2012-04-20T07:53:32-05:00 2011-06-30 PARENTEBEARD LLC 400 MARKET STREET WILLIAMSPORT PA 17701 990 2010-07-01 240795411 EVANGELICAL COMMUNITY HOSPITAL EVAN 5705222741 ONE HOSPITAL DRIVE LEWISBURG PA 17837 JAMES STOPPER CPA CFO 5705222741 2012-04-18 1 JULIUS GREEN 5703236023 2010 2016-02-24 21:20:13Z MICHAEL O'KEEFE ONE HOSPITAL DRIVE LEWISBURG PA 17837 156786174 0 X WWW.EVANHOSPITAL.COM X 1926 PA PROVIDE HEALTH CARE SERVICES TO THE PUBLIC AND TO BE THE COMMUNITY'S HEALTH CARE PROVIDER OF CHOICE. 20 18 1371 614 4043887 813791 2786638 3490178 114538362 122053729 2591073 3770727 3000785 3348102 122916858 132662736 22000 56950 0 0 56875722 58431004 0 0 568162 52750551 57488181 109648273 115976135 13268585 16686601 177099609 219250555 58486321 81402247 118613288 137848308 X EVANGELICAL COMMUNITY HOSPITAL, A NON-PROFIT HEALTH CARE PROVIDER, SERVES UNION, SNYDER AND NORTHUMBERLAND COUNTIES AS WELL AS SURROUNDING COMMUNITIES. THE HOSPITAL PROVIDES A BROAD RANGE OF HEALTH CARE SERVICES THAT ARE CONSISTENTLY HIGH QUALITY, COMPASSIONATE, ACCESSIBLE AND COST-EFFECTIVE. IN PARTNERSHIP WITH A STRONG AND DIVERSE MEDICAL STAFF, THE HOSPITAL PROMOTES A HEALTHY LIFESTYLE AND PROVIDES ADVANCED MEDICAL CARE IN AN ATMOSPHERE THAT IS CARING AND COMPASSIONATE. THIS IS ACCOMPLISHED BY MAINTAINING A CHALLENGING, ENERGIZED WORK ENVIRONMENT FOR OUR VALUED EMPLOYEES WHO EXEMPLIFY OUR CORE VALUES: QUALITY SERVICE, COMPASSION, RESPECT, PROFESSIONALISM, INTEGRITY, COOPERATION AND CREATIVITY. 0 0 97043232 56950 119680890 MEETING THE HEALTHCARE NEEDS OF THE COMMUNITY IS AT THE HEART OF EVANGELICAL COMMUNITY HOSPITAL'S MISSION AS A NOT-FOR-PROFIT CHARITABLE ORGANIZATION. THE HOSPITAL'S RESOURCES PROVIDE FOR LONG-TERM INITIATIVES SUCH AS RECRUITMENT AND RETENTION OF OUTSTANDING MEDICAL PROFESSIONALS, ENHANCED TECHNOLOGIES AND NEW FACILITIES AND SERVICES.THE HOSPITAL IS LICENSED TO ACCOMMODATE 127 OVERNIGHT PATIENTS, 12 ACUTE REHABILITATION UNIT PATIENTS AND 18 NEWBORN BABIES. IT IS A NOT-FOR-PROFIT COMMUNITY HOSPITAL OFFERING A FULL CONTINUUM OF CARE. SERVICES RANGE FROM COMPREHENSIVE DIAGNOSTIC TESTS TO DELICATE MICROSURGERY AND FROM SPECIFIC TREATMENT PROGRAMS TO NUMEROUS OUTPATIENT SERVICES.IN ADDITION TO PROVIDING HOSPITAL-BASED MEDICAL SERVICES, EVANGELICAL PROVIDES A NUMBER OF COMMUNITY-BASED SERVICES DESIGNED TO IMPROVE THE HEALTH OF AREA RESIDENTS. MANY OF THE EMPLOYEES AND MEDICAL STAFF LEAD HEALTH EDUCATION AND SCREENINGS AS WELL AS SUPPORT GROUPS FOR INDIVIDUALS IN THE COMMUNITY LIVING WITH SERIOUS OR CHRONIC HEALTH CONDITIONS. WHETHER THROUGH CHARITABLE CARE, SUBSIDIZED HOSPITAL PROGRAMS AND SERVICES, OR COMMUNITY HEALTH EDUCATION, EVANGELICAL STRIVES TO RESPOND TO THE VALLEY'S MOST PRESSING HEALTH NEEDS. 97043232 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 1 1 1 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 1 1 1 0 0 1 63 0 1 1371 1 1 1 0 0 0 0 1 1 0 0 0 0 X 20 18 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 PA X EVANGELICAL COMMUNITY HOSPITAL 5705222000 ONE HOSPITAL DRIVE LEWISBURG PA 17837 MARTHA BARRICK 1.00 X X 0 0 0 JOHN GRIFFITH 1.00 X X 0 0 0 TIM APPLE 1.00 X 0 0 0 JULIE BARNA DMD 1.00 X 0 0 0 CAROL GRAYBEAL 1.00 X 0 0 0 BROOKS GRONLUND 1.00 X 0 0 0 ROBERT GRONLUND 1.00 X 0 0 0 ROGER HADDON JR 1.00 X 0 0 0 JOHN MECKLEY ESQ 1.00 X 0 0 0 JAMES MORGAN JR MD 1.00 X 0 0 0 R DAVID MYERS 1.00 X 0 0 0 FREDRIK PAULSEN JR 1.00 X 0 0 0 JULIA REDCAY DO 1.00 X 0 0 0 W GALE REISH MD 1.00 X 0 0 0 SUSAN FORGETT RHEAM CPA 1.00 X 0 0 0 JOHN E RICE MD 1.00 X 0 0 0 NORMAN RICH 1.00 X 0 0 0 HENRY A TRUSLOW IV 1.00 X 0 0 0 MICHAEL WIMER 1.00 X 0 0 0 P RONALD ZUG 1.00 X 0 0 0 CHRISTOPHER D OLSON DO 1.00 X 0 0 0 JEANETTE WILLIAMS 1.00 X 0 0 0 SARA KIRKLAND 1.00 X 0 0 0 JOHN MATHIAS 1.00 X 0 0 0 JAMES APPLE 1.00 X 0 0 0 MICHAEL N O'KEEFE 40.00 X X 361161 0 101125 JAMES A STOPPER 40.00 X 122892 0 34410 J LAWRENCE GINSBURG 40.00 X 545654 0 152783 KENDRA A AUCKER 40.00 X 199727 0 55924 TAMI RADECKE 40.00 X 153131 0 42877 PAUL TARVES 40.00 X 188181 0 52691 MARK K KRAMMES 48.00 X 229986 0 64396 SANDRA S WALKER 49.00 X 223992 0 62718 LORI K GOODLING 48.00 X 218136 0 61078 RAYMOND J TOMASZEWSKI 48.00 X 214621 0 60094 COLLEEN FRITZ 47.00 X 212351 0 59458 CHRISTINE M MARTIN 40.00 X 79985 0 22396 RICHARD E SMITH JR 40.00 X 170927 0 47859 2840759 0 795413 25 1 1 0 THE QUANDEL GROUP INC 3033 NORTH FRONT ST SUITE 201 HARRISBURG PA 17110 CONSTRUCTION 7191859 AFS ENERGY SYSTEMS 420 OAK STREET PO BOX 170 LEMOYNE PA 17043 CONSTRUCTION 926250 BURT HILL STANTEC ARCHITECTURE INC 13980 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 ARCHITECT 826947 THE ADVISORY BOARD COMPANY PO BOX 79461 BALTIMORE MD 21279 MANAGEMENT SERVICES 582500 DIVERSIFIED CLINICAL SERVICES PO BOX 636981 CINCINNATI OH 45263 MANAGEMENT SERVICES 546665 89 6500 107260 227400 3149018 67389 3490178 NET PATIENT SERVICE RE 621400 119044169 119044169 LABORATORY SERVICES 621500 3009560 3009560 122053729 2273775 2273775 1868671 2173697 -305026 -305026 -305026 23280189 108926 21696886 195277 1583303 -86351 1496952 1496952 73610 107260 54225 19385 19385 1278 3353 -2075 -2075 BILLING AND CODING FEE 541900 562327 562327 CAFETERIA AND VENDING 722210 558151 558151 ADMINISTRATIVE FEE INC 541900 472000 472000 2043340 636721 1406619 3635818 132662736 119680890 4043887 5447781 56950 56950 2466967 690751 1776216 43869834 37160758 6486412 222664 1385300 1140872 237688 6740 7518571 6501412 977811 39348 3190332 2627418 547393 15521 266901 263113 3788 133178 43190 89988 307753 7650 300103 8609567 6221517 2261862 126188 493473 28629 444583 20261 26998484 24241217 2717583 39684 1133292 171642 961650 1758328 1758328 116321 102108 10290 3923 175673 118262 49385 8026 1527439 1527439 6220758 6220758 192467 192467 FEDERAL TAXES 280000 280000 BAD DEBT 6222471 6222471 MA MODERNIZATION PAYMEN 1192647 1192647 BILLING AND COLLECTION 369000 10621 358379 LOSS ON REFINANCING 286495 286495 1203934 806125 315790 82019 115976135 97043232 18364741 568162 1465 1545 22663582 21459829 1026948 1285223 9961572 10755446 1744377 1654714 2540533 2792321 1456765 2136929 164540945 78509436 73726892 86031509 57366549 83071772 1939694 2479998 4671232 7581269 177099609 219250555 12872502 16092996 33945000 51755000 11668819 