2014-04-11T11:40:20-05:00 2013-06-30 BKD LLP 910 E ST LOUIS STE 200 SPRINGFIELD MO 658062523 990 2012-07-01 240802108 CHARLES COLE MEMORIAL HOSPITAL % RON RAPP CONTROLLER CHAR 8142749300 1001 EAST SECOND STREET Suite COUDERSPORT PA 16915 EDWARD C PITCHFORD 8142749300 2014-04-05 true Brian D Todd 4178658701 2012 2015-11-30 17:44:51Z EDWARD PITCHFORD 1001 EAST SECOND STREET COUDERSPORT PA 16915 87497338 false X http://www.charlescolehospital.com/ X 1967 PA CCMH PROVIDES EXCELLENT HEALTH CARE SERVICES BY PROVIDING INPATIENT, OUTPATIENT AND PRIMARY CARE SERVICES TO THE SURROUNDING COMMUNITY. SEE SCHEDULE O FOR MORE INFORMATION. 13 9 718 63 59664 58352 702961 1100072 73182076 80419342 -24785 662938 200871 224985 74061123 82407337 0 0 0 0 32066073 34251160 48000 18500 18500 41140996 44227326 73255069 78496986 806054 3910351 58973125 61179485 43577089 39271637 15396036 21907848 X THE PURPOSE OF CHARLES COLE MEMORIAL HOSPITAL IS TO PROVIDE EXCELLENT HEALTHCARE SERVICES, RESPONDING TO THE NEEDS OF THE COMMUNITIES WE SERVE. false false 18855370 44662821 CCMH OFFERS OUTPATIENT SERVICES, EXCEEDING 369,000 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. CCMH'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. 16902492 12245983 CHARLES COLE MEMORIAL HOSPITAL 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, 90,700 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. 13670144 20401356 CHARLES COLE MEMORIAL HOSPITAL OFFERS VARIOUS INPATIENT SERVICES. CCMH ADMITTED 1,770 PATIENTS LAST YEAR (5,750 ACUTE CARE DAYS) TO INPATIENT SERVICES INCLUDING MEDICAL/SURGICAL, INTENSIVE CARE AND OBSTETRICS UNITS. CCMH'S 24-HOUR EMERGENCY DEPARTMENT ADMITTED 990 PATIENTS LAST YEAR AND SAW 9,960 VISITS LAST YEAR. THE HOSPITAL'S MATERNITY UNIT WELCOMED 200 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. 18788029 3109182 68216035 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 false false false false false false true true false false false false false true true true false false true 44 0 true 718 true true true false false false false false false false false false X 13 9 false false true false true true false true true false false true true true true true true true false false PA X RON RAPP CONTROLLER 8142745250 1001 EAST SECOND STREET COUDERSPORT PA 16915 X MICHAEL E CALLAHAN 40.0 1.0 X X 189541 0 23781 JASON TRONETTI 40.0 1.0 X 312557 0 27682 CHARLES UPDEGRAFF 1.0 1.0 X X 0 0 0 RON CASKEY 1.0 1.0 X X 0 0 0 REVEREND RANDALL HEADLEY 1.0 1.0 X X 0 0 0 KALLIOPI NESTOR 40.0 1.0 X 224537 0 25410 ROBERT SMITH 1.0 1.0 X 0 0 0 RUSSELL STREICH 1.0 1.0 X 0 0 0 DAVID BUCKLER 1.0 2.0 X 0 0 0 DAVID CRANDALL 1.0 1.0 X X 0 0 0 JEANNE MIGLICIO 1.0 1.0 X 0 0 0 THOMAS SHAFFER 1.0 1.0 X 0 0 0 CLIFFORD WOOD 1.0 1.0 X 0 0 0 EDWARD C PITCHFORD 40.0 2.0 X 325716 0 27726 CYNTHIA HARDESTY 40.0 1.0 X 177057 0 12457 BRADLEY GIANNOTTI 40.0 X 908215 0 21634 TERRENCE FOUST 40.0 X 766033 0 13688 SAKET PRASAD 40.0 X 630863 0 19576 CHRISTAN CARAMIA 40.0 X 437661 0 29415 BEVERLY PRINCE 40.0 X 387639 0 24244 4359819 0 225613 35 false true false JAMES BARKE MD PHYSICIAN PRACTICE 623559 FOOT ANKLE INNOVATIONS PC PHYSICIAN 402164 BKD LLP AUDIT/TAX/CONSULTING 119093 ABDUL MAJEED MD PHYSICIAN 111420 4 888498 211574 1100072 NET PATIENT SERVICE REVENUE 621990 74955602 74955602 PHARMACY 446110 4322430 4322430 CAFETERIA 722514 373345 373345 OTHER 621990 767965 767965 80419342 304129 304129 0 0 263516 258712 4804 0 4804 4804 5133685 56413 4815573 15716 318112 40697 358809 358809 0 0 0 GAIN ON INVESTMENT IN EQUITY INVESTEE 900099 166024 166024 INCOME FROM INVESTMENT IN SUBSIDIARIES 