2013-05-13T10:36:58-05:00 2012-06-30 WithumSmithBrown PC 465 South St Ste 200 Morristown NJ 079606497 990 2011-07-01 230517130 DELAWARE COUNTY MEMORIAL HOSPITAL % PHILIP J RYAN CPA DELA 6104476252 501 NORTH LANSDOWNE AVENUE DREXEL HILL PA 19026 PHILIP J RYAN 2013-04-29 true 9738989494 2011 2016-03-07 17:11:31Z PATRICK J GAVIN 100 W SPROUL RD HLTHPLX PAV II SPRINGFIELD PA 19064 198342254 false X WWW.CROZER.ORG X 1925 PA DELAWARE COUNTY MEMORIAL HOSPITAL IS COMMITTED TO THE IMPROVED HEALTH STATUS OF THOSE WE SERVE AND WILL DEPLOY ITS RESOURCES IN A COST- EFFECTIVE AND COMMUNITY-RESPONSIVE MANNER. 20 9 1379 107 326196 -28820 500279 90166 193561581 195803431 1339496 1289755 966079 1123096 196367435 198306448 625000 625000 0 0 93610681 97284003 0 0 0 104607356 103654803 198843037 201563806 -2475602 -3257358 134209649 134603213 107257132 136530530 26952517 -1927317 DELAWARE COUNTY MEMORIAL HOSPITAL IS COMMITTED TO THE IMPROVED HEALTH STATUS OF THOSE WE SERVE. THROUGH A SEAMLESS, USER-FRIENDLY CONTINUUM OF QUALITY HEALTH SERVICES INCLUDING PRIMARY AND HEALTH PROMOTION, ACUTE AND LONG-TERM CARE, THROUGH REHABILITATION AND RESTORATIVE CARE, CROZER-KEYSTONE WILL DEPLOY ITS RESOURCES IN A COST-EFFECTIVE AND COMMUNITY-RESPONSIVE MANNER. WORKING IN PARTNERSHIP WITH OUR PHYSICIANS AND OTHER HEALTH PROFESSIONALS, WE WILL SEEK TO FORGE NEW ALLIANCES WITH OTHER COMMUNITY HEALTH AND SOCIAL SERVICE ORGANIZATIONS. WORKING WITH OUR COMMUNITY, OUR GOAL IS TO BUILD A HEALTHY PLACE TO LIVE AND WORK, AND A SOUND ENVIRONMENT IN WHICH TO BUILD AND MAINTAIN OUR FAMILIES. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT. false false 108700051 374375 109258314 THE ORGANIZATION IS AN AFFILIATE OF THE CROZER-KEYSTONE HEALTH SYSTEM; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. EXPENSES ARE INCURRED IN PROVIDING MEDICALLY NECESSARY INPATIENT HEALTHCARE SERVICES IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT. 60792182 209375 74601107 THE ORGANIZATION IS AN AFFILIATE OF THE CROZER-KEYSTONE HEALTH SYSTEM; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. EXPENSES ARE INCURRED IN PROVIDING MEDICALLY NECESSARY OUTPATIENT HEALTHCARE SERVICES IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT. 11976967 41250 11944010 THE ORGANIZATION IS AN AFFILIATE OF THE CROZER-KEYSTONE HEALTH SYSTEM; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. EXPENSES ARE INCURRED IN PROVIDING MEDICALLY NECESSARY EMERGENCY ROOM HEALTHCARE SERVICES IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT. 181469200 true true false true false false false false true true false true false true false false true false false true false false false false false true true true false true true false false false false false false false false true false false false false false false true true true true false true 148 0 true 1379 true true true false false false false false false false false false X 20 9 false false false false true true true true true false false true true true true true true true true false PA X PHILIP J RYAN CPA 6104476252 100 W SPROUL RD HLTHPLX PAV II SPRINGFIELD PA 19064 X JEROME S PARKER PHD 1.0 X X 0 0 0 GAIL M WHITAKER ESQ 1.0 X X 0 0 0 PETER L OETINGER 1.0 X X 0 0 0 ANN F SWAN 1.0 X X 0 0 0 FRED A AKL PHD PE 1.0 X 0 0 0 DAVID B ARSHT DO 1.0 X 0 86557 17814 CORLISS BOGGS 1.0 X 0 0 0 JOHN D BOWERS 1.0 X 0 0 0 BEVERLEE L DELUCA 1.0 X 0 0 0 ANTHONY E DIMARCO DO 55.0 X 0 196754 40155 BRUCE G FISCHER 1.0 X 0 0 0 PATRICK J GAVIN 55.0 X X 0 443120 42272 HORACE B GRIFFITH III 1.0 X 0 0 0 ROBERT B HEMPHILL 1.0 X 0 0 0 JACQUELINE M KRAEUTLER ESQ 1.0 X 0 0 0 EDWARD LAPORTA MD 1.0 X 0 0 0 JEFFREY H LOOSE MD 55.0 X 0 244503 43797 JOAN K RICHARDS 55.0 X X 0 1150678 222391 G GUY SMITH ESQ 1.0 X 0 0 0 ROBERT N SPEARE ESQ 1.0 X 0 0 0 RICHARD I BENNETT TERM 72911 55.0 X 0 1960593 259923 DONALD W LEGREID ESQ 55.0 X 0 332447 36293 WILLIAM MCCUNE 55.0 X 0 315830 41274 PHILIP J RYAN CPA 55.0 X 0 510592 145141 ROBERT E WILSON 55.0 X 0 698848 172986 STEPHEN P SULLIVAN 55.0 X 242783 0 39029 JUN YANG 55.0 X 205198 0 45662 XIAOFEI YING 55.0 X 181499 0 40690 JO ZETTA F SHAWL 55.0 X 172776 0 22701 ALI KOOHDARY MD 55.0 X 169264 0 28106 971520 5939922 1198234 133 false true false CYBERKNIFE CENTER OF PHILADELPHIA L 40 BURTON HILLS BOULEVARD SUITE 32 NASHVILLE TN 37215 RADIOSURGERY 8744406 DELCO RADIOLOGY ASSOCIATES 8701 D WEST CHESTER PIKE UPPER DARBY PA 19082 RADIOLOGY 1542519 SOCIETY HILL ANESTHESIA 501 N LANSDOWNE AVENUE DREXEL HILL PA 19026 ANESTHESIA 840002 HCSC LAUNDRY 2171 28TH STREET SOUTH WEST ALLENTOWN PA 18103 LAUNDRY 653459 QUEST DIAGNOSTICS PO BOX 828669 PHILADELPHIA PA 191828669 LAB 557895 38 90166 90166 NET PATIENT SERVICE REVENUE 541900 192146711 192146711 OTHER HEALTHCARE RELATED REVENUE 811000 3656720 3330524 326196 195803431 1317646 1317646 0 0 115591 115591 115591 115591 7915 35806 -35806 7915 -27891 -27891 0 0 0 CAFETERIA REVENUE 722210 567852 567852 PARKING REVENUE 812930 439653 439653 1007505 198306448 195477235 326196 2412851 625000 625000 0 0 0 0 0 72666082 65399474 7266608 4664220 4197798 466422 14817152 13335437 1481715 5136549 4622894 513655 8258988 7433089 825899 6209 5588 621 11850 10665 1185 0 0 0 36958914 33263023 3695891 795522 715970 79552 7700241 6930217 770024 0 0 1939607 1745646 193961 212781 191503 21278 0 0 1457927 1312134 145793 0 5582669 5024402 558267 2227779 2005001 222778 MEDICAL SUPPLIES 15302622 13772360 1530262 0 PROVISION FOR BAD DEBT 13773157 12395841 1377316 0 REPAIRS AND MAINTENANCE 3060483 2754435 306048 0 UTILITIES 1889983 1700985 188998 0 4476071 4027738 448333 201563806 181469200 20094606 0 4346 4461 1481730 71435 685654 0 23198228 21466664 0 0 0 0 9393454 9643810 1663378 1627582 496732 734744 157862378 128042402 30355146 29819976 0 0 0 0 65135630 66167112 248964 207313 1546387 4860116 134209649 134603213 17782539 18209084 0 0 0 0 43017733 39701437 0 0 0 0 0 0 0 0 46456860 78620009 107257132 136530530 X 22991709 -5560793 2630014 2302682 1330794 1330794 26952517 -1927317 134209649 134603213 X -3257358 -25622476 X X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false true true false false LOBBYING ACTIVITIES SCHEDULE C, PART II-B; QUESTION 1 THE ORGANIZATION IS AN AFFILIATE IN THE CROZER-KEYSTONE HEALTH SYSTEM AND CONTROLLED AFFILIATES ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. CROZER-KEYSTONE HEALTH SYSTEM PAYS ALL LOBBYING EXPENDITURES ON BEHALF OF ALL AFFILIATES WITHIN THE SYSTEM AND REPORTS THESE EXPENDITURES ON THE CROZER-KEYSTONE HEALTH SYSTEM FEDERAL FORM 990. THESE LOBBYING EXPENDITURES INCLUDE (1) PAYMENTS TO OUTSIDE INDEPENDENT FIRMS AND (2) AN ALLOCATED PORTION OF THE DUES PAID TO THE AMERICIAN HOSPITAL ASSOCIATION AND THE HOSPITAL AND HEALTHSYSTEM ASSOCIATION OF PENNSYLVANIA. 3960808 440117 -89681 677768 3633476 3401550 422440 467367 330549 3960808 2945320 512081 335064 390915 3401550 3690016 390679 -612933 522442 2945320 0.63370 0.36630 true false 12811 12811 61308450 46808001 14500449 235099 220265 14834 95433757 80407476 15026281 872261 606660 265601 29819976 CASH AND CASH EQUIVALENTS 5425557 F TAX-EXEMPT ORGANIZATION 15813000 F MUTUAL FUND FIXED INCOME 19796078 F MUTUAL FUND EQUITY 2929834 F COMMON AND COLLECTIVE TRUSTS 11480383 F U.S. GOVERNMENT OBLIGATIONS 2891963 F CORPORATE BONDS 758323 F OTHER INVESTMENTS 7071974 F 66167112 0 PENSION LIABILITY 48944654 DUE TO AFFILIATES 23626088 OTHER LIABILITIES 3766794 PAYABLES TO THIRD-PARTY PAYORS 2282473 78620009 TEXT OF FIN 48 AUDITED FINANCIAL STATEMENT FOOTNOTE SCHEDULE D, PART X THE ORGANIZATION IS AN AFFILIATE WITHIN THE CROZER-KEYSTONE HEALTH SYSTEM AND CONTROLLED AFFILIATES ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. CROZER-KEYSTONE HEALTH SYSTEM ("CKHS") IS THE TAX-EXEMPT PARENT OF THE SYSTEM. THE SYSTEM ISSUES CONSOLIDATED AUDITED FINANCIAL STATEMENTS WHICH INCLUDE ALL RELATED ENTITIES; INCLUDING THIS ORGANIZATION. