2011-05-13T07:35:23-05:00 2010-06-30 GRANT THORNTON LLP 2001 MARKET STREET SUITE 3100 PHILADELPHIA PA 19103 990 2009-07-01 251737079 Canonsburg General Hospital CANO 4123306022 C/O Tax Dept Two Alleghney Center Pittsburgh PA 15212 David Kiehn 2011-05-09 true GRANT THORNTON LLC 2155614200 2009 2016-02-24 21:20:13Z Roy Santarella 30 Isabella Street Pittsburgh PA 15212 50704138 false X www.wpahs.org X 1994 PA See Form 990, Page 2, Part III, Line 1 13 10 606 234 138937 -35439 338851 458685 52052718 49043346 58197 24664 1130204 1147220 53579970 50673915 500 4300 0 0 25550549 22345660 0 0 92563 26817771 26586774 52368820 48936734 1211150 1737181 24866634 24067386 40276731 40971673 -15410097 -16904287 CANONSBURG GENERAL HOSPITAL IS AN ORGANIZATION DEFINED BY OUR TALENTED PEOPLE. AN ORGANIZATION COMMITTED TO EXCELLENCE; AN ORGANIZATION WITH ONE PURPOSE AND ONE MISSION. OUR ONE PURPOSE IS TO IMPROVE THE HEALTH OF THE PEOPLE IN THE WESTERN PENNSYLVANIA REGION. OUR ONE MISSION IS TO PRACTICE MEDICINE, EDUCATE AND CONDUCT RESEARCH AS AN INTEGRATED TEAM OF PHYSICIANS, NURSES AND SUPPORT PROFESSIONALS WHO ARE COMMITTED TO IMPROVING THE HEALTH OF OUR PATIENTS. false false 4575248 0 3696504 The purpose of Canonsburg General Hospital is to improve the health of the people in Western Pennsylvania. In order to accomplish this mission, Canonsburg General Hospital provides rehabilitiation services to those individuals in need of treatment in order to regain their quality of life. 3522345 4300 1796718 The purpose of Canonsburg General Hospital is to improve the health of the people in Western Pennsylvania. In order to accomplish this mission, Canonsburg General Hospital provides uncompensated care and community benefit to individuals in need of medical attention. See Schedule O - Statement of Program Service Accomplishments and Schedule H. 2091423 0 1992070 The purpose of Canonsburg General Hospital is to improve the health of the people in Western Pennsylvania. In order to accomplish this mission, Canonsburg General Hospital provides oncology services to those individuals in need of treatment in their battle against cancer. 29776665 0 41558054 39965681 true true false true false false false false true true false true false false false false false false true false true false false true true false false false false false false false false false false false false false false false true false false false true 61 0 true 606 true true true false false false false true true false false false 13 10 false false false false false false false true true false false true true true true true true true true false PA X DAVID KIEHN 4123306005 TWO ALLEGHENY CENTER 11TH FLOOR Pittsburgh PA 15212 Joseph Macerelli 2.0 X 0 0 0 William Burt 2.0 X 0 0 0 Carol Pankas 2.0 X 0 0 0 William Thomeier MD 2.0 X 0 0 0 Charles LaBelle 2.0 X 0 0 0 Michael Alterio 2.0 X 0 0 0 David Celko MD 2.0 X 0 0 0 David Burkey MD 2.0 X 0 0 0 David McClenahan 2.0 X 0 0 0 Joseph Cerenzia 2.0 X 0 0 0 Kimberly Malinky 40.0 X X 0 259692 0 Christopher Olivia MD 2.0 X X 0 1879499 0 Jeffrey Gretz MD 2.0 X 0 219606 0 Roy Santarella 2.0 X 0 1217922 0 Thomas Albanesi 2.0 X 0 313976 0 Judy Hlafcsak 2.0 X 0 612759 0 Deborah Olszewski 2.0 X 0 207729 0 Sharon Loftus 2.0 X 0 282552 0 Eugene Trout 40.0 X 0 139955 0 Thomas Corkery MD 40.0 X 0 222557 0 Terry Wiltrout 40.0 X 116916 0 0 Teresa Gordon 40.0 X 191714 0 0 Denise Westwood 40.0 X 145146 0 0 Laurie Molinda MD 40.0 X 148330 0 0 Cathleen Allinder 40.0 X 141971 0 0 Patti Pratt 40.0 X 127279 0 0 Jerry Fedele X 0 252175 0 Dawn Javersack X 0 102025 0 871356 5710447 0 10 true true false Allegheny Chesapeake Physical The 3053 New Germany Road EBENSBURG PA 15931 Physical Therapy 1055451 Open MRI of Washington County LLC PO Box 450 NEW STANTON PA 15672 MRI Services 390384 Metz Associates 2 Woodland Drive DALLAS PA 18612 Management Service 173301 Aramark Corporation PO Box 33170 NEWARK NJ 07188 Concession Services 107646 Clean Care PO Box 40330 PITTSBURGH PA 15201 Linen Services 300617 6 26052 9025 423608 458685 PATIENT SERVICE REVENUE 621500 49043346 48945610 97736 49043346 24664 24664 0 0 34744 34744 34744 5260 29484 0 50831 26052 30223 20608 20608 0 0 REVENUE MATCH GRANTS 621110 204092 204092 CAFETERIA 621110 149680 149680 SCHOOL DISTRICT NURSING SERVICES 621110 216782 216782 521314 485373 35941 1091868 50673915 50001537 138937 74756 3500 3500 800 800 0 0 130491 110917 19574 0 18677464 15875844 2719916 81704 514881 437649 77232 1673313 1422316 250997 1349511 1147084 196388 6039 0 0 55816 55816 0 0 1382 1244 138 4006611 3205289 799312 2010 137688 137688 339689 305720 33136 833 0 0 840221 756199 84022 21414 19273 1948 193 0 9109 8199 560 350 1401855 1261670 140185 4471464 626004 3845460 2427018 2184316 242702 761495 761495 REPAIR AND MAINTENANCE 1763270 1586943 176327 PATIENT MEDICATIONS 7004114 7004114 PATIENT BAD DEBT - AT CHARGE 2238032 2238032 DIETARY 319009 287108 31313 588 LICENSE AND FEES 168390 151551 16839 620197 570414 48937 846 48936734 39965681 8878490 92563 32455 4887 3325097 2636265 102098 268340 4978069 3989855 904856 716475 314730 521816 44370414 30940294 13102360 13430120 306215 551232 225453 311709 1575301 1636687 24866634 24067386 4284951 4229553 2667720 2635806 27318231 26945760 6005829 7160554 40276731 40971673 X -15879304 -17680705 396233 699484 72974 76934 -15410097 -16904287 24866634 24067386 X false true true X true true X false false false RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 0 0 13568 418483 13568 418483 48923166 1648957517 48936734 1649376000 1000000 1000000 250000 250000 1000000 1000000 1000000 1000000 4000000 6000000 568458 613479 585102 418483 2185522 250000 250000 250000 250000 1000000 1500000 0 0 0 0 0 Lobbying Expenditures Form 990, Schedule C, Page 2, Part II-A, Line 1b, Column A Canonsburg General Hospital (CGH) has