TY 2017 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)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(1) PHILIP W GUARNESCHELLI...................................................................... CO-CHAIR	1.00 .................	X	X		0	0
(2) WILLIAM H PUGH...................................................................... SECRETARY/TREASURER	1.00 .................	X	X		0	0
(3) JAMES W JORDAN...................................................................... DIRECTOR	1.00 .................	X			0	0
(4) ROBERT WHALEN...................................................................... DIRECTOR	1.00 .................	X			0	0
(5) ERIKA SAUNDERS MD...................................................................... DIRECTOR	1.00 .................	X			0	0
(6) SUSAN COMP...................................................................... DIRECTOR	1.00 .................	X			0	0
(7) ALAN BRECHBILL...................................................................... CO-CHAIR	1.00 .................	X	X		0	0
(8) SUSAN PROMES MD...................................................................... DIRECTOR	1.00 .................	X			0	0
(9) WILLIAM BIRD MD...................................................................... DIRECTOR	1.00 .................	X			0	0
(10) MICHAEL HUFF...................................................................... DIRECTOR (TERM EXP. 1/2018)	1.00 .................	X			0	0
(11) TAYLOR ANDREWS...................................................................... DIRECTOR	1.00 .................	X			0	0
(12) WILLIAM DALY...................................................................... CEO (UNTIL NOV. 2018)	40.00 .................		X		252,796	22,086
(13) THERESA TERRY-WILLIAMS...................................................................... CHIEF NURSING OFFICER	40.00 .................		X		135,739	15,142
(14) BRIAN M MORGAN...................................................................... CHIEF FINANCIAL OFFICER	40.00 .................		X		71,434	8,914
(15) KIMBERLY FEEMAN...................................................................... CEO (AS OF 11/2018)	40.00 .................		X		0	0
(16) RICHARD PRENSNER...................................................................... PHYSICIAN	40.00 .................			X	267,393	37,937
(17) ROSE WHITLEY...................................................................... REGISTERED NURSE	40.00 .................			X	126,182	26,618

(A) Name and business address	(B) Description of services	(C) Compensation
UPMC PINNACLE 409 SOUTH SECOND ST HARRISBURG,PA171058700	ADMIN & SUPPORT SVCS	6,973,524
PENN STATE HEALTH 500 UNIVERSITY DR HERSHEY,PA17033	PSYCH. PHYSICIAN SVCS	5,346,540
WEST SHORE ANESTHESIA ASSOCIATES LTD PO BOX 1050 CAMP HILL,PA17001	ECT ANESTHESIOLOGISTS	315,900
DIANE ANGSTADT MD, 1801 SCARLET LANE MIDDLETOWN,PA17057	PSYCH. PHYSICIAN SVCS	228,200
EBO SOLUTIONS LLC PO BOX 67015 HARRISBURG,PA17106	BILLING/COLLECTION SVCS	191,186
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 9

- 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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

PENNSYLVANIA PSYCHIATRIC INSTITUTE

Employer identification number

26-1699000

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 12, 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 agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

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 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

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) 2019

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. 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—2018. 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—2019. 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—2018. 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) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. 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—2018. 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) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d 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 12a or 12b 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) 2019

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) 2019

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 (explain in Part VI). 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) 2019

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 2019 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-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

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) 2019

Additional Data

Software ID:
Software Version:

- 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.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Name of the organization

PENNSYLVANIA PSYCHIATRIC INSTITUTE

Employer identification number

26-1699000

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. Don't 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 isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2

Name of organization PENNSYLVANIA PSYCHIATRIC INSTITUTE

Part I Contributors	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
		$	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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 3

Name of organization PENNSYLVANIA PSYCHIATRIC INSTITUTE		Employer identification number 26-1699000

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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 4


Name of organization PENNSYLVANIA PSYCHIATRIC INSTITUTE			Employer identification number 26-1699000
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) (2019)

Additional Data

Software ID:
Software Version:

- 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.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

PENNSYLVANIA PSYCHIATRIC INSTITUTE

Employer identification number

26-1699000

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 7/25/06, 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 FASB 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 FASB 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 FASB 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) 2019

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

Term 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 .....
b	Buildings ....
c	Leasehold improvements	757,121	284,402	472,719
d	Equipment ....	3,755,700	2,371,753	1,383,947
e	Other .....	18,802		18,802
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				1,875,468

Schedule D (Form 990) 2019

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
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)
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) 2019

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	39,709,474
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	0
3	Subtract line 2e from line 1..................		3	39,709,474
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	0
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5	39,709,474

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	38,021,885
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	0
3	Subtract line 2e from line 1...................		3	38,021,885
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	0
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5	38,021,885

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

PART X, LINE 2:

PENNSYLVANIA PSYCHIATRIC INSTITUTE (PPI) ADHERES TO THE PROVISIONS OF THE FINANCIAL ACCOUNTING STANDARDS BOARD CODIFICATION 740, INCOME TAXES(ASC 740). ASC 740 PRESCRIBES A COMPREHENSIVE MODEL FOR FINANCIAL STATEMENT RECOGNITION, MEASUREMENT, CLASSIFICATION AND DISCLOSURE OF UNCERTAIN TAX POSITIONS. PPI HAS CONCLUDED THAT THERE ARE NO UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE COMBINED FINANCIAL STATEMENTS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO FISCAL YEAR 2015.

