Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 07-01-2010 and ending 06-30-2011
BCheck if applicable:
CName of organization
OHIO VALLEY GENERAL HOSPITAL
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
25 HECKEL ROAD
 
Room/suite
City or town, state or country, and ZIP + 4
MCKEES ROCKS, PA15136
D Employer identification number

25-0967480
E Telephone number

G Gross receipts $ 105,848,240
F Name and address of principal officer:
DAVID W SCOTT
25 HECKEL ROAD
MCKEES ROCKS,PA15136
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.OHIOVALLEYHOSPITAL.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1906
M State of legal domicile: PA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TAX-EXEMPT HOSPITAL SYSTEM DEDICATED TO SERVING THE GREATER PITTSBURGH COMMUNITY.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 15
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 15
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 658
6 Total number of volunteers (estimate if necessary) .... 6 112
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 176,345 226,632
9 Program service revenue (Part VIII, line 2g) ......... 58,364,495 62,249,990
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 5,432,395 4,110,081
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 854,144 360,359
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 64,827,379 66,947,062
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
14 Benefits paid to or for members (Part IX, column (A), line 4) .... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 27,989,599 26,141,350
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 37,539,917 40,952,783
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 65,529,516 67,094,133
19 Revenue less expenses. Subtract line 18 from line 12...... -702,137 -147,071
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 130,048,339 133,852,209
21 Total liabilities (Part X, line 26)............ 58,721,197 52,505,017
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 71,327,142 81,347,192
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: SINCE ITS BEGINNING IN 1906, PITTSBURGH'S OHIO VALLEY GENERAL HOSPITAL HAS NURTURED A COMMITMENT TO PROVIDE THE COMMUNITY WITH A PERSONALIZED APPROACH TO QUALITY HEALTH CARE. THIS DEDICATION HAS ESTABLISHED THE FOUNDATION FOR THE HOSPITAL TO GROW AND MEET THE COMMUNITY'S HEALTH CARE NEEDS WITH EXPANDED SERVICES, NEW PROGRAMS, AND ADVANCED TECHNOLOGY AND EDUCATION. THAT SAME TRADITION OF CARE AND COMMUNITY SERVICE WILL CONTINUE TO GUIDE US AS OHIO VALLEY GENERAL HOSPITAL MEETS THE CHALLENGES OF THE 21ST CENTURY.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 40,289,341 including grants of $ 0 ) (Revenue $ 62,364,187 )
OHIO VALLEY GENERAL HOSPITAL (THE"HOSPITAL") IS A NOT-FOR-PROFIT CORPORATION INCORPORATED UNDER THE LAWS OF THE COMMONWEALTH OF PENNSYLVANIA. THE HOSPITAL IS A TAX-EXEMPT CHARITABLE ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED (THE "CODE"), AND EXEMPT FROM FEDERAL INCOME TAXATION UNDER SECTION 501(A) OF THE CODE. THE HOSPITAL OWNS AND OPERATES:- A GENERAL ACUTE CARE HOSPITAL (THE "HOSPITAL");- THE RESIDENCE AT WILLOW HEIGHTS ("WILLOW HEIGHTS"), AN INDEPENDENT LIVING FACILITY;- THE RESIDENCE AT WILLOW LANE ("WILLOW LANE"), AN ASSISTED LIVING FACILITY (TOGETHER WITH WILLOW HEIGHTS, THE "SENIOR LIVING FACILITIES");- A SCHOOL OF NURSING; AND- A SCHOOL OF RADIOGRAPHY.LOCATED IN KENNEDY TOWNSHIP, PENNSYLVANIA, A SUBURBAN COMMUNITY ON THE SOUTH BANKS OF THE OHIO RIVER, APPROXIMATELY SEVEN MILES OF DOWNTOWN PITTSBURGH. THE HOSPITAL ALSO OPERATES A WOUND HEALING AND PAIN MANAGEMENT SERVICES AT TWO OFF-SITE LOCATIONS.THE HOSPITAL AND THE SENIOR LIVING FACILITIES SERVE RESIDENTS OF PITTSBURGH'S WESTERN SUBURBS, INCLUDING COMMUNITIES NEAR THE PITTSBURGH INTERNATIONAL AIRPORT. THE HOSPITAL IS LICENSED FOR 138 ACUTE-CARE BEDS HOUSED IN A BUILDING ORIGINALLY CONSTRUCTED IN 1949 (THE "HOSPITAL FACILITIES"). THE CAMPUS ON WHICH THE HOSPITAL FACILITIES ARE SITUATED (THE "CAMPUS") ALSO INCLUDES THE SCHOOL OF NURSING BUILDING, A MEDICAL OFFICE BUILDING (THE "MOB") AND, ACROSS HECKEL ROAD, THE SENIOR LIVING FACILITIES.SINCE ITS FOUNDING IN THE EARLY 1900S, THE HOSPITAL HAS FULFILLED A COMMUNITY COMMITMENT TO PROVIDE A PERSONALIZED APPROACH TO QUALITY HEALTH CARE TO RESIDENTS OF PITTSBURGH'S WESTERN SUBURBS. THIS DEDICATION HAS ESTABLISHED THE FOUNDATION FOR THE HOSPITAL TO GROW AND MEET THE COMMUNITY'S HEALTH CARE NEEDS WITH EXPANDED SERVICES, NEW PROGRAMS, ADVANCED TECHNOLOGY AND EDUCATION.WITH ITS CLOSE PROXIMITY TO THE CITY OF PITTSBURGH (THE "CITY"), THE HOSPITAL HAS THE UNIQUE ADVANTAGE OF A MEDICAL STAFF WHOSE SPECIALISTS PRACTICE AT BOTH THE HOSPITAL AS WELL AS AT TERTIARY-CARE HOSPITALS LOCATED IN THE CITY.FACILITIES AND SERVICESTHE HOSPITAL WAS ORGANIZED IN 1906 TO OWN AND OPERATE THE HOSPITAL AS A NON-SECTARIAN INSTITUTION. THE HOSPITAL, ORIGINALLY KNOWN AS MCKEES ROCKS GENERAL HOSPITAL, WAS FOUNDED, BUILT, EQUIPPED AND FURNISHED IN 1900 BY DR. SAMUEL M. BLACK ON A SITE IN STOWE TOWNSHIP, PENNSYLVANIA, OVERLOOKING THE BOROUGH OF MCKEES ROCKS. IN 1901, THE SCHOOL OF NURSING WAS INAUGURATED WITH SIX STUDENTS ENROLLED IN A TWO-YEAR COURSE. THE HOSPITAL OPERATED IN THIS ORIGINAL FACILITY UNTIL IT WAS REPLACED BY THE HOSPITAL FACILITIES, WHICH OPENED NEARBY IN 1949.THE HOSPITAL'S STRATEGIC PLANNING PROCESS IS DESIGNED TO ENABLE THE HOSPITAL TO RESPOND SWIFTLY AND EFFECTIVELY TO CHALLENGES AND OPPORTUNITIES PRESENTED BY THE HEALTH CARE NEEDS OF THE COMMUNITY. THE HOSPITAL'S STRATEGIC PLANNING PROCESS IS A COLLABORATIVE AND ONGOING EFFORT AMONG THE HOSPITAL'S GOVERNING BOARD, ITS MEDICAL