2012-05-14T15:54:19-05:00 2011-06-30 PARENTEBEARD LLC 1650 MARKET STREET SUITE 4500 PHILADELPHIA PA 19103 990 2010-07-01 231548822 PHILHAVEN PHIL 7172702414 283 SOUTH BUTLER ROAD PO BOX 550 MOUNT GRETNA PA 17064 PHILIP D HESS 7172702414 2012-05-11 1 JULIUS C GREEN 2159720701 2010 2016-02-24 21:20:13Z PHILIP D HESS 283 SOUTH BUTLER ROAD PO BOX 550 MOUNT GRETNA PA 17064 58619433 0 X WWW.PHILHAVEN.ORG X 1949 PA PHILHAVEN PROVIDES BEHAVIORAL HEALTH SERVICES TO INDIVIDUALS IN CENTRAL PA. 15 15 1143 75 529248 136331 1207974 883871 51371076 53218563 825950 158777 451365 4317592 53856365 58578803 0 0 0 0 41272947 43056217 18000 37324 236031 11011279 11778353 52302226 54871894 1554139 3706909 28684853 32601888 9173790 9297647 19511063 23304241 X AS AN EXPRESSION OF CHRIST'S LOVE, PHILHAVEN PROMOTES HOPE, HEALING AND WHOLENESS THROUGH THE PROVISION OF BEHAVIORAL RESOURCES. 0 0 22090669 27299097 PHILHAVEN'S INPATIENT PSYCHIATRIC PROGRAM IS AVAILABLE TO INDIVIDUALS WHO ARE IN MOST SEVERE STRESS AND/OR DANGER OF HARMING THEMSELVES OR OTHERS. THE INPATIENT PROGRAM PROVIDES A 24-HOUR A DAY THERAPEUTIC MILIEU AND INTERVENTIONS THAT SERVE TO STABILIZE ACUTE PSYCHIATRIC SYMPTOMS. SERVICES ARE PROVIDED TO CHILDREN AND ADOLESCENTS AGES 3 TO 18 AND ADULTS OVER 18 YEARS OF AGE. TYPICAL LENGTH OF STAY IS UP TO SIX DAYS FOR ADULTS AND NINE DAYS FOR CHILDREN/ADOLESCENTS. ADDITIONALLY, PHILHAVEN OFFERS EXTENDED ACUTE PSYCHIATRIC INPATIENT SERVICES FOR ADULTS THAT REQUIRE LONG-TERM INTENSIVE INTERVENTIONS TO STABILIZE THEIR SYMPTOMS. ONCE BEHAVIORAL STABILIZATION IS ACHIEVED, THE PATIENT IS THEN PREPARED FOR TRANSITION TO THE NEXT LEVEL OF APPROPRIATE CARE. THIS PROGRAM SERVED 2,042 INDIVIDUALS DURING THE JUNE 30, 2011 FISCAL YEAR. 11304456 12191650 PHILHAVEN'S CHILDREN'S/ADOLESCENTS' BEHAVIORAL HEALTH REHABILITATION SERVICE (BHRS) PROGRAM INCLUDES BOTH COMMUNITY BASED AND AFTER SCHOOL SERVICES. THE GOAL OF ALL BHRS SERVICES IS TO ENHANCE THE CHILD'S/ADOLESCENT'S ABILITY TO FUNCTION EMOTIONALLY, SOCIALLY, AND BEHAVIORALLY. INDIVIDUALIZED INTERVENTIONS SERVE TO FACILITATE YOUTH'S BEHAVIORAL STABILIZATION AND EMOTIONAL GROWTH. MENTAL HEALTH SPECIALISTS HELP YOUTH LEARN SKILLS AND COPING STRATEGIES, WHICH ENABLE THE YOUTH TO PRVENT DETERIORATION AND MORE RESTRICTIVE SERVICES. AFTERSCHOOL SERVICES ARE PROVIDED MONDAY - FRIDAY AFTER SCHOOL FOR CHILDREN AGES SIX TO 12 YEARS. COMMUNITY BASED SERVICES ARE PROVIDED IN SCHOOLS AND HOMES BY TRAINED THERAPEUTIC SUPPORT STAFF, MOBILE THERAPISTS, AND BEHAVIORAL SPECIALISTS CONSULTANTS. THIS PROGRAM SERVED 2,520 INDIVIDUALS DURING THE JUNE 30, 2011 FISCAL YEAR. 15024167 13727816 PHILHAVEN'S OUTPATIENT PROGRAM PROVIDES THE LEAST RESTRICTIVE TYPE OF MENTAL HEALTH TREATMENT AVAILABLE AT PHILHAVEN. STAFF WHO ARE PROFESSIONALLY TRAINED IN PSYCHIATRY, PSYCHOLOGY, SOCIAL WORK, AND COUNSELING STRIVE TO PROVIDE OUTPATIENT