BROOKVILLE HOSPITAL: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization: BROOKVILLE HOSPITAL (EIN 25-0984595)
Tax period: 2013-07-01 to 2014-06-30
Filed: 2015-05-15
IRS object ID: 201501359349301765
Schema version: 2013v4.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule G
Schedule H
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2015-05-15T08:44:35-05:00	ReturnTs
Tax Period End	2014-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	BKD LLP	BusinessNameLine1

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	910 E ST LOUIS 200/PO BOX 1190	AddressLine1
City	SPRINGFIELD	City
State	MO	State
ZIP Code	658062523	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2013-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	250984595	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BROOKVILLE HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
In Care Of	% JESSICA PARK	InCareOfNm
Business Name Control	BROO	BusinessNameControlTxt
Phone	8148492312	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	100 HOSPITAL ROAD	AddressLine1
Address Line2	Suite	AddressLine2
City	BROOKVILLE	City
State	PA	State
ZIP Code	15825	ZIPCode

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JULIANNE PEER	PersonNm
Person Title	PRESIDENT	PersonTitleTxt
Phone	8148492312	PhoneNum
Signature	2015-05-08	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Brian D Todd	PreparerPersonNm
PTIN	P00422601	PTIN
Phone	8148492312	PhoneNum

Field	Value	IRS element (for citing)
Tax	2013	TaxYr
Build TS	2016-03-07 17:11:31Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	PENN HIGHLANDS BROOKVILLE	BusinessNameLine1

Field	Value	IRS element (for citing)
Principal Officer	JULIANNE PEER	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	100 HOSPITAL ROAD	AddressLine1
City	BROOKVILLE	City
State	PA	State
ZIP Code	15825	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	$26,533,528	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.BROOKVILLEHOSPITAL.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1915	FormationYr
Legal Domicile State	PA	LegalDomicileStateCd
Activity Or Mission	BROOKVILLE HOSPITAL IS A 35 BED CRITICAL ACCESS HOSPITAL THAT PROVIDES QUALITY HEALTHCARE SERVICES. OUTPATIENT SERVICES INCLUDE RADIOLOGY, LAB, REHABILITATION, AND HOME HEALTH.	ActivityOrMissionDesc
Voting Members Governing Body	9	VotingMembersGoverningBodyCnt
Voting Members Independent	5	VotingMembersIndependentCnt
Total Employee	286	TotalEmployeeCnt
Total Volunteers	9	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$126,287	PYContributionsGrantsAmt
CY Contributions Grants	$130,127	CYContributionsGrantsAmt
PY Program Service Revenue	$27,381,792	PYProgramServiceRevenueAmt
CY Program Service Revenue	$26,332,064	CYProgramServiceRevenueAmt
PY Investment Income	$82,242	PYInvestmentIncomeAmt
CY Investment Income	$23,093	CYInvestmentIncomeAmt
PY Other Revenue	$47,159	PYOtherRevenueAmt
CY Other Revenue	$30,724	CYOtherRevenueAmt
PY Total Revenue	$27,637,480	PYTotalRevenueAmt
CY Total Revenue	$26,516,008	CYTotalRevenueAmt
PY Grants And Similar Paid	$2,997	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$1,850	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$13,676,108	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$13,475,810	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$15,470,531	PYOtherExpensesAmt
CY Other Expenses	$14,384,723	CYOtherExpensesAmt
PY Total Expenses	$29,149,636	PYTotalExpensesAmt
CY Total Expenses	$27,862,383	CYTotalExpensesAmt
PY Revenues Less Expenses	-$1,512,156	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$1,346,375	CYRevenuesLessExpensesAmt
Total Assets BOY	$20,417,412	TotalAssetsBOYAmt
Total Assets EOY	$18,152,186	TotalAssetsEOYAmt
Total Liabilities BOY	$10,583,881	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$9,641,100	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$9,833,531	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$8,511,086	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	TO PROVIDE QUALITY HEALTHCARE SERVICES TO THE COMMUNITIES THAT WE SERVE IN A COST-EFFECTIVE MANNER. SEE SCHEDULE O FOR ADDITIONAL INFORMATION.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$18,727,256	ExpenseAmt
Grant	$1,850	GrantAmt
Revenue	$20,249,357	RevenueAmt
Desc	BROOKVILLE HOSPITAL PROVIDES A WIDE VARIETY OF OUTPATIENT SERVICES TO THE COMMUNITY. WE HAVE A PHYSICIAN STAFFED 24 HOUR EMERGENCY DEPARTMENT THAT PROVIDED OVER 9,000 VISITS THIS YEAR AND 3 FAMILY PRACTICE CLINICS THAT HAD OVER 17,000 VISITS. WE ALSO PROVIDE OUTPATIENT PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY, GENERAL RADIOLOGY, CAT SCAN, MRI, PET, ULTRASOUND, NUCLEAR MEDICINE, CARDIOLOGY, LABORATORY SERVICES, PAIN CLINIC, AND OUTPATIENT PSYCH SERVICES. OUR SURGEONS PERFORMED OVER 1,600 SURGERIES AND OUR HOME HEALTH AGENCY PROVIDED OVER 6,000 VISITS. SEE SCHEDULE O FOR ADDITIONAL INFORMATION.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$5,625,482	ExpenseAmt
Revenue	$6,082,707	RevenueAmt
Desc	BROOKVILLE HOSPITAL IS A 35 BED HOSPITAL THAT PROVIDED INPATIENT SERVICES TO 822 PATIENTS THIS YEAR. INPATIENT SERVICES INCLUDED TREATMENTS FOR BOTH MEDICAL AND SURGICAL PATIENTS. MANY OF OUR PATIENTS WERE TREATED IN THE GERO-PSYCHIATRIC UNIT OF THE HOSPITAL. THIS UNIT SPECIALIZES IN PSYCHIATRIC DISORDERS FOR PATIENTS OVER THE AGE OF 55.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$24,352,738	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	false	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	Yes (true)	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	Yes (true)	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	Yes (true)	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	44	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	286	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	Yes (true)	QuidProQuoContributionsInd
Quid Pro Quo Contri Discl	Yes (true)	QuidProQuoContriDisclInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	9	GoverningBodyVotingMembersCnt
Independent Voting Member	5	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	false	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	PA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	JESSICA PARK	PersonNm
Phone	8148491408	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	100 HOSPITAL ROAD	AddressLine1
City	BROOKVILLE	City
State	PA	State
ZIP Code	15825	ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd
JULIANNE PEER
PRESIDENT BEGINNING 8/2013	40.0	0.0	Yes (X)	Yes (X)	$132,605	$0	$19,639
JOHN SUTIKA
DIRECTOR/DRMC PRESIDENT/CEO	3.0	40.0	Yes (X)		$0	$390,352	$15,728
L GENE HOAK
SECRETARY	3.0	0.0	Yes (X)	Yes (X)	$0		$0
RONALD KING
CHAIRMAN	3.0	0.0	Yes (X)	Yes (X)	$0		$0
TIMOTHY PENDLETON MD
DIRECTOR	3.0	40.0	Yes (X)		$0	$399,580	$15,712
ROSE CAMPBELL
PRESIDENT/DIRECTOR END 8/2013	3.0	40.0	Yes (X)	Yes (X)	$0	$200,540	$15,529
WILLIAM YOUNG
VICE CHAIRMAN	3.0	0.0	Yes (X)	Yes (X)	$0		$0
TODD P STOLTZ
DIRECTOR	3.0	0.0	Yes (X)		$0		$0
EDWARD YAHNER
DIRECTOR	3.0	0.0	Yes (X)		$0		$0
H ED RICHARDS DMO
TREASURER BEGINNING 7/2013	3.0	0.0	Yes (X)	Yes (X)	$0		$0
EMERSON TURNBULL
CRNA	40.0	0.0			$151,313	$0	$25,206	Yes (X)
CYRIL GAMIS MD
PHYSICIAN	40.0	0.0			$253,409	$0	$16,119	Yes (X)
DAVID GIRARDI DO
PHYSICIAN	40.0	0.0			$312,611	$0	$21,695	Yes (X)
BARRY J SNYDER MD
PHYSICIAN	40.0	0.0			$150,004	$0	$13,081	Yes (X)
TANIS PENDLETON
PHYSICIAN	40.0	0.0			$132,605		$5,835	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,132,547	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$990,472	TotReportableCompRltdOrgAmt
Total Other Compensation	$148,544	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	8	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

