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        <PersonNm>Dr Ghassan K Bejjani</PersonNm>
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        <PersonNm>Dr Stephen Iorfido</PersonNm>
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      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 5 Facility , 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility , 1 - DUBOIS REGIONAL MEDICAL CENTER. THE 2024 CHNA PROCESS BEGAN IN JANUARY 2024, AND THE COLLECTION OF QUANTITATIVE AND QUALITATIVE DATA CONCLUDED IN JUNE 2024. AS PART OF THIS NEEDS ASSESSMENT, A VAST NUMBER OF RESIDENTS, EDUCATORS, GOVERNMENT AND HEALTHCARE PROFESSIONALS, AND HEALTH AND HUMAN SERVICES LEADERS IN THE PENN HIGHLANDS DUBOIS SERVICE AREA PARTICIPATED IN THE STUDY. INFORMATION COLLECTED FROM LEADERS PROVIDED A DEEPER UNDERSTANDING OF COMMUNITY MATTERS, HEALTH EQUITY FACTORS, AND COMMUNITY NEEDS. PENN HIGHLANDS DUBOIS COLLECTED COMMUNITY AND KEY INFORMANT SURVEYS, COMMUNITY STAKEHOLDER INTERVIEWS, AND FOCUS GROUP DATA TO ENGAGE AND CAPTURE THE COMMUNITY'S PERSPECTIVE. DATA TYPES SUCH AS COUNTY DEMOGRAPHICS AND CHRONIC DISEASE PREVALENCE WERE GATHERED FROM LOCAL, STATE, AND FEDERAL DATABASES TO COMPILE SECONDARY DATA. COMMUNITY SURVEYS, ALONG WITH STAKEHOLDER AND LOW-INCOME RESIDENT INTERVIEWS, WERE INITIATED TO GARNER PARTICIPATION FROM ALL MEMBERS RESIDING OR WORKING IN THE PRIMARY SERVICE AREA. THE DATA COLLECTED IDENTIFIED THE NEEDS, HIGH-RISK BEHAVIORS, BARRIERS, SOCIETAL ISSUES, AND CONCERNS OF THE UNDERSERVED AND VULNERABLE POPULATIONS. INFORMATION FROM FOCUS GROUPS WITH SENIORS AND HEALTHCARE PROFESSIONALS WHO INTERACT WITH RESIDENTS WITH CHRONIC CONDITIONS WAS INCLUDED IN THE COLLECTION PHASE. WHILE MULTIPLE STEPS MADE UP THE CHNA PROCESS, TRIPP UMBACH, A NATIONALLY RENOWNED HEALTHCARE CONSULTING FIRM, WORKED CLOSELY WITH WORKING GROUP MEMBERS TO COLLECT, ANALYZE, AND IDENTIFY THE RESULTS TO COMPLETE THE HOSPITAL'S ASSESSMENT. COMMUNITY LEADER INTERVIEWS: FROM FEBRUARY TO APRIL 2024, PENN HIGHLANDS DUBOIS CONDUCTED 36 PHONE INTERVIEWS WITH COMMUNITY LEADERS FROM THE FOLLOWING PROFESSIONAL BACKGROUNDS - GOVERNMENT LEADERS, PROFESSIONALS WITH ACCESS TO COMMUNITY HEALTH-RELATED DATA, PUBLIC HEALTH EXPERTS, REPRESENTATIVES OF UNDERSERVED POPULATIONS, AND SOCIAL SERVICE REPRESENTATIVES. PUBLIC COMMENTARY: FROM FEBRUARY TO APRIL 2024, TRIPP UMBACH SOLICITED COMMENTS FROM COMMUNITY STAKEHOLDERS RELATED TO THE FY21 CHNA AND ISP. COMMUNITY HEALTH SURVEY: FROM MARCH TO APRIL 2024, A SURVEY OF 1,254 RESIDENTS WAS CONDUCTED BY PENN HIGHLANDS DUBOIS IN COLLABORATION WITH TRIPP UMBACH. FOCUS GROUPS: TWO FOCUS GROUPS WERE HELD REPRESENTING THE NORTHWEST AND SOUTHWEST REGIONS OF PENN HIGHLANDS HEALTHCARE. A GROUP OF NINE SENIORS REPRESENTING THE NORTHWEST REGION AND A GROUP OF SIX PROVIDERS OF RESIDENTS WITH CHRONIC CONDITIONS REPRESENTING THE SOUTHWEST REGION. LOW-INCOME RESIDENT INTERVIEWS: TRIPP UMBACH CONDUCTED 8 PHONE INTERVIEWS WITH LOW-INCOME RESIDENTS WHICH WAS CRITICAL IN UNDERSTANDING AND ADDRESSING THIS DEMOGRAPHIC'S UNIQUE HEALTH CHALLENGES. SECONDARY DATA REPORT: UTILIZING MULTIPLE PUBLICLY AVAILABLE REPORTS AT THE LOCAL, STATE, AND NATIONAL LEVEL, INFORMATION WAS GATHERED REGARDING: DISPARITIES, PUBLIC HEALTH PRIORITIES RELATED TO DISEASE PREVALENCE, SOCIOECONOMIC FACTORS, HEALTH OUTCOMES, AND HEALTH DETERMINANTS. PENN HIGHLANDS DUBOIS WILL LEVERAGE ITS STRENGTHS, EXTENSIVE RESOURCES, AND BROAD OUTREACH CAPABILITIES TO COLLABORATE EFFECTIVELY WITH COMMUNITY PARTNERS. TOGETHER, PENN HIGHLANDS DUBOIS WILL IDENTIFY AND IMPLEMENT THE MOST IMPACTFUL STRATEGIES TO ADDRESS THE UNIQUE HEALTH NEEDS OF THEIR COMMUNITIES. THIS CONCERTED EFFORT AIMS TO ENHANCE OVERALL HEALTH, ADDRESS URGENT HEALTH NEEDS, AND IMPROVE THE WELL-BEING OF RESIDENTS WITHIN THEIR SERVICE AREAS. THE CAREFUL PRIORITIZATION OF IDENTIFIED NEEDS WILL SHAPE AND DRIVE COMMUNITY HEALTH IMPROVEMENT INITIATIVES, ENSURING THAT THE PENN HIGHLANDS DUBOIS EFFORTS BENEFIT THE RESIDENTS THEY SERVE.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 6a Facility , 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility , 1 - DUBOIS REGIONAL MEDICAL CENTER. CHNA CONDUCTED WITH OTHER HOSPITAL FACILITIES: - PENN HIGHLANDS BROOKVILLE - PENN HIGHLANDS CLEARFIELD - PENN HIGHLANDS CONNELLSVILLE - PENN HIGHLANDS DUBOIS - PENN HIGHLANDS ELK - PENN HIGHLANDS HUNTINGDON - PENN HIGHLANDS MON VALLEY - PENN HIGHLANDS STATE COLLEGE - PENN HIGHLANDS TYRONE</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 6b Facility , 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility , 1 - DUBOIS REGIONAL MEDICAL CENTER. TRIPP UMBACH, A HEALTHCARE CONSULTING FIRM</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 11 Facility , 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility , 1 - DUBOIS REGIONAL MEDICAL CENTER. SENIOR LEADERS FROM PENN HIGHLANDS DUBOIS REVIEWED THE PREVIOUS IMPLEMENTATION STRATEGY PLAN AND REFINED AND REINFORCED KEY STRATEGIES. THEY PRIORITIZED SPECIFIC INITIATIVES AND EXPLORED WAYS TO SUSTAIN AND ENHANCE SERVICES FOR THE BROADER COMMUNITY THROUGH THE UPDATED PLAN. SENIOR LEADERSHIP FROM PENN HIGHLANDS HEALTHCARE AND PENN HIGHLANDS DUBOIS CONTRIBUTED TO THE CHNA/ISP WORKING GROUP. MOVING FORWARD, SENIOR LEADERS WILL REGULARLY EVALUATE THE STRATEGY PLAN, MAKING ADJUSTMENTS AS NEEDED TO BETTER ALIGN WITH THE COMMUNITY'S EVOLVING HEALTH NEEDS. THE 2024 CHNA FOR PENN HIGHLANDS DUBOIS HIGHLIGHTED THE FOLLOWING COMMUNITY NEEDS: - ACCESS TO CARE - BEHAVIORAL HEALTH; AND - CHRONIC DISEASES/CONDITIONS PENN HIGHLANDS DUBOIS SUMMARY OF IMPLEMENTATION STRATEGY: PENN HIGHLANDS DUBOIS HAS COMPLETED AN IMPLEMENTATION STRATEGY THAT ADDRESSES