FURP.ORG / PUBLIC DATA EXPLORER

HERITAGE VALLEY HEALTH SYSTEM INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
HERITAGE VALLEY HEALTH SYSTEM INC (EIN 25-1801532)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-15
IRS object ID
201311359349301071
Schema version
2011v1.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-05-15T06:40:41-07:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DELOITTE TAX LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12500 ONE PPG PLACEAddressLine1
CityPITTSBURGHCity
StatePAState
ZIP Code15222ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN251801532EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1VALLEY MEDICAL FACILITIES INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlVALLNameControl
Phone4127416600Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1720 BLACKBURN ROADAddressLine1
CitySEWICKLEYCity
StatePAState
ZIP Code15143ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameBRYAN J RANDALLName
TitleVICE PRESIDENT, FINANCE & CFOTitle
Phone4127416600Phone
Date Signed2013-05-01DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameRUDY BILICHName
Phone4123387200Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonBRYAN J RANDALL VICE PRESIDENT FINANameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1720 BLACKBURN ROADAddressLine1
CitySEWICKLEYCity
StatePAState
ZIP Code15143ZIPCode
FieldValueIRS element (for citing)
Gross Receipts457016871GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.heritagevalley.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1996YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionTo improve the health and well-being of all people in the communities we serve.ActivityOrMissionDescription
Nbr Voting Members Governing Body21NbrVotingMembersGoverningBody
Nbr Independent Voting Members17NbrIndependentVotingMembers
Total Nbr Employees3499TotalNbrEmployees
Total Nbr Volunteers246TotalNbrVolunteers
Total Gross UBI6178704TotalGrossUBI
Contributions Grants Prior Year4511327ContributionsGrantsPriorYear
Contributions Grants Current Year4228814ContributionsGrantsCurrentYear
Program Service Revenue Prior Year344681490ProgramServiceRevenuePriorYear
Program Service Revenue CY347210883ProgramServiceRevenueCY
Investment Income Prior Year16389229InvestmentIncomePriorYear
Investment Income Current Year7530506InvestmentIncomeCurrentYear
Other Revenue Prior Year16243661OtherRevenuePriorYear
Other Revenue Current Year15724428OtherRevenueCurrentYear
Total Revenue Prior Year381825707TotalRevenuePriorYear
Total Revenue Current Year374694631TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year592275GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY594324GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year213372388SalariesEtcPriorYear
Salaries Etc Current Year199748972SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year163980970OtherExpensePriorYear
Other Expenses Current Year164281617OtherExpensesCurrentYear
Total Expenses Prior Year377945633TotalExpensesPriorYear
Total Expenses Current Year364624913TotalExpensesCurrentYear
Revenues Less Expenses Prior Year3880074RevenuesLessExpensesPriorYear
Revenues Less Expenses CY10069718RevenuesLessExpensesCY
Total Assets BOY431023093TotalAssetsBOY
Total Assets EOY406050371TotalAssetsEOY
Total Liabilities BOY188130241TotalLiabilitiesBOY
Total Liabilities EOY219904250TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY242892852NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY186146121NetAssetsOrFundBalancesEOY
Mission DescriptionTo improve the health andMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense356205384Expense
Revenue346126148Revenue
DescriptionTHE HOSPITALS COMPRISING VALLEY MEDICAL FACILITIES PROVIDE ROUTINE AND AUXILLARY MEDICAL/SURGICAL, PSYCHIATRIC, AND REHABILITATION SERVICES TO THE COMMUNITIES SERVED BY THE HOSPITALS REGARDLESS OF PATIENT'S ABILITY TO PAY. DURING THE FISCAL YEAR, THE HOSPITALS HAD 24,547 INPATIENT ADMISSIONS, 1,771 NEWBORN ADMISSIONS, AND 113,650 INPATIENT DAYS. THE FACILITIES ALSO ENCOUNTERED 102,280 EMERGENCY ROOM VISITS, 17,530 OUTPATIENT SURGERIES, 171 OPEN HEART PROCEDURES, 3,003 CARDIAC CATHETERIZATIONS AND 315,176 DIAGNOSTIC IMAGING PROCEDURES.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense1396922Expense
Revenue1084735Revenue
DescriptionSCHOOL OF NURSING TO PROMOTE AND PROVIDE SUPPORT TO THE HOSPITALS.Description
FieldValueIRS element (for citing)
Total Program Service Expense357602306TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiestrueReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiestrueForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096137NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees3499NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members21NbrVotingGoverningBodyMembers
Number Independent Voting Members17NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChapterstrueLocalChapters
Policies Reference ChapterstruePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledPAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonFINANCE DEPARTMENT CO VALLEY MEDICANamePerson
Telephone Number4127416600TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1420 ROUSER ROAD SUITE 201AddressLine1
CityMOON TOWNSHIPCity
StatePAState
ZIP Code15108ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerKey EmployeeKeyEmployeeReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
NORMAN F MITRY
President40.00XXX539115044481
RICHARD HOGAN MD
Director40.00X030893133432
RICHARD KIM MD
Director2.00X000
JAMES SCIBILIA MD
Director40.00X037032236383
LYNN GEORGE PHD
Director2.00X000
JOSEPH BECHERER
Director2.00X000
A GARY CHACE
Treasurer2.00XX000
GR ORR III
Vice Chair2.00XX000
THOMAS JOHNSON ESQ
Director2.00X000
CLAUDIO LOFFREDA MD
Director2.00X000
DAVID MOTLEY
Director2.00X000
ALEXANDER VASILAKIS MD
Director40.00X052654834541
TOM LEYDIG
Director2.00X000
DENNIS PEGDEN PHD
Director2.00X000
DAVID M RAFALKO MD
Director2X
JOHANNAH M ROBB CPA
Secretary2XX
SCOTT M ELSTE
Director2X
LAURA A VASSAMILLET
Director2X
GARRY HOGAN
Chairman2XX
MARY KIRSCH CPA
Director2X
THOMAS ARBOGAST ESQ
Director2X
JOHN LUELLEN MD
Chief Quality Officer40X34845241459
JOHN CINICOLA MD
Chief Medical Officer40X42021035158
DANIEL BROOKS MD
V.P. Community Health40X29266038678
SHARON LOFTUS ESQ
V.P. & Deputy General Counsel/Asst. Secretary40XX26755924918
FieldValueIRS element (for citing)
Total Reportable Comp From Org5239660TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2389227TotalReportableCompFrmRltdOrgs
Total Other Compensation820214TotalOtherCompensation
Number Individuals GT100 K106NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ALLSCRIPTS
24630 NETWORK PLACECHICAGOIL60673Computer Professional Services5047919
WESTERN PENNSYLVANIA ANESTHESIA ASSOC
PO BOX 643483PITTSBURGHPA15264Professional Services3476950
OHIO VALLEY PERFUSION ASSOCIATES INC
628 SCOTT RIDGE RDHARMONYPA16037Professional Services742426
EDGEWORTH DEVELOPMENT ASSOCIATES INC
PO BOX 520JOHNSTOWNPA15907Rent588467
ADVACARE HOME SERVICES INC
200 VILLANI DRIVE SUITE 3009BRIDGEVILLEPA15017Professional Services582124
FieldValueIRS element (for citing)
Number Of Contractors GT100 K33NumberOfContractorsGT100K
Government Grants3942826GovernmentGrants
All Other Contributions285988AllOtherContributions
Total Contributions4228814TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenue
All other Patient Payments900099170356298354974
Medicare HMO Payments900099101542432
Medicare/Medicaid payments90009958878003
Medicaid HMO Payments90009916434150
FieldValueIRS element (for citing)
Total Program Service Revenue347210883TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column3492568TotalRevenueColumn
Exclusion$3,492,568ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities86360178Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities82169731Securities
Other152509Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities4190447Securities
Other-152509Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column4037938TotalRevenueColumn
Exclusion$4,037,938ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Sale of Drugs90009957906945790694
Nursing Tuition900099894391894391
Six-Sigma Training9000993303633036

