2023-11-15T13:45:57-06:00 2022-12-31 FORVIS LLP 111 E Wayne St Suite 600 Fort Wayne IN 46802 990 2022-07-01 753126134 HEALTH SERVICES OF CLARION INC % TOM ALBANESI HEAL 7242836666 1 HOSPITAL WAY BUTLER PA 16001 TOM ALBANESI CFO 8142263470 2023-11-15 true ERIC HUSS 999009999 Anne E White P01708202 2604604000 2 2022 2023-04-26 12:10:37Z X KAREN ALLEN 1 HOSPITAL WAY BUTLER PA 16001 0 false X N/A X 2003 PA TO PROVIDE QUALITY PATIENT CARE UNDER THE DIRECTION OF PHYSICIANS AND ADVANCED PRACTICE PROVIDERS. X 4 3 0 3 0 0 0 0 258655 0 26 0 0 0 258681 0 0 0 0 0 0 0 0 0 0 30119 0 30119 0 228562 0 11724 0 2721904 0 -2710180 0 X MISSION: HEALTH SERVICES OF CLARION, INC. SHALL ASSIST CLARION HOSPITAL IN THE RECRUITMENT AND RETENTION OF PHYSICIANS IN THEIR SERVICE AREA WHO SHARE IN AND DEMONSTRATE THE VALUES OF CLARION HOSPITAL. HEALTH SERVICES OF CLARION, INC. IS COMMITTED TO PROVIDE QUALITY PATIENT CARE SERVICES UNDER THE DIRECTION OF PHYSICIANS WHO POSSESS THE COMPREHENSIVE KNOWLEDGE AND SKILLS NECESSARY TO MEET THE NEEDS OF THE PATIENTS. VISION: HEALTH SERVICES OF CLARION, INC. ENDEAVORS TO PROVIDE AN ALTERNATIVE RECRUITMENT MODEL TO ASSIST CLARION HOSPITAL IN RECRUITING PHYSICIANS TO THE COMMUNITIES IT SERVES. HEALTH SERVICES OF CLARION, INC. MAY PROVIDE OPPORTUNITIES FOR PHYSICIANS FROM CLARION HOSPITAL'S RESIDENCY TRAINING PROGRAM AND NEW PHYSICIANS RECRUITED TO THE AREA WITH AN EMPLOYMENT RELATIONSHIP AS SECURITY DURING THE START-UP PHASE OF THEIR PRACTICES. false true 0 0 HEALTH SERVICES OF CLARION, INC. PROVIDES PROFESSIONAL HEALTHCARE SERVICES, INCLUDING INPATIENT AND OUTPATIENT, TO CLARION COUNTY AND THE SURROUNDING COMMUNITIES. 0 true false false false false false false false false false false false false false false false false false false false false false false false false false false false false true false false false false false false false false false false true false false true false false false true 0 0 0 true false false false false false false false false false false false false X 4 3 false false false false false false false true true false false false true true true true true false false false PA X TOM ALBANESI 7242836666 1 HOSPITAL WAY BUTLER PA 16001 STEVEN DAVIS SECRETARY/TREASURER 1.0 40.0 X X 0 369433 47778 PATRICK KAHLE CHAIR 1.0 1.0 X X 0 0 0 RICK RATHFON DIRECTOR 1.0 0.0 X 0 0 0 WOODROW YEANEY DIRECTOR 1.0 0.0 X 0 0 0 CONNIE BEICHNER EXECUTIVE DIRECTOR 40.0 0.0 X 0 0 0 0 369433 47778 0 false true false 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11724 0 0 0 0 0 0 0 0 0 0 0 11724 0 2721904 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2721904 