SURVIVOR AND A PARTNER TO GET AWAY AND FOCUS ON THEIR RELATIONSHIP AS IT RELATED TO A CANCER DIAGNOSIS. THE HOSPITAL WILL BE ANNOUNCING A CANCER SERVICE LINE IN JANUARY 2015. F) DEVELOP AND EXECUTE OUTREACH EFFORTS TO IMPROVE ACCESS TO CARE AT EVANGELICAL COMMUNITY HOSPITAL AND THE LARGER HEALTH SERVICES NETWORK.A. IMPLEMENTATION OF A CALL CENTER FOR PHYSICIAN AND SERVICE REFERRALSB. DEVELOP OUTREACH EFFORTS TO ENCOURAGE USE OF EMERGENCY DEPARTMENT'S NEW "ERGENT CARE" TO REDUCE THE WAITING TIME TO RECEIVE CARE FOR EMERGENT ILLNESSES AND INJURIES. PROGRESS: THE CALL CENTER HAS PROVEN TO BE A BENEFIT. WE AVERAGE 60-70 CALLS WITH APPROXIMATELY A THIRD BEING "WARM" TRANSFERS TO A PHYSICIAN'S OFFICE. OUR ER FAST TRACK PROGRAM IS CALLED "ERGENT CARE" AND HAS BEEN OPERATING SUCCESSFULLY FOR OVER TWO YEARS.G) DEVELOP AN ACCESS TO CARE TEAM COMPRISED OF KEY PERSONNEL FROM HOSPITAL SERVICE AREAS WITH THE GOAL TO ENHANCE OUR ABILITY TO PROVIDE BETTER ACCESS TO CARE. THEY INCLUDE: MANAGED CARE, REGISTRATION, FINANCE, PATIENT ACCOUNTS, COMMUNITY HEALTH, EMSO, EMERGENCY DEPARTMENT, OUTPATIENT CASE MANAGEMENT COORDINATOR, NURSING, SOCIAL SERVICES, AND MARKETING & PUBLIC RELATIONS2.) IMPROVING HEALTHY BEHAVIORS -NEED FOR INCREASED AWARENESS AND EDUCATION, MOTIVATION AND/OR INCENTIVES FOR RESIDENTS WHO PRACTICE HEALTHY BEHAVIORS AND INCREASE ACCESS TO HEALTHY OPTIONS IN THE REGION.A) CONTINUE TO OFFER A VARIETY OF EDUCATIONAL PROGRAMMING FOR THE YOUTH IN THE COMMUNITY AT NO COST. EVANGELICAL COMMUNITY HOSPITAL OFFERS A WIDE VARIETY OF EDUCATIONAL PROGRAMS GEARED TOWARD HEALTHY EATING, HYGIENE, STAYING ACTIVE AND LIVING TOBACCO FREE. THESE PROGRAMS WILL BE OFFERED WITHIN OUR SERVICE AREA AND WILL SPECIFICALLY TARGET LOCAL SCHOOL DISTRICTS. ADDITIONAL PROGRAMMING WILL BE ADDED FOR SPECIFIC IDENTIFIED POPULATIONS, I.E. PRESCHOOLS, YMCA'S, AND OTHER FACILITIES AS REQUESTED. PROGRESS: WE CONTINUE TO INCREASE OUR VISIBILITY IN THE NUMEROUS SCHOOL DISTRICTS IN OUR AREA. WE ALSO EVALUATE AND IMPROVE OUR PROGRAMMING ON A REGULAR BASIS.B) DEVELOP AND IMPLEMENT A WALKING PROGRAM FOR THE YOUTH. THE WALKING PROGRAM WILL PROMOTE TAKING HEALTHIER STEPS FOR STAYING ACTIVE. THIS PROGRAM WILL BE OFFERED TO LOCAL SCHOOL DISTRICTS AS A BEFORE SCHOOL PROGRAM. THROUGH THE WALKING PROGRAM WE WILL OFFER MATERIAL ON HEALTHY EATING AND LIVING TOBACCO FREE TO ALL SCHOOL DISTRICTS WITHIN THE HOSPITAL'S FOOTPRINT. PROGRESS: THE PROGRAM WAS DEVELOPED BUT WAS NOT ABLE TO BE IMPLEMENTED AT THE SCHOOLS. WE CURRENTLY HAVE STAFF ASSISTING WITH AN AFTER SCHOOL PROGRAM, "GIRLS ON THE RUN." THIS INTERNATIONAL PROGRAM FOCUSES ON SEVERAL ASPECTS THAT OUR WALKING PROGRAM PLANNED TO INCORPORATE. C) DEVELOP AND IMPLEMENT "10,000 STEPS" PROGRAM INTO THE GREATER SUSQUEHANNA VALLEY. THIS PROGRAM WILL PROMOTE GOOD HEALTH AND HELP PARTICIPANTS DEVELOP A FITNESS REGIME BY ENCOURAGING THEM TO STRIVE FOR 10,000 STEPS A DAY (THE EQUIVALENT OF WALKING ROUGHLY FIVE MILES). A PERSON WHO WALKS AT LEAST 10,000 STEPS A DAY COULD BURN 2,000 - 3,500 EXTRA CALORIES PER WEEK. PROGRESS: WE PROMOTED TWO HEALTHY LIFESTYLE EVENTS. ONE FOR ANY COMMUNITY MEMBER AND THE OTHER WAS TARGETED AT OUR SENIOR POPULATION. D) DEVELOP AND IMPLEMENT A NEW EDUCATIONAL PROGRAM TO OFFER LOCAL YMCA'S AND SUMMER/DAY CAMPS TO EDUCATE STUDENTS ON THE IMPORTANCE OF HEALTHY EATING, BEING ACTIVE, AND LIVING TOBACCO FREE. PROGRESS: WE HAVE BEEN SUCCESSFUL IN DEVELOPING PROGRAMMING FOR OUR LOCAL YMCA AND SUMMER/DAY CAMPS. ALL PROGRAMMING FOCUSES ON HEALTHY LIFESTYLES. IN SUMMER 2015 WE PLAN TO PILOT A NEW PROGRAM AT OUR LOCAL Y FOCUSING ON PRE AND POST SCREENINGS AND HEALTHY LIFESTYLE EDUCATIONAL KNOWLEDGE.E) PARTNER WITH CLINICAL OUTCOMES GROUP, INC. IN SUNBURY AND THE PA DEPARTMENT OF HEALTH TO PROMOTE YOUNG LUNGS AT PLAY, A PROGRAM DESIGNED TO PROVIDE AWARENESS OF THE EFFECTS OF SECOND HAND SMOKE ON CHILDREN AND YOUTH. THE HOSPITAL WILL HELP BRING THIS PROGRAM INTO PARKS, RECREATIONAL FACILITIES, BOROUGHS, TOWNSHIP AND COUNTIES BY PRESENTING YOUNG LUNGS