2022-08-08T12:43:15-05:00 2021-12-31 520783935 SMITH ELLIOTT KEARNS & COMPANY LLC 19 BROOKWOOD AVE STE 101 CARLISLE PA 17015 990 2021-01-01 251546810 KEYSTONE RURAL HEALTH CENTER KEYS 7177097906 111 CHAMBERS HILL DRIVE SUITE 200 CHAMBERSBURG PA 17201 JOANNE COCHRAN PRESIDENT/CEO 7177097906 2022-07-27 true JOANNE COCHRAN 999009999 GREGORY P HALL CPA P00156653 7172439104 2022-07-27 2021 2022-09-23 18:48:47Z JOANNE COCHRAN 111 CHAMBERS HILL DRIVE SUITE 200 CHAMBERSBURG PA 17201 91742638 false X WWW.KEYSTONEHEALTH.ORG X 1987 PA PROVIDER OF HEALTH CARE SERVICES TO THE GENERAL POPULATION TARGETING UNINSURED, LOW-INCOME AND MEDICAL ASSISTANCE INDIVIDUALS. 12 12 652 36 0 13831145 22560741 52109691 66367402 866877 838866 91823 98759 66899536 89865768 0 0 43437135 44310850 0 20332 17047219 16550280 60484354 60861130 6415182 29004638 74257896 105417846 4965689 5215875 69292207 100201971 X PROVIDER OF HEALTH CARE SERVICES TO THE GENERAL POPULATION TARGETING UNINSURED, LOW-INCOME AND MEDICAL ASSISTANCE INDIVIDUALS. false false 8093015 9264785 PROVIDER OF PEDIATRIC SERVICES TO THE GENERAL POPULATION TARGETING LOW INCOME MEDICARE AND MEDICAL ASSISTANCE INDIVIDUALS. SEE SCHEDULE O. 6450686 5404877 PROVIDER OF DENTAL SERVICES TO THE GENERAL POPULATION TARGETING LOW INCOME INDIVIDUALS. SEE SCHEDULE O. 5849476 7712988 PROVIDER OF BEHAVIORAL HEALTH SERVICES TO THE GENERAL POPULATION TARGETING LOW INCOME INDIVIDUALS. SEE SCHEDULE O. 32008116 43984752 PROVIDER OF WOMEN'S HEALTH, INTERNAL MEDICINE, PHARMACY SERVICES, HIV SERVICES, URGENT CARE, FAMILY MEDICINE, AUDIOLOGY AND SPEECH, INFECTIOUS DISEASE, PEDIATRIC THERAPIES, CHIROPRACTIC, FOOT AND ANKLE, 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. 32008116 43984752 52401293 true true false false false false false false false false true false false false true true true false false false false false false false false false false false false true false false false false false false false false false false false false false true true false false false true 42 0 true 652 true false false false false false false false false false false false false X 12 12 false false false false false false false true true false false true true true true true true true true false PA X X JOHN J MCELWEE JR CFO 7177097912 111 CHAMBERS HILL DRIVE SUITE 200 CHAMBERSBURG PA 17201 JOANNE COCHRAN PRESIDENT/CE 50.00 X 487391 0 21846 RAGHAVENDRA TIRUPATHI GOVINDARAJU PHYSICIAN 50.00 X 429912 0 40621 THOMAS P ORNDORF PHYSICIAN 50.00 X 377539 0 38649 JOHN J MCELWEE JR VP/CFO 50.00 X 368153 0 21878 MICHAEL J COLLI PHYSICIAN 50.00 X 323832 0 39335 YVETTE BROWN PHYSICIAN 50.00 