2015-02-12T08:33:30-06:00 2014-06-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2013-07-01 240802108 CHARLES COLE MEMORIAL HOSPITAL % RON RAPP CHAR 8142749300 1001 EAST SECOND STREET Suite COUDERSPORT PA 16915 EDWARD C PITCHFORD CEO 8142749300 2015-02-10 true Brian D Todd P00422601 8142749300 2013 2016-02-25 16:41:14Z EDWARD PITCHFORD 1001 EAST SECOND STREET COUDERSPORT PA 16915 121760233 false X WWW.COLEMEMORIAL.ORG X 1967 PA COLE MEMORIAL PROVIDES EXCELLENT HEALTH CARE SERVICES BY PROVIDING INPATIENT, OUTPATIENT AND PRIMARY CARE SERVICES TO THE SURROUNDING COMMUNITY. SEE SCHEDULE O. 13 9 687 59 56786 55519 1100072 435844 80419342 82532092 662938 1239026 224985 -712779 82407337 83494183 0 0 0 0 34251160 34879345 18500 35000 35000 44227326 45855489 78496986 80769834 3910351 2724349 61179485 71501755 39271637 45661108 21907848 25840647 X THE PURPOSE OF COLE MEMORIAL IS TO PROVIDE EXCELLENT HEALTHCARE SERVICES, RESPONDING TO THE NEEDS OF THE COMMUNITIES WE SERVE. false false 19090626 43477319 COLE MEMORIAL OFFERS OUTPATIENT SERVICES, EXCEEDING 368,000 TESTS/TREATMENTS ANNUALLY THROUGHOUT THE HOSPITAL'S FOUR-COUNTY AREA AND INCLUDING IMAGING, LAB, AND REHABILITATION SERVICES. OUTPATIENT SURGERIES EXCEED 4,000 ANNUALLY. THE PATTERSON CANCER CARE CENTER OFFERS FULL SERVICE RADIATION AND MEDICAL ONCOLOGY SERVICES AND HOUSES AN AMERICAN CANCER SOCIETY PATIENT RESOURCE CENTER ONSITE. THE CANCER CENTER IS HOME TO A VARIETY OF SUPPORT GROUPS, AS WELL AS FREQUENT FREE CANCER SCREENINGS FOR THE PUBLIC. COLE MEMORIAL'S HOME HEALTH AND HOSPICE SERVICES ASSIST PATIENTS THROUGHOUT THE REGION, WITH A GROWING NUMBER OF REFERRALS AND LOWER INFECTION RATES AMONG STATE AND NATIONAL AVERAGES. 17382480 12599481 COLE MEMORIAL PROVIDES PRIMARY CARE TO ITS SURROUNDING COMMUNITIES. THE HOSPITAL PROVIDES PRIMARY CARE TO THE SURROUNDING COMMUNITIES IN FOUR COUNTIES AT RURAL HEALTH CENTERS(RHCS), LOCATED IN COUDERSPORT, GALETON, ULYSSES, WESTFIELD, SHINGLEHOUSE, PORT ALLEGANY, ELDRED, SMETHPORT, AND EMPORIUM. COLLECTIVELY, 90,200 PATIENT VISITS WERE REPORTED LAST YEAR. FOUR OF THOSE LOCATIONS ALSO INCLUDE WELLNESS AND REHABILITATION CENTERS, MAKING IT MORE CONVENIENT FOR PATIENTS TO RECEIVE THE CARE THEY NEED CLOSE TO HOME. SEE SCHEDULE O FOR DETAIL. 13686165 20775694 COLE MEMORIAL OFFERS VARIOUS INPATIENT SERVICES. COLE MEMORIAL ADMITTED 1,550 PATIENTS LAST YEAR (5,080 ACUTE CARE DAYS) TO INPATIENT SERVICES INCLUDING MEDICAL/SURGICAL, INTENSIVE CARE AND OBSTETRICS UNITS. COLE MEMORIAL'S 24-HOUR EMERGENCY DEPARTMENT ADMITTED 840 PATIENTS LAST YEAR AND SAW 9,430 VISITS LAST YEAR. THE HOSPITAL'S MATERNITY UNIT WELCOMED 150 BABIES INTO THE WORLD LAST YEAR AND ALSO SUPPORTS MOTHERS-TO-BE WITH REGULAR LAMAZE AND BREASTFEEDING SUPPORT PROGRAMS AND THE HEALTHY BEGINNINGS PLUS PROGRAM FOR LOW INCOME MOTHERS. 19846690 5679598 70005961 true true false true false false false false true true true false false false true false false true false false false false false true false false true true false false true true false false false false false false false false true true false false false false false true true true false false true 40 0 true 687 true true true false false false false false false false false false X 13 9 false false false false true true false true true false false true true true true true true true false false PA X RON RAPP 8142745250 1001 EAST SECOND STREET COUDERSPORT PA 16915 X MICHAEL E CALLAHAN PHYSICIAN, 2ND VICE CHAIR 40.0 1.0 X X 109960 0 10883 JASON TRONETTI PHYSICIAN, DIRECTOR 40.0 1.0 X 348561 0 29464 CHARLES UPDEGRAFF TREASURER 1.0 1.0 X X 0 0 0 RON CASKEY SECRETARY 1.0 1.0 X X 0 0 0 REVEREND RANDALL HEADLEY CHAIRMAN 1.0 1.0 X X 0 0 0 KALLIOPI NESTOR PHYSICIAN, DIRECTOR 40.0 1.0 X 228883 0 13530 ROBERT SMITH DIRECTOR 1.0 1.0 X 0 0 0 RUSSELL STREICH DIRECTOR 1.0 1.0 X 0 0 0 DAVID BUCKLER DIRECTOR 1.0 1.0 X 0 0 0 DAVID CRANDALL 1ST VICE CHAIRMAN 1.0 1.0 X X 0 0 0 JEANNE MIGLICIO DIRECTOR 1.0 1.0 X 0 0 0 THOMAS SHAFFER DIRECTOR 1.0 1.0 X 0 0 0 CLIFFORD WOOD DIRECTOR 1.0 1.0 X 0 0 0 EDWARD C PITCHFORD PRESIDENT, CEO & ASST. SEC. 40.0 2.0 X 353122 0 31046 CYNTHIA HARDESTY VICE PRESIDENT, CNE 40.0 1.0 X 186687 0 12945 BRADLEY GIANNOTTI PHYSICIAN 40.0 0.0 X 939399 0 24910 TERRANCE FOUST PHYSICIAN 40.0 0.0 X 799190 0 17654 SAKET PRASAD PHYSICIAN 40.0 0.0 X 619605 0 25731 CHRISTAN CARAMIA PHYSICIAN 40.0 0.0 X 465115 0 31244 PHONG NGUYEN PHYSICIAN 40.0 0.0 X 414614 0 14359 4465136 0 211766 36 false true false JAMES BARKE MD PHYSICIAN PRACTICE 655800 FOOT ANKLE INNOVATIONS PC PHYSICIAN 404106 BKD LLP AUDIT/TAX/CONSULTING 127560 ALLEGHANY HOSPITAL ASSOCIATES PHYSICIAN PRACTICE 323750 4 321832 114012 435844 NET PATIENT SERVICE REVENUE 621990 76829755 76829755 PHARMACY 446110 4704447 4704447 CAFETERIA 722514 