AT PLAY WHEN NEEDED. PROGRESS: WE CONTINUE TO ADVOCATE FOR AREA FACILITIES, BOROUGHS, TOWNSHIPS ETC. TO ADOPT THE YOUNG LUNGS AT PLAY.F) DEVELOP AN IMPROVING HEALTHY BEHAVIORS TEAM COMPRISED OF KEY PERSONNEL FROM HOSPITAL SERVICE AREAS WITH THE EXPECTATION TO ENHANCE OUR COMMUNITY'S EDUCATION, ACCESS AND AWARENESS OF HEALTHY BEHAVIORS. TEAM PARTICIPANTS WOULD INCLUDE PERSONNEL FROM: ADMINISTRATION, CENTER FOR BREAST HEALTH, NUTRITIONAL SERVICES, FINANCE, CARDIAC REHABILITATION, COMMUNITY HEALTH, OUTPATIENT CLINIC, PULMONARY SERVICES, FITNESS CENTER, CENTER FOR ORTHOPEDICS, DIABETIC EDUCATION, REHABILITATION SERVICES, WOMEN'S ADVISORY GROUP, AND MARKETING/PR.3.) COMMUNITY DEVELOPMENT, SPECIFICALLY TRANSPORTATION- BECAUSE OF THE RURAL NATURE OF OUR REGION, THE LACK OF TRANSPORTATION AND LIMITED TRANSLATION SERVICES CREATE MAJOR BARRIERS FOR COMMUNITY MEMBERS TO ACCESS HEALTHCARE AND OTHER PRIMARY HEALTH RESOURCES IN OUR AREA.THE ISSUE OF ENSURING ADEQUATE PUBLIC TRANSPORTATION FOR VALLEY RESIDENTS IS A CONCERN FOR EVANGELICAL COMMUNITY HOSPITAL, ESPECIALLY AS THE LACK OF TRANSPORTATION CREATES SIGNIFICANT BARRIERS FOR SOME RESIDENTS WHEN ATTEMPTING TO ACCESS HEALTHCARE. RESIDENTS MAY HAVE THE ABILITY TO SCHEDULE APPOINTMENTS WITH HEALTHCARE PROVIDERS, BUT MAY NEED TO CANCEL THOSE SAME APPOINTMENTS DUE TO THEIR INABILITY TO FIND ADEQUATE TRANSPORTATION TO AND FROM AN APPOINTMENT. THIS PRACTICE DISCOURAGES HEALTHCARE PROVIDERS' (PHYSICIANS AND DENTISTS) ACCEPTANCE OF STATE FUNDED HEALTH INSURANCES DUE TO THE INABILITY OF THE UN/ UNDER INSURED TO KEEP THEIR SCHEDULED APPOINTMENTS.SEE CONTINUATION BELOW PART VI, LINE 3: AS A COMMUNITY HOSPITAL, EVANGELICAL IS DEDICATED TOIMPROVING THE HEALTH AND WELL-BEING OF ALL ITS CONSTITUENTS. THROUGH THEFINANCIAL ASSISTANCE PROGRAM, MEDICAL CARE IS PROVIDED REGARDLESS OF APATIENT'S ABILITY TO PAY, INSUFFICIENT HEALTH INSURANCE OR WHETHER AGOVERNMENT-SPONSORED PROGRAM COVERS THE FULL COST OF SERVICES. AND AS THECOUNTRY'S ECONOMIC FUTURE REMAINS UNCERTAIN, EVANGELICAL WILL CONTINUE TOPROVIDE CARE FOR THOSE WHO NEED IT.EVANGELICAL WILL PROVIDE SERVICES AT NO CHARGE OR REDUCED CHARGES TO THOSEWHO ARE FINANCIALLY UNABLE TO PAY FOR THOSE SERVICES.EVANGELICAL WILL NOT ARBITRARILY RESTRICT THE PROVISIONS OF HEALTHSERVICES TO CERTAIN INDIVIDUALS OR GROUPS.EVANGELICAL COMMUNITY HOSPITAL'S REGISTRATION DEPARTMENT REPRESENTATIVESINFORM OUR UNINSURED OR UNDER INSURED PATIENTS, OF OUR FINANCIALASSISTANCE PROGRAM. FINANCIAL ASSISTANCE APPLICATIONS ARE OFFERED TOTHESE PATIENTS AND IN ADDITION, THEY HAVE THE OPPORTUNITY TO CALL OURFINANCIAL COUNSELOR. THE FINANCIAL COUNSELOR DISCUSSES THE AVAILABILITY OFVARIOUS GOVERNMENT BENEFITS SUCH AS MEDICAID OR STATE PROGRAMS TO ASSISTTHE PATIENT WITH QUALIFICATIONS FOR THESE PROGRAMS. THE FINANCIALCOUNSELOR WILL ALSO ASSIST THE PATIENT IN COMPLETING THE PROPER PAPERWORKFOR ASSISTANCE.THE FINANCIAL COUNSELORS AND CASE MANAGEMENT STAFF WORK CLOSELY TOIDENTIFY AND ASSIST ELIGIBLE PATIENTS. OUR SELF-PAY VENDOR ALSO INFORMSTHE PATIENT THAT EVANGELICAL HAS A FINANCIAL ASSISTANCE PROGRAM AND AFINANCIAL COUNSELOR WHO WILL SEND THEM AN APPLICATION IF REQUESTED. OURTHIRD PARTY VENDOR WORKS ON BEHALF OF THE ORGANIZATION TO FOLLOW THEHOSPITAL'S POLICIES REGARDING PATIENT NOTIFICATION AND THE AVAILABILITYOF FINANCIAL ASSISTANCE. EVANGELICAL'S FINANCIAL ASSISTANCE POLICY ISPOSTED ON THE EVANGELICAL WEBSITE(HTTP://WWW.EVANHOSPITAL.COM/PATIENTS/INSURANCE/CHARITY-CARE)ALONG WITH AN APPLICATION FOR PATIENTS TO COMPLETE FOR FINANCIALASSISTANCE.EVANGELICAL COMMUNITY HOSPITAL WILL MAKE AVAILABLE A WRITTEN NOTICE TOEACH PATIENT OR THEIR REPRESENTATIVE OF THE EXISTENCE, CRITERIA ANDMECHANISM FOR RECEIVING FINANCIAL ASSISTANCE. THE HOSPITAL WILL CREATE ANDMAINTAIN RECORDS DEMONSTRATING THAT THE REQUIRED CRITERIA AND MECHANISMARE ESTABLISHED (HOSPITAL WILL RECORD ANY AND ALL REQUESTS FOR FINANCIALASSISTANCE, THE DISPOSITION AND THE DOLLAR AMOUNT OF EVANGELICAL'SFINANCIAL ASSISTANCE PROGRAM PROVIDED). IN ALL