2013-05-14T10:48:57-05:00 2012-06-30 GRANT THORNTON LLP 2001 MARKET STREET SUITE 3100 PHILADELPHIA PA 19103 990 2011-07-01 251875178 Alle-Kiski Medical Center % MATTHEW PETERSON ALLE 4123306022 C/O Tax Dept Two Allegheny Center Pittsburgh PA 15212 MATTHEW PETERSON 2013-05-10 true 2155614200 2011 2016-02-24 21:20:13Z Matthew Peterson Two Allegheny Center 11th Fl Pittsburgh PA 15212 164755963 false X www.wpahs.org X 2000 PA See Form 990, Page 2, Part III, Question 1 12 8 1264 273 4734976 -943664 0 75653 122312091 123807673 1211579 1031554 5670227 4877521 129193897 129792401 7175 1168 0 0 53384921 55223034 0 0 0 66414619 68225339 119806715 123449541 9387182 6342860 86913877 92939334 97223681 94485665 -10309804 -1546331 X ALLE-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. false false 16663307 0 16871605 The 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. 15679007 0 15852840 The 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. 7972619 0 7194947 The 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. 70418928 1168 83888283 Other Medical Services Provided To Our Patients 70418928 1168 83888283 110733861 true true false true false false false false true true false false false true true false true false false false false false false false false true true false false true false false false false false false false true false false false false false true true true false false true 138 0 true 1264 true true true false false false false false false false false false X 12 8 true true false false false false false true true false false true true true true true true true true false PA X X MATTHEW PETERSON 4123306005 TWO ALLEGHENY CENTER 11TH FLOOR Pittsburgh PA 15212 Russell Evans 1.0 X X 0 0 0 Ruth Becker 1.0 X 0 0 0 David Bonvenuto 1.0 X 0 0 0 Jason Ross 1.0 X 0 0 0 Russell Livingston 1.0 X 0 0 0 Ginger Taylor 1.0 X 0 0 0 Jerry Taylor MD 1.0 X 0 0 0 Janis Evans 1.0 X 0 0 0 John Balacko MD 1.0 X 0 482705 0 Hadi Firoz MD 1.0 X 0 244820 0 Ned Laubacher 40.0 X X 0 358350 0 John Isherwood 1.0 X 0 0 0 Diane Dismukes 1.0 X X 0 739638 0 Emanual Dinatale 1.0 X 0 0 0 Roy Santarella 1.0 X 0 971890 0 Jodi Hirsch 1.0 X 0 201560 0 Robert Brandfass 1.0 X 0 436568 0 David Kiehn 1.0 X 0 543218 0 Matthew Peterson 1.0 X 0 177970 0 Michael Sirott 1.0 X 0 64848 0 Michael Harlovic 40.0 X 234153 0 0 George Sandora 40.0 X 0 160675 0 William Englert 40.0 X 162496 0 0 Susan Manzi MD 1.0 X 0 486014 0 Janet Boehm 40.0 X 125308 0 0 Walter Hoover 40.0 X 136397 0 0 Nancy Kantorski 40.0 X 111468 0 0 Diane Bowser 40.0 X 115417 0 0 Mary Wasilowski 40.0 X 111326 0 0 Christopher Olivia MD X 0 4107961 0 Dawn Gideon X 0 520867 0 Thomas Albanesi X 0 317580 0 Judy Hlafcsak X 0 258918 0 996565 10073582 0 11 true true false Valentour English Bodnar Howell 470 Washington Road PITTSBURGH PA 15228 Architect Services 244949 Clean Care PO Box 40330 PITTSBURGH PA 15201 Linen Services 470156 Emergency Medicine Physician -Alle- 4535 Dressler Road CANTON OH 44718 Emergency Med. Care 173000 Laser Technology Services Ltd 1009 Merchant Street AMBRIDGE PA 15003 