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ALSO CONTAIN CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. IN 2006, FASB INTERPRETATION NO. 48 (FIN 48), ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, AN INTERPRETATION OF SFAS NO. 109, ACCOUNTING FOR INCOME TAXES, WAS ISSUED. FIN 48 CREATES A SINGLE MODEL TO ADDRESS UNCERTAINTY IN TAX POSITION AND CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING THE MINIMUM RECOGNITION THRESHOLD A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. UNDER THE REQUIREMENTS OF FIN 48, A TAX-EXEMPT ORGANIZATION MAY BE REQUIRED TO RECORD AN OBLIGATION AS THE RESULT OF A TAX POSITION HISTORICALLY TAKEN ON VARIOUS TAX EXPOSURES ITEMS. PRIOR TO FIN 48, THE DETERMINATION OF WHEN TO RECORD A LIABILITY FOR A TAX EXPOSURE WAS BASED ON WHETHER A LIABILITY WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE IN ACCORDANCE WITH SFAS NO. 5, ACCOUNTING FOR CONTINGENCIES. ON JULY 1, 2007, CKHS ADOPTED FIN 48. THE IMPACT OF THE ADOPTION OF FIN 48 ON CKHS'S CONSOLIDATED FINANCIAL STATEMENTS IS NOT SIGNIFICANT. ENDOWMENT FUNDS SCHEDULE D, PART V RESTRICTED FUNDS ARE USED TO SUPPORT THE CHARITABLE ACTIVITIES AND PROGRAMS OF THE ORGANIZATION AND ITS AFFILIATES. true Central America and the Caribbean 1 1 Program Services FINANCIAL VEHICLE 0 1 1 1 1 0 0 false false false false false false MONITORING GRANT FUNDS SCHEDULE F, PART I CROZER-KEYSTONE HEALTH SYSTEM, A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION, PAID CASSATT INSURANCE COMPANY, LTD. $2,088,064; A FINANCIAL VEHICLE, ON BEHALF OF AND FOR THE BENEFIT OF THIS ORGANIZATION. true true true X true X true true true false false 6328189 0 6328189 0.03370 31610478 23021598 8588880 0.04570 0 0 0 0.00000 37938667 23021598 14917069 0.07940 33 115737 538111 0 538111 0.00290 1 0 542816 373329 169487 0.00090 4 0 2776057 527452 2248605 0.01200 1 0 103980 10115 93865 0.00050 1 33 2469 0 2469 0.00000 40 115770 3963433 910896 3052537 0.01630 40 115770 41902100 23932494 17969606 0.09570 true 13773157 63982556 72879389 -8896833 X true true 1 1 DELAWARE COUNTY MEMORIAL HOSPITAL

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2010 WEST CHESTER PIKE SUITE 115 HAVERTOWN PA 19083

RADIOSURGERY CKHS HOMEHEALTH

5030 STATE ROAD SUITE 3001 DREXEL HILL PA 19026

HOME HEALTH DCMH SPORTS MEDICINE DEPARTMENT

1500 GARRETT ROAD UPPER DARBY PA 19082

SPORTS MEDICINE FINANCIAL ASSISTANCE ELIGIBILITY SCHEDULE H, PART I, LINE 3C NOT APPLICABLE. COMMUNITY BENEFIT REPORT SCHEDULE H, PART I, LINE 6A PLEASE NOTE THAT THE ORGANIZATION PREPARES A COMMUNITY BENEFIT REPORT ON A SEMI-ANNUAL BASIS WHICH IT MAKES AVAILABLE TO THE PUBLIC. A COMMUNITY BENEFIT REPORT IS PREPARED EVERY TWO YEARS. SUBSIDIZED HEALTH SERVICES SCHEDULE H, PART I; QUESTION 7G NO COSTS RELATING TO SUBSIDIZED HEALTHCARE SERVICES ARE ATTRIBUTABLE TO ANY PHYSICIAN CLINICS. PERCENT OF TOTAL EXPENSE SCHEDULE H, PART I; QUESTION 7 COLUMN (F) THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $13,773,157. CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFIT COST SCHEDULE H, PART I, QUESTION 7 WORKSHEET 2 WAS USED TO CALCULATE THE COST TO CHARGE RATIO. COMMUNITY BUILDING ACTIVITIES SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES UNDERTAKEN BY THIS ORGANIZATION IMPROVE THE MEDICAL AND SOCIOECONOMIC WELL-BEING OF THE COMMUNITIES IN OUR CARE. THIS IS ACCOMPLISHED THROUGH SERVICE ON STATE AND REGIONAL ADVOCACY COMMITTEES AND BOARDS, VOLUNTEERISM WITH LOCAL COMMUNITY-BASED NON-PROFIT ADVOCACY GROUPS, AND PARTICIPATION IN CONFERENCES AND OTHER EDUCATIONAL ACTIVITIES TO PROMOTE UNDERSTANDING OF THE ROOT CAUSES OF HEALTH CONCERNS. THIS ORGANIZATION PROVIDES EDUCATIONAL MATERIALS, CONDUCTS COMMUNITY HEALTH FAIRS AND HOLDS HEALTH EDUCATION SEMINARS AND OUTREACH SESSIONS FOR ITS PATIENTS AND FOR COMMUNITY PROVIDERS. PRESENTATIONS ARE PROVIDED BY PHYSICIANS, NURSES AND OTHER HEALTHCARE PROFESSIONALS. BAD DEBT EXPENSE SCHEDULE H, PART III, SECTION A; QUESTION 4 BAD DEBT EXPENSE WAS CALCULATED USING THE PROVIDERS' BAD DEBT EXPENSE FROM FINANCIAL STATEMENT, NET OF ACCOUNTS WRITTEN OFF AT CHARGES. THE ORGANIZATION AND ITS AFFILIATES PREPARE AND ISSUE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM'S ALLOWANCE FOR DOUBTFUL ACCOUNTS (BAD DEBT EXPENSE) METHODOLOGY AND CHARITY CARE POLICIES ARE CONSISTENTLY APPLIED ACROSS ALL HOSPITAL AFFILIATES. THE ATTACHED TEXT WAS OBTAINED FROM THE FOOTNOTES TO THE AUDITED FINANCIAL STATEMENTS OF THE ORGANIZATION. RECEIVABLES FOR PATIENT CARE PATIENT ACCOUNTS RECEIVABLE FOR WHICH CKHS RECEIVES PAYMENT UNDER COST REIMBURSEMENT, PROSPECTIVE PAYMENT FORMULAE, OR NEGOTIATED RATES, WHICH COVER THE MAJORITY OF PATIENT SERVICES, ARE STATED AS THE ESTIMATED NET AMOUNTS RECEIVABLE FROM PAYORS, WHICH ARE GENERALLY LESS THAN THE ESTABLISHED BILLING RATES OF CKHS. PATIENT ACCOUNTS RECEIVABLE ARE REPORTED NET OF PROVISIONS BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. ALLOWANCE FOR DOUBTFUL ACCOUNTS CKHS PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR ESTIMATED LOSSES RESULTING FROM THE UNWILLINGNESS OR INABILITY OF PATIENTS TO MAKE PAYMENTS FOR SERVICES. THE ALLOWANCE IS DETERMINED BY ANALYZING SPECIFIC ACCOUNTS, HISTORICAL AND EXPECTED DATA AND TRENDS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. PATIENT ACCOUNTS RECEIVABLE ARE CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS WHEN MANAGEMENT DETERMINES THAT RECOVERY IS UNLIKELY AND CKHS CEASES COLLECTION EFFORTS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWABLE FOR DOUBTFUL ACCOUNTS BASED ON HISTORICAL WRITE-OFF EXPERIENCE. THE RESULTS OF MANAGEMENT'S EVALUATION ARE THEN USED TO MAKE MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. ADDITIONALLY, CKHS FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES, WHICH ARE SUBJECT TO CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY CKHS. FOR THE YEARS ENDED JUNE 30, 2012 AND 2011, THE PROVISION FOR BAD DEBTS INCLUDES FAVORABLE COLLECTION EXPERIENCE ON ACCOUNTS RECEIVABLE FROM PRIOR YEARS OF APPROXIMATELY $400,000 AND $4,255,000, RESPECTIVELY. CHARITY CARE AND COMMUNITY SERVICE CKHS PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN THE ESTABLISHED RATES. BECAUSE CKHS DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. ADDITIONALLY, CKHS SPONSORS CERTAIN OTHER PROGRAMS WHICH PROVIDE SUBSTANTIAL BENEFIT TO THE BROADER COMMUNITY. SUCH PROGRAMS INCLUDE SERVICES TO NEEDY POPULATIONS INCLUDING COMMUNITY SERVICE PROGRAMS AND SERVICES FOR SCHOOL-AGED CHILDREN AND THE ELDERLY. CKHS ALSO ACTIVELY SPONSORS PROGRAMS ON HEALTH EDUCATION AND WELLNESS. COMMUNITY BENEFIT SCHEDULE H, PART III, SECTION B; QUESTION 8 MEDICARE COSTS WERE DERIVED FROM THE 2012 TEN MONTH INTERIM COST REPORT. MEDICARE UNDERPAYMENTS AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THE ORGANIZATION BELIEVES THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. AS OUTLINED MORE FULLY BELOW THE ORGANIZATION BELIEVES THAT THESE SERVICES AND RELATED COSTS PROMOTE THE HEALTH OF THE COMMUNITY AS A WHOLE AND ARE RENDERED IN CONJUNCTION WITH THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES AND MISSION IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER WITHOUT REGARD TO RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY AND CONSISTENT WITH THE COMMUNITY BENEFIT STANDARD PROMULGATED BY THE IRS. THE COMMUNITY BENEFIT STANDARD IS THE CURRENT STANDARD FOR A HOSPITAL FOR RECOGNITION AS A TAX-EXEMPT AND CHARITABLE ORGANIZATION UNDER INTERNAL REVENUE CODE ("IRC") 501(C)(3). THE ORGANIZATION IS RECOGNIZED AS A TAX-EXEMPT ENTITY AND CHARITABLE ORGANIZATION UNDER 501(C)(3) OF THE IRC. ALTHOUGH THERE IS NO DEFINITION IN THE TAX CODE FOR THE TERM "CHARITABLE" A REGULATION PROMULGATED BY THE DEPARTMENT OF THE TREASURY PROVIDES SOME GUIDANCE AND STATES THAT "[T]HE TERM CHARITABLE IS USED IN SECTION 501(C)(3) IN ITS GENERALLY ACCEPTED LEGAL SENSE," AND PROVIDES EXAMPLES OF CHARITABLE PURPOSES, INCLUDING THE RELIEF OF THE POOR OR UNPRIVILEGED; THE PROMOTION OF SOCIAL WELFARE; AND THE ADVANCEMENT OF EDUCATION, RELIGION, AND SCIENCE. NOTE IT DOES NOT EXPLICITLY ADDRESS THE ACTIVITIES OF HOSPITALS. IN THE ABSENCE OF EXPLICIT STATUTORY OR REGULATORY REQUIREMENTS APPLYING THE TERM "CHARITABLE" TO HOSPITALS, IT HAS BEEN LEFT TO THE IRS TO DETERMINE THE CRITERIA HOSPITALS MUST MEET TO QUALIFY AS IRC 501(C)(3) CHARITABLE ORGANIZATIONS. THE ORIGINAL STANDARD WAS KNOWN AS THE CHARITY CARE STANDARD. THIS STANDARD WAS REPLACED BY THE IRS WITH THE COMMUNITY BENEFIT STANDARD WHICH IS THE CURRENT STANDARD. CHARITY CARE STANDARD IN 1956, THE IRS ISSUED REVENUE RULING 56-185, WHICH ADDRESSED THE REQUIREMENTS HOSPITALS NEEDED TO MEET IN ORDER TO QUALIFY FOR IRC 501(C)(3) STATUS. ONE OF THESE REQUIREMENTS IS KNOWN AS THE "CHARITY CARE STANDARD." UNDER THE STANDARD, A HOSPITAL HAD TO PROVIDE, TO THE EXTENT OF ITS FINANCIAL ABILITY, FREE OR REDUCED-COST CARE TO PATIENTS UNABLE TO PAY FOR IT. A HOSPITAL THAT EXPECTED FULL PAYMENT DID NOT, ACCORDING TO THE RULING, PROVIDE CHARITY CARE BASED ON THE FACT THAT SOME PATIENTS ULTIMATELY FAILED TO PAY. THE RULING