4A (Expenses $ 31298813 including grants of $ 0) (Revenue $ 29540312)
THE HOSPITAL SERVED THE HEALTHCARE NEEDS OF THE COMMUNITY AND SURROUNDING AREAS WITH 927 ADMISSIONS, 7,887 PATIENT DAYS, 45,405 OUTPATIENT VISITS AND 9,700 EMERGENCY ROOM VISITS. THE HOSPITAL PROVIDED A SIGNIFICANT AMOUNT OF HEALTHCARE TO THE INDIGENT AND LOW INCOME INDIVIDUALS REGARDLESS OF THE ABILITY TO PAY.

SCHEDULE H, PART V SECTION B, LINE 5
COMMUNITY INPUT: HIGHLANDS HOSPITAL'S LEADERSHIP TEAM FORMED A STEERING COMMITTEE THAT CONSISTED OF HOSPITAL LEADERS WHO REPRESENTED THE BROAD INTERESTS OF THEIR LOCAL REGION. THESE INCLUDED REPRESENTATIVES WHO UNDERSTOOD THE NEEDS AND ISSUES RELATED TO VARIOUS UNDERREPRESENTED GROUPS INCLUDING MEDICALLY UNDERSERVED POPULATIONS, LOW-INCOME PERSON, MINORITY GROUPS, AND THOSE WITH CHRONIC DISEASE NEEDS, AND INTERNAL PROGRAM MANAGERS. THE HIGHLANDS HOSPITAL STEERING COMMITTEE MET TWO TIMES BETWEEN MARCH 2021 AND APRIL 2021 TO PROVIDE GUIDANCE ON THE VARIOUS COMPONENTS OF THE CHNA. KEY INFORMANT SURVEY: THE CHNA LEADERSHIP IDENTIFIED KEY COMMUNITY STAKEHOLDERS TO PARTICIPATE IN KEY INFORMANT SURVEY. THE CHNA STEERING REFINED THE STAKEHOLDER LIST TO ENSURE BROAD COMMUNITY REPRESENTATION. STRATEGY SOLUTIONS, INC DEVELOPED THE KEY INFORMANT SURVEY AND CREATED AN ONLINE SURVEY. HIGHLANDS HOSPITAL STAFF REACHED OUT TO THE COMMUNITY STAKEHOLDERS TO INVITE THEM TO PARTICIPATE. A TOTAL OF 17 SURVEYS WERE COMPLETED.

SCHEDULE H, PART V, SECTION B, LINE 7A
CHNA AVAILABILITY: HTTPS://WWW.HIGHLANDSHOSPITAL.ORG/ABOUT-US/COMMUNITYNEEDS

SCHEDULE H, PART V, SECTION B, LINE 10A
IMPLEMENTATION STRATEGY: HTTPS://WWW.HIGHLANDSHOSPITAL.ORG/ABOUT-US/COMMUNITYNEEDS