Laser Service 174400 Ohio Mobile Lithotripsy LLC PO Box 714774 COLUMBUS OH 432714774 Lithotripsy Service 158600 8 70653 5000 75653 PATIENT SERVICE REVENUE 621500 123807673 119615021 4192652 123807673 569685 569685 0 0 887556 887556 887556 542324 345232 35424311 1120 34963562 460749 1120 461869 461869 0 0 0 SCHOOL OF NURSING TUITION 621110 1548092 1548092 CAFETERIA SALES 621110 786521 786521 HIGMARK QUALITY INCENTIVE AWARD 621110 749000 749000 906352 906352 3989965 129792401 123604986 4734976 1376786 1168 1168 0 0 0 424855 361127 63728 0 43593812 37054740 6539072 0 1794403 1525243 269160 6269753 5329290 940463 3140211 2669179 471032 518694 518694 104910 94419 10491 0 0 0 145999 145999 4605066 4144559 460507 9100 8190 910 589034 530131 58903 0 0 3481370 3133233 348137 91850 82665 9185 0 18463 16617 1846 3497699 3425017 72682 14672810 13205529 1467281 6476737 5829063 647674 1136381 1136381 PATIENT CARE COSTS 15552511 15552511 BAD DEBT 9169858 9169858 REPAIR AND MAINTENANCE 3890461 3501415 389046 PA ACT 49 - QUALITY CARE 1815468 1815468 2448928 2148058 300870 123449541 110733861 12715680 0 4255 4255 16875365 21841961 48499 0 10423847 12779072 0 0 0 0 0 0 1480293 1447304 710046 742999 136477028 107218386 29995846 29258642 21645200 22893369 126252 130306 0 0 2724021 2257047 2880253 1584379 86913877 92939334 9912113 9344001 0 0 3178283 3062589 65648819 64630994 0 0 0 0 3126834 3817245 0 0 15357632 13630836 97223681 94485665 X -10418130 -1725440 108326 179109 0 0 -10309804 -1546331 86913877 92939334 X 6342860 2420613 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 0 0 19274 225684 19274 225684 123235395 1698163316 123254669 1698389000 1000000 1000000 250000 250000 1000000 1000000 1000000 1000000 4000000 6000000 585102 418483 424588 225684 1653857 250000 250000 250000 250000 1000000 1500000 0 0 0 0 0 Lobbying Expenditures Form 990, Schedule C, Page 2, Part II-A, Line 1b, Column (a) Alle-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. 108326 70653 130 179109 108131 195 108326 106555 968 608 108131 102387 2760 1408 106555 1.00000 false false 27912 27912 85104994 65350690 19754304 564796 450100 114696 44561687 38774726 5786961 6217639 2642870 3574769 29258642 0 ACCRUED PENSION COSTS 11324860 THIRD PARTY SETTLEMENTS 1299351 ASBESTOS RETIREMENT OBLIGATION 78872 DUE TO AFFILIATED ORGANIZATIONS 927753 13630836 AKMC Inclusion In The Consolidated Audit of WPAHS Form 990, Schedule D, Part X Question 2, Part XII and XIII Alle-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 Funds Schedule D, Page 2, Part V, Line 4 The 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. true true true X true X true true false true true 390329 390329 0.00320 11504037 6889557 4614480 0.03740 11894366 6889557 5004809 0.04060 514881 514881 0.00420 3588810 3560606 28204 0.00020 187860 159167 28693 0.00020 8665 8665 0.00010 4300216 3719773 580443 0.00470 16194582 10609330 5585252 0.04530 9780 9780 0.00010 358429 358429 0.00290 368209 368209 0.00300 true 2403420 901624 18833876 19845976 -1012100 X true true 1 1 Alle-Kiski Medical Center

