2013-05-15T06:40:41-07:00 2012-06-30 DELOITTE TAX LLP 2500 ONE PPG PLACE PITTSBURGH PA 15222 990 2011-07-01 251801532 VALLEY MEDICAL FACILITIES INC VALL 4127416600 720 BLACKBURN ROAD SEWICKLEY PA 15143 BRYAN J RANDALL 4127416600 2013-05-01 true RUDY BILICH 4123387200 2011 2016-02-24 21:20:13Z BRYAN J RANDALL VICE PRESIDENT FINA 720 BLACKBURN ROAD SEWICKLEY PA 15143 457016871 false X www.heritagevalley.org X 1996 PA To improve the health and well-being of all people in the communities we serve. 21 17 3499 246 6178704 4511327 4228814 344681490 347210883 16389229 7530506 16243661 15724428 381825707 374694631 592275 594324 0 213372388 199748972 0 0 163980970 164281617 377945633 364624913 3880074 10069718 431023093 406050371 188130241 219904250 242892852 186146121 To improve the health and false false 356205384 346126148 THE 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. 1396922 1084735 SCHOOL OF NURSING TO PROMOTE AND PROVIDE SUPPORT TO THE HOSPITALS. 357602306 true false false true false false false false false true true true false false true true true true false false true false false false false false true true false true true true false false false false false false false true true true false false false false false true false false false true 137 0 true 3499 true true true false false false false false false false false false false false false false false X 21 17 true false false false true true true true true false true true true true true true true true true true false PA X FINANCE DEPARTMENT CO VALLEY MEDICA 4127416600 420 ROUSER ROAD SUITE 201 MOON TOWNSHIP PA 15108 X NORMAN F MITRY 40.00 X X X 539115 0 44481 RICHARD HOGAN MD 40.00 X 0 308931 33432 RICHARD KIM MD 2.00 X 0 0 0 JAMES SCIBILIA MD 40.00 X 0 370322 36383 LYNN GEORGE PHD 2.00 X 0 0 0 JOSEPH BECHERER 2.00 X 0 0 0 A GARY CHACE 2.00 X X 0 0 0 GR ORR III 2.00 X X 0 0 0 THOMAS JOHNSON ESQ 2.00 X 0 0 0 CLAUDIO LOFFREDA MD 2.00 X 0 0 0 DAVID MOTLEY 2.00 X 0 0 0 ALEXANDER VASILAKIS MD 40.00 X 0 526548 34541 TOM LEYDIG 2.00 X 0 0 0 DENNIS PEGDEN PHD 2.00 X 0 0 0 DAVID M RAFALKO MD 2 X JOHANNAH M ROBB CPA 2 X X SCOTT M ELSTE 2 X LAURA A VASSAMILLET 2 X GARRY HOGAN 2 X X MARY KIRSCH CPA 2 X THOMAS ARBOGAST ESQ 2 X JOHN LUELLEN MD 40 X 348452 41459 JOHN CINICOLA MD 40 X 420210 35158 DANIEL BROOKS MD 40 X 292660 38678 SHARON LOFTUS ESQ 40 X X 267559 24918 5239660 2389227 820214 106 true true false ALLSCRIPTS 24630 NETWORK PLACE CHICAGO IL 60673 Computer Professional Services 5047919 WESTERN PENNSYLVANIA ANESTHESIA ASSOC PO BOX 643483 PITTSBURGH PA 15264 Professional Services 3476950 OHIO VALLEY PERFUSION ASSOCIATES INC 628 SCOTT RIDGE RD HARMONY PA 16037 Professional Services 742426 EDGEWORTH DEVELOPMENT ASSOCIATES INC PO BOX 520 JOHNSTOWN PA 15907 Rent 588467 ADVACARE HOME SERVICES INC 200 VILLANI DRIVE SUITE 3009 BRIDGEVILLE PA 15017 Professional Services 582124 33 3942826 285988 4228814 All other Patient Payments 900099 170356298 354974 Medicare HMO Payments 900099 101542432 Medicare/Medicaid payments 900099 58878003 Medicaid HMO Payments 900099 16434150 347210883 3492568 3492568 86360178 82169731 152509 4190447 -152509 4037938 4037938 Sale