SERVICES TO CLIENTS IN A CONSCIENTIOUS AND CARING MANNER AS THEY WORK TOWARD THEIR THERAPEUTIC GOALS. PHILHAVEN STRIVES TO PROVIDE INDIVIDUALS AND THEIR FAMILIES WITH THE SKILLS AND RESOURCES NECESSARY TO LIVE HEALTHY, FULFILLED LIVES WITHIN THEIR HOMES AND COMMUNITIES. SPECIFIC SERVICES OFFERED INCLUDE EVALUATIONS AND ASSESSMENTS, PSYCHIATRIC MEDICATION MANAGEMENT, PSYCHIATRIC CONSULTATION, INDIVIDUAL THERAPY, FAMILY THERAPY, GROUP THERAPY, AND MARRIAGE COUNSELING. THIS PROGRAM SERVED 17,253 INDIVIDUALS DURING THE JUNE 30, 2011 FISCAL YEAR. PHILHAVEN PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE PHILHAVEN DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. CRITERIA FOR CHARITY CARE CONSIDER THE PATIENT'S FAMILY INCOME, NET WORTH, ETC.PHILHAVEN MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE AND COMMUNITY SERVICE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FOREGONE BASED ON ESTABLISHED RATES FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE AND COMMUNITY SERVICES POLICIES, THE ESTIMATED COST OF THOSE SERVICES AND THE NUMBER OF PATIENTS RECEIVING SERVICES UNDER THESE POLICIES. CHARGES FOREGONE FOR CHARITY CARE SERVICE WERE $200,078 AND $183,056 FOR THE YEARS ENDED JUNE 30, 2011 AND 2010, RESPECTIVELY. ADDITIONALLY, PHILHAVEN SPONSORS CERTAIN OTHER SERVICE PROGRAMS AND CHARITY SERVICES WHICH PROVIDE SUBSTANTIAL BENEFIT TO THE BROADER COMMUNITY. SUCH PROGRAMS INCLUDE EDUCATIONAL FEATURES FOR THE GENERAL COMMUNITY AS WELL AS FOR OTHER PROFESSIONAL HEALTH CARE PROVIDERS IN THE COMMUNITY ON SUCH TOPICS AS WOMEN'S ISSUES, PAIN MANAGEMENT, STRESS MANAGEMENT, SUBSTANCE ABUSE AS WELL AS OTHER MENTAL HEALTH ISSUES. CHARITY SERVICES ARE ALSO PROVIDED TO LOCAL DISASTER RESPONSE PROFESSIONALS FOLLOWING TRAUMATIC EVENTS IN THE COMMUNITY. 48419292 1 1 0 1 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 97 0 1 1143 1 1 1 0 0 0 0 1 1 0 0 0 0 X 15 15 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 PA X MATTHEW D ROGERS CFO 7172702414 283 SOUTH BUTLER ROAD MOUNT GRETNA PA 17064 REBECCA BURKHOLDER 1.50 X X 0 0 0 KENNETH L MOORE 1.50 X X 0 0 0 JANET BRENEMAN 1.30 X 0 0 0 ROBERT FORTNA 1.30 X 0 0 0 JANET R STAUFFER 1.50 X X 0 0 0 SAM THOMAS 1.30 X 0 0 0 ROBERT HOFFMAN 1.30 X 0 0 0 GEORGE STOLTZFUS 1.50 X X 0 0 0 AARON GROFF 1.30 X 0 0 0 JAMES SPICER 1.30 X 0 0 0 MONIQUA ACOSTA 1.30 X 0 0 0 DUANE BRITTON 1.30 X 0 0 0 AUDREY GROFF 1.30 X 0 0 0 JAMES HERR 1.30 X 0 0 0 DAVID WARREN 1.30 X 0 0 0 FRANCIS D SPARROW MD 52.00 X 300000 0 31242 PHILIP D HESS 50.00 X 177047 0 37097 MATTHEW ROGERS 50.00 X 100708 0 7857 OLANIYI I OLULEYE 40.00 X 252143 0 31555 EUGENIA ABONYI 40.00 X 245029 0 22478 PAUL YEUNG 40.00 X 240728 0 25655 MUSTAFA KALEEM 40.00 X 254923 0 38234 THOMAS FENSTERMACHER 40.00 X 226229 0 37764 1796807 0 231882 28 0 1 0 GLS ENTERPRISES PO BOX 673 LEBANON PA 17042 PHARMACY 327975 ALLCARE