1301 Carlisle Street Natrona Heights PA 15065

X X X Alle-Kiski Medical Center 1 true true 200. true 400. true X X X X X X true true X X X X true X true X X X X X true X false true 7 Vandergrift Outpatient Care Center

244 Longfellow Street Vandergrift PA 15690

Outpatient Care Center Citizens Ambulatory Care Center

651 Fourth Avenue New Kensington PA 15065

Ambulatory Care Center AVH Outpatient Physical Therapy

1620 Pacific Avenue Natrona Heights PA 15065

Physical Therapy Allegheny Valley Hospital Prolab

1620 Pacific Avenue Natrona Heights PA 15065

Laboratory Services Allegheny Valley Hospital Prolab

2692 Leechburg Road Lower Burrell PA 15068

Laboratory Services Destination Wellness

590 Pittsburgh Mills Circle Tarentum PA 15084

General Health and Wellness AKMC Radiological Imaging

2801 Freeport Road Natorna Heights PA 15065

Radiological Imaging Bad Debt Expense Financial Statement Footnote and Costing Methodology Schedule H, Part III, Question 4 Alle-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 Methodology Schedule H, Part III, Question 8 Alle-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 Assistance Schedule H, Part III, Question 9b Patients 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 Care Schedule H, Part V, Line 19 Alle-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 Services Schedule H, Part V, Line 21 The 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 Assessment Schedule H, Part VI, Line 2 Alle-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 Assistance Schedule H, Part VI, Line 3 Alle-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 Information Schedule H, Part VI, Line 4 Alle-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 Health Schedule H, Part VI, Line 5 The 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 System Schedule H, Part VI, Line 6 West 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 Report Schedule H, Part VI, Line 7 Alle-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. X X X X true false false false false false false false false John Balacko MD 0 448917 0 33236 0 552 0 9800 0 10412 0 502917 0 0 Hadi Firoz MD 0 244590 0 0 0 230 0 9143 0 9483 0 263446 0 0 Christopher Olivia MD 0 677905 0 2500000 0 930056 0 1884800 0 10553 0 6003314 0 3507618 Ned Laubacher 0 309922 0 48068 0 360 0 9800 0 9829 0 377979 0 0 Michael Harlovic 205037 0 28670 0 446 0 9594 0 8145 0 251892 0 0 0 Roy Santarella 0 605727 0 171437 0 194726 0 1301114 0 11650 0 2284654 0 117174 Thomas Albanesi 0 50974 0 0 0 266606 0 43578 0 6445 0 367603 0 239282 Judy Hlafcsak 0 0 0 0 0 258918 0 17210 0 240 0 276368 0 258918 Jodi Hirsch 0 185882 0 15500 0 178 0 8091 0 1205 0 210856 0 0 Robert Brandfass 0 364311 0 60764 0 11493 0 9800 0 19628 0 465996 0 0 David Kiehn 0 451544 0 90090 0 1584 0 579119 0 12145 0 1134482 0 0 Dawn Gideon 0 0 0 0 0 520867 0 0 0 0 0 520867 0 520867 George Sandora 0 143643 0 16536 0 496 0 83386 0 8212 0 252273 0 0 William Englert 143692 0 18544 0 260 0 9745 0 722 0 172963 0 0 0 Diane Dismukes 0 413921 0 100000 0 225717 0 833367 0 10967 0 1583972 0 0 Matthew Peterson 0 165051 0 12862 0 57 0 7748 0 5141 0 190859 0 0 Susan Manzi MD 0 421712 0 63750 0 552 0 9800 0 11065 0 506879 0 0 Additional Compensation Disclosure Form 990, Schedule J, Page 1, Line 4a The 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 Compensation Schedule J, Part II, Column C Retirement 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 Jason Ross Organization Director 266910 See Schedule O false Subsequent Event - Corporate Affiliation Form 990 - General Information West 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. The details of the affiliation will be documented in the footnotes to the Audited Financial Statements. Due to the considerable complexities associated with this affiliation, the audited financial statements have not been issued at the date of the filing of this tax return. Upon issuance, we will amend this tax return to include a copy of the audited financial statements. Statement of Program Service Accomplishments Form 990, Page 2, Part III, Line 4a