EMPHASIZED THAT A LOW LEVEL OF CHARITY CARE DID NOT NECESSARILY MEAN THAT A HOSPITAL HAD FAILED TO MEET THE REQUIREMENT SINCE THAT LEVEL COULD REFLECT ITS FINANCIAL ABILITY TO PROVIDE SUCH CARE. THE RULING ALSO NOTED THAT PUBLICLY SUPPORTED COMMUNITY HOSPITALS WOULD NORMALLY QUALIFY AS CHARITABLE ORGANIZATIONS BECAUSE THEY SERVE THE ENTIRE COMMUNITY, AND A LOW LEVEL OF CHARITY CARE WOULD NOT AFFECT A HOSPITAL'S EXEMPT STATUS IF IT WAS DUE TO THE SURROUNDING COMMUNITY'S LACK OF CHARITABLE DEMANDS. COMMUNITY BENEFIT STANDARD IN 1969, THE IRS ISSUED REVENUE RULING 69-545, WHICH "REMOVE[D]" FROM REVENUE RULING 56-185 "THE REQUIREMENTS RELATING TO CARING FOR PATIENTS WITHOUT CHARGE OR AT RATES BELOW COST." UNDER THE STANDARD DEVELOPED IN REVENUE RULING 69-545, WHICH IS KNOWN AS THE "COMMUNITY BENEFIT STANDARD," HOSPITALS ARE JUDGED ON WHETHER THEY PROMOTE THE HEALTH OF A BROAD CLASS OF INDIVIDUALS IN THE COMMUNITY. THE RULING INVOLVED A HOSPITAL THAT ONLY ADMITTED INDIVIDUALS WHO COULD PAY FOR THE SERVICES (BY THEMSELVES, PRIVATE INSURANCE, OR PUBLIC PROGRAMS SUCH AS MEDICARE), BUT OPERATED A FULL-TIME EMERGENCY ROOM THAT WAS OPEN TO EVERYONE. THE IRS RULED THAT THE HOSPITAL QUALIFIED AS A CHARITABLE ORGANIZATION BECAUSE IT PROMOTED THE HEALTH OF PEOPLE IN ITS COMMUNITY. THE IRS REASONED THAT BECAUSE THE PROMOTION OF HEALTH WAS A CHARITABLE PURPOSE ACCORDING TO THE GENERAL LAW OF CHARITY, IT FELL WITHIN THE "GENERALLY ACCEPTED LEGAL SENSE" OF THE TERM "CHARITABLE," AS REQUIRED BY TREAS. REG. 1.501(C)(3)-1(D)(2). THE IRS RULING STATED THAT THE PROMOTION OF HEALTH, LIKE THE RELIEF OF POVERTY AND THE ADVANCEMENT OF EDUCATION AND RELIGION, IS ONE OF THE PURPOSES IN THE GENERAL LAW OF CHARITY THAT IS DEEMED BENEFICIAL TO THE COMMUNITY AS A WHOLE EVEN THOUGH THE CLASS OF BENEFICIARIES ELIGIBLE TO RECEIVE A DIRECT BENEFIT FROM ITS ACTIVITIES DOES NOT INCLUDE ALL MEMBERS OF THE COMMUNITY, SUCH AS INDIGENT MEMBERS OF THE COMMUNITY, PROVIDED THAT THE CLASS IS NOT SO SMALL THAT ITS RELIEF IS NOT OF BENEFIT TO THE COMMUNITY. THE IRS CONCLUDED THAT THE HOSPITAL WAS "PROMOTING THE HEALTH OF A CLASS OF PERSONS THAT IS BROAD ENOUGH TO BENEFIT THE COMMUNITY" BECAUSE ITS EMERGENCY ROOM WAS OPEN TO ALL AND IT PROVIDED CARE TO EVERYONE WHO COULD PAY, WHETHER DIRECTLY OR THROUGH THIRD-PARTY REIMBURSEMENT. OTHER CHARACTERISTICS OF THE HOSPITAL THAT THE IRS HIGHLIGHTED INCLUDED THE FOLLOWING: ITS SURPLUS FUNDS WERE USED TO IMPROVE PATIENT CARE, EXPAND HOSPITAL FACILITIES, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH; IT WAS CONTROLLED BY A BOARD OF TRUSTEES THAT CONSISTED OF INDEPENDENT CIVIC LEADERS; AND HOSPITAL MEDICAL STAFF PRIVILEGES WERE AVAILABLE TO ALL QUALIFIED PHYSICIANS. THE AMERICAN HOSPITAL ASSOCIATION ("AHA") BELIEVES THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THIS ORGANIZATION AGREES WITH THE AHA POSITION. AS OUTLINED IN THE AHA LETTER TO THE IRS DATED AUGUST 21, 2007 WITH RESPECT TO THE FIRST PUBLISHED DRAFT OF THE NEW FORM 990 AND SCHEDULE H, THE AHA FELT THAT THE IRS SHOULD INCORPORATE THE FULL VALUE OF THE COMMUNITY BENEFIT THAT HOSPITALS PROVIDE BY COUNTING MEDICARE UNDERPAYMENTS (SHORTFALL) AS QUANTIFIABLE COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: - PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD. - MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE. RECENTLY, MEDICARE REIMBURSES HOSPITALS ONLY 92 CENTS FOR EVERY DOLLAR THEY SPEND TO TAKE CARE OF MEDICARE PATIENTS. THE MEDICARE PAYMENT ADVISORY COMMISSION ("MEDPAC") IN ITS MARCH 2007 REPORT TO CONGRESS CAUTIONED THAT UNDERPAYMENT WILL GET EVEN WORSE, WITH MARGINS REACHING A 10-YEAR LOW AT NEGATIVE 5.4 PERCENT. - MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR. MORE THAN 46 PERCENT OF MEDICARE SPENDING IS FOR BENEFICIARIES WHOSE INCOME IS BELOW 200 PERCENT OF THE FEDERAL POVERTY LEVEL. MANY OF THOSE MEDICARE BENEFICIARIES ARE ALSO ELIGIBLE FOR MEDICAID -- SO CALLED "DUAL ELIGIBLES." THERE IS EVERY COMPELLING PUBLIC POLICY REASON TO TREAT MEDICARE AND MEDICAID UNDERPAYMENTS SIMILARLY FOR PURPOSES OF A HOSPITAL'S COMMUNITY BENEFIT AND INCLUDE THESE COSTS ON FORM 990, SCHEDULE H, PART I. MEDICARE UNDERPAYMENT MUST BE SHOULDERED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE COMMUNITY'S ELDERLY AND POOR. THESE UNDERPAYMENTS REPRESENT A REAL COST OF SERVING THE COMMUNITY AND SHOULD COUNT AS A QUANTIFIABLE COMMUNITY BENEFIT. BOTH THE AHA AND THIS ORGANIZATION ALSO FEEL THAT PATIENT BAD DEBT IS A COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. LIKE MEDICARE UNDERPAYMENT (SHORTFALLS), THERE ALSO ARE COMPELLING REASONS THAT PATIENT BAD DEBT SHOULD BE COUNTED AS QUANTIFIABLE COMMUNITY BENEFIT AS FOLLOWS: - A SIGNIFICANT MAJORITY OF BAD DEBT IS ATTRIBUTABLE TO LOW-INCOME PATIENTS, WHO, FOR MANY REASONS, DECLINE TO COMPLETE THE FORMS REQUIRED TO ESTABLISH ELIGIBILITY FOR HOSPITALS' CHARITY CARE OR FINANCIAL ASSISTANCE PROGRAMS. A 2006 CONGRESSIONAL BUDGET OFFICE ("CBO") REPORT, NONPROFIT HOSPITALS AND THE PROVISION OF COMMUNITY BENEFITS, CITED TWO STUDIES INDICATING THAT "THE GREAT MAJORITY OF BAD DEBT WAS ATTRIBUTABLE TO PATIENTS WITH INCOMES BELOW 200% OF THE FEDERAL POVERTY LINE." - THE REPORT ALSO NOTED THAT A SUBSTANTIAL PORTION OF BAD DEBT IS PENDING CHARITY CARE. UNLIKE BAD DEBT IN OTHER INDUSTRIES, HOSPITAL BAD DEBT IS COMPLICATED BY THE FACT THAT HOSPITALS FOLLOW THEIR MISSION TO THE COMMUNITY AND TREAT EVERY PATIENT THAT COMES THROUGH THEIR EMERGENCY DEPARTMENT, REGARDLESS OF ABILITY TO PAY. PATIENTS WHO HAVE OUTSTANDING BILLS ARE NOT TURNED AWAY, UNLIKE OTHER INDUSTRIES. BAD DEBT IS FURTHER COMPLICATED BY THE AUDITING INDUSTRY'S STANDARDS ON REPORTING CHARITY CARE. MANY PATIENTS CANNOT OR DO NOT PROVIDE THE NECESSARY, EXTENSIVE DOCUMENTATION REQUIRED TO BE DEEMED CHARITY CARE BY AUDITORS. AS A RESULT, ROUGHLY 40% OF BAD DEBT IS PENDING CHARITY CARE. - THE CBO CONCLUDED THAT ITS FINDINGS "SUPPORT THE VALIDITY OF THE USE OF UNCOMPENSATED CARE [BAD DEBT AND CHARITY CARE] AS A MEASURE OF COMMUNITY BENEFITS" ASSUMING THE FINDINGS ARE GENERALIZABLE NATIONWIDE; THE EXPERIENCE OF HOSPITALS AROUND THE NATION REINFORCES THAT THEY ARE GENERALIZABLE. AS OUTLINED BY THE AHA, DESPITE COLLECTION POLICY SCHEDULE H, PART III, SECTION B; QUESTION 9B ACCOUNTS CONSIDERED TO BE CHARITY CARE ARE NOT INCLUDED IN THE BAD DEBT EXPENSE, BUT RATHER, ACCOUNTED FOR AS AN ALLOWANCE. IT IS THE POLICY OF THE CROZER-KEYSTONE HEALTH SYSTEM BUSINESS OFFICE, AND ALL ITS HOSPITAL AFFILIATES, TO TREAT ALL PATIENTS EQUALLY REGARDLESS OF INSURANCE AND THEIR ABILITY TO PAY. FOR ACCOUNTS DETERMINED TO BE "SELF-PAY" AND/OR ACCOUNTS WITH BALANCE AFTER PRIMARY INSURANCE PAYMENTS, THE COLLECTION POLICY REQUIRES: SENDING FOUR STATEMENTS, A MINIMUM OF ONE PRE-COLLECTION LETTER, TELEPHONE CONTACT FOR ANY ACCOUNT OVER $10 OR AT THE DISCRETION OF THE ACCOUNT REPRESENTATIVE AND/OR SUPERVISOR. THE FACILITY ALSO HAS A CHARITY CARE ACCESS POLICY TO ASSURE PATIENTS ARE PROVIDED WITH CHARITY CARE ASSISTANCE DETERMINED BY STATE AND FEDERAL REGULATIONS. IT IS THE POLICY TO INFORM ALL PATIENTS DEEMED SELF-PAY OF THE APPROPRIATE ASSISTANCE PROGRAMS AVAILABLE. PATIENTS APPLYING FOR CHARITY CARE ASSISTANCE WILL BE FINANCIALLY SCREENED BY A RESOURCE ADVISOR TO DETERMINE ELIGIBILITY ACCORDING TO STATE AND FEDERAL GUIDELINES AND WILL BE INFORMED OF DOCUMENTATION NEEDED TO COMPLETE A CHARITY CARE APPLICATION. PATIENTS NOT ELIGIBLE FOR CHARITY CARE WILL BE FINANCIALLY COUNSELED FOR ALL OTHER OPTIONS. QUALIFIED PATIENTS WILL BE REFERRED TO ALL APPROPRIATE AGENCIES OR PROGRAMS TO MEET OTHER FINANCIAL NEEDS. AT THE TIME OF THE PATIENT VISIT AND PART OF THE REGISTRATION PROCESS AT THE FACILITY, THE FOLLOWING OPTIONS ARE MADE AVAILABLE TO PATIENTS: - FINANCIAL COUNSELING FOR POSSIBLE ELIGIBILITY FOR MEDICAL ASSISTANCE INCLUDING MEDICAID AND SSI; - FINANCIAL COUNSELING FOR POSSIBLE ELIGIBILITY FOR THE CROZER-KEYSTONE HEALTH SYSTEM PAYMENT ASSISTANCE PROGRAM; AND, - FINANCIAL ARRANGEMENTS INCLUDING: 1. CASH/CREDIT CARD (AMERICAN EXPRESS, DISCOVER, VISA, MASTERCARD), OR 2. FLEXIBLE PAYMENT PLANS. IN ADDITION TO THE ABOVE OPTIONS, THE FACILITY HAS ESTABLISHED A SELF-PAY ASSISTANCE PROGRAM FOR OUR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR MEDICAID OR THE PENNSYLVANIA HOSPITAL CARE PAYMENT ASSISTANCE PROGRAM. THE SELF-PAY ASSISTANCE PROGRAM RATES ARE REFLECTIVE OF MEDICARE REIMBURSEMENT, AS REFERRED BY THE STATE OF PENNSYLVANIA. FACILITY INFORMATION SCHEDULE H, PART