2022-05-16T12:47:10-05:00 2021-06-30 390859910 BAKER TILLY US LLP 1570 FRUITVILLE PIKE SUITE 400 LANCASTER PA 17601 990 2020-07-01 231360851 UPMC HANOVER UPMC 7172318245 PO BOX 8700 HARRISBURG PA 171058700 ALISON BERNHARDT CHIEF FINANCIAL OFFICER 7172318245 2022-05-16 1 ALISON BERNHARDT XXX-XX-XXXX KERRI N BOGDA CPA P00760402 7177404863 X 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z PHILIP GUARNESCHELLI PO BOX 8700 HARRISBURG PA 171058700 188976210 0 X WWW.UPMCPINNACLE.COM X 1924 PA NON-PROFIT COMMUNITY HOSPITAL DEDICATED TO PROMOTING WELLNESS WITHIN THE GREATER HANOVER AREA. 15 12 1082 99 118596 0 4969409 10236176 153414247 176044125 163246 255520 469423 -1002808 159016325 185533013 79790 84808 0 0 77050450 70168407 0 0 0 84418457 94484727 161548697 164737942 -2532372 20795071 113394946 107997217 62101315 55001034 51293631 52996183 X WE ARE A NOT-FOR-PROFIT COMMUNITY HOSPITAL WHICH IS DEDICATED TO THE PROMOTION OF WELLNESS, PRESERVATION OF HEALTH, AND THE PROVISION OF DIAGNOSTIC AND THERAPEUTIC SERVICES TO THE PEOPLE OF THE GREATER HANOVER AREA. WE WILL BE THE PROVIDER OF CHOICE FOR HOSPITAL SUPPORTED ACUTE CARE, DIAGNOSTIC, THERAPEUTIC, REHABILITATIVE, AND WELLNESS SERVICES REQUIRED TO SUPPORT OUR NETWORK OF CARE. 0 0 140000312 84808 175943051 UPMC HANOVER OPERATES A NOT-FOR PROFIT HOSPITAL WITH SERVICE INCLUDING OBSTETRICS, EMERGENCY, CARDIAC CARE, CRITICAL CARE, OCCUPATIONAL HEALTH, SURGICAL SERVICES, AND A WIDE RANGE OF CARE SERVICES INCLUDING MEDICAL, SURGICAL, OBSTETRIC/GYNECOLOGICAL, PEDIATRIC AND CRITICAL CARE. OUR MEDICAL SURGICAL UNITS ARE STAFFED IN THREE LOCATIONS, FOR A COMBINED TOTAL OF 60 BEDS. TOTAL PATIENTS DISCHARGED BY THESE UNITS DURING THE YEAR ENDED JUNE 30, 2021 WERE 3,968. OBSTETRICS/GYNECOLOGY STAFFS A TOTAL OF 18 BEDS AND DISCHARGED 492 PATIENTS. THE PEDIATRIC UNIT IS EQUIPPED WITH 5 BEDS AND HAD 48 PATIENTS DISCHARGED. THERE ARE 10 BEDS IN THE CRITICAL CARE UNIT AND 264 PATIENTS WERE DISCHARGED. THERE WERE 497 DISCHARGES FROM THE NURSERY AND 135 DISCHARGES FROM THE EMERGENCY DEPARTMENT AND OVERFLOW AS WELL. UPMC HANOVER PROVIDES A WIDE RANGE OF DIAGNOSTIC AND SUPPORT SERVICES FOR BOTH INPATIENTS AND OUTPATIENTS. THESE SERVICES INCLUDE, BUT ARE NOT LIMITED TO, LABORATORY, IMAGING SERVICES, CARDIAC SERVICES, TOTAL WOUND CARE SERVICES, HYPERBARIC OXYGEN THERAPY, AND OUTPATIENT PHYSICAL THERAPY SERVICES. IMAGING SERVICES INCLUDE RADIOLOGY, NUCLEAR MEDICINE, MRI, ULTRASOUND, AND CT SCANNING. CARDIAC SERVICES ARE COMPRISED OF CARDIAC REHAB, DIAGNOSTIC TESTING, CARDIAC CATHETERIZATION, CATHETER CARDIAC INTERVENTION AND PERIPHERAL CATHETER BASED VASCULAR INTERVENTION. UPMC HANOVER PROVIDES FOR PHYSICAL, OCCUPATIONAL AND SPEECH THERAPIES. UPMC HANOVER PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA WITHOUT CHARGE OR AT A REDUCED FEE. CHARGES ARE EXCUSED FOR SERVICES RENDERED AND SUPPLIES FURNISHED UNDER THE FINANCIAL ASSISTANCE POLICY. 