TY 2015 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)
(1) HOWARD GOLDBERG MD BOARD MEMBER	2.0 ................. 0.0	X
(2) JOHN W MCILVANE III BOARD MEMBER	2.0 ................. 0.0	X
(3) WILLIAM MCGOWEN BOARD MEMBER	2.0 ................. 0.0	X
(4) ARTHUR GABRIEL II BOARD MEMBER	2.0 ................. 0.0	X
(5) ROBERT YOUNG BOARD MEMBER	2.0 ................. 0.0	X
(6) ROBERT GRIFFIN BOARD MEMBER	2.0 ................. 1.0	X
(7) DARLENE BIGLER BOARD MEMBER	2.0 ................. 0.0	X
(8) GRANT MINOR BOARD MEMBER	2.0 ................. 0.0	X
(9) CYNTHIA WEST MD BOARD MEMBER (THROUGH 12/31/15)	2.0 ................. 0.0	X
(10) GERALD PRADO BOARD MEMBER	2.0 ................. 0.0	X
(11) DANIEL MILLER BOARD SECRETARY-TREASURER	4.0 ................. 2.0	X
(12) THOMAS NORTHROP BOARD CHAIRPERSON	4.0 ................. 4.0	X
(13) BRIAN SMITH BOARD VICE-CHAIRPERSON	4.0 ................. 2.0	X
(14) ARLENE A RICKER BOARD MEMBER	2.0 ................. 1.0	X
(15) TRACI MCDONALD BOARD MEMBER	2.0 ................. 0.0	X
(16) RICHARD A APREA MD BOARD MEMBER (BEGINNING 1/1/16)	2.0 ................. 0.0	X
(17) DAVID MICHAEL CAMPSEY MD BOARD MEMBER (BEGINNING 1/1/16)	2.0 ................. 0.0	X

(A) Name and business address	(B) Description of services	(C) Compensation
MEDFIT COMMUNITY HEALTH SERVICE 25 HANOVER ROAD FLORHAM,NJ07932	WELLNESS SERVICES	2,592,467
Emcare Inc 7032 Collection Center Drive Chicago,IL60693	Physician Services	1,878,018
Keystone Anesthesia Consultants 2000 Oxford Drive Bethel Park,PA15218	Anesthesia	1,648,454
Pittsburgh Critical Care 1789 S Braddock Ave Pittsburgh,PA15218	Physician Services	1,311,235
PARIS COMPANIES 67 HOOVER AVENUE DUBOIS,PA15801	LINEN SERVICE	815,671
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 24

- TIN:

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

Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

The Washington Hospital

Employer identification number

25-0965600

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.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ))

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross 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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ..............

Provide the following information about the supported organization(s).

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

Page 2

Part II

Support Schedule for Organizations Described in Sections 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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10.

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2015. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2014. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2015. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the facts-and-circumstances test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 3

Part III

Support Schedule for Organizations Described in Section 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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2015. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2014. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2015

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2015

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2015 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2015	(iii) Distributable Amount for 2015
1 Distributable amount for 2015 from Section C, line 6
2 Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......
e From 2014.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2015 distributable amount
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2015 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2015 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2016. Add lines 3j and 4c.
8 Breakdown of line 7:
a
b
c Excess from 2013.......
d From 2014.......
e From 2015.......

Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Name of the organization

The Washington Hospital

Employer identification number

25-0965600

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... 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 on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, 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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2

Name of organization The Washington Hospital

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 3

Name of organization The Washington Hospital		Employer identification number 25-0965600

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 4


Name of organization The Washington Hospital			Employer identification number 25-0965600
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. 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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No.from Part I

(b) Purpose 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

(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

(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

(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) (2015)

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

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

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

If the organization answered "Yes" on 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" on 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" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

The Washington Hospital

Employer identification number

25-0965600

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures ...................................................................................................................... SchCMd Bullet

Volunteer hours .............................................................................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

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

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

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-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2015

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 SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(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? ..............................................................................................................	Yes No

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 separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2012	(b) 2013	(c) 2014	(d) 2015	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2015

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)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

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:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

22,180

Total. Add lines 1c through 1i ....................................................................................................

22,180

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

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

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	LOBBYING COSTS REPORTED IN PART II-B LINE I CONSIST OF THE PORTION OF MEMBERSHIP DUES ATTRIBUTABLE TO LOBBYING ACTIVITIES. THE HOSPITAL DOES NOT DIRECTLY LOBBY OR PARTICIPATE IN POLITICAL ACTIVITIES.
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	LOBBYING COSTS REPORTED IN PART II-B LINE I CONSIST OF THE PORTION OF MEMBERSHIP DUES ATTRIBUTABLE TO LOBBYING ACTIVITIES. THE HOSPITAL DOES NOT DIRECTLY LOBBY OR PARTICIPATE IN POLITICAL ACTIVITIES.

Schedule C (Form 990 or 990EZ) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

The Washington Hospital

Employer identification number

25-0965600

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

			(a) Donor advised funds	(b) Funds and other accounts

1	Total number at end of year ....
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ....

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? ...........

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can 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? ............................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax 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, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, 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" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), 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 XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), 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)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

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 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2015

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII 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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" on 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	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land ...	9,272,620		9,272,620
b	Buildings	160,752,446	91,920,746	68,831,700
c	Leasehold improvements
d	Equipment ...	115,918,990	75,506,066	40,412,924
e	Other ...	1,172,354		1,172,354
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				119,689,598

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. 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
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Investments in Affiliates & Related Long Term Receivables	16,441,284	F
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)	16,441,284

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
ACCRUED PENSION COSTS	7,448,273
DUE TO THIRD PARTY PAYORS	6,122,493
BOND SWAP LIABILITY	6,850,062
POST-RETIREMENT BENEFIT OBLIGATION	1,612,870
INSURANCE LIABILITIES	7,732,258
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	29,765,956
2. Liability for uncertain tax positions. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
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 (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	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 XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
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 XIII.) ............	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 XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation

Schedule D (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

See separate instructions. Right pointing arrow large image

Information about Schedule F (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization
The Washington Hospital

Employer identification number

25-0965600

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.

For grantmakers.Does the organization maintain records to substantiate the amount of its grants and

other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used

to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(b) Number of offices in the region	(c) Number of employees, agents, and independent contractors in region	(d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region)	(f) Total expenditures for and investments in region
	Central America and the Caribbean			Investments	3,628,819
















3a	Sub-total .....	0	0		3,628,819
b	Total from continuation sheets to Part I ...	0	0		0
c	Totals (add lines 3a and 3b)	0	0		3,628,819

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2015

Schedule F (Form 990) 2015

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name of organization		(b) IRS code section and EIN (if applicable)	(a)(c) Region	(b)(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of non-cash assistance	(h) Description of non-cash assistance	(i) Method of valuation (book, FMV, appraisal, other)

2	Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) 2015

Schedule F (Form 990) 2015Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance		(b) Region	(c) Number of recipients	(d) Amount of cash grant	(e) Manner of cash disbursement	(f) Amount of non-cash assistance	(g) Description of non-cash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) 2015

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2015

Page 5

Part V

Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).

ReturnReference	Explanation

Schedule F (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

The Washington Hospital

Employer identification number

25-0965600

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance 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	Financial Assistance at cost (from Worksheet 1) . . .			730,240		730,240	0.33 %
b	Medicaid (from Worksheet 3, column a) . . . . .			29,505,946	21,685,679	7,820,267	3.51 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .					0	0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	0	0	30,236,186	21,685,679	8,550,507	3.84 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).			1,694,215	203,830	1,490,385	0.67 %
f	Health professions education (from Worksheet 5) . . .			15,810,343	10,489,364	5,320,979	2.39 %
g	Subsidized health services (from Worksheet 6) . . . .			68,455,394	64,700,444	3,754,950	1.69 %
h	Research (from Worksheet 7) .					0	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .			120,893		120,893	0.05 %
j	Total. Other Benefits . .	0	0	86,080,845	75,393,638	10,687,207	4.80 %
k	Total. Add lines 7d and 7j .	0	0	116,317,031	97,079,317	19,237,714	8.64 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015

Schedule H (Form 990) 2015

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(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					0	0 %
2	Economic development					0	0 %
3	Community support					0	0 %
4	Environmental improvements					0	0 %
5	Leadership development and training for community members					0	0 %
6	Coalition building					0	0 %
7	Community health improvement advocacy					0	0 %
8	Workforce development			222,219		222,219	0.10 %
9	Other			120,484		120,484	0.05 %
10	Total	0	0	342,703	0	342,703	0.15 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

6,856,087

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

33,745,186

Enter Medicare allowable costs of care relating to payments on line 5.....