of Drugs 900099 5790694 5790694 Nursing Tuition 900099 894391 894391 Six-Sigma Training 900099 33036 33036 9006307 1095640 7910667 15724428 374694631 348845940 6178704 15441173 594324 594324 5704230 0 5704230 0 151469855 150921883 547972 0 9520011 9520011 0 0 22656555 22656555 0 0 10398321 10245578 152743 0 258468 83853 174615 0 260440 260440 0 0 19505 0 19505 0 227748 227706 42 0 1325288 1325288 0 0 3440749 3440036 713 0 3970643 3920063 50580 0 474293 443157 31136 0 133655 133655 0 0 3401199 3401199 0 0 26697599 26697599 0 0 Medical and other Supplies 54451419 54405906 45513 0 other outside services 26527375 26381684 145691 0 drugs 15489940 15489940 0 0 Bad Debts 14578425 14578425 0 0 13024871 12875004 149867 0 364624913 357602306 7022607 0 2408532 5406794 4951181 5108633 261810 252474 34345834 39078150 6295147 6635486 8694627 8533067 438317675 274528598 166388403 163789077 161173087 140035609 45969354 36569476 535118 641605 431023093 406050371 44345448 44181873 68484757 67147739 10165125 10203610 65134911 98371028 188130241 219904250 X 228109944 171133804 8408274 8655317 6374634 6357000 242892852 186146121 431023093 406050371 X 10069718 -66816449 X X false true true X true true X 0 0 0 0 0 0 true true false false false true 19505 true 55185 false false 74690 false Pt II-B Line 1i Other 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. 284583000 4416000 -26958000 1087000 6712000 1280000 252962000 259195000 4906000 27943000 21000 5978000 1462000 284583000 240777000 4160000 28999000 21000 13230000 1490000 259195000 0.94100 0.02500 0.03400 true true true 2285807 2285807 141365786 78817831 62547955 1690934 593283 1097651 275171289 191586654 83584635 17803859 3530830 14273029 163789077 Interest in Assets Held by Foundations 9443861 F Other Investments 283574 F Commingled Funds 19626640 C Alternative Investments 7215401 C 36569476 Accrued pensions and other long term liabilities 98371028 Workers Comp Reserve Long Term 98371028 374694631 364624913 10069718 -7196866 843470 -60463088 -66816484 -56746766 371839089 -2194817 -2194817 374033906 660725 660725 374694631 364471263 364471263 153650 153650 364624913 Pt X Line #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 2d Loss on Bond Refunding Pt XIII Line 4b Other Adjustments: Restricted Fund Expenses Pt XII Line 4b Other Adjustments: Restricted Fund Income Pt XI Line 8 Pension obligation adjustment Pt V Line 4 Board 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 Central America Investments 7215000 7215000 7215000 true false true true true false Pt I Line 2 Valley Medical Facilities Inc. does not make grants outside the United States. true true X true X 300.00000 true X 450.00000 true true true false true true 7662295 7662295 0.02100 35086784 21336937 13749847 0.03770 42749079 21336937 21412142 0.05870 219761 169965 49796 0.00010 1428025 1184372 243653 0.00070 531480 380833 150647 0.00040 2179266 1735170 444096 0.00120 44928345 23072107 21856238 0.05990 3375 3375 0.00000 76170 76170 0.00020 113003 113003 0.00030 52271 52271 0.00010 244819 244819 0.00060 false 6026959 3013479 156670647 162291382 -5620735 X true true 2 1 HERITAGE VALLEY BEAVER