140000312 1 1 0 0 0 0 0 0 1 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 0 0 1082 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 PA X ALISON BERNHARDT CHIEF FINANCIAL O 7172318245 PO BOX 8700 HARRISBURG PA 171058700 PHILIP W GUARNASCHELLI BD MBR/PRESIDENT AND CEO 1.00 40.00 X X 0 1397279 40949 CHRISTOPHER P MARKLEY ESQ BD MBR(UNTIL 4/21)/SR VP/GEN COUNSEL 1.00 40.00 X 0 635513 32995 DOUGLAS C DYER BD MBR(UNTIL 9/20)/SVP, PLAN & BUS. DEV. 1.00 40.00 X 0 509057 40075 SUSAN COMP BD MBR/SVP, NURSING OPS & CNO 1.00 40.00 X 0 475164 15101 ALAN J STOCK CHAIR 1.00 2.00 X X 0 0 0 ANDREW D RIGGLE CFP TREASURER 1.00 0.00 X X 0 0 0 BARBARA A RUPP VICE CHAIR 1.00 0.00 X X 0 0 0 BONY R DAWOOD BOARD MEMBER (UNTIL NOV 2020) 1.00 0.00 X 0 0 0 G STEVEN MCKONLY ESQ BOARD MEMBER (UNTIL DEC 2020) 1.00 2.00 X 0 0 0 JAMES P HELT BOARD MEMBER 1.00 0.00 X 0 0 0 JILL R ROHRBAUGH BOARD MEMBER 1.00 0.00 X 0 0 0 JOHN-PAUL LUNN ESQ SECRETARY 1.00 0.00 X X 0 0 0 KARA M DARLINGTON CPA BOARD MEMBER 1.00 0.00 X 0 0 0 PAUL F SPEARS MD BOARD MEMBER 1.00 2.00 X 0 0 0 VANESSA BERGER BOARD MEMBER 1.00 0.00 X 0 0 0 KEVIN HAYWARD BOARD MEMBER 1.00 1.00 X 0 0 0 DOUGLAS NEIDICH BOARD MEMBER 1.00 4.00 X 0 0 0 DAVID MARTIN BOARD MEMBER 1.00 15.00 X 0 0 0 LOUIS BAVERSO BOARD MEMBER 1.00 40.00 X 0 515522 39126 MICHAEL W GASKINS PRESIDENT/SR. VP, HANOVER & MEMORIAL 40.00 1.00 X 661027 0 47840 MICHAEL A HOCKENBERRY VP & COO 40.00 1.00 X 296692 0 30228 DONNA L MULLER ASST. TREASURER/VP FINANCE 40.00 1.00 X 245687 0 13042 MARIA FINNEY SUPERVISOR CHIEF PHARMACIST 40.00 0.00 X 162804 0 23449 TERRI CORBIN DIRECTOR QUALITY MANAGEMENT 40.00 0.00 X 149858 0 19822 ANDREW RINEHART CLINICAL STAFF PHARMACIST 40.00 0.00 X 158103 0 27283 NANCY ESCHRICH CLINICAL STAFF PHARMACIST 40.00 0.00 X 158559 0 21549 JODI LAFFERTY CLINICAL DIR. OF SURGICAL SERVICES 40.00 0.00 X 159748 0 20934 1992478 3532535 372393 46 0 1 0 HANOVER ANESTHESIOLOGY & PAIN MEDICINE 250 FAME AVE SUITE 110 HANOVER PA 17331 ANESTHESIA SERVICES 2458578 QUEST DIAGNOSTICS 12436 COLLECTIONS CENTER DR CHICAGO IL 60693 LAB TEST PROCESSING 1405553 OSS HEALTH 1861 POWDER MILL RD YORK PA 17402 ORTHOPAEDIC SERVICES 587230 UNIVERSITY OF MARYLAND SURGICAL ASSOCIAT PO BOX 62523 BALTIMORE MD 21264 PHYSICIAN FEES 473416 SHARED MEDICAL SERVICES INC 209 LIMESTONE PASS COTTAGE GROVE WI 53527 PET/CT SERVICES 288848 11 1404725 8455200 376251 10236176 NET PATIENT SERVICE REVENUE 621990 175943051 175943051 LAB SERVICE NET REVENUE 621990 101074 101074 176044125 227822 227822 322 322 1461869 2904842 -1442973 -1442973 17522 -1460495 562512 3219 538355 0 24157 3219 27376 27376 CAFETERIA SALES 721110 269399 269399 OTHER MISC INCOME 900099 164728 164728 INSURANCE REFUND 900099 6038 6038 440165 185533013 175943051 118596 -764810 84808 84808 1264662 1264662 54748405 52259639 2488766 2456848 2331315 125533 7984180 7510398 473782 3714312 3471025 243287 10983856 10983856 26556 26556 5069975 4695006 374969 131452 101218 30234 994152 415746 578406 1915999 383200 1532799 3576563 2217469 1359094 104874 92289 12585 2913 2651 262 959935 959935 8509364 4680150 3829214 -318995 -318995 PHYSICIAN