37,441,705

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-3,696,519

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(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 %
1WPHO	LOCAL HEALTHCARE NETWORK	50 %	0.71 %	49.29 %
2TRI-STATE SURGERY	SURGERY CENTER	50 %	4.68 %	45.32 %
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2015

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?1 Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	THE WASHINGTON HOSPITAL 155 WILSON AVENUE WASHINGTON,PA15301 www.washingtonhospital.org 230201	X	X	X	X

Schedule H (Form 990) 2015

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	THE WASHINGTON HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 15

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): http://www.washingtonhospital.org/files/WH/Complete-2015-CHNA-6-30-16.pdf

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): http://whs.org/files/WH/The%20WHS%20CHNA%20Implementation%20Plan%20revised%202017.pdf

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2015

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	THE WASHINGTON HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.0% and FPG family income limit for eligibility for discounted care of 400.0%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

http://whs.org/patient-resources/financial-assistance/

The FAP application form was widely available on a website (list url):

http://whs.org/patient-resources/financial-assistance/

A plain language summary of the FAP was widely available on a website (list url):
http://whs.org/patient-resources/financial-assistance/

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2015

Page 6

Part VFacility Information (continued)

	THE WASHINGTON HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that
can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Section C)

During the tax year, did the hospital facility charge any FAP-eligible individual 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? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2015

Page 7

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - The Washington Hospital. IN ORDER TO TAKE INTO ACCOUNT INPUT FROM THE COMMUNITY THAT THE HOSPITAL SERVES, THE ASSESSMENT INCLUDED A RANDOM COMMUNITY SURVEY AND INTERVIEWS WITH THE FOLLOWING COMMUNITY REPRESENTATIVES WHO HAVE AN EXPERTISE IN THE PUBLIC HEALTH CLIMATE IN OUR SERVICE AREA: MS. DERICCI HORWATT, PROGRAM DIRECTOR OF GATEWAY VISION DR. MARY JO PODGURSKI, EXECUTIVE DIRECTOR OF ACADEMY OF ADOLESCENT HEALTH JENNIFER JOHNSON, COORDINATOR OF THE WASHINGTON COUNTY DEPARTMENT OF HUMAN SERVICES, HOMELESS SERVICES AND HOUSING ASSISTANCE PROGRAM.
Schedule H, Part V, Section B, Line 6a Facility , 1	Facility , 1 - The Washington Hospital. The Community Health Needs Assessment was conducted in conjunction with the following hospitals: TGCH, Inc, a hospital doing business as Washington Health System Greene and located in Waynesburg, PA Monongahela Valley Hospital
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - The Washington Hospital. THE NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT WERE REVIEWED AND PRIORITIZED BASED ON MAGNITUDE OF THE NEED, POTENTIAL IMPACT ON THE COMMUNITY HEALTH, COST, ENVIRONMENTAL FACTORS AND PRACTICALITY. AN IMPLEMENTATION PLAN WAS DEVELOPED AND APPROVED BY THE BOARD OF TRUSTEES. THE HOSPITAL WILL FOCUS THE IMPLEMENTATION ON TREATING TWO OF THE TOP NEEDS, DIABETES PREVALENCE AND LATE STAGE BREAST CANCER. THE FOLLOWING HEALTH NEEDS ARE NOT BEING ADDRESSED IN THE INITIAL IMPLEMENTATION STRATEGY: SUICIDE ADULT OBESITY TOBACCO USE EXCESSIVE ALCOHOL USE
Schedule H, Part V, Section B, Line 22 Facility , 1	Facility , 1 - The Washington Hospital. The maximum amount that can be charged to a financial assistance policy (FAP) eligible patient ranges from 40%-60% of the gross charge, depending on the service provided. The discount provided is intended to approximate the net collection for all payers.

Schedule H (Form 990) 2015

Page 8

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?14
Name and address		Type of Facility (describe)
1	TRI-STATE SURGERY CENTER 95 LEONARD AVENUE WASHINGTON,PA15301	SURGERY CENTER
2	WILFRED R CAMERON WELLNESS CENTER 240 WELLNESS WAY WASHINGTON,PA15301	FITNESS CENTER
3	WASHINGTON HOSPITAL FAMILY MEDICINE CTR 95 LEONARD AVENUE WASHINGTON,PA15301	FAMILY MEDICINE
4	TWH LAB & RADIOLOGY CENTER 67 EAST PIKE STREET CANONSBURG,PA15317	LAB STATIONS & OUTPATIENT RADIOLOGY
5	WOUND & SKIN HEALING CENTER 208 WELLNESS WAY WASHINGTON,PA15301	OUTPATIENT OFFICE
6	WASHINGTON HOSPITAL FAMILY MEDICINE CTR 67 EAST PIKE STREET CANONSBURG,PA15317	FAMILY MEDICINE
7	TWH LAB & RADIOLOGY CENTER 3415 MILLERS RUN CECIL,PA15321	LAB STATIONS & OUTPATIENT RADIOLOGY
8	CHILDREN'S THERAPY CENTER 1000 WATERDAM PLAZA DRIVE MCMURRAY,PA15317	CHILDREN'S THERAPY
9	DIABETES EDUCATION & MANAGEMENT PROGRAM 95 LEONARD AVENUE WASHINGTON,PA15301	OUTPATIENT OFFICE
10	CHILDREN'S THERAPY CENTER 289 NORTH AVENUE WASHINGTON,PA15301	CHILDREN'S THERAPY
11	TWH LAB & RADIOLOGY CENTER 343 E ROY FURMAN HIGHWAY WAYNESBURG,PA15370	LAB STATIONS & OUTPATIENT RADIOLOGY
12	TWH LAB & RADIOLOGY CENTER 4198 WASHINGTON ROAD MCMURRAY,PA15317	LAB STATIONS & OUTPATIENT RADIOLOGY
13	WASHINGTON HOSPITAL FAMILY MEDICINE CTR 3415 MILLERS RUN ROAD CECIL,PA15321	FAMILY MEDICINE
14	TWH LAB & RADIOLOGY CENTER 95 LEONARD AVE WASHINGTON,PA15301	LAB STATIONS & OUTPATIENT RADIOLOGY

Schedule H (Form 990) 2015

Page 9

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.