INSTANCES, PATIENTCONFIDENTIALITY WILL BE PROTECTED.ELIGIBILITY WILL BE DETERMINED BY COMPARING HOUSEHOLD FAMILY INCOMEAGAINST THE INCOME POVERTY GUIDELINES. INCOME IS DEFINED AS THE TOTAL ANNUAL CASH RECEIPTS BEFORE TAXES FROM ALL SOURCES.AN INDIVIDUAL NOTICE OF AVAILABILITY OF EVANGELICAL'S FINANCIAL ASSISTANCEPROGRAM WILL BE GIVEN TO EACH PATIENT OR THEIR REPRESENTATIVE PRIOR TOSERVICES BEING RENDERED, WITH THE EXCEPTION OF EMERGENCY SERVICES. THESENOTICES SHALL BE AVAILABLE IN ALL REGISTRATION AREAS OF THE HOSPITAL ANDSHALL INCLUDE THE MOST CURRENT AVAILABLE "HOUSEHOLD INCOME GUIDELINES" AS PUBLISHED IN THE FEDERAL REGISTER.THE PATIENT ACCOUNTS DIRECTOR OR HIS/HER DESIGNEE SHALL REVIEW ALLAPPLICATIONS FOR THE EVANGELICAL FINANCIAL ASSISTANCE PROGRAM. IT IS THEAPPLICANT'S RESPONSIBILITY TO PROVIDE PROOF OF INCOME.WHEN LANGUAGE IS A BARRIER, EVANGELICAL OFFERS A SPECIAL INTERPRETERCONFERENCING TELEPHONE SERVICE. INTERPRETATION SERVICES ARE AVAILABLE FORA MULTITUDE OF PATIENT/CAREGIVER INTERACTIONS. WHEN A NON-ENGLISH SPEAKINGPATIENT, NO MATTER HIS OR HER NATIVE TONGUE, CALLS IN TO THE HOSPITAL, HEOR SHE WILL BE ABLE TO BE UNDERSTOOD THROUGH A TELEPHONE INTERPRETER.THIS IS AVAILABLE FOR OUTBOUND CALLS TO THE PATIENT AS WELL. THE PROCESSCONTRIBUTES TO IMPROVED PATIENT CARE AND CLINICAL OUTCOMES AND MAKES AVITAL DIFFERENCE IN THE QUALITY OF SERVICE EVANGELICAL IS ABLE TO PROVIDETO NON-ENGLISH SPEAKING PATIENTS. PART VI, LINE 4: EVANGELICAL COMMUNITY HOSPITAL (ECH) IS LOCATED IN LEWISBURG, PA (UNION COUNTY), THE HEART OF CENTRAL PA. THE HOSPITAL IS CONVENIENTLY LOCATED OFF INTERSTATE 80 ON U.S. ROUTE 15. ECH SERVES THE RESIDENTS OF UNION, SNYDER & NORTHUMBERLAND COUNTIES AND SURROUNDING AREAS. ECH IS THE 3RD LARGEST EMPLOYER IN UNION COUNTY WITH MORE THAN 1,200 EMPLOYEES. ACCORDING TO THE HOSPITAL AND HEALTHSYSTEM ASSOCIATION OF PENNSYLVANIA, ECH'S TOTAL IMPACT ON THE REGIONAL ECONOMY TOPS MORE THAN $180 MILLION. ECH IS A 132 LICENSED-BED ACUTE CARE COMMUNITY HOSPITAL WITH OVER 1,200 EMPLOYEES AND NEARLY 200 MEDICAL STAFF MEMBERS. ECH HAS A BUSY EMERGENCY DEPARTMENT WITH OVER 28,565 VISITS IN 2013. ECH HAS EARNED THE PATIENT SAFETY EXCELLENCE AWARD FOUR OF THE PAST FIVE YEARS FROM HEALTHGRADES (A LEADING NATIONAL INDEPENDENT HEALTHCARE RATINGS ORGANIZATION). THE PRIMARY SERVICE AREA OF RESIDENTS OF ECH INCLUDES: 17810, 17812, 17843, 17813, 17730, 17827, 17829, 17831, 17876, 17833, 17835, 17837, 17749, 17842, 17844, 17845, 17847, 17850, 17853, 17855, 17856, 17857, 17861, 17862, 17864, 17865, 17086, 17870, 17801, 17880, 17882, 17772, 17883, 17777, 17886, 17887, 17885, 17889. OUR SECONDARY SERVICE AREA IS FROM THE FOLLOWING ZIP CODES: 16820, 17866, 17014, 17017, 17821, 17823, 17830, 17737, 17834, 17836, 17045, 17840, 17747, 17832, 17049, 17841, 17062, 17752, 17851, 17756, 17860, 17080, 16872, 17867, 17868, 17872, 17877, 17881, 17884, 16882. THE REGION IS HOME TO SEVERAL COLLEGES, UNIVERSITIES AND TECHNICAL SCHOOLS AS WELL AS STRONG PUBLIC SCHOOL SYSTEMS. IT HAS A VERY DIVERSE HISTORY AND RURAL APPEAL, YET FEATURES BUSINESS AND HEALTHCARE FACILITIES USING THE LATEST ADVANCES IN SCIENCE AND TECHNOLOGY. ADDITIONAL HOSPITALS IN OUR REGION CONSIST OF GEISINGER MEDICAL CENTER, SUNBURY COMMUNITY HOSPITAL (FOR-PROFIT SYSTEM), SHAMOKIN AREA COMMUNITY HOSPITAL, SUSQUEHANNA HEALTH SYSTEM, AND BLOOMSBURG HOSPITAL. ACCORDING TO THE MOST RECENT DATA FROM THE NEEDS ASSESSMENT, THE REGION IS PRIMARILY RURAL IN NATURE. THIS DATA WAS REAFFIRMED DURING THE ASSESSMENT PROCESS THROUGH COMMUNITY LEADERS AND KEY STAKEOLDER INTERVIEWS AND FOCUS GROUP DISCUSSIONS. FURTHERMORE WITH THE RURAL NATURE OF OUR AREA AND THE LACK OF A COORDINATED AND INTEGRATED TRANSPORTATION SYSTEM LIMITS COMMUNITY MEMBERS TO ACCESSIBLE HEALTH CARE AND RECREATIONAL OPPORTUNITIES. WITH THE LIMITATIONS OF ACCESSIBILITY TO HEALTHCARE AND HEALTHY OPTIONS LEADS TO UNHEALTHY LIFESTYLES AND OVER USE OF OUR EMERGENCY DEPARTMENT SERVICES. CITY-DATA.COM FOR UNION COUNTY INDICATES THAT THE POPULATION CONSISTS OF: WHITE NON-HISPANIC (85.2%), BLACK (6.8%), HISPANIC (5.2%), TWO OR MORE RACES (1.2%), AND ASIAN ALONE (1.2%). THE MEDIAN RESIDENT AGE IS 38.0. ESTIMATED MEDIAN HOUSEHOLD INCOME IN 2009: $49,803; RESIDENTS WITH INCOME BELOW THE POVERTY LEVEL IN 2009: 8.8%; PERSONS ENROLLED IN HOSPITAL INSURANCE AND/OR SUPPLEMENTAL MEDICAL INSURANCE (MEDICARE) IN JULY 1, 2003: 6,234 (5,612 AGED, 622 DISABLED); POPULATION WITHOUT HEALTH INSURANCE COVERAGE IN 2000: 11%; CHILDREN UNDER 18 WITHOUT HEALTH INSURANCE COVERAGE IN 2000: 9%; 89.6% OF RESIDENTS OF UNION COUNTY SPEAK ENGLISH AT HOME; 3.7% OF RESIDENTS SPEAK SPANISH AT HOME; 5.7% OF RESIDENTS SPEAK OTHER INDO-EUROPEAN LANGUAGE AT HOME; 0.8% OF RESIDENTS SPEAK ASIAN OR PACIFIC ISLAND LANGUAGE AT HOME; 0.2% OF RESIDENTS SPEAK OTHER LANGUAGE AT HOME.CITY-DATA.COM FOR SNYDER COUNTY INDICATES THE POPULATION CONSISTS OF: WHITE NON-HISPANIC (96.4%), HISPANIC (1.4%), BLACK (1.0%); THE MEDIAN RESIDENT AGE IS 36.7. ESTIMATED MEDIAN HOUSEHOLD INCOME IN 2009: $44,426 RESIDENTS WITH INCOME BELOW THE POVERTY LEVEL IN 2009: 9.9%; PERSONS ENROLLED IN HOSPITAL INSURANCE AND/OR SUPPLEMENTAL MEDICAL INSURANCE (MEDICARE) IN JULY 1, 2003: 6,148 (5,230 AGED, 918 DISABLED); POPULATION WITHOUT HEALTH INSURANCE COVERAGE IN 2000: 9%; CHILDREN UNDER 18 WITHOUT HEALTH INSURANCE COVERAGE IN 2000: 8%; 92.0% OF RESIDENTS OF SNYDER COUNTY SPEAK ENGLISH AT HOME; 1.5% OF RESIDENTS SPEAK SPANISH AT HOME; 6.3% OF RESIDENTS SPEAK OTHER INDO-EUROPEAN LANGUAGE AT HOME; 0.2% OF RESIDENTS SPEAK ASIAN OR PACIFIC ISLAND LANGUAGE AT HOME; 0.1% OF RESIDENTS SPEAK OTHER LANGUAGE AT HOME.CITY-DATA.COM FOR NORTHUMBERLAND COUNTY INDICATES THAT THE POPULATION CONSISTS OF: WHITE NON-HISPANIC (95.5%), BLACK (2.0%), HISPANIC (1.8%), TWO OR MORE RACES (0.5%); ESTIMATED MEDIAN HOUSEHOLD INCOME IN 2009: $37,602; RESIDENTS WITH INCOME BELOW THE POVERTY LEVEL IN 2009: 11.9%; PERSONS ENROLLED IN HOSPITAL INSURANCE AND/OR SUPPLEMENTAL MEDICAL INSURANCE (MEDICARE) IN JULY 1, 2003: 19,762 (16,930 AGED, 2,832 DISABLED); POPULATION WITHOUT HEALTH INSURANCE COVERAGE IN 2000: 10%; CHILDREN UNDER 18 WITHOUT HEALTH INSURANCE COVERAGE IN 2000: 8%; 95.6% OF RESIDENTS OF NORTHUMBERLAND COUNTY SPEAK ENGLISH AT HOME; 1.5% OF RESIDENTS SPEAK SPANISH AT HOME; 2.6% OF RESIDENTS SPEAK OTHER INDO-EUROPEAN LANGUAGE AT HOME; 0.3% OF RESIDENTS SPEAK ASIAN OR PACIFIC ISLAND LANGUAGE AT HOME; 0.1% OF RESIDENTS SPEAK OTHER LANGUAGE AT HOME.ECH OPERATES AN EMERGENCY DEPARTMENT THAT IS OPEN TO ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES. WE HAVE OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. ECH HAS A BOARD OF DIRECTORS IN WHICH INDEPENDENT COMMUNITY PERSONS ARE REPRESENTED. ECH IS AFFILIATED WITH HEALTHCARE FACILITIES, SUCH AS GEISINGER MEDICAL CENTER, TO PROVIDE THE BEST MEDICAL CARE FOR OUR PATIENTS. ECH WORKS WITH THE FOLLOWING ORGANIZATIONS: PENN COLLEGE, CENTRAL SUSQUEHANNA INTERMEDIATE UNIT, BLOOMSBURG UNIVERSITY, AND THOMAS JEFFERSON UNIVERSITY TO ENGAGE IN TRAINING AND EDUCATION OF HEALTH CARE PROFESSIONALS. ECH PROVIDES FINANCIAL AID TO SUPPORT STUDENTS CHOOSING THE NURSING PROFESSION THROUGH THE MAE KEEFER AND CRYSTAL SNYDER NURSING SCHOLARSHIP FUND.ECH PARTICIPATES WITH THE FOLLOWING MAJOR HEALTH PLANS: CAPITAL BLUE CROSS, GEISINGER HEALTH PLAN, HIGHMARK BLUESHIELD, HEALTHAMERICA/HEALTH ASSURANCE, KEYSTONE HEALTH PLAN CENTRAL, AND MEDICARE.THE SECONDARY DATA COLLECTION FINDINGS FROM THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT SUMMARIZES THE FOLLOWING WITH REGARD TO DEMOGRAPHICS AND THE NEEDS OF THE COMMUNITY. EVANGELICAL SERVICE AREA SHOWS A SLIGHT DECLINE IN POPULATION OVER THE PAST FIVE YEARS WHILE PENNSYLVANIA, AS A STATE, SHOWS A SLIGHT INCREASE. KEY FINDINGS: ANNUAL AVERAGE INCOME IN OUR SERVICE AREA IS $53,064. NORTHUMBERLAND COUNTY HAS THE LOWEST AVERAGE INCOME AT $45,871. AVERAGE INCOME IN ALL OF PENNSYLVANIA IS $64,000.16.6% OF EVANGELICAL'S SERVICE AREA IS REPORTED AS NOT HAVING A HIGH SCHOOL DIPLOMA. THIS IS FOUR POINTS HIGHER THAN THE STATE