ServicesServicesDesc	CompensationCompensationAmt
DUBOIS REGIONAL MEDICAL CENTER
HOSPITAL MANAGEMENT	$1,579,995
SCHUMACHER GROUP DBA BRKVLE EMER GR
EMERGENCY PHYSICIANS	$488,140
NORTHFORK REHABILITATION
PHYSICAL THERAPY	$814,640
PENN HIGHLANDS HEALTHCARE
HOSPITAL MANAGEMENT	$344,180
WESTERN HEALTHCARE LLC
EMERGENCY PHYSICIANS	$456,688

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	14	CntrctRcvdGreaterThan100KCnt
Fundraising	$26,169	FundraisingAmt
Related Organizations	$8,286	RelatedOrganizationsAmt
Government Grants	$82,140	GovernmentGrantsAmt
All Other Contributions	$13,532	AllOtherContributionsAmt
Total Contributions	$130,127	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE	621110	$25,524,297	$25,524,297
EHR REVENUE	621110	$348,738	$348,738
MEAL TICKETS	722210	$73,604	$73,604
OTHER REVENUE	900099	$75,732	$75,732
PHARMACY REVENUE	446110	$309,693	$309,693

Field	Value	IRS element (for citing)
Total Program Service Revenue	$26,332,064	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$22,743	TotalRevenueColumnAmt
Exclusion	$22,743	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$39,186	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$39,186	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$39,186	TotalRevenueColumnAmt
Exclusion	$39,186	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$350	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	$350	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$350	TotalRevenueColumnAmt
Exclusion	$350	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$24,558	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$26,169	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$17,520	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$7,038	TotalRevenueColumnAmt
Exclusion	$7,038	ExclusionAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	LOSS ON EXTINGUISHMENT OF DEBT	Desc
Business	900099	BusinessCd
Total Revenue Column	-$15,500	TotalRevenueColumnAmt
Exclusion	-$15,500	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	-$15,500	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$26,516,008	TotalRevenueColumnAmt
Related Or Exempt Func Income	$26,332,064	RelatedOrExemptFuncIncomeAmt
Exclusion	$53,817	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$1,850	TotalAmt
Program Services	$1,850	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$152,244	TotalAmt
Management And General	$152,244	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$181,274	TotalAmt
Management And General	$181,274	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$10,059,862	TotalAmt
Program Services	$9,441,557	ProgramServicesAmt
Management And General	$618,305	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$276,544	TotalAmt
Program Services	$257,653	ProgramServicesAmt
Management And General	$18,891	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$2,065,261	TotalAmt
Program Services	$1,905,791	ProgramServicesAmt
Management And General	$159,470	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$740,625	TotalAmt
Program Services	$678,526	ProgramServicesAmt
Management And General	$62,099	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$2,310,559	TotalAmt
Program Services	$1,950,112	ProgramServicesAmt
Management And General	$360,447	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$6,971	TotalAmt
Management And General	$6,971	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$175,963	TotalAmt
Management And General	$175,963	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$4,495,926	TotalAmt
Program Services	$3,624,810	ProgramServicesAmt
Management And General	$871,116	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$53,620	TotalAmt
Management And General	$53,620	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$914,601	TotalAmt
Program Services	$577,760	ProgramServicesAmt
Management And General	$336,841	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$10,255	TotalAmt
Program Services	$9,681	ProgramServicesAmt
Management And General	$574	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$710,360	TotalAmt
Program Services	$581,651	ProgramServicesAmt
Management And General	$128,709	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$75,024	TotalAmt
Program Services	$43,419	ProgramServicesAmt
Management And General	$31,605	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$25,234	TotalAmt
Program Services	$15,337	ProgramServicesAmt
Management And General	$9,897	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$190,787	TotalAmt
Program Services	$160,950	ProgramServicesAmt
Management And General	$29,837	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$1,665,425	TotalAmt
Program Services	$1,404,960	ProgramServicesAmt
Management And General	$260,465	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$270,858	TotalAmt
Program Services	$234,051	ProgramServicesAmt
Management And General	$36,807	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES & DRUGS	$1,919,530	$1,919,530
BAD DEBT	$1,507,659	$1,507,659
LICENSES, DUES, SUBSCRIPTIONS	$51,951	$37,441	$14,510

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$27,862,383	TotalAmt
Program Services	$24,352,738	ProgramServicesAmt
Management And General	$3,509,645	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$362,734	BOYAmt
EOY	$358,786	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$4,163,287	BOYAmt
EOY	$4,440,382	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$4,572,188	BOYAmt
EOY	$3,635,543	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$52,772	BOYAmt
EOY	$33,690	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$509,935	BOYAmt
EOY	$557,849	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$343,528	BOYAmt
EOY	$221,501	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$41,964,387	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$35,013,175	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$8,238,626	BOYAmt
EOY	$6,951,212	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$36,198	BOYAmt
EOY	$18,476	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$37,502	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$2,138,144	BOYAmt
EOY	$1,897,245	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$20,417,412	BOYAmt
EOY	$18,152,186	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$4,354,037	BOYAmt
EOY	$5,078,994	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$42,869	BOYAmt
EOY	$0	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$3,697,799	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$5,889,903	BOYAmt
EOY	$864,307	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$297,072	BOYAmt
EOY	$0	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$10,583,881	BOYAmt
EOY	$9,641,100	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$9,543,805	BOYAmt
EOY	$8,187,459	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$95,410	BOYAmt
EOY	$105,381	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$194,316	BOYAmt
EOY	$218,246	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$9,833,531	BOYAmt
EOY	$8,511,086	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$20,417,412	BOYAmt
EOY	$18,152,186	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$1,346,375	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$23,930	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$900	OtherActivitiesAmt
Total Lobbying Expenditures	$900	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE C, PART II-B, LINE 1(I)	FormAndLineReferenceDesc
Explanation	THE ORGANIZATION PAYS DUES TO HOSPITAL COUNCIL OF WESTERN PENNSYLVANIA. A PORTION OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp
CY Minus3 Yr Endwmt Fund		CYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt Fund		CYMinus4YrEndwmtFundGrp

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$205,546	OtherCostOrOtherBasisAmt
Book Value	$205,546	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$8,173,310	OtherCostOrOtherBasisAmt
Depreciation	$6,535,644	DepreciationAmt
Book Value	$1,637,666	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$204,286	OtherCostOrOtherBasisAmt
Depreciation	$202,221	DepreciationAmt
Book Value	$2,065	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$30,699,725	OtherCostOrOtherBasisAmt
Depreciation	$26,919,806	DepreciationAmt
Book Value	$3,779,919	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,681,520	OtherCostOrOtherBasisAmt
Depreciation	$1,355,504	DepreciationAmt
Book Value	$1,326,016	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$6,951,212	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDesc	Book ValueBookValueAmt
BEN INT IN PERPETUAL TRUST	$218,246
INTEREST RECEIVABLE	$2,166
OTHER ASSETS	$12,991
DUE FROM AFFILIATES	$1,479,407
EST AMT DUE FROM THIRD PARTIES	$184,435

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$1,897,245	TotalBookValueOtherAssetsAmt
Total Rev Etc Audited Fincl Stmt	$25,015,898	TotalRevEtcAuditedFinclStmtAmt
Other Revenue	-$1,507,659	OtherRevenueAmt
Revenue Not Reported	-$1,507,659	RevenueNotReportedAmt
Revenue Subtotal	$26,523,557	RevenueSubtotalAmt
Other Revenues Not Included	-$7,549	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	-$7,549	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$26,516,008	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$26,372,244	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	$17,520	OtherExpensesIncludedAmt
Expenses Not Reported	$17,520	ExpensesNotReportedAmt
Expenses Subtotal	$26,354,724	ExpensesSubtotalAmt
Other Expenses Not Included	$1,507,659	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$1,507,659	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$27,862,383	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE D, PART X, LINE 2	UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
SCHEDULE D, PART XI, LINE 2D	OTHER REVENUE ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12: $(1,507,659) BAD DEBT EXPENSE
SCHEDULE D, PART XI, LINE 4B	OTHER REVENUE ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ (17,520) SPECIAL EVENT EXPENSE 9,971 TEMPORARILY RESTRICTED CONTRIBUTIONS & INVESTMENT RETURN ------------ $ (7,549)
SCHEDULE D, PART XII, LINE 2D	OTHER EXPENSE ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25: $ 17,520 SPECIAL EVENT EXPENSE
SCHEDULE D, PART XII, LINE 4B	OTHER EXPENSE ON FORM 990, PART IX, LINE 25 BUT NOT ON LINE 1: $ 1,507,659 BAD DEBT EXPENSE

