2014-05-14T14:15:29-05:00 2013-06-30 990 2012-07-01 251875178 Alle-Kiski Medical Center % MATTHEW PETERSON ALLE 4125446668 C/O Tax Dept 120 Fifth Ave Suit Suite Pittsburgh PA 15212 Elizabeth Allen 4125446668 2014-05-09 2012 2016-03-07 17:11:31Z X Matthew Peterson 30 Isabella Street Pittsburgh PA 15212 195627889 false X www.wpahs.org X 2000 PA See Form 990, Page 2, Part III, Question 1 13 10 1235 169 4526454 -2813158 75653 10020 123807673 116972070 1031554 1175923 4877521 7791006 129792401 125949019 1168 1000 0 0 55223034 57640689 0 0 0 68225339 70515458 123449541 128157147 6342860 -2208128 92939334 102598203 94485665 134186914 -1546331 -31588711 X Alle-Kiski Medical Center is a team of care givers committed to improving health and promoting wellness in our communities, one person at a time. We pledge to consistently deliver safe, compassionate quality healthcare by treating the whole person - body, mind and spirit. false false 35040045 15611433 Alle-Kiski Medical Center is a team of care givers committed to improving health and promoting wellness in our communities, one person at a time. We pledge to consistently deliver safe, compassionate quality healthcare by treating the whole person - body, mind and spirit. To complete this mission, Alle-Kiski Medical Center provides Medical services to all patients regardless of their ability to pay. 23986058 8002153 Alle-Kiski Medical Center is a team of care givers committed to improving health and promoting wellness in our communities, one person at a time. We pledge to consistently deliver safe, compassionate quality healthcare by treating the whole person - body, mind and spirit. Alle-Kiski Medical Center provides Onocology services to all patients regardless of their ability to pay. 8045475 6646996 Alle-Kiski Medical Center is a team of care givers committed to improving health and promoting wellness in our communities, one person at a time. We pledge to consistently deliver safe, compassionate quality healthcare by treating the whole person - body, mind and spirit. Alle-Kiski Medical Center provides Behavioral Health services to all patients regardless of their ability to pay. 47288705 1000 89676689 Other Medical Services Provided To Our Patients 47288705 1000 89676689 114360283 true true false false false false false false false true true true false false true true false true false false false false false false false false true true false false true true false false false false false false false false false false false false false false false true true true false false true 89 0 true 1235 true true true false false false false false false false false false X 13 10 true true true false true true true true true false false true true true true true true true true false PA X MATTHEW PETERSON 4123306090 30 ISABELLA STREET Pittsburgh PA 15212 X Russell Evans 1.0 X X David Bonvenuto 1.0 X Jason Ross 1.0 X Russell Livingston 1.0 X Ginger Taylor 1.0 X David Shin MD 1.0 X Janis Evans 1.0 X Hadi Firoz MD 1.0 39.0 X 0 334716 0 Robin Bergstrom 1.0 X Jerry Taylor MD 1.0 X John Balacko MD 1.0 39.0 X 0 594268 0 Emanual Dinatale 1.0 X John Isherwood 1.0 X Ned Laubacher 1.0 39.0 X X 0 333121 0 Robert Brandfass 1.0 39.0 X 0 478243 0 Matthew Peterson 1.0 39.0 X 0 281808 0 Michael Sirott 1.0 39.0 X 0 193042 0 Michael Harlovic 40.0 X 230813 0 0 William Englert 40.0 X 146703 0 0 Walter Hoover 40.0 X 140696 0 0 Nancy Kantorski 40.0 X 112714 0 0 Diane Bowser 40.0 X 115939 0 0 Mary Wasilowski 40.0 X 117502 0 0 Eric Yarnell 40.0 X 147611 0 0 Christopher Olivia MD X 0 1261143 0 Diane Dismukes X 0 833367 0 Roy Santarella X 0 703046 0 David Kiehn X 0 619128 0 George Sandora X 0 157687 0 1011978 5789569 0 12 true true false MModal Services LTD PO Box 102467 ATLANTA GA 30368 Transcription Servic 324857 Clean Care 51ST and AV R R PITTSBURGH PA 15201 Linen Services 475031 Emergency Medicine Physician -Alle- 4535 Dressler Road CANTON OH 44718 Emergency Med. Care 168000 Laser Technology Services Ltd 1009 Merchant Street AMBRIDGE PA 15003 Laser Service 143450 JSO Associates 1301 Carlisle St NATRONA HEIGHTS PA 15065 Lithotripsy Service 156098 5 X 10020 10020 PATIENT SERVICE REVENUE 621500 116972070 112909503 4062567 116972070 645359 642214 0 0 763238 763238 0 763238 463887 299351 70208552 882 69678870 529682 882 