Form990
Click to see attachment
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 07-01-2019 , and ending 06-30-2020
BCheck if applicable:
CName of organization
EVANGELICAL COMMUNITY HOSPITAL
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
ONE HOSPITAL DRIVE
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
LEWISBURG, PA17837
D Employer identification number

24-0795411
E Telephone number

G Gross receipts $ 291,469,739
F Name and address of principal officer:
KENDRA A AUCKER
ONE HOSPITAL DRIVE
LEWISBURG,PA17837
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.EVANHOSPITAL.COM
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1926
M State of legal domicile: PA
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: PROVIDE HEALTH CARE SERVICES TO THE PUBLIC AND TO BE THE COMMUNITY'S HEALTH CARE PROVIDER OF CHOICE.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 13
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 1,761
6 Total number of volunteers (estimate if necessary) ............. 6 176
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 8,904,977
b Net unrelated business taxable income from Form 990-T, line 39 ......... 7b 668,144
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 20,567,955 20,959,661
9 Program service revenue (Part VIII, line 2g) ......... 206,468,204 193,247,494
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 7,056,706 5,631,809
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 8,062,163 9,335,145
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 242,155,028 229,174,109
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 54,311 72,164
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) 90,672,434 88,774,356
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 98,184 97,434
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet631,920    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 88,996,715 89,031,356
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 179,821,644 177,975,310
19 Revenue less expenses. Subtract line 18 from line 12....... 62,333,384 51,198,799
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 410,791,219 455,729,514
21 Total liabilities (Part X, line 26)............. 134,111,434 160,884,105
22 Net assets or fund balances. Subtract line 21 from line 20..... 276,679,785 294,845,409
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2019)
Form 990 (2019)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: WE PROVIDE EXCEPTIONAL HEALTHCARE, ACCESSIBLE TO ALL, IN THE SAFEST AND MOST COMPASSIONATE ATMOSPHERE POSSIBLE. OUR VISION: WE WILL BE OUR COMMUNITY'S HEALTHCARE PROVIDER OF CHOICE BY PATIENTS, PHYSICIANS, AND EMPLOYEES.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 138,322,687 including grants of $ 72,164 ) (Revenue $ 196,956,433 )
MEETING THE HEALTHCARE NEEDS OF THE COMMUNITY IS AT THE HEART OF EVANGELICAL COMMUNITY HOSPITAL'S MISSION AS A NOT-FOR-PROFIT CHARITABLE ORGANIZATION. THE HOSPITAL'S RESOURCES PROVIDE FOR LONG-TERM INITIATIVES SUCH AS RECRUITMENT AND RETENTION OF OUTSTANDING MEDICAL PROFESSIONALS, ENHANCED TECHNOLOGIES, AND NEW FACILITIES AND SERVICES.THE HOSPITAL IS LICENSED TO ACCOMMODATE 132 OVERNIGHT PATIENTS, 9 ACUTE REHABILITATION UNIT PATIENTS AND 18 NEWBORN BABIES. IT IS A NOT-FOR-PROFIT COMMUNITY HOSPITAL OFFERING A FULL CONTINUUM OF CARE. SERVICES RANGE FROM COMPREHENSIVE DIAGNOSTIC TESTS TO DELICATE MICROSURGERY AND FROM SPECIFIC TREATMENT PROGRAMS TO NUMEROUS OUTPATIENT SERVICES. CONTINUED ON SCHEDULE O.IN ADDITION TO PROVIDING HOSPITAL-BASED MEDICAL SERVICES, EVANGELICAL PROVIDES A NUMBER OF COMMUNITY-BASED SERVICES DESIGNED TO IMPROVE THE HEALTH OF AREA RESIDENTS. MANY OF THE EMPLOYEES AND MEDICAL STAFF LEAD HEALTH EDUCATION AND SCREENINGS AS WELL AS SUPPORT GROUPS FOR INDIVIDUALS IN THE COMMUNITY LIVING WITH SERIOUS OR CHRONIC HEALTH CONDITIONS. WHETHER THROUGH CHARITABLE CARE, SUBSIDIZED HOSPITAL PROGRAMS AND SERVICES, OR COMMUNITY HEALTH EDUCATION, EVANGELICAL STRIVES TO RESPOND TO THE VALLEY'S MOST PRESSING HEALTH NEEDS.
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 expensesMediumBullet138,322,687
Form 990 (2019)
Form 990 (2019)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D,
Part IIIClick to see attachment..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D,
Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII
Click to see attachment......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....Click to see attachment
17
Yes
 
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............ Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................Click to see attachment
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
 
No
Form 990 (2019)
Form 990 (2019)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I .... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or 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? If "Yes," complete Schedule L, Part IIClick to see attachment...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part IIIClick to see attachment.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................Click to see attachment
28a
Yes
 
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..Click to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................Click to see attachment
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ..
1a
87
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
Form 990 (2019)
Form 990 (2019)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
1,761
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
Form 990 (2019)
Form 990 (2019)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
13
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
8
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
 
No
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
PA
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletJAMES A STOPPER CPA CFOONE HOSPITAL DRIVE   LEWISBURG,PA17837 (570) 522-2000
Form 990 (2019)
Form 990 (2019)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

See instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(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)
(D)
Reportable compensation from the organization (W-2/1099-MISC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) MATTHEW W REISH MD......................................................................
DIRECTOR
1.00
.................
39.00
X           889,493 0 25,698
(2) KENDRA A AUCKER......................................................................
PRESIDENT/CHIEF EXECUTIVE OFFICER
40.00
.................
1.00
    X       734,855 0 152,574
(3) SHAWN P MCGLAUGHLIN MD......................................................................
DIRECTOR
40.00
.................
 
X           723,132 0 30,019
(4) JOHN F DEVINE......................................................................
VP MEDICAL AFFAIRS
40.00
.................
 
      X     692,508 0 59,318
(5) JAMES A STOPPER CPA......................................................................
TREASURER/CHIEF FINANCIAL OFFICER
40.00
.................
1.00
    X       552,985 0 65,464
(6) CHRISTOPHER J MOTTO MD......................................................................
DIRECTOR
1.00
.................
43.00
X           475,139 0 17,035
(7) BRADLEY MUDGE......................................................................
SURGEON
40.00
.................
 
      X     441,913 0 22,764
(8) WILLIAM P ANDERSON......................................................................
SECRETARY/CHIEF OPERATING OFFICER
40.00
.................
 
    X       337,078 0 64,704
(9) JULIA E REDCAY DO......................................................................
DIRECTOR
1.00
.................
39.00
X           375,816 0 22,444
(10) DALE E MOYER......................................................................
VP OF INFORMATION SYSTEM
40.00
.................
 
      X     329,185 0 51,354
(11) TAMARA F PERSING......................................................................
VP OF NURSING ADMINISTRATION
40.00
.................
 
      X     265,153 0 53,814
(12) KATHRYN M GIORGINI......................................................................
HOSPITALIST/PALLIATIVE CARE
40.00
.................
 
      X     257,851 0 33,385
(13) DAVID M ZELECHOSKI MD......................................................................
DIRECTOR
1.00
.................
39.00
X           232,795 0 20,684
(14) RACHEL V SMITH......................................................................
VP PEOPLE & CULTURE
40.00
.................
 
      X     219,514 0 28,584
(15) ANGELA K LAHR......................................................................
AVP CLINICAL OPERATIONS
40.00
.................
 
      X     171,908 0 33,224
(16) PAUL E TARVES......................................................................
FORMER VP OF NURSING ADMINISTRATION
0.00
.................
 
          X 190,353 0 0
(17) RANDALL STRAUSSER......................................................................
DIRECTOR OF PHARMACY SERVICES
40.00
.................
 
        X   165,375 0 22,724
Form 990 (2019)
Form 990 (2019)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title
(B)
Average hours per week (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)
(D)
Reportable compensation from the organization (W-2/1099-MISC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) WILLIAM FRANQUET........................................................................
AVP REVENUE CYCLE
40.00
.......................  
        X   152,259 0 21,068
(19) JOSHUA TITUS........................................................................
PHARMACIST
40.00
.......................  
        X   154,314 0 13,779
(20) RUTH SPROUT........................................................................
ASST DIRECTOR OF PHARMACY
40.00
.......................  
        X   145,283 0 21,670
(21) JOSHUA MILLER........................................................................
PHARMACIST
40.00
.......................  
        X   152,409 0 13,566
(22) TIMOTHY J APPLE........................................................................
CHAIR
1.00
.......................0.10
X   X       0 0 0
(23) JOHN D STEELE JR........................................................................
VICE CHAIR
1.00
.......................0.10
X   X       0 0 0
(24) JOHN E MECKLEY ESQ........................................................................
DIRECTOR
1.00
.......................0.10
X           0 0 0
(25) ROGER S HADDON JR........................................................................
DIRECTOR
1.00
.......................0.10
X           0 0 0
(26) JEFFREY J KAPSAR........................................................................
DIRECTOR
1.00
.......................0.10
X           0 0 0
(27) AMANDA G KESSLER ESQ........................................................................
DIRECTOR
1.00
.......................0.10
X           0 0 0
(28) LINDA J KORB PHD NCPSYA........................................................................
DIRECTOR
1.00
.......................0.10
X           0 0 0
(29) TIMM A MOYER........................................................................
DIRECTOR
1.00
.......................0.10
X           0 0 0
(30) SUSAN J FETTERMAN RN MSN MBA FAC........................................................................
DIRECTOR (UNTIL 10/19)
1.00
.......................  
X           0 0 0
(31) MARK D HUBER........................................................................
DIRECTOR (UNTIL 12/19)
1.00
.......................0.10
X           0 0 0
(32) FRANK D DAVIS PHD........................................................................
DIRECTOR (UNTIL 10/19)
1.00
.......................  
X           0 0 0
(33) SUSAN L LANTZ MA EDD........................................................................
DIRECTOR (UNTIL 10/19)
1.00
.......................  
X           0 0 0
(34) TERI J MACBRIDE........................................................................
DIRECTOR (UNTIL 10/19)
1.00
.......................  
X           0 0 0
(35) CHRISTA L MARTIN PHD........................................................................
DIRECTOR (UNTIL 10/19)
1.00
.......................  
X           0 0 0
(36) KARL A VOSS PHD........................................................................
DIRECTOR (UNTIL 10/19)
1.00
.......................  
X           0 0 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 7,659,318 0 773,872
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet61
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
QUANDEL CONSTRUCTION

2601 MARKET PL STE 200
HARRISBURG,PA17110
CONSTRUCTION 19,895,517
RENOVO SOLUTIONS

4 EXECUTIVE CIRCLE
IRVINE,CA92614
PREVENTATIVE MAINTENANCE-EQUIPMENT 1,431,748
ZARTMAN CONSTRUCTION

3000 POINT TOWNSHIP DRIVE
NORTHUMBERLAND,PA178578864
CONSTRUCTION 1,211,392
T-ROSS BROS CONSTRUCTION

RTS 147 45
MONTANDON,PA178500070
CONSTRUCTION 789,975
SILVERTIP INC

PO BOX 50
LEWISBURG,PA178370050
CONSTRUCTION 640,740
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet35
Form 990 (2019)
Form 990 (2019)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c 202,014
d Related organizations1d  
e Government grants (contributions)1e 10,585,653
f All other contributions, gifts, grants, and similar amounts not included above1f 10,171,994
g Noncash contributions included in lines 1a - 1f:$ 1g 28,350
h Total. Add lines 1a-1f.......MediumBullet 20,959,661
 Program Service RevenueAmt Business Code
2a NET PATIENT SERVICE REVENUE 621400 193,247,494 193,247,494    
b
c
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 193,247,494
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 3,985,528     3,985,528
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   4,519,287 6a
b Less: rental expenses   4,949,634 6b
c Rental income or (loss)   -430,347 6c
d Net rental income or (loss).......MediumBullet -430,347     -430,347
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 1,657,448 57,226,868 7a
b Less: cost or other basis and sales expenses 1,813,863 55,424,172 7b
c Gain or (loss) -156,415 1,802,696 7c
d Net gain or (loss).........MediumBullet 1,646,281     1,646,281
8a Gross income from fundraising events (not including $ 202,014of contributions reported on line 1c). See Part IV, line 18 ....
8a 85,536
b Less: direct expenses ... 8b 107,961
c Net income or (loss) from fundraising events..MediumBullet -22,425   -22,425
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..MediumBullet        
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..MediumBullet        
Business Code Miscellaneous Revenue
11a LABORATORY SERVICES 621500 3,398,501   3,398,501  
b BILLING FEES FROM AFFILIATE 541900 1,937,476   1,937,476  
c CAFETERIA AND VENDING SALES 722210 595,121     595,121
d All other revenue .... 3,856,819 310,438 3,569,000 -22,619
e Total. Add lines 11a–11d ...... MediumBullet 9,787,917
12 Total revenue. See instructions.....MediumBullet 229,174,109 193,557,932 8,904,977 5,751,539
Form 990 (2019)
Form 990 (2019)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....    
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 72,164 72,164
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 ........... 7,610,361 3,572,565 4,037,796  
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........ 64,119,080 50,972,439 12,888,953 257,688
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 1,717,327 1,646,367 64,114 6,846
9 Other employee benefits ....... 10,328,767 7,387,980 2,891,606 49,181
10 Payroll taxes ........... 4,998,821 3,886,790 1,093,517 18,514
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 1,718,683 44,016 1,674,667  
c Accounting ........... 116,116 6,750 109,366  
d Lobbying ........... 9,496   9,496  
e Professional fundraising services. See Part IV, line 17 97,434 97,434
f Investment management fees ...... 730,047 17,795 712,252  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 8,848,235 6,420,918 2,358,946 68,371
12 Advertising and promotion .... 543,795 9,109 534,686  
13 Office expenses ....... 32,850,812 31,863,341 962,102 25,369
14 Information technology ...... 11,916,487 1,572,553 10,299,269 44,665
15 Royalties ..        
16 Occupancy ........... 3,191,236 2,774,542 416,694  
17 Travel ............ 181,543 174,210 5,960 1,373
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 123,782 63,817 56,128 3,837
20 Interest ........... 1,126,964 1,126,964    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 10,532,212 10,203,169 329,043  
23 Insurance ... 1,089,283 1,051,501 37,782  
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 FEDERAL TAXES 51,974   51,974  
b BAD DEBT EXPENSE 13,380,426 13,380,426    
c MA MODERNIZATION 779,820 779,820    
d EQUIPMENT RENTAL & MAIN 519,580 519,580    
e All other expenses 1,320,865 775,871 486,352 58,642
25 Total functional expenses. Add lines 1 through 24e 177,975,310 138,322,687 39,020,703 631,920
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 MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2019)
Form 990 (2019)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 5,245 1 5,343
2 Savings and temporary cash investments ......... 37,615,604 2 65,721,007
3 Pledges and grants receivable, net ...... 2,204,609 3 2,184,500
4 Accounts receivable, net ............. 18,955,341 4 18,592,208
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 ............ 5,036,901 8 5,349,085
9 Prepaid expenses and deferred charges ...... 4,732,322 9 5,976,703
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 344,345,027
b Less: accumulated depreciation 10b 130,044,440 171,118,094 10c 214,300,587
11 Investments—publicly traded securities . 145,022,165 11 112,773,541
12 Investments—other securities. See Part IV, line 11 ..... 6,541,354 12 11,175,199
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ............... 8,659,784 14 8,659,784
15 Other assets. See Part IV, line 11 ........... 10,899,800 15 10,991,557
16 Total assets. Add lines 1 through 15 (must equal line 33)... 410,791,219 16 455,729,514
Liabilities 17 Accounts payable and accrued expenses ..... 28,191,464 17 47,145,224
18 Grants payable ...   18  
19 Deferred revenue ......... 237,522 19 221,070
20 Tax-exempt bond liabilities ......... 90,328,839 20 88,802,393
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 .........
175,000 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 1,018,882 23 10,411,343
24 Unsecured notes and loans payable to unrelated third parties ..   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 14,159,727 25 14,304,075
26 Total liabilities. Add lines 17 through 25.. 134,111,434 26 160,884,105
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 267,704,096 27 285,461,670
28 Net assets with donor restrictions ........... 8,975,689 28 9,383,739
Organizations that do not follow FASB ASC 958, check here MediumBullet 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 ........... 276,679,785 32 294,845,409
33 Total liabilities and net assets/fund balances ........ 410,791,219 33 455,729,514
Form 990 (2019)
Form 990 (2019)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
229,174,109
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
177,975,310
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
51,198,799
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
276,679,785
5
Net unrealized gains (losses) on investments ...............
5
-1,127,414
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-31,905,761
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
294,845,409
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2019)
Form 990 (2019)
Additional Data