Form and Line Reference	Explanation
Schedule H, Part I, Line 7 Column F - Bad Debt Expense	BAD DEBT EXPENSE IS NOT INCLUDED IN THE EXPENSES IN THE LINE 7 PERCENT OF TOTAL EXPENSES CALCULATION.
Schedule H, Part V, Section B, Line 20 Indicate efforts made before before any actions	LINE 20 WAS LEFT BLANK BECAUSE NONE OF THE ACTIONS DESCRIBED IN LINE 19 ARE PERMITTED UNDER OUR POLICY
Schedule H, Part I, Line 7 Explanation of costing methodology used for calculating line 7 table	THE HOSPITAL'S COST-TO-CHARGE RATIOS WERE USED TO CALCULATE ALL AMOUNTS REPORTED ON LINE 7. ALTHOUGH WORKSHEET 2 WAS NOT USED TO CALCULATE THIS RATIO, WE PREPARED A SIMILAR CALCULATION THAT WE FEEL IS MORE DETAILED. SIMILAR TO WORKSHEET 2, WE STARTED WITH OUR OVERALL COST-TO-CHARGE RATIO AND ADJUSTED FOR THE COMMUNITY BENEFITS INCLUDED IN PART I AND THE MEDICAID PROVIDER TAXES WE PAID.
Schedule H, Part II Describe how community building activities promote the health of the community	THE HOSPITAL'S COMMUNITY BUILDING ACTIVITIES CONSIST OF EMERGENCY PREPAREDNESS PREPARATION AND TRAINING, PHYSICIAN RECRUITMENT IN SPECIALTIES THAT ARE UNDER SERVED IN OUR AREA AND VOLUNTARY PAYMENTS IN LIEU OF TAXES TO THE CITY AND SCHOOL DISTRICT. THE HOSPITAL HAS DEVELOPED POLICIES AND PROCEDURES TO FOLLOW IN THE EVENT OF DIFFERENT COMMUNITY EMERGENCIES AND CONDUCTS REGULAR DRILLS TO HELP ENSURE PREPAREDNESS. THE HOSPITAL ALSO REGULARLY REVIEWS THE TYPES OF PHYSICIANS PRACTICING IN THE AREA AND ACTIVELY RECRUITS PHYSICIANS IN THOSE AREAS THAT ARE UNDER SERVED.
Schedule H, Part I, Line 7g Subsidized Health Services	PROGRAMS REPORTED AS SUBSIDIZED HEALTH SERVICES INCLUDE HOSPITAL BASED PROGRAMS WHOSE PURPOSE IS TO SERVE A MEDICAL NEED TO THE COMMUNITY, THE LARGEST BEING AN INPATIENT PSYCHIATRIC UNIT. SERVICES PROVIDED TO MEDICARE RECIPIENTS WHICH ARE NOT REPORTABLE ON THE MEDICARE COST REPORT ARE ALSO INCLUDED IN SUBSIDIZED HEALTH SERVICES. THERE ARE NO PHYSICIAN CLINICS REPORTED AS SUBSIDIZED SERVICES.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	THE HOSPITAL FOLLOWS AICPA GUIDANCE IN REPORTING BAD DEBT AS A DEDUCTION FROM NET PATIENT SERVICE REVENUE. ACCOUNTS ARE DEEMED TO BE BAD DEBT AFTER ALL REASONABLE COLLECTION EFFORTS ARE APPLIED. THE HOSPITAL HAS A GENEROUS INTEREST-FREE PAYMENT PLAN POLICY AND DOES NOT CLASSIFY ACCOUNTS ON A PAYMENT PLAN AS BAD DEBT. ANY ACCOUNTS THAT ARE DETERMINED TO BE CHARITY CARE ARE EXCLUDED FROM BAD DEBT TOTALS. ANY DISCOUNT OR SETTLEMENTS PROVIDED TO PATIENTS ARE ALSO EXCLUDED FROM BAD DEBT TOTALS. THE AMOUNT DUE FROM A PATIENT IS WRITTEN OFF TO BAD DEBT ONCE THE ACCOUNT IS DEEMED UNCOLLECTABLE. THE HOSPITAL CONVERTS ALL BAD DEBT ACCOUNTS TO GROSS CHARGES AND APPLIES AN OVERALL COST-TO-CHARGE RATIO TO DETERMINE THE COST OF BAD DEBT REPORTED ON PART III, LINE 2. THE AUDITED FINANCIAL STATEMENTS OF THE HOSPITAL DISCLOSES/DESCRIBES BAD DEBT AS FOLLOWS: BALANCE SHEET: THE AMOUNT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS CLEARLY DISCLOSED WITH PATIENT ACCOUNTS RECEIVABLE FOR ALL YEARS PRESENTED. STATEMENT OF OPERATIONS: BAD DEBT IS CLEARLY REPORTED AS A SEPARATE DEDUCTION FROM NET PATIENT SERVICE REVENUE FOR ALL YEARS PRESENTED. FOOTNOTES: FOOTNOTE 1, "PATIENT ACCOUNTS RECEIVABLE" IS FOUND ON PAGE 9 OF THE AUDITED FINANCIAL STATEMENTS.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	ALTHOUGH WE RECOGNIZE THE POSSIBILITY THAT SOME OF THE BAD DEBT COSTS COULD QUALIFY UNDER OUR CHARITY CARE POLICY, WE HAVE NO REASONABLE WAY TO DETERMINE THOSE AMOUNTS.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	THE AUDITED FINANCIAL STATEMENTS OF THE HOSPITAL DISCLOSES/DESCRIBES BAD DEBT AS FOLLOWS: BALANCE SHEET: THE AMOUNT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS CLEARLY DISCLOSED WITH PATIENT ACCOUNTS RECEIVABLE FOR ALL YEARS PRESENTED. STATEMENT OF OPERATIONS: BAD DEBT IS CLEARLY REPORTED AS A SEPARATE DEDUCTION FROM NET PATIENT SERVICE REVENUE FOR ALL YEARS PRESENTED. FOOTNOTES: FOOTNOTE 1, "PATIENT ACCOUNTS RECEIVABLE" IS FOUND ON PAGE 9 OF THE AUDITED FINANCIAL STATEMENTS.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	THE HOSPITAL'S SERVICE AREA HAS A VERY HIGH ELDERLY POPULATION. MEDICARE MAKES UP 61% OF THE INPATIENT PATIENT CARE DAYS AND 40% OF THE OUTPATIENT SERVICES PROVIDED BY THE HOSPITAL. AS THE LARGEST HOSPITAL IN THE COUNTY, WE PROVIDE A WIDE ARRAY OF SERVICES TO OUR COMMUNITY. OUR ELDERLY POPULATION DOES NOT HAVE TO TRAVEL TO THE NEAREST LARGE CITY HOSPITAL TO SEEK CARE FOR MOST SERVICES. MEDICARE PATIENTS GENERALLY HAVE MULTIPLE HEALTH CONDITIONS THAT CAN EASILY COMPLICATE THE CARE PROVIDED TO THEM. THE CURRENT INPATIENT PAYMENT SYSTEM PROVIDES PAYMENT FOR THE HEALTH CONDITION THAT PRECIPITATED AN ADMISSION TO THE HOSPITAL - IT DOES NOT NECESSARILY TAKE INTO ACCOUNT ALL OF THE OTHER UNDERLYING ILLNESSES THAT MUST BE TREATED OR ATTENDED TO DURING A PATIENT'S STAY. AS SUCH, TREMENDOUS RESOURCES CAN BE USED TO TREAT A MEDICARE PATIENT WITH MULTIPLE ILLNESSES YET THE HOSPITAL MAY ONLY BE PAID FOR RESOURCES ASSOCIATED WITH THE ADMITTING ILLNESS. THE HOSPITAL STRIVES TO PROVIDE ALL NEEDED CARE TO OUR PATIENTS WITHOUT CONSIDERATION OF PAYMENT SHORTFALLS. AS SUCH, WE FEEL STRONGLY THAT THE MEDICARE SHORTFALLS INCURRED BY THE HOSPITAL ARE A COMMUNITY BENEFIT. THE MEDICARE COSTS ARE CALCULATED USING COST-TO-CHARGE RATIOS THAT HAVE BEEN CALCULATED BASED ON THE DEPARTMENT WHERE THE SERVICES WERE PROVIDED.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	THE HOSPITAL HAS A WRITTEN BAD DEBT POLICY IT FOLLOWS FOR ALL PATIENTS. IF A PATIENT IS DETERMINED TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE, THE ACCOUNT IS EXCLUDED FROM THE NORMAL COLLECTION PROCESS. THOSE ACCOUNTS ARE HANDLED UNDER THE SEPARATE CHARITY CARE POLICY. IF AN ACCOUNT IS SET UP ON A PAYMENT PLAN, ONLY THE CURRENT MONTHLY PAYMENT AMOUNT IS PURSUED UNDER THE COLLECTION POLICY.
Schedule H, Part V, Section B, Line 16a FAP website	- THE WASHINGTON HOSPITAL: Line 16a URL: http://whs.org/patient-resources/financial-assistance/;
Schedule H, Part V, Section B, Line 16b FAP Application website	- THE WASHINGTON HOSPITAL: Line 16b URL: http://whs.org/patient-resources/financial-assistance/;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- THE WASHINGTON HOSPITAL: Line 16c URL: http://whs.org/patient-resources/financial-assistance/;