SCHEDULE H, PART V, SECTION B, LINE 11
ADDRESSING IDENTIFIED NEEDS: HIGHLANDS HOSPITAL DEVELOPED AN IMPLEMENTATION PLAN TO ADDRESS THE SIGNIFICANT NEEDS IDENTIFIED THROUGH ITS CHNA. AS WITH MOST HEALTH CARE FACILITIES, HIGHLANDS HOSPITAL HAS LIMITED FINANCIAL RESOURCES TO ADDRESS ALL ISSUES IDENTIFIED IN THE CHNA. IN CONJUNCTION WITH ITS 2021 COMMUNITY HEALTH NEEDS ASSESSMENT, HIGHLANDS HOSPITAL DEVELOPED A SYSTEM-WIDE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) TO GUIDE COMMUNITY BENEFIT AND POPULATION HEALTH IMPROVEMENT ACTIVITIES ACROSS THE HIGHLANDS' SERVICE AREA. HIGHLANDS' FOCUS WILL BE ON BEHAVIORAL HEALTH (INCLUDING AUTISM AND PTSD), CHRONIC DISEASE/DIABETES, WOMEN'S HEALTH, AND ACCESS TO CARE. HEALTH PRIORITY: BEHAVIORAL HEALTH GOAL: INCREASE ACCESS TO BEHAVIORAL HEALTH SERVICES WITH A FOCUS ON DEVELOPING BEST PRACTICES TO IDENTIFY, TREAT, AND REFER PATIENTS PRESENTING WITH BEHAVIORAL HEALTH CONCERNS. HEALTH PRIORITY: CHRONIC DISEASE/DIABETES GOAL: DECREASE PREVENTABLE CHRONIC DISEASE BY ENSURING ACCESS TO RESOURCES, KNOWLEDGE, AND OPPORTUNITIES FOR INDIVIDUALS TO ADOPT HEALTHY BEHAVIORS. GOAL: IMPROVE MANAGEMENT AND OUTCOMES FOR PATIENTS DIAGNOSED WITH DIABETES. HEALTH PRIORITY: WOMEN'S HEALTH GOAL: INCREASE ACCESS TO WOMEN'S HEALTH CARE SERVICES FOCUSING ON DEVELOPMENT AND IMPLEMENTATION OF BEST PRACTICE STANDARDS OF CARE WITH THE OVERALL GOAL OF IMPROVING HEALTH OUTCOMES FOR WOMEN AND FAMILIES. HEALTH PRIORITY: ACCESS TO CARE GOAL: IMPROVE INDIVIDUAL, COMMUNITY AND POPULATION HEALTH BY ADDRESSING SOCIAL DETERMINANTS THAT INCREASE BARRIERS TO HEALTHCARE AND CAUSE DISPARITIES IN HEALTH OUTCOMES.

SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, & 16C
FAP, FAP APPLICATION, PLAIN LANGUAGE SUMMARY: WWW.HIGHLANDSHOSPITAL.ORG/GENERAL-INFORMATION/CHARITY-CARE

SCHEDULE H, PART V, SECTION B, LINE 20E
OTHER EFFORTS: THE BILLING STATEMENT STATES THAT THERE IS A FAP AVAILABLE AND GIVES INFORMATION ON HOW TO CONTACT SOMEONE FOR THE APPLICATION.

SCHEDULE H, PART I, LINE 7, COLUMN F
PERCENT OF TOTAL EXPENSES: THE PERCENT OF TOTAL EXPENSES ON SCHEDULE H, PART I, LINE 7, COLUMN (F), WAS CALCULATED USING TOTAL EXPENSES ON FORM 990, PART IX, LINE 25, COLUMN (A).

SCHEDULE H, PART I, LINE 7
COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEET 1 AND 3.

SCHEDULE H, PART III, SECTION A, LINE 2
BAD DEBT EXPENSE METHODOLOGY: THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 014-09. 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, 2022. 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.

SCHEDULE H, PART III, SECTION A, LINE 3
BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE: BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING POVERTY LIMIT DEMOGRAPHIC INFORMATION OBTAINED THROUGH THE U.S. CENSUS BUREAU. THE MOST RECENT US CENSUS BUREAU INDICATES THAT 16.8 PERCENT OF FAYETTE COUNTY WAS CONSIDERED TO LIVE IN POVERTY.

SCHEDULE H, PART III, SECTION A, LINE 4
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 19 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.

SCHEDULE H, PART III, SECTION C, LINE 8
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. THE ORGANIZATION USES INFORMATION FROM THE MEDICARE COST REPORT TO COMPUTE THE MEDICARE ALLOWABLE COSTS OF CARE ON LINE 6.

SCHEDULE H, PART III, SECTION C, LINE 9B
COLLECTION POLICY: PATIENTS ARE NOT BILLED ONCE THEY ARE DETERMINED TO QUALIFY FOR CHARITY CARE.