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

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow 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
EVANGELICAL COMMUNITY HOSPITAL
 
Employer identification number

24-0795411
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.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
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

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) right arrow (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) right arrow (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  
12
12
 
13
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
14
14
 
15
15
 
16a
b
17a
b
18
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

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) right arrow (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) right arrow (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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2019

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
No
1
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.
1
 
 
2
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).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
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.
3b
 
 
c
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.
3c
 
 
4a
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.
4a
 
 
b
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.
4b
 
 
c
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.
4c
 
 
5a
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).
5a
 
 
b
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?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
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.
6
 
 
7
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) .
7
 
 
8
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).
8
 
 
9a
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.
9a
 
 
b
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.
9b
 
 
c
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.
9c
 
 
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
 
 
b
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

Schedule A (Form 990 or 990-EZ) 2019
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
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
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
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
No
1
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.
1
 
 
2
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.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
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).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
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?
1
 
 
2
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).
2
 
 
3
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.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
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.
2a
 
 
b
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.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
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.
3a
 
 
b
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.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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  
7
Schedule A (Form 990 or 990-EZ) 2019

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:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Name of the organization
EVANGELICAL COMMUNITY HOSPITAL
 
Employer identification number

24-0795411
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution: An organization that 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
EVANGELICAL COMMUNITY HOSPITAL
 
Employer identification number
24-0795411
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


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(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
EVANGELICAL COMMUNITY HOSPITAL
 
Employer identification number

24-0795411
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
EVANGELICAL COMMUNITY HOSPITAL
 
Employer identification number

24-0795411
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 $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Additional Data


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

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

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

SchCMd Bullet Complete if the organization is described below. SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd BulletGo 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
EVANGELICAL COMMUNITY HOSPITAL
 
Employer identification number

24-0795411
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

2
Political campaign activity expenditures (see instructions) ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities (see instructions) ..................................................................
 

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

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

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

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

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the 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


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
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
No
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
9,496
j
Total. Add lines 1c through 1i ....................................................................................................
9,496
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) 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."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
Part IV
Supplemental Information
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 PERCENTAGE OF ANNUAL HAP AND AHA DUES WERE USED FOR LOBBYING; THIS AMOUNTED TO $9,496 FOR THE FISCAL YEAR ENDING JUNE 30, 2020.
Schedule C (Form 990 or 990EZ) 2019


Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," 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
EVANGELICAL COMMUNITY HOSPITAL
 
Employer identification number

24-0795411
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 ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds 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? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
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.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
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.
1a
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.
b
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 $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
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

Schedule D (Form 990) 2019
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part 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  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
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 .... 8,760,698 8,165,164 7,862,290 7,418,085 5,826,952
b Contributions ... 22,134 20,575 25,625 185,221 1,171,492
c Net investment earnings, gains, and losses 590,484 741,483 436,912 425,034 563,204
d Grants or scholarships ... 18,795 20,331 22,500 23,000 13,407
e Other expenditures for facilities
and programs ...
94,907 113,399 104,484 112,547 104,824
f Administrative expenses .... 37,347 32,794 32,679 30,503 25,332
g End of year balance ...... 9,222,267 8,760,698 8,165,164 7,862,290 7,418,085
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet74.000 %
b
Permanent endowment SchDMd Bullet26.000 %
c
Term endowment SchDMd Bullet0 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
Yes
 
(ii) Related organizations .................
3a(ii)
 
No
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
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 .....   23,105,120 23,105,120
b Buildings ....   139,508,874 52,682,495 86,826,379
c Leasehold improvements   14,822,664 3,146,017 11,676,647
d Equipment ....   98,263,981 72,566,505 25,697,476
e Other .....   68,644,388 1,649,423 66,994,965
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 214,300,587
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
Page 3
Part VII
Investments—Other 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.)Small Bullet  
Part VIII
Investments—Program 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.)Small Bullet  
Part IX
Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
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  
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 14,304,075
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

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 ....... 1 222,196,645
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a -1,127,414
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d -10,907,645
e Add lines 2a through 2d ..................... 2e -12,035,059
3 Subtract line 2e from line 1.................. 3 234,231,704
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 -5,057,595
c Add lines 4a and 4b.................... 4c -5,057,595
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 229,174,109
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 ........... 1 204,031,021
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 38,667,569
e Add lines 2a through 2d.................... 2e 38,667,569
3 Subtract line 2e from line 1................... 3 165,363,452
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 12,611,858
c Add lines 4a and 4b..................... 4c 12,611,858
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 177,975,310
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 V, LINE 4: ENDOWMENT FUNDS WILL BE USED TO SUPPORT VARIOUS HOSPITAL PROGRAMS SUCH AS FUNDING HELPLINE SERVICES, COMMUNITY HEALTH EDUCATION, HOSPICE SERVICES, PRE-HOSPITAL SERVICES, FAMILY PLACE (OB SERVICES), PROVIDE NURSING SCHOLARSHIPS AND TO PROVIDE FOOD, SERVICE, OR CARE FOR PEOPLE WHO DO NOT HAVE THE MEANS TO PAY FOR THE SERVICE.
PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE NETTED AGAINST REVENUE ON AFS -12,185,676. INVESTMENT EXPENSES NETTED AGAINST REVENUE ON AFS -426,182. POSTRETIREMENT BENEFIT LIABILITY ADJUSTMENT 139,382. NET ASSETS RELEASED FROM RESTRICTIONS -76,863. VALUATION LOSS -87,837. CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENT -14,048. CONTRIBUTIONS FROM ACQUISITION 1,743,579.
PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -4,949,634. SPECIAL EVENTS EXPENSE -107,961.
PART XII, LINE 2D - OTHER ADJUSTMENTS: EQUITY TRANSFER WITH AFFILIATES 33,609,974. RENTAL EXPENSES 4,949,634. SPECIAL EVENTS EXPENSE 107,961.
PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE NETTED AGAINST REVENUE ON AFS 12,185,676. INVESTMENT EXPENSES NETTED AGAINST REVENUE ON AFS 426,182.
Schedule D (Form 990) 2019


Additional Data


Software ID:  
Software Version:  




SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrowAttach to Form 990 or Form 990-EZ.
right arrowGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
EVANGELICAL COMMUNITY HOSPITAL
 
Employer identification number

24-0795411
Part I
Fundraising Activities.Complete if the organization answered "Yes" on Form 990, Part IV, line 17.
Form 990-EZ filers are not required to complete this part.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.


(i) Name and address of individual
or entity (fundraiser)
(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity
(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i)
(vi) Amount paid to
(or retained by)
organization
Yes No
 
PRIDE PHILANTHROPY
1397 CHESTNUT COVE TRAIL 20988
 
JASPER, GA30143
CAMPAIGN CONSULTANT   No 0 84,000 -84,000
 
PROCOPIA
1106 NORTH SHERIDAN AVENUE
 
PITTSBURGH, PA15206
GRANT WRITING CONSULTANT   No 0 7,500 -7,500
 
JAMES E CONNELL & ASSOCIATES
15 PINEWALD DRIVE PO BOX 3335
 
PINEHURST, NC283743335
PLANNED GIVING CONSULTANT   No 0 5,934 -5,934
             
             
             
             
             
             
             
Total . . . . . . . . . . . . . . . . . . . . right arrow   97,434 -97,434
3
List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.
PA
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2019
Schedule G (Form 990 or 990-EZ) 2019
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.









VerticalRevenue
(a) Event #1

GALA
(event type)
(b) Event #2

GOLF CLASSIC
(event type)
(c) Other events

1
(total number)
(d) Total events
(add col. (a) through col. (c))

1

Gross receipts . . . . .

161,230

64,660

61,660

287,550

2

Less: Contributions . . . .

106,560

43,234

52,220

202,014
3 Gross income (line 1 minus
line 2) . . . . . .

54,670

21,426

9,440

85,536



VerticalDirectExpenses
4 Cash prizes . . . . .   1,960   1,960
5 Noncash prizes . . . . 26,411     26,411
6 Rent/facility costs . . . . 1,700 9,600   11,300
7 Food and beverages . . . 21,084 7,617 5,104 33,805
8 Entertainment . . . . 6,550     6,550
9 Other direct expenses . . . 17,518 4,980 5,437 27,935
10 Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . . right arrow 107,961
11 Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . . right arrow -22,425
Part III
Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue
(a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo
(c) Other gaming (d) Total gaming (add col.(a) through col.(c))

1

Gross revenue . . . . .

 

 

 

 
VerticalDirectExpenses

2

Cash prizes . . . . .

 

 

 

 

3

Noncash prizes . . . .

 

 

 

 

4

Rent/facility costs . . . .

 

 

 

 

5

Other direct expenses . . .

 

 

 

 


6


Volunteer labor . . . .
%
%
%


7

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

 

8

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

 

9
Enter the state(s) in which the organization conducts gaming activities:
a
Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .
b
If "No," explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .
b
If "Yes," explain:
 
Schedule G (Form 990 or 990-EZ) 2019
Schedule G (Form 990 or 990-EZ) 2019
Page 3
11
Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? . . . . . . . . . . . . . . . . .
13
Indicate the percentage of gaming activity conducted in:
a
The organization's facility . . . . . . . . . . . . . . . . . .
13a
%
b
An outside facility . . . . . . . . . . . . . . . . . . . .
13b
%
14
Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? . . . . . . . . . . . . . . . . . . . . . . . .
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address of the third party:
Name right arrow
Address right arrow
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? . . . . . . . . . . . . . . . . . . .
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.
Return Reference Explanation
Schedule G (Form 990 or 990-EZ) 2019
Additional Data


Software ID:  
Software Version:  
SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" 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
EVANGELICAL COMMUNITY HOSPITAL
 
Employer identification number

24-0795411
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
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.
3
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.
a
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:
3a
Yes
 
%
b
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: . . . . . . . .
3b
Yes
 
%
c
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.
4
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"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
  1,873 531,252   531,252 0.320 %
b Medicaid (from Worksheet 3, column a) . . . . . 2 21,105 17,379,182 7,429,334 9,949,848 6.050 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . . 1 95 29,296   29,296 0.020 %
d Total Financial Assistance and Means-Tested Government Programs . . . . . 3 23,073 17,939,730 7,429,334 10,510,396 6.390 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4). 608 25,076 149,111 11,140 137,971 0.080 %
f Health professions education (from Worksheet 5) . . . 166 1,156 43,353   43,353 0.030 %
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . . 44   145,250   145,250 0.090 %
j Total. Other Benefits . . 818 26,232 337,714 11,140 326,574 0.200 %
k Total. Add lines 7d and 7j . 821 49,305 18,277,444 7,440,474 10,836,970 6.590 %
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 1 150 665   665 0 %
3 Community support 61 2,242 16,208   16,208 0.010 %
4 Environmental improvements            
5 Leadership development and
training for community members
13 107 481   481 0 %
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total 75 2,499 17,354   17,354 0.010 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
2,734,697
3
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. ......
3
 
4
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
5
Enter total revenue received from Medicare (including DSH and IME).....
5
60,040,508
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
84,567,656
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-24,527,148
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
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 .........................

