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        <PersonNm>JOANNE COCHRAN</PersonNm>
        <TitleTxt>PRESIDENT/CE</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>JOHN J MCELWEE JR</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID K GRANT</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>THEODORE J GUARRIELLO</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>EKEZIE MC FRANCIS</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL J COLLI</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>YVETTE BROWN</PersonNm>
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            <BusinessNameLine1Txt>BRANDALE GENERAL CONTRACTORS</BusinessNameLine1Txt>
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          <USAddress>
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      <ContractorCompensationGrp>
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            <BusinessNameLine1Txt>R&amp;S MOWERY &amp; SONS</BusinessNameLine1Txt>
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          <USAddress>
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      <ContractorCompensationGrp>
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        </ContractorName>
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          <USAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
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      <ContractorCompensationGrp>
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          <USAddress>
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        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 3, PART X</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CENTER IS A NOT-FOR-PROFIT CORPORATION ORGANIZED UNDER THE PROVISIONS OF THE NONPROFIT LAWS OF THE COMMONWEALTH OF PENNSYLVANIA. THE CENTER HAS RECEIVED A RULING FROM THE INTERNAL REVENUE SERVICE THAT IT IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND FILES A FORM 990, "RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX". THE FORM 990 IS GENERALLY SUBJECT TO EXAMINATION FOR A PERIOD OF THREE YEARS AFTER THE RETURNS ARE FILED. THE CENTER IS CLASSIFIED AS A PUBLIC CHARITY.</ExplanationTxt>
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        <FormAndLineReferenceDesc>FORM 990 - ORGANIZATION'S MISSION</FormAndLineReferenceDesc>
        <ExplanationTxt>PROVIDER OF HEALTH CARE SERVICES TO THE GENERAL POPULATION TARGETING UNINSURED, LOW-INCOME AND MEDICAL ASSISTANCE INDIVIDUALS. KEYSTONE HEALTH, FOUNDED IN 1986, IS A PUBLIC NOT-FOR-PROFIT ORGANIZATION THAT OFFERS HEALTH CARE AND, WHEN NEEDED, SOCIAL SERVICES TO UNDERSERVED AND VULNERABLE POPULATIONS AS WELL AS TO THE ENTIRE COMMUNITY OF FRANKLIN COUNTY, PENNSYLVANIA. KEYSTONE IS DESIGNATED BY THE FEDERAL GOVERNMENT