SCHEDULE H, PART VI, LINE 2
NEEDS ASSESSMENT: DURING FISCAL YEAR 2022, HIGHLANDS HOSPITAL CONDUCTED A COUNTY-WIDE COMMUNITY NEEDS HEALTH ASSESSMENT (CHNA). THIS STUDY WAS CONDUCTED TO IDENTIFY THE HEALTH NEEDS AND ISSUES OF THE REGION AND TO PROVIDE USEFUL INFORMATION TO PUBLIC HEALTH AND HEALTH CARE PROVIDERS, POLICY MAKERS, COLLABORATIVE GROUPS, SOCIAL SERVICE AGENCIES, COMMUNITY GROUPS AND ORGANIZATIONS, CHURCHES, BUSINESSES, AND CONSUMERS WHO ARE INTERESTED IN IMPROVING THE HEALTH STATUS OF THE COMMUNITY AND REGION. THE RESULTS ENABLE THE MEDICAL CENTER, LOCAL HEALTH DEPARTMENT, AND OTHER PROVIDERS TO MORE STRATEGICALLY ESTABLISH PRIORITIES, DEVELOP INTERVENTIONS, AND COMMIT RESOURCES.

SCHEDULE H, PART VI, LINE 3
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: CHARITY CARE IS PROVIDED TO PATIENTS WITH A DEMONSTRATED INABILITY TO PAY. A PATIENT IS ELIGIBLE FOR CHARITY CARE CONSIDERATION BASED UPON MEETING CERTAIN INCOME ELIGIBILITY CRITERIA. HIGHLANDS HOSPITAL PROVIDES MEDICALLY NECESSARY TREATMENT TO ALL WHO SEEK IT, WITHOUT REGARD TO AGE, RACE, SEX, RELIGION, OR NATIONAL ORIGIN. HIGHLANDS HOSPITAL WILL PROVIDE FREE OR BELOW COST CARE TO THOSE PATIENTS WHO UPON COMPLETION OF PROPER APPLICATION ARE DETERMINED ELIGIBLE FOR SUCH DISCOUNTS. HOSPITAL STAFF PROVIDE CHARITY CARE INFORMATION TO PATIENTS UPON REGISTRATION AND INFORMATION IS INCLUDED IN ADMISSIONS PACKETS.

SCHEDULE H, PART VI, LINE 4
COMMUNITY INFORMATION: HIGHLANDS HOSPITAL PRIMARY SERVICE AREA COVERS THE COUNTIES OF FAYETTE AND WESTMORELAND. THE POPULATION IN BOTH FAYETTE AND WESTMORELAND COUNTIES HAS BEEN DECREASING AND IS PROJECTED TO CONTINUE TO DECREASE INTO 2026. THE COUNTIES ARE PREDOMINATELY CAUCASIAN AND THERE ARE SLIGHTLY MORE FEMALES. THE MEDIAN AGE IS SLIGHTLY HIGHER IN WESTMORELAND COUNTY (47.7 VS 45.5) AND IS PROJECTED TO INCREASE IN BOTH COUNTIES INDICATING THE POPULATION IS AGING. APPROXIMATELY HALF OF THE POPULATION IN EITHER COUNTY IS MARRIED WHILE ONE IN TEN ARE DIVORCED. JUST UNDER ONE THIRD OF RESIDENTS (29.5%) IN WESTMORELAND COUNTY HAVE A COLLEGE DEGREE, WHILE ONLY 17.7% OF THOSE IN FAYETTE ARE COLLEGE GRADUATES. THE AVERAGE HOUSEHOLD INCOME IS OVER $13,000 HIGHER IN WESTMORELAND COUNTY COMPARED TO FAYETTE COUNTY. MOST OF THE LABOR FORCE IN BOTH COUNTIES IS EMPLOYED, WITH APPROXIMATELY HALF OF THOSE EMPLOYED HOLDING WHITE COLLAR OCCUPATIONS. THE DEMOGRAPHICS OF THE COMMUNITY INCLUDES A HIGH PERCENTAGE OF ELDERLY AND LOW INCOME HOUSEHOLDS. MANY OF THESE RESIDENTS ARE UNINSURED AND UNDERINSURED RESULTING IN A HIGH PERCENTAGE OF UNCOMPENSATED CARE. THE POPULATION, ALSO, HAS A HIGH VOLUME OF CHRONIC ILLNESSES SUCH AS CORONARY DISEASE, DIABETES AND PULMONARY DISEASE.