9b

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
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)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 EVANGELICAL COMMUNITY HOSPITAL
ONE HOSPITAL DRIVE
LEWISBURG,PA17837
570201
X X         X   INPATIENT REHABILITATION, HOSPICE  
Schedule H (Form 990) 2019
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)
EVANGELICAL COMMUNITY HOSPITAL
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
1
Yes No
Community Health Needs Assessment
1 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?........................ 1   No
2 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............... 2   No
3 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...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 18
5 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 ................. 5 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.................................. 6a Yes  
b 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. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): WWW.EVANHOSPITAL.COM/HEALTH-AND-WELLNESS
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 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   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
EVANGELICAL COMMUNITY HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
WWW.EVANHOSPITAL.COM/FOR-PATIENTS/FINANCIAL-ASSISTANCE-PROGRAM-GUIDELINES
b
WWW.EVANHOSPITAL.COM/FOR-PATIENTS/FINANCIAL-ASSISTANCE-PROGRAM-GUIDELINES
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
EVANGELICAL COMMUNITY HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
17 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?.................................. 17 Yes  
18 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:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 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):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
EVANGELICAL COMMUNITY HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
22 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.
a
b
c
d
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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
EVANGELICAL COMMUNITY HOSPITAL PART V, SECTION B, LINE 5: COMMUNITY ENGAGEMENT WAS AN INTEGRAL PART OF THE 2018 CHNA. WEBINARS WERE HELD IN OCTOBER AND NOVEMBER 2017 TO ANNOUNCE THE ONSET OF THE CHNA AND ENCOURAGE BROAD PARTICIPATION ACROSS THE REGION. THROUGHOUT OCTOBER AND NOVEMBER 2017, A KEY INFORMANT SURVEY WAS SENT TO APPROXIMATELY 1,000 REPRESENTATIVES OF HEALTH AND HUMAN SERVICE ORGANIZATIONS, RELIGIOUS INSTITUTIONS, CIVIC ASSOCIATIONS, BUSINESSES, ELECTED OFFICIALS AND OTHER COMMUNITY REPRESENTATIVES. PARTNER FORUMS WERE HELD THROUGHOUT THE REGION IN JANUARY 2018 TO BRING TOGETHER THESE PARTNERS TO REVIEW RESEARCH FINDINGS AND PROVIDE FEEDBACK ON THE MOST PRESSING COMMUNITY HEALTH NEEDS. IN MARCH AND APRIL 2018, FOCUS GROUPS WITH SENIORS WERE HELD TO BETTER UNDERSTAND CHALLENGES AND OPPORTUNITIES TO IMPROVING HEALTH AMONG HIGH RISK POPULATIONS. COMMUNITY FORUMS ARE PLANNED FOR FALL 2018 TO PRESENT CHNA FINDINGS ANDIMPLEMENTATION PLANS TO COMMUNITY RESIDENTS AND PROVIDE A FORUM FOR DIALOGUE ABOUT ADDRESSING COMMUNITY HEALTH NEEDS.
EVANGELICAL COMMUNITY HOSPITAL PART V, SECTION B, LINE 6A: THE 2018 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED IN PARTNERSHIP WITH EVANGELICAL COMMUNITY HOSPITAL, ALLIED SERVICES INTEGRATED HEALTH SYSTEM, AND GEISINGER. THE STUDY AREA INCLUDED 19 COUNTIES ACROSS CENTRAL, NORTHEASTERN, AND SOUTH CENTRAL PENNSYLVANIA WHICH REPRESENT THE COLLECTIVE SERVICE AREAS OF THE COLLABORATING HOSPITALS. TO DISTINGUISH UNIQUE SERVICE AREAS AMONG HOSPITALS AND FOSTER COOPERATION WITH LOCAL COMMUNITY PARTNERS TO IMPACT HEALTH NEEDS, REGIONAL RESEARCH AND LOCAL REPORTING WAS DEVELOPED.
EVANGELICAL COMMUNITY HOSPITAL PART V, SECTION B, LINE 6B: ALLIED SERVICES INTEGRATED HEALTH SYSTEM
EVANGELICAL COMMUNITY HOSPITAL PART V, SECTION B, LINE 11: ACCORDING TO THIS MOST RECENT ASSESSMENT THE KEY IDENTIFIED NEEDS ARE AS FOLLOWED: 1. ADDRESSING NEEDS RELATED TO BEHAVIORAL HEALTH AND SUBSTANCE ABUSEWE CONTINUE TO MONITOR OUR TELE-PSYCH SERVICE UTILIZATION. DURING THIS FISCAL YEAR THESE SERVICES WERE UTILIZED AN AVERAGE OF 29 TIMES PER QUARTER FOR THE ED AND APPROXIMATELY 16 TIMES A QUARTER FOR INPATIENT. RESPONSE TIMES CONTINUE TO BE WITHIN THE EXPECTED RANGE (WITHIN 2 HOURS).OPIOID REVERSAL KITS (NALOXONE) AND EDUCATION CONTINUES TO BE OFFERED TO VARIOUS ORGANIZATIONS AND INDIVIDUALS THROUGHOUT OUR THREE-COUNTY SERVICE AREA. THE COMMUNITY HEALTH AND WELLNESS DEPARTMENT DEVELOPED AND HAD APPROVED AN EDUCATIONAL PRESENTATION TO INCREASE RESPONSE TIMES FOR GETTING REQUESTED KITS IN HAND. EVANGELICAL MEDICAL SERVICES ORGANIZATION (EMSO) CONTINUES TO OFFER DEPRESSION SCREENING AND MAKE RECOMMENDATIONS REGARDING THE FINDINGS. WITH OUR CURRENT EHR THERE ARE LIMITATIONS TO TRACKING THE DATA THEY CAN EXTRACT RELATED SPECIFICALLY TO REFERRALS. THE COMMUNITY THAT CARES (CTC) IN THE SHIKELLAMY SCHOOL DISTRICT TRANSITIONED TO A UNITED WAY SUPPORTED PROGRAM. COMMUNITY HEALTH AND WELLNESS (CHW) ATTENDS MONTHLY MEETINGS AND PROVIDES SUPPORT THROUGH PROGRAMMING. DURING THIS FISCAL YEAR TWO CHW STAFF ATTENDED A STRENGTHENING FAMILIES TRAINING PROGRAM AND WILL ASSIST WITH PROGRAMMING IN THE FALL.HOSPITAL STAFF PARTICIPATED IN BOTH THE NORTHUMBERLAND COUNTY OPIOID COALITION AND THE SNYDER/UNION COUNTY OPIOID COALITION. COMMUNITY HEALTH AND WELLNESS PROVIDES NALOXONE TRAINING AND FREE NALOXONE KITS. 220 KITS WERE DISTRIBUTED IN FY19 AND OVER 250 EXPIRED KITS WERE REPLACED.ECH IS RESPONDING TO FOOD INSECURITY BY ASKING DIRECT FOOD AVAILABILITY QUESTIONS AND IF PATIENTS ARE IDENTIFIED AS FOOD INSECURE WE ARE OFFERING THEM A ONE TIME FOOD BOX ALONG WITH LITERATURE FOR THE LOCAL FOOD BANK.2. REDUCING THE IMPACT OF HEALTH CONCERNS RELATED TO LIFESTYLENEW WORKSITE WELLNESS CLIENTS HAVE INCREASED BY NINE WITH TWO HAVING COMMITTED TO YEAR-ROUND PROGRAMMING.ENDOCRINOLOGY OF EVANGELICAL WAS ESTABLISHED IN MARCH 2018. DURING THIS FISCAL YEAR WE HAVE SEEN 4050 PATIENTS.ECH PROVIDED FOUR FREE SKIN CANCER SCREENINGS. WE HAD 61 PARTICIPANTS TAKE PART IN THE SCREENINGS. OUT OF THE 61 SCREENED 36 WERE BROUGHT BACK IN FOR BIOPSY. FROM THE BIOPSIES 18 WERE DIAGNOSED PRECANCEROUS; 2 BASAL CELL; 2 SQUAMOUS AND 13 DYSPLASTIC NEVI. THE CANCER COMMITTEE WILL BE USING SKIN CANCER SCREENINGS TO ADDRESS STANDARD 4.2, "SCREENING PROGRAMS".ECH CONTINUES TO OFFER THE LOW DOSE CT LUNG SCREENING PROGRAM. DURING THIS FISCAL YEAR, THERE WERE 95 REFERRALS WITH 76 QUALIFYING.3. INCREASING ACCESS TO HEALTHCAREMOBILE HEALTH OF EVANGELICAL CONTINUES TO FOCUS RURAL AREAS AND OFFERING LOST COST OR FREE HEALTH SCREENS SUCH AS BLOOD SCREENS, BLOOD PRESSURE SCREENINGS, GLUCOSE SCREENING AND HEEL BONE DENSITY SCREENINGS. A TOTAL OF 54 VISITS WERE MADE REACHING 610 SCREENING PARTICIPANTS. SOME OF THE AREAS OF SERVICE WERE; BERWICK, SELINSGROVE, SPRING MILLS, LOGANTON, BEAVER SPRINGS, PORT TREVORTON AND MONTGOMERY.THE PLAIN COMMUNITY PROGRAM HAS SEEN AN APPROXIMATE 22% INCREASE IN UTILIZATION OF THE PROGRAM AND ABOUT A 19% INCREASE IN GROSS REVENUE FROM LAST FISCAL YEAR TO THIS FISCAL YEAR TO DATE.FY19 UTILIZATION OF PLAIN COMMUNITY PROGRAM:ECH ENCOUNTERS CHARGESFY2017 2,266 $6,855,403FY2018 2,268 $8,309,429FY2019 2,638 $9,843,948 EMSO ENCOUNTERS CHARGESFY2017 2,221 $799,977FY2018 2,662 $1,351,370FY2019 3,359 $1,690,0424. THE IMPACT OF SOCIO-ECONOMIC STATUS ON HEALTH OUTCOMESIN COLLABORATION WITH THE GREATER SUSQUEHANNA VALLEY UNITED WAY WE OFFERED A PROGRAM TITLED EVERY BABY NEEDS A LAPTOP. THIS FREE PROGRAM IS DESIGNED TO ASSIST AND EDUCATE PARENTS ON THE IMPORTANCE OF READING, TALKING AND SINGING TO YOUR BABY TO ASSIST WITH LEARNING AND BRAIN DEVELOPMENT. CH&W OFFERED OVER 3,000 PREVENTATIVE SCREENINGS TO THE COMMUNITY, PROVIDED SCHOOL BASED EDUCATIONAL PROGRAMMING TO OVER 23,000 STUDENTS, REACHING MORE THAN 33,000 INDIVIDUALS.ECH HAS ESTABLISHED A PLAN TO PROVIDE FOOD BOXES TO PATIENTS WHO ARE IDENTIFIED AS FOOD INSECURE. THE FOOD BOXES WILL BE DISTRIBUTED THROUGH THE HOSPITAL TO HOME PROGRAM. DURING FY19 39 FOOD BOXES WERE DISTRIBUTED TO PATIENTS IDENTIFYING AS FOOD INSECURE.
EVANGELICAL COMMUNITY HOSPITAL PART V, SECTION B, LINE 13H: MEDICAL ASSISTANCE DENIAL
EVANGELICAL COMMUNITY HOSPITAL PART V, SECTION B, LINE 16J: POLICY IS PRESENTED TO PATIENTS BY HRSI WHEN WORKING WITH PATIENTS ON MEDICAL ASSISTANCE APPLICATIONS. HRSI IS A THIRD PARTY USED BY EVANGELICAL COMMUNITY HOSPITAL TO WORK WITH PATIENTS FOR OBTAINING FINANCIAL ASSISTANCE.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2019
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
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 6A: THE COMMUNITY BENEFIT REPORT IS AVAILABLE ON THE HOSPITAL'S WEBSITE OR UPON REQUEST.
PART I, LINE 7: THE HOSPITAL USED THE COST-TO-CHARGE RATIO TO DETERMINE THE AMOUNTS INCLUDED IN LINE 7.
PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24B, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $13,380,426.
PART II, COMMUNITY BUILDING ACTIVITIES: AS A COMMUNITY AND HEALTH RESOURCE FOR MORE THAN 90 YEARS, EVANGELICAL COMMUNITY HOSPITAL HAS CONTINUALLY DEMONSTRATED ITS COMMITMENT TO THE CENTRAL SUSQUEHANNA VALLEY BY TAKING CARE OF PATIENTS NEEDING TREATMENT, AND BY ITS OUTREACH TO THE COMMUNITY. BEYOND THE DAILY CARE OF PATIENTS, THE HOSPITAL EXTENDS ITS REACH TO PROVIDE PREVENTION AND WELLNESS EDUCATION TO RESIDENTS OF THE VALLEY. OUTREACH INCLUDES CHARITY-CARE FOR THOSE WHO CANNOT AFFORD MEDICAL TREATMENT, HEALTH SCREENINGS TARGETING THE UN/UNDER-INSURED, HEALTH EDUCATION FOCUSING ON HEALTHY LIFESTYLE CHANGES, CHILD SAFETY SEAT INSPECTIONS, SCHOOL AGED HEALTH INITIATIVES, AND LECTURES ON HEALTH CONCERNS AND TOPICS. MANY OF THESE PROGRAMS ARE PROVIDED AT MINIMAL OR NO COST AND ARE SUBSIDIZED USING HOSPITAL RESOURCES.
PART III, LINE 2: THE COSTING METHODOLOGY USED IN DETERMINING BAD DEBT EXPENSE AT COST IS BAD DEBT EXPENSE TIMES THE COST TO CHARGE RATIO. IN DETERMINING BAD DEBT EXPENSE, PATIENT LIABILITIES ARE NET OF THIRD-PARTY PAYMENTS AND ANY PATIENT PAYMENTS.
PART III, LINE 3: WE BELIEVE THAT A PORTION OF OUR BAD DEBTS RESULTS FROM SERVICES PROVIDED TO PATIENTS WHO MEET THE CHARITY CARE GUIDELINES BUT WERE UNABLE OR UNWILLING TO PROVIDE THE APPROPRIATE DOCUMENTATIONS TO ALLOW THAT CLASSIFICATION. THESE WOULD BE CLASSIFIED AS BAD DEBT EXPENSE TIMES THE COST TO CHARGE RATIO TO ARRIVE AT COST. EVANGELICAL COMMUNITY HOSPITAL PROVIDES CARE TO ALL PATIENTS WHO NEED IT, REGARDLESS OF THEIR ABILITY TO PAY. THIS IS PART OF THE HOSPITAL'S MISSION.