FAMILY HEALTH PO BOX 1210 LEBANON PA 17042 PHYSICIAN SERVICES 207000 KE LLC 607 PINKERTON ROAD MTJOY PA 17552 OFFICE RENTAL 180464 GOOD SAMARITAN HOSPITAL PO BOX 1281 LEBANON PA 17042 MEDICAL LAB SVC 165192 MOORE BUSINESS PARK 780 EDEN ROAD LANCASTER PA 17601 OFFICE RENTAL 147500 6 35250 500000 348621 883871 NET PATIENT SERVICE RE 624100 53218563 53218563 53218563 136781 8034 128747 5303 5601 -298 -298 -298 10112 17070 -19193 24379 29305 -7309 21996 21996 13560 35250 29843 -16283 -16283 INS. PREM. RECOVERY 624100 3812609 3812609 FARM INCOME 110000 521214 521214 MISCELLANEOUS INCOME 624100 350 350 4334173 58578803 53218563 529248 3947121 549722 515784 31996 1942 33966077 31721400 2129364 115313 380365 380365 5747758 5618345 98302 31111 2412295 2248041 155816 8438 64861 64861 1431 1431 69075 13240 55835 96400 96400 37324 37324 17951 1607 16344 1853810 1190060 650179 13571 66785 57 66728 3025468 2361072 656398 7998 133088 133088 3147313 2417613 729700 399581 383042 16539 539759 368529 171230 1241078 323356 917722 BAD DEBTS 398567 398567 BOOKS, DUES & SUBSCRIPT 210710 60994 148978 738 FARM EXPENSES 193271 193271 FEDERAL INCOME TAX 33371 33371 TAXES AND LICENSES 16654 16654 269180 109063 157060 3057 54871894 48419292 6216571 236031 23398 25467 1236385 2375342 532167 438668 6888519 9213342 21402 19928 1324205 1388741 41282324 29393562 12002375 11888762 5347082 5845626 890610 936246 12640 10273 406070 459493 28684853 32601888 4814087 5358250 8634 16079 4351069 3923318 9173790 9297647 X 18389263 22310553 689539 513623 432261 480065 19511063 23304241 28684853 32601888 X 3706909 86269 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 96400 0 0 0 96400 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: THE HOSPITAL ENGAGED A PROFESSIONAL LOBBYING FIRM TO ASSIST IN SECURING GOVERNMENTAL FUNDING FOR SPECIALIZED PROGRAMS. 429302 60967 490269 401011 28291 429302 473539 -72528 401011 0.00000 1.00000 0.00000 0 0 355952 355952 16488807 10459796 6029011 23912848 18908539 5004309 524717 25227 499490 11888762 58578803 54871894 3706909 86269 86269 3793178 58389096 86269 4846 -299922 -208807 58597903 16344 -35444 -19100 58578803 54595918 4846 35444 40290 54555628 16344 299922 316266 54871894 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE PURPOSE OF THESE DONOR RESTRICTED FUNDS IS TO PROVIDE A STABLE SOURCE OF PERPETUAL FINANCIAL SUPPORT FOR THE PHILHAVEN PROGRAMS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: PHILHAVEN IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES. THE FARM'S INCOME IS TAXABLE FOR FEDERAL PURPOSES AS UNRELATED BUSINESS INCOME. PHILHAVEN AND THE FARM PRESCRIBE A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY IN RECORDING TAX LIABILITIES IN THE FINANCIAL STATEMENTS. MEASUREMENT AND RECOGNITION OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. NO SUCH LIABILITIES ARE RECORDED AT JUNE 