2014-05-15T12:54:57-05:00 2013-06-30 135381590 BDO USA LLP 7101 WISCONSIN AVENUE BETHESDA MD 20814 990 2012-07-01 231360851 HANOVER HOSPITAL INC HANO 7176373711 300 HIGHLAND AVENUE HANOVER PA 173312214 MICHAEL GASKINS 7176373711 2014-05-15 1 MICHAEL SORRELLS CPA P00001737 3016544900 2012 2015-11-30 17:44:51Z JAMES WISSLER 300 HIGHLAND AVENUE HANOVER PA 173312214 152091481 0 X WWW.HANOVERHOSPITAL.ORG X 1924 PA NON-PROFIT COMMUNITY HOSPITAL DEDICATED TO PROMOTING WELLNESS WITHIN THE GREATER HANOVER AREA. 16 13 1437 225 3008701 1082402 1374791 3500792 140774903 137206043 366645 30340 1273989 1462358 143790328 142199533 62654 105708 0 0 68192961 71101949 0 0 117545 68487625 60929400 136743240 132137057 7047088 10062476 156016413 161014373 73868322 72665361 82148091 88349012 X WE ARE A NOT-FOR-PROFIT COMMUNITY HOSPITAL WHICH IS DEDICATED TO THE PROMOTION OF WELLNESS, PRESERVATION OF HEALTH, AND THE PROVISION OF DIAGNOSTIC AND THERAPEUTIC SERVICES TO THE PEOPLE OF THE GREATER HANOVER AREA.WE WILL BE THE PROVIDER OF CHOICE FOR HOSPITAL SUPPORTED ACUTE CARE, DIAGNOSTIC, THERAPEUTIC, REHABILITATIVE, AND WELLNESS SERVICES REQUIRED TO SUPPORT OUR NETWORK OF CARE. 0 0 89152325 105708 134324250 HANOVER HOSPITAL, INC ("HH") OPERATES A NOT-FOR-PROFIT HOSPITAL WITH SERVICES INCLUDING OBSTETRICS, EMERGENCY, CARDIAC CARE, CRITICAL CARE, REHABILITATION, OCCUPATIONAL HEALTH, SURGICAL SERVICES, AND A WIDE RANGE OF THERAPEUTIC AND DIAGNOSTIC SUPPORT SERVICES. (SEE SCHEDULE O FOR CONTINUATION.) 89152325 1 1 0 1 0 0 0 0 1 1 1 0 0 0 1 1 1 1 0 0 0 0 0 0 1 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 0 0 1 160 0 1 1437 1 1 1 0 0 0 0 1 1 0 0 0 0 X 16 13 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X DONNA MULLER 7173162032 310 STOCK STREET SUITE 7 HANOVER PA 17331 PAUL F DENDE DO 1.00 52.00 X 0 543643 39670 MICHAEL R DENNEY DO 1.00 X 3000 0 0 THOMAS K HOWARD MD 1.00 X 0 0 0 LAVERNE L LEESE 1.00 X 0 0 0 G STEVEN MCKONLY ESQUIRE 1.00 X 1754 0 0 TROY E ECKERT 1.00 X 0 0 0 MARCOS A UGARTE MD 1.00 X 0 0 0 C DANIEL WEBER 1.00 X 0 0 0 JILL R ROHRBAUGH 1.00 X 0 0 0 JOHN-PAUL LUNN 1.00 X 0 0 0 BARBARA A RUPP 1.00 X 0 0 0 ALAN J STOCK 1.00 X X 0 0 0 JAMES E WISSLER 40.00 X X 236053 0 10033 PAUL F SPEARS MD 1.00 X X 0 0 0 JOHN R SCHNITZER CPA 1.00 X X 0 0 0 DYLAN B LISSETTE 1.00 X X 0 0 0 MICHAEL W GASKINS 40.00 X 290274 0 32207 MICHAEL H ADER 1.00 49.00 X 21600 348875 23579 MARY P SAUNDERS 40.00 X 200618 0 15143 MICHAEL A HOCKENBERRY 40.00 X 176271 0 33594 DANIEL L LEIB 40.00 X 132316 0 32286 CONNIE ROBINSON 40.00 X 130967 0 9985 NANCY J ESCHRICH 40.00 X 130116 0 14574 REBECCA E GOODERMUTH 40.00 X 158302 0 23576 ANDREW C RINEHART 40.00 X 125471 0 32750 1606742 892518 267397 34 0 1 0 HUNTZINGER MANAGEMENT GROUP 670 N RIVER STREET SUITE 401 PLAINS PA 18705 CONSULTING - IT SVCS 2865948 HANOVER ANESTHESIOLOGY & PAIN 250 FAME AVENUE SUITE 110 HANOVER PA 17331 ANESTHESIA SVCS 1289190 GE HEALTHCARE PO BOX 640944 PITTSBURGH PA 152640944 PREVENTIVE MAINTENANCE 1238086 AMN HEALTHCARE ALLIED INC PO BOX 281939 ATLANTA GA 30384 AGENCY STAFFING 1009439 MCKAY CONSULTING 8590 BUSINESS PARK DRIVE SHREVEPORT LA 71105 CONSULTING 866983 20 105643 3395149 366758 3500792 NET PATIENT SVC REV 621990 133096593 133096593 LAB SERVICE REV 621500 3564669 576205 2988464 EMERGENCY ROOM 621990 544781 544781 137206043 835710 835710 335053 121104 213949 213949 20237 193712 8859843 55555 9097047 623721 -237204 -568166 -805370 -805370 45818 105643 50076 -4258 -4258 FOOD SERVICES/CATERING 722210 529716 529716 PURCH REBATES/DISCNTS 900099 240199 240199 SUBSCRIPTIONS 900099 164770 164770 317982 106671 211311 1252667 142199533 134324250 3008701 1365790 X 105708 105708 1413615 565446 848169 51515721 39032429 12436219 47073 1934727 1465904 467055 1768 12484568 8571567 3898813 14188 3753318 2857809 891658 3851 922038 47762 874276 59804 59804 115144 115144 55741 55741 14823911 10017240 4804324 2347 443250 7087 431784 4379 22742937 20596087 2130392 16458 2957279 471614 2462892 22773 3036386 1048474 1987912 363312 177597 183168 2547 3503319 3503319 9772181 3719121 6052256 804 1534266 1534266 UNRELATED BUS INC