HIGHMARK HEALTH: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
HIGHMARK HEALTH (EIN 25-1875178)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-07-17
IRS object ID
201311989349300426
Schema version
2011v1.5
Note
A later return for the same period supersedes this one.
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)
Timestamp2013-07-17T15:34:28-05:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1GRANT THORNTON LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12001 MARKET STREET SUITE 3100AddressLine1
CityPHILADELPHIACity
StatePAState
ZIP Code19103ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN251875178EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Alle-Kiski Medical CenterBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% MATTHEW PETERSONInCareOfName
Name ControlALLENameControl
Phone4123306022Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1C/O Tax Dept Two Allegheny CenterAddressLine1
CityPittsburghCity
StatePAState
ZIP Code15212ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMATTHEW PETERSONName
TitleTREASURERTitle
Date Signed2013-07-16DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone2155614200Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Amended ReturnXAmendedReturn
Name Of Principal Officer PersonMatthew PetersonNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1Two Allegheny Center 11th FlAddressLine1
CityPittsburghCity
StatePAState
ZIP Code15212ZIPCode
FieldValueIRS element (for citing)
Gross Receipts164755963GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.wpahs.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2000YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionSee Form 990, Page 2, Part III, Question 1ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees1264TotalNbrEmployees
Total Nbr Volunteers273TotalNbrVolunteers
Total Gross UBI4734976TotalGrossUBI
Net Unrelated Business Txbl Income-943664NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year75653ContributionsGrantsCurrentYear
Program Service Revenue Prior Year122312091ProgramServiceRevenuePriorYear
Program Service Revenue CY123807673ProgramServiceRevenueCY
Investment Income Prior Year1211579InvestmentIncomePriorYear
Investment Income Current Year1031554InvestmentIncomeCurrentYear
Other Revenue Prior Year5670227OtherRevenuePriorYear
Other Revenue Current Year4877521OtherRevenueCurrentYear
Total Revenue Prior Year129193897TotalRevenuePriorYear
Total Revenue Current Year129792401TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year7175GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1168GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year53384921SalariesEtcPriorYear
Salaries Etc Current Year55223034SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year66414619OtherExpensePriorYear
Other Expenses Current Year68225339OtherExpensesCurrentYear
Total Expenses Prior Year119806715TotalExpensesPriorYear
Total Expenses Current Year123449541TotalExpensesCurrentYear
Revenues Less Expenses Prior Year9387182RevenuesLessExpensesPriorYear
Revenues Less Expenses CY6342860RevenuesLessExpensesCY
Total Assets BOY86913877TotalAssetsBOY
Total Assets EOY92939334TotalAssetsEOY
Total Liabilities BOY97223681TotalLiabilitiesBOY
Total Liabilities EOY94485665TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-10309804NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-1546331NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionALLE-KISKI MEDICAL CENTER IS AN ORGANIZATION DEFINED BY OUR TALENTED PEOPLE. AN ORGANIZATION COMMITTED TO EXCELLENCE; AN ORGANIZATION WITH ONE PURPOSE AND ONE MISSION. OUR ONE PURPOSE IS TO IMPROVE THE HEALTH OF THE PEOPLE IN THE WESTERN PENNSYLVANIA REGION. OUR ONE MISSION IS TO PRACTICE MEDICINE, EDUCATE AND CONDUCT RESEARCH AS AN INTEGRATED TEAM OF PHYSICIANS, NURSES AND SUPPORT PROFESSIONALS WHO ARE COMMITTED TO IMPROVING THE HEALTH OF OUR PATIENTS.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense16663307Expense
Grants0Grants
Revenue16871605Revenue
DescriptionThe purpose of Alle-Kiski Medical Center is to improve the health of the people in Western Pennsylvania. In order to accomplish this mission, Alle-Kiski Medical Center provides surgical procedures to individuals in need of medical treatment.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense15679007Expense
Grants0Grants
Revenue15852840Revenue
DescriptionThe purpose of Alle-Kiski Medical Center is to improve the health of the people in Western Pennsylvania. In order to accomplish this mission, Alle-Kiski Medical Center provides cardiovascular services to those individuals in need of medical treatment.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense7972619Expense
Grants0Grants
Revenue7194947Revenue
DescriptionThe purpose of Alle-Kiski Medical Center is to improve the health of the people in Western Pennsylvania. In order to accomplish this mission, Alle-Kiski Medical Center provides behavioral health services to those individuals in need of medical treatment.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense70418928Expense
Grants1168Grants
Revenue83888283Revenue
DescriptionOther Medical Services Provided To Our PatientsDescription
FieldValueIRS element (for citing)
Total Of Other Program Service Exp70418928TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt1168TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev83888283TotalOfOtherProgramServiceRev
Total Program Service Expense110733861TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096138NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1264NumberOfEmployees
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
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
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
Own WebsiteXOwnWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMATTHEW PETERSONNamePerson
Telephone Number4123306005TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1TWO ALLEGHENY CENTER 11TH FLOORAddressLine1
CityPittsburghCity
StatePAState
ZIP Code15212ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (33 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Russell Evans
Chair1.0XX000
Ruth Becker
Director1.0X000
David Bonvenuto
Director1.0X000
Jason Ross
Director1.0X000
Russell Livingston
Director1.0X000
Ginger Taylor
Director1.0X000
Jerry Taylor MD
Ex Officio Director1.0X000
Janis Evans
Director1.0X000
John Balacko MD
Director1.0X04827050
Hadi Firoz MD
Director1.0X02448200
Ned Laubacher
Hospital President & CEO40.0XX03583500
John Isherwood
Ex Officio Director1.0X000
Diane Dismukes
Health System President & CEO1.0XX07396380
Emanual Dinatale
Ex-Officio Director1.0X000
Roy Santarella
Treasurer1.0X09718900
Jodi Hirsch
Assistant Secretary1.0X02015600
Robert Brandfass
Secretary1.0X04365680
David Kiehn
Assistant Treasurer1.0X05432180
Matthew Peterson
Treasurer1.0X01779700
Michael Sirott
Assistant Secretary1.0X0648480
Michael Harlovic
Sr. VP and Chief Oper. Officer40.023415300X
George Sandora
Vice President of Finance40.001606750X
William Englert
VP - Business Development40.016249600X
Susan Manzi MD
Chair- System Dept of Medicine1.004860140X
Janet Boehm
Registered Nurse40.012530800X
Walter Hoover
Physician40.013639700X
Nancy Kantorski
Pharmacist40.011146800X
Diane Bowser
Pharmacist40.011541700X
Mary Wasilowski
Pharmacist40.011132600X
Christopher Olivia MD
Health System President & CEO041079610X
Dawn Gideon
Ex Officio Director05208670X
Thomas Albanesi
Assistant Treasurer03175800X
Judy Hlafcsak
Secretary02589180X
FieldValueIRS element (for citing)
Total Reportable Comp From Org996565TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs10073582TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K11NumberIndividualsGT100K
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
Valentour English Bodnar Howell
470 Washington RoadPITTSBURGHPA15228Architect Services244949
Clean Care
PO Box 40330PITTSBURGHPA15201Linen Services470156
Emergency Medicine Physician -Alle-
4535 Dressler RoadCANTONOH44718Emergency Med. Care173000
Laser Technology Services Ltd
1009 Merchant StreetAMBRIDGEPA15003Laser Service174400
Ohio Mobile Lithotripsy LLC
PO Box 714774COLUMBUSOH432714774Lithotripsy Service158600
FieldValueIRS element (for citing)
Number Of Contractors GT100 K8NumberOfContractorsGT100K
Government Grants70653GovernmentGrants
All Other Contributions5000AllOtherContributions
Total Contributions75653TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT SERVICE REVENUEDescription
Business Code621500BusinessCode
Total Revenue Column123807673TotalRevenueColumn
Related Or Exempt Function Income119615021RelatedOrExemptFunctionIncome
Unrelated Business Revenue4192652UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Program Service Revenue123807673TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column569685TotalRevenueColumn
Exclusion$569,685ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real887556Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real887556Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column887556TotalRevenueColumn
Unrelated Business Revenue542324UnrelatedBusinessRevenue
Exclusion$345,232ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities35424311Securities
Other1120Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities34963562Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities460749Securities
Other1120Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column461869TotalRevenueColumn
Exclusion$461,869ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
SCHOOL OF NURSING TUITION62111015480921548092
CAFETERIA SALES621110786521786521
HIGMARK QUALITY INCENTIVE AWARD621110749000749000