AVERAGE OF 12.6%. ACCORDING TO THE COUNTY HEALTH RANKINGS EVANGELICAL SHOWS A POOR RANKING IN THE FOLLOWING CATEGORIES: EMPLOYMENT, EDUCATION AND DIET AND EXERCISE. WE KNOW THAT THESE THREE FACTORS ARE HIGHLY CORRELATED: I.E. POOR EMPLOYMENT CAN LEAD TO LOWER INCOME WHICH CAN THEN LEAD TO FEWER OPTIONS FOR GOOD EDUCATIONAL OPPORTUNITIES AND THEREFORE POORER HEALTH DECISIONS IN TERMS OF DIET AND EXERCISE. WHEN COMPARED TO THE REST OF THE STATE AND EVEN THE UNITED STATES AS A WHOLE, EVANGELICAL SHOWS VERY LITTLE DIVERSITY WITH ONLY 5.1% OF THE POPULATION IDENTIFYING AS A RACE/ETHNICITY OTHER THAN WHITE, NON-HISPANIC. PENNSYLVANIA IS AT 19.6% AND THE UNITED STATES AT 35%. SUNBURY AND ALLENWOOD SCORED THE HIGHEST IN THE COMMUNITY NEED INDEX, MEANING THEY HAVE THE MOST BARRIERS TO COMMUNITY HEALTH CARE ACCESS. SUNBURY SHOWED VERY HIGH RATES OF INDIVIDUALS LIVING IN POVERTY; 65 AND OLDER (11%), FAMILIES WITH MARRIED INDIVIDUALS WITH CHILDREN (17%), AND FAMILIES WITH SINGLE INDIVIDUALS WITH CHILDREN (50%). ALLENWOOD SHOWS THE HIGHEST UNEMPLOYMENT RATE AT 17%, BUT THIS COULD BE MISLEADING DUE TO A FEDERAL PRISON BEING LOCATED IN THAT TOWN. TURBOTVILLE SHOWS THE LOWEST UNEMPLOYMENT RATE (4%) AND LOWEST RATE OF INDIVIDUALS LIVING IN POVERTY; 65 AND OLDER (9%), MARRIED WITH CHILDREN LIVING IN POVERTY (5%) AND SINGLE LIVING WITH CHILDREN IN POVERTY (8%). ACCORDING TO THE COUNTY HEALTH RANKINGS (PENNSYLVANIA'S COUNTIES ARE RANKED 1 THROUGH 67. 1 BEING THE BEST SCORE AND 67 BEING THE WORST) UNION AND SNYDER COUNTIES RANKED IN THE TOP 5 FOR HEALTH OUTCOMES WHILE NORTHUMBERLAND COUNTY RANKED IN THE BOTTOM 15 FOR HEALTH OUTCOMES. UNION COUNTY WAS NAMED THE HEALTHIEST COUNTY AND RANKED NUMBER ONE IN QUALITY OF CARE ACCORDING TO THE 2011 COUNTY HEALTH RANKINGS. CONSEQUENTLY, UNION COUNTY RANKED IN THE BOTTOM FIVE FOR ITS BUILT ENVIRONMENT WHICH REFERS TO ACCESS TO RECREATIONAL FACILITIES, LIMITED ACCESS TO HEALTHY FOODS AND NUMBER OF FAST FOOD RESTAURANTS. TOBACCO USE IN EVANGELICAL'S SERVICE AREA RANKED AS FOLLOWS; NORTHUMBERLAND COUNTY WAS 54 OUT OF 67 COUNTIES, UNION COUNTY WAS 38 OUT OF 67 AND SNYDER COUNTY CAME IN AT THE LOWEST WITH A RANKING OF 16 OUT OF 67. WITH REGARD TO ALCOHOL USE EVANGELICAL'S SERVICE AREA RANKED AS FOLLOWS; NORTHUMBERLAND COUNTY, 38, UNION COUNTY, 19 , AND SNYDER COUNTY, NUMBER 1 (OUT OF 67). PART VI, LINE 5: EVANGELICAL COMMUNITY HOSPITAL HAS A TOTAL OF 132 PATIENT BEDS AND 18 BASSINETS. THERE ARE NEARLY 200 PHYSICIANS ON STAFF, AND NEARLY 900 CLINICAL EMPLOYEES, INCLUDING LAB TECHNICIANS, NURSES, NURSING ASSISTANCES, PHYSICAL, OCCUPATIONAL AND SPEECH THERAPISTS, RADIOLOGY TECHNICIANS, PHLEBOTOMISTS, AND SUPPORT PERSONNEL. EACH OF THESE PROFESSIONALS IS HIGHLY TRAINED TO DELIVER QUALITY AND SAFE CARE TO INPATIENTS AND OUTPATIENTS. THE HOSPITAL HAS:1) AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE SUSQUEHANNA VALLEY REGION;2) A BOARD OF DIRECTORS WHO GOVERN THE ORGANIZATION. THE BOARD IS COMPRISED OF COMMUNITY AND BUSINESS LEADERS, AND PHYSICIANS REPRESENTING THE GEOGRAPHIC AREA OF OUR REGION;3) AN EMERGENCY DEPARTMENT THAT IS OPEN TO ALL PERSONS IN NEED REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES;4) A HOSPICE PROGRAM THAT PROVIDES END-OF-LIFE CARE TO ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR CARE;5) A BIOETHICS COMMITTEE COMPRISED OF VOLUNTEERS WHO ARE PHYSICIANS, NURSES, SOCIAL SERVICE WORKERS, PASTORAL CAREGIVERS, EDUCATORS, AND OTHER PROFESSIONALS. THEY DISCUSS AND ADDRESS ETHICAL ISSUES AND DILEMMAS THAT ARE PRESENTED FOR REVIEW;6) A HISTORY OF PROVIDING FINANCIAL SUPPORT TO OTHER NONPROFIT ORGANIZATIONS FOR THE PURPOSE OF HEALTH PROMOTION AND IN COLLABORATING TO MEET UNMET NEEDS IN THE COMMUNITY.7) A COMMUNITY HEALTH AND WELLNESS DEPARTMENT THAT IS FUNDED USING HOSPITAL RESOURCES. THE DEPARTMENT INITIATES AND ORGANIZES PREVENTION, WELLNESS AND HEALTH EDUCATION LECTURES, EVENTS AND ACTIVITIES DEVELOPED FOR THE SOLE PURPOSE OF IMPROVING THE HEALTH OF THOSE IN OUR REGION. THE COMMUNITY HEALTH AND