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column9006307TotalRevenueColumn
Related Or Exempt Function Income1095640RelatedOrExemptFunctionIncome
Exclusion$7,910,667ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue15724428TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column374694631TotalRevenueColumn
Related Or Exempt Function Income348845940RelatedOrExemptFunctionIncome
Unrelated Business Revenue6178704UnrelatedBusinessRevenue
Exclusion$15,441,173ExclusionAmount

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total594324Total
Program Services594324ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total5704230Total
Program Services0ProgramServices
Management And General5704230ManagementAndGeneral
Fundraising0Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total151469855Total
Program Services150921883ProgramServices
Management And General547972ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total9520011Total
Program Services9520011ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total22656555Total
Program Services22656555ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total10398321Total
Program Services10245578ProgramServices
Management And General152743ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total258468Total
Program Services83853ProgramServices
Management And General174615ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total260440Total
Program Services260440ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total19505Total
Program Services0ProgramServices
Management And General19505ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total227748Total
Program Services227706ProgramServices
Management And General42ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1325288Total
Program Services1325288ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total3440749Total
Program Services3440036ProgramServices
Management And General713ManagementAndGeneral
Fundraising0Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3970643Total
Program Services3920063ProgramServices
Management And General50580ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total474293Total
Program Services443157ProgramServices
Management And General31136ManagementAndGeneral
Fundraising0Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total133655Total
Program Services133655ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total3401199Total
Program Services3401199ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total26697599Total
Program Services26697599ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Medical and other Supplies5445141954405906455130
other outside services26527375263816841456910
drugs154899401548994000
Bad Debts145784251457842500

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total13024871Total
Program Services12875004ProgramServices
Management And General149867ManagementAndGeneral
Fundraising0Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total364624913Total
Program Services357602306ProgramServices
Management And General7022607ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2408532BOY
EOY5406794EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY4951181BOY
EOY5108633EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY261810BOY
EOY252474EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY34345834BOY
EOY39078150EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY6295147BOY
EOY6635486EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY8694627BOY
EOY8533067EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis438317675LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec274528598LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY166388403BOY
EOY163789077EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY161173087BOY
EOY140035609EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY45969354BOY
EOY36569476EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY535118BOY
EOY641605EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY431023093BOY
EOY406050371EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY44345448BOY
EOY44181873EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY68484757BOY
EOY67147739EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY10165125BOY
EOY10203610EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY65134911BOY
EOY98371028EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY188130241BOY
EOY219904250EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY228109944BOY
EOY171133804EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY8408274BOY
EOY8655317EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY6374634BOY
EOY6357000EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY242892852BOY
EOY186146121EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY431023093BOY
EOY406050371EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses10069718ReconcilationRevenueExpenses
Reconcilation Other Changes-66816449ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii
Public Support Total1700PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Pertcentage1700PublicSupportPertcentage170
Public Support Total5090PublicSupportTotal509
Public Support Percentage5090PublicSupportPercentage509
Investment Income Percentage0InvestmentIncomePercentage

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteerstrueVolunteers
Paid Staff Or ManagementtruePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationstrueGrantsOtherOrganizations
Grants Other Organizations$19,505GrantsOtherOrganizationsAmount
Direct Contact LegislatorstrueDirectContactLegislators
Direct Contact Legislators$55,185DirectContactLegislatorsAmount
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB74690TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV (2 entries)

IdentifierIdentifierExplanationExplanation
Pt II-B Line 1iOther lobbying Activities: A portion of Hospital and
HEALTH SYSTEM ASSOCIATION OF PA (HAP) DUES ARE LOBBYING EXPENSES. ADDITIONALLY, THE ORGANIZATION RETAINS THE LAW FIRM OF BUCHANAN INGERSOLL & ROONEY TO LOBBY ON THEIR BEHALF.

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance284583000BeginningOfYearBalance
Contributions4416000Contributions
Investment Earnings Or Losses-26958000InvestmentEarningsOrLosses
Grants Or Scholarships1087000GrantsOrScholarships
Other Expenditures6712000OtherExpenditures
Administrative Expenses1280000AdministrativeExpenses
End Of Year Balance252962000EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance259195000BeginningOfYearBalance
Contributions4906000Contributions
Investment Earnings Or Losses27943000InvestmentEarningsOrLosses
Grants Or Scholarships21000GrantsOrScholarships
Other Expenditures5978000OtherExpenditures
Administrative Expenses1462000AdministrativeExpenses
End Of Year Balance284583000EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance240777000BeginningOfYearBalance
Contributions4160000Contributions
Investment Earnings Or Losses28999000InvestmentEarningsOrLosses
Grants Or Scholarships21000GrantsOrScholarships
Other Expenditures13230000OtherExpenditures
Administrative Expenses1490000AdministrativeExpenses
End Of Year Balance259195000EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.94100BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.02500PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.03400TermEndowmentEOYBalance
Endowments Held By Unrelated OrgstrueEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgstrueEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RtrueAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis2285807OtherCostOrOtherBasis
Book Value2285807BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis141365786OtherCostOrOtherBasis
Depreciation78817831Depreciation
Book Value62547955BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1690934OtherCostOrOtherBasis
Depreciation593283Depreciation
Book Value1097651BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis275171289OtherCostOrOtherBasis
Depreciation191586654Depreciation
Book Value83584635BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis17803859OtherCostOrOtherBasis
Depreciation3530830Depreciation
Book Value14273029BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings163789077TotalOfBookValueLandBuildings