made the IRC Section 501(h) election. CGH has not made any political expenditure and no direct lobbying expenditures. CGH is a member of the West Penn Allegheny Health System (WPAHS). WPAHS employs an Executive Vice President for external affairs to lobby issues of importance to WPAHS and all of its members. WPAHS also elected to engage the services of outside consultants to assist us in lobbying issues of importance. The lobbying expenditures of $13,568 attributed to CGH on Schedule C, Page 2, Part II-A reflect expenditures allocated to CGH from WPAHS and do not reflect direct expenditures made by CGH. 469207 460881 10255 163880 45 776418 290085 183331 -1398 2624 187 469207 0.10000 0.90000 true false 2410450 2410450 25527490 18641513 6885977 279707 275373 4334 15069455 12023408 3046047 1083312 1083312 13430120 DUE FROM AFFILIATES 1542653 RECEIVABLES - NON PATIENT 94034 1636687 0 ACCRUED PENSION COST 6704229 INSURANCE LIABILITIES 456325 7160554 CGH Inclusion In The Consolidated Audit of WPAHS Form 990, Schedule D, Part X, Question 2, Part XII and XIII Canonsburg General Hospital does not receive its own independent audit. It is a member of a regional healthcare system named West Penn Allegheny Health System. West Penn Allegheny Health System receives a consolidated audit that includes the operations of Canonsburg General Hospital. The following analysis represents the reconciliation between the Canonsburg General Hospital financial statement net income and the net income as reported on Form 990, Page 1, line 19: Net income per financial statements $1,328,636 Plus: Income and expense reclassified from restricted net assets on the financial statements to unrestricted income and expense on Form 990 408,545 ___________ Net income per Form 990 $ 1,737,181 The following is the footnote to the audited consolidated financial statements of the West Penn Allegheny Health System for FASB ASC 740: "WPAHS adopted FASB ASC 740, Income Taxes, which clarifies the accounting for uncertainty in income taxes recognized in an enterprise's financial statements. FASB ASC 740 prescribes a more-likely than-not recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken or expected to be taken. Under FASB ASC 740, tax positions will be evaluated for recognition, derecognition, and measurement using consistent criteria and will provide more information about the uncertainty in income tax assets and liabilities. Based on an analysis prepared by WPAHS, it was determined that the application of FASB ASC 740 had no material effect on the recorded tax assets and liabilities of WPAHS." Golf Event 76883 26052 50831 14398 9479 6346 0 76883 26052 50831 14398 9479 6346 30223 20608 true true true X true X true true true false true true 285131 285131 0.00580 2789922 1645798 1144124 0.02340 3075053 1645798 1429255 0.02920 97925 97925 0.00200 61711 61711 0.00120 187558 150920 36639 0.00080 9658 9658 0.00020 356852 150920 205933 0.00420 3431905 1796718 1635188 0.03340 418 418 0.00010 19156 19156 0.00040 53586 53586 0.00110 73160 73160 0.00160 true 621501 173817 10634763 12056350 -1421587 X true true Canonsburg General Hospital

100 Medical Boulevard Canonsburg PA 15317

X Healthworks

400 Southpointe Suite 235 Canonsburg PA 15317

X Canonsburg Community Healthcare Center

36 East Pike Street Canonsburg PA 15317

X Canonsburg General Hospital does not issue separate audited financial statements, and therefore, a footnote does not exist. Bad debt expense is accounted for on a charge basis in our internal financial statements. A cost to charge ratio is applied to the internal figures to convert the charge to cost. It is the opinion of Canonsburg General Hospital management that because patients are often reluctant to complete the required charity care paperwork that an unquantifiable amount of charity care results in bad debt. Thus, it is our opinion that bad debt expense can be considered a justifiable component of uncompensated care. Canonsburg General Hospital takes the shortfall in Medicare into consideration in its provision of charity care and below cost services to the community. The primary service area for Canonsburg General Hospital is Western Pennsylvania. Western Pennsylvania includes Allegheny County which has the third largest percentage of adults age 65 or older in the United States. The shortfall in Medicare subsidized by Canonsburg General Hospital is a direct reflection of our commitment to the community and is a benefit to the community we serve. The costing source used to determine the amount reported on Line 6 is the Medicare Cost Report. Patients that qualify for charity care or financial assistance are provided with an approval letter with the effective dates for the assistance. At any time the individual presents for services within a 90 day span of approval, they show the letter and will be registered as a charity care case. Charity care cases are designated in the internal computerized systems with unique plan codes that prevent billing to the patient. Reports are run to capture the patient accounts registered with the charity care plan codes so they can be written off to charity care. Canonsburg General Hospital management and staff utilize multiple strategies to continually monitor and assess the health care needs of the communities it serves. One approach to assessing needs involves surveying community members about health needs related to national and state health goals. Canonsburg General Hospital also acts on expressed community needs by responding to direct community requests for health screenings, outreach events and other health-related activities and by maintaining longstanding programs that are well attended and positively evaluated by community participants. In addition, Canonsburg General Hospital gathers community input through