530564 530564 0 0 0 ELECTRONIC HEALTH RECORDS 621110 2582247 2582247 SCHOOL OF NURSING TUITION 621110 1649091 1649091 CAFETERIA REVENUE 621110 771380 771380 2025050 2025050 7027768 125949019 119937271 4526454 1472129 1000 1000 0 0 0 405447 405447 0 45669280 38818888 6850392 2268372 1928117 340255 6187140 5259069 928071 3110450 2643882 466568 799975 799975 43921 39529 4392 0 0 0 0 53455 53455 3273245 2945920 327325 9302 8372 930 542284 488056 54228 0 0 3594026 3234623 359403 89194 80275 8919 0 12689 11420 1269 3503002 3430210 72792 16073352 14466017 1607335 6286245 5657620 628625 1811629 1811629 PATIENT CARE COSTS 14807793 14807793 BAD DEBT 9758674 9758674 REPAIR AND MAINTENANCE 4394200 3954780 439420 PA ACT 49 - QUALITY CARE 1815468 1815468 3647004 3198941 448063 128157147 114360283 13796864 0 X 4255 3264 21841961 10419447 0 7777 12779072 13635034 0 0 0 0 0 0 1447304 1386999 742999 912305 36493251 671184 29258642 35822067 22893369 22878425 130306 15046364 0 0 2257047 -77829 1584379 2564350 92939334 102598203 9344001 9165540 0 0 3062589 2791815 64630994 63560927 0 0 0 0 3817245 2863960 0 0 13630836 55804672 94485665 134186914 X -1725440 -31767937 179109 179226 0 0 -1546331 -31588711 92939334 102598203 X -2208128 -1182007 -26652245 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 179109 20 97 179226 108326 70653 130 179109 108131 195 108326 106555 968 608 108131 102387 2760 1408 106555 1.00000 false false 588000 588000 22506454 369058 22137396 0 0 0 10903484 268362 10635122 2495314 33765 2461549 35822067 INVESTMENT IN AMERINET 47349 F INVESTMENT IN VHA 33075 F INVESTMENT ACCT 14965940 F 15046364 0 ACCRUED PENSION COSTS 12898134 THIRD PARTY SETTLEMENTS 1776517 ASBESTOS RETIREMENT OBLIGATION 85252 DUE TO AFFILIATED ORGANIZATION 41044769 55804672 X AKMC Inclusion In The Consolidated Audit of WPAHS Form 990, Schedule D, Part X Question 2 and Part XIII Alle-Kiski Medical Center does not receive its own independent audit. It is a member of a regional healthcare system named West Penn Allegheny Health System. West Penn Allegheny Health System receives a consolidated audit that includes the operations of Alle-Kiski Medical Center. The following analysis represents the reconciliation between the Alle-Kiski Medical Center financial statement net income and the net income as reported on Form 990, Page 1, line 19: Net Income Per Financial Statements ($3,390,253) Plus: Income Reclassified From Restricted Net Assets on the Financial Statements to Unrestricted Revenue on Form 990 118 Less: Unrealized Loss on Investments reflected as current year gain on the financial statements reclassified through net assets on Form 990 1,182,007 ___________ Net Income Per Form 990 ($2,208,128) The following is the footnote to the audited consolidated financial statements of the West Penn Allegheny Health System for FASB ASC 740: WPAHS adopted Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) 740, Income Taxes, which clarifies the accounting for uncertainty in income taxes recognized in an enterprise's financial statements. FASB ASC 740 prescribes a more-likely than-not recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken or expected to be taken. Under FASB ASC 740, tax positions will be evaluated for recognition, derecognition, and measurement using consistent criteria and will provide more information about the uncertainty in income tax assets and liabilities. Based on an analysis prepared by WPAHS, it was determined that the application of FASB ASC 740 had no material effect on the recorded assets and liabilities of WPAHS. Intended Use of the Organization Endowment Funds Schedule D, Page 2, Part V, Line 4 The intended use of Alle-Kiski Medical Center term endowments are for but not exclusive to: capital improvements, research, education, departmental needs, operating efficiencies, and overall patient care. true true true X true X true true false true true 347305 347305 0.00290 10470297 6154820 4315477 0.03640 10817602 6154820 4662782 0.03930 608296 608296 0.00510 3304034 3298590 5444 188175 133948 54227 0.00050 6806 6806 0.00010 4107311 3432538 674773 0.00570 14924913 9587358 5337555 0.04500 9572 9572 0.00010 361171 361171 0.00310 370743 370743 0.00320 true 2531400 949635 17513762 21425246 -3911484 X true true 1 1 Alle-Kiski Medical Center