AS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC). BECAUSE OF THIS DESIGNATION, KEYSTONE RECEIVES FEDERAL GRANTS AND A PROSPECTIVE PAYMENT RATE REIMBURSEMENT FROM MEDICAID AND MEDICARE FOR PROVIDING SERVICES TO ELIGIBLE PATIENTS AND TO UNDERSERVED POPULATIONS. KEYSTONE HEALTH IS IDENTIFIED AS AN ESSENTIAL COMMUNITY PROVIDER BY THE AFFORDABLE CARE ACT AS WELL AS THE AMERICAN HEALTH CARE ACT. AT PRESENT, KEYSTONE HEALTH OPERATES SEVENTEEN PRIMARY CARE PRACTICES IN FRANKLIN COUNTY. SERVICES PROVIDED IN CHAMBERSBURG AT THE 820 FIFTH AVENUE SITE INCLUDE: FAMILY PRACTICE, AUDIOLOGY AND SPEECH. CRISIS INTERVENTION IS PROVIDED AT THE CHAMBERSBURG HOSPITAL; DENTAL IS PROVIDED AT 767 FIFTH AVENUE AND ALSO IN MONT ALTO. SERVICES PROVIDED AT THE 830 FIFTH AVENUE COCHRAN PROFESSIONAL CENTER INCLUDE: URGENT CARE; PEDIATRICS CHAMBERSBURG, WOMEN'S CARE; INFECTIOUS DISEASES; INTERNAL MEDICINE HIV/STD AND KEYSTONE PHARMACY. KEYSTONE CONTRACTS WITH 17 OTHER PHARMACIES THROUGHOUT FRANKLIN COUNTY FOR A SPECIAL DISCOUNTED PROGRAM (340B) FOR OUR DISADVANTAGED PATIENTS. KEYSTONE ALSO OPERATES PEDIATRIC PRACTICES IN WAYNESBORO AND A SCHOOL BASED HEALTH CENTER AT CHAMBERSBURG AREA SENIOR HIGH SCHOOL. KEYSTONE PROVIDES STD AND FAMILY PLANNING OUTREACH SERVICES AT 51 SOUTH MAIN STREET AND 455 LINCOLN WAY EAST. KEYSTONE ALSO OPERATES AN OCCUPATIONAL THERAPY AND SPEECH THERAPY PRACTICE AT THE FORMER SCHOOL FOR VETERAN CHILDREN IN SCOTLAND. KEYSTONE HAS JUST CONSTRUCTED AND MADE OPERATIONAL IN MAY OF 2018 A STAND-ALONE BEHAVIORAL HEALTH AND DRUG AND ALCOHOL CENTER AT 110 CHAMBERS HILL DRIVE IN CHAMBERSBURG. KEYSTONE ALSO MANAGES THE STATE MIGRANT AND SEASONAL FARMWORKER PROGRAM WITH KEYSTONE- OPERATED SITES IN ERIE, MERCER, CRAWFORD, WARREN, SOMERSET, FULTON, NORTHUMBERLAND, SNYDER, UNION, COLUMBIA, CARBON, MONTOUR, LUZERNE, LANCASTER, BERKS, SCHUYLKILL, LEHIGH, CHESTER, CUMBERLAND, FRANKLIN AND ADAMS COUNTIES. THE STRENGTH OF THE KEYSTONE NETWORK IS THAT ALL SERVICES ARE PROVIDED IN A MISSION-DRIVEN ENVIRONMENT FOCUSING ON ACCESSIBLE, AFFORDABLE, CULTURALLY APPROPRIATE, HIGH-QUALITY AND COMPASSIONATE CARE OFFERED TO ANYONE AND EVERYONE REGARDLESS OF ABILITY TO PAY, ETHNIC BACKGROUND OR DISEASE. DURING 2018, KEYSTONE TREATED 52,883 INDIVIDUALS THROUGH 226,360 VISITS. THE KEYSTONE SYSTEM-WIDE PATIENT MIX WAS AS FOLLOWS: 43.7% MEDICAID PATIENTS, 41.8% PRIVATE INSURANCE PATIENTS, 9.4% MEDICARE PATIENTS, AND 5.1% UNINSURED PATIENTS. THE LOW-INCOME POPULATION AND THE MIGRANT FARMWORKER POPULATION OF FRANKLIN COUNTY ARE DECLARED HEALTH PROFESSIONAL SHORTAGE POPULATIONS (HPSP). IN ADDITION, THE BOROUGH OF CHAMBERSBURG IS DECLARED A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) AND FANNETT AND METAL TOWNSHIPS ARE DECLARED A MEDICALLY UNDERSERVED AREA (MUA). FRANKLIN COUNTY ALSO HAS A MEDICAL, DENTAL AND MENTAL HEALTH