Schedule H, Part VI, Line 2 Needs assessment	THE PRIMARY METHOD THAT THE HOSPITAL USES TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES IS THROUGH ASSESSING THE TOTAL NUMBER OF PHYSICIANS PROVIDING MEDICAL SERVICES TO THE AREAS SERVED. THE QUALITATIVE STANDARD DOES NOT FACTOR THE ECONOMIC OR FINANCIAL BENEFITS TO THE HOSPITAL OF ANY RECRUITMENT OF PHYSICIANS IN ADDRESSING THE CONTINUUM OF NEED. THE ASSESSMENT FOCUSES ON COMMUNITY NEED AS A DETERMINING FACTOR IN ASSESSING THE APPROPRIATENESS OF PHYSICIAN RECRUITMENT INITIATIVES. THE APPROACH TO EVALUATING PHYSICIAN NEED IS BASED ON THE FOLLOWING FACTORS: -DEFINING THE DEMOGRAPHIC PROFILE AND PAYOR MIX OF THE HOSPITAL'S SERVICE AREA. -RESEARCHING UNIQUE SERVICE AREA FACTORS THAT MIGHT INFLUENCE THE DEMAND FOR HEALTHCARE SERVICES WITHIN THE AREA. -IDENTIFYING THE TOTAL NUMBER OF PHYSICIANS BY SPECIALTY IN THE DEFINED SERVICE AREA. -DEVELOPING A PROFILE OF THE CURRENT MEDICAL STAFF. -UTILIZING SIX ESTABLISHED PHYSICIAN NEEDS ASSESSMENT MODELS TO IDENTIFY POTENTIAL PHYSICIAN SURPLUSES OR DEFICITS IN EACH MEDICAL SPECIALTY. -EXAMINING RESULTS OF THE MEDICAL STAFF SURVEY AND PHYSICIAN FOCUS INTERVIEWS TO DETERMINE THE PERCEIVED RECRUITMENT NEEDS OF THE HOSPITAL'S EXISTING STAFF PHYSICIANS AND TO IDENTIFY MEDICAL COMMUNITY CONCERNS. -CONDUCT A COMMUNITY SURVEY TO INTEGRATE PERCEIVED SHORTAGES INTO RECOMMENDATIONS. -EVALUATING RESULTS OF THE ABOVE EFFORTS IN THE CONTEXT OF OUR MEDICAL STAFFING AND CONSULTING EXPERIENCE. OTHER WAYS TO ASSESS THE COMMUNITIES' HEALTH NEEDS INCLUDES CONDUCTING VARIOUS HEALTH SCREENINGS, SEMINARS AND EDUCATION SESSIONS HELD FOR THE GENERAL PUBLIC.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	THE HOSPITAL ATTEMPTS TO INFORM ALL UNINSURED PATIENTS OF AVAILABLE PROGRAMS TO ASSIST THEM IN OBTAINING HEALTH CARE SERVICES. INPATIENT: ANY PATIENT ADMITTED TO THE HOSPITAL WITHOUT INSURANCE IS PROVIDED ASSISTANCE IN APPLYING FOR THE STATE MEDICAL ASSISTANCE PROGRAM. A HOSPITAL REPRESENTATIVE WILL EXPLAIN THE STATE PROGRAMS TO THE PATIENT AND ASSIST IN THE PREPARATION OF THE APPLICATION AND GATHERING OF INFORMATION, IF APPLICABLE. IF THE PATIENT DOES NOT QUALIFY FOR ASSISTANCE, THE REPRESENTATIVE INFORMS HIM/HER OF THE HOSPITAL'S CHARITY CARE PROGRAM. OUTPATIENT: CERTAIN OUTPATIENT AREAS (EMERGENCY ROOM, REGISTRATION) HAVE SIGNS THAT LET PATIENTS KNOW THE HOSPITAL HAS A CHARITY CARE PROGRAM. SOME AREAS ALSO HAVE MEDICAL ASSISTANCE APPLICATIONS ON HAND TO GIVE TO PATIENTS. CONSISTENT WITH THE HOSPITAL MISSION, ALL PATIENTS REQUIRING IMMEDIATE CARE ARE TREATED WITHOUT REGARD TO THEIR ABILITY TO PAY. ALLPATIENTS: FOR PATIENTS THAT ARE UNINSURED OR UNDER INSURED, A HOSPITAL REPRESENTATIVE IS AVAILABLE TO DISCUSS OPTIONS FOR PAYMENT WITH THE PATIENT. WHEN APPROPRIATE, PAYMENT FOR ELECTIVE SERVICES IS DISCUSSED UPFRONT AND IF THE PATIENT IS ABLE TO PAY, IS COLLECTED IN ADVANCE OF SERVICE. EFFORTS ARE MADE TO COLLECT PATIENT LIABILITIES IN CERTAIN AREAS SUCH AS OPSU AND ADMISSIONS. INSURANCE COPAYS ARE ATTEMPTED TO BE COLLECTED IN THE EMERGENCY DEPARTMENT IN ACCORDANCE WITH EMTALA REGULATIONS. WHEN THERE IS A BALANCE DUE (SELF-PAY OR BALANCE AFTER INSURANCE) AND NO COLLECTION WAS MADE IN ADVANCE OF OR AT THE TIME OF SERVICE, A STATEMENT WILL BE SENT TO PATIENTS PROVIDING A PHONE NUMBER FOR THEM TO CALL AND DISCUSS PAYMENT OPTIONS. IF THE PATIENT DOES NOT CALL OR MAKE PAYMENT, A HOSPITAL REPRESENTATIVE WILL CALL HIM/HER TO DISCUSS THE AMOUNT DUE AND TO DETERMINE IF THEY ARE ELIGIBLE FOR ANY PROGRAMS OR INSURANCES OR TO MAKE PAYMENT ARRANGEMENTS THAT CAN HELP THE PATIENT. AT ANY POINT IN THE CONVERSATION, IF THE PATIENT SAYS HE/SHE CANNOT AFFORD TO PAY THE BILL, THE PATIENT IS OFFERED A CHARITY CARE APPLICATION. ONCE THE CHARITY CARE APPLICATION IS COMPLETE, IF THE PATIENT DOES NOT QUALIFY BUT CONTINUES TO EXPRESS CONCERNS ABOUT BEING ABLE TO PAY HIS/HER BILL, THE ACCOUNT IS REVIEWED FOR THE POSSIBILITY OF A DISCOUNT OR AN AFFORDABLE PAYMENT PLAN. THE HOSPITAL STRIVES TO ACCOMMODATE EVERY PATIENT'S FINANCIAL SITUATION IF POSSIBLE. THE HOSPITAL'S CHARITY CARE PROGRAM PROVIDES FOR FREE OR DISCOUNTED CARE BASED ON FEDERAL POVERTY GUIDELINES (FPG). DEPENDING ON INCOME LEVEL, INDIVIDUALS WITHOUT INSURANCE CAN QUALIFY FOR DISCOUNTS RANGING BETWEEN 60-100%. INDIVIDUALS WITH INSURANCE CAN QUALIFY FOR DISCOUNTS RANGING BETWEEN 10-100%. ALL BILLS FOR PATIENTS WITHOUT INSURANCE COVERAGE ARE DISCOUNTED TO THE AVERAGE OF OUR TOP COMMERCIAL PAYORS. DISCOUNTS RANGE FROM 30% TO 60% DEPENDING ON THE TYPE OF SERVICE PROVIDED.
Schedule H, Part VI, Line 4 Community information	THE WASHINGTON HOSPITAL (TWH) IS A 206 BED ACUTE CARE GENERAL HOSPITAL LOCATED IN WASHINGTON, PENNSYLVANIA. FOUNDED IN 1897, THE HOSPITAL SERVES THE SURROUNDING COMMUNITIES WITH A TOTAL PATIENT DRAW OF OVER 320,000 RESIDENTS LIVING IN 63 ZIP CODES. THE SERVICE AREA EXTENDS TO THE WESTERN AND SOUTHERN BORDERS OF PENNSYLVANIA. THERE ARE THREE OTHER GENERAL ACUTE CARE HOSPITALS THAT SERVE PORTIONS OF TWH'S GEOGRAPHIC AREA, HOWEVER, TWH IS THE LARGEST HOSPITAL PROVIDING THE BROADEST RANGE OF SERVICES TO THE COMMUNITY. TWH IS THE ONLY HOSPITAL THAT OFFERS OBSTETRICAL, CARDIOTHORACIC, ELECTROPHYSIOLOGY, INTERVENTIONAL CARDIAC PROCEDURES, ACUTE REHABILITATION, DIABETES MANAGEMENT, WOUND CARE AND CHILDREN'S THERAPY SERVICES TO THE SERVICE AREA. THE GEOGRAPHIC AREA OF SERVICE IS QUITE LARGE AND HAS A SUBSTANTIAL RURAL COMPONENT. AT LEAST THREE AREAS WITHIN TWH'S SERVICE AREA ARE DESIGNATED AS MEDICALLY UNDESERVED AND/OR AREAS WITH A HEALTH CARE PROFESSIONAL SHORTAGE. APPROXIMATELY 16% OF THE PATIENTS SERVED ARE MEDICAL ASSISTANCE AND ANOTHER 2% ARE UNINSURED. TO FURTHER SUPPORT THE LARGE GEOGRAPHIC AREA, TWH PROVIDES SPACE FOR A MEDICAL HELICOPTER TO BE STATIONED FULL TIME IN THE SERVICE AREA. HOUSEHOLD INCOME/ECONOMIC FACTORS CAN HAVE A SIGNIFICANT IMPACT ON THE GENERAL HEALTH OF A SERVICE AREA. LOWER HOUSEHOLD INCOME MAY REFLECT LOWER PRIMARY CARE UTILIZATION AND HIGHER CRITICAL CARE UTILIZATION. VARIOUS STUDIES AND ARTICLES ALSO SUGGEST GREATER RELIANCE ON HOSPITAL EMERGENCY ROOMS FOR NON-EMERGENCY DIAGNOSIS AND TREATMENT IN LOW-INCOME AREAS. THE HOSPITAL'S SERVICE AREA MAY HAVE SOME HOUSEHOLD INCOME RELATED FACTORS THAT WOULD DRIVE AN ADDITIONAL NEED FOR PHYSICIAN SERVICES WITHIN PORTIONS OF THE COMMUNITY. APPROXIMATELY 15,000 HOUSEHOLDS (11%) WITHIN THE PRIMARY SERVICE AREA EARN LESS THAN $15,000 PER YEAR. A LACK OF AVAILABLE RESOURCES TO THE INDIGENT MAY INCREASE VOLUMES IN THE EMERGENCY ROOM, AS PATIENTS LACKING PRIMARY CARE ACCESS OFTEN SEEK ROUTINE CARE THROUGH EMERGENCY SERVICES.
Schedule H, Part VI, Line 5 Promotion of community health	THE WASHINGTON HOSPITAL STRIVES TO PROMOTE THE COMMUNITY HEALTH IN MANY AREAS. THE HOSPITAL HAS AN OPEN MEDICAL STAFF. ALL APPLICANTS WHO MEET THE REQUIREMENTS ARE GRANTED MEDICAL STAFF PRIVILEGES. THE HOSPITAL ACTIVELY RECRUITS PHYSICIANS IN AREAS IDENTIFIED AS HAVING A NEED IN THE COMMUNITY. THE HOSPITAL'S BOARD OF TRUSTEES IS COMPRISED OF COMMUNITY LEADERS WHO RESIDE IN THE COMMUNITIES WE SERVE AND WHOSE INSIGHT AND EXPERIENCE IS INVALUABLE IN PROVIDING DIRECTION TO THE HOSPITAL IN PROMOTING THE COMMUNITY HEALTH. THE HOSPITAL PROVIDES MANY SCREENING AND EDUCATIONAL PROGRAMS IN THE COMMUNITY. THE HOSPITAL PARTICIPATES IN REGIONAL EMERGENCY PREPAREDNESS AND IS ACTIVE IN ENSURING WE CAN RESPOND TO A COMMUNITY EMERGENCY. THE HOSPITAL OPERATES A WELLNESS CENTER TO PROMOTE FITNESS AND A HEALTHY LIFESTYLE. THE HOSPITAL FUNDS A TEEN OUTREACH PROGRAM. THIS PROGRAM PROMOTES ABSTINENCE, PREGNANCY PREVENTION AND EDUCATION TO TEENAGERS IN THE COMMUNITIES THE HOSPITAL SERVES.

