2012-05-15T12:59:56-05:00 2011-06-30 PARENTEBEARD LLC 400 MARKET STREET WILLIAMSPORT PA 17701 990 2010-07-01 240795436 GNADEN HUETTEN MEMORIAL HOSPITAL GNAD 6103771300 211 NORTH 12TH STREET LEHIGHTON PA 182351195 ANDREW E HARRIS 6103771300 2012-05-15 1 JULIUS C GREEN CPA JD 5703236023 2010 2016-02-24 21:20:13Z ANDREW E HARRIS 211 NORTH 12TH STREET LEHIGHTON PA 182351195 61475912 0 X WWW.BLMTN.ORG X 1947 PA OPERATES A 101 BED ACUTE CARE HOSP, A 91 BED SKILLED NURSING FACILITY & A HOME HEALTH CARE AGENCY. 16 15 817 104 0 0 281756 310128 57251697 60458091 57142 37731 394727 599899 57985322 61405849 639038 1295860 0 0 29445075 31314073 0 0 0 28163441 27934320 58247554 60544253 -262232 861596 32158989 31439458 37689284 31829318 -5530295 -389860 X PROMOTE, MAINTAIN AND RESTORE THE GOOD HEALTH OF ALL THE PEOPLE IN THE COMMUNITIES WE SERVE THROUGH PARTNERSHIPS FOR EXCELLENCE IN HEALTHCARE SERVICE DELIVERY. 0 0 52573359 1295860 60458091 GNADEN HUETTEN MEMORIAL HOSPITAL (THE "HOSPITAL"), LOCATED IN LEHIGHTON, PENNSYLVANIA, IS A 101-BED, NOT-FOR-PROFIT GENERAL ACUTE CARE HOSPITAL SERVING THE RESIDENTS OF CARBON, SCHUYLKILL AND MONROE COUNTIES. THE HOSPITAL'S SERVICES PROVIDE BOTH INPATIENT AND OUTPATIENT CARE, INCLUDING HOME HEALTH CARE, MEDICAL/SURGICAL SERVICES, MENTAL HEALTH SERVICES AND ACUTE REHABILITATION SERVICES. THE HOSPITAL ALSO OFFERS A BROAD ARRAY OF ANCILLARY SERVICES SUCH AS RADIOLOGY, EMERGENCY, CARDIOLOGY AND REHABILITATION SERVICES.DURING THE PERIOD OF JULY 1, 2010 THROUGH JUNE 30, 2011, THE HOSPITAL HAD A TOTAL OF 3,202 ADMISSIONS AND 15,953 PATIENT DAYS. TOTAL OCCUPANCY FOR THE HOSPITAL WAS 46%. IN ADDITION, THERE WERE A TOTAL OF 20,644 EMERGENCY ROOM VISITS AND 18,075 HOME HEALTH CARE VISITS. IN ADDITION TO THE SERVICES PROVIDED AS INDICATED ABOVE, THE HOSPITAL ALSO PROVIDES LONG-TERM CARE SERVICES THROUGH AN ON-CAMPUS 91-BED SKILLED NURSING UNIT. DURING THE PERIOD OF JULY 1, 2010 THROUGH JUNE 30, 2011, THE SKILLED NURSING UNIT HAD 228 ADMISSIONS AND PATIENT DAYS OF APPROXIMATELY 47,900. TOTAL OCCUPANCY FOR THE SKILLED NURSING UNIT WAS 95.6%. 52573359 1 1 0 1 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 54 0 1 817 1 0 0 0 0 0 0 0 0 1 0 X 16 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X ANDREA L ANDRAE 6103777003 211 NORTH 12TH STREET LEHIGHTON PA 18235 X BARBARA GREEN 1.00 X 0 0 0 CONRAD BIEGE 1.00 X X 0 0 0 JAIME MENDES 1.00 X 0 0 0 WILLIAM H FEGLEY JR 1.00 X 0 0 0 PATRICK HANLEY DO 1.00 X X 0 0 0 MICHAEL HARLEMAN 1.00 X X 0 0 0 MARK SVERCHEK 1.00 X 0 0 0 WILLIAM MASON 1.00 X 0 0 0 WILLIAM MARKSON MD 1.00 X 0 0 0 THOMAS MUNSHOWER DO 1.00 X 0 0 0 SHELBA SHEFNER 1.00 X 0 0 0 RICHARD ROTHFLEISCH MD 1.00 X 0 0 0 STEVEN SERFASS 1.00 X 0 0 0 LOUIS SPORTELLI DC 1.00 X 0 0 0 PATRICK REILLY 1.00 X X 0 0 0 ANDREW E HARRIS 25.00 X X 380741 0 46182 KRISTA RIMSKY 20.00 X 112689 0 16903 JASON HOWAY 20.00 X 103078 0 15462 CLEMENT MCGINLEY 20.00 X 138294 0 18944 TERRENCE PURCELL 25.00 X 134942 21 18411 ANTONETTE GIBSON 25.00 X 102745 0 14035 972489 21 129937 7 0 1 0 REHAB CARE GROUP PO BOX 502096 ST LOUIS MO 63150 ADMINISTER ACUTE REHAB PROGRAM 1416485 CARDIOLOGY ASSOCIATES 1241 BLAKESLEE BLVD LEHIGHTON PA 18235 ADMINISTER CARDIOLOGY PROGRAM 521632 LAB CORP OF AMERICA 231 MAPLE AVENUE BURLINGTON NC 272162140 LAB SERVICES 466494 ISS SOLUTIONS PO BOX 713700-1066 PHILADEPHIA PA 191911066 EQUIPMENT SERVICES 359740 SIEMENS MEDICAL SOLUTIONS USA PO BOX 7777 W3580 PHILADEPHIA PA 19175 IT SERVICES 349851 