The Guthrie Clinic

“The organization is the tax-exempt parent entity of the guthrie clinic and affiliates; a tax-exempt integrated healthcare delivery system ("system"). This organization pays all outstanding accounts payable invoices on behalf of most other affiliates within the system. In conjunction with this service, this organization also prepares and issues forms 1099 to these vendors receiving payments where applicable and files these forms 1099 with the internal revenue service. This organization allocates these payments to the appropriate affiliates within the system via an intercompany account.”

“The organization is the tax-exempt parent enity of the guthrie clinic and affiliates; a tax-exempt integrated healthcare delivery system ("system"). This organization's federal form 990 was provided to each voting member of the organization's governing body (its board of directors) prior to the filing of the federal form 990 with the internal revenue service ("irs"). As part of the tax return preparation process the organization hired a professional certified public accounting ("cpa") firm with experience and expertise in both healthcare and not-for-profit tax return preparation to prepare the federal form 990. The cpa firm's tax professionals worked closely with the organization's finance personnel and internal working group to obtain the information needed in order to prepare a complete and accurate tax return. The cpa firm prepared a draft federal form 990 and furnished it to the organization's finance personnel and internal working group for their review. The organization's finance personnel and internal working group reviewed the draft federal form 990 and discussed questions and comments with the cpa firm. Revisions were made to the draft federal form 990 where necessary and a final draft was furnished by the cpa firm to the organization's finance personnel and internal working group for final review and approval. Following this review, the final form 990 was provided to each voting member of this organization's governing body prior to filing with the irs.”

“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 tgc board/committee and tgc 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.”

“The organization is the tax-exempt parent entity of the guthrie clinic and affiliates; a tax-exempt integrated healthcare delivery system. The organization's board of directors maintains the guthrie clinic compensation committee ("committee"). The committee has adopted a written executive compensation philosophy which it follows when it reviews and approves of the compensation and benefits of the guthrie clinic's senior management. The committee also reviews the compensation and benefits of other officers and key employees of the guthrie clinic and affiliates; including, without limitation, the chief executive officers of the guthrie clinic and affiliates hospitals and medical centers. The committee, which is required by the corporation's bylaws to be comprised solely of independent directors, seeks guidance and substantiation from a nationally recognized compensation consultant. The committee reviews the "total compensation" of the individuals which is intended to include both current and deferred compensation and all employee benefits, both qualified and non-qualified. The committee's review is done on at least an annual basis and ensures that the "total compensation" of senior management of the organization is reasonable. The actions taken by the committee enable the organization to receive the rebuttable presumption of reasonableness for purposes of internal revenue code section 4958 with respect to the total compensation of certain members of the senior management team. The three factors which must be satisfied in order to receive the rebuttable presumption of reasonableness are the following: 1. The compensation arrangement is approved in advance by an "authorized body" of the applicable tax-exempt organization which is composed entirely of individuals who do not have a "conflict of interest" with respect to the compensation arrangement; 2. The authorized body obtained and relied upon "appropriate data as to comparability" prior to making its determination; and 3. The authorized body "adequately documented the basis for its determination" concurrently with making that determination. The committee is comprised of members of the board of directors each of who are independent and are free from any conflicts of interest. The committee relied upon appropriate comparable data; specifically, the committee obtained a written compensation study from an independent firm which specializes in the review of hospital and healthcare system executive compensation and benefits throughout the united states. This study used comparable geographic and demographic market data including, but not limited to, similarly sized healthcare systems and hospitals, # of licensed beds and net patient service revenue. The committee adequately documented the basis for its determination through the timely preparation of written minutes of the compensation committee meetings during which the executive compensation and benefits was reviewed and subsequently approved. The actions outlined above with respect to the committee and the establishment of the rebuttable presumption of reasonableness applies to certain the guthrie clinic senior management personnel. The compensation and benefits of certain other individuals contained in this form 990, where applicable, are reviewed annually by the guthrie clinic and affiliates president/chief executive officer with assistance from the organization's human resources department in conjunction with the individual's job performance during the year and is based upon other objective factors designed to ensure that reasonable and fair market value compensation is paid by the organization. Other objective factors include market survey data for comparable positions, individual goals and objectives, personnel reviews, evaluations, self-evaluations and performance feedback meetings.”

