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) ROBERT HOUSEL...................................................................... CHAIRMAN	10.00 .................	X	X		0	0	0
(2) RAY WILMARTH JR...................................................................... CHAIRMAN (UNTIL 11/17)	10.00 ................. 1.00	X	X		0	0	0
(3) CHRIS CATERSON...................................................................... SECRETARY-TREASURER	10.00 .................	X	X		0	0	0
(4) LOREN STONE...................................................................... CHIEF EXECUTIVE OFFICER	49.00 ................. 1.00	X	X		103,261	0	16,980
(5) REXFORD CATLIN...................................................................... DEVELOPMENT OFFICER	49.00 ................. 1.00	X	X		94,948	0	12,649
(6) BARRY BERKOWITZ...................................................................... DIRECTOR	1.00 ................. 1.00	X			0	0	0
(7) IHAB DANA MD...................................................................... PHYSICIAN/DIRECTOR	50.00 .................	X			748,816	0	0
(8) ADAM M DIAZ...................................................................... DIRECTOR	1.00 .................	X			0	0	0
(9) ROGER DOOLITTLE...................................................................... DIRECTOR	1.00 ................. 1.00	X			0	0	0
(10) LYNN JOINES...................................................................... DIRECTOR	1.00 ................. 1.00	X			0	0	0
(11) ERIC LEWIS...................................................................... DIRECTOR	1.00 .................	X			0	0	0
(12) LARRY SOUDER...................................................................... DIRECTOR	1.00 .................	X			0	0	0
(13) JOSEPH SPEICHER DO...................................................................... PHYSICIAN/DIRECTOR	50.00 .................	X			288,847	0	0
(14) ROBERT COY...................................................................... DIRECTOR (UNTIL 5/17)	1.00 .................	X			0	0	0
(15) JOSEPHINE BRADLEY...................................................................... CHIEF FINANCIAL OFFICER	50.00 .................		X		89,525	0	0
(16) VICTORIJA PAOLUCCI...................................................................... REGISTERED NURSE	60.00 .................			X	109,695	0	0

(A) Name and business address	(B) Description of services	(C) Compensation
IHAB DANA MD, 100 HOSPITAL DRIVE MONTROSE,PA18801	MEDICAL SERVICES	748,816
HASSAN KHALIL MD, 100 HOSPITAL DRIVE MONTROSE,PA18801	MEDICAL SERVICES	626,127
SHASHANK BHATT MD, 100 HOSPITAL DRIVE MONTROSE,PA18801	MEDICAL SERVICES	375,777
JOSE ENRIQUE NAZAR MD, 100 HOSPITAL DRIVE MONTROSE,PA18801	MEDICAL SERVICES	364,728
JOSEPH SPEICHER DO, 100 HOSPITAL DRIVE MONTROSE,PA18801	MEDICAL SERVICES	288,847
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

ENDLESS MOUNTAINS HEALTH SYSTEMS INC

Employer identification number

23-2720289

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

ENDLESS MOUNTAINS HEALTH SYSTEMS INC

Employer identification number

23-2720289

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 ENDLESS MOUNTAINS HEALTH SYSTEMS INC

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
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

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

Page 3

Name of organization ENDLESS MOUNTAINS HEALTH SYSTEMS INC		Employer identification number 23-2720289

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 ENDLESS MOUNTAINS HEALTH SYSTEMS INC			Employer identification number 23-2720289
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 C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

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

OMB No. 1545-0047

2019

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

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

Name of the organization

ENDLESS MOUNTAINS HEALTH SYSTEMS INC

Employer identification number

23-2720289

Part I-A

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

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2019

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

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

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

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) Total

2a	Lobbying nontaxable amount

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

c	Total lobbying expenditures

d	Grassroots nontaxable amount

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

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2019

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

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

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

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

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

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

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

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

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

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

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

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

Yes

1,841

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

1,841

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

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

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

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

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

Part IV

Supplemental Information

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

Return Reference	Explanation
PART II-B, LINE 1:	A PORTION OF THE ORGANIZATION'S DUES PAID TO THE HOSPITAL ASSOCIATION OF PENNSYLVANIA ("HAP") ARE USED FOR LOBBYING PURPOSES.

Schedule C (Form 990 or 990EZ) 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

ENDLESS MOUNTAINS HEALTH SYSTEMS INC

Employer identification number

23-2720289

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 .....	85,893		85,893
b	Buildings ....	32,539,615	7,893,409	24,646,206
c	Leasehold improvements	23,694	1,185	22,509
d	Equipment ....	7,772,366	5,745,484	2,026,882
e	Other .....	241,985		241,985
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				27,023,475

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
(1)DEFERRED FINANCING COSTS				106,174
(2)ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS				4,151,896
(3)INSURANCE RECOVERIES RECEIVABLE				400,000
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				4,658,070

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
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	1,501,953
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	23,513,329
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	23,513,329
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	-17,990
c	Add lines 4a and 4b....................			4c	-17,990
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	23,495,339

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	24,471,051
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	17,990
e	Add lines 2a through 2d....................			2e	17,990
3	Subtract line 2e from line 1...................			3	24,453,061
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	24,453,061

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:	THE CORPORATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S FINANCIAL STATEMENTS AND PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. MANAGEMENT DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2017 AND 2016.
PART XI, LINE 4B - OTHER ADJUSTMENTS:	RENTAL EXPENSES -17,990.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	RENTAL EXPENSES 17,990.

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

ENDLESS MOUNTAINS HEALTH SYSTEMS INC

Employer identification number

23-2720289

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other %

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

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

Yes

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

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

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

Yes

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

Yes

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

Yes

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

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

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

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .	44,561		44,561	0.200 %
b	Medicaid (from Worksheet 3, column a) . . . . .
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	44,561		44,561	0.200 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	13,108		13,108	0.060 %
f	Health professions education (from Worksheet 5) . . .
g	Subsidized health services (from Worksheet 6) . . . .	284,217	92,015	192,202	0.840 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	730		730	0 %
j	Total. Other Benefits . .	298,055	92,015	206,040	0.900 %
k	Total. Add lines 7d and 7j .	342,616	92,015	250,601	1.100 %

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	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

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. ......

1,637,432

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. ......

207,954

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).....