21 142946 41449 125733 310128 NET PATIENT SVC REV 621990 60458091 60458091 60458091 38794 38794 160635 63000 97635 97635 97635 6000 7063 -1063 -1063 -1063 CAFETERIA MEALS 900099 182773 182773 MATERNITY HEALTH 621990 122947 122947 BLACK LUNG COALITION 624100 72229 72229 124315 55908 68407 502264 61405849 60709175 0 386546 1295860 1295860 426923 426923 22409564 19678762 2730802 1578188 1389467 188721 4683541 4123480 560061 2215857 1950883 264974 127941 127941 90920 90920 4758 4758 7082371 5565839 1516532 153607 131 153476 6126376 5645096 481280 914236 311615 602621 1445593 1445593 135549 122215 13334 9839 4880 4959 686393 686393 2381723 2381723 1707453 1707453 BAD DEBT EXPENSE 3950896 3950896 DRUGS 1252843 1252843 REPAIRS & MAINTENANCE 391721 382247 9474 LAUNDRY & LINENS 220399 220399 DUES & SUBSCRIPTIONS 167931 57958 109973 1083771 394868 688903 60544253 52573359 7970894 0 2187 2028 1343762 630715 5883845 6516293 746891 831467 419595 619088 60711639 44421323 18038551 16290316 2488763 2440941 3235395 4108610 32158989 31439458 6933093 6881917 10955000 10080000 271385 109314 19529806 14758087 37689284 31829318 X -5614606 -476484 84311 86624 -5530295 -389860 32158989 31439458 X 861596 4278839 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 4758 0 0 0 4758 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: A PORTION OF THE DUES PAID TO THE HOSPITAL & HEALTHSYSTEM ASSOCIATION OF PENNSYLVANIA ($4,758) WAS DETERMINED TO BE FOR LOBBYING PURPOSES. 84311 0 15994 12024 1657 86624 636097 41098 -414 592470 84311 1022053 -39694 346262 636097 1.00000 0 0 477770 477770 25956003 16221903 9734100 663068 478885 184183 32558365 26915133 5643232 1056433 805402 251031 16290316 DUE FROM PALMERTON HOSPITAL 2364568 BENEFICIAL INTEREST IN PERPETUAL TRUST 86624 DEFERRED FINANCING COSTS, NET 121893 OTHER ASSETS 635594 PHYSICIAN INCOME GUARANTEE 899931 4108610 OBLIGATIONS UNDER CAPITAL LEASES 1226896 BLUE CROSS WORKING CAPITAL ADVANCE 304227 PENSION LIABILITY 12524440 ESTIMATED MEDICAL MALPRACTICE CLAIMS LIABILITY 702524 14758087 61405849 60544253 861596 4278839 4278839 5140435 65747688 4278839 4278839 61468849 -63000 -63000 61405849 60607253 63000 63000 60544253 0 60544253 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: PART V, LINE 4: TERM ENDOWMENT FUNDS ARE USED FOR THE PURCHASE OF PLANT AND EQUIPMENT TO FURTHER THE MISSION OF THE ORGANIZATION. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE HOSPITAL ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S FINANCIAL STATEMENTS AND PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. MANAGEMENT HAS DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2011 OR 2010. THE HOSPITAL'S FEDERAL EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURNS FOR 2008, 2009, AND 2010 REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. PART XI, LINE 8 - OTHER ADJUSTMENTS: PENSION LIABILITY ADJUSTMENT 4,276,526. VALUATION GAIN 2,313. PART XII, LINE 2D - OTHER ADJUSTMENTS: PENSION LIABILITY ADJUSTMENT 4,276,526. VALUATION GAIN 2,313. PART XII, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -63,000. PART XIII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 63,000. 1 1 X 1 X 1 X 1 0 0 130285 105754 24531 0.00040 8859580 6854569 2005011 0.03540 8989865 6960323 2029542 0.03580 161719 161719 0.00290 8800 8800 0.00020 3885433 2700777 1184656 0.02090 66102 53531 12571 0.00020 4122054 2754308 1367746 0.02420 13111919 9714631 3397288 0.06000 0 1500057 150006 20612430 19409324 1203106 X 1 0 1 1 GNADEN HUETTEN MEMORIAL HOSPITAL INC