TAXES 384004 384004 DUES TO OUTSIDE ORGANIZ 177570 58206 118007 1357 38258 26270 11988 132137057 89152325 42867187 117545 2674 2494 9432227 11248575 1354904 673999 14547154 13587920 3021029 3276022 2313883 2387403 184434292 95511323 87277896 88922969 31735982 35535826 1428967 1401383 4901697 3977782 156016413 161014373 14877533 13634074 50494052 49292853 5069693 6494256 3427044 3244178 73868322 72665361 X 78682664 87424458 3320765 783339 144662 141215 82148091 88349012 156016413 161014373 X 10062476 2665186 -55741 -6471000 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 17108 17108 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: THE FOLLOWING PORTIONS OF THE DUES PAID TO VARIOUS ENTITIES WERE USED FOR LOBBYING PURPOSES: HOSPITAL & HEALTHSYSTEM ASSOCIATION OF PENNSYLVANIA - $8,087, YORK COUNTY ECOMOMIC ALLIANCE - $271. PAYMENT TO LAW FIRM FOR ADVOCACY TO EXTEND AND ENHANCE THE MEDICARE MDH PROGRAM: $8,750 1 15509 31 1070 14470 1 13895668 517380 2443928 3000 33762 27308 16792906 13681355 365692 -110985 1500 38894 13895668 10948733 386168 2405437 3000 55983 13681355 10655584 133632 1224661 1065145 10948732 12146275 76577 -1498956 68312 10655584 0.99160 0.00840 0 0 2143865 2143865 118438021 56144078 62293943 1794613 934098 860515 56407034 38433147 17973887 5650759 5650759 88922969 OBLIGATIONS UNDER CAPITAL LEASE 1688307 ADVANCES RECEIVED FROM THIRD-PARTY PAYORS 521201 DEFERRED COMPENSATION 570217 ESTIMATED 3RD PARTY PAYOR SETTLEMENTS 464453 3244178 X 145615483 2665186 11418 2676604 142938879 -739346 -739346 142199533 132832080 11418 739346 750764 132081316 55741 55741 132137057 PART IV, LINE 1B: PART IV, LINE 1B: JOSEPH & PATRICIA HUMBERT ORIGINALLY CONTRIBUTED $20,000 TO HANOVER HOSPITAL, INC. THE DONORS RECEIVE SEMI-ANNUAL DISTRIBUTIONS OF $535 AND HANOVER HOSPITAL, INC. RECEIVES INTEREST INCOME AND PAYS BANK FEES ON THE FUNDS. THE BALANCE OF THE FUND WHEN BOTH DONORS HAVE EXPIRED IS A CONTRIBUTION TO HANOVER HOSPITAL, INC. DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: BOARD DESIGNATED FUNDS ARE ASSETS SET ASIDE BY THE BOARD OF TRUSTEES FOR FUTURE CAPITAL IMPROVEMENTS, OVER WHICH THE BOARD RETAINS CONTROL AND MAY, AT ITS DISCRETION, SUBSEQUENTLY USE FOR OTHER PURPOSES. THE FOLLOWING ENDOWMENTS' INCOMES ARE USED FOR THE PURPOSE OF PROVIDING HANOVER HOSPITAL STAFF SCHOLARSHIPS FOR CONTINUING EDUCATION IN THE NOTED SPECIALTIES: BATHON-CRITICAL CARE, CARDIAC AND EMERGENCY SERVICES PATHOLOGISTS- LABORATORY KIRKPATRICK-MATERNITY/OBSTETRICS SHIPMAN-RADIOLOGY BONNIE HART-OPERATING ROOM STEVE LAWRENCE-EMERGENCY MEDICINE THE JACKIE LAWRENCE ENDOWMENT IS RESTRICTED FOR THE PURPOSE OF AWARDING A $500 SCHOLARSHIP TO A DELONE CATHOLIC HIGH SCHOOL SENIOR THAT IS PURSUING A BACHELOR OF SCIENCE- NURSING DEGREE. THE LEHMAN ENDOWMENT FUND IS TO SUPPORT A "WENDELL LEHMAN EDUCATION DAY" FOR THE HANOVER HOSPITAL CARDIAC SERVICES STAFF. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE HOSPITAL ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. MANAGEMENT DETERMINED THAT THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2013 AND 2012. THE TAX RETURNS FOR THE YEARS ENDED JUNE 30, 2010 THROUGH JUNE 30, 2013 REMAIN SUBJECT TO EXAMINATION BY MAJOR TAX JURISDICTIONS. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -121,104. GAIN (LOSS) ON SALE OF PROPERTY AND EQUIPMENT -568,166. FUNDRAISING EXPENSES -50,076. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 121,104. LOSS (GAIN) ON SALE OF ASSETS 568,166. FUNDRAISING EXPENSES 50,076. GOLF TOURNAMENT 151461 105643 45818 17733 31257 1086 151461 105643 45818 17733 31257 1086 50076 -4258 1 1 1 X 1 X 1 1 1 0 1 1 2434 882487 0 882487 0.00670 14504 8809548 2349152 6460396 0.04890 16938 9692035 2349152 7342883 0.05560 21 93137 189433 225 189208 0.00140 2 766 96003 0 96003 0.00070 2 0 71037 0 71037 0.00050 25 93903 356473 225 356248 0.00260 25 110841 10048508 2349377 7699131 0.05820 2 287 6874 0 6874 0.00010 2 287 6874 6874 0.00010 1 2355390 16141 31018668 45024986 -14006318 X 1 1 1 CHERRY TREE CANCER CENTER LLP DIAGNOSTIC ONCOLOGY CENTER 0.50000 0.00000 0.00000 1 1 HANOVER HOSPITAL INC