LOSSES 26509854 26509854 MEDICAL SUPPLIES 16574906 16574906 PHARMACY 7439584 7439584 BAD DEBT 5868118 5868118 6135621 5362936 772685 164737942 140000312 24737630 0 1740 1540 10394123 -12087 15618502 19498228 587426 652526 1341521 1165610 111599858 33658122 77580700 77941736 7669586 8488555 201348 261109 113394946 107997217 5559693 4410543 257262 238422 34237783 31698174 22046577 18653895 62101315 55001034 X 50836811 51700042 456820 1296141 51293631 52996183 113394946 107997217 X 20795071 -93164 -18999355 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 5380 -6 5374 0 0 4079627 28146 21437 500 -460754 4589464 3888291 65143 241457 4925 110339 4079627 41916770 53112 -5522175 -5500 497 32564419 3888291 48850426 227516 -4600839 500 2504419 55414 41916770 49755714 121838 3843449 12983 4802433 55159 48850426 0.88350 0.11650 0.00000 0 0 2410649 2410649 62001647 10532589 51469058 2441024 959109 1481915 41531888 22166424 19365464 3214650 3214650 77941736 OBLIGATIONS UNDER CAPITAL LEASE 1078779 MEDICARE ADVANCED PAYMENTS 15595412 OTHER LONG TERM LIABILITIES 1979704 18653895 X PART IV, LINE 2B: JOSEPH & PATRICIA HUMBERT ORIGINALLY CONTRIBUTED TO UPMC PINNACLE HANOVER. THE TWO DONORS PASSED AWAY BUT THE BALANCE OF THE FUND IS BEING HELD UNTIL THEIR SON PASSES AWAY. HE RECEIVES A DISTRIBUTION FROM THE FUND EVERY SIX MONTHS, HOWEVER IN MARCH 2021, HE DONATED THE BALANCE OF THE FUND TO UPMC HANOVER. PART V, LINE 4: BOARD DESIGNATED FUNDS ARE ASSETS SET ASIDE BY THE BOARD OF TRUSTEES FOR FUTURE CAPITAL IMPROVEMENTS, OVER WHICH THE BOARD RETAINS CONTROL AND MAY, AT ITS DISCRETION, SUBSEQUENTLY USE FOR OTHER PURPOSES. THE FOLLOWING ENDOWMENTS' INCOMES ARE USED FOR THE PURPOSE OF PROVIDING UPMC HANOVER STAFF SCHOLARSHIPS FOR CONTINUING EDUCATION IN THE NOTED SPECIALTIES: BATHON-CRITICAL CARE, CARDIAC AND EMERGENCY SERVICES PATHOLOGISTS- LABORATORY KIRKPATRICK-MATERNITY/OBSTETRICS SHIPMAN-RADIOLOGY BONNIE HART-OPERATING ROOM STEVE LAWRENCE-EMERGENCY MEDICINE THE JACKIE LAWRENCE ENDOWMENT IS RESTRICTED FOR THE PURPOSE OF AWARDING A $500 SCHOLARSHIP TO A DELONE CATHOLIC HIGH SCHOOL SENIOR WHO IS PURSUING A BACHELOR OF SCIENCE- NURSING DEGREE. THE LEHMAN ENDOWMENT FUND IS TO SUPPORT A "WENDELL LEHMAN EDUCATION DAY" FOR THE UPMC HANOVER CARDIAC SERVICES STAFF. PART X, LINE 2: AN EXTERNAL AUDIT IS COMPLETED AT A CONSOLIDATED UPMC SYSTEM LEVEL ONLY, INCLUDING UPMC AND ALL TAXABLE AND TAX-EXEMPT SUBSIDIARIES. TAX BENEFITS ARE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION BY THE TAX AUTHORITIES BASED ON THE TECHNICAL MERITS OF THE POSITION. SUCH TAX POSITIONS ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS GREATER THAN 50% LIKELY TO BE REALIZED UPON ULTIMATE SETTLEMENT WITH THE TAX AUTHORITIES ASSUMING FULL KNOWLEDGE OF THE POSITION AND ALL RELEVANT FACTS. AS OF JUNE 30, 2021, UPMC DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS RECORDED. 