1301 Carlisle Street Natrona Heights PA 15065

X X X Alle-Kiski Medical Center true X X X X X X X X 12 true false true X X X X X X X false false true true 200. true 400. true X X X X X X true true X X X X true false X X X X true X false true 7 Vandergrift Outpatient Care Center

244 Longfellow Street Vandergrift PA 15690

Outpatient Care Center Citizens Ambulatory Care Center

651 Fourth Avenue New Kensington PA 15065

Ambulatory Care Center AVH Outpatient Physical Therapy

1620 Pacific Avenue Natrona Heights PA 15065

Physical Therapy Allegheny Valley Hospital Prolab

1620 Pacific Avenue Natrona Heights PA 15065

Laboratory Services Allegheny Valley Hospital Prolab

2692 Leechburg Road Lower Burrell PA 15068

Laboratory Services Destination Wellness

590 Pittsburgh Mills Circle Tarentum PA 15084

General Health and Wellness AKMC Radiological Imaging

2801 Freeport Road Natorna Heights PA 15065

Radiological Imaging Bad Debt Expense Financial Statement Footnote and Costing Methodology Schedule H, Part III, Question 4 Alle-Kiski Medical Center does not issue separate audited financial statements and therefore a footnote does not exist. Bad Debt expense is accounted for on a charge basis in our internal financial statements. A cost to charge ratio is applied to the internal figures to convert the charge to cost. It is the opinion of Alle-Kiski Medical Center management that because patients are often reluctant to complete the required charity care paperwork that an unquantifiable amount of charity care results in bad debt. Thus, it is our opinion that bad debt expense can be considered a justifiable component of charity care. Medicare Shortfall as a Community Benefit and Costing Methodology Schedule H, Part III, Question 8 Alle-Kiski Medical Center receives overall reimbursement from medicare less than the cost of the services provided. As such, we consider the shortfall a community benefit. The source used to determine the amount reported on line 6 is the Medicare Cost Report. Collection Practices For Patients Who Qualify For Financial Assistance Schedule H, Part III, Question 9b Patients that qualify for charity care or financial assistance are provided with an approval letter with the effective dates for the assistance. At any time the individual presents for services within a 90 day span of approval, they show the letter and will be registered as a charity care case. Charity care cases are designated in the internal computerized systems with unique plan codes that prevent billing to the patient. Reports are run to capture the patient accounts registered with the charity care plan codes so they can be written off to charity care. Charges For Medical Care Schedule H, Part V, Line 19 Alle-Kiski Medical Center offers uninsured patients a fifty percent (50%) discount on total gross charges to all hospital charges. The intent of the discount is to standardize charging practices for covered and non covered patients. The discount is offered during patient contact for elective/ urgent (non cosmetic) procedures during the financial counseling process, as well as during the patient statement cycle process for services provided (including Emergency services.) Patient statements are clearly marked with the uninsured discount, reducing the 'amount owed' of the gross charges. An uninsured discount of 50% is applied to the patient account either at the time of payment or prior to transferring the account to bad debt upon conclusion of the routine four statement cycle, for any unpaid balances. Charges Equal To Gross Charges For Patient Services Schedule H, Part V, Line 21 The facility offers a variety of procedures. For elective and non medically emergent procedures not covered by health plans, individual fee schedules are published and communicated prior to services. Patients are contacted in advance of the procedure by financial counselors and are required to pay for services in full based on the fee schedule. The patient is required to pay the hospital fee schedule for the technical component and the physician for the professional services rendered. Health Needs Assessment Schedule H, Part VI, Line 2 Alle-Kiski Medical Center (AKMC) management and staff utilize multiple strategies to continually monitor and assess the health care needs of the communities it serves. One approach to assessing needs involves surveying community members about health needs related to national and state health goals. Alle-Kiski Medical Center also acts on expressed community needs by responding to direct community requests for health screenings, outreach events and other health-related activities and by maintaining longstanding programs that are well attended and positively evaluated by community participants. In addition, Alle-Kiski Medical Center gathers community input through participation in area rotaries, chambers of commerce, through partnerships with community organizations and other community engagement activities. Another means is through reviewing and taking appropriate actions on feedback gathered from the following sources: routine market assessments; patient and family satisfaction surveys; Press Ganey surveys; patient, patient family and staffs' suggestions for improving patient safety; medical staff input and physician surveys. Alle-Kiski Medical Center ( AKMC) conducted a Community Health Needs Assessment (CHNA) during the year ended June 30, 2013 in accordance with IRC Section 501(r) and the guidance documented in the Internal Revenue Bulletin 2011-30, Notice 2011-52 and the proposed regulations issued April 5, 2013. The CHNA process began in August 2012 and concluded in May 2013. The Board of Directors that govern AKMC approved an implementation strategy designed to address the community health needs identified in the CHNA on September 23, 2013. The CHNA process included input from persons representing the broad interests of the community including individuals with special knowledge of or expertise in public health, organizations with information relevant to the health needs of the community and representatives of medically underserved populations. To achieve this end, the Hospital included representatives of the following organizations in the conduct of the CHNA: West Penn Allegheny Health System; Highmark, Inc.; Allegheny-Kiski Health Foundation; Family Services of Western Pennsylvania; Allegheny Valley Association of Churches; Citizens General Hospital Foundation; Tri-City Life Center, Inc.; Citizens Family Health Clinic; and Community Health Clinic, Inc. The results of the CHNA identified multiple health needs in the communities we serve. The Hospital addressed the following health needs: diabetes, colorectal cancer and breast cancer. The CHNA identified the following health needs the Hospital chose not to address: high blood pressure/hypertension, cardiovascular disease and obesity. We did not specifically address these because either (1) the health need was considered to be a co-morbidity to a condition we chose to focus on, such as blood pressure/hypertension and obesity could be positively impacted as part of an effective diabetes management program or (2) a strong program already exists within the hospital, as is the case with cardiovascular disease. The Hospital has made