V, SECTION B, QUESTIONS 1J, 3, 4, 5C, 6I & 7 NOT APPLICABLE. FACILITY INFORMATION SCHEDULE H, PART V, SECTION B, QS 9,10,11H,13G,15E,16E,17E,18D,19D,20&21 NOT APPLICABLE. NEEDS ASSESSMENT SCHEDULE H, PART VI; QUESTION 2 CROZER-KEYSTONE HEALTH SYSTEM RESPONDS TO THE COMMUNITY'S IDENTIFIED NEEDS BY SEEKING OUT PARTNERSHIPS AND OPPORTUNITIES WHICH WILL TARGET THE IDENTIFIED NEEDS. SELECTION OF STAFF TAKES INTO CONSIDERATION THE INDIVIDUAL AND CULTURAL COMPOSITION OF THE COMMUNITIES TO BE SERVED. WE HAVE FOUND THAT INDIVIDUALS IDENTIFIY MORE CLOSELY AND ARE MORE INCLINED TO PARTICIPATE IN PROGRAMS WHERE THERE ARE INDIVIDUALS OF SIMILAR CHARACTERISTICS. ONCE STAFF IS SELECTED, TRAINING AND SUPERVISION OCCUR ON AN ONGOING BASIS TO ASSURE THAT TARGETED GOALS ARE BEING MET AND THAT THE COMMUNITY IS POSITIVELY RESPONDING TO PROGRAMS. COMMUNITY PROGRAMS TAKE PLACE IN SEVERAL VENUES SUCH AS SCHOOLS, HOSPITALS, HOUSING UNITS, COMMUNITY CENTERS, CHURCHES AND SHOPPING AREAS. EACH ENCOUNTER IS INTENDED TO RAISE AWARENESS ABOUT COMMUNITY HEALTH AND RESOURCES THAT ARE AVAILABLE TO ADDRESS COMMUNITY HEALTH NEEDS. COMMUNICATION REGARDING COMMUNITY HEALTH ACTIVITIES IS IN THE FORM OF FLYERS, POSTERS, BUSINESS CARDS, TELEVISION, RADIO AND NEWSPRINT. HEALTH LITERACY IS TAKEN INTO CONSIDERATION WHEN GENERATING ALL COMMUNITY HEALTH COMMUNICATIONS. AS WE CONTINUE WORKING TOWARD ACHIEVING THE HEALTHY PEOPLE 2010 GOALS FOR DELAWARE COUNTY WE MUST BUILD HEALTHY COMMUNITY PARTNERSHIPS WITH VARIOUS COMMUNITY ORGANIZATIONS AND INDIVIDUALS. IT IS IMPERATIVE THAT ALL SECTORS OF THE COMMUNITY (HEALTHCARE, BUSINESS, EDUCATION, GOVERNMENT, LAW ENFORCEMENT, PUBLIC HEALTH AND OTHERS) RECOGNIZE AND EMBRACE THEIR PUBLIC ACCOUNTABILITY FOR COMMUNITY HEALTH. A TRULY HEALTHY COMMUNITY REQUIRES A COLLABORATIVE EFFORT BY ALL THE SHAREHOLDERS IN THE COMUNITY. CROZER-KEYSTONE HEALTH SYSTEM IS COMMITTED TO IMPROVING THE QUALITY OF LIFE FOR ALL WHO LIVE, WORK AND PLAY IN DELAWARE COUNTY. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI; QUESTION 3 CHARITY CARE SIGNS ARE POSTED THROUGHOUT THE FACILITY, MAINLY IN PATIENT REGISTRATION AREAS. SIGNS ARE POSTED IN BOTH ENGLISH AND SPANISH. ALL PATIENTS DEEMED SELF-PAY ARE SCREENED FOR FINANCIAL ASSISTANCE BY A RESOURCE ADVISOR ACCORDING TO THE FEDERAL POVERTY GUIDELINES AND REFERRED TO APPROPRIATE AGENCIES OR PROGRAMS. COMMUNITY INFORMATION SCHEDULE H, PART VI; QUESTION 4 THIS ORGANIZATION IS IN A DIVERSE SUBURBAN LOCATION SERVING DIVERSE COMMUNITIES RANGING FROM INNER CITY COMMUNITIES IN CHESTER TO MORE AFFLUENT SUBURBAN AREAS. THIS ORGANIZATION IS LOCATED IN DREXEL HILL, PA, IN DELAWARE COUNTY. DELAWARE COUNTY IS THE FIFTH MOST POPULOUS COUNTY IN THE STATE WITH 49 MUNICIPALITIES. THIS ORGANIZATION IS COMMITTED TO SERVICE FOR ITS COMMUNITIES AND SERVES BOTH INNER CITY AND SUBURBAN AREAS. ABOUT 34% OF ITS INPATIENTS ARE OF MINORITY RACE/ETHNICITY. IN ADDITION, APPROXIMATELY 6% OF ITS PATIENTS ARE OF UNDERINSURED AND UNINSURED PAYER CATEGORIES. PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI; QUESTION 5 THE ORGANIZATION, AND THE ENTIRE CROZER-KEYSTONE HEALTH SYSTEM PROMOTE THE HEALTH OF THE COMMUNITY ON A DAILY BASIS THROUGHOUT THE YEAR. THE SYSTEM COORDINATES AND OFFERS NUMEROUS COMMUNITY BENEFIT PROGRAMS, ACTIVITIES, AND SUPPORT GROUPS TO THE COMMUNITY. PLEASE REFER TO SCHEDULE O FOR A DETAILED COMMUNITY BENEFIT STATEMENT. AFFILIATED HEALTHCARE SYSTEM SCHEDULE H, PART VI; QUESTION 6 NOT FOR PROFIT CROZER-KEYSTONE HEALTH SYSTEM AND AFFILIATES ENTITIES: CROZER-KEYSTONE HEALTH SYSTEM CROZER-KEYSTONE HEALTH SYSTEM ("CKHS") IS A NOT FOR PROFIT HOLDING COMPANY BASED IN SPRINGFIELD, PENNSYLVANIA. CKHS IS THE SOLE CORPORATE MEMBER OF A NUMBER OF NOT FOR-PROFIT ENTITIES AND THE SOLE SHAREHOLDER OF VARIOUS OTHER FOR-PROFIT ENTITIES. AS THE PARENT ORGANIZATION OF A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM, CKHS STRIVES TO CONTINUALLY DEVELOP AND OPERATE AN INTEGRATED HEALTHCARE DELIVERY SYSTEM WHICH PROVIDES A COMPREHENSIVE SPECTRUM OF MEDICALLY NECESSARY HEALTHCARE SERVICES TO THE RESIDENTS OF PENNSYLVANIA COUNTIES INCLUDING DELAWARE, CHESTER, MONTGOMERY AND PHILADELPHIA, PENNSYLVANIA, SOUTHERN NEW JERSEY AND NORTHERN DELAWARE. CROZER-KEYSTONE HEALTH SYSTEM IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A SUPPORTING ORGANIZATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). CKHS ENSURES THAT ITS SYSTEM PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. NO INDIVIDUALS ARE DENIED NECESSARY MEDICAL CARE, TREATMENT OR SERVICES. CROZER-KEYSTONE HEALTH SYSTEM HOSPITALS INCLUDE: CROZER-CHESTER MEDICAL CENTER AND DELAWARE COUNTY MEMORIAL HOSPITAL. EACH OF THESE HOSPITALS OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. EACH PROVIDE MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF- PAY, MEDICARE AND MEDICAID PATIENTS; 2. EACH OPERATE AN ACTIVE EMERGENCY ROOM FOR ALL PERSONS; WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3. EACH MAINTAIN AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL OF EACH RESTS WITH ITS BOARD OF TRUSTEES AND THE BOARD OF TRUSTEES OF CROZER-KEYSTONE HEALTH SYSTEM. BOTH BOARDS ARE COMPRISED OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY; AND 5. SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE; PROGRAMS AND ACTIVITIES. CROZER-CHESTER MEDICAL CENTER CROZER-CHESTER MEDICAL CENTER ("CCMC") IS COMPRISED OF THE FOLLOWING HOSPITALS: CROZER-CHESTER MEDICAL CENTER, A 426-BED NON-PROFIT TEACHING HOSPITAL LOCATED IN UPLAND, DELAWARE COUNTY, PENNSYLVANIA, SPRINGFIELD HOSPITAL, A 33-BED NON-PROFIT ACUTE CARE MEDICAL CENTER LOCATED IN SPRINGFIELD, DELAWARE COUNTY, PENNSYLVANIA AND TAYLOR HOSPITAL, A 144-BED NON-PROFIT ACUTE CARE MEDICAL CENTER LOCATED IN RIDLEY PARK, DELAWARE COUNTY, PENNSYLVANIA. CCMC IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, CCMC PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. MOREOVER, CCMC OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. DELAWARE COUNTY MEMORIAL HOSPITAL DELAWARE COUNTY MEMORIAL HOSPITAL ("DCMH") IS A 225-BED NON-PROFIT ACUTE CARE MEDICAL CENTER LOCATED IN DREXEL HILL, DELAWARE COUNTY, PENNSYLVANIA. DCMH IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, DCMH PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. MOREOVER, DCMH OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. CROZER-CHESTER FOUNDATION CROZER-CHESTER FOUNDATION IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(1). THROUGH FUNDRAISING ACTIVITIES THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF CROZER-CHESTER MEDICAL CENTER; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. DELCO MEMORIAL FOUNDATION DELCO MEMORIAL FOUNDATION IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THROUGH FUNDRAISING ACTIVITIES THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF DELAWARE COUNTY MEMORIAL HOSPITAL; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. HEALTH ACCESS NETWORK HEALTH ACCESS NETWORK IS AN AFFILIATE OF CROZER-KEYSTONE HEALTH SYSTEM, A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. HEALTH ACCESS NETWORK IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(1). THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. DELCO SYSTEM SERVICES, INC. DELCO SYSTEM SERVICES, INC. IS AN INACTIVE ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). THE ORGANIZATION WAS CREATED TO PROVIDE NURSING HOME SERVICES IN SUPPORT OF ALL AFFILIATES WITHIN THE CROZER-KEYSTONE HEALTH SYSTEM. FOR PROFIT CROZER-KEYSTONE HEALTH SYSTEM AND AFFILIATES ENTITIES: CROZER-KEYSTONE SERVICES A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS CROZER-KEYSTONE HEALTH SYSTEM. THE ORGANIZATION IS LOCATED IN UPLAND, DELAWARE COUNTY, PENNSYLVANIA. THE ORGANIZATION PROVIDES VARIOUS SERVICES TO INDIVIDUALS AND COMPANIES IN SUPPORT OF CKHS AND AFFILIATES. PENNSYLVANIA HEALTH CLUB, INC. A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS CROZER-KEYSTONE SERVICES. THE ORGANIZATION IS LOCATED IN SPRINGFIELD, DELAWARE COUNTY, PENNSYLVANIA. THE ORGANIZATION PROVIDES VARIOUS SERVICES TO INDIVIDUALS AND COMPANIES IN SUPPORT OF CKHS AND AFFILIATES. true CROZER-KEYSTONE HEALTH SYSTEM 100 W SPROUL RD HLTHPLX PAV II SPRINGFIELD PA 19064 222540851 501(C)(3) 625000 PROGRAM SUPPORT 1 GRANT FUND MONITORING SCHEDULE I, PART I, QUESTION 2 GRANTS ARE MONITORED BY THE ORGANIZATION'S FINANCE PERSONNEL THROUGH THE UTILIZATION OF COST CENTERS AND OTHER INFORMATION; INCLUDING WRITTEN DOCUMENTATION AND RECEIPTS. X X X X true true