370541 370541 OTHER 621990 627349 627349 82532092 253903 253903 0 0 265371 279873 -14502 0 -14502 -14502 38928190 43110 37872200 113977 1055990 -70867 985123 985123 0 0 0 GAIN ON INVESTMENT IN EQUITY INVESTEE 900099 203202 203202 INCOME FROM INVESTMENT IN SUBSIDIARIES 900099 -84487 56786 -141273 LOSS ON EXTINGUISHMENT OF DEBT 900099 -816992 -816992 -698277 83494183 82532092 56786 469461 X 0 0 0 0 1240033 639844 600189 0 333157 176955 156202 26079167 22141756 3937411 757206 404392 352814 4522833 3964145 558688 1946949 1490891 456058 683933 683933 164592 9397 155195 127164 127164 0 35000 35000 50280 50280 16087429 15264456 822973 166980 578 166402 5258109 3735561 1522548 0 0 2302948 2133490 169458 386169 344166 42003 0 292949 174737 118212 1049553 939731 109822 0 3083021 2760426 322595 1011332 387803 623529 MEDICAL SUPPLIES & DRUGS 10834937 10834937 BAD DEBT 3684986 3684986 LICENSES, DUES, SUBSCRIPTIONS 526744 233777 292967 RECRUITING & RETENTION 144363 144363 80769834 70005961 10728873 35000 3751622 5496302 1572899 12027870 65739 0 9099480 7852653 0 0 0 0 0 0 1160358 1167930 1603029 1319402 70482610 44992834 25287965 25489776 15117001 13627429 1896128 2420079 536314 805621 0 0 1088950 1294693 61179485 71501755 15132864 12271142 0 0 0 0 17838950 30012945 9029 4070 0 0 3564725 724174 100000 0 2626069 2648777 39271637 45661108 X 17805684 21382406 108028 37683 3994136 4420558 21907848 25840647 61179485 71501755 X 2724349 846750 361700 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true false true 10250 10250 false SCHEDULE C, PART II-B, LINE 1I THE ORGANIZATION IS A MEMBER OF HAP, AHA, AND HCWP. $10,250 OF DUES ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES. false true X 3994146 660852 234440 4420558 3877382 378612 261848 3994146 4280877 -106295 297200 3877382 3667800 942900 329823 4280877 3616355 437150 385705 3667800 1.00000 true false 1135847 1135847 40181580 23357963 16823617 27031143 20278241 6752902 2134040 1356630 777410 25489776 0 DUE TO THIRD PARTY PAYERS 2103754 MALPRACTICE LIABILITY 545023 2648777 80217798 846750 7750 -3294290 -2439790 82657588 836595 836595 83494183 77322191 7750 279873 287623 77034568 50280 3684986 3735266 80769834 SCHEDULE D, PART IV, LINE 2B ESCROW ACCOUNTS: THE CORPORATION HAS AN ESCROW ACCOUNT FOR THEIR SKILLED NURSING FACILITY PATIENTS WHO REQUEST THE USE OF THE ACCOUNT. THIS AMOUNT IS REPORTED ON FORM 990, PART X, LINE 21. SCHEDULE D, PART V, LINE 4 ENDOWMENT FUND: THE ENDOWMENT FUND WAS ESTABLISHED TO ALLOW THE HOSPITAL TO PROVIDE HEALTHCARE SERVICES TO POOR AND NEEDY PATIENTS. 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: $(3,684,986) BAD DEBT EXPENSE (50,280) INVESTMENT MANAGEMENT FEES 440,976 UNRESTRICTED NARR ------------- $(3,294,290) SCHEDULE D, PART XI, LINE 4B OTHER REVENUE ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ (279,873) RENTAL EXPENSES 242,506 UNRESTRICTED CONTRIBUTIONS 475 UNRESTRICTED INVESTMENT RETURN 192,436 TRNA CONTRIBUTIONS (513) TRNA INVESTMENT RETURN 681,564 PRNA INVESTMENT RETURN ------------ $ 836,595 SCHEDULE D, PART XII, LINE 2D OTHER EXPENSES ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25: $ 279,873 RENTAL EXPENSES SCHEDULE D, PART XII, LINE 4B OTHER EXPENSES ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $3,684,986 BAD DEBT EXPENSE X X true DELTA DEVELOPMENT GROUP INC GRANT WRITING false 35000 35000 SCHEDULE G, PART I, LINE 2B FUNDRAISING ACTIVITIES: THE ORGANIZATION HIRED DELTA DEVELOPMENT GROUP, INC., FOR GRANT WRITING SERVICES. THE AGREEMENT PROVIDED FOR A MONTHLY FEE FOR PROFESSIONAL FUNDRAISING SERVICES AS WELL AS REIMBURSEMENT OF ADDITIONAL FUNDRAISING EXPENSES. true true X true X true X true true true false true false 970473 970473 0.01260 13676937 11192539 2484398 0.03220 14647410 11192539 3454871 0.04480 100062 20254 79808 0.00100 1118120 1118120 0.01450 28048659 20560743 7487916 0.09710 3210 3210 29270051 20580997 8689054 0.11260 43917461 31773536 12143925 0.15740 4 120 1588 1588 10 791 28171 15707 12464 0.00020 33 863 4549 4549 0.00010 3 280 1017 1017 50 2054 35325 15707 19618 0.00030 true 3684986 556433 14494373 14350865 143508 X true true 1 1 CHARLES COLE MEMORIAL HOSPITAL 1001 EAST 2ND STREET COUDERSPORT PA 16915 www.colememorial.org 031801 X X X X CHARLES COLE MEMORIAL HOSPITAL 1 true X X X X X X X X X 12 true false true X http://www.colememorial.org/about.aspx X X X X X false false true true 200. true 400. true X X X X X X X X true true X X X X X true false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 3 COMMUNITY INPUT: COLE MEMORIAL USED A 6-STEP APPROACH TO COMPLETE THE NEEDS ASSESSMENT. INCLUDED IN THIS APPROACH WERE SEVERAL DATA ANALYSES, BASED ON SECONDARY SOURCE DATA AUGMENTED WITH COMMUNITY HEALTH SURVEY DATA. SINCE THE SERVICE AREA DOES NOT COMPRISE