30, 2011 AND 2010. THE ORGANIZATION'S FEDERAL EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURNS FOR THE YEARS ENDED JUNE 30, 2010, 2009, AND 2008 REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. PART XII, LINE 2D - OTHER ADJUSTMENTS: INCOME TAX EXPENSE -41,831. FUNDRAISING EXPENSES RPT AS NON-OPERATING GAIN/LOSS -258,091. PART XII, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSE -29,843. RENTAL EXPENSES -5,601. PART XIII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 29,843. RENTAL EXPENSES 5,601. PART XIII, LINE 4B - OTHER ADJUSTMENTS: INCOME TAX EXPENSE 41,831. FUNDRAISING EXPENSES RPT AS NON-OPERATING GAIN/LOSS 258,091. X X 1 BENEVON 4528 EIGHT AVENUE NE SEATTLE WA 98105 FUNDRAISING PROGRAM CONSULTANT 0 294562 27200 267362 ENDOWMENT HORIZONS PO BOX 196 WATERVILLE OH 43566 CONSULTING ON PLANNED GIVING PROGRAM 0 0 5140 0 294562 32340 267362 PA GOLF TOURNAMENT 48810 35250 13560 2272 4421 19575 2274 1301 48810 35250 13560 2272 4421 19575 2274 1301 29843 -16283 1 1 1 X 1 X 1 0 0 198044 58468 139576 0.00250 102362 102362 0.00190 300406 58468 241938 0.00440 348202 184869 163333 0.00300 93188 93188 0.00170 441390 184869 256521 0.00470 741796 243337 498459 0.00910 0 400201 293798 2803249 2773665 29584 X 1 1 1 1 PHILHAVEN

283 SOUTH BUTLER ROAD PO BOX 550 MOUNT GRETNA PA 17064

X PHILHAVEN 1 0 1 1 150.000000000000 1 300.000000000000 1 X X X 1 1 X X 1 X 1 X X X X 0 X X 0 1 PART I, LINE 7: A COST TO CHARGE RATIO WAS USED TO DETERMINE THE AMOUNTS REPORTED IN THE CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS ITEMS. COST ACCOUNTING WAS USED TO DETERMINE THE AMOUNTS REPORTED IN THE OTHER BENEFITS SECTION. BAD DEBT AND OTHER WRITE-OFFS ARE EXCLUDED IN THE DENOMINATOR WHICH, IF INCLUDED, WOULD INCREASE THE PERCENTAGE OF CHARITY CARE REPORTED. THE AMOUNT OF BAD DEBT NOT INCLUDED IN THE CALCULATION WAS $400,201. PART II: N/A PART III, LINE 4: PHILHAVEN RECOGNIZES THE PROVISION FOR BAD DEBTS AND THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED ON HISTORICAL EXPERIENCE. A COST CHARGE RATIO WAS USED TO DETERMINE THE AMOUNTS REPORTED AS BAD DEBT. BAD DEBT IS RECORDED BASED ON THE NET BALANCE OF THE AGED RECEIVABLES ACCOUNT. ALL DISCOUNTS AND PAYMENTS ARE RECORDED PRIOR TO THE ADJUSTMENT OF THE BAD DEBT ACCOUNT. A SAMPLE OF CHARITY CARE APPLICATIONS WAS REVIEWED TO DETERMINE A RATIO OF REQUESTED CHARITY CARE TO GRANTED CHARITY CARE. THIS PERCENTAGE WAS APPLIED TO THE BAD DEBT BALANCE. PART III, LINE 8: PHILHAVEN USES A COST TO CHARGE RATIO FOR APPLICABLE LEVELS OF CARE REIMBURSED BY MEDICARE. THESE INCLUDE INPATIENT, OUTPATIENT AND DAY/IOP PROGRAMS. PART III, LINE 9B: THE ORGANIZATION DOES NOT PURSUE COLLECTIONS AGAINST PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE. THIS POLICY, HOWEVER, IS NOT CURRENTLY DOCUMENTED. THE ORGANIZATION IS WORKING TO MAKE THE POLICY AGAINST COLLECTION