211 NORTH 12TH STREET LEHIGHTON PA 18235

X X X SKILLED NURSING FACILITY NOT REQUIRED 1 PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES INCLUDED UNDER SCHEDULE H FOR THE PALMERTON HOSPITAL ARE THE ADULT DAY SERVICES PROGRAM AND THE EMERGENCY DEPARTMENT. ADULT DAY SERVICES OF THE BLUE MOUNTAIN HEALTH SYSTEM OFFERS AN ALTERNATIVE TO NURSING CARE WHILE PROVIDING RESPITE FOR THOSE CARING FOR SOMEONE AT HOME. THE PROGRAM OFFERS A WARM, FRIENDLY ATMOSPHERE AND THE OPPORTUNITY FOR SENIORS TO DEVELOP FRIENDSHIPS WHILE PARTICIPATING IN ACTIVITIES THEY ENJOY. OUR EXPERIENCED STAFF INCLUDES REGISTERED NURSES, LICENSED PRACTICAL NURSES, CERTIFIED THERAPEUTIC RECREATION SPECIALISTS AND CERTIFIED NURSE AIDES. THE PALMERTON HOSPITAL PROVIDED SUBSIDIES OF APPROXIMATELY $110,000 TO THE ADULT DAY SERVICES CENTER DURING FY2011.THE EMERGENCY DEPARTMENT LOCATED AT PALMERTON HOSPITAL PROVIDES AROUND-THE-CLOCK EMERGENCY SERVICES TO THE SURROUNDING COMMUNITIES WITHIN CARBON COUNTY. CARE IS PROVIDED TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY OR THEIR INSURANCE STATUS. DURING FY2011, THE PALMERTON EMERGENCY DEPARTMENT SAW 12,169 PATIENTS WITH A SUBSIDIZED COST TO PROVIDE THESE SERVICES OF $997,000 OF WHICH $605,000 IS INCLUDED IN THE MEDICAID SHORTFALL.SUBSIDIZED HEALTH SERVICES INCLUDED UNDER SCHEDULE H FOR THE GNADEN HUETTEN MEMORIAL HOSPITAL ARE THE FAMILY PLANNING CLINIC AND THE EMERGENCY DEPARTMENT. THE NATIONAL FAMILY PLANNING PROGRAM, ALSO KNOW AS TITLE X (TEN) OF THE PUBLIC HEALTH SERVICE ACT, WAS ESTABLISHED IN 1970 TO ENSURE THAT NO AMERICAN WOMAN WOULD BE DENIED ACCESS TO FAMILY PLANNING ASSISTANCE BECAUSE OF HER ECONOMIC CONDITION. FOR MORE THAN THREE DECADES, TITLE X HAS BEEN AN INTEGRAL COMPONENT OF OUR NATION'S PUBLIC HEALTH CARE SYSTEM, PROVIDING HIGH QUALITY FAMILY PLANNING SERVICES AND OTHER PREVENTIVE HEALTH CARE TO LOW-INCOME OR UNINSURED INDIVIDUALS WHO MAY OTHERWISE LACK ACCESS TO HEALTH CARE. MATERNAL AND FAMILY HEALTH SERVICES ADMINISTERS THE PROGRAM THROUGH A NETWORK OF DIRECT AND CONTRACT SERVICE PROVIDERS. IN ADDITION TO DIRECT SITES, THE NETWORK SYSTEM INCLUDES HOSPITALS, PLANNED PARENTHOOD AFFILIATES, COMMUNITY HEALTH CENTERS AND PHYSICIAN GROUPS. THE GNADEN HUETTEN MEMORIAL HOSPITAL PROVIDED SUBSIDIES OF APPROXIMATELY $17,000 TO OUR FAMILY PLANNING CLINIC DURING FY2011. THE EMERGENCY DEPARTMENT LOCATED AT GNADEN HUETTEN MEMORIAL HOSPITAL PROVIDES AROUND-THE-CLOCK EMERGENCY SERVICES TO THE SURROUNDING COMMUNITIES WITHIN CARBON COUNTY. CARE IS PROVIDED TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY OR THEIR INSURANCE STATUS. DURING FY2011, THE GNADEN HUETTEN MEMORIAL HOSPITAL EMERGENCY DEPARTMENT SAW 20,644 PATIENTS WITH A SUBSIDIZED COST TO PROVIDE THESE SERVICES OF $2,772,000 OF WHICH $1,604,000 IS INCLUDED IN THE MEDICAID SHORTFALL. PART I, L7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25 COLUMN (A) BUT SUBTRACTED OUT FOR PURPOSES OF CALCULATING THE PERCENTAGE ON SCH H, PART I, LINE 7, COLUMN (F) IS $3,950,896. PART II: IN 2011, THE HOSPITALS, PROGRAMS AND SERVICES OF THE BLUE MOUNTAIN HEALTH SYSTEM PROVIDED MANY COMMUNITY HEALTH IMPROVEMENT SERVICES. INCLUDED IN THIS CATEGORY ARE THE COMMUNITY OUTREACH PROGRAMS AND SERVICES OFFERED BY THE HEALTH SYSTEM'S COMMUNITY EDUCATION PROGRAM THAT INCLUDES HEALTH AND WELLNESS EDUCATION, LIFE-SAVING CPR AND EMERGENCY SUPPORT AND INFORMATION, AND SPECIFIC PROGRAMMING