Schedule D (Form 990) 2019

Additional Data

Software ID:
Software Version:

- 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

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

PENNSYLVANIA PSYCHIATRIC INSTITUTE

Employer identification number

26-1699000

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 25000.0000000000 %

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? . . . . . .

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		(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) . . .	61,724		61,724	0.160 %
b	Medicaid (from Worksheet 3, column a) . . . . .	14,406,237	11,548,619	2,857,618	7.520 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	14,467,961	11,548,619	2,919,342	7.680 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).
f	Health professions education (from Worksheet 5) . . .
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .
j	Total. Other Benefits . .
k	Total. Add lines 7d and 7j .	14,467,961	11,548,619	2,919,342	7.680 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

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	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	1		2,160	2,160	0.010 %
4	Environmental improvements
5	Leadership development and training for community members	11	220	3,400	3,400	0.010 %
6	Coalition building	4		4,680	4,680	0.010 %
7	Community health improvement advocacy	19	2,480	5,680	5,680	0.010 %
8	Workforce development
9	Other
10	Total	35	2,700	15,920	15,920	0.040 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

3,065,794

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. ......

98,105

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).....

11,548,619

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

14,406,237

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

-2,857,618

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 %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2019

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?1Name, 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)			Other (describe)
1	PENNSYLVANIA PSYCHIATRIC INSTITUTE 2501 NORTH THIRD STREET HARRISBURG,PA171102098 WWW.PPIMHS.ORG 325480	X	ACUTE PSYCHIATRIC

Schedule H (Form 990) 2019

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)

	PENNSYLVANIA PSYCHIATRIC INSTITUTE
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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

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. ............................

Yes

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): WWW.PPIMS.ORG/ABOUT-US/COMMUNITY-PROGRAMS

Other website (list url): WWW.GEISINGER.ORG, WWW.UPMCPINNACLE.COM, HMC.PENNSTATEHEALTH.ORG

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): WWW.PPIMHS.ORG/ABOUT-US/COMMUNITY-PROGRAMS

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) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	PENNSYLVANIA PSYCHIATRIC INSTITUTE
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 250.000000000000%
and FPG family income limit for eligibility for discounted care of 400.000000000000%

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)

Was widely publicized 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):

WWW.PPIMHS.ORG/PATIENT-AND-VISITORS

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

WWW.PPIMHS.ORG

A plain language summary of the FAP was widely available on a website (list url):
WWW.PPIMHS.ORG/PATIENTS-AND-VISITORS/PATIENT-BILLING-INFORMATION

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)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	PENNSYLVANIA PSYCHIATRIC INSTITUTE
Name of hospital facility or letter of facility reporting group

Yes

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 nonpayment?..................................

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

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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

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

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

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)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

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

	PENNSYLVANIA PSYCHIATRIC INSTITUTE
Name of hospital facility or letter of facility reporting group

Yes

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 a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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) 2019

Page 8

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, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 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
PENNSYLVANIA PSYCHIATRIC INSTITUTE	PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPRESENTED A COMMUNITY-WIDE PROCESS WHERE UPMC PINNACLE CARLISLE, PENN STATE HEALTH, UPMC PINNACLE, AND PENNSYLVANIA PSYCHIATRIC INSTITUTE CONNECTED WITH A WIDE RANGE OF PUBLIC AND PRIVATE ORGANIZATIONS, SUCH AS EDUCATIONAL INSTITUTIONS, HEALTH-RELATED PROFESSIONALS, LOCAL GOVERNMENT OFFICIALS, HUMAN SERVICE ORGANIZATIONS, AND FAITH-BASED ORGANIZATIONS TO EVALUATE THE COMMUNITY'S HEALTH AND SOCIAL NEEDS. THE ASSESSMENT INCLUDED PRIMARY DATA COLLECTION, INTERVIEWS WITH COMMUNITY STAKEHOLDERS, FOCUS GROUPS WITH KEY AUDIENCES, AND COMMUNITY FORUMS.
PENNSYLVANIA PSYCHIATRIC INSTITUTE	PART V, SECTION B, LINE 6A: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED WITH UPMC PINNACLE CARLISLE, UPMC PINNACLE, AND PENN STATE HEALTH.
PENNSYLVANIA PSYCHIATRIC INSTITUTE	PART V, SECTION B, LINE 6B: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED WITH THE FOLLOWING ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES: HAMILTON HEALTH CENTER, A FEDERALLY QUALIFIED HEALTH CENTER, AND UPMC FOR LIFE.
PENNSYLVANIA PSYCHIATRIC INSTITUTE	PART V, SECTION B, LINE 11: THE LAST COMMUNITY HEALTH NEEDS ASSESSMENT WAS APPROVED BY THE BOARD IN OCTOBER 2018 AND THE RELATED IMPLEMENTATION PLAN IS IN PREPARATION.
PENNSYLVANIA PSYCHIATRIC INSTITUTE	PART V, SECTION B, LINE 16J: PENNSYLVANIA PSYCHIATRIC INSTITUTE USES THE LOOK-BACK METHOD WHEN CALCULATING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE.

