Guthrie Healthcare System

The Guthrie clinic is a nonprofit health care organization that serves to coordinate the activity of Guthrie medical group, p.c. (gmg) and the affiliates within Guthrie Healthcare System (ghs; see form 990, schedule r, for a listing of affiliates of ghs, including robert packer hospital (rph)). Through the activities of the gmg, ghs, rph, and its other affiliates (collectively referred to as "Guthrie"), the Guthrie clinic provides charitable community-based health care services and programs to improve the health and well-being of the people and communities served by its facilities and providers. These charitable activities include providing primary care and specialty physician services, as well as operating a tertiary care teaching hospital, community hospitals, a research institute, home care, hospice care and a long-term care facility. The Guthrie research institute and Guthrie clinical research functions of the donald Guthrie foundation (research institute), a subsidiary of ghs, furthers these charitable activities through providing basic science research and patient access to the region's largest panel of clinical trials. The facilities and provider offices of Guthrie are located in 23 communities throughout the northern tier of Pennsylvania and southern tier of new york, with the greatest concentration of services provided principally in bradford county, Pennsylvania and chemung and steuben counties, new york. The vision of Guthrie is to help shape the delivery of health care in the region through working collaboratively with physicians and other providers, and by distributing its services throughout the region based on community needs. Guthrie seeks to be the provider of choice for patients in the twin tier region, and to be recognized for its superior quality and service. It also strives to advance the practice of medicine through its commitment to teaching and research. In keeping with this vision, the core values of the Guthrie clinic are as follows: patient-centeredness, excellence and teamwork. Guthrie providers and facilities provide care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Because it does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenue on the financial statements of Guthrie entities. Costs for services and supplies furnished under Guthrie's charity care policy amounted to approximately $2.6 million in 2014 and $3.2 million in 2013 when measured at the appropriate entity's established rates. As part of its charitable mission, Guthrie provides care through its hospital emergency departments. It ensures that an emergency-based treatment or hospital admission is not delayed or denied pending determination of coverage or a requirement for prepayment or deposit. As a result of this policy, Guthrie experienced approximately $3.74 million and $3.71 million in bad debts for 2014 and 2013, respectively. In addition to the charity care program and the emergency department bad debts discussed above, Guthrie supports numerous other charitable community activities. Examples of these activities include medical education for physicians and nurses, the trauma program and medical research. The estimated cost, net of reimbursement, for these programs was $16.1 million and $16.4 million in 2014 and 2013, respectively. Guthrie also provides services to patients who participate in the medicaid programs. Revenues generated from patients who participate in the medicaid program are subject to substantial discounts that result in reimbursement for services rendered below the cost of providing such services. In order for patients to meet the guidelines for the medicaid program, various income-based criteria must be met that validate patients' inability to pay for services and ineligibility under other programs. The estimated loss incurred by Guthrie from providing services to medicaid patients amounted to $22.0 million and $19.9 million in 2014 and 2013, respectively. The total cost to Guthrie in supporting these charitable mission programs was approximately $44.0 million and $42.9 million in 2014 and 2013, respectively. As discussed, rph and the gmg work closely together in fulfilling Guthrie's charitable mission. A regional level ii trauma center, rph is a tertiary care teaching hospital, located in sayre, Pennsylvania, serving the southern tier of new york and the northern tier of Pennsylvania. It also provides residency programs in family practice, internal medicine, and general surgery as well as a fellowship program in vascular surgery. Medical student training is provided for students from affiliated medical schools. Allied health education is also provided for respiratory therapy, nursing, laboratory science and radiologic technology for students from Pennsylvania and new york colleges and universities. Centers of excellence within rph include the following: advanced & minimally invasive surgery; behavioral health services; breast and imaging center; comprehensive cancer center; cardiovascular care center; the center for wound care and hyperbaric medicine; dialysis centers; joint camp program for orthopedic surgery, sports medicine; kidney stone treatment center; first impressions birthing center; sleep disorders testing; and specialty eye care. Rph strives to enhance the quality of life in the communities it serves by providing superior health care services and by leading continuous improvement of community health. It achieves this mission by organizing services and directing resources toward meeting community health needs through collaboration with community agencies and by compassionate, effective and affordable means. Rph works closely with the gmg to ensure that the skills and knowledge of the medical staff produce the maximum community health benefit. As a member of the Guthrie Healthcare System, rph integrates its programs and activities with those of the long-term care and education and research divisions, so that continuity and synergy result. As part of ghs, the vision of rph is to play a leadership role in the development and provision of tertiary-level acute care services. Evidence that rph is successfully fulfilling this role can be seen in its continued accomplishments. Highlights of those achievements include continued accreditation by the Pennsylvania trauma systems foundation board as a level ii trauma center and receipt of full chest pain center accreditation with pci (percutaneous coronary intervention) from the society of cardiovascular patient care. Guthrie weight loss center has been accredited as a level 1 facility under the bariartic surgery center network (bscn) accrediation program of the american college of surgeons (acs). Rph is a magnet designated hospital. As part of a fully-integrated health delivery System that organizes its services on a regional basis and is accountable for improving the health of the population it serves; rph accepts responsibility for meeting the health care needs of the community and is able to document the cost effectiveness and quality of services provided. Corning hospital breast care center was awarded a full three year accrediation in stereotactic breast biopsy by the american college of radiology (acr) and received the american heart association/american stroke associations's get with the guidelines stroke gold plus achievement award. The gmg is a multi-specialty physician group practice that includes nearly 350 specialist and primary care physicians and mid-level providers, headquartered in a facility adjacent to rph. Physicians within the gmg provide comprehensive medical care using advanced technologies and methodologies for both diagnosis and treatment. Further, the gmg provides a broad range of educational opportunities for physicians and other health care providers. It also works closely with the research institute, where research contributes to recruiting and retaining physician specialists to serve the region and sustaining proficient medical practices. The gmg is committed to the advancement of medical knowledge and skills, and every effort is made to provide personal, compassionate medical care. The gmg operates a regional office network in 23 communities in Pennsylvania and new york, encompassing all of the major population centers in the twin tiers area. The gmg and ghs have developed certain guiding principles for the provision of patient care, which include a commitment the following: practice of clinical excellence, utilization of the synergy of a multi-specialty medical group practice, development of an integrated System that provides a continuum of care, provision of local access to care through support of a regional medical office network, provision of services to a distinct geographic region, and proactive operations. The gmg, through the provision of primary care services with ease of access to specialty and