Other Securities OtherSecurities (4 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
Interest in Assets Held by Foundations9443861F
Other Investments283574F
Commingled Funds19626640C
Alternative Investments7215401C
FieldValueIRS element (for citing)
Total Of Book Value Securities36569476TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Accrued pensions and other long term liabilities$98,371,028
Workers Comp Reserve Long Term
FieldValueIRS element (for citing)
Total Of Amounts98371028TotalOfAmounts
Total Revenue374694631TotalRevenue
Total Expenses364624913TotalExpenses
Excess Or Deficit For Year10069718ExcessOrDeficitForYear
Net Unrealized GL On Investments-7196866NetUnrealizedGLOnInvestments
Donated Services And Facilities843470DonatedServicesAndFacilities
Other-$60,463,088OtherAmount
Total Adjustments-66816484TotalAdjustments
Excess Or Deficit Per FS-56746766ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt371839089TotRevenueEtcAuditedFinclStmt
Other Revenues-2194817OtherRevenues
Revenue Not Rptd F990-2194817RevenueNotRptdF990
Revenue Subtotal374033906RevenueSubtotal
Other Revenues Not Included660725OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt660725RevenueNotRptdOnFinStmt
Total Revenue Per Form990374694631TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt364471263TotExpensesEtcAuditedFinclStmt
Expenses Subtotal364471263ExpensesSubtotal
Other Expenses Not Included153650OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt153650ExpensesNotRptdOnFinStmt
Total Expenses Per Form990364624913TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (8 entries)

IdentifierIdentifierExplanationExplanation
Pt XLine #2 Valley Medical Facilities (VMF)adopted the uncertain tax provisions of
Accounting Standards Codification (ASC) 740 Income Taxes (FAS 109/FIN 48) as of July 1, 2010. There was no material impact as a result of the adoption. VMF does not have any material uncertain tax positions as of June 20, 2010 and 2011. VMF does not expect a material change in the ASC 740 uncertain tax positions in the next 12 months.
Pt XII Line 2dLoss on Bond Refunding
Pt XIII Line 4bOther Adjustments: Restricted Fund Expenses
Pt XII Line 4bOther Adjustments: Restricted Fund Income
Pt XI Line 8Pension obligation adjustment
Pt V Line 4Board designated assets are unrestricted funds under the control
OF THE BOARD OF DIRECTORS. THE MAJORITY OF THESE FUNDS ARE HELD IN THE MASTER TRUST. THE REMAINING FUNDS ARE IN THE CHECKING AND MONEY MARKET ACCOUNTS. ALL INTEREST, REALIZED GAINS/LOSSES, AND UNREALIZED GAINS/LOSSES ASSOCIATED WITH THESE FUNDS REMAIN AS BOARD DESIGNATED FUNDS. DONOR RESTRICTED SPECIFIC PURPOSE FUNDS ARE COMPOSED OF BOTH TEMPORARY AND PERMANENTLY RESTRICTED FUNDS. ALL FUNDS EARN INTEREST, REALIZED GAINS/LOSSES, AND UNREALIZED GAINS/LOSSES. INTEREST CAN BE RESTRICTED BY THE DONOR

Schedule F IRS990ScheduleF

Accts Actvs Out US Table AcctsActvsOutUSTable

FieldValueIRS element (for citing)
RegionCentral AmericaRegion
Type Of Activities ConductedInvestmentsTypeOfActivitiesConducted
Total Expenditures7215000TotalExpenditures
FieldValueIRS element (for citing)
Subtotal Amount Spent7215000SubtotalAmountSpent
Total Amount Spent7215000TotalAmountSpent
Transfer To Foreign CorptrueTransferToForeignCorp
Interest In Foreign TrustfalseInterestInForeignTrust
Own Foreign CorptrueOwnForeignCorp
Passive Foreign Invest CotruePassiveForeignInvestCo
Foreign PartnershiptrueForeignPartnership
Boycott CountriesfalseBoycottCountries

Form990 Schedule F Part V Form990ScheduleFPartV

FieldValueIRS element (for citing)
IdentifierPt I Line 2Identifier
ExplanationValley Medical Facilities Inc. does not make grants outside the United States.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage300.00000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage450.00000DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense7662295TotalCommunityBenefitExpense
Net Community Benefit Expense7662295NetCommunityBenefitExpense
Percent Of Total Expense0.02100PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense35086784TotalCommunityBenefitExpense
Direct Offsetting Revenue21336937DirectOffsettingRevenue
Net Community Benefit Expense13749847NetCommunityBenefitExpense
Percent Of Total Expense0.03770PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense42749079TotalCommunityBenefitExpense
Direct Offsetting Revenue21336937DirectOffsettingRevenue
Net Community Benefit Expense21412142NetCommunityBenefitExpense
Percent Of Total Expense0.05870PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense219761TotalCommunityBenefitExpense
Direct Offsetting Revenue169965DirectOffsettingRevenue
Net Community Benefit Expense49796NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense1428025TotalCommunityBenefitExpense
Direct Offsetting Revenue1184372DirectOffsettingRevenue
Net Community Benefit Expense243653NetCommunityBenefitExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense531480TotalCommunityBenefitExpense
Direct Offsetting Revenue380833DirectOffsettingRevenue
Net Community Benefit Expense150647NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense2179266TotalCommunityBenefitExpense
Direct Offsetting Revenue1735170DirectOffsettingRevenue
Net Community Benefit Expense444096NetCommunityBenefitExpense
Percent Of Total Expense0.00120PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense44928345TotalCommunityBenefitExpense
Direct Offsetting Revenue23072107DirectOffsettingRevenue
Net Community Benefit Expense21856238NetCommunityBenefitExpense
Percent Of Total Expense0.05990PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Total Community Building Expense3375TotalCommunityBuildingExpense
Net Community Building Expense3375NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense76170TotalCommunityBuildingExpense
Net Community Building Expense76170NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense113003TotalCommunityBuildingExpense
Net Community Building Expense113003NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense52271TotalCommunityBuildingExpense
Net Community Building Expense52271NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense244819TotalCommunityBuildingExpense
Net Community Building Expense244819NetCommunityBuildingExpense
Percent Of Total Expense0.00060PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$6,026,959BadDebtExpenseAmount
Amount Attributable To3013479AmountAttributableTo
Amount Reimbursed By Medicare156670647AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare162291382CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-5620735MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost Accounting SystemXCostAccountingSystem
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities2NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalTeaching HospitalTeachingHospitalEr24 HoursEr24Hours
HERITAGE VALLEY BEAVER
11000 DUTCH RIDGE ROADBEAVERPA15009XXXX
HERITAGE VALLEY SEWICKLEY
2720 BLACKBURN ROADSEWICKLEYPA15143XXX

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (2 entries)