Schedule H (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization
The Washington Hospital

Employer identification number
25-0965600

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section if applicable	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of non-cash assistance	(h) Purpose of grant or assistance

(1) Washington City Mission
84 West Wheeling Street
Washington,PA15301

25-1051749

501c3

28,200

To subsidize the Arbuckle Medical Clinic at the City Mission

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2015

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of non-cash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of non-cash assistance

(1) Wellness Center Scholarships	105	0	84,381	Retail Value	Free & reduced cost memberships to our wellness center based on financial need
(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference	Explanation
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.	The hospital provides an organizational grant in support of a local non-profit with which it has a close working relationship.

Schedule I (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

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" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

The Washington Hospital

Employer identification number

25-0965600

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ................

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization?

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization?

Any related organization? .........................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on 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 ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2015

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(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 in column(B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1ALISA R RUCKER VP FINANCE / CFO	(i) (ii)	260,245 ------------- 0	48,774 ------------- 0	18,000 ------------- 0	1,783 ------------- 0	15,399 ------------- 0	344,201 ------------- 0	0 ------------- 0
2GARY B WEINSTEIN PRESIDENT / CEO	(i) (ii)	585,579 ------------- 0	115,683 ------------- 0	32,000 ------------- 0	3,998 ------------- 0	16,105 ------------- 0	753,365 ------------- 0	0 ------------- 0
3BROOK T WARD Executive VP / COO	(i) (ii)	296,644 ------------- 0	53,993 ------------- 0	26,000 ------------- 0	2,054 ------------- 0	17,497 ------------- 0	396,188 ------------- 0	0 ------------- 0
4RODNEY LOUK VP INFORMATION & ANCILLARY SERVICES	(i) (ii)	252,672 ------------- 0	48,515 ------------- 0	24,000 ------------- 0	1,773 ------------- 0	8,269 ------------- 0	335,229 ------------- 0	0 ------------- 0
5KAREN BRAY VP PATIENT CARE SERVICES	(i) (ii)	198,561 ------------- 0	42,865 ------------- 0	24,000 ------------- 0	1,447 ------------- 0	15,188 ------------- 0	282,061 ------------- 0	0 ------------- 0
6COLLEEN ALLISON VP REG. AFFAIRS & QUALITY	(i) (ii)	202,336 ------------- 0	42,043 ------------- 0	24,000 ------------- 0	1,463 ------------- 0	15,199 ------------- 0	285,041 ------------- 0	0 ------------- 0
7WALTER P SLOMIANY MD ASSOC DIRECTOR FAMILY MEDICINE	(i) (ii)	246,510 ------------- 0	0 ------------- 0	13,725 ------------- 0	1,419 ------------- 0	15,852 ------------- 0	277,506 ------------- 0	0 ------------- 0
8PAUL CULLEN MD VP OF MEDICAL AFFAIRS	(i) (ii)	363,132 ------------- 0	61,607 ------------- 0	24,000 ------------- 0	2,447 ------------- 0	15,815 ------------- 0	467,001 ------------- 0	0 ------------- 0
9JEFFREY MINTEER MD DIRECTOR OF FAMILY MEDICINE	(i) (ii)	325,071 ------------- 0	0 ------------- 0	24,000 ------------- 0	1,903 ------------- 0	15,852 ------------- 0	366,826 ------------- 0	0 ------------- 0
10BARBARA MCCULLOUGH VP HUMAN RESOURCES	(i) (ii)	191,720 ------------- 0	39,674 ------------- 0	24,000 ------------- 0	1,393 ------------- 0	17,083 ------------- 0	273,870 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2015

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation

Schedule J (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization
The Washington Hospital

Employer identification number
25-0965600

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
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	WASHINGTON COUNTY HOSPITAL AUTHORITY 2008A	25-6001043	938592HJ4	06-26-2008	16,800,000	REFUND BONDS ISSUED 7/08/2004		X		X		X
B	WASHINGTON COUNTY HOSPITAL AUTHORITY 2007	25-6001043	938592HH8	03-29-2007	40,000,000	HOSPITAL EXPANSION AND RENOVATION		X		X		X
C	WASHINGTON COUNTY HOSPITAL AUTHORITY 2013A	25-6001043	938592JC7	02-12-2013	15,336,902	REFUND BONDS ISSUED 4/01/1998		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	1,060,000		990,000		1,040,000
2 Amount of bonds legally defeased ..............	0		0		0
3 Total proceeds of issue ..................	16,800,000		41,436,000		15,336,902
4 Gross proceeds in reserve funds .............	0		0		0
5 Capitalized interest from proceeds .............	0		0		0
6 Proceeds in refunding escrows ...............	0		0		0
7 Issuance costs from proceeds ...............	221,939		370,220		298,603
8 Credit enhancement from proceeds .............	16,950		61,003		0
9 Working capital expenditures from proceeds .............	0		0		0
10 Capital expenditures from proceeds .............	0		41,004,777		0
11 Other spent proceeds .............	16,561,111		0		15,038,299
12 Other unspent proceeds .............	0		0		0
13 Year of substantial completion .............	2008		2009		2013
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....	X			X	X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		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		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2015

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 of bond-financed property? .............		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
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 ....
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 .........
6 Total of lines 4 and 5 .............	0 %		0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........		X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...	X		X			X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......					X
b Exception to rebate? ........						X
c No rebate due? .........						X
If "Yes" to line 2c, provide in Part VI the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X		X			X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?	X		X			X
b Name of provider ..........	PNC BANK		PNC BANK
c Term of hedge .........	1500 %		3000 %
d Was the hedge superintegrated? ......	X		X
e Was the hedge terminated? ........		X		X

Schedule K (Form 990) 2015

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		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? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...		X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?		X		X		X