X 326060 0 30252 EKEZIE MC FRANCIS PHYSICIAN 50.00 X 290943 0 35673 DAVID K GRANT COO 50.00 X 269477 0 32211 THEODORE J GUARRIELLO DIRECTOR OF 50.00 X 166815 0 22867 SILA ALEGRET-BARTEL BOARD MEMBER 1.00 X 0 0 0 SCOTT BROWN BOARD MEMBER 1.00 X 0 0 0 JOSE DIEUDONNE VICE CHAIR 1.00 X X 0 0 0 MATTHEW FOGAL BOARD MEMBER 1.00 X 0 0 0 CARRIE GRAY CHAIR 1.00 X X 0 0 0 REV KIBREAB GUDETA BOARD MEMBER 1.00 X 0 0 0 VIRGINIA HARRIGER BOARD MEMBER 1.00 X 0 0 0 TIMOTHY G HENRY BOARD MEMBER 1.00 X 0 0 0 KAREN JOHNSTON SECRETARY 1.00 X X 0 0 0 MICHAEL E KUGLER BOARD MEMBER 1.00 X 0 0 0 WILLIAM MORGAN BOARD MEMBER 1.00 X 0 0 0 JEFF TRUHAN TREASURER 1.00 X X 0 0 0 3040122 283332 75 false true false 21027832 1532909 22560741 PATIENT SERVICE FEES 621110 51720356 51720356 OTHER SERVICE REVENUE 621110 13126411 13126411 PREMIUM REVENUE 621110 1113770 1113770 MANAGEMENT FEE REVENUE 621110 406865 406865 66367402 620293 620293 2094943 500 1876870 218073 500 218573 218573 MISCELLANEOUS INCOME 621110 98759 98759 98759 89865768 66466161 838866 1390638 1390638 33850713 30332828 3504171 13714 1085423 961763 123115 545 5530620 4625512 904001 1107 2453456 2145221 307147 1088 57396 57396 45905 45905 48634 48634 1352626 1150634 201992 118147 82411 33518 2218 327785 221643 105448 694 582668 49331 533337 806621 675610 130921 90 57072 49585 7487 22396 10381 12015 1768796 1358270 409944 582 150221 23175 127046 SUPPLIES 7963645 7954452 9193 COVID-19 EXPENSES 1088914 1088352 562 340B ADMIN FEES 739046 739046 REPAIRS AND MAINTENANCE 355858 129927 225931 1064550 803152 261104 294 60861130 52401293 8439505 20332 7800 7600 11789960 35928411 597060 1608655 4668014 3938725 579126 590084 575197 674310 43604760 12175496 32477224 31429264 23176918 30878585 386597 362212 74257896 105417846 2937624 3182670 5140 2028065 2028065 4965689 5215875 X 69292207 100201971 69292207 100201971 74257896 105417846 X 29004638 1905126 X false true X true true true X 7189120 7082771 7799705 13831145 22560741 58463482 40927269 46870361 53584573 52109691 66367402 259859296 48116389 53953132 61384278 65940836 88928143 318322778 318322778 397643 456138 524155 401607 571659 2351202 397643 456138 524155 401607 571659 2351202 53705 45967 64458 91823 98757 354710 48567737 54455237 61972891 66434266 89598559 321028690 0.99160 0.99150 0.01000 0.01000 X PART III, LINE 12 MISCELLANEOUS INCOME 354,710 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4034671 4034671 30498929 6639681 23859248 9071160 5535815 3535345 31429264 ESTIMATED PAYABLE UNDER THIRD PARTY 2028065 2028065 X 89817134 89817134 48634 48634 89865768 60812496 60812496 48634 48634 