THE HOSPITAL'S IMPLEMENTATION STRATEGY TO MEET THE COMMUNITY HEALTH NEEDS IDENTIFIED IN THIS CHNA. THE FOLLOWING IS A SUMMARY OF THAT SEPARATE, MORE COMPREHENSIVE IMPLEMENTATION STRATEGY REPORT. THE ISP REPORT AIMS TO IDENTIFY THE GOALS, OBJECTIVES, AND STRATEGIES THAT PENN HIGHLANDS DUBOIS WILL USE TO ADDRESS THE HEALTH PRIORITIES IDENTIFIED IN THE RECENT CHNA. THE FINDINGS FROM THE CHNA WILL OUTLINE ACTIONABLE STEPS THAT HEALTHCARE ORGANIZATIONS AND THEIR COMMUNITY PARTNERS WILL TAKE TO IMPROVE HEALTH OUTCOMES. THE ISP REPORT DETAILS STRATEGIES, RESOURCES, AND PARTNERSHIPS NECESSARY TO TACKLE THE MOST PRESSING HEALTH ISSUES, ENSURING THE PROPOSED INITIATIVES ARE IMPACTFUL. TO ACCESS A COPY OF THE FULL IMPLEMENTATION STRATEGY PLAN, PLEASE GO TO https://www.phhealthcare.org/HEALTH-WELLNESS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. CHNA SIGNIFICANT HEALTH NEED: ACCESS TO CARE GOAL: IMPROVE ACCESS TO CARE FOR RESIDENTS WITHIN THE PENN HIGHLANDS DUBOIS SERVICE AREA. OBJECTIVES: 1. EXPAND ACCESS TO NEUROLOGY SERVICES BY TELEMEDICINE AVAILABILITY. 2. HAVE A PHYSICIAN CHAMPION TO SERVE AS AN ADVISOR AS BARRIERS ARE IDENTIFIED AND ADDRESSED REGARDING NEUROLOGY SERVICE EXPANSION. 3. CREATE AND IMPLEMENT GUIDELINES REGARDING NEW REFERRALS AND WAIT TIMES FOR NEW APPOINTMENTS/ EXISTING PATIENTS AND WAIT TIMES FOR FOLLOW-UP APPOINTMENTS. 4. PROVIDE BREAST NAVIGATION SERVICES TO THE PENN HIGHLANDS DUBOIS REGION FOR PATIENTS GOING THROUGH AN ABNORMAL BREAST IMAGING STUDY AND BREAST CANCER DIAGNOSIS. 5. EXPAND ACCESS TO THE BREAST NAVIGATOR ROLE ACROSS PHH AND THE COMMUNITY EDUCATION AND AWARENESS IMPLEMENT VIDEO CHAT WITH NURSE NAVIGATOR FOR PATIENT BREAST EDUCATION. 6. IMPROVE THE NUMBER OF BASELINE LUNG SCREENINGS BY 3%. 7. NAVIGATOR VISITS TO PCPS. 8. EDUCATION TO HEALTH CARE PROVIDERS AND STAFF. 9. DISTRIBUTION OF INFORMATION REGARDING LUNG CANCER SCREENING. 10. RECRUIT A PULMONOLOGIST. 11. EXPAND PHYSICAL THERAPY INTERVENTIONS BY 2% PER FY FOR A TOTAL OF 6% IN 3 YEARS. 12. EXPAND HOURS AND FLEX STAFF ACCORDING TO DEMAND. 13. MAINTAIN PULMONOLOGY SERVICES TO CLEARFIELD COUNTY RESIDENTS BY THE PLACEMENT OF A PULMONOLOGIST TO PROVIDE COMPREHENSIVE/ DIAGNOSTIC SERVICES LOCALLY, 2 DAYS/MONTH. 14. DEDICATE 2 DAYS TO THE PENN HIGHLANDS CLEARFIELD OFFICE. PENN HIGHLANDS DUBOIS'S AVAILABLE RESOURCES INCLUDE, PENN HIGHLANDS HEALTH (PHH) PRACTICE MANAGEMENT, DR. CAMERON - PHYSICIAN CHAMPION FOR TELEMEDICINE, AND NEUROLOGY STAFF. PENN HIGHLANDS DUBOIS'S COLLABORATIVE PARTNERS INCLUDE, AGAPE, COMMUNITY ORGANIZATIONS, CHURCH GROUPS, HEALTH FAIRS, PRIVATE PRACTICES, AREA AGENCY ON AGING (AAA), SENIOR CENTERS, PUBLIC HOUSING AUTHORITY, RURAL HEALTHCARE CLINIC, FREE CLINIC FRENCHVILLE, U. ORTHOPEDICS - STATE COLLEGE CONTACT, AND PCP IN MVCMBM. CHNA SIGNIFICANT HEALTH NEED: ACCESS TO CARE (CANCER) GOAL: EARLY DETECTION AND PREVENTION OBJECTIVES: 1. INCREASE COMMUNITY AWARENESS AND ENGAGEMENT REGARDING CANCER PREVENTION AND SCREENING. 2. SEEK OPPORTUNITIES FOR PUBLIC SPEAKING ENGAGEMENTS. 3. PROGRESSIVELY EXPAND ADVOCACY GROUPS, INCLUDING COMMUNITY VOLUNTEERS AND PATIENT GROUPS, TO COVER ALL REGIONS. 4. FEATURE MONTHLY AWARENESS CAMPAIGNS TO THE COMMUNITY REGARDING SPECIFIC CANCER MONTHS. EXAMPLE: MARCH COLON AND OCTOBER BREAST. 5. TRI-COUNTY SUNDAY EDUCATION ARTICLES FOR THE COMMUNITY RADIO EDUCATION SPOTS 6. INCREASE CANCER AWARENESS AMONG INFLUENTIAL GROUPS AND THE PUBLIC. 7. BI-MONTHLY SOCIAL COMMITTEE MEETINGS. 8. ENGAGE AND MOBILIZE KEY STAKEHOLDERS WITHIN THE CANCER COMMUNITY WHO WILL CHAMPION THE DEVELOPMENT AND IMPLEMENTATION OF AN AWARENESS PLAN FOR CANCER PREVENTION. 9. DEVELOP RELATIONSHIPS WITH STAKEHOLDERS WITHIN THE CANCER COMMUNITY. PENN HIGHLANDS DUBOIS'S AVAILABLE RESOURCES INCLUDE, PHYSICIANS, ADVANCED PRACTICE PHYSICIANS (APP), REGISTERED NURSES, GI LAB PHYSICIAN LEADERS, GI LAB ADMINISTRATION LEADERS, PHH PRACTICE MANAGEMENT, AND PHH MARKETING. PENN HIGHLANDS DUBOIS'S COLLABORATIVE PARTNERS INCLUDE, PHARMACEUTICAL COMPANIES, AREA AGENCY ON AGING (AAA), AND STAKEHOLDERS IN THE CANCER COMMUNITY CHNA SIGNIFICANT HEALTH NEED: BEHAVIORAL HEALTH GOAL: COLLABORATE WITH COMMUNITY SUBSTANCE ABUSE PROVIDERS TO REDUCE SUBSTANCE ABUSE. OBJECTIVES: 1. IDENTIFY AVAILABLE TRANSPORTATION TO TREATMENT. 2. DEVELOP A LIST OF HOSPITAL DETOX BEDS AND REHABS IN THE AREA. 3. EDUCATE THE STAFF ON DRUG TRENDS AND TREATMENT. PENN HIGHLANDS DUBOIS'S AVAILABLE RESOURCES INCLUDE PHH STAFF. PENN HIGHLANDS DUBOIS'S COLLABORATIVE PARTNERS INCLUDE, LOCAL CONSTABLES, UBER, DRUG AND ALCOHOL TREATMENT PROVIDERS, SOCIAL SERVICE AGENCIES, CEN CLEAR DRUG AND ALCOHOL, CLEARFIELD JEFFERSON DRUG &amp; ALCOHOL COMMISSION, PYRAMID HEALTHCARE, WORK WITH LOCAL VISTA (AMERICORPS FUNDED PROGRAM AT JUNIATA COLLEGE), AND NET LEARNING ON DRUG TRENDS AND TREATMENT. CHNA SIGNIFICANT HEALTH NEED: CHRONIC DISEASES/CONDITIONS GOAL: EXPAND AWARENESS AND SERVICES TO PROMOTE PREVENTIVE HEALTH AND WELLNESS THROUGHOUT THE COMMUNITY. OBJECTIVES: 1. INCREASE HEALTHY WEIGHT LOSS. 2. EXPAND NUTRITION AND HEALTH INFORMATION TO SCHOOLS. 3. HOST MINI NUTRITION/HEALTH FAIRS. 4. PROVIDE NUTRITION AND HEALTH INFORMATION TO EMPLOYEES AND THE COMMUNITY. 5. PROMOTE HEALTHY SELECTIONS IN THE CAFETERIAS FOR VISITORS AND EMPLOYEES. 6. EXPAND SUPPORT FOR PARKINSON'S DISEASE. 7. REDUCE OSTEOPOROSIS AMONG ADULT FEMALE PATIENTS. 8. OPEN SATELLITE SITES OF THE DIABETES &amp; NUTRITION WELLNESS CENTER IN CLARION AND PROVIDE DIABETES AND NUTRITION EDUCATION ON A BIMONTHLY BASIS AT EACH LOCATION. 9. MAINTAIN ENROLLMENT WITH THE CENTER FOR MEDICARE AND MEDICAID SERVICES FOR DIABETES PREVENTION PROGRAM. 