Hospital Facility NumberHospitalFacilityNumberCHNA ConductedCHNAConductedCommunity DefinitionCommunityDefinitionHow Data ObtainedHowDataObtainedCommunity Health NeedsCommunityHealthNeedsNeeds Assessment ConductedNeedsAssessmentConductedTake Into AccountTakeIntoAccountOther FacilitiesOtherFacilitiesCHNA Widely AvailableCHNAWidelyAvailableAdopt Implement StrategyAdoptImplementStrategyExecute Implement StrategyExecuteImplementStrategyAll Needs AddressedAllNeedsAddressedEligibility Criteria ExplainedEligibilityCriteriaExplainedUses FPG FreeUsesFPGFreeFPG Free PercentFPGFreePercentUses FPG DiscountedUsesFPGDiscountedFPG Discount PercentFPGDiscountPercentExplains BasisExplainsBasisIncome LevelIncomeLevelExplains Application MethodExplainsApplicationMethodIncludes Publicity MeasuresIncludesPublicityMeasuresAvailable On RequestAvailableOnRequestActions On NonpaymentActionsOnNonpaymentPermit Report To Credit AgencyPermitReportToCreditAgencyCollection ActivitiesCollectionActivitiesReport To Credit AgencyReportToCreditAgencyNotify Upon AdmissionNotifyUponAdmissionNotified All PatientsNotifiedAllPatientsDocumented DeterminationDocumentedDeterminationNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyUsed Other MethodUsedOtherMethodAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossCharges
HERITAGE VALLEY BEAVER
1trueXXX09truetruefalseXXfalsetruetrue300true450trueXtruetrueXtrueXtrueXXXXtrueXfalsefalse
HERITAGE VALLEY SEWICKLEY
2trueXXX09truetruefalseXXfalsetruetrue300true450trueXtruetrueXtrueXtrueXXXXtrueXfalsefalse

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities12NumberOfOtherFacilities

Other Facilities OtherFacilities (12 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
BEAVER -CALCUTTA IMAGING & LAB SERVICES
48462 BELL SCHOOL ROAD SUITE BEAST LIVERPOOLOH43920Laboratory and Imaging
BEAVER - HERITAGE VALLEY DIAGNOSTIC CENTER - ELLWOOD CITY
1677 STATE ROUTE 65ELLWOOD CITYPA16117Diagnostic Center
BEAVER - HERITAGE VALLEY DIAGNOSTIC CENTER - HOPEWELL
5000 INDUSTRIAL BOULEVARDALIQUIPPAPA15001Diagnostic Center
BEAVER - WOMEN'S HEALTH CENTER
200 PLEASANT DRIVEALIQUIPPAPA15001Imaging Services
BEAVER - FAMILY PRACTICE CENTER
1125 7TH AVENUEBEAVER FALLSPA15010Residency Program
BEAVER - HERITAGE VALLEY SIGNATURE REHAB
1030 BEANER HOLLOW ROADBEAVERPA15009Rehabilitation Services
BEAVER - SIGNATURE REHAB - HOPEWELL
3000 INDUSTRIAL BLVDALIQUIPPAPA15001Rehabilitation Services
BEAVER - HERITAGE VALLEY BADEN - LAB (PHLEBOTOMY)
280 OHIO RIVER BLVDBADENPA15005Laboratory Services
SEWICKLEY - HERITAGE VALLEY HEALTH CENTER
935 THORN RUN ROADMOON TWPPA15108Outpatient Surgery
SEWICKLEY - HERITAGE VALLEY OPEN MRI AND LABORATORY DRAW SITE
ROBINSON PLAZA THREE SUITE 210B PARPITTSBURGHPA15208Laboratory and Imaging
SEWICKLEY- HERITAGE VALLEY REHABILITATION SERVICES - WEST ALLEGHENY SIGNATU
300 PENN LINCOLN DRIVEIMPERIALPA15126Rehabilitation Services
SEWICKLEY - HERITAGE VALLEY HEALTH SYSTEM EDGEWORTH SQUARE
111 HAZEL LANESEWICKLEYPA15143Psychiatric Services

Form990 Schedule H Part VI Form990ScheduleHPartVI (277 entries)