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation
Schedule K, Part II, Line 3 TOTAL PROCEEDS OF ISSUE	THE DIFFERENCE BETWEEN THE TOTAL PROCEEDS AMOUNT REPORTED ON PART II, LINE 3 AND THE ISSUE PRICE REPORTED ON PART I, COLUMN (E) IS INVESTMENT INCOME.
Schedule K, Part IV, Line 4a QUALIFIED HEDGE	THE 2007 BOND ISSUE CONSISTED OF TWO PORTIONS: 2007A (ISSUE PRICE: $15,000,000) AND 2007B (ISSUE PRICE: $25,000,000). THE QUALIFIED HEDGE IDENTIFIED RELATES ONLY TO THE 2007B PORTION OF THE 2007 BOND ISSUE.
Schedule K, Part V PROCEDURES TO UNDERTAKE CORRECTIVE ACTION	ALTHOUGH WE DO NOT HAVE WRITTEN PROCEDURES TO UNDER TAKE CORRECTIVE ACTION, WE DO NOT BELIEVE WE ARE IN VIOLATION OF ANY FEDERAL TAX REQUIREMENTS.
Schedule K, Part III, Line 9 PROCEDURES TO ENSURE BONDS ARE REMEDIATED	WE DO NOT HAVE WRITTEN PROCEDURES TO ENSURE THAT ALL NON QUALIFIED BONDS OF THE ISSUE ARE REMEDIATED IN ACCORDANCE WITH THE REQUIREMENTS UNDER REGULATIONS SECTIONS 1.141-12 AND 1.145-2. HOWEVER, WE BELIEVE THAT WE ARE IN FULL COMPLIANCE WITH ALL APPLICABLE REQUIREMENTS RELATED TO OUR TAX-EXEMPT BONDS.
Schedule K, Part IV, Line 7 PROCEDURES TO MONITOR REQUIREMENTS OF SECTION 148	WE DO NOT HAVE WRITTEN PROCEDURES TO MONITOR THE REQUIREMENTS OF SECTION 148. HOWEVER, WE BELIEVE THAT WE ARE IN FULL COMPLIANCE WITH ALL APPLICABLE REQUIREMENTS RELATED TO OUR TAX-EXEMPT BONDS.

Schedule K (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Information about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

The Washington Hospital

Employer identification number

25-0965600

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) 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	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

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-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No










Total ............... $

Part III

Grants or Assistance Benefiting 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 assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2015

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?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) OBSERVER REPORTER	ENTITY MORE THAN 35% OWNED BY THOMAS NORTHROP, BOARD MEMBER	138,194	NEWSPAPER ADVERTISING		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

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 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

The Washington Hospital

Employer identification number

25-0965600

Return Reference	Explanation
Form 990, Part III, Line 4d Description of other program services	(Expenses $ 2,682,780 including grants of $ 112,581)(Revenue $ 37,801,165) OTHER PROGRAM SERVICES INCLUDE A MULTITUDE OF ACTIVITIES PERFORMED BY THE HOSPITAL TO DO BUSINESS IN THE COMMUNITY AND PROVIDE VALUABLE COMMUNITY BENEFITS. ACTIVITIES IN THIS CATEGORY INCLUDE, BUT ARE NOT LIMITED TO, A TEENAGE ABSTINENCE EDUCATION PROGRAM, A FAMILY PRACTICE RESIDENCY PROGRAM, A SCHOOL OF NURSING, A SCHOOL FOR X-RAY TECHNICIANS, HOSPICE SERVICES, CERTAIN EMERGENCY DEPARTMENT SERVICES, OPERATION OF A WELLNESS CENTER, RENTAL ACTIVITIES, AND OPERATION OF AN EMPLOYEE CAFETERIA.
Form 990, Part VI, Line 2 FAMILY OR BUSINESS RELATIONSHIP	THE HOSPITAL'S BOARD OF TRUSTEES IS MADE UP OF HIGHLY RESPECTED LEADERS IN THE COMMUNITY. BOARD MEMBERS ARE SELECTED AND VOTED ON BY THE ENTIRE BOARD. THE HOSPITAL DOES NOT COMPENSATE OR SELECT BOARD MEMBERS. THE HOSPITAL HAS A CONFLICT OF INTEREST POLICY AND QUERIES BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES EACH YEAR ABOUT ANY BUSINESS OR FAMILY RELATIONSHIPS. THERE HAVE BEEN NO FAMILY RELATIONSHIPS REPORTED. ALTHOUGH NOT CLASSIFIED AS BUSINESS RELATIONSHIPS FOR THIS PURPOSE, NORMAL ARMS LENGTH BUSINESS TRANSACTIONS DO EXIST BETWEEN SOME BOARD MEMBERS. THE BUSINESS TRANSACTIONS ARE GENERALLY IRRELEVANT AND IMMATERIAL TO THE OPERATIONS OF THE HOSPITAL. THE HOSPITAL DOES NOT RECEIVE ANY BENEFITS FROM THE RELATIONSHIPS THAT EXIST AMONG BOARD MEMBERS NOR DOES IT INFLUENCE THE RELATIONSHIPS IN ANY WAY.
Form 990, Part VI, Line 6 Classes of members or stockholders	THE PARENT CORPORATION OF THE WASHINGTON HOSPITAL IS WASHINGTON HEALTH CARE SERVICES, INC. THE PARENT CORPORATION HAS THE FOLLOWING POWERS OVER THE BOARD OF TRUSTEES OF THE HOSPITAL: 1. THE POWER TO RATIFY THE SELECTION OF MEMBERS OF THE BOARD OF TRUSTEES OF THE WASHINGTON HOSPITAL. 2. THE POWER TO APPROVE ANY AMENDMENT, CHANGE, SUSPENSION OR REPEAL OF THE ARTICLES OF INCORPORATION OF THE WASHINGTON HOSPITAL, OR OF THE BYLAWS. 3. THE POWER TO NULLIFY ANY ACTION OF THE BOARD OF TRUSTEES OF THE WASHINGTON HOSPITAL WHICH THE BOARD OF TRUSTEES OF THE PARENT CORPORATION DETERMINES TO BE AN ULTRA VIRES ACT; THAT IS, ANY ACT OUTSIDE THE SCOPE OF THE LEGITIMATE POWERS OR BEYOND THE PURPOSE OF THE WASHINGTON HOSPITAL.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	THE PARENT CORPORATION OF THE WASHINGTON HOSPITAL IS WASHINGTON HEALTH CARE SERVICES, INC. THE PARENT CORPORATION HAS THE POWER TO RATIFY THE SELECTION OF MEMBERS OF THE BOARD OF TRUSTEES OF THE WASHINGTON HOSPITAL.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	THE PARENT CORPORATION OF THE WASHINGTON HOSPITAL IS WASHINGTON HEALTH CARE SERVICES, INC. THE PARENT CORPORATION HAS THE FOLLOWING POWERS OVER THE BOARD OF TRUSTEES OF THE HOSPITAL: 1. THE POWER TO RATIFY THE SELECTION OF MEMBERS OF THE BOARD OF TRUSTEES OF THE WASHINGTON HOSPITAL. 2. THE POWER TO APPROVE ANY AMENDMENT, CHANGE, SUSPENSION OR REPEAL OF THE ARTICLES OF INCORPORATION OF THE WASHINGTON HOSPITAL, OR OF THE BYLAWS. 3. THE POWER TO NULLIFY ANY ACTION OF THE BOARD OF TRUSTEES OF THE WASHINGTON HOSPITAL WHICH THE BOARD OF TRUSTEES OF THE PARENT CORPORATION DETERMINES TO BE AN ULTRA VIRES ACT; THAT IS, ANY ACT OUTSIDE THE SCOPE OF THE LEGITIMATE POWERS OR BEYOND THE PURPOSE OF THE WASHINGTON HOSPITAL.
Form 990, Part VI, Line 11b Review of form 990 by governing body	PRIOR TO BEING FILED, THE FORM 990 IS REVIEWED BY THE MEMBERS OF THE FINANCE COMMITTEE AS DESIGNATED BY THE ENTIRE BOARD OF TRUSTEES. THE FINANCE COMMITTEE MEETS WITH HOSPITAL MANAGEMENT AND REVIEWS THE CONTENT OF THE FORM 990. AFTER FILING OF THE FORM 990, THE FINANCE COMMITTEE REPORTS THE REVIEW AND ANY NOTABLE ITEMS FROM THE REVIEW TO THE FULL BOARD OF TRUSTEES.
Form 990, Part VI, Line 12c Conflict of interest policy	THE HOSPITAL'S CONFLICT OF INTEREST POLICY IS MONITORED PRIMARILY BY HOSPITAL MANAGEMENT. EACH YEAR A CONFLICT OF INTEREST STATEMENT MUST BE COMPLETED BY ALL BOARD OF TRUSTEE MEMBERS AS WELL AS CERTAIN KEY MANAGEMENT EMPLOYEES OF THE HOSPITAL. THE QUESTIONNAIRE IS DISTRIBUTED BY HOSPITAL MANAGEMENT AND ALL RESPONSES MUST BE RECEIVED. IF NECESSARY, THE ASSISTANCE OF THE BOARD CHAIRPERSON IS SOUGHT TO OBTAIN ALL RESPONSES. THE RESPONSES ARE INITIALLY REVIEWED BY HOSPITAL MANAGEMENT. ANY EXCEPTIONS OR POTENTIAL CONFLICTS ARE REVIEWED BY THE CEO AND BOARD CHAIRPERSON. ANY NECESSARY ACTION IS DETERMINED BY THE CHAIRPERSON AND ADDRESSED AT THE BOARD LEVEL. GREAT CARE IS TAKEN BY THE BOARD CHAIRPERSON TO ENSURE THAT AN INDEPENDENT BOARD IS IN PLACE. IN THE EVENT THAT A CONFLICT EXISTS, THAT PERSON IS PROHIBITED FROM PARTICIPATING IN ANY RELATED DECISION MAKING ON THAT ISSUE.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	THE EXECUTIVE COMPENSATION COMMITTEE DETERMINES THE COMPENSATION OF THE EXECUTIVES. AN INDEPENDENT CONSULTANT'S REVIEW OF EXECUTIVE SALARIES IS THE PRIMARY TOOL USED TO MAKE THEIR DETERMINATION (THE MOST RECENT CONSULTING REVIEW WAS IN MAY 2016). THE RESULTS OF MANAGEMENT'S SURVEY AND COMPARISON DATA WILL ALSO BE TAKEN INTO CONSIDERATION. ALL ACTIVITIES OF THE EXECUTIVE COMPENSATION COMMITTEE ARE REPORTED TO THE BOARD OF TRUSTEES.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	THE BOARD OF TRUSTEES ELECTS A PERSONNEL COMMITTEE TO HANDLE COMPENSATION, BENEFITS AND EMPLOYEE RELATED ISSUES RELATED TO THE HOSPITAL. THE GENERAL COMPENSATION PROCESS FOR ALL EMPLOYEES STARTS WITH HOSPITAL MANAGEMENT COMPILING SURVEY AND COMPARISON INFORMATION AND MAKING RECOMMENDATIONS FOR SALARY ADJUSTMENTS TO THE PERSONNEL COMMITTEE. THE PERSONNEL COMMITTEE REVIEWS THAT INFORMATION ANNUALLY, HAS DISCUSSIONS WITH HOSPITAL MANAGEMENT AND ULTIMATELY APPROVES OR DENIES THE RECOMMENDATIONS FOR SALARY ADJUSTMENTS.
Form 990, Part VI, Line 19 Required documents available to the public	THE HOSPITAL MAKES FORM 990 AND 990-T AVAILABLE TO THE PUBLIC BY REQUEST. THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT ROUTINELY AVAILABLE TO THE PUBLIC.
Form 990, Part VIII, Line 2f Other Program Service Revenue	ALL OTHER - Total Revenue: 112519, Related or Exempt Function Revenue: 6967, Unrelated Business Revenue: 105552, Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	ALL OTHER - Total Revenue: 490561, Related or Exempt Function Revenue: 449270, Unrelated Business Revenue: 41291, Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part IX, Line 11g Other Fees	Information system fees & contracts - Total Expense: 4186778, Program Service Expense: 3441518, Management and General Expenses: 745260, Fundraising Expenses: 0; Wellness Center fees & costs - Total Expense: 2225249, Program Service Expense: 1814127, Management and General Expenses: 411122, Fundraising Expenses: 0; Lab fees & services - Total Expense: 2100073, Program Service Expense: 2100073, Management and General Expenses: 0, Fundraising Expenses: 0; Anesthesia fees & services - Total Expense: 1832266, Program Service Expense: 1832266, Management and General Expenses: 0, Fundraising Expenses: 0; Other - Total Expense: 14438932, Program Service Expense: 11168786, Management and General Expenses: 3270146, Fundraising Expenses: 0;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	Pension Settlement Charge - -21068853; Transfers to Affiliates - -12502303; Change in Pension Liability - 10446868; Net Restricted Contributions - 2438612; Net Assets Released From Restriction - -1924262; Bond Swap Loss - -1681710; Auxiliary Gain - -261093;