5,662,750

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

5,611,399

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

51,351

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)
1	ENDLESS MOUNTAINS HEALTH SYSTEMS INC 100 HOSPITAL DRIVE MONTROSE,PA18801 136701	X	X	X	X

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)

	ENDLESS MOUNTAINS HEALTH SYSTEMS INC
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 16

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

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

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

Yes

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

Hospital facility’s website (list url): WWW.ENDLESSCARE.ORG

Other website (list url):

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16

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

Yes

If "Yes" (list url): WWW.ENDLESSCARE.ORG

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)

	ENDLESS MOUNTAINS HEALTH SYSTEMS INC
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 100.000000000000%
and FPG family income limit for eligibility for discounted care of 200.000000000000%

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.ENDLESSCARE.ORG/PATIENTS-VISITORS/BILLING-INSURANCE

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

WWW.ENDLESSCARE.ORG/PATIENTS-VISITORS/BILLING-INSURANCE

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

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

	ENDLESS MOUNTAINS HEALTH SYSTEMS INC
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)

	ENDLESS MOUNTAINS HEALTH SYSTEMS INC
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
ENDLESS MOUNTAINS HEALTH SYSTEMS, INC.	PART V, SECTION B, LINE 5: THE 2016 CHNA USED BOTH PRIMARY AND SECONDARY RESEARCH TO ILLUSTRATE AND COMPARE HEALTH TRENDS AND DISPARITIES ACROSS THE SERVICE AREA. PRIMARY RESEARCH WAS USED TO SOLICIT INPUT FROM KEY COMMUNITY STAKEHOLDERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING EXPERTS IN PUBLIC HEALTH AND INDIVIDUALS REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. SECONDARY RESEARCH METHODS WERE USED TO IDENTIFY DEMOGRAPHIC AND HEALTH TRENDS ACROSS GEOGRAPHIC AREAS AND POPULATIONS.THE 2016 CHNA BUILDS UPON THE HOSPITAL'S 2013 CHNA AND SUBSEQUENT COMMUNITY HEALTH IMPROVEMENT PLAN. THE CHNAS WERE CONDUCTED IN A TIMELINE TO COMPLY WITH REQUIREMENTS SET FORTH IN THE AFFORDABLE CARE ACT, AS WELL AS TO FURTHER THE SYSTEM'S COMMITMENT TO COMMUNITY HEALTH IMPROVEMENT AND POPULATION HEALTH MANAGEMENT. THE FINDINGS WILL GUIDE COMMUNITY BENEFIT INITIATIVES AND ENGAGE PARTNERS TO ADDRESS IDENTIFIED HEALTH NEEDS.SPECIFIC RESEARCH METHODS INCLUDED: A COMPILATION AND ANALYSIS OF SECONDARY HEALTH AND SOCIOECONOMIC INDICATORS FOR SUSQUEHANNA COUNTY AND KEY INFORMANT INTERVIEWS TO SOLICIT INPUT ON COMMUNITY HEALTH NEEDS AND PRIORITIES.COMMUNITY ENGAGEMENT WAS A KEY COMPONENT OF THE 2016 EMHS CHNA. THE CHNA INCLUDED PARTICIPATION OF PUBLIC HEALTH EXPERTS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. KEY INFORMANT INTERVIEWS WERE CONDUCTED TO COLLECT INSIGHTS ABOUT VULNERABLE POPULATIONS AND ALIGN COMMUNITY HEALTH IMPROVEMENT EFFORTS. THE FOLLOWING IS A LIST OF ORGANIZATIONS THAT PROVIDED VALUABLE INSIGHT INTO THE CHNA RESEARCH: AREA AGENCY ON AGING, BLUE RIDGE SCHOOL DISTRICT, COMMUNITY FOUNDATION OF THE ENDLESS MOUNTAINS, ELK LAKE SCHOOL DISTRICT, ENDLESS MOUNTAINS BUSINESS ASSOCIATION, MONTROSE AREA SCHOOL DISTRICT, MONTROSE JUNIOR SENIOR HIGH SCHOOL, NEPA COMMUNITY HEALTH CARE, SCRANTON COUNSELING CENTER, SUSQUEHANNA COUNTY, SUSQUEHANNA COUNTY DEPARTMENT OF PLANNING, SUSQUEHANNA COUNTY SHERIFF'S OFFICE, & UNITED WAY OF SUSQUEHANNA COUNTY.
ENDLESS MOUNTAINS HEALTH SYSTEMS, INC.	PART V, SECTION B, LINE 11: SECONDARY DATA STATISTICS AND INPUT FROM KEY INFORMANTS WERE CONSIDERED IN DETERMINING COMMUNITY HEALTH PRIORITIES. CONSISTENT WITH THE 2013 CHNA FINDINGS, ENDLESS MOUNTAINS HEALTH SYSTEMS WILL FOCUS ON THE FOLLOWING TWO HEALTH PRIORITIES OVER THE 2016-19 REPORTING CYCLE: ACCESS TO CARE AND CHRONIC DISEASE PREVENTION & MANAGEMENT. ENDLESS MOUNTAINS HEALTH SYSTEMS DEVELOPED A COMMUNITY HEALTH IMPLEMENTATION PLAN TO GUIDE COMMUNITY BENEFIT ACTIVITIES FOR THE 2017-19 REPORTING CYCLE. THE PLAN BUILDS UPON PREVIOUS HEALTH IMPROVEMENT ACTIVITIES, WHILE RECOGNIZING NEW HEALTH NEEDS AND A CHANGING HEALTH CARE DELIVERY ENVIRONMENT, TO ADDRESS THE MOST PRESSING COMMUNITY HEALTH NEEDS.PRIORITY AREA: ACCESS TO HEALTH CAREGOAL: IMPROVE ACCESS TO COMPREHENSIVE, QUALITY HEALTH CARE SERVICES.OBJECTIVES:- INCREASE ACCESS TO PRIMARY AND SPECIALTY CARE PROVIDERS.- INCREASE THE PROPORTION OF RESIDENTS RECEIVING PREVENTIVE HEALTH CARE SERVICES.- INCREASE THE PROPORTION OF RESIDENTS WITH HEALTH INSURANCE.STRATEGIES- IDENTIFY AND RECRUIT PRIMARY AND SPECIALTY CARE PROVIDERS TO EMHS TO REDUCE PHYSICIAN TO PATIENT RATIO.- HOST FREE COMMUNITY HEALTH SCREENINGS TO RAISE AWARENESS OF RISK FACTORS AND INCREASE EARLY DETECTION OF DISEASE.- CONTINUE PARTNERSHIPS WITH BEHAVIORAL HEALTH PROVIDERS TO INCREASE ACCESS TO BEHAVIORAL HEALTH SERVICES IN THE ED AND COMMUNITY SETTINGS.- CONTINUE SCREENING AND ENROLLMENT ASSISTANCE TO AID UNINSURED INDIVIDUALS IN OBTAINING AVAILABLE HEALTH INSURANCE PROGRAMS.PRIORITY AREA: CHRONIC DISEASE PREVENTION & MANAGEMENTGOAL: IMPROVE CHRONIC DISEASE OUTCOMES THROUGH PREVENTION AND DISEASE MANAGEMENT SERVICES.OBJECTIVES:- INCREASE COMMUNITY EDUCATION AND OUTREACH THAT PROMOTES CHRONIC DISEASE PREVENTION.- INCREASE DISEASE SELF-MANAGEMENT OPPORTUNITIES FOR INDIVIDUALS CURRENTLY DIAGNOSED WITH A CHRONIC CONDITION.- INCREASE THE NUMBER OF PERSONS WHOSE CHRONIC CONDITION HAS BEEN DIAGNOSED.STRATEGIES- SUPPORT THE SUSQUEHANNA COUNTY OBESITY REDUCTION EFFORT (SCORE)- CONTINUE FREE OR LOW COST DIABETES EDUCATION AND NUTRITION COUNSELING FOR INDIVIDUALS DIAGNOSED WITH DIABETES OR PRE-DIABETES.- CONTINUE TO PROVIDE COMMUNITY EDUCATION THROUGH SPECIAL EVENTS, PRINTED MATERIALS, WEBSITE RESOURCES, AND SOCIAL AND OTHER MEDIA TO INCREASE KNOWLEDGE RELATED TO CHRONIC DISEASE PREVENTION AND MANAGEMENT.- HOST FREE COMMUNITY HEALTH SCREENINGS TO RAISE AWARENESS OF RISK FACTORS AND INCREASE EARLY DETECTION OF DISEASE.THE EMHS BOARD OF DIRECTORS REVIEWED AND APPROVED THE REPORT OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND ADOPTED THE IMPLEMENTATION PLAN TO ADDRESS PRIORITY AREAS ON DECEMBER 22, 2016. BOTH DOCUMENTS WERE MADE WIDELY AVAILABLE TO THE PUBLIC THROUGH THE HOSPITAL'S WEBSITE (WWW.ENDLESSCARE.ORG).WHILE EMHS HAS NOT ADOPTED BEHAVIORAL HEALTH AS ONE OF OUR PRIORITY FOCUS AREAS, WE RECOGNIZE MENTAL HEALTH CARE AND SUBSTANCE ABUSE AS GROWING ISSUES WITHIN OUR COMMUNITY. AS A CRITICAL ACCESS HOSPITAL, WE WILL CONTINUE TO FOCUS OUR COMMUNITY HEALTH PRIORITIES ON ENSURING ACCESS TO TIMELY, HIGH QUALITY CARE AND REDUCING THE BURDEN OF CHRONIC DISEASE WITHIN OUR COMMUNITY. IN RESPECT TO BEHAVIORAL HEALTH NEEDS, WE WILL CONTINUE OUR ENGAGEMENT AND PARTNERSHIP WITH THE SUICIDE AWARENESS INITIATIVE AND THE NEPA COMMUNITY HEALTH CARE AND SCRANTON COUNSELING CENTER TO COLLABORATIVELY ADDRESS BEHAVIORAL HEALTH NEEDS.
PART V, SECTION B, LINE 16I	EMHS DOES NOT HAVE AN LEP POPULATION WITHIN ITS SERVICE AREA, THEREFORE, THE FAP POLICY, APPLICATION, AND SUMMARY, ARE ONLY REQUIRED TO BE IN ENGLISH.