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column906352TotalRevenueColumn
Related Or Exempt Function Income906352RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue3989965TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column129792401TotalRevenueColumn
Related Or Exempt Function Income123604986RelatedOrExemptFunctionIncome
Unrelated Business Revenue4734976UnrelatedBusinessRevenue
Exclusion$1,376,786ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total1168Total
Program Services1168ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total424855Total
Program Services361127ProgramServices
Management And General63728ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total43593812Total
Program Services37054740ProgramServices
Management And General6539072ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1794403Total
Program Services1525243ProgramServices
Management And General269160ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total6269753Total
Program Services5329290ProgramServices
Management And General940463ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3140211Total
Program Services2669179ProgramServices
Management And General471032ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total518694Total
Management And General518694ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total104910Total
Program Services94419ProgramServices
Management And General10491ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total145999Total
Management And General145999ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total4605066Total
Program Services4144559ProgramServices
Management And General460507ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total9100Total
Program Services8190ProgramServices
Management And General910ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total589034Total
Program Services530131ProgramServices
Management And General58903ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3481370Total
Program Services3133233ProgramServices
Management And General348137ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total91850Total
Program Services82665ProgramServices
Management And General9185ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total18463Total
Program Services16617ProgramServices
Management And General1846ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total3497699Total
Program Services3425017ProgramServices
Management And General72682ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total14672810Total
Program Services13205529ProgramServices
Management And General1467281ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total6476737Total
Program Services5829063ProgramServices
Management And General647674ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1136381Total
Program Services1136381ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PATIENT CARE COSTS1555251115552511
BAD DEBT91698589169858
REPAIR AND MAINTENANCE38904613501415389046
PA ACT 49 - QUALITY CARE18154681815468

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2448928Total
Program Services2148058ProgramServices
Management And General300870ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total123449541Total
Program Services110733861ProgramServices
Management And General12715680ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY4255BOY
EOY4255EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY16875365BOY
EOY21841961EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY48499BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY10423847BOY
EOY12779072EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1480293BOY
EOY1447304EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY710046BOY
EOY742999EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis136477028LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec107218386LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY29995846BOY
EOY29258642EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY21645200BOY
EOY22893369EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY126252BOY
EOY130306EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY2724021BOY
EOY2257047EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2880253BOY
EOY1584379EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY86913877BOY
EOY92939334EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY9912113BOY
EOY9344001EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY3178283BOY
EOY3062589EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY65648819BOY
EOY64630994EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY3126834BOY
EOY3817245EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY15357632BOY
EOY13630836EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY97223681BOY
EOY94485665EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-10418130BOY
EOY-1725440EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY108326BOY
EOY179109EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-10309804BOY
EOY-1546331EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY86913877BOY
EOY92939334EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses6342860ReconcilationRevenueExpenses
Reconcilation Other Changes2420613ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Org Belongs To Affiliated GroupXOrgBelongsToAffiliatedGroup

Total Grassroots Lobbying TotalGrassrootsLobbying

FieldValueIRS element (for citing)
Filing Organizations Totals0FilingOrganizationsTotals
Affiliated Group Totals0AffiliatedGroupTotals

Total Direct Lobbying TotalDirectLobbying

FieldValueIRS element (for citing)
Filing Organizations Totals19274FilingOrganizationsTotals
Affiliated Group Totals225684AffiliatedGroupTotals

Total Lobbying Expenditures TotalLobbyingExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals19274FilingOrganizationsTotals
Affiliated Group Totals225684AffiliatedGroupTotals

Other Exempt Purpose Expenditures OtherExemptPurposeExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals123235395FilingOrganizationsTotals
Affiliated Group Totals1698163316AffiliatedGroupTotals

Total Exempt Purpose Expenditures TotalExemptPurposeExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals123254669FilingOrganizationsTotals
Affiliated Group Totals1698389000AffiliatedGroupTotals

Lobbying Nontaxable LobbyingNontaxableAmount

FieldValueIRS element (for citing)
Filing Organizations Totals1000000FilingOrganizationsTotals
Affiliated Group Totals1000000AffiliatedGroupTotals

Grassroots Nontaxable GrassrootsNontaxableAmount

FieldValueIRS element (for citing)
Filing Organizations Totals250000FilingOrganizationsTotals
Affiliated Group Totals250000AffiliatedGroupTotals
FieldValueIRS element (for citing)
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx

Lobbying Nontaxable Amount2 LobbyingNontaxableAmount2

FieldValueIRS element (for citing)
Current Year Minus31000000CurrentYearMinus3
Current Year Minus21000000CurrentYearMinus2
Current Year Minus11000000CurrentYearMinus1
Current Year1000000CurrentYear
Total4000000Total
FieldValueIRS element (for citing)
Lobbying Ceiling$6,000,000LobbyingCeilingAmount

Total Lobbying Expenditures2 TotalLobbyingExpenditures2

FieldValueIRS element (for citing)
Current Year Minus3585102CurrentYearMinus3
Current Year Minus2418483CurrentYearMinus2
Current Year Minus1424588CurrentYearMinus1
Current Year225684CurrentYear
Total1653857Total

Grassroots Nontaxable Amount2 GrassrootsNontaxableAmount2

FieldValueIRS element (for citing)
Current Year Minus3250000CurrentYearMinus3
Current Year Minus2250000CurrentYearMinus2
Current Year Minus1250000CurrentYearMinus1
Current Year250000CurrentYear
Total1000000Total
FieldValueIRS element (for citing)
Grassroots Ceiling$1,500,000GrassrootsCeilingAmount

Grassroots Lobbying Expenditures GrassrootsLobbyingExpenditures

FieldValueIRS element (for citing)
Current Year Minus30CurrentYearMinus3
Current Year Minus20CurrentYearMinus2
Current Year Minus10CurrentYearMinus1
Current Year0CurrentYear
Total0Total