1 1 X 1 X 250.000000000000 1 X 1 1 1 0 0 949500 949500 0.00580 11095950 5512192 5583758 0.03390 12045450 5512192 6533258 0.03970 15 1709 403307 8572 394735 0.00240 1 264 4594571 4594571 0.02790 2 3464 84808 84808 0.00050 18 5437 5082686 8572 5074114 0.03080 18 5437 17128136 5520764 11607372 0.07050 3305 239205 239205 0.00150 3305 239205 239205 0.00150 1 5868118 858521 31910962 38007566 -6096604 X 1 1 1 1 UPMC HANOVER 300 HIGHLAND AVENUE HANOVER PA 17331 WWW.UPMCPINNACLE.COM 081801 UPMC HANOVER 231360851 X X X UPMC HANOVER 1 0 0 1 X X X X X X X X 18 1 1 0 1 X WWW.UPMCPINNACLE.COM X X 1 18 1 WWW.UPMCPINNACLE.COM 0 1 X 250.000000000000 400.000000000000 X X X X 1 1 X X X X 1 X WWW.UPMCPINNACLE.COM X WWW.UPMCPINNACLE.COM X WWW.UPMCPINNACLE.COM X X X X X 1 0 X X X X 1 X 0 0 UPMC HANOVER PART V, SECTION B, LINE 5: UPMC HANOVER AND UPMC MEMORIAL COLLABORATED WITH OTHER ORGANIZATIONS TO CONDUCT THE ADAMS AND YORK COUNTY COMMUNITY NEEDS HEALTH ASSESSMENT 2018. WITHIN THE DEVELOPMENT OF THE 2018 ASSESSMENT, SEVERAL RESOURCES WERE USED AND GIVEN CONSIDERATION TO IDENTIFY SIGNIFICANT ISSUES WITHIN THE COMMUNITY. THE PRIMARY AND SECONDARY DATA SOURCES USED FOR THE CHNA ARE AS FOLLOWS: THE ROBERT WOOD JOHNSON FOUNDATION COUNTY HEALTH RANKINGS, THE 2015 CHNA SURVEY, AND THE PENNSYLVANIA DEPARTMENT OF HEALTH'S EPI QMS DATA RETRIEVAL SYSTEM. THE REGIONAL CHNA COMMITTEE HIRED STAFF FROM THE FLOYD INSTITUTE FOR PUBLIC POLICY AT FRANKLIN AND MARSHALL COLLEGE TO ASSIST WITH CONDUCTING THE SURVEYING AND DATA COLLECTION. THE SURVEY RESULTS WERE WEIGHTED BY GENDER, EDUCATION, RACE, AND AGE. THE CHNA SURVEY INFORMATION IS BASED ON A BEHAVIORAL RISK FACTOR SURVEY OF 467 ADULT RESIDENTS OF ADAMS COUNTY AND 793 ADULT RESIDENTS OF YORK COUNTY. THE SURVEY INTERVIEWING TOOK PLACE FROM DECEMBER 4, 2017 THROUGH FEBRUARY 25, 2018. THE SURVEY SAMPLE WAS DESIGNED TO BE REPRESENTATIVE OF THE ADULT NON-INSTITUTIONALIZED POPULATION OF THE TWO COUNTIES. UPMC HANOVER PART V, SECTION B, LINE 6A: UPMC MEMORIAL UPMC HANOVER PART V, SECTION B, LINE 7D: THE CHNA WILL BE PRESENTED TO A VARIETY OF SOCIAL SERVICE AGENCIES OVER THE NEXT YEAR. UPMC HANOVER PART V, SECTION B, LINE 11: THE HOSPITAL ADDRESSES THE NEEDS INDENTIFIED BY THE CHNA THROUGH PROGRAMS LIKE LOW COST OR NO COST BLOOD PRESSURE, LABORATORY AND PULMONARY SCREENINGS MULTIPLE TIMES THROUGH-OUT THE YEAR. IN ADDITION, THE HOSPITAL CREATES EDUCATIONAL PROGRAMS TO ADDRESS HEALTHCARE KNOWLEDGE SHORTFALLS INDENTIFIED BY THE CHNA SUCH AS SMOKING CESSATION, NEWBORN CARE, NUTRITIONAL WORKSHOPS, ETC. THE HOSPITAL SPONSORS BETTER LIVING RADIO EACH WEEKDAY ON A LOCAL RADIO STATION THAT PROVIDES HEALTH INFORMATION TO AREA RESIDENTS. THE HOSPITAL PROVIDES SPEAKERS FOR COMMUNITY GROUPS ON HEALTH RELATED TOPICS UPON REQUEST. THE HOSPITAL WORKS COLLABORATIVELY WITH OTHER LOCAL HEALTHCARE PROVIDERS TO ADDRESS ANY NEEDS IDENTIFIED BY THE CHNA THAT CAN'T BE ADDRESSED BY THE HOSPITAL. THE HOSPITAL WILL NOT ADDRESS PSYCHIATRIC NEEDS SINCE THE HOSPITAL'S APPROACH IS TO WORK WITH OTHER LOCAL MEDICAL PROVIDERS WHO HANDLE THIS SPECIFIC NEED. UPMC HANOVER PART V, SECTION B, LINE 15E: IN INSTANCES WHEN AN UNINSURED