the CHNA widely available to the public. To accomplish this, we have published an executive summary and the full results of AKMC's CHNA at http://www.wpahs.org/community-health-needs-assessments. Patient Education For Eligibility For Assistance Schedule H, Part VI, Line 3 Alle-Kiski Medical Center displays signage in various patient Admission, Registration and Emergency Department areas that alerts that patient to Account Assistance program availability and contact information. During the preservice process, patients are evaluated to determine financial assistance options. Alle-Kiski Medical Center offers the "Account Assistance Program" which consists of application assistance for governmental eligibility, Charity Care application completion and submission support, as well as uninsured provisions. Account Assistance summaries are available on the West Penn Allegheny Health system website www.wpahs.org under the link titled, "Care for Uninsured" are available to the public. The Charity Care application, as well as, a Medical Assistance check list is available for patients who wish to self-apply. In addition to the documents, toll free telephone numbers regarding Account Assistance, charity and/or other financial inquiries are available. The website also contains a copy of the brochure that summarizes the Account Assistance program, as well as provides various governmental and internal numbers to patients seeking additional support. Alle-Kiski Medical Center also provides on-site support through Financial Counselor staff who are available to work with patient walk in's. Financial Counselors work directly with the patients as well as designated agency support regarding qualifying patients for Medical Assistance. Both week day and weekend coverage is available to the patients, as well as field support needed for post discharge follow up needed for application submission. The above support is available at no charge to the patient. Community Served Information Schedule H, Part VI, Line 4 Alle-Kiski Medical Center, located in Natrona Heights Pennsylvania, provides health care services to residents of Allegheny, Armstrong, Beaver and Butler Counties. Located approximately 20 miles outside of Pittsburgh, Natrona Heights has approximately 10,500 residents. Allegheny County consists of approximately 1,227,000 residents living in a land area of approximately 730 square miles. The median housing value in Allegheny County is $118,700. Armstrong County consists of approximately 69,000 residents living in a land area of approximately 654 square miles. The median housing value in Armstrong County is $91,600. Beaver County consists of approximately 171,000 residents living in a land area of approximately 434 square miles. The median housing value in Beaver County is $113,600. Butler County consists of approximately 185,000 residents living in a land area of approximately 789 square miles. The median housing value in Butler County is $162,900. Together, Allegheny, Armstrong, Beaver and Bulter Counties form the primary service area for Alle-Kiski Medical Center. Promotion of Community Health Schedule H, Part VI, Line 5 The Alle-Kiski Medical Center (AKMC) Emergency Department cares for the community by operating 24 hours a day, 7 days a week with highly skilled and trained emergency medicine physicians and nurses. The Emergency Department is open to all individuals regardless of their ability to pay. The emergency response capabilities of AKMC are provided in conjunction with Alle-Kiski Paramedic Unit for Life Support Emergency Response (AKPULSER), a paramedic response unit and a separate 501(c)(3) organization. AKMC staffs the emergency department physicians who provide medical command to the AKPULSER ambulance crew in the field. Our emergency response service has been designated as the primary 911 responder for the greater Alle-Kiski Valley Service Area. The voting members of the AKMC Board of Directors consist of a majority of independent community members without personal financial ties to the hospital or any of its affiliated organizations. Affiliated Healthcare System Schedule H, Part VI, Line 6 West Penn Allegheny Health System (WPAHS) is comprised of some of the oldest and best-known names in health care in western Pennsylvania. From their inception, the system's hospitals have been in the vanguard of patient care, medical research and health sciences education. Comprised of two tertiary and three community hospitals, WPAHS includes Allegheny General Hospital and The Western Pennsylvania Hospital, both in Pittsburgh; Alle-Kiski Medical Center in Natrona Heights; Canonsburg General Hospital in Canonsburg; and The Western Pennsylvania Hospital - Forbes Regional Campus in Monroeville. Offering a comprehensive range of medical and surgical services, the hospitals serve Pittsburgh and the surrounding five-state areas, house nearly 1,600 beds and employ more than 11,000 people. Together, the WPAHS hospitals admit nearly 56,000 patients, log over 164,000 emergency visits and deliver more than 3,800 newborns each year. Combined, the hospitals are among the leaders in percentages of total surgeries, cardiac surgeries, neurosurgeries and cardiac catheterization procedures performed throughout the region. Through the West Penn Allegheny Health System, Alle-Kiski Medical Center (AKMC) is able to ensure that area residents have access to a complete continuum of health care services. Also, through appropriate integration across the system, both clinically and operationally, the hospital is able to remain a high-quality, low-cost provider with linkages to the latest medical research and advanced technology. AKMC's main campus is in Natrona Heights. The 228-bed hospital serves as AKMC's inpatient facility and offers a broad spectrum of programs, including medical and surgical services, inpatient psychiatric care and geriatric psychiatric care, cardiology and orthopaedics. Virtually all outpatient services are available on the hospital campus. AKMC's Ambulatory Care Center presents a wide array of outpatient programs, including medical oncology services, laboratory studies, cardiac diagnostics and radiology services, such as routine X-rays, CT scans, mammography and ultrasound. In addition, the site is the home of the Joslin Diabetes Center Affiliate at AKMC and an Urgent Care Center for the treatment of minor medical emergencies. On April 29, 2013, WPAHS consummated an affiliation with Highmark Health, a 501(c)(3) tax exempt organization. This affiliation was one step toward the creation of an integrated delivery system named Allegheny Health Network. In addition to WPAHS, the Allegheny Health Network also includes Jefferson Regional Medical Center, Saint Vincent Health System and Saint Vincent Health Center. State Filing of Community Benefit Report Schedule H, Part VI, Line 7 Alle-Kiski Medical Center files the community benefit report with the State of Pennsylvania as part of our obligation to furnish the State of Pennsylvania with a copy of the IRS Form 990 and related schedules. X true true X X X X true false false false false false false false false Hadi Firoz MD 0 294038 0 40438 0 240 0 8125 0 9476 0 352317 0 0 Christopher Olivia MD 0 0 0 0 0 1261143 0 625000 0 7325 0 1893468 0 1250000 