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Name Of Event1	GOLF OUTING	NameOfEvent1Amt
Gross Receipts Event1	$30,209	GrossReceiptsEvent1Amt
Charitable Contri Event1	$20,519	CharitableContriEvent1Amt
Gross Revenue Event1	$9,690	GrossRevenueEvent1Amt
Cash Prizes Event1	$0	CashPrizesEvent1Amt
Non Cash Prizes Event1	$3,053	NonCashPrizesEvent1Amt
Rent Facility Costs Event1	$3,240	RentFacilityCostsEvent1Amt
Food And Beverage Event1	$3,200	FoodAndBeverageEvent1Amt
Entertainment Event1	$0	EntertainmentEvent1Amt
Other Direct Expenses Event1	$296	OtherDirectExpensesEvent1Amt
Name Of Event2	1-100 EVENT	NameOfEvent2Amt
Gross Receipts Event2	$20,518	GrossReceiptsEvent2Amt
Charitable Contri Event2	$5,650	CharitableContriEvent2Amt
Gross Revenue Event2	$14,868	GrossRevenueEvent2Amt
Cash Prizes Event2	$3,650	CashPrizesEvent2Amt
Non Cash Prizes Event2	$733	NonCashPrizesEvent2Amt
Rent Facility Costs Event2	$445	RentFacilityCostsEvent2Amt
Food And Beverage Event2	$2,869	FoodAndBeverageEvent2Amt
Entertainment Event2	$0	EntertainmentEvent2Amt
Other Direct Expenses Event2	$34	OtherDirectExpensesEvent2Amt
Other Events Total	0	OtherEventsTotalCnt
Gross Receipts Other Events	$0	GrossReceiptsOtherEventsAmt
Charitable Contri Other Events	$0	CharitableContriOtherEventsAmt
Gross Revenue Other Events	$0	GrossRevenueOtherEventsAmt
Cash Prizes Other Events	$0	CashPrizesOtherEventsAmt
Non Cash Prizes Other Events	$0	NonCashPrizesOtherEventsAmt
Rent Fclty Costs Other Events	$0	RentFcltyCostsOtherEventsAmt
Food And Beverage Other Events	$0	FoodAndBeverageOtherEventsAmt
Entertainment Other Events	$0	EntertainmentOtherEventsAmt
Oth Direct Expnss Other Events	$0	OthDirectExpnssOtherEventsAmt
Gross Receipts Total	$50,727	GrossReceiptsTotalAmt
Charitable Contributions Tot	$26,169	CharitableContributionsTotAmt
Gross Revenue Total Events	$24,558	GrossRevenueTotalEventsAmt
Cash Prizes Total Events	$3,650	CashPrizesTotalEventsAmt
Non Cash Prizes Total Events	$3,786	NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events	$3,685	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$6,069	FoodAndBeverageTotalEventsAmt
Entertainment Total Events	$0	EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events	$330	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$17,520	DirectExpenseSummaryEventsAmt
Net Income Summary	$7,038	NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	false	FPGReferenceDiscountedCareInd
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	false	AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$190,584	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$190,584	NetCommunityBenefitExpnsAmt
Total Expense	0.00720	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$213,901	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$53,798	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$160,103	NetCommunityBenefitExpnsAmt
Total Expense	0.00600	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,101,954	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$894,899	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,207,055	NetCommunityBenefitExpnsAmt
Total Expense	0.04550	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,506,439	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$948,697	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,557,742	NetCommunityBenefitExpnsAmt
Total Expense	0.05870	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,290	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$4,290	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,850	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,850	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,140	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$6,140	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,512,579	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$948,697	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,563,882	NetCommunityBenefitExpnsAmt
Total Expense	0.05900	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$1,507,659	BadDebtExpenseAmt
Bad Debt Expense Attributable	$230,672	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$12,920,298	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$13,778,716	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$858,418	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	false	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BROOKVILLE HOSPITAL	BusinessNameLine1

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	100 HOSPITAL ROAD	AddressLine1
City	BROOKVILLE	City
State	PA	State
ZIP Code	15825	ZIPCode