10. OFFER DIABETES PREVENTION PROGRAMMING THROUGHOUT THE PHH SERVICE AREA BY BEGINNING WITH 1 COHORT PER YEAR. 11. CREATE EDUCATIONAL MATERIAL, INCLUDING MENUS/ GROCERY LISTS FOR PHH PATIENTS ON HEALTHY EATING AT THE LOCAL DOLLAR STORES. PHH PROVIDERS CAN DISTRIBUTE THESE MATERIALS TO PATIENTS WHEN FOOD INSECURITY IS IDENTIFIED. PROVIDE MENUS ELECTRONICALLY TO PARTNERS FOR DISTRIBUTION TO THEIR RECIPIENTS. 12. PROMOTE PHYSICAL ACTIVITY THROUGHOUT THE COMMUNITY. 13. OFFER YOGA AND PILATES CLASS/2 DAYS A WEEK. PENN HIGHLANDS DUBOIS'S AVAILABLE RESOURCES INCLUDE, PHH REHABILITATION DEPT./ FACILITIES, CARDIAC REHABILITATION, PHH MARKETING/COMMUNICATION, AND PHPN PROVIDERS. PENN HIGHLANDS DUBOIS'S COLLABORATIVE PARTNERS INCLUDE, SCHOOL FOOD SERVICE, COMMUNITY RESOURCES, MORRISON WEBSITES, HEALTH AND HUMAN SERVICES ORGANIZATIONS, FOOD VENDORS, PROVIDERS IN THE GEOGRAPHICAL AREA, CMS, CDC DIABETES PREVENTION SUPPORT CENTER, DOLLAR STORE OWNERS, AREA AGENCY ON AGING, MANAGERS OF LOW-INCOME HOUSING, FOOD BANKS, AND CHURCHES. SIGNIFICANT HEALTH NEEDS NOT ADDRESSED: THE ISP IS NOT MEANT TO PROVIDE AN EXHAUSTIVE LIST OF HOW PENN HIGHLANDS DUBOIS ADDRESSES THE COMMUNITY'S NEEDS. INSTEAD, IT HIGHLIGHTS SPECIFIC ACTIONS THE HOSPITAL COMMITS TO PURSUING AND TRACKING IN RESPONSE TO THE IDENTIFIED PRIORITIES. WHILE THE ISP LISTS INTERNAL AND EXTERNAL PARTNERS, NUMEROUS CLINICAL DEPARTMENTS WILL COLLABORATE ON THESE EFFORTS. THEIR INVOLVEMENT MAY INCLUDE PARTICIPATION IN CLINICAL PROGRAMS AND PROTOCOLS OR CONTRIBUTING TO EDUCATIONAL OUTREACH BY SHARING KNOWLEDGE INDIVIDUALLY OR AS A TEAM, ALL WITH THE GOAL OF ADDRESSING THE COMMUNITY'S HEALTH NEEDS.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 16 Facility , 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility , 1 - DUBOIS REGIONAL MEDICAL CENTER. FAP AVAILABILITY FINANCIAL COUNSELORS DISCUSS THE AVAILABILITY OF DISCOUNTED AND CHARITY CARE INDIVIDUALLY WITH PATIENTS.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 20 Facility , 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility , 1 - DUBOIS REGIONAL MEDICAL CENTER. OTHER EFFORTS: THE BILLING STATEMENT STATES THAT THERE IS A FAP AVAILABLE AND GIVES INFORMATION ON HOW TO CONTACT SOMEONE FOR THE APPLICATION.</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>0</FacilityNum>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part I LINE 7 COLUMN (F)</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PERCENT OF TOTAL EXPENSE ON SCHEDULE H, PART I, LINE 7, COLUMN (F) WAS CALCULATED USING TOTAL EXPENSES ON FORM 990, PART IX, LINE 25, COLUMN (A).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COST TO CHARGE RATIO COMPUTED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATIONS ON IRS WORKSHEETS 1 AND 3. WORKSHEET 6 USED ACTUAL COST DATA.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBT EXPENSE METHODOLOGY: THE HOSPITAL HAS ADOPTED THE REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2025. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 3 Bad Debt Expense Methodology</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBT ATTRIBUTABLE TO CHARITY CARE: THE SYSTEM HAS DETERMINED IT HAS PROVIDED IMPLICIT PRICE CONCESSIONS TO UNINSURED PATIENTS AND PATIENTS WITH OTHER UNINSURED BALANCES SUCH AS COPAYS AND DEDUCTIBLES. THE IMPLICIT PRICE CONCESSIONS INCLUDED IN ESTIMATING THE TRANSACTION PRICE REPRESENT THE DIFFERENCE BETWEEN AMOUNTS BILLED TO PATIENTS AND THE AMOUNTS THE SYSTEM EXPECTS TO COLLECT BASED ON ITS COLLECTION HISTORY WITH THOSE PATIENTS. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE FOR FINANCIAL REPORTING. LINE 3 REPORTS THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS FROM THE INTERNAL FINANCIAL STATEMENTS. BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING POVERTY LIMIT DEMOGRAPHIC INFORMATION OBTAINED THROUGH THE US CENSUS BUREAU.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBT EXPENSE FOOTNOTE: THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE. THAT NOTE CAN BE FOUND ON PAGE 9 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 8 Community benefit &amp; methodology for determining medicare costs</FormAndLineReferenceDesc>
        <ExplanationTxt>COMMUNITY BENEFIT: SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. MEDICARE TOTAL REVENUE RECEIVED AND ALLOWABLE COSTS ARE CALCULATED USING VARIOUS LINES FROM THE MEDICARE COST REPORT. FOR THE PROFESSIONAL COMPONENT REVENUE, INTERNAL REPORTS ARE USED. THE PROFESSIONAL COST IS CALCULATED USING THE NON-ALLOWABLE PHYSICIAN COSTS FROM THE COST REPORT MULTIPLIED BY THE PERCENTAGE OF MEDICARE PCS TO TOTAL PCS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance</FormAndLineReferenceDesc>
        <ExplanationTxt>COLLECTION POLICY: THE ACTIONS THAT PHH/PHPN MAY TAKE WITH REGARD TO THE NON-PAYMENT BY AN INDIVIDUAL WHO IS ABLE TO PAY FOR SERVICES, INCLUDING COLLECTION ACTIONS AND POSSIBLE REPORTING TO CREDIT AGENCIES ARE CONTAINED IN PHH/PHPN'S BILLING AND COLLECTION POLICY. FOR INDIVIDUALS WHO QUALIFY FOR FAP AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED MEDICAL BILLS, PHH/PHPN WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTIONS AGENCIES. PHH/PHPN WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS (ECA) SUCH AS LAWSUITS, LIENS ON RESIDENCES OR OTHER SIMILAR LEGAL ACTIONS FOR ANY INDIVIDUAL WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FAP. REASONABLE EFFORTS SHALL INCLUDE: A) NOTIFYING THE INDIVIDUAL OF THE FAP UPON ADMISSION, IN WRITTEN AND ORAL COMMUNICATIONS WITH THE INDIVIDUAL REGARDING THEIR BILL AND INCLUDING INFORMATION ON THE FAP ON STATEMENTS; B) WRITTEN DOCUMENTATION THAT PHH/PHPN HAS ATTEMPTED TO OFFER THE INDIVIDUAL THE OPPORTUNITY TO APPLY FOR FINANCIAL ASSISTANCE PURSUANT TO THIS POLICY AND THAT THE INDIVIDUAL HAS NOT COMPLIED WITH THE APPLICATION REQUIREMENTS; C) VALIDATING THAT THE INDIVIDUAL OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD-PARTY PAYMENTS HAVE BEEN IDENTIFIED AND BILLED BY PHH/PHPN; D) DOCUMENTATION THAT THE INDIVIDUAL HAS BEEN OFFERED A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 16a FAP website</FormAndLineReferenceDesc>