PART III, LINE 4: ACCOUNTS RECEIVABLE ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. THE ALLOWANCE FOR DOUBTFUL COLLECTIONS ARE ESTIMATED BASED UPON A PERIODIC REVIEW OF THE ACCOUNTS RECEIVABLE AGING, PAYOR CLASSIFICATIONS AND APPLICATION OF HISTORICAL WRITE-OFF PERCENTAGES. THE COSTING METHODOLOGY USED IN DETERMINING BAD DEBTS EXPENSE AT COST AND ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTED TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS BAD DEBT EXPENSE TIMES THE COST TO CHARGE RATIO. IN DETERMINING BAD DEBT EXPENSE, PATIENT LIABILITIES ARE NET OF THIRD-PARTY PAYMENTS AND ANY PATIENT PAYMENTS. THE METHOD THE ORGANIZATION USES TO DETERMINE THE AMOUNT THAT REASONABLY COULD BE ATTRIBUTED TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY, BUT DID NOT ADEQUATELY COMPLETE THE CHARITY CARE PAPERWORK. WE BELIEVE THAT A PORTION OF OUR BAD DEBTS RESULTS FROM SERVICES PROVIDED TO PATIENTS WHO MEET THE CHARITY CARE GUIDELINES BUT WERE UNABLE OR UNWILLING TO PROVIDE THE APPROPRIATE DOCUMENTATIONS TO ALLOW THAT CLASSIFICATION. THESE WOULD BE CLASSIFIED AS BAD DEBT EXPENSE TIMES THE COST TO CHARGE RATIO TO ARRIVE AT COST. THE ORGANIZATION ACCOUNTS FOR DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS AS A REDUCTION OF REVENUE/ACCOUNTS RECEIVABLE AND ARE NOT COMPONENTS OF BAD DEBT EXPENSE. EVANGELICAL COMMUNITY HOSPITAL PROVIDES CARE TO ALL PATIENTS WHO NEED IT, REGARDLESS OF THEIR ABILITY TO PAY. THIS IS PART OF THE HOSPITAL'S MISSION.
PART III, LINE 8: THE HOSPITAL CONTINUES TO PROVIDE CARE TO ALL PRESENTING AND ADMITTED PATIENTS, REGARDLESS OF ABILITY TO PAY. NOTWITHSTANDING THE COSTS TO PROVIDE CARE, RECEIVING "LESS" THAN WHAT IT COSTS TO PROVIDE ADEQUATE CARE TO MEDICARE COVERED LIVES DOES THE HOSPITAL A DISSERVICE. THIS SHORTFALL SHOULD COUNT AS A COMMUNITY BENEFIT. THE HOSPITAL USES THE COST-TO-CHARGE RATIO TO DETERMINE THE MEDICARE ALLOWABLE COSTS.
PART III, LINE 9B: IN ACCORDANCE WITH THE COLLECTION POLICY, BAD DEBT ACCOUNTS WILL BE ELIGIBLE FOR A CHARITY CARE DISCOUNT IF THE PATIENT MEETS CHARITY CARE POLICY GUIDELINES. THE PATIENT WILL NEED TO SUPPLY INCOME INFORMATION IN ORDER TO DETERMINE ELIGIBILITY FOR CHARITY CARE PER POLICY. ALSO SEE RESPONSES TO PART III SECTION A ABOVE.
PART VI, LINE 2: DEPARTMENT TO ASSIST WITH TREATMENT REFERRALS AND WARM HANDOFFS. AS OF NOVEMBER 2020, IN APRIL OF 2018 EVANGELICAL COMMUNITY HOSPITAL (ECH) COMPLETED ANOTHER COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE ASSESSMENT WAS CONDUCTED BY BAKER TILLY IN PARTNERSHIP WITH GEISINGER AND ALLIED SERVICES AS A REGIONAL COLLABORATIVE EFFORT TO ASSESS THE NEEDS OF OUR COMMUNITY. THIS ASSESSMENT WAS A REGIONAL APPROACH WITH EVANGELICAL SERVICES AREA BEING PART OF THE CENTRAL REGION WHICH IS COMPRISED OF THE FOLLOWING COUNTIES: CLINTON, COLUMBIA, LYCOMING, MONTOUR, NORTHUMBERLAND, SCHUYLKILL, SNYDER, SULLIVAN AND UNION. EVANGELICAL'S NEEDS ASSESSMENT INCLUDED A FIVE-COUNTY REGION CONSISTING OF SNYDER, UNION, NORTHUMBERLAND, LYCOMING AND JUNIATA COUNTIES. THE ASSESSMENT WAS COMPLETED IN APRIL OF 2018 AND ADOPTED BY THE EVANGELICAL BOARD OF DIRECTORS IN MAY 2018. FISCAL YEAR 2020 IS ECH'S SECOND YEAR FOR REPORTING ON OUR 2018 CHNA KEY IDENTIFIED NEEDS. THOSE NEEDS OF OUR COMMUNITY WERE IDENTIFIED AS 1.) ACCESS TO CARE; 2.) BEHAVIORAL HEALTH; 3.) CHRONIC DISEASE PREVENTION AND MANAGEMENT. THIS PLAN PROVIDED A ROADMAP FOR OUR HOSPITAL TO MEET SPECIFIC NEEDS WITHIN OUR SERVICE AREA. BELOW ARE THREE KEY IDENTIFIED NEEDS, THE ACTION STEPS AND HOW THE HOSPITAL ADDRESSED THESE NEEDS FOR THE 2018 IMPLEMENTATION PLAN.1. ACCESS TO CAREACTION ITEM 1: PROVIDE FREE OR REDUCED-FEE HEALTH SCREENINGS AND PREVENTIVE PROGRAMS, SUCH AS SKIN CANCER SCREENINGS, BLOOD SUGAR TESTING, BLOOD PRESSURE CHECKS, COMPREHENSIVE BLOOD SCREENINGS, AND MORE. EVANGELICAL COMMUNITY HOSPITAL OFFERED THE FOLLOWING FREE OR REDUCED-FEE SCREENINGS AT VARIOUS TIMES AND LOCATIONS THROUGHOUT THE COMMUNITY IN FY2020: COMPREHENSIVE BLOOD SCREENINGS 790COMMUNITY HEALTH SCREENINGS (MEN'S, WOMEN'S, HUNTERS, HEART) 204SKIN SCREENINGS 89BLOOD PRESSURE/BLOOD SUGAR SCREENS 580HEEL SCAN/BONE DENSITY CLINICS 48(FY2020 PROGRAMMING WAS SIGNIFICANTLY REDUCED DUE TO THE COVID-19 PANDEMIC)ACTION ITEM 2: EXPAND THE FREE FOOD BOX PROGRAM TO INCLUDE THE USE OF HOSPITAL TO HOME TO ASSIST WITH PROVIDING FOOD BOXES FOR PATIENTS WHO IDENTIFY AS FOOD INSECURE. DURING 2020 EVANGELICAL COMMUNITY HOSPITAL DISTRIBUTED 62 FOOD BOXES TO PATIENTS IDENTIFIED AS FOOD INSECURE. THE PROGRAM IS PROVIDED IN PARTNERSHIP WITH CASE MANAGEMENT AND HOSPITAL TO HOME.ACTION ITEM 3: WORK WITH THE NURSE-FAMILY PARTNERSHIP PROGRAM FOR AT-RISK, YOUNG, EXPECTANT WOMEN TO IMPROVE PREGNANCY OUTCOMES, CHILD HEALTH AND DEVELOPMENT, AND ECONOMIC SELF-SUFFICIENCY FOR THE FAMILY.EVANGELICAL MADE 36 REFERRALS TO THE NURSE FAMILY PARTNERSHIP. THIS COLLABORATIVE PROGRAM INVOLVES A NURSE MAKING HOME VISITS OVER 30 MONTHS FROM BEFORE BIRTH UNTIL THE BABY IS AGE TWO. MORE THAN 30 YEARS OF RANDOMIZED, CONTROLLED TRIALS SHOW THAT FAMILIES WHO PARTICIPATE IN THE NURSE-FAMILY PARTNERSHIP MODEL FARE BETTER THAN THOSE NOT IN THE PROGRAM. ACTION ITEM 4: IN FY20 EVANGELICAL COMMUNITY HOSPITAL, GEISINGER, THE MILLER CENTER FOR RECREATION AND WELLNESS, AND THE GREATER SUSQUEHANNA VALLEY YMCA CAME TOGETHER TO MAKE A POSITIVE, LASTING IMPACT ON THE HEALTH AND WELLNESS OF THE REGION. EVANGELICAL AND GEISINGER FORMED THEIR FIRST JOINT VENTURE AT THE MILLER CENTER. THE CENTER WAS TRANSFERRED TO THE JOINT VENTURE BY THE MILLER FAMILY. THE NEW ENTITY IS KNOWN AS THE LEWISBURG YMCA AT THE MILLER CENTER, POWERED BY EVANGELICAL AND GEISINGER. THE NEWLY FORMED JOINT VENTURE WILL OFFER COMPREHENSIVE AND AFFORDABLE WELLNESS AND RECREATION PROGRAMS FOR ALL GENERATIONS IN THE HEART OF THE COMMUNITY.- AS OF JUNE 30, 2020, THE LEWISBURG YMCA AT THE MILLER CENTER HAD A TOTAL OF 2,635 MEMBERS. PRIOR TO THE JOINT VENTURE FORMATION, MEMBERSHIP AT THE FACILITY WAS 1,620 INCREASING MEMBERSHIP BY 1,015.- 53 MEMBERS WERE GRANTED FINANCIAL ASSISTANCE TO JOIN THE FACILITY - PRIOR TO FACILITY CLOSURE DUE TO COVID-19, THE AVERAGE FACILITY USE WAS 546 INDIVIDUAL CHECK-INS PER DAY, BEFORE THE JOINT VENTURE TRANSITION THE FACILITY WAS AVERAGING 224 CHECK-INS PER DAY. UTILIZATION OF THE FACILITY EFFECTIVELY DOUBLED.ACTION ITEM 5: EVANGELICAL REGIONAL MOBILE MEDICAL SERVICES (ERMMS) BEGAN OPERATION ON OCTOBER 1, 2019 AS A WHOLLY OWNED SUBSIDIARY OF EVANGELICAL COMMUNITY HOSPITAL. THIS IS IN RESPONSE TO THE GROWING CHALLENGES FACING INDEPENDENT VOLUNTEER AMBULANCE SERVICES. - THROUGH OUR COLLABORATION WITH LOCAL MUNICIPALITIES AND FIRE DEPARTMENTS, EVANGELICAL CAN PROVIDE EMERGENCY AMBULANCE SERVICE AT OUR AMBULANCE STATIONS IN MIFFLINBURG, HUMMEL'S WHARF AND AT EVANGELICAL COMMUNITY HOSPITAL. ERMMS ALSO PROVIDES EMT AND PARAMEDIC STAFF FOR WARRIOR RUN AREA FIRE DEPARTMENT, WHITE DEER TOWNSHIP VOLUNTEER FIRE DEPARTMENT, BOROUGH OF MILTON AND RELIANCE HOSE COMPANY.- ERMMS OWNS OR STAFFS 5 MOBILE INTENSIVE CARE UNITS, 3 BASIC LIFE SUPPORT AMBULANCES, 1 MEDIC UNIT, 1 NON-EMERGENT TRANSPORT AMBULANCE AND 1 WHEELCHAIR/STRETCHER VAN SERVING UNION, SNYDER AND NORTHUMBERLAND COUNTIES- SINCE THE FORMATION OF EVANGELICAL REGIONAL MOBILE MEDICAL SERVICES, THEY HAVE RESPONDED TO 1000 CALLS ON AVERAGE PER MONTH. OF THOSE CALLS, ERMMS HAD 235 RESPONSES TO CARDIAC ARRESTS AND PROVIDED STANDBY EMS SERVICES TO 33 EVENTS- AS PART OF ERMMS COMMITMENT TO PATIENT CARE THROUGHOUT THE GREATER SUSQUEHANNA VALLEY, A WHEELCHAIR VAN IS BEING INTRODUCED TO ITS FLEET OF SERVICE VEHICLES. A HEALTHCARE TRANSPORTATION GAP HAS BEEN A LONG-STANDING CONCERN IN OUR REGION. THIS ADDITION TO EVANGELICAL'S FLEET OF EMERGENCY RESPONSE VEHICLES WILL ALLOW THE OPPORTUNITY TO EXPAND AND ASSIST MORE LOCAL RESIDENTS WITH TRANSPORTATION NEEDS FOR MEDICAL CARE. ACTION ITEM 6: UTILIZE MOBILE HEALTH OF EVANGELICAL TO REACH POPULATIONS THAT ARE IN AREAS LACKING PRIMARY CARE AND HEALTH SCREENING OPTIONS LOCALLY- FUNDED ENTIRELY THROUGH BUSINESS AND COMMUNITY DONATIONS, MOBILE HEALTH OF EVANGELICAL SEEKS TO IMPROVE ACCESS TO HEALTHCARE BY OVERCOMING THE BARRIERS OF TRANSPORTATION, DISTANCE, AND COST OF CARE. THE 38-FOOT UNIT FEATURES A WELCOME/REGISTRATION AREA, BLOOD DRAW AREA, AND TWO EXAM ROOMS. OFFERED SERVICES INCLUDE PRIMARY AND SPECIALTY CARE, DENTAL HYGIENE, AND HEALTH EDUCATION. SELECT SERVICES ARE PROVIDED FREE OF CHARGE. - THE HOSPITAL ALSO PROVIDES COMPREHENSIVE HEALTH SCREENINGS AS PART OF MOBILE HEALTH OF EVANGELICAL. THE FOLLOWING FREE OR REDUCED-FEE SCREENINGS WERE OFFERED IN FY2020:COMPREHENSIVE BLOOD SCREENINGS 141BLOOD PRESSURE/BLOOD SUGAR SCREENINGS 87HEEL SCAN/BONE DENSITY CLINICS 30ORAL HEALTH 17GENERAL HEALTH CHECK-UPS CANCELED DUE TO PANDEMIC2. BEHAVIORAL HEALTHACTION ITEM 1: SERVE AS THE COUNTY/REGIONAL CENTRALIZED COORDINATING ENTITY (CCE) FOR SNYDER, UNION AND NORTHUMBERLAND COUNTIES TO PROVIDE FREE NALOXONE TO ALL FIRST RESPONDERS. THE HOSPITAL PROVIDED 235 INDIVIDUALS WITH NARCAN TRAINING AND DISTRIBUTED OVER 500 OPIOID REVERSAL KITS TO VARIOUS FIRST RESPONDERS, AGENCIES ACTING AS FIRST RESPONDERS AND INDIVIDUALS WHO MAY NEED TO ACT AS A FIRST RESPONDER. ACTION ITEM 2: EVALUATE THE USAGE AND EFFECTIVENESS OF OUR TELE-PSYCHIATRIC PROGRAM - EVANGELICAL CONTINUES TO PROVIDE TELE-PSYCH SERVICES FOR INPATIENT AND EMERGENCY DEPARTMENT PATIENTS- PRIOR TO APRIL 2020 WE WERE PROVIDING SERVICES, ON AVERAGE, 11 TIMES FOR INPATIENT AND 58 IN THE EMERGENCY DEPARTMENT QUARTERLY.- IN THE LAST QUARTER OF FY2020 VOLUMES INCREASED TO 35 INPATIENT AND 96 EMERGENCY DEPARTMENT.- AVERAGE RESPONSE TIMES ARE 4 HOURS FOR INPATIENT AND 2 HOURS FOR EMERGENCY DEPARTMENT. ACTION ITEM 3: SUPPORT AND PARTICIPATE IN THE EFFORTS BY LOCAL OPIOID COALITIONS IN SNYDER, UNION AND NORTHUMBERLAND COUNTIES. IN LATE 2018, THE NORTHUMBERLAND AND SNYDER-UNION OPIOID COALITIONS JOINED FORCES WITH THE COLUMBIA-MONTOUR COALITION TO FORM UNITED IN RECOVERY. INDIVIDUALLY AND COLLECTIVELY, THE COALITIONS WORK TO BRING DIVERSE ORGANIZATIONS AND INDIVIDUALS TOGETHER TO EDUCATE, CHANGE POLICIES, EXPAND ACCESS, AND IMPROVE TREATMENT FOR OPIOID ADDICTION. IN RESPONSE TO COVID-19, THE COALITIONS ESTABLISHED A RESOURCE AND INFORMATION WEBSITE FOR VIRTUAL RECOVERY AND BASIC NEEDS. EVANGELICAL COMMUNITY HEALTH AND WELLNESS STAFF SERVE AS REPRESENTATIVES ON BOTH NORTHUMBERLAND AND SNYDER-UNION OPIOID COALITIONS.