Schedule H (Form 990) 2019

Page 9

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?
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2019

Page 10

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
PART I, LINE 7:	THE SOURCE USED TO DETERMINE THE AMOUNT OF MEANS-TESTED GOVERNMENT PROGRAMS WAS THE 2017 MEDICAL ASSISTANCE COST REPORT, SCHEDULES S-6 AND S-7, AND THE MEDICARE COST REPORT SCHEDULE C.
PART I, LN 7 COL(F):	BAD DEBT EXPENSE OF $3,065,794 IS INCLUDED IN NET PATIENT REVENUE ON FORM 990, PART VIII LINE 2A, AND THEREFORE IS NOT INCLUDED FOR THE PURPOSES OF CALCULATING THE APPLICABLE EXPENSE PERCENTAGES OF SCHEDULE H.
PART II, COMMUNITY BUILDING ACTIVITIES:	PPI VOLUNTEERS AT PRINCE OF PEACE FOOD PANTRY EACH MONTH TO BE ON HAND TO ADVISE AND SUPPORT CONSUMERS EXPERIENCING CHALLENGES IN THEIR EVERYDAY LIVES. APPROX. 3 STAFF X 2 HOURS EACH PER MONTH.PART II, LINE 5: PPI PARTICIPATED IN TRAINING AND PRESENTING AT THE FOLLOWING EVENTS: EMOTIONAL WELLNESSMENTAL HEALTH SIGNS & SYMPTOMS DEPRESSION IN MOTHERSMENTAL HEALTH FIRST AID ADULTS MENTAL HEALTH FIRST AID MENTAL HEALTH FIRST AID - CHILDREN MENTAL HEALTH TRAINING SUBSTANCE ABUSE TRAININGSIGNS & SYMPTOMS ACCESS TO PPI SERVICESPART II, LINE 6: THE DIRECTOR OF BUSINESS DEVELOPMENT & ADMISSIONS VOLUNTEERS AS A BOARD OF DIRECTOR AT JEWISH FAMILY SERVICES, APPROXIMATELY 6 HOURS PER MONTH (ADDITIONAL TIME IF NEEDED) ADVISING COUNSEL AND PROVIDING MENTAL HEALTH, ADOPTION, EDUCATION AND CASE MANAGEMENT SERVICES TO THE COMMUNITY. PPI ALSO PROMOTES JFS AS AN EQUAL OPPORTUNITIES PARTNER PROVIDING SERVICES TO ALL RELIGIOUS AND NON-RELIGIOUS JEWISH AND NON-JEWISH FAMILY CLIENTS. PPI ALSO WORKS COLLABORATIVELY WITH JFS TO TRAIN THE COMMUNITY ON "IDENTIFYING SIGNS & SYMPTOMS" 2 X PER YEAR AND CULTURAL SENSITIVITY IN THE WORKPLACE (AS NEEDED).THE MANAGER OF SOCIAL SERVICES IS A BOARD MEMBER OF PAXTON MINISTRIES WHO MEET MONTHLY FOR APPROXIMATELY 2 HOURS TO DISCUSS VOTE ON, AND IMPLEMENT ORGANIZATION CHANGES.PPI ALSO CONTINUED ITS COLLABORATION AMONG UNITED WAY, HAMILTON HEALTH & THE PPI - ACCESS TO HEALTH CARE PROGRAM. PPI PERSONNEL ALSO ATTEND THEN HAMILTON HEALTH HEALTHY START ADVISORY GROUP MEETING QUARTERLY.
PART III, LINE 2:	ACTUAL BAD DEBTS WERE GROSSED UP BY A CONTRACTUAL AMOUNT TO ARRIVE AT TOTAL ESTIMATED GROSS REVENUES. THE COST TO CHARGE RATIO WAS APPLIED TO THE ESTIMATED GROSS REVENUES TO ESTIMATE THE COST OF BAD DEBT.
PART III, LINE 4:	THE FINANCIAL STATEMENTS DO NOT HAVE A SPECIFIC NOTE ON BAD DEBT EXPENSE; RATHER, THE FINANCIAL STATEMENTS EVALUATE BAD DEBTS BASED ON ITS ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOOTNOTE 2, SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES, ADDRESSES THIS AS FOLLOWS: "THE PREPARATION OF FINANCIAL STATEMENTS IN CONFORMITY WITH ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRES MANAGEMENT TO MAKE ESTIMATES AND ASSUMPTIONS THAT AFFECT THE REPORTED AMOUNTS OF ASSETS AND LIABILITIES AND DISCLOSURE OF CONTINGENT ASSETS AND LIABILITIES AT THE DATE OF THE FINANCIAL STATEMENTS AND THE REPORTED AMOUNTS OF REVENUES AND EXPENSES DURING THE REPORTING PERIOD." THESE SIGNIFICANT ESTIMATES INCLUDE THE ACCOUNTS RECEIVABLE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND CONTRACTUAL ALLOWANCES. ACTUAL RESULTS COULD DIFFER FROM THOSE ESTIMATES AS THEY ARE PREPARED BASED ON CERTAIN ASSUMPTIONS WHICH ARE SUBJECT TO CHANGE. THE FOOTNOTE FOR THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS, "ACCOUNTS RECEIVABLE ARE RECORDED AT THEIR ESTIMATED NET REALIZABLE VALUE. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS ESTIMATED BASED UPON HISTORICAL COLLECTION RATES."