60861130 SCHEDULE D, PAGE 3, PART X THE CENTER IS A NOT FOR PROFIT CORPORATION ORGANIZED UNDER THE PROVISIONS OF THE NON PROFIT 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. SCHEDULE D, PAGE 4, PART XI, LINE 4B INVESTMENT MANAGEMENT FEES 48,634 SCHEDULE D, PAGE 4, PART XII, LINE 4B INVESTMENT MANAGEMENT FEES 48,634 X X X false false false false false false false false false JOANNE COCHRAN PRESIDENT/CEO 487391 11600 10246 509237 RAGHAVENDRA TIRUPATHI GOVINDARAJU PHYSICIAN 410412 19500 11600 29021 470533 THOMAS P ORNDORF PHYSICIAN 358761 18778 11600 27049 416188 JOHN J MCELWEE JR VP/CFO 349153 19000 11600 10278 390031 MICHAEL J COLLI PHYSICIAN 323832 9818 29517 363167 YVETTE BROWN PHYSICIAN 322082 3978 10468 19784 356312 EKEZIE MC FRANCIS PHYSICIAN 271443 19500 9889 25784 326616 DAVID K GRANT COO 269477 8765 23446 301688 THEODORE J GUARRIELLO DIRECTOR OF IT 166815 6529 16338 189682 FORM 990, PART III 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. 2021 KEYSTONE RURAL HEALTH CENTER UNFORTUNATELY, 2021 WAS A CONTINUATION OF 2020 REGARDING COVID-19. ANOTHER VERY ATYPICAL YEAR FOR HEALTH CARE ORGANIZATIONS THROUGHOUT OUR COUNTRY. THERE WERE PEAKS AND VALLEYS IN THE NUMBER OF COMMUNITY MEMBERS GETTING TESTED AND IN POSITIVITY RATES. HOWEVER, THERE WAS ONE SIGNIFICANT CHANGE- WE NOW HAD A VACCINE TO COMBAT THIS PANDEMIC. IN FACT, WE HAD 3 OPTIONS FOR VACCINATION. DUE TO THE HOLIDAYS (CHRISTMAS AND NEW YEAR'S), JANUARY BROUGHT A PEAK IN CASES AND IN DAILY DEATHS. 21% OF PATIENTS IN CHAMBERSBURG HOSPITAL AND 25% OF PATIENTS IN WAYNESBORO WERE DIAGNOSED WITH COVID-19. DURING THE LAST QUARTER OF 2021, FRANKLIN COUNTY HAD THE HIGHEST CASES PER CAPITA IN THE REGION. KEYSTONE WAS TESTING 150-200 PATIENTS DAILY WITH A POSITIVITY RATE OF 25%. KEYSTONE TOOK ON THE RESPONSIBILITY TO VACCINATE ALL HEALTH CARE WORKERS IN THE COMMUNITY, NOT JUST ITS OWN EMPLOYEES. DURING THE PEAK OF COVID, KEYSTONE DENTAL HAD BEEN CLOSED FOR MONTHS AND PEDIATRICS AND KEYSTONE PEDIATRIC DEVELOPMENTAL CENTER (AUDIOLOGY, SPEECH, AND OCCUPATIONAL THERAPY) WERE IMPACTED FROM CHILDREN NOT COMING FOR CARE DUE TO THE PANDEMIC. PRIMARY CARE SITES WERE ALSO IMPACTED, BUT NOT TO THE SAME DEGREE. BEHAVIORAL HEALTH HAD BEEN UTILIZING TELEMEDICINE AND TELEPHONE FOR THEIR DELIVERY CARE MODEL, SO THEY WERE NOT IMPACTED TO THE SAME DEGREE AS PRIMARY CARE SITES LIKE FAMILY AND INTERNAL MEDICINE. FEBRUARY BROUGHT SOME GOOD NEWS. THE 7-DAY TREND FOR COVID WAS DOWN IN THE COUNTY, AND DAILY DEATHS LEVELED OFF. THE POSITIVITY RATE FOR THE COUNTY LOWERED TO 16.2 %. KEYSTONE AND THE COUNTY BEGAN TO SHIFT FROM TESTING TO