TO HELP PEOPLE MAKE HEALTHIER LIFESTYLE CHOICES. ALSO INCLUDED ARE THE MYRIAD OF SUPPORT GROUP ACTIVITIES THAT HELP PATIENTS AND THEIR FAMILIES MANAGE CHRONIC HEALTH CONDITIONS.DURING DIFFICULT ECONOMIC TIMES WHEN MORE PEOPLE ARE UNEMPLOYED OR ARE STRUGGLING TO MAKE ENDS MEET, COMMUNITY MEMBERS RELY UPON THE HOSPITALS OF THE BLUE MOUNTAIN HEALTH SYSTEM'S LONG STANDING TRADITION TO PROVIDE NEEDED MEDICAL CARE REGARDLESS OF INSURANCE COVERAGE OR FINANCIAL ABILITY TO PAY FOR SERVICES.FOR THE BLUE MOUNTAIN HEALTH SYSTEM, FISCAL YEAR 2010 WAS ONE OF THE MOST CHALLENGING FINANCIAL YEARS IN ITS HISTORY. DECREASING GOVERNMENT REIMBURSEMENT, LOWER THAN ANTICIPATED PATIENT VOLUME AND GREATER NUMBERS OF PEOPLE NEEDING FINANCIAL ASSISTANCE COMBINED TO CREATE NEARLY THE PERFECT STORM, WREAKING HAVOC WITH OUR FINANCIAL EXPECTATIONS EARLY ON IN THE YEAR. YET, THE HEALTH SYSTEM NEVER WAVERED FROM EITHER ITS NOT-FOR-PROFIT MISSION OR ITS ATTENTION TO QUALITY CARE AND PATIENT SAFETY. IN FACT, ANY SURPLUS FUNDS ARE USED FOR TWO MAIN ITEMS, CAPITAL EQUIPMENT PURCHASES OR FOR STAFF COMPENSATION. THE BLUE MOUNTAIN HEALTH SYSTEM PROVIDED OVER $4,800,000 IN PROGRAMS AND SERVICES TO MEET THE HEALTH NEEDS OF THE RESIDENTS OF OUR COMMUNITIES. THAT NUMBER, HOWEVER, REFLECTS ONLY A SMALL PIECE OF THE ORGANIZATION'S MISSION-DRIVEN STORY OF THIS PAST YEAR. (GNADEN HUETTEN MEMORIAL HOSPITAL - $3,400,000 AND PALMERTON HOSPITAL - $1,400,000).ATTENTIVE TO THE NEEDS OF OUR COMMUNITY'S LOWER INCOME AND MOST VULNERABLE POPULATIONS, THE HEALTH SYSTEM SERVED 450 PATIENTS THROUGH ITS FINANCIAL ASSISTANCE PROGRAMS. OVERALL, APPROXIMATELY $4,490,000 WAS PROVIDED IN FREE AND SUBSIDIZED PATIENT CARE. (GNADEN HUETTEN MEMORIAL HOSPITAL - $3,210,000 AND PALMERTON HOSPITAL - $1,280,000), WHICH ADDRESSES IDENTIFIED COMMUNITY HEALTH NEEDS OF ACCESS AND AFFORDABILITY OF MEDICAL CARE.IN THE AREA OF COMMUNITY HEALTH SERVICES, THERE WAS AN INCREASE IN BOTH THE INVESTMENT AND NUMBERS SERVED THROUGH COMMUNITY HEALTH AND WELLNESS EDUCATION AS WELL AS SCREENINGS AND FAIRS.THE BLUE MOUNTAIN HEALTH SYSTEM INVESTED APPROXIMATELY $216,000 (GNADEN HUETTEN MEMORIAL HOSPITAL - $162,000 AND PALMERTON HOSPITAL - $54,000) AND PROVIDED HEALTH AND WELLNESS EDUCATION FOR HUNDREDS OF COMMUNITY MEMBERS LAST YEAR. ONE AREA WHERE THE HEALTH SYSTEM'S INVESTMENT INCREASED DRAMATICALLY WAS IN EMERGENCY PREPAREDNESS AND RESPONSE - WORKING WITH THE CARBON COUNTY EMERGENCY MANAGEMENT AGENCY - WITH MORE THAN 50 STAFF PERSONS VOLUNTEERING TO PROVIDE NEARLY 2,000 FREE INFLUENZA VACCINES TO AREA RESIDENTS.IN THE FALL OF 2010, THE BLUE MOUNTAIN HEALTH SYSTEM COLLABORATED WITH THE CARBON COUNTY EMERGENCY MANAGEMENT AGENCY ON THE LARGEST SERVICE PROJECT IN RECENT YEARS - AN EMERGENCY PREPAREDNESS DRIVE-THRU INFLUENZA VACCINATION PROGRAM IN WHICH MORE THAN 2,100 FREE SEASONAL INFLUENZA VACCINATIONS WERE DISTRIBUTED TO AREA RESIDENTS. THIS PROGRAM WAS FOUND TO BE AN INVALUABLE ARRANGEMENT IN THE EVENT OF A MASS INOCULATION WOULD BE NEEDED. LOCAL FIRE, POLICE, AND AMBULANCE PERSONNEL AS WELL AS THE LOCAL SCHOOL DISTRICTS AND COLLEGE AND UNIVERSITY STUDENTS WERE INVOLVED IN THE PLANNING OF THE EVENT. APPROXIMATELY 50 STAFF PERSONS FROM THE HEALTH SYSTEM DONATED THEIR TIME AND EFFORT TO ENSURE THE PROJECT WAS A SUCCESSFUL ONE. THE HEALTH SYSTEM'S "HEALTHY SMILES, HAPPY KIDS" DENTAL VAN PROVIDES UNDER- OR NON-INSURED CHILDREN IN CARBON AND SCHUYLKILL COUNTIES WITH PREVENTATIVE AND RESTORATIVE DENTAL