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierLobbying ExpendituresIdentifier
Return ReferenceForm 990, Schedule C, Page 2, Part II-A, Line 1b, Column (a)ReturnReference
ExplanationAlle-Kiski Medical Center (AKMC) has made the IRC Section 501(h) election. AKMC has not made any political expenditures and no direct lobbying expenditures. AKMC is a member of the West Penn Allegheny Health System (WPAHS). WPAHS employs an Executive Vice President for External Affairs to lobby issues of importance to WPAHS and all of its members. WPAHS also elected to engage the services of outside consultants to assist us in lobbying issues of importance. The lobbying expenditures of $19,274 attributed to AKMC on Schedule C, Page 2, Part II-A reflect expenditures allocated to AKMC from WPAHS and do not reflect direct expenditures made by AKMC.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance108326BeginningOfYearBalance
Contributions70653Contributions
Investment Earnings Or Losses130InvestmentEarningsOrLosses
End Of Year Balance179109EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance108131BeginningOfYearBalance
Investment Earnings Or Losses195InvestmentEarningsOrLosses
End Of Year Balance108326EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance106555BeginningOfYearBalance
Contributions968Contributions
Investment Earnings Or Losses608InvestmentEarningsOrLosses
End Of Year Balance108131EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance102387BeginningOfYearBalance
Contributions2760Contributions
Investment Earnings Or Losses1408InvestmentEarningsOrLosses
End Of Year Balance106555EndOfYearBalance
FieldValueIRS element (for citing)
Term Endowment EOY Balance1.00000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis27912OtherCostOrOtherBasis
Book Value27912BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis85104994OtherCostOrOtherBasis
Depreciation65350690Depreciation
Book Value19754304BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis564796OtherCostOrOtherBasis
Depreciation450100Depreciation
Book Value114696BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis44561687OtherCostOrOtherBasis
Depreciation38774726Depreciation
Book Value5786961BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis6217639OtherCostOrOtherBasis
Depreciation2642870Depreciation
Book Value3574769BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings29258642TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
ACCRUED PENSION COSTS$11,324,860
THIRD PARTY SETTLEMENTS$1,299,351
ASBESTOS RETIREMENT OBLIGATION$78,872
DUE TO AFFILIATED ORGANIZATIONS$927,753
FieldValueIRS element (for citing)
Total Of Amounts13630836TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
AKMC Inclusion In The Consolidated Audit of WPAHSForm 990, Schedule D, Part X Question 2, Part XII and XIIIAlle-Kiski Medical Center does not receive its own independent audit. It is a member of a regional healthcare system named West Penn Allegheny Health System. West Penn Allegheny Health System receives a consolidated audit that includes the operations of Alle-Kiski Medical Center. The following analysis represents the reconciliation between the Alle-Kiski Medical Center financial statement net income and the net income as reported on Form 990, Page 1, line 19: Net Income Per Financial Statements $6,545,516 Plus: Income Reclassified From Restricted Net Assets on the Financial Statements to Unrestricted Revenue on Form 990 70,783 Less: Unrealized Gain on Investments reflected as current year gain on the financial statements reclassified through net assets on Form 990 (273,439) ___________ Net Income Per Form 990 $6,342,860 The following is the footnote to the audited consolidated financial statements of the West Penn Allegheny Health System for FASB ASC 740: WPAHS adopted Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) 740, Income Taxes, which clarifies the accounting for uncertainty in income taxes recognized in an enterprise's financial statements. FASB ASC 740 prescribes a more-likely than-not recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken or expected to be taken. Under FASB ASC 740, tax positions will be evaluated for recognition, derecognition, and measurement using consistent criteria and will provide more information about the uncertainty in income tax assets and liabilities. Based on an analysis prepared by WPAHS, it was determined that the application of FASB ASC 740 had no material effect on the recorded assets and liabilities of WPAHS.
Intended Use of the Organization Endowment FundsSchedule D, Page 2, Part V, Line 4The intended use of Alle-Kiski Medical Center term endowments are for but not exclusive to: capital improvements, research, education, departmental needs, operating efficiencies, and overall patient care.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense390329TotalCommunityBenefitExpense
Net Community Benefit Expense390329NetCommunityBenefitExpense
Percent Of Total Expense0.00320PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense11504037TotalCommunityBenefitExpense
Direct Offsetting Revenue6889557DirectOffsettingRevenue
Net Community Benefit Expense4614480NetCommunityBenefitExpense
Percent Of Total Expense0.03740PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense11894366TotalCommunityBenefitExpense
Direct Offsetting Revenue6889557DirectOffsettingRevenue
Net Community Benefit Expense5004809NetCommunityBenefitExpense
Percent Of Total Expense0.04060PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense514881TotalCommunityBenefitExpense
Net Community Benefit Expense514881NetCommunityBenefitExpense
Percent Of Total Expense0.00420PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense3588810TotalCommunityBenefitExpense
Direct Offsetting Revenue3560606DirectOffsettingRevenue
Net Community Benefit Expense28204NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense187860TotalCommunityBenefitExpense
Direct Offsetting Revenue159167DirectOffsettingRevenue
Net Community Benefit Expense28693NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense8665TotalCommunityBenefitExpense
Net Community Benefit Expense8665NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense4300216TotalCommunityBenefitExpense
Direct Offsetting Revenue3719773DirectOffsettingRevenue
Net Community Benefit Expense580443NetCommunityBenefitExpense
Percent Of Total Expense0.00470PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense16194582TotalCommunityBenefitExpense
Direct Offsetting Revenue10609330DirectOffsettingRevenue
Net Community Benefit Expense5585252NetCommunityBenefitExpense
Percent Of Total Expense0.04530PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense9780TotalCommunityBuildingExpense
Net Community Building Expense9780NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense358429TotalCommunityBuildingExpense
Net Community Building Expense358429NetCommunityBuildingExpense
Percent Of Total Expense0.00290PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense368209TotalCommunityBuildingExpense
Net Community Building Expense368209NetCommunityBuildingExpense
Percent Of Total Expense0.00300PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$2,403,420BadDebtExpenseAmount
Amount Attributable To901624AmountAttributableTo
Amount Reimbursed By Medicare18833876AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare19845976CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-1012100MedicareSurplusOrShortfall

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 Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Alle-Kiski Medical CenterBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11301 Carlisle StreetAddressLine1
CityNatrona HeightsCity
StatePAState
ZIP Code15065ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Alle-Kiski Medical CenterBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent200.FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent400.FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Collection ActivitiestrueCollectionActivities
Report To Credit AgencyXReportToCreditAgency
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargestrueGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities7NumberOfOtherFacilities

Other Facilities OtherFacilities (7 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
Vandergrift Outpatient Care Center
244 Longfellow StreetVandergriftPA15690Outpatient Care Center
Citizens Ambulatory Care Center
651 Fourth AvenueNew KensingtonPA15065Ambulatory Care Center
AVH Outpatient Physical Therapy
1620 Pacific AvenueNatrona HeightsPA15065Physical Therapy
Allegheny Valley Hospital Prolab
1620 Pacific AvenueNatrona HeightsPA15065Laboratory Services
Allegheny Valley Hospital Prolab
2692 Leechburg RoadLower BurrellPA15068Laboratory Services
Destination Wellness
590 Pittsburgh Mills CircleTarentumPA15084General Health and Wellness
AKMC Radiological Imaging
2801 Freeport RoadNatorna HeightsPA15065Radiological Imaging