SOME OF THE ENTIRE COUNTIES WE SERVE, COLE MEMORIAL ASKED LOCAL RESIDENTS TO NOTE IF THEY PERCEIVED THE PROBLEMS, OR NEEDS IDENTIFIED BY SECONDARY SOURCES TO EXIST IN THEIR PORTION OF THE COUNTY THEY LIVE IN. DATA SOURCES USED INCLUDED SEVERAL WEBSITES TO ASSESS THE HEALTH NEEDS OF THE COUNTIES SERVED, ACCESS CURRENT POPULATION DATA, ASSESS CHARACTERISTICS OF CERTAIN HEALTH OBJECTIVES, ADDRESS THE PROBLEM OF ESCALATING HEALTH COSTS, AND CAPTURE DATA THAT CAN HELP UNDERSTAND HEALTH STATISTICS. TO OBTAIN DATA WITHIN THE COMMUNITIES SERVED BY COLE MEMORIAL, ALL COMMUNITY MEMBERS WERE INVITED TO COMPLETE A SURVEY, WHICH WOULD REMAIN ANONYMOUS. THE ADMINISTRATION OF AN INTERNET-BASED AND PAPER SURVEY WAS PROMOTED THROUGH ADVERTISEMENTS IN LOCAL NEWSPAPERS, BLOGS, AND TELEVISION AND WAS DISTRIBUTED TO LOCAL CIVIC AND HEALTH ORGANIZATIONS. SCHEDULE H, PART V, SECTION B, LINE 6 IMPLEMENTATION STRATEGY: IN RESPONSE TO THE RESULTS OF COLE MEMORIAL'S MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT, THE ORGANIZATION ADOPTED AN IMPLEMENTATION STRATEGY. THE IMPLEMENTATION STRATEGY CAN BE FOUND AT THE FOLLOWING URL, AS PART OF THE CHNA: HTTP://WWW.COLEMEMORIAL.ORG/ABOUT.ASPX SCHEDULE H, PART V, SECTION B, LINE 7 ADDRESSING IDENTIFIED NEEDS: ALTHOUGH COLE MEMORIAL RECOGNIZES THE IMPORTANCE OF ALL THE NEEDS IDENTIFIED BY THE COMMUNITY, SUCH AS TRANSPORTATION, WE WILL NOT DIRECTLY DESIGN STRATEGIES FOR THIS ISSUE IN THE IMPLEMENTATION PLAN. TRANSPORTATION DID NOT RANK HIGH IN THE NEEDS ASSESSMENT AND THE STEERING COMMITTEE FELT THAT THERE IS NOT ENOUGH FUNDING AND AVAILABLE RESOURCES TO MAKE THIS A HIGH PRIORITY AT THIS TIME. 11 PORT ALLEGANY HEALTH CENTER 45 PINE STREET PORT ALLEGANY PA 16743 RURAL HEALTH CENTER REHABILITATION LAB SERVICES, RADIOLOGY SHINGLEHOUSE HEALTH CENTER 128 LYONS STREET SHINGLEHOUSE PA 16748 RURAL HEALTH CENTER LAB SERVICES ELDRED HEALTH CENTER 139 MAIN STREET ELDRED PA 16371 RURAL HEALTH CENTER LAB SERVICES EMPORIUM HEALTH CENTER SIZERVILLE ROAD EMPORIUM PA 15834 RURAL HEALTH CENTER LAB SERVICES GALETON HEALTH CENTER 30 RIVER STREET GALETON PA 16922 RURAL HEALTH CENTER LAB SERVICES WESTFIELD RURAL HEALTH CLINIC 222 CHURCH STREET WESTFIELD PA 16950 RURAL HEALTH CENTER LAB SERVICES HEWITT MANOR 111 WEST HONEOYE STREET SHINGLEHOUSE PA 16748 REHABILITATION SMETHPORT HEALTH CENTER 83 MARVIN STREET SMETHPORT PA 16749 RURAL HEALTH CENTER LAB SERVICES NORTHERN POTTER HEALTH CENTER 511 ACADEMY STREET ULYSSES PA 16948 RURAL HEALTH CENTER LAB SERVICES CENTRAL POTTER HEALTH CENTER 46 ELK STREET COUDERSPORT PA 16915 RURAL HEALTH CENTER LAB SERVICES HOME HEALTH 269 ROUTE 6 COUDERSPORT PA 16915 HOME HEALTH OFFICES 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 $3,684,986. SCHEDULE H, PART I, LINE 7G SUBSIDIZED HEALTH SERVICES: SEVERAL RURAL HEALTH CLINICS WERE INCLUDED IN THE COMPUTATION OF SUBSIDIZED HEALTH SERVICES ON LINE 7G. COLE MEMORIAL PROVIDES PRIMARY CARE TO THE SURROUNDING COUNTIES AT THESE RURAL HEALTH CENTERS. THESE SERVICES ARE PROVIDED IN RURAL AREAS WHERE THERE WOULD BE A SHORTAGE OF QUALITY MEDICAL CARE WITHOUT THE SERVICES. COLE MEMORIAL CONTINUES TO PROVIDE THESE SERVICES AS A BENEFIT TO THE COMMUNITY DESPITE KNOWING THAT FINANCIAL SHORTFALLS WILL BE SUSTAINED. SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1, 3, AND 6. SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES: SEE NARRATIVE AT SCHEDULE H, PART VI, LINE 4. SCHEDULE H, PART III, SECTION A, LINES 2 & 3 BAD DEBT EXPENSE METHODOLOGY: LINE 2 REPORTS THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS FROM THE AUDITED FINANCIAL STATEMENTS. LINE 3 WAS DETERMINED BY MULTIPLYING THE BAD DEBT EXPENSE (LINE 2) BY THE PERCENT OF PERSONS BELOW THE POVERTY LEVEL BASED ON US CENSUS BUREAU DATA FOR 2008 - 2012. SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT EXPENSE: THE HOSPITAL PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS, WHICH IS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE PATIENT OR THIRD-PARTY PAYER. SCHEDULE H, PART III, SECTION B, LINE 8 COMMUNITY BENEFIT: MEDICARE DATA COMPUTED USING THE MEDICARE COST REPORT FILED WITH CMS WAS UTILIZED FOR THE COMPUTATIONS IN PART III, SECTION B. MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT, AS COLE MEMORIAL IS CLASSIFIED AS A CRITICAL ACCESS HOSPITAL. THIS CLASSIFICATION SHOWS THAT COLE MEMORIAL IS IN A MEDICALLY UNDERSERVED AREA AND AT A HEALTH PROFESSIONAL SHORTAGE AREA. THIS DEMONSTRATES THAT COLE MEMORIAL IS THE ONLY REASONABLE SOURCE OF HOSPITAL CARE AVAILABLE TO MEDICARE BENEFICIARIES IN OUR SERVICE AREA, AND LIKEWISE TREATS ALL BENEFICIARIES IN OUR SERVICE AREA THAT PRESENT THEMSELVES FOR CARE, DESPITE KNOWING WE WILL GENERALLY LOSE MONEY CARING FOR MEDICARE PATIENTS. ADDITIONALLY, 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: EFFORTS ARE MADE TO IDENTIFY PATIENTS WHO MAY BE ELIGIBLE FOR CHARITY CARE IN ACCORDANCE WITH THE HOSPITAL'S CHARITY CARE POLICY OR THE PHYSICIAN NETWORK SLIDING FEE SCALE PRIOR TO THE STATEMENT PROCESS WHEN POSSIBLE. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: UNDERSTANDING THE HEALTH NEEDS OF THE COMMUNITY ALLOWS COLE MEMORIAL TO DESIGN AND IMPLEMENT COST-EFFECTIVE STRATEGIES THAT IMPROVE THE HEALTH STATUS OF THE POPULATIONS WE SERVE. A COMPREHENSIVE DATA DRIVEN ASSESSMENT PROCESS CAN IDENTIFY PRIORITY HEALTH NEEDS AND ISSUES RELATED TO PREVENTION, DIAGNOSIS AND TREATMENT THROUGH QUANTITATIVE AND QUALITATIVE DATA. COLE MEMORIAL'S COMMUNITY HEALTH NEEDS ASSESSMENT FOCUSES ON THE 28 ZIP CODES THAT WE SERVE. TO HELP GUIDE THE PROCESS USED FOR THE ASSESSMENT, A CHNA STEERING COMMITTEE WAS CONVENED. THIS COMMITTEE'S ROLE WAS TO PROVIDE INPUT ON: (A) IDENTIFICATION OF EXISTING DATA SOURCES FOR THE STUDY; (B) CONTENT OF THE COMMUNITY ONLINE SURVEY QUESTIONNAIRE; (C) INTERPRETATION OF SURVEY FINDINGS; (D) REVIEW OF RECOMMENDATIONS, AND; (E) DATA DISSEMINATION AND A FOLLOW-UP PLAN. IN ADDITION TO THE CHNA STEERING COMMITTEE, COLE MEMORIAL'S ADVISORY COMMITTEES WHICH REPRESENTED PUBLIC HEALTH, GOVERNMENT, FORMER AND PRESENT BOARD MEMBERS, FOUNDATIONS, PASTORS, SCHOOL NURSES, AND VARIOUS OTHER ORGANIZATIONS, PROVIDED CRITICAL INPUT INTO THE NEEDS ASSESSMENT, FROM INITIAL CONCEPT TO HOW THE DATA WOULD BE SHARED WITH COMMUNITIES IN OUR SPRING AND FALL MEETINGS IN 2013. THE SET OF MEASURES USED IN THIS ASSESSMENT WAS SELECTED TO REFLECT EVOLVING NATIONAL AND STATE BENCHMARKS FOR CHRONIC DISEASE MANAGEMENT, ACCESS TO PRIMARY CARE, DENTAL AND SMOKING/TOBACCO. MOST INDICATORS WERE DERIVED FROM PUBLIC DATA SOURCES, INCLUDING U.S. CENSUS DATA, HEALTHY PEOPLE 2020 AND COUNTY HEALTH RANKINGS. A COMPLETE LIST OF DATA SOURCES AND YEARS IS INCLUDED IN APPENDIX E OF THE CHNA. OTHER INDICATORS WERE DERIVED FROM AN ONLINE AND PAPER SURVEY CONDUCTED SPECIFICALLY FOR THIS COMMUNITY HEALTH NEEDS ASSESSMENT. THE ONLINE-BASED AND PAPER FORM SURVEY WAS DEVELOPED BY THE CHNA STEERING COMMITTEE IN JUNE 2012. AN INITIAL REVIEW OF ELEMENTS CONTAINED IN PRIOR COMMUNITY HEALTH NEEDS ASSESSMENT BACK IN 2010 WAS USED. THE SURVEY (APPENDIX C OF THE CHNA) WAS APPROVED AND PROGRAMMED FOR DATA COLLECTION ON AUGUST 1, 2012. THE SURVEY GATHERED INFORMATION FROM CAMERON, MCKEAN, POTTER AND TIOGA RESIDENTS IN THE FOLLOWING AREAS: o HEALTH SERVICES ACCESS AND UTILIZATION o CHRONIC DISEASE MANAGEMENT o YOUTH HEALTH & HEALTH CARE o PRIMARY CARE o WEIGHT o SMOKING o DENTAL CARE o RISK FACTORS o HEALTH INSURANCE o HEALTH CARE BARRIERS o WELLNESS ACTIVITIES AND EXERCISE o DEMOGRAPHICS THE DATA COLLECTION PHASE BEGAN ON AUGUST 1, 2013 AND WAS COMPLETED BY AUGUST 17, 2013. A TOTAL OF 706 COMMUNITY MEMBERS COMPLETED THE SURVEY. THE TOP SIX HEALTH CONCERNS CONVEYED BY THE SURVEY RESPONDENTS AND SECONDARY DATA OF THE COLE MEMORIAL SERVICE AREA INCLUDED OBESITY, ACCESS TO CARE, DIABETES, DENTAL, SMOKING AND HEART DISEASE. WE MADE OUR COMMUNITY HEALTH NEEDS ASSESSMENT WIDELY AVAILABLE VIA WEBSITE. WE ALSO HAVE PLACED HARD COPIES IN OUR ACCOUNTING DEPARTMENT AND COMMUNITY OUTREACH DEPARTMENT. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: THE PATIENT FINANCIAL COUNSELOR CONTACTS SELF-PAY PATIENTS/GUARANTORS TO DISCUSS PAYMENT ARRANGEMENTS. IF THEY ARE UNABLE TO PAY - SHE EXPLAINS THE PROCESS OF APPLYING FOR CHARITY WHICH INCLUDES APPLYING FOR PA MEDICAL ASSISTANCE FIRST AND IF THEY ARE DENIED OR HAVE A PORTION TO PAY, THEN THEY CAN APPLY FOR CHARITY. THE CHARITY APPLICATION IS ON THE BACK OF OUR SELF-PAY STATEMENTS. ALSO, THE HOSPITAL OWNED PHYSICIAN PRACTICES ARE AWARE OF THIS PROGRAM AND REFER PATIENTS/GUARANTORS TO THE PATIENT FINANCIAL COUNSELOR. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: COLE MEMORIAL SERVES PATIENTS MAINLY FROM POTTER, MCKEAN, TIOGA, CAMERON AND ELK COUNTIES IN NORTHCENTRAL PA. ALL OF THE COUNTIES THAT WE SERVE ARE CONSIDERED RURAL AND MOUNTAINOUS. CAMERON COUNTY CURRENTLY HAS THE HIGHEST UNEMPLOYMENT RATE IN THE STATE AND ALL OF THE COUNTIES SERVED ARE BATTLING THE EFFECTS OF THE ECONOMY AND JOB LOSS. OUR POPULATION IS ALSO AGING AS THE AREA OFFERS LITTLE FOR A YOUNGER DEMOGRAPHIC IN THE WAY OF EMPLOYMENT, EDUCATION AND CULTURE. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: THE MISSION OF COLE MEMORIAL IS LARGELY DEPENDENT ON PROVIDING SERVICES AND CARE TO THOSE INDIVIDUALS WHO MAY NOT HAVE THE RESOURCES TO BE AWARE OF, ABLE TO PAY FOR, OR HAVE THE EDUCATION/KNOWLEDGE ABOUT CARE, PROGRAMS AND SERVICES THAT ARE AVAILABLE TO THEM. THROUGH VARIOUS ACTIVITIES COLE MEMORIAL REACHES OUT TO OUR COMMUNITIES TO EDUCATE, IMPROVE HEALTH, PREVENT AND TREAT DISEASE AND SUPPORT INDIVIDUALS AND GROUPS. COLE MEMORIAL, IN COOPERATION WITH COMMUNITY BASED GROUPS SUCH AS 4 ROTARIES AND OSWAYO VALLEY MEMORIAL LIBRARY, PROVIDE FIVE COMPREHENSIVE BLOOD ANALYSIS ANNUALLY. COMPREHENSIVE BLOOD ANALYSIS SCREENINGS ARE PROVIDED IN FIVE RURAL COMMUNITIES: GALETON, SMETHPORT, PORT ALLEGANY, SHINGLEHOUSE AND COUDERSPORT. CBA'S SCREEN OVER 30 OF THE MOST COMMON BLOOD TESTS THAT DETECT HEALTH ISSUES SUCH AS CORONARY HEART DISEASE, LIVER DISEASE, KIDNEY DISEASE, CANCER, THYROID DISEASE, DIABETES, ANEMIA, BONE DISEASE AND RESPIRATORY DISEASE. THESE SCREENINGS ARE PROVIDED AT A FRACTION OF THE COST OF HAVING THESE TESTS PERFORMED THROUGH A FAMILY PHYSICIAN. ALL PARTICIPANTS AND THEIR PRIMARY MEDICAL PROVIDER ARE SENT THE RESULTS AND PROVIDERS FOLLOW-UP WITH INDIVIDUALS WHOSE SCREENING RESULTS INDICATE ABNORMALITIES. FOR MANY INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED AND LIKELY WOULD NOT SEEK MEDICAL CARE UNTIL IT WAS EMERGENT, THESE EVENTS PROVIDE AN AVENUE TO MONITOR THEIR HEALTH AND DETECT POTENTIAL ISSUES BEFORE THEY BECOME EMERGENT. IN ADDITION, THE LOCAL CO-SPONSORS RECEIVE A PORTION OF THE PROCEEDS FROM THESE EVENTS AND UTILIZE THE FUNDS TO PROVIDE SCHOLARSHIPS AND SUPPORT TO LOCAL STUDENTS AND PROJECTS TO BENEFIT THE COMMUNITY. ANNUALLY, COLE MEMORIAL PARTNERS WITH THE AREA AGENCY ON AGING AND THE PENNSYLVANIA DEPARTMENT OF HEALTH TO ADMINISTER SEASON INFLUENZA AND PNEUMOCOCCAL VACCINE TO POTTER COUNTY RESIDENTS WHO ARE OVER THE AGE OF 60 AT NO COST. HOWEVER, RESIDENTS WHO ARE UNDER THE AGE OF 60 WITH A CHRONIC DISEASE ARE ELIGIBLE AS WELL. FY2011 654 NO-COST INFLUENZA VACCINES AND 50 PNEUMOCOCCAL VACCINES WERE ADMINISTERED THROUGH 11 CLINICS IN 7 COMMUNITIES. IN MANY CASES THE UNDERSERVED POPULATIONS ARE MORE LIKELY TO BECOME ILL AND POTENTIALLY FACE EMERGENT HEALTH NEEDS FROM VACCINE-PREVENTABLE DISEASE. BY PROVIDING CLINICS AT COUNTY SENIOR CENTERS AND IN RURAL COMMUNITY SETTINGS MANY INDIVIDUALS WHO WOULD LIKELY NOT RECEIVE THESE COMMON VACCINES CAN BE IMMUNIZED AT NO COST AND IN CLOSE PROXIMITY TO THEIR HOMES. ALSO IN CONJUNCTION WITH THE AREA AGENCY ON AGING, COLE MEMORIAL PROVIDES NO-COST EDUCATION TO COUNTY SENIOR CENTERS. COLE MEMORIAL PROVIDED 7 HEALTH EDUCATION PROGRAMS, EACH PRESENTED AT 4 SENIOR CENTERS FOR A TOTAL OF 30+ SESSIONS. TOPICS INCLUDED IMMUNIZATIONS, QUESTION TO ASK YOUR HEALTHCARE PROVIDER, INJURY PREVENTION, THE DIABETIC FOOT & GOUT, REDUCE RISK OF CANCER/ SIGNS AND SYMPTOMS OF CANCER, AND QUESTIONS REGARDING YOUR MEDICATIONS. FINALLY, AS AN ON-GOING EFFORT TO PROVIDE FULL-SPECTRUM CANCER CARE TO INDIVIDUALS IN RURAL NORTH CENTRAL PENNSYLVANIA, THE PATTERSON CANCER CARE CENTER PHYSICIANS AND STAFF PROVIDED APPROXIMATELY 170 NO-COST CANCER SCREENINGS. SCREENINGS INCLUDED SCREENINGS FOR PROSTATE, COLORECTAL AND SKIN CANCER. SCREENINGS WERE PERFORMED BY ONCOLOGY PHYSICIANS WHO SPECIALIZE IN THE DETECTION, DIAGNOSIS AND TREATMENT OF CANCER. INDIVIDUALS PARTICIPATING IN THESE SCREENINGS WERE BOTH MALE AND FEMALE, ADULT AND SENIOR AND UNINSURED/UNDERINSURED. ALONG WITH MANY OTHER PROGRAMS SUCH AS SUPPORT GROUPS, SPEAKER'S BUREAU, 9 AGENCY WELLNESS COLLABORATIVE, WORKFORCE DEVELOPMENT, ECONOMIC SUPPORT, COMMUNITY LEADERSHIP, PARTNERSHIPS WITH LOCAL CIVIC, GOVERNMENT, SCHOOL DISTRICTS AND COMMUNITY GROUPS, COLE MEMORIAL CONTINUES EFFORTS TO ASSURE THAT HEALTHCARE, IN ALL FORMS, IS ACCESSIBLE AND AVAILABLE TO THOSE WHO MAY OTHERWISE GO WITHOUT. COLE MEMORIAL PROVIDES THE COMMUNITY WITH SPACE FOR EVENTS, MEETINGS AND PROGRAMS SUCH AS SUPPORT GROUPS, ANNUAL EVENTS, TRAINING SESSIONS AND YOUTH SPORTS. COLE MEMORIAL'S EMPLOYEE GIVING CLUB, HEART OF COLE, HAS A DESIGNATED GROUP THAT FOCUSES ON COMMUNITY CONNECTIONS. COLE MEMORIAL STRIVES TO LIVE UP TO ITS NON-PROFIT MISSION EVERY DAY, PROVIDING EXCELLENT HEALTHCARE SERVICES TO OUR AREA AND LISTENING AND RESPONDING TO THE COMMUNITIES WE SERVE. IN AN EFFORT TO PLAN FOR THE UNIQUE NEEDS OF COMMUNITIES IN THE SERVICE AREA, FIVE COMMUNITY BENEFIT ADVISORY COMMITTEES WERE ESTABLISHED AS A MAJOR INITIATIVE TO DEEPEN AND STRENGTHEN ITS CONNECTION WITH THE COMMUNITY AND TO LINK COMMUNITY BENEFIT ACTIVITIES TO STRATEGIC AND OPERATIONAL PLANS. THE ROLE OF THE COMMITTEES IS TO IDENTIFY THE NEEDS AND CONCERNS OF THE COMMUNITY, ADVISE ABOUT THE BEST WAY TO PARTNER WITH THE COMMUNITY, AID IN THE DEVELOPMENT OF MEANINGFUL COMMUNITY PROGRAMS AND ACTIVITIES, AND PROMOTE IMPROVED COMMUNICATIONS BETWEEN THE HOSPITAL AND THE COMMUNITY. THE HOSPITAL PROVIDES DEDICATED ADMINISTRATIVE TIME TO PLANNING AND CONDUCTING FIVE CBAC MEETINGS IN THE COMMUNITIES WE SERVE THREE TIMES PER YEAR. LASTLY, COLE MEMORIAL OFTEN PARTNERS WITH FUNDING FOUNDATIONS TO PROVIDE HEALTH SPECIFIC IMPROVEMENT INITIATIVES IN THE COMMUNITIES WHICH WE SERVE. AS AN EXAMPLE, COLE MEMORIAL, WITH FUNDING FROM THE MAKING STRIDES AGAINST BREAST CANCER FOUNDATION, TO PROVIDE A NIGHT FOR WOMEN WHO HAVE OR HAD BREAST CANCER. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: THE AFFILIATED HEALTH CARE SYSTEM INCLUDES CHARLES COLE MEMORIAL HOSPITAL (COLE MEMORIAL), COLE CARE, INC., HENDORN, INC., AND COLE FOUNDATION. COLE MEMORIAL (THE "HOSPITAL") PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES TO PATIENTS IN COUDERSPORT, PENNSYLVANIA. THE HOSPITAL ALSO OPERATES A HOME HEALTH AGENCY AND A NUMBER OF PHYSICIAN CLINICS IN THE SAME GEOGRAPHIC AREA. COLE CARE, INC., A WHOLLY OWNED SUBSIDIARY OF THE HOSPITAL, OPERATES A DURABLE MEDICAL EQUIPMENT COMPANY FOR THE SALE AND RENTAL OF EQUIPMENT. HENDORN, INC., D/B/A COLE MANOR (COLE MANOR), OF WHICH THE HOSPITAL IS THE SOLE CORPORATE MEMBER, OWNS AND OPERATES A 30-BED PERSONAL CARE RESIDENTIAL FACILITY AND PROVIDES HOMEMAKER SERVICES. COLE FOUNDATION PROVIDES SUPPORT TO THESE ORGANIZATIONS THROUGH FUNDRAISING ACTIVITIES. X X X X X false false false false false false false true false JASON TRONETTI PHYSICIAN, DIRECTOR 246070 0 102251 0 240 0 6372 0 23092 0 378025 0 0 0 KALLIOPI NESTOR PHYSICIAN, DIRECTOR 228558 0 0 0 325 0 5750 0 7780 0 242413 0 0 0 EDWARD C PITCHFORD PRESIDENT, CEO & ASST. SEC. 285070 0 43261 0 24791 0 6375 0 24671 0 384168 0 0 0 CYNTHIA HARDESTY VICE PRESIDENT, CNE 149708 0 18011 0 18968 0 4388 0 8557 0 199632 0 0 0 BRADLEY GIANNOTTI PHYSICIAN 934221 0 4278 0 900 0 6375 0 18535 0 964309 0 0 0 TERRANCE FOUST PHYSICIAN 695681 0 102969 0 540 0 6375 0 11279 0 816844 0 0 0 SAKET PRASAD PHYSICIAN 523602 0 77610 0 18393 0 6375 0 19356 0 645336 0 0 0 CHRISTAN CARAMIA PHYSICIAN 464673 0 0 0 442 0 6375 0 24869 0 496359 0 0 0 PHONG NGUYEN PHYSICIAN 414221 0 0 0 393 0 6375 0 7984 0 428973 0 0 0 SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS: SOME OF THOSE LISTED IN FORM 990, PART VII RECEIVED PAYOUTS OF ACCRUED BONUSES AND ACCRUED ADDITIONAL BONUSES FOR PARTICIPATING IN THE EXECUTIVE TEAM INCENTIVE COMPENSATION PROGRAM. EACH PARTICIPANT HAD AN ESTABLISHED TARGET TOTAL COMPENSATION BASED ON INDUSTRY SURVEYS AND THE INCENTIVE PROGRAM COMPRISED APPROXIMATELY 10% OF THE TARGETED TOTAL COMPENSATION. THE BONUS WAS BASED ON OVERALL PERFORMANCE. A POTTER COUNTY HOSPITAL AUTHORITY 256691439 2013-12-19 20575000 REFUND BONDS/LOAN,PURCH CAP EQUIP false false false B POTTER COUNTY HOSPITAL AUTHORITY 256691439 2014-06-25 9800000 OPER ROOM EXPANSION,FACIL UPGRADES false false false A 0 0 20575000 700000 0 14949169 127545 0 0 3954913 0 843373 true false false true B 0 0 9800000 300000 0 0 41073 0 0 65717 0 9393210 false false false true A false false false false 0.00000 0.00000 0.00000 false false false true B false false false false 0.00000 0.00000 0.00000 false false false true A false true false false false false 0 false 0 false true B false true false false false false 0 false 0 false true A true B true COLE CARE COMMON BOARD MEMBERS 7917971 RENT, DIVIDENDS, SERVICES false EDMOND HARDESTY HUSBAND OF C. HARDESTY 151114 EMPLOYEE OF HOSPITAL false ADAM NESTOR HUSBAND OF K. NESTOR 89013 EMPLOYEE OF HOSPITAL false VICTORIA COPP SISTER OF J. MIGLICIO 36036 EMPLOYEE OF HOSPITAL false NANCY RUDOLPH SISTER OF J. MIGLICIO 45397 EMPLOYEE OF HOSPITAL false FORM 990, PART I, LINE 1 ORGANIZATION'S MISSION: COLE MEMORIAL IS A FULL SERVICE, COMPREHENSIVE HEALTH SYSTEM, SERVING POTTER, MCKEAN, CAMERON, AND TIOGA COUNTIES IN RURAL, NORTH CENTRAL PA AND PORTIONS OF NEW YORK STATE AND IS THE ONLY HOSPITAL IN POTTER COUNTY (COUDERSPORT, PA). COLE MEMORIAL IS A CRITICAL ACCESS HOSPITAL PROVIDING PRIMARY, EMERGENCY, AND SPECIALTY CARE, AS WELL AS REHABILITATION AND WELLNESS SERVICES TO PATIENTS WITHIN A 50-MILE RADIUS. COLE MEMORIAL STRIVES TO LIVE UP TO ITS NON-PROFIT MISSION EVERY DAY, PROVIDING EXCELLENT HEALTHCARE SERVICES TO OUR AREA AND LISTENING AND RESPONDING TO THE COMMUNITIES WE SERVE. IN AN EFFORT TO PLAN FOR THE UNIQUE NEEDS OF COMMUNITIES IN THE SERVICE AREA, FIVE COMMUNITY BENEFIT ADVISORY COMMITTEES WERE ESTABLISHED AS A MAJOR INITIATIVE TO DEEPEN AND STRENGTHEN OUR CONNECTION WITH THE COMMUNITY AND TO LINK COMMUNITY BENEFIT ACTIVITIES TO STRATEGIC AND OPERATIONAL PLANS. THE ROLE OF THE COMMITTEES ARE TO IDENTIFY THE NEEDS AND CONCERNS OF THE COMMUNITY, ADVISE ABOUT THE BEST WAY TO PARTNER WITH THE COMMUNITY, AID IN THE DEVELOPMENT OF MEANINGFUL COMMUNITY PROGRAMS AND ACTIVITIES, AND PROMOTE IMPROVED COMMUNICATIONS BETWEEN THE HOSPITAL AND THE COMMUNITY. THE HOSPITAL PROVIDES DEDICATED ADMINISTRATIVE TIME TO PLANNING AND CONDUCTING FIVE CBAC MEETINGS IN THE COMMUNITIES WE SERVE THREE TIMES PER YEAR. FORM 990, PART III, LINE 4 PROGRAM SERVICE ACCOMPLISHMENTS: LINE 4B ONE OUTLYING CENTER OFFERS IMAGING