IdentifierIdentifierExplanationExplanation
Pt I Line 3cPart 1. Line 3C: The Organization provides charity care to
qualifying individuals and families based on a sliding scale using
Federal Health & Human Services Poverty Guidelines. accounting for family
size at 300% of the poverty level for free care, a 75% discount for
families at 350%, a 50% discount for families at 400%
and a 25% discount for families at 450%
Pt I Line 6aPart 1 Line 6a See attached Community Benefit Report.
Pt I Line 7gPart 1 Line 7g Family Medicine & Family Planning Clinic Subsidy
Pt III Line 4There is no bad debt footnote required for the financial statements
audited by Deloitte & Touche LLP. Cost of bad debts in Lines 2 and 3 is
based on calculations of cost to charges applied to bad debt charges.
Pt III Line 8The Organization believes the entire shortfall of reimbursement
versus cost ($5,620,735) should be considered community benefit
since it results in a loss therefore lessening government burden. Costs associated with
the shortfall were determined from the Organization's cost accounting system.
Pt III Line 9bWithin the Organization's bad debt/collection policy, there is
reference to the fact that patients are provided several options,
one of which being the application for Charity Care in satisfying the
outstanding balance of their account. If the patient pursues Charity
Care, there is a separate policy detailing the steps
required to qualify for Charity Care.
Pt VI Line 2The Organization assesses community health care needs
in several ways. Utilization of services, especially inpatient and
emergency department, are reviewed at least annually to determine the top
reasons for admission/seeking care. Available health statistics data is
reviewed at least annually from the Pennsylvania Department of Health to
measure the status of health conditions in Beaver and Allegheny Counties
including data on performance compared to Healthy People 2020.
Administration is in continuing dialogue with its Medical Staff and other
health professionals regarding community health needs.
Periodically the organization holds a strategic planning process
for selected service lines. Previous strategic clinical planning study
groups have included the topics of diabetes care, breast health, emergency
services and cardiology. In 2009, the Organization completed a
Community Health Needs Assessment. The assessment included 600 household
telephone surveys conducted by an area market research firm with
additional input gathered from patients, employees, medical staff,
citizens and management. The assessment affirmed the Organizations's
current Community Health Services and indicated some additional areas to
consider for expansion.
Pt VI Line 3The Organization is committed to assisting all self
pay patients in applying for State Medicaid. Currently the Organization
engages a third party service to interview and complete the Medicaid
application on all patients admitted with no health insurance.
During the application process, patients are made aware of the Charity Care
Program in the event they are denied State Medicaid. The financial
information obtained during this process is used in determining if the
patients qualify for the Charity Care Program.
If the patient is denied for Medicaid, they receive monthly statements
reflecting the outstanding balance owed. The Organization makes the
patients aware of the Charity Care Program on the back side of all self pay
patient statements. The statement directs all inquiries regarding Charity
Care to the Patient Accounting Department. The patients are provided with
the guidelines of the program at the point they contact Patient Accounting.
This phone call usually results in the application along with the current
guidelines being mailed to the patient for completion.
In addition, reference to the Charity Care Program is included in the
"Patient Guide" which is provided to all patients admitted.
Pt VI Line 4Service Area & Population - the Organization serves
residents in the Western Pennsylvania counties of Allegheny, Beaver, Butler
and Lawrence; Columbiana County in Eastern Ohio; and the panhandle
of West Virginia. Our primary service area includes all of Beaver County,
Northwestern Allegheny County, Southwestern Butler County, Southern
Lawrence County, Eastern Columbiana County (Ohio), and Hancock and Brooke
Counties (West Virginia). The population in our primary service
area is approximately 458,000 people. The area is predominantly
surburban although it includes towns, boroughs and rural areas.
Selected Demographic Statistics
Beaver County is emphasized as a plurality of the Organization's patients
are residents of this county.
The percentage of those 65 and older ranges from a low of 15.4% in
Butler County to a high of 19.0% in Brooke County; Beaver County is 18.5%,
substantially higher than the United States average of 13.3%.
Median household income ranges from a low of $39,502 in Columbiana
County to a high of $56,878 in Butler County; Beaver County is $46,190,
substantially lower than the United States average of $51,914.
The percentage of those below the poverty level ranges from a low of
8.3% in Butler County to a high of 16.0% in Columbiana County; Beaver
County is 11.1%, substantially lower than the United States average of 13.8%.
Uninsured adults ranges from a low of 10% in Allegheny, Beaver and Butler
Counties to a high of 15% in Columbiana County.
In Summary, the Organization's service area is older and less affluent
than the United States average but the percentage at or below the poverty level is
lower as the National Average includes inner cities.
In Fiscal 2011, Medicaid was 7.0 Percent of net patient revenue at the
Sewickley Campus and 6.3 percent at the Beaver Campus for a Weighted
Average of 6.6 Percent. This is typical for most suburban service areas.
In our Community Health Needs Assessment Survey, 9.3% of the adult
respondents stated that they did not have health insurance coverage of some
kind. In comparison, 13% of Pennsylvania adults reported no health
insurance. However, the Pennsylvania result is for adults aged 18 to 64,
while the needs assessment included some people over age 60, of whom only
4% reported not having health insurance of some kind. Rates of adults
without health insurance are expected to climb until unemployment levels
decrease when the current economic recession starts to abate.
Medically Underserved Areas (MUAS) & Medically Underserved Populations (MUPS)
MUAS in the Organization's primary service area include:
Beaver Falls (Part)
Bridgewater
Aliquippa (Part)
Coraopolis
Mars
MUPS in the Organizations's service area include:
Columbiana County-Medicaid eligible population.
Pt IIExecutive Summary- During Fiscal 2012, the Organization
participated in over one hundred activities providing community benefit.
A selection of these activities included:
*Participated in eleven (11) major health fairs providing free
screenings & health information.
*Presented health & wellness information, including mental health
issues, at various school & community group events.
*Sponsored five (5) monthly support groups and working with six (6)
other monthly support groups.
*Provided manikins to local first responder organizations for CPR
Certification activities.
*Day of caring participants - value of donated time - $3,567.
*Participated in local school career days.
*Provided free clinical services or donating medical equipment to
several community not-for-profit organizations.
The organization also subsidizes various programs that benefit both the
health and well being of the patients in the communities we serve and the
students seeking to further their education in the health services field.
Examples of these programs include:
* Family Medicine and Family Planning Clinics
* School of Nursing
COMMUNITY HEALTH EDUCATION & OUTREACH
*Maternal & Child health staff at Heritage Valley, Sewickley-conducted
over fifteen (15) sessions of different prenatal education topics
and also provided support groups for pregnancy loss and new mothers.
*Staff of the Community Health Services Department participated in
fifty-four (54) health fairs/education sessions.
*Car Seats are rented at discounted rates to parents in
need for safe transport of newborns.
*Family Medicine Residents provided free physicals and provided
health education on smoking avoidance and sex education.
* The Hospital Division Laboratory provided four hundred forty two (442) legal alcohol test for area
police departments and also assisted with student high school projects and community health fairs.
*Womens's Health Center staff performed approximately six-hundred forty-five
(645) osteoporosis health screenings at twenty three (23) community
events or for patients and visitors at the Women's Health Center.
*The Sterile Processing Department lends manikins to local
fire departments, EMS units and police for CPR certification activities.
*School of Nursing faculty and staff provided over seven
hundred and thirty eight (738) hours of community service at
thirty eight (38) events.
*Management and staff from several departments participated in
local school career days.
*Heritage Valley-Beaver Laboratory services worked with
high school students on science fair projects.
*Community groups use the conference center/education center
at the hospitals for meetings; the pro-rated facility
cost of these meetings was $6,103.
COMMUNITY-BASED CLINICAL SERVICES
*The Family Medicine Clinic (Beaver Falls) conducts free
physicals for the foster grandparent program.
*The Laboratory provided legal alcohol tests for area police departments at a testing cost of
$4,199 and also spent $240 in supply costs for assisting with student high
school projects and community health fairs for a total expense of $4,439.
HEALTHCARE SUPPORT SERVICES
*The Organization sponsors or works directly with five (5) support
groups that meet monthly at an Organization hospital or in the
community; the Organization is involved in another six (6) support groups
that meet monthly in various community settings.
DONATIONS TO NOT-FOR-PROFIT ORGANIZATIONS
*Payments to local municipalities (in lieu of taxes) - $46,252
*Donation of a parcel of land on the Beaver Campus for the
Brighton Township Volunteer Fire Department at a cost of $3,375.
*The Organization sponsored events held by community
not-for-profit organizations and donated $62,500 to these
organizations (net of value received.)
* Donation to Cameos of Caring - $4,000.
* Donation of twenty-five (25) bassinets to third world countries.
*Donation of Various equipment and supplies valued
at $47,832, to third world countries.
* Donation of a Rolloscope Film Viewer to Ohio Valley Hospital.
* Donation of a salt/snow plow truck to Brighton Township for $66,751.
MEDICAL EDUCATION
*---SCHOOL OF NURSING SUBSIDY - $211,054
The Organization serves as a site for numerous health
and adminstrative/professional internships and administrating nursing
students from Community College of Beaver County, Robert Morris
University and Kent State University who use the Organization as a site for clinical
training with no tuition or monetary reimbursement. Coordination
of these unpaid internships requires approximately 900 hours
of staff time, valued at $32,599.
SUBSIDIZED HEALTH SERVICES
*Family Medicine Clinic & Family Planning Clinic (Beaver Falls)
- $150,647 loss. (excluding estimated Medicaid &
Medicare underpayments separately reported)
*Nutritional Counseling Services are subsidized - $49,796
The Organization is committed to offering a robust range of services to meet community
needs; therefore some services such as Emergency Department services &
Maternal/Child Health services are operated with significant subsidies.
MEDICAL STAFF PRIVILEGES
In general, both the Beaver and Sewickley campuses have an open medical staff and
privileges are granted to qualified physicians who meet established criteria. There
are, however, certain departments and/or services that are closed due to contractual
arrangements with third party providers. Four departments are closed. The emergency
room department is closed to physicians who are employed by the Organization,
and to physicians otherwise contracted by the Organization. For
the departments of radiology, pathology and anesthesiology, the Organization
has exclusive contracts with the contracting physician groups, and thus,
privileges in these departments are limited to those physicians who have a contractual
relationship with the group. In addition, the Organization has an exclusive
contract with a third party provider for the provision of hospitalist services at the
Beaver campus and has exclusive contracts with third party providers for the provision
of telemedicine stroke services at each of the campuses.
Quality Improvements in Patient Care
The Organization reorganized Quality under a new physician Chief Quality Officer
this year. Quality, Patient Safety, and Customer Satisfaction are defined as strategic
imperatives our the Organization. Compliance with National Patient Safety Goals
and CMS Core Measures exceeds 98%. Core Measures are actively managed with enhanced reporting
and engagement of nursing and physician staff. Performance improvement initiatives are ongoing in
the areas of infection control, patient safety, and the customer experience.
Consistent year-over-year improvement is being demonstrated on the Organizations balanced
scorecard across all facets of Quality, Safety, and Customer Satisfaction.
INVESTMENTS IN FACILITIES AND EQUIPMENT
---The Organization has a significant capital budget, of approximately $30
million annually, primarily funded by operating margins.
---Both foundations support facility enhancements and equipment purchases.
The Sewickley Valley Hospital Foundation supports initiatives
such as the purchase of maternity and infant care equipment
and educational equipment for the School of Nursing.
Heritage Valley Beaver Foundation supports initiatives such as
the purchase of cardiology and pediatric equipment.
MEDICAL EDUCATION
The Organization has a Family Practice Residency Program in Beaver Falls,
with an associated clinic, and a School of Nursing in Moon Township. Both
affiliated foundations offer Nursing School scholarships.
COMMUNITY HEALTH SERVICES
Community Health Services is a robust set of programs and services that focus
on families and individuals suffering from chronic illness.
The benefits of these programs are demonstrated through
clinical outcomes that relate to healthy living and improved functioning:
---Pediatric Asthma
---Diabetes
---Pregnancy Health Services (Designed for high-risk pregnancies)
---Community Advanced Illness (Palliative care for end of life services).
---Childhood obesity
---LifeSmart (pre-diabete/obesity)
---Smoking Cessation
---Community Outreach Services
---Community Crisis Counseling
These services are supported through Grants from the Foundations.
Pt VI Line 6Part VI Line 7: The Organization is a wholly owned subsidiary of
Heritage Valley Health System, Inc. and provides inpatient and
outpatient health care and related services to the residents of Beaver
County, PA, and Northwestern Allegheny County, PA, and the surrounding
areas through its two acute care hospitals: Heritage Valley, Beaver
and Heritage Valley,Sewickley.
The Organization is part of an independent, community-based
health system, unaffiliated with any other health care system.
The roles of the Organization and its affiliated foundations are
documented elsewhere in this form. The contracted physician practices
also participate in community health improvement efforts. Several
physicians participated in the diabetes clinical program and several
have met certain criteria to be identified under the NCQA's diabetes
physician recognition program. Also, one of the senior pediatricians
in Tri-State Pediatric Associates is a champion for the
Organization's childhood obesity program.
Pt V Sec B 3Community input was gathered in 2 ways. 600 telephone surveys were
conducted by a research firm of adults in the service area, selected at random;
83 members of the public answered a short version of the survey
through the health system's website.
Pt V Sec B 7It is not possible for the Organization to address every need of the
Community. See attached Community Benefit Report for a description
of services provided to the Community.
Pt V Sec B 19dUninsured individuals are expected to pay the equivalent
of the Medicaid DRG case rate payment for inpatient accounts
and 45% of charges for outpatient accounts.
Pt V Sec B 4Heritage Valley Sewickley
Pt V Sec B 4Heritage Valley Beaver
Pt VSchedule H part V. The last Needs Assessment was done
in 2009. At that time there was not the requirement to
make it available to the public. That was passed at a
later date. The next Needs Assessment performed will be
made available to the public.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained
Total Nbr Of501 C3 And Govt Grants0TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part III Form990ScheduleIPartIII (4 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsAmount Of Cash GrantAmountOfCashGrantMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistance
Tuition Reimbursement31140481FMVN/A
Educational Assistance113288193FMVN/A
Loan Forgiveness412000FMVN/A
PHEAA/PELL Grants77153650FMVN/A