Field	Value	IRS element (for citing)
Website Address	WWW.PHHEALTHCARE.ORG	WebsiteAddressTxt
State License	28050101	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	BROOKVILLE HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
CHNA Conducted	11	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	WWW.PHHEALTHCARE.ORG	OwnWebsiteURLTxt
Adopt Implementation Strategy	Yes (X)	AdoptImplementationStrategyInd
All Needs Addressed	false	AllNeedsAddressedInd
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Used Deter Elig Free Care	Yes (true)	FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care	200.	FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt Care	false	FPGUsedDetermEligDscntCareInd
Explained Basis	Yes (true)	ExplainedBasisInd
Income Level	Yes (X)	IncomeLevelInd
Asset Level	Yes (X)	AssetLevelInd
Medical Indigency	Yes (X)	MedicalIndigencyInd
Insurance Status	Yes (X)	InsuranceStatusInd
Uninsured Discount	Yes (X)	UninsuredDiscountInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
Available On Request	Yes (X)	AvailableOnRequestInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Collection Activities	false	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified Before Discharge	Yes (X)	FAPNotifiedBeforeDischargeInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Lowest Negotiated Rates	Yes (X)	LowestNegotiatedRatesInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 3	COMMUNITY INPUT: THE ORGANIZATION TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY BY CONDUCTING INTERVIEWS WITH KEY COMMUNITY STAKEHOLDERS AND FOCUS GROUPS WITH COMMUNITY RESIDENTS AS WELL AS HOLDING A COMMUNITY HEALTH PLANNING RETREAT.
SCHEDULE H, PART V, SECTION B, LINE 4	CHNA CONDUCTED WITH OTHER HOSPITAL FACILITIES: THE CHNA WAS CONDUCTED ALONG WITH DUBOIS REGIONAL MEDICAL CENTER, A RELATED ORGANIZATION.
SCHEDULE H, PART V, SECTION B, LINE 6	IMPLEMENTATION STRATEGY: IN RESPONSE TO THE RESULTS OF BROOKVILLE HOSPITAL'S MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT, THE ORGANIZATION ADOPTED AN IMPLEMENTATION STRATEGY. THE IMPLEMENTATION STRATEGY IS ATTACHED. PENN HIGHLANDS BROOKVILLE LISTENS TO COMMUNITY CONCERNS, ANALYZES HEALTHCARE UTILIZATION AND COSTS, EXPLORES ACCESS ISSUES, COLLABORATES WITH AND DEVELOPS EFFECTIVE PROGRAMS TO IMPROVE THE HEALTH OF THOSE IN THIS PORTION OF WEST CENTRAL PENNSYLVANIA. BASED ON THE COMMUNITY HEALTH NEEDS ASSESSMENT FINDINGS AND THE PRIORITIZED NEEDS, THREE COMMUNITY NEEDS WILL BE ADDRESSED AND FURTHER EXPLORED. DESPITE MANY CHALLENGES FACING A RURAL, CRITICAL ACCESS HOSPITAL, PENN HIGHLANDS BROOKVILLE, IN COLLABORATION WITH OTHER PARTNERS IN OUR REGION, MADE STRIDES TO MEET MANY OF THE COMMUNITY NEEDS. OF THE IDENTIFIED CHNA AND PRIORITIZED HEALTH NEEDS, PENN HIGHLANDS BROOKVILLE FOCUSED ON FOUR OF THE COMMUNITY REQUIREMENTS: " PROVIDER WORKFORCE " ACCESS TO CARE " DENTAL CARE PROVIDER WORKFORCE AND ACCESS TO CARE WHILE OUR STUDY NOTES THAT THOSE IN NEED OF HEALTHCARE OFTEN CITE THE LACK OF INSURANCE AS THE MAIN BARRIER, PENN HIGHLANDS BROOKVILLE TOOK ON THIS ISSUE IN ORDER TO ADDRESS THE PERCEPTION THAT THERE ARE NOT ENOUGH PROVIDERS TO SERVE COMMUNITY RESIDENTS. TACKLING THE LACK OF AVAILABLE PHYSICIANS AND ALLIED HEALTH PROFESSIONALS IN THE AREA WAS ALSO DONE TO HELP AND IMPROVE COMMUNITY RESIDENTS' ABILITY TO ACCESS AFFORDABLE HEALTHCARE SERVICES AND INFORMATION. ACCESS TO AFFORDABLE HEALTHCARE AND PREVENTIVE HEALTHCARE AND WELLNESS WERE IDENTIFIED AS DIRECT NEEDS FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT. DURING THE FISCAL YEAR, THE SYSTEM PHYSICIAN RECRUITERS USED THE FOLLOWING TOOLS TO ENGAGE POTENTIAL CANDIDATES: CONTINGENCY FIRMS; ADVERTISING JOB BOARDS (PRACTICE LINK, CAREER MD, JOURNAL OF FAMILY PRACTICE, HEALTHECAREERS); CAREER FAIRS (PITTSBURGH, GREENSBURG, PHILADELPHIA); COMMUNICATION WITH RESIDENCY PROGRAM DIRECTORS IN SURROUNDING STATES; AND COMMUNICATION WITH COLLEAGUES TO POOL CANDIDATES. PENN HIGHLANDS BROOKVILLE ALSO ENGAGED AN EMERGENCY MEDICINE PHYSICIAN STAFFING GROUP TO PROVIDE PHYSICIANS FOR ITS EMERGENCY DEPARTMENT. THE HOSPITAL HAS THREE RURAL HEALTH CLINICS, ONE IN BROOKVILLE, ONE IN MARIENVILLE AND ONE IN NEW BETHLEHEM. THERE ARE THREE PHYSICIANS AND FOUR ADVANCED PRACTICE PROVIDERS WORKING IN THOSE THREE CLINICS. THE RECENT ADDITION OF THE FOURTH ALLIED HEALTH PROFESSIONAL ALSO INCREASED THE BROOKVILLE REGION'S ACCESS TO PRIMARY CARE. PENN HIGHLANDS BROOKVILLE WAS ALSO ABLE TO REESTABLISH ACCESS TO A FELLOWSHIP-TRAINED CARDIOLOGIST BY PARTNERING WITH DUBOIS REGIONAL CARDIOLOGY ASSOCIATES TO STAFF A LOCAL OFFICE AND PROVIDE CONSULTATIONS IN THE HOSPITAL TWO DAYS PER WEEK. THOSE SEEKING LOCAL ACCESS TO OUTPATIENT OBSTETRICAL AND GYNECOLOGICAL CARE ARE ALSO NOW ABLE TO SEE A PHYSICIAN IN BROOKVILLE THANKS TO THE ADDITION OF A NEW OFFICE OF PENN HIGHLANDS WOMEN'S CARE. IN ADDITION TO PLACING QUALIFIED PROVIDERS IN PRACTICES AROUND OUR SERVICE AREA, PENN HIGHLANDS BROOKVILLE IS WORKING ON A PLAN TO INCLUDE AS QCARE PROGRAM IN THE REGION. THIS WILL FOCUS ON ACCESS AND AFFORDABILITY FOR THOSE SEEKING CARE FOR URGENT NEEDS THAT ARE NOT EMERGENCIES. IN 2016, PENN HIGHLANDS BROOKVILLE WILL BE WORKING WITH LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE TO PROVIDE CLINICAL SETTINGS FOR MEDICAL STUDENTS TO GET HANDS-ON OPPORTUNITIES TO EXPAND THEIR MEDICAL EDUCATION. A GENERAL MEDICAL EDUCATION PROGRAM WILL BE PART OF A SYSTEM-WIDE INITIATIVE THAT WILL BRING MEDICAL RESIDENTS IN THE FIELDS OF FAMILY MEDICINE, INTERNAL MEDICINE AND EMERGENCY MEDICINE TO PENN HIGHLANDS BROOKVILLE IN 2017. ADDITIONAL PARTNERSHIPS WILL ALSO INCLUDE A PHYSICIAN ASSISTANT TRAINING PROGRAM WITH LOCK HAVEN UNIVERSITY AND AN EDUCATIONAL/TRAINING PROGRAM FOR MID-LEVEL PROVIDERS WITH THE UNIVERSITY OF PITTSBURGH MEDICAL CENTER. DENTAL CARE MANY AVENUES FOR EXPANDING ACCESS TO DENTAL CARE IN OUR COMMUNITIES WERE EXPLORED WITH PARTNERS THROUGHOUT OUR HEALTH SYSTEM. DISCUSSIONS WITH CURRENT PROVIDERS ABOUT PLANS FOR ADDITIONAL STAFFING, THE REVIEW OF A MOBILE DENTAL UNIT FOR THE REGION AND DISCUSSIONS WITH OTHER STAKE-HOLDERS TO GENERATE NEW OPTIONS FOR DENTAL CARE WERE ALL INCLUDED IN THE PROCESS. THIS PRIORITY PROVED VERY CHALLENGING. NO NEW PROVIDERS OR PARTNERS COULD BE IDENTIFIED FOR OUR REGION FOR ANY INITIATIVES THAT WERE REVIEWED. MUCH TIME WAS DEVOTED TO STUDYING HOW MOBILE DENTAL UNITS WORK IN RURAL COMMUNITIES AND DEMONSTRATIONS OF MOBILE UNITS WERE CONDUCTED. FOLLOWING EXTENSIVE REVIEW AND DISCUSSION, OFFICIALS DETERMINED THAT PURCHASING A MOBILE UNIT WAS NOT FEASIBLE FOR OUR SYSTEM. THE TWO MAJOR FACTORS INCLUDED COST AND THE LACK OF A QUALIFIED PROVIDER TO RUN THE UNIT.
SCHEDULE H, PART V, SECTION B, LINE 7	ADDRESSING IDENTIFIED NEEDS: BROOKVILLE HOSPITAL AND DUBOIS REGIONAL MEDICAL CENTER HAVE DEMONSTRATED THAT THEY WISH TO LISTEN TO COMMUNITY CONCERNS, ANALYZE HEALTHCARE UTILIZATION AND COSTS, EXPLORE ACCESS ISSUES, AND COLLABORATE WITH AND DEVELOP EFFECTIVE PROGRAMS TO IMPROVE THE HEALTH OF THOSE IN WEST CENTRAL PA. BASED ON THE COMMUNITY HEALTH NEEDS ASSESSMENT FINDINGS AND THE PRIORITIZED NEEDS, THREE COMMUNITY NEEDS WILL BE IMPLEMENTED AND FURTHER EXPLORED. IT IS IMPORTANT TO NOTE THAT WHILE PROVIDER WORKFORCE WAS NOT A COMMUNITY NEED THAT WAS A DIRECT RESULT OF THE CHNA, BROOKVILLE HOSPITAL AND DRMC WILL TACKLE THIS ISSUE IN ORDER TO INCREASE THE MANPOWER AND WORKFORCE ISSUES THAT DIRECTLY AFFECT COMMUNITY RESIDENTS. TACKLING THE LACK OF AVAILABLE PHYSICIANS AND ALLIED HEALTH PROFESSIONALS IN THE AREA WILL ALSO HELP TO IMPROVE COMMUNITY RESIDENTS' ABILITY TO ACCESS HEALTH SERVICES (BRIDGING THE GAP BETWEEN SERVICE PROVIDERS AND END-USERS) AND HEALTH INFORMATION. THIS PRIORITIZED NEED WAS A DIRECT HEALTH NEED FROM THE COMMUNITY HEALTH ASSESSMENT. THE PROGRAMS DESCRIBED IN THE FOLLOWING IMPLEMENTATION PLAN ADDRESSES THE TARGETED HEALTH PRIORITIES THAT HOSPITAL LEADERS BELIEVE WILL HAVE THE MOST IMPACT WITHIN THE COMMUNITY. OF THE IDENTIFIED CHNA AND PRIORITIZED HEALTH NEEDS, BROOKVILLE HOSPITAL AND DRMC WILL FOCUS ON THREE OF THE COMMUNITY REQUIREMENTS: 1. ACCESS TO CARE 2. DENTAL CARE 3. PROVIDER WORKFORCE EACH OF THE HEALTH NEEDS IDENTIFIED WITHIN THE CHNA ARE IMPORTANT AND ARE BEING ADDRESSED TO SOME DEGREE BY ORGANIZATIONS, PROGRAMS/INITIATIVES OPERATED BY REGIONAL AND LOCAL COMMUNITY-BASED ORGANIZATIONS OR BY BROOKVILLE HOSPITAL AND/OR DRMC. THROUGH ANALYSIS AND DISCUSSIONS RESULTING FROM A WORK SESSION HELD WITH REPRESENTATIVES FROM BROOKVILLE HOSPITAL AND DRMC, THE FOLLOWING NEEDS IDENTIFIED IN THE CHNA THAT WILL NOT BE ADDRESSED ARE: 1. ACCESSING HEALTH INFORMATION / LACK OF ACCESS (BRIDGING GAP BETWEEN SERVICE PROVIDERS AND END-USERS) 2. DRUG/ALCOHOL PREVENTION 3. HEALTH EDUCATION AND COMMUNICATION
SCHEDULE H, PART V, SECTION B, LINE 11	CRITERIA FOR DISCOUNTED CARE: ALL PATIENTS THAT ARE PROVIDED CARE BUT PRESENT WITHOUT INSURANCE ARE GRANTED A 20% DISCOUNT. ONLY FREE CARE IS PROVIDED USING THE FEDERAL POVERTY GUIDELINES.