participation in area rotaries, chambers of commerce and through partnerships with community organizations. Another means is through reviewing and taking appropriate actions on feedback gathered from the following sources: routine market assessments; patient and family satisfaction surveys; Press Ganey surveys; patient, patient family and staffs' suggestions for improving patient safety; medical staff input and physician surveys. Canonsburg General Hospital displays signage that describes the charity care policy and process at each of our registration sites. We also include information related to charity care in the patient brochures available at the registration sites. A summary of our charity care policy is available on our internet page www.wpahs.org, as well as the actual application. In addition, our internet page provides toll free telephone numbers that are available for patient inquiries concerning charity care. Our counselors can assist individuals with the process of applying for charity care. Our counselors can also assist patients in obtaining governmental assistance by helping identifying areas of assistance that they may qualify to obtain. If we are unsuccessful in helping the patient qualify, we use outside consultants to work with the patients to further help the qualification process. This is provided at no charge to the patient. Canonsburg General Hospital, located in Canonsburg Pennsylvania, provides health care services to residents of Allegheny and Washington Counties. Located approximately 20 miles outside of Pittsburgh, Canonsburg has approximately 8,700 residents. Washington County consists of approximately 207,400 residents living in a land area of approximately 857 square miles. The median housing value in Washington County is $87,500. Allegheny County consists of approximately 1,218,000 residents living in a land area of approximately 730 square miles. The median housing value in Allegheny County is $84,200. Together, Washington and Allegheny County form the primary service area for Canonsburg General Hospital. The Canonsburg General Hospital community building activities promote and enhance the health of the community by providing readily available resources to patients and all community members for the identification of needed healthcare services. In addition, Canonsburg General Hospital also has a voice in many worth community associations, groups and boards that directly contribute to the health and well-being of communities in which we serve. West Penn Allegheny Health System (WPAHS) is comprised of some of the oldest and best-known names in health care in western Pennsylvania. From their inception, the system's hospitals have been in the vanguard of patient care, medical research and health sciences education. Comprised of two tertiary and four community hospitals, WPAHS includes Allegheny General Hospital and The Western Pennsylvania Hospital, both in Pittsburgh; Alle-Kiski Medical Center in Natrona Heights; Canonsburg General Hospital in Canonsburg; The Western Pennsylvania Hospital - Forbes Regional Campus in Monroeville; and Allegheny General Hospital - Suburban Campus in Bellevue. Offering a comprehensive range of medical and surgical services, the hospitals serve Pittsburgh and the surrounding five-state area, house nearly 2,000 beds and employ more than 11,000 people. Together, the WPAHS hospitals admit nearly 74,000 patients, log over 196,000 emergency visits and deliver more than 4,500 newborns each year. Combined, the hospitals are among the leaders in percentages of total surgeries, cardiac surgeries, neurosurgeries and cardiac catheterization procedures performed throughout the region. Through the West Penn Allegheny Health System, Canonsburg General Hospital is able to ensure that area residents have access to a complete continuum of health care services. And through appropriate integration across the system, both clinically and operationally, the hospital is able to remain a high-quality, low-cost provider with linkages to the latest medical research and advanced technology. Canonsburg General Hospital provides a wide range of medical and surgical services, with advanced diagnostic and treatment services accessible on both an inpatient and outpatient basis. The hospital has an active and growing ambulatory care center, along with emergency medicine services, and an occupational medicine program. The facility also offers specialized services in acute patient rehabilitation, as well as having a strong focus on health education and preventative care that reflects a deep commitment to wellness and health improvement. X X X X X true false false false false false false false false Kimberly Malinky 0 205833 0 53575 0 284 0 18656 0 10102 0 288450 0 0 Christopher Olivia MD 0 1261933 0 500000 0 117566 0 12435 0 15604 0 1907538 0 0 Roy Santarella 0 765721 0 325000 0 127201 0 13965 0 19822 0 1251709 0 0 Thomas Albanesi 0 272366 0 41250 0 360 0 10725 0 10829 0 335530 0 0 Judy Hlafcsak 0 424098 0 143160 0 45501 0 10744 0 6212 0 629715 0 0 Deborah Olszewski 0 165729 0 41400 0 600 0 10403 0 1666 0 219798 0 0 Sharon Loftus 0 281643 0 0 0 909 0 13004 0 2472 0 298028 0 0 Dawn Javersack 0 0 0 0 0 102025 0 0 0 0 0 102025 0 0 Jerry Fedele 0 0 0 0 0 252175 0 1133 0 0 0 253308 0 0 Thomas Corkery MD 0 222071 0 0 0 486 0 9704 0 10128 0 242389 0 0 Teresa Gordon 191430 0 0 0 284 0 8498 0 10438 0 210650 0 0 0 Jeffrey Gretz MD 0 219395 0 0 0 211 0 8016 0 11359 0 238981 0 0 Additional Compensation Disclosure Form 990, Schedule J, Page 1, Part I, Question 4a The following represents additional disclosure for Schedule J, line 4a pertaining to officers and key employees listed in Form 990, Part VII, Section A, Line 1a receiving severance pay during the calendar year ending within the June 30, 2010 fiscal year end: Jerry