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Bad Debt Expense Financial Statement Footnote and Costing MethodologySchedule H, Part III, Question 4Alle-Kiski Medical Center does not issue separate audited financial statements and therefore a footnote does not exist. Bad Debt expense is accounted for on a charge basis in our internal financial statements. A cost to charge ratio is applied to the internal figures to convert the charge to cost. It is the opinion of Alle-Kiski Medical Center management that because patients are often reluctant to complete the required charity care paperwork that an unquantifiable amount of charity care results in bad debt. Thus, it is our opinion that bad debt expense can be considered a justifiable component of charity care.
Medicare Shortfall as a Community Benefit and Costing MethodologySchedule H, Part III, Question 8Alle-Kiski Medical Center receives overall reimbursement from medicare less than the cost of the services provided. As such, we consider the shortfall a community benefit. The source used to determine the amount reported on line 6 is the Medicare Cost Report.
Collection Practices For Patients Who Qualify For Financial AssistanceSchedule H, Part III, Question 9bPatients that qualify for charity care or financial assistance are provided with an approval letter with the effective dates for the assistance. At any time the individual presents for services within a 90 day span of approval, they show the letter and will be registered as a charity care case. Charity care cases are designated in the internal computerized systems with unique plan codes that prevent billing to the patient. Reports are run to capture the patient accounts registered with the charity care plan codes so they can be written off to charity care.
Charges For Medical CareSchedule H, Part V, Line 19Alle-Kiski Medical Center offers uninsured patients a fifty percent (50%) discount on total gross charges to all hospital charges. The intent of the discount is to standardize charging practices for covered and non covered patients. The discount is offered during patient contact for elective/ urgent (non cosmetic) procedures during the financial counseling process, as well as during the patient statement cycle process for services provided (including Emergency services.) Patient statements are clearly marked with the uninsured discount, reducing the 'amount owed' of the gross charges. An uninsured discount of 50% is applied to the patient account either at the time of payment or prior to transferring the account to bad debt upon conclusion of the routine four statement cycle, for any unpaid balances.
Charges Equal To Gross Charges For Patient ServicesSchedule H, Part V, Line 21The facility offers a variety of procedures. For elective and non medically emergent procedures not covered by health plans, individual fee schedules are published and communicated prior to services. Patients are contacted in advance of the procedure by financial counselors and are required to pay for services in full based on the fee schedule. The patient is required to pay the hospital fee schedule for the technical component and the physician for the professional services rendered.
Health Needs AssessmentSchedule H, Part VI, Line 2Alle-Kiski Medical Center management and staff utilize multiple strategies to continually monitor and assess the health care needs of the communities it serves. One approach to assessing needs involves surveying community members about health needs related to national and state health goals. Alle-Kiski Medical Center also acts on expressed community needs by responding to direct community requests for health screenings, outreach events and other health-related activities and by maintaining longstanding programs that are well attended and positively evaluated by community participants. In addition, Alle-Kiski Medical Center gathers community input through participation in area rotaries, chambers of commerce, through partnerships with community organizations and other community engagement activities. Another means is through reviewing and taking appropriate actions on feedback gathered from the following sources: routine market assessments; patient and family satisfaction surveys; Press Ganey surveys; patient, patient family and staffs' suggestions for improving patient safety; medical staff input and physician surveys. In addition to the ongoing community health monitoring and assessment, Alle-Kiski Medical Center is actively working towards a formal community health needs assessment (CHNA) that will be completed for the year ending June 30, 2013. This formal needs assessment will have the findings published and available to the general public as well as an implementation strategy adopted by the Board of Directors. The needs assessment will involve systematically analyzing demographic and other health-related data, considering local, state and national health goals, understanding existing community health resources and programs, as well as engaging and actively soliciting input from community partners and community members with special knowledge of public health. It is expected that the AKMC Board of Directors will approve and implement the CHNA plan prior to June 30, 2013.
Patient Education For Eligibility For AssistanceSchedule H, Part VI, Line 3Alle-Kiski Medical Center displays signage in various patient Admission, Registration and Emergency Department areas that alerts that patient to Account Assistance program availability and contact information. During the preservice process, patients are evaluated to determine financial assistance options. Alle-Kiski Medical Center offers the "Account Assistance Program" which consists of application assistance for governmental eligibility, Charity Care application completion and submission support, as well as uninsured provisions. Account Assistance summaries are available on the West Penn Allegheny Health system website www.wpahs.org under the link titled, "Care for Uninsured" are available to the public. The Charity Care application, as well as, a Medical Assistance check list is available for patients who wish to self-apply. In addition to the documents, toll free telephone numbers regarding Account Assistance, charity and/or other financial inquiries are available. The website also contains a copy of the brochure that summarizes the Account Assistance program, as well as provides various governmental and internal numbers to patients seeking additional support. Alle-Kiski Medical Center also provides on-site support through Financial Counselor staff who are available to work with patient walk in's. Financial Counselors work directly with the patients as well as designated agency support regarding qualifying patients for Medical Assistance. Both week day and weekend coverage is available to the patients, as well as field support needed for post discharge follow up needed for application submission. The above support is available at no charge to the patient.
Community Served InformationSchedule H, Part VI, Line 4Alle-Kiski Medical Center, located in Natrona Heights Pennsylvania, provides health care services to residents of Allegheny, Armstrong, Beaver and Butler Counties. Located approximately 20 miles outside of Pittsburgh, Natrona Heights has approximately 10,500 residents. Allegheny County consists of approximately 1,227,000 residents living in a land area of approximately 730 square miles. The median housing value in Allegheny County is $118,700. Armstrong County consists of approximately 69,000 residents living in a land area of approximately 654 square miles. The median housing value in Armstrong County is $91,600. Beaver County consists of approximately 171,000 residents living in a land area of approximately 434 square miles. The median housing value in Beaver County is $113,600. Butler County consists of approximately 185,000 residents living in a land area of approximately 789 square miles. The median housing value in Butler County is $162,900. Together, Allegheny, Armstrong, Beaver and Bulter Counties form the primary service area for Alle-Kiski Medical Center.
Promotion of Community HealthSchedule H, Part VI, Line 5The Alle-Kiski Medical Center (AKMC) Emergency Department cares for the community by operating 24 hours a day, 7 days a week with highly skilled and trained emergency medicine physicians and nurses. The Emergency Department is open to all individuals regardless of their ability to pay. The emergency response capabilities of AKMC are provided in conjunction with Alle-Kiski Paramedic Unit for Life Support Emergency Response (AKPULSER), a paramedic response unit and a separate 501(c)(3) organization. AKMC staffs the emergency department physicians who provide medical command to the AKPULSER ambulance crew in the field. Our emergency response service has been designated as the primary 911 responder for the greater Alle-Kiski Valley Service Area. The voting members of the AKMC Board of Directors consist of a majority of independent community members without personal financial ties to the hospital or any of its affiliated organizations.
Affiliated Healthcare SystemSchedule H, Part VI, Line 6West Penn Allegheny Health System (WPAHS) is comprised of some of the oldest and best-known names in health care in western Pennsylvania. From their inception, the system's hospitals have been in the vanguard of patient care, medical research and health sciences education. Comprised of two tertiary and three community hospitals, WPAHS includes Allegheny General Hospital and The Western Pennsylvania Hospital, both in Pittsburgh; Alle-Kiski Medical Center in Natrona Heights; Canonsburg General Hospital in Canonsburg; and The Western Pennsylvania Hospital - Forbes Regional Campus in Monroeville. Offering a comprehensive range of medical and surgical services, the hospitals serve Pittsburgh and the surrounding five-state areas, house nearly 1,600 beds and employ more than 11,000 people. Together, the WPAHS hospitals admit nearly 56,000 patients, log over 164,000 emergency visits and deliver more than 3,800 newborns each year. Combined, the hospitals are among the leaders in percentages of total surgeries, cardiac surgeries, neurosurgeries and cardiac catheterization procedures performed throughout the region. Through the West Penn Allegheny Health System, Alle-Kiski Medical Center (AKMC) is able to ensure that area residents have access to a complete continuum of health care services. Also, through appropriate integration across the system, both clinically and operationally, the hospital is able to remain a high-quality, low-cost provider with linkages to the latest medical research and advanced technology. AKMC's main campus is in Natrona Heights. The 228-bed hospital serves as AKMC's inpatient facility and offers a broad spectrum of programs, including medical and surgical services, inpatient psychiatric care and geriatric psychiatric care, cardiology and orthopaedics. Virtually all outpatient services are available on the hospital campus. AKMC's Ambulatory Care Center presents a wide array of outpatient programs, including medical oncology services, laboratory studies, cardiac diagnostics and radiology services, such as routine X-rays, CT scans, mammography and ultrasound. In addition, the site is the home of the Joslin Diabetes Center Affiliate at AKMC and an Urgent Care Center for the treatment of minor medical emergencies.
State Filing of Community Benefit ReportSchedule H, Part VI, Line 7Alle-Kiski Medical Center files the community benefit report with the State of Pennsylvania as part of our obligation to furnish the State of Pennsylvania with a copy of the IRS Form 990 and related schedules.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
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 (17 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
John Balacko MD
0448917033236055209800010412050291700
Hadi Firoz MD
02445900002300914309483026344600
Christopher Olivia MD
0677905025000000930056018848000105530600331403507618
Ned Laubacher
030992204806803600980009829037797900
Michael Harlovic
205037028670044609594081450251892000
Roy Santarella
06057270171437019472601301114011650022846540117174
Thomas Albanesi
0509740002666060435780644503676030239282
Judy Hlafcsak
00000258918017210024002763680258918
Jodi Hirsch
018588201550001780809101205021085600
Robert Brandfass
036431106076401149309800019628046599600
David Kiehn
04515440900900158405791190121450113448200
Dawn Gideon
00000520867000005208670520867
George Sandora
0143643016536049608338608212025227300
William Englert
14369201854402600974507220172963000
Diane Dismukes
04139210100000022571708333670109670158397200
Matthew Peterson
01650510128620570774805141019085900
Susan Manzi MD
0421712063750055209800011065050687900