“The organization is the tax-exempt parent entity of the guthrie clinic and affiliates; a tax-exempt integrated healthcare delivery system ("system"). The organization has issued tax exempt bonds to finance various capital improvement projects, renovations and equipment. In conjunction with the issuance of these tax-exempt bonds, the organization's financial statements were included with the tax-exempt bond prospectus which was made available to the general public for review. In addition, the organization's filed certificate of incorporation and any amendments can be obtained and reviewed through the commonwealth of pennsylvania. The organization's conflict of interest policy and questionnaire is not open for public inspection.”

“Core form, part vii and schedule j reflect certain board members and officers receiving compensation and benefits from this organization and/or related organizations. Please note this remuneration was for services rendered as full-time employees of this organization or a related organization and not for services rendered as a voting member or officer of this organization's board of directors. Frederick j. Bloom, m.d. Served as the president of guthrie medical group, p.c.; a related internal revenue code section 501(c)(3) tax-exempt organization, until april 30, 2023. Dr. Bloom is still employed within the guthrie clinic as the chief population health officer.”

“The organization is the tax-exempt parent entity of the guthrie clinic; a tax-exempt integrated healthcare delivery system ("system"). Certain board of directors members, officers and/or directors listed on core form, part vii and schedule j of this form 990 may hold similar positions with both this organization and other affiliates within the system. The hours shown on this form 990, for board members who receive no compensation for services rendered in a non-board capacity, represent the estimated hours devoted per week for this organization. To the extent these individuals serve as a member of the board of directors of other related organizations in the system, their respective hours per week per organization are approximately the same as reflected in core form, part vii of this form 990. The hours reflected on core form, part vii of this form 990, for board members who receive compensation for services endered in a non-board capacity, paid officers and key employees, reflect total hours worked per week on behalf of the guthrie clinic and affiliates; not solely this organization.”

“The Guthrie Clinic is a tax-exempt nonprofit health care organization incorporated for the purpose of conducting exclusively charitable, scientific and educational activities. The Guthrie Clinic ("TGC") acts as the tax-exempt parent of the system ("Guthrie"), a tax-exempt section 501(c)(3) integrated health care delivery system. The sole member of each entity is either TGC or another Guthrie system affiliate controlled or owned by TGC. Guthrie offers patients a full-spectrum of health services incorporating primary care, complex specialty care, behavioral health services, surgical services, inpatient care, durable medical equipment services, home health, long-term care, palliative care and hospice care. Our integrated approach creates a better experience for our patients and is working to decrease the cost of the delivery of health care. Guthrie serves a large population of people over a wide geographic area. Regardless of how patients enter the Guthrie system, our electronic health records enables our specialists and primary care physicians to actively collaborate - literally and virtually - to coordinate patient care. Our robust electronic health records enables Guthrie physicians and clinicians to quickly gain a comprehensive understanding of patients' health needs and our patient portal, eguthrie, allows patients to access their health information easily on a computer, tablet or smart phone. Guthrie mission & values ======================== As a non-profit tax-exempt health care system, Guthrie, its physicians and employees are focused on improving the health and well-being of the communities it serves. Guthrie's mission, vision and values statements articulate the principles on which the organization was founded and exists today. Mission ------- Guthrie works with the communities we serve to help each person attain optimal, life-long health and well-being. We will do so by providing integrated, clinically-advanced services that prevent, diagnose, and treat disease, within an environment of compassion, learning, and discovery. Vision ------ Improving health through clinical excellence and compassion; every patient; every time. Values ------ - patient-centeredness - teamwork - excellence A long history of service and growth ==================================== Guthrie Medical Group --------------------- Guthrie Medical Group is tax-exempt multispecialty group practice that was founded in 1910 by Dr. Donald Guthrie. Within a year of his arrival, Dr. Guthrie expanded services at Guthrie Robert Packer Hospital as he recruited physician specialists to join Guthrie, which he intended to model after the Mayo Clinic where he had just completed his residency. Learning and education ---------------------- Academics are a distinguishing characteristic of the Guthrie organization, which date back to 1901 when the School of Nursing was founded. The Donald Guthrie Research Foundation started in 1942 and with funds from the Emily Guthrie estate, the Guthrie Research Institute was formed in 1980. Guthrie's commitment to learning and education includes the internal medicine residency program in 1958, general surgery residency program in 1959, and the family practice residency program in 1993. Regional offices ---------------- Guthrie has grown in size and capability in the last century, and now serves as a major regional referral center where more than 1,600 physicians send their patients. In 1977, Guthrie opened its first regional office in Troy, Pa. Today, Guthrie has 76 regional offices located across 10,000 square miles, providing primary and specialty care and testing to its patients, close to where they live. Five hospitals -------------- In addition to its longstanding relationship with Robert Packer Hospital, Guthrie acquired Troy Community Hospital in 1985, Corning Hospital in 1999, Towanda Memorial Hospital in 2015 and Cortland Medical Center in 2019. Guthrie today ------------- Today, one of the longest established group practic”