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:	GLOBAL COST TO CHARGE RATIO WAS UTILIZED TO COMPUTE COST OF CHARITY CARE PROVIDED. ALLOWABLE COST DIVIDED BY TOTAL CHARGES.
PART I, LINE 7G:	INCLUDED IN THE SUBSIDIZED HEALTH SERVICES ARE COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC. TOTAL PHYSICIAN CLINIC COSTS WERE $284,217.
PART I, LN 7 COL(F):	THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $1,637,432.
PART II, COMMUNITY BUILDING ACTIVITIES:	EMHS AND ITS STAFF SUPPORT LOCAL HEALTH SERVICE AND COMMUNITY SERVICE PROJECTS. THE STAFF OF EMHS CONTRIBUTE BOTH THEIR TIME AND FINANCIALLY TO THE SUSQUEHANNA COUNTY LIBRARY, AMERICAN CANCER SOCIETY, UNITED WAY, AND OTHER WORTHWHILE CAUSES. EMHS WORKS WITH LOCAL EMS PROVIDERS IN PREPARATION FOR NATURAL DISASTERS AND MASS CASUALTY SITUATIONS. EMHS SUPPORTS THE CRITICAL INCIDENT STRESS MANAGEMENT (CISM) TEAM AND PROVIDED ITS STARTUP TRAINING FUNDING. THE AT-RISK ELDERLY AND LOW-INCOME POPULATIONS OF SUSQUEHANNA COUNTY AND SURROUNDING COUNTIES IS BETTER SERVED BY HAVING EMHS AS A PARTNER WITH MULTIPLE SOCIAL SERVICE, EMERGENCY RESPONSE, AND HUMAN SERVICE AGENCIES.
PART III, LINE 2:	BAD DEBT EXPENSE IS CALCULATED BASED ON ACTUAL WRITE-OFFS THROUGHOUT THE YEAR AND IS ESTIMATED AT COST USING THE RATIO OF PATIENT CARE COST TO CHARGES.
PART III, LINE 3:	EMHS ESTIMATED THAT 12.7% OF THE AMOUNT OF BAD DEBT WOULD BE CONVERTED TO UNCOMPENSATED CARE, IF INDIVIDUALS APPLIED. THIS IS BASED ON THE POPULATION STATISTICS FOR POVERTY LEVEL IN SUSQUEHANNA COUNTY, PENNSYLVANIA.
PART III, LINE 4:	ACCOUNTS RECEIVABLE, PATIENTS ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. THE ALLOWANCE FOR DOUBTFUL COLLECTIONS IS ESTIMATED BASED UPON A PERIODIC REVIEW OF THE ACCOUNTS RECEIVABLE AGING, PAYOR CLASSIFICATIONS AND APPLICATION OF HISTORICAL WRITE-OFF PERCENTAGES.
PART III, LINE 8:	ALLOWABLE COSTS WERE DETERMINED USING THE COST-TO-CHARGE RATIO FROM THE MEDICARE COST REPORT. THERE WAS A SURPLUS.
PART III, LINE 9B:	COLLECTIONS ARE PURSUED UP TO THE POINT THAT A PATIENT COMPLETES AND IS APPROVED FOR CHARITY CARE. ONCE CHARITY CARE IS APPROVED, NO FURTHER COLLECTION EFFORTS ARE MADE.
PART VI, LINE 2:	THE COMPLETION OF THE CHNA ENABLED ENDLESS MOUNTAINS HEALTH SYSTEMS AND ITS PARTNERS TO TAKE AN IN-DEPTH LOOK AT ITS GREATER COMMUNITY. THE FINDINGS FROM THE ASSESSMENT WERE UTILIZED BY ENDLESS MOUNTAINS HEALTH SYSTEM TO PRIORITIZE PUBLIC HEALTH ISSUES AND DEVELOP A COMMUNITY HEALTH IMPLEMENTATION PLAN FOCUSED ON MEETING COMMUNITY NEEDS. ENDLESS MOUNTAINS HEALTH SYSTEMS IS COMMITTED TO THE PEOPLE IT SERVES AND THE COMMUNITIES THEY LIVE IN. HEALTHY COMMUNITIES LEAD TO LOWER HEALTH CARE COSTS, ROBUST COMMUNITY PARTNERSHIPS, AND AN OVERALL ENHANCED QUALITY OF LIFE.A KEY INFORMANT SURVEY WAS CONDUCTED WITH 14 COMMUNITY REPRESENTATIVES TO SOLICIT INFORMATION ABOUT HEALTH NEEDS AND DISPARITIES WITHIN SUSQUEHANNA COUNTY. KEY INFORMANTS WERE ASKED A SERIES OF QUESTIONS ABOUT THEIR PERCEPTIONS OF HEALTH NEEDS IN THE COMMUNITY, HEALTH DRIVERS, BARRIERS TO CARE, QUALITY AND RESPONSIVENESS OF HEALTH PROVIDERS, AND RECOMMENDATIONS FOR COMMUNITY HEALTH IMPROVEMENT.KEY INFORMANTS SERVE DIVERSE POPULATIONS ACROSS SUSQUEHANNA COUNTY. CHILDREN/YOUTH, FAMILIES, AND LOW INCOME/POOR ARE THE MOST COMMONLY SERVED POPULATIONS BY KEY INFORMANTS. "OTHER" POPULATIONS INCLUDE INDIVIDUALS WITH BEHAVIORAL HEALTH CONCERNS AND INTELLECTUAL DISABILITIES AND SMALL BUSINESS OWNERS.MENTAL HEALTH AND SUBSTANCE ABUSE WERE IDENTIFIED BY KEY INFORMANTS AS BEING AMONG THE TOP HEALTH CONDITIONS AFFECTING SUSQUEHANNA COUNTY RESIDENTS. BOTH ISSUES ARE GROWING CONCERNS AND THERE IS A LACK OF SERVICES WITHIN THE COMMUNITY TO ADEQUATELY ADDRESS THEM. SUSQUEHANNA COUNTY HAS HAD A SERIOUS MENTAL HEALTH ISSUE IN THE PAST WITH AN EPIDEMIC OF OVERDOSES AND SUICIDES, AS RESIDENTS FELT THERE WERE NO SERVICES IN THE COUNTY TO HELP. THIS COMMUNITY HAS A HIGH RATE OF DRUG ADDICTION WITH FEW SUPPORTS TO TREAT THEM.INFORMANTS IDENTIFIED STIGMA AS A BARRIER TO ACCESSING BEHAVIORAL HEALTH SERVICES THAT ARE AVAILABLE. DUE TO THE STIGMA ATTACHED TO ACCESSING MENTAL HEALTH SERVICES, THE MAJORITY OF OLDER PERSONS WITH MENTAL ILLNESS DON'T SEEK HELP. MOST OFTEN THEIR MENTAL ILLNESS PREVENTS THEM FROM ACCEPTING SERVICES THAT COULD IMPROVE THEIR QUALITY OF LIFE.ACCESS TO HEALTH CARE WAS ALSO RECOGNIZED AS A TOP HEALTH CONCERN IN THE COMMUNITY. ACCESS TO CARE IS IMPACTED BY A NUMBER OF FACTORS, INCLUDING HEALTH INSURANCE COVERAGE, TRANSPORTATION, HEALTH SYSTEM NAVIGATION, ETC., BUT KEY INFORMANTS EMPHASIZED THE LACK OF AVAILABLE PROVIDERS IN SUSQUEHANNA COUNTY. MANY PEOPLE TRAVEL TO SCRANTON/WB OR BINGHAMTON AREAS FOR ACCESS TO PROVIDERS. MOST ANY SPECIALTY IS OVER ONE HOUR OF TRAVEL.SOCIAL DETERMINANTS OF HEALTH ARE THE TOP CONTRIBUTING FACTOR TO HEALTH CONDITIONS AMONG RESIDENTS, ACCORDING TO KEY INFORMANTS. ONE INFORMANT STATED, "POVERTY IS A GREAT CREATOR OF MANY ILLS." DRUG/ALCOHOL ABUSE, EDUCATION/AWARENESS REGARDING HEALTH, AND INABILITY TO AFFORD CARE WERE ALSO IDENTIFIED AS TOP CONTRIBUTORS.KEY INFORMANTS WERE ASKED TO SHARE OPEN-ENDED FEEDBACK REGARDING HEALTH-RELATED ASSETS AND BARRIERS IN THE COMMUNITY AND THEIR RECOMMENDATIONS FOR HELPING RESIDENTS OPTIMIZE THEIR HEALTH.INFORMANTS WERE FIRST ASKED TO PROVIDE EXAMPLES OF PROGRAMS/INITIATIVES/PARTNERSHIPS THAT HAVE BEEN SUCCESSFUL IN HELPING RESIDENTS IN THE COMMUNITY OPTIMIZE THEIR HEALTH. INFORMANTS REFERENCED A NUMBER OF COMMUNITY INITIATIVES, INCLUDING:- EMHS PARTNERSHIP WITH NEPA COMMUNITY HEALTH CARE AND SCRANTON COUNSELING CENTER FOR PSYCHIATRIC CONSULTATIONS AND PATIENT VISITS IN THE ER- FREE IMMUNIZATIONS FOR CERTAIN AGE GROUPS- GET A SCREENING GIVE A SCREENING PROGRAM FOR FREE BREAST CANCER SCREENINGS AT EMHS- PARTNERSHIPS WITH LOCAL HEALTH CARE FACILITIES TO OFFER CHRONIC DISEASE SELF-MANAGEMENT PROGRAMS, EXERCISE CLASSES, AND FALL ASSESSMENTS- STEP BY STEP, INC.