        <ExplanationTxt>- DUBOIS REGIONAL MEDICAL CENTER: Line 16a URL: HTTPS://WWW.PHHEALTHCARE.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE-POLICY;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 16b FAP Application website</FormAndLineReferenceDesc>
        <ExplanationTxt>- DUBOIS REGIONAL MEDICAL CENTER: Line 16b URL: HTTPS://WWW.PHHEALTHCARE.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE-POLICY;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 16c FAP plain language summary website</FormAndLineReferenceDesc>
        <ExplanationTxt>- DUBOIS REGIONAL MEDICAL CENTER: Line 16c URL: HTTPS://WWW.PHHEALTHCARE.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE-POLICY;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 2 Needs assessment</FormAndLineReferenceDesc>
        <ExplanationTxt>NEEDS ASSESSMENT: THE HOSPITAL COLLECTS DATA ON AN ONGOING BASIS REGARDING PATIENTS WHO TRAVEL TO OUTLYING AREAS FOR SERVICES NOT OFFERED BY DRMC. BASED ON THIS DATA, SERVICES ARE ADDED AND IMPROVED UPON IN ORDER TO SERVE THE NEEDS OF THE COMMUNITY AS EFFECTIVELY AND EFFICIENTLY AS POSSIBLE. DRMC ROUTINELY SENDS PATIENT SATISFACTION SURVEYS TO THOSE RECEIVING MEDICAL SERVICES. THESE SURVEYS ALLOW PATIENTS TO OFFER SUGGESTIONS REGARDING HOW THE HOSPITAL COULD BETTER SERVE THEM AS PATIENTS AND THE COMMUNITY AS A WHOLE. DRMC OFFERS A VARIETY OF EDUCATION PROGRAMS THAT ALLOW EMPLOYEES TO INTERACT ON A ONE-ON-ONE BASIS WITH THE RESIDENTS OF THE COMMUNITY AS A WHOLE. IN ADDITION, THE MEDICAL STAFF OF THE HOSPITAL CONSISTENTLY PARTICIPATES IN RESEARCH AND CONTINUING MEDICAL EDUCATION. THIS KNOWLEDGE ALLOWS THE HOSPITAL TO REMAIN UPDATED ON THE LATEST MEDICAL NEWS AND TECHNIQUES IN ORDER TO OFFER PATIENTS THE HIGHEST AND MOST INNOVATIVE LEVELS OF CARE. DRMC HIRED AN OUTSIDE FIRM TO ASSIST WITH THE CREATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE CONTRACTOR GATHERED SECONDARY DATA IN CLEARFIELD AND SURROUNDING COUNTIES, CONDUCTED VARIOUS FOCUS GROUPS WITH KEY AUDIENCES AND USERS OF HEALTHCARE AND SOCIAL SERVICES TO IDENTIFY AREAS FOR PERSPECTIVE IMPROVEMENT WITHIN THE COMMUNITY. THE CONTRACTOR HAS DEVELOPED A MASTER PLAN OF INITIATIVES FOR DRMC WHICH HAS BEEN POSTED ON THE HOSPITAL'S WEBSITE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 3 Patient education of eligibility for assistance</FormAndLineReferenceDesc>
        <ExplanationTxt>PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: DRMC POSTS A NOTICE OF CHARITY CARE AT ALL POINTS OF REGISTRATION, INCLUDING ALL EMPLOYED PHYSICIAN PRACTICES. THE NOTICE INCLUDES A STATEMENT AS TO THE AVAILABILITY OF CHARITY CARE AND HOW TO APPLY. DRMC EMPLOYS A FINANCIAL COUNSELOR WHO MEETS INDIVIDUALLY WITH ALL INPATIENTS ADMITTED TO THE FACILITY WHO INDICATE NO HEALTH CARE COVERAGE. THE FINANCIAL COUNSELOR INTERVIEWS THE PATIENT, AND, IF APPROPRIATE, DISCUSSES AND EDUCATES THE PATIENT RELATIVE TO MEDICAL ASSISTANCE, BLUE CHIP AND THE HOSPITAL'S CHARITY PROGRAM. THE FINANCIAL COUNSELOR COMPLETES AND ASSISTS THE PATIENTS WITH THE NECESSARY APPLICATIONS AND FOLLOW-THRU WITH THE PHYSICIAN AND THE ASSIGNED COUNTY BOARD OF ASSISTANCE CASEWORK. THE FINANCIAL COUNSELOR ALSO CONTACTS OTHER PATIENTS WITH LARGE DOLLAR ACCOUNT BALANCES TO DISCUSS AND EDUCATE THE PATIENT'S NEED FOR FINANCIAL ASSISTANCE. ADDITIONALLY, DRMC EMPLOYS A CREDIT COLLECTIONS STAFF WHO ALSO CONTACTS, EDUCATES AND OFFERS ASSISTANCE TO OTHER PATIENTS WITH FINANCIAL NEED TO HELP WITH HEALTH CARE COSTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 4 Community information</FormAndLineReferenceDesc>
        <ExplanationTxt>COMMUNITY INFORMATION: THE HOSPITAL'S LICENSED BEDS ARE HOUSED IN TWO FACILITIES IN DUBOIS AND CLEARFIELD, TWO SMALL TOWNS IN CENTRAL PENNSYLVANIA. In 2024, 41 ZIP codes were identified as the primary service area for DuBois Regional Medical Center (DRMC) and Penn Highlands Clearfield (a campus of Penn Highlands Dubois). Most patient discharges from Penn Highlands DuBois originate from Clearfield County and Jefferson County, comprising over 80% of the hospital's patients. The facilities' location in Central Pennsylvania allows it to serve a wide region, meeting the healthcare needs of both urban and rural populations. Based on the 2022 US Census Bureau, around 11-13% of the population in these two counties live below the federal poverty level.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 5 Promotion of community health</FormAndLineReferenceDesc>