“Guthrie Cortland Medical Center =============================== Guthrie Cortland Medical Center, an independent, nonprofit, 162-bed acute care facility with an attached 80-bed residential care facility, joined the Guthrie healthcare system in January 2019. For over 125 years, the people of Cortland have turned to us first for the best in medical care. - acute and inpatient care - cancer care - emergency care - infusion services - labor and delivery care - laboratory services - imaging and radiology - mental health service - outpatient therapy services - respiratory services - surgical services Robert Packer Hospital at Towanda campus ======================================== Robert Packer Hospital at Towanda campus, a 21-bed community hospital in Towanda, PA, joined Guthrie in April 2015. Robert Packer Hospital at Towanda campus serves Bradford and Sullivan counties as well as the surrounding communities and offers additional specialty care services including pain management and hand surgery. Long-term care services are provided for patients at Robert Packer Hospital at Towanda campus with a skilled nursing unit and 94-bed personal care home. - imaging services - medical/surgical services - orthopedic surgery - 24-hour emergency services with 24-hour laboratory, radiology and ultrasound support - ambulatory surgery - cardiology stress testing - laboratory services - rehabilitation - physical and occupational therapy - sub-acute care - EMS services Guthrie Troy Community Hospital =============================== Located in Troy, PA., Guthrie Troy Community Hospital is 25-bed, critical access hospital. A new facility was built in 2013 and offers a wide range of inpatient and outpatient services including sub-acute and ventilator management programs and is a level IV trauma center. - imaging services - medical/surgical services - orthopedic surgery - 24-hour emergency services with 24-hour laboratory, radiology and ultrasound support - ambulatory surgery - coronary care, cardiology stress testing - rehabilitation - sub-acute care - ventilator management program Guthrie Medical Group ===================== Guthrie values are founded on the life and work of Donald Guthrie, MD, who came to the booming railroad town of Sayre, PA. In 1910. After a three-year surgical residency under the exacting tutelage of Drs. Charles A. and William Mayo of the Mayo Clinic, Dr. Guthrie began to replicate the Mayo's multi-specialty group practice model to create the organization that now bears his name. Guthrie Medical Group is a multi-specialty group practice of more than 372 physicians and 274 advanced practice providers have more than 1,380,000 patient visits each year. With its headquarters in a large medical office complex adjacent to Guthrie Robert Packer Hospital in Sayre, PA., the regional office network encompasses 45 subspecialty and primary sites in 29 communities throughout Pennsylvania and New York. Guthrie's primary care network encompasses all of the major population centers in the twin tiers and provides easy and convenient access to the best medical care available in the region. Guthrie Foundation for Education and Research ============================================= The Guthrie Foundation for Education and Research is a 501(c)(3) and separate entity within The Guthrie Clinic. The foundation was established in 1942 with an initial gift of $25,000 from Dr. Guthrie. This was prior to governmental funded research and the original charter specified that these funds were to be used to "foster education and research on the campus of the Robert Packer Hospital". Since the initial inception, the foundation has grown and evolved however, still maintains a similar vision to develop, grow and conduct meaningful quality research to improve the lives of patients in the twin tiers community. In 2014, under a broader organizational re-structure the foundation was re-named the Donald Guthrie Foundation however, still maintained its same mission state”

“Guthrie Robert Packer Hospital has earned two Achievement Awards from The Hospital and Health system Association of Pennsylvania (HAP) for its outstanding efforts to improve health care in the communities it serves. Winners were chosen for their exceptional work in employing innovative approaches to strengthening the safety and quality of care, enhancing operations and patients' experience, and partnering with their communities to address public health needs. Guthrie represented two of the twelve winning projects, selected from a group of 82 total submissions and was awarded the following recognitions: - Optimal Operations Award for implementing a new team-based approach to nursing to reduce staff turnover and vacancies, improve patient and staff satisfaction, and improve quality. - In Safe Hands Award for implementing new procedures to reduce hospital-acquired infections. Guthrie Robert Packer Hospital was recognized as a 2023 Outpatient Joint Replacement Excellence AwardT recipient by Healthgrades, the leading marketplace connecting doctors and patients. This achievement reflects Guthrie Robert Packer Hospital's outstanding clinical outcomes for outpatient knee and hip replacement and distinguishes Guthrie Robert Packer Hospital in the top 10% nationwide for outpatient joint replacement. Covid-19 response ----------------- Guthrie's response to covid-19 was rapid and coordinated, with system-wide interdisciplinary teams addressing everything from escalating the delivery of personal protective equipment, to creating infection prevention practices, to ensuring constant community updates and education. Guthrie's response teams focused on patient and staff safety. The organization was committed to maintaining a patient-centered approach throughout its response. The health care system also decided on a coordinated system approach to ensure a consistent response to a rapidly changing emergency spanning guthrie's wide geography. Evolution was immediate in dealing with treatment protocols for patients, safety protections, acquisition of supplies, or testing. The organization implemented outdoor testing tents at Guthrie Robert Packer Hospital in Sayre, Guthrie Cortland Medical Center and Guthrie Corning hospital in an effort to keep covid-19 outside of its facilities. In an effort to slow the spread of covid while continuing to care for patients, Guthrie's physicians and clinical staff expanded its telemedicine program. In total, the information technology department delivered and set up more than 300 webcams, 260 laptops, and 525 ipads. Before covid, Guthrie performed a small number of specialty-based telemedicine visits, approximately 12 per week, and by May 2020, the health system had rolled out virtual care for ambulatory visits and was doing more than 3,000 a week. Guthrie was heavily involved in covid vaccine distribution. Guthrie leaders recognized its unique position in the community, given the 12-county area the health system serves. This is a much broader area than Guthrie's regional health care partners, so there was a unique responsibility to distribute and administer as many vaccines as possible. The organization used its network of regional offices, offered vaccinations at some of its hospitals, and created a mass-vaccination center in a former department store in Sayre, PA. This space allowed for proper social distancing and accommodated up to 700 patients a day. The health system also coordinated with local public health departments, community leaders, businesses, and human services agencies to help improve access and overcome barriers to vaccination. Guthrie's mass-vaccination site was recognized for its efficient and patient-focused care with a visit from Pennsylvania governor Tom Wolf on April 21, 2021. Community benefit ----------------- Guthrie tax-exempt hospitals provide significant community benefit for purposes of form 990 schedule h part i reporting. Schedule h part i follows the catholic health association”

“Edmund Sabanegh, m.d. served as a voting member/officer of this organization's governing body. Dr. Sabanegh IS LISTED AS A DIRECTOR/OFFICER on other guthrie clinic related affiliates forms 990. THIS IS HIS SOLE ROLE WITH THESE ORGANIZATIONS. HE PROVIDES NO SERVICES TO OR FOR THESE ORGANIZATIONS AND IS NOT INVOLVED IN THE MANAGEMENT OR DAY TO DAY ACTIVITIES OF THESE ORGANIZATIONs. ACCORDINGLY, HIS COMMON LAW EMPLOYER/EMPLOYEE RELATIONSHIP IS WITH THE GUTHRIE CLINIC (EIN: 23-3055017). THE GUTHRIE CLINIC FILED A 2022 FORM 4720 WHICH INCLUDED A REMITTANCE OF EXCISE TAX RELATED TO DR. SABANEGH'S COMPENSATION IN EXCESS OF $1M.”

“other changes in net assets or fund balance includes: - MINIMUM PENSION LIABILITY ADJUSTMENT - $1,412,590; - CHANGE IN FAIR VALUE OF DERIVATIVE INSTRUMENT - $257,080; - LOSS ON DERIVATIVE INSTRUMENT - ($76,215); - RESTRUCTURING EXPENSE - ($207,744); - OTHER LOSS - ($512,894); - TEMPORARILY RESTRICTED NET ASSETS NPV FUTURE INSTALLMENTS - $5,409; - TEMPORARILY RESTRICTED NET ASSETS EARNINGS DISTRIBUTION - ($1,511,617); - TEMPORARILY RESTRICTED NET ASSETS RELEASED FROM RESTRICTION - ($194,081); - TEMPORARILY RESTRICTED EQUITY TRANSFER TO RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION - ($1,920,050); - TEMPORARILY RESTRICTED NET ASSETS RELEASED FROM GRANTS - ($989,566); - TEMPORARILY RESTRICTED PLEDGES - ($125,022); - MERGER ACQUISITION COSTS - ($3,613,755); AND - NET ASSETS RELEASED FROM RESTRICTIONS USED FOR THE PURCHASE PPE - $628,416.”

“The organization is the tax-exempt parent entity of the guthrie clinic and affiliates; a tax-exempt integrated healthcare delivery system ("system"). An independent cpa firm audited the consolidated financial statements of the system and all entities within the system for the years ended june 30, 2023 and june 30, 2022; respectively. The independent cpa firm issued an unmodified opinion with respect to the audited consolidated financial statements.”

“This organization is the tax-exempt parent entity of the guthrie clinic and affiliates; a tax-exempt integrated healthcare delivery system ("system"). The system engaged an independent accounting firm to prepare and issue a system wide consolidated audit under the single audit act and omb circular a-133 audit. This organization was included in the system wide a-133 audit.”

“THE ORGANIZATION IS A MEMBER OF THE GUTHRIE CLINIC; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM HAS A NUMBER OF OUTSTANDING LONG-TERM OBLIGATED GROUP DEBT LIABILITIES, INCLUDING THE FOLLOWING BOND ISSUANCES: - HEALTH CARE FACILITIES AUTHORITY OF SAYRE, HEALTH CARE REVENUE BONDS, SERIES 2007; and - CENTRAL BRADFORD PROGRESS AUTHORITY, HEALTH CARE REVENUE BONDS, SERIES 2021A; SERIES 2021B; SERIES 2021C; AND SERIES 2021D. THE BONDS OUTLINED ABOVE AND VARIOUS OTHER LONG-TERM BORROWINGS ARE ALLOCATED BY THE GUTHRIE CLINIC ("TGC"); THE TAX-EXEMPT PARENT OF THE SYSTEM, TO THE FOLLOWING SYSTEM MEMBER HOSPITALS AND CERTAIN OTHER AFFILIATES. THE BALANCE SHEET OF THESE RESPECTIVE MEMBER HOSPITALS AND CERTAIN OTHER AFFILIATES REFLECTS A TGC OBLIGATED GROUP LIABILITY. ACCORDINGLY, THIS TGC OBLIGATED GROUP LIABILITY IS REFLECTED ON THE BALANCE SHEET OF THE FOLLOWING SUBSIDIARY ORGANIZATIONS: - CORNING HOSPITAL, EIN: 16-0393490 - GUTHRIE CORTLAND MEDICAL CENTER, EIN: 15-0532079 - GUTHRIE MEDICAL GROUP, P.C., EIN: 25-0815795 - ROBERT PACKER HOSPITAL, EIN: 24-0795463 - TROY COMMUNITY HOSPITAL, EIN: 24-0800337 SCHEDULE K WAS PREPARED ON A CONSOLIDATED BASIS AND IS INCLUDED IN THE FORM 990 OF THE GUTHRIE CLINIC, EIN: 23-3055017.”