13554251 58486321 81402247 X 113040176 130964510 1401450 1696335 4171662 5187463 118613288 137848308 177099609 219250555 X 16686601 2548419 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2853652 380340 207310 16598 67522 5505 3351677 2701406 123011 102387 2000 66203 4949 2853652 2623000 229877 -101037 11900 34346 4188 2701406 0.57300 0.42700 0.00000 0 0 3402982 3402982 70203750 25688734 44515016 4277948 2310734 1967214 68607931 50509968 18097963 18048334 18048334 86031509 BLUE CROSS CURRENT FINANCING ADVANCE 1057200 ACCRUED POSTRETIREMENT BENEFIT COSTS 5394555 ESTIMATED MEDICAL MALPRACTICE CLAIMS LIABILITY 586949 CHARITABLE GIFT ANNUITIES PAYABLE 713587 DEFERRED COMPENSATION 1892625 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 1247201 CAPITAL LEASE OBLIGATION 1332847 ENVIRONMENTAL REMEDIATION LIABILITY 1329287 13554251 132662736 115976135 16686601 4066555 -1518136 2548419 19235020 138757225 4066555 518215 4584770 134172455 300103 -1809822 -1509719 132662736 119522205 3846173 3846173 115676032 300103 300103 115976135 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: ENDOWMENT FUNDS WILL BE USED TO SUPPORT VARIOUS HOSPITAL PROGRAMS SUCH AS FUNDING HELPLINE SERVICES, COMMUNITY HEALTH EDUCATION, HOSPICE SERVICES, PRE-HOSPITAL SERVICES, FAMILY PLACE (OB SERVICES), PROVIDE NURSING SCHOLARSHIPS AND TO PROVIDE FOOD, SERVICE, OR CARE FOR PEOPLE WHO DO NOT HAVE THE MEANS TO PAY FOR THE SERVICE. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE CORPORATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING 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 THAT THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2011 OR 2010. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENT 29,255. VALUATION GAIN 593,717. POSTRETIREMENT BENEFIT LIABILITY ADJUSTMENT -191,108. EQUITY TRANSFER TO AFFILIATE -1,950,000. PART XII, LINE 2D - OTHER ADJUSTMENTS: CHANGES IN VALUE OF SPLIT INTEREST AGREEMENT 29,255. VALUATION GAIN 593,717. POSTRETIREMENT BENEFIT LIABILITY ADJUSTMENT -191,108. LOSS ON DISPOSAL OF PROPERTY AND EQUIPMENT 86,351. PART XII, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -2,173,697. SPECIAL EVENTS EXPENSE -57,578. REFUND OF INCOME TAX NETTED AGAINST EXPENSE ON FINANCIAL STATEMENTS 421,453. PART XIII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 2,173,697. SPECIAL EVENTS EXPENSE 57,578. EQUITY TRANSFER TO AFFILIATE 1,950,000. LOSS ON DISPOSAL OF PROPERTY AND EQUIPMENT 86,351. REFUND OF INCOME TAX NETTED AGAINST EXPENSE ON FINANCIAL STATEMENTS -421,453. GOLF TOURNAMENT 66240 38086 28154 395 10636 EVAN GALA 107365 61909 45456 43194 1 7265 7265 180870 107260 73610 395 53830 54225 19385 1 1 1 X 1 X 1 1 0 1 1 1478 217566 0 217566 0.00200 20303 9211729 5359258 3852471 0.03510 793 92975 92975 0.00080 22574 9522270 5359258 4163012 0.03790 35 5042 150368 601 149767 0.00140 13 285 360235 360235 0.00330 1 1250 1250 0.00000 49 5327 511853 601 511252 0.00470 49 27901 10034123 5359859 4674264 0.04260 4 150 3333 3333 0.00000 1 1772 1772 0.00000 12 190 18569 18569 0.00020 18 128 839271 149415 689856 0.00630 35 468 862945 149415 713530 0.00650 1 3107480 217566 27324581 35912698 -8588117 X 1 1 1 1 EVANGELICAL COMMUNITY HOSPITAL

ONE HOSPITAL DRIVE LEWISBURG PA 17837

X X X INPATIENT REHABILITATION, HOSPICE NOT REQUIRED 1 PART I, L7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $6,222,471. NET UNREIMBURSED MEDICAID EXPENSE DECREASED FROM $5,327,387 IN FY 2010 TO $3,852,471 IN FY 2011 MAINLY AS A RESULT OF PAYMENTS RECEIVED FROM THE COMMONWEALTH OF PA UNDER THE MEDICAL ASSISTANCE PAYMENT MODERNIZATION ACT 49 OF 2010. THIS ACT MODERNIZES PENNSYLVANIA'S INPATIENT FEE-FOR-SERVICE HOSPITAL PAYMENT SYSTEM, ESTABLISHES ENHANCED HOSPITAL PAYMENTS THROUGH THE STATE'S MEDICAL ASSISTANCE MANAGED CARE PROGRAM, AND SECURES ADDITIONAL MATCHING MEDICAID FUNDS THROUGH THE ESTABLISHMENT OF THE QUALITY CARE ASSESSMENT, A FEE PAID BY HOSPITALS THAT ALLOWS THE STATE TO ACCESS ADDITIONAL FEDERAL DOLLARS. ACT 49 COVERS FYS 2011-2013 ONLY. AT THIS TIME, THERE ARE NO PROVISIONS FOR THESE PAYMENTS TO CONTINUE PAST FY 2013 AND FY 2013 PAYMENTS CAN BE SUBSTANTIALLY REDUCED FROM CURRENT LEVELS. TOTAL COMMUNITY BENEFITS AS A PERCENTAGE OF TOTAL EXPENSES AMOUNTED TO 6.45% IN FY 2010 AND 4.91% IN FY 2011. HAD THE HOSPITAL NOT RECEIVED THESE PAYMENTS, FY 2011 WOULD HAVE REFLECTED A COMMUNITY BENEFITS PERCENTAGE OF 5.55% PART II: AS A COMMUNITY AND HEALTH RESOURCE FOR MORE THAN 85 YEARS, EVANGELICAL COMMUNITY HOSPITAL HAS CONTINUALLY DEMONSTRATED ITS COMMITMENT TO THE CENTRAL SUSQUEHANNA VALLEY BY TAKING CARE OF PATIENTS NEEDING TREATMENT IN THE HOSPITAL, AND BY ITS OUTREACH TO THE COMMUNITY. BEYOND THE DAILY CARE OF PATIENTS, THE HOSPITAL EXTENDS ITS REACH TO PROVIDE PREVENTION AND WELLNESS EDUCATION TO RESIDENTS OF THE VALLEY. OUTREACH INCLUDES CHARITY CARE FOR THOSE WHO CANNOT AFFORD CARE, HEALTH EDUCATION, HEALTH SCREENINGS, HEALTH FAIRS, SAFETY INSPECTIONS, RECYCLING EVENTS, AND LECTURES ON HEALTH CONCERNS AND TOPICS. MANY OF THESE PROGRAMS ARE PROVIDED AT MINIMAL OR NO COST, AND ARE SUBSIDIZED USING HOSPITAL RESOURCES.COMMUNITY BENEFIT: A COMMUNITY BENEFIT COMMITTEE WAS FORMED IN 2010 TO DEVELOP NEW WAYS OF IDENTIFYING AND ADDRESSING HEALTH NEEDS IN OUR REGION. THE COMMITTEE HAS DEVELOPED A PROCESS FOR THE DOCUMENTING AND TRACKING OF COMMUNITY BENEFIT DELIVERED BY EACH OF THE 1,200 EMPLOYEES WORKING AT THE HOSPITAL. EXTENDING THE HOSPITAL'S OUTREACH TO THOSE WHO CANNOT AFFORD CARE, OR WHO HAVE DIFFICULTY ACCESSING CARE, IS A KEY OBJECTIVE OF THIS COMMITTEE. THE COMMITTEE CONSISTS OF MEMBERS FROM THE HOSPITAL'S BOARD OF DIRECTORS, EXECUTIVE TEAM, MANAGEMENT STAFF, AS WELL AS FRONT LINE CLINICAL AND ADMINISTRATIVE EMPLOYEES. THE COMMUNITY BENEFIT COMMITTEE WORKS COOPERATIVELY WITH DEPARTMENTS OF THE HOSPITAL AND OTHER ORGANIZATIONS IN THE COMMUNITY TO ADDRESS UNMET NEEDS. THIS YEAR THE HOSPITAL'S COMMUNITY BENEFIT COMMITTEE WORKED WITH UNION-SNYDER COMMUNITY ACTION CENTER ON A REGIONAL 2011 IMPLEMENTATION INITIATIVE. THE COMMUNITY BENEFIT COMMITTEE HAS A STRATEGIC PLAN TO ADDRESS THE NEEDS AS IDENTIFIED IN THE ASSESSMENT AND PRIORITIZED ITS PROGRAMS TO ADDRESS UNMET NEEDS. HOSPITAL EXECUTIVES, ITS BOARD OF DIRECTORS, AND