STAFF LEADERSHIP AND ITS SENIOR ADMINISTRATIVE TEAM. THE STRATEGIC PLAN FEATURES THE FOLLOWING COMPONENTS: FACILITIES AND SERVICES DEVELOPMENT, PHYSICIAN DEVELOPMENT, AND COMMUNICATIONS AND THE DEVELOPMENT OF APPROPRIATE REIMBURSEMENT CONTRACTS WITH KEY THIRD PARTY PAYORS TO SUPPORT ITS MISSION OF SERVING THE HEALTH CARE NEEDS OF THE COMMUNITY.FACILITIES AND SERVICES DEVELOPMENTAS ANY INDEPENDENT COMMUNITY HOSPITAL LOCATED IN AN URBAN AREA, THE HOSPITAL RECOGNIZES THAT MAINTAINING AND EVEN IMPROVING ITS CAPABILITIES TO SERVE THE COMMUNITY IS PARAMOUNT. THE HOSPITAL'S RECENT FACILITIES AND SERVICES DEVELOPMENT INITIATIVES HAVE BEEN DESIGNED TO INCREASE THE BREADTH AND DEPTH OF THE ORGANIZATION'S SERVICE LINES.THE FOLLOWING ARE A FEW EXAMPLES OF NEW FACILITIES AND SERVICES THAT DEMONSTRATE THE HOSPITAL'S RESPONSE TO NEEDS AND OPPORTUNITIES IN THE COMMUNITY:- THE SENIOR LIVING FACILITIES (AS HEREINAFTER DEFINED) ENHANCED THE CONTINUUM OF CARE OFFERED BY THE HOSPITAL TO THE ELDERLY, A KEY CONSTITUENCY IN ITS COMMUNITY;- THE INPATIENT REHABILITATION UNIT REPLACED A TRANSITIONAL (SUB-ACUTE) CARE UNIT ADDRESSED A DEMONSTRATED NEED AMONG COMMUNITY AREA RESIDENTS;- THE CARDIAC CATHETERIZATION LABORATORY HAS GREATLY EXPANDED THE HOSPITAL'S DIAGNOSTIC CAPABILITIES AND ENABLES THE HOSPITAL TO ADMIT THOSE EMERGENCY DEPARTMENT PATIENTS NEEDING SUCH SERVICES;- THE WOUND CARE CENTER PROVIDES OPPORTUNITIES FOR PHYSICIANS TO EXPAND THE SCOPES OF THEIR PRACTICES IN THE CONTEXT OF A RECOGNIZED REGIONAL COMMUNITY LEADER FOR THESE HIGHLY SPECIALIZED SERVICES;- THE OPENING OF THE PULMONARY HEALTH CENTER IN 2003 ADDRESSED A DEFINED NEED AMONG COMMUNITY RESIDENTS WITH RESPIRATORY DISORDERS, PARTLY ATTRIBUTABLE TO THE RELATIVELY HIGH CONCENTRATION OF RETIREES FROM THE COAL, STEEL AND OTHER HEAVY INDUSTRIES.COMMUNICATIONSTHE HOSPITAL IS ENGAGED IN ONGOING EFFORTS TO ENHANCE THE HOSPITAL'S IMAGE IN THE COMMUNITIES IT SERVES. COMMUNITY ACTIVITIES INCLUDE: HEALTH FAIRS AND SCREENINGS, EDUCATIONAL SESSIONS AND ADVERTISING EFFORTS (INTERNET, PRINT, RADIO AND TELEVISION). HISTORICAL PERSPECTIVEUPON ITS OPENING IN 1949, THE HOSPITAL FACILITIES HAD A CAPACITY OF 130 BEDS AND 35 BASSINETS. SEVERAL FACILITIES IMPROVEMENT AND EQUIPMENT ACQUISITION PROJECTS HAVE BEEN COMPLETED AND NEW PROGRAMS INITIATED SINCE THEN IN THE YEARS INDICATED:- 1963 EXPANSION OF THE HOSPITAL FACILITIES FEATURING THE ADDITION OF 21 NEW BEDS AND NEW OPERATING ROOMS, AND THE RELOCATION OF ANCILLARY DEPARTMENTS TO FACILITATE GROWTH OF OUTPATIENT SERVICES;- 1978 ADDITION TO THE HOSPITAL FACILITIES FEATURING IMPROVEMENTS TO OUTPATIENT AND ANCILLARY DEPARTMENTS, AND THE ADDITION OF ANOTHER 27 BEDS;- 1987 INSTALLATION OF A CT SCANNER IN THE RADIOLOGY DEPARTMENT;- 1988 OPENING OF THE MOB;- 1987 - 1992 EXTENSIVE RENOVATIONS TO VARIOUS PATIENT FLOORS, THE NUCLEAR MEDICINE DEPARTMENT AND THE MAIN ENTRANCE AND LOBBY;- 1992 OPENING OF A 25,000 SQUARE-FOOT ADDITION TO THE SOUTH WING OF THE HOSPITAL FACILITIES WHICH PROVIDED SPACE FOR A CRITICAL CARE SUITE, CARDIOLOGY DEPARTMENT, RESPIRATORY THERAPY DEPARTMENT AND CARDIAC REHABILITATION UNIT;- 1992 OPENING OF THE WOUND CARE CENTER FOR THE SPECIALIZED TREATMENT OF CHRONIC WOUNDS, ONE OF THE FIRST PROGRAMS OF THIS TYPE IN WESTERN PENNSYLVANIA;- 1994 EXTENSIVE RENOVATIONS TO THE HOSPITAL FACILITIES' SECOND FLOOR WHICH PROMOTED THE CONSOLIDATION OF OUTPATIENT REGISTRATION AND NUMEROUS OUTPATIENT PROGRAMS IN A SINGLE LOCATION READILY ACCESSIBLE BY ELEVATED WALKWAY FROM THE MOB, AND WHICH ENCOMPASSED EXTENSIVE UPGRADES TO THE REHABILITATION SERVICES DEPARTMENT, THE LABORATORY AND THE RADIOLOGY DEPARTMENT;- 1997 COMPLETE REDESIGN OF THE EMERGENCY DEPARTMENT, INCLUDING THE INTERIOR PATIENT CARE AREAS, AS WELL AS THE EXTERIOR AMBULANCE AND AUTOMOBILE ACCESS ROADWAY;- 1999 CLOSURE OF THE HOSPITAL'S TRANSITIONAL (SUB-ACUTE) CARE UNIT TO MAKE WAY FOR A 15-BED INPATIENT REHABILITATION UNIT, WHICH WAS SUBSEQUENTLY EXPANDED TO 16 BEDS;- 2001 ESTABLISHMENT OF A CARDIAC CATHETERIZATION LABORATORY (THE "CATH LAB") WITH NEW STATE-OF-THE-ART EQUIPMENT;- 2001 OPENING OF THE HOSPITAL'S PAIN TREATMENT CENTER;- 2003 OPENING OF THE HOSPITAL'S PULMONARY HEALTH CENTER; AND- 2007 OPENING OF THE OBSTETRICS AND SURGICAL SERVICES WING.THE NEW MATERNITY & NURSERY UNIT INCLUDES:- 16,000 SQUARE FEET OF SPACE TO ACCOMMODATE GYNECOLOGICAL SURGERY;- TEN PRIVATE INPATIENT ROOMS FOR MATERNITY AND GYNECOLOGICAL SURGERY;- FOUR LABOR, DELIVERY AND RECOVERY ROOMS ("LDRS");- A SPECIALLY-EQUIPPED ROOM FOR PERFORMING CESAREAN SECTIONS; AND- A NEW NURSERY FEATURING A STATE-OF-THE-ART INFANT SECURITY SYSTEM.THE MATERNITY & NURSERY UNIT REPLACES A UNIT HOUSED IN THE ORIGINAL 1949 HOSPITAL FACILITIES. HOSPITAL MANAGEMENT BELIEVES THAT THIS INVESTMENT REFLECTS THE NEEDS AND DEMANDS OF COMMUNITY RESIDENTS, AND REPRESENTS A DEPARTURE FROM THE TREND BY MANY COMMUNITY HOSPITALS TO DISCONTINUE MATERNITY SERVICE.THE HOSPITAL FACILITIES' NEW SURGICAL SERVICES UNIT INCLUDES:- 16,000 SQUARE FEET OF SPACE THAT ENABLES THE CONSOLIDATION OF INPATIENT AND OUTPATIENT SURGERY, ENDOSCOPY AND RECOVERY AREAS ON A SINGLE FLOOR;- FOUR LARGER OPERATING ROOMS THAT ACCOMMODATES STATE-OF-THE-ART EQUIPMENT;- TWO SPECIAL ORTHOPAEDIC OPERATING ROOMS;- ONE CYSTOSCOPY ROOM FOR UROLOGICAL PROCEDURES; AND- INDIVIDUAL ROOMS FOR OUTPATIENTS INSTEAD OF OPEN-AREA "CORRALS" COMMONLY FOUND IN OTHER HOSPITALS, ALL IN A MORE PATIENT-FRIENDLY ENVIRONMENT.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 40,289,341
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part IIIClick to see attachment........................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
 