        <ExplanationTxt>PROMOTION OF COMMUNITY HEALTH: DUBOIS REGIONAL MEDICAL CENTER OFFERS RESIDENTS OF WEST CENTRAL PENNSYLVANIA THE COMBINATION OF ADVANCED HEALTHCARE IN A WARM, FRIENDLY ENVIRONMENT. WIDELY RECOGNIZED AS ONE OF THE LEADING HEALTH CENTERS OF ITS KIND IN THE COMMONWEALTH, DRMC IS AN OASIS OF CLINICAL AND TECHNICAL EXCELLENCE, WITH A FOCUS ON PATIENT-CENTERED CARE. OUR COMBINED VISION IS TO BE POSITIONED AS THE PREMIER PROVIDER OF COMPREHENSIVE, QUALITY SERVICES TO OUR BROAD REGION. PROVIDING INPATIENT AND OUTPATIENT HOSPITAL CARE REPRESENTS THE LARGEST PORTION OF THESE SERVICES. DRMC'S MISSION IN MAINTAINING THESE SERVICES IS ACCOMPLISHED BY PROVIDING ACCESS TO HEALTHCARE SERVICES FOR ALL, INCLUDING INDIVIDUALS WHO ARE UNABLE TO PAY FOR SUCH SERVICES. DRMC HAS A TRADITION OF SERVING THE POOR AND UNDER-PRIVILEGED OF THE AREA BY PROVIDING CARE PROGRAMS AND SERVICES TO ENHANCE THEIR QUALITY OF LIFE. BEYOND THE INPATIENT AND OUTPATIENT HOSPITAL CARE, THERE ARE MANY OTHER WAYS IN WHICH DRMC AND OUR EMPLOYEES SERVE OUR COMMUNITY EVERY DAY. IN ADDITION TO GIVING TO ORGANIZATIONS, THEY PROVIDE INFORMATION ON HEALTH AND SAFETY TO THE COMMUNITY. THEY PROVIDE DIRECT PATIENT CARE ON A VOLUNTEER BASIS AT THE LOCAL DUBOIS FREE CLINIC. THE CLINIC WAS ESTABLISHED FOR LOW-INCOME PEOPLE WHO COULD NOT AFFORD HEALTH INSURANCE. THE SUCCESS AND REPUTATION OF DRMC IS A DIRECT RESULT OF THE DEDICATED EFFORTS OF OUR BOARD OF DIRECTORS, ADMINISTRATION, PHYSICIANS AND STAFF. WITH THE CONTINUED SUPPORT OF THE DRMC FAMILY AND THE COMMUNITIES WE SERVE, DRMC WILL REMAIN A VALUABLE RESOURCE TO OUR AREA.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 6 Affiliated health care system</FormAndLineReferenceDesc>
        <ExplanationTxt>DUBOIS REGIONAL MEDICAL CENTER IS PART OF PENN HIGHLANDS HEALTHCARE (PHH, SYSTEM). PHH IS A NOT-FOR-PROFIT CORPORATION ORGANIZED TO COORDINATE AND MANAGE THE INTEGRATION OF THE DELIVERY OF HEALTHCARE SERVICES TO THE NORTH CENTRAL PENNSYLVANIA AREA. THE SYSTEM INCLUDES THE CONSOLIDATED FINANCIAL STATEMENTS OF PENN HIGHLANDS HEALTHCARE, PENN HIGHLANDS DUBOIS, PENN HIGHLANDS ELK, PENN HIGHLANDS CLEARFIELD, PENN HIGHLANDS CONNELLSVILLE, PENN HIGHLANDS HUNTINGDON, PENN HIGHLANDS MON VALLEY AND PENN HIGHLANDS TYRONE. PHH OPERATES 9 HOSPITAL FACILITIES ACROSS PENNSYLVANIA, EACH OF WHICH IS THE LARGEST EMPLOYER IN ITS HOMETOWN. THE SYSTEM ALSO INCLUDES A VARIETY OF OTHER AFFILIATES THAT SUPPORT ITS EXEMPT MISSION, SUCH AS NURSING HOMES, HOME CARE AGENCIES, MEDICAL EQUIPMENT SUPPLIERS, PHARMACIES, ETC.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 7 State filing of community benefit report</FormAndLineReferenceDesc>
        <ExplanationTxt>PA</ExplanationTxt>
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        <PersonNm>Dr Julia Wonderling</PersonNm>
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        <PersonNm>Steven M Fontaine</PersonNm>
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        <PersonNm>William Chinn</PersonNm>
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        <ExplanationTxt>CEO COMPENSATION: PENN HIGHLANDS HEALTHCARE, INC. (PHH), A RELATED ORGANIZATION, DETERMINES THE COMPENSATION OF THE CEO. PHH USES THE FOLLOWING METHODS TO DETERMINE THE COMPENSATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY BOARD OR COMPENSATION COMMITTEE.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan</FormAndLineReferenceDesc>
        <ExplanationTxt>MARK NORMAN AND STEVE FONTAINE PARTICIPATE IN A 457(F) PLAN CONTAINING EXCESS EMPLOYER CONTRIBUTIONS OVER THE 457(F) LIMIT. DURING CALENDAR YEAR 2024. MARK NORMAN CONTRIBUTED $28,320 INTO THE PLAN. THERE WERE NO DISTRIBUTIONS FROM THE PLAN.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Schedule J, Part I, Line 7 Non-fixed payments</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION PROVIDED DISCRETIONARY BONUSES TO THE REPORTABLE INDIVIDUALS ON PART VII, SECTION A TO THE EXTENT BONUSES WERE PAID BY THE FILING ORGANIZATION. DISCRETIONARY BONUSES ARE APPROVED BY THE BOARD.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Form 990, Part VI, Line 6 Classes of members or stockholders</FormAndLineReferenceDesc>
        <ExplanationTxt>MEMBERS: PENN HIGHLANDS HEALTHCARE (PHH) HOLDS CERTAIN POWERS, INCLUDING THE APPROVAL OF THE ELECTION AND REMOVAL OF OFFICERS AND DIRECTORS AND APPROVAL OF ANY AND ALL AMENDMENTS TO THE BYLAWS OR OTHER ORGANIZATIONAL/GOVERNANCE DOCUMENTS. PHH SHALL HAVE THE FOLLOWING POWERS WITH RESPECT TO THE ELECTION AND REMOVAL OF DIRECTORS: PRIOR TO THE END OF PHH'S FISCAL YEAR, THE PHH BOARD WILL MEET TO ELECT THE DIRECTORS, WITH THE EXCEPTION OF EX-OFFICIO DIRECTORS. AT LEAST SIXTY (60) DAYS IN ADVANCE OF THIS MEETING, ALL INDIVIDUALS BEING CONSIDERED FOR APPOINTMENT AS A DIRECTOR (WHETHER ELECTED OR EX-OFFICIO) SHALL BE REFERRED TO THE BOARD OF THIS CORPORATION AND/OR THIS CORPORATION'S GOVERNANCE/NOMINATING COMMITTEE, IF APPLICABLE. THE BOARD AND/OR GOVERNANCE/NOMINATING COMMITTEE SHALL REVIEW THE QUALIFICATIONS THEREOF AND SUBMIT ITS RECOMMENDATIONS TO THE PHH GOVERNANCE/NOMINATING COMMITTEE. IN ACCORDANCE WITH THE COVENANT AGREEMENT, THE SISTERS OF MERCY SHALL HAVE THE PREROGATIVE TO NOMINATE UP TO 3 OF ITS MEMBERS TO THE BOARD. TO THE EXTENT POSSIBLE, THE SISTERS OF MERCY SHALL NOMINATE THESE INDIVIDUALS IN A FASHION SO THAT THE TERMS OF THE INDIVIDUALS ARE STAGGERED. THE INDIVIDUALS SELECTED BY THE SISTERS OF MERCY TO SERVE ON THE BOARD SHALL FIRST BE SUBMITTED TO THE BOARD FOR REVIEW AND RECOMMENDATION PRIOR TO BEING NOMINATED AND ELECTED. THE BOARD OF PHH HAS THE POWER TO REMOVE SUCH DIRECTOR AT ANY TIME WITH OR WITHOUT CAUSE. ONCE THE SLATE OF CANDIDATES IS NOMINATED BY THE PHH GOVERNANCE/NOMINATING COMMITTEE, THE BOARD OF DRMC SHALL SUBMIT TO THE PHH BOARD FOR ELECTION SUCH SLATE OF CANDIDATES FOR THE OPEN BOARD POSITIONS. THE PHH BOARD MAY ELECT BY A VOTE OF THE MAJORITY OR REFUSE TO ELECT EACH CANDIDATE SUBMITTED BY THE BOARD OF DRMC AND MAY NOT ELECT ANY CANDIDATE NOT SUBMITTED BY THE BOARD OF DRMC AND NOMINATED BY THE PHH GOVERNANCE/NOMINATING COMMITTEE. IN THE EVENT THAT THIS ORGANIZATION DESIRES TO FILL A VACANCY OCCURRING ON ITS BOARD, THE PHH GOVERNANCE/NOMINATING COMMITTEE AND THE BOARD OF PHH, AT THE REQUEST OF DRMC, SHALL ACT TO FILL SUCH VACANCY. SUBJECT TO THE APPROVAL OF PHH AS SET FORTH IN THE BYLAWS, THE ARTICLES AND THE BYLAWS MAY BE ALTERED, AMENDED, OR REPEALED AND NEW BYLAWS OR ARTICLES MAY BE ADOPTED BY THE AFFIRMATIVE VOTE OF TWO-THIRDS (2/3) OF THE BOARD. WRITTEN NOTICE OF THE INTENT TO AMEND THE BYLAWS OR THE ARTICLES AND A DRAFT OF THE PROPOSED CHANGE SHALL BE SENT TO ALL DIRECTORS, BY THE SECRETARY, AT LEAST FIVE (5) DAYS PRIOR TO ANY MEETING AT WHICH AMENDMENT OF THE BYLAWS OR THE ARTICLES IS INTENDED.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 7a Members or stockholders electing members of governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>SEE LINE 6 NARRATIVE ABOVE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders</FormAndLineReferenceDesc>