0 X -2710180 0 0 0 -2710180 0 11724 0 X 0 2710180 X false true X true false X SCHEDULE A, PART I, LINE 3 ALTHOUGH EXEMPT FROM TAXATION AS A COOPERATIVE HOSPITAL SERVICE ORGANIZATION, THE ORGANIZATION IS NOT, AND IS NOT REQUIRED TO BE, LICENSED AS A HOSPITAL IN THE STATE OF PENNSYLVANIA. THEREFORE, IRC 501(R) DOES NOT APPLY AND SCHEDULE H IS NOT REQUIRED. false true false false false false false false false STEVEN DAVIS SECRETARY/TREASURER 0 300914 0 60183 0 8336 0 21064 0 26714 0 417211 PART I, LINE 3: THE SECRETARY/TREASURER IS PAID BY BUTLER HEALTHCARE PROVIDERS, A NONPROFIT RELATED CORPORATION. BUTLER HEALTHCARE PROVIDERS USES THE FOLLOWING METHODS TO ESTABLISH COMPENSATION FOR THE SECRETARY/TREASURER: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEY OR STUDY, INDEPENDENT LEGAL REVIEW, AND APPROVAL BY THE BOARD AND BOARD COMPENSATION COMMITTEE. PART I, LINES 4B: ALL OF THE BENEFITS LISTED HEREUNDER ARE ALSO REPORTED ON THE 990 FOR BUTLER HEALTHCARE PROVIDERS, A RELATED NONPROFIT CORPORATION. NO ADDITIONAL PAYMENTS ARE MADE BY HEALTH SERVICES OF CLARION, INC. 4(B) THE ORGANIZATION UTILIZES A SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAM (SERP) TO RECRUIT AND RETAIN LEADERSHIP TALENT. VESTING PERIODS ARE 5 AND 10 YEARS FOR ALL EXECUTIVES, WITH THE EXCEPTION OF THE PRESIDENT/CEO, AT AGE 65. THE THIRD VESTING PERIOD FOR THE PRESIDENT/CEO IS AGE 60. ELIGIBLE EXECUTIVES RECEIVE DISTRIBUTIONS UPON REACHING THE VESTING PERIODS. ALL CONTRIBUTIONS TO THE SERP HAVE BEEN REPORTED PREVIOUSLY AND ARE REPORTED ANNUALLY. THE ANNUAL ACCRUAL AMOUNTS FOR CALENDAR YEAR 2022 WERE: STEVEN DAVIS $21,064. FURNITURE & FIXTURES 2022-07-01 11724 BOOK VALUE 251441961 BUTLER MEDICAL PROVIDERS ONE HOSPITAL WAY BUTLER PA 16001 501(c)(3) false false false false true true true true false FORM 990, PART III, LINE 3 DURING THE 7/1/22 - 12/31/22 PERIOD, THE NECESSARY STEPS WERE TAKEN TO DISSOLVE HEALTH SERVICES OF CLARION, INC. ALL PROGRAM SERVICES WERE CEASED BY 12/31/22. FORM 990, PART VI, SECTION B, LINE 11B: THE COMPLETED 990 WAS PREPARED BY THE TAX DEPARTMENT OF AN EXTERNAL AUDIT FIRM IN CONJUNCTION WITH HOSPITAL STAFF AND REVIEWED BY THE CFO. THE HEALTH SERVICES OF CLARION, INC. BOARD MEMBERS NO LONGER MEET DUE TO THE DISSOLUTION OF HEALTH SERVICES OF CLARION, INC., THEREFORE THE FORM 990 WAS NOT REVIEWED BY THE BOARD MEMBERS THAT SERVED AT THE TIME OF DISSOLUTION. FORM 990, PART VI, SECTION B, LINE 12C: THE RESPONSES TO THE CONFLICT OF INTEREST DISCLOSURE FORM ARE COLLECTED AND REVIEWED ANNUALLY BY THE CHIEF LEGAL COUNSEL AND THE