VACCINATING. TIER 1A VACCINATION BEGAN FOR INDIVIDUALS 65 AND OLDER AND THOSE WITH A BMI >30. KEYSTONE MADE PLANS TO VACCINATE RESIDENTS IN HOUSING DEVELOPMENTS,ESPECIALLY LOW-INCOME AREAS. THE BOROUGH WAS DEVELOPING ITS 10-YEAR PLAN. ONE OF THEIR REDEVELOPMENT PLANS INCLUDED THE SOUTHGATE MALL. SEVERAL REPRESENTATIVES FROM THE BOROUGH MET WITH MEMBERS OF KEYSTONE'S MANAGEMENT AND BOARD TEAMS TO INQUIRE ABOUT KEYSTONE'S PARTICIPATION IN THIS PLAN. THERE WAS NO COMMITMENT FROM KEYSTONE; HOWEVER, WE DID SHARE OUR INTEREST IN HAVING A KEYSTONE PRESENCE IF THE REDEVELOPMENT PLAN EVER CAME TO FRUITION. MARCH SAW FALLING NUMBERS IN COVID CASES, BOTH NATIONALLY AND LOCALLY. THE POSITIVITY RATE FOR FRANKLIN COUNTY WAS 6.9%. WE BEGAN TO OPEN VACCINATIONS TO THE COMMUNITY. THE KEYSTONE CEO EXPRESSED INTEREST IN COMMISSIONING A COMMITTEE TO ADDRESS INCLUSION AND DIVERSITY. THE BOARD SUPPORTED THE FORMATION OF THE COMMITTEE. KEYSTONE RELOCATED ITS AGRICULTURAL WORKER PROGRAM OFFICE FROM GETTYSBURG TO AN IMPROVED FACILITY IN GARDNERS. THE PROGRAM HAD MANY POSITIVE CHANGES OVER THE LAST TWO YEARS. APRIL BROUGHT AN UPSWING IN NEW COVID CASES. NUMBERS ROSE FROM 4% TO 11% OF PATIENTS WITH COVID IN THE CHAMBERSBURG HOSPITAL. TESTING AT KEYSTONE ALSO ROSE. KEYSTONE REOPENED ITS DOWNTOWN TESTING SITE WHICH HAD BEEN IN OPERATION DURING THE HEIGHT OF COVID. THE BURDEN OF DISEASE BEGAN SHIFTING TO A YOUNGER POPULATION, AND CHILDREN WERE PLAYING A LARGER ROLE IN THE SPREAD. THOSE 50 AND OLDER WERE SEEING MUCH LESS POSITIVITY IN TESTING. THIS WAS 25% OF ALL THOSE VACCINATED IN THE COUNTY. WE CENTRALIZED ALL VACCINATION EFFORTS TO THE 111 CHAMBERS HILL DRIVE SITE TO INCREASE OUR EFFICIENCY. THE KEYSTONE NAVIGATORS PROGRAM EXPANDED ITS SCOPE, AND OUR NAVIGATORS WERE NOW ABLE TO APPROVE DUAL ELIGIBLE MEDICAID/MEDICARE INDIVIDUALS FOR THIS BENEFIT. KEYSTONE PHARMACY BEGAN TO DELIVER MEDICATIONS TO OUR PATIENTS. THE BOARD APPROVED KEYSTONE TO PARTICIPATE IN WELLSPAN'S ACCESS AND TRAINING GRANT USING DENTAL RESIDENTS FROM YORK HOSPITAL. THE BOARD ALSO APPROVED KEYSTONE PARTICIPATING IN A PARTNERSHIP WITH LECOC (LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE) BY ACCEPTING CLERKSHIPS, INTERNS, AND RESIDENTS FROM LECOM FOR PEDIATRICS, OBSTETRICS, AND PHARMACY. KEYSTONE APPLIED FOR AND RECEIVED A PENNSYLVANIA ASSOCIATION OF COMMUNITY HEALTH CENTERS COVID TESTING GRANT FOR 1,135,904.25 USING THE PERIOD AUGUST 2020 TO AUGUST 2022. THE CEO CHALLENGED KEYSTONE'S HPSA/HPSP SCORES, AND AS A RESULT, OUR DENTAL SCORE WAS CHANGED FROM 15 TO 19, AND OUR PRIMARY CARE SCORE 10 TO 16. THIS WAS DONE IN ORDER FOR