EFFORTS FOR FINANCIALLY NEEDY PATIENTS MORE FORMALIZED IN THEIR WRITTEN PROCEDURES. PHILHAVEN PART V, SECTION B, LINE 17E: A MINIMUM OF THREE ATTEMPTS TO COLLECT PAYMENT FROM THE PATIENT IS REQUIRED PRIOR TO REFERRAL TO A CREDIT AGENCY. PHILHAVEN PART V, SECTION B, LINE 19D: THE HOSPITAL CHARGES THE USUAL AND CUSTOMARY (GROSS) CHARGE TO SELF-PAY PATIENTS. PHILHAVEN PART V, SECTION B, LINE 21: USUAL AND CUSTOMARY (GROSS) CHARGES ARE USED TO INVOICE SELF-PAY PATIENTS. PART VI, LINE 2: PHILHAVEN SENIOR MANAGEMENT REGULARLY MEETS WITH LEADERSHIP OF THE COUNTY GOVERNMENTS AND LEADERSHIP OF LOCAL COMMUNITY HOSPITALS, HEALTH SYSTEMS AND OTHER PHYSICAL HEALTHCARE PROVIDERS TO IDENTIFY HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES RELATED TO MENTAL HEALTH AND PSYCHIATRY. ADDITIONALLY PHILHAVEN REGULARLY SURVEYS ITS OWN PATIENTS TO GAIN A BETTER UNDERSTANDING OF THEIR NEEDS AND SATISFACTION WITH SERVICES PROVIDED. PART VI, LINE 3: THE "CHARITY CARE" POLICY IS POSTED IN ALL ADMISSIONS / WAITING AREAS. UPON ADMISSION THE PATIENT IS INFORMED, IN WRITING, OF THEIR LIABILITY. SHOULD A PATIENT BE IDENTIFIED UPON ADMISSION OR DURING THE COURSE OF TREATMENT AS HAVING NO INSURANCE COVERAGE A CHARITY CARE COORDINATOR WILL MEET WITH THEM OR THEIR RESPONSIBLE PARTY TO REVIEW THE "CHARITY CARE" POLICY AND ASSIST IN APPLICATION FOR FINANCIAL ASSISTANCE THROUGH THE CHARITY CARE POLICY AND/OR THROUGH AN APPLICATION TO MEDICAL ASSISTANCE. PART VI, LINE 4: PHILHAVEN PRIMARILY SERVES FOUR COUNTIES IN CENTRAL PENNSYLVANIA (LEBANON, LANCASTER, YORK, AND DAUPHIN). THESE COUNTIES INCLUDE THE CITIES OF HARRISBURG, LANCASTER, LEBANON, AND YORK ALONG WITH RURAL AREAS. FIFTY-FOUR PERCENT OF THE PATIENTS WE SERVE ARE FEMALE AND FORTY-SIX PERCENT ARE MALE. ADDITIONALLY SEVENTY-THREE PERCENT OF THE PATIENTS WE SERVE ARE CAUCASIAN, TEN PERCENT ARE HISPANIC, FOUR PERCENT ARE AFRICAN-AMERICAN, AND THIRTEEN PERCENT IDENTIFY THEMSELVES AS ANOTHER RACE OR MIXED RACE. PART VI, LINE 6: PHILHAVEN MAKES MEMBERS OF ITS MEDICAL AND CLINICAL STAFF AVAILABLE TO VARIOUS COMMUNITY ORGANIZATIONS. INCLUDED IN THIS ARE PSYCHIATRIC: PHILHAVEN PROVIDES CONSULTATIONS FROM ITS MEDICAL STAFF MEMBERS TO LOCAL COMMUNITY AND ACUTE CARE HOSPITALS. ADDITIONALLY PHILHAVEN PROVIDES MEDICAL STAFF AND CLINICAL STAFF TO A LOCAL SCHOOL DISTRICT FOR PSYCHIATRIC AND THERAPEUTIC CONSULTATION OR DIRECT SERVICES SERVICES AT NO CHARGE. PHILHAVEN ENCOURAGES ITS SENIOR MANAGEMENT AND EMPLOYEES TO VOLUNTEER THEIR TIME FOR LOCAL NON-PROFIT ORGANIZATIONS. THESE STAFF PROVIDE MENTAL HEALTH EXPERTISE TO NON-PROFIT AGENCIES PROVIDING SERVICES TO HOMELESS PERSONS, PERSONS WITH DEVELOPMENTAL DISABILITIES, AND PERSONS WITH MENTAL ILLNESS. ADDITIONALLY, PHILAHVEN ALLOWS SOME LOCAL NON-PROFIT ORGANIZATIONS USE OF ITS TRAINING FACILITIES AT NO CHARGE INCLUDING OTHER HEALTH CARE ORGANIZATIONS. TRAININGS