false false false false false true false ANTHONY E DIMARCO DO 0 196538 0 0 0 216 0 12200 0 27955 0 236909 0 0 PATRICK J GAVIN 0 379310 0 63000 0 810 0 15700 0 26572 0 485392 0 0 JEFFREY H LOOSE MD 0 243002 0 0 0 1501 0 16700 0 27097 0 288300 0 0 JOAN K RICHARDS 0 739591 0 198800 0 212287 0 205482 0 16909 0 1373069 0 198044 RICHARD I BENNETT TERM 72911 0 298017 0 117453 0 1545123 0 233976 0 25947 0 2220516 0 1293013 DONALD W LEGREID ESQ 0 280775 0 49350 0 2322 0 15700 0 20593 0 368740 0 0 WILLIAM MCCUNE 0 264999 0 46550 0 4281 0 16700 0 24574 0 357104 0 0 PHILIP J RYAN CPA 0 398550 0 95550 0 16492 0 107209 0 37932 0 655733 0 0 ROBERT E WILSON 0 383887 0 93100 0 221861 0 161431 0 11555 0 871834 0 218297 STEPHEN P SULLIVAN 203513 0 35875 0 3395 0 14546 0 24483 0 281812 0 0 0 JUN YANG 205198 0 0 0 0 0 13852 0 31810 0 250860 0 0 0 XIAOFEI YING 181499 0 0 0 0 0 12016 0 28674 0 222189 0 0 0 JO ZETTA F SHAWL 152067 0 20020 0 689 0 11540 0 11161 0 195477 0 0 0 ALI KOOHDARY MD 168575 0 0 0 689 0 10469 0 17637 0 197370 0 0 0 COMPENSATION INFORMATION PART VII AND SCHEDULE J TAXABLE COMPENSATION REPORTED HEREIN IS DERIVED FROM 2011 FORMS W-2. COMPENSATION INFORMATION SCHEDULE J, PART I; QUESTION 4A RICHARD I. BENNETT WAS THE CEO OF CKHS HOSPITALS FROM 7/1/2011 THROUGH 7/29/2011. HE RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $189,916. THIS AMOUNT WAS INCLUDED IN HIS 2011 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. COMPENSATION INFORMATION SCHEDULE J, PART I; QUESTION 4B THE AMOUNT REFLECTED IN COLUMN B (III) FOR THE FOLLOWING INDIVIDUALS INCLUDES AMOUNTS RELATING TO PARTICIPATION IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") BECAUSE THE INDIVIDUALS HAVE SATISFIED BOTH THE AGE AND THE YEARS OF SERVICE REQUIREMENTS SPECIFIED BY THE SERP. THESE AMOUNTS WERE INCLUDED IN EACH INDIVIDUAL'S 2011 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: JOAN K. RICHARDS, $198,044; RICHARD I. BENNETT, $1,293,013 AND ROBERT E. WILSON, $218,297. HOWEVER, THE INDIVIDUALS DID NOT ACTUALLY RECEIVE ALL OF THESE FUNDS. THE INDIVIDUALS ONLY RECEIVED AN AMOUNT SUFFICIENT TO COVER THEIR RESPECTIVE INDIVIDUAL FEDERAL AND STATE TAX LIABILITIES ASSOCIATED WITH THEIR GROSS AMOUNT. IN ADDITION THESE FUNDS STILL REMAIN SUBJECT TO A RISK OF RECEIPT BY THE INDIVIDUALS UNTIL THEIR RETIREMENT FROM EMPLOYMENT AT THE CROZER-KEYSTONE HEALTH SYSTEM. THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE FOLLOWING INDIVIDUALS INCLUDES UNVESTED BENEFITS IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") WHICH ARE SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THE INDIVIDUALS MAY NEVER ACTUALLY RECEIVE THIS UNVESTED BENEFIT AMOUNT. THE AMOUNTS OUTLINED HEREIN WERE NOT INCLUDED IN THESE INDIVIDUAL'S 2011 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: JOAN K. RICHARDS, $188,782, RICHARD I. BENNETT, $217,276, PHILIP J. RYAN, CPA, $90,509 AND ROBERT E. WILSON, $144,731. COMPENSATION INFORMATION SCHEDULE J, PART I; QUESTION 7 CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2011 WHICH AMOUNTS WERE INCLUDED IN COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2011 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT. COMPENSATION INFORMATION SCHEDULE J, PART II, COLUMN F THE AMOUNT REPORTED IN SCHEDULE J, PART II, COLUMN F FOR THE FOLLOWING INDIVIDUALS INCLUDES VESTED BENEFITS IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") BECAUSE THE AMOUNT WAS NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THIS AMOUNT WAS TREATED AS TAXABLE INCOME AND REPORTED ON EACH INDIVIDUAL'S 2011 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES AS FOLLOWS: JOAN K. RICHARDS, $198,044; RICHARD I. BENNETT, $1,293,013 AND ROBERT E. WILSON, $218,297. THESE AMOUNTS WERE REPORTED ON PRIOR YEAR FORMS 990 AS ACCRUED NON-TAXABLE BENEFITS. DELAWARE COUNTY AUTHORITY 231973437 246006QQ6 2006-12-21 108624866 REFUND BONDS AND NEW CAPITAL false false true DELAWARE COUNTY AUTHORITY 231973437 246006RG7 2010-08-02 30000000 REFUND 02 VARIABLE BONDS false false true 0 0 43362145 3022937 0 0 137102 0 0 40130543 0 0 2006 true true true true 0 0 7647000 0 0 0 57519 0 0 0 0 0 2010 true true true true false false false false 0.00000 0.00000 0.00000 true false false false false 0.00000 0.00000 0.00000 true false false false 0 false 0 false false false false false 0 false 0 false false X MICHELLE GRIFFITH FAMILY MEMBER - GRIFFITH 34672 EMPLOYEE false PATRICIA E LAPORTA FAMILY MEMBER - LAPORTA 45691 EMPLOYEE false COMMUNITY BENEFIT STATEMENT CORE FORM, PART III BACKGROUND ========== DELAWARE COUNTY MEMORIAL HOSPITAL ("DCMH") IS A GENERAL MEDICAL AND SURGICAL HOSPITAL. DCMH IS RECOGNIZED BY THE IRS AS AN INTERNAL REVENUE CODE SECTION 501(C) (3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, DCMH PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, CCMC OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. DCMH PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUAL'S REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF-PAY, MEDICARE AND MEDICAID PATIENTS; 2. DCMH OPERATES AN ACTIVE EMERGENCY ROOM FOR ALL PERSONS WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3. DCMH MAINTAINS AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL OF DCMH RESTS WITH ITS BOARD OF TRUSTEES AND THE BOARD OF TRUSTEES OF CROZER-KEYSTONE HEALTH SYSTEM. BOTH BOARDS ARE COMPRISED OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY; AND 5. SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE, PROGRAMS AND ACTIVITIES. THE OPERATIONS OF DCMH, AS SHOWN THROUGH THE FACTORS OUTLINED ABOVE AND OTHER INFORMATION CONTAINED HEREIN, CLEARLY DEMONSTRATE THE HOSPITAL PROVIDES SUBSTANTIAL COMMUNITY BENEFIT AND THAT THE USE AND CONTROL OF DCMH IS FOR THE BENEFIT OF THE PUBLIC AND THAT NO PART OF THE INCOME OR NET EARNINGS OF THE ORGANIZATION INURES TO THE BENEFIT OF ANY PRIVATE INDIVIDUAL NOR IS ANY PRIVATE INTEREST BEING SERVED OTHER THAN INCIDENTALLY. DCMH'S SOLE CORPORATE MEMBER IS CROZER-KEYSTONE HEALTH SYSTEM ("CKHS"), A TAX-EXEMPT PENNSYLVANIA NON-PROFIT PARENT CORPORATION. CROZER-KEYSTONES HEALTH SYSTEM IS A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM CONSISTING OF A GROUP OF AFFILIATED HEALTHCARE ORGANIZATIONS. THE INTEGRATED NETWORK OF HEALTHCARE PROVIDERS THROUGHOUT THE COMMONWEALTH OF PENNSYLVANIA PROVIDES SUBSTANTIAL COMMUNITY BENEFIT. THE SOLE MEMBER OR STOCKHOLDER OF EACH ENTITY IS EITHER CKHS OR ANOTHER CKHS AFFILIATE CONTROLLED OR OWNED BY CKHS. CKHS PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. MOREOVER, CKHS PROVIDES HEALTHCARE SERVICES TO PATIENTS WHO MEET CERTAIN CRITERIA DEFINED BY THE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF HEALTH AND SENIOR SERVICES WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. CKHS MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE AMOUNT OF CHARITY CARE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY. DELAWARE COMMUNITY MEMORIAL HOSPITAL ==================================== DELAWARE COUNTY MEMORIAL HOSPITAL ("DCMH"), ONE OF THE FOUNDING HOSPITALS OF CKHS, IS A 225-BED NOT-FOR-PROFIT COMMUNITY HOSPITAL THAT OFFERS A BROAD RANGE OF ACUTE AND SPECIALIZED SERVICES. FOUNDED IN 1925, DCMH TOTAL ADMISSIONS AND OBSERVATIONS EXCEED 11,200 PATIENTS, TREATS 40,600 EMERGENCY DEPARTMENT PATIENTS, AND DELIVERS ABOUT 1,700 BABIES EACH YEAR. FEATURED SERVICES INCLUDE: - CARDIAC SERVICES - EMERGENCY DEPARTMENT AND 14-BED CRITICAL INTENSIVE CARE UNIT - FOX CHASE CROZER-KEYSTONE CANCER PARTNERSHIP: THE DELAWARE COUNTY REGIONAL CANCER CENTER - MRI - CRITICAL INTENSIVE CARE UNIT - POSITRON EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY (PET/CT) IMAGING - WOMAN'S DIAGNOSTIC CENTER - THE MATERNITY CENTER AND COMPREHENSIVE GYNECOLOGIC SERVICES - LEVEL IIA NEONATAL INTENSIVE CARE NURSERY - SURGICENTER, A FULL RANGE OF INPATIENT AND OUTPATIENT SURGICAL SERVICES - OUTPATIENT REHABILITATION AND SPORTS MEDICINE CENTER - FULL RANGE OF MUSCULOSKELETAL SERVICES INCLUDING ORTHOPEDIC, REHABILITATION, SPINE AND SPORTS MEDICINE SERVICES. - HEALTHLINE SERVICES FOR COMMUNITY EDUCATION - CENTER FOR WOUND HEALING AND HYPERBARIC MEDICINE - SLEEP CENTER - CYBERKNIFE SERVICES WITH CK CENTER OF PHILADELPHIA, LLC - CENTER FOR BREAST HEALTH - CENTER FOR MATERNAL FETAL MEDICINE AND PERINATAL TESTING CENTER - CROZER KEYSTONE HOME CARE AND HOSPICE - GASTROENTEROLOGY SERVICES INCLUDING ENDOSCOPY LABORATORY - DCMH CENTER FOR REGIONAL REHABILITATION - INTERVENTIONAL RADIOLOGY AND VASCULAR