No
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. ..... Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II..
21
 
No
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III.....
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II........................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III............... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
Yes
 
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
161
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
658
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
15
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
15
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
 
No
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
 
No
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
PA
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
TADESSE TEFERA
25 HECKEL ROAD
MCKEES ROCKS,PA15136
(412) 777-6547
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) FRANK J CLEMENTS ESQ
DIRECTOR
 1.00 X           0 0 0
(2) JANE A DIXON
DIRECTOR
 1.00 X           0 0 0
(3) CHRISTOPHER G DONOHUE
DIRECTOR
 1.00 X           0 0 0
(4) SUSAN W KLIXBULL
DIRECTOR
 1.00 X           0 0 0
(5) ANTHONY F LISANTI
DIRECTOR
 1.00 X           0 0 0
(6) DANIEL B LONG
DIRECTOR
 1.00 X           0 0 0
(7) GARY G SAUER MD
DIRECTOR
 1.00 X           0 0 0
(8) CHARLES B SNYDER
DIRECTOR
 1.00 X           0 0 0
(9) VICTOR J THOMAS MD
DIRECTOR
 1.00 X           0 0 0
(10) MICHAEL E LALLY MD
PRESIDENT, MEDICAL STAFF
 1.00 X           0 0 0
(11) ANGELO D LUPARIELLO MD
PRESIDENT - ELECT, MEDICAL S
 1.00 X           0 0 0
(12) MARK R SCHOLL
CHAIRMAN
 1.00 X   X       0 0 0
(13) GENE M BATTISTELLA DO
VICE CHAIRMAN
 1.00 X   X       0 0 0
(14) MARK S BRENNAN
TREASURER
 1.00 X   X       0 0 0
(15) JOSEPH C CIRELLI
SECRETARY
 1.00 X   X       0 0 0
(16) DAVID W SCOTT
PRESIDENT AND CEO
 40.00     X       208,586 0 52,746
(17) TADESSE TEFERA
CFO
 40.00     X       128,960 0 32,840
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) THOMAS OSELLA
DIRECTOR - PHARMACY
 40.00         X   113,862 0 28,465
(19) VICTORIA MELL
DIRECTOR - HUMAN RESOURCE
 40.00         X   101,366 0 25,941
(20) DR HUWAIDA MANSOUR
PHYSICIAN
 40.00         X   185,850 0 46,462
(21) WILLIAM F PROVENZANO
FORMER - CEO
 40.00           X 439,768 0 192,485
(22) WILLIAM J DAY
FORMER - CFO
 40.00           X 131,020 0 32,755
















1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 1,309,412 0 411,694
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet7
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
TEDCO CONSTRUCTION COMPANY
TEDCO PLACE
CARNEGIE,PA15106 		CONSTRUCTION CONTRACTOR 2,714,954
REHAB CARE
PO BOX 502096
ST LOUIS,MO63150 		CARE PROVIDER 672,884
ARAMARK HEALTH CARE
25271 NETWORK PLACE
CHICAGO,IL60673 		CARE PROVIDER 656,248
NATIONAL HEALING CORPORATION
PO BOX 850001
ORLANDO,FL32885 		CARE PROVIDER 438,743
MEDITECH
PO BOX 74569
CHICAGO,IL60696 		SOFTWARE PROVIDER 395,833
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet57
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 186,933
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		39,699
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 226,632
Program Service Revenue Business Code
2a PATIENT REVENUE 621,400 56,817,988 56,817,988    
b NURSING/ASSISTED LIVIN 623,000 5,432,002 5,432,002    
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 62,249,990
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 1,051,959     1,051,959
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross Rents 806,983  
b Less: rental expenses 729,899  
c Rental income or (loss) 77,084  
d Net rental income or (loss).......MediumBullet 77,084     77,084
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 41,229,401  
b Less: cost or other basis and sales expenses 38,102,641 68,638
c Gain or (loss) 3,126,760 -68,638
d Net gain or (loss)..........MediumBullet 3,058,122     3,058,122
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a CAFETERIA 722,210 156,621     156,621
b NURSING ENTRANCE FEES 611,600 111,197 111,197    
c PURCHASE DISCOUNTS 900,099 90,890     90,890
d All other revenue .... -75,433 3,000   -78,433
e Total. Add lines 11a–11d ......MediumBullet 283,275
12 Total revenue. See Instructions....MediumBullet 66,947,062 62,364,187 0 4,356,243
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21    
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 423,132   423,132  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 20,146,023 12,224,584 7,921,439  
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 1,562,958 948,401 614,557  
9 Other employee benefits ....... 2,199,601 1,334,715 864,886  
10 Payroll taxes ........... 1,809,636 1,098,085 711,551  
11 Fees for services (non-employees):        
a Management ...... 1,303,837 791,167 512,670  
b Legal ......... 807,089 489,741 317,348  
c Accounting ........... 132,722 80,536 52,186  
d Lobbying ...........        
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ...... 274,470   274,470  
g Other .......... 6,966,588 4,227,317 2,739,271  
12 Advertising and promotion .... 583,705 354,192 229,513  
13 Office expenses ....... 11,045,831 6,702,598 4,343,233  
14 Information technology ......        
15 Royalties ..        
16 Occupancy ........... 3,354,135 2,035,285 1,318,850  
17 Travel ............ 65,257 39,598 25,659  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings ....        
20 Interest ........... 1,861,595 1,129,614 731,981  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 4,980,746 3,022,311 1,958,435  
23 Insurance .............. 2,455,410 1,489,940 965,470  
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a BAD DEBT 5,524,393 3,352,195 2,172,198 0
b MEDICAID ASSESSMENT 752,524 456,631 295,893 0
c EDUCATION AND RECRUITIN 313,741 190,378 123,363 0
d LICENSES AND DUES 276,872 168,006 108,866 0
e COLLECTION EXPENSE 95,469 57,930 37,539 0
f All other expenses 158,399 96,117 62,282  
25 Total functional expenses. Add lines 1 through 24f 67,094,133 40,289,341 26,804,792 0
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 3,637 1 4,437
2 Savings and temporary cash investments ....... 2,729,171 2 2,716,731
3 Pledges and grants receivable, net .........   3  
4 Accounts receivable, net ......... 5,028,778 4 5,145,623
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 718,892 8 786,056
9 Prepaid expenses and deferred charges ............ 525,259 9 605,773
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 117,017,895
b Less: accumulated depreciation. ..... 10b 54,184,834 62,065,428 10c 62,833,061
11 Investments—publicly traded securities .......... 49,519,931 11 50,213,985
12 Investments—other securities. See Part IV, line 11 ......   12  
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 9,457,243 15 11,546,543
16 Total assets. Add lines 1 through 15 (must equal line 34)... 130,048,339 16 133,852,209
Liabilities 17 Accounts payable and accrued expenses . 19,991,905 17 16,567,848
18 Grants payable ..........   18  
19 Deferred revenue .......... 554,486 19 401,293
20 Tax-exempt bond liabilities .......... 32,133,460 20 25,827,964
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties .. 6,041,346 23 9,396,932
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 0 25 310,980
26 Total liabilities. Add lines 17 through 25..... 58,721,197 26 52,505,017
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 71,182,671 27 81,162,707
28 Temporarily restricted net assets ..... 144,471 28 184,485
29 Permanently restricted net assets .....   29  
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 71,327,142 33 81,347,192
34 Total liabilities and net assets/fund balances ..... 130,048,339 34 133,852,209
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
66,947,062
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
67,094,133
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
-147,071
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
71,327,142
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
10,167,121
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
81,347,192
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
OHIO VALLEY GENERAL HOSPITAL
 