SERVICES, WHILE ALL RHCS PROVIDE LAB DRAWS SO PATIENTS DON'T HAVE TO DRIVE TO RECEIVE NECESSARY TESTING. IN ADDITION TO THE FAMILY AND INTERNAL MEDICINE SERVICES AT RHCS, PHYSICIAN PRACTICES ALSO PROVIDE SPECIALTY CARE INCLUDING PEDIATRICS, GASTROENTEROLOGY, ORTHOPEDICS, PHYSIATRY, SURGERY, PODIATRY, OBSTETRICS/GYNECOLOGY AND ONCOLOGY. LINE 4C IN ADDITION TO THE HOSPITAL'S ACUTE CARE FLOORS, COLE MEMORIAL CARES FOR PATIENTS IN ITS 49-BED SKILLED NURSING AND REHABILITATION UNIT WHICH REPORTED 16,353 DAYS LAST YEAR. A 10-BED INPATIENT GERIATRIC BEHAVIORAL HEALTH UNIT ADMITTED 163 PATIENTS LAST YEAR. LINE 4D THE ORGANIZATION ALSO OFFERS CARDIO-PULMONARY SERVICES, CLINICAL SERVICES, CLINICS, AND CORPORATE SERVICES. FORM 990, PART VI, SECTION A, LINES 6 & 7A MEMBERS: THE MEMBERS OF THE CORPORATION, COLE MEMORIAL, SHALL BE KNOWN AS COMMUNITY BENEFIT ADVISORS ("ADVISORS"), WHOSE FUNCTIONS AND QUALIFICATIONS SHALL INCLUDE THE FOLLOWING: (A) PROMOTE THE PROGRAMS, GOALS AND OBJECTIVES OF COLE MEMORIAL; (B) EDUCATE THEIR PUBLIC CONTACTS, BOTH ON HEALTH CARE ISSUES AND ON SERVICES AND PROGRAMS AVAILABLE THROUGH COLE MEMORIAL, AND SEEK THEIR SERVICES WHEN NECESSARY AND APPROPRIATE; (C) PROVIDE AN IMPORTANT LINK BETWEEN COLE MEMORIAL, THE OTHER INSTITUTIONS AND BUSINESSES WHICH THEY REPRESENT, AND THE COMMUNITIES SERVED BY THE HOSPITAL; (D) ATTEND REGULAR MEETINGS, TO SHARE INFORMATION ON ACTIVITIES AND TAKE APPROPRIATE ACTION TO SUPPORT AND GUIDE COLE MEMORIAL; (E) PROVIDE SPECIAL ASSISTANCE ON PROJECTS AND ISSUES WHEN REQUESTED; (F) PARTICIPATE IN FUNDRAISING EFFORTS TO BENEFIT PATIENT CARE PROGRAMS FOR COLE MEMORIAL; AND (G) BE A CITIZEN IN GOOD STANDING, AS DETERMINED BY THE EXECUTIVE COMMITTEE OF THE BOARD, IN A COMMUNITY SERVED BY THE HOSPITAL. THE MEMBERS SHALL BE DIVIDED INTO TWO CLASSES: (A) ACTIVE ADVISORS (B) HONORARY ADVISORS THE ADVISORS SHALL ANNUALLY ELECT: (A) SUCCESSORS TO THE BOARD OF DIRECTORS WHOSE TERMS EXPIRE. (B) HONORARY DIRECTORS AND HONORARY ADVISORS. UPON NOMINATION BY THE EXECUTIVE COMMITTEE PER SECTION 5.2.2.(E) OF THESE BYLAWS, ALL ADVISORS SHALL BE ELECTED BY A TWO THIRDS VOTE OF THE MEMBERS PRESENT AND VOTING AT A DULY CALLED MEETING OF THE MEMBERS WHICH A QUORUM IS PRESENT. (A) AN ACTIVE ADVISOR OF COLE MEMORIAL SHALL BE A MEMBER FOR A TERM OF FIVE (5) YEARS AFTER HIS ELECTION, OR UNTIL HIS EARLIER RESIGNATION. THERE IS NO LIMIT ON THE NUMBER OF TERMS AN ADVISOR CAN SERVE. (B) AN HONORARY ADVISOR MAY BE ELECTED BY THE ACTIVE ADVISORS AND SHALL SERVE FOR LIFE, IN RECOGNITION OF MERITORIOUS OR FAITHFUL SERVICE TO COLE MEMORIAL OR IN RECOGNITION OF DISTINGUISHED ACHIEVEMENT. (C) EACH ADVISOR OWES A DUTY OF UNDIVIDED AND UNQUALIFIED LOYALTY TO THE ORGANIZATION. ADVISORS MAY NOT USE THEIR POSITIONS TO PROFIT PERSONALLY OR TO ASSIST OTHERS IN PROFITING IN ANY WAY AT THE EXPENSE OF THE ORGANIZATION. (D) ADVISORS SHALL AVOID ALL CONFLICTS OF INTEREST AND THE APPEARANCE OF ANY CONFLICT OF INTEREST. A CONFLICT OF INTEREST OCCURS IN ANY SITUATION IN WHICH ONE IS POTENTIALLY NOT ABLE TO REMAIN IMPARTIAL OR MAINTAIN OBJECTIVITY IN CHOOSING BETWEEN THE INTERESTS OF THE ORGANIZATION AND ONE'S PERSONAL INTERESTS OR THE INTERESTS OF THIRD PARTIES. TO AVOID THE APPEARANCE OF A CONFLICT OF INTEREST, AN ADVISOR SHALL NOT PARTICIPATE IN THE MAKING OF ANY DECISION OR RECOMMENDATION CONCERNING A MATTER WHICH MAY RESULT IN ANY BENEFIT OR FINANCIAL GAIN, EITHER DIRECTLY OR INDIRECTLY, TO THE ADVISOR OR A MEMBER OF HIS/HER IMMEDIATE FAMILY. IN ADDITION, FULL DISCLOSURE OF THE PERTINENT FACTS REGARDING THE POTENTIAL CONFLICT OF INTEREST SHOULD BE PROVIDED BY THE ADVISOR. (E) NO ADVISOR SHALL HAVE ANY VESTED RIGHT, INTEREST OR PRIVILEGE OF, IN, OR TO THE ASSETS, FUNCTIONS, AFFAIRS OR FRANCHISES OF THE CORPORATION OR ANY SUCH RIGHT, INTEREST OR PRIVILEGE WHICH MAY BE TRANSFERABLE OR INHERITABLE, OR WHICH SHALL CONTINUE IF HIS MEMBERSHIP CEASES. NO ADVISOR SHALL BE AN EMPLOYEE OF THE HOSPITAL OR ANY OF ITS AFFILIATES. (F) ADVISORS SHALL INCLUDE REPRESENTATIVES FROM VARIOUS ECONOMIC, SOCIAL AND OCCUPATIONAL GROUPS BROADLY REPRESENTATIVE OF THE DEMOGRAPHIC CHARACTERISTICS OF THE COMMUNITIES SERVED BY THE HOSPITAL, AND SHALL ALL HAVE AN INTEREST IN AND COMMITMENT TO FURTHER THE HEALTH AND WELL-BEING OF THE CITIZENS OF THE HOSPITAL'S SERVICE AREA. (G) THE SECRETARY OF THE BOARD SHALL ACT AS LIAISON TO THE COMMUNITY BENEFIT ADVISORS. THE NUMBER OF ADVISORS SHALL NOT BE LESS THAN FIFTY (50) NOR MORE THAN ONE HUNDRED (100), EXCLUSIVE OF HONORARY ADVISORS. EVERY ACTIVE ADVISOR SHALL BE ENTITLED TO ONE (1) VOTE AT ANY MEETING OF THE ADVISORS IN WHICH A VOTE IS TAKEN FOR ANY ELECTION OR ON ANY MATTER OR TRANSACTION. IN THE CASE OF VOTING FOR THE ELECTION OF DIRECTORS, EACH ADVISOR MUST CAST ONE (1) VOTE FOR EACH