SCHEDULE H, PART VI, LINE 5
PROMOTION OF COMMUNITY HEALTH: THE GOVERNING BOARD IS MADE UP OF INDIVIDUALS WHO LIVE AND/OR WORK IN THE COMMUNITY WHO VOLUNTEER THEIR TIME AND SERVICES TO ASSIST IN THE GOVERNANCE OF THE ORGANIZATION. MEDICAL STAFF IS OPEN TO ALL QUALIFIED PHYSICIANS WHO EXPRESS AN INTEREST TO JOIN. THE MEDICAL STAFF OPERATES INDEPENDENTLY OF THE ADMINISTRATIVE MANAGEMENT OF THE ORGANIZATION. THE ORGANIZATION CURRENTLY LACKS SURPLUS FUNDS. IT UTILIZES GRANTS AND CONTRIBUTIONS FOR THE ADVANCEMENT OF SERVICES AND IMPROVEMENTS.

SCHEDULE H, PART VI, LINE 6
AFFILIATED HEALTH CARE SYSTEM: PENN HIGHLANDS CONNELLSVILLE 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 DUBIOUS, PENN HIGHLANDS ELK, PENN HIGHLANDS CLEARFIELD, PENN HIGHLANDS TYRONE, PENN HIGHLANDS HUNTINGDON, AND PENN HIGHLANDS MON VALLEY. THE PENN HIGHLANDS HUNTINGDON PORTION OF THE PHH SYSTEM INCLUDES THE FOLLOWING ENTITIES AND OPERATIONS: -PENN HIGHLANDS HUNTINGDON PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT, EMERGENCY CARE SERVICES AND URGENT CARE SERVICES TO FURTHER THE HEALTH AND WELLNESS OF RESIDENTS IN HUNTINGDON, PENNSYLVANIA, AND SURROUNDING AREAS. -PENN HIGHLANDS HUNTINGDON FOUNDATION EARNS REVENUE THROUGH FUNDRAISING TO SUPPORT HEALTH CARE PROGRAMS OF PENN HIGHLANDS HUNTINGDON. THE PENN HIGHLANDS DUBOIS PORTION OF THE PHH SYSTEM INCLUDES THE FOLLOWING ENTITIES AND OPERATIONS: -DUBOIS REGIONAL MEDICAL CENTER (DRMC) PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES TO RESIDENTS IN DUBOIS, PENNSYLVANIA, AND SURROUNDING AREAS. -BROOKVILLE HOSPITAL (BROOKVILLE), A CRITICAL ACCESS HOSPITAL IN BROOKVILLE, PENNSYLVANIA. BROOKVILLE EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES. -BROOKVILLE INCLUDES BROOKCARE, A CORPORATION WHOSE PRIMARY BUSINESS IS TO RENT OFFICE SPACE TO PHYSICIANS AND VARIOUS DEPARTMENTS OF BROOKVILLE HOSPITAL. -JEFFCO HEALTH SERVICES, A POST-ACUTE HEALTHCARE SERVICE PROVIDER. -DUBOIS MEDICAL RISK RETENTION GROUP (DMRRG), PROVIDES LIABILITY INSURANCE TO DUBOIS COMPANIES AS WELL AS EMPLOYEE HEALTH INSURANCE FOR THE SYSTEM. DUBOIS IS THE SOLE MEMBER OF THE CLASS A VOTING AND PARTICIPATING CERTIFICATES OF DMRRG. -DUBOIS REGIONAL MEDICAL GROUP (DRMG), PROVIDES PRIMARY CARE AND SPECIALTY PHYSICIAN SERVICES. -WRC SENIOR SERVICES IS A HOUSING, HEALTHCARE, AND RESIDENT SERVICE PROVIDER IN WESTERN PENNSYLVANIA. -WRC PENNSYLVANIA MEMORIAL HOME, A CORPORATION THAT OWNS AND OPERATES A CONTINUING CARE RETIREMENT COMMUNITY. -WRC HEALTH CARE SUPPORTIVE SERVICES, A HOME AND COMMUNITY-BASED SERVICES PROVIDER. -WRC NORTH FORK HEIGHTS, A HOUSING PROJECT FOR LOW-INCOME ELDERLY INDIVIDUALS REGULATED BY THE UNITED STATES DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT (HUD). THE PENN HIGHLANDS