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

The Washington Hospital

Employer identification number

25-0965600

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) 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 entity?
(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	Yes	No
(1)WASHINGTON HEALTHCARE SERVICES INC 155 WILSON AVENUE WASHINGTON,PA15301 25-1509768	HEALTH SYSTEM PARENT	PA	501(c)(3	Type II	NA		No
(2)THE WASHINGTON HOSPITAL FOUNDATION 155 WILSON AVENUE WASHINGTON,PA15301 25-1708215	SUPPORT TWH	PA	501(c)(3	Type II	WHCS	Yes
(3)TGCH Inc 350 Bonar Avenue Waynesburg,PA15370 47-3884840	Hospital	PA	501(c)(3	3	WHCS	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2015

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	(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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	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	(i) Section 512(b)(13) controlled entity?
(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	Yes	No
(1) WASHINGTON PHYSICIANS SERVICES ORG 155 WILSON AVENUE WASHINGTON,PA15301 25-1780139	PHYS OFFICES	PA	NA	C Corporation				No
(2) PHOENIX-WASHINGTON INC 800 MANOR DRIVE WASHINGTON,PA15301 25-1492898	SUBSTANCE TRT	PA	NA	C Corporation				No
(3) HEALTH FUTURES INC 155 WILSON AVENUE WASHINGTON,PA15301 25-1533189	URGENT CARE	PA	NA	C Corporation				No

Schedule R (Form 990) 2015

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

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, or (iv) rent from a controlled entity .....................

Yes

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

Yes

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

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 related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) Phoenix-Washington Inc	A	1,397,435	Actual Amount
(2) Washington Physician Services Org	B	6,000,000	Actual Amount
(3) TGCH Inc	B	6,502,304	Actual Amount
(4) The Washington Hospital Foundation	C	2,018,546	Actual Amount
(5) Phoenix-Washington Inc	D	522,048	Actual Amount
(6) Washington Physician Services Org	J	499,572	Actual Amount
(7) Phoenix-Washington Inc	L	1,060,741	Actual Amount
(8) The Washington Hospital Foundation	Q	443,653	Actual Amount

Schedule R (Form 990) 2015

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)	(e) Are all partners section 501(c)(3) organizations?		(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?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2015

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

1	Briefly describe the organization’s mission or most significant activities: THE WASHINGTON HOSPITAL IS A COMMUNITY HOSPITAL DEDICATED TO IMPROVING HEALTH / PROVIDING PATIENT CARE TO ALL PERSONS WITHOUT REGARD TO RACE, COLOR, RELIGION, SEX, NATIONAL ORIGIN, DISABILITY OR ABILITY TO PAY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	16
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 2015 (Part V, line 2a) ......	5	1,946
6	Total number of volunteers (estimate if necessary) .............	6	419
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	5,288,100
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	-85,100

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,953,378	2,018,546
9	Program service revenue (Part VIII, line 2g) .........	233,555,373	238,947,886
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	7,533,233	5,068,965
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	4,303,290	4,748,144
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	247,345,274	250,783,541
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	112,581
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)	119,905,958	123,763,973
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	95,736,221	98,682,281
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	215,642,179	222,558,835
19	Revenue less expenses. Subtract line 18 from line 12.......	31,703,095	28,224,706
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	317,017,124	322,194,115
21	Total liabilities (Part X, line 26).............	136,240,427	141,569,086
22	Net assets or fund balances. Subtract line 21 from line 20.....	180,776,697	180,625,029

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	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 100,895,839 including grants of $ 0 ) (Revenue $ 95,106,448 )
	INPATIENT ACUTE SERVICES WERE PROVIDED TO 11,789 PATIENTS IN THE COMMUNITY. THE WASHINGTON HOSPITAL PROVIDES A WIDE ARRAY OF MEDICAL AND SURGICAL SERVICES. SURGICAL SPECIALTIES INCLUDE NEUROSURGERY, CARDIOLOGY, CARDIOTHORACIC SURGERY, ORTHOPEDICS, OBSTETRICS, GYNECOLOGY, GASTROENTEROLOGY, UROLOGY AND GENERAL SURGERY. SERVICES WERE RENDERED REGARDLESS OF A PATIENT'S ABILITY TO PAY. ALL QUALITY MEASURES REQUIRED BY MEDICARE AND MAJOR INSURANCE CARRIERS WERE MET. 19% OF THE INPATIENT CASES WERE MEDICAL ASSISTANCE; 54% OF THE PATIENT CASES WERE MEDICARE.

4b	(Code: ) (Expenses $ 81,189,416 including grants of $ 0 ) (Revenue $ 103,983,537 )
	A WIDE VARIETY OF OUTPATIENT SERVICES WERE PROVIDED TO THE COMMUNITY INCLUDING LAB, RADIOLOGY, SURGICAL, OBSERVATION, EMERGENCY AND THERAPEUTIC SERVICES. APPROXIMATELY 300,000 OUTPATIENT VISITS WERE PERFORMED DURING THE YEAR. SERVICES WERE RENDERED REGARDLESS OF THE PATIENT'S ABILITY TO PAY. ALL QUALITY MEASURES REQUIRED BY MEDICARE AND MAJOR INSURANCE CARRIERS WERE MET. 16% OF THE OUTPATIENT VISITS WERE MEDICAL ASSISTANCE; 37% OF THE OUTPATIENT VISITS WERE MEDICARE.