Form990 Schedule I Part IV Form990ScheduleIPartIV (20 entries)

IdentifierIdentifierExplanationExplanation
Pt I Line 2Educational Assistance is granted to active, eligible full-time and part-time
employees. Current and future educational, training and staffing needs
of the Organization are taken into consideration when granting educational assistance.
The grade report for employees receiving educational assistance must show a grade of "C" or better
for Undergraduate and a "B" or better for Graduate level courses.
Pt I Line 2Loan Forgiveness - Scholarships are provided to individuals who are entering or those who are
presently enrolled in Nursing School to obtain their RN License. The
applicant mut submit proof of acceptance into Nursing School, copies of
invoices, and proof of final grades maintaining at least a 2.0 GPA.
Scholarship recipients are contractually bound to certain employment
stipulations and if these obligations are not met, the scholarship must be repaid.
Pt I Line 2Tuition Reimbursement - Provided to candidates employed as RNs by the
Organization who are enrolled in the Penn State BSN Program. The
receipient must be in good employment standing, and must submit proof of
grades with at least a 2.0 GPA and invoice for tuition. Recipients are bound
to certain employment stipulations, and if obligations are not met, the
payment may be pro-rated.
Pt I Line 2Pell is title IV funds provided by the Dept. of Education.
PHEAA is state grant funds provided by PA.
All funds are credited to student accounts.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (26 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgs
NORMAN F MITRY
49000239690942330055569170
RICHARD HOGAN MD
2885002043122377331308
JAMES SCIBILIA MD
36969263024448394770
ALEXANDER VASILAKIS MD
4999992654920310546858
JOHN LUELLEN MD
3355681288429858378310
JOHN CINICOLA MD
38000034440577022473442683
DANIEL BROOKS MD
27500013365429527811320471
SHARON LOFTUS ESQ
25000112150540814412281971
BRUCE E EDWARDS
23500015228100427414278646
DAVID W CARLETON
22365610935365435573273818
BRYAN J RANDALL
25807716848413927264306328
KATHY HARLEY
1846178991431221514219434
MARCIA FERRARO
174424850513328196257
LINDA HOMYK
1596177776313929477200009
THOMAS PANGBURN MD
3307262702129856387603
RONALD D LECKEY MD
2949992719529793351987
MICHAEL BARTON MD
2392655199729737320999
DAVID THIMONS DO
436627930818729464664
JUSTIN DOSCH MD
224066150004923927279315584
ROSEMARY M NOLAN
1480772490150567
RICK BEAVER
1850018991423012216210438
GEORGE BRETT III MD
130309130309
JAMES MEDITCH MD
25983125137284968
PETER MANOLUKAS DO
1451114511
JOHN CY WRIGHT MD
480000327512122495397
J ZDUNEK DO
2000009550010149305649