INTRODUCTION 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 - Continued Form 990, Page 2, Part III, Line 4a Nutrition 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 Directors Form 990, Page 6, Part VI, Section A, Line 2 The 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 Company Form 990, Page 6, Part VI, Section A, Line 3 Alle-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 Process Form 990, Page 6, Part VI, Section B, Line 11a Form 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 Policy Form 990, Page 6, Part VI, Section B, Line 12c Alle-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 Compensation Form 990, Page 6, Part VI, Section B, Line 15b The 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 Documents Form 990, Page 6, Part VI, Section C, Line 19 Alle-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 Expense Form 990, Page 9, Part VIII, Line 6b Alle-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 Allocation Form 990, Page 7, Part VII, Section A, Column B Alle-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 Issuance Form 990, Page 11, Part X, Line 20 Alle-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 Assets Form 990, Page 12, Part XI, Line 5 The 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 Persons Schedule L, Part IV Jason 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. West Penn Allegheny Health System Inc 4800 Friendship Avenue Pittsburgh PA 15224 250969492 Healthcare PA 501(c)(3) 3 NA false Allegheny Singer Research Institute 320 East North Avenue Pittsburgh PA 15212 251320493 Sci. Research PA 501(c)(3) 4 NA false Canonsburg General Hospital 100 Medical Boulevard Canonsburg PA 15317 251737079 Healthcare PA 501(c)(3) 3 NA false Allegheny Medical Practice Network 4800 Friendship Avenue Pittsburgh PA 15224 251838457 Healthcare PA 501(c)(3) 3 NA false Allegheny Specialty Practice Network 320 East North Avenue Pittsburgh PA 15212 251838458 Healthcare PA 501(c)(3) 3 NA false West Penn Allegheny Oncology Network 4800 Friendship Avenue Pittsburgh PA 15224 113683376 Healthcare PA 501(c)(3) 11-III FL NA false West Penn Physician Practice Network 4800 Friendship Avenue Pittsburgh PA 15224 251494317 Healthcare PA 501(c)(3) 9 NA false CGH Ambulance Service Inc 100 Medical Boulevard Canonsburg PA 15317 232939715 Emer Response PA 501(c)(3) 9 NA false Alle-Kiski Medical Center Trust 1301 Carlisle Street Natrona Heights PA 15065 205855753 Fundraising PA 501(c)(3) 11-I AKMC true Forbes Health Foundation 2570 Haymaker Road Monroeville PA 15146 251798379 Fundraising PA 501(c)(3) 7 NA false Suburban Health Foundation 100 South Jackson Avenue Pittsburgh PA 15202 251472073 Fundraising PA 501(c)(3) 11-I NA false Western Pennsylvania Hospital Foundation 4800 Friendship Avenue Pittsburgh PA 15224 251470766 Fundraising PA 501(c)(3) 11-I NA false West Allegheny Hospital 100 Medical Boulevard Pittsburgh PA 15317 251054206 Inactive PA 501(c)(3) 3 NA false Greater Canonsburg Health System 100 Medical Boulevard Canonsburg PA 15317 251488089 Inactive PA 501(c)(3) 11-I NA false Canonsburg HealthHospital Foundation 100 Medical Boulevard Canonsburg PA 15317 251818505 Inactive PA 501(c)(3) 11-I NA false Burn Care Associates 4800 Friendship Avenue Pittsburgh PA 15224 232899534 Healthcare PA NA C Corporation Medical Center Clinic 4800 Friendship Avenue Pittsburgh PA 15224 232894939 Healthcare PA NA C Corporation West Penn Corporate Medical Services 4800 Friendship Avenue Pittsburgh PA 15224 251437405 Healthcare PA NA C Corporation West Penn Neurosurgery 4800 Friendship Avenue Pittsburgh PA 15224 251630719 Inactive PA NA C Corporation Friendship Insurance Company Barclays House Shedden Road Grand Cayman Cayman Islands CJ PO Box 1051 980116952 Insurance CJ NA C Corporation false false true false false false false false false false false false false false true true false false Alle-Kiski Medical Center Trust 1c 224212 Alle-Kiski Medical Center Trust 1p 220140 Transactions with Affiliated Organizations Schedule R, Part V, Line 2 Alle-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.