300 HIGHLAND AVENUE HANOVER PA 17331

X X X HANOVER HOSPITAL 1 1 X X X X X X X X 12 1 1 1 X X X X X X X X X 0 0 1 1 200.000000000000 1 350.000000000000 1 X X X X X X X 1 1 X X X X X X 1 0 1 X 0 0 12 HILLSIDE DIAGNOSTIC CENTER

250 FAME AVE STE 104 HANOVER PA 17331

LAB, MRI, X-RAY, CT SCAN, US SOUTH HANOVER

1404 BALTIMORE ST HANOVER PA 17331

LAB & X-RAY CHERRY TREE

785 CHERRY TREE CT HANOVER PA 17331

REHAB & PEDIATRICS REHAB SPRING GROVE

2030 THISTLE HILL DR SPRING GROVE PA 17362

LAB, REHAB, X-RAY LITTLESTOWN

300 W KING ST LITTLESTOWN PA 17340

LAB & REHAB NEW OXFORD

5615 YORK RD NEW OXFORD PA 17350

LAB & X-RAY EICHELBERGER LAB

195 STOCK ST HANOVER PA 17331

OUTPATIENT LAB YORK STREET

400 YORK ST HANOVER PA 17331

REHAB HILLSIDE CARDIAC DIAGNOSTIC

250 FAME AVE STE 207 HANOVER PA 17331

CARDIAC REHAB HILLSIDE LUNG & SLEEP CENTER

250 FAME AVE STE 200 HANOVER PA 17331

PULMONOLOGY & SLEEP CENTER HILLSIDE REHAB

250 FAME AVE STE 100 HANOVER PA 17331

REHAB HANOVER MEDICAL FITNESS CENTER

250 FAME AVE STE 100 HANOVER PA 17331

FITNESS CENTER PART I, LINE 7: CHARITY CARE, UNREIMBURSED MEDICAID AND SUBSIDIZED HEALTH SERVICES WERE CALCULATED USING WORKSHEET 2 (RATIO OF PATIENT CARE COST TO CHARGES) FROM THE INSTRUCTIONS FOR SCHEDULE H. PART I, LINE 7G: THE SUBSIDIZED HEALTH SERVICES WERE DETERMINED USING OUR COST ACCOUNTING SYSTEM, BEFORE MANUALLY REMOVING THE CHARITY CARE AND MEDICAID REVENUE. PART I, L7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25 COLUMN (A) BUT SUBTRACTED OUT FOR PURPOSES OF CALCULATING THE PERCENTAGE ON SCH H, PART I, LINE 7, COLUMN (F) IS $5,353,158. PART II: HANOVER HOSPITAL OFFERS A WIDE VARIETY OF LECTURES, PRESENTATIONS AND OTHER PROGRAMS TO EDUCATE THE PUBLIC ABOUT HEALTH ISSUES, SUCH AS CHRONIC DISEASE PREVENTION, CANCER PREVENTION, MENTAL HEALTH AWARENESS, CARDIOVASCULAR DISEASE PREVENTION, AND HEALTHY BEHAVIORS. WE ALSO HAVE STRONG COMMUNITY COLLABORATIONS WITH HANOVER AREA YMCA, HANOVER CHAMBER OF COMMERCE, HANOVER YWCA, HEALTHY YORK COUNTY COALITION, HEALTHY ADAMS COUNTY, AND NUMEROUS OTHER ORGANIZATIONS. PART III, LINE 4: BAD DEBT EXPENSE IS THE UNCOLLECTIBLE PORTION OF CHARGES GENERATED BY PATIENT CARE. THIS SHOULD BE INCLUDED IN COMMUNITY BENEFIT TO SHOW HOW MUCH MONEY WAS DEEMED UNCOLLECTIBLE FROM PATIENTS.THE ALLOWABLE ADJUSTMENT IS TAKEN PRIOR TO WHEN THE REMAINING BALANCE IS WRITTEN OFF TO BAD DEBT EXPENSE. IF ANY PAYMENTS COME IN SUBSEQUENTLY, THE WRITE-OFF IS REVERSED AND THE BAD DEBT EXPENSE IS REDUCED.BAD DEBT EXPENSE WAS DETERMINED USING THE COST TO CHARGE RATIO. PART III, LINE 8: THE ORGANIZATION IS PROVIDING CARE TO COMMUNITY MEMBERS WHO ARE ENROLLED IN MEDICARE BUT THE ORGANIZATION CANNOT COLLECT ON THE SHORTFALL BECAUSE OF THE GOVERNMENT'S LIMITATIONS ON ALLOWABLE CHARGES. THE SAME LEVEL OF CARE IS PROVIDED TO ALL PATIENTS NO MATTER WHAT THE INSURANCE SITUATION, SO THE ORGANIZATION SHOULD BE ALLOWED TO CLAIM THE MEDICARE SHORTFALL AS COMMUNITY BENEFIT.MEDICARE ALLOWABLE COST OF CARE WAS OBTAINED FROM THE MEDICARE COST REPORT. PART III, LINE 9B: PATIENTS WHO QUALIFY FOR 100% CHARITY CARE HAVE THEIR ACCOUNT BALANCES WRITTEN OFF AS SOON AS ELIGIBILITY IS