Structural Deficit
Structural Deficit
Structural Deficit Market Archetype Mechanical Natural
Tier
Priority Review
Trajectory Thumbprint

Structural Deficit

What does this mean?

Persistently low financial health over 5 years despite strong programmatic output. They are borrowing from their future (or bleeding an endowment) to pay for today's programs.

The Path Forward

The Truth-Teller

Forces necessary, painful cuts to preserve the core. It demands that the organization stop borrowing from its future and align its current programmatic output with actual sustainable revenue.

The Truth-Teller
The Truth-Teller
Institutional Health Scores
5-yr trend: Structural Deficit ↓
Overall
35
Score
Governance
50
Score
Financial
0
Score
Program
60
Score

Institutional Epochs

2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
Financial Era
Governance Era
Trajectory Era
Structural Deficit

Historical Performance

Year Revenue Top Comp Comp % Rev Score Phase Label Outlook Details
2024 Hidden Hidden — — Unknown —
2023 Hidden Hidden — 35 Financially Distressed Recovery
2022 — — — 32 Critical Intervention Needed Decline Risk
2021 — — — 41 Financially Distressed Recovery
2020 — — — 32 Critical Intervention Needed Stable Watch
2019 — — — 35 Financially Distressed Recovery
2018 — — — 32 Critical Intervention Needed Stable Watch
2017 — — — 32 Critical Intervention Needed Stable Watch
2016 — — — 32 Critical Intervention Needed Stable Watch
2015 — — — 32 Critical Intervention Needed Stable Watch
2014 — — — 32 Critical Intervention Needed Stable Watch
2013 — — — 32 Critical Intervention Needed Stable Watch
2012 — — — 32 Critical Intervention Needed Stable Watch
2011 — — — 32 Critical Intervention Needed Stable Watch

Officer compensation history

Tax year 2025

Name Title Phone Email Compensation
PATRICK J CASTAGNA Board Member —
LOIS BROMMER DUQUETTE Secretary —
JAMES G CASSELL III Board Member —
MARK A BONSALL FSA Board Member —
DAVID BRONSTEIN DO Board Member —
CALVIN FLURY Board Member —
ROBERT FUNK VICE PRESIDE —
CHRISTOPHER GEBHARD Board Member —
DOUGLASS C HENRY JR Board Member —
WENDIE DIMATTEO HOLSINGER Board Member —
FRANK TOMECEK JR Board Member —
MARCIA OSTFELD-SHIVODER Board President —
BRIAN FALCK Board Member —
HAROLD RHOADS Board Member —
BARBARA KAUFFMAN Board Member —
JODY FORNEY-COLE Board Member —

Tax year 2023

Name Title Phone Email Compensation
PATRICK J CASTAGNA Board President —
LOIS BROMMER DUQUETTE VICE PRESIDE —
JAMES G CASSELL III Treasurer —
MARK A BONSALL FSA Board Member —
DAVID BRONSTEIN DO Board Member —
JERRY FLURY Board Member —
BOB FUNK Board Member —
CHRISTOPHER GEBHARD Board Member —
DOUGLASS C HENRY JR Board Member —
WENDIE DIMATTEO HOLSINGER Board Member —
MARCIA OSTFELD SHIVODER Board Member —
FRANK TOMECEK JR Board Member —

Tax year 2022

Name Title Phone Email Compensation
PATRICK J CASTAGNA Board President —
LOIS BROMMER DUQUETTE VICE PRESIDE —
JAMES G CASSELL III Treasurer —
STEVE GIBBLE Secretary —
MARK A BONSALL FSA Board Member —
DAVID BRONSTEIN DO Board Member —
JERRY FLURY Board Member —
J THOMAS DUNLEVY Board Member —
BOB FUNK Board Member —
CHRISTOPHER GEBHARD Board Member —
DOUGLASS C HENRY JR Board Member —
WENDIE DIMATTEO HOLSINGER Board Member —
MARCIA OSTFELD SHIVODER Board Member —
FRANK TOMECEK JR Board Member —

Tax year 2021

Name Title Phone Email Compensation
PATRICK J CASTAGNA Board President —
DAVID BRONSTEIN DO Board Member —
J THOMAS DUNLEVY Board Member —
LOIS BROMMER DUQUETTE VICE PRESIDE —
MARK A BONSALL FSA Board Member —
JERRY FLURY Board Member —
BOB FUNK Board Member —
CHRIS GEBHARD Board Member —
STEVE GIBBLE Secretary —
DOUGLASS C HENRY Board Member —
HEATHER HOHENWARTER Board Member —
WENDIE DIMATTEO HOLSINGER Board Member —
JAMES G CASSELL III Treasurer —
LYNN PHILLIPS Board Member —
MARCIA OSTFELD SHIVODER Board Member —
Officer contact details, exact compensation figures, and active litigation are available to verified members.
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Score breakdown

Score breakdown

Financial resilience
0 / 100
weight 40%
Governance risk
50 / 100
weight 40%
Program scale
60 / 100
weight 20%
Overall
35 / 100
Priority Review

The three components combine into a single 0–100 score weighted as shown. Full methodology →

Peer comparison

Compared to 462 other orgs in PA with NTEE prefix A6.

Most-divergent component: financial score sits 53 points below the peer median (0 vs. 53).

5-year trend: Structural Deficit

Persistently low financial health over 5 years despite strong programmatic output. They are borrowing from their future (or bleeding an endowment) to pay for today's programs.

What's driving this score

What would change this score

The two changes that would most improve this score:

  1. Build cash reserves to at least 3 months of operating expenses — moves financial resilience score meaningfully (~10 points).

Improving governance is a board decision. These are the levers.