2015-05-15T08:44:35-05:00 2014-06-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2013-07-01 250984595 BROOKVILLE HOSPITAL % JESSICA PARK BROO 8148492312 100 HOSPITAL ROAD Suite BROOKVILLE PA 15825 JULIANNE PEER PRESIDENT 8148492312 2015-05-08 true Brian D Todd P00422601 8148492312 2013 2016-03-07 17:11:31Z PENN HIGHLANDS BROOKVILLE JULIANNE PEER 100 HOSPITAL ROAD BROOKVILLE PA 15825 26533528 false X WWW.BROOKVILLEHOSPITAL.ORG X 1915 PA BROOKVILLE HOSPITAL IS A 35 BED CRITICAL ACCESS HOSPITAL THAT PROVIDES QUALITY HEALTHCARE SERVICES. OUTPATIENT SERVICES INCLUDE RADIOLOGY, LAB, REHABILITATION, AND HOME HEALTH. 9 5 286 9 0 0 126287 130127 27381792 26332064 82242 23093 47159 30724 27637480 26516008 2997 1850 0 0 13676108 13475810 0 0 0 15470531 14384723 29149636 27862383 -1512156 -1346375 20417412 18152186 10583881 9641100 9833531 8511086 X TO PROVIDE QUALITY HEALTHCARE SERVICES TO THE COMMUNITIES THAT WE SERVE IN A COST-EFFECTIVE MANNER. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. false false 18727256 1850 20249357 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. 5625482 6082707 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. 24352738 true true false true false false false false false false true false false true false false false true false false false false false false true false true true false false true false false false true false false false true false false false false false true true true false false true 44 0 true 286 true false false false false false true true false false false false X 9 5 true false false false true true true true true false false true true true true true true true false false PA X JESSICA PARK 8148491408 100 HOSPITAL ROAD BROOKVILLE PA 15825 JULIANNE PEER PRESIDENT BEGINNING 8/2013 40.0 0.0 X X 132605 0 19639 JOHN SUTIKA DIRECTOR/DRMC PRESIDENT/CEO 3.0 40.0 X 0 390352 15728 L GENE HOAK SECRETARY 3.0 0.0 X X 0 0 RONALD KING CHAIRMAN 3.0 0.0 X X 0 0 TIMOTHY PENDLETON MD DIRECTOR 3.0 40.0 X 0 399580 15712 ROSE CAMPBELL PRESIDENT/DIRECTOR END 8/2013 3.0 40.0 X X 0 200540 15529 WILLIAM YOUNG VICE CHAIRMAN 3.0 0.0 X X 0 0 TODD P STOLTZ DIRECTOR 3.0 0.0 X 0 0 EDWARD YAHNER DIRECTOR 3.0 0.0 X 0 0 H ED RICHARDS DMO TREASURER BEGINNING 7/2013 3.0 0.0 X X 0 0 EMERSON TURNBULL CRNA 40.0 0.0 X 151313 0 25206 CYRIL GAMIS MD PHYSICIAN 40.0 0.0 X 253409 0 16119 DAVID GIRARDI DO PHYSICIAN 40.0 0.0 X 312611 0 21695 BARRY J SNYDER MD PHYSICIAN 40.0 0.0 X 150004 0 13081 TANIS PENDLETON PHYSICIAN 40.0 0.0 X 132605 5835 1132547 990472 148544 8 false true false DUBOIS REGIONAL MEDICAL CENTER HOSPITAL MANAGEMENT 1579995 SCHUMACHER GROUP DBA BRKVLE EMER GR EMERGENCY PHYSICIANS 488140 NORTHFORK REHABILITATION PHYSICAL THERAPY 814640 PENN HIGHLANDS HEALTHCARE HOSPITAL MANAGEMENT 344180 WESTERN HEALTHCARE LLC EMERGENCY PHYSICIANS 456688 14 26169 8286 82140 13532 130127 NET PATIENT SERVICE REVENUE 621110 25524297 25524297 EHR REVENUE 621110 348738 348738 MEAL TICKETS 722210 73604 73604 OTHER REVENUE 900099 75732 75732 PHARMACY REVENUE 446110 309693 309693 26332064 22743 22743 0 0 39186 39186 0 39186 39186 350 350 350 350 24558 26169 17520 7038 7038 0 0 LOSS ON EXTINGUISHMENT OF DEBT 900099 -15500 -15500 -15500 26516008 26332064 53817 X 0 1850 1850 0 0 152244 152244 0 181274 181274 10059862 9441557 618305 276544 257653 18891 2065261 1905791 159470 740625 678526 62099 2310559 1950112 360447 6971 6971 175963 175963 0 0 0 4495926 3624810 871116 53620 53620 914601 577760 336841 10255 9681 574 0 710360 581651 128709 75024 43419 31605 0 25234 15337 9897 190787 160950 29837 0 1665425 1404960 260465 