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Additional Compensation DisclosureForm 990, Schedule J, Page 1, Line 4aThe following represents additional disclosure for Schedule J, line 4a pertaining to officers and key employees listed in Form 990, Part VII, Section A, Line 1a receiving severance pay during the calendar year ending within the June 30, 2012 fiscal year end: Dawn Gideon $520,867 Judy Hlafcsak $259,157 Christopher Olivia, MD $625,000 Roy Santarella $117,174 Diane Dismukes $166,673 Tom Albanesi $228,782 The following list represents Officers, Directors or Key Employees of Alle-Kiski Medical Center listed on Form 990, Part VII who did not serve a full consecutive twelve month tenure during the year ended June 30, 2012 along with the dates served: Directors: Ruth Becker 07-01-2011 - 12-31-2011 Janis Evans 01-31-2012 - 06-30-2012 Officers and Key Employees: Diane Dismukes 07-01-2011 - 10-31-2011 Roy Santarella 07-01-2011 - 11-01-2011 David Kiehn 07-01-2011 - 12-30-2011 Jodi Hirsch 01-31-2012 - 05-31-2012 Matt Peterson 01-31-2012 - 06-30-2012 Michael Sirott 05-31-2012 - 06-30-2012
Deferred CompensationSchedule J, Part II, Column CRetirement and other deferred compensation reflect amounts accrued to the benefit of the applicable individuals related to qualified pension and severance plans. In this regard, the following individuals have amounts accrued related to future severance payments to be made: Christopher Olivia, MD Roy Santarella Judy Hlafcsak Thomas Albanesi David Kiehn Diane Dismukes George Sandora