CARE. IN 2011, THE DENTAL VAN TEAM, CONSISTING OF A BOARD-CERTIFIED DENTIST, A DENTAL HYGIENIST AND A DENTAL ASSISTANT/DRIVER, CARED FOR 1,910 CHILDREN. THE VAN HAS BECOME THE "DENTAL HOME" FOR MORE THAN 1,610 CHILDREN SINCE ITS INCEPTION.FREE SCREENING MAMMOGRAMS AND BREAST ULTRASOUND PROCEDURES ARE PROVIDED TO WOMEN, AND MEN, WHO ARE UNINSURED OR WHO HAVE NO INSURANCE AS PART OF THE HEALTH SYSTEM'S WOMEN'S HEALTH SERVICES PROGRAM. DURING 2011, NEARLY 150 PERSONS TOOK ADVANTAGE OF THE BLUE MOUNTAIN HEALTH SYSTEM'S BREAST CANCER VOUCHER SCREENING PROGRAM. THE HEALTH SYSTEM'S LADIES NIGHT OUT EVENT SERVED APPROXIMATELY 250 WITH BREAST CANCER AWARENESS AND EDUCATION. SUPPORT GROUPS - ADULT DAY SERVICES CAREGIVER SUPPORT GROUP, WOMEN'S BREAST CANCER SUPPORT GROUP, BARIATRIC & WEIGHT LOSS SUPPORT GROUPSHEALTH FAIRS - CHILDREN'S HEALTH FAIR AND THE NATIONAL SENIOR HEALTH AND FITNESS DAYWORKFORCE WELLNESS PROGRAMHEALTH IMAGES TELEVISION PROGRAM/COMMUNITY NEWSLETTERGENERAL SCREENINGS PROVIDED AT OTHER ORGANIZATION'S EVENTS - BLOOD PRESSURE, CHOLESTEROL, BODY FAT ANALYSIS, STROKE RISK, DEPRESSION. FAMILY PLANNING CLINICHAVING HIGHLY TRAINED MEDICAL PERSONNEL BENEFITS EVERYONE IN THE COMMUNITY. BEYOND ON-GOING EDUCATION FOR PHYSICIANS, NURSES, EMERGENCY MEDICAL TECHNICIANS, AND OTHER CLINICIANS, THE BLUE MOUNTAIN HEALTH SYSTEM SUPPORTED NUMEROUS INITIATIVES IN 2011 TO FURTHER THE CAPABILITIES OF AREA MEDICAL PERSONNEL, INVESTING $17,600 IN HEALTH PROFESSIONS EDUCATION (GNADEN - $8,800 AND PALMERTON - $8,800). THE HEALTH SYSTEM PROVIDED CLINICAL ROTATIONS TO MEDICAL STUDENTS OF PENNSYLVANIA STATE UNIVERSITY AND PENNSYLVANIA COLLEGE OF OSTEOPATHIC MEDICINE THROUGH THE EAST CENTRAL AREA HEALTH EDUCATION CENTER. LIVING ACCOMMODATIONS ARE PROVIDED DURING THE TIME OF EACH STUDENT'S ROTATION. THROUGH THE HEALTH SYSTEM'S STAFF DEVELOPMENT DEPARTMENT, NUMEROUS PERSONS WERE TRAINED IN CPR, ALS, PALS, AND RHYTHM MONITORING. THE HEALTH SYSTEM ALSO PROVIDED A CLINICAL SETTING FOR UNDERGRADUATE NURSING STUDENTS ENROLLED IN VARIOUS LOCAL COLLEGES AND UNIVERSITIES, NAMELY, LEHIGH CARBON COMMUNITY COLLEGE, NORTHAMPTON AREA COMMUNITY COLLEGE, CEDAR CREST COLLEGE, WILKES UNIVERSITY AND JOHNSON COLLEGE OF TECHNOLOGY. HAVING HIGHLY TRAINED MEDICAL PERSONNEL BENEFITS EVERYONE IN THE COMMUNITY. BEYOND ON-GOING EDUCATION FOR PHYSICIANS, NURSES, EMERGENCY MEDICAL TECHNICIANS, AND OTHER CLINICIANS, THE BLUE MOUNTAIN HEALTH SYSTEM SUPPORTED NUMEROUS INITIATIVES IN 2010 TO FURTHER THE CAPABILITIES OF AREA MEDICAL PERSONNEL. PART III, LINE 4: ACCOUNTS RECEIVABLE, PATIENTS ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. THE ALLOWANCE FOR DOUBTFUL COLLECTIONS IS BASED UPON A PERIODIC REVIEW OF THE ACCOUNTS RECEIVABLE AGING, PAYOR CLASSIFICATIONS, AND APPLICATION OF HISTORICAL WRITE-OFF PERCENTAGES. THE TOTAL AMOUNT OF BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 WAS ESTIMATED BASED ON A PERCENTAGE OF TOTAL ADJUSTED PATIENT COST TO TOTAL ADJUSTED PATIENT CHARGES. THE TOTAL ADJUSTED PATIENT COSTS WAS CALCULATED AS FOLLOWS: TOTAL OPERATING EXPENSES AS REPORTED IN THE AUDITED FINANCIAL STATEMENTS LESS BAD DEBT EXPENSE, MEDICAID AND OTHER PROVIDER TAXES, NON PATIENT-CARE ACTIVITIES, AND NET COMMUNITY BENEFIT EXPENSE. TOTAL ADJUSTED OPERATING EXPENSES WERE APPROXIMATELY $25,877,000 FOR FY2011. TOTAL ADJUSTED PATIENT CHARGES WAS CALCULATED AS FOLLOWS: GROSS PATIENT CHARGES LESS GROSS CHARGES FOR COMMUNITY BENEFIT PROGRAMS. TOTAL ADJUSTED