4c	(Code: ) (Expenses $ 5,410,942 including grants of $ 0 ) (Revenue $ 4,640,138 )
	THE HOSPITAL SUPPORTS A 30 BED INPATIENT BEHAVIORAL HEALTH UNIT. IT IS ONE OF THE LARGEST UNITS OF ITS KIND IN THE HOSPITAL'S EXTENDED SERVICE AREA AND SERVED 993 PATIENTS THIS YEAR. SERVICES ARE RENDERED TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE UNIT HAS A VERY HIGH PERCENTAGE OF PATIENTS WITH MEDICAL ASSISTANCE (54%) AND 3% WHO ARE UNINSURED.

	(Code: ) (Expenses $ 2,682,780 including grants of $ 112,581 ) (Revenue $ 37,801,165 )
	OTHER PROGRAM SERVICES INCLUDE A MULTITUDE OF ACTIVITIES PERFORMED BY THE HOSPITAL TO DO BUSINESS IN THE COMMUNITY AND PROVIDE VALUABLE COMMUNITY BENEFITS. ACTIVITIES IN THIS CATEGORY INCLUDE, BUT ARE NOT LIMITED TO, A TEENAGE ABSTINENCE EDUCATION PROGRAM, A FAMILY PRACTICE RESIDENCY PROGRAM, A SCHOOL OF NURSING, A SCHOOL FOR X-RAY TECHNICIANS, HOSPICE SERVICES, CERTAIN EMERGENCY DEPARTMENT SERVICES, OPERATION OF A WELLNESS CENTER, RENTAL ACTIVITIES, AND OPERATION OF AN EMPLOYEE CAFETERIA.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 2,682,780 including grants of $ 112,581 ) (Revenue $ 37,801,165 )
4e	Total program service expenses190,178,977

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)				(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
(A) Name and Title
(18) ALISA R RUCKER VP FINANCE / CFO	40.0 .......................10.0	X			327,019	0	17,182
(19) GARY B WEINSTEIN PRESIDENT / CEO	40.0 .......................10.0	X			733,262	0	20,103
(20) BROOK T WARD Executive VP / COO	40.0 .......................10.0	X			376,637	0	19,551
(21) RODNEY LOUK VP INFORMATION & ANCILLARY SERVICES	40.0 .......................0.0		X		325,187	0	10,042
(22) KAREN BRAY VP PATIENT CARE SERVICES	40.0 .......................0.0		X		265,426	0	16,635
(23) COLLEEN ALLISON VP REG. AFFAIRS & QUALITY	40.0 .......................0.0			X	268,379	0	16,662
(24) WALTER P SLOMIANY MD ASSOC DIRECTOR FAMILY MEDICINE	40.0 .......................0.0			X	260,235	0	17,271
(25) PAUL CULLEN MD VP OF MEDICAL AFFAIRS	40.0 .......................0.0			X	448,739	0	18,262
(26) JEFFREY MINTEER MD DIRECTOR OF FAMILY MEDICINE	40.0 .......................1.0			X	349,071	0	17,755
(27) BARBARA MCCULLOUGH VP HUMAN RESOURCES	40.0 .......................0.0			X	255,394	0	18,476

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	3,609,349	0	171,939

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	2,018,546
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a-1f:$
h Total.Add lines 1a-1f.......		2,018,546

		Business Code
2a	HOSPITAL IP AND OP SERVICES	900099	231,440,780	227,987,235	3,453,545
b	WELLNESS CENTER	713940	4,965,394	4,965,394
c	EDUCATION/TUITION	611600	844,461	844,461
d	DRUG SALES	446110	1,579,585	1,565,720	13,865
e	SERVICES TO AFFILIATES	541900	5,147	5,147
f	All other program service revenue.			112,519	6,967	105,552	0
g Total.Add lines 2a–2f.....			238,947,886

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			5,035,500			5,035,500
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		2,950,557
b	Less: rental expenses		2,500,953
c	Rental income or (loss)	0	449,604
d	Net rental income or (loss)......			449,604			449,604
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	33,465
b	Less: cost or other basis and sales expenses	0
c	Gain or (loss)	33,465	0
d	Net gain or (loss).....			33,465			33,465
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..
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..
10a	Gross sales of inventory, less returns and allowances ..
	a		878,617
b	Less: cost of goods sold ..b		617,524
c	Net income or (loss) from sales of inventory..			261,093	261,093
Business Code			Miscellaneous Revenue
11a	MANAGEMENT SERVICES		541610	1,092,161		1,092,161
b	PARKING REVENUE		812930	743,042	743,042
c	CAFETERIA SALES		900099	1,711,683	1,129,997	581,686
d	All other revenue ....			490,561	449,270	41,291	0
e	Total. Add lines 11a–11d ......			4,037,447
12	Total revenue. See Instructions......			250,783,541	237,958,326	5,288,100	5,518,569

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	28,200	28,200
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	84,381	84,381
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0	0
4	Benefits paid to or for members	0	0
5	Compensation of current officers, directors, trustees, and key employees ....	2,319,247	1,906,413	412,834	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0	0	0	0
7	Other salaries and wages	99,894,913	82,113,292	17,781,621	0
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	556,094	457,107	98,987	0
9	Other employee benefits .......	13,975,174	11,487,547	2,487,627	0
10	Payroll taxes ...........	7,018,545	5,769,221	1,249,324	0
11	Fees for services (non-employees):
a	Management ......	116,196	116,196	0	0
b	Legal .........	314,810	0	314,810	0
c	Accounting ...........	285,711	0	285,711	0
d	Lobbying ...........	22,180	0	22,180	0
e	Professional fundraising services. See Part IV, line 17	0			0
f	Investment management fees ......	0	0	0	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	24,783,298	20,356,770	4,426,528	0
12	Advertising and promotion ....	970,912	798,086	172,826	0
13	Office expenses .......	4,590,788	3,773,613	817,175	0
14	Information technology ......	423,890	348,436	75,454	0
15	Royalties ..	0	0	0	0
16	Occupancy ...........	3,830,546	3,148,696	681,850	0
17	Travel ............	398,483	327,552	70,931	0
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0	0	0	0
19	Conferences, conventions, and meetings ....	0	0	0	0
20	Interest ...........	1,259,018	1,259,018	0	0
21	Payments to affiliates .......	0	0	0	0
22	Depreciation, depletion, and amortization ..	13,790,895	11,336,071	2,454,824	0
23	Insurance ...	3,503,127	3,101,397	401,730	0
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	36,102,579	36,102,579	0	0
b	MEDICAL ASSISTANCE TAX ASSESSMENT	4,804,375	4,804,375	0	0
c
d
e	All other expenses	3,485,473	2,860,027	625,446	0
25	Total functional expenses. Add lines 1 through 24e	222,558,835	190,178,977	32,379,858	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			14,217,121	1	21,867,353
2	Savings and temporary cash investments .........			0	2	0
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			23,439,828	4	22,423,714
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
					5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6	0
7	Notes and loans receivable, net ....			3,469,884	7	2,835,730
8	Inventories for sale or use ........			1,931,775	8	2,014,775
9	Prepaid expenses and deferred charges ......			3,631,448	9	3,236,707
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	287,116,410
b	Less: accumulated depreciation	10b	167,426,812	120,297,414	10c	119,689,598
11	Investments—publicly traded securities .			128,297,165	11	129,392,231
12	Investments—other securities. See Part IV, line 11 .....			0	12
13	Investments—program-related. See Part IV, line 11 ..			16,010,829	13	16,441,284
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			5,721,660	15	4,292,723
16	Total assets. Add lines 1 through 15 (must equal line 34)...			317,017,124	16	322,194,115

17	Accounts payable and accrued expenses .....	23,993,595	17	22,381,999
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	67,838,062	20	64,421,131
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other 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 ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24	25,000,000
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D	44,408,770	25	29,765,956
26	Total liabilities. Add lines 17 through 25..	136,240,427	26	141,569,086

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	167,104,238	27	166,379,262
28	Temporarily restricted net assets ...........	2,341,995	28	2,896,859
29	Permanently restricted net assets	11,330,464	29	11,348,908
	Organizations that do not follow SFAS 117 (ASC 958), check here 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 ...........	180,776,697	33	180,625,029
34	Total liabilities and net assets/fund balances ........	317,017,124	34	322,194,115

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No