HPSA DESIGNATION. KEYSTONE DENTAL IS THE ONLY DENTAL PRACTICE IN FOUR COUNTIES THAT ROUTINELY PROVIDES DENTAL CARE TO LOW-INCOME, MEDICAL ASSISTANCE CLIENTS AND UNINSURED CLIENTS. KEYSTONE PROVIDES A SLIDING FEE WITH DISCOUNTED RATES FOR THOSE WHO QUALIFY FOR THE PROGRAM. IF IT WERE NOT FOR KEYSTONE DENTAL, THESE POPULATIONS WOULD HAVE LITERALLY NO ACCESS TO DENTAL CARE. ONE OF THE GREATEST HEALTH CARE ACCESS BARRIERS FOR FRANKLIN COUNTY RESIDENTS IS FINANCIAL. LOW-INCOME AND UNINSURED INDIVIDUALS REQUIRE A SOURCE OF REGULAR, CONTINUOUS PRIMARY AND PREVENTIVE CARE IN ORDER TO YIELD BETTER HEALTH OUTCOMES AND MINIMIZE HEALTH DISPARITIES. IN ORDER TO ASSURE THE RESIDENTS OF OUR COMMUNITY THAT ARE POOR OR FINANCIALLY DISADVANTAGED RECEIVE CARE, KEYSTONE HAS A SYSTEM IN PLACE TO DETERMINE ELIGIBILITY FOR PATIENT DISCOUNTS ADJUSTED ON THE BASIS OF THE PATIENT'S ABILITY TO PAY. THIS SYSTEM PROVIDES FOR FULL DISCOUNTS TO INDIVIDUALS AND FAMILIES WITH ANNUAL INCOMES AT OR BELOW 100% OF THE POVERTY GUIDELINES (ONLY A NOMINAL FEE IS CHARGED) AND FOR THOSE WITH INCOMES BETWEEN 101% AND 200% OF POVERTY GUIDELINES, FEES ARE CHARGED IN ACCORDANCE WITH A SLIDING FEE DISCOUNT POLICY BASED ON FAMILY SIZE AND INCOME. MANY CLIENTS DO NOT QUALIFY FOR THE SLIDING FEE BUT STILL DO NOT EARN ENOUGH MONEY TO BE ABLE TO PAY FOR THEIR CARE IN A TIMELY WAY. THESE PATIENTS ARE PLACED ON A PAYMENT PLAN, WHICH MANY KEYSTONE CLIENTS UTILIZE. ANOTHER BARRIER TO HEALTH CARE ACCESS IS LANGUAGE AND CULTURE. ONE IN 18 CLIENTS DOES NOT HAVE ENGLISH AS A PRIMARY LANGUAGE. ALL SERVICES PROVIDED BY KEYSTONE ARE CULTURALLY AND LINGUISTICALLY APPROPRIATE. THROUGH KEYSTONE PROVIDERS, TRANSLATORS AND ACCESS TO A LANGUAGE LINE, WE ARE FORTUNATE TO HAVE INDIVIDUALS WHO CAN PROVIDE SERVICES TO EVERY PATIENT THAT IS WITHIN THE KEYSTONE SYSTEM, INCLUDING THE DEAF. KEYSTONE OFFERS ACCESSIBLE HOURS OF SERVICE INCLUDING A WALK-IN PROGRAM FROM 8 AM TO 7 PM MONDAY THROUGH FRIDAY AT PEDIATRICS AND 7 AM TO 8 PM COVERAGE DAILY AT OUR URGENT CARE OFFICE. KEYSTONE OFFERS TIMELY SERVICES THROUGH OUR SAME-DAY ACUTE APPOINTMENT SYSTEM AT ALL SITES. KEYSTONE PARTICIPATES IN THE FEDERAL 340B DRUG DISCOUNT PROGRAM. THROUGH THIS PROGRAM, KEYSTONE CAN PURCHASE PHARMACEUTICALS AT REDUCED PRICES AND PASS THE SAVINGS ON TO ITS PATIENTS. THIS GIVES KEYSTONE'S UNINSURED PATIENTS ACCESS TO SIGNIFICANT DISCOUNTS ON THEIR PRESCRIPTION MEDICATIONS. WHILE THIS PROGRAM IS OPEN TO ANY KEYSTONE PATIENT, THOSE WHO BENEFIT THE MOST ARE THE UNINSURED WHO CAN APPLY THEIR SLIDING FEE DISCOUNT TO THE ALREADY REDUCED 340B PROGRAM DISCOUNTS. 