- SUSQUEHANNA COUNTY SUICIDE AWARENESS INITIATIVE- SUSQUEHANNA COUNTY TRANSPORTATIONKEY INFORMANTS WERE THEN ASKED WHAT RESOURCES ARE NEEDED IN THE COMMUNITY TO PROMOTE HEALTH. INFORMANTS OVERWHELMINGLY IDENTIFIED THE NEED TO IMPROVE ACCESS TO HEALTH CARE FOR RESIDENTS, PARTICULARLY RELATED TO BEHAVIORAL HEALTH NEEDS. SPECIFIC RECOMMENDATIONS INCLUDED:- COMPLEMENTARY/NATUROPATHIC MEDICINE- MEDICAL TRANSPORTATION- MEDICATION-ASSISTED TREATMENT FOR SUBSTANCE ABUSE- MENTAL HEALTH SERVICES- OPIOID RECOVERY/REHABILITATION SERVICESKEY INFORMANTS ALSO IDENTIFIED THE NEED FOR RESOURCES TO ADDRESS SOCIAL DETERMINANTS OF HEALTH (POVERTY, EDUCATION, EMPLOYMENT) AND HEALTHY FOOD ACCESS.KEY INFORMANTS WERE THEN ASKED WHAT LOCAL AND REGIONAL HEALTH CARE PROVIDERS COULD DO BETTER TO OPTIMIZE THE HEALTH OF RESIDENTS IN THE COMMUNITY. INFORMANTS MADE THE FOLLOWING RECOMMENDATIONS:- CONDUCT GREATER HEALTH OUTREACH, INCLUDING COMPREHENSIVE WELL VISITS AND HOME CARE- CONTINUE TO RECRUIT OUTSIDE RESOURCES AND DEVELOP INNOVATIVE PARTNERSHIPS TO ADDRESS HEALTH CARE SHORTAGES AND NEEDS- CREATE STRONGER ALLIANCES AMONG COUNTY PROVIDERS TO ADDRESS HEALTH ISSUES- EXPLORE ALTERNATIVES TO PHARMACEUTICAL MEDICINES, PARTICULARLY FOR OLDER ADULTS- EXPLORE OPPORTUNITIES TO REDUCE PATIENT COSTS AND IMPROVE THE PATIENT-PROVIDER RELATIONSHIP- INCREASE AWARENESS OF AVAILABLE HEALTH SERVICES WITHIN THE COMMUNITY- OFFER HEALTH AND WELLNESS PROGRAMS IN THE VARIOUS COMMUNITIES THROUGHOUT THE COUNTY, TARGETING RURAL AREAS AND OLDER ADULTS WHO CANNOT TRAVEL FOR SERVICES- PARTNER WITH EMS PROVIDERS TO DISTRIBUTE HEALTH INFORMATION AND PROMOTE AVAILABLE COMMUNITY RESOURCES BY PROVIDING REFERRALS TO PATIENTS- PROVIDE MORE EDUCATION REGARDING HEALTH RISK BEHAVIORS AND DISEASE PREVENTIONKEY INFORMANTS ARE COMMITTED TO IMPROVING THE HEALTH OF SUSQUEHANNA COUNTY RESIDENTS. THEY IDENTIFIED THE MOST PRESSING NEEDS IN THE COMMUNITY, PARTICULARLY RELATED TO ACCESS TO CARE AND BEHAVIORAL HEALTH, AND OFFERED RECOMMENDATIONS AND INNOVATIVE STRATEGIES TO ADDRESS THEM. INFORMANTS EMPHASIZED THAT SUSQUEHANNA COUNTY IS A RURAL AREA AND THERE IS A NEED TO BRING HEALTH AND WELLNESS SERVICES DIRECTLY TO RESIDENTS ACROSS THE VARIOUS COMMUNITIES. THEY RECOMMENDED COUNTY AND REGIONAL PARTNERSHIPS TO ADDRESS RURAL HEALTH CARE SHORTAGES AND IMPROVE HEALTH STATUS.
PART VI, LINE 3:	PATIENTS ARE INFORMED VIA WRITTEN POSTINGS AT THE INTAKE AREA AND FACE-TO-FACE AND TELEPHONE CONSULTATION WITH FINANCIAL SUPPORT STAFF.
PART VI, LINE 4:	ENDLESS MOUNTAINS HEALTH SYSTEMS PROVIDES SERVICE TO RESIDENTS OF SUSQUEHANNA COUNTY AND PARTS OF WYOMING, BRADFORD, LACKAWANNA COUNTIES IN PENNSYLVANIA AS WELL AS PORTIONS OF BROOME COUNTY NY. THE SUSQUEHANNA COUNTY POPULATION OF 43,930 IS EXPECTED TO REMAIN STABLE, DECREASING 0.2% BY 2021. THE POPULATION IS PRIMARILY WHITE WITH LESS THAN 3% OF RESIDENTS IDENTIFYING AS ANOTHER RACE AND LESS THAN 2% OF RESIDENTS IDENTIFYING AS HISPANIC OR LATINO. SUSQUEHANNA COUNTY HAS A HIGHER MEDIAN AGE AND RESIDENTS ARE MORE LIKELY TO SPEAK ENGLISH AS THEIR PRIMARY LANGUAGE WHEN COMPARED TO STATE AND NATIONAL BENCHMARKS. EDUCATION IS THE LARGEST PREDICTOR OF POVERTY AND ONE OF THE MOST EFFECTIVE MEANS OF REDUCING INEQUALITIES. COMPARED TO THE STATE AND NATION, RESIDENTS IN SUSQUEHANNA COUNTY ARE MORE LIKELY TO HAVE ACHIEVED A HIGH SCHOOL DIPLOMA OR EQUIVALENT, BUT LESS LIKELY TO HAVE HAD COLLEGE EXPERIENCE OR A DEGREE. THE EDUCATION STATISTICS ARE CONSISTENT WITH THE OLDER POPULATION AND MORE PROMINENT BLUE COLLAR WORKFORCE.
PART VI, LINE 5:	EMHS HAS AN OPEN MEDICAL STAFF, A BOARD COMPOSED OF COMMUNITY MEMBERS FROM THE AREAS IT SERVES, UTILIZES INCOME TO FURTHER ITS PROVISION OF SERVICE AND ABILITY TO INCREASE THE AVAILABILITY OF MEDICAL CARE TO THE COMMUNITY.
PART VI, LINE 6:	EMHS OPERATES A NOT-FOR-PROFIT ACUTE CARE HOSPITAL WHICH PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES. EMHS ALSO PROVIDES CHARITY CARE TO PATIENTS WHO MEET CERTAIN CRITERIA. THE ONLY AFFILIATED ORGANIZATION IS ENDLESS MOUNTAINS MEDICAL CARE FOUNDATION (EMMCF). EMMCF WAS ESTABLISHED TO SOLICIT CONTRIBUTIONS FROM THE GENERAL PUBLIC SOLELY FOR THE FUNDING OF OPERATIONS AND CAPITAL ACQUISITIONS BY THE HOSPITAL. EMMCF RAISES FUNDS THROUGH A NUMBER OF ACTIVITIES, INCLUDING ANNUAL APPEALS, SPECIAL EVENTS INCLUDING A GOLF TOURNAMENT, MEMORIAL AND TRIBUTE GIVING, PRIVATE AND CORPORATE FOUNDATION GRANTS, AND PLANNED GIVING VEHICLES SUCH AS BEQUESTS.
PART VI, LINE 7, REPORTS FILED WITH STATES	PA