CORPORATE COMPLIANCE OFFICER, WHO THEN REVIEWS THE SAME WITH THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF TRUSTEES. CONFLICT OF INTEREST DISCLOSURE FORMS ARE COMPLETED BY ALL TRUSTEES, OFFICERS, COMMITTEE MEMBERS, MEMBERS OF MANAGEMENT, EMPLOYED PHYSICIANS AS WELL AS THE EXECUTIVE TEAM. IN THE EVENT A RELATIONSHIP RESULTS IN A POTENTIAL CONFLICT FOR AN ISSUE BEING DISCUSSED BY THE BOARD, THE TRUSTEE RECUSES HIMSELF/HERSELF FROM THE DISCUSSION AND VOTE. THE RECUSAL IS DOCUMENTED IN THE MINUTES. THE CHIEF LEGAL OFFICER AND/OR CORPORATE COMPLIANCE OFFICER ATTENDS ALL BOARD MEETINGS AND ENSURES THAT ANY NEEDED RECUSALS OCCUR. FORM 990, PART VI, SECTION B, LINE 15A & 15B: BUTLER HEALTH SYSTEM EXECUTIVE COMPENSATION PHILOSOPHY & PROCESS: ALTHOUGH COMPENSATED THROUGH BUTLER HEALTHCARE PROVIDERS, THIS PHILOSOPHY AND PROCESS APPLIES TO CLARION HOSPITAL. THE BOARD OF TRUSTEES RECOGNIZES THE GREAT CHALLENGES AND DIFFICULTIES THAT HEALTHCARE EXECUTIVES FACE, PARTICULARLY IN THE CURRENT ERA OF NATIONAL AND STATE HEALTHCARE REFORM. IN ADDITION, THE PITTSBURGH REGIONAL MARKET IS HIGHLY COMPETITIVE AND CHANGING RAPIDLY. THE BOARD COMPETES FOR AND SEEKS EXECUTIVE TALENT ON A NATIONAL BASIS. IT ENGAGES EXPERT COMPENSATION CONSULTANTS, UTILIZING NATIONAL COMPARATIVE DATA TO GUIDE THE DETERMINATION OF COMPETITIVE, APPROPRIATE LEVELS OF COMPENSATION. THE TOTAL COMPENSATION PROGRAM FOR EXECUTIVES CONSISTS OF CASH COMPENSATION AND BENEFITS. FACTORS TAKEN INTO CONSIDERATION IN DETERMINING COMPENSATION FOR EXECUTIVES INCLUDE: MARKET DEMAND AND COMPETITION FOR SIMILAR POSITIONS, EXPERIENCE AND TENURE, AND ACTUAL PERFORMANCE AND EFFECTIVENESS. BASED ON THESE AND OTHER PERTINENT CRITERIA, BHS TARGETS TOTAL COMPENSATION TO FALL WITHIN A RANGE OF THE 25TH TO 75TH PERCENTILE OF THE MARKET. BHS EXECUTIVE COMPENSATION GENERALLY WILL NOT EXCEED THE 75TH PERCENTILE OF THE MARKET. EXCEPTIONS TO THIS MAY BE SUBJECT TO REVIEW AND RECOMMENDATION BY THE COMPENSATION COMMITTEE, WHICH IN TURN IS SUBJECT TO REVIEW AND APPROVAL BY THE BOARD OF TRUSTEES. EXCEPTION MUST BE SUPPORTED BY ORGANIZATIONAL AND/OR INDIVIDUAL PERFORMANCE, OR A RETENTION/RECRUITMENT CIRCUMSTANCE THAT WARRANTS SUCH COMPENSATION. THE COMPENSATION COMMITTEE CONSISTS EXCLUSIVELY OF INDEPENDENT INDIVIDUALS WITH NO REAL OR PERCEIVED CONFLICTS OF INTEREST IN RECOMMENDING EXECUTIVE COMPENSATION GUIDELINES AND LEVELS. WHILE BENEFITS ARE ACCOUNTED FOR IN SCHEDULE J, ACTUAL "TAKE HOME" PAY TO THE EXECUTIVE TYPICALLY CONSISTS ONLY OF BASE SALARY, AND INCENTIVE AWARD EARNED, IF EARNED. APPLICABLE TAXES OR OTHER WITHHOLDINGS