2018 YEAR HIGHLIGHTS 2018 MARKED KEYSTONE'S 32ST YEAR OF SERVICE TO OUR COMMUNITY AND WAS ANOTHER YEAR OF OPPORTUNITY FOR PROGRESS, WHICH KEYSTONE MET HEAD-ON. A FEW EXAMPLES WERE: - KEYSTONE BEGAN CONSTRUCTION OF A 68,000 SQ. FT. BUILDING AT CHAMBERS HILL THAT WILL HOUSE THE RELOCATION OF URGENT CARE, INFECTIOUS DISEASE, HIV/AIDS/STD CLINICS AS WELL AS OUTREACH CLINICS, KEYSTONE PEDIATRIC THERAPIES, PEDIATRIC DENTAL, CENTRALIZED MEDICAL RECORDS AND ADMINISTRATION AND EXECUTIVE OFFICES. - KEYSTONE HELD A CERVICAL CANCER AWARENESS CAMPAIGN AND OFFERED FREE PAP TESTS TO UNINSURED WOMEN AT OUR COMMUNITY OUTREACH OFFICE. FORTY-FIVE WOMEN WERE SCREENED, AND FOUR WERE FOUND TO HAVE ABNORMAL RESULTS - A POTENTIALLY LIFE-SAVING FINDING. - KEYSTONE CREATED AN IT BOARD COMMITTEE TO ASSIST MANAGEMENT WITH THE DECISIONS RELATED TO OUR CHOICE FOR ELECTRONIC MEDICAL RECORDS AND IT SYSTEMS FOR THE COMPANY. - KEYSTONE COLLABORATED WITH FRANKLIN COUNTY HEAD START BY PERMITTING A HEAD START WORKER TO BE PLACED WITHIN OUR KEYSTONE WOMEN'S CARE OFFICE IN ORDER TO REGISTER PREGNANT MOTHERS INTO THE HEAD START PROGRAM FOR THE MANY ADVANTAGES OF EARLY CHILDHOOD INTERVENTION THROUGH HEAD START PROGRAMMING. - KEYSTONE EMPLOYEES UNDERWENT DIVERSITY TRAINING OFFERED BY SUMMIT HEALTH AND A LOCAL EDUCATOR TRAINED IN DIVERSITY AND INCLUSION EDUCATION. - A CAMPAIGN WAS HELD FOR COLORECTAL CANCER SCREENING THROUGHOUT THE ORGANIZATION, AND PROVIDED FREE TAKE-HOME TESTS TO MANY UNINSURED PATIENTS. ALSO THAT MONTH, SOUTH CENTRAL COMMUNITY ACTION PROGRAM (SCCAP) BEGAN MEETING WITH KEYSTONE PROVIDERS TO HELP THEM BETTER UNDERSTAND THE FINANCIAL AND ECONOMIC BARRIERS (SOCIAL DETERMINANTS OF HEALTH) MANY OF OUR PATIENTS FACE. - KEYSTONE DEVELOPED A PATIENT ORIGIN ANALYSIS ON ITS PATIENT POPULATION. WE ALSO BEGAN TO USE RISK STRATIFICATION FOR OUR PATIENT POPULATION. KEYSTONE UNDERWENT A NATIONAL HEALTH SERVICE CORPS REVIEW BY HRSA. KEYSTONE PERFORMED EXCEPTIONALLY WELL AND OUR OUTCOME WAS EXTREMELY POSITIVE. - ON MAY 7, KEYSTONE RELOCATED ITS BEHAVIORAL HEALTH PROGRAM INTO OUR NEWLY BUILT FACILITY AT 110 CHAMBERS HILL DRIVE. WE CELEBRATED OUR RIBBON CUTTING CEREMONY ON MAY 10, WITH MANY COMMUNITY AND STATE REPRESENTATIVES PRESENT. - FROM JUNE 5-7 KEYSTONE UNDERWENT ITS OPERATIONAL SITE REVIEW WITH HRSA. KEYSTONE WAS FOUND TO HAVE NO DEFICIENCIES, WHICH WAS AN OUTSTANDING OUTCOME. - KEYSTONE'S COMMUNITY RESPONDER PROGRAM OBTAINED NATIONAL RECOGNITION FOR ITS WORK WITH POLICE DEPARTMENTS IN DIVERTING INDIVIDUALS FROM JAIL TO TREATMENT CENTERS. - KEYSTONE BEGAN TO COLLECT SOCIAL DETERMINANTS OF HEATH DATA ON ITS PATIENTS AND ALSO BEGAN DISCUSSING UTILIZING THE PRAPARE TOOL, RECOMMENDED BY HRSA. - KEYSTONE BEGAN TO USE TMS, TRANSCRANIAL MAGNETIC STIMULATION, IN OUR BEHAVIORAL HEALTH OFFICE FOR PATIENTS SUFFERING FROM MAJOR DEPRESSIVE DISORDER. - THE PA DHS APPROVED LICENSED PROFESSIONAL COUNSELORS (LPCS) AND LICENSED MARRIAGE AND FAMILY THERAPISTS (LMFTS) AS ELIGIBLE BEHAVIORAL HEALTH PROVIDERS FOR FQHCS. THIS CHANGE WILL ASSIST KEYSTONE GREATLY IN HIRING NEW BEHAVIORAL HEALTH PROVIDERS. - KEYSTONE SIGNED WITH THE KEYSTONE HEALTH INFORMATION EX</ExplanationTxt>