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonJason RossNamePerson
FieldValueIRS element (for citing)
RelationshipOrganization DirectorRelationship
Amount Of Transaction266910AmountOfTransaction
Description Of TransactionSee Schedule ODescriptionOfTransaction
Sharing Of RevenuesfalseSharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (14 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990 Amendment - Audited Financial StatementsForm 990 - General InformationWest Penn Allegheny Health System, Inc., the sole member of Alle-Kiski Medical Center has consummated a formal affiliation on April 29, 2013 to establish a regional integrated health care services delivery system. Due to the considerable complexities associated with this affiliation, the audited financial statements were not issued at the date of the filing of the tax return. The audit financial statements have now been issued and we are amending this tax return to include the audited financial statements. The details of the affiliation are documented in the footnotes to the Audited Financial Statements.
Statement of Program Service AccomplishmentsForm 990, Page 2, Part III, Line 4aINTRODUCTION TO ALLE-KISKI MEDICAL CENTER Alle-Kiski Medical Center is dedicated to providing exceptional health care to nearly 170,000 people in portions of Allegheny, Butler, Westmoreland and Armstrong counties. AKMC is part of the West Penn Allegheny Health System. Organized in 2000, WPAHS (www.wpahs.org) is comprised of West Penn Allegheny Health System, Inc. (WPAHS, Inc.), Canonsburg General Hospital (CGH), Allegheny Medical Practice Network (AMPN), Allegheny Specialty Practice Network (ASPN), Allegheny-Singer Research Institute (ASRI), West Penn Allegheny Oncology Network (WPAON), West Penn Physician Practice Network (WPPPN), Canonsburg General Hospital Ambulance Service (CGH Ambulance), Alle-Kiski Medical Center Trust (AKMC Trust), Forbes Health Foundation (FHF), Suburban Health Foundation (SHF), The Western Pennsylvania Hospital Foundation (WPHF) as well as AKMC. AKMC is comprised of a hospital campus, located in Allegheny County at 1301 Carlisle Street, Natrona Heights, Pa., and outpatient care centers located throughout the community. The AVH Outpatient Care Center - New Kensington is located in Westmoreland County at 651 Fourth Avenue, New Kensington, Pa., and offers a number of outpatient services, including radiology, laboratory, medical oncology and hematology, the Joslin Diabetes Center and an Urgent Care Center for minor emergencies. AKMC also offers two off-campus lab draw sites, one in Lower Burrell, Pa., and another in Natrona Heights, Pa. An off-campus outpatient physical therapy center in Natrona Heights offers patients rehabilitation services in a convenient location. AKMC Radiological Imaging, located in Allegheny County at 2801 Freeport Road, Natrona Heights Pa., offers outpatient radiology imaging services including X-rays, CT scans, mammography, MRI, ultrasound and bone-density testing. The AKMC outpatient care center in Vandergrift offers basic imaging services, cardiac services, lab draws and sleep studies. Honors and awards bestowed upon AVH for Fiscal 2012 include recognition by U.S. News & World Report placing AKMC in the top ten hospitals in the region for overall quality care with noted recognition as high performing in Gastroenterology and Pulmonology. Additionally the readers of the Valley News Dispatch voted AKMC as 2013 Readers' Choice Award "Best Hospital" for the tenth consecutive year. For the 12 months ended June 30, 2012, AKMC treated 8,605 inpatient discharges, 221,487 outpatients, 47,310 emergency department and urgent care center visits and 6,096 inpatient and outpatient surgeries. The hospital has 314 physicians on staff and 1,084 employees. PURPOSE AND MISSION Alle-Kiski Medical Center is an organization defined by our talented people. We are an organization committed to excellence; a organization with one purpose and one mission. Our purpose is to improve the health of the people in the Western Pennsylvania region. Our mission is to practice medicine, educate and conduct research as an integrated team of physicians, nurses and support professionals who are committed to improving the health of our patients. UNCOMPENSATED CARE To enhance the health status of the community in which it operates and consistent with its tax-exempt status, AKMC provides needed health care services to individuals regardless of their ability to pay for all or part of the services rendered. These services include both inpatient and outpatient services as well as an emergency room that remains available 24 hours a day. Consistent with the filing of Schedule H, the components of uncompensated care include charity care and unreimbursed Medicaid costs. AKMC provided uncompensated care at a cost of $5,004,809 in Fiscal 2012. COMMUNITY ASSESSMENT Community Health Improvement Services and Community Benefit Operations Community health improvement services and community benefit operations include activities intended to improve health and wellness. They extend beyond patient care activities and are subsidized by the Hospital. The programs ranged from community health education to free clinics and screenings. Consistent with the filing of Schedule H, AKMC provided the following community health services during Fiscal 2012 at an estimated cost of $514,881. Destination Wellness - Destination Wellness is a community health and wellness education resource center sponsored by AKMC. One of the few community-based outreach centers of its kind, Destination Wellness is a storefront located in the Galleria at Pittsburgh Mills shopping mall. Destination Wellness provides a variety of health-related activities including classes and "Doc Talks" on topics ranging from arthritis to peripheral vascular disease. Destination Wellness is staffed with a registered dietitian and registered nurses to assist visitors in finding a physician, checking blood pressure or researching a topic in the on-site health resource library. During Fiscal 2012, Destination Wellness sponsored or hosted 243 events with a total of 25,324 attendees. Destination Wellness also sponsors the "Mills Milers", a no-charge, indoor walking program designed to engage members of the community in physical exercise in a safe, controlled environment. Numerous programs are available exclusively for members of the Mills Milers. Over 2,280 members have enrolled in this program since its inception in September, 2005. Paramedics Staffing - AKMC staffs the mall with on-site paramedics to respond to a variety medical emergencies at the mall and surrounding businesses. In Fiscal 2012 paramedics responded to 163 calls. PriorityCare Senior Membership Program - AKMC offers this outreach program to adults age 55 and older with the purpose of improving their health and their knowledge about health care and other issues related to the aging process. A newsletter is mailed quarterly to over 13,000 households reaching a total membership of over 18,000 adults. Cumulatively, over 36,000 adults have enrolled in the program. In addition to health education articles, the newsletter keeps members informed about hospital and community services and contains a calendar of monthly educational programs and support groups. Childbirth Education - AKMC offered a class involving the experience of childbirth and newborn care. Class topics included areas of interest such as breast feeding, newborn care and sibling interaction. Babysitting Classes - Six babysitting classes were held in Fiscal 2012. The classes are an educational tool to help teach parents and babysitters on safe sitting techniques.
Statement of Program Service Accomplishments - ContinuedForm 990, Page 2, Part III, Line 4aNutrition Clinic - AKMC teaches individuals how to change their eating habits through meal planning and behavior modification. Staffed by registered nutritionists, the clinic focuses on a variety of diets, including diabetic, cardiac rehabilitation, weight control, digestive disorders, food allergies, high blood pressure, healthy meal plans for children and food and drug interaction. Medical Professional Talks - AKMC hosts many "Doc Talks" at the campus and in the community. These events target all segments of the community population and are presented on current topics of interest. The Doc Talks are interactive and include topics such as, but not limited to: Coping with Chronic Pain, Congestive Heart Failure, Understanding and Managing Hypertension, Eye Health, Prostate Health and Women's Health. Community Health Fairs, Screenings and Workshops - AKMC provides numerous health fairs within the community and at community events. These fairs target a broad range of community members and focus on topics that are prevalent to the well-being of the community. Exercise Classes - During Fiscal 2012, the Hospital sponsored a variety of exercise classes free of charge to members of the community. Classes included Belly Dancing, Tai Chi and Yoga. Support Groups - AKMC acknowledges the stress and distress medical conditions can cause to families and their loved ones. AKMC sponsors a variety of support groups in the community to address these needs. Examples of support groups sponsored by AKMC would include but not be limited to Alzheimer's, Diabetes and Restless Leg Syndrome. Health Professions Education AKMC provides aspiring health professionals with many educational opportunities to further their career in healthcare. Consistent with the filing of Schedule H, AKMC provided these services at a cost of $28,204 in Fiscal 2012. Citizens School of Nursing - Open since 1913, the Citizens School of Nursing has provided over 2,200 graduates with a strong foundation on which to build their future nursing careers. The school earned its first National League of Nursing accreditation in 1960 and continues to enjoy the privilege of full accreditation, due in part to a constantly evolving curriculum that consistently meets the needs of its students and reflects the changes of the nursing profession. The school prepares each student with the knowledge and skills necessary to exceed the challenges of providing quality nursing in the 21st century. CPR Classes - Medical staff instructors from the Hospital teach a variety of CPR classes each year. These classes range from Basic Life Support for Healthcare providers, to Friends & Family CPR, to Automated External Defibrillator usage. In total, AKMC held 54 classes in Fiscal 2012. Subsidized Health Services Subsidized health services represent those programs provided to the community by AKMC despite the fact the Hospital incurs a financial loss to do so. AKMC recognizes the need of its community and voluntarily subsidizes these programs in support of its charitable mission. In this regard, AKMC subsidized the treatment of drug and alcohol abuse. Consistent with the filing of Schedule H, AKMC provided subsidized health services at a cost of $28,693 in Fiscal 2012. Financial Contributions This category includes monetary and in-kind services donated to individuals and the community at large. In-kind services include hours donated by staff to the community during hospital work hours, overhead expenses of meetings, other space donated to not-for-profit community groups, and donations of food, equipment, and supplies. Consistent with the filing of Schedule H, AKMC provided financial contributions during Fiscal 2012 totaling $8,665. Cash Donations - AKMC supports the community through cash contributions made at the discretion of the Hospital and its directors, benefiting not only the non-profit recipient but ultimately the community as a whole. The Hospital made cash contributions totaling $1,168 including contributions to: The American Cancer Society In-Kind Donations - In addition to the cash contributions listed above, AKMC also made in-kind donations of time and resources to help support various community functions. For Fiscal 2012, in-kind contributions amounted to $7,497 and consisted of the following: AARP's 55 Alive Mature Driving Program - The Hospital co-sponsored this two-day driver refresher course 24 times during Fiscal 2012. During the year, 257 drivers participated in the program offered at the Hospital's main campus, the Outpatient Care Center in New Kensington or Destination Wellness. Free meeting space, parking, refreshments and publicity are provided through the hospital. Look Good - Feel Better! - The hospital provides free space for the American Cancer Society to host the program Look Good - Feel Better, a program directed toward helping cancer patients feel good about their appearance. Goodwill Donation of Computer Equipment - The hospital donated 10 computer towers, monitors and other miscellaneous equipment to Goodwill Industries to help advance their mission. Community Building Activities Community Building Activities include activities engaged in for the purpose of improving or protecting the health, future and wellbeing of the community. Consistent with the filing of Schedule H, AKMC provided these services at a cost of $368,199 in Fiscal 2012. Social Services - AKMC social work services are available to help patients and their families adjust to changes in their lives due to illness and hospitalization. Our social workers help patients and families identify and manage factors that may interfere with health and recovery. Through counseling, discharge planning and providing information and referrals, the staff helps to ensure a comfortable return home or other level of care that is appropriate at the time of discharge. Board Memberships - AKMC employees serve as board members on numerous local boards including the local Rotary, New Kensington Chamber of Commerce, Strongland Chamber of Commerce, Alle-Kiski Paramedic Unit for Life Support Emergency Response (AKPULSER) and the YMCA. School Tours - AKMC provides free hospital tours to nursery schools, scout troops, career clubs and other groups as requested. Approximately 90 visitors toured the Hospital in Fiscal 2012.