        <ExplanationTxt>SEE LINE 6 NARRATIVE ABOVE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>THE GOVERNING BODY HAS NOT AUTHORIZED ANY COMMITTEES TO ACT ON ITS BEHALF.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b Review of form 990 by governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ORGANIZATION. THE DRAFT FORM 990 IS REVIEWED BY THE CFO AND THE SYSTEM CONTROLLER. AFTER ALL SUGGESTED CHANGES FROM THE CFO AND SYSTEM CONTROLLER ARE MADE, THE UPDATED DRAFT FORM 990 IS PROVIDED FOR REVIEW TO THE FULL BOARD. ANY QUESTIONS OR COMMENTS FROM THE BOARD ARE ADDRESSED BEFORE FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c Conflict of interest policy</FormAndLineReferenceDesc>
        <ExplanationTxt>MONITORING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY: PENN HIGHLANDS HEALTHCARE, INC. (PHH), MAINTAINS A CONFLICT OF INTEREST POLICY WHICH APPLIES TO ALL SUBSIDIARIES. THE CONFLICT OF INTEREST POLICY APPLIES TO BOARD MEMBERS, OFFICERS, EXECUTIVE EMPLOYEES, AND ANY OTHER MANAGER OR SUPERVISOR EXERCISING SUBSTANTIAL INFLUENCE OVER OPERATIONS. EACH COVERED PERSON WILL PROMPTLY AND FULLY DISCLOSE ALL MATERIAL FACTS OF EVERY ACTUAL OR POTENTIAL DUAL INTEREST EXISTING AT THE TIME WHEN HE/SHE BECOMES A COVERED PERSON, AND ANNUALLY THROUGH EACH PHH SYSTEM ENTITY'S DISCLOSURE STATEMENT, WHICH REQUESTS DISCLOSURE OF RELATIONSHIPS, INVESTMENTS, AND TRANSACTIONS THAT MAY LEAD TO AN ACTUAL CONFLICT OF INTEREST. ALL COMPLETED DISCLOSURE STATEMENTS WILL BE PROVIDED TO THE PHH GOVERNANCE/NOMINATING COMMITTEE. THIS COMMITTEE, IN CONSULTATION WITH THE CHAIRPERSON OR VICE CHAIRPERSON OF EACH PHH SYSTEM ENTITY'S BOARD, SHALL EVALUATE THE COMPLETED DISCLOSURE STATEMENTS AND DETERMINE IF THERE ARE ANY CONFLICTS THAT ARE SO PERVASIVE AS TO RENDER ANY COVERED PERSON INELIGIBLE FOR SERVICE. THE CHAIRPERSON OF EACH PHH SYSTEM ENTITY'S BOARD WILL DISCLOSE TO THE FULL BOARD OF SAID PHH SYSTEM ENTITY ALL DUAL INTERESTS REPORTED TO HIM OR HER UNDER THE POLICY AND WILL ALSO MAKE THE DISCLOSURE STATEMENTS OF ALL COVERED PERSONS AVAILABLE TO DIRECTORS AT ANY TIME DURING THE YEAR. IF A POTENTIAL DUAL INTEREST ARISES AS A RESULT OF A CONTEMPLATED PHH SYSTEM ENTITY BOARD (OR COMMITTEE) ACTION, THE CHAIRPERSON OF SAID PHH SYSTEM ENTITY'S BOARD OR THE INTERESTED PERSON SHALL, OR ANY OTHER DIRECTOR MAY, RAISE THE QUESTION OF THE INTERESTED PERSON'S DUAL INTEREST. THE DISINTERESTED MEMBERS OF THE PHH SYSTEM ENTITY'S BOARD (OR COMMITTEE) WILL EVALUATE THE DISCLOSURES AND THE MATERIAL FACTS RELATING TO THE TRANSACTION, ARRANGEMENT, OR POLICY GIVING RISE TO THE DUAL INTEREST TO DETERMINE WHETHER THEY INVOLVE ACTUAL CONFLICTS OF INTEREST AND MAY ATTEMPT TO DEVELOP ALTERNATIVES TO REMOVE THE CONFLICT FROM THE TRANSACTION, ARRANGEMENT, OR POLICY. A COVERED PERSON WHO HAS A DUAL INTEREST SHALL NOT BE PRESENT FOR OR SHALL LEAVE ANY PORTION OF A MEETING AT WHICH A PHH SYSTEM ENTITY'S BOARD (OR COMMITTEE) IS VOTING TO DETERMINE WHETHER A CONFLICT EXISTS, BUT MAY BE PRESENT PRIOR TO THE VOTE TO MAKE A PRESENTATION TO SAID BOARD (OR COMMITTEE), TO DISCLOSE ADDITIONAL FACTS, OR TO RESPOND TO QUESTIONS. IF A PHH SYSTEM ENTITY'S BOARD (OR COMMITTEE) DETERMINES THAT AN ACTUAL CONFLICT OF INTEREST EXISTS, THE INTERESTED PERSON SHALL BE SO ADVISED AND THE CHAIRPERSON OF A PHH SYSTEM ENTITY'S BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE OR DIRECT MANAGEMENT TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, IF THIS HAS NOT ALREADY BEEN DONE. ANY INTERESTED PERSON WHO HAS AN ACTUAL CONFLICT OF INTEREST WITH RESPECT TO THE TRANSACTION OR ARRANGEMENT DOES NOT PARTICIPATE IN AND IS NOT PRESENT FOR THE VOTE REGARDING ANY SUCH TRANSACTION OR ARRANGEMENT. IF AN INDIVIDUAL WHOSE COMPANY OR EMPLOYER HAS A BUSINESS RELATIONSHIP WITH A PHH SYSTEM ENTITY, BUT THE INDIVIDUAL DOES NOT HAVE AN ACTUAL CONFLICT OF INTEREST WITH RESPECT TO THIS BUSINESS RELATIONSHIP, THE INDIVIDUAL MAY NONETHELESS VOLUNTARILY RECUSE HIM/HERSELF FROM VOTING ON ANY MATTERS RELATED TO THE RELATIONSHIP.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15b Process to establish compensation of other employees</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION DETERMINATION: THE PENN HIGHLANDS HEALTHCARE EXECUTIVE COMPENSATION COMMITTEE CONSULTS WITH THE HEALTHCARE CONSULTING FIRM, YAFEE AND COMPANY TO OBTAIN COMPARABLE DATA TO MAKE RECOMMENDATIONS TO THE BOARD OF DIRECTORS REGARDING EXECUTIVE COMPENSATION. THE PENN HIGHLANDS HEALTHCARE BOARD OF DIRECTORS IS ACUTELY AWARE OF THE HEIGHTENED PUBLIC SCRUTINY OF EXECUTIVE COMPENSATION AND THE NEED TO CONSIDER REGULATORY COMPLIANCE WHEN SETTING EXECUTIVE PAY. COMPENSATION REVIEWS ARE DONE ON A CONTINUOUS BASIS. COMPENSATION DETERMINATIONS OF PHH EMPLOYED OFFICERS ARE MADE BY THE PHH COMPENSATION COMMITTEE. COMPENSATION DETERMINATIONS OF CERTAIN EMPLOYED OFFICERS ARE ALSO REVIEWED AND APROVED BY THE PHH COMPENSATION COMMITTEE AND SHARED WITH THE COMPENSATION COMMITTEE OR BOARD. THE COMPENSATION COMMITTEE OF PHH STRIVE TO TAKE THE STEPS NECESSARY TO QUALIFY FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER FEDERAL TAX LAW. THE PHH EXECUTIVE COMPENSATION