Fedele $252,175 Dawn Javersack $102,025 The following list represents Officers, Directors or Key Employees of Canonsburg General Hospital listed on Form 990, Part VII who did not serve a full consecutive twelve month tenure for the year ended June 30, 2010 along with the dates served: Director: Joseph Cerenzia 11-19-2009 - 06-30-2010 Officers: Deborah Olszewski 01-28-2010 - 06-30-2010 Sharon Loftus 07-01-2009 - 12-31-2009 Allegheny County Hospital Development Authority 251327925 01728AG83 2007-06-19 758726273 See Schedule O false false Statement of Program Service Accomplishments Form 990, Page 2, Part III, Question 4 INTRODUCTION TO CANONSBURG GENERAL HOSPITAL Canonsburg General Hospital (CGH) is a 104-bed community hospital located 25 miles southwest of Pittsburgh. The hospital's primary service areas are northern Washington and southern Allegheny counties. CGH is part of the West Penn Allegheny Health System (WPAHS). Organized in 2000, WPAHS (www.wpahs.org) consists of West Penn Allegheny Health System, Inc. (WPAHS, Inc.), Alle-Kiski Medical Center (AKMC), Allegheny Medical Practice Network (AMPN), Allegheny Specialty Practice Network (ASPN), Allegheny-Singer Research Institute (ASRI), West Penn Allegheny Oncology Network (WPAON), West Penn Physician Practice Network (WPPPN), Canonsburg General Hospital Ambulance Service, Inc. (CGH Ambulance), Alle-Kiski Medical Center Trust (AKMC Trust), Forbes Health Foundation (FHF) and The Western Pennsylvania Hospital Foundation (WPHF) in addition to CGH. Supporting both a charitable and an academic mission, WPAHS has a strong commitment to medical research and education and is dedicated to training future generations of health-care professionals. Today, the system has two clinical campuses: Allegheny General Hospital serves as the clinical campus for the Drexel University College of Medicine in Philadelphia, and The Western Pennsylvania Hospital serves as the clinical campus for Temple University School of Medicine in Philadelphia. This affiliation ensures that CGH area residents have access to a complete continuum of health care services. Through appropriate integration across the System both clinically and operationally, the Hospital is able to remain a high quality, low-cost provider with linkages to the latest medical research and advanced technology. New equipment/programs/services implemented during the year ended June 30, 2010 (Fiscal 2010) included the purchase of a digital mammography unit, a stereotactic biopsy table, and a fixed Magnetic Resonance Imaging (MRI) unit. Additionally, the hospital has opened a Center for Women's Health, which includes services of gynecology, breast health, and medical nutritional counseling. Accreditations achieved in Fiscal 2010 for the Canonsburg General Hospital Imaging Department included: American College of Radiology - Mammographic Imaging, Ultrasound Imaging, Magnectic Resonance Imaging Services and Computed Tomography Services The Intersocietal Commission for the Accreditation of Nuclear Medicine Laboratories - Nuclear Medicine/Nuclear Cardiology The Intersocietal Commission for the Accreditation of Echocardiography Laboratories The CGH Imaging Department received a Certificate of Registration for radiation producing machines by the Commonwealth of Pennsylvania - Department of Environmental Protection and became a Certified Mammography Facility by the US Department of Health and Human Services. In addition, CGH earned The Joint Commission's Gold Seal of Approval by demonstrating compliance with The Joint Commission's national standards for health care quality and safety. CGH participated in the Quality Blue program sponsored by Highmark that measured quality initiatives to reduce Methicillin Resistant Staph Aureus (MRSA), Urinary Tract Infections, C-Diff Infections, and Emergency Department Throughput. The Hospital achieved the maximum level of reimbursement for the Highmark Quality Blue FY2010. CGH provides a wide range of medical and surgical services, with diagnostic and treatment services easily accessible on both an inpatient and outpatient basis. The Hospital offers specialized services in acute inpatient rehabilitation, as well as having a strong focus on health education and preventive care programs that reflect its commitment to wellness and health improvement. Our ambulatory care center offers a full complement of outpatient services including same-day surgery, Gastrointestinal (GI) procedures, Computed Tomography (CT) scans, pain management and sleep labs. Other specific departments and services available at CGH include medical imaging, laboratory testing and analysis, acute care and intensive care units, and rehabilitation services. During Fiscal 2010, CGH admitted 3,802 patients, registered 67,641 outpatient visits including outpatient emergency department visits, treated 2,276 inpatients and 18,833 outpatient emergency department patients including some patients who would later be admitted to the hospital, and performed 1,586 outpatient surgeries. CGH has an employed workforce of 501 employees as well as 230 physicians on its medical staff. Statement of Program Service Accomplishments - Continued Form 990, Page 2, Part III, Question 4 PURPOSE AND MISSION Canonsburg General Hospital is an organization defined by our talented people. We are an organization committed to excellence; a organization with one purpose and one mission. Our purpose is to improve the health of the people in the Western Pennsylvania region. Our mission is to practice medicine, educate and conduct research as an integrated team of physicians, nurses and support professionals who are committed to improving the health of our patients. UNCOMPENSATED CARE To enhance the health status of the community in which it operates and consistent with its tax-exempt