WELLNESS TEAM OFFERS: HEALTH SCREENINGS, HEALTH FAIRS, LECTURES, SUPPORT GROUPS, FLU SHOTS, AND SAFETY INSPECTIONS. IN 2012, THE COMMUNITY HEALTH AND WELLNESS STAFF PROVIDED MORE THAN 950 FLU VACCINATIONS AND CERTIFIED MORE THAN 3350 IN FIRST AID AND CPR, INCLUDING 68 YOUTH, WHO ATTENDED OUR SAFE SITTER BABYSITTING PROGRAM.EVANGELICAL COMMUNITY HOSPITAL HAS AN OPEN MEDICAL STAFF THAT SUPPORTS THE COMMUNITY HEALTH CARE NEEDS. THE HOSPITAL IS SUPPORTIVE OF ITS EMPLOYEES TO BE INVOLVED IN THE COMMUNITY ORGANIZATIONS TO SUPPORT AND TO BE A PART OF ADDRESSING THE NEEDS OF THE COMMUNITY. SURPLUS FUNDS OF THE HOSPITAL ARE USED TO DEVELOP EMPLOYEES AND FURTHER EDUCATE STAFF TO KEEP UP WITH THE EVER CHANGING HEALTHCARE TECHNOLOGY AND NEW TREATMENT PLANS FOR DISEASES, AS WELL AS CAPITAL NEEDS OF THE ORGANIZATION TO KEEP THE NECESSARY NEW MEDICAL EQUIPMENT AVAILABLE TO BETTER TREAT THE PATIENTS OF THE COMMUNITY. PART VI, LINE 6: THE ORGANIZATION IS PART OF AN AFFILIATED HEALTH CARE SYSTEM DUE TO THE HOSPITAL HAVING COMMON GOVERNANCE AND CONTROL FOR EVANGELICAL MEDICAL SERVICES ORGANIZATION AND EVANGELICAL COMMUNITY HOSPITAL HOMECARE PRODUCTS. EVANGELICAL MEDICAL SERVICES ORGANIZATION PROVIDE HEALTHCARE SERVICES IN THE FORM OF PRIMARY AND SPECIALTY CARE PHYSICIANS TO THE COMMUNITY. HOMECARE PRODUCTS PROVIDED DURABLE MEDICAL EQUIPMENT AND OXYGEN TO SUPPORT THE COMMUNITY NEEDS. EVANGELICAL AMBULATORY SURGICAL CENTER IS AN OUTPATIENT SURGICAL CENTER THAT PROVIDES SERVICES TO PATIENTS OF THE COMMUNITY. PART VI, LINE 7, REPORTS FILED WITH STATES PA PART VI LINE 2 CONTINUATION: IN RESPONSE TO THIS IDENTIFIED NEED, HOSPITAL ADMINISTRATION HAS PROVIDED TIME DURING BUSINESS HOURS FOR A MEMBER OF THE COMMUNITY BENEFIT COMMITTEE TO SERVE ON THE REGIONAL NORTH CENTRAL PA PUBLIC TRANSPORTATION TASK FORCE. THE REPRESENTATIVE HAS BEEN SERVING AS A MEMBER OF THIS COMMITTEE SINCE 2012. IN ADDITION, KEY PERSONNEL IN SOCIAL SERVICES, CASE MANAGEMENT AND THE EMERGENCY DEPARTMENT ARE WORKING TOGETHER TO ADDRESS TRANSPORTATION ISSUES AS THEY RELATE TO PATIENTS WHO COME TO THE HOSPITAL FOR EMERGENT OR SCHEDULED CARE, BUT ARE UNABLE TO RETURN HOME DUE TO THE LACK OF TRANSPORTATION. A SPECIAL FUND HAS BEEN ESTABLISHED FOR THIS PURPOSE MAKING TAXI FARE AVAILABLE TO THESE PATIENTS WHEN NEEDED. IN ADDITION, THE REPRESENTATIVES OF THE HOSPITAL WILL CONTINUE TO ADVOCATE AND SUPPORT EFFORTS IN OUR COMMUNITY TO ADDRESS AND SOLVE THE MOST URGENT TRANSPORTATION NEEDS IN THE VALLEY, ESPECIALLY AS THEY RELATE TO THOSE WHO HAVE DIFFICULTY ACCESSING HEALTHCARE DUE TO LACK OF TRANSPORTATION. HOWEVER, A SPECIAL SUBCOMMITTEE OF THE COMMUNITY BENEFITS COMMITTEE, SUCH AS THOSE FOR IMPROVING ACCESS TO HEALTHCARE OR IMPROVING HEALTHY BEHAVIORS, WILL NOT BE DEVELOPED AND STAFFED FOR THE PURPOSE OF ADDRESSING TRANSPORTATION NEEDS. 1 SCHOLARSHIPS 27 77100 CASH N/A PART I, LINE 2: APPLICANTS MUST APPLY FOR NURSING AND TRAINING DEPARTMENT SCHOLARSHIPS. APPLICATIONS ARE REVIEWED BY A COMMITTEE TO DETERMINE IF THE APPLICANTS MEET THE ELIGIBILITY REQUIREMENTS. APPLICANTS ARE REVIEWED BASED ON COMMUNITY SERVICE AND/OR EXTRA CURRICULAR ACTIVITIES, ACADEMIC STANDING, QUALITY OF ESSAY, FINANCIAL NEED, ETC. X X X X 0 1 0 0 0 0 0 1 0 MICHAEL N O'KEEFE PRESIDENT/CEO (NON-VOTING) 345020 0 25000 0 347261 0 86408 0 11616 0 815305 0 226366 0 JOHN E RICE MD DIRECTOR/PHYSICIAN 0 239100 0 0 0 0 0 4782 0 19858 0 263740 0 0 TODD STEFAN MD EX-OFFICIO (NON-VOTING)/PHYSICIAN 0 448903 0 17857 0 0 0 8978 0 19858 0 495596 0 0 KENDRA A AUCKER CHIEF OPERATING OFFICER 380630 0 39083 0 119169 0 37956 0 11545 0 588383 0 79745 0 JAMES A STOPPER CHIEF FINANCIAL OFFICER 227802 0 27433 0 0 0 18810 0 17118 0 291163 0 0 0 J LAWRENCE GINSBURG VP MEDICAL AFFAIRS 373060 0 30103 0 0 0 61064 0 11545 0 475772 0 0 0 PAUL E TARVES VP OF NURSING 249369 0 19280 0 64058 0 23257 0 17118 0 373082 0 51300 0 DALE E MOYER CHIEF INFORMATION OFFICER 214556 0 16795 0 51176 0 22858 0 17081 0 322466 0 44299 0 MARK K KRAMMES CHIEF CRNA 238119 0 0 0 0 0 9800 0 17118 0 