Field	Value	IRS element (for citing)
Facility	5	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	FacilityFacilityTxt
PHYSICAL THERAPY BUILDING
88 INDUSTRIAL PARK RD	BROOKVILLE	PA	15825	OUTPATIENT PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY
CHARLES PROFESSIONAL BUILDING
240 ALLEGHENY BLVD	BROOKVILLE	PA	15825	PHYSICIAN OFFICES, HOME HEALTH
DAVID L MILLER MEDICAL CENTER
BROOKVILLE STREET	FAIRMOUNT	PA	16224	RADIOLOGY, LAB, PHYSICAL AND OCCUPATIONAL THERAPY, AND RURAL HEALTH CLINIC
ALLEGHENY HEALTH CENTER
22 INDUSTRIAL PARK RD	BROOKVILLE	PA	15825	RURAL HEALTH CLINIC
MARIENVILLE FAMILY HEALTH
125 CHESTNUT ST	MARIENVILLE	PA	16239	RURAL HEALTH CLINIC

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART I, LINE 7, COLUMN F	PERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25 OF THE FORM 990, WAS REDUCED BY BAD DEBT EXPENSE OF $1,507,659.
SCHEDULE H, PART I, LINE 7	COSTING METHODOLOGY: THE COST TO CHARGE RATIO COMPUTED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATIONS ON IRS WORKSHEETS 1 AND 3.
SCHEDULE H, PART III, SECTION A, LINE 2	BAD DEBT EXPENSE: THE ORGANIZATION CALCULATED BAD DEBT USING THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS PER THE AUDITED FINANCIAL STATEMENTS.
SCHEDULE H, PART III, SECTION A, LINE 3	BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE: BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING POVERTY LIMIT DEMOGRAPHIC INFORMATION OBTAINED THROUGH THE U.S. CENSUS BUREAU. THE MOST RECENT US CENSUS BUREAU INDICATES THAT 15.3 PERCENT OF JEFFERSON COUNTY WAS CONSIDERED TO LIVE IN POVERTY.
SCHEDULE H, PART III, SECTION, LINE 4	BAD DEBT EXPENSE FOOTNOTE: THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE: THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HOSPITAL BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT.
SCHEDULE H, PART III, SECTION B, LINE 8	COMMUNITY BENEFIT: SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY.
SCHEDULE H, PART III, SECTION C, LINE 9B	COLLECTION POLICY: A CHARITY CARE APPLICATION IS GOOD FOR SIX MONTHS ONCE APPROVED. ALSO PATIENTS ARE SENT THREE STATEMENTS BEFORE BEING SENT TO COLLECTION AGENCY, SO THEY HAVE TIME TO CONTACT THE BILLING OFFICE FOR CHARITY CARE.
SCHEDULE H, PART VI, LINE 2	NEEDS ASSESSMENT: A COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED BY TRIPP UMBACH BETWEEN MARCH AND AUGUST 2012 FOR CLEARFIELD AND JEFFERSON COUNTIES. NEEDS IDENTIFIED INCLUDED LACK OF ECONOMIC DEVELOPMENT AND GROWTH, HIGH UNEMPLOYMENT RATES, AND AN UNATTRACTIVE REGION FOR YOUNG FAMILIES REGARDING POOR ECONOMIC CONDITIONS. THE OVERALL WELL-BEING OF THE AREA INDICATES CHRONIC DISEASES, ENGAGEMENT OF POOR HEALTH BEHAVIORS, LACK OF HEALTH EDUCATION, DIET AND EXERCISE OPTIONS, DRUG AND ALCOHOL ABUSE, AND MENTAL HEALTH ISSUES. THERE ARE LIMITED FUNDING RESOURCES AT HEALTH AND COMMUNITY ORGANIZATIONS, TRANSPORTATION ISSUES, AND HOUSING LIMITATIONS, AS WELL AS ACCESS ISSUES FOR LARGE UNDERINSURED AND UNINSURED POPULATIONS, LIMITED PROGRAMS TO ADDRESS HEALTH NEEDS, LIMITED BASIC CARE SERVICES, AND AN INABILITY AND/OR LACK OF KNOWLEDGE ON HOW TO ACCESS EXISTING HEALTH SERVICES. THE TOP COMMUNITY HEALTH NEEDS IDENTIFIED WERE ACCESSING PRIMARY HEALTHCARE AND PREVENTIVE CARE, BASIC COMMUNITY SERVICES (ESPECIALLY DENTAL SERVICES), DRUG/ALCOHOL PREVENTION, AND HEALTH EDUCATION/COMMUNICATION.
SCHEDULE H, PART VI, LINE 3	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: INFORMATION IS POSTED AT REGISTRATION AREA AND IN WAITING AREAS. SELF PAY PATIENTS ARE GIVEN INFORMATION WITH THE FIRST BILL. THE CARE MANAGEMENT DEPARTMENT WORKS WITH ALL INPATIENTS AND WITH OUTPATIENTS AS NEEDED/REQUESTED.
SCHEDULE H, PART VI, LINE 4	COMMUNITY INFORMATION: BROOKVILLE HOSPITAL SERVES BROOKVILLE AND THE SURROUNDING COMMUNITIES. THE SERVICE AREA EXTENDS NORTH TO MARIENVILLE AND SOUTH TO NEW BETHLEHEM, AND INCLUDES JEFFERSON COUNTY, FOREST COUNTY AND CLARION COUNTY. THIS SERVICE AREA IS IN A RURAL PART OF WESTERN PENNSYLVANIA, WITH MANY RESIDENTS LIVING BELOW OR WELL BELOW THE NATIONAL AND STATE INCOME AVERAGE. ACCORDING TO THE US CENSUS BUREAU'S MOST RECENT DATA, APPROXIMATELY 15 PERCENT OF INDIVIDUALS LIVING IN THIS AREA WERE CONSIDERED TO LIVE IN POVERTY. THE MEDIAN HOUSEHOLD INCOME IN THE SERVICE AREA IS APPROXIMATELY $38,500. FROM THE RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT, THE SERVICE AREA INCLUDES 22% OF UNINSURED ADULTS, 7.8% OF CHILDREN WHO ARE UNINSURED. UNEMPLOYMENT RATES FOR CLEARFIELD AND JEFFERSON COUNTY WERE JUST OVER 8%. THE MEDIAN AGE OF THE POPULATION IS ABOUT 42, WITH ABOUT 18% 65 AND OVER. CLEARFIELD COUNTY HAS A 45.9% URBAN POPULATION, WHILE JEFFERSON HAS A 33.8% URBAN POPULATION.
SCHEDULE H, PART VI, LINE 5	PROMOTION OF COMMUNITY HEALTH: BROOKVILLE HOSPITAL PARTICIPATES IN AND PROVIDES MANY HEALTH FAIR AND COUNSELING OPPORTUNITIES THROUGHOUT THE YEAR, INCLUDING THOSE ASSOCIATED WITH MENTAL HEALTH, DIABETES, NUTRITION AND WEIGHT MANAGEMENT. ALSO, THE ORGANIZATION WORKS TO PROMOTE LEARNING THROUGH THE MEDICAL EXPLORERS PROGRAM AND LOCAL CAREER DAYS.
SCHEDULE H, PART VI, LINE 6	AFFILIATED HEALTH CARE SYSTEM: BROOKVILLE HOSPITAL IS A SUBSIDIARY OF DUBOIS REGIONAL MEDICAL CENTER (DRMC). DRMC HAS AN AFFILIATION AGREEMENT WITH CLEARFIELD HOSPITAL, CREATING PENN HIGHLANDS HEALTHCARE, WHICH BECAME THE PARENT AND SOLE MEMBER OF DRMC AND CLEARFIELD.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (true)	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JULIANNE PEER
PRESIDENT BEGINNING 8/2013	$123,216	$0	$6,685	$0	$2,704	$0	$4,690	$0	$14,949	$0	$152,244	$0	$0	$0
JOHN SUTIKA
DIRECTOR/DRMC PRESIDENT/CEO	$0	$300,458	$0	$48,000	$0	$41,894	$0	$10,200	$0	$5,528	$0	$406,080	$0	$0
EMERSON TURNBULL
CRNA	$151,244	$0	$0	$0	$69	$0	$5,823	$0	$19,383	$0	$176,519	$0	$0	$0
TIMOTHY PENDLETON MD
DIRECTOR	$0	$399,104	$0	$0	$0	$476	$0	$10,200	$0	$5,512	$0	$415,292	$0	$0
ROSE CAMPBELL
PRESIDENT/DIRECTOR END 8/2013	$0	$174,420	$0	$17,247	$0	$8,873	$0	$8,651	$0	$6,878	$0	$216,069	$0	$0
CYRIL GAMIS MD
PHYSICIAN	$253,340	$0	$0	$0	$69	$0	$0	$0	$16,119	$0	$269,528	$0	$0	$0
DAVID GIRARDI DO
PHYSICIAN	$312,598	$0	$0	$0	$13	$0	$5,576	$0	$16,119	$0	$334,306	$0	$0	$0
BARRY J SNYDER MD
PHYSICIAN	$149,886	$0	$0	$0	$118	$0	$4,616	$0	$8,465	$0	$163,085	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE J, PART I, LINE 4B	NONQUALIFIED RETIREMENT PLAN: JOHN SUTIKA PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THROUGH RELATED ORGANIZATION DUBOIS REGIONAL MEDICAL CENTER. HIS PAYMENT WAS $10,194.
SCHEDULE J, PART I, LINE 7	NON-FIXED PAYMENTS: A PORTION OF JULIANNE PEER, DEBRA THOMAS, AND JOHN SUTIKA'S BONUSES WERE BASED ON BOARD DISCRETION, WHILE THE MAJORITY WAS BASED ON FORMULAS USING INFORMATION BASED ON FINANCE, GROWTH, QUALITY/SAFETY, PEOPLE, AND SERVICE.
SCHEDULE J, PART I, LINE 3	CEO COMPENSATION DETERMINATION PENN HIGHLANDS HEALTHCARE (PHH), A RELATED ORGANIZATION, COMPLETES THE REVIEW OF THE CEO'S COMPENSATION, USING THE FOLLOWING METHODS: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (2 entries)