Michael Harlovic 230315 0 0 0 498 0 9434 0 8732 0 248979 0 0 0 Roy Santarella 0 0 0 0 0 703046 0 585817 0 183 0 1289046 0 703046 John Balacko MD 0 487034 0 106682 0 552 0 10000 0 10052 0 614320 0 0 Robert Brandfass 0 317358 0 150717 0 10168 0 0 0 10801 0 489044 0 0 David Kiehn 0 13033 0 100000 0 506095 0 0 0 725 0 619853 0 564419 George Sandora 0 88018 0 0 0 69669 0 5782 0 5114 0 168583 0 69389 Diane Dismukes 0 0 0 0 0 833367 0 0 0 183 0 833550 0 833367 Ned Laubacher 0 326975 0 0 0 6146 0 10000 0 9487 0 352608 0 0 Matthew Peterson 0 231605 0 50000 0 203 0 6250 0 9353 0 297411 0 0 Michael Sirott 0 192662 0 0 0 380 0 0 0 9370 0 202412 0 0 Additional Compensation Disclosure Form 990, Schedule J, Page 1, Line 4a The following represents additional disclosure for Schedule J, line 4a pertaining to officers and key employees listed in Form 990, Part VII, Section A, Line 1a receiving severance pay during the calendar year ending within the June 30, 2013 fiscal year end: Christopher Olivia, MD $1,250,000 Diane Dismukes $ 833,367 Roy Santarella $ 703,046 David Kiehn $ 464,419 George Sandora $ 69,389 Deferred Compensation Schedule J, Part II, Column C Retirement and other deferred compensation reflect amounts accrued to the benefit of the applicable individuals related to qualified pension and severance plans. In this regard, the following individuals have amounts accrued related to future severance payments to be made: Christopher Olivia, MD Roy Santarella George Sandora Bond Information Form 990, Schedule K, Part VI Alle-Kiski Medical Center is a member of the West Penn Allegheny Health System obligated group in regards to 2007 Allegheny County Hospital Development Authority tax-exempt bonds. Accordingly, Schedule K has been inserted into this Form 990 for full disclosure purposes. The IRS Form 990 filed for West Penn Allegheny Health System, Inc., EIN: 25-0969492 contains the full disclosure for schedule K. IRS Form 990 - Organizational Comment IRS Form 990 On April 29, 2013, West Penn Allegheny Health System, Inc., the parent organization of the West Penn Allegheny Health System formalized an affiliation with Highmark Health, EIN: 45-3674900, a 501(c)(3) tax exempt organization to become a member of a newly created integrated delivery system named Allegheny Health Network (the "Network"). West Penn Allegheny Health System, Inc. is the sole member of Alle-Kiski Medical Center. In addition to West Penn Allegheny Health System, the Allegheny Health Network also consists of Jefferson Regional Medical Center, Saint Vincent Health Center and Saint Vincent Health System. In total, the Network consists of 22 different organizations exempt from federal income tax under IRS Section 501(c)(3). The parent organization of the Network is Allegheny Health Network, EIN: 45-3674924, a 501(c)(3) tax exempt organization. Together, these organizations have combined to create a cost-effective health system that raises quality, enhances outcomes and preserves consumer choice for everyone. Statement of Program Service Accomplishments Form 990, Page 2, Part III, Line 4a INTRODUCTION TO ALLE-KISKI MEDICAL CENTER Alle-Kiski Medical Center is dedicated to providing exceptional health care to nearly 170,000 people in portions of Allegheny, Butler, Westmoreland and Armstrong counties. AKMC is a member of the Allegheny Health Network by virtue of being affiliated with West Penn Allegheny Health System (WPAHS). Organized in 2000, WPAHS (www.wpahs.org) is comprised of West Penn Allegheny Health System, Inc. (WPAHS, Inc.), Canonsburg General Hospital (CGH), Allegheny Medical Practice Network (AMPN), Allegheny Specialty Practice Network (ASPN), Allegheny-Singer Research Institute (ASRI), West Penn Allegheny Oncology Network (WPAON), West Penn Physician Practice Network (WPPPN), Canonsburg General Hospital Ambulance Service (CGH Ambulance), Alle-Kiski Medical Center Trust (AKMC Trust), Forbes Health Foundation (FHF), Suburban Health Foundation (SHF), The Western Pennsylvania Hospital Foundation (WPHF) as well as AKMC. AKMC is comprised of a hospital campus, located in Allegheny County at 1301 Carlisle Street, Natrona Heights, Pa., and outpatient care centers located throughout the community. The AVH Outpatient Care Center - New Kensington is located in Westmoreland County at 651 Fourth Avenue, New Kensington, Pa., and offers a number of outpatient services, including radiology, laboratory, medical oncology and hematology, the Joslin Diabetes Center and an Urgent Care Center for minor emergencies. AKMC also offers two off-campus lab draw sites, one in Lower Burrell, Pa., and another in Natrona Heights, Pa. An off-campus outpatient physical therapy center in Natrona Heights offers patients rehabilitation services in a convenient location. AKMC Radiological Imaging, located in Allegheny County at 2801 Freeport Road, Natrona Heights Pa., offers outpatient radiology imaging services including X-rays, CT scans, mammography, MRI, ultrasound and bone-density testing. The AKMC outpatient care center in Vandergrift offers basic imaging services, cardiac services, lab draws and sleep studies. For the 12 months ended June 30, 2013, AKMC treated 7,523 inpatient discharges, 216,933 outpatients, 44,593 emergency department and urgent care center visits and 5,731 inpatient and outpatient surgeries. The hospital has 313 physicians on staff and 1,235 employees at December 31, 2012. PURPOSE AND MISSION Alle-Kiski Medical Center is a team of care givers committed to improving health and promoting wellness in our communities, one person at a time. We pledge to consistently deliver safe, compassionate quality healthcare by treating the whole person - body, mind and spirit. UNCOMPENSATED CARE To enhance the health status of the community in which it operates and consistent with its tax-exempt status, AKMC provides needed health care services to individuals regardless of their ability to pay for all or part of the services rendered. These services include both inpatient and outpatient services as well as an emergency room that remains available 24 hours a day. Consistent with the filing of Schedule H, the components of uncompensated care include charity care and unreimbursed Medicaid costs. AKMC provided uncompensated care at a cost of $4,662,782 in Fiscal 2013. COMMUNITY ASSESSMENT Community Health Improvement Services and Community Benefit Operations Community health improvement services and community benefit operations include activities intended to improve health and wellness. They extend beyond patient care activities and are subsidized by the Hospital. The programs ranged from community health education to free clinics and screenings. Consistent with the filing of Schedule H, AKMC provided the following community health services during Fiscal 2013 at an estimated cost of $608,296. Destination Wellness - Destination Wellness is a community health and wellness education resource center sponsored by AKMC. One of the few community-based outreach centers of its kind, Destination Wellness is a storefront located in the Galleria at Pittsburgh Mills shopping mall. Destination Wellness provides a variety of health-related activities including classes and "Doc Talks" on topics ranging from arthritis to peripheral vascular disease. Destination