KEYSTONE TO HIRE NATIONAL HEALTH SERVICE CORPS SCHOLARS. THE BOARD APPROVED KEYSTONE TO APPLY FOR THE HRSA AMERICAN RESCUE ACT FOR 9,702,750. KEYSTONE RECEIVED THIS GRANT. OUR PATIENT VISITS WERE FINALLY INCREASING IN FAMILY MEDICINE, INTERNAL MEDICINE, PEDIATRICS, AND WOMEN'S CARE. MAY BROUGHT GOOD NEWS WITH THE US SEEING NEW CASES AGAIN GOING DOWNWARD. HOSPITAL RATES AND DEATHS BEGAN DECREASING. HOWEVER, WE BEGAN TO EXPERIENCE VACCINATION HESITANCY, AND OUR TREND LINE FOR DAILY VACCINATIONS WAS DOWN NATIONALLY AND LOCALLY. FRANKLIN COUNTY HAD MUCH LOWER RATES THAN THE STATE AND THE COUNTRY, WITH ONLY 35% OF RESIDENTS RECEIVING AT LEAST ONE DOSE. KEYSTONE PERFORMED 17,500 VACCINATIONS TO DATE. THOSE INDIVIDUALS TESTING POSITIVE FOR COVID WERE MOSTLY UNVACCINATED INDIVIDUALS. THE 21 CENTURY CURES ACT WENT INTO EFFECT THIS MONTH. THIS ACT PROHIBITS PATIENTS FROM BEING DENIED ACCESS TO HIS/HER MEDICAL RECORDS. THERE ARE LARGE FINES FOR NON-COMPLIANCE. THROUGH ELECTRONIC HEALTH RECORDS SYSTEM EPIC, KEYSTONE AND WELLSPAN WOULD COMPLY. KEYSTONE BEHAVIORAL HEALTH WAS APPROVED TO BE INCLUDED IN THE NATIONAL SUICIDE HOTLINE 988. KEYSTONE'S SCHOOL BASED HEALTH CENTER AT CHAMBERSBURG AREA SENIOR HIGH SCHOOL (CASHS) HAD BEEN SHUTTERED FOR THE SPRING SESSION; HOWEVER, KEYSTONE PLANNED TO OPEN IT IN THE FALL. JUNE ARRIVED, WHICH BROUGHT SAM KING'S LAST OFFICIAL KEYSTONE BOARD MEETING AFTER NEARLY 30 YEARS OF SERVICE, MOST OF THOSE YEARS SPENT AS THE CHAIR OF OUR BOARD. EPIC CONTINUED TO GO WELL AND COVID CASES DECREASED AT THIS TIME. OUR COUNTY'S 7-DAY ROLLING CASE COUNT WAS DOWN, AND KEYSTONE'S RATE CONTINUED TO FALL AS WELL. VACCINATION DEMAND CONTINUED TO DECLINE. THE BURDEN OF DISEASE CONTINUED TO SHIFT TO YOUNGER PEOPLE, MOSTLY UNDER 20 YEARS OF AGE. THE CEO ANNOUNCED THE PRIORITY AREAS FOR 2022 WHICH INCLUDED: RETHINKING PRIMARY CARE IN A POST-COVID WORLD; ENSURING HIGH-QUALITY CARE IS AVAILABLE; PAYING FOR HIGH QUALITY TEAMS TO CARE FOR PEOPLE; AND TRAINING PRIMARY CARE TEAMS WHERE PEOPLE LIVE AND WORK. IN ESSENCE, A REDESIGN OF KEYSTONE'S CARE. BECAUSE OF THE EVER-INCREASING DEMAND FOR BEHAVIORAL HEALTH CARE, THE CEO PLANNED TO EXPLORE THE POSSIBILITY OF DEVELOPING A CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC THAT WOULD OPERATE AS A WALK-IN STABILIZATION BEHAVIORAL HEALTH CENTER OFFERING A CRISIS INTERVENTION PROGRAM. KEYSTONE PREPARED TO LOSE BOTH OF ITS PEDIATRIC DENTISTS FOR VARIOUS REASONS IN AUGUST AND SEPTEMBER. THERE WAS A SIGNIFICANT NEED IN OUR COMMUNITY FOR PEDIATRIC DENTISTS, SO WE WERE ALREADY RECRUITING FOR REPLACEMENTS. WITH THE BOARD'S APPROVAL, KEYSTONE