LABORATORY - VASCULAR AND ENDOVASCULAR CARE MISSION STATEMENT ================= DCMH IS COMMITTED TO THE IMPROVED HEALTH STATUS OF THOSE WE SERVE. THROUGH A SEAMLESS, USER-FRIENDLY CONTINUUM OF QUALITY HEALTH SERVICES INCLUDING PRIMARY AND HEALTH PROMOTION, ACUTE AND LONG-TERM CARE, THROUGH REHABILITATION AND RESTORATIVE CARE, CROZER-KEYSTONE WILL DEPLOY ITS RESOURCES IN A COST-EFFECTIVE AND COMMUNITY-RESPONSIVE MANNER. WORKING IN PARTNERSHIP WITH OUR PHYSICIANS AND OTHER HEALTH PROFESSIONALS, WE WILL SEEK TO FORGE NEW ALLIANCES WITH OTHER COMMUNITY HEALTH AND SOCIAL SERVICE ORGANIZATIONS. WORKING WITH OUR COMMUNITY, OUR GOAL IS TO BUILD A HEALTHY PLACE TO LIVE AND WORK, AND A SOUND ENVIRONMENT IN WHICH TO BUILD AND MAINTAIN OUR FAMILIES. SELECTED ACCOMPLISHMENTS ======================== DELAWARE COUNTY HEAD START COLLABORATION FOR NUTRITION AND PHYSICAL ACTIVITY OUTREACH ------------------------------------------------------------------- CKHS COMMUNITY HEALTH OFFERS PROGRAMMING TO MEET THE HEALTHY PEOPLE 2010 GOALS OF DECREASING OBESITY AND INCREASING FRUIT AND VEGETABLE CONSUMPTION AND DAILY PHYSICAL ACTIVITY. PROGRAMS PROVIDE EDUCATION TO PROMOTE THE IMPORTANCE OF HEALTHFUL EATING, PORTION SIZE CONTROL, AND THE IMPLEMENTATION OF DAILY PHYSICAL ACTIVITY. IT IS BEST TO BEGIN EDUCATING CHILDREN ABOUT HEALTHFUL BEHAVIORS FROM AN EARLY AGE, AND THEREFORE CKHS COMMUNITY HEALTH PARTNERS WITH CHESPENN HEALTH SERVICES AND THE DELAWARE COUNTY INTERMEDIATE UNIT ("DCIU") TO PROVIDE THIS EDUCATION TO ITS YOUNGEST STUDENTS. APPROXIMATELY 500 STUDENTS BETWEEN THE AGES OF 3 AND 5 IN DELAWARE COUNTY HEAD START PROGRAMS PARTICIPATED IN INTERACTIVE EDUCATION PROGRAMS FOCUSED ON PROMOTING HEALTHFUL NUTRITION AND PHYSICAL ACTIVITY BEHAVIORS. THE PROGRAM HAS BEEN WELL RECEIVED BY HEAD START FACILITIES AND THE DCIU. THE PROGRAM WILL CONTINUE AND LOOKS TO EXPAND ITS REACH WITHIN THE COMING YEAR. NEW MOMS/NEW PARENT PROJECT AND IDECIDE CAMPAIGN ----------------------------------------------- CKHS' WOMEN AND CHILDREN'S HEALTH SERVICES IN DELAWARE COUNTY, PENNSYLVANIA, IN PARTNERSHIP WITH THE PENNSYLVANIA DEPARTMENT OF HEALTH, WAS AWARDED A TWO-YEAR FEDERAL GRANT TO CREATE A SOCIAL MARKETING DEMONSTRATION PROJECT. THIS WAS ONE OF THIRTEEN GRANTS AWARDED NATIONALLY, WITH THE CROZER-KEYSTONE GRANT BEING THE ONLY ONE AWARDED IN PENNSYLVANIA. THE ULTIMATE GOAL OF THIS PROJECT WAS TO LEARN WHAT SOCIAL MARKETING STRATEGIES WORK TOWARD PROMOTION AND EDUCATION ON PRECONCEPTION CARE AND MATERNAL HEALTH; BOTH CONTRIBUTING LONG TERM TO LOWERING THE INFANT MORTALITY AND MORBIDITY RATE IN DELAWARE COUNTY, PA. THIS SOCIAL MARKETING DEMONSTRATION PROJECT WAS NAMED THE NEW MOMS/NEW PARENTS PROJECT. IN ORDER TO ACHIEVE THESE GOALS, THE NEW MOMS/NEW PARENTS PROJECT CREATED A HEALTH EDUCATION AND MARKETING CAMPAIGN TARGETING AN AUDIENCE OF 13-25 YEAR OLD WOMEN CALLED IDECIDE. THE IDECIDE CAMPAIGN HAS FOCUSED ON SEVEN MAIN HEALTH TOPICS WITHIN PRECONCEPTION CARE AND MATERNAL HEALTH INCLUDING: THE IMPORTANCE OF A MEDICAL HOME, SEXUAL HEALTH, SAFE RELATIONSHIPS, NUTRITION, EXERCISE, MENTAL HEALTH/STRESS, AND FOLIC ACID. ADDITIONALLY, THE IMPORTANCE OF GIRLS AND WOMEN TAKING CARE OF THEMSELVES WELL BEFORE THEY GET PREGNANT OR CONSIDER PREGNANCY WAS ALSO STRESSED IN ORDER TO HELP INCREASE THE CHANCES THAT IN THE FUTURE THEY WILL HAVE A HEALTHY BABY. THE GIRLS AND WOMEN THE CAMPAIGN TARGETED LIVED IN LOW INCOME AREAS AND OFTEN LACKED THE HEALTH LITERACY AND AWARENESS TO UNDERSTAND HOW TO BE HEALTHY AND HOW TO STAY HEALTHY. TO CREATE THE IDECIDE CAMPAIGN AND TO VALIDATE THE PROJECT WITH DATA, THE PROJECT PARTNERED WITH THE PUBLIC HEALTH MANAGEMENT CORPORATION ("PHMC") TO CONDUCT EXTENSIVE FOCUS GROUPS AND STREET INTERCEPTS WITH THE IDENTIFIED TARGET AUDIENCE TO LEARN ABOUT THEIR OPINIONS AND ATTITUDES TOWARDS PRECONCEPTION CARE, INTERCONCEPTION CARE, AND HEALTH IN GENERAL. THE EVALUATION PROCESS FOUND THAT GIRLS AND WOMEN AGED 13-25 FELT THAT THEY WERE OFTEN TOO BUSY TO EAT HEALTHY AND THAT MOST WOMEN THEIR AGE ATE POORLY OUT OF CONVENIENCE. THOSE SURVEYED ALSO EXPRESSED THAT THEY FELT THAT ALL OF THE PROJECT'S THEMES WERE IMPORTANT, BUT BECAUSE LIFE IS OFTEN BUSY AND HECTIC, IT IS HARD TO STAY PHYSICALLY, MENTALLY, AND SEXUALLY HEALTHY. LASTLY, THEY FELT THAT PREGNANCY AND SEXUAL HEALTH NEEDED TO BE DISCUSSED MORE WITH TEENS. PHMC ALSO CONDUCTED A FOCUS GROUP WITH HEALTHCARE PROVIDERS TO GAUGE PROBLEMS AND CONCERNS ABOUT THEIR PATIENTS IN THE AGE RANGE, AS WELL AS TO LEARN WHAT AREAS DOCTORS AND CARE GIVERS FELT THAT GIRLS 13-25 LACKED IN KNOWLEDGE. COMMUNITY BENEFIT STATEMENT CONTINUED CORE FORM, PART III WHILE TEEN PREGNANCY HAS BEEN SLOWLY DECLINING IN PENNSYLVANIA, THERE HAS ACTUALLY BEEN A SLIGHT INCREASE IN CHESTER. WITH THE IDECIDE CAMPAIGN, IT WAS HOPED THE STRATEGIES EMPLOYED WOULD HELP TO DECREASE TEEN UNPLANNED PREGNANCIES AND HELP EMPOWER GIRLS AND YOUNG WOMEN TO HELP THEMSELVES AND THEIR COMMUNITIES. ONCE THE RESEARCH WAS EVALUATED, THE PROJECT BEGAN TO IMPLEMENT THE INTERACTIVE IDECIDE CAMPAIGN. THE MAIN FOCUS OF THE CAMPAIGN WAS TO CONDUCT HEALTH PRESENTATIONS IN DELAWARE COUNTY SCHOOLS ABOUT THE IDENTIFIED FOCUS TOPICS. IN ADDITION TO HEALTH PRESENTATIONS IN SCHOOLS, THE PROJECT ALSO LAUNCHED AN EXTENSIVE VIRTUAL CAMPAIGN. BY USING NEW MEDIA TECHNOLOGIES SUCH AS FACEBOOK, TWITTER, AND AN INTERACTIVE WEBSITE, THE CAMPAIGN WAS ABLE TO REACH THE TARGET AUDIENCE MORE EFFECTIVELY WITH TOOLS THAT THEY USE EVERY DAY. FOR THE SOCIAL MEDIA NETWORK SITES, THE CAMPAIGN PUBLISHED A "TIP OF THE DAY" THAT RELATED TO THE HEALTH TOPICS. THE CAMPAIGN ALSO IMPLEMENTED STRATEGIES TO ENGAGE THE AUDIENCE THROUGH DISCUSSION QUESTIONS ON A MESSAGE BOARD AS WELL AS COMMENTS TO THEIR ACTUAL PAGES. WITH THE WEBSITE, INTERACTIVE FEATURES WERE POSTED INCLUDING A HEALTH QUIZ, VIDEOS, HOT TOPICS, RESOURCES, AND UPCOMING EVENTS. WHEN WORKING WITH AN AUDIENCE WHOSE TRENDS CHANGE WEEKLY, IT WAS VERY IMPORTANT TO SPEAK IN A LANGUAGE THAT THEY UNDERSTAND, THROUGH TOOLS THAT THEY KNOW HOW TO USE EFFECTIVELY. THROUGH THE PROJECT'S PRE AND POST- TEST EVALUATIONS, IT WAS LEARNED THAT THERE WERE SUCCESSES IN RAISING AWARENESS ABOUT THE TOPIC AREAS AND THAT THE GIRLS THAT PARTICIPATED ENJOYED THE STYLE AND LOOK OF THE IDECIDE CAMPAIGN. BY COMBINING THE VARIOUS BACKGROUNDS OF THE TEAM, USING NEW AND INNOVATIVE MEDIA, AND UTILIZING TRADITIONAL TIME-TESTED METHODS SUCH AS INTERACTIVE PRESENTATIONS, THE CAMPAIGN DEVELOPED A CUTTING-EDGE PROGRAM FOR THE TARGET AUDIENCE THAT WAS BOTH INTERESTING AND ENGAGING. THE NEW MOMS/NEW PARENTS PROJECT ENDED THE TWO-YEAR DEMONSTRATION PROJECT ON AUGUST 31, 2010. TOBACCO PREVENTION ART CONTEST ------------------------------ THE TOBACCO PREVENTION & CESSATION PROGRAM RECEIVED DONATIONS IN THE MEMORY OF A LOCAL RESIDENT KATHLEEN JONES. THESE FUNDS MADE IT POSSIBLE FOR CKHS COMMUNITY HEALTH EDUCATION'S TOBACCO PREVENTION AND CESSATION PROGRAM TO HOST AN ANTI-TOBACCO ART CONTEST FOR 10TH GRADERS IN THE CHESTER-UPLAND SCHOOL DISTRICT. MORE THAN 450 10TH GRADE STUDENTS THROUGHOUT THE DISTRICT WERE EDUCATED ABOUT THE DANGERS OF TOBACCO USE, TOBACCO MARKETING TACTICS TOWARDS YOUTH AND THE EFFECTS OF SECONDHAND SMOKE. THE STUDENTS CREATED A PIECE OF ART THAT WOULD PROMOTE A TOBACCO-FREE AND HEALTHY LIFESTYLE. ONE OF THE TOP ENTRIES SUMMED UP THE MESSAGE EMBODIED IN THIS OUTREACH PROGRAM FOR YOUNG ADULTS AS: "DON'T LET YOUR DREAMS END UP IN SMOKE!" IN THE COMING YEAR, THE PROGRAM WILL EDUCATE MORE YOUTHS ABOUT THE DANGERS OF TOBACCO USE TO PREVENT TODAY'S YOUTHS FROM BECOMING TOMORROW'S TOBACCO VICTIMS. BODY AND SOUL: A CELEBRATION OF HEALTHY LIVING FOR AFRICAN AMERICAN CHURCHES ------------------------------------------------------------------- THE CKHS COMMUNITY HEALTH EDUCATION PROGRAM WAS CHOSEN BY THE PA DEPARTMENT OF HEALTH AND FOX CHASE CANCER CENTER TO PARTICIPATE IN THE BODY AND SOUL PROGRAM. CKHS COMMUNITY HEALTH EDUCATION DEPARTMENT HAS A LONG STANDING POSITIVE RELATIONSHIP WITH THE CHESTER AND VICINITY MINISTERIAL COMMITTEE, THE AFRICAN-AMERICAN CHURCHES AND PARISH NURSES IN CHESTER, WHICH ENABLED THE PROGRAM TO ENLIST FIVE LOCAL CHURCHES TO PARTICIPATE IN THE BODY AND SOUL PROGRAM. BODY AND SOUL IS A WELLNESS PROGRAM FOR AFRICAN-AMERICAN CHURCHES. IT IS A PROVEN PROGRAM THAT EMPOWERS CHURCH MEMBERS TO LIVE HEALTHIER LIFESTYLES. THE CKHS STAFF EDUCATED CHURCH MEMBERS REGARDING WAYS TO MAKE PERMANENT CHANGES IN DAILY LIVING FOR BETTER HEALTH AND CANCER