PATIENT MAY APPEAR ELIGIBLE FOR A CHARITY CARE/FINANCIAL ASSISTANCE DISCOUNT, BUT LACKS DOCUMENTATION TO SUPPORT IT, CONSIDERATION WILL BE GIVEN BASED ON CIRCUMSTANCES PRESENTED OR CREDIT AGENCY INCOME DATA FOR PRESUMPTIVE CHARITY CARE/FINANCIAL ASSISTANCE. THIS WILL INCLUDE, BUT IS NOT LIMITED TO; HOMELESSNESS, NO INCOME, PARTICIPATION IN WOMEN INFANTS AND CHILDREN PROGRAMS (WIC), FOOD STAMP ELIGIBILITY, OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED (E.G. MEDICAID SPEND-DOWN), INFORMATION FROM FAMILY OR FRIENDS, LOW INCOME HOUSING PROVIDED AS VALID ADDRESS, PATIENT DECEASED WITH NO KNOWN ESTATE, ELIGIBLE FOR STATE FUNDED PRESCRIPTION PROGRAM, AND CREDIT BUREAU SOFT CREDIT CHECKS THAT ARE ONLY SEEN BY THE PATIENT/ GUARANTOR. UPMC HANOVER PART V, SECTION B, LINE 20E: ANY INDIVIDUAL WHO CALLS HOSPITAL CUSTOMER SERVICE AND MENTIONS THEY CANNOT AFFORD TO PAY THE AMOUNT BILLED IS ORALLY NOTIFIED OF THE FAP AND THE FAP PROCESS. 13 1 - HILLSIDE DIAGNOSTIC CENTER 250 FAME AVE STE 104 HANOVER PA 17331 LAB, MRI, X-RAY, CT SCAN, US 2 - SOUTH HANOVER MEDICAL CENTER 1404 BALTIMORE ST HANOVER PA 17331 EKG, LAB, X-RAY 3 - HILLSIDE CARDIAC DIAGNOSTIC 250 FAME AVE STE 104 HANOVER PA 17331 CARDIAC REHAB 4 - THISTLE HILL PROFESSIONAL CENTER 2030 THISTLE HILL DR SPRING GROVE PA 17362 LAB & X-RAY 5 - NEW OXFORD MEDICAL CENTER 5615 YORK RD NEW OXFORD PA 17350 LAB & X-RAY 6 - LITTLESTOWN MEDICAL CENTER 300 W KING ST LITTLESTOWN PA 17340 LAB 7 - EICHELBERGER LAB 195 STOCK ST HANOVER PA 17331 OUTPATIENT LAB 8 - HILLSIDE LUNG & SLEEP CENTER 250 FAME AVE STE 200 HANOVER PA 17331 PULMONOLOGY & SLEEP CENTER 9 - YORK STREET 400 YORK ST HANOVER PA 17331 PEDIATRIC REHAB 10 - HANOVER MEDICAL FITNESS CENTER 250 FAME AVE STE 100 HANOVER PA 17331 FITNESS CENTER 11 - TOTAL WOUND CARE CENTER 3130 GRANDVIEW RD HANOVER PA 17331 WOUND CARE, HYERBARIC OXYGEN 12 - SOUTH HANOVER MEDICAL OFFICE BUILDING 2201 BRUNSWICK DRIVE HANOVER PA 17331 LAB, X-RAY 13 - PULMONARY AND SLEEP MEDICINE 20 EXPEDITION TRAIL GETTYSBURG PA 17325 PULMONARY PART I, LINE 7: THE COST OF CHARITY CARE AND UNREIMBURSED MEDICAID COSTS ARE CALCULATED BY THE HOSPITAL'S COST-TO-CHARGE RATIO FOR EACH OF THE INDIVIDUAL SERVICES PROVIDED TO THE PATIENT. IT UTILIZES HOSPITAL EXPENSES FROM THE GENERAL LEDGER AND REVENUE DETAILS FROM THE PATIENT ACCOUNTING SYSTEM. EACHDEPARTMENT WITHIN THE HOSPITAL IS CLASSIFIED AS EITHER INDIRECT (OVERHEAD) OR DIRECT (PATIENT CARE AREAS). EXPENSES ARE CLASSIFIED AS FIXED OR VARIABLE AS THEY RELATE TO PATIENT VOLUME. LOGICAL STATISTICS ARE USED TO ALLOCATE OVERHEAD EXPENSES TO THE PATIENT CARE DEPARTMENTS. USING EITHER ARATIO OF COST-TO-CHARGE OR RVUS (RELATIVE VALUE UNITS), THE DIRECT AND INDIRECT COSTS FOR EACH DEPARTMENT ARE ALLOCATED TO THE SERVICES THEY PROVIDE. PART I, LINE 7G: LOSSES ATTRIBUTED TO PRIMARY CARE AND CLINICS ARE INCLUDED AS SUBSIDIZED HEALTH SERVICES. PART II, COMMUNITY BUILDING ACTIVITIES: UPMC HANOVER IS FOCUSED ON GETTING MORE INVOLVED IN COMMUNITY EVENTS, COALITIONS/TASK FORCES, DEVELOPING