Relationship With OrgRelationshipWithOrgTxt	Loan PurposeLoanPurposeTxt	Loan From OrganizationLoanFromOrganizationInd	Original PrincipalOriginalPrincipalAmt	Balance DueBalanceDueAmt	DefaultDefaultInd	Board Or Committee ApprovalBoardOrCommitteeApprovalInd	Written AgreementWrittenAgreementInd
JULIANNE PEER
OFFICE	EDUC. REIMB.	Yes (X)	$20,000	$14,773	false	false	Yes (true)
TANIS PENDLETON
HCE	INCOME SUB.	Yes (X)	$45,000	$18,917	false	Yes (true)	Yes (true)

Field	Value	IRS element (for citing)
Total Balance Due	$33,690	TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
LINDA GRINDER
SISTER OF RON KING	$48,669	EMPLOYEE OF HOSPITAL	false
TANIS PENDLETON
SISTER OF T PENDLETON	$132,605	EMPLOYEE OF HOSPITAL	false

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART III, LINE 1	ORGANIZATION'S MISSION: MISSION STATEMENT OUR MISSION IS TO PROVIDE QUALITY HEALTHCARE SERVICES TO THE COMMUNITIES THAT WE SERVE IN A COST EFFECTIVE MANNER. VISION STATEMENT OUR VISION IS TO BE THE PROVIDER OF CHOICE IN PROMOTING HEALTHCARE FOR THE COMMUNITIES THAT WE SERVE. VALUE STATEMENT -SERVICE EXCELLENCE THAT IS RESPONSIVE TO THE NEEDS OF THOSE WE SERVE. -DIGNITY & COMPASSION IN CARING FOR PATIENTS AND THEIR FAMILIES. -RESPECT TREATING EACH OTHER WITH FAIRNESS, HONESTY, AND TRUST. -TEAMWORK CHARACTERIZED BY UNITY OF PURPOSE, FLEXIBILITY AND EMPOWERMENT OF PEOPLE. -PLANNING BUILDING ON THE PAST AND ANTICIPATING THE FUTURE TO MEET OUR GOALS. -FINANCIAL HEALTH TO ENSURE THE CONTINUATION OF OUR MISSION. -ACTIVE PARTICIPATION BY PATIENTS AND FAMILIES IN THEIR HEALTHCARE.
FORM 990, PART III, LINE 4A	PROGRAM SERVICE: BROOKVILLE HOSPITAL ESTIMATED VALUE OF FREE CARE, COMMUNITY SERVICE, CHARITABLE CONTRIBUTIONS, AND PROFESSIONAL AND COMMUNITY EDUCATION. UNCOMPENSATED CHARITY CARE UNCOMPENSATED CHARITY CARE CHARGES WRITTEN OFF WERE $389,000. THE TOTAL DOES NOT INCLUDE BAD DEBT. THE HOSPITAL'S DETERMINATION OF INABILITY TO PAY DIFFERENTIATES CHARITY CARE FROM BAD DEBT, WHICH IS DETERMINED BY ABILITY TO PAY BUT UNWILLINGNESS TO DO SO. BAD DEBT THE HOSPITAL'S BAD DEBT AMOUNT WRITTEN OFF WAS $1,507,659 IN FY 2014. CHARITY CARE SERVICE THE HOSPITAL OWNS AND OPERATES THE ALLEGHENY, NEW BETHLEHEM, AND MARIENVILLE HEALTH CENTERS. THESE ARE RURAL HEALTH CLINICS THAT ARE AVAILABLE TO THE COMMUNITY. CHARITY CARE IS OFFERED TO PATIENTS OF THESE CLINICS. COMMUNITY VOLUNTEER ASSISTANCE APPROXIMATELY 40 ACTIVE HOSPITAL VOLUNTEERS ASSISTED WITH THE PROVISION OF SERVICES BY THE HOSPITAL. THE AUXILIARY HAS ABOUT 28 MEMBERS THAT HOLD FUND RAISING EVENTS THROUGHOUT THE YEAR. THE FUNDS FROM THESE EVENTS ARE GIVEN BACK TO THE HOSPITAL FOR VARIOUS PROJECTS. PASTORAL CARE THE HOSPITAL HAS VOLUNTEER PASTORS THAT PERFORM MINISTRY TO THE HOSPITAL'S PATIENTS, PATIENTS' FAMILIES, AND STAFF. THIS SERVICE IS AVAILABLE 24 HOURS A DAY/7 DAYS A WEEK. PATIENT COMMENT SURVEYS THE HOSPITAL DISTRIBUTES SURVEYS TO INPATIENT, OUTPATIENTS, AMBULATORY SURGERY, EMERGENCY ROOM, AND HOME CARE PATIENTS TO ASSESS THE NEEDS OF THE PATIENTS IN OUR COMMUNITY REGARDING CARE AND OPPORTUNITIES TO IMPROVE THAT CARE. RESULTS ARE RECEIVED QUARTERLY AND COMPARED TO PRIOR RESULTS. TIME IS SPENT BY HOSPITAL STAFF IN EVALUATING RESULTS, WITH DEPARTMENTAL AND CONSUMER FOLLOW-UP AND WORK PROCESS REDESIGN TO IMPROVE CARE AND SATISFACTION. FOREIGN LANGUAGE & SIGN LANGUAGE INTERPRETING SERVICE THE HOSPITAL PROVIDES INTERPRETING SERVICES AT NO CHARGE TO FOREIGN LANGUAGE AND SIGN LANGUAGE SPEAKING PATIENTS AND PATIENT FAMILY MEMBERS. THESE SERVICES ARE PERFORMED ON AN ON-CALL BASIS. HOSPITAL EMPLOYEES WHO SPEAK A FOREIGN LANGUAGE OR ARE TRAINED IN SIGN LANGUAGE CAN BE USED TO TRANSLATE. THE HOSPITAL ALSO SUBSCRIBES TO AN ON-LINE INTERPRETING SERVICE, LANGUAGE LINE SERVICES. COMMUNITY EDUCATION / PUBLIC AFFAIRS ACTIVITIES IN OUR ROLES AS A LEADING PROVIDER OF HEALTH AND HEALTH-RELATED SERVICES TO JEFFERSON AND SURROUNDING COUNTIES, BROOKVILLE HOSPITAL RECOGNIZES OUR RESPONSIBILITY TO HELP THE PEOPLE OF OUR SERVICE AREA ACHIEVE AND MAINTAIN OPTIMUM HEALTH STATUS. THE ADMINISTRATION AND EDUCATION DEPARTMENT AND THE HEALTHY COMMUNITY COMMITTEE, OFFERS A SERIES OF PROGRAMS THROUGHOUT THE YEAR TO ACHIEVE THIS ROLE. BROOKVILLE HOSPITAL'S EDUCATIONAL EFFORTS ARE HEALTH-RELATED TO HELP FULFILL OUR MISSION OF HELPING PEOPLE IN OUR SERVICE AREA ACHIEVE AND MAINTAIN OPTIMUM HEALTH STATUS. EFFORTS IN THIS AREA INCLUDE FREE COMMUNITY HEALTH AND PATIENT EDUCATION PUBLICATIONS, MATERIALS TO PROMOTE HEALTH-RELATED ACTIVITIES, A PHYSICIAN REFERRAL LINE, AND PARTICIPATION IN LOCAL HEALTH FAIRS. PATIENT SUPPORT AND EDUCATION NUTRITIONAL COUNSELING A REGISTERED DIETITIAN IS AVAILABLE TO MEET WITH PATIENTS AND FAMILIES TO ASSESS NUTRITIONAL NEEDS AND DETERMINE APPROPRIATE NUTRITIONAL GOALS AND STRATEGIES. IN ADDITION, CLASSES ARE OFFERED THROUGHOUT THE YEAR TO THE COMMUNITY ON HEALTHY COOKING, LOW FAT DIET, DIABETES, CARDIOVASCULAR HEALTH. MAMMOGRAMS IN COOPERATION WITH AREA PHYSICIANS, THE HOSPITAL PROVIDES REDUCED FEE MAMMOGRAMS WITH INTERPRETATIONS ON AN ANNUAL BASIS FOR HIGH RISK WOMEN WHO ARE LOW INCOME AND GENERALLY UNINSURED. COMMUNITY CLASSES THE HOSPITAL OFFERS A VARIETY OF COMMUNITY EDUCATION CLASSES THAT INCLUDES CPR, DIABETES EDUCATION, AND A NEW WAY OF LIFE. PATIENT EDUCATION PUBLICATIONS INCLUDES A VARIETY OF PUBLICATIONS SUCH AS THE PATIENT VISITOR GUIDE, THE PATIENT RIGHTS & RESPONSIBILITIES BOOKLET, ADVANCE DIRECTIVES, ETC. MATERIALS TO PROMOTE HEALTH-RELATED ACTIVITIES MATERIALS INCLUDE PROMOTING A VARIETY OF ACTIVITIES INCLUDING HEALTH SCREENING ADS, CANCER ASSESSMENT AND BREAST HEALTH AWARENESS MATERIALS, AND DIABETES EDUCATION CLASSES. VOLUNTARISM BROOKVILLE HOSPITAL'S WORK FORCE, ONE OF THE LARGEST IN THE REGION, IS COMPRISED OF MANY INDIVIDUALS WHO ENGAGE IN PERSONAL COMMUNITY SERVICE. THESE INDIVIDUALS GIVE OF THEIR TIME, TALENT, AND RESOURCES TO MAKE OUR COMMUNITY A BETTER PLACE TO LIVE AND WORK. PHYSICIANS AND EMPLOYEES VOLUNTEER THEIR TIME INDIVIDUALLY, BENEFITING COMMUNITY ORGANIZATIONS AND CAUSES. DURING