APPROVED. PATIENTS WHO QUALIFY FOR A LESSER AMOUNT ARE EXPECTED TO PAY THE REMAINING BALANCE AT THE TIME OF APPROVAL. IF NECESSARY, A PAYMENT PLAN IS SET UP FOR THE BALANCE. HANOVER HOSPITAL PART V, SECTION B, LINE 4: THE HOSPITAL'S CHNA WAS CONDUCTED WITH: MEMORIAL HOSPITAL AND WELLSPAN HEALTH. HANOVER HOSPITAL PART V, SECTION B, LINE 7: ALL OF THE NEEDS IN ITS MOST RECENTLY CONDUCTED CHNA THAT THE HOSPITAL DID NOT ADDRESS: THE HOSPITAL WILL NOT ADDRESS PSYCHIATRIC NEEDS SINCE THE HOSPITAL DOES NOT HAVE THE CAPACITY TO HANDLE PSYCHIATRIC PATIENTS. THE HOSPITAL'S APPROACH IS TO WORK WITH OTHER LOCAL MEDICAL PROVIDERS WHO HANDLE THIS SPECIFIC NEED. HANOVER HOSPITAL PART V, SECTION B, LINE 20D: SERVICES ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS POLICY WILL BE DISCOUNTED ON A SLIDING SCHEDULE, IN ACCORDANCE WITH FINANCIAL NEED, AS DETERMINED IN REFERENCE TO FEDERAL POVERTY LEVELS (FPL) IN EFFECT AT THE TIME OF DETERMINATION. THE BASIS FOR THE AMOUNTS HANOVER HOSPITAL WILL DISCOUNT IS AS FOLLOWS:1. PATIENTS WHOSE FAMILY INCOME IS AT OR BELOW 200% OF THE FPL ARE ELIGIBLE TO RECEIVE FREE CARE.2. PATIENTS WHOSE FAMILY INCOME IS AT OR ABOVE 201% BUT NOT MORE THAN 350% OF THE FPL ARE ELIGIBLE TO RECEIVE DISCOUNTS BASED ON THE FOLLOWING SLIDING FEE SCHEDULE:3. 201% - 250% - 75% DISCOUNT4. 251% - 300% - 50% DISCOUNT5. 301% - 350% - 25% DISCOUNT6. ABOVE 350% - CASE-BY-CASE7. PATIENTS WHOSE FAMILY INCOME IS ABOVE 350% OF THE FPL MAY BE ELIGIBLE TO RECEIVE ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES AT THE DISCRETION OF HANOVER HOSPITAL. PART VI, LINE 2: A COMMUNITY HEALTH ASSESSMENT PROVIDES THE INFORMATION NEEDED TO CONSIDER WHEN DEVELOPING EFFECTIVE INTERVENTIONS SO THAT COMMUNITIES MAY IDENTIFY ISSUES OF GREATEST CONCERN AND DECIDE TO COMMIT RESOURCES TO THOSE AREAS, THEREBY MAKING THE GREATEST POSSIBLE IMPACT ON COMMUNITY HEALTH STATUS.SEVERAL COMMUNITY ORGANIZATIONS COME TOGETHER TO FORM A COMMITTEE WHOSE RESPONSIBILITY IS TO FORMULATE QUESTIONS TO BE ASKED OF COMMUNITY MEMBERS. A CONSULTANT THEN COLLECTS THE DATA AND ANALYZES IT ON OUR BEHALF. THE GREATEST NEEDS ARE THEN DETERMINED AND PROGRAMS ARE DESIGNED AROUND THOSE NEEDS. PART VI, LINE 3: NOTIFICATION OF THE FINANCIAL ASSISTANCE POLICY, WHICH SHALL INCLUDE A CONTACT NUMBER, WILL BE DISTRIBUTED BY VARIOUS MEANS INCLUDING, BUT NOT LIMITED TO, POSTING NOTICES IN PROMINENT PATIENT LOCATIONS AND PLACING INFORMATION ON PATIENT STATEMENTS. HANOVER HOSPITAL WILL ALSO PUBLICIZE A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY ON THE FACILITY WEBSITE AND IN BROCHURES AVAILABLE IN PATIENT ACCESS AREAS. SUCH NOTICES AND SUMMARY INFORMATION WILL BE PROVIDED IN THE PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVED BY HANOVER HOSPITAL. PART VI, LINE 4: THE COMMUNITY DEFINED FOR THIS ASSESSMENT INCLUDES EACH OF THE PENNSYLVANIA ZIP CODES: 17316, 17301, 17350, 17364, 17362, 17344, 17331, 17329 & 17340. SECONDARY DATA IS COLLECTED AND REPRESENTATIVE OF THE ENTIRE COUNTIES OF YORK AND ADAMS. PART VI, LINE 5: HANOVER HOSPITAL FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF ITS COMMUNITY THROUGH THE FOLLOWING. HANOVER HOSPITAL UTILIZES