PART VI, LINE 3: AS A COMMUNITY HOSPITAL, EVANGELICAL IS DEDICATED TO IMPROVING THE HEALTH AND WELL-BEING OF ALL ITS CONSTITUENTS. THROUGH THE FINANCIAL ASSISTANCE PROGRAM, MEDICAL CARE IS PROVIDED REGARDLESS OF A PATIENT'S ABILITY TO PAY, INSUFFICIENT HEALTH INSURANCE OR WHETHER A GOVERNMENT-SPONSORED PROGRAM COVERS THE FULL COST OF SERVICES. AS THE COUNTRY'S ECONOMIC FUTURE REMAINS UNCERTAIN, EVANGELICAL WILL CONTINUE TO PROVIDE CARE FOR THOSE WHO NEED IT. EVANGELICAL WILL PROVIDE SERVICES AT NO CHARGE OR REDUCED CHARGES TO THOSE WHO ARE FINANCIALLY UNABLE TO PAY FOR THOSE SERVICES. EVANGELICAL WILL NOT ARBITRARILY RESTRICT THE PROVISIONS OF HEALTH SERVICES TO CERTAIN INDIVIDUALS OR GROUPS. EVANGELICAL'S REGISTRATION DEPARTMENT REPRESENTATIVES INFORM OUR UNINSURED OR UNDER INSURED PATIENTS OF OUR FINANCIAL ASSISTANCE PROGRAM. FINANCIAL ASSISTANCE APPLICATIONS ARE OFFERED TO THESE PATIENT AND, IN ADDITION, THEY HAVE THE OPPORTUNITY TO CALL OUR FINANCIAL COUNSELOR. THE FINANCIAL COUNSELOR DISCUSSES THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS SUCH AS MEDICAID OR STATE PROGRAMS TO ASSIST THE PATIENT WITH QUALIFICATIONS FOR THESE PROGRAMS. THE FINANCIAL COUNSELOR WILL ALSO ASSIST THE PATIENT IN COMPLETING THE PROPER PAPERWORK FOR ASSISTANCE. THE FINANCIAL COUNSELORS AND CASE MANAGEMENT STAFF WORK CLOSELY TO IDENTIFY AND ASSIST ELIGIBLE PATIENTS. OUR SELF-PAY VENDOR ALSO INFORMS THE PATIENT THAT EVANGELICAL HAS A FINANCIAL ASSISTANCE PROGRAM AND A FINANCIAL COUNSELOR WHO WILL SEND THEM AN APPLICATION IF REQUESTED. OUR THIRD PARTY VENDOR WORKS ON BEHALF OF THE ORGANIZATION TO FOLLOW THE HOSPITAL'S POLICIES REGARDING PATIENT NOTIFICATION AND THE AVAILABILITY OF FINANCIAL ASSISTANCE. EVANGELICAL'S FINANCIAL ASSISTANCE POLICY IS POSTED ON THE EVANGELICAL WEBSITE (HTTP://WWW.EVANHOSPITAL.COM/PATIENTS/INSURANCE/CHARITY-CARE) ALONG WITH AN APPLICATION FOR PATIENTS TO COMPLETE FOR FINANCIAL ASSISTANCE.EVANGELICAL COMMUNITY HOSPITAL WILL MAKE AVAILABLE A WRITTEN NOTICE TO EACH PATIENT OR THEIR REPRESENTATIVE OF THE EXISTENCE, CRITERIA AND MECHANISM FOR RECEIVING FINANCIAL ASSISTANCE. THE HOSPITAL WILL CREATE AND MAINTAIN RECORDS DEMONSTRATING THAT THE REQUIRED CRITERIA AND MECHANISM ARE ESTABLISHED (HOSPITAL WILL RECORD ANY AND ALL REQUESTS FOR FINANCIAL ASSISTANCE, THE DISPOSITION AND THE DOLLAR AMOUNT OF EVANGELICAL'S FINANCIAL ASSISTANCE PROGRAM PROVIDED). IN ALL INSTANCES, PATIENT CONFIDENTIALITY WILL BE PROTECTED. ELIGIBILITY WILL BE DETERMINED BY COMPARING HOUSEHOLD FAMILY INCOME AGAINST THE INCOME POVERTY GUIDELINES. INCOME IS DEFINED AS THE TOTAL ANNUAL CASH RECEIPTS BEFORE TAXES FROM ALL SOURCES. AN INDIVIDUAL NOTICE OF AVAILABILITY OF EVANGELICAL'S FINANCIAL ASSISTANCE PROGRAM WILL BE GIVEN TO EACH PATIENT OR THEIR REPRESENTATIVE PRIOR TO SERVICES BEING RENDERED, WITH THE EXCEPTION OF EMERGENCY SERVICES. THESE NOTICES SHALL BE AVAILABLE IN ALL REGISTRATION AREAS OF THE HOSPITAL AND SHALL INCLUDE THE MOST CURRENT AVAILABLE "HOUSEHOLD INCOME GUIDELINES" AS PUBLISHED IN THE FEDERAL REGISTER. THE PATIENT ACCOUNTS DIRECTOR OR HIS/HER DESIGNEE SHALL REVIEW ALL APPLICATIONS FOR THE EVANGELICAL FINANCIAL ASSISTANCE PROGRAM. IT IS THE APPLICANT'S RESPONSIBILITY TO PROVIDE PROOF OF INCOME. WHEN LANGUAGE IS A BARRIER, EVANGELICAL OFFERS A SPECIAL INTERPRETER CONFERENCING TELEPHONE SERVICE. INTERPRETATION SERVICES ARE AVAILABLE FOR A MULTITUDE OF PATIENT/CAREGIVER INTERACTIONS. WHEN A NON-ENGLISH SPEAKING PATIENT, NO MATTER HIS OR HER NATIVE TONGUE, CALLS IN TO THE HOSPITAL, HE OR SHE WILL BE ABLE TO BE UNDERSTOOD THROUGH A TELEPHONE INTERPRETER. THIS IS AVAILABLE FOR OUTBOUND CALLS TO THE PATIENT AS WELL. THE PROCESS CONTRIBUTES TO IMPROVED PATIENT CARE AND CLINICAL OUTCOMES AND MAKES A VITAL DIFFERENCE IN THE QUALITY OF SERVICE EVANGELICAL IS ABLE TO PROVIDE TO NON-ENGLISH SPEAKING PATIENTS.
PART VI, LINE 4: EVANGELICAL COMMUNITY HOSPITAL (ECH) IS LOCATED IN LEWISBURG, PENNSYLVANIA (UNION COUNTY), THE HEART OF CENTRAL PENNSYLVANIA. THE HOSPITAL IS CONVENIENTLY LOCATED OFF INTERSTATE 80 ON U.S. ROUTE 15. THE HOSPITAL SERVES THE RESIDENTS OF UNION, SNYDER, NORTHUMBERLAND, AND LOWER LYCOMING COUNTIES AS WELL AS SURROUNDING AREAS. ECH IS THE SECOND LARGEST EMPLOYER IN UNION COUNTY WITH MORE THAN 1,400 EMPLOYEES. ECH IS A 132 OVERNIGHT LICENSED-BED, 12 ACUTE REHAB, AND 18 BASSINET CARE COMMUNITY HOSPITAL WITH OVER 1,400 EMPLOYEES. ECH HAS A BUSY EMERGENCY DEPARTMENT WITH 28,376 VISITS IN FISCAL YEAR 2020. IN ADDITION TO EMERGENCY CARE, THE HOSPITAL INTRODUCED A NEW URGENT CARE PRACTICE IN 2016 THAT ANSWERS THE NEEDS OF PATIENTS WHO HAVE URGENT MEDICAL NEEDS THAT DO NOT RISE TO THE LEVEL OF EMERGENCY CARE. FOR THE PATIENT THIS MEANS SHORTER WAIT TIMES AND LOWER TREATMENT COSTS FOR THOSE CONDITIONS.THE PRIMARY SERVICE AREA OF RESIDENTS OF ECH INCLUDES:17086, 17730, 17749, 17772, 17777, 17801, 17847, 17850, 17857, 17865, 17812, 17813, 17827, 17831, 17833, 17842, 17843, 17853, 17861, 17862, 17864, 17870, 17876, 17810, 17835, 17837, 17844, 17845, 17855, 17856, 17883, 17885, 17886, 17887, 17889OUR SECONDARY SERVICE AREA IS FROM THE FOLLOWING ZIP CODES:16820, 16872, 16882, 17014, 17017, 17045, 17049, 17062, 17080, 17737, 17747, 17752, 17756, 17821, 17823, 17830, 17832, 17834, 17836, 17840, 17841, 17851, 17860, 17866, 17867, 17868, 17872, 17877, 17881, 17884, 17701, 17702, 17703, 17754 THE REGION IS HOME TO SEVERAL COLLEGES, UNIVERSITIES, AND TECHNICAL SCHOOLS AS WELL AS STRONG PUBLIC SCHOOL SYSTEMS. IT HAS A VERY DIVERSE HISTORY AND RURAL APPEAL, YET FEATURES BUSINESS AND HEALTHCARE FACILITIES USING THE LATEST ADVANCES IN SCIENCE AND TECHNOLOGY. ADDITIONAL HOSPITALS IN OUR REGION CONSIST OF GEISINGER MEDICAL CENTER, GEISINGER - SHAMOKIN AREA COMMUNITY HOSPITAL, UPMC SUSQUEHANNA, AND GEISINGER - BLOOMSBURG HOSPITAL. ACCORDING TO THE MOST RECENT DATA FROM THE COMMUNITY HEATH NEEDS ASSESSMENT OUR REGION IS DESCRIBED AS PRIMARILY RURAL IN NATURE. THIS DATA WAS REAFFIRMED DURING THE ASSESSMENT PROCESS THROUGH COMMUNITY LEADERS AND KEY STAKEHOLDER INTERVIEWS AND FOCUS GROUP DISCUSSIONS. FURTHERMORE WITH THE RURAL NATURE OF OUR AREA AND THE LACK OF A COORDINATED AND INTEGRATED TRANSPORTATION SYSTEM THIS LIMITS COMMUNITY MEMBERS TO ACCESSIBLE HEALTH CARE AND RECREATIONAL OPPORTUNITIES. THE LIMITATIONS OF ACCESSIBILITY TO HEALTHCARE AND HEALTHY OPTIONS LEAD TO UNHEALTHY LIFESTYLES AND OVERUSE OF OUR EMERGENCY DEPARTMENT SERVICES.CITY-DATA.COM FOR UNION COUNTY INDICATES THAT THE POPULATION CONSISTS OF: WHITE NON-HISPANIC (90.1%), BLACK (7.0%), HISPANIC (6.9%), TWO OR MORE RACES (1.9%), AND ASIAN (1.8%)THE MEDIAN RESIDENT AGE IS 39.3ESTIMATED MEDIAN HOUSEHOLD INCOME IN 2017: $55,371 RESIDENTS WITH INCOME BELOW THE POVERTY LEVEL IN 2017: 10.5%POPULATION WITHOUT HEALTH INSURANCE COVERAGE IN 2013: 12.2% CHILDREN UNDER 19 WITHOUT HEALTH INSURANCE COVERAGE IN 2013: 6.5% 89.7% OF RESIDENTS OF UNION COUNTY SPEAK ENGLISH AT HOME4.4% OF RESIDENTS SPEAK SPANISH AT HOME4.1% OF RESIDENTS SPEAK OTHER INDO-EUROPEAN LANGUAGE AT HOME1.2% OF RESIDENTS SPEAK ASIAN OR PACIFIC ISLAND LANGUAGE AT HOME0.5% OF RESIDENTS SPEAK OTHER LANGUAGES AT HOMECITY-DATA.COM FOR SNYDER COUNTY INDICATES THE POPULATION CONSISTS OF:WHITE NON-HISPANIC (100.5%), HISPANIC (2.6%), BLACK (1.0%), TWO OR MORE RACES (1.0%), AND ASIAN (0.9%)THE MEDIAN RESIDENT AGE IS 39.7ESTIMATED MEDIAN HOUSEHOLD INCOME IN 2017: $55,113RESIDENTS WITH INCOME BELOW THE POVERTY LEVEL IN 2017: 10.4%POPULATION WITHOUT HEALTH INSURANCE COVERAGE IN 2013: 14.1% CHILDREN UNDER 19 WITHOUT HEALTH INSURANCE COVERAGE IN 2013: 8% 88% OF RESIDENTS OF SNYDER COUNTY SPEAK ENGLISH AT HOME2.3% OF RESIDENTS SPEAK SPANISH AT HOME8.3% OF RESIDENTS SPEAK OTHER INDO-EUROPEAN LANGUAGE AT HOME0.4% OF RESIDENTS SPEAK ASIAN OR PACIFIC ISLAND LANGUAGE AT HOMEOF RESIDENTS SPEAK OTHER LANGUAGES AT HOME CITY-DATA.COM FOR NORTHUMBERLAND COUNTY INDICATES THAT THE POPULATION CONSISTS OF: WHITE NON-HISPANIC (90.8%), BLACK (3.4%), HISPANIC (2.5%), AND TWO OR MORE RACES (0.7%)ESTIMATED MEDIAN HOUSEHOLD INCOME IN 2017: $44,892THE MEDIAN RESIDENT AGE IS 44.6RESIDENTS WITH INCOME BELOW THE POVERTY LEVEL IN 2017: 14.4%POPULATION WITHOUT HEALTH INSURANCE COVERAGE IN 2013: 12.4% CHILDREN UNDER 19 WITHOUT HEALTH INSURANCE COVERAGE IN 2013: 6.3% 95.7% OF RESIDENTS OF NORTHUMBERLAND COUNTY SPEAK ENGLISH AT HOME1.3% OF RESIDENTS SPEAK SPANISH AT HOME2.3% OF RESIDENTS SPEAK OTHER INDO-EUROPEAN LANGUAGE AT HOME0.2% OF RESIDENTS SPEAK ASIAN OR PACIFIC ISLAND LANGUAGE AT HOME0.2% OF RESIDENTS SPEAK OTHER LANGUAGES AT HOMEECH OPERATES AN EMERGENCY DEPARTMENT THAT IS OPEN TO ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES. WE HAVE OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. ECH HAS A BOARD OF DIRECTORS IN WHICH INDEPENDENT COMMUNITY PERSONS ARE REPRESENTED. ECH LOOKS FOR OPPORTUNITIES TO WORK WITH HEALTHCARE FACILITIES, SUCH AS GEISINGER MEDICAL CENTER, TO PROVIDE THE BEST MEDICAL CARE FOR OUR PATIENTS. ECH WORKS WITH THE FOLLOWING HIGHER EDUCATION INSTITUTIONS (I.E. COLLEGES, TECHNICAL SCHOOL AND INTERMEDIATE UNITS): PENN COLLEGE, CENTRAL SUSQUEHANNA INTERMEDIATE UNIT, BLOOMSBURG UNIVERSITY, AND SUN-AREA VO-TECH. WE WORK WITH THESE HIGHER EDUCATION INSTITUTIONS TO ENGAGE IN TRAINING AND EDUCATION OF HEALTH CARE PROFESSIONALS. ECH PROVIDES FINANCIAL AID TO SUPPORT STUDENTS CHOOSING THE HEALTHCARE PROFESSION THROUGH THE MAE KEEFER SCHOLARSHIP FUND, THE CRYSTAL D. SNYDER NURSING SCHOLARSHIP FUND, AND THE JOHN FAMILY HEALTH CAREERS SCHOLARSHIP FUND FOR CLINICAL SERVICES.ECH PARTICIPATES WITH THE FOLLOWING MAJOR HEALTH PLANS: CAPITAL BLUE CROSS, GEISINGER HEALTH PLAN, HIGHMARK BLUESHIELD, AETNA/HEALTH AMERICA, KEYSTONE HEALTH PLAN CENTRAL, AMERIHEALTH NE, UPMC, HUMANA, UHC/OPTUM VA COMMUNITY CARE NETWORK, HUMANA MILITARY TRICARE, GATEWAY HEALTH, VIBRA HEALTH PLAN, PA HEALTH & WELLNESS, MEDICAID AND MEDICARE.KEY FINDINGS:THE ECH STUDY AREA IS PROJECTED TO GROW IN POPULATION 0.5% BY THE YEAR 2022. SNYDER COUNTY SHOWING THE LARGEST PROJECTED GROWTH AT 2.2% THE ECH STUDY AREA SHOWS A RATE OF OLDER RESIDENTS (AGED 65 AND OLDER) AT 20.22%; THIS IS HIGHER THAN STATE (18.1%) AND NATIONAL (15.6%) NORMS. THE AVERAGE ANNUAL HOUSEHOLD INCOME FOR ECH STUDY AREA IS JUST ABOVE $52,000; WHICH IS BELOW STATE AND NATIONAL NORMS (AROUND $56,000 FOR BOTH). THE ECH STUDY AREA REPORTS 15.67% OF THE RESIDENTS HAVING LESS THAN A HIGH SCHOOL DIPLOMA; THIS IS HIGHER THAN THE STATE RATE (10.1%)PORT TREVORTON REPORTS THE HIGHEST RATE OF RESIDENTS WITHOUT HIGH SCHOOL DIPLOMAS (33.4%)MONTANDON REPORTS THE HIGHEST RATE OF RESIDENTS LIVING IN POVERTY AT 17.6%IN OUR STUDY AREA, CLINTON COUNTY SHOWS THE HIGHEST RATE OF PEOPLE LIVING IN POVERTY AT 16.4%. IN THE ECH SERVICE AREA, LYCOMING AND NORTHUMBERLAND SHOW THE HIGHEST RATES AT 14.5% AND 13.8% RESPECTIVELY.NORTHUMBERLAND COUNTY REPORTS THE LARGEST RISE IN ADULT OBESITY FOR THE ECH STUDY AREA COUNTIES; GOING FROM 31.7% TO 35%.UNION COUNTY SAW A DECLINE IN ADULT OBESITY GOING FROM 30.2% TO 28%SNYDER COUNTY SAW A DECLINE IN DIABETES AMONG ADULTS GOING FROM 9.2% TO 8.5%ALL COUNTIES SAW AN INCREASE IN CHILDHOOD OBESITY AMONG STUDENTS 7-12 GRADE