Employer identification number

25-0967480
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
OHIO VALLEY GENERAL HOSPITAL
 
Employer identification number

25-0967480
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule—
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
OHIO VALLEY GENERAL HOSPITAL
  		Employer identification number

25-0967480
Part I
Contributors (see Instructions)
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
OHIO VALLEY GENERAL HOSPITAL
  		Employer identification number

25-0967480
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
OHIO VALLEY GENERAL HOSPITAL
  		Employer identification number

25-0967480
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
OHIO VALLEY GENERAL HOSPITAL
 
Employer identification number

25-0967480
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c) except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities ....................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2010

Schedule C (Form 990 or 990-EZ) 2010
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
Organization's
Totals 		(b) Affiliated Group
Totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) Total
             
2a Lobbying non-taxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots non-taxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2010


Schedule C (Form 990 or 990-EZ) 2010
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? If "Yes," describe in Part IV ..........................
Yes
 
1,800
j
Total. lines 1c through 1i ...................................
1,800
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: OHIO VALLEY GENERAL HOSPITAL (OVGH) IS A MEMBER OF THE HOSPITAL COUNCIL OF WESTERN PA (HCWPA) & THE AMERICAN HOSPITAL ASSOCIATION (AHA). DURING THE FISCAL YEAR ENDING JUNE 30, 2011, OVGH PAID $12,000 IN DUES TO THE HCWPA AND $0 TO THE AHA. THE PORTION OF DUES ALLOCABLE TO LOBBYING ACTIVITIES WERE $1,800 & $0 RESPECTIVELY.
Schedule C (Form 990 or 990EZ) 2010

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
OHIO VALLEY GENERAL HOSPITAL
 
Employer identification number

25-0967480
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance ....      
b Contributions ........      
c Investment earnings or losses ...      
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		     
f Administrative expenses ....      
g End of year balance ......      
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet  
c
Term endowment: SchDMd Bullet  
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   24,010 24,010
b Buildings ................   72,022,073 27,390,972 44,631,101
c Leasehold improvements ............        
d Equipment ................   37,287,672 25,229,473 12,058,199
e Other .................   7,684,140 1,564,389 6,119,751
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 62,833,061
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) DEFERRED FINANCING COSTS 742,360
(2) DUE FROM AFFILIATES 9,504,937
(3) ESTIMATED THIRD PARTY-PAYOR SETTLEMENTS 1,299,246






Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 11,546,543
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  
DERIVATIVE FINANCIAL INSTRUMENTS 310,980








Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 310,980
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1  
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2  
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3  
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8  
9 Total adjustments (net). Add lines 4 - 8 ............................. 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10  
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5  
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5  
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE CORPORATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD IS MET. MANAGEMENT DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2011. THE CORPORATION'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN OPERATING EXPENSES. THE CORPORATION'S FEDERAL INCOME TAX AND INFORMATIONAL RETURNS FOR 2010, 2009, AND 2008 REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
OHIO VALLEY GENERAL HOSPITAL
 
Employer identification number

25-0967480
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Does the organization have a charity care policy? If "No," skip to question 6a...........
1a
Yes
 
b
If "Yes," is it a written policy? .......................
1b
Yes
 
2
If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.
3
Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.
a
Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low
income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If
"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....
3b
 
No
c
If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Does the organization's policy provide free or discounted care to the "medically indigent"? ......
4
Yes
 
5a
Does the organization budget amounts for free or discounted care provided under its charity care policy? ...
5a
Yes
 
b
If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............
5c
 
No
6a
Does the organization prepare an annual community benefit report?.............
6a
Yes
 
6b
If "Yes," does the organization make it available to the public? ..............
6b
 
No
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Charity Care and Certain Other Community Benefits at Cost
Charity Care and
Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Charity care at cost (from
Worksheets 1 and 2) .. 		    95,584   95,584 0.140 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) . 		    5,357,649 2,892,699 2,464,950 3.670 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....            
dTotal Charity Care and
Means-Tested Government Programs ..... 		    5,453,233 2,892,699 2,560,534 3.810 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		9 4,260 25,776 5,367 20,409 0.030 %
f Health professions education
(from Worksheet 5) .. 		11 180 417,922 400 417,522 0.620 %
g Subsidized health services
(from Worksheet 6) .. 		    4,470,708 3,467,432 1,003,276 1.500 %
h Research (from Worksheet 7)            
i Cash and in-kind contributions
to community groups
(from Worksheet 8) .. 		    4,875   4,875 0.010 %
jTotal Other Benefits ... 20 4,440 4,919,281 3,473,199 1,446,082 2.160 %
kTotal. Add lines 7d and 7j. .. 20 4,440 10,372,514 6,365,898 4,006,616 5.970 %
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 2
Part II
Community Building Activities Complete this table if the organization conducted any community building activities.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development 1 33 917   917 0 %
9 Other            
10 Total 1 33 917   917  
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense (at cost).....
2
1,561,783
3
Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..
3
291,076
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
11,155,462
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
11,753,967
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-598,505
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:
Section C. Collection Practices
9a
Does the organization have a written debt collection policy? ...............
9a
Yes
 