PREVENTION, INCLUDING EATING A DIET RICH IN FRUITS AND VEGETABLES AND INCREASING PHYSICAL ACTIVITY. THE CHURCHES WERE THEN SUPPORTED BY THE CKHS STAFF AS THEY IMPLEMENTED ACTIVITIES THAT ENCOURAGED CHURCH MEMBERS TO INCORPORATE THE CONCEPTS LEARNED INTO EVERYDAY LIVING, CHURCH ACTIVITIES AND CHURCH POLICY. THE ACTIVITIES INCLUDED SUCH THINGS AS TASTE-TESTINGS OF HEALTHY FOODS, SERVING HEALTHY FOODS AT CHURCH FUNCTIONS, AND EXERCISE CLASSES. THE PROGRAM WAS AN ENORMOUS SUCCESS AT EACH CHURCH. CHURCHES WERE OFFERED SMALL STIPENDS TO PAY FOR THE PURCHASE OF FRUITS AND VEGETABLES, EXERCISE VIDEOS, DOOR PRIZES, ETC. AS A RESULT OF THIS PROGRAM'S SUCCESS, SUPPLEMENTAL FUNDS FROM THE PENNSYLVANIA DEPARTMENT OF HEALTH WERE AWARDED TO INCLUDE A TOBACCO EDUCATION COMPONENT TO THE SERVICES OFFERED TO CHESTER BODY AND SOUL CHURCHES. KEEPING OUR BODIES HEALTHY - TOBACCO AWARENESS IS A CULTURALLY-APPROPRIATE TOBACCO EDUCATION SESSION BASED ON THE PATHWAYS TO FREEDOM GUIDE FOR AFRICAN-AMERICANS. THE CKHS STAFF EDUCATED CHURCH MEMBERS ON THE IMPACT OF TOBACCO USE ON THE AFRICAN-AMERICAN COMMUNITY; HOW TOBACCO PRODUCTS AFFECT THE BODY; WAYS TO QUIT SUCCESSFULLY OR HELP LOVED-ONES AS THEY QUIT; AND CULTURALLY-TAILORED EDUCATIONAL RESOURCES WERE MADE AVAILABLE FOR USE IN THE CHURCH. BRINGING PEOPLE TO THE TABLE ---------------------------- THE COMMUNITY HEALTH COMMITTEE MEETING BRINGS INDIVIDUALS TOGETHER FROM ACROSS THE SYSTEM. THIS OPPORTUNITY TO SHARE IDEAS AND INFORMATION, AND TO COLLABORATE IN THEIR EFFORTS TO PROVIDE OUTREACH AND IMPROVE THE HEALTH OF OUR COMMUNITY. CROZER-KEYSTONE HEART INSTITUTE -------------------------------------------- CKHS HAS THE LONGEST HISTORY OF PROVIDING CARDIOVASCULAR CARE TO THE PEOPLE OF DELAWARE COUNTY, AND WE'RE PROUD OF OUR MANY ACCOMPLISHMENTS. IN DELAWARE COUNTY, WE'RE THE FIRST HEALTHCARE SYSTEM TO: - PERFORM OPEN HEART SURGERY - PERFORM PRIMARY ANGIOPLASTY - ESTABLISH OPEN HEART AND REHABILITATION UNITS - ESTABLISH AN INTERVENTIONAL HEART PROGRAM - ESTABLISH AN ELECTROPHYSIOLOGY PROGRAM TO TREAT HEART RHYTHM DISORDERS - OFFER CARDIAC RESYNCHRONIZATION THERAPY, A UNIQUE DEVICE THERAPY TO TREAT HEART FAILURE WHEN YOU COME TO ANY CROZER-KEYSTONE HOSPITAL WITH A HEART PROBLEM, OUR TEAM OF HEART SPECIALISTS EVALUATE YOUR CONDITION IMMEDIATELY AND DECIDES UPON A COURSE OF ACTION. THE TEAM DETERMINES THE SERIOUSNESS OF YOUR CONDITION, WHETHER IT IS AN EMERGENCY, AND WHAT TREATMENT YOU NEED. WHATEVER YOUR HEART REQUIRES, CKHS CAN HELP -- FROM DIAGNOSIS TO TREATMENT TO REHABILITATION -- OUR DEDICATION AND EXPERIENCE IS UNMATCHED IN DELAWARE COUNTY. MATERNITY ------------- EVERY YEAR, MORE NEWBORN BABIES ARE WELCOMED INTO THE WORLD BY THE CARING PROFESSIONALS AT DELAWARE COUNTY MEMORIAL HOSPITAL THAN BY ANY OTHER HEALTH SYSTEM IN DELAWARE COUNTY. APPROXIMATELY 1,700 BABIES ARE BORN AT DCMH EVERY YEAR. CROZER-KEYSTONE SLEEP CENTERS ------------------------------------------ FEW THINGS ARE AS FRUSTRATING AS NOT BEING ABLE TO SLEEP. CONVERSELY, FALLING ASLEEP AT INAPPROPRIATE TIMES (SUCH AS WHEN DRIVING) IS JUST AS BOTHERSOME AND CAN EVEN BE DANGEROUS. FORTUNATELY, THERE IS A TRUSTED RESOURCE RIGHT HERE IN DELAWARE COUNTY. THE CROZER-KEYSTONE SLEEP CENTERS. FOR MORE THAN 30 YEARS WE'VE HELPED THOUSANDS OF PEOPLE FROM DELAWARE COUNTY AND BEYOND TO FALL ASLEEP AND STAY ASLEEP AT THE RIGHT TIME AND IN THE RIGHT PLACE. THE CROZER-KEYSTONE SLEEP CENTERS ARE LOCATED AT THREE SITES FOR OUR PATIENTS' CONVENIENCE: - CROZER HEALTH PAVILION AT BRINTON LAKE (GLEN MILLS) - DELAWARE COUNTY MEMORIAL HOSPITAL (DREXEL HILL) - TAYLOR HOSPITAL (RIDLEY PARK) OUR ACCREDITED, MULTIDISCIPLINARY PROGRAM FOR THE INVESTIGATION AND TREATMENT OF SLEEP PROBLEMS WAS ESTABLISHED IN 1978. IT IS THE OLDEST NATIONALLY ACCREDITED PROGRAM FOR THE EVALUATION OF PATIENTS WITH SLEEP-RELATED PROBLEMS IN THE GREATER DELAWARE VALLEY. OUR SITES ARE STAFFED BY PHYSICIANS WITH SPECIAL TRAINING IN SLEEP DISORDERS. OUR COMPASSIONATE AND CARING TECHNICAL STAFF ARE ENCOURAGED TO OBTAIN NATIONAL REGISTRATION BY THE BOARD OF POLYSOMNOGRAPHIC TECHNOLOGISTS. COMMUNITY BENEFIT STATEMENT CONTINUED CORE FORM, PART III SELECT CENTERS OF EXCELLENCE ============================ DELAWARE COUNTY REGIONAL CANCER CENTER (DELAWARE COUNTY MEMORIAL HOSPITAL) -------------------------------------------------------------------------- THE DELAWARE COUNTY REGIONAL CANCER CENTER ("DCRCC") PROVIDES A COMPREHENSIVE APPROACH TO CANCER CARE, COMBINING STATE-OF-THE-ART DIAGNOSIS AND TREATMENT WITH SUPPORTIVE CARE. PHYSICIANS AND STAFF WORK AS A MULTIDISCIPLINARY TEAM, USING THE NEWEST TECHNOLOGIES AND THERAPIES, TO TAILOR TREATMENT TO EACH PATIENT'S CONDITION AND SITUATION. THE TREATMENT OPTIONS AVAILABLE INCLUDE SURGERY, RADIATION THERAPY AND MEDICAL ONCOLOGY. OUR SERVICES ARE PROVIDED TO PATIENTS BY A TALENTED, SPECIALLY TRAINED AND COMPASSIONATE TEAM OF PHYSICIANS, NURSES AND STAFF MEMBERS. DCRCC PROFESSIONALS REMAIN ON THE FOREFRONT OF CANCER CARE, EXPLORING AND IMPLEMENTING THE LATEST TECHNOLOGY TO ENHANCE EACH PATIENT'S TREATMENT PLAN. THE MEMBERS OF YOUR TEAM WORK CLOSELY TOGETHER TO PLAN AND CARRY OUT TREATMENT. THE CANCER CENTER IS PARTNERED WITH FOX CHASE CANCER CENTER, WHICH HAS BEEN DESIGNATED A COMPREHENSIVE CANCER CENTER BY THE NATIONAL CANCER INSTITUTE. THE CANCER CENTER OFFERS ALL OF THE BENEFITS OF A LARGE ACADEMIC MEDICAL CENTER, INCLUDING ACCESS TO CLINICAL TRIALS. RESIDENCY/EDUCATION =================== CKHS OFFERS NUMEROUS CHALLENGING AND FULLY ACCREDITED RESIDENCY PROGRAMS AS ONE OF THE LEADING HEALTHCARE SYSTEMS IN THE DELAWARE VALLEY. NOTABLY, CKHS OFFERS STELLAR ALLOPATHIC RESIDENTS IN FAMILY PRACTICE, INTERNAL MEDICINE, OBSTETRICS AND GYNECOLOGY, PEDIATRICS AND TRANSITIONAL YEAR, AS WELL AS OSTEOPATHIC INTERNAL MEDICINE, PODIATRIC RESIDENCY AND A VARIETY OF OSTEOPATHIC AND ALLIED HEALTH TRAINING PROGRAMS. CKHS IS A TOP-RATED REGIONAL HEALTH SYSTEM WITH A LONGSTANDING TEACHING TRADITION AND A SUPERB FACULTY OFFERING THE BENEFITS OF A UNIVERSITY-BASED TEACHING MODEL, PLUS THE ADVANTAGES OF COMMUNITY-BASED RESIDENCY PROGRAMS. EACH YEAR, APPROXIMATELY 97 TO 100 PERCENT OF CKHS' HIGHLY COMPETITIVE ALLOPATHIC RESIDENCY POSITIONS ARE FILLED THROUGH THE NATIONAL RESIDENT MATCHING PROGRAM. AS A WHOLE, CKHS' RESIDENCIES ARE COMMITTED TO DEVELOPING HIGHLY SKILLED PHYSICIANS WHO MASTER THE SCIENCE OF THEIR SPECIALTY, THE PRACTICE OF TOP-QUALITY PATIENT CARE AND THE ART OF TEACHING NEW GENERATIONS OF DOCTORS. CKHS' RESIDENTS RECEIVE RIGOROUS ACADEMIC EXPERIENCES AND HANDS-ON CLINICAL AND RESEARCH OPPORTUNITIES, WHICH FULLY PREPARE THEM TO PURSUE THEIR CAREER GOALS. IN FACT, CKHS IS PARTICULARLY PROUD OF THE OUTSTANDING PERFORMANCES ITS GRADUATES CONTINUE TO ACHIEVE ON NATIONAL BOARD EXAMINATIONS. FOSTERING A WELL-ROUNDED EDUCATIONAL EXPERIENCE, CKHS RESIDENCIES PROVIDE STRONG DIDACTIC INSTRUCTION THAT REINFORCES THE CLINICAL, ETHICAL AND PRACTICE-MANAGEMENT ASPECTS OF MEDICINE. THE RESIDENCY PROGRAMS ALSO EMPHASIZE THE USE OF COMPUTERS AT THE POINT OF CARE TO ACCESS EXPERT INFORMATION, DECISION SUPPORT, LITERATURE SEARCHES, DRUG INTERACTIONS AND PATIENT EDUCATION MATERIALS. AS THEY TRAIN, CKHS RESIDENTS HAVE THE OPPORTUNITY TO USE CKHS' OWN CUTTING-EDGE FACILITIES, AS WELL AS THOSE OF OUR WORLD-CLASS EDUCATIONAL AFFILIATES. THE MAJORITY OF RESIDENCY TRAINING TAKES PLACE AT CROZER-CHESTER MEDICAL CENTER ("CCMC"), A NOT-FOR-PROFIT TERTIARY-CARE TEACHING HOSPITAL. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 CROZER-KEYSTONE HEALTH SYSTEM ("CKHS") IS THE SOLE MEMBER OF THIS ORGANIZATION. CKHS HAS THE RIGHT TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF DIRECTORS AND HAS CERTAIN RESERVED POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION B; QUESTION 11B THE ORGANIZATION IS AN AFFILIATE IN THE CROZER-KEYSTONE HEALTH SYSTEM AND CONTROLLED AFFILIATES ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. CROZER-KEYSTONE HEALTH SYSTEM IS THE TAX-EXEMPT PARENT ORGANIZATION OF THE SYSTEM. THE ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO AND made available TO THE AUDIT COMMITTEE OF CROZER-KEYSTONE HEALTH SYSTEM FOR REVIEW BY ITS MEMBERS PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE ("IRS"). FOLLOWING THIS REVIEW THE FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY, ITS BOARD OF DIRECTORS, PRIOR TO FILING WITH THE IRS. THE CROZER-KEYSTONE HEALTH SYSTEM BOARD OF DIRECTORS HAS DELEGATED TO ITS AUDIT COMMITTEE THE RESPONSIBILITY TO OVERSEE, REVIEW AND APPROVE OF THE FEDERAL FORM 990, INCLUDING THE PREPARATION, REVIEW AND FILING PROCESS. AS PART OF THE TAX RETURN PREPARATION PROCESS THE ORGANIZATION HIRED A PROFESSIONAL CPA FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE PERSONNEL AND VARIOUS OTHER INDIVIDUALS OF THE ORGANIZATION AND THE SYSTEM TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S FINANCE PERSONNEL AND OTHER INDIVIDUALS FOR THEIR REVIEW. THE ORGANIZATION'S FINANCE PERSONNEL AND OTHER INDIVIDUALS REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S FINANCE PERSONNEL AND VARIOUS OTHER INDIVIDUALS FOR FINAL REVIEW AND APPROVAL PRIOR TO PRESENTATION OF THE FEDERAL FORM 990 TO THE MEMBERS OF THE CROZER-KEYSTONE HEALTH SYSTEM AUDIT COMMITTEE AND THEREAFTER PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY, ITS BOARD OF DIRECTORS, PRIOR TO FILING WITH THE IRS. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION B; QUESTION 12 THE ORGANIZATION REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. ANNUALLY ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS AND SENIOR MANAGEMENT PERSONNEL ARE REQUIRED TO REVIEW THE EXISTING CONFLICT OF INTEREST POLICY AND COMPLETE A QUESTIONNAIRE. THE COMPLETED QUESTIONNAIRES ARE RETURNED TO THE ORGANIZATION'S LEGAL DEPARTMENT AND VP/GENERAL COUNSEL FOR REVIEW. THEREAFTER THE LEGAL DEPARTMENT AND VP/GENERAL COUNSEL PREPARE A SUMMARY OF THE COMPLETED QUESTIONNAIRES WHICH CONTAINS INFORMATION DISCLOSED ON AN INDIVIDUAL BY INDIVIDUAL BASIS. THEREAFTER, THE VP/GENERAL COUNSEL OF THE ORGANIZATION PRESENTS THIS SUMMARY TO THE ORGANIZATION'S BOARD OF DIRECTORS FOR ITS REVIEW AND DISCUSSION. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION B; QUESTION 15 THE ORGANIZATION IS AN AFFILIATE IN THE CROZER-KEYSTONE HEALTH SYSTEM, A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM WHOSE TAX-EXEMPT PARENT ORGANIZATION IS CROZER-KEYSTONE HEALTH SYSTEM ("CKHS"). CKHS' BOARD OF DIRECTORS MAINTAINS A COMPENSATION COMMITTEE ("COMMITTEE"). THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF DIRECTORS EACH OF WHOM IS INDEPENDENT AND FREE FROM ANY CONFLICTS OF INTEREST. THE COMMITTEE HAS ADOPTED A WRITTEN COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES OR CONCURS WITH THE COMPENSATION AND BENEFITS OF CKHS' SENIOR MANAGEMENT, INCLUDING: THE PRESIDENT/CHIEF EXECUTIVE OFFICER, SENIOR VICE PRESIDENT ADMINISTRATION & CHIEF INFORMATION OFFICER, AND SENIOR VICE PRESIDENT/CHIEF FINANCIAL OFFICER. THE COMPENSATION COMMITTEE BYLAWS OUTLINE THE POWERS AND FUNCTIONS OF THE COMPENSATION COMMITTEE. THE COMMITTEE RELIES UPON APPROPRIATE COMPARABLE DATA FROM AN INDEPENDENT CONSULTING FIRM WHICH SPECIALIZES IN REVIEWING HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS STUDY USES COMPARABLE GEOGRAPHICAL AND DEMOGRAPHIC MARKET DATA INCLUDING, BUT NOT LIMITED TO, SIMILARLY SIZED HEALTHCARE SYSTEMS AND HOSPITALS, NUMBER OF LICENSED BEDS, AND NET PATIENT REVENUE ON BOTH A REGIONAL AND NATIONAL BASIS. THE COMMITTEE DOCUMENTS ITS BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS ARE REVIEWED AND SUBSEQUENTLY APPROVED. THE COMPENSATION AND BENEFITS OF THE PRESIDENT/CHIEF EXECUTIVE OFFICER ARE REVIEWED BY THE COMMITTEE ON AN ANNUAL BASIS IN CONJUNCTION WITH THE INDIVIDUAL'S JOB PERFORMANCE. THE COMPENSATION COMMITTEE THEN RECOMMENDS TO CKHS' BOARD OF DIRECTORS APPROPRIATE COMPENSATION FOR THE PRESIDENT/CHIEF EXECUTIVE OFFICER. THE BOARD OF DIRECTOR'S THEN REVIEWS THE COMMITTEE'S RECOMMENDATION AND APPROVES THE COMPENSATION OF THE PRESIDENT/CHIEF EXECUTIVE OFFICER BASED ON THE COMMITTEE'S RECOMMENDATION. THE PRESIDENT/CHIEF EXECUTIVE OFFICER ESTABLISHES, AFTER DISCUSSION WITH AND CONCURRENCE BY THE COMMITTEE, THE COMPENSATION LEVELS OF THE EXECUTIVE VICE PRESIDENT/CHIEF OPERATING OFFICER; SENIOR VICE PRESIDENT/CHIEF FINANCIAL OFFICER; SENIOR VICE PRESIDENT ADMINISTRATION & CHIEF INFORMATION OFFICER; AND CERTAIN OTHER INDIVIDUALS DEEMED TO BE DISQUALIFIED PERSONS PURSUANT TO THE INTERNAL REVENUE SERVICE DEFINITION. THIS IS DONE WITH COMPARABLE MARKET DATA PROVIDED BY AN INDEPENDENT CONSULTANT. THE PRESIDENT/CHIEF EXECUTIVE OFFICER ALSO RECEIVES ASSISTANCE FROM CKHS' HUMAN RESOURCES DEPARTMENT IN CONJUNCTION WITH EACH INDIVIDUAL'S JOB PERFORMANCE DURING THE YEAR. COMPENSATION REVIEW AND APPROVAL IS ALSO BASED UPON OTHER OBJECTIVE FACTORS DESIGNED TO ENSURE THAT REASONABLE AND FAIR MARKET VALUE COMPENSATION IS PAID BY CKHS. OTHER OBJECTIVE FACTORS INCLUDE MARKET SURVEY DATA FOR COMPARABLE POSITIONS, INDIVIDUAL GOALS AND OBJECTIVES, PERSONNEL REVIEWS, AND EVALUATIONS. THE ACTIVITIES AND PROCEDURES FOLLOWED BY THE COMMITTEE ENABLE CKHS TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF ALL INDIVIDUALS DISCLOSED ON THIS FORM 990, INCLUDING THE PRESIDENT/CEO, EXECUTIVE VICE PRESIDENT/COO, SENIOR VICE PRESIDENT ADMINISTRATION/CIO AND SENIOR VICE PRESIDENT/CFO. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION C; QUESTION 19 THE ORGANIZATION HAS ISSUED TAX-EXEMPT BONDS TO FINANCE VARIOUS CAPITAL IMPROVEMENT PROJECTS, RENOVATIONS AND EQUIPMENT. IN CONJUNCTION WITH THE ISSUANCE OF THESE TAX-EXEMPT BONDS, THE ORGANIZATION'S FINANCIAL STATEMENTS WERE INCLUDED WITH THE TAX-EXEMPT BOND PROSPECTUS WHICH WAS MADE AVAILABLE TO THE GENERAL PUBLIC FOR REVIEW. THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE COMMONWEALTH OF PENNSYLVANIA. COMPENSATION INFORMATION DISCLOSURE CORE FORM, PART VII AND SCHEDULE J PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM THE ORGANIZATION OR A RELATED ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OR INDEPENDENT CONTRACTORS OF THE ORGANIZATION OR A RELATED ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THIS ORGANIZATION'S BOARD OF DIRECTORS. RELATED HOURS DISCLOSURE CORE FORM, PART VII, SECTION A, COLUMN B THE ORGANIZATION IS AN AFFILIATE WITHIN THE CROZER-KEYSTONE HEALTH SYSTEM AND CONTROLLED AFFILIATES ("SYSTEM"). THE SYSTEM INCLUDES BOTH FOR-PROFIT AND NOT FOR-PROFIT ORGANIZATIONS. CERTAIN BOARD OF DIRECTOR MEMBERS, OFFICERS AND/OR DIRECTORS LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENT THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF DIRECTORS OF OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY ONE HOUR. THE HOURS REFLECTED ON PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS AND KEY EMPLOYEES, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF CROZER-KEYSTONE HEALTH SYSTEM AND CONTROLLED AFFILIATES; NOT SOLELY THIS ORGANIZATION. OFFICER DISCLOSURE CORE FORM, PART VII AND SCHEDULE J PATRICK J. GAVIN WAS THE PRESIDENT OF CROZER-CHESTER MEDICAL CENTER; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION, FROM JULY 1, 2011 THROUGH JANUARY 31, 2012. MR. GAVIN BECAME THE SENIOR VICE PRESIDENT, PRESIDENT OF HOSPITAL OPERATIONS STARTING FEBRUARY 1, 2012. OTHER CHANGES IN NET ASSETS CORE FORM, PART XI; QUESTION 5 OTHER CHANGES IN NET ASSETS OR FUND BALANCES INCLUDE: - CHANGE IN NET UNREALIZED GAINS AND LOSSES ON INVESTMENTS; ($694,304); - OTHER CHANGES IN PENSION AND OTHER ACCRUED RETIREMENT BENEFITS LIABILITIES; ($24,909,840); - NET ASSETS RELEASED FROM RESTRICTIONS USE FOR PURCHASE OF PROPERTY AND EQUIPMENT; $200,000; - CHANGE IN BENEFICIAL INTEREST IN FOUNDATION; $109,000; - TEMPORARILY RESTRICTED CONTRIBUTIONS; $440,117; - CHANGE IN NET UNREALIZED GAINS AND LOSSES ON INVESTMENTS - TEMPORARILY RESTRICTED; ($136,339); - NET ASSETS RELEASED FROM TEMPORARY RESTRICTIONS; ($677,768); - INVESTMENT INCOME - TEMPORARILY RESTRICTED; $46,658. AUDITED FINANCIAL STATEMENTS CORE FORM, PART XII, QUESTION 2 THE ORGANIZATION IS AN AFFILIATE WITHIN THE CROZER-KEYSTONE HEALTH SYSTEM AND CONTROLLED AFFILIATES ("SYSTEM"). An INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF THE TAXPAYER AND ALL AFFILIATES FOR THE FISCAL YEARS ENDED JUNE 30, 2012 AND JUNE 30, 2011; RESPECTIVELY AND ISSUED A CONSOLIDATED FINANCIAL STATEMENT WITH CONSOLIDATING SCHEDULES BY ENTITY. AN UNQUALIFIED OPINION WAS ISSUED EACH YEAR BY THE INDEPENDENT CPA FIRM. THE TAXPAYER'S AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR. FINANCIAL STATEMENTS AND REPORTING CORE FORM, PART XII; QUESTION 3 THE ORGANIZATION IS AN AFFILIATE IN THE CROZER-KEYSTONE HEALTH SYSTEM ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE SYSTEM ENGAGED A BIG FOUR INDEPENDENT ACCOUNTING FIRM TO PREPARE AND ISSUE A SYSTEM WIDE CONSOLIDATED A-133 AUDIT. THIS ORGANIZATION WAS INCLUDED IN THE SYSTEM WIDE A-133 AUDIT. 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