ARE DEDUCTED. ANNUAL INCREASES IN BASE PAY, IF ANY, ARE BASED ON COMPETITIVE MARKET TRENDS FROM THE COMPARISON GROUP. SUPPLEMENTAL RETIREMENT BENEFITS ARE USED AS A VEHICLE FOR EXECUTIVE RECRUITMENT AND RETENTION WITH APPROPRIATE VESTING PERIODS. THE BOARD OF TRUSTEES REVIEWS AND APPROVES EXECUTIVE COMPENSATION IN ITS ENTIRETY, INCLUDING THE USE OF "TALLY SHEETS", WHICH DISCLOSE 100% EXECUTIVE COMPENSATION. THE BOARD OF TRUSTEES ENGAGES EXTERNAL COMPENSATION AND LEGAL EXPERTISE TO ASSURE REASONABLENESS OF EXECUTIVE COMPENSATION LEVELS. FORM 990, PART VI, SECTION C, LINE 19: HISTORICAL FINANCIAL INFORMATION IS PROVIDED TO THE PUBLIC AT THE ANNUAL PUBLIC BOARD MEETING. BYLAWS, ARTICLES OF INCORPORATION AND THE CONFLICT OF INTEREST POLICY ARE POSTED ON THE WEBSITE. FORM 990, PART XI, LINE 9 TRANSFER TO BUTLER MEDICAL PROVIDERS: ASSETS - (11,724) DEBT - 2,721,940 TOTAL - 2,710,180 BUTLER HEALTH SYSTEM 1 HOSPITAL WAY BUTLER PA 16001 251441855 HC DELIV SVCS PA 501(C)(3) LINE 10 N/A false BUTLER HEALTH SYSTEM FOUNDATION 1 HOSPITAL WAY BUTLER PA 16001 261543883 FUNDRAISING PA 501(C)(3) LINE 12A, I BHS false BUTLER HEALTHCARE PROVIDERS 1 HOSPITAL WAY BUTLER PA 16001 250965274 HOSPITAL PA 501(C)(3) LINE 3 BHS false BUTLER MEDICAL PROVIDERS 1 HOSPITAL WAY BUTLER PA 16001 251441961 PHY. PRACTICE PA 501(C)(3) LINE 3 BHS false CLARION HEALTHCARE SYSTEM ONE HOSPITAL DRIVE CLARION PA 16214 251534023 HOLDING COMP PA 501(C)(3) LINE 12A, I BHS false CLARION HOSPITAL ONE HOSPITAL DRIVE CLARION PA 16214 251010039 HOSPITAL PA 501(C)(3) LINE 3 CHS false CLARION HOSPITAL SELF INS TRUST FUND ONE HOSPITAL DRIVE CLARION PA 16214 250766602 SELF-INS. PA 501(C)(3) LINE 12A, I CHS false NIXSAR CORPORATION 1 HOSPITAL WAY BUTLER PA 16001 251441960 REAL ESTATE PA 501(C)(3) LINE 12B,II BHS false BUTLER MEMORIAL HOSPITAL AUXILIARY 1 HOSPITAL WAY BUTLER PA 16001 251457575 AUXILIARY PA 501(C)(3) LINE 10 BHS false BUTLER AMBULATORY SURGERY CENTER LLC 102 TECHNOLOGY DRIVE BUTLER PA 16001 061728190 SURGERY CENTE PA BHS false 0 false BHS FASTERCARE 1 HOSPITAL WAY BUTLER PA 16001 271961562 URGENT CARE PA BHP false 0 false BHS FASTER CARE LABORATORY 1 HOSPITAL WAY BUTLER PA 16001 800628384 LAB. SERVICES PA BHP false 0 false CLARION DEVELOPMENT CORPORATION ONE HOSPITAL DRIVE CLARION PA 16214 251516298 PHARMACY PA CHS C CORP false PCA OF BUTLER PC 480 E JEFFERSON STREET BUTLER PA 16001 251351445 PHYS. OFFICE PA BHS C CORP false false false false false false false false false false false false false false false false false false true false TRANSFER TO BUTLER MEDICAL PROVIDERS R 2710180 BOOK VALUE