b
If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......
9b
Yes
 
Part IV
Management Companies and Joint Ventures
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 3
Part VFacility Information
Section A. Hospital Facilities
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many hospital facilities did the organization operate during the tax year?1
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 OHIO VALLEY GENERAL HOSPITAL
25 HECKEL ROAD
MCKEES ROCKS,PA15136 		X X   X     X    
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:NA
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8    
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9    
If “Yes,” indicate the FPG family income limit for eligibility for free care:   %
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10    
If “Yes,” indicate the FPG family income limit for eligibility for discounted care:   %
11 Explained the basis for calculating amounts charged to patients?................. 11    
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12    
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13    
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14    
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16    
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18    
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20    
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21    
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 7
Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many non-hospital facilities did the organization operate during the tax year?6
Name and address Type of Facility (Describe)
1 THE RESIDENCE AT WILLOW LANE
15 HECKEL ROAD
MCKEES ROCKS,PA15136 		ASSISTED LIVING
2 THE RESIDENCE AT WILLOW LANE
15 HECKEL ROAD
MCKEES ROCKS,PA15136 		ASSISTED LIVING
3 THE RESIDENCE AT WILLOW LANE
15 HECKEL ROAD
MCKEES ROCKS,PA15136 		ASSISTED LIVING
4 THE RESIDENCE AT WILLOW LANE
15 HECKEL ROAD
MCKEES ROCKS,PA15136 		ASSISTED LIVING
5 THE RESIDENCE AT WILLOW LANE
15 HECKEL ROAD
MCKEES ROCKS,PA15136 		ASSISTED LIVING
6 THE RESIDENCE AT WILLOW LANE
15 HECKEL ROAD
MCKEES ROCKS,PA15136 		ASSISTED LIVING
7
8
9
10
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 8
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2 Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
    PART I, LINE 3C: OHIO VALLEY GENERAL HOSPITAL USES THE FEDERAL POVERTY GUIDELINES BASED AT 150% OF THE FPG TO DETERMINE ELIGIBILITY FOR THE OHIO VALLEY CARES PROGRAM FOR FREE CARE. WE DO NOT CURRENTLY OFFER DISCOUNTED CARE.
    PART I, LINE 7: THE HOSPITAL USED WORKSHEET 2 OF THE FORM 990, SCHEDULE H INSTRUCTIONS TO CALCULATE THE COST TO CHARGE RATIO. THE EDUCATION DEPARTMENT DIRECT EXPENSES WERE DIVIDED BY THE TOTAL EDUCATION DEPARTMENT EXPENSES TO CALCULATE THE INDIRECT EXPENSE PERCENT FOR LINE 7(F).THE GENERAL SERVICES COST CENTER DIRECT EXPENSES WERE DIVIDED BY TOTAL EXPENSES OF THAT COST CENTER TO CALCULATE THE INDIRECT EXPENSES FOR LINE 7(E).
    PART I, L7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN A THAT WAS REMOVED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN SCHEDULE H, PART I, LINE 7, COLUMN (F) WAS $5,524,393.
    PART II: THE HOSPITAL HAS PROMOTED THE HEALTH OF THE COMMUNITY FOR OVER 100 YEARS. THE SCHOOLS OF NURSING AND RADIOLOGY HAVE BOTH SUPPLIED HEALTH CARE PROFESSIONALS FOR THE AREA AND HAVE BEEN THE SOURCE OF SATISFYING CAREERS FOR MANY IN THE COMMUNITY.
    PART III, LINE 4: ACCOUNTS RECEIVABLE ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. THE ALLOWANCE FOR DOUBTFUL COLLECTIONS IS ESTIMATED BASED UPON A PERIODIC REVIEW OF THE ACCOUNTS RECEIVABLE AGING, PAYOR CLASSIFICATIONS, AND APPLICATION OF HISTORICAL WRITE-OFF PERCENTAGES.BAD DEBT EXPENSE IS LISTED ON THE STATEMENT OF OPERATIONS AS THE PROVISION FOR DOUBTFUL COLLECTIONS AND REPRESENTS THE AMOUNT WRITTEN OFF THAT PATIENTS COULD PAY BUT CHOOSE NOT TO PAY.WORKSHEET 2 OF THE IRS FORM 990, SCHEDULE H INSTRUCTIONS WAS USED TO CALCULATE THE COST-TO-CHARGE RATIO THAT WAS MULTIPLIED BY THE BAD DEBT EXPENSE AT CHARGES TO DETERMINE COST.BAD DEBT EXPENSE INCURRED BY THE HOSPITAL SHOULD BE CONSIDERED A BENEFIT FOR THOSE IN THE COMMUNITY WHO RECEIVE SERVICES. AS A NOT-FOR-PROFIT HOSPITAL, OHIO VALLEY SERVES ALL PATIENTS; THAT IS THE HOSPITAL'S MISSION AND IS WHAT DIFFERENTIATES OHIO VALLEY GENERAL HOSPITAL FROM FOR-PROFIT HOSPITALS.IF PATIENTS PAY A PORTION OF THEIR BALANCE, ANY REMAINING AMOUNT WOULD BE SENT OUT FOR COLLECTION (BAD DEBT) PER THE HOSPITAL'S NORMAL BAD DEBT PROCESS.
    PART III, LINE 8: OVER 50 PERCENT OF OHIO VALLEY GENERAL HOSPITAL PATIENTS ARE MEDICARE RECIPIENTS. THIS IS A DEMONSTRATED NEED OF THE COMMUNITY. MEDICARE'S PARTICIPATION AT OVGH MEETS A COMMUNITY BENEFIT OBJECTIVE, BECAUSE THE PATIENT POPULATION INCLUDES VULNERABLE AND UNDERSERVED MEDICARE PATIENTS. SINCE THE SERVICE PROVIDED MEETS THE DEFINITION OF A COMMUNITY BENEFIT, THE SHORTAGE IN ITEM 7 SHOULD BE CONSIDERED A COMMUNITY BENEFIT. THE HOSPITAL PROVIDES CARE FOR ALL MEDICARE PATIENTS, EVEN THOUGH IT IS NOT REIMBURSED BY MEDICARE FOR ALL MEDICARE BENEFICIARIES.THE AMOUNTS ABOVE WERE TAKEN DIRECTLY FROM THE MEDICARE COST REPORT.
    PART III, LINE 9B: ALL PATIENTS PRESENTING WITH NO INSURANCE OR LIMITED COVERAGE ARE PROVIDED WITH THE GUIDELINES FOR THE OHIO VALLEY CARE PROGRAM. PATIENTS CAN QUALIFY FOR FREE CARE BASED ON THE INFORMATION THEY PROVIDE. IF A PATIENT IS PLACED INTO A BAD DEBT STATUS THEY MAY STILL ESTABLISH INDIGENCE AT ANY TIME AND BE COMPATIBLE WITH THE OHIO VALLEY CARE PROGRAM POLICY AND PROCEDURE GUIDELINES. DOCUMENTATION SUPPORTING THE DETERMINATION OF INDIGENCE WILL BE AVAILABLE UPON REQUEST. THE DOCUMENTATION WILL INCLUDE NOTES ON THE PATIENT'S ACCOUNT IN OUR PATIENT ACCOUNTING SYSTEM AND OTHER INFORMATION THAT CAN BE RETRIEVED AS NEEDED TO SUPPORT THE INDIGENCE STATUS OF THE PATIENT OR RESPONSIBLE PARTY.IF AN ACCOUNT QUALIFIES FOR INDIGENCE THE DEBT MAY BE DEEMED UNCOLLECTIBLE WITHOUT APPLYING ANY FURTHER COLLECTION EFFORTS. THERE WILL NOT BE ANY OTHER LEGAL SOURCE OF RESPONSIBILITY FOR PAYMENT.