ITS MANAGERS HAVE BEEN PROVIDED EDUCATIONAL PRESENTATIONS ON THE RESULTS OF THE 2009 COMMUNITY HEALTH NEEDS ASSESSMENT AND THE WAYS IN WHICH THE HOSPITAL IS WORKING TO MEET THESE NEEDS.PROGRAMS AND SERVICES THAT HAVE BEEN DEVELOPED TO ADDRESS COMMUNITY NEEDS INCLUDE: HEALTH EDUCATION AND IMMUNIZATIONS IN LOCAL INDUSTRIES, BUSINESSES AND SCHOOLS; COMMUNITY RECYCLING EVENT, INTERNSHIP PROGRAMS FOR HIGH SCHOOL AND COLLEGE STUDENTS, FREE OR REDUCED CARE FOR PATIENTS WHO CANNOT AFFORD CARE, PHONE CALLS TO LOCAL WOMEN ENCOURAGING THEM TO GET A MAMMOGRAM, HEALTH SCREENINGS FOR MEN AND WOMEN, HEALTH FAIRS TO EDUCATE THE COMMUNITY ON AVAILABLE RESOURCES AND HOW TO ACCESS CARE, BREAST CANCER AND CARDIAC AND HEART DISEASE AWARENESS AND EDUCATION.IN 2011, OUR CHILD SAFETY SEAT PROGRAM REPLACED 61 FAULTY SEATS AT NO COST TO OUR PATIENTS, OUR MEN'S AND WOMEN'S HEALTH SCREENINGS SERVED MORE THAN 144 MEN AND WOMEN WHO COMPLETED A YEARLY PHYSICAL EXAM FOR MINIMAL FEE (CHARITY CARE WAS PROVIDE FOR THOSE WHO COULD NOT AFFORD THE FEE); 113 BIKE HELMETS WERE DISTRIBUTED TO CHILDREN AND YOUTH IN THE COMMUNITY AT NO CHARGE; HOSPITAL PERSONNEL PROVIDED MORE THAN 25 NO-COST HEALTH-FOCUSED LECTURES TO RESIDENTS OF THE COMMUNITY. THE SEVENTH ANNUAL TELL-A-FRIEND MAMMATHON, A JOINT EFFORT BETWEEN EVANGELICAL COMMUNITY HOSPITAL'S THYRA M. HUMPHREYS CENTER FOR BREAST HEALTH AND THE AMERICAN CANCER SOCIETY, PLACED 5,366 CALLS AND SPOKE TO 1,511 WOMEN AND LEFT 1,564 MESSAGES ABOUT THE IMPORTANCE OF EARLY DETECTION. DURING THE EVENT, 153 WOMEN MADE APPOINTMENTS AT THE CENTER FOR BREAST HEALTH FOR THEIR ANNUAL MAMMOGRAM, AND 956 MADE A COMMITMENT TO SCHEDULE THEIR EXAMS AT THE CENTER OF ANOTHER FACILITY OF THEIR CHOICE.CANCER AWARENESS AND EDUCATION IS EXTREMELY IMPORTANT. THE FOLLOWING PROGRAMS WERE OFFERED IN 2010; THE CORRESPONDING NUMBER BESIDE THE PROGRAM DOCUMENTS THE NUMBER OF PEOPLE SERVED:- LOOK GOOD, FEEL BETTER (1-3 WOMEN MONTHLY)- CANCER SUPPORT GROUP (TWO MONTHLY GROUPS WITH 5-6 PARTICIPANTS EACH)- HOSPITAL'S EMPLOYEE HEALTH FAIR (275 EMPLOYEES AND FAMILY MEMBERS RECEIVED EDUCATION ON BREAST CANCER AWARENESS, SMOKING CESSATION, EARLY DETECTION AND PREVENTATIVE HEALTH ACTIVITIES.- BREAST CANCER SURVIVOR LECTURE (54 PARTICIPANTS)- I CAN COPE SURVIVOR PROGRAM (10 PARTICIPANTS)- COPING WITH THE HOLIDAYS PROGRAM (12 PARTICIPANTS)- BREAST CANCER EDUCATION WITH AMERICAN CANCER SOCIETY (40 PARTICIPANTS)- SURVIVORSHIP LECTURE (98 PARTICIPANTS)- LIFE AFTER LOSS BEREAVEMENT SUPPORT GROUP (8 PARTICIPANTS)OTHER HEALTH EDUCATION AND PREVENTION ACTIVITIES INCLUDE:- MONTHLY SUPPORT GROUPS (629 PARTICIPANTS)- HEALTH SCREENINGS FOR THE UN- AND UNDERINSURED (0 PARTICIPANTS IN 2011)- TALK WITH THE DOC LECTURE SERIES (304 PARTICIPANTS)- NAVIGATING MEDICARE OPTIONS (116 PARTICIPANTS)- BROWN BAG SEMINARS (150 PARTICIPANTS)PROPER HAND WASHING IS ESSENTIAL FOR PEOPLE OF ALL AGES TO LIMIT AND PROHIBIT THE SPREAD OF DISEASE AND GERMS. EVANGELICAL COMMUNITY HOSPITAL'S "GERM CITY" PROGRAM USES AN ENTERTAINING TECHNIQUE TO STRESS THE IMPORTANCE OF FREQUENT, EFFECTIVE HAND WASHING AND SEE IMMEDIATE RESULTS. IN 2011, MORE THAN 2,510 STUDENTS IN THE LOCAL SCHOOLS PARTICIPATED IN THE GERM CITY PROGRAM AND WERE EDUCATED ON PROPER HAND WASHING TECHNIQUES.THE HOSPITAL'S "SPEAKER'S BUREAU" OFFERS PRESENTATIONS AND LECTURES TO HELP EDUCATE THE REGION ON THE MOST PRESSING HEALTH CARE NEEDS AND THE WAYS IN WHICH THE HOSPITAL IS MEETING THOSE NEEDS. IN 2011, MORE THAN 3 PRESENTATIONS WERE PROVIDED IN THE COMMUNITY BY HOSPITAL EMPLOYEES AT NO COST TO THE PARTICIPANTS OR ORGANIZING GROUP. PART III, LINE 4: ACCOUNTS RECEIVABLE 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 ARE ESTIMATED BASED UPON A PERIODIC REVIEW OF THE ACCOUNTS RECEIVABLE AGING, PAYOR CLASSIFICATIONS AND APPLICATION OF HISTORICAL WRITE-OFF PERCENTAGES. THE COSTING METHODOLOGY USED IN DETERMINING BAD DEBTS EXPENSE AT COST AND ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTED TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS BAD DEBT EXPENSE TIMES THE COST TO CHARGE RATIO. IN DETERMINING BAD DEBT EXPENSE, PATIENT LIABILITIES ARE NET OF THIRD-PARTY PAYMENTS AND ANY PATIENT PAYMENTS. THE METHOD THE ORGANIZATION USES TO DETERMINE THE AMOUNT THAT REASONABLY COULD BE ATTRIBUTED TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY, BUT DID NOT ADEQUATELY COMPLETE THE CHARITY CARE PAPERWORK: WE BELIEVE THAT A PORTION OF OUR BAD DEBTS RESULTS FROM SERVICES PROVIDED TO PATIENTS WHO MEET THE CHARITY CARE GUIDELINES BUT WERE UNABLE OR UNWILLING TO PROVIDE THE APPROPRIATE DOCUMENTATIONS TO ALLOW THAT CLASSIFICATION. THESE WOULD BE CLASSIFIED AS BAD DEBT EXPENSE TIMES THE COST TO CHARGE RATIO TO ARRIVE AT COST. THE ORGANIZATION ACCOUNTS FOR DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS AS A REDUCTION OF REVENUE/ACCOUNTS RECEIVABLE AND ARE NOT COMPONENTS OF BAD DEBT EXPENSE. EVANGELICAL COMMUNITY HOSPITAL PROVIDES CARE TO ALL PATIENTS WHO NEED IT, REGARDLESS OF THEIR ABILITY TO PAY. THIS IS PART OF THE HOSPITAL'S MISSION. PART III, LINE 8: THE HOSPITAL CONTINUES TO PROVIDE CARE TO ALL PRESENTING AND ADMITTED PATIENTS, REGARDLESS OF ABILITY OR PAY. NOTWITHSTANDING THE COSTS TO PROVIDE CARE, RECEIVING "LESS" THAN WHAT IT COSTS TO PROVIDE ADEQUATE CARE TO MEDICARE COVERED LIVES DOES THE HOSPITAL A DISSERVICE. THIS SHORTFALL SHOULD COUNT AS A COMMUNITY BENEFIT. THE HOSPITAL USES THE COST-TO-CHARGE RATIO TO DETERMINE THE MEDICARE ALLOWABLE COSTS. PART III, LINE 9B: IN ACCORDANCE WITH THE COLLECTION POLICY, BAD DEBT ACCOUNTS WILL BE ELIGIBLE FOR A CHARITY CARE DISCOUNT IF THE PATIENT MEETS CHARITY CARE POLICY GUIDELINES. THE PATIENT WILL NEED TO SUPPLY INCOME INFORMATION IN ORDER TO DETERMINE ELIGIBILITY FOR CHARITY CARE PER POLICY. ALSO SEE RESPONSE TO PART III LINE 4 ABOVE. PART VI, LINE 2: IN 2009, EVANGELICAL COMMUNITY HOSPITAL PARTICIPATED IN A FIVE-COUNTY (SNYDER, UNION, MONTOUR, NORTHUMBERLAND AND COLUMBIA) COMMUNITY HEALTH NEEDS ASSESSMENT. THE ASSESSMENT WAS CONDUCTED BY ACTION HEALTH, AN ORGANIZATION THAT FOSTERS COLLABORATION BETWEEN HOSPITALS AND LOCAL EDUCATIONAL INSTITUTIONS FOR THE PURPOSE OF MEETING THE HEALTH NEEDS OF THE COMMUNITY. THE FIRST STEP IN THE PROCESS WAS FOR ACTION HEALTH TO FORM A NEEDS ASSESSMENT OVERSIGHT COMMITTEE. IN MAY 2009, THE OVERSIGHT COMMITTEE SELECTED GEISINGER HEALTH RESEARCH TO CONDUCT THE ASSESSMENT AND REPORT ON THE FINDINGS. THE ASSESSMENT CONSISTED OF FOCUS GROUPS, COMMUNITY INTERVIEWS, AND SURVEYS DISTRIBUTED TO A CLUSTERED RANDOMIZED SAMPLE OF RESIDENTS IN THE FIVE-COUNTY AREA. FROM THE SURVEY DISTRIBUTION, 3,300 WERE RETURNED (A 36% RESPONSE RATE). FOCUS GROUP AND COMMUNITY INTERVIEWS CONSISTED OF HOSPITAL STAKEHOLDERS, BUSINESS AND NONPROFIT LEADERS, COUNTY AND GOVERNMENT OFFICIALS, AS WELL AS LEADERS FROM FAITH-BASED ORGANIZATIONS, SCHOOLS AND UNIVERSITIES. THE 2009 NEEDS ASSESSMENT REPORT MAY BE FOUND ON THE ACTION HEALTH WEBSITE AT: HTTP://ACTIONHEALTHPA.