PROGRAMS, CONDUCTING SPEAKING ENGAGEMENTS, AND CREATING PARTNERSHIPS WITH LOCAL AGENCIES, ORGANIZATIONS AND BUSINESSES IN THE GREATER HANOVER AREA AND THROUGHOUT YORK AND ADAMS COUNTIES TO ADDRESS THE NEEDS OF THE CHNA FINDINGS. OUR TARGET POPULATIONS ARE THE COMMUNITY AT LARGE, OUR PATIENTS, AND OUR EMPLOYEES. TO IMPROVE THE HEALTH OF THE RESIDENTS OF THE COMMUNITIES IT SERVES, UPMC HANOVER PROVIDES HEALTH EDUCATION AND WELLNESS OPPORTUNITIES FOR MEMBERS OF THE COMMUNITY, BY OFFERING THE FOLLOWING HEALTH AND EDUCATION PROGRAMS:-$5 PRODUCE VOUCHERS - IN AN EFFORT TO COMBAT OBESITY AND PROMOTE NUTRITION, $5 PRODUCE VOUCHERS ARE GIVEN AT THE MARKET DAYS PRODUCE STAND, HEALTH FAIRS, AND HANOVER MEDICAL GROUP DOCTOR'S OFFICES. IN PARTNERSHIP WITH THE MARKETS OF HANOVER, THE MARKET DAYS PRODUCE STAND IS HELD ON THE 1ST FRIDAY OF THE MONTH FROM MAY THROUGH SEPTEMBER AT THE HILLSIDE MEDICAL CENTER. IN FY21, 126 VOUCHERS WERE CLAIMED.-COOKING DEMONSTRATIONS - HEALTH EDUCATORS HAVE TRAINED HEALTHY COOKING DEMONSTRATIONS. THESE DEMONSTRATIONS TEACH PARTICIPANTS HOW PREPARE HEALTHY MEALS OR THEMSELVES AND THEIR FAMILIES. IN FY21, THIS PROGRAM WAS PUT ON HOLD DUE TO COVID. -FREE HEALTH SCREENINGS - FREE BMI, BLOOD PRESSURE, FALL RISK ASSESSMENT, AND VARIOUS OTHER SCREENINGS ARE OFFERED AT LOCAL BUSINESSES, COMMUNITY EVENTS, SENIOR CENTERS, THE YMCA, HEALTH FAIRS, AND THE UPMC HANOVER MAIN LOBBY. IN FY21 THE MAIN FOCUS WAS COORDINATING COMMUNITY COVID VACCINE CLINICS. APPROXIMATELY 5000 COMMUNITY MEMBERS PARTICIPATED IN THOSE COMMUNITY CLINICS. -MATTER OF BALANCE - A PROGRAM FOR OLDER ADULTS THAT HELPS REDUCE THEIR FEAR OF FALLING, LEARN HOW TO MAKE ENVIRONMENTAL CHANGES IN AND AROUND THEIR HOMES, BECOME MORE ASSERTIVE, LEARN WAYS TO CHANGE THEIR FALL RISK BEHAVIORS, AND PRACTICE EXERCISES THAT WILL HELP INCREASE THEIR STRENGTH, BALANCE, AND FLEXIBILITY. CLASSES ARE 2 HOURS IN LENGTH AND HELD FOR 8 WEEK SESSIONS. FY21 THIS PROGRAM WAS HALTED DUE TO COVID RESTRICTIONS.-HEALTH FAIRS/OUTREACH EVENTS - UPMC HANOVER PROVIDED REPRESENTATION AT VARIOUS COMMUNITY, BUSINESS AND SCHOOL EVENTS, EACH TIME PROVIDING MATERIALS ON NUTRITION, PHYSICAL ACTIVITY, AND MENTAL HEALTH. IN FY 21, A SENIOR HEALTH FAIR WAS CONDUCTED WITH 295 PARTICIPANTS. -SUPPORT GROUPS - UPMC HANOVER PROVIDES SUPPORT GROUPS FOR BREAST FEEDING, DEPRESSION, GRIEF, INFANT BEREAVEMENT, RESPIRATORY THERAPY, EARLY STAGE DEMENTIA, OSTOMEY AND STROKE. IN FY 21 THESE GROUPS WERE PUT ON HOLD DUE TO COVID.-TOBACCO CESSATION PROGRAM - IN FY 21, 256 PEOPLE PARTICIPATED IN TOBACCO CESSATION PROGRAMS THROUGHOUT UPMC CENTRAL PA.