PATIENT CHARGES WERE APPROXIMATELY $73,908,000 FOR FY2011.MANAGEMENT DETERMINED APPROXIMATELY 10% OF THE TOTAL BAD DEBT EXPENSE REPORTED ON LINE 2 WAS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. PART III, LINE 8: NONE OF THE MEDICARE SHORTFALL REPORTED IN LINE 8 WAS TREATED AS A COMMUNITY BENEFIT. AMOUNTS REPORTED ON LINE 6 WERE OBTAINED FROM THE MEDICARE COST REPORT. PART VI, LINE 2: THE HOSPITALS OF THE BLUE MOUNTAIN HEALTH SYSTEM ASSESS THE COMMUNITY HEALTH NEEDS THROUGH REVIEW OF EMERGENCY ROOM STATISTICS AS WELL AS INQUIRY DURING REGULAR PENNSYLVANIA DEPARTMENT OF HEALTH SURVEYS TO IDENTIFY FAR-REACHING HEALTH NEEDS FACED BY PEOPLE IN THE COMMUNITIES SERVED BY THE HOSPITALS. THOSE RESULTS ARE EVALUATED OVER TIME AND SERVE AS THE BASIS TO DEVELOP NEW OR EXPANDED PLANS TO ADDRESS SERVICES IN RESPONSE TO NEED. THE BLUE MOUNTAIN HEALTH SYSTEM DEVELOPS PROGRAMS AND SERVICES TO ADDRESS COMMUNITY HEALTH NEEDS AND MAKES INVESTMENTS IN INITIATIVES THAT ALIGN WITH THE HEALTH SYSTEM'S CORE MISSION.BEYOND THAT FOCUS ARE PROGRAMS AND SERVICES THAT BENEFIT EVERY RESIDENT AND SUPPORT THE FAR REACHING GOAL OF A HEALTHIER COMMUNITY. THE HEALTH SYSTEM RELIES ON THE ENGAGEMENT AND SUPPORT OF KEY STAKEHOLDERS, INCLUDING THE MEDICAL STAFF OF THE HOSPITALS OF THE BLUE MOUNTAIN HEALTH SYSTEM, AS WELL AS THE VITAL CARBON COUNTY PARTNERS FOR PROGRESS AND NUMEROUS OTHER COMMUNITY ORGANIZATIONS. TOGETHER, WE WORK TOWARD DEVELOPING A NETWORK OF CARE AND SUPPORT THAT PROVIDES QUALITY MEDICAL CARE FOR OUR COMMUNITY MEMBERS.THE HEALTH SYSTEM CONTINUES TO USE DATA FROM THE PARTNERS FOR PROGRESS COMMUNITY ASSESSMENT 2009 AS A GUIDE IN DEVELOPING PROGRAMS AND SERVICES AND MAKING COMMUNITY BENEFIT INVESTMENTS. THE HEALTH SYSTEM IS IN THE EARLY STAGES OF COMPLETING THE REQUIRED COMMUNITY HEALTH NEEDS ASSESSMENT, WHICH IS EXPECTED TO BE COMPLETED, AS REQUIRED, BY THE AFFORDABLE CARE ACT BY 2013. ADULT PRIORITY NEEDSPRIMARY- AFFORDABILITY OF HEALTH CARE- ACCESSIBILITY OF MEDICAL CARE- ACCESS TO AFFORDABLE MENTAL AND BEHAVIORAL HEALTH CARESECONDARY- ACCESS TO AFFORDABLE PRESCRIPTION MEDICATIONS- SUBSTANCE ABUSE PREVENTION AND TREATMENTOTHER- SMOKING PREVENTION AND CESSATION- NUTRITION- WEIGHT MANAGEMENT AND EXERCISEYOUTH AND TEEN NEEDS- ACCESS AND AFFORDABILITY OF CARE- DENTAL- HEALTH CARE- SUICIDE PREVENTION- MENTAL AND BEHAVIORAL HEALTH- FAMILY PLANNING SERVICES PART VI, LINE 3: IN ACCORDANCE WITH PENNSYLVANIA STATE REPORTING REQUIREMENTS, THE BLUE MOUNTAIN HEALTH SYSTEM'S CHARITY CARE EXPENSE IS REPORTED BASED UPON COSTS VERSUS CHARGES. CHARITY CARE INCLUDES THE HEALTH SYSTEM'S TRADITIONAL INPATIENT AND EMERGENCY SERVICES, AS WELL AS THE CARE PROVIDED AS PART OF EXTERNAL EDUCATIONAL PROGRAMS AND SERVICES SUCH AS THROUGH OUR FAMILY PLANNING PROGRAM.MORE PEOPLE WERE SERVED THROUGH THE HOSPITAL'S CHARITABLE CARE AND FINANCIAL ASSISTANCE PROGRAMS IN VIRTUALLY ALL CATEGORIES, AS FOLLOWS:- GNADEN HUETTEN MEMORIAL HOSPITAL CHARITABLE CARE - 293 PATIENTS IN FY 2011- PALMERTON HOSPITAL CHARITABLE CARE - 163 PATIENTS IN FY 2011- BLUE MOUNTAIN HEALTH SYSTEM'S "HEALTHY SMILES, HAPPY KIDS" DENTAL VAN - 1,910 SERVED IN FY 2011SIGNAGE IS VISIBLE IN ALL BLUE MOUNTAIN HEALTH SYSTEM POINTS OF REGISTRATION IN ORDER TO CREATE AWARENESS OF THE FINANCIAL ASSISTANCE PROGRAM. IN RECENT YEARS, THE HEALTH SYSTEM HAS EXPANDED THE NUMBER OF FINANCIAL COUNSELORS AVAILABLE TO ASSIST PATIENTS. A KEY GOAL IS TO IDENTIFY COMMUNITY MEMBERS IN NEED SOONER. COUNSELORS