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/.FOCUS GROUP FINDINGS VARIED SOMEWHAT AMONG THE DIFFERENT COMMUNITIES WITHIN THE FIVE-COUNTY AREA. CONSISTENT FINDINGS ACROSS THE REGION INCLUDE:1) MEDICAL AND SPECIALTY CARE - RESIDENTS HAVE DIFFICULTY NAVIGATING THE COMPLEX HEALTHCARE INDUSTRY AND SYSTEMS, ESPECIALLY IN FINDING THE NEEDED SPECIALTY CARE. SURVEY PARTICIPANTS NOTED THAT THERE IS LIMITED CARE AVAILABLE FOR THOSE WHO ARE UNINSURED OR UNDERINSURED.2) DENTAL CARE - RESIDENTS IDENTIFIED THE NEED TO FIND ADEQUATE DENTAL CARE FOR LOW-INCOME RESIDENTS OR FOR THOSE WHO DO NOT HAVE INSURANCE. THERE ARE A FEW AREA DENTISTS WHO ACCEPT STATE-ASSISTANCE (MEDICAID/CHIP) AS A FORM OF PAYMENT FOR DENTAL CARE AND THERE IS NO DENTAL CARE FOR LOW-INCOME ADULTS. CHILDREN WITH STATE FUNDED INSURANCE MUST OFTEN OBTAIN THEIR DENTAL CARE OUTSIDE THE REGION, NECESSITATING TRAVEL WHICH MAYBE A PROBLEM FOR FAMILIES WITH NO DEPENDABLE TRANSPORTATION.3) MENTAL HEALTH AND SUBSTANCE ABUSE - TREATMENT FOR MENTAL HEALTH AND SUBSTANCE ABUSE IS VERY LIMITED. INPATIENT MENTAL HEALTH SERVICES ARE ALSO LIMITED AND RESIDENTS DO NOT KNOW HOW TO ACCESS OR NAVIGATE THE MENTAL HEALTH SYSTEM IN OUR REGION.4) SOCIAL AND SUPPORT SERVICES - RESIDENTS DO NOT SEEM TO KNOW WHERE TO GO TO OBTAIN INFORMATION ABOUT AVAILABILITY OF ALL KINDS OF SOCIAL AND SUPPORT SERVICES. THERE IS ALSO LIMITED COORDINATION OF INFORMATION AND SERVICES BETWEEN AGENCIES AND ORGANIZATIONS.5) HOMELESSNESS - THERE IS LIMITED ACCESS TO SHELTERS FOR THE HOMELESS OR FOR THOSE IN NEED OF TRANSITIONAL HOUSING.6) CONSUMER EDUCATION - THERE IS A GREAT NEED FOR CONSUMER EDUCATION AND PROMOTION OF: HEALTH LITERACY, HEALTH AND WELLNESS, PARENTING EDUCATION, AND PREVENTATIVE CARE.7) PUBLIC TRANSPORTATION - WHILE THE FOCUS GROUP PARTICIPANTS ACKNOWLEDGED THE TREMENDOUS WORK OF THE UNION-SNYDER TRANSPORTATION AUTHORITY (USTA) AND OTHER SIMILAR TRANSPORT SYSTEMS, THERE WAS GENERAL AGREEMENT THAT THERE IS A NEED FOR EXPANDED PUBLIC TRANSPORTATION.8) FOOD - PARTICIPANTS CITED THAT FOOD PANTRIES ARE DIFFICULT TO LOCATE AND MAY BE LIMITED IN THEIR ABILITY TO MEET THE INCREASING COMMUNITY DEMANDS FOR FOOD.9) AFFORDABLE CHILD CARE - PARTICIPANTS EXPRESSED CONCERN REGARDING LACK OF 24-HOUR CHILD CARE. 24-HOUR CARE IS NEEDED DUE TO RESIDENTS WHO WORK SECOND OR THIRD SHIFTS.10) EDUCATION FOR SPECIAL GROUPS - PARTICIPANTS NOTED THAT THERE ARE DEMOGRAPHIC GROUPS WITH UNIQUE NEEDS AND THAT A ONE-SIZE-FITS-ALL APPROACH IS NOT OPTIMAL TO MEET THESE NEEDS. PARTICIPANTS RECOMMENDED THAT SPECIAL PROGRAMS BE DEVELOPED FOR UNMET NEEDS OF THE FOLLOWING GROUPS: SENIORS, NON-ENGLISH SPEAKERS, GRANDPARENTS RAISING GRANDCHILDREN, AND ADOLESCENTS.11) LACK OF HEALTH INSURANCE - DUE TO RISING UNEMPLOYMENT, HEALTH INSURANCE COVERAGE IS LACKING. IN ADDITION, IT WAS NOTED THAT RESIDENTS OF THE MIDDLE CLASS ARE LACKING IN THEIR ABILITY TO ACCESS ASSISTANCE WHILE UNEMPLOYED, SUCH AS FOOD AND UTILITY ASSISTANCE.12) DOMESTIC VIOLENCE - WITH THE INCREASE OF UNEMPLOYMENT THERE HAS BEEN A REPORTED INCREASE IN DOMESTIC VIOLENCE. SURVEY PARTICIPANTS RECOMMENDED AN INCREASE IN THE OFFERING OF STRESS MANAGEMENT AND OTHER PROACTIVE STRATEGIES TO REDUCE DOMESTIC VIOLENCE.13) TOBACCO USE - THERE IS A CONTINUED NEED FOR AFFORDABLE TOBACCO CESSATION PROGRAMS IN THE REGION.14) LIMITED COMPUTER ACCESS - THIS WAS NOTED AS A SIGNIFICANT BARRIER TO FINDING APPROPRIATE HEALTHCARE OPTIONS, FOR NAVIGATING THE HEALTHCARE SYSTEM, AND IN ACCESSING HEALTH INFORMATION, AS WELL AS HEALTH AND SOCIAL SERVICES.IN ADDITION, THE 2009 COMMUNITY HEALTH NEEDS ASSESSMENT REVEALED THE MOST PREVALENT CHRONIC HEALTH CONDITIONS IN OUR COMMUNITY AS: - DIABETES- HIGH BLOOD PRESSURE- HEART DISEASE AS A MEMBER OF ACTION HEALTH AND THE COMMUNITY HEALTH NEEDS ASSESSMENT OVERSIGHT COMMITTEE, EVANGELICAL COMMUNITY HOSPITAL HAS TAKEN AN ACTIVE ROLE IN THE ASSESSMENT PROCESS AND PARTICIPATES ACTIVELY ON THE COMMITTEE. FOLLOWING THE REVIEW OF THE 2009 COMMUNITY HEALTH NEEDS ASSESSMENT REPORT, THE HOSPITAL HAS DEVELOPED THREE STANDING TASKFORCES LED BY EDUCATORS IN THE COMMUNITY HEALTH EDUCATION OFFICE. THE SOLE PURPOSE OF THE TASKFORCES IS TO ADDRESS THREE CRITICAL UNMET COMMUNITY NEEDS: 1) NAVIGATING THE HEALTHCARE SYSTEM; 2) REDUCING OBESITY; AND 3) DECREASING TOBACCO USE. PROGRAMMING IN CLINICAL DEPARTMENTS, PATIENT PROCESSES, AND OUTREACH EFFORTS TO THE COMMUNITY WILL BE MODIFIED TO FOCUS ON MEETING THE IDENTIFIED UNMET NEEDS AND WAYS IN WHICH EVANGELICAL COMMUNITY HOSPITAL CAN BRING ABOUT SYSTEMIC CHANGE.IN OCTOBER 2011, A NEW ACTION HEALTH COMMUNITY HEALTH NEEDS ASSESSMENT OVERSIGHT COMMITTEE WAS FORMED AND EVANGELICAL COMMUNITY HOSPITAL HAS DESIGNATED TWO MANAGEMENT LEVEL INDIVIDUALS TO SERVE ON THIS COMMITTEE. THE COMMITTEE HAS BEGUN ITS WORK TO ASSESS THE NEEDS OF THE COMMUNITY THROUGH A 2012 COMMUNITY NEEDS ASSESSMENT. PART VI, LINE 3: AS A COMMUNITY HOSPITAL, EVANGELICAL IS DEDICATED TO IMPROVING THE HEALTH AND WELL-BEING OF ALL ITS CONSTITUENTS. THROUGH THE FINANCIAL ASSISTANCE PROGRAM, MEDICAL CARE IS PROVIDED REGARDLESS OF A PATIENT'S ABILITY TO PAY, INSUFFICIENT HEALTH INSURANCE OR WHETHER A GOVERNMENT-SPONSORED PROGRAM COVERS THE FULL COST OF SERVICES. AND AS THE COUNTRY'S ECONOMIC FUTURE REMAINS UNCERTAIN, EVANGELICAL WILL CONTINUE TO PROVIDE CARE FOR THOSE WHO NEED IT. EVANGELICAL WILL PROVIDE SERVICES AT NO CHARGE OR REDUCED CHARGES TO THOSE WHO ARE FINANCIALLY UNABLE TO PAY FOR THOSE SERVICES. EVANGELICAL WILL NOT ARBITRARILY