APPLIED FOR AND WAS THE RECIPIENT OF A 1.2 MILLION GRANT TO BE UTILIZED FOR THE CONSTRUCTION OF A NEW TWO-STORY,35,000 SQ. FT. FACILITY ON 2.61 ACRES OF LAND WITH 175 PARKING SPACES AT 100 CHAMBERS HILL DRIVE. THE COST WOULD BE BETWEEN 9 AND 10 MILLION.THERE WAS A LENGTHY DISCUSSION REGARDING KEYSTONE'S MINIMUM WAGE. MOST BUSINESSES HAD INCREASED THEIR MINIMUM WAGE TO 15 PER HOUR. KEYSTONE'S MINIMUM WAGE WAS 11.71. OUR CFO BEGAN WORKING OUT A PROCESS/PLAN TO RAISE OUR MINIMUM WAGE TO 15. IN JULY, THROUGH AN EMAIL SENT AND APPROVED BY OUR BOARD, KEYSTONE'S MINIMUM WAGE WAS APPROVED TO BE RAISED TO 15 PER HOUR. THIS AFFECTED 167 STAFF MEMBERS FOR A TOTAL COST OF 419,000. KEYSTONE RECEIVED ITS DEEMING LETTER FOR 2022. KEYSTONE SIGNED THE MEDICARE ACO AGREEMENT WITH WELLSPAN FOR A NO-RISK POSITION FOR KEYSTONE. AUGUST BROUGHT A RESURGENCE OF COVID- 19 RELATED TO THE DELTA VARIANT. TESTING AND POSITIVITY RATES INCREASED. IN ADDITION TO COVID, RESPIRATORY SYNCYTIAL VIRUS (RSV) ALSO INFECTED RESIDENTS. OUR 340B PROGRAM UNDERWENT A HRSA AUDIT AND SUCCESSFULLY MET ALL THE STANDARDS. KEYSTONE WAS DEVELOPING A PATIENT ACCESS CENTER WITH A PLAN TO ULTIMATELY SERVE AS A CENTRAL POINT OF ACCESS TO FACILITATE THE PLACEMENT OF NEW PATIENTS, SCHEDULE APPOINTMENTS, AND PROVIDE MEDICAL RECORDS TO OUR PATIENTS. A MANAGER WAS H FORM 990, PAGE 2, PART III, LINE 4D PROVIDER OF WOMEN'S HEALTH, INTERNAL MEDICINE, PHARMACY SERVICES, HIV SERVICES, URGENT CARE, FAMILY MEDICINE, AUDIOLOGY AND SPEECH, INFECTIOUS DISEASE, PEDIATRIC THERAPIES, CHIROPRACTIC, FOOT AND ANKLE, 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. FORM 990, PAGE 6, PART VI, LINE 11B THE ORGANIZATION PROVIDED A COPY OF THE FEDERAL FORM 990 TO THE BOARD OF DIRECTORS PRIOR TO THE FILING OF THE FORM 990. FORM 990, PAGE 6, PART VI, LINE 12C CONFLICT OF INTEREST POLICY IS REVIEWED AT ANNUAL EMPLOYEE EVALUATIONS AND ANNUALLY WITH THE BOARD OF DIRECTORS' SELF-EVALUATIONS. FORM 990, PAGE 6, PART VI, LINE 15A THE BOARD OF DIRECTORS MEETS IN A CLOSED SESSION TO DISCUSS THE COMPENSATION AND PERFORMANCE OF THE CEO. FORM 990, PAGE 6, PART VI, LINE 15B 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. FORM 990, PAGE 6, PART VI, LINE 19 THE GOVERNING DOCUMENTS ARE MADE AVAILABLE TO REVIEW UPON REQUEST. FORM 990, PART XI, LINE 9 INVESTMENT MANAGEMENT FEES -48,634 INVESTMENT MANAGEMENT FEES 48,634 KEYSTONE PHYSICIAN SERVICES 111 CHAMBERS HILL DRIVE SUITE 200 CHAMBERSBURG PA 17201 200283725 CARDIOLOGY PA 501C 7 KEYSTONE R true false false false false false false false false false false false false false false false false false false false