status, CGH provides needed health care services to individuals regardless of their ability to pay for all or part of the services rendered. These services include both inpatient and outpatient services as well as an emergency room that is available 24 hours a day. Consistent with the filing of Schedule H, the components of uncompensated care include charity care and unreimbursed Medicaid costs. CGH provided uncompensated care at a cost of $1,445,521 in Fiscal 2010 broken down as follows: MA Shortfall (net) $1,144,124 Charity Care 285,131 _________ Total $1,429,255 COMMUNITY ASSESSESSMENT Community Health Improvement Services and Community Benefit Operations Community health improvement services and community benefit operations include activities carried out to improve community health. They extend beyond patient care to include activities that are subsidized by the Hospital. The activities range from community health clinics and screenings to health education programs designed to raise community awareness of various healthcare topics and issues. Consistent with the filing of Schedule H, CGH provided these services at a cost of $97,925 in Fiscal 2010. Women & Wellness - CGH conducted a program entitled "Women and Wellness". This program brought together top clinicians and the newest research information available. The goal of the program was to educate women on areas of health interest and concern. Topics included breast cancer overviews, breast cancer risk and reduction, weight management, heart disease, and contraceptive options. Flu Vaccinations - Flu vaccinations were provided free of charge to local fire, police and ambulance personnel of Canonsburg, Fort Cherry, North Strabane and Houston at Canonsburg General Hospital. Medivan Service - CGH provides a free transportation service to area residents who require testing or treatment at the Hospital. The Hospital provides this program to enhance access to healthcare for those members of the community who do not have access to adequate transportation. During Fiscal 2010, a total of 3,477 trips were made. Statement of Program Service Accomplishments - Continued Form 990, Page 2, Part III, Question 4 Health Fairs and Screenings - CGH sponsored various health fairs throughout the year. Services made available to the public at these fairs included blood pressure, cholesterol, glucose, body composition, bone density and lung capacity screenings. Support Groups - Free support is provided at CGH in areas which reflect the communities' needs. Support groups are provided for emotional concerns such as avoiding holiday overeating, emotional eating, and how to get through the holidays while coping with the loss of a loved one. Additionally, CGH also supports discussion groups focusing on hospice services and Alzheimer's support. Ask The Doctor Show - The Hospital, in collaboration with cable television, produced a monthly health education program. A CGH general surgeon hosts the 30-minute live show. Physician guests answer questions regarding a variety of topics. Videotaped copies of the show are sent to other local cable televisions stations to air. Ask The Pharmacist - A registered pharmacist is available to answer questions from the public on over the counter and prescription medications from 10 am to 2 pm, Monday through Friday. Pastoral Care - CGH, in association with Canonsburg Ministerial Association, contracts with a Hospital Chaplain to provide spiritual guidance and healing to CGH patients and their respective families. Bereavement Series - Three times a year, the Hospital Chaplain leads six-week series on the process of grief. A complimentary grief and loss support dinner is held monthly at the Hospital. Festivals - CGH participated in several local festivals throughout the year where first aid supplies were donated and CGH provided health care services, handed out health information and performed blood pressure screenings. 55 Alive Drivers Education Classes - The Hospital provides a meeting place, advertisement and refreshments for a driver education program for the elderly. Four, two-day courses are held for new members and four, one-day refresher courses are held for recurring members. Diabetes Awareness and Education - A registered pharmacist conducts quarterly presentations to the general public on diabetes related topics such as oral and insulin medications and the side effects of those medications. In addition, CGH sponsors a four-week course designed to promote diabetes awareness and education three times a year. The courses provide education on diabetes, diet, eye care, insulin pumps, foot care and coping skills. Sessions are in conjunction with other local agencies. Hospital Tours - 50 children from local pre-schools and elementary schools were given tours of the hospital. The event promotes awareness and comfort among area children who someday may need to visit the Hospital. If gives the chaperones awareness of the services the Hospital provides in the case of an emergency. Summer Camp Splash Program - This program is targeted to educate children attending summer camp about basic first aid, summer safety tips, hazardous weather emergencies and water safety concerns. Safe Sitter - This program is designed to teach boys and girls how to handle emergencies when caring for young children. CGH held 11 Safe Sitter classes during Fiscal 2010. Teaching Staff Wellness Day - Teachers and staff of a local school district were provided with health education, information about cholesterol and blood pressure reduction through diet and exercise, as well as receive blood pressure and body mass index screenings. Poison Presentations - Five presentations were given during the year to provide education to young children about the various types of poisons and how to avoid them. Glo-Germ Presentations - 16 presentations were made to pre-school and elementary grade children about how to properly wash hands. Educational lessons were given in conjunction with a photosynthesized gel to children. 