RESTRICT THE PROVISIONS OF HEALTH SERVICES TO CERTAIN INDIVIDUALS OR GROUPS.EVANGELICAL COMMUNITY HOSPITAL'S REGISTRATION DEPARTMENT REPRESENTATIVES INFORM OUR UNINSURED OR UNDER INSURED PATIENTS, OF OUR FINANCIAL ASSISTANCE PROGRAM. FINANCIAL ASSISTANCE APPLICATIONS ARE OFFERED TO THESE PATIENTS AND IN ADDITION, THEY HAVE THE OPPORTUNITY TO CALL OUR FINANCIAL COUNSELOR. THE FINANCIAL COUNSELOR DISCUSSES THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS SUCH AS MEDICAID OR STATE PROGRAMS TO ASSIST THE PATIENT WITH QUALIFICATIONS FOR THESE PROGRAMS. THE FINANCIAL COUNSELOR WILL ALSO ASSIST THE PATIENT IN COMPLETING THE PROPER PAPERWORK FOR ASSISTANCE. THE FINANCIAL COUNSELORS AND CASE MANAGEMENT STAFF WORK CLOSELY TO IDENTIFY AND ASSIST ELIGIBLE PATIENTS. OUR SELF-PAY VENDOR ALSO INFORMS THE PATIENT THAT EVANGELICAL HAS A FINANCIAL ASSISTANCE PROGRAM AND A FINANCIAL COUNSELOR WHO WILL SEND THEM AN APPLICATION IF REQUESTED. OUR THIRD PARTY VENDOR WORKS ON BEHALF OF THE ORGANIZATION TO FOLLOW THE HOSPITAL'S POLICIES REGARDING PATIENT NOTIFICATION AND THE AVAILABILITY OF FINANCIAL ASSISTANCE. EVANGELICAL'S FINANCIAL ASSISTANCE POLICY IS POSTED ON THE EVANGELICAL WEBSITE (HTTP://WWW.EVANHOSPITAL.COM/SERVICES/COMMUNITY_RESOURCES/CHARITY_CARE) ALONG WITH AN APPLICATION FOR PATIENTS TO COMPLETE FOR FINANCIAL ASSISTANCE. EVANGELICAL COMMUNITY HOSPITAL WILL MAKE AVAILABLE A WRITTEN NOTICE TO EACH PATIENT OR THEIR REPRESENTATIVE OF THE EXISTENCE, CRITERIA AND MECHANISM FOR RECEIVING FINANCIAL ASSISTANCE. THE HOSPITAL WILL CREATE AND MAINTAIN RECORDS DEMONSTRATING THAT THE REQUIRED CRITERIA AND MECHANISM ARE ESTABLISHED (HOSPITAL WILL RECORD ANY AND ALL REQUESTS FOR FINANCIAL ASSISTANCE, THE DISPOSITION AND THE DOLLAR AMOUNT OF EVANGELICAL'S FINANCIAL ASSISTANCE PROGRAM PROVIDED). IN ALL INSTANCES, PATIENT CONFIDENTIALITY WILL BE PROTECTED.ELIGIBILITY WILL BE DETERMINED BY COMPARING HOUSEHOLD FAMILY INCOME AGAINST THE INCOME POVERTY GUIDELINES. INCOME IS DEFINED AS THE TOTAL ANNUAL CASH RECEIPTS BEFORE TAXES FROM ALL SOURCES.AN INDIVIDUAL NOTICE OF AVAILABILITY OF EVANGELICAL'S FINANCIAL ASSISTANCE PROGRAM WILL BE GIVEN TO EACH PATIENT OR THEIR REPRESENTATIVE PRIOR TO SERVICES BEING RENDERED, WITH THE EXCEPTION OF EMERGENCY SERVICES. THESE NOTICES SHALL BE AVAILABLE IN ALL REGISTRATION AREAS OF THE HOSPITAL AND SHALL INCLUDE THE MOST CURRENT AVAILABLE "HOUSEHOLD INCOME GUIDELINES" AS PUBLISHED IN THE FEDERAL REGISTER.THE PATIENT ACCOUNTS DIRECTOR OR HIS/HER DESIGNEE SHALL REVIEW ALL APPLICATIONS FOR THE EVANGELICAL FINANCIAL ASSISTANCE PROGRAM. IT IS THE APPLICANT'S RESPONSIBILITY TO PROVIDE PROOF OF INCOME. WHEN LANGUAGE IS A BARRIER, EVANGELICAL OFFERS A SPECIAL INTERPRETER CONFERENCING TELEPHONE SERVICE. INTERPRETATION SERVICES ARE AVAILABLE FOR A MULTITUDE OF PATIENT/CAREGIVER INTERACTIONS. WHEN A NON-ENGLISH SPEAKING PATIENT, NO MATTER HIS OR HER NATIVE TONGUE, CALLS IN TO THE HOSPITAL, HE OR SHE WILL BE ABLE TO BE UNDERSTOOD THROUGH A TELEPHONE INTERPRETER. THIS IS AVAILABLE FOR OUTBOUND CALLS TO THE PATIENT AS WELL. THE PROCESS CONTRIBUTES TO IMPROVED PATIENT CARE AND CLINICAL OUTCOMES AND MAKES A VITAL DIFFERENCE IN THE QUALITY OF SERVICE EVANGELICAL IS ABLE TO PROVIDE TO NON-ENGLISH SPEAKING PATIENTS. PART VI, LINE 4: EVANGELICAL COMMUNITY HOSPITAL (ECH) IS LOCATED IN LEWISBURG, PA (UNION COUNTY), THE HEART OF CENTRAL PA. THE HOSPITAL IS CONVENIENTLY LOCATED OFF INTERSTATE 80 ON U.S. ROUTE 15. ECH SERVES THE RESIDENTS OF UNION, SNYDER & NORTHUMBERLAND COUNTIES AND SURROUNDING AREAS. ECH IS THE 3RD LARGEST EMPLOYER IN UNION COUNTY WITH MORE THAN 1,200 EMPLOYEES. ACCORDING TO THE HOSPITAL AND HEALTHSYSTEM ASSOCIATION OF PENNSYLVANIA, ECH'S TOTAL IMPACT ON THE REGIONAL ECONOMY TOPS MORE THAN $180 MILLION. ECH IS A 127 LICENSED-BED ACUTE CARE COMMUNITY HOSPITAL WITH OVER 1,200 EMPLOYEES AND NEARLY 200 MEDICAL STAFF MEMBERS. ECH HAS A BUSY EMERGENCY DEPARTMENT WITH OVER 31,500 VISITS IN 2010. ECH HAS EARNED THE PATIENT SAFETY EXCELLENCE AWARD FOUR OF THE PAST FIVE YEARS FROM HEALTHGRADES (A LEADING NATIONAL INDEPENDENT HEALTHCARE RATINGS ORGANIZATION) WHICH PUTS ECH IN THE TOP 5% OF ALL HOSPITALS IN THE COUNTRY FOR PATIENT SAFETY, SHARING THIS DISTINCTION WITH ONLY 242 OTHERS. THE PRIMARY SERVICE AREA OF RESIDENTS OF ECH INCLUDES: 17810, 17812, 17843, 17813, 17730, 17827, 17829, 17831, 17876, 17833, 17835, 17837, 17749, 17842, 17844, 17845, 17847, 17850, 17853, 17855, 17856, 17857, 17861, 17862, 17864, 17865, 17086, 17870, 17801, 17880, 17882, 17772, 17883, 17777, 17886, 17887, 17885, 17889.OUR SECONDARY SERVICE AREA IS FROM THE FOLLOWING ZIP CODES: 16820, 17866, 17014, 17017, 17821, 17823, 17830, 17737, 17834, 17836, 17045, 17840, 17747, 17832, 17049, 17841, 17062, 17752, 17851, 17756, 17860, 17080, 16872, 17867, 17868, 17872, 17877, 17881, 17884, 16882.THE REGION IS HOME TO SEVERAL COLLEGES, UNIVERSITIES AND TECHNICAL SCHOOLS AS WELL AS STRONG PUBLIC SCHOOL SYSTEMS. IT HAS A VERY DIVERSE HISTORY AND RURAL APPEAL, YET FEATURES BUSINESS AND HEALTHCARE FACILITIES USING THE LATEST ADVANCES IN SCIENCE AND TECHNOLOGY. ADDITIONAL HOSPITALS IN OUR REGION CONSIST OF GEISINGER MEDICAL CENTER, SUNBURY COMMUNITY HOSPITAL (FOR-PROFIT SYSTEM), SHAMOKIN AREA COMMUNITY HOSPITAL, SUSQUEHANNA HEALTH SYSTEM, AND BLOOMSBURG HOSPITAL. ACCORDING TO MOST NATIONAL DATA COLLECTION EFFORTS THE REGION IS PRIMARILY A RURAL REGION. THIS IS CONFIRMED IN RESPONDENT REPORTS FROM THE NEEDS ASSESSMENT. ABOUT 61% OF RESPONDENTS IN THE REGION DESCRIBED THEIR PLACE OF RESIDENCE AS RURAL.MANY PARTICIPANTS RESPONDING TO THE COMMUNITY NEEDS ASSESSMENT REPORTED SIGNIFICANT BARRIERS TO ACCESSING HEALTH CARE IN THEIR COMMUNITIES. THESE WERE PRIMARILY RELATED TO LACK OF HEALTH CARE COVERAGE, LACK OF UNDERSTANDING ABOUT HOW TO NAVIGATE THE HEALTHCARE SYSTEM AND WHERE TO GO FOR HELP, TRANSPORTATION, LOW INCOME AND LOCATING HEALTH CARE PROVIDERS AND PAYING FOR SERVICES-PARTICULARLY DENTAL CARE. CITY-DATA.COM FOR UNION COUNTY INDICATES THAT THE POPULATION CONSISTS OF: WHITE NON-HISPANIC (87.6%), BLACK (6.9%), HISPANIC (3.9%), TWO OR MORE RACES (1.4%) THE MEDIAN RESIDENT AGE IS 35.8. ESTIMATED MEDIAN HOUSEHOLD INCOME IN 2009: $49,803 RESIDENTS WITH INCOME