Wellness is staffed with a registered dietitian and registered nurses to assist visitors in finding a physician, checking blood pressure or researching a topic in the on-site health resource library. During Fiscal 2013, Destination Wellness sponsored or hosted 188 events. Destination Wellness also sponsors the "Mills Milers", a no-charge, indoor walking program designed to engage members of the community in physical exercise in a safe, controlled environment. Numerous programs are available exclusively for members of the Mills Milers. Over 2,280 members have enrolled in this program since its inception in September, 2005. Paramedics Staffing - AKMC staffs the mall with on-site paramedics to respond to a variety medical emergencies at the mall and surrounding businesses. In Fiscal 2013 paramedics responded to 172 calls. PriorityCare Senior Membership Program - AKMC offers this outreach program to adults age 55 and older with the purpose of improving their health and their knowledge about health care and other issues related to the aging process. A newsletter is mailed quarterly to over 13,000 households reaching a total membership of over 18,000 adults. Cumulatively, over 36,000 adults have enrolled in the program. In addition to health education articles, the newsletter keeps members informed about hospital and community services and contains a calendar of monthly educational programs and support groups. Childbirth Education - AKMC offered a class involving the experience of childbirth and newborn care. Class topics included areas of interest such as breast feeding, newborn care and sibling interaction. Babysitting Classes - Six babysitting classes were held in Fiscal 2013. The classes are an educational tool to help teach parents and babysitters on safe sitting techniques. techniques. Doc/Medical Professionals Talks - AVH hosts many "Doc Talks" at the campus and in the community. These events target all segments of the community population and are presented on current topics of interest. The Doc Talks are interactive and include topics such as, but not limited to: Coping with Chronic Pain, Congestive Heart Failure, Understanding and Managing Hypertension, Eye Health, Prostate Health and Women's Health. Statement of Program Service Accomplishments - Continued Form 990, Page 2, Part III, Line 4a Community Health Fairs, Screenings and Workshops - AKMC provides numerous health fairs within the community and at community events. These fairs target a broad range of community members and focus on topics that are prevalent to the well-being of the community. Exercise Classes - During Fiscal 2013, the Hospital sponsored a variety of exercise classes free of charge to members of the community. Classes included Belly Dancing, Tai Chi and Yoga. Support Groups - AKMC acknowledges the stress and distress medical conditions can cause to families and their loved ones. AKMC sponsors a variety of support groups in the community to address these needs. Examples of support groups sponsored by AKMC would include but not be limited to Alzheimer's, Cardiac Disease and Restless Leg Syndrome. Health Professions Education AKMC provides aspiring health professionals with many educational opportunities to further their career in healthcare. Consistent with the filing of Schedule H, AKMC provided these services at a cost of $5,444 in Fiscal 2013. Citizens School of Nursing - Open since 1913, the Citizens School of Nursing has provided over 2,200 graduates with a strong foundation on which to build their future nursing careers. The school earned its first National League of Nursing accreditation in 1960 and continues to enjoy the privilege of full accreditation, due in part to a constantly evolving curriculum that consistently meets the needs of its students and reflects the changes of the nursing profession. The school prepares each student with the knowledge and skills necessary to exceed the challenges of providing quality nursing in the 21st century. Financial Contributions This category includes monetary and in-kind services donated to individuals and the community at large. In-kind services include hours donated by staff to the community during hospital work hours, overhead expenses of meetings, other space donated to not-for-profit community groups, and donations of food, equipment, and supplies. Consistent with the filing of Schedule H, AKMC provided financial contributions during Fiscal 2013 totaling $6,806. Cash Donations - AKMC supports the community through cash contributions made at the discretion of the Hospital and its directors, benefiting not only the non-profit recipient but ultimately the community as a whole. The Hospital made cash contributions totaling $1,000 including contributions to: The American Cancer Society In-Kind Donations - In addition to the cash contributions listed above, AKMC also made in-kind donations of time and resources to help support various community functions. For Fiscal 2013, in-kind contributions amounted to $5,806 and consisted of the following: AARP's 55 Alive Mature Driving Program - The Hospital co-sponsored this two-day driver refresher course 22 times during Fiscal 2013. During the year, 243 drivers participated in the program offered at the Hospital's main campus, the Outpatient Care Center in New Kensington or Destination Wellness. Free meeting space, parking, refreshments and publicity are provided through the hospital. Look Good - Feel Better! - The hospital provides free space for the American Cancer Society to host the program Look Good - Feel Better, a program directed toward helping cancer patients feel good about their appearance. Community Building Activities Community Building Activities include activities engaged in for the purpose of improving or protecting the health, future and wellbeing of the community. Consistent with the filing of Schedule H, AKMC provided these services at a cost of $370,743 in Fiscal 2013. Social Services - AKMC social work services are available to help patients and their families adjust to changes in their lives due to illness and hospitalization. Our social workers help patients and families identify and manage factors that may interfere with health and recovery. Through counseling, discharge planning and providing information and referrals, the staff helps to ensure a comfortable return home or other level of care that is appropriate at the time of discharge. Board Memberships - AKMC employees serve as board members on numerous local boards including the local Rotary, New Kensington Chamber of Commerce, Strongland Chamber of Commerce, Alle-Kiski Paramedic Unit for Life Support Emergency Response (AKPULSER) and the YMCA. Family Relationships Among Alle-Kiski Medical Center Directors Form 990, Page 6, Part VI, Section A, Line 2 The following Alle-Kiski Medical Center Directors are related as husband and wife: Russell Evans Janis Evans Jerry Taylor, MD Ginger Taylor Operational Oversight By A Third Party Management Company Form 990, Page 6, Part VI, Section A, Line 3 Alle-Kiski Medical Center ( AKMC) is a member of the Allegheny Health Network by virtue of being affiliated with West Penn Allegheny Health System (System). The System consists of thirteen operational IRC Section 501(c)(3) organizations. The