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

ENDLESS MOUNTAINS HEALTH SYSTEMS INC

Employer identification number

23-2720289

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

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)
1IHAB DANA MD PHYSICIAN/DIRECTOR	(i) (ii)	748,816 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	748,816 ------------- 0	0 ------------- 0
2JOSEPH SPEICHER DO PHYSICIAN/DIRECTOR	(i) (ii)	288,847 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	288,847 ------------- 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

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

ENDLESS MOUNTAINS HEALTH SYSTEMS INC

Employer identification number

23-2720289

Return Reference	Explanation
FORM 990, PART VI, SECTION B, LINE 11B	THE CEO OF THE HOSPITAL WILL REVIEW THE DRAFT 990 AND THE ENTIRE BOARD WILL RECEIVE A COPY BEFORE FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C	ENDLESS MOUNTAINS HEALTH SYSTEMS REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY BEING FAMILIAR WITH ANY CONFLICTS THAT EACH BOARD MEMBER IDENTIFIES ON HIS/HER ANNUAL CONFLICT OF INTEREST STATEMENT. THE EXECUTIVE ADMINISTRATIVE ASSISTANT ENSURES THE COMPLETION OF THE CONFLICT OF INTEREST POLICY BY THE BOARD MEMBERS AND CEO REVIEWS THE COMPLETED FORM AND EVALUATES ANY ISSUES NOTED. EACH BOARD MEMBER IS REQUIRED TO IDENTIFY ANY POTENTIAL CONFLICTS THAT MAY ARISE IN THE COURSE OF THEIR DUTY AS A DIRECTOR AND WILL NOT BE COUNTED AS A VOTE FOR THE ITEM AND WILL BE ASKED TO WITHDRAW FROM THE ROOM AND DISCUSSION AS LONG AS THE ITEM BEING DISCUSSED IS A CONFLICT.
FORM 990, PART VI, SECTION B, LINE 15	WAGE SURVEYS OF COMPARABLE FACILITIES ARE USED BY THE BOARD IN DETERMINING EXECUTIVE COMPENSATION. THE ORGANIZATION REVIEWS OTHER CRITICAL ACCESS HOSPITAL 990S AND PA CRITICAL ACCESS WAGE AND SALARY SURVEY. THE ORGANIZATION USES THIS DATA TO DETERMINE FAIR MARKET VALUE OF SALARIES WHEN SALARY INCREASES ARE CONSIDERED AND ALSO AT RANDOM INTERVALS. THE PROCESS IS DOCUMENTED IN THE BOARD MINUTES AND THE EMPLOYEE PERSONNEL FILES.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11G	PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,498,649. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,498,649. MAINTENANCE CONTRACT FEES: PROGRAM SERVICE EXPENSES 299,234. MANAGEMENT AND GENERAL EXPENSES 8,200. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 307,434. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 293,380. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 293,380. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 55,093. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 55,093. CONTRACTED LABOR: PROGRAM SERVICE EXPENSES 44,560. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 44,560. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 1,977,083. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,977,083.
FORM 990 AMENDED RETURN CHECKED YES	THE ENDLESS MOUNTAINS HEALTH SYSTEM, INC. 2017 990 RETURN IS BEING AMENDED TO CORRECT THE FOLLOWING ITEMS DUE TO AUDIT ADJUSTMENTS MADE AFTER THE FILING DATE OF THE ORIGINAL RETURN: FORM 990 PAGE 1 PART I SUMMARY LINE 8 CURRENT YEAR COLUMN CONTRIBUTIONS AND GRANTS HAS BEEN CORRECTED TO $221,554 FORM 990 PAGE 1 PART I SUMMARY LINE 9 CURRENT YEAR COLUMN PROGRAM SERVICE REVENUE HAS BEEN CORRECTED TO $23,003,652 FORM 990 PAGE 1 PART I SUMMARY LINE 10 CURRENT YEAR COLUMN INVESTMENT INCOME HAS BEEN CORRECTED TO ($290,287) FORM 990 PAGE 1 PART I SUMMARY LINE 11 CURRENT YEAR COLUMN OTHER REVENUE HAS BEEN CORRECTED TO $560,420 FORM 990 PAGE 1 PART I SUMMARY LINE 12 CURRENT YEAR COLUMN TOTAL REVENUE HAS BEEN CORRECTED TO $23,495,339 FORM 990 PAGE 1 PART I SUMMARY LINE 15 CURRENT YEAR COLUMN SALARIES, OTHER COMPENSATION, EMPLOYEE BENEFITS HAS BEEN CORRECTED TO $8,865,140 FORM 990 PAGE 1 PART I SUMMARY LINE 17 CURRENT YEAR COLUMN OTHER EXPENSES HAS BEEN CORRECTED TO $15,587,921 