1000 DUTCH RIDGE ROAD BEAVER PA 15009

X X X X 2 HERITAGE VALLEY SEWICKLEY

720 BLACKBURN ROAD SEWICKLEY PA 15143

X X X HERITAGE VALLEY BEAVER 1 true X X X 09 true true false X X false true true 300 true 450 true X true true X true X true X X X X true X false false HERITAGE VALLEY SEWICKLEY 2 true X X X 09 true true false X X false true true 300 true 450 true X true true X true X true X X X X true X false false 12 BEAVER -CALCUTTA IMAGING & LAB SERVICES

48462 BELL SCHOOL ROAD SUITE B EAST LIVERPOOL OH 43920

Laboratory and Imaging BEAVER - HERITAGE VALLEY DIAGNOSTIC CENTER - ELLWOOD CITY

1677 STATE ROUTE 65 ELLWOOD CITY PA 16117

Diagnostic Center BEAVER - HERITAGE VALLEY DIAGNOSTIC CENTER - HOPEWELL

5000 INDUSTRIAL BOULEVARD ALIQUIPPA PA 15001

Diagnostic Center BEAVER - WOMEN'S HEALTH CENTER

200 PLEASANT DRIVE ALIQUIPPA PA 15001

Imaging Services BEAVER - FAMILY PRACTICE CENTER

1125 7TH AVENUE BEAVER FALLS PA 15010

Residency Program BEAVER - HERITAGE VALLEY SIGNATURE REHAB

1030 BEANER HOLLOW ROAD BEAVER PA 15009

Rehabilitation Services BEAVER - SIGNATURE REHAB - HOPEWELL

3000 INDUSTRIAL BLVD ALIQUIPPA PA 15001

Rehabilitation Services BEAVER - HERITAGE VALLEY BADEN - LAB (PHLEBOTOMY)

280 OHIO RIVER BLVD BADEN PA 15005

Laboratory Services SEWICKLEY - HERITAGE VALLEY HEALTH CENTER

935 THORN RUN ROAD MOON TWP PA 15108

Outpatient Surgery SEWICKLEY - HERITAGE VALLEY OPEN MRI AND LABORATORY DRAW SITE

ROBINSON PLAZA THREE SUITE 210B PAR PITTSBURGH PA 15208

Laboratory and Imaging SEWICKLEY- HERITAGE VALLEY REHABILITATION SERVICES - WEST ALLEGHENY SIGNATU

300 PENN LINCOLN DRIVE IMPERIAL PA 15126

Rehabilitation Services SEWICKLEY - HERITAGE VALLEY HEALTH SYSTEM EDGEWORTH SQUARE