    PART VI, LINE 2: THE BOARD MEMBERS AND HOSPITAL ADMINISTRATORS RECEIVE INPUT FROM COMMUNITY MEMBERS CONCERNING THEIR NEEDS. THE HOSPITAL HAS A COMMUNITY BENEFIT COMMITTEE THAT IS UNDERTAKING A COMMUNITY NEEDS ASSESSMENT. THE HOSPITAL HAS "SENIORITY" CLUB, EDUCATIONAL MEETINGS, AND RECEIVES INPUT FROM THE COMMUNITY.
    PART VI, LINE 3: THE CHARITY CARE POLICY (OHIO VALLEY CARES) AND FINANCIAL ASSISTANCE CONTACT INFORMATION IS AVAILABLE IN THE ADMISSION AREA, THE EMERGENCY ROOM, OUTPATIENT REGISTRATION AND OTHER AREAS OF THE ORGANIZATION IN WHICH PATIENT ARE LIKELY TO BE PRESENT. INTERPRETATION SERVICES ARE AVAILABLE FOR NON-ENGLISH SPEAKING INDIVIDUALS.OHIO VALLEY GENERAL HOSPITAL (OVGH) PROVIDES FINANCIAL COUNSELING TO THOSE IN NEED. OUR POLICY FOR THE PURPOSE OF PROVIDING INPATIENT AND/OR OUTPATIENT SERVICES TO THE INDIGENT STATES:THE FINANCIAL COUNSELOR WILL IDENTIFY PATIENTS AND/OR GUARANTORS THAT MAY QUALIFY FOR CHARITY CARE RELIEF IN ADDITION TO DISCUSSING THE ALTERNATIVE OF PUBLIC ASSISTANCE.THERE ARE TWO (2) OUTSIDE VENDORS THAT ARE AVAILABLE TO ASSIST PATIENTS IN THE APPLICATION PROCESS FOR PUBLIC ASSISTANCE.THE FINANCIAL COUNSELOR WILL CONDUCT A PRIVATE INTERVIEW WITH THE PATIENT AND/OR GUARANTOR AND DISCUSS THE CHARITY ALTERNATIVE AND PARAMETERS. THE FINANCIAL COUNSELOR WILL DISTRIBUTE THE CHARITY CARE APPLICATION AND ASSIST IN ITS COMPLETION AS NECESSARY. THEY WILL FURTHER REQUEST:1. THE MOST RECENT IRS TAX RETURN AND W-2 PROOF OF NON-FILING STATUS2. COPIES OF THE APPLICANTS MOST RECENT PAY STUBS, IF APPROPRIATE3. DENIAL NOTICE RECEIVED FROM MEDICAL ASSISTANCE, IF APPROPRIATETHE FINANCIAL COUNSELOR WILL REFER THE COMPLETED CHARITY CARE APPLICATION AND ANY/ALL ATTACHMENTS TO THE DIRECTOR OF PATIENT FINANCIAL SERVICES FOR REVIEW AND PROCESSING OF THE REQUEST. THE FINANCIAL COUNSELOR WILL ENTER COMMENTS THAT CONVEY ANY AND ALL ACTIONS TAKEN IN THE NOTES FEATURE OF THE HOSPITAL PATIENT ACCOUNTING SYSTEM. THE DIRECTOR OF PATIENT FINANCIAL SERVICES WILL DETERMINE THE CHARITY CARE ELIGIBILITY BASED ON FEDERAL POVERTY GUIDELINES AND:1. INCOME LEVEL2. FAMILY SIZEAN ALTERNATIVE METHOD IS TO HAVE ALL SELF PAY ACCOUNTS AND BALANCES AFTER INSURANCE PROCESSED THROUGH A PRESUMPTIVE CHARITY CARE ANALYSIS TOOL TO DETERMINE ELIGIBILITY BASED ON OVGH GUIDELINES OR IN ACCORDANCE WITH FORM 990 SCHEDULE H LANGUAGE.
    PART VI, LINE 4: OVGH IS PART OF THE HIGHLY COMPETITIVE PITTSBURGH, PENNSYLVANIA HEALTH CARE ENVIRONMENT. MANY OF THE HOSPITALS ARE INTERNATIONALLY RECOGNIZED. OVGH SERVES A MIX OF FIFTEEN SMALL, URBAN AND SUBURBAN COMMUNITIES IN ITS PRIMARY SERVICE AREA. SMALL MANUFACTURING AND OTHER BUSINESSES HAVE REPLACED THE LARGE STEEL MILLS. OVGH IS LOCATED IN MCKEES ROCKS, PENNSYLVANIA WHICH IS ITS PRIMARY SERVICE AREA. OVGH ALSO SERVES SURROUNDING COMMUNITIES WHICH INCLUDE: KENNEDY TWP, ROBINSON TOWNSHIP, MOON TOWNSHIP, CRAFTON, CORLISS, NORTH FAYETTE, MCDONALD, CORAOPOLIS, SEWICKLEY, BELLVUE, AVONWORTH, AND OHIO TOWNSHIP. THE COMMUNITIES MENTIONED ABOVE PROVIDE A LARGE CROSS SECTION OF SOCIO-ECONOMIC CLASSES AND A WIDE RANGE OF ETHNIC AND CULTURAL DIVERSITY AS WELL.THE POPULATION AND BIRTH RATE IN THE AREA IS DECLINING. 8.5% OF RESIDENTS HAVE NO HEALTH INSURANCE (2007). THERE ARE HIGH MEDICARE AND MEDCAID POPULATIONS AND THE 9.5 RATE OF DIABETES IS ABOVE THE NATIONAL AVERAGE. THE AREA OBESITY RATE IS 28.2 (2009), HIGHER THAN THE BENCHMARK AVERAGE OF 27 THAT MOST CITIES ARE TRYING TO REDUCE TO. HEART ATTACK RATES ARE 31.7 (2005), ABOVE THE NATIONAL AVERAGE OF 30.1. HEART DISEASE HAS LONG BEEN THE NUMBER ONE CAUSE OF DEATH IN THE AREA FOR MANY YEARS. THE POVERTY RATE WAS 11.2% FOR INDIVIDUALS PRIOR TO THE 2008 DOWNTURN IN THE ECONOMY.OVGH RETAINS MEMBERSHIP IN MANY COMMUNITY BASED ORGANIZATIONS SUCH AS THE MCKEES ROCKS ROTARY, FOR (FOCUS ON RENEWAL), THE WESTERN AREA YMCA, THE PARKWAY WEST ROTARY, AND THE AIRPORT AREA CHAMBER OF COMMERCE TO NAME A FEW.OVGH PROVIDES MANY PROGRAMS AS COMMUNITY OUTREACH RESOURCES TO PROACTIVELY PROMOTE HEALTHY LIFESTYLES. BY TAKING A PROACTIVE APPROACH TO HEALTHY LIFESTYLES, OVGH NOT ONLY PROVIDES MUCH NEEDED SERVICES TO ITS COMMUNITIES BUT IT ALSO ALLOWS US TO INTERACT WITH ITS CONSTITUENTS AND ASSESS WHAT THEIR NEEDS ARE ON AN ONGOING BASIS. SOME OF THE SERVICES PROVIDED SOLELY BY OVGH ARE: AN EMERGENCY DEPARTMENT OPEN TO ALL PERSONS REGARDLESS OF RACE, COLOR, SEX OR CREED, OR ABILITY TO PAY. OPERATES AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS, DIABETIC EDUCATION AND TRAINING, SAFE HAVEN, ORTHOPEDIC EDUCATION PROGRAMS, CONTINUOUS EDUCATION PROGRAMS FOR EMT'S AND PARAMEDICS, INDEPENDENT, ASSISTED AND MEMORY CARE UNITS, CARDIAC REHAB AND OCCUPATIONAL REHAB AND MEDICINE. ADDITIONALLY, OVGH RUNS A SCHOOL OF NURSING THAT IS A 20 MONTH DIPLOMA PROGRAM FOR RN AND A 24 MONTH CERTIFICATE PROGRAM FOR RADIOLOGIC TECHNOLOGY.
    PART VI, LINE 6: THE HOSPITAL PROMOTES THE HEALTH OF THE COMMUNITY BY IDENTIFYING, CONSTRUCTING FACILITIES AND STARTING NEW PROGRAMS, SUCH AS MEMORY CARE AND GEROPSYCH THAT WILL HELP THE COMMUNITY AND IMPROVE PATIENT CARE. THE HOSPITAL EXTENDS MEDICAL PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY.THIRTY-TWO PERCENT OF THE MEMBERS OF THE BOARD OF DIRECTORS LIVE IN THE HOSPITAL'S PRIMARY SERVICE AREA. THE HOSPITAL'S EMERGENCY DEPARTMENT IS OPEN 24 HOURS PER DAY. PAIN AND WOUND CARE DEPARMENTS SERVE THE COMMUNITY IN TWO SITES OFF THE HOSPITAL CAMPUS.THERE ARE NO BOARD MEMBERS THAT ARE EMPLOYEES AND NO BOARD MEMBER'S FAMILY MEMBERS THAT ARE ON THE BOARD OR ARE EMPLOYEES.THE HOSPITAL CEO, CFO, DON, HR DIRECTOR AND DIRECTOR OF OUTPATIENT PHYSICIAN SERVICES RECOMMEND TO THE BOARD IMPROVEMENTS IN PATIENT CARE. FOR EXAMPLE, THE ORTHOPEDIC CENTER. ANY 'SURPLUS' FUNDS ARE USED FOR PATIENT CARE ENHANCEMENTS, EXEMPLIFIED BY ALL OF THE CONSTRUCTION THAT HAS BEEN UNDERTAKEN IN RECENT YEARS.
    PART VI, LINE 7: N/A
  FORM 990, PART VI, LINE 7: THE ORGANIZATION IS NOT REQUIRED TO FILE A COMMUNITY BENEFIT REPORT WITH ANY STATE.
Schedule H (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
OHIO VALLEY GENERAL HOSPITAL
 