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        <FormAndLineReferenceDesc>FORM 990, PAGE 2, PART III, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION CEASED PROVIDING CARDIOLOGY SERVICES EFFECTIVE JANUARY 1, 2018.</ExplanationTxt>
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        <FormAndLineReferenceDesc>FORM 990, PAGE 2, PART III, LINE 4D</FormAndLineReferenceDesc>
        <ExplanationTxt>PROVIDER OF BEHAVIORAL HEALTH, INTERNAL MEDICINE, PHARMACY SERVICES, HIV SERVICES, URGENT CARE, FAMILY MEDICINE, AUDIOLOGY AND SPEECH, INFECTIOUS DISEASE, PEDIATRIC THERAPIES, CRISIS, COMMUNITY OUTREACH, AGRICULTURE WORKER PROGRAM AND SCHOOL BASED CLINIC TO THE GENERAL POPULATION TARGETING LOW INCOME MEDICARE AND MEDICAL ASSISTANCE INDIVIDUALS. IN ADDITION, WE ARE A PROVIDER OF HEALTH CARE SERVICES TO THE MIGRANT WORKER POPULATION OF THE COMMONWEALTH OF PENNSYLVANIA.</ExplanationTxt>
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        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION PROVIDED A COPY OF THE FEDERAL FORM 990 TO THE BOARD OF DIRECTORS PRIOR TO THE FILING OF THE FORM 990.</ExplanationTxt>
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        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>CONFLICT OF INTEREST POLICY IS REVIEWED AT ANNUAL EMPLOYEE EVALUATIONS AND ANNUALLY WITH THE BOARD OF DIRECTORS' SELF-EVALUATIONS.</ExplanationTxt>
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        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS MEETS IN A CLOSED SESSION TO DISCUSS THE COMPENSATION AND PERFORMANCE OF THE CEO.</ExplanationTxt>
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        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COMPENSATION OF ALL OFFICERS AND KEY EMPLOYEES IS REVIEWED WITH THE CEO AS PART OF THE ANNUAL EVALUATION PROCESS. GUIDELINES CONCERNING SALARY ADJUSTMENTS ARE REVIEWED ANNUALLY AS PART OF THE BUDGETING PROCESS. THE BUDGET SUBMISSION IS SUBSEQUENTLY REVIEWED BY THE FINANCE COMMITTEE AND APPROVED BY THE ORGANIZATION'S BOARD OF DIRECTORS.</ExplanationTxt>
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        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE GOVERNING DOCUMENTS ARE MADE AVAILABLE TO REVIEW UPON REQUEST.</ExplanationTxt>
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        <ExemptCodeSectionTxt>501C</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>KEYSTONE R</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>false</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>false</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>false</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>