BELOW THE POVERTY LEVEL IN 2009: 8.8%PERSONS ENROLLED IN HOSPITAL INSURANCE AND/OR SUPPLEMENTAL MEDICAL INSURANCE (MEDICARE) IN JULY 1, 2003: 6,234 (5,612 AGED, 622 DISABLED); POPULATION WITHOUT HEALTH INSURANCE COVERAGE IN 2000: 11%; CHILDREN UNDER 18 WITHOUT HEALTH INSURANCE COVERAGE IN 2000: 9%89.6% OF RESIDENTS OF UNION COUNTY SPEAK ENGLISH AT HOME; 3.7% OF RESIDENTS SPEAK SPANISH AT HOME; 5.7% OF RESIDENTS SPEAK OTHER INDO-EUROPEAN LANGUAGE AT HOME; 0.8% OF RESIDENTS SPEAK ASIAN OR PACIFIC ISLAND LANGUAGE AT HOME; 0.2% OF RESIDENTS SPEAK OTHER LANGUAGE AT HOME CITY-DATA.COM FOR SNYDER COUNTY INDICATES THE POPULATION CONSISTS OF: WHITE NON-HISPANIC (97.4%), HISPANIC (1.0%), BLACK (0.8%) THE MEDIAN RESIDENT AGE IS 36.7. ESTIMATED MEDIAN HOUSEHOLD INCOME IN 2009: $44,426 RESIDENTS WITH INCOME BELOW THE POVERTY LEVEL IN 2009: 9.9%PERSONS ENROLLED IN HOSPITAL INSURANCE AND/OR SUPPLEMENTAL MEDICAL INSURANCE (MEDICARE) IN JULY 1, 2003: 6,148 (5,230 AGED, 918 DISABLED); POPULATION WITHOUT HEALTH INSURANCE COVERAGE IN 2000: 9%; CHILDREN UNDER 18 WITHOUT HEALTH INSURANCE COVERAGE IN 2000: 8%92.0% OF RESIDENTS OF SNYDER COUNTY SPEAK ENGLISH AT HOME; 1.5% OF RESIDENTS SPEAK SPANISH AT HOME; 6.3% OF RESIDENTS SPEAK OTHER INDO-EUROPEAN LANGUAGE AT HOME; 0.2% OF RESIDENTS SPEAK ASIAN OR PACIFIC ISLAND LANGUAGE AT HOME; 0.1% OF RESIDENTS SPEAK OTHER LANGUAGE AT HOMECITY-DATA.COM FOR NORTHUMBERLAND COUNTY INDICATES THAT THE POPULATION CONSISTS OF: WHITE NON-HISPANIC (96.6%), BLACK (1.5%), HISPANIC (1.1%), TWO OR MORE RACES (0.6%) ESTIMATED MEDIAN HOUSEHOLD INCOME IN 2009: $37,602; RESIDENTS WITH INCOME BELOW THE POVERTY LEVEL IN 2009: 11.9%; PERSONS ENROLLED IN HOSPITAL INSURANCE AND/OR SUPPLEMENTAL MEDICAL INSURANCE (MEDICARE) IN JULY 1, 2003: 19,762 (16,930 AGED, 2,832 DISABLED)POPULATION WITHOUT HEALTH INSURANCE COVERAGE IN 2000: 10%; CHILDREN UNDER 18 WITHOUT HEALTH INSURANCE COVERAGE IN 2000: 8%; 95.6% OF RESIDENTS OF NORTHUMBERLAND COUNTY SPEAK ENGLISH AT HOME; 1.5% OF RESIDENTS SPEAK SPANISH AT HOME; 2.6% OF RESIDENTS SPEAK OTHER INDO-EUROPEAN LANGUAGE AT HOME; 0.3% OF RESIDENTS SPEAK ASIAN OR PACIFIC ISLAND LANGUAGE AT HOME; 0.1% OF RESIDENTS SPEAK OTHER LANGUAGE AT HOME ECH OPERATES AN EMERGENCY DEPARTMENT THAT IS OPEN TO ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES. WE HAVE OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. ECH HAS A BOARD OF DIRECTORS IN WHICH INDEPENDENT COMMUNITY PERSONS ARE REPRESENTED. ECH IS AFFILIATED WITH HEALTHCARE FACILITIES, SUCH AS GEISINGER MEDICAL CENTER, TO PROVIDE THE BEST MEDICAL CARE FOR OUR PATIENTS. ECH WORKS WITH THE FOLLOWING ORGANIZATIONS: PENN COLLEGE, CENTRAL SUSQUEHANNA INTERMEDIATE UNIT, BLOOMSBURG UNIVERSITY, AND THOMAS JEFFERSON UNIVERSITY TO ENGAGE IN TRAINING AND EDUCATION OF HEALTH CARE PROFESSIONALS. ECH PROVIDES FINANCIAL AID TO SUPPORT STUDENTS CHOOSING THE NURSING PROFESSION THROUGH THE MAE KEEFER AND CRYSTAL SNYDER NURSING SCHOLARSHIP FUND.ECH PARTICIPATES WITH THE FOLLOWING MAJOR HEALTH PLANS: CAPITAL BLUE CROSS, GEISINGER HEALTH PLAN, HIGHMARK BLUESHIELD, HEALTHAMERICA/HEALTH ASSURANCE, KEYSTONE HEALTH PLAN CENTRAL, AND MEDICARE.THE COMMUNITY NEEDS ASSESSMENT SUMMARIZED THE FOLLOWING REGARDING THE DEMOGRAPHICS AND NEEDS OF OUR COMMUNITY: NEARLY 39% OF RESPONDENTS WERE SENIOR CITIZENS; MORE THAN HALF OF RESPONSES REPRESENT HOUSEHOLDS WITH INCOME OF $40,000 PER YEAR OR LESS; ABOUT ONE-THIRD OF AREA RESIDENTS REPORT THAT THEIR FINANCIAL CIRCUMSTANCES ARE SOMEWHAT OR MUCH WORSE OFF COMPARED TO TWO YEARS AGO; WHILE THE EDUCATIONAL LEVELS OF AREA RESIDENTS ARE GENERALLY QUITE HIGH DUE TO THE PRESENCE OF OCCUPATIONS THAT REQUIRE HIGHER LEVELS OF EDUCATION, ABOUT 1 OUT OF 9 ADULTS IN THE REGION DO NOT HAVE A HIGH SCHOOL DIPLOMA. THOSE WITHOUT A HIGH SCHOOL DIPLOMA HAVE A SIGNIFICANTLY INCREASED RISK FOR UNEMPLOYMENT, LOW INCOME, AND HOUSING ISSUES. MOST RESIDENTS HAVE LIVED IN THE AREA FOR TEN OR MORE YEARS. ABOUT 8.2% HAVE MOVED TWO OR MORE TIMES IN THE PAST TWO YEARS. ABOUT TWO-THIRDS OF HOUSEHOLDS IN THE REGION HAVE A COMPUTER IN THEIR HOME. AMONG THOSE WITH A COMPUTER, 74.0% USE THE COMPUTER DAILY. SENIOR HOUSEHOLDS ARE THE LEAST LIKELY TO REPORT HAVING A COMPUTER OR USING A COMPUTER REGULARLY. COMMUNITY COHESION - 91% OF AREA RESIDENTS INDICATED THAT THEY FEEL SAFE OR VERY SAFE AT HOME. SENIOR RESIDENTS ARE SOMEWHAT LESS LIKELY TO FEEL SAFE IN THEIR NEIGHBORHOODS. RESIDENTS WHO DO NOT FEEL SAFE IN THEIR NEIGHBORHOOD ARE LESS LIKELY TO ASK FOR ASSISTANCE SUCH AS A RIDE TO AN APPOINTMENT. TOBACCO AND ALCOHOL USE - ABOUT 16% OF AREA ADULTS USE TOBACCO PRODUCTS. TWO-THIRDS OF THESE INDIVIDUALS HAVE ATTEMPTED TO STOP USING TOBACCO. MOST ADULTS IN THE REGION HAVE USED ALCOHOL AT SOME TIME IN THEIR LIVES. ABOUT 6% OF ADULTS REPORTED ALCOHOL USE CONSISTENT WITH BINGE DRINKING DURING THE PAST THIRTY DAYS. ONE THIRD OF THOSE WHO REPORTED DRINKING FIVE OR MORE DRINKS THE LAST TIME ALCOHOL WAS CONSUMED HAD PROBLEMS ASSOCIATED WITH DRINKING SUCH AS FAMILY OR LEGAL PROBLEMS. NEARLY 60% OF THESE INDIVIDUALS BELIEVED THAT THEY HAD A DRINKING PROBLEM AND NEARLY HALF OF THOSE WHO DRANK FIVE OR MORE DRINKS THE LAST TIME THEY DRANK WERE UNABLE TO GET HELP WHEN SOUGHT DURING THE PAST YEAR. PREVENTION AND HEALTHY LIFESTYLES - GENERALLY, THERE IS A NEED FOR INCREASED COMPLIANCE WITH PREVENTION AND HEALTHY LIFESTYLE PRACTICES. IT APPEARS THAT INDIVIDUALS WITH A CHRONIC HEALTH CONDITION ARE LIKELY TO HAVE HAD MANY OF THE SCREENING AND PREVENTION PROCEDURES THAT ARE INDICATED. HOWEVER, AMONG THOSE WITHOUT A DIAGNOSED HEALTH CONDITION, AND AMONG THOSE WHO ARE UNDER AGE 65 YEARS, THERE IS A MUCH LOWER RATE OF COMPLIANCE WITH RECOMMENDED EVALUATIONS AND PREVENTION ACTIVITIES. SEE SCHEDULE O FOR CONTINUATION PART VI, LINE 6: EVANGELICAL COMMUNITY HOSPITAL HAS A TOTAL OF 127 PATIENT BEDS AND 18 BASSINETS. THERE ARE NEARLY 200 PHYSICIANS ON STAFF, AND NEARLY 900 CLINICAL EMPLOYEES, INCLUDING LAB TECHNICIANS, NURSES, NURSING ASSISTANCES, PHYSICAL, OCCUPATIONAL AND SPEECH THERAPISTS, RADIOLOGY TECHNICIANS, PHLEBOTOMISTS, AND SUPPORT PERSONNEL. EACH ARE HIGHLY TRAINED TO DELIVER QUALITY AND SAFE CARE TO INPATIENTS AND OUTPATIENTS. THE HOSPITAL HAS:1) AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREAS;2) A