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierPt I Line 4aIdentifier
ExplanationFormer COO was paid a severance package.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1THE HOSPITAL AUTHORITY OF THE COUNTY OF BEAVERBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN251247712IssuerEIN
CUSIP Number074863FX4CUSIPNumber
Date Issued2012-01-19DateIssued
Issue Price72496375IssuePrice
Description Of PurposeRefund Issue Dated 08/4/1998DescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired3225000AmountRetired
Total Proceeds72496375TotalProceeds
Issuance Costs From Proceeds840042IssuanceCostsFromProceeds
Other Spent Proceeds71656333OtherSpentProceeds
Current RefundingtrueCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledfalseForm8038TFiled
Variable Rate IssuefalseVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC
Gross Proceeds InvestedfalseGrossProceedsInvested
Exception To RebatefalseExceptionToRebate

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonSEE SUPPLEMENTAL INFORMATIONNamePerson
FieldValueIRS element (for citing)
Relationshipsee supplemental informationRelationship
Description Of Transactionsee supplemental informationDescriptionOfTransaction
Sharing Of RevenuesfalseSharingOfRevenues

Form990 Schedule L Part V Form990ScheduleLPartV (57 entries)

IdentifierIdentifierExplanationExplanation
Part IVA. Name of Interested Person
B. Relationship between interested person and the organization
C. Amount of Transaction
D. Description of Transaction
E. Sharing of Organization Revenues? (Y or N)
.
1. a - James Scibilia, M.D.
b - Board Director of Valley Medical Facilities
c - $0
d - James Scibilia is a board member of Tri-State Pediatric Associates, Inc. -
The listed for item C above represents payment by Valley Medical Facilities to Tri-State Pediatric Associates, Inc. for services rendered.
e - NO
.
2. a - Norman F. Mitry
b - Board Director of Valley Medical Facilities
c - $133,127
d - Norman F. Mitry is a board member of Heritage Valley Medical Group, Inc. -
The listed for item C above represents payment by Valley Medical Facilities to Heritage Valley Medical Group, Inc. for services rendered.
e - NO
.
3. a - Norman F. Mitry
b - Board Director of Valley Medical Facilities
c - $0
d - Norman F. Mitry is a board member of Tri-State Pediatric Associates, Inc. -
The listed for item C above represents payment by Valley Medical Facilities to Tri-State Pediatric Associates, Inc. for services rendered.
e - NO
.
4. a - Norman F. Mitry
b - Board Director of Valley Medical Facilities
c - $0
d - Norman F. Mitry is a board member of Tri-State Obstetrics & Gynecology Associates, Inc. -
The listed for item C above represents payment by Valley Medical Facilities to Tri-State Obstetrics & Gynecology Associates, Inc. for services rendered.
e - NO
.
5. a - Mary Kirsch, CPA
b - Board Director of Valley Medical Facilities
c - $0
d - Mary Kirsch, CPA is a Senior Financial Manager of Simio, LLC
of which Dennis Pedgen, another Board Member of Valley Medical
Facilities, owns more than 35%.
e - NO
.
6. a - Marcia Ferrero
b - Key Employee of Valley Medical Facilities
c - $3,476,950
d - Marcia Ferrero's spouse is a board member and full partner of Western Pennsylvania
Anesthesia Assoc. which Valley Medical Facilities pays for services rendered.
e - NO
.
7. a - Claudio Loffreda
b - Board Director of Valley Medical Facilities
c - $3,476,950
d - Claudio Loffreda is an employee of Western Pennsylvania Anesthesia
Association. The listed for item C above represents payment by
Valley Medical Facilities to Western Pennsylvania Anesthesia
Association, In.c for services rendered.
e - NO

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (117 entries)