COMMITTEES ARE RESPONSIBLE FOR (1) DETERMINING THE OVERALL TOTAL COMPENSATION STRATEGY FOR ALL THEIR RESPECTIVE CORPORATE OFFICERS, (2) APPROVING ALL COMPENSATION AND BENEFITS DECISIONS FOR CORPORATE OFFICERS, AND (3) REPORTING SUCH ACTIONS TO THE PHH BOARD ON A CONTINUOUS BASIS. IN ADDITION, THE EXECUTIVE COMPENSATION COMMITTEES, AS APPLICABLE, EXPRESSLY DETERMINE THE REASONABLENESS OF TOTAL COMPENSATION AND BENEFITS FOR ALL CORPORATE OFFICERS, AND ASSURES THAT ALL OFFICER COMPENSATION DECISIONS ARE MADE AFTER THOROUGH CONSIDERATION OF AND COMPARISON TO THE MARKET PRACTICES OF OTHER SIMILARLY SITUATED NOT-FOR-PROFIT HEALTHCARE EXECUTIVES IN COMPARABLE ORGANIZATIONS. THE EXECUTIVE COMPENSATION COMMITTEES CONSIST OF BOARD MEMBERS WHO DO NOT HAVE MATERIAL FINANCIAL INTERESTS THAT COULD BE AFFECTED BY THE OFFICER COMPENSATION DECISIONS MADE BY THE COMMITTEES. THE COMPARABILITY DATA USED TO ASSIST THE EXECUTIVE COMPENSATION COMMITTEES IN THEIR COMPENSATION DELIBERATIONS ARE COMPILED BY AN INDEPENDENT, NATIONAL COMPENSATION CONSULTING FIRM THAT IS RETAINED BY AND REPORTS DIRECTLY TO THE EXECUTIVE COMPENSATION COMMITTEES. THE DATA COLLECTED BY THE CONSULTANT CONSISTS OF MARKET INFORMATION FOR EXECUTIVES IN FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS. THE DELIBERATIONS AND DECISIONS OF THE EXECUTIVE COMPENSATION COMMITTEES ARE CONTEMPORANEOUSLY DOCUMENTED, REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEES, AND PROVIDED TO THE BOARD OF PHH, AS APPLICABLE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19 Required documents available to the public</FormAndLineReferenceDesc>
        <ExplanationTxt>GOVERNING DOCUMENT AVAILABILITY: THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE LOCATED IN THE ADMINISTRATION OFFICES OF DUBOIS REGIONAL MEDICAL CENTER. THEY ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g Other Fees</FormAndLineReferenceDesc>
        <ExplanationTxt>PROFESSIONAL FEES - Total Expense: 35823176, Program Service Expense: 31166163, Management and General Expenses: 4657013, Fundraising Expenses: ; OTHER FEES - Total Expense: 315701, Program Service Expense: 274660, Management and General Expenses: 41041, Fundraising Expenses: ; LABORATORY FEES - Total Expense: 5387507, Program Service Expense: 4687131, Management and General Expenses: 700376, Fundraising Expenses: ; CONTRACT LABOR - Total Expense: 23704424, Program Service Expense: 20622849, Management and General Expenses: 3081575, Fundraising Expenses: ; OUTSIDE SERVICES - Total Expense: 21761654, Program Service Expense: 18932639, Management and General Expenses: 2829015, Fundraising Expenses: ;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9 Other changes in net assets or fund balances</FormAndLineReferenceDesc>
        <ExplanationTxt>INTERCOMPANY TRANSFERS AND OTHER CHANGES IN NET ASSETS - 31559257; Total - 31559257;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VII, SECTION A BOARD MEMBER COMPENSATION</FormAndLineReferenceDesc>
        <ExplanationTxt>NO TRUSTEES RECEIVE ANY COMPENSATION FOR THEIR TRUSTEE DUTIES. STEVE FONTAINE IS COMPENSATED AS CEO OF THE PENN HIGHLANDS HEALTHCARE SYSTEM. MARK NORMAN IS COMPENSATED AS COO OF THE PENN HIGHLANDS HEALTHCARE SYSTEM. DR. JULIA WONDERLING AND DR. JAMES DEVLIN ARE COMPENSATED FOR THEIR ROLES AS PHYSICIANS WITHIN THE HEALTH SYSTEM.</ExplanationTxt>
      </SupplementalInformationDetail>
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        <EIN>251552925</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>DRMC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>WRC NORTH FORK HEIGHTS</BusinessNameLine1Txt>
        </DisregardedEntityName>
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          <AddressLine1Txt>985 ROUTE 28</AddressLine1Txt>
          <CityNm>BROOKVILLE</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15825</ZIPCd>
        </USAddress>
        <EIN>251684846</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WRC SR SRVCS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>WRC PENNSYLVANIA MEMORIAL HOME</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>985 ROUTE 28</AddressLine1Txt>
          <CityNm>BROOKVILLE</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15825</ZIPCd>
        </USAddress>
        <EIN>250718600</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WRC SR SRVCS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MONONGAHELA VALLEY HOSPITAL FOUNDATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1163 COUNTRY CLUB ROAD</AddressLine1Txt>
          <CityNm>MONONGAHELA</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15063</ZIPCd>
        </USAddress>
        <EIN>825336533</EIN>
        <PrimaryActivitiesTxt>FUNDRAISING</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Type II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PHH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MONONGAHELA VALLEY HOSPITAL INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1163 COUNTRY CLUB ROAD</AddressLine1Txt>
          <CityNm>MONONGAHELA</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15063</ZIPCd>
        </USAddress>
        <EIN>237218917</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PHH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>CLEARFIELD EMS</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>713 W FRONT ST</AddressLine1Txt>
          <CityNm>CLEARFIELD</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>16830</ZIPCd>
        </USAddress>
        <EIN>251672659</EIN>
        <PrimaryActivitiesTxt>EMS SERVICE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PHH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>BROOKVILLE HOSPITAL</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>100 HOSPITAL RD</AddressLine1Txt>