THE YEAR. EMPLOYEES SPEND TIME PROVIDING CARE, EDUCATING THE COMMUNITY, AND SERVING ON BOARDS OF SOCIAL SERVICE AGENCIES. EMPLOYEES ALSO VOLUNTEER THEIR TIME FOR ADOPT A HIGHWAY, MARCH OF DIMES WALK AMERICA, THE M/S WALK, AND SIT ON VARIOUS COMMUNITY BOARDS. CONTRIBUTIONS EACH YEAR, BROOKVILLE HOSPITAL RECEIVES REQUESTS FOR FINANCIAL SUPPORT FROM NUMEROUS ORGANIZATIONS PROVIDING VALUABLE SERVICES TO OUR COMMUNITY. WHILE WE ARE A NOT-FOR-PROFIT ORGANIZATION, WE DO PROVIDE SUPPORT ON A LIMITED BASIS. UNITED FUND CAMPAIGN BROOKVILLE HOSPITAL EMPLOYEES CONTRIBUTE FUNDS TO THE COMMUNITY THROUGH THE UNITED FUND CAMPAIGN. INFECTION CONTROL COMMUNITY SERVICE THE INFECTION CONTROL DEPARTMENT SHARES POLICIES, PROCEDURES, AND EXPERTISE WITH OTHER HOSPITALS, NURSING HOMES, AND HEALTH CARE PROVIDERS. IN SOLVING INFECTION-RELATED PROBLEMS, HELPING TO DEVELOP PROGRAMS, ETC., AS REQUESTED. THE INFECTION CONTROL DEPARTMENT ALSO PROVIDES FOLLOW-UP TO BLOOD/BODY FLUID EXPOSURES EXPERIENCED BY HOSPITAL PERSONNEL. FOLLOW-UP IS GENERALLY COMPLICATED AND INVOLVES BLOOD WORK FOR EMPLOYEES AND PATIENTS AND COUNSELING AS PROVIDED AFTER EACH EXPOSURE. INFECTION CONTROL COMMUNICATES REGULARLY WITH ALL AREA HEALTH BUREAUS REPORTING COMMUNICABLE DISEASES, THUS AFFORDING CONTINUITY OF FOLLOW-UP INVESTIGATION FOR POTENTIALLY EXPOSED PATIENTS AND STAFF. COMMUNITY EDUCATION WE WORK WITH HIGH SCHOOL STUDENTS TO EDUCATE THEM ABOUT HEALTHCARE CAREERS THROUGH JOB FAIRS AT THE SCHOOL AND BY OFFERING JOB SHADOWING OPPORTUNITIES IN BOTH CLINICAL AND NON-CLINICAL AREAS.
FORM 990, PART IV, LINE 24A	TAX EXEMPT BOND ISSUE: A REFINANCING BOND ISSUE WAS NEGOTIATED BY THE PARENT COMPANY OF BROOKVILLE HOSPITAL, PENN HIGHLANDS HEALTHCARE, INC., TO BENEFIT THE HOSPITALS WITHIN THE PENN HIGHLANDS SYSTEM. PENN HIGHLANDS HEALTHCARE, INC. REPORTED THIS BOND ISSUE ON SCHEDULE K OF ITS FORM 990. PENN HIGHLANDS HEALTHCARE, INC. DOES NOT CARRY THIS LIABILITY ON ITS BALANCE SHEET. RATHER, BROOKVILLE HOSPITAL IS LEGALLY RESPONSIBLE FOR ITS PORTION OF THE LIABILITY AND THUS, REPORTS ITS SHARE ON ITS BALANCE SHEET.
FORM 990, PART VI, SECTION A, LINE 2	BOARD MEMBER RELATIONSHIPS: JOHN SUTIKA AND TIM PENDLETON, MD HAVE A BUSINESS RELATIONSHIP. TIM PENDLETON, MD AND TANIS PENDLETON, MD, HAVE A FAMILY RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 6	MEMBERS/STOCKHOLDERS: DUBOIS REGIONAL MEDICAL CENTER (DRMC) IS THE SOLE MEMBER OF BROOKVILLE HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7A	DECISION APPROVALS: AS THE SOLE MEMBER OF BROOKVILLE HOSPITAL, DRMC'S RESERVED POWERS INCLUDE THE RIGHT TO ELECT THE BOARD OF DIRECTORS OF BROOKVILLE HOSPITAL. CANDIDATES ARE SUBMITTED TO DRMC THROUGH A NOMINATING PROCESS THAT INVOLVES THE APPROVAL OF BROOKVILLE HOSPITAL'S BOARD. AS THE OTHER BODY OF DRMC, PHH HAS THE AUTHORITY TO APPROVE DRMC'S ELECTION OF BROOKVILLE HOSPITAL'S BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B	DECISION APPROVALS: AS THE SOLE MEMBER OF BROOKVILLE HOSPITAL, DRMC'S RESERVED POWERS INCLUDE: -APPROVAL OF ALL FUNDAMENTAL TRANSACTIONS; -APPROVAL OF ALL STRATEGIC PLANS, BUDGETS, AND FEASIBILITY PLANS; -APPROVAL OF THE INCURRENCE, RE-FINANCING OR PREPAYMENT OF ALL INDEBTEDNESS IN EXCESS OF $10,000; -WITH SOME EXCEPTIONS, THE APPROVAL OF THE SECURING OF ANY ENCUMBRANCE OF ASSETS; -WITH SOME EXCEPTIONS, APPROVAL OF THE MAKING OF ANY CAPITAL EXPENDITURES OR ANY CAPITAL ADDITIONS OR IMPROVEMENTS GREATER THAN $10,000; -APPROVAL OF ANY AND ALL AMENDMENTS OF THE ARTICLES AND/OR BYLAWS; -APPROVAL OF ANY CHANGE IN MISSION OR DIRECTION; -APPROVAL OF THE ESTABLISHMENT OF, OR TERMINATION OR WITHDRAWAL FROM, ANY SUBSIDIARY, JOINT VENTURE, OR OTHER PARTNERSHIP OR SHARED GOVERNANCE ARRANGEMENT; -APPROVAL OF AGREEMENTS OF $50,000 OR MORE; AND -APPROVAL OF THIRD PARTY PAYOR AGREEMENTS, COLLECTIVE BARGAINING AGREEMENTS AND AGREEMENTS BETWEEN BROOKVILLE HOSPITAL AND DRMC. AS THE OTHER BODY OF DRMC, PHH HAS THE POWER TO REVIEW AND APPROVE ANY ACTION TAKEN BY DRMC IN EXERCISING THE RESERVED POWERS LISTED ABOVE.
FORM 990, PART VI, SECTION B, LINE 11B	990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE FORM 990 IS REVIEWED BY THE CFO AND CEO AND A COPY IS PROVIDED TO THE BOARD MEMBERS WHO HAVE AN OPPORTUNITY TO ASK QUESTIONS BEFORE THE 990 IS FILED. IN ADDITION, THE REVIEW AND APPROVAL OF THE FORM 990 WILL BE ON THE AGENDA FOR THE NEXT BOARD MEETING AFTER FILING OF THE FORM 990. IF THERE ARE NECESSARY SIGNFICANT CHANGES IDENTIFIED DURING THIS PROCESS, THE ORGANIZATION WILL CONSIDER AMENDING TO REFLECT THESE CHANGES.
FORM 990, PART VI, SECTION B, LINE 12C	CONFLICT OF INTEREST POLICY: THE CONFLICT OF INTEREST STATEMENTS ARE REVIEWED BY THE CEO. ANY BOARD MEMBER WITH A CONFLICT OR POTENTIAL CONFLICT WOULD ABSTAIN FROM VOTING ON ANY MATTER RELATED TO THAT CONFLICT. ADDITIONALLY, THE BOARD MEMBERS ARE GIVEN A QUESTIONNAIRE TO COMPLETE TO ASSIST THE ORGANIZATION IN PROPERLY ANSWERING THE QUESTIONS FOR THE NEW FORM 990. CORPORATE OFFICERS AND KEY EMPLOYEES ARE ALSO REQUIRED TO ANNUALLY DISCLOSE CONFLICTS OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15A	CEO COMPENSATION REVIEW: PHH COMPLETES A REVIEW OF EXECUTIVE SALARIES USING AN INDEPENDENT CONSULTANT AND A COMPENSATION COMMITTEE. THE INDEPENDENT CONSULTANT USES COMPARABILITY DATA IN THE REVIEW AND THE DECISION IS DOCUMENTED IN THE BOARD MINUTES. COMPENSATION WAS LAST REVIEWED IN JUNE 2014.
FORM 990, PART VI, SECTION C, LINE 19	DOCUMENT DISCLOSURE: A FINANCIAL SUMMARY IS PUBLISHED IN THE PAPER EACH YEAR WITH THE ANNUAL REPORT TO THE COMMUNITY. THIS FINANCIAL SUMMARY AND ANNUAL REPORT CAN ALSO BE REVIEWED IN THE HOSPITAL ADMINISTRATIVE OFFICES. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC.
FORM 990, PART IX, LINE 11G, COLUMN A	OTHER FEES FOR SERVICES: $1,598,686 OUTSIDE SERVICES 2,430,012 CONTRACT LABOR 405,425 SERVICE CONTRACTS 61,803 PHYSICIAN FEES ---------- $4,495,926 TOTAL OTHER FEES FOR SERVICES
FORM 990, PART XI, LINE 9	OTHER CHANGES IN NET ASSETS: $23,930 CHANGE IN BENEFICIAL INTEREST IN TRUST