-UPMC HANOVER PROVIDES A COURTESY VAN TO ENSURE THAT LACK OF TRANSPORTATION DOES NOT PREVENT PATIENTS FROM KEEPING THEIR APPOINTMENTS. IN FY 21, 1,890 PARTICPANTS TOOK ADVANTAGE OF THIS SERVICE. PART III, LINE 2: THE PERCENTAGE OF TOTAL PATIENT CARE EXPENSES TO GROSS REVENUE WAS CALCULATED. THIS PERCENTAGE WAS APPLIED TO THE GROSS BAD DEBTS TO ESTIMATE THE NEW BAD DEBTS EXPENSE. PART III, LINE 3: FOR THE PORTION OF BAD DEBT EXPENSE THAT IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY, THE HOSPITAL DETERMINED THE ZIP CODES THAT PRIMARILY INCLUDE PUBLIC HOUSING, LOW INCOME, AND/OR POVERTY. BAD DEBT WRITE-OFFS FOR THE FISCAL YEAR ARE REVIEWED TO DETERMINE THE ACCOUNTS WHERE THE PATIENT ADDRESS WAS LOCATED IN THOSE ZIP CODES. AN OVERALL COST-TO-CHARGE RATIO WAS THEN APPLIED TO THIS AMOUNT TO ARRIVE AT AN EXPENSE FIGURE. THIS METHOD CONTINUES TO BE HONED AS WE FURTHER DEVELOP OUR PRESUMPTIVE CHARITY CARE AND FINANCIAL AID APPROACH. PART III, LINE 4: THE FINANCIAL STATEMENTS DO NOT HAVE A SPECIFIC NOTE ON BAD DEBT EXPENSE; RATHER THE FINANCIAL STATEMENTS EVALUATE BAD DEBTS IN ITS ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE FOOTNOTE RELATED TO THE ALLOWANCE IS SUMMARIZED AS FOLLOWS: ACCOUNTS RECEIVABLE ARE RECORDED AT THEIR ESTIMATED NET REALIZABLE VALUE. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS ESTIMATED BASED UPON HISTORICAL COLLECTION RATES.THE BAD DEBT EXPENSE ON PART III, LINE 2 WAS CALCULATED BY TAKING THE AMOUNT WRITTEN OFF TO BAD DEBT FOR EACH ACCOUNT AND CONVERTING IT TO CHARGES BY APPROPRIATELY ADJUSTING THE AMOUNT BY THE PAYOR REIMBURSEMENT PERCENTAGE FOR THAT ACCOUNT. THEN, THE COST-TO-CHARGE RATIO METHODOLOGY FOR EACH SPECIFIC ACCOUNT, UTILIZING THE COSTS FROM THE HOSPITAL COST ACCOUNTING SYSTEM (DESCRIBED IN DETAIL ABOVE), WAS APPLIED TO THIS CALCULATED PORTION OF THE TOTAL CHARGES. PART III, LINE 8: THE MEDICARE COSTS WERE DETERMINED BASED ON THE HOSPITALS' COST TO CHARGE RATIO FOR THE SERVICES RENDERED. PART III, LINE 9B: PATIENTS ARE NOTIFIED OF OUR CHARITY CARE POLICY IN A VARIETY OF WAYS. THERE ARE POSTERS INFORMING PATIENTS OF OUR CHARITY CARE POLICY AND A PLAIN LANGUAGE VERSION OF THE POLICY HANDED OUT TO THE UNINSURED AT ALL THE REGISTRATION SITES. ALL OF OUR PATIENT ACCOUNT STATEMENTS CONTAIN LANGUAGE THAT INDICATES THERE IS FINANCIAL AID AVAILABLE FOR QUALIFYING INDIVIDUALS. IN ADDITION, THE POLICY AND APPLICATION ARE POSTED ON THE HOSPITAL WEBSITE IN BOTH ENGLISH AND SPANISH. PATIENTS WHO APPLY FOR FINANCIAL ASSISTANCE AND PROVIDE ALL THE NECESSARY DOCUMENTATION REQUIREMENTS ARE NOTIFIED WITHIN THIRTY DAYS OF THE HOSPITAL'S DECISION. WHEN THE APPROVAL IS DETERMINED, THE APPROPRIATE DISCOUNT IS POSTED TO THE PATIENT ACCOUNT IMMEDIATELY. THE FINANCIAL ASSISTANCE DISCOUNT WILL BE APPLIED TO SERVICE FOR THE PREVIOUS TWELVE MONTHS AND SUBSEQUENT SIX MONTHS. THE HOSPITAL'S COLLECTION POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE. NO ADDITIONAL COLLECTION EFFORTS ARE MADE. APPLICANTS APPROVED FOR ONLY PARTIAL DISCOUNT WILL BE REQUIRED TO MAKE REASONABLE PAYMENT ARRANGEMENTS ON THEIR BALANCE IN ACCORDANCE WITH THE HOSPITAL'S CREDIT AND COLLECTION POLICY. THIS POLICY DOES PERMIT THE USE OF BOTH INTERNAL COLLECTION STAFF AND EXTERNAL COLLECTION AGENCIES WHO WILL ENGAGE IN STANDARD ACCEPTABLE BUSINESS PRACTICES WHICH INCLUDE PHONE CALLS, MAILING AND THE REPORTING OF UNPAID DEBT TO THE CREDIT REPORTING AGENCIES, BUT UNDER NO CIRCUMSTANCES