FORM 990 PAGE 1 PART I SUMMARY LINE 18 CURRENT YEAR COLUMN TOTAL EXPENSES HAS BEEN CORRECTED TO $24,453,061 FORM 990 PAGE 1 PART I SUMMARY LINE 19 CURRENT YEAR COLUMN REVENUE LESS THAN EXPENSES HAS BEEN CORRECTED TO ($957,722) FORM 990 PAGE 1 PART I SUMMARY LINE 20 CURRENT YEAR COLUMN TOTAL ASSETS HAS BEEN CORRECTED TO $35,937,346 FORM 990 PAGE 1 PART I SUMMARY LINE 21 CURRENT YEAR COLUMN TOTAL LIABILITIES HAS BEEN CORRECTED TO $28,357,241 FORM 990 PAGE 1 PART I SUMMARY LINE 22 CURRENT YEAR COLUMN NET ASSETS HAS BEEN CORRECTED TO $7,580,105 FORM 990 PAGE 2 PART III STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS LINE 4A EXPENSES HAS BEEN CORRECTED TO $23,512,948 FORM 990 PAGE 2 PART III STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS LINE 4A REVENUE HAS BEEN CORRECTED TO $23,003,652 FORM 990 PAGE 9 PART VIII STATEMENT OF REVENUE LINE 1F ALL OTHER CONTRIBUTIONS HAS BEEN CORRECTED TO $23,605 FORM 990 PAGE 9 PART VIII STATEMENT OF REVENUE LINE 1H TOTAL CONTRIBUTIONS HAS BEEN CORRECTED TO $221,554 FORM 990 PAGE 9 PART VIII STATEMENT OF REVENUE LINE 2A, COLUMNS (A) AND (B) NET PATIENT SVC REVENUE HAS BEEN CORRECTED TO $22,683,931 FORM 990 PAGE 9 PART VIII STATEMENT OF REVENUE LINE 7A, COLUMN (II) GROSS AMOUNT FROM SALES OF ASSETS HAS BEEN CORRECTED TO $147,100 FORM 990 PAGE 9 PART VIII STATEMENT OF REVENUE LINE 7B, COLUMN (II) COST OF SALE OF ASSETS HAS BEEN CORRECTED TO $441,301 FORM 990 PAGE 9 PART VIII STATEMENT OF REVENUE LINE 7C, COLUMN (II) GAIN OR (LOSS) HAS BEEN CORRECTED TO ($294,201) FORM 990 PAGE 9 PART VIII STATEMENT OF REVENUE LINE 7D, COLUMNS (A) AND (D) NET GAIN OR (LOSS) HAS BEEN CORRECTED TO ($294,201) FORM 990 PAGE 9 PART VIII STATEMENT OF REVENUE LINE 11D, COLUMNS (A) AND (D), ALL OTHER REVENUE HAS BEEN CORRECTED TO $108,082 FORM 990 PAGE 9 PART VIII STATEMENT OF REVENUE LINE 11E, COLUMN (A), TOTAL MISCELLANEOUS REVENUE HAS BEEN CORRECTED TO $551,122 FORM 990 PAGE 9 PART VIII STATEMENT OF REVENUE LINE 12 COLUMN (A), TOTAL REVENUE HAS BEEN CORRECTED TO $23,495,339 FORM 990 PAGE 9 PART VIII STATEMENT OF REVENUE LINE 12 COLUMN (B), TOTAL REVENUE HAS BEEN CORRECTED TO $23,003,652 FORM 990 PAGE 9 PART VIII STATEMENT OF REVENUE LINE 12 COLUMN (D), TOTAL REVENUE HAS BEEN CORRECTED TO ($75,326) FORM 990 PAGE 10 PART IX STATEMENT OF FUNCTIONAL EXPENSES LINE 11, OTHER SALARIES AND WAGES, COLUMN (A) HAS BEEN CORRECTED TO $5,894,534 FORM 990 PAGE 10 PART IX STATEMENT OF FUNCTIONAL EXPENSES LINE 11, OTHER SALARIES AND WAGES, COLUMN (C) HAS BEEN CORRECTED TO $411,124 FORM 990 PAGE 10 PART IX STATEMENT OF FUNCTIONAL EXPENSES LINE 13, OFFICE EXPENSES, COLUMN (A) HAS BEEN CORRECTED TO $1,034,754 FORM 990 PAGE 10 PART IX STATEMENT OF FUNCTIONAL EXPENSES LINE 13, OFFICE EXPENSES COLUMN (B) HAS BEEN CORRECTED TO $919,000 FORM 990 PAGE 10 PART IX STATEMENT OF FUNCTIONAL EXPENSES LINE 13, OFFICE EXPENSES COLUMN (C) HAS BEEN CORRECTED TO $115,754 FORM 990 PAGE 10 PART IX STATEMENT OF FUNCTIONAL EXPENSES LINE 20, INTEREST, COLUMNS (A) AND (B) HAS BEEN CORRECTED TO $988,635 FORM 990 PAGE 10 PART IX STATEMENT OF FUNCTIONAL EXPENSES LINE 22, DEPRECIATION, DEPLETION, AND AMORTIZATION, COLUMNS (A) AND (B) HAS BEEN CORRECTED TO $3,113,197 FORM 990 PAGE 10 PART IX STATEMENT OF FUNCTIONAL EXPENSES LINE 24A, PHARMACEUTICAL, COLUMNS (A) AND (B) HAS BEEN CORRECTED TO $1,759,505 FORM 990 PAGE 10 PART IX STATEMENT OF FUNCTIONAL EXPENSES LINE 24D, PATIENT SUPPLIES, COLUMNS (A) AND (B) HAS BEEN CORRECTED TO $597,124 FORM 990 PAGE 10 PART IX STATEMENT OF FUNCTIONAL EXPENSES LINE 24E, ALL OTHER EXPENSES, COLUMN (A) HAS BEEN CORRECTED TO $355,145 FORM 990 PAGE 10 PART IX STATEMENT OF FUNCTIONAL EXPENSES LINE 24E, ALL OTHER EXPENSES, COLUMN (B) HAS BEEN CORRECTED TO $294,152 FORM 990 PAGE 10 PART IX STATEMENT OF FUNCTIONAL EXPENSES LINE 24E, ALL OTHER EXPENSES, COLUMN (C) HAS BEEN CORRECTED TO $60,993 FORM 990 PAGE 10 PART IX STATEMENT OF FUNCTIONAL EXPENSES LINE 