parent organization for AKMC and the other eleven operational IRC Section 501(c)(3) organizations is West Penn Allegheny Health System, Inc. (WPAHS, Inc.). The board of directors of WPAHS, Inc. is comprised of a majority of independent members. On November 7, 2011 (Effective Date), the board of directors of WPAHS, Inc. engaged Alvarez & Marsal Healthcare Industry Group, LLC (A&M) to assign an Interim Chief Executive Officer of the System, Interim Chief Operating Officer of the System and Interim Chief Financial Officer of the System. All individuals appointed to their respective positions are under the employment of A&M and have daily oversight of all matters pertinent to the operation of the System as a whole and all organizations on an independent basis. All interim management personnel under the employment of A&M are responsible to and report to the WPAHS, Inc. board of directors. The term of the engagement is to last one year from the effective date with the option to renew the engagement beyond the initial one year term. During the course of the engagement, the WPAHS, Inc. board of directors upon written notice may cause any individual employed by A&M to be removed from their respective position and replaced by another similarly qualified individual. AKMC did not directly compensate A&M for their management services. WPAHS, Inc. compensates A&M directly for these services. The decision was made to allocate a portion of the expenditures of WPAHS, Inc. to AKMC. Thus, the portion of management expense allocated from WPAHS, Inc. to AKMC is reflected on Form 990, Page 10, Line 11a. On April 29, 2013, West Penn Allegheny Health System, Inc., the sole member of Alle-Kiski Medical Center consummated a formal affiliation to establish a regional integrated health care services delivery system. With the establishment of this formal affiliation, the management team from A&M were removed from their respective positions and ceased to provide management services. Change to Organizational Governing Documents Form 990, Page 6, Part VI, Section A, Question 4 The bylaws of Alle-Kiski Medical Center were amended effective May 17, 2013 to reflect an affiliation with Highmark Health, EIN: 45-3674900 and the creation of a regional integrated healthcare delivery system, the parent organization of which is Allegheny Health Network, EIN: 45-3674924. In accordance with the affiliation, Highmark Health assumed certain reserve powers over Alle-Kiski Medical Center. Among the reserve powers given to Highmark Health includes the right to approve the election, re-election and removal of all officers of the corporation; to amend, revise and restate the corporation's Articles of Incorporation and Bylaws; adopt or change the mission, purpose, philosophy or objective of the corporation; to change the general structure of the corporation; to dissolve or liquidate, consolidate or merge and sell or acquire assets in excess of certain thresholds; approve the capital, operating plan and budget of the corporation; approve the incurrence of debt by the corporation and the making of capital expenditures in excess of certain thresholds; to approve donations or other transfers in excess of certain thresholds; approve the strategic plan and mission statement; approve investment policies; approve the closure or relocation of a licensed healthcare facility; approve the creation of or dissolution of subsidiary corporations, partnerships or other joint ventures in excess of certain thresholds; manage the corporations program for compliance with all legal requirements; selection of auditors and the designation of the fiscal year of the corporation. Form 990 Review Process Form 990, Page 6, Part VI, Section B, Line 11a The IRS Form 990 of the Alle-Kiski Medical Center was prepared by the Highmark Health Tax Department. Prior to filing the final tax return with the Internal Revenue Service, members of senior management reviewed components of the tax return and the voting members of the governing body received a copy of the tax return. Monitoring and Enforcement of the Conflict of Interest Policy Form 990, Page 6, Part VI, Section B, Line 12c Alle-Kiski Medical Center is a member of the Allegheny Health Network by virtue of being affiliated with West Penn Allegheny Health System (WPAHS). WPAHS has a corporate compliance department that monitors and oversees compliance with the conflict of interest policy of all organizations in the health system. The following describes the manner in which the corporate compliance department monitors and oversees compliance with the conflict of interest policy for Alle-Kiski Medical Center as well as the other WPAHS affiliates: Conflict of Interest disclosure forms are completed on an annual basis by all board members, officers, employees who have a title of Manager and above, physicians in leadership roles, Pharmacy and Therapeutic Committee members, all employees of the System's Compliance and Internal Audit Departments as well as personnel involved with contracting in the Corporate Purchasing Department. Upon completion of the above disclosure statement by all applicable individuals, a report is generated listing all individuals that have reported a conflict. The System Compliance Officer and General Counsel review the conflicts disclosed. Those that require additional information or clarification receive a letter from the Compliance Officer requesting such. Once received, all additional information is added to the report and again reviewed by the Compliance Officer and General Counsel. Those conflicts that require a mitigation plan are sent to the respective organization's senior management for development of the mitigation plan. The organization's senior management is responsible to discuss the mitigation plan with the individual as needed and monitor compliance with the mitigation plan. Once mitigation is received, a final report is reviewed by System Executive Compliance Council with the Legal Department and the Allegheny Health Network(AHN)senior management and finally with the AHN Audit and Compliance Subcommittee of the Board. Process Used To Determine Executive Compensation Form 990, Page 6, Part VI, Section B, Line 15b The West Penn Allegheny Health Systems (WPAHS) process for determining compensation for executive positions (including officers, key employees and other management positions) within Alle-Kiski Medical Center is covered by the WPAHS Executive Compensation Policy. This policy was approved by the West Penn Allegheny Health System, Inc. Board of Directors. It is the policy of WPAHS and its Board of Directors to compensate its executives in accordance with the market and in relation to the experience, service and accomplishments of the individual both prior to and during their service with WPAHS. The Compensation Committee of the West Penn Allegheny Health System, Inc. Board of Directors approves the compensation for WPAHS senior executives. The Compensation Committee approves the initial compensation for newly hired senior executives, which shall include all compensation components, including without limitation, base compensation, incentive compensation, deferred compensation, fringe and other benefits, as well as the total compensation. It shall also