PART III, LINE 8:	MEDICARE SHOULD BE CONSIDERED A COMMUNITY BENEFIT IN PART BECAUSE THE MEDICARE BASE PER DIEM IS APPROXIMATELY $500 PER DAY BELOW COST. THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS: FISCAL YEAR ENDING 2017 MEDICARE COST REPORT WORKSHEETS D-1, PART II, E PART B, AND E-3, PART II. THE COST REPORT USES A COMBINATION OF DATA FROM THE GENERAL LEDGER AND QUERIES FROM THE DECISION SUPPORT DATABASE FOR DETERMINATION OF MEDICARE ALLOWABLE COSTS.
PART III, LINE 9B:	IT IS THE POLICY OF PPI TO CONSIDER EACH PATIENT'S ABILITY TO PAY FOR HIS OR HER MEDICAL CARE BY PROVIDING A LEVEL OF CHARITY CARE AND FINANCIAL ASSISTANCE TO UNINSURED PATIENTS REQUIRING MEDICALLY NECESSARY HEALTH CARE SERVICES BASED ON FINANCIAL ELIGIBILITY CRITERIA. PPI IS COMMITTED TO TREATING PATIENTS WHO HAVE FINANCIAL NEEDS WITH THE SAME DIGNITY AND CONSIDERATION THAT IS EXTENDED TO ALL OF ITS PATIENTS CONSISTENT WITH THE MISSION OF PPI.A PATIENT WHO IS IDENTIFIED AS A POTENTIAL RECIPIENT OF CHARITY CARE IS ASKED TO COMPLETE AN APPLICATION, ALONG WITH SUPPORTING DOCUMENTATION, WHICH WILL BE REVIEWED AND A DETERMINATION WILL BE PROVIDED WITHIN TWO WEEKS. IF APPROVED, THE DISCOUNT IS APPLIED TO ALL OPEN ACCOUNTS AND IS EFFECTIVE FOR SIX MONTHS FROM THE DATE OF APPROVAL. PATIENTS PROVIDED PARTIAL FINANCIAL AID DISCOUNTS ARE EXPECTED TO MAKE REASONABLE PAYMENT ARRANGEMENTS. UNINSURED PATIENTS ARE INTERVIEWED BY HEALTHCARE RECEIVABLE SPECIALISTS, INC. (HRSI) TO DETERMINE MEDICAL ASSISTANCE ELIGIBILITY. IN TOTAL 518 PATIENTS WERE REFERRED TO HRSI TO COMPLETE MEDICAL ASSISTANCE APPLICATIONS DURING FISCAL YEAR 2018.
PART VI, LINE 2:	IN CONJUNCTION WITH FOUR OTHER AREA HOSPITALS AND A FEDERALLY QUALIFIED HEALTH CENTER, PPI ASSESSES THE NEEDS THROUGH THE CHNA AND COLLABORATES WITH OTHER COMMUNITY ORGANIZATIONS LOOKING AT THEIR COMPILED DATA AND FINDINGS. PPI CONTINUES TO ASSIST REFERRING FACILITIES THROUGH TRAININGS AND FURTHER COLLABORATION MEETINGS TO REDUCE WAIT TIMES IN THEIR EMERGENCY ROOMS. PPI'S "DIRECT ADMISSION PROCESS" TO REFER PATIENTS FROM AN OUTPATIENT CLINIC FACILITY DIRECTLY TO PPI (SUBJECT TO OUR CRITERIA) NOW INCLUDES EDUCATIONAL FACILITIES. THIS ACCELERATES THE DELIVERY OF NEEDED TREATMENT.PPI CONTINUES TO ENHANCE AND ASSIST PROVIDERS AND PATIENTS BY MAKING OUTPATIENT APPOINTMENTS AND REQUESTS FOR INFORMATION AND SERVICES AVAILABLE THROUGH MULTIPLE MEDIA AT A TIME THAT BETTER SUITS EACH INDIVIDUAL'S NEEDS.
PART VI, LINE 3:	PPI CONTRACTS WITH HEALTHCARE RECEIVABLE SPECIALISTS (HRSI) TO ASSIST UNINSURED PATIENTS, WITHOUT THE RESOURCES TO PAY THEIR PPI BILLINGS, IN OBTAINING ELIGIBILITY UNDER THE MEDICAL ASSISTANCE PROGRAM. IN ADDITION, THE PPI BILLING SERVICE REVIEWS BAD DEBTS FOR POSSIBLE CHARITY CARE TREATMENT. BROCHURES ARE AVAILABLE SUMMARIZING THE PPI GUIDE TO PATIENT BILLING AND PAYMENT POLICIES. FINANCIAL ASSISTANCE DIRECTION IS INCLUDED IN THE BROCHURE AND THE BROCHURES ARE AVAILABLE UPON REQUEST. IN ADDITION, AT PATIENT ENTRY LOCATIONS, CHARITY CARE AND FINANCIAL ASSISTANCE POSTERS HAVE BEEN POSTED.
PART VI, LINE 4:	PPI PROVIDES THE INPATIENT AND OUTPATIENT PSYCHIATRIC NEEDS TO ASSURE A COMPLETE CONTINUUM OF CARE FOR OUR TWO MEMBER ORGANIZATIONS, PENN STATE HEALTH IN HERSHEY, PENNSYLVANIA AND UPMC PINNACLE IN HARRISBURG, PENNSYLVANIA, BOTH IN DAUPHIN COUNTY. APPROXIMATELY 79% OF OUR INPATIENT ADMISSIONS ARE FROM THESE TWO ORGANIZATIONS. HERSHEY IS A SUBURBAN SETTING AND HARRISBURG IS AN URBAN SETTING. IN ADDITION, APPROXIMATELY 2% OF OUR ADMISSIONS ARE FROM OUR OUTPATIENT CLINICS.OUR PAYER MIX IS MEDICARE 35%, MEDICAID 34%, BLUES 19%, HMO 8%, OTHER THIRD PARTY 2%, AND SELF-PAY 2%. APPROXIMATELY 22% OF OUR ADMISSIONS ARE NOT INSURED OF WHICH APPROXIMATELY 90% BECOME ELIGIBLE FOR MEDICAL ASSISTANCE. APPROXIMATELY 35% OF OUR PATIENTS ARE ADMITTED WITH MEDICAL ASSISTANCE.THERE ARE TWO OTHER HOSPITALS IN THE AREA THAT SERVICE AN INPATIENT PSYCHIATRIC POPULATION, HOLY SPIRIT - A GEISINGER AFFILIATE IN CUMBERLAND COUNTY, TO OUR WEST, AND PHILHAVEN BEHAVIORAL HEALTHCARE IN LEBANON COUNTY, TO OUR EAST. PPI ALSO RECEIVES REFERRALS FOR INPATIENT PSYCHIATRIC CARE FROM ALL OTHER COUNTIES IN CENTRAL PENNSYLVANIA WHERE PSYCHIATRIC RESOURCES ARE LIMITED.
PART VI, LINE 5:	PPI HAS THREE COMMUNITY MEMBERS ON OUR GOVERNING BODY. ONE IS THE EXECUTIVE DIRECTOR OF THE PENNSYLVANIA CHAPTER OF THE NATIONAL ALLIANCE ON MENTAL ILLNESS, THE SECOND IS CEO OF H. B. MCCLURE, A LOCAL PLUMBING, HEATING AND AIR CONDITIONING COMPANY, AND THE THIRD IS A PARTNER AT ANDREWS AND JOHNSON LAW OFFICE. A MAJORITY OF THE MEDICAL STAFF IS PROVIDED BY PENN STATE HEALTH, OUR LOCAL ACADEMIC MEDICAL CENTER, WITH WHOM WE HAVE A CONTRACTUAL RELATIONSHIP FOR THIS SERVICE. PPI HAS THE ABILITY TO PROVIDE EMERGENCY MEDICAL STAFF PRIVILEGES IF NEEDED. PPI HAS OPERATED AT A LOSS IN EACH YEAR OF EXISTENCE, WHEN EXCLUDING THE FINANCIAL SUPPORT OF ITS MEMBER ORGANIZATIONS, PENN STATE HEALTH AND UPMC PINNACLE.
PART VI, LINE 6:	OVER TEN YEARS AGO, A STATE-OWNED INPATIENT PSYCHIATRIC HOSPITAL LOCATED IN THE CITY OF HARRISBURG WAS CLOSED RESULTING IN A COMMUNITY NEED FOR INPATIENT PSYCHIATRIC SERVICES. IN ADDITION, DURING THE SAME TIMEFRAME, THE STATE HAS CLOSED OTHER INPATIENT PSYCHIATRIC HOSPITALS CAUSING INCREASED LENGTH OF STAY FOR ISOLATED PATIENTS AND CREATING PLACEMENT ISSUES FOR THE PENNSYLVANIA PSYCHIATRIC INSTITUTE (PPI).PPI IS A NON-PROFIT ORGANIZATION THAT WAS CREATED ON JANUARY 10, 2008 BY A JOINT VENTURE BETWEEN PENN STATE MILTON S. HERSHEY MEDICAL CENTER AND UPMC PINNACLE, COLLECTIVELY KNOWN AS "MEMBERS" IN RESPONSE TO THE SIGNIFICANT VOID THAT WAS CREATED BY THE CLOSURE OF THE STATE-OWNED PSYCHIATRIC HOSPITALS. THE MEMBERS ARE REQUIRED TO FUND PPI AND ITS FUTURE OPERATIONS. THE MISSION OF PENNSYLVANIA PSYCHIATRIC INSTITUTE (PPI) IS TO PROVIDE BEHAVIORAL HEALTH SERVICES TO THE RESIDENTS OF CENTRAL PENNSYLVANIA AND THE SURROUNDING REGIONS. WE CREATE SPECIALIZED BEHAVIORAL HEALTH TREATMENT PROGRAMS FOR CHILDREN, ADOLESCENTS, ADULTS, AND MATURE ADULTS SO THAT THE UNIQUE NEEDS OF EACH GROUP CAN BE ADDRESSED SEPARATELY. PPI TREATS MENTAL HEALTH AND SUBSTANCE USE DISORDERS AT OUR MAIN PSYCHIATRIC HOSPITAL ON THIRD STREET IN HARRISBURG, PA. WE ALSO PROVIDE OUTPATIENT MENTAL HEALTH SERVICES FOR ADULTS AT OUR DIVISION STREET CLINIC AND OUTPATIENT AND PARTIAL HOSPITALIZATION TREATMENT FOR CHILDREN, ADOLESCENTS, AND TEENS AT OUR THIRD STREET CLINIC.