WILL THE HOSPITALS OR ITS CONTRACTED COLLECTION AGENCY ADOPT "EXTRAORDINARY COLLECTION ACTIONS" THAT ENTAIL ANY LEGAL COURSE OF ACTION OR JUDICIAL PROCESSES SUCH AS LAWSUITS OR LIENS. PART VI, LINE 2: TOGETHER WITH UPMC MEMORIAL, UPMC HANOVER COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT IN MAY 2018 FOR ADAMS AND YORK COUNTIES AND NORTHERN MARYLAND. YORK COUNTY RANKS 19 OUT OF 67 PENNSYLVANIA COUNTIES IN HEALTHY OUTCOMES AND 13 OUT OF 67 IN HEALTH FACTORS WHILE ADAMS COUNTY RANKS 10 AND 11, RESPECTIVELY.THE REGION SHOWS HIGH RATES OF OBESITY, LOW BIRTH RATE WEIGHT BABIES, TEEN BIRTHS AND LOW RATES OF MENTAL HEALTH PROVIDERS. COUNTY HEALTH RANKINGS HELPS COUNTIES UNDERSTAND WHAT INFLUENCES HOW HEALTHY RESIDENTS ARE AND HOW LONG THEY WILL LIVE. THE RANKINGS LOOK AT HEALTH OUTCOMES (LENGTH OF LIFE AND QUALITY OF LIFE) AND HEALTH FACTORS THAT INCLUDE HEALTH BEHAVIORS (TOBACCO USE, DIET AND EXERCISE, ALCOHOL AND DRUG USE, SEXUAL ACTIVITY), CLINICAL CARE (ACCESS, QUALITY), SOCIAL AND ECONOMIC FACTORS (EDUCATION, EMPLOYMENT, INCOME, FAMILY AND SOCIAL SUPPORT, COMMUNITY SAFETY), AND THE PHYSICAL ENVIRONMENT (AIR AND WATER QUALITY, HOUSING AND TRANSPORTATION). IN THE FALL OF 2017 THROUGH MARCH 2018 UPMC HANOVER WAS A PARTNERING HOSPITAL OF THE REGION COLLABORATING WITH OTHERS TO ASSESS THE COMMUNITY HEALTH NEEDS OF THE REGION. IN JUNE 2018, A COMMUNITY FORUM WAS HELD TO REVIEW AND SHARE THE FULL COMMUNITY HEALTH NEEDS ASSESSMENT AND TO GET INPUT FROM THE COMMUNITY. THE THREE PRIORITIES THAT CAME OUT OF THE ASSESSMENT WERE:1. PHYSICAL HEALTH (IMPROVING TRENDS IN PHYSICAL ACTIVITY AND NUTRITION)2. BEHAVIORAL HEALTH (REDUCE HIGH RATE OF ADULT DEPRESSION)3. MATERNAL CHILD HEALTH (REDUCE LOW BIRTHWEIGHT BABIES, REDUCE TEEN BIRTH RATE, REDUCE SEXUALLY TRANSMITTED DISEASES AND SEXUALLY TRANSMITTED INFECTIONS).UPMC HANOVER HAS DEVELOPED A FRAMEWORK TO IMPROVE THOSE NEEDS. THE UPMC HANOVER BOARD OF DIRECTORS ACCEPTED THESE THREE PRIORITIES AND DEVELOPED THE FOLLOWING GOALS AND OBJECTIVES:PRIORITY 1: PHYSICAL HEALTH, PHYSICAL ACTIVITY AND TOBACCOGOALS: PROMOTE HEALTH AND REDUCE CHRONIC DISEASE RISK, THROUGH THE CONSUMPTION OF HEALTHFUL DIETS AND ACHIEVEMENT AND MAINTENANCE OF HEALTHY BODY WEIGHTS. DECREASE ILLNESS, DISABILITY AND DEATH RELATED TO TOBACCO USE, VAPING AND SECONDHAND SMOKE EXPOSURE.STRATEGY 1: INCREASE KNOWLEDGE AND ACCESS TO FRESH PRODUCE IN THE REGION BY 2022. WE WILL PROVIDE EDUCATIONAL LEARNING OPPORTUNITIES TO A VARIETY OF AGE GROUPS AND POPULATIONS, OFFER BMI SCREENINGS, CONDUCT COOKING DEMOS, AND PROVIDE $5 PRODUCE VOUCHERS. COMMUNITY OUTREACH WILL ALSO BE INCREASED BY PROVIDING PRODUCE STANDS TO INCREASE ACCESS TO FRESH PRODUCE.STRATEGY 2: IMPROVE HEALTH, FITNESS AND QUALITY OF LIFE THROUGH INCREASED PHYSICAL ACTIVITY.STRATEGY 3: DECREASE ILLNESS, DISABILITY AND DEATH RELATED TO TOBACCO USE/VAPING AND SECONDHAND SMOKE EXPOSURE. WE WILL CONDUCT FREEDOM FROM SMOKING CLASSES AS WELL AS 1-ON-1 TOBACCO CESSATION COUNSELING.PRIORITY 2: BEHAVIORAL HEALTHGOALS: IMