Guthrie Risk Retention Group

“Delegation of management duties gavin foggon, board secretary, is employed by marsh management services, inc., the firm that provides captive management services to guthrie risk retention group. A portion of their compensation may be allocable to work performed for the guthrie risk retention group. ---------------”

“Membership information the guthrie clinic has the controlling membership interest in the guthrie risk retention group. The guthrie clinic, robert packer hospital, and corning hospital are members of the guthrie risk retention group. Guthrie exempt affiliates can be issued regular membership interests. ---------------”

“Membership information the guthrie clinic, as the controlling member, has the sole right and authority to appoint the members of the board of directors. -------------”

“Membership information guthrie risk retention group board of directors reports to the guthrie clinic, controlling member. Certain decisions of the guthrie risk retention group are subject to the approval of the guthrie clinic. ---------------”

“Form 990 review process the organization's form 990 is provided to the board of directors for review and is also reviewed by the organization's finance personal and an independent accounting firm prior to filing with the irs. ---------------”

“Conflict of interest policy the conflict of interest disclosure policy sets forth that all persons, including employees, agents and board/committee members, particularly those involved in decision-making for the guthrie clinic (tgc), act in an appropriate manner and will not participate in any actions that might create a personal or professional conflict of interest and/or not be in the best interest of tgc. All members of any tgh board/ committee and tgh senior management must make full disclosure of any possible conflict of interest through the use of the conflict of interest disclosure form and refrain from voting or participating in decision-making involving any possible conflict of interest.the form is distributed to all board/committee members and employees (when applicable) annually by the tgc administration office. Tgc board/committee members or employees must complete the conflict of interest disclosure form. This form should be completed when there is any situation where a possible conflict of interest exists, and/or on an annual basis and/or at the time of appointment or election of new board/committee members. If the form is not completed within 13 months of the last signing, the tgc board chairman will be advised. Any individual having a conflict of interest or possible conflict of interest on any matter should excuse themselves from the portion of the meeting or meetings where the matter is discussed and not vote or use his or her personal influence on the matter. The minutes of the meeting or meetings should reflect the disclosure, the abstention from voting, and any action taken to determine whether a conflict of interest existed. ---------------”

“Compensation review and approval this organization has no employees. It is an affiliate of the guthrie clinic. Compensation arrangements involving any of our officers and/or key employees are established by the guthrie clinic pursuant to a process that satisfies the rebuttable presumption procedure available for section 4958 excess benefit transactions for tax purposes. Executive compensation is generally established within a written employment agreement. Compensation is determined based on market studies, presented to the guthrie clinic compensation committee, and subsequently approved by the board of directors. ---------------”

“Governing documents the organization's forms 1023 and 990 filings are available for public inspection upon request. ---------------”

“Governing documents the organization does not make its governing documents, conflict of interest policy, and financial statements available to the public. ---------------”

“Statement of program service accomplishments the guthrie clinic is the controlling member of the guthrie risk retention group. The guthrie clinic is a nonprofit health care organization incorporated for the purpose of conducting exclusively charitable, scientific and educational activities. The guthrie clinic (tgc) acts as the parent of an integrated section 501(c)(3) health care delivery system, consisting of the corporation and other directly and indirectly controlled entities (see form 990, schedule r, for a listing of the affiliates of tgc) including but not limited to guthrie medical group, p.c.(gmg) and robert packer hospital (rph). Through the activities of gmg, 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, and hospice care. The guthrie research institute and guthrie clinical research functions of the donald guthrie foundation, a subsidiary of tgc, furthers these charitable activities through providing 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 $1.56 million in 2017 and $1.49 million in 2016 when measured at the appropriate entity's estimated cost. 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 $2.56 million and $2.86 million in bad debts for 2017 and 2016, 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 $16.4 million and $16.1 million in 2017 and 2016, 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”

“FOR THE PROVISION OF PATIENT CARE, WHICH INCLUDE A COMMITMENT TO 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 SUB-SPECIALTY CARE, FOCUSES ON MAKING AN INTEGRATED SYSTEM OF HEALTH CARE EASILY ACCESSIBLE TO PATIENTS. WITH ITS PRIMARY CONCERN THE DIAGNOSIS AND TREATMENT OF DISEASE AND ILLNESS, IT ALSO SEEKS TO ACTIVELY IMPROVE THE HEALTH OF THE COMMUNITY IT SERVES THROUGH PREVENTION, HEALTH SCREENINGS, AND EDUCATION. THE GMG WELCOMES ANY PATIENT SEEKING CARE. -------------------- FORM 990, PART IV, LINE 12b DETAIL OF CONSOLIDATED FINANCIAL STATEMENTS THE ORGANIZATION'S FINANCIAL STATEMENTS WERE AUDITED ON A CONSOLIDATED BASIS WITH THE GUTHRIE CLINIC AND AFFILIATES. THE AUDITED STATEMENTS WERE ISSUED BOTH ON A CONSOLIDATED AND SEPARATE BASIS. ---------------”

“Reconciliation of net assets detail of other changes in net assets or fund balances: return of capital to insured affiliates $3,000,000.”