265037 0 0 0 SANDRA S WALKER NURSE ANESTHETIST 202336 0 0 0 0 0 8112 0 298 0 210746 0 0 0 LORI K GOODLING NURSE ANESTHETIST 194819 0 0 0 0 0 3926 0 5840 0 204585 0 0 0 ROSEMARY S BURG NURSE ANESTHETIST 193433 0 0 0 0 0 2636 0 11545 0 207614 0 0 0 COLLEEN A FRITZ NURSE ANESTHETIST 189506 0 0 0 0 0 7803 0 11545 0 208854 0 0 0 PART I, LINE 4B THE FOLLOWING INDIVIDUALS RECEIVED A DISTRIBUTION FROM A SUPPLMENTAL NONQUALIFIED RETIREMENT PLAN: MICHAEL O'KEEFE - $347,261 KENDRA AUCKER - $119,169 PAUL TARVES - $64,058 DALE MOYER - $51,176 THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLMENTAL NONQUALIFIED RETIREMENT PLAN: MICHAEL O'KEEFE - $73,812 J. LAWRENCE GINSBURG - $47,790 KENDRA AUCKER - $28,056 PAUL TARVES - $18,600 DALE MOYER - $16,406 JAMES STOPPER - $10,145 PART I, LINE 7 THE EXECUTIVE TEAM IS ELIGIBLE TO RECEIVE A BONUS (BASED ON A % OF SALARY) WHEN THEIR INDIVIDUAL GOALS ARE MET FOR THE YEAR. GOALS ARE SET FOR EACH INDIVIDUAL BASED ON FINANCIAL AND OPERATIONAL RESULTS. THESE GOALS ARE REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE. A UNION COUNTY HOSPITAL AUTHORITY 232739624 2013-10-24 19694697 CAPITAL IMPROVEMENTS, REFINANCE 2004 BONDS, ISSUANCE COSTS 0 0 0 B UNION COUNTY HOSPITAL AUTHORITY 232739624 906460DJ6 2011-03-03 30235000 SERIES OF 2011 BONDS - FUND CONSTRUCTION & REFUND OUTSTANDING 2009 BONDS 0 0 0 A 160000 19694697 19486977 207720 2013 1 1 1 1 B 3875000 29719008 2252124 377544 27089340 2012 1 0 1 1 A 0 0 0 0 0.00000 0.00320 0.00320 0 0 1 B 0 0 0 0 0.00000 0.00320 0.00320 0 0 1 A 0 0 1 0 0 0 0 0 1 B 0 0 1 0 0 0 0 0 1 A 1 B 1 SCHEDULE K, PART II, LINE 3: TOTAL PROCEEDS OF ISSUE FOR BOND B ARE LESS THAN THE ISSUE PRICE LISTED IN PART I DUE TO THE UNDERWRITER'S DISCOUNT OF $241,880. JOHN D GRIFFITH DIRECTOR OF THE BOARD 450091 JOHN D. GRIFFITH LEASES PROPERTY TO THE HOSPITAL AT AN ARM'S LENGTH TRANSACTION. 0 FORM 990, PART III, LINE 2 THE HOSPITAL ACQUIRED SUN ORTHOPAEDIC GROUP'S PHYSICAL THERAPY BUSINESS LINE. FORM 990, PART VI, SECTION A, LINE 2 JAMES APPLE IS THE FATHER OF TIM APPLE AND BOTH SERVE ON THE BOARD. ROBERT GRONLUND IS THE FATHER OF BROOKS GRONLUND AND BOTH SERVE ON THE BOARD. FORM 990, PART VI, SECTION A, LINE 3 MANAGEMENT SERVICES FOR THE WOUND AND HYBERBARIC OXYGEN THERAPY ("HBOT") DEPARTMENT WERE OUTSOURCED TO DIVERSIFIED CLINICAL SERVICES. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 WAS REVIEWED BY THE FINANCE DEPARTMENT AND THE AUDIT COMMITTEE OF THE BOARD AT AN AUDIT COMMITTEE MEETING PRIOR TO FILING. THEY WILL HAVE THE OPPORTUNUITY TO ASK QUESTIONS AND CHANGES CAN BE MADE AS A RESULT IF NECESSARY BEFORE THE RETURN IS FILED. FORM 990, PART VI, SECTION B, LINE 12C A CONFLICT OF INTEREST STATEMENT IS REQUIRED TO BE SIGNED ANNUALLY BY ALL VOTING BOARD MEMBERS, UPPER MANAGEMENT, AND KEY EMPLOYEES. THE HUMAN RESOURCES DEPARTMENT MONITORS COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY VERIFYING ALL FORMS ARE COMPLETED AND SIGNED. HR MAINTAINS COPIES OF ALL COMPLETED CONFLICT OF INTEREST STATEMENTS. MEMBERS WITH CONFLICTS ARE REQUIRED TO ABSTAIN FROM VOTING OR BEING A PART OF ACTIVE DISCUSSIONS WHERE THEY ARE IN DIRECT CONFLICT. ANYONE IN VIOLATION OF THE CONFLICT OF INTEREST POLICY IS ASKED TO STEP DOWN FROM THE BOARD. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD'S EXECUTIVE COMPENSATION COMMITTEE, WHICH IS COMPOSED SOLELY OF INDEPENDENT MEMBERS OF THE BOARD, HAS ADOPTED AND FOLLOWS A PROCESS FOR REVIEWING AND DETERMINING THE COMPENSATION OF THE CEO AND THE EXECUTIVE MANAGEMENT TEAM. THE EXECUTIVE MANAGEMENT TEAM CONSISTS OF THE FOLLOWING POSITIONS: CHIEF OPERATING OFFICER, CHIEF FINANCIAL OFFICER, VICE PRESIDENT OF MEDICAL AFFAIRS, VICE PRESIDENT - NURSING, ASSOCIATED VICE PRESIDENT - DEVELOPMENT, VICE PRESIDENT - HUMAN RESOURCES, CHIEF INFORMATION OFFICER, ASSOCIATE VICE PRESIDENT - SUBSIDIARY OPERATIONS. THE COMMITTEE HAS ENGAGED AN INDEPENDENT COMPENSATION CONSULTANT TO PROVIDE INFORMATION AND ADVICE TO THE COMMITTEE, INCLUDING BUT NOT LIMITED TO, PROVIDING INDEPENDENT