Family Relationships Among Alle-Kiski Medical Center DirectorsForm 990, Page 6, Part VI, Section A, Line 2The following Alle-Kiski Medical Center Directors are related as husband and wife: Russell Evans Janis Evans Jerry Taylor, MD Ginger Taylor
Operational Oversight By A Third Party Management CompanyForm 990, Page 6, Part VI, Section A, Line 3Alle-Kiski Medical Center (AKMC) is a member of the West Penn Allegheny Health System (System). The System consists of thirteen operational IRC Section 501(c)(3) organizations. The parent organization for AKMC and the other eleven operational IRC Section 501(c)(3) organizations is West Penn Allegheny Health System, Inc. (WPAHS, Inc.). The board of directors of WPAHS, Inc. is comprised of a majority of independent members. Effective November 7, 2011 (Effective Date), the board of directors of WPAHS, Inc. engaged Alvarez & Marsal Healthcare Industry Group, LLC (A&M) to assign an Interim Chief Executive Officer of the System, Interim Chief Operating Officer of the System and Interim Chief Financial Officer of the System. All individuals appointed to their respective positions are under the employment of A&M and have daily oversight of all matters pertinent to the operation of the System as a whole and all organizations on an independent basis. All interim management personnel under the employment of A&M are responsible to and report to the WPAHS, Inc. board of directors. The term of the engagement is to last one year from the effective date with the option to renew the engagement beyond the initial one year term. During the course of the engagement, the WPAHS, Inc. board of directors upon written notice may cause any individual employed by A&M to be removed from their respective position and replaced by another similarly qualified individual. AKMC did not directly compensate A&M for their management services. WPAHS, Inc. compensates A&M directly for these services. The decision was made to allocate a portion of the expenditures of WPAHS, Inc. to AKMC. Thus, the portion of management expense allocated from WPAHS, Inc. to AKMC is reflected on Form 990, Page 10, Line 11a. As of the date of the filing of this tax return, A&M continues to provide management oversight to AKMC and the System under the supervision of the WPAHS, Inc. board of directors.
Form 990 Review ProcessForm 990, Page 6, Part VI, Section B, Line 11aForm 990 is prepared internally by an employee of the West Penn Allegheny Health System, Inc. (Health System) Tax Department who is a certified public accountant. The document is then reviewed internally by top management officials of the Health System. A detailed external review is conducted by Health System external tax advisors, who sign the return as preparer. The Chair of the organization's Board of Directors, or another Board Member otherwise designated by the Chair, along with members of the Audit and Compliance committee of the Health System Board review the Form 990 and recommend changes or accept the document as presented. A copy of the Form 990 is made available to every board member for review prior to filing the document with the Internal Revenue Service.
Monitoring and Enforcement of the Conflict of Interest PolicyForm 990, Page 6, Part VI, Section B, Line 12cAlle-Kiski Medical Center is a member of the West Penn Allegheny Health System (WPAHS). WPAHS has a corporate compliance department that monitors and oversees compliance with the conflict of interest policy of all organizations in the health system. The following describes the manner in which the corporate compliance department monitors and oversees compliance with the conflict of interest policy for Alle-Kiski Medical Center as well as the other WPAHS affiliates: Conflict of Interest disclosure forms are completed on an annual basis by all board members, officers, employees who have a title of Manager and above, physicians in leadership roles, Pharmacy and Therapeutic Committee members, all employees of the System's Compliance and Internal Audit Departments as well as personnel involved with contracting in the Corporate Purchasing Department. Upon completion of the above disclosure statement by all applicable individuals, a report is generated listing all individuals that have reported a conflict. The System Compliance Officer and General Counsel review the conflicts disclosed. Those that require additional information or clarification receive a letter from the Compliance Officer requesting such. Once received, all additional information is added to the report and again reviewed by the Compliance Officer and General Counsel. Those conflicts that require a mitigation plan are sent to the respective organization's senior management for development of the mitigation plan. The organization's senior management is responsible to discuss the mitigation plan with the individual as needed and monitor compliance with the mitigation plan. Once mitigation is received, a final report is reviewed with the System Executive Compliance Council and finally the Audit & Compliance Committee of the Board.
Process Used To Determine Executive CompensationForm 990, Page 6, Part VI, Section B, Line 15bThe West Penn Allegheny Health Systems (WPAHS) process for determining compensation for executive positions (including officers, key employees and other management positions) within Alle-Kiski Medical Center is covered by the WPAHS Executive Compensation Policy. This policy was approved by the West Penn Allegheny Health System, Inc. Board of Directors. It is the policy of WPAHS and its Board of Directors to compensate its executives in accordance with the market and in relation to the experience, service and accomplishments of the individual both prior to and during their service with WPAHS. The Compensation Committee of the West Penn Allegheny Health System, Inc. Board of Directors approves the compensation for WPAHS senior executives. The Compensation Committee approves the initial compensation for newly hired senior executives, which shall include all compensation components, including without limitation, base compensation, incentive compensation, deferred compensation, fringe and other benefits, as well as the total compensation. It shall also approve all base compensation adjustments and all incentive compensation awards, as well as material changes to deferred compensation, fringe, or other benefits. The Compensation Committee uses comparability data provided by the System Human Resources Department, which may include industry surveys, expert compensation studies, documented compensation of persons holding similar positions, or other comparable data in approving any executive compensation. The Compensation Committee shall periodically retain the services of an independent compensation consultant to provide an expert opinion report as to the reasonableness of total compensation of Alle-Kiski Medical Center officers and key employees. Each Compensation Committee member voting on a senior executive's compensation arrangement ensures that he or she has no conflict of interest, including that he or she (a) does not economically benefit from the proposed employment; (b) does not receive compensation subject to the approval of the proposed employee; and (c) has no material financial interest affected by the transaction. The Compensation Committee consists of five independent Board Members of West Penn Allegheny Health System, Inc. All decisions of the Compensation Committee regarding executive compensation matters are documented.
Public Access To Organizational DocumentsForm 990, Page 6, Part VI, Section C, Line 19Alle-Kiski Medical Center (AKMC) does not make its governing documents available to the public. AKMC is a member of the West Penn Allegheny Health System (WPAHS). The WPAHS makes available their annual and quarterly financial statements through the use of a dissemination agent. These financial statements are on a consolidated basis with AKMC being one of the consolidated entities. In addition, the WPAHS annual report and quarterly financial results are available on the WPAHS website. WPAHS has adopted a conflict of interest policy that is uniformly applied to all organizations of the health system, including AKMC. A condensed version of this conflict of interest policy is available on the WPAHS website.
Rental ExpenseForm 990, Page 9, Part VIII, Line 6bAlle-Kiski Medical Center does not account for rental expense in a manner that would allow for a direct offset of rental income on Form 990, page 9, Part VIII, Line 6b. The components of rental expense are reflected on Form 990, Page 10, Statement of Functional Expense.
Officer, Director and Key Employee Hour AllocationForm 990, Page 7, Part VII, Section A, Column BAlle-Kiski Medical Center (AKMC) is part of an integrated healthcare delivery system named West Penn Allegheny Health System. Individuals employed by one organization may be assigned to provide management for an affiliated organization. As such, many individuals play key roles or serve as officers or directors on multiple affiliated organizations. Each individual will be assigned forty hours to the organization of their actual employment. If the individual is employed by one organization and appointed as an officer, director or key employee of affiliated organizations the hour allocation on Form 990, Part VII, Page 7, Column (B) takes various factors into account when attempting to assign hours in a reasonable manner. Thus, it is possible for a single individual to have hours assigned in excess of forty hours per week if all affiliated organization IRS Forms 990 is taken into account. Directors who are not employed and volunteer their services are assigned one hour of service. The actual time served for all individuals disclosed in IRS Form 990 can vary based upon the need of the organization.
Purpose Of Tax Exempt Bond IssuanceForm 990, Page 11, Part X, Line 20Alle-Kiski Medical Center is a member of the West Penn Allegheny Health System obligated group in regards to 2007 Allegheny County Hospital Development Authority tax-exempt bonds. Accordingly, Schedule K has been inserted into this Form 990 for full disclosure purposes. The purpose of the issue of the Allegheny County Hospital Development Authority (ACHDA) Hospital Revenue Bonds, Series 2007 A is to refund the outstanding ACHDA Series 2000A and B Bond Issues, the Dauphin County General Authority (DCGA) Series 1992A and B Hospital Bonds, the Pennsylvania Higher Education Facility Authority (PHEFA) Series 1991A Revenue Bonds, the Monroeville Hospital Authority (MHA) Series 1992 and 1995 Revenue Bonds, the funding of a project fund for certain prior and future capital expenditures and to pay the cost of issuing Series 2007A Debt. The amount of $64,630,994 reflected on Form 990, Page 11, Line 20 represents the internal allocation of debt to Alle-Kiski Medical Center by the parent organization, West Penn Allegheny Health System, Inc. The IRS Form 990 filed by West Penn Allegheny Health System, Inc., EIN: 25-0969492 has completed Schedule K in its entirety. Please refer to the IRS Form 990 filed by West Penn Allegheny Health System, Inc., EIN: 25-0969492 to review Schedule K with regard to this bond issue.
Other Changes In Net AssetsForm 990, Page 12, Part XI, Line 5The following is a reconciliation of the other changes in net assets of Alle-Kiski Medical Center for the year ended June 30, 2012: Change in Minimum Pension Liability $1,947,432 Net Transfers To Affiliated Organizations 224,212 Unrealized Gain on Investments Reclassified from Operations to Net Assets 273,439 Prior Year Suspense Account Reclassification (24,470) ___________ Other Changes in Net Assets $ 2,420,613
Transactions With Interested PersonsSchedule L, Part IVJason Ross, a director of Alle-Kiski Medical Center is also an officer of Allegheny Valley Bank. Allegheny Valley Bank provides lending services to Alle-Kiski Medical Center. All terms and conditions of the lending service is done at fair market value.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (15 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
West Penn Allegheny Health System Inc
4800 Friendship AvenuePittsburghPA15224250969492HealthcarePA501(c)(3)3NAfalse
Allegheny Singer Research Institute
320 East North AvenuePittsburghPA15212251320493Sci. ResearchPA501(c)(3)4NAfalse
Canonsburg General Hospital
100 Medical BoulevardCanonsburgPA15317251737079HealthcarePA501(c)(3)3NAfalse
Allegheny Medical Practice Network
4800 Friendship AvenuePittsburghPA15224251838457HealthcarePA501(c)(3)3NAfalse
Allegheny Specialty Practice Network
320 East North AvenuePittsburghPA15212251838458HealthcarePA501(c)(3)3NAfalse
West Penn Allegheny Oncology Network
4800 Friendship AvenuePittsburghPA15224113683376HealthcarePA501(c)(3)11-III FLNAfalse
West Penn Physician Practice Network
4800 Friendship AvenuePittsburghPA15224251494317HealthcarePA501(c)(3)9NAfalse
CGH Ambulance Service Inc
100 Medical BoulevardCanonsburgPA15317232939715Emer ResponsePA501(c)(3)9NAfalse
Alle-Kiski Medical Center Trust
1301 Carlisle StreetNatrona HeightsPA15065205855753FundraisingPA501(c)(3)11-IAKMCtrue
Forbes Health Foundation
2570 Haymaker RoadMonroevillePA15146251798379FundraisingPA501(c)(3)7NAfalse
Suburban Health Foundation
100 South Jackson AvenuePittsburghPA15202251472073FundraisingPA501(c)(3)11-INAfalse
Western Pennsylvania Hospital Foundation
4800 Friendship AvenuePittsburghPA15224251470766FundraisingPA501(c)(3)11-INAfalse
West Allegheny Hospital
100 Medical BoulevardPittsburghPA15317251054206InactivePA501(c)(3)3NAfalse
Greater Canonsburg Health System
100 Medical BoulevardCanonsburgPA15317251488089InactivePA501(c)(3)11-INAfalse
Canonsburg HealthHospital Foundation
100 Medical BoulevardCanonsburgPA15317251818505InactivePA501(c)(3)11-INAfalse