ELK (ELK) PORTION OF THE PHH SYSTEM INCLUDES THE FOLLOWING ENTITIES AND OPERATIONS: -ELK REGIONAL HEALTH CENTER (ELK) PROVIDES PRIMARY ACUTE CARE MEDICAL SERVICES AT TWO CAMPUSES, THE ST. MARYS HEALTH CENTER IN ST. MARYS, PENNSYLVANIA, AND THE RIDGWAY HEALTH CENTER IN RIDGWAY, PENNSYLVANIA. -COMMUNITY NURSES, INC. AND SUBSIDIARIES (COMMUNITY NURSES), IS COMPRISED OF COMMUNITY NURSES HOME HEALTH AND HOSPICE, INC., WHICH PROVIDES SKILLED NURSING, PROFESSIONAL HOME HEALTH AND HOSPICE SERVICES, HOME HEALTH AIDE, PHYSICAL THERAPY, SPEECH THERAPY AND OCCUPATIONAL THERAPY; COMMUNITY NURSES HOME HEALTH SUPPORT SERVICES, INC., WHICH PROVIDES VARIOUS NONPROFESSIONAL HOME HEALTH RELATED SUPPORTIVE SERVICES, AND HELPMATES WHICH PROVIDES PRIVATE DUTY HOME COMPANION, RESPITE, PERSONAL CARE AND HOMEMAKER SERVICES. -ELK REGIONAL PROFESSIONAL GROUP, INC., IS COMPRISED OF VARIOUS PHYSICIAN PRACTICES. -ELCO HOUSING, INC., WAS FORMED TO OPERATE EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF AND TO CARRY OUT THE PURPOSES OF ELK BY SERVING AS A GENERAL PARTNER IN ELCO GLEN LIMITED PARTNERSHIP, THE PURPOSE OF WHICH IS TO ACQUIRE, CONSTRUCT, PROVIDE AND OPERATE RENTAL HOUSING AND RELATED FACILITIES SUITED TO THE NEEDS AND LIVING REQUIREMENTS OF ELIGIBLE OCCUPANTS AS DETERMINED BY THE FARMERS HOME ADMINISTRATION (FMHA). -ELK VENTURES, LLC (ELK VENTURES), A SINGLE MEMBER LLC OF ELK REGIONAL HEALTH CENTER, WAS FORMED TO OPERATE EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF AND TO CARRY OUT THE PURPOSES OF ELK. THE PENN HIGHLANDS CLEARFIELD (CLEARFIELD) PORTION OF THE PHH SYSTEM INCLUDES THE FOLLOWING ENTITIES AND OPERATIONS: -CLEARFIELD HOSPITAL PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES TO PATIENTS IN CLEARFIELD COUNTY AND THE SURROUNDING AREAS. -CLEARFIELD MEDICAL ASSOCIATES (CMA), OWNS AND OPERATES THE MEDICAL ARTS BUILDING LOCATED ON CLEARFIELD HOSPITAL'S CAMPUS. -CLEAR-CARE CORPORATION (CLEAR-CARE), PROVIDES MEDICAL EQUIPMENT TO CUSTOMERS. THE PENN HIGHLANDS TYRONE PORTION OF THE PHH SYSTEM INCLUDES THE FOLLOWING ENTITIES AND OPERATIONS: -TYRONE HOSPITAL WHICH PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE HOSPITAL SERVICES. -TYRONE FOUNDATION WHICH PROVIDES SUPPORT. THE PENN HIGHLANDS MON VALLEY PORTION OF THE PHH SYSTEM INCLUDED THE FOLLOWING ENTITIES AND OPERATIONS: -MON VALE HOSPITAL WHICH PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE HOSPITAL SERVICES. -MONONGAHELA VALLEY HOSPITAL FOUNDATION WHICH PROVIDES SUPPORT. THE PENN HIGHLANDS CONNELLSVILLE PORTION OF THE PHH SYSTEM INCLUDES THE FOLLOWING ENTITIES AND OPERATIONS: -HIGHLANDS HOSPITAL WHICH PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE HOSPITAL SERVICES; -HIGHLANDS FOUNDATION WITH PROVIDES SUPPORT.