PROACTIVELY SEEK OUT PATIENTS PRIOR TO TREATMENT IN AN EFFORT TO CONNECT THEM WITH PUBLIC INSURANCE PROGRAMS AS APPROPRIATE OR TO ENCOURAGE THEM TO COMPLETE AN ASSISTANCE APPLICATION. THE RESULT IS MORE CHARITY CARE AND LESS REPORTED AS BAD DEBT; MOST IMPORTANTLY, COMMUNITY MEMBERS ARE PROVIDED WITH THE SUPPORT TO ACCESS THE MEDICAL CARE THEY NEED. PART VI, LINE 4: THE MEDIAN INCOME OF HOUSEHOLDS IN CARBON COUNTY WAS $47,283. SEVENTY-FOUR PERCENT OF THE HOUSEHOLDS RECEIVED EARNINGS AND 25 PERCENT RECEIVED RETIREMENT INCOME OTHER THAN SOCIAL SECURITY. THIRTY-NINE PERCENT OF THE HOUSEHOLDS RECEIVED SOCIAL SECURITY. THE AVERAGE INCOME FROM SOCIAL SECURITY WAS $15,428.IN 2005-2009, 10 PERCENT OF PEOPLE OF CARBON COUNTY WERE IN POVERTY. SIXTEEN PERCENT OF RELATED CHILDREN UNDER 18 WERE BELOW THE POVERTY LEVEL, COMPARED WITH 7 PERCENT OF PEOPLE 65 YEARS OLD AND OVER. SEVEN PERCENT OF ALL FAMILIES AND 27 PERCENT OF FAMILIES WITH A FEMALE HOUSEHOLDER AND NO HUSBAND PRESENT HAD INCOMES BELOW THE POVERTY LEVEL.TWO PERCENT OF THE PEOPLE LIVING IN CARBON COUNTY IN 2005-2009 WERE FOREIGN BORN. NINETY-EIGHT PERCENT WAS NATIVE, INCLUDING 80 PERCENT WHO WERE BORN IN PENNSYLVANIA. AMONG PEOPLE AT LEAST FIVE YEARS OLD LIVING IN CARBON COUNTY IN 2005-2009, 4 PERCENT SPOKE A LANGUAGE OTHER THAN ENGLISH AT HOME. OF THOSE SPEAKING A LANGUAGE OTHER THAN ENGLISH AT HOME, 32 PERCENT SPOKE SPANISH AND 68 PERCENT SPOKE SOME OTHER LANGUAGE; 22 PERCENT REPORTED THAT THEY DID NOT SPEAK ENGLISH "VERY WELL." PART VI, LINE 6: THE MEDICAL STAFF OF THE BLUE MOUNTAIN HEALTH SYSTEM IS AN OPEN MEDICAL STAFF ALLOWING SUBMISSIONS FOR PRIVILEGES AND CREDENTIALING FROM ANY INTERESTED PHYSICIAN OR SURGEON. THE BOARD OF DIRECTORS IS COMPRISED OF 16 INDIVIDUALS FROM VARIOUS COMMUNITY ORGANIZATIONS SUCH AS FINANCIAL INSTITUTIONS, TELECOMMUNICATION, RECREATION, AND REPRESENTATION FROM THE MEDICAL STAFF. OF THE 16 MEMBERS OF THE BOARD OF DIRECTORS, 13 RESIDE IMMEDIATELY WITHIN THE PRIMARY SERVICE AREA OF THE HEALTH SYSTEM. ALL OF THE BOARD MEMBERS ARE INDEPENDENT, WITH THE EXCEPTION OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, WHO IS EMPLOYED DIRECTLY BY THE HEALTH SYSTEM. PART VI, LINE 7: THE HOSPITALS OF THE BLUE MOUNTAIN HEALTH SYSTEM ARE REGIONAL PROVIDERS OF HEALTH CARE SERVICES TO THE PEOPLE LIVING IN CARBON COUNTY AND PARTS OF MONROE, LEHIGH, NORTHAMPTON AND SCHUYLKILL COUNTIES. BLUE MOUNTAIN HEALTH SYSTEM INCLUDES PALMERTON HOSPITAL, A 70-BED COMMUNITY HOSPITAL LOCATED IN PALMERTON; GNADEN HUETTEN MEMORIAL HOSPITAL, A 111-BED COMMUNITY HOSPITAL; THE SUMMIT AT BLUE MOUNTAIN, A 91-BED NURSING AND REHABILITATION CENTER, BOTH LOCATED IN LEHIGHTON AND AN ADULT DAY SERVICE CENTER IN PALMERTON. COMBINED, THESE FACILITIES HAVE BEEN SERVING THE FAMILIES OF OUR AREA FOR MORE THAN 150 YEARS. THE HOSPITALS OF THE BLUE MOUNTAIN HEALTH SYSTEM ARE FULLY ACCREDITED BY THE JOINT COMMISSION. DIAGNOSTIC OUTPATIENT SERVICES, INCLUDING VASCULAR TESTING, MAMMOGRAPHY, ULTRASOUND, CARDIAC REHABILITATION AND THE CLINICAL LABORATORY ARE ALSO ACCREDITED BY THEIR RESPECTIVE NATIONAL PROFESSIONAL ORGANIZATIONS. 