PART VI, LINE 5: AS A COMMUNITY AND HEALTH RESOURCE FOR MORE THAN 90 YEARS, EVANGELICAL COMMUNITY HOSPITAL HAS CONTINUALLY DEMONSTRATED ITS COMMITMENT TO THE CENTRAL SUSQUEHANNA VALLEY BY TAKING CARE OF PATIENTS NEEDING TREATMENT, AND BY ITS OUTREACH TO THE COMMUNITY. BEYOND THE DAILY CARE OF PATIENTS, THE HOSPITAL EXTENDS ITS REACH TO PROVIDE PREVENTION AND WELLNESS EDUCATION TO RESIDENTS OF THE VALLEY. OUTREACH INCLUDES CHARITY-CARE FOR THOSE WHO CANNOT AFFORD MEDICAL TREATMENT, HEALTH SCREENINGS TARGETING THE UN/UNDER-INSURED, HEALTH EDUCATION FOCUSING ON HEALTHY LIFESTYLE CHANGES, CHILD SAFETY SEAT INSPECTIONS, SCHOOL AGED HEALTH INITIATIVES, AND LECTURES ON HEALTH CONCERNS AND TOPICS. MANY OF THESE PROGRAMS ARE PROVIDED AT MINIMAL OR NO COST AND ARE SUBSIDIZED USING HOSPITAL RESOURCES.THE HOSPITAL CONTINUES TO FOCUS ON DEVELOPING NEW WAYS OF IDENTIFYING AND ADDRESSING HEALTH NEEDS IN OUR REGION. THE HOSPITAL UTILIZES AN INTERNAL DOCUMENTATION PROCESS DEVELOPED TO CAPTURE COMMUNITY BENEFIT OUTREACH DELIVERED BY THE MAJORITY OF ITS EMPLOYEES. COMMUNITY BENEFIT LEADERS WORKS COOPERATIVELY WITH DEPARTMENTS OF THE HOSPITAL AND OTHER ORGANIZATIONS IN THE COMMUNITY TO ADDRESS UNMET NEEDS. THE HOSPITAL ALSO PRODUCES AN ANNUAL REPORT WHICH OUTLINES OUR COMMUNITY BENEFIT EFFORTS. CANCER AWARENESS AND EDUCATION ARE EXTREMELY IMPORTANT. THE FOLLOWING PROGRAMS WERE OFFERED IN FY20; THE CORRESPONDING NUMBER BESIDE THE PROGRAM DOCUMENTS THE NUMBER OF PEOPLE SERVED. THE IMPACT OF COVID 19 IS EVIDENT IN PROGRAMS AND EVENTS WE WERE ABLE TO OFFER IN 2020. TO THIS POINT SOME OF OUR PROGRAMS AND EVENTS HAD TO BE CANCELED. I CAN COPE SURVIVOR PROGRAM - 45 PARTICIPANTSLIFE AFTER LOSS BEREAVEMENT SUPPORT GROUP CANCELED DUE TO COVID 19 OTHER HEALTH EDUCATION AND PREVENTION ACTIVITIES INCLUDE:MONTHLY SUPPORT GROUPS - 29 PARTICIPANTS (REPORTED)FREE HEART HEALTH SCREENINGS - 59 PARTICIPANTSCOMPREHENSIVE BLOOD SCREENINGS - 790 PARTICIPANTSMEN'S HEALTH SCREEN CANCELED DUE TO COVID 19WOMEN'S HEALTH SCREEN - 92 PARTICIPANTSHUNTER'S HEALTH SCREEN - 53 PARTICIPANTSFREE SKIN SCREENINGS - 89LOW DOSE CT SCAN SCREENING - 88 REFERRALS 75 QUALIFIEDBLOOD DRAW SERVICES A COMMUNITY CLINIC - 33 PARTICIPANTSCHILD SAFETY SEAT INSPECTIONS 201; REPLACEMENTS - 56 FREE T-DAP VACCINATION FOR NEW DADS AND GRANDPARENTS - 60 VACCINATIONS GIVENYOUTH BIKE HELMET GIVEAWAY PROGRAM CANCELED DUE TO COVID 19FREEDOM FROM SMOKING CESSATION PROGRAM - 8PROPER HAND WASHING IS ESSENTIAL FOR PEOPLE OF ALL AGES TO LIMIT AND PROHIBIT THE SPREAD OF DISEASE AND GERMS. EVANGELICAL COMMUNITY HOSPITAL'S GERM CITY/BUG LIGHT PROGRAM USES AN ENTERTAINING TECHNIQUE TO STRESS THE IMPORTANCE OF FREQUENT, EFFECTIVE HAND WASHING AND SEE IMMEDIATE RESULTS. IN FY20, MORE THAN 3064 STUDENTS IN THE LOCAL SCHOOLS PARTICIPATED IN THE GERM CITY/BUG LIGHT PROGRAM AND WERE EDUCATED ON PROPER HAND WASHING TECHNIQUES. ADDITIONAL PROGRAMS FOCUSING ON HEALTHY BEHAVIORS WERE PRESENTED TO LOCAL SCHOOL DISTRICTS. SOME OF THESE PROGRAMS INCLUDE: HEARTPOWER, MYPLATE, HYGIENE 101, ONLINE SAFETY, OUTDOOR/SUMMER SAFETY, HANDS ONLY CPR, STRESS/EMPATHY, TOBACCO/SMOKING/VAPING/JUULING EDUCATION AND MORE. A TOTAL OF 15,418 STUDENTS WERE EDUCATED THROUGH THESE AND OTHER PROGRAMS.THE HOSPITAL IS LICENSED TO ACCOMMODATE 132 OVERNIGHT PATIENTS, 12 ACUTE REHAB PATIENTS, AND 18 BASSINETS. OUR CLINICAL STAFF, INCLUDES LAB TECHNICIANS, NURSES, NURSING ASSISTANCES, PHYSICAL, OCCUPATIONAL AND SPEECH THERAPISTS, RADIOLOGY TECHNICIANS, PHLEBOTOMISTS, AND SUPPORT PERSONNEL. EACH OF THESE PROFESSIONALS IS HIGHLY TRAINED TO DELIVER QUALITY AND SAFE CARE TO INPATIENTS AND OUTPATIENTS. THE HOSPITAL HAS:1. AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE SUSQUEHANNA VALLEY REGION;2. A BOARD OF DIRECTORS WHO GOVERN THE ORGANIZATION. THE BOARD IS COMPRISED OF COMMUNITY AND BUSINESS LEADERS, AND PHYSICIANS REPRESENTING THE GEOGRAPHIC AREA OF OUR REGION;3. AN EMERGENCY DEPARTMENT THAT IS OPEN TO ALL PERSONS IN NEED REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES;4. A HOSPICE PROGRAM THAT PROVIDES END-OF-LIFE CARE TO ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR CARE;5. THE ADDITION OF MOBILE HEALTH OF EVANGELICAL IN FEBRUARY 2018. COMMUNITY HEALTH AND WELLNESS STAFF CONTINUE TO PROVIDE OUTREACH TO RESIDENTS THROUGH FREE OR LOW COST SCREENING EVENTS, HEALTH FAIRS, SPEAKING ENGAGEMENTS, COMMUNITY EVENTS AND MORE. 6. A BIOETHICS COMMITTEE COMPRISED OF VOLUNTEERS WHO ARE PHYSICIANS, NURSES, SOCIAL SERVICE WORKERS, PASTORAL CAREGIVERS, EDUCATORS, AND OTHER PROFESSIONALS. THEY DISCUSS AND ADDRESS ETHICAL ISSUES AND DILEMMAS THAT ARE PRESENTED FOR REVIEW;7. A HISTORY OF PROVIDING FINANCIAL SUPPORT TO OTHER NONPROFIT ORGANIZATIONS FOR THE PURPOSE OF HEALTH PROMOTION AND IN COLLABORATING TO MEET UNMET NEEDS IN THE COMMUNITY.8. OUR THYRA M. HUMPHREY CENTER FOR BREAST HEALTH PROVIDES FREE AND/OR REDUCED FEE BREAST IMAGING SERVICES SPECIFICALLY TARGETING OUR UN/UNDERINSURED POPULATION. EXTENSIVE TELEPHONE EDUCATION/COUNSELING SERVICES ARE PROVIDED TO NEWLY DIAGNOSED PATIENTS THROUGH OUR NAVIGATION PROGRAM AT NO CHARGE TO THE PATIENT.9. A COMMUNITY HEALTH AND WELLNESS DEPARTMENT THAT IS FUNDED USING HOSPITAL RESOURCES. THE DEPARTMENT INITIATES AND ORGANIZES PREVENTION, WELLNESS AND HEALTH EDUCATION LECTURES, EVENTS AND ACTIVITIES DEVELOPED FOR THE SOLE PURPOSE OF IMPROVING THE HEALTH OF THOSE IN OUR REGION. THE COMMUNITY HEALTH AND WELLNESS TEAM OFFERS: HEALTH SCREENINGS, HEALTH FAIRS, LECTURES, SUPPORT GROUPS, FLU SHOTS, AND CHILD SAFETY SEAT INSPECTIONS. IN FY20, THE COMMUNITY HEALTH AND WELLNESS STAFF PROVIDED OVER 250 FLU VACCINATIONS TO AREA BUSINESSES AND CERTIFIED MORE THAN 2280 IN FIRST AID AND CPR, INCLUDING 36 YOUTH, WHO ATTENDED OUR SAFE SITTER BABYSITTING PROGRAM.
PART VI, LINE 6: THE ORGANIZATION IS PART OF AN AFFILIATED HEALTH CARE SYSTEM DUE TO THE HOSPITAL HAVING COMMON GOVERNANCE AND CONTROL FOR EVANGELICAL MEDICAL SERVICES ORGANIZATION. EVANGELICAL MEDICAL SERVICES ORGANIZATION PROVIDES HEALTHCARE SERVICES IN THE FORM OF PRIMARY AND SPECIALTY CARE PHYSICIANS TO THE COMMUNITY.
PART VI, LINE 7, REPORTS FILED WITH STATES PA
PART VI, LINE 2 CONTINUED: ACTION ITEM 4: WORK TO IMPROVE AND INCREASE ACCESS TO OPIOID AWARENESS AND EDUCATION MATERIALS AND REFERRALS TO TREATMENT. EVANGELICAL SECURED $653,200 IN US DEPARTMENT OF LABOR NATIONAL HEALTH EMERGENCY DISLOCATED WORKER DEMONSTRATION GRANT FUNDING FOR A MULTI-LEVEL APPROACH TO EDUCATE ITS ENTIRE PROFESSIONAL STAFF ABOUT BEST TREATMENT PRACTICES AND ELIMINATING STIGMA RELATED TO OPIOID USE DISORDER. AS PART OF THE GRANT FUNDING, MORE THAN HALF OF THE EVANGELICAL WORKFORCE WAS TRAINED IN REDUCING STIGMA AND BIAS, AND SIX CLINICIANS AND NURSES COMPLETED THE CHEMICAL DEPENDENCY CERTIFICATION PROGRAM THROUGH THE PENNSYLVANIA COLLEGE OF TECHNOLOGY. IN FY2019, A CERTIFIED RECOVERY SPECIALIST WAS EMBEDDED IN THE HOSPITAL EMERGENCY DEPARTMENT TO ASSIST WITH TREATMENT REFERRALS AND WARM HANDOFFS. AS OF NOVEMBER 2020, 112 REFERRALS HAVE BEEN MADE.3. CHRONIC DISEASE PREVENTION AND MANAGEMENTACTION ITEM 1: DEVELOP PROGRAMS AND EVENTS FOCUSED ON DIABETES EDUCATION AND PREVENTION EVANGELICAL OFFERS A FREE DIABETES RESOURCE PROGRAM ACCREDITED THROUGH THE DIABETES EDUCATION ACCREDITATION PROGRAM (DEAP) OF THE AMERICAN ASSOCIATION OF DIABETES EDUCATORS (AADE). PROGRAM CLASSES ARE TAUGHT BY A REGISTERED NURSE/CERTIFIED DIABETES EDUCATOR. COVERED TOPICS INCLUDE INTRODUCTION TO DIABETES; DIETARY MANAGEMENT; COMPLICATION PREVENTION; HOME BLOOD GLUCOSE MONITORING; AND MEDICATION OPTIONS. THE EVANGELICAL COMMUNITY HEALTH AND WELLNESS TEAM ALSO DEVELOPED A PROGRAM TO ADDRESS PRE-DIABETES EDUCATION. ACTION ITEM 2: CONTINUE TO PROMOTE AND EDUCATE THE COMMUNITY ABOUT A VARIETY OF HEALTH SCREENINGS.THROUGH VARIOUS SCREENING EVENTS AND GRANT FUNDS EVANGELICAL OFFERED 88 LOW DOSE CT SCANS AND SCHEDULED 75 APPOINTMENTS, 133 MAMMOGRAMS AND 77 IFOB SCREENING KITS IN FY2020. ACTION ITEM 3: OFFER A VARIETY OF ADULT AND SCHOOL AGED WELLNESS PROGRAMS TO AIMED TO PROMOTE A HEALTHY LIFESTYLE AND REDUCE THE RISK FOR CHRONIC HEALTH CONDITIONS.EVANGELICAL'S HEALTH AND WELLNESS PROGRAMS REACHED NEARLY 22,000 YOUTH AND ADULTS IN THE COMMUNITY IN FY2020 YOUTH EDUCATIONAL PROGRAMS 20,559ADULT/COMMUNITY EDUCATIONAL PROGRAMS 792WORKSITE SITE WELLNESS HEALTH PROMOTION PROGRAMS 636(FY2020 PROGRAMMING WAS SIGNIFICANTLY REDUCED DUE TO THE COVID-19 PANDEMIC)EVANGELICAL KNOWS THAT STAYING FIT, DISEASE PREVENTION, AND NECESSARY INTERVENTION ARE ESSENTIAL TOOLS IN HELPING INDIVIDUALS ACHIEVE THEIR HEALTH AND WELLNESS GOALS. THE HOSPITAL OFFERED A WIDE RANGE OF PROGRAMS IN FY2020, INCLUDING THE FOLLOWING:- FREEDOM FROM SMOKING: A SEVEN-WEEK SESSION TO LEARN TO OVERCOME TOBACCO ADDICTION WITH THE HELP OF A CERTIFIED EDUCATOR.- SAFE SITTER: A ONE-DAY COMPREHENSIVE BABYSITTING COURSE FOR CHILDREN AGES 11 AND OLDER.- SAFE AT HOME: A 90-MINUTE PROGRAM FOR STUDENTS IN GRADES 4 THROUGH 6 THAT ENCOURAGES THEIR FIRST STEPS TO BECOMING INDEPENDENT BY TEACHING THEM HOW TO PRACTICE SAFE HABITS AND PREVENT UNSAFE SITUATIONS- EDUCATIONAL PROGRAMS FOR CHILDREN: FREE PROGRAMS WITH TOPICS THAT COVER NUTRITION, HOW TO HAVE A HEALTHY HEART, HANDS ONLY CPR, THE DANGERS OF TOBACCO PRODUCTS, SUMMER SAFETY, STRESS MANAGEMENT, PERSONAL HYGIENE, BIKE HELMET SAFETY, AND ONLINE SAFETY.- SENIOR STRONG: DESIGNED TO HELP INDIVIDUALS AGE 55 OR OLDER LIVE AN ACTIVE, HEALTHY LIFESTYLE, THE PROGRAM INCLUDES HEALTH SCREENINGS, EXERCISE CLASSES, LECTURES ON A VARIETY OF HEALTH TOPICS, BROWN BAG MEDICINE CHECKS, AND OTHER SPECIAL EVENTS AND COURSES DESIGNED ESPECIALLY FOR SENIORS.- CHILDBIRTH EDUCATION CLASSES: FREE OR REDUCED-FEE PROGRAMS WITH TOPICS THAT COVER PREPARED CHILDBIRTH, NEWBORN CARE, PRENATAL BREASTFEEDING, AND CHILD SAFETY SEAT INSPECTIONS.- TALK WITH THE DOC AND SPEAKERS BUREAU: SEMINARS ON A VARIETY OF HEALTH TOPICS.- THE PLAIN COMMUNITY PROGRAM CONTINUES TO BE A HIGHLY UTILIZED PROGRAMFY20 UTILIZATION OF PLAIN COMMUNITY PROGRAM:ECH - ENCOUNTERS - CHARGESFY2018 - 2,268 - $8,309,429FY2019 - 2,638 - $9,843,948FY2020 - 2,483 - $9,626,525 EMSO - ENCOUNTERS - CHARGESFY2018 - 2,662 - $1,351,370FY2019 - 3,359 - $1,690,042FY2020 - 1,662 - $1,662,014
Schedule H (Form 990) 2019
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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
EVANGELICAL COMMUNITY HOSPITAL
 