900099 54157 59664 -5507 220181 82407337 80419342 59664 828259 0 0 0 0 1404179 839196 564983 322088 172154 149934 25048209 21276707 3771502 821624 689457 132167 4749348 3714828 1034520 1905712 1578700 327012 398667 398667 188646 188646 129992 129992 0 18500 18500 61015 61015 16058581 15358315 700266 136646 1083 135563 5001059 3620351 1380708 0 0 2134287 1966287 168000 343185 304522 38663 0 334785 187044 147741 1150967 1029159 121808 0 2555256 2284832 270424 1197025 528099 668926 MEDICAL SUPPLIES & DRUGS 10493536 10493536 BAD DEBT 3542804 3542804 LICENSES, DUES, SUBSCRIPTIONS 369964 230294 139670 RECRUITING & RETENTION 130911 130911 78496986 68216035 10262451 18500 805193 3751622 1582372 1572899 188609 65739 8269567 9099480 0 0 0 0 0 0 1173740 1160358 1718605 1603029 69247873 43959908 23354095 25287965 14266810 15117001 1696602 1896128 385098 536314 0 0 5532434 1088950 58973125 61179485 20839387 15132864 0 0 0 0 18686837 17838950 18092 9029 0 0 2948230 3564725 0 100000 1084543 2626069 43577089 39271637 X 11287807 17805684 230847 108028 3877382 3994136 15396036 21907848 58973125 61179485 X 3910351 659887 1941574 X false true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true false true 10950 10950 false LOBBYING ACTIVITIES SCHEDULE C, PART II-B, LINE 1I THE ORGANIZATION IS A MEMBER OF HAP, AHA, AND HCWP. $10,950 OF DUES ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES. false true 3877382 378612 261858 3994136 4280877 -106295 297200 3877382 3667800 942900 329823 4280877 3616355 437150 385705 3667800 4837234 -1006344 214535 3616355 1.00000 true false 1135847 1135847 40437920 22141614 18296306 25912166 20515277 5396889 1761940 1303017 458923 25287965 0 DUE TO THIRD PARTY PAYERS 2187218 MALPRACTICE LIABILITY 438851 2626069 81694999 659887 -1630937 -971050 82666049 -258712 -258712 82407337 75151879 258712 258712 74893167 61015 3542804 3603819 78496986 ESCROW ACCOUNTS SCHEDULE D, PART IV, LINE 2B 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. ENDOWMENT FUND SCHEDULE D, PART V, LINE 4 THE ENDOWMENT FUND WAS ESTABLISHED TO ALLOW THE HOSPITAL TO PROVIDE HEALTHCARE SERVICES TO POOR AND NEEDY PATIENTS. UNCERTAIN TAX POSITIONS SCHEDULE D, PART X, LINE 2 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. OTHER REVENUE INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12 SCHEDULE D, PART XI, LINE 2D $ 1,981,033 AMORTIZATION OF NET LOSS (3,542,804) BAD DEBT EXPENSE (61,015) INVESTMENT MANAGEMENT FEES (8,151) TRANSFER TO COLE FOUNDATION ------------- $(1,630,937) OTHER REVENUE INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1 SCHEDULE D, PART XI, LINE 4B $ (258,712) RENTAL EXPENSES OTHER EXPENSES INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25 SCHEDULE D, PART XII, LINE 2D $ 258,712 RENTAL EXPENSES OTHER EXPENSES INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1 SCHEDULE D, PART XII, LINE 4B $ 3,542,804 BAD DEBT EXPENSE X X true DELTA DEVELOPMENT GROUP INC GRANT WRITING false 18500 18500 PA FUNDRAISING ACTIVITIES SCHEDULE G, PART I, LINE 2B 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 true 921007 12406 908600 0.01210 13759193 9037725 4721468 0.06300 14680200 9050131 5630068 0.07510 100312 16545 83767 0.00110 349658 349658 0.00470 24237072 17217010 7020062 0.09370 3575 3575 24690617 17233555 7457062 0.09950 39370817 26283686 13087130 0.17460 3640 3640 0.00010 2853 2853 2935 2935 4066 4066 0.00010 450 450 13944 13944 0.00020 true 3542804 517249 13832657 13697344 135313 X true true 1 1 CHARLES COLE MEMORIAL HOSPITAL

1001 EAST 2ND STREET COUDERSPORT PA 16915