Schedule H (Form 990) 2019

Additional Data

Software ID:
Software Version:

- 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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

PENNSYLVANIA PSYCHIATRIC INSTITUTE

Employer identification number

26-1699000

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 on 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 on 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 nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

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) 2019

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)
1WILLIAM DALY CEO (UNTIL NOV. 2018)	(i) (ii)	252,796 ------------- 0	0 ------------- 0	0 ------------- 0	13,850 ------------- 0	8,236 ------------- 0	274,882 ------------- 0	0 ------------- 0
2THERESA TERRY-WILLIAMS CHIEF NURSING OFFICER	(i) (ii)	135,739 ------------- 0	0 ------------- 0	0 ------------- 0	6,906 ------------- 0	8,236 ------------- 0	150,881 ------------- 0	0 ------------- 0
3RICHARD PRENSNER PHYSICIAN	(i) (ii)	267,393 ------------- 0	0 ------------- 0	0 ------------- 0	13,347 ------------- 0	24,590 ------------- 0	305,330 ------------- 0	0 ------------- 0
4ROSE WHITLEY REGISTERED NURSE	(i) (ii)	126,182 ------------- 0	0 ------------- 0	0 ------------- 0	7,680 ------------- 0	18,938 ------------- 0	152,800 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2019

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
PART I, LINE 7	A HOSPITALIST MAY QUALIFY FOR ADDITIONAL COMPENSATION BY MEETING QUALITY OF CARE OUTCOME INDICATORS AGREED UPON BETWEEN THE CHIEF MEDICAL OFFICER AND THE HOSPITALIST. THE ADDITIONAL COMPENSATION MAY BE NO MORE THAN $6,000 ANNUALLY.

Schedule J (Form 990) 2019

Additional Data

Software ID:
Software Version:

- 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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

PENNSYLVANIA PSYCHIATRIC INSTITUTE

Employer identification number

26-1699000

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 6	THE MEMBERS OF THE ORGANIZATION ARE PENN STATE HEALTH AND UPMC PINNACLE. THESE ORGANIZATIONS REPRESENT A SINGLE CLASS OF MEMBERS. ADMISSION OF ADDITIONAL MEMBERS, IF ANY, SHALL BE IN ACCORDANCE WITH THE AGREEMENT BETWEEN MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7A	THE BOARD OF DIRECTORS CONSISTS OF 4 DIRECTORS DESIGNATED BY PENN STATE HEALTH AND 4 DIRECTORS DESIGNATED BY UPMC PINNACLE. THESE 8 DIRECTORS THEN SELECT UP TO THREE COMMUNITY BOARD MEMBERS AND ANY ADDITIONAL MEMBERS, NOT EXCEEDING A TOTAL OF 4 ADDITIONAL MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7B	THE FOLLOWING ACTIONS REQUIRE APPROVAL BY THE MEMBER DIRECTORS: (A) THE SALE OF THE ORGANIZATION OR SUBSTANTIALLY ALL OF THE ASSETS; (B) A CHANGE IN LOCATION OF THE HOSPITAL; (C) THE ADMISSION OF NEW MEMBERS; (D) THE DISSOLUTION OF THE ORGANIZATION; (E) THE INCURRING OF INDEBTEDNESS IN EXCESS OF $10,000; (F) A CAPITAL EXPENDITURE IN EXCESS OF THE AMOUNT APPROVED IN THE CAPITAL BUDGET; (G) THE APPOINTMENT OF AUDITORS; (H) ANY AMENDMENT TO THE ORGANIZATION'S BYLAWS.
FORM 990, PART VI, SECTION B, LINE 11B	THE FORM 990 WILL BE REVIEWED BY THE CEO PRIOR TO FILING. EACH BOARD MEMBER WILL RECEIVE A COPY PRIOR TO THE FILING OF THE RETURN.
FORM 990, PART VI, SECTION B, LINE 12C	IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE AND NATURE OF HIS OR HER FINANCIAL INTEREST TO THE DIRECTORS AND ANY RELEVANT COMMITTEE MEMBERS. AN INTERESTED PERSON SHALL INCLUDE ANY DIRECTOR, OFFICER, OR MEMBER OF A COMMITTEE OF THE CORPORATION OR AN ENTITY AFFILIATED WITH THE CORPORATION WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST IN A PROPOSED TRANSACTION. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, THE INTERESTED PERSON SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD OR COMMITTEE MEETING, BUT AFTER THE PRESENTATION, HE OR SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POSSIBLE CONFLICT OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15	MEMBERS OF THE BOARD ARE PART OF A SEARCH COMMITTEE THAT ESTABLISHES SALARY RECOMMENDATIONS AND ANALYSIS USING COMPARABILITY DATA FOR THE CEO POSITION UPON HIS INITIAL HIRE WITH THE INTENTION TO MAINTAIN COMPENSATION WITHIN FAIR MARKET RANGE FOR THE INDUSTRY. ANNUALLY, A PERFORMANCE REVIEW IS PERFORMED UPON WHICH A MERIT INCREASE IS BASED. INCREASES ARE APPROVED BY THE BOARD. COMPENSATION FOR SENIOR LEADERSHIP IS BASED ON A HUMAN RESOURCES FORMULA IN CONJUNCTION WITH COMPARABILITY DATA AND APPROVED BY THE CEO. ANNUALLY, BASED ON SUGGESTIONS FROM THE CEO, SENIOR LEADERSHIP RECEIVE MERIT INCREASES BASED ON PERFORMANCE. CEO RECOMMENDATIONS ARE REVIEWED AND APPROVED BY THE BOARD. THE BOARD DETERMINES THE MAXIMUM ORGANIZATIONAL MERIT RATE INCREASES.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE FOR PUBLIC INSPECTION. THE ORGANIZATION INCLUDES A COPY OF ITS FINANCIAL STATEMENTS WITH THE STATE REGISTRATION FILED WITH THE PENNSYLVANIA DEPARTMENT OF STATE, BUREAU OF CHARITABLE ORGANIZATIONS. THESE DOCUMENTS ARE A MATTER OF PUBLIC RECORD AND CAN BE VIEWED AT THE BUREAU OFFICE.
FORM 990, PART IX, LINE 11G	PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 6,567,939. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,567,939. CONSULTING FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 26,504. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 26,504. RECRUITING EXPENSES: PROGRAM SERVICE EXPENSES 570. MANAGEMENT AND GENERAL EXPENSES 80,439. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 81,009. OUTSOURCING EXPENSES: PROGRAM SERVICE EXPENSES 402,613. MANAGEMENT AND GENERAL EXPENSES 3,230,875. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,633,488. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 25,652. MANAGEMENT AND GENERAL EXPENSES 48,334. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 73,986.
FORM 990, PART VI, LINE 1B	THE MEMBERS OF THE PENNSYLVANIA PSYCHIATRIC INSTITUTE (PPI) ARE PENN STATE HEALTH AND UPMC PINNACLE. THE BOARD OF DIRECTORS CONSISTS OF 4 DIRECTORS DESIGNATED BY PENN STATE HEALTH AND 4 DIRECTORS DESIGNATED BY UPMC PINNACLE. THE MEMBERS ARE NOT CONSIDERED TO BE RELATED ORGANIZATIONS TO PPI SINCE NEITHER MEMBER HAS A CONTROLLING INTEREST IN PPI. AS SUCH, THE MEMBERS ARE NOT REPORTED ON SCHEDULE R AS RELATED ORGANIZATIONS. ALSO, THE COMPENSATION PAID BY THE MEMBERS TO THE MEMBER DIRECTORS FOR THEIR SERVICES PERFORMED AS EMPLOYEES OF THE MEMBERS (NOT PPI) IS NOT REPORTED AS COMPENSATION PAID BY A RELATED ORGANIZATION. HOWEVER, IN THE INTEREST OF TRANSPARENCY, PPI IS NOT REPORTING THE EIGHT MEMBER DIRECTORS DESIGNATED BY THE MEMBERS AS BEING INDEPENDENT BOARD MEMBERS.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: PROVIDE COMPREHENSIVE BEHAVIORAL HEALTH SERVICES FOR PATIENTS THROUGHOUT CENTRAL PENNSYLVANIA.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	10
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	3
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	437
6	Total number of volunteers (estimate if necessary) .............	6	1
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	8,062,233	14,263,315
9	Program service revenue (Part VIII, line 2g) .........	24,421,683	25,439,352
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,455	2,941
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,290	3,866
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	32,486,661	39,709,474
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	20,047,235	22,541,886
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	13,066,992	15,479,999
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	33,114,227	38,021,885
19	Revenue less expenses. Subtract line 18 from line 12.......	-627,566	1,687,589
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	7,055,944	8,692,661
21	Total liabilities (Part X, line 26).............	4,413,540	4,362,668
22	Net assets or fund balances. Subtract line 21 from line 20.....	2,642,404	4,329,993