COMPENSATION COMPARABILITY DATA FOR FUNCTIONALLY COMPARABLE POSITIONS IN SIMILARLY SITUATED HOSPITALS. THE DATA IS PROVIDED ON AN ANNUAL BASIS AND IS REVIEWED BY THE COMMITTEE, ALONG WITH OTHER INFORMATION, PRIOR TO APPROVING ANY CHANGES TO COMPENSATION. THE INDEPENDENCE OF THE COMMITTEE'S MEMBERS IS REVIEWED AND VERIFIED PRIOR TO THE START OF THE ANNUAL COMPENSATION REVIEW PROCESS. SHOULD A CONFLICT PRESENT, THOSE INDIVIDUALS WITH ACTUAL OR PERCEIVED CONFLICTS ABSTAIN FROM VOTING UNTIL SUCH TIME AS THE CONFLICT CAN BE RESOLVED OR A REPLACEMENT MEMBER IS APPOINTED TO THE COMMITTEE. THE COMMITTEE'S DELIBERATIONS AND DECISIONS ARE GUIDED BY A WRITTEN COMPENSATION PHILOSOPHY AND DOCUMENTED THROUGH WRITTEN MINUTES TAKEN DURING EACH MEETING. THE MINUTES INCLUDE, AMONG OTHER THINGS, THE WRITTEN MATERIALS DISTRIBUTED OR PRESENTED DURING THE MEETING AND THE SPECIFIC DECISIONS TAKEN AT THE MEETING. THE LAST REVIEW TOOK PLACE IN 2014. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, LINE 1 THE EXECUTIVE COMMITTEE OF THE BOARD IS COMPRISED OF THE CHAIRPERSON, THE VICE-CHAIRPERSON OF THE BOARD, THE IMMEDIATE PAST CHAIRPERSON OF THE BOARD, THE CHAIR OF THE FINANCE COMMITTEE AND THE PRESIDENT OF THE MEDICAL STAFF. NO PERSON IS ELIGIBLE TO SERVE ON THE EXECUTIVE COMMITTEE IN MORE THAN ONE CAPACITY. IN THE EVENT THAT ANY PERSON IS ELIGIBLE TO SERVE ON THE EXECUTIVE COMMITTEE IN MORE THAN ONE CAPACITY, THE CHAIRPERSON SHALL NOMINATE ANOTHER BOARD MEMBER TO SERVE ON THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL INCLUDE AT LEAST ONE PHYSICIAN WHO IS A BOARD MEMBER. THE PRESIDENT SHALL SERVE AS AN EX-OFFICIO MEMBER OF THE EXECUTIVE COMMITTEE WITHOUT A VOTE. THE EXECUTIVE COMMITTEE IS EMPOWERED TO ACT FOR THE BOARD IN THE GOVERNANCE OF ECH BETWEEN REGULAR MEETINGS OF THE BOARD, WHEN SUCH ACTION IS REQUIRED FOR THE TIMELY CONDUCT OF ECH BUSINESS, EXCEPT THE FOLLOWING: 1) SUCH POWERS AS MAY BY LAW OR THESE BYLAWS BE REQUIRED TO BE EXERCISED BY THE BOARD: 2) SUCH POWERS AS THE BOARD MAY BY RESOLUTION EXPRESSLY RESERVE TO ITSELF: 3) THE PURCHASE OR SALE OF REAL PROPERTY; 4) HIRING OR TERMINATING THE EMPLOYMENT OF THE PRESIDENT; 5) AMENDING OR REVISING THE BOARD APPROVED BUDGET; 6) TAKING ANY ACTION WHICH IS A "FUNDAMENTAL CHANGE" WITHIN THE MEANING OF CHAPTER 59 OF THE NONPROFIT CORPORATION LAW OF 1988 (OR ANY SIMILAR SUCCESSOR STATUTE); 7) THE BORROWING OF MONEY; 8) COMMITMENTS OR EXPENDITURES GREATER THAN $500,000. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENT 33,439. VALUATION GAIN 402,348. POSTRETIREMENT BENEFIT LIABILITY ADJUSTMENT -666,975. NET TRANSFERRS WITH AFFILIATES -6,672,620. EVANGELICAL AMBULATORY SURGICAL CENTER 210 JPM ROAD LEWISBURG PA 17837 233021240 HEALTHCARE - SURGERY PA 1325382 833048 EVANGELICAL COMMUNITY HOSPITAL EVANGELICAL-GEISINGER HEALTH LLC 100 N ACADEMY AVENUE DANVILLE PA 178224031 460567687 HEALTHCARE PA N/A RELATED 208399 670368 0 0 0.50000 CENTRAL SUSQUEHANNA HEALTHCARE PROVIDERS INC ONE HOSPITAL DRIVE LEWISBURG PA 17837 232452170 MEDICAL SERVICES PA EVANGELICAL COMMUNITY HOSPITAL C 169366 211341 0.50000 0 ECH PHARMACY & HOMECARE PRODUCTS INC ONE HOSPITAL DRIVE LEWISBURG PA 17837 232353576 SALES OF MEDICAL DRUGS AND SUPPLIES PA EVANGELICAL MEDICAL SERVICE ORGANIZATION C 1163375 1.00000 0 EVANGELICAL MEDICAL SERVICE ORGANIZATION ONE HOSPITAL DRIVE LEWISBURG PA 17837 232809429 MEDICAL SERVICES PA EVANGELICAL COMMUNITY HOSPITAL C 25440065 16263772 1.00000 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 1 1 EVANGELICAL MEDICAL SERVICES ORGANIZATION R 8200000 CASH EVANGELICAL MEDICAL SERVICES ORGANIZATION P 1375464 CASH EVANGELICAL MEDICAL SERVICES ORGANIZATION O 1795305 HOURS SPENT WORKING FOR AFFILIATE EVANGELICAL COMMUNITY HOSPITAL PHARMACY & HOME CARE PRODUCTS INC O 75179 HOURS SPENT WORKING FOR AFFILIATE EVANGELICAL COMMUNITY HOSPITAL PHARMACY & HOME CARE PRODUCTS INC J 80000 CASH EVANGELICAL MEDICAL SERVICES ORGANIZATION J 169700 CASH EVANGELICAL COMMUNITY HOSPITAL PHARMACY & HOME CARE PRODUCTS INC S 1527380 CASH