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (15 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrganizationControlledOrganizationInd
PENN HIGHLANDS HEALTHCARE
100 HOSPITAL AVENUE	DUBOIS	PA	15801	320345810	MGMT SERVICES	PA	501(C)(3)	11 C III-FI	NA	false
DUBOIS REGIONAL MEDICAL CENTER
100 HOSPITAL AVENUE	DUBOIS	PA	15801	251490707	HEALTHCARE	PA	501(C)(3)	3	PHH	false
ELK REGIONAL HEALTH CENTER FOUNDATION
763 JOHNSONBURG ROAD	ST MARYS	PA	15857	251636685	SUPPORT	PA	501(C)(3)	11A I	PHH	false
ELCO HOUSING
759 JOHNSONBURG ROAD	ST MARYS	PA	15857	251639115	HOUSING	PA	501(C)(3)	7	PHH	false
ELK REGIONAL PROFESSIONAL GROUP INC
763 JOHNSONBURG ROAD	ST MARYS	PA	15857	251875183	HEALTH CARE	PA	501(C)(3)	3	PHH	false
ELK REGIONAL HEALTH CENTER AUXILIARY
763 JOHNSONBURG ROAD	ST MARYS	PA	15857	251429093	SUPPORT	PA	501(C)(3)	7	PHH	false
ELK REGIONAL HEALTH SYSTEM
763 JOHNSONBURG ROAD	ST MARYS	PA	15857	251636723	HEALTH CARE	PA	501(C)(3)	9	PHH	false
COMMUNITY NURSES HOME HEALTH & HOSPICE
757 JOHNSONBURG ROAD STE 200	ST MARYS	PA	15857	250996070	HEALTH CARE	PA	501(C)(3)	9	CNI	false
COMMUNITY NURSES HOME SUPPORT SERVICES
757 JOHNSONBURG ROAD STE 200	ST MARYS	PA	15857	251623601	HEALTH CARE	PA	501(C)(3)	9	CNI	false
COMMUNITY NURSES INC
757 JOHNSONBURG ROAD STE 200	ST MARYS	PA	15857	251623598	HEALTH CARE	PA	501(C)(3)	7	PHH	false
ELK REGIONAL HEALTH CENTER
763 JOHNSONBURG ROAD	ST MARYS	PA	15857	250585280	HOSPITAL	PA	501(C)(3)	3	PHH	false
CLEARFIELD HOSPITAL
809 TURNPIKE DR	CLEARFIELD	PA	16830	250979346	HOSPITAL	PA	501(C)(3)	3	PHH	false
NATHANIEL D YINGLING CANCER CENTER
815 DOCTORS DR	CLEARFIELD	PA	16830	205114093	RADIATION ONC	PA	501(C)(3)	3	PHH	false
CLEAR-MED PROVIDER CORPORATION
PO BOX 1260	CLEARFIELD	PA	16830	251657668	OUTPAT. PHYS.	PA	501(C)(3)	3	PHH	false
DRMC EMPLOYEE BENEFITS PLAN TRUST
100 HOSPITAL AVE	DUBOIS	PA	15801	256332829	DRMC EMP BENE	PA	501(C)(9)		PHH	false

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd
BROOKCARE INC
100 HOSPITAL ROAD	BROOKVILLE	PA	15825	251477768	OFFICE SPACE	PA	NA	C CORP	$277,582	$1,002,606	1.00000	Yes (true)
CHARITABLE TRUST
				256171730	TRUST	PA	NA	TRUST	$23,930	$218,292	1.00000	Yes (true)

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (true)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	false	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (true)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	BROOKCARE INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Transaction Type	K	TransactionTypeTxt
Involved	$94,944	InvolvedAmt
Method Of Amount Determination	FMV	MethodOfAmountDeterminationTxt