111 HAZEL LANE SEWICKLEY PA 15143

Psychiatric Services Pt I Line 3c Part 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 6a Part 1 Line 6a See attached Community Benefit Report. Pt I Line 7g Part 1 Line 7g Family Medicine & Family Planning Clinic Subsidy Pt III Line 4 There 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 8 The 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 9b Within 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 2 The 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 3 The 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 4 Service 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 II Executive 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 6 Part 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 3 Community 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 7 It 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 19d Uninsured 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 4 Heritage Valley Sewickley Pt V Sec B 4 Heritage Valley Beaver Pt V Schedule 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. true 0 Tuition Reimbursement 31 140481 FMV N/A Educational Assistance 113 288193 FMV N/A Loan Forgiveness 4 12000 FMV N/A PHEAA/PELL Grants 77 153650 FMV N/A Pt I Line 2 Educational 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 2 Loan 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 2 Tuition 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 2 Pell 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. X X X X X true false false false false false false false false NORMAN F MITRY 490002 39690 9423 30055 569170 RICHARD HOGAN MD 288500 20431 22377 331308 JAMES SCIBILIA MD 369692 630 24448 394770 ALEXANDER VASILAKIS MD 499999 26549 20310 546858 JOHN LUELLEN MD 335568 12884 29858 378310 JOHN CINICOLA MD 380000 34440 5770 22473 442683 DANIEL BROOKS MD 275000 13365 4295 27811 320471 SHARON LOFTUS ESQ 250001 12150 5408 14412 281971 BRUCE E EDWARDS 235000 15228 1004 27414 278646 DAVID W CARLETON 223656 10935 3654 35573 273818 BRYAN J RANDALL 258077 16848 4139 27264 306328 KATHY HARLEY 184617 8991 4312 21514 219434 MARCIA FERRARO 174424 8505 13328 196257 LINDA HOMYK 159617 7776 3139 29477 200009 THOMAS PANGBURN MD 330726 27021 29856 387603 RONALD D LECKEY MD 294999 27195 29793 351987 MICHAEL BARTON MD 239265 51997 29737 320999 DAVID THIMONS DO 436627 9308 18729 464664 JUSTIN DOSCH MD 224066 15000 49239 27279 315584 ROSEMARY M NOLAN 148077 2490 150567 RICK BEAVER 185001 8991 4230 12216 210438 GEORGE BRETT III MD 130309 130309 JAMES MEDITCH MD 259831 25137 284968 PETER MANOLUKAS DO 14511 14511 JOHN CY WRIGHT MD 480000 3275 12122 495397 J ZDUNEK DO 200000 95500 10149 305649 Pt I Line 4a Former COO was paid a severance package. THE HOSPITAL AUTHORITY OF THE COUNTY OF BEAVER 251247712 074863FX4 2012-01-19 72496375 Refund Issue Dated 08/4/1998 false false false 3225000 72496375 840042 71656333 true false true true false false false false false false SEE SUPPLEMENTAL INFORMATION see supplemental information see supplemental information false Part IV A. 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 Pt VI, Line 2 A. 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 24f TELEPHONE 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 2 Effective 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 6 Valley 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 7a 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 7b 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 11a A 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 12c Certain 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 12c Section 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 15 Compensation 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 19 The 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 XI Line #5. Other changes in net assets. Changes in restricted net assets. See Schedule D Part XI. Pt XII, Line 2c Part 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. HERITAGE VALLEY SEWICKLEY FOUNDATION 420 ROUSER ROAD MOON TOWNSHIP PA 15108 251801533 FUNDRAISING PA 501(c)3 11C NA false HERITAGE VALLEY BEAVER FOUNDATION 420 ROUSER ROAD MOON TOWNSHIP PA 15108 251441516 FUNDRAISING PA 501(C)3 11C NA false HERITAGE VALLEY HEALTH SYSTEM INC 1000 DUTCH RIDGE ROAD BEAVER PA 15009 251441518 PARENT SUPPORTING ORG PA 501(C)3 11C NA false VALLEY MEDICAL FACILITIES INC WORKERS COMPENSATION TRUST FUND 420 ROUSER ROAD MOON TOWNSHIP PA 15108 251463381 Provide Worker's Compensation Benefits PA 501(C)3 11C NA false TRI-STATE OBSTETRICS & GYNECOLOGY 420 ROUSER ROAD MOON TOWNSHIP PA 15108 251776052 PHYSICIAN PRACTICE PA C 0.00000 TRI-STATE PEDIATRIC ASSOCIATES INC 420 ROUSER ROAD MOON TOWNSHIP PA 15108 251775950 PHYSICIAN PRACTICE PA C 0.00000 HERITAGE VALLEY MEDICAL GROUP INC 420 ROUSER ROAD MOON TOWNSHIP PA 15108 251775949 PHYSICIAN PRACTICE PA C 0.00000 TRI-STATE GYNECOLOGY INC 420 ROUSER ROAD SUITE 201 MOON TOWNSHIP PA 15108 841647473 PHYSICIAN PRACTICE PA C 0.00000 HERITAGE VALLEY HEALTH INSURANCE COMPANY PO BOX 1051 GRAND CAYMAN CJ PROFESSIONAL LIABILITY CAPTIVE CJ C 0.00000 false false true false false false false false true false false true true true true true true true HERITAGE VALLEY SEWICKLEY FOUNDATION c l 520914 FMV HERITAGE VALLEY BEAVER FOUNDATION c l 1650680 FMV HERITAGE VALLEY HEALTH SYSTEM INC r 912395 FMV VALLEY MEDICAL FACILITIES INC WORKERS COMPENSATION TRUST FUND q 1200000 FMV Part IV Effective 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.