X X X X CHARLES COLE MEMORIAL HOSPITAL 1 true X X X X X X X X X 12 true false true X X X X X X false false true true 200. true 400. true X X X X X X X true true X X X X X true false X X X X true X false false 10 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 PERCENT OF TOTAL EXPENSE SCHEDULE H, PART I, LINE 7, COLUMN F 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. SUBSIDIZED HEALTH SERVICES SCHEDULE H, PART I, LINE 7G SEVERAL RURAL HEALTH CLINICS WERE INCLUDED IN THE COMPUTATION OF SUBSIDIZED HEALTH SERVICES ON LINE 7G. CCMH 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. CCMH CONTINUES TO PROVIDE THESE SERVICES AS A BENEFIT TO THE COMMUNITY DESPITE KNOWING THAT FINANCIAL SHORTFALLS WILL BE SUSTAINED. COSTING METHODOLOGY SCHEDULE H, PART I, LINE 7 THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1 AND 3. OTHER IRS WORKSHEETS USED ACTUAL COST METHOD. BAD DEBT EXPENSE METHODOLOGY SCHEDULE H, PART III, SECTION A, LINES 2 & 3 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 2006 - 2010. BAD DEBT EXPENSE SCHEDULE H, PART III, SECTION A, LINE 4 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. COMMUNITY BENEFIT SCHEDULE H, PART III, SECTION B, LINE 8 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 CCMH IS CLASSIFIED AS A CRITICAL ACCESS HOSPITAL. THIS CLASSIFICATION SHOWS THAT CCMH IS IN A MEDICALLY UNDERSERVED AREA AND AT A HEALTH PROFESSIONAL SHORTAGE AREA. THIS DEMONSTRATES THAT CCMH 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. COLLECTION PRACTICES SCHEDULE H, PART III, SECTION C, LINE 9B 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. COMPLETION OF NEEDS ASSESSMENT SCHEDULE H, PART V, SECTION B, LINE 3 CHARLES COLE MEMORIAL HOSPITAL 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, CCMH 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 CCMH, 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. IMPLEMENTATION STRATEGY SCHEDULE H, PART V, SECTION B, LINE 6 IN RESPONSE TO THE RESULTS OF CHARLES COLE MEMORIAL HOSPITAL'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 ADDRESSING IDENTIFIED NEEDS SCHEDULE H, PART V, SECTION B, LINE 7 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. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI, LINE 3 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. NEEDS ASSESSMENT SCHEDULE H, PART VI, LINE 2 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 MEMORIALS 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 COMMITTEES 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 MEMORIALS 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 2012. 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) 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) 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: - HEALTH SERVICES ACCESS AND UTILIZATION - CHRONIC DISEASE MANAGEMENT - YOUTH HEALTH & HEALTH CARE - PRIMARY CARE - WEIGHT - SMOKING - DENTAL CARE - RISK FACTORS - HEALTH INSURANCE - HEALTH CARE BARRIERS - WELLNESS ACTIVITIES AND EXERCISE - DEMOGRAPHICS THE DATA COLLECTION PHASE BEGAN ON AUGUST 1, 2012 AND WAS COMPLETED BY AUGUST 17, 2012. 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. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI, LINE 3 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. COMMUNITY INFORMATION SCHEDULE H, PART VI, LINE 4 CCMH 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. PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI, LINE 5 THE MISSION OF CHARLES COLE MEMORIAL HOSPITAL INDICATES THAT THE HOSPITAL RESPONDS TO THE HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES AND 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 CHARLES COLE REACHES OUT TO OUR COMMUNITIES TO EDUCATE, IMPROVE HEALTH, PREVENT AND TREAT DISEASE AND SUPPORT INDIVIDUALS AND GROUPS. CHARLES COLE, IN COOPERATION WITH COMMUNITY BASED GROUPS SUCH AS ROTARY 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, CHARLES COLE PARTNERS WITH THE AREA AGENCY ON AGING AND THE PENNSYLVANIA DEPARTMENT OF HEALTH TO ADMINISTER SEASON INFLUENZA AND PNEUMOCCOCAL 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. IN FY2013, 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, CHARLES COLE PROVIDES NO-COST EDUCATION TO COUNTY SENIOR CENTERS. IN FY 2013, CCMH 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, CHARLES COLE MEMORIAL HOSPITAL CONTINUES EFFORTS TO ASSURE THAT HEALTHCARE, IN ALL FORMS, IS ACCESSIBLE AND AVAILABLE TO THOSE WHO MAY OTHERWISE GO WITHOUT. CCMH PROVIDES THE COMMUNITY WITH SPACE FOR EVENTS, MEETINGS AND PROGRAMS SUCH AS SUPPORT GROUPS, ANNUAL EVENTS, TRAINING SESSIONS AND YOUTH SPORTS. CCMH'S EMPLOYEE GIVING CLUB, HEART OF COLE, HAS A DESIGNATED GROUP THAT FOCUSES ON COMMUNITY CONNECTIONS. THE GROUP ANNUALLY UTILIZES APPROXIMATELY $10,000 ON COMMUNITY CONNECTIONS INCLUDING DONATIONS, IN FY13 SPECIFICALLY TO SERVE INDIVIDUALS AND FAMILIES THROUGH MONETARY AND NON-PERISHABLE FOOD DONATIONS TO LOCAL FOOD BANKS AND TO PURCHASE OF HEALTHCARE-RELATED ITEMS TO BE USED AS GIVE-AWAYS AT COMMUNITY EVENTS. CHARLES COLE 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, CCMH OFTEN PARTNERS WITH FUNDING FOUNDATIONS TO PROVIDE HEALTH SPECIFIC IMPROVEMENT INITIATIVES IN THE COMMUNITIES WHICH WE SERVE. AS AN EXAMPLE, CCMH, WITH FUNDING FROM THE MAKING STRIDES AGAINST BREAST CANCER FOUNDATION, TO PROVIDE A NIGHT FOR WOMEN WHO HAVE OR HAD BREAST CANCER. AFFILIATED HEALTH CARE SYSTEM SCHEDULE H , PART VI, LINE 6 THE AFFILIATED HEALTH CARE SYSTEM INCLUDES CHARLES COLE MEMORIAL HOSPITAL, COLE CARE, INC, AND HENDORN, INC. CHARLES COLE MEMORIAL HOSPITAL (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. X X X X X false false false false false false false true false MICHAEL E CALLAHAN 187408 0 0 0 2134 0 4750 0 19031 0 213322 0 0 0 JASON TRONETTI 231127 0 81208 0 222 0 6250 0 21432 0 340239 0 0 0 KALLIOPI NESTOR 224217 0 0 0 320 0 5688 0 19722 0 249947 0 0 0 EDWARD C PITCHFORD 269642 0 28000 0 28074 0 6250 0 21476 0 353442 0 0 0 CYNTHIA HARDESTY 140083 0 15440 0 21534 0 4441 0 8016 0 189514 0 0 0 BRADLEY GIANNOTTI 900028 0 7287 0 900 0 4827 0 16808 0 929850 0 0 0 TERRENCE FOUST 656590 0 108903 0 540 0 6250 0 7438 0 779721 0 0 0 SAKET PRASAD 518963 0 94023 0 17876 0 6250 0 13326 0 650439 0 0 0 CHRISTAN CARAMIA 437269 0 0 0 392 0 6250 0 23165 0 467076 0 0 0 BEVERLY PRINCE 384867 0 0 0 2772 0 3750 0 20494 0 411883 0 0 0 BONUS SCHEDULE J, PART I, LINE 7 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. COLE CARE COMMON BOARD MEMBERS 7372001 RENT, DIVIDENDS, SERVICES false EDMOND HARDESTY HUSBAND OF C. HARDESTY 149934 EMPLOYEE OF HOSPITAL false ADAM NESTOR HUSBAND OF K. NESTOR 85238 EMPLOYEE OF HOSPITAL false VICTORIA COPP SISTER OF J. MIGLICIO 34198 EMPLOYEE OF HOSPITAL false NANCY RUDOLPH SISTER OF J. MIGLICIO 52718 EMPLOYEE OF HOSPITAL false ORGANIZATION'S MISSION FORM 990, PART I, LINE 1 CHARLES COLE MEMORIAL HOSPITAL 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). CCMH 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. CHARLES COLE 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. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4 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 INPATIENT SATISFACTION RANKS IN THE TOP 12% FOR OUR INPATIENT SERVICES ACROSS THE NATION. IN ADDITION TO THE HOSPITAL'S ACUTE CARE FLOORS, COLE MEMORIAL CARES FOR PATIENTS IN ITS 49-BED LONG TERM CARE 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. SIGNIFICANT CHANGES TO BYLAWS FORM 990, PART VI, SECTION A, LINE 4 THE BYLAWS WERE AMENDED TO TRANSFER TO THE AUDIT COMMITTEE THE FINANCIAL OPERATIONS RESPONSIBILITIES CURRENTLY RESIDING WITH THE FINANCE COMMITTEE, AND TO RESTRUCTURE AND ELIMINATE THE EXISTING FINANCE COMMITTEE TO BECOME EXCLUSIVELY THE INVESTMENT COMMITTEE. MEMBERS FORM 990, PART VI, SECTION A, LINES 6 & 7A THE MEMBERS OF THE CORPORATION, THE CHARLES COLE MEMORIAL HOSPITAL, SHALL BE KNOWN AS COMMUNITY BENEFIT ADVISORS ("ADVISORS"), WHOSE FUNCTIONS AND QUALIFICATIONS SHALL INCLUDE THE FOLLOWING: (A) PROMOTE THE PROGRAMS, GOALS AND OBJECTIVES OF CHARLES COLE MEMORIAL HOSPITAL; (B) EDUCATE THEIR PUBLIC CONTACTS, BOTH ON HEALTH CARE ISSUES AND ON SERVICES AND PROGRAMS AVAILABLE THROUGH CHARLES COLE MEMORIAL HOSPITAL, AND SEEK THEIR SERVICES WHEN NECESSARY AND APPROPRIATE; (C) PROVIDE AN IMPORTANT LINK BETWEEN CHARLES COLE MEMORIAL HOSPITAL, 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 CHARLES COLE MEMORIAL HOSPITAL; (E) PROVIDE SPECIAL ASSISTANCE ON PROJECTS AND ISSUES WHEN REQUESTED; (F) PARTICIPATE IN FUNDRAISING EFFORTS TO BENEFIT PATIENT CARE PROGRAMS FOR CHARLES COLE MEMORIAL HOSPITAL; 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 CHARLES COLE MEMORIAL HOSPITAL 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 CHARLES COLE MEMORIAL HOSPITAL 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 REVIEW PROCESS FORM 990, PART VI, SECTION B, LINE 11B 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 AUDIT / COMP COMMITTEE FOR REVIEW. AFTER THE AUDIT / COMP COMMITTEE HAS REVIEWED, A FULL COPY IS DISTRIBUTED TO THE BOARD OF DIRECTORS and THE COMMITTEE WILL REPORT THEIR REVIEW OF FORM 990 TO THE ENTIRE BOARD OF DIRECTORS PRIOR TO THE CEO'S FINAL SIGNATURE. MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C 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 AUDIT 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. COMPENSATION DETERMINATION FORM 990, PART VI, SECTION B, LINE 15A A REVIEW WAS CONDUCTED IN 2012 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 AUDIT/COMPENSATION COMMITTEE. DOCUMENT AVAILABILITY FORM 990, PART VI, SECTION C, LINE 19 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. BOARD MEMBER COMPENSATION FORM 990, PART VII, SECTION A NO BOARD MEMBERS RECEIVE ANY COMPENSATION FOR THEIR DIRECTOR DUTIES. MICHAEL CALLAHAN IS COMPENSATED BY CHARLES COLE MEMORIAL HOSPITAL AS A PHYSICIAN. JASON TRONETTI IS COMPENSATED BY CHARLES COLE MEMORIAL HOSPITAL AS A PHYSICIAN. KALLIOPI NESTOR IS COMPENSATED BY CHARLES COLE MEMORIAL HOSPITAL AS A PHYSICIAN. EACH WORK APPROXIMATELY 40 HOURS PER WEEK IN THESE ROLES. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 9 $ 1,981,033 AMORTIZATION OF NET LOSS (31,308) AUXILIARY NET ASSET TRANSFER TO COLE FOUNDATION (8,151) TRANSFER TO COLE FOUNDATION ------------- $ 1,941,574 HENDORN INC DBA COLE MANOR 1001 EAST SECOND STREET COUDERSPORT PA 16915 231972659 RESIDENT CARE PA 501(C)(3) 11B II CCMH 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) 11B II CCMH true COLE CARE INC 1001 EAST 2ND STREET COUDERSPORT PA 16915 251497347 DURABLE MED E PA CCMH C CORPORATION 8755121 912107 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 175058 FMV COLE CARE INC L 175644 FMV HENDORN INC M 403985 FMV COLE CARE INC O 6958546 FMV COLE CARE INC P 62753 FMV