          <CityNm>BROOKVILLE</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15825</ZIPCd>
        </USAddress>
        <EIN>250984595</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>DRMC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ELK REGIONAL HEALTH CENTER</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>763 JOHNSONBURG ROAD</AddressLine1Txt>
          <CityNm>ST MARYS</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15857</ZIPCd>
        </USAddress>
        <EIN>250585280</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PHH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>JC BLAIR MEMORIAL HOSPITAL</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1225 WARM SPRINGS AVENUE</AddressLine1Txt>
          <CityNm>HUNTINGDON</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>16652</ZIPCd>
        </USAddress>
        <EIN>231352159</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>PHH</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>PENN HIGHLANDS TYRONE</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>187 HOSPITAL DRIVE</AddressLine1Txt>
          <CityNm>TYRONE</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>16686</ZIPCd>
        </USAddress>
        <EIN>231440116</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PHH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>PREMIER HEALTH CARE STAFFING INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>100 HOSPITAL AVE</AddressLine1Txt>
          <CityNm>DUBOIS</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15802</ZIPCd>
        </USAddress>
        <EIN>874757426</EIN>
        <PrimaryActivitiesTxt>STAFFING SRVCS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C Corporation</EntityTypeTxt>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>PENN HIGHLANDS LIFE'S JOURNEY</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>100 HOSPITAL AVE</AddressLine1Txt>
          <CityNm>DUBOIS</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15801</ZIPCd>
        </USAddress>
        <EIN>824943778</EIN>
        <PrimaryActivitiesTxt>MEDICAL SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>DRMC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
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        <ShareOfEOYAssetsAmt>427304</ShareOfEOYAssetsAmt>
        <OwnershipPct>1</OwnershipPct>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>DUBOIS REGIONAL MEDICAL GROUP</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>PO BOX 447</AddressLine1Txt>
          <CityNm>DUBOIS</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15801</ZIPCd>
        </USAddress>
        <EIN>251856569</EIN>
        <PrimaryActivitiesTxt>MEDICAL SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>DRMC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C Corporation</EntityTypeTxt>
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        <ShareOfEOYAssetsAmt>10313206</ShareOfEOYAssetsAmt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>JC BLAIR MEDICAL SERVICES INC</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>1225 WARM SPRINGS AVENUE</AddressLine1Txt>
          <CityNm>HUNTINGDON</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>16652</ZIPCd>
        </USAddress>
        <EIN>251881378</EIN>
        <PrimaryActivitiesTxt>HEALTH CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
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      <ReceiptOfIntAnntsRntsRyltsInd>true</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>true</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>true</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>true</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>true</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>true</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>true</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>true</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>true</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>true</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>true</TransferFromOtherOrgInd>
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        <OtherOrganizationName>
          <BusinessNameLine1Txt>PENN HIGHLANDS BROOKVILLE</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>A</TransactionTypeTxt>
        <InvolvedAmt>203302</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>PENN HIGHLANDS ELK</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>906159</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>PENN HIGHLANDS HUNTINGDON</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>1014389</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>PENN HIGHLANDS JEFFERSON MANOR</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>56578</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>PENN HIGHLANDS CONNELLSVILLE</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>193996</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>PENN HIGHLANDS TYRONE</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>632343</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>JC BLAIR MEDICAL SERVICES INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>3060914</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>PREMIER HEALTH CARE STAFFING INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>2365669</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>COMMUNITY NURSES INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>A</TransactionTypeTxt>
        <InvolvedAmt>15746</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>