POSITION TO BE FILLED OR THE BALLOT WILL BE VOID AS IT PERTAINS TO THE ELECTION OF DIRECTORS. VOTING FOR DIRECTORS SHALL BE BY WRITTEN BALLOT BY FIRST CLASS MAIL, POSTMARKED NO LATER THAN TWENTY (20) DAYS PRIOR TO THE DATE SELECTED FOR THE ANNUAL MEETING. EVERY ADVISOR SHALL BE ENTITLED IN RETURNING HIS BALLOT FOR THE ANNUAL ELECTION OF DIRECTORS, TO DIRECT THAT HIS VOTE BE WITHHELD FROM ONE (1) OR MORE OF THE CANDIDATES SUBMITTED BY THE NOMINATING COMMITTEE AND ANY SUCH ADVISOR MAY, ON HIS BALLOT, MAY SET FORTH THE NAME OF ANY PERSON FOR WHOM HE WISHES TO RECORD HIS VOTE FOR A DIRECTOR OF THE CORPORATION. RESULTS OF THE ELECTION PROCESS WILL BE ANNOUNCED AT THE ANNUAL MEETING OF THE ADVISORS. HONORARY ADVISORS SHALL RECEIVE NOTICES OF AND MAY ATTEND ALL MEETINGS OF THE ADVISORS BUT SHALL NOT BE ENTITLED TO VOTE ON ANY MATTER. THE ELECTION PROCESS WILL BE ANNOUNCED AT THE ANNUAL MEETING OF THE ADVISORS. HONORARY ADVISORS SHALL RECEIVE NOTICES OF AND MAY ATTEND ALL MEETINGS OF THE ADVISORS BUT SHALL NOT BE ENTITLED TO VOTE ON ANY MATTER. FORM 990, PART VI, SECTION B, LINE 11B FORM 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 990 IS THEN REVIEWED BY THE ACCOUNTING DEPARTMENT AND THE CONTROLLER. IT IS THEN PRESENTED TO THE GOVERNANCE OVERSIGHT COMMITTEE FOR REVIEW. AFTER THE GOVERNANCE OVERSIGHT COMMITTEE HAS REVIEWED, A FULL COPY IS DISTRIBUTED TO THE BOARD OF DIRECTORS PRIOR TO THE CEO'S FINAL SIGNATURE. THE OVERSIGHT COMMITTEE WILL REPORT THEIR REVIEW OF FORM 990 TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: MEMBERS OF THE BOARD OF DIRECTORS; BOARD COMMITTEES; MANAGEMENT EMPLOYEES; AND MEDICAL STAFF WITH ADMINISTRATIVE RESPONSIBILITIES ARE COVERED UNDER THE CONFLICT OF INTEREST POLICY. THE LEVELS AT WHICH ACTUAL CONFLICTS ARE REVIEWED ARE THE COMPLIANCE OFFICER AND GOVERNANCE OVERSIGHT COMMITTEE OF THE BOARD OF DIRECTORS. RESTRICTIONS INCLUDE: A MEMBER OF THE BOARD/BOARD COMMITTEE MUST DISCLOSE THE EXISTENCE OF HIS/HER FINANCIAL INTEREST. A VOTING MEMBER OF ANY COMMITTEE WHOSE SCOPE OF RESPONSIBILITIES INCLUDES COMPENSATION MATTERS AND WHO RECEIVES COMPENSATION, DIRECTLY OR INDIRECTLY, FROM THE HOSPITAL FOR SERVICES IS PRECLUDED FROM VOTING ON MATTERS PERTAINING TO THAT MEMBER'S COMPENSATION. PHYSICIANS WHO RECEIVE COMPENSATION, DIRECTLY OR INDIRECTLY, FROM THE HOSPITAL, WHETHER AS EMPLOYEES OR INDEPENDENT CONTRACTORS, ARE PRECLUDED FROM MEMBERSHIP ON ANY COMMITTEE WHOSE PRIMARY SCOPE OF RESPONSIBILITIES INCLUDES COMPENSATION MATTERS. A MANAGEMENT EMPLOYEE, OR A MEDICAL STAFF MEMBER WITH ADMINISTRATIVE RESPONSIBILITIES MUST DISCLOSE TO THE SENIOR LEADER THE EXISTENCE OF THE FINANCIAL INTEREST AND ALL RELATED MATERIAL FACTS. FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION DETERMINATION: A REVIEW WAS CONDUCTED IN 2013 FOR PRESIDENT & CEO EDWARD PITCHFORD BY 3C COMPENSATION CONSULTING CONSORTIUM, LLC, LOCATED IN PITTSBURGH, PENNSYLVANIA. THE BOARD WOULD HAVE TO APPROVE ANY INCREASE RECOMMENDED BY THE GOVERNANCE OVERSIGHT COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT AVAILABILITY: THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS CAN BE VIEWED ONSITE THROUGH A WRITTEN REQUEST TO THE ORGANIZATION'S CORPORATE COMPLIANCE OFFICER. REQUESTS FOR FINANCIAL STATEMENTS AND 990'S ARE FORWARDED TO THE FINANCE / ACCOUNTING DEPARTMENT AND ARE OPEN FOR PUBLIC INSPECTION. FORM 990, PART VII, SECTION A BOARD MEMBER COMPENSATION: NO BOARD MEMBERS RECEIVE ANY COMPENSATION FOR THEIR DIRECTOR DUTIES. MICHAEL CALLAHAN IS COMPENSATED BY COLE MEMORIAL AS A PHYSICIAN. JASON TRONETTI IS COMPENSATED BY COLE MEMORIAL AS A PHYSICIAN. KALLIOPI NESTOR IS COMPENSATED BY COLE MEMORIAL AS A PHYSICIAN. EACH WORK APPROXIMATELY 40 HOURS PER WEEK IN THESE ROLES. FORM 990, PART IX, LINE 11G OTHER FEES FOR SERVICES: $ 9,780,863 PROFESSIONAL FEES 5,788,453 PURCHASED SERVICES 366,076 DIRECTOR FEES 152,037 CONTRACTED SERVICES ---------- $16,087,429 FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: $361,700 AMORTIZATION OF NET LOSS HENDORN INC DBA COLE MANOR 1001 EAST SECOND STREET COUDERSPORT PA 16915 231972659 RESIDENT CARE PA 501(C)(3) 11A I COLE MEM true HAMOTCOLE VENTURES INC 1001 EAST SECOND STREET COUDERSPORT PA 16915 273172100 REAL ESTATE PA 501(C)(3) 11A I NA false COLE FOUNDATION INC 1001 EAST SECOND ST COUDERSPORT PA 16915 455417308 SUPPORT PA 501(C)(3) 11A I COLE MEM true COLE CARE INC 1001 EAST 2ND STREET COUDERSPORT PA 16915 251497347 DURABLE MED EQUIP PA COLE MEMORIAL C CORPORATION 9634083 971411 1.00000 true true false false false false false false false false true true true true true true true false true false COLE CARE INC A/J 178970 FMV COLE CARE INC L 187152 FMV HENDORN INC M 448322 FMV COLE CARE INC O 7500661 FMV COLE CARE INC P 51188 FMV HENDORN INC R 105487 FMV