270858 234051 36807 MEDICAL SUPPLIES & DRUGS 1919530 1919530 BAD DEBT 1507659 1507659 LICENSES, DUES, SUBSCRIPTIONS 51951 37441 14510 27862383 24352738 3509645 0 362734 358786 4163287 4440382 0 0 4572188 3635543 52772 33690 0 0 0 0 509935 557849 343528 221501 41964387 35013175 8238626 6951212 0 0 36198 18476 0 0 0 37502 2138144 1897245 20417412 18152186 4354037 5078994 0 0 42869 0 0 3697799 0 0 0 0 5889903 864307 0 0 297072 0 10583881 9641100 X 9543805 8187459 95410 105381 194316 218246 9833531 8511086 20417412 18152186 X -1346375 23930 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 900 900 false SCHEDULE C, PART II-B, LINE 1(I) THE ORGANIZATION PAYS DUES TO HOSPITAL COUNCIL OF WESTERN PENNSYLVANIA. A PORTION OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING. 205546 205546 8173310 6535644 1637666 204286 202221 2065 30699725 26919806 3779919 2681520 1355504 1326016 6951212 BEN INT IN PERPETUAL TRUST 218246 INTEREST RECEIVABLE 2166 OTHER ASSETS 12991 DUE FROM AFFILIATES 1479407 EST AMT DUE FROM THIRD PARTIES 184435 1897245 25015898 -1507659 -1507659 26523557 -7549 -7549 26516008 26372244 17520 17520 26354724 1507659 1507659 27862383 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 GOLF OUTING 30209 20519 9690 0 3053 3240 3200 0 296 1-100 EVENT 20518 5650 14868 3650 733 445 2869 0 34 0 0 0 0 0 0 0 0 0 0 50727 26169 24558 3650 3786 3685 6069 0 330 17520 7038 true true X true X false true true false false 190584 190584 0.00720 213901 53798 160103 0.00600 2101954 894899 1207055 0.04550 2506439 948697 1557742 0.05870 4290 4290 0.00020 1850 1850 0.00010 6140 6140 0.00030 2512579 948697 1563882 0.05900 true 1507659 230672 12920298 13778716 -858418 X true false 1 1 BROOKVILLE HOSPITAL 100 HOSPITAL ROAD BROOKVILLE PA 15825 WWW.PHHEALTHCARE.ORG 28050101 X X X X BROOKVILLE HOSPITAL 1 true X X X X 11 true true true X WWW.PHHEALTHCARE.ORG X false false true true 200. false true X X X X X true true X true false X X X X true X false false 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. 5 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 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. false true false false false false false true false JULIANNE PEER PRESIDENT BEGINNING 8/2013 123216 0 6685 0 2704 0 4690 0 14949 0 152244 0 0 0 JOHN SUTIKA DIRECTOR/DRMC PRESIDENT/CEO 0 300458 0 48000 0 41894 0 10200 0 5528 0 406080 0 0 EMERSON TURNBULL CRNA 151244 0 0 0 69 0 5823 0 19383 0 176519 0 0 0 TIMOTHY PENDLETON MD DIRECTOR 0 399104 0 0 0 476 0 10200 0 5512 0 415292 0 0 ROSE CAMPBELL PRESIDENT/DIRECTOR END 8/2013 0 174420 0 17247 0 8873 0 8651 0 6878 0 216069 0 0 CYRIL GAMIS MD PHYSICIAN 253340 0 0 0 69 0 0 0 16119 0 269528 0 0 0 DAVID GIRARDI DO PHYSICIAN 312598 0 0 0 13 0 5576 0 16119 0 334306 0 0 0 BARRY J SNYDER MD PHYSICIAN 149886 0 0 0 118 0 4616 0 8465 0 163085 0 0 0 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 JULIANNE PEER OFFICE EDUC. REIMB. X 20000 14773 false false true TANIS PENDLETON HCE INCOME SUB. X 45000 18917 false true true 33690 LINDA GRINDER SISTER OF RON KING 48669 EMPLOYEE OF HOSPITAL false TANIS PENDLETON SISTER OF T PENDLETON 132605 EMPLOYEE OF HOSPITAL false 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 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 BROOKCARE INC 100 HOSPITAL ROAD BROOKVILLE PA 15825 251477768 OFFICE SPACE PA NA C CORP 277582 1002606 1.00000 true CHARITABLE TRUST 256171730 TRUST PA NA TRUST 23930 218292 1.00000 true false false true false false false false false false false true false false true true true true false false BROOKCARE INC K 94944 FMV