180 children participated in these presentations. Health Professions Education CGH provides aspiring health professionals with many educational opportunities to further their career in healthcare. Consistent with the filing of Schedule H, CGH provided these services at a cost of $61,711 in Fiscal 2010. Technicians Training - CGH offers an opportunity for students in Radiology and Nuclear Medicine to complete their student externships within the Hospital's Medical Imaging Department. Radiology students work directly with a Registered Radiology Technologist. Emergency Medical and Paramedic Training - CGH's pre-hospital care department provides continuing education training to emergency medical technicians and paramedics from local ambulance departments. In addition, space is donated for a seminar on proper burn treatment. Information Technology Training - A student from Pittsburgh Technical Institute did his internship with a CGH Microcomputer Specialist for training in all aspects of hospital information technology. Physical Therapy Training - Physical therapy students receive mentoring and training by CGH therapists during clinical rotations. Medical Records Orientation - Students from the University of Pittsburgh and the Community College of Allegheny College complete a 112-hour directed practice, spending time with medical records and quality service employees. Pharmacy Training - Pharmacy students from the University of Pittsburgh and Duquesne University receive required rotation hours through the CGH Pharmacy Department. An average of 20 students per month rotate through the Pharmacy Department. Health Professions Job Shadowing - 14 students from local high schools shadowed CGH health care professionals to learn more about a particular health related specialty. Statement of Program Service Accomplishments - Continued Form 990, Page 2, Part III, Question 4 Subsidized Health Services Subsidized health services represent those programs provided to the community by CGH despite the fact the Hospital incurs a financial loss to do so. CGH recognizes the need of its community and voluntarily subsidizes these programs in support of its charitable mission. Among the subsidized health services provided by CGH are drug, alcohol and mental health services. Consistent with the filing of Schedule H, CGH provided subsidized health services at a cost of $36,639 in Fiscal 2010. Financial Contributions This category includes cash and in-kind services donated to individuals and/or the community at large. In-kind services include hours donated by staff to the community during hospital work hours, overhead expenses of physical space donated to not-for-profit community groups, and the free provision of food, equipment, supplies and giveaway items as well as monetary donations. Consistent with the filing of Schedule H, CGH provided these contributions at a cost of $9,658 in Fiscal 2010. Cash Donations - CGH supports the community through cash contributions made at the discretion of the Hospital and its directors, benefiting not only the non-profit recipient but also ultimately the community as a whole. During Fiscal 2010, CGH made cash donations totaling $4,300 to the following organizations: American Heart Association McDonald Volunteer Fire Department Houston Volunteer Fire Department North Strabane Volunteer Fire Department In-kind Donations - In addition to the cash contributions, CGH also made in-kind donations of time and resources to help support various community functions. The Hospital donated space for community food drives, blood drives, girl scouts, boy scouts, clothing drives, ministerial associations, United Way, Rotary International, local emergency medical service providers and fire departments, insurance company information sessions and for patient financial support. In addition, the Hospital donated products and equipment to various local charitable organizations including Brother's Brother Foundation; a foundation that promotes international health and education, a local humane society, and local youth sports teams. Community Building Activities Community Building Activities include activities engaged in for the purpose of improving or protecting the health, future and wellbeing of the community. Consistent with the filing of Schedule H, CGH provided these services at a cost of $73,160 in Fiscal 2010. Social Work Services - The services of a professionally trained medical social worker is available to all patients and families for crisis intervention, counseling and discharge planning. The social worker handles problems that may arise during hospitalization or at the time of discharge. The social worker also provides counseling, emotional support and information regarding community services and programs. Representation on Community Boards and Partnerships - Several leaders at CGH reside on community boards and partnerships. These organizations include the Washington County Chamber of Commerce, Washington County Community Health Partners, SouthPointe CEO Association, Greater Canonsburg Economic Development Committee, American Heart Association, Hospital Councils of Western Pennsylvania, Nutritional Task Force and Health Assessment Program, The Child Seat Review, Pennsylvania Emergency Nurses Association, and the Western Area Career Advisory Board. Mom's Shower - CGH hosts the annual Mom's Shower for low-income women who are pregnant or have toddlers. This one-day event incorporates service providers from several counties to distribute information, resources and products to new or expectant mothers. Thanksgiving Essay Contest: The