APPROXIMATELY 300 VOLUNTEERS OFFERING SUPPORT TO THE ORGANIZATION, FROM THE BOARD OF DIRECTORS TO THOSE WHO DELIVER FLOWERS AND TRANSPORT PATIENTS. THESE VOLUNTEERS ARE ALSO ACTIVE COMMUNITY MEMBERS LIVING IN THE HOSPITAL'S PRIMARY SERVICE AREA. THROUGH THEIR INVOLVEMENT AT THE HOSPITAL, THEY ARE ABLE TO COMMUNICATE ITS PROGRAMS AND SERVICES THAT BENEFIT THE WELFARE OF THE COMMUNITY. HANOVER HOSPITAL ALSO EMPLOYS APPROXIMATELY THIRTY PHYSICIANS. THESE PHYSICIANS SPECIALIZE IN FAMILY MEDICINE, INTERNAL MEDICINE, GENERAL SURGERY, GERIATRICS, LUNG AND SLEEP MEDICINE, ENDOCRINOLOGY, AND CARDIOLOGY. OUR PHYSICIANS WORK WITH THOUSANDS OF FAMILIES PROVIDING EXCEPTIONAL CARE. FINALLY, HANOVER HOSPITAL APPLIES ITS SURPLUS FUNDS BY REINVESTING IN THE ORGANIZATION. OVER THE PAST YEAR, THE HOSPITAL HAS PAID FOR THE EXPENSES TO ROLL OUT A COMMUNITY-WIDE ELECTRONIC MEDICAL RECORD (EMR). HANOVER IS ONE OF THE VERY FEW COMMUNITIES TO HAVE APPROXIMATELY EIGHTY PERCENT OF ITS EMPLOYED AND AFFILIATED PHYSICIAN PRACTICES JOIN THIS ROLL OUT. TOGETHER THE HOSPITAL AND ITS PHYSICIANS ARE COMMITTED TO PROVIDING A TIMELY, ACCURATE RECORD FOR PATIENTS TO REDUCE UNNECESSARY TESTING AND REDUCE COSTS. IN ADDITION TO THE EMR, THE HOSPITAL HAS INVESTED FUNDS TO IMPROVE TECHNOLOGY AND TO OPEN NEW CENTERS. MOST RECENTLY, THE HOSPITAL OPENED ITS THIRD EXPRESS CARE IN NEW OXFORD. THROUGH OUR MOST VALUABLE ASSETS, OUR VOLUNTEERS AND EMPLOYEES, ALONG WITH OUR ONGOING COMMITMENT TO OUR COMMUNITY HANOVER HOSPITAL HAS FURTHERED ITS EXEMPT PURPOSE. REPORTS FILED WITH STATES PART VI, LINE 7 PA 1 EICHELBERGER PERFORMING ARTS CENTER 195 STOCK STREET SUITE 200 HANOVER PA 17331 232915952 501(C)(3) 10000 N/A N/A ANNUAL SPONSORSHIP AMERICAN HEART ASSOCIATION 5455 NORTH HIGH STREET COLUMBUS OH 43214 135613797 501(C)(3) 10000 N/A N/A ANNUAL SPONSORSHIP FOR GO RED LUNCHEON SWEET CHARITIES- CANCER PATIENT FUND 1150 CARLISLE STREET HANOVER PA 17331 113662416 501(C)(3) 30000 N/A N/A GOLF TOURNAMENT SPONSORSHIPS FRIENDS OF CODORUS STATE PARK 1066 BLOOMING GROVE ROAD HANOVER PA 17331 562675802 501(C)(3) 10000 N/A N/A 2013 CODORUS BLAST SPONSORSHIP NEW HOPE MINISTRIES INC PO BOX 448 DILLSBURG PA 17019 232223120 501(C)(3) 18000 HANOVER FAMILY CENTER 5 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: DONATIONS ARE MADE TO 501(C)(3) PUBLIC CHARITIES FOR USE IN EXEMPT ACTIVITIES RELATED TO HEALTHCARE. ADDITIONAL DONATIONS ARE MADE TO LOCAL NON-CHARITABLE ORGANIZATIONS TO SUPPORT THE COMMUNITY. X X X X X X 0 1 0 0 0 0 0 0 0 PAUL F DENDE DO 0 299761 0 241668 0 2214 0 12500 0 27170 0 583313 0 0 JAMES E WISSLER 199154 0 14096 0 22803 0 0 0 10033 0 246086 0 0 0 MICHAEL W GASKINS 225784 0 63500 0 990 0 4746 0 27461 0 322481 0 0 0 MICHAEL H ADER 21600 216832 0 130459 0 1584 0 7589 0 15990 21600 372454 0 0 MARY P SAUNDERS 187935 0 0 0 12683 0 8959 0 6184 0 215761 0 0 0 MICHAEL A HOCKENBERRY 152539 0 19500 0 4232 0 7607 0 25987 0 209865 0 0 0 DANIEL L LEIB 132141 0 0 0 175 0 6526 0 25760 0 164602 0 0 0 REBECCA E GOODERMUTH 155308 0 0 0 2994 0 7488 0 16088 0 181878 0 0 0 ANDREW C RINEHART 125346 0 0 0 125 0 6095 0 26655 0 158221 0 0 0 PART I, LINE 4B THE PRESIDENT, JAMES