25, TOTAL FUNCTIONAL EXPENSES, COLUMN (A) HAS BEEN CORRECTED TO $24,453,061 FORM 990 PAGE 10 PART IX STATEMENT OF FUNCTIONAL EXPENSES LINE 25, TOTAL FUNCTIONAL EXPENSES, COLUMN (B) HAS BEEN CORRECTED TO $23,512,948 FORM 990 PAGE 10 PART IX STATEMENT OF FUNCTIONAL EXPENSES LINE 25, TOTAL FUNCTIONAL EXPENSES, COLUMN (C) HAS BEEN CORRECTED TO $940,113 FORM 990 PAGE 11 PART X BALANCE SHEET LINE 8, INVENTORIES FOR SALE OR USE, COLUMN (B) HAS BEEN CORRECTED TO $498,024 FORM 990 PAGE 11 PART X BALANCE SHEET LINE 10A, LAND, BUILDING, AND EQUIPMENT COST HAS BEEN CORRECTED TO $40,663,553 FORM 990 PAGE 11 PART X BALANCE SHEET LINE 10B, LESS: ACCUMULATED DEPRECIATION HAS BEEN CORRECTED TO $13,640,078 FORM 990 PAGE 11 PART X BALANCE SHEET LINE 10C, LAND, BUILDING AND EQUIPMENT, COLUMN (B) HAS BEEN CORRECTED TO $27,023,475 FORM 990 PAGE 11 PART X BALANCE SHEET LINE 15, OTHER ASSETS, COLUMN (B) HAS BEEN CORRECTED TO $4,658,070 FORM 990 PAGE 11 PART X BALANCE SHEET LINE 16, TOTAL ASSETS, COLUMN (B) HAS BEEN CORRECTED TO $35,937,346 FORM 990 PAGE 11 PART X BALANCE SHEET LINE 17, ACCOUNTS PAYABLE AND ACCRUED EXPENSES, COLUMN (B) HAS BEEN CORRECTED TO $2,293,658 FORM 990 PAGE 11 PART X BALANCE SHEET LINE 26, TOTAL LIABILITIES, COLUMN (B) HAS BEEN CORRECTED TO $28,357,241 FORM 990 PAGE 11 PART X BALANCE SHEET LINE 27, UNRESTRICTED NET ASSETS, COLUMN (B) HAS BEEN CORRECTED TO $7,572,279 FORM 990 PAGE 11 PART X BALANCE SHEET LINE 28, TEMPORARILY RESTRICTED NET ASSETS, COLUMN (B) HAS BEEN CORRECTED TO $7,826 FORM 990 PAGE 11 PART X BALANCE SHEET LINE 33, TOTAL NET ASSETS COLUMN (B) HAS BEEN CORRECTED TO $7,580,105 FORM 990 PAGE 11 PART X BALANCE SHEET LINE 34, TOTAL LIABILITIES AND NET ASSETS, COLUMN (B) HAS BEEN CORRECTED TO $35,937,346 FORM 990 PAGE 11 PART X RECONCILLIATION OF NET ASSETS LINE 1, TOTAL REVENUE HAS BEEN CORRECTED TO $23,495,339 FORM 990 PAGE 11 PART X RECONCILLIATION OF NET ASSETS LINE 2, TOTAL EXPENSES HAS BEEN CORRECTED TO $24,453,061 FORM 990 PAGE 11 PART X RECONCILLIATION OF NET ASSETS LINE 3, REVENUE LESS EXPENSES HAS BEEN CORRECTED TO ($957,722) FORM 990 PAGE 11 PART X RECONCILLIATION OF NET ASSETS LINE 10, NET ASSETS AT END OF YEAR HAS BEEN CORRECTED TO $7,580,105 FORM 990 SCHEDULE D PAGE 2 PART VI, LINE 1A, LAND, COLUMNS (B) AND (D) HAS BEEN CORRECTED TO $85,893 FORM 990 SCHEDULE D PAGE 2 PART VI, LINE 1B, BUILDINGS, COLUMN (B) HAS BEEN CORRECTED TO $32,539,615 FORM 990 SCHEDULE D PAGE 2 PART VI, LINE 1B, BUILDINGS, COLUMN (C) HAS BEEN CORRECTED TO $7,893,409 FORM 990 SCHEDULE D PAGE 2 PART VI, LINE 1B, BUILDINGS, COLUMN (D) HAS BEEN CORRECTED TO $24,646,206 FORM 990 SCHEDULE D PAGE 2 PART VI, LINE 1D, EQUIPMENT, COLUMN (B) HAS BEEN CORRECTED TO $7,772,366 FORM 990 SCHEDULE D PAGE 2 PART VI, LINE 1D, EQUIPMENT, COLUMN (C) HAS BEEN CORRECTED TO $5,745,484 FORM 990 SCHEDULE D PAGE 2 PART VI, LINE 1D, EQUIPMENT, COLUMN (D) HAS BEEN CORRECTED TO $2,026,882 FORM 990 SCHEDULE D PAGE 2 PART VI, LINE 1E, OTHER, COLUMNS (B) AND (D) HAS BEEN CORRECTED TO $241,985 FORM 990 SCHEDULE D PAGE 2 PART VI LAND, BUILDINGS, AND EQUIPMENT TOTAL COLUMN (D) HAS BEEN CORRECTED TO $27,023,475 FORM 990 SCHEDULE D PAGE 3 PART IX OTHER ASSETS LINE 2, ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS HAS BEEN CORRECTED TO $4,151,896 FORM 990 SCHEDULE D PAGE 4 PART XI RECONCILLIATION OF REVENUE LINE 1, TOTAL REVENUE PER AUDITED FINANCIAL STATEMENTS AND LINE 3 HAS BEEN CORRECTED TO $23,513,329 FORM 990 SCHEDULE D PAGE 4 PART XI RECONCILLIATION OF REVENUE LINE 5, TOTAL REVENUE HAS BEEN CORRECTED TO $23,495,339 FORM 990 SCHEDULE D PAGE 4 PART XI RECONCILLIATION OF EXPENSES LINE 1, TOTAL EXPENSES PER AUDITED FINANCIAL STATEMENTS HAS BEEN CORRECTED TO $24,471,051 FORM 990 SCHEDULE D PAGE 4 PART XI RECONCILLIATION OF EXPENSES LINE 3 HAS BEEN CORRECTED TO $24,453,061 FORM 990 SCHEDULE D PAGE 4 PART XI RECONCILLIATION OF EXPENSES LINE 5, TOTAL EXPENSES HAS BEEN CORRECTED TO $24,453,061