SPONSORED BY PHILHAVEN ARE ALSO MADE AVAILABLE TO OTHER MENTAL HEALTH AND PHYSICAL HEALTHCARE PROVIDERS ON A VARIETY OF MENTAL HEALTH TOPICS IMPROVING THE OTHER HEALTHCARE PROVIDERS' ABILITY TO SERVE PATIENTS WITH MENTAL ILLNESS. PART VI, LINE 7: N/A X X X X X 0 0 0 0 0 0 0 0 0 FRANCIS D SPARROW MD 300000 0 0 0 0 0 15925 0 15317 0 331242 0 0 0 PHILIP D HESS 177047 0 0 0 0 0 18562 0 18535 0 214144 0 0 0 OLANIYI I OLULEYE 252143 0 0 0 0 0 11317 0 20238 0 283698 0 0 0 EUGENIA ABONYI 245029 0 0 0 0 0 13995 0 8483 0 267507 0 0 0 PAUL YEUNG 240728 0 0 0 0 0 5417 0 20238 0 266383 0 0 0 MUSTAFA KALEEM 254923 0 0 0 0 0 19699 0 18535 0 293157 0 0 0 THOMAS FENSTERMACHER 226229 0 0 0 0 0 19229 0 18535 0 263993 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 PHILHAVEN IS CONTROLLED BY THE LANCASTER CONFERENCE OF THE MENNONITE CHURCH. UNDER THE BYLAWS OF PHILHAVEN CONTROL IS EXERCISED VIA CERTAIN RESERVE POWERS, INCLUDING THE APPROVAL AND APPOINTMENT OF MEMBERS OF THE GOVERNING BODY, APPROVAL OF THE APPOINTMENT OF THE CHIEF EXECUTIVE OFFICER AND APPROVAL OF AMENDMENTS TO THE BYLAWS AND ARTICLES OF INCORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE LANCASTER MENNONITE CONFERENCE APPOINTS THREE MEMBERS OF THE BOARD OF DIRECTORS. ADDITIONALLY, THE LANCASTER MENNONITE CONFERENCE WILL APPROVE THE SELECTION OF ALL AT-LARGE MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE LANCASTER MENNONITE CONFERENCE MUST APPROVE ANY CHANGE TO THE EXISTING BY-LAWS. FORM 990, PART VI, SECTION B, LINE 11 THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS PERFORMS AN INITIAL REVIEW OF THE 990. UPON THE FINANCE COMMITTEE'S APPROVAL, THE 990 GETS DISTRIBUTED TO ALL BOARD MEMBERS ELECTRONICALLY. EACH BOARD MEMBER WILL THEN HAVE THE OPPORTUNITY TO REVIEW THE 990 BEFORE THE RETURN'S SUBMISSION TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ALL MEMBERS OF THE BOARD OF DIRECTORS, EMPLOYEES WHO ARE DIRECTORS OR ABOVE, LICENSED PROFESSIONALS AND INDEPENDENT LICENSED PRACTITIONERS ARE SUBJECT TO PHILHAVEN'S CONFLICT OF INTEREST POLICIES. PHILHAVEN REQUIRES EACH MEMBER OF THE BOARD OF DIRECTORS TO DISCLOSE CONFLICTS OF INTEREST, OR POTENTIAL CONFLICTS OF INTEREST, TO THE PRESIDENT OF THE BOARD OF DIRECTORS ON AN ANNUAL BASIS. THE PRESIDENT MUST DISCLOSE CONFLICTS OF INTEREST, OR POTENTIAL CONFLICTS OF INTEREST, TO THE FULL BOARD OF DIRECTORS ON AN ANNUAL BASIS. IF A CONFLICT OF INTEREST IS IDENTIFIED THAT HAS NOT BEEN DECLARED THE BOARD MAY DECLARE BY RESOLUTION CARRIED BY TWO-THIRDS OF ITS MEMBERS PRESENT AT THE MEETING, THAT A CONFLICT OF INTEREST EXISTS AND THE MEMBER OF THE BOARD THUS FOUND TO BE IN CONFLICT SHALL WITHDRAW FROM THE MEETING OR REFRAIN FROM DISCUSSION OR VOTING IN RELATION TO THE MATTER. UPON HIRE AND ANNUALLY THEREAFTER ANY EMPLOYEE OR INDEPENDENT PRACTITIONER SUBJECT TO THE POLICIES IS REQUIRED TO COMPLETE A DISCLOSURE STATEMENT. ADDITIONALLY PHILHAVEN'S CHIEF LEGAL OFFICER IS REQUIRED TO REVIEW ALL CONTRACTS OR AGREEMENTS WITH OTHER CARE PROVIDERS OR FOR OTHER SERVICES TO IDENTIFY ANY CONFLICTS OF INTEREST. SHOULD A CONFLICT OF INTEREST WITH AN EMPLOYEE OR WITH AN AGREEMENT OR CONTRACT WITH A THIRD PARTY BE IDENTIFIED, THE CHIEF LEGAL OFFICE AND MEDICAL DIRECTOR SHALL REVIEW THE CIRCUMSTANCES TO MAKE A DECISION ON THE APPROPRIATE ACTION. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS SHALL DETERMINE AND APPROVE IN ADVANCE THE COMPENSATION ARRANGEMENTS FOR IDENTIFIED EXECUTIVE EMPLOYEES WHO ARE IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER PHILHAVEN'S AFFAIRS. EXECUTIVE EMPLOYEES SUBJECT TO THIS POLICY INCLUDE THE CHIEF EXECUTIVE OFFICER AND MEDICAL DIRECTOR. IN MAKING ITS DETERMINATION, THE EXECUTIVE COMMITTEE SHALL RELY UPON APPROPRIATE DATA AND INFORMATION AS TO THE COMPARABILITY OF COMPENSATION ARRANGEMENTS. RELEVANT FACTORS THAT MAY BE CONSIDERED INCLUDE, BUT ARE NOT LIMITED TO: 1. COMPENSATION PAID BY SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX-EXEMPT, FOR FUNCTIONALLY COMPARABLE POSITIONS; 2. CURRENT COMPENSATION SURVEYS CONDUCTED BY INDEPENDENT FIRMS; 3. EXECUTIVE EMPLOYEE'S SALARY HISTORY WITH OTHER ORGANIZATIONS; 4. ACTUAL WRITTEN OFFERS FROM SIMILAR ORGANIZATIONS COMPETING FOR THE SERVICES OF THE EXECUTIVE; AND 5. AVAILABILITY OF SIMILARLY QUALIFIED EXECUTIVES IN THE GEOGRAPHIC AREA. THE EXECUTIVE COMMITTEE'S DECISION MUST BE CONTEMPORANEOUSLY DOCUMENTED IN WRITING. THE CEO DETERMINES THE COMPENSATION FOR THE CHIEF FINANCIAL OFFICER. FORM 990, PART VI, SECTION C, LINE 19 PHILHAVEN DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC THROUGH THE INTERNET OR OTHER SIMILAR MEDIA. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO EMPLOYEES AT ANY TIME VIA THE COMPANY INTRA-NET. AUDITED FINANCIAL STATEMENTS ARE ROUTINELY SUBMITTED TO OTHER PARTIES INCLUDING FINANCIAL INSTITUTIONS AND LOCAL GOVERNMENT AGENCIES. ANY OF THESE DOCUMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 86,269. AUDIT OVERSIGHT: FORM 990, PART XII, LINE 2C PHILHAVEN'S FINANCE COMMITTEE OF THE BOARD OF DIRECTORS SERVES AS THE AUDIT COMMITTEE. THE AUDIT COMMITTEE IS RESPONSIBLE FOR APPOINTING INDEPENDENT AUDITORS INCLUDING INTERVIEWING POTENTIAL FIRMS AND ESTABLISHING THE TERMS OF THE CONTRACTUAL AGREEMENTS. ADDITIONALLY THE AUDIT COMMITTEE IS RESPONSIBLE FOR REVIEWING AND APPROVING THE AUDITED FINANCIAL STATEMENTS. AT THE CONCLUSION OF THE AUDIT THE AUDIT COMMITTEE MEETS WITH THE INDEPENDENT AUDITORS WITHOUT MANAGEMENT PRESENT TO REVIEW THE RESULTS OF THE AUDIT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. KE LLC 283 S BUTLER ROAD PO BOX 550 MT GRETNA PA 17064 232647658 REAL ESTATE RENTAL PA N/A UNRELATED 55636 936246 0 8034 1 0.50000 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 KE LLC J 153690 FMV