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 27,523,867 including grants of $ 0 ) (Revenue $ 25,439,352 )
	PENNSYLVANIA PSYCHIATRIC INSTITUTE (PPI) IS A FREESTANDING HEALTHCARE FACILITY THAT SPECIALIZES IN PSYCHIATRIC AND SUBSTANCE ABUSE TREATMENT. IN-PATIENT CARE IS PROVIDED ON A 24-HOUR BASIS, SEVEN DAYS A WEEK, IN AN 89 BED ACUTE CARE PSYCHIATRIC SETTING. DUAL DIAGNOSIS TREATMENT OCCURS WITHIN THE CONTEXT OF MILIEU AND GROUP MODALITIES OF TREATMENT. ELECTROCONVULSIVE THERAPY (ECT) SERVICES ARE PROVIDED FOR BOTH INPATIENTS AND OUTPATIENTS 5 DAYS A WEEK. OUTPATIENT, INTENSIVE OUTPATIENT AND PARTIAL HOSPITALIZATION SERVICES ARE PROVIDED AT TWO OUTPATIENT CLINIC SITES. PPI'S ADVANCEMENT IN RECOVERY PROGRAM OFFERS A COMPREHENSIVE MEDICATION ASSISTED TREATMENT PROGRAM FOR INDIVIDUALS STRUGGLING WITH OPIOID USE DISORDER.PPI IS COMMITTED TO THE PROVISION OF QUALITY BEHAVIORAL HEALTH SERVICES FOR OUR COMMUNITY. OUR RESOURCES ARE UTILIZED TO MEET INDIVIDUAL PATIENT AND FAMILY GOALS IN THE MOST EFFICIENT AND EFFECTIVE MANNER POSSIBLE. THIS IS ACCOMPLISHED THROUGH THE USE OF EVIDENCE-BASED CLINICAL PRACTICE AND BENCHMARKING THROUGHOUT THE INDUSTRY AS MEMBERS OF THE NATIONAL ASSOCIATION OF PSYCHIATRIC HEALTH SYSTEMS.OUR PATIENT CARE IS BUILT UPON THE RELATIONSHIP THAT OCCURS BETWEEN STAFF AND PATIENTS ALLOWING US TO FOCUS OUR RESOURCES AROUND THE PATIENT'S INDIVIDUAL STRENGTHS AS THE BASIS OF CARE.WE PRACTICE HOLISTIC CARE BY MEETING THE NEEDS OF OUR WHOLE PATIENT. WE BELIEVE IT IS THE PARTNERSHIP BETWEEN THE PATIENTS, FAMILIES, AND US AS CARE PROVIDERS THAT CAN PRODUCE POSITIVE TREATMENT OUTCOMES. THE FOUNDATION OF OUR CARE CENTERS ON THIS RELATIONSHIP.PPI PROVIDES INDIVIDUALIZED CARE AS EVIDENCED BY THE WORK OF THE MULTIDISCIPLINARY TREATMENT TEAM. THE TEAM IS MADE UP OF A PHYSICIAN, REGISTERED NURSES, LICENSED PRACTICAL NURSES, BEHAVIORAL HEALTH SPECIALISTS, ACTIVITY THERAPISTS, AND CARE COORDINATORS. THE MODALITIES OF CARE INCLUDE MILIEU, GROUP AND INDIVIDUAL THERAPIES. WE PROVIDE EDUCATIONAL GROUPS SUCH AS SKILL BUILDING GROUPS AND ACTIVITY GROUPS TO MEET THE INDIVIDUAL NEEDS.DURING THE FISCAL YEAR PPI HAD INPATIENT ADMISSIONS OF 2,067, PROVIDED ONGOING SUPPORT THROUGH THE OUTPATIENT PROGRAMS, PARTIAL HOSPITALIZATION PROGRAMS, AND SUBSTANCE USE DISORDER PROGRAMS OF THE ORGANIZATION. PPI PROVIDED $149,362 IN CHARITY CARE SERVICES AND SUPPORTED $85,326 OF ADDICTION SERVICES IN THE ADVANCEMENT IN RECOVERY PROGRAM THROUGH FEDERAL GRANT FUNDS AWARDED TO SUPPORT THE NATIONAL OPIOD EPIDEMIC.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses27,523,867