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:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

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

ENDLESS MOUNTAINS HEALTH SYSTEMS INC

Employer identification number

23-2720289

Part I

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

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)ENDLESS MOUNTAINS MEDICAL CARE FOUNDATION 100 HOSPITAL DRIVE MONTROSE,PA18801 23-2934943	PROVIDES FINANCIAL SUPPORT TO ENDLESS MOUNTAINS HEALTH SYSTEMS, INC.	PA	501(C)(3)	LINE 12B, II	N/A		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2019

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No

Schedule R (Form 990) 2019

Page 3

Part V

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

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

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

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

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

Yes

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

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

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

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

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

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

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

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

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

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

Yes

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

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

Yes

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

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

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

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

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2019

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

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

Schedule R (Form 990) 2019

Page 5

Part VII

Supplemental Information

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

Return Reference	Explanation

Schedule R (Form 990) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: OPERATES A NOT-FOR-PROFIT ACUTE CARE HOSPITAL LOCATED IN MONTROSE, PENNSYLVANIA.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	12
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	8
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	278
6	Total number of volunteers (estimate if necessary) .............	6	10
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	345,459
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	-6,851

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	809,198	221,554
9	Program service revenue (Part VIII, line 2g) .........	21,741,443	23,003,652
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	3,253	-290,287
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	542,952	560,420
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	23,096,846	23,495,339
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)	9,016,482	8,865,140
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)....	15,061,610	15,587,921
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	24,078,092	24,453,061
19	Revenue less expenses. Subtract line 18 from line 12.......	-981,246	-957,722
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	37,838,615	35,937,346
21	Total liabilities (Part X, line 26).............	29,300,788	28,357,241
22	Net assets or fund balances. Subtract line 21 from line 20.....	8,537,827	7,580,105

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 23,512,948 including grants of $ 0 ) (Revenue $ 23,003,652 )
	OPERATED A NOT-FOR-PROFIT ACUTE CARE HOSPITAL WHICH PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES. DURING THE YEAR ENDED DECEMBER 31, 2017, PATIENT DAYS WERE 3,362, OUTPATIENT VISITS WERE 22,720 AND EMERGENCY DEPARTMENT VISITS WERE 6,701.EMHS ALSO PROVIDED CHARITY CARE TO PATIENTS WHO MET CERTAIN CRITERIA. COST OF CHARGES FORGONE FOR SERVICES RENDERED AND SUPPLIES FURNISHED UNDER THE CHARITY CARE POLICY AMOUNTED TO APPROXIMATELY $50,000 IN 2017.

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 expenses23,512,948

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	1,435,092	0	29,629

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	34,033
e	Government grants (contributions)		1e	163,916

f	All other contributions, gifts, grants, and similar amounts not included above		1f	23,605

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

h Total. Add lines 1a-1f.......		221,554

		Business Code
2a	NET PATIENT SVC REV	623000	22,683,931	22,683,931
b	MEANINGFUL USE	621990	319,721	319,721
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		23,003,652

3 Investment income (including dividends, interest, and othersimilar amounts) ......			3,914			3,914
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........			13,208			13,208
		(ii) Personal	(i) Real
6a	Gross rents		14,080	6a
b	Less: rental expenses		17,990	6b
c	Rental income or (loss)		-3,910	6c
d	Net rental income or (loss).......			-3,910			-3,910
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	147,100		7a
b	Less: cost or other basis and sales expenses	441,301		7b
c	Gain or (loss)	-294,201		7c
d	Net gain or (loss).........			-294,201			-294,201
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	RETAIL PHARMACY REVENUE		446110	345,459		345,459
b	CAFETERIA REVENUE		722210	74,742			74,742
c	MA MODERNIZATION		624310	22,839			22,839
d	All other revenue ....			108,082			108,082
e	Total. Add lines 11a–11d ......			551,122
12	Total revenue. See instructions.....			23,495,339	23,003,652	345,459	-75,326

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 ...........	1,355,026	1,260,517	94,509
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........	5,894,534	5,483,410	411,124
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......	1,112,632	1,035,030	77,602
10	Payroll taxes ...........	502,948	467,869	35,079
11	Fees for services (non-employees):
a	Management ......
b	Legal .........
c	Accounting ...........	66,248		66,248
d	Lobbying ...........	1,841		1,841
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	4,176,199	4,112,906	63,293
12	Advertising and promotion ....	1,572		1,572
13	Office expenses .......	1,034,754	919,000	115,754
14	Information technology ......	350,791	350,791
15	Royalties ..
16	Occupancy ...........	564,079	551,981	12,098
17	Travel ............
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	988,635	988,635
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	3,113,197	3,113,197
23	Insurance ...	327,203	327,203
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	PHARMACEUTICAL	1,759,505	1,759,505
b	BAD DEBT EXPENSE	1,637,432	1,637,432
c	MEDICAL SUPPLIES	614,196	614,196
d	PATIENT SUPPLIES	597,124	597,124
e	All other expenses	355,145	294,152	60,993
25	Total functional expenses. Add lines 1 through 24e	24,453,061	23,512,948	940,113	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 ........			300	1	300
2	Savings and temporary cash investments .........			1,578,502	2	1,962,163
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			2,109,504	4	1,613,500
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 ............			527,250	8	498,024
9	Prepaid expenses and deferred charges ......			114,162	9	92,246
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	40,663,553
b	Less: accumulated depreciation	10b	13,640,078	30,492,361	10c	27,023,475
11	Investments—publicly traded securities .			69,941	11	89,568
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 ...........			2,946,595	15	4,658,070
16	Total assets. Add lines 1 through 15 (must equal line 33)...			37,838,615	16	35,937,346

17	Accounts payable and accrued expenses .....	2,810,119	17	2,293,658
18	Grants payable ...		18
19	Deferred revenue .........	158,607	19	45,269
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 ..	24,960,626	23	24,266,428
24	Unsecured notes and loans payable to unrelated third parties ..	249,933	24	249,933
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	1,121,503	25	1,501,953
26	Total liabilities. Add lines 17 through 25..	29,300,788	26	28,357,241

	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 ...........	8,537,827	32	7,580,105
33	Total liabilities and net assets/fund balances ........	37,838,615	33	35,937,346