Employer identification number
24-0795411
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
(if applicable)
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
noncash assistance
(h) Purpose of grant
or assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
 
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2019

Schedule I (Form 990) 2019
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients
(c) Amount of
cash grant
(d) Amount of
noncash assistance
(e) Method of valuation (book,
FMV, appraisal, other)
(f) Description of noncash assistance
(1) NURSING SCHOLARSHIPS 34 72,164 0 N/A N/A
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
PART I, LINE 2: APPLICANTS MUST APPLY FOR NURSING AND TRAINING DEPARTMENT SCHOLARSHIPS. APPLICATIONS ARE REVIEWED BY A COMMITTEE TO DETERMINE IF THE APPLICANTS MEET THE ELIGIBILITY REQUIREMENTS. APPLICANTS ARE REVIEWED BASED ON COMMUNITY SERVICE AND/OR EXTRA CURRICULAR ACTIVITIES, ACADEMIC STANDING, QUALITY OF ESSAY, FINANCIAL NEED, ETC.
Schedule I (Form 990) 2019



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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
EVANGELICAL COMMUNITY HOSPITAL
 
Employer identification number

24-0795411
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes 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 .........
1b
Yes
 
2
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? ..
2
 
No
3
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.
4
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:
a
Receive a severance payment or change-of-control payment? .............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
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:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
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:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
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 ............
7
Yes
 
8
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 ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2019

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
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1MATTHEW W REISH MD
DIRECTOR
(i)

(ii)
533,461
-------------
0
356,032
-------------
0
0
-------------
0
10,862
-------------
0
14,836
-------------
0
915,191
-------------
0
0
-------------
0
2KENDRA A AUCKER
PRESIDENT/CHIEF EXECUTIVE OFFICER
(i)

(ii)
578,427
-------------
0
141,428
-------------
0
15,000
-------------
0
132,463
-------------
0
20,111
-------------
0
887,429
-------------
0
0
-------------
0
3SHAWN P MCGLAUGHLIN MD
DIRECTOR
(i)

(ii)
723,132
-------------
0
0
-------------
0
0
-------------
0
14,735
-------------
0
15,284
-------------
0
753,151
-------------
0
0
-------------
0
4JOHN F DEVINE
VP MEDICAL AFFAIRS
(i)

(ii)
497,147
-------------
0
49,991
-------------
0
145,370
-------------
0
57,092
-------------
0
2,226
-------------
0
751,826
-------------
0
145,370
-------------
0
5JAMES A STOPPER CPA
TREASURER/CHIEF FINANCIAL OFFICER
(i)

(ii)
357,686
-------------
0
79,625
-------------
0
115,674
-------------
0
48,954
-------------
0
16,510
-------------
0
618,449
-------------
0
115,674
-------------
0
6CHRISTOPHER J MOTTO MD
DIRECTOR
(i)

(ii)
447,389
-------------
0
27,750
-------------
0
0
-------------
0
8,993
-------------
0
8,042
-------------
0
492,174
-------------
0
0
-------------
0
7BRADLEY MUDGE
SURGEON
(i)

(ii)
392,757
-------------
0
49,156
-------------
0
0
-------------
0
7,908
-------------
0
14,856
-------------
0
464,677
-------------
0
0
-------------
0
8WILLIAM P ANDERSON
SECRETARY/CHIEF OPERATING OFFICER
(i)

(ii)
274,288
-------------
0
62,790
-------------
0
0
-------------
0
48,694
-------------
0
16,010
-------------
0
401,782
-------------
0
0
-------------
0
9JULIA E REDCAY DO
DIRECTOR
(i)

(ii)
370,816
-------------
0
5,000
-------------
0
0
-------------
0
7,309
-------------
0
15,135
-------------
0
398,260
-------------
0
0
-------------
0
10DALE E MOYER
VP OF INFORMATION SYSTEM
(i)

(ii)
215,582
-------------
0
39,856
-------------
0
73,747
-------------
0
32,181
-------------
0
19,173
-------------
0
380,539
-------------
0
73,747
-------------
0
11TAMARA F PERSING
VP OF NURSING ADMINISTRATION
(i)

(ii)
225,673
-------------
0
39,480
-------------
0
0
-------------
0
34,269
-------------
0
19,545
-------------
0
318,967
-------------
0
0
-------------
0
12KATHRYN M GIORGINI
HOSPITALIST/PALLIATIVE CARE
(i)

(ii)
247,851
-------------
0
10,000
-------------
0
0
-------------
0
5,205
-------------
0
28,180
-------------
0
291,236
-------------
0
0
-------------
0
13DAVID M ZELECHOSKI MD
DIRECTOR
(i)

(ii)
232,795
-------------
0
0
-------------
0
0
-------------
0
4,809
-------------
0
15,875
-------------
0
253,479
-------------
0
0
-------------
0
14RACHEL V SMITH
VP PEOPLE & CULTURE
(i)

(ii)
199,504
-------------
0
20,010
-------------
0
0
-------------
0
26,919
-------------
0
1,665
-------------
0
248,098
-------------
0
0
-------------
0
15ANGELA K LAHR
AVP CLINICAL OPERATIONS
(i)

(ii)
156,819
-------------
0
15,089
-------------
0
0
-------------
0
14,434
-------------
0
18,790
-------------
0
205,132
-------------
0
0
-------------
0
16PAUL E TARVES
FORMER VP OF NURSING ADMINISTRATION
(i)

(ii)
0
-------------
0
0
-------------
0
190,353
-------------
0
0
-------------
0
0
-------------
0
190,353
-------------
0
190,353
-------------
0
17RANDALL STRAUSSER
DIRECTOR OF PHARMACY SERVICES
(i)

(ii)
165,375
-------------
0
0
-------------
0
0
-------------
0
6,920
-------------
0
15,804
-------------
0
188,099
-------------
0
0
-------------
0
18WILLIAM FRANQUET
AVP REVENUE CYCLE
(i)

(ii)
138,607
-------------
0
13,652
-------------
0
0
-------------
0
5,802
-------------
0
15,266
-------------
0
173,327
-------------
0
0
-------------
0
19JOSHUA TITUS
PHARMACIST
(i)

(ii)
154,314
-------------
0
0
-------------
0
0
-------------
0
6,054
-------------
0
7,725
-------------
0
168,093
-------------
0
0
-------------
0
20RUTH SPROUT
ASST DIRECTOR OF PHARMACY
(i)

(ii)
145,283
-------------
0
0
-------------
0
0
-------------
0
6,059
-------------
0
15,611
-------------
0
166,953
-------------
0
0
-------------
0
21JOSHUA MILLER
PHARMACIST
(i)

(ii)
152,409
-------------
0
0
-------------
0
0
-------------
0
5,841
-------------
0
7,725
-------------
0
165,975
-------------
0
0
-------------
0
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
PART I, LINE 1A KENDRA A. AUCKER, PRESIDENT/CEO, HAS A FLEXIBLE BENEFIT ALLOWANCE PER HER CONTRACT. THE EXPENSES AVAILABLE FOR REIMBURSEMENT UNDER THIS ALLOWANCE ARE: AUTOMOBILE ALLOWANCE AND AUTO EXPENSES; SUPPLEMENTAL LTD PREMIUMS; AND CLUB MEMBERSHIPS. THE AMOUNT PROVIDED WAS INCLUDED IN TAXABLE COMPENSATION AND REPORTED ON HER W-2.
PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLMENTAL NONQUALIFIED RETIREMENT PLAN AND RECEIVED THE FOLLOWING DISTRIBUTIONS IN CALENDAR YEAR 2019: KENDRA AUCKER - NO DISTRIBUTION JAMES A. STOPPER - $115,674 WILLIAM P. ANDERSON - NO DISTRIBUTION JOHN F. DEVINE - $145,370 TAMARA F. PERSING - NO DISTRIBUTION DALE E. MOYER - $73,747 TAMARA PERSING - NO DISTRIBUTION RACHEL SMITH - NO DISTRIBUTION PAUL TARVES - $190,353
PART I, LINE 7 THE EXECUTIVE TEAM IS ELIGIBLE TO RECEIVE A BONUS (BASED ON A % OF SALARY) WHEN THEIR INDIVIDUAL GOALS ARE MET FOR THE YEAR. GOALS ARE SET FOR EACH INDIVIDUAL BASED ON FINANCIAL AND OPERATIONAL RESULTS. THESE GOALS ARE REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE.
Schedule J (Form 990) 2019

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Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part , line 24a. Provide descriptions,
explanations, and any additional information in Part .
SchKMediumBullet Attach to Form 990.

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
EVANGELICAL COMMUNITY HOSPITAL
 
Employer identification number
24-0795411
Part
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A UNION COUNTY HOSPITAL AUTHORITY - SERIES 2018A
 
23-2739624   06-21-2018 17,371,471 SEE PART VI   X   X   X
B UNION COUNTY HOSPITAL AUTHORITY - SERIES 2018B
 
23-2739624 906460DK3 06-21-2018 55,541,980 SEE PART VI   X   X   X
C UNION COUNTY HOSPITAL AUTHORITY - SERIES 2018C
 
23-2739624 906460DR8 06-21-2018 19,365,000 SEE PART VI   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 1,724,419 115,000 500,000  
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 17,371,471 55,541,980 19,365,000  
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 95,753 213,434 93,078  
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds .............   48,585,432    
11 Other spent proceeds ............. 17,275,718 308,084 19,271,922  
12 Other unspent proceeds .............   6,435,030    
13 Year of substantial completion ............. 2018 2018
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2018, a current refunding issue)? ........
X     X X      
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2018, an advance refunding issue)? ........
  X   X X      
16 Has the final allocation of proceeds been made? .......... X     X X      
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X      
Part
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X    
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............   X   X   X    
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2019

Schedule K (Form 990) 2019
Page 2
Part
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............   X   X   X    
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?                
c Are there any research agreements that may result in private business use of bond-financed property? .............   X   X   X    
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0 % 0 % 0 %  
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0.320 % 0.670 % 0.320 %  
6 Total of lines 4 and 5 ............. 0.320 % 0.670 % 0.320 %  
7 Does the bond issue meet the private security or payment test? ...   X   X   X    
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X    
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X   X      
Part
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X    
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X   X    
b Exception to rebate? ........ X   X   X      
c No rebate due? .........   X   X   X    
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? .....   X X   X      
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X    
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
Schedule K (Form 990) 2019

Schedule K (Form 990) 2019
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X    
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X    
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X      
Part
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X      
Part
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
SCHEDULE K, PART I, BOND ISSUES: (A) ISSUER NAME: UNION COUNTY HOSPITAL AUTHORITY - SERIES OF 2018A HOSPITAL REVENUE BONDS (F) DESCRIPTION OF PURPOSE: REFINANCE OF 2013 HOSPITAL REVENUE BONDS AND PAYMENT OF ISSUANCE COSTS. (A) ISSUER NAME: UNION COUNTY HOSPITAL AUTHORITY- SERIES OF 2018B HOSPITAL REVENUE BONDS (F) DESCRIPTION OF PURPOSE: CONSTRUCTION/RENOVATION PROJECTS (INCLUDING PATIENT BED TOWER) AND PAYMENT OF ISSUANCE COSTS. (A) ISSUER NAME: UNION COUNTY HOSPITAL AUTHORITY- SERIES OF 2018C HOSPITAL REVENUE BONDS (F) DESCRIPTION OF PURPOSE: REFINANCE OF 2011 HOSPITAL REVENUE BONDS AND PAYMENT OF ISSUANCE COSTS.
Schedule K (Form 990) 2019

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Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
EVANGELICAL COMMUNITY HOSPITAL
 
Employer identification number

24-0795411
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e) Original principal amount (f) Balance due (g) In default? (h) Approved by board or committee? (i) Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2019
Schedule L (Form 990 or 990-EZ) 2019
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) JOHN D GRIFFITH SEE PART V 338,145 SEE PART V   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (A) NAME OF PERSON: JOHN D. GRIFFITH(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: SERVES AS AN EMERITIS DIRECTOR ON THE BOARD OF DIRECTORS(D) JOHN D. GRIFFITH LEASES PROPERTY TO THE HOSPITAL IN AN ARM'S LENGTH TRANSACTION.
Schedule L (Form 990 or 990-EZ) 2019


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SCHEDULE M
(Form 990)


Department of the Treasury
Internal Revenue Service
Noncash Contributions
Right pointing arrow large imageComplete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
Right pointing arrow large imageGo to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
EVANGELICAL COMMUNITY HOSPITAL
 
Employer identification number

24-0795411
Part I
Types of Property
(a)
Check if applicable
(b)
Number of contributions or items contributed
(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g
(d)
Method of determining
noncash contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods .......
     
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded .        
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests ....
       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures .....
       
14 Qualified conservation
contribution—Other ...
       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( AUCTION ITEMS ) X 4 11,871 AT COST
26 Other Right pointing arrow large image ( PPE AND MASKS ) X 2 9,229 AT COST
27 Other Right pointing arrow large image ( STUFFED ANIMALS ) X 1 6,900 AT COST
28 Other Right pointing arrow large image ( FOOD ) X 1 350 AT COST
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement
29
 
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?
31
 
No
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ..........................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) (2019)
Schedule M (Form 990) (2019)
Page 2
Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Return Reference Explanation
PART I, COLUMN (B): THE NUMBER IN COLUMN B REPRESENTS THE NUMBER OF DONORS.
Schedule M (Form 990) (2019)

Additional Data


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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
EVANGELICAL COMMUNITY HOSPITAL
 
Employer identification number

24-0795411
Return Reference Explanation
FORM 990, PART VI, SECTION B, LINE 11B A FULL COPY OF THE FORM 990 WAS REVIEWED BY THE AUDIT COMMITTEE OF THE BOARD DURING AN AUDIT COMMITTEE MEETING PRIOR TO FILING. THEY HAVE THE OPPORTUNUITY TO ASK QUESTIONS AND CHANGES CAN BE MADE AS A RESULT IF NECESSARY BEFORE THE RETURN IS FILED. A FULL COPY OF THE 990 IS THEN MADE AVAILABLE TO ALL BOARD MEMBERS BEFORE FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C A CONFLICT OF INTEREST STATEMENT IS REQUIRED TO BE SIGNED ANNUALLY BY ALL VOTING BOARD MEMBERS, UPPER MANAGEMENT, AND KEY EMPLOYEES. THE HUMAN RESOURCES (HR) DEPARTMENT MONITORS COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY VERIFYING ALL FORMS ARE COMPLETED AND SIGNED. HR MAINTAINS COPIES OF ALL COMPLETED CONFLICT OF INTEREST STATEMENTS. MEMBERS WITH CONFLICTS ARE REQUIRED TO ABSTAIN FROM VOTING OR BEING A PART OF ACTIVE DISCUSSIONS WHERE THEY ARE IN DIRECT CONFLICT. ANYONE IN VIOLATION OF THE CONFLICT OF INTEREST POLICY IS ASKED TO STEP DOWN FROM THE BOARD.
FORM 990, PART VI, SECTION B, LINE 15 THE BOARD'S EXECUTIVE COMPENSATION COMMITTEE, WHICH IS COMPOSED SOLELY OF INDEPENDENT MEMBERS OF THE BOARD, HAS ADOPTED AND FOLLOWS A PROCESS FOR REVIEWING AND DETERMINING THE COMPENSATION OF THE CEO AND THE EXECUTIVE MANAGEMENT TEAM. THE EXECUTIVE MANAGEMENT TEAM CONSISTS OF THE FOLLOWING POSITIONS: CHIEF OPERATING OFFICER, CHIEF FINANCIAL OFFICER, VICE PRESIDENT OF MEDICAL AFFAIRS, VICE PRESIDENT - NURSING, ASSOCIATED VICE PRESIDENT - DEVELOPMENT, VICE PRESIDENT - HUMAN RESOURCES, CHIEF INFORMATION OFFICER, ASSOCIATE VICE PRESIDENT - SUBSIDIARY OPERATIONS. THE COMMITTEE HAS ENGAGED AN INDEPENDENT COMPENSATION CONSULTANT TO PROVIDE INFORMATION AND ADVICE TO THE COMMITTEE, INCLUDING BUT NOT LIMITED TO, PROVIDING INDEPENDENT COMPENSATION COMPARABILITY DATA FOR FUNCTIONALLY COMPARABLE POSITIONS IN SIMILARLY SITUATED HOSPITALS. THE DATA IS PROVIDED ON AN ANNUAL BASIS AND IS REVIEWED BY THE COMMITTEE, ALONG WITH OTHER INFORMATION, PRIOR TO APPROVING ANY CHANGES TO COMPENSATION. THE INDEPENDENCE OF THE COMMITTEE'S MEMBERS IS REVIEWED AND VERIFIED PRIOR TO THE START OF THE ANNUAL COMPENSATION REVIEW PROCESS. SHOULD A CONFLICT PRESENT, THOSE INDIVIDUALS WITH ACTUAL OR PERCEIVED CONFLICTS ABSTAIN FROM VOTING UNTIL SUCH TIME AS THE CONFLICT CAN BE RESOLVED OR A REPLACEMENT MEMBER IS APPOINTED TO THE COMMITTEE. THE COMMITTEE'S DELIBERATIONS AND DECISIONS ARE GUIDED BY A WRITTEN COMPENSATION PHILOSOPHY AND DOCUMENTED THROUGH WRITTEN MINUTES TAKEN DURING EACH MEETING. THE MINUTES INCLUDE, AMONG OTHER THINGS, THE WRITTEN MATERIALS DISTRIBUTED OR PRESENTED DURING THE MEETING AND THE SPECIFIC DECISIONS TAKEN AT THE MEETING. THE LAST REVIEW TOOK PLACE IN 2016.
FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VI, LINE 1: THE EXECUTIVE COMMITTEE OF THE BOARD IS COMPRISED OF THE CHAIRPERSON, THE VICE-CHAIRPERSON OF THE BOARD, THE IMMEDIATE PAST CHAIRPERSON OF THE BOARD, THE CHAIR OF THE FINANCE COMMITTEE, AND THE PRESIDENT OF THE MEDICAL STAFF. NO PERSON IS ELIGIBLE TO SERVE ON THE EXECUTIVE COMMITTEE IN MORE THAN ONE CAPACITY. IN THE EVENT THAT ANY PERSON IS ELIGIBLE TO SERVE ON THE EXECUTIVE COMMITTEE IN MORE THAN ONE CAPACITY, THE CHAIRPERSON SHALL NOMINATE ANOTHER BOARD MEMBER TO SERVE ON THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL INCLUDE AT LEAST ONE PHYSICIAN WHO IS A BOARD MEMBER. THE PRESIDENT SHALL SERVE AS AN EX-OFFICIO MEMBER OF THE EXECUTIVE COMMITTEE WITHOUT A VOTE. THE EXECUTIVE COMMITTEE IS EMPOWERED TO ACT FOR THE BOARD IN THE GOVERNANCE OF ECH BETWEEN REGULAR MEETINGS OF THE BOARD, WHEN SUCH ACTION IS REQUIRED FOR THE TIMELY CONDUCT OF ECH BUSINESS, EXCEPT THE FOLLOWING: 1) SUCH POWERS AS MAY BY LAW OR THESE BYLAWS BE REQUIRED TO BE EXERCISED BY THE BOARD; 2) SUCH POWERS AS THE BOARD MAY BY RESOLUTION EXPRESSLY RESERVE TO ITSELF; 3) THE PURCHASE OR SALE OF REAL PROPERTY; 4) HIRING OR TERMINATING THE EMPLOYMENT OF THE PRESIDENT; 5) AMENDING OR REVISING THE BOARD APPROVED BUDGET; 6) TAKING ANY ACTION WHICH IS A "FUNDAMENTAL CHANGE" WITHIN THE MEANING OF CHAPTER 59 OF THE NONPROFIT CORPORATION LAW OF 1988 (OR ANY SIMILAR SUCCESSOR STATUTE); 7) THE BORROWING OF MONEY; AND 8) COMMITMENTS OR EXPENDITURES GREATER THAN $500,000.
FORM 990, PART XI, LINE 9: EQUITY TRANSFER WITH AFFILIATES -33,609,974. POSTRETIREMENT BENEFIT LIABILITY ADJUSTMENT 139,382. NET ASSETS RELEASED FROM RESTRICTIONS -76,863. VALUATION LOSS -87,837. CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENT -14,048. CONTRIBUTIONS FROM ACQUISITION 1,743,579.
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:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach 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
EVANGELICAL COMMUNITY HOSPITAL
 
Employer identification number

24-0795411
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

(1) PLAZA 15 REALTY LLC
1 HOSPITAL DRIVE
LEWISBURG,PA17837
83-4309247
REAL ESTATE PA 1,889,017 21,335,160 EVANGELICAL COMMUNITY HOSPITAL
 
(2) EVANGELICAL REGIONAL MOBILE MEDICAL SERVICES
1 HOSPITAL DRIVE
LEWISBURG,PA17837
84-1973047
MOBILE MEDICAL SERVICES PA 2,273,241 4,120,248 EVANGELICAL COMMUNITY HOSPITAL
 








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?
Yes No
(1)THE MILLER CENTER FOR RECREATION AND WELLNESS
120 HARDWOOD DRIVE

LEWISBURG,PA17837
47-3104877
RECREATION AND WELLNESS CENTER PA 501(C)(3) PF EVANGELICAL COMMUNITY HOSPITAL
 
Yes
 












For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2019
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



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

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




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



(k)
Percentage
ownership


Yes No Yes No
(1) EVANGELICAL-GEISINGER HEALTH LLC

100 N ACADEMY AVENUE
DANVILLE,PA178224031
46-0567687
HEALTHCARE PA N/A
RELATED 117,052 1,195,754   No     No 50.000 %
(2) KEYSTONE ACCOUNTABLE CARE ORG LLC

100 N ACADEMY AVENUE
DANVILLE,PA17822
45-5484165
HEALTHCARE PA N/A
RELATED -729,661 101,052   No     No 10.000 %










Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) EVANGELICAL MEDICAL SERVICE ORGANIZATION

ONE HOSPITAL DRIVE
LEWISBURG,PA17837
23-2809429
MEDICAL SERVICES PA EVANGELICAL COMMUNITY HOSPITAL
 
C 49,251,726 38,007,597 100.000 % Yes  












Schedule R (Form 990) 2019
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
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
Yes
 
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) EVANGELICAL MEDICAL SERVICES ORGANIZATION

J 818,130 CASH
(2) EVANGELICAL MEDICAL SERVICES ORGANIZATION

O 1,723,066 HOURS SPENT WORKING FOR AFFILIATE
(3) EVANGELICAL MEDICAL SERVICES ORGANIZATION

P 2,266,183 CASH
(4) EVANGELICAL MEDICAL SERVICES ORGANIZATION

R 33,609,974 CASH


Schedule R (Form 990) 2019
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)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(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?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2019
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


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