BOARD OF DIRECTORS WHO GOVERN THE ORGANIZATION. THE BOARD IS COMPRISED OF COMMUNITY AND BUSINESS LEADERS, AND PHYSICIANS REPRESENTING THE GEOGRAPHIC AREA OF OUR REGION;3) AN EMERGENCY DEPARTMENT THAT IS OPEN TO ALL PERSONS IN NEED REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES;4) A HOSPICE PROGRAM THAT PROVIDES END-OF-LIFE CARE TO ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR CARE;5) A BIOETHICS COMMITTEE COMPRISED OF VOLUNTEERS WHO ARE PHYSICIANS, NURSES, SOCIAL SERVICE WORKERS, PASTORAL CAREGIVERS, EDUCATORS, AND OTHER PROFESSIONALS. THEY DISCUSS AND ADDRESS ETHICAL ISSUES AND DILEMMAS THAT ARE PRESENTED FOR REVIEW;6) PROVIDES FINANCIAL SUPPORT TO OTHER NONPROFIT ORGANIZATIONS FOR THE PURPOSE OF HEALTH PROMOTION AND COLLABORATING TO MEET UNMET NEEDS IN THE COMMUNITY.7) THE HOSPITAL'S COMMUNITY HEALTH EDUCATION DEPARTMENT IS FUNDED USING HOSPITAL RESOURCES. THE DEPARTMENT INITIATES AND ORGANIZES PREVENTION, WELLNESS AND HEALTH EDUCATION LECTURES, EVENTS AND ACTIVITIES DEVELOPED FOR THE SOLE PURPOSE OF IMPROVING THE HEALTH OF THOSE IN OUR REGION. THE COMMUNITY HEALTH EDUCATION STAFF OFFERS: HEALTH SCREENINGS, HEALTH FAIRS, LECTURES, SUPPORT GROUPS, FLU SHOTS, AND SAFETY INSPECTIONS. IN FISCAL YEAR 2011, THE COMMUNITY HEALTH EDUCATION STAFF PROVIDED MORE THAN 1439 FLU VACCINATIONS AND MORE THAN 1000 CHILDREN AND PARENTS ATTENDED THE ANNUAL CHILDREN'S HEALTH FAIR.ANY SURPLUS FUNDS ARE REINVESTED IN THE CAPITAL OF THE HOSPITAL, USED FOR TECHNOLOGY PURCHASES FOR THE LATEST MEDICAL EQUIPMENT, AND HELD FOR FUTURE USES FOR CARE OF THE INDIGENT. PART VI, LINE 7: THE ORGANIZATION IS PART OF AN AFFILIATED HEALTH CARE SYSTEM DUE TO THE HOSPITAL HAVING COMMON GOVERNANCE AND CONTROL FOR EVANGELICAL MEDICAL SERVICES ORGANIZATION AND EVANGELICAL COMMUNITY HOSPITAL HOMECARE PRODUCTS. EVANGELICAL MEDICAL SERVICESORGANIZATION PROVIDES HEALTHCARE SERVICES IN THE FORM OF PRIMARY AND SPECIALTY CARE PHYSICIANS TO THE COMMUNITY. HOMECARE PRODUCTS PROVIDES DURABLE MEDICAL EQUIPMENT AND OXYGEN TO THE SUPPORT THE COMMUNITY NEEDS. REPORTS FILED WITH STATES PART VI, LINE 7 PA 1 NURSING SCHOLARSHIPS 19 36950 CASH N/A JOHNS FAMILY SCHOLARSHIPS 4 20000 CASH N/A PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: APPLICANTS MUST APPLY FOR NURSING AND TRAINING DEPARTMENT SCHOLARSHIPS. APPLICATIONS ARE REVIEWED BY A COMMITTEE TO DETERMINE IF THE APPLICANTS MEET THE ELIGIBILITY REQUIREMENTS. APPLICANTS ARE REVIEWED BASED ON COMMUNITY SERVICE AND/OR EXTRA CURRICULAR ACTIVITIES, ACADEMIC STANDING, QUALITY OF ESSAY, FINANCIAL NEED, ETC. X X X X 1 1 0 0 0 0 0 0 0 MICHAEL N O'KEEFE 361161 0 0 0 0 0 36558 0 64567 0 462286 0 0 0 JAMES A STOPPER 122892 0 0 0 0 0 0 0 34410 0 157302 0 0 0 J LAWRENCE GINSBURG 545654 0 0 0 0 0 41326 0 111457 0 698437 0 0 0 KENDRA A AUCKER 199727 0 0 0 0 0 14235 0 41689 0 255651 0 0 0 TAMI RADECKE 153131 0 0 0 0 0 14721 0 28156 0 196008 0 0 0 PAUL TARVES 188181 0 0 0 0 0 16520 0 36171 0 240872 0 0 0 MARK K KRAMMES 229986 0 0 0 0 0 0 0 64396 0 294382 0 0 0 SANDRA S WALKER 223992 0 0 0 0 0 0 0 62718 0 286710 0 0 0 LORI K GOODLING 218136 0 0 0 0 0 0 0 61078 0 279214 0 0 0 RAYMOND J TOMASZEWSKI 214621 0 0 0 0 0 0 0 60094 0 274715 0 0 0 COLLEEN FRITZ 212351 0 0 0 0 0 0 0 59458 0 271809 0 0 0 RICHARD E SMITH JR 170927 0 0 0 0 0 13321 0 34538 0 218786 0 0 0 PART I, LINES 4A-B RICHARD E. SMITH, JR. RECEIVED $48,750 OF SEVERENCE PAYMENTS. UNION COUNTY HOSPITAL AUTHORITY 232739624 906460CT5 2004-08-01 23463224 SERIES OF 2004 BONDS - FUND CONSTRUCTION & RENOVATIONS PROJECTS 0 0 0 UNION COUNTY HOSPITAL AUTHORITY 232739624 2011-03-03 29960888 SERIES OF 2011 BONDS - FUND CONSTRUCTION & REFUND OUTSTANDING 2009 BONDS 0 0 0 2140000 23474907 1753500 771220 15232482 5717705 2004 1 1 1 1 29719008 2252124 377544 11245154 15844186 1 0 1 1 0 0 0 0 0.00000 0.00320 0.00320 1 0 0 0 0 0.00000 0.00320 0.00320 1 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE K, PART II, LINE 3: TOTAL PROCEEDS OF ISSUE FOR BOND A IS LESS THAN THE ISSUE PRICE LISTED IN PART I DUE TO THE UNDERWRITER'S DISCOUNT OF $189,280 OFFSET BY INVESTMENT EARNINGS OF $200,963. TOTAL PROCEEDS OF ISSUE FOR BOND B IS LESS THAN THE ISSUE PRICE LISTED IN PART I DUE TO THE UNDERWRITER'S DISCOUNT OF $241,880. JOHN D GRIFFITH DIRECTOR OF THE BOARD 426965 JOHN D. GRIFFITH LEASES PROPERTY TO THE HOSPITAL AT AN ARM'S LENGTH TRANSACTION. 0 JAMES W MORGAN JR MD DIRECTOR OF THE BOARD 305158 THE HOSPITAL PAYS DR. MORGAN'S PRACTICE FOR MEDICAL DIRECTORSHIPS THAT ARE SERVED BY DOCTORS WITHIN HIS PRACTICE. 0 X ADVERTISEMENT SPACE 1 5661 FMV X SPORTING EVENT 1 1368 FMV X ACCOMODATIONS 1 8400 FMV X FUNDRAISING PRIZES 286 51960 FMV 0 0 0 FORM 990, PART VI, SECTION A, LINE 2 JAMES APPLE IS THE FATHER OF TIM APPLE AND BOTH SERVE ON THE BOARD. ROBERT GRONLUND IS THE FATHER OF BROOKS GRONLUND AND BOTH SERVE ON THE BOARD. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 WAS REVIEWED BY THE FINANCE DEPARTMENT WITH THE AUDIT COMMITTEE AT AN AUDIT COMMITTEE MEETING PRIOR TO FILING. THEY WILL HAVE THE OPPORTUNUITY TO ASK QUESTIONS AND CHANGES CAN BE MADE AS A RESULT IF NECESSARY BEFORE THE RETURN IS FILED. FORM 990, PART VI, SECTION B, LINE 12C A CONFLICT OF INTEREST STATEMENT IS REQUIRED TO BE SIGNED ANNUALLY BY ALL VOTING BOARD MEMBERS, UPPER MANAGMENT, AND KEY EMPLOYEES. THE HUMAN RESOURCES DEPARTMENT MONITORS COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY VERIFYING ALL FORMS ARE COMPLETED AND SIGNED. HR MAINTAINS COPIES OF ALL COMPLETED CONFLICT OF INTEREST STATEMENTS. MEMBERS WITH CONFLICTS ARE REQUIRED TO ABSTAIN FROM VOTING OR BEING A PART OF ACTIVE DISCUSSIONS WHERE THEY ARE IN DIRECT CONFLICT. ANYONE IN VIOLATION OF THE CONFLICT OF INTEREST POLICY IS ASKED TO STEP DOWN FROM THE BOARD. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD'S EXECUTIVE COMPENSATION COMMITTEE, WHICH IS COMPOSED SOLELY OF INDEPENDENT MEMBERS OF THE BOARD, HAS ADOPTED AND FOLLOWS A PROCESS FOR REVIEWING AND DETERMINING THE COMPENSATION OF THE CEO AND THE EXECUTIVE MANAGEMENT TEAM. THE EXECUTIVE MANAGEMENT TEAM CONSISTS OF THE FOLLOWING POSITIONS: CHIEF OPERATING OFFICER, CHIEF FINANCIAL OFFICER, VICE PRESIDENT OF MEDICAL AFFAIRS, VICE PRESIDENT - NURSING, VICE PRESIDENT - DEVELOPMENT, VICE PRESIDENT - HUMAN RESOURCES, CHIEF INFORMATION OFFICER, VICE PRESIDENT - SUBSIDIARY OPERATIONS. THE COMMITTEE HAS ENGAGED AN INDEPENDENT COMPENSATION CONSULTANT TO PROVIDE INFORMATION AND ADVICE TO THE COMMITTEE, INCLUDING BUT NOT LIMITED TO, PROVIDING INDEPENDENT COMPENSATION COMPARABILITY DATA FOR FUNCTIONALLY COMPARABLE POSITIONS IN SIMILARLY SITUATED HOSPITALS. THE DATA IS PROVIDED ON AN ANNUAL BASIS AND IS REVIEWED BY THE COMMITTEE, ALONG WITH OTHER INFORMATION, PRIOR TO APPROVING ANY CHANGES TO COMPENSATION. THE INDEPENDENCE OF THE COMMITTEE'S MEMBERS IS REVIEWED AND VERIFIED PRIOR TO THE START OF THE ANNUAL COMPENSATION REVIEW PROCESS. SHOULD A CONFLICT PRESENT, THOSE INDIVIDUALS WITH ACTUAL OR PERCEIVED CONFLICTS ABSTAIN FROM VOTING UNTIL SUCH TIME AS THE CONFLICT CAN BE RESOLVED OR A REPLACEMENT MEMBER IS APPOINTED TO THE COMMITTEE. THE COMMITTEE'S DELIBERATIONS AND DECISIONS ARE GUIDED BY A WRITTEN COMPENSATION PHILOSOPHY AND DOCUMENTED THROUGH WRITTEN MINUTES TAKEN DURING EACH MEETING. THE MINUTES INCLUDE, AMONG OTHER THINGS, THE WRITTEN MATERIALS DISTRIBUTED OR PRESENTED DURING THE MEETING AND THE SPECIFIC DECISIONS TAKEN AT THE MEETING. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 4,066,555. CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENT 29,255. VALUATION GAIN 593,717. POSTRETIREMENT BENEFIT LIABILITY ADJUSTMENT -191,108. EQUITY TRANSFER TO AFFILIATE -1,950,000. TOTAL TO FORM 990, PART XI, LINE 5: 2,548,419. FORM 990, SCHEDULE H, PART VI, LINE 4 ADDITIONALLY, THOSE WHO HAVE NO HEALTH INSURANCE ARE LESS LIKELY TO HAVE THESE PREVENTION AND SCREENING PROCEDURES: * INFLUENZA VACCINES WERE MORE LIKELY AMONG SENIORS AND THOSE WITH INSURANCE. * LESS THAN TWO-THIRDS OF ADULTS WHO DO NOT HAVE HYPERTENSION (HIGH BLOOD PRESSURE) REPORTED A BLOOD PRESSURE CHECK IN THE PAST YEAR. * MOST YOUNG ADULTS DID NOT PLAN TO GET THE H1N1 VACCINE DURING THE HEIGHT OF THE INFLUENZA OUTBREAK. * ABOUT 37% OF AREA ADULTS DO NOT EXERCISE REGULARLY EACH WEEK. AN ADDITIONAL ONE-THIRD EXERCISE ONE TO THREE DAYS EACH WEEK. WHILE THE REMAINING 31% EXERCISE FOUR OR MORE DAYS EACH WEEK. * MOST RESIDENTS REPORT WALKING AS THEIR USUAL EXERCISE. THUS, PROMOTING HEALTHY WALKABLE COMMUNITIES SHOULD BE AN IMPORTANT PUBLIC HEALTH AGENDA ITEM FOR THE REGION. * HOUSEHOLD INCOME WAS ASSOCIATED WITH THE ABILITY TO AFFORD A HEALTHY DIET. NEARLY 7% OF LOW INCOME FAMILIES ARE OFTEN OR VERY OFTEN UNABLE TO AFFORD A HEALTHY DIET. HOUSEHOLDS WITH CHILDREN WERE MORE LIKELY TO REPORT THAT THEY COULD NOT AFFORD FRESH FRUITS AND VEGETABLES. HEALTH STATUS THE MOST PREVALENT CHRONIC HEALTH CONDITIONS REPORTED BY ADULTS INCLUDED: HIGH BLOOD PRESSURE ARTHRITIS DIABETES ANXIETY AND DEPRESSION HEART DISEASE HIGH BLOOD PRESSURE IS MOST PREVALENT AMONG ADULTS OVER THE AGE OF 44 YEARS, WHILE ANXIETY AND DEPRESSION IS MOST PREVALENT AMONG 18-44 YEAR OLDS. ABOUT 13% OF RESPONDENTS MET CRITERIA FOR SERIOUS PSYCHOLOGICAL DISTRESS. THESE INDIVIDUALS MAY HAVE NEED FOR TREATMENT FOR CONDITIONS SUCH AS DEPRESSION OR ANXIETY. ACCESS TO HEALTH CARE AND HEALTH INFORMATION ABOUT 90% OF AREA RESIDENTS HAVE A USUAL SOURCE OF HEALTH CARE. HOWEVER, AMONG THOSE RESIDENTS WHO DO NOT HAVE HEALTH INSURANCE, NEARLY 41% REPORTED THAT THEY DID NOT HAVE A USUAL SOURCE OF CARE. MORE THAN 5% OF AREA RESIDENTS ARE UNABLE TO AFFORD PRESCRIBED MEDICINES OFTEN OR VERY OFTEN. UNINSURANCE STATUS REDUCES THE LIKELIHOOD THAT A RESIDENT OF THE AREA WILL HAVE SEEN A HEALTH CARE PROVIDER IN THE PAST TWO YEARS. MOST AREA RESIDENTS OBTAIN HEALTH INFORMATION FROM THEIR HEALTH CARE PROVIDER. HOWEVER, MORE THAN 40% OBTAIN SOME HEALTH INFORMATION FROM THE INTERNET. COMMUNITY PROBLEMS THE MOST SIGNIFICANT COMMUNITY PROBLEMS NOTED BY AREA RESIDENTS INCLUDED: UNEMPLOYMENT DOMESTIC VIOLENCE CHILD ABUSE DRUG ABUSE UNDERAGE DRINKING AFFORDABLE CHILDCARE PERSONAL AND HOUSEHOLD NEEDS DURING THE PAST YEAR AMONG THE SERVICES OR ASSISTANCE THAT AREA RESIDENTS WERE REPORTED HAVING DIFFICULTY ACCESSING WAS: * PAYING FOR PRESCRIPTION MEDICATION, MENTAL HEALTH SERVICES, DENTAL CARE, AND MEDICAL CARE. * FINDING MENTAL HEALTH CARE, SUBSTANCE ABUSE TREATMENT, DENTAL CARE, MEDICAL CARE AND CHILDCARE. * LOCATING OR APPLYING FOR SOCIAL SERVICES, FOOD PANTRY AND OTHER FOOD ASSISTANCE, HEATING ASSISTANCE, LEGAL ASSISTANCE, AND ADULT ACCESS. CONCLUSION THEMES ACROSS THE FOCUS GROUPS, INTERVIEWS AND SURVEYS WERE SIMILAR. THERE IS CONSIDERABLE WORK TO BE DONE BY AREA AGENCIES AND THE ORGANIZATION. THERE IS A SIGNIFICANT NEED FOR HEALTH AND WELLNESS EDUCATION AND SUPPORT AND PROMOTION OF WELLNESS EDUCATION AND PHYSICAL ACTIVITY. A VERY CLEAR NEED IS PRESENT IN HELPING AREA RESIDENTS NAVIGATE THE HEALTH CARE AND SOCIAL SERVICE SYSTEM. THERE IS NO CLEAR ROAD MAP FOR AREA RESIDENTS IN LOCATING SERVICES. FOR EXAMPLE, THERE IS NOT A LISTING IN THE PHONE BOOK OR ON THE INTERNET FOR FOOD BANKS. THE GREATEST NEEDS APPEAR TO BE IN OBTAINING HEALTH AND DENTAL CARE FOR LOW INCOME AND UNINSURED RESIDENTS. THE PROBLEM IS A MULTI-LEVEL PROBLEM THAT BEGINS WITH LOCATING PROVIDERS AND IS CLOSELY FOLLOWED BY NEGOTIATING PAYMENT STRATEGIES FOR SERVICES. IT IS UNLIKELY THAT THESE PROBLEMS CAN BE RESOLVED BY ONE ORGANIZATION BUT MAY OFFER OPPORTUNITIES FOR PARTNERSHIP ACROSS MANY ORGANIZATIONS. PREVENTION AND EDUCATION FOR SUBSTANCE USE DISORDERS AND TOBACCO USE IS ONE OF MANY ISSUES THAT WILL REQUIRE THE DEVELOPMENT OF STRATEGIES FOR REACHING MANY DIFFERENT CONSTITUENCIES. A FREQUENTLY NOTED CONCERN IN THE FOCUS GROUPS WAS THAT A MINORITY POPULATION WAS NOT REACHED BY EXISTING SERVICES. THESE POPULATIONS INCLUDED SENIORS, TEENS, IMMIGRANT POPULATIONS, AND OTHERS. EDUCATION FOR CONSUMER ISSUES AS WELL AS HEALTH ISSUES CANNOT BE ASSUMED TO BE "ONE SIZE FITS ALL" AND MUST BE TAILORED TO POPULATIONS OF NEED. EVANGELICAL IS COLLABORATING WITH AREA HOSPITALS THROUGH "ACTION HEALTH" ALONG WITH SEVERAL COMMUNITY ORGANIZATIONS TO USE THIS DATA TO DEVELOP PARTNERSHIPS FOR MEETING THE NEEDS OF AREA RESIDENTS. OUR STRATEGIC PLAN CALLS FOR EXPANDING PROGRAMS AND SERVICES TO ADDRESS COMMUNITY NEEDS AND GROWING OUTREACH EFFORTS TO UNDER SERVED COMMUNITIES. 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