Employer identification number

25-0967480
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
Yes
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) DAVID W SCOTT (i)
(ii)		 208,586
0 		0
0 		0
0 		10,790
0 		41,956
0 		261,332
0 		0
0
(2) TADESSE TEFERA (i)
(ii)		 128,960
0 		0
0 		0
0 		0
0 		32,840
0 		161,800
0 		0
0
(3) DR HUWAIDA MANSOUR (i)
(ii)		 185,850
0 		0
0 		0
0 		0
0 		46,462
0 		232,312
0 		0
0
(4) WILLIAM F PROVENZANO (i)
(ii)		 439,768
0 		0
0 		0
0 		104,167
0 		88,318
0 		632,253
0 		0
0
(5) WILLIAM J DAY (i)
(ii)		 131,020
0 		0
0 		0
0 		0
0 		32,755
0 		163,775
0 		0
0











Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
  PART I, LINE 1A OHIO VALLEY GENERAL HOSPITAL PAID THE LOCAL COUNTRY CLUB MEMBERSHIP DUES FOR THE HOSPITAL'S FORMER CEO. THESE DUES OF $2,390 ARE INCLUDED IN THE FORMER CEO'S TAXABLE INCOME.
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
OHIO VALLEY GENERAL HOSPITAL
 
Employer identification number
25-0967480
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A ALLEGHENY COUNTY HOSPITAL DEVELOPMENT AUTHORITY
  		25-1327925 01728AZG4 05-29-2003 9,319,477 CAPITAL IMPROVEMENTS & EQUIPMENT FOR SCHOOL OF NURSING   X   X   X
B ALLEGHENY COUNTY HOSPITAL DEVELOPMENT AUTHORITY
  		25-1327925 01728AB88 04-21-2005 23,500,623 CONSTRUCTION OF MED SURG & OB GYN WING   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . .        
2 Amount of bonds defeased . . . .        
3 Total proceeds of issue . . . . 9,145,000 23,500,623    
4 Gross proceeds in reserve funds . .        
5 Capitalized interest from proceeds. 1,004,091 1,004,091    
6 Proceeds in refunding escrow. . . . .        
7 Issuance costs from proceeds . . . 159,428 376,938    
8 Credit enhancement from proceeds.        
9 Working capital expenditures from proceeds . .        
10 Capital expenditures from proceeds . . 8,985,572 23,493,062    
11 Other spent proceeds . .        
12 Other unspent proceeds. . .        
13 Year of substantial completion . . . 2003 2008
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue?   X   X        
15 Were the bonds issued as part of an advance refunding issue?   X   X        
16 Has the final allocation of proceeds been made? . . X   X          
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . X   X          
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X   X        
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . .   X   X        
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use?   X   X        
b Are there any research agreements that may result in private business use of bond-financed property? . .   X   X        
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? . X   X          
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet 0 % 0 %    
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet 0 % 0 %    
6 Total of lines 4 and 5 . . .. . . . . . 0 % 0 %    
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X   X          
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X        
2 Is the bond issue a variable rate issue?   X   X        
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X   X        
b Name of provider .  
  		 
  		 
  		 
 
c Term of hedge . .        
d Was the hedge superintegrated? .                
e Was a hedge terminated? .                
4a Were gross proceeds invested in a GIC? .   X   X        
b Name of provider .  
  		 
  		 
  		 
 
c Term of GIC . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? .                
5 Were any gross proceeds invested beyond an available temporary period? .   X   X        
6 Did the bond issue qualify for an exception to rebate? . . .   X   X        
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
Schedule K (Form 990) 2010

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
OHIO VALLEY GENERAL HOSPITAL
 
Employer identification number

25-0967480
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2010
Schedule L (Form 990 or 990-EZ) 2010
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) DR DAVID A PROVENZANO SON OF FORMER CEO, WILLIAM PROVENZANO 665,723 DAVID PROVENZANO IS AN EMPLOYEE AND MEDICAL DIRECTOR OF OHIO VALLEY ANESTHESIA/PAIN MANAGEMENT (A RELATED ORGANIZATION).   No
(2) DR DANA DELLAPIAZZO DAUGHTER IN LAW OF FORMER CEO, WILLIAM PROVENZANO 111,526 DANA DELLAPIAZZO IS AN ANESTHESIOLOGIST FOR OHIO VALLEY ANESTHESIA SERVICES, INC. (A RELATED ORGANIZATION).   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
OHIO VALLEY GENERAL HOSPITAL
 