IdentifierIdentifierExplanationExplanation
Pt VI, Line 2A. Name of Interested Person
B. Relationship between interested person and the organization
C. Amount of Transaction
D. Description of Transaction
E. Sharing of Organization Revenues? (Y or N)
1. a - James Scibilia, M.D.
b - Board Director of Valley Medical Facilities
c - $0
d - James Scibilia is a board member of Tri-State Pediatric Associates, Inc. -
The listed for item C above represents payment by Valley Medical Facilities to
Tri-State Pediatric Associates, Inc. for services rendered.
e - NO
2. a - Norman F. Mitry
b - Board Director of Valley Medical Facilities
c - $133,127
d - Norman Mitry is a board member of Heritage Valley Medical Group, Inc. -
The listed for item C above represents payment by Valley Medical Facilities to
Heritage Valley Medical Group, Inc. for services rendered.
e - NO
3. a - Norman F. Mitry
b - Board Director of Valley Medical Facilities
c - $0
d - Norman Mitry is a board member of Tri-State Pediatric Associates, Inc. -
The listed for item C above represents payment by Valley Medical Facilities to
Tri-State Pediatric Associates, Inc. for services rendered.
Form 990, Part IX, Line 24fTELEPHONE 873271. 873271. 0. 0. POSTAGE AND SHIPPING 291285. 291285. 0. 0. FEES, ADMIN AND OTHER 2945423. 2886269. 59154. 0. DUES 229454. 138817. 90637. 0. EQUIPMENT RENTAL AND MAINTENACE 8685438. 8685362. 76. 0.
e - NO
4. a - Norman F. Mitry
b - Board Director of Valley Medical Facilities
c - $0
d - Norman Mitry is a board member of Tri-State Obstetrics & Gynecology Associates, Inc.
The listed for item C above represents payment by Valley Medical Facilities to
Tri-State Obstetrics & Gynecology Associates, Inc. for services rendered.
e - NO
5. a - Mary Kirsch, CPA
b - Board Director of Valley Medical Facilities
c - $0
d - Mary Kirsch, CPA is a Senior Financial Manager of Simio, LLC
of which Dennis Pedgen, another board member of Valley
Medical Facilities, owns more than 35%.
e - NO
6. a - Marcia Ferrero
b - Key Employee of Valley Medical Facilities
c - $3,476,950
d - Marcia Ferrero's spouse is a board member and full partner of Western Pennsylvania
Anesthesia Assoc. which Valley Medical Facilities pays for services rendered.
e - NO
Pt VI, Line 2Effective January 1, 2012, Sewickley Valley Medical Group, Inc. (SVMG) merged with Tri-
State Medical Group, Inc. (TSMG) to become a single entity known as Heritage Valley
Medical Group, Inc. (HVMG). Concurrent with this change, the accounting year for HVMG
changed from a calendar year basis to a fiscal year beginning July 1 through June 30.
.
Pt VI, Line 6Valley Medical Facilities (VMF) is owned 100% by
Heritage Valley Health System (The System), its Parent Company. The
System has the right to participate in selected management decisions.
.
Pt VI, Line 7aVMF is owned 100% by Heritage
Valley Health System (The System), its Parent Company. The System has
the right to participate in selected management decisions.
.
Pt VI, Line 7bVMF is owned 100% by Heritage
Valley Health System (The System), its Parent Company. The System has
the right to participate in selected management decisions.
.
Pt VI, Line 11aA draft of the completed Form 990 and all
associated forms is made available electronically to all Board of
Directors Members and Senior Management for review and comment prior to
filing with the Internal Revenue Service (IRS). The Board of Directors
has delegated the responsibility for review and approval of the Form 990 to the
Finance Committee of the Board, which meets, reviews, and approves the
Form 990 prior to filing.
.
Pt VI, Line 12cCertain non-merit employees with job responsibilities
that provide an opportunity to influence business decisions are required
to sign the Conflict of Interest form annually. These Conflict of Interest
statements are reviewed annually by the Department Director and System
Director for Corporate Compliance to determine if a conflict exists.
Any potential conflicts are referred to the appropriate Vice President and
Human Resources to confirm and resolve the conflict.
For Merit Employees, Conflict of Interest statements are reviewed annually by
the Department Manager, Vice President or CEO. Any potential conflicts are
managed by the CEO.
Other Potentially Interested Parties, such as Board Members, Officers and
Highly Compensated employees sign a statement annually which affirms such
person has received a copy of the Conflict of Interest Policy, has read and
understands the policy, has agreed to comply with the policy, and
understands that the Organization is a charitable organization and that in
order to maintain its Federal Tax Exemption it must engage primarily in
activities which accomplish one or more of its tax exempt purposes. The
Chairperson of the Board reviews annually a summary of the disclosure
statements so that the Board members are familiar with potential conflicts.
.
Pt VI, Line 12cSection B Line 14- The Organization has a record retention policy which
provides for the retention of business and medical records, including destruction.
.
Pt VI, Line 15Compensation for the President/CEO and members of senior
management involved a review of the results of the Yaffe
& Company, Inc. 2011 Executive Compensation Report for Hospitals
& Systems, May 2011 with the Executive Evaluation and Compensation
Committee of the Board of Directors in December 2011. In
February of 2012 a representative from Mercer met with this
Committee and as part of the presentation, noted the salaries
were reasonable when compared to the market.
.
Pt VI, Line 19The Organization publishes condensed financial
statements for public use on its website www.heritagevalley.org.
Governing documents and policies, including conflicts of interest,
are made available upon request.
.
Pt VII, Col (E)Part VII Section A Estimate of Average Hours per week
devoted to related organizations. See attached Document
.
Pt XILine #5. Other changes in net assets. Changes in restricted net assets.
See Schedule D Part XI.
Pt XII, Line 2cPart XI, Line 2C - The Organization has a committee that assumes
responsibility for oversight of audit, review, or compilation of its
financial statement and selection of an independent accountant.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
HERITAGE VALLEY SEWICKLEY FOUNDATION
420 ROUSER ROADMOON TOWNSHIPPA15108251801533FUNDRAISINGPA501(c)311CNAfalse
HERITAGE VALLEY BEAVER FOUNDATION
420 ROUSER ROADMOON TOWNSHIPPA15108251441516FUNDRAISINGPA501(C)311CNAfalse
HERITAGE VALLEY HEALTH SYSTEM INC
1000 DUTCH RIDGE ROADBEAVERPA15009251441518PARENT SUPPORTING ORGPA501(C)311CNAfalse
VALLEY MEDICAL FACILITIES INC WORKERS COMPENSATION TRUST FUND
420 ROUSER ROADMOON TOWNSHIPPA15108251463381Provide Worker's Compensation BenefitsPA501(C)311CNAfalse

Form990 Schedule R Part IV Form990ScheduleRPartIV (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateType Of EntityTypeOfEntityPercentage OwnershipPercentageOwnershipAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityCountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountry
TRI-STATE OBSTETRICS & GYNECOLOGY
420 ROUSER ROADMOON TOWNSHIPPA15108251776052PHYSICIAN PRACTICEPAC0.00000
TRI-STATE PEDIATRIC ASSOCIATES INC
420 ROUSER ROADMOON TOWNSHIPPA15108251775950PHYSICIAN PRACTICEPAC0.00000
HERITAGE VALLEY MEDICAL GROUP INC
420 ROUSER ROADMOON TOWNSHIPPA15108251775949PHYSICIAN PRACTICEPAC0.00000
TRI-STATE GYNECOLOGY INC
420 ROUSER ROAD SUITE 201MOON TOWNSHIPPA15108841647473PHYSICIAN PRACTICEPAC0.00000
HERITAGE VALLEY HEALTH INSURANCE COMPANY
PROFESSIONAL LIABILITY CAPTIVEC0.00000PO BOX 1051GRAND CAYMANCJCJ
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
HERITAGE VALLEY SEWICKLEY FOUNDATION
c l520914FMV
HERITAGE VALLEY BEAVER FOUNDATION
c l1650680FMV
HERITAGE VALLEY HEALTH SYSTEM INC
r912395FMV
VALLEY MEDICAL FACILITIES INC WORKERS COMPENSATION TRUST FUND
q1200000FMV

Form990 Schedule R Part VII Form990ScheduleRPartVII (4 entries)

IdentifierIdentifierExplanationExplanation
Part IVEffective January 1, 2012, Sewickley Valley Medical Group, Inc. (SVMG) merged with Tri-
State Medical Group, Inc. (TSMG) to become a single entity known as Heritage Valley
Medical Group, Inc. (HVMG). Concurrent with this change, the accounting year for HVMG
changed from a calendar year basis to a fiscal year beginning July 1 through June 30.