(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) JESSICA STEFANIC........................................................................ CRNP	40.00 .......................	X	115,160	0	30,522
(19) NANGALYA TIRTHALA........................................................................ PHYSICIAN	40.00 .......................	X	135,784	0	5,007
(20) STEPHANIE KEGEL........................................................................ SERVICE LINE DIRECTOR	40.00 .......................	X	109,880	0	23,734

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	1,214,368	0	169,960

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

f	All other contributions, gifts, grants, and similar amounts not included above		1f	14,263,315

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		14,263,315

		Business Code
2a	PATIENT REVENUE	621110	25,439,352	25,439,352
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		25,439,352

3 Investment income (including dividends, interest, and othersimilar amounts) ......			3,058			3,058
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)			6c
d	Net rental income or (loss).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory			7a
b	Less: cost or other basis and sales expenses	117		7b
c	Gain or (loss)	-117		7c
d	Net gain or (loss).........			-117			-117
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	MISCELLANEOUS INCOME		900099	3,834			3,834
b	MEDICAL RECORDS		900099	32			32
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			3,866
12	Total revenue. See instructions.....			39,709,474	25,439,352	0	6,807

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	555,182		555,182
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	16,406,080	14,525,262	1,880,818
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	672,928	597,445	75,483
9	Other employee benefits .......	3,698,202	3,032,103	666,099
10	Payroll taxes ...........	1,209,494	1,047,341	162,153
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	113,194		113,194
c	Accounting ...........	33,721		33,721
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	42,099		42,099
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	10,382,926	6,996,774	3,386,152
12	Advertising and promotion ....	228,511	108,175	120,336
13	Office expenses .......	584,661	326,603	258,058
14	Information technology ......	151,174	147,920	3,254
15	Royalties ..
16	Occupancy ...........	2,880,791	142,018	2,738,773
17	Travel ............	21,872	17,701	4,171
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	81,403	51,710	29,693
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	414,947	324,875	90,072
23	Insurance ...	227,492	6,300	221,192
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	176,703	168,642	8,061
b	DUES AND SUBSCRIPTIONS	124,265	30,998	93,267
c	SAFETY COMPLIANCE	16,240		16,240
d
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	38,021,885	27,523,867	10,498,018	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 ........				1
2	Savings and temporary cash investments .........			1,111,019	2	2,418,227
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			3,867,657	4	4,156,413
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............				8
9	Prepaid expenses and deferred charges ......			191,220	9	242,553
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	4,531,623
b	Less: accumulated depreciation	10b	2,656,155	1,886,048	10c	1,875,468
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........				15
16	Total assets. Add lines 1 through 15 (must equal line 33)...			7,055,944	16	8,692,661

17	Accounts payable and accrued expenses .....	4,413,540	17	4,362,668
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
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		25
26	Total liabilities. Add lines 17 through 25..	4,413,540	26	4,362,668

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........		27
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	2,642,404	32	4,329,993
33	Total liabilities and net assets/fund balances ........	7,055,944	33	8,692,661