Form990 Schedule R Part IV Form990ScheduleRPartIV (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityProvince Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryPostal CodeAddressForeign/PostalCodeLegal Domicile Foreign CountryLegalDomicileForeignCountry
Burn Care Associates
4800 Friendship AvenuePittsburghPA15224232899534HealthcarePANAC Corporation
Medical Center Clinic
4800 Friendship AvenuePittsburghPA15224232894939HealthcarePANAC Corporation
West Penn Corporate Medical Services
4800 Friendship AvenuePittsburghPA15224251437405HealthcarePANAC Corporation
West Penn Neurosurgery
4800 Friendship AvenuePittsburghPA15224251630719InactivePANAC Corporation
Friendship Insurance Company
980116952InsuranceNAC CorporationBarclays House Shedden RoadGrand CaymanCayman IslandsCJPO Box 1051CJ
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 OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
Alle-Kiski Medical Center Trust
1c224212
Alle-Kiski Medical Center Trust
1p220140

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierTransactions with Affiliated OrganizationsIdentifier
Return ReferenceSchedule R, Part V, Line 2ReturnReference
ExplanationAlle-Kiski Medical Center has chosen not to complete Schedule R, Part V, line 2 for organizations that are not controlled entities within the meaning of section 512(b)(13). The disclosure of this information is only required for organizations listed in Schedule R, Part V, line 2 that are controlled entities within the meaning of section 512(b)(13). The only organization listed in Schedule R, Part V, line 2 that is a controlled entity within the meaning of section 512(b)(13) for Alle-Kiski Medical Center is the Alle-Kiski Medical Center Trust.Explanation

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