1 THE PALMERTON HOSPITAL 135 LAFAYETTE AVENUE PALMERTON PA 18071 135562316 501(C)(3) 1295860 N/A N/A TO FUND OPERATIONS OF THE PALMERTON HOSPITAL 1 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: ASSISTANCE IS PROVIDED TO RELATED ENTITIES FOR FINANCIAL SUPPORT. MANAGEMENT OF THE HEALTH SYSTEM OVERSEES THE USE OF FUNDS AT THE AFFILIATED ENTITIES. X 1 1 X X X X 0 0 0 0 0 0 0 0 0 ANDREW E HARRIS 307883 0 61200 0 11658 0 0 0 46182 0 426923 0 0 0 CLEMENT MCGINLEY 126294 0 12000 0 0 0 0 0 18944 0 157238 0 0 0 TERRENCE PURCELL 122743 0 12199 21 0 0 0 0 18411 0 153353 21 0 0 PART I, LINE 1A THE ORGANIZATION INCLUDED $2,760 FOR CLUB DUES IN PRESIDENT/CEO ANDREW HARRIS' REPORTABLE INCOME FOR THE FISCAL YEAR ENDED JUNE 30, 2011. THIS AMOUNT WAS INCLUDED AS TAXABLE INCOME FOR MR. HARRIS. FORM 990, PART VI, SECTION B, LINE 11 THE BMHS STAFF COMMUNICATED TO THE FINANCE COMMITTEE OF THE BOARD THAT THE FORMS 990 WERE PREPARED BY PARENTEBEARD LLC, AS WELL AS COMMUNICATING INFORMATION CONTAINED IN THE FILING. THE BOARD WAS ALSO PROVIDED ACCESS TO THE RETURN THROUGH A SECURED WEBSITE. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT POLICY MUST BE SIGNED OFF ON AN ANNUAL BASIS BY ALL GOVERNING BODY MEMBERS, OFFICERS, AND KEY EMPLOYEES. THIS PROCESS IS MONITORED BY THE ADMINISTRATIVE ASSISTANT TO THE PRESIDENT/CEO. ANY CONFLICTS NOTED WOULD BE COMMUNICATED TO THE COMPLIANCE COMMITTEE. THERE HAVE BEEN NO OCCURENCES OF UNDISCLOSED CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15 SENIOR MANAGEMENT SALARIES ARE DETERMINED BY THE MARKET. HUMAN RESOURCES PARTICIPATE IN VARIOUS SALARY SURVEYS TO DETERMINE THE CORRECT SALARY RANGE. THE APPALACHIAN HOSPITAL HUMAN RESOURCE SOCIETY CONDUCTS AN ANNUAL SALARY SURVEY FOR ALL POSITIONS. IN ADDITION, THE PENNSYLVANIA HOSPITAL ASSOCIATION CONDUCTS AN ANNUAL SURVEY WITH YAFFE ASSOCIATES FOR SENIOR MANAGEMENT EMPLOYEES. THE MARKET DATA IS ANALYZED AND THE GOAL IS TO PAY AT THE 50 PERCENTILE. SALARIES ARE RECOMMENDED BY HUMAN RESOURCES AND APPROVED BY THE PRESIDENT AND CEO. THE EXECUTIVE COMMITTEE OF THE BOARD SERVES AS THE COMPENSATION COMMITTEE AND APPROVES RECOMMENDATIONS FOR SALARY INCREASES. THE EXECUTIVE COMMITTEE APPROVES INCREASES FOR THE CEO. REVIEW AND APPROVAL PROCESS IS DOCUMENTED. SENIOR MANAGEMENT HAS RECEIVED THE SAME GENERAL INCREASES AS THE STAFF EMPLOYEES RECEIVED. FORM 990, PART VI, SECTION C, LINE 19 FORM 990, PART VI, SECTION C, LINE 19: UPON REQUEST, THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND/OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART VII, SECTION A: ALL BOARD DIRECTORS SPENT AN AVERAGE OF 4 HOURS PER WEEK FOR GNADEN HUETTEN MEMORIAL HOSPITAL AND ALL RELATED ENTITIES. AVERAGE HOURS PER WEEK FOR OFFICERS AND EMPLOYEES FOR THE HOSPITAL AND ALL RELATED ENTITIES WERE AS FOLLOWS: ANDREW HARRIS - 50 HOURS KRISTA RIMSKY - 40 HOURS JASON HOWAY - 40 HOURS CLEMENT MCGINLEY - 40 HOURS TERRENCE PURCELL - 50 HOURS ANTONETTE GIBSON - 50 HOURS CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: PENSION LIABILITY ADJUSTMENT 4,276,526. VALUATION GAIN 2,313. TOTAL TO FORM 990, PART XI, LINE 5: 4,278,839. BLUE MOUNTAIN HEALTH SYSTEM INC 211 NORTH 12TH STREET LEHIGHTON PA 182351195 201311316 MAINTAINS AN INTEGRATED HEALTH CARE SYSTEM. PA 501(C)(3) 11A N/A 0 CMS MEDICAL CARE CORPORATION 211 NORTH 12TH STREET LEHIGHTON PA 182351195 232473899 OWNS AND OPERATES AMBULATORY CARE CENTERS IN VARIOUS COMMUNITIES PA 501(C)(3) 3 GNADEN HUETTEN MEMORIAL HOSPITAL 1 THE PALMERTON HOSPITAL 135 LAFAYETTE AVENUE PALMERTON PA 18071 235562316 OPERATES AN ACUTE CARE HOSP, PROVIDNG INPATIENT, OUTPATIENT & EMERGENCY CARE PA 501(C)(3) 3 BLUE MOUNTAIN HEALTH SYSTEM INC 0 0 1 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 CMS MEDICAL CARE CORPORATION M 56000 FMV CMS MEDICAL CARE CORPORATION N 319577 FMV