Hospital Children Services Department sponsors a Thanksgiving essay contest for elementary age students. The essays are intended to promote healthy themes to children. Each essay is focused on a healthy topic and the reasons why the child is thankful. Each child completes an essay and the essay is judged by a community forum. The winners receive a U.S. Savings Bond. Halloween Trail: The Hospital sponsors the annual Halloween Trail to provide a fun and safe way for children to celebrate Halloween. Treats are provided free of charge and hospital employees dress in costume and pass out treats. Approximately 1,000 children attended the free event held at the hospital. Form 990 Review Process Form 990, Page 6, Part VI, Section A, Question 10 Form 990 is prepared internally by an employee of the West Penn Allegheny Health System, Inc. (Health System) Tax Department who is a certified public accountant. The document is then reviewed internally by top management officials including the Chief Financial Officer and Chief Administrative Officer of the Health System. A detailed external review is conducted by Health System external tax advisors, who sign the return as preparer. The Chair of the organization's Board of Directors, or another Board Member otherwise designated by the Chair, along with members of the Audit and Compliance committee of the Health System Board review the Form 990 and recommend changes or accept the document as presented. A copy of the Form 990 is made available to every board member for review prior to filing the document with the Internal Revenue Service. Monitoring and Enforcement of the Conflict of Interest Policy Form 990, Page 6, Part VI, Section B, Question 12c Canonsburg General Hospital is a member of the West Penn Allegheny Health System (WPAHS). WPAHS has a corporate compliance department that monitors and oversees compliance with the conflict of interest policy of all organizations in the health system. The following describes the manner in which the corporate compliance department monitors and oversees compliance with the conflict of interest policy for Canonsburg General Hospital as well as the other WPAHS affiliates: Conflict of Interest disclosure forms are completed on an annual basis by all board members, officers, employees who have a title of Manager and above, physicians in leadership roles, Pharmacy Committee members, Therapeutic Committee members, all employees of the System's Internal Audit Department as well as the employees involved with contracting in the Corporate Purchasing Department. Upon completion of the above disclosure statement by all applicable individuals, a report is generated listing all individuals that have reported a conflict. The System Compliance Officer and General Counsel review the conflicts disclosed. Those that require additional information or clarification receive a letter from the Compliance Officer requesting such. Once received, all additional information is added to the report and again reviewed by the Compliance Officer and General Counsel. Those conflicts that require a mitigation plan are sent to the respective organization's senior management for development of the mitigation plan. The organization's senior management is responsible to discuss the mitigation plan with the individual as needed and monitor compliance with the mitigation plan. Once mitigation is received, a final report is reviewed with the System Compliance Executive Committee and finally the Audit & Compliance Committee of the Board. In addition, all WPAHS board members, officers and key employees complete an annual independence disclosure statement which assists the System's Compliance Officer and Internal Audit Department to determine and monitor the levels of independence in each of the System's tax exempt affiliates as well as to determine the level of Form 990, Schedule L reporting. Process Used To Determine Executive Compensation Form 990, Page 6, Part VI, Section B, Question 15 West Penn Allegheny Health Systems (WPAHS) process for determining compensation for executive positions (including officers, key employees and other management positions) within Canonsburg General Hospital is covered by the WPAHS Executive Compensation Policy. This policy was approved by the West Penn Allegheny Health System, Inc. Board of Directors. It is the policy of WPAHS and its Board of Directors to compensate its executives in accordance with the market and in relation to the experience, service and accomplishments of the individual both prior to and during their service with WPAHS. The Compensation Committee of the West Penn Allegheny Health System, Inc. Board of Directors approves the compensation for WPAHS senior executives. The Compensation Committee approves the initial compensation for newly hired senior executives, which shall include all compensation components, including without limitation, base compensation, incentive compensation, deferred compensation, fringe and other benefits, as well as the total compensation. It shall also approve all base compensation adjustments and all incentive compensation awards, as well as material changes to deferred compensation, fringe, or other benefits. The Compensation Committee uses comparability data provided by the System Human Resources Department, which may include industry surveys, expert compensation studies, documented compensation of persons holding similar positions, or other comparable data in approving any executive compensation. The Compensation Committee shall periodically retain the services of an independent compensation consultant to provide an expert opinion report as to the reasonableness of total compensation of Canonsburg General Hospital officers and key employees. Each Compensation Committee member voting on a senior executive's compensation