approve all base compensation adjustments and all incentive compensation awards, as well as material changes to deferred compensation, fringe, or other benefits. The Compensation Committee uses comparability data provided by the System Human Resources Department, which may include industry surveys, expert compensation studies, documented compensation of persons holding similar positions, or other comparable data in approving any executive compensation. The Compensation Committee shall periodically retain the services of an independent compensation consultant to provide an expert opinion report as to the reasonableness of total compensation of Alle-Kiski Medical Center officers and key employees. Each Compensation Committee member voting on a senior executive's compensation arrangement ensures that he or she has no conflict of interest, including that he or she (a) does not economically benefit from the proposed employment; (b) does not receive compensation subject to the approval of the proposed employee; and (c) has no material financial interest affected by the transaction. The Compensation Committee consists of five independent Board Members of West Penn Allegheny Health System, Inc. All decisions of the Compensation Committee regarding executive compensation matters are documented. Public Access To Organizational Documents Form 990, Page 6, Part VI, Section C, Line 19 Alle-Kiski Medical Center (AKMC) does not make its governing documents available to the public. AKMC is a member of the West Penn Allegheny Health System (WPAHS). The WPAHS makes available their annual and quarterly financial statements through the use of a dissemination agent. These financial statements are on a consolidated basis with AKMC being one of the consolidated entities. In addition, the WPAHS annual report and quarterly financial results are available on the WPAHS website. WPAHS has adopted a conflict of interest policy that is uniformly applied to all organizations of the health system, including AKMC. A condensed version of this conflict of interest policy is available on the WPAHS website. Officer, Director and Key Employee Hour Allocation Form 990, Page 7, Part VII, Section A, Column B Alle-Kiski Medical Center ( AKMC)is a member of the Allegheny Health Network by virtue of being affiliated with West Penn Allegheny Health System (WPAHS). Individuals employed by one organization may be assigned to provide management for an affiliated organization. As such, many individuals play key roles or serve as officers or directors on multiple affiliated organizations. Each individual will be assigned forty hours to the organization of their actual employment. If the individual is employed by one organization and appointed as an officer, director or key employee of affiliated organizations the hour allocation on Form 990, Part VII, Page 7, Column (B) takes various factors into account when attempting to assign hours in a reasonable manner. Thus, it is possible for a single individual to have hours assigned in excess of forty hours per week if all affiliated organization IRS Forms 990 is taken into account. Directors who are not employed and volunteer their services are assigned one hour of service. The actual time served for all individuals disclosed in IRS Form 990 can vary based upon the need of the organization. Officers and Directors - Partial Year Terms Form 990, Page 7, Part VII, Column C The following list represents Officer or Directors of Alle-Kiski Medical Center listed on Form 990, Part VII who did not serve a full consecutive twelve month tenure during the year ended June 30, 2013 along with the dates served: Robert Brandfass 07-01-2012 - 11-16-2012 Jerry Taylor, MD 07-01-2012 - 02-28-2013 Robin Bergstrom 02-28-2013 - 06-30-2013 David Shin, MD 02-28-2013 - 06-30-2013 Michael Sirott 02-28-2013 - 06-30-2013 Rent Expense Form 990, Page 9, Part VIII, Line 6b Alle-Kiski Medical Center does not account for rental expense in a manner that would allow for a direct offset of rental income on Form 990, page 9, Part VIII, Line 6b. The components of rental expense are reflected on Form 990, Page 10, Statement of Functional Expense. Purpose Of Tax Exempt Bond Issuance Form 990, Page 11, Part X, Line 20 Alle-Kiski Medical Center is a member of the West Penn Allegheny Health System obligated group in regards to 2007 Allegheny County Hospital Development Authority tax-exempt bonds. Accordingly, Schedule K has been inserted into this Form 990 for full disclosure purposes. The purpose of the issue of the Allegheny County Hospital Development Authority (ACHDA) Hospital Revenue Bonds, Series 2007 A is to refund the outstanding ACHDA Series 2000A and B Bond Issues, the Dauphin County General Authority (DCGA) Series 1992A and B Hospital Bonds, the Pennsylvania Higher Education Facility Authority (PHEFA) Series 1991A Revenue Bonds, the Monroeville Hospital Authority (MHA) Series 1992 and 1995 Revenue Bonds, the funding of a project fund for certain prior and future capital expenditures and to pay the cost of issuing Series 2007A Debt. The amount of $63,560,927 reflected on Form 990, Page 11, Line 20 represents the internal allocation of debt to Alle-Kiski Medical Center by the parent organization, West Penn Allegheny Health System, Inc. The IRS Form 990 filed by West Penn Allegheny Health System, Inc., EIN: 25-0969492 has completed Schedule K in its entirety. Please refer to the IRS Form 990 filed by West Penn Allegheny Health System, Inc., EIN: 25-0969492 to review Schedule K with regard to this bond issue. Other Changes In Net Assets Form 990, Page 12, Part XI, Line 9 The following is a reconciliation of the other changes in net assets of Alle-Kiski Medical Center for the year ended June 30, 2013: Change in Minimum Pension Liability $1,264,704 Net Transfers To Affiliated Organizations 58,006 Purchase Accounting Adjustments (27,974,955) ___________ Other Changes in Net Assets ($26,652,245) Highmark Health 120 Fifth Ave Suite 922 Pittsburgh PA 15222 453674900 Healthcare PA 501(c)(3) 11-I NA false Allegheny Health Network 120 Fifth Ave Suite 922 Pittsburgh PA 15222 453674924 Healthcare PA 501(c)(3) 11-I Highmark Hea false Allegheny Medical Practice Network 4800 Friendship Ave Pittsburgh PA 15224 251838457 Healthcare PA 501(c)(3) 3 WPAHS Inc false Allegheny Singer Research Institute 320 East North Ave Pittsburgh PA 15212 251320493 Sci Research PA 501(c)(3) 4 WPAHS Inc false Allegheny Specialty Practice Network 320 East North Ave Pittsburgh PA 15212 251838458 Healthcare PA 501(c)(3) 3 WPAHS 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true true false false Alle-Kiski Medical Center Trust 1q 50740 Transactions with Affiliated Organizations Schedule R, Part V, Line 2 Alle-Kiski Medical Center has chosen not to complete Schedule R, Part V, line 2 for organizations that are not controlled entities within the meaning of section 512(b)(13). The disclosure of this information is only required for organizations listed in Schedule R, Part V, line 2 that are controlled entities within the meaning of section 512(b)(13). The only organization listed in Schedule R, Part V, line 2 that is a controlled entity within the meaning of section 512(b)(13) for Alle-Kiski Medical Center is the Alle-Kiski Medical Center Trust.