Employer identification number

25-0967480
Identifier Return Reference Explanation
NEW PROGRAM SERVICES FORM 990, PART III, LINE 2 WILLOW BROOK PROVIDES SHORT-TERM (8-10 DAYS) INPATIENT SERVICES TO ADULTS AGE 65+ WHO HAVE MENTAL HEALTH NEEDS. IT IS RECOVERY-CENTERED IN ITS APPROACH AND STRIVES TO HELP INDIVIDUALS TO NOT ONLY ADDRESS THEIR MENTAL HEALTH NEEDS, BUT ALSO RECONNECT WITH THEIR HOPES AND PERSONAL MOTIVATIONS. ITS GOAL IS TO PROVIDE A SAFE, THERAPEUTIC ENVIRONMENT WHICH ALLOWS PEOPLE TO MAINTAIN AS MUCH NORMALCY IN THEIR EVERYDAY ROUTINES AS POSSIBLE. THE TEAM OF THE GEROPSYCHIATRIC UNIT WILL WORK IN TANDEM WITH OHIO VALLEY GENERAL HOSPITAL'S MEDICAL SERVICES TO ENSURE THAT BOTH MEDICAL AND PSYCHIATRIC NEEDS ARE ADDRESSED SIMULTANEOUSLY AND COHESIVELY. WILLOW BROOK IS STAFFED BY A MULTIDISCIPLINARY TEAM AND OFFERS COMPREHENSIVE SERVICES, INCLUDING: ASSESSMENT AND DIAGNOSIS; MEDICATION MANAGEMENT AND PHYSICAL NURSING SUPPORT; PRIMARY THERAPY; COMMUNITY, FAMILY GROUP THERAPIST; REHABILITATION SUPPORT; GROUP WORK AND GROUP ACTIVITIES; AND DISCHARGE PLANNING TO HELP OLDER ADULTS AND THEIR FAMILIES PREPARE TO RETURN TO THE COMMUNITY. THE 21-BED UNIT HAS BOTH PRIVATE AND SEMI-PRIVATE ROOMS.
FORM 990, PART VI, SECTION B, LINE 11   A DRAFT OF THE FORM 990 IS PRESENTED TO THE FINANCE COMMITTEE FOR ITS PRELIMINARY APPROVAL AND THEN TO THE BOARD OF DIRECTORS FOR FINAL APPROVAL BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE (IRS). THE BOARD OF DIRECTORS APPROVES THE FINAL DRAFT OF THE FORM 990 BEFORE IT IS FILED WITH IRS.
  FORM 990, PART VI, SECTION B, LINE 12C EVERY YEAR THE SECRETARY OF THE BOARD OF DIRECTORS OF OHIO VALLEY GENERAL HOSPITAL ("OVGH") DISTRIBUTES TO THE BOARD OF DIRECTORS AND HOSPITAL MANAGEMENT THE CONFLICT OF INTEREST POLICY. EACH RECIPIENT MUST LIST ANY POSSIBLE CONFLICT, SIGN AND RETURN THE CONFLICT STATEMENT. INCLUDED IN THE POLICY IS SPECIFIC LANGUAGE REGARDING THE CONDUCT OF THE INDIVIDUAL WITH THE POTENTIAL CONFLICT. EACH DISCLOSURE STATEMENT IS REVIEWED BY THE SECRETARY OF THE BOARD, WHO REPORTS THE FINDINGS TO THE FULL BOARD. A LIST OF ANNUAL PAYMENTS MADE TO THE DISCLOSED ENTITIES IS MAINTAINED BY THE HOSPITAL'S PRESIDENT'S OFFICE.
  FORM 990, PART VI, SECTION B, LINE 15 THE HOSPITAL UTILIZES THE HOSPITAL COUNCIL OF WESTERN PA'S SALARY SURVEY IN DETERMING COMPENSATION FOR OFFICERS AND KEY EMPLOYEES TO ENSURE COMPENSATION DOES NOT EXCEED FAIR MARKET VALUE. THE OFFICERS OF THE BOARD OF DIRECTORS APPROVES ALL SALARY INCREASES FOR THE CEO, COO, AND CFO.
  FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
  FORM 990, PART VII: IN THE INTEREST OF FULL DISCLOSURE AND TRANSPARENCY, THE FOLLOWING LISTING REPRESENTS THE OFFICERS AND HIGHEST COMPENSATED EMPLOYEES OF THE FOLLOWING OHIO VALLEY GENERAL HOSPITAL AFFILIATED ENTITIES: THE HIGHEST COMPENSATED EMPLOYEES, DIRECTORS AND OFFICERS FOR THE OHIO VALLEY ANETHESIA PAIN MANAGEMENT, INC.: DR. DAVID PROVENZANO SALARY $528,320 BENEFITS $137,403 THE HIGHEST COMPENSATED EMPLOYEES OTHER THAN DIRECTORS AND OFFICERS FOR THE OHIO VALLEY PROFESSIONAL SERVICES, INC.: DR. SHARMA VIDHU SALARY $155,010 BENEFITS $38,752 DR. SAMINA NASSER SALARY $135,840 BENEFITS $33,960 THE HIGHEST COMPENSATED EMPLOYEES, DIRECTORS AND OFFICERS FOR THE OHIO VALLEY ANESTHESIA SERVICES, INC.: DR. THOMAS BIJO SALARY $344,649 BENEFITS $86,162 THE HIGHEST COMPENSATED EMPLOYEES OTHER THAN DIRECTORS AND OFFICERS FOR THE OHIO VALLEY ANESTHESIA SERVICES, INC.: DR. HANNAH HELIGER SALARY $307,749 BENEFITS $76,937 DR. KWAN LEE SALARY $197,896 BENEFITS $49,474 DR. CHRIS BARTON HAYES SALARY $309,602 BENEFITS $77,401
CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 5,328,322. PENSION LIABILITY ADJUSTMENT 5,109,765. CHANGE IN FAIR VALUE OF DERIVATIVE -310,980. CHANGE IN TEMPORARILY RESTRICTED NET ASSETS 40,014. TOTAL TO FORM 990, PART XI, LINE 5: 10,167,121.
COMMITTEE THAT ASSUMES RESPONSIBILITY OF THE AUDIT FORM 990, PART XII, LINE 2C THIS ORGANIZATION DOES HAVE A COMMITTEE THAT ASSUMES THE RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS & THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THE ORGANIZATION DID NOT CHANGE THIS OVERSIGHT PROCESS OR ITS SELECTION PROCESS FROM THE PREVIOUS YEAR.
TRANSACTIONS WITH INTERESTED PERSONS FORM 990, SCHEDULE L, PART I PLEASE NOTE THAT PART IV, ITEM 25A HAS BEEN ANSWERED "NO," HOWEVER, AS NOTED IN THE 2009 FORM 990, THE ORGANIZATION WAS TO HAVE COMPLETED A REVIEW OF POTENTIAL TRANSACTIONS WITH DISQUALIFIED PERSONS. A REVIEW WAS CONDUCTED BY AN INDEPENDENT COMPENSATION CONSULTING FIRM AND AS A RESULT OF THIS STUDY IT WAS CONCLUDED THAT THERE WERE NO EXCESS BENEFIT TRANSACTIONS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


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SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
OHIO VALLEY GENERAL HOSPITAL
 
Employer identification number

25-0967480
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity

















Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) OVGH PROFESSIONAL LIABILITY SELF INSURANCE

25 HECKEL ROAD

MCKEES ROCK,PA15136
25-1619844 		PROVIDES MALPRACTICE INSURANCE TO THE HOSPITAL PA 501(C)(3) LINE 11A, I OHIO VALLEY GENERAL HOSPITAL
 
 
No
(2) OVGH WORKER COMPENSATION SELF INSURANCE TRUST

25 HECKEL ROAD

MCKEES ROCK,PA15136
25-1619842 		FOR THE HOSPITAL TO COVER ITS WORKERS COMPENSATION CLAIMS PA 501(C)(3) LINE 11A, I OHIO VALLEY GENERAL HOSPITAL
 
 
No
(3) PITTSBURGH'S OHIO VALLEY GENERAL HOSPITAL FOUNDATION

25 HECKEL ROAD

MCKEES ROCK,PA15136
25-1792662 		TO PROVIDE SUPPORT TO OHIO VALLEY GENERAL HOSPITAL PA 501(C)(3) LINE 11A, I OHIO VALLEY GENERAL HOSPITAL
 
 
No








For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) OHIO VALLEY ANESTHESIA SERVICES INC
25 HECKEL ROAD
MCKEES ROCK,PA15136
20-5830183 		PROVIDES SURGERY AND ANESTHESIA SERVICES TO PATIENTS PA OHIO VALLEY GENERAL HOSPITAL
  		C -789,642 243,410 100.000 %
(2) OHIO VALLEY ANESTHESIA PAIN MANAGEMENT INC
25 HECKEL ROAD
MCKEES ROCK,PA15136
20-5696032 		PROVIDES PAIN MANAGMENT SERVICES TO PATIENTS PA OHIO VALLEY GENERAL HOSPITAL
  		C -313,318 112,984 100.000 %
(3) OHIO VALLEY PROFESSIONAL SERVICES INC
25 HECKEL ROAD
MCKEES ROCK,PA15136
20-5689859 		EXTENSION OF THE HOSPITAL TO PROVIDE HEALTH SERVICES TO THE COMMUNITY PA OHIO VALLEY GENERAL HOSPITAL
  		C -215,035 237,815 100.000 %








Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) PITTSBURGH'S OHIO VALLEY GENERAL HOSPITAL FOUNDATION

 C 186,933 COST
(2) PITTSBURGH'S OHIO VALLEY GENERAL HOSPITAL FOUNDATION

 D 335,363 NET BOOK VALUE
(3) OHIO VALLEY ANESTHESIA PAIN MANAGEMENT INC

 D 1,556,521 NET BOOK VALUE
(4) OHIO VALLEY PROFESSIONAL SERVICES INC

 D 2,553,851 NET BOOK VALUE
(5) OHIO VALLEY ANESTHESIA SERVICES INC

 D 4,872,584 NET BOOK VALUE
(6) OHIO VALLEY ANESTHESIA PAIN MANAGEMENT INC

 P 522,450 COST
(7) OHIO VALLEY PROFESSIONAL SERVICES INC

 P 493,330 COST
(8) OHIO VALLEY ANESTHESIA SERVICES INC

 P 1,503,502 COST
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


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