arrangement ensures that he or she has no conflict of interest, including that he or she (a) does not economically benefit from the proposed employment; (b) does not receive compensation subject to the approval of the proposed employee; and (c) has no material financial interest affected by the transaction. The Compensation Committee consists of three independent Board Members of West Penn Allegheny Health System, Inc. All decisions of the Compensation Committee regarding executive compensation matters are documented. Public Availability of Organizational Documents Form 990, Page 6, Part VI, Section C, Question 19 Canonsburg General Hospital (CGH) makes its governing documents available to the public upon request. CGH is a member of the West Penn Allegheny Health System (WPAHS). The WPAHS makes available their annual and quarterly financial statements through the use of a dissemination agent. These financial statements are on a consolidated basis with CGH being one of the consolidated entities. WPAHS has adopted a conflict of interest policy that is uniformly applied to all organizations of the health system, including CGH. A condensed version of this conflict of interest policy is available on the WPAHS website. The condensed policy is contained in the code of ethics disclosure. Purpose of Tax Exempt Bond Issue Form 990, Page 11, Line 20 Canonsburg General Hospital is a member of the West Penn Allegheny Health System obligated group in regards to 2007 Allegheny County Hospital Development Authority tax-exempt bonds. Accordingly, Schedule K has been inserted into this Form 990 for full disclosure purposes. The purpose of the issue of the Allegheny County Hospital Development Authority (ACHDA) Hospital Revenue Bonds, Series 2007 A is to refund the outstanding ACHDA Series 2000A and B Bond Issues, refund the Dauphin County General Authority (DCGA) Series 1992A and B Hospital Bonds, the Pennsylvania Higher Education Facility Authority (PHEFA) Series 1991A Revenue Bonds, the Monroeville Hospital Authority (MHA) Series 1992 and 1995 Revenue Bonds, the funding of a project fund for certain prior and future capital expenditures and to pay the cost of issuing Series 2007A Debt. The amount of $26,945,760 reflected on Form 990, Page 11, Line 20 represents the internal allocation of debt to Canonsburg General Hospital by the parent organization, West Penn Allegheny Health System, Inc. The IRS Form 990 filed by West Penn Allegheny Health System, Inc., EIN: 25-0969492 has completed Schedule K in its entirety. Please refer to the Form 990 filed by West Penn Allegheny Health System, Inc., EIN: 25-0969492 to review Schedule K with regard to this bond issue. Transfers With Affiliated Organizations Schedule R, Part V, Line 2 Canonsburg General Hospital has chosen to complete Schedule R, Part V, line 2 in order to disclose transactions with affiliated organizations. No organization listed in Schedule R, Part V, line 2 is a controlled entity within the meaning of section 512(b)(13). West Penn Allegheny Health System Inc 4800 Friendship Avenue Pittsburgh PA 15224 250969492 Healthcare PA 501(C)(3) 3 NA Alle-Kiski Medical Center 1301 Carlisle Street Natrona Heights PA 15065 251875178 Healthcare PA 501(c)(3) 3 NA Allegheny Singer Research Institute 320 East North Avenue Pittsburgh PA 15212 251320493 Sci. Research PA 501(c)(3) 4 NA Allegheny Medical Practice Network 4800 Friendship Avenue Pittsburgh PA 15224 251838457 Healthcare PA 501(c)(3) 3 NA Allegheny Specialty Practice Network 320 East North Avenue Pittsburgh PA 15212 251838458 Healthcare PA 501(c)(3) 3 NA West Penn Allegheny Oncology Network 4800 Friendship Avenue Pittsburgh PA 15224 113683376 Healthcare PA 501(c)(3) 11-III FL NA West Penn Physician Practice Network 4800 Friendship Avenue Pittsburgh PA 15224 251494317 Healthcare PA 501(c)(3) 9 NA CGH Ambulance Service Inc 100 Medical Boulevard Canonsburg PA 15317 232939715 Emer Response PA 501(c)(3) 9 NA Alle-Kiski Medical Center Trust 1301 Carlisle Street Natrona Heights PA 15065 205855753 Fundraising PA 501(c)(3) 11-I NA Forbes Health Foundation 2570 Haymaker Road Monroeville PA 15146 251798379 Fundraising PA 501(c)(3) 7 NA Suburban Health Foundation 100 South Jackson Avenue Pittsburgh PA 15202 251472073 Fundraising PA 501(c)(3) 11-I NA Western Pennsylvania Hospital Foundation 4800 Friendship Avenue Pittsburgh PA 15224 251470766 Fundraising PA 501(c)(3) 11-I NA West Allegheny Hospital 100 Medical Boulevard Canonsburg PA 15317 251054206 Inactive PA 501(c)(3) 3 NA Greater Canonsburg Health System 100 Medical Boulevard Canonsburg PA 15317 251488089 Inactive PA 501(c)(3) 11-I NA Canonsburg HealthHospital Foundation 100 Medical Boulevard Canonsburg PA 15317 251818505 Inactive PA 501(c)(3) 11-I NA Burn Care Associates 4800 Friendship Avenue Pittsburgh PA 15224 232899534 Healthcare PA NA C Corporation Liberty Physicians 4800 Friendship Avenue Pittsburgh PA 15224 251637318 Healthcare PA NA C Corporation Medical Center Clinic 4800 Friendship Avenue Pittsburgh PA 15224 232894939 Healthcare PA NA C Corporation West Penn Corporate Medical Services Inc 4800 Friendship Avenue Pittsburgh PA 15224 251437405 Healthcare PA NA C Corporation West Penn Medical Associates 4800 Friendship Avenue Pittsburgh PA 15224 251666783 Healthcare PA NA C Corporation West Penn Neurosurgery 4800 Friendship Avenue Pittsburgh PA 15224 251630719 Healthcare PA NA C Corporation West Penn OBGYN Multispecialists PC 4800 Friendship Avenue Pittsburgh PA 15224 251619226 Healthcare PA NA C Corporation false true true false false false false false false false false false false false false true false false Allegheny Medical Practice Network 1b 1759374 Allegheny Specialty Practice Network 1b 695000 West Penn Allegheny Health System Inc 1p 177625 West Penn Allegheny Health System Inc 1c 203614