WISSLER, PARTICIPATED IN A SERP AND RECEIVED $14,096 IN REPORTABLE COMPENSATION. A GENERAL AUTHORITY OF SOUTHCENTRAL PENNSYLVANIA 232982233 84129NEB1 2005-10-12 32293464 RENOVATIONS, DEBT SERVICE FUND, AND COST TO INSURE & ISSUE BONDS 0 0 0 B GENERAL AUTHORITY OF SOUTHCENTRAL PENNSYLVANIA 232982233 84129NGH6 2013-04-15 15610000 REFINANCE 2002 SERIES BOND ISSUE 0 0 0 A 32293464 1784627 1854432 476117 989784 29042966 2008 0 0 1 1 B 17367146 16996983 2671140 237756 0 0 0 0 A 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 ALAN STOCK BOARD MEMBER & PRESIDENT OF EICHOLTZ 289416 ALAN STOCK OWNS EICHOLTZ COMPANY. THE HOSPITAL PURCHASED OFFICE EQUIPMENT FROM EICHOLTZ COMPANY.THE BOARD MAINTAINS A CONFLICT OF INTEREST POLICY AND ALL TRANSACTIONS WITH EICHOLTZ COMPANY WERE CONDUCTED AT ARM'S LENGTH. 0 X 1 366758 FAIR MARKET VALUE 0 1 1 THIRD PARTY USE: PART I, LINE 32B: HAVERFORD SELLS NON-CASH CONTRIBUTIONS OF SECURITIES. PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED): FORM 990, PART III, LINE 4A: HH PROVIDES ACUTE CARE SERVICES INCLUDING MEDICAL, SURGICAL, OBSTETRIC/GYNECOLOGICAL, PEDIATRIC, AND CRITICAL CARE. THE MEDICAL/SURGICAL UNITS ARE STAFFED ON TWO FLOORS, FOR A COMBINED TOTAL OF 58 BEDS. TOTAL PATIENTS DISCHARGED BY THESE UNITS DURING THE YEAR ENDED JUNE 30, 2013 WERE 3,847. OBSTETRICS/GYNECOLOGY STAFFS A TOTAL OF 18 BEDS AND DISCHARGED 739 PATIENTS. THE PEDIATRIC UNIT IS EQUIPPED WITH 5 BEDS AND HAD 174 DISCHARGES. THERE ARE 10 BEDS IN OUR CRITICAL CARE UNIT AND 334 PATIENTS WERE DISCHARGED. THE CENTER FOR ACUTE REHABILITATIVE MEDICINE HAS 15 BEDS, AND DISCHARGED 261 PATIENTS THIS YEAR. THERE WERE 617 DISCHARGES FROM THE NURSERY DURING THE YEAR AS WELL. HH PROVIDES A WIDE RANGE OF DIAGNOSTIC AND SUPPORT SERVICES FOR BOTH INPATIENTS AND OUTPATIENTS. THESE SERVICES INCLUDE, BUT ARE NOT LIMITED TO, LABORATORY, IMAGING SERVICES, CARDIAC SERVICES, AND REHAB FACILITIES. IMAGING SERVICES INCLUDES RADIOLOGY, NUCLEAR MEDICINE, MRI, ULTRASOUND, AND CT SCAN. CARDIAC SERVICES ARE COMPRISED OF REHAB, DIAGNOSTIC, AND A CARDIAC CATHETERIZATION LAB. HH PROVIDES MULTIPLE OUTPATIENT FACILITIES FOR PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY. HH ALSO PROVIDED CARE TO PATIENTS WHO MET CERTAIN CRITERIA WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. CHARGES FOREGONE FOR SERVICES RENDERED AND SUPPLIES FURNISHED UNDER THE FINANCIAL ASSISTANCE POLICY AMOUNTED TO APPROXIMATELY $2,005,653 DURING THE YEAR ENDED JUNE 30, 2013. FORM 990, PART VI, SECTION A, LINE 4 AMENDMENTS TO THE HANOVER HOSPITAL BYLAWS: ARTICLE VI OFFICERS, SECTION 6.10. VICE PRESIDENTS - AMEND TO INCLUDE THE TITLE OF EXECUTIVE VICE PRESIDENT. ONE OR MORE MEMBERS OF SENIOR MANAGEMENT MAY BE AFFORDED THE TITLE OF "EXECUTIVE VICE PRESIDENT" AND/OR "VICE PRESIDENT" BY THE PRESIDENT/CEO TO HOLD SUCH TITLE AT THE SOLE DISCRETION OF SUCH OFFICER. THE "EXECUTIVE VICE PRESIDENTS"/"VICE PRESIDENTS" SHALL NOT BE OFFICERS OF THE CORPORATION UNLESS ELECTED AS SUCH BY THE BOARD OF DIRECTORS OF THE CORPORATION PURSUANT TO SECTION 6.03 HEREOF OR APPOINTED AS SUCH BY THE PRESIDENT/CEO EXERCISING THE AUTHORITY TO APPOINT SUCH OFFICERS PURSUANT TO SECTION 6.03 HEREOF. PAGE 30 QUALITY COUNCIL CHARTER. UNDER MEMBERSHIP, INCLUDE THE POSITION OF VICE PRESIDENT OF MANAGEMENT OF INFORMATION SYSTEMS. FORM 990, PART VI, SECTION B, LINE 11 REVIEW OF THE DRAFT OF THE FORM 990 IS PERFORMED BY MANAGEMENT WITH THE OUTSIDE ACCOUNTING FIRM. ALL MEMBERS OF THE BOARD OF DIRECTORS ARE GIVEN A FINAL COPY OF THE FORM 990 PRIOR TO FILING WITH THE IRS. THE FINAL SUBMISSION IS REVIEWED BY THE FINANCE COMMITTTEE SO THAT THEIR QUESTIONS AND CONCERNS MAY BE ADDRESSED. FORM 990, PART VI, SECTION B, LINE 12C HH'S CODE OF CONDUCT CONTAINS PRINCIPLES OUTLINING THE POLICY OF HH AND STANDARDS THAT ARE INTENDED TO PROVIDE GUIDANCE TO ALL INDIVIDUALS PARTICIPATING IN HH'S OPERATIONS. THE PRINCIPLES AND STANDARDS SHALL BE DISTRIBUTED AT LEAST ANNUALLY TO ALL DIRECTORS, OFFICERS, EMPLOYEES AND AGENTS OF HH. INDIVIDUALS ARE RESPONSIBLE TO ENSURE THAT THEIR BEHAVIOR AND ACTIVITY IS CONSISTENT WITH THE CODE OF CONDUCT. THE TERM "INDIVIDUALS" INCLUDES DIRECTORS, EMPLOYEES AND AGENTS OF HH AND INCLUDES ANY PERSON WHO FILLS SUCH A ROLE OR PROVIDES SERVICES ON BEHALF OF HH INCLUDING NON-EMPLOYED MEMBERS OF HH'S MEDICAL STAFF PROVIDING SERVICES IN HH, NON-PHYSICIAN PRACTITIONERS EXERCISING PRIVILEGES IN HH, INTERNS AND MEDICAL STUDENTS AND SHALL INCLUDE VOLUNTEERS IN HH. UPON HIRE AND ANNUALLY THEREAFTER, ALL EMPLOYEES MUST COMPLETE OUR COMPLIANCE TRAINING, INCLUDING REVIEW OF OUR CODE OF CONDUCT STATEMENT. A COPY OF THE CODE OF CONDUCT IS LOCATED IN HH'S ADMINISTRATIVE POLICY MANUAL. OUR CODE OF CONDUCT HAS STANDARDS AND POLICIES THAT ADDRESS CONFLICTS OF INTEREST. IT IS EACH EMPLOYEE'S RESPONSIBILITY TO REVIEW AND COMPLY WITH THE CODE OF CONDUCT OR DISCUSS ANY QUESTIONS OR REPORT ANY CONCERNS TO THE CORPORATE DIRECTOR OF COMPLIANCE. INDIVIDUALS ARE INSTRUCTED THAT THEY OWE UNDIVIDED AND UNQUALIFIED LOYALTY TO HH. INDIVIDUALS MAY NOT USE THEIR POSITIONS TO PROFIT PERSONALLY OR TO ASSIST OTHERS IN PROFITING IN ANY WAY AT THE EXPENSE OF HH. INDIVIDUALS ARE EXPECTED TO CONDUCT THEMSELVES SO AS TO AVOID ACTUAL IMPROPRIETY AND/OR APPEARANCE OF IMPROPRIETY IN DEALING WITH HH AND TO AVOID DISCLOSURE OR PRIVATE USE OF THE BUSINESS AFFAIRS OR PLANS OF HH. DETERMINATION OF WHETHER A CONFLICT OF INTEREST EXISTS OR NOT AND THE ASSIGNMENT OF ANY NECESSARY ACTION IS MADE BY THE HH'S AUDIT COMMITTEE, A SUBCOMMITTEE OF OUR BOARD OF DIRECTORS. PARTICIPATION ON BOARD OF DIRECTORS/TRUSTEES: - AN INDIVIDUAL MUST OBTAIN APPROVAL OF HH COMPLIANCE OFFICER PRIOR TO SERVING AS A MEMBER OF THE BOARD OF DIRECTORS/TRUSTEES OF ANY ORGANIZATION WHOSE INTERESTS MAY CONFLICT WITH THOSE OF HH. AN INDIVIDUAL WHO IS ASKED OR SEEKS TO SERVE ON THE BOARD OF DIRECTORS/TRUSTEES OF ANY ORGANIZATION WHOSE INTEREST WOULD NOT IMPACT HH (E.G., CIVIC, CHARITABLE, FRATERNAL, ETC.) WILL NOT BE REQUIRED TO OBTAIN APPROVAL. - INDIVIDUALS SHALL SEEK THE APPROVAL OF HH COMPLIANCE OFFICER PRIOR TO RETAINING ANY FEES OR COMPENSATION (OTHER THAN REIMBURSEMENT FOR EXPENSES) THAT ARE RECEIVED BY THE INDIVIDUAL FOR BOARD SERVICES WHICH MAY HAVE BEEN RENDERED DURING NORMAL PAID WORK TIME AS AN EMPLOYEE OF HH. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE, CONSISTING OF INDEPENDENT MEMBERS OF THE HANOVER HOSPITAL BOARD OF DIRECTORS, COMMISSIONED AN INDEPENDENT AGENCY TO ESTABLISH A SALARY RANGE UTILIZING FOUR INDEPENDENT COMPENSATION SURVEYS. THE COMPENSATION OF TOP MANAGEMENT OFFICIALS WAS SET BY THE COMMITTEE UTILIZING THIS DATA AND WAS SUBSEQUENTLY APPROVED BY THE BOARD OF DIRECTORS IN EXECUTIVE SESSION. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION MAKES FORMS 1023, 990 AND 990-T AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. OTHER FEES FORM 990, PART IX, LINE 11G AGENCY HELP: PROGRAM SERVICE EXPENSES 1,184,692. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,184,692. PHYSICANS FEES: PROGRAM SERVICE EXPENSES 3,674,152. MANAGEMENT AND GENERAL EXPENSES 14,349. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,688,501. CONTRACTED SERVICES AND MGMT.: PROGRAM SERVICE EXPENSES 1,273,222. MANAGEMENT AND GENERAL EXPENSES 3,306,225. FUNDRAISING EXPENSES 2,347. TOTAL EXPENSES 4,581,794. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 1,249,927. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,249,927. BLOOD PROCESSING: PROGRAM SERVICE EXPENSES 587,614. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 587,614. MAINT AND REPAIRS: PROGRAM SERVICE EXPENSES 352,719. MANAGEMENT AND GENERAL EXPENSES 346,604. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 699,323. LAUNDRY - CONTRACTED: PROGRAM SERVICE EXPENSES 43,375. MANAGEMENT AND GENERAL EXPENSES 323,394. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 366,769. BIOMEDICAL EQUIP MAINT: PROGRAM SERVICE EXPENSES 1,544,535. MANAGEMENT AND GENERAL EXPENSES 601,619. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,146,154. OTHER: PROGRAM SERVICE EXPENSES 107,004. MANAGEMENT AND GENERAL EXPENSES 212,133. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 319,137. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: NET ASSET TRANSFER TO AFFILIATE -6,471,000. OVERSIGHT OF AUDIT: FORM 990, PART XII, LINE 2C THERE HAVE BEEN NO CHANGES DURING THE YEAR IN THE PROCESS FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS. FORM 990, SCHEDULE K, PART III, LINE 3 THERE ARE NO MANAGEMENT OR SERVICE CONTRACTS OR RESEARCH AGREEMENTS RELATING TO THE FINANCED PROPERTIES FOR THE 2005 BONDS. HANOVER HEALTHCARE PLUS INC 300 HIGHLAND AVENUE HANOVER PA 173312214 222658574 PARENT COMPANY OF NOT-FOR-PROFIT HEALTHCARE SERVICE ORGANIZATION PA 501(C)(3) 11A N/A 0 CHERRY TREE CANCER CENTER LLP PO BOX 2767 YORK PA 17405 232915628 OPERATES A THERAPEUTIC RADIATION TREATMENT FACILITY PA N/A RELATED 1135776 1583737 0 1 0.50000 HANOVER APOTHECARY INC 310 STOCK STREET SUITE 1 HANOVER PA 17331 030594256 PROVIDES PHARMACY SERVICES PA N/A C 1244073 1708923 1.00000 0 HANOVER HEALTH CORPORATION INC 300 HIGHLAND AVENUE HANOVER PA 17331 900498067 OPERATES SEVERAL OUTPATIENT MEDICAL CARE FACILITIES PA N/A C 17026650 7890084 1.00000 0 0 1 0 1 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 HANOVER HEALTH CORPORATION INC M 1320806 FAIR MARKET VALUE HANOVER HEALTH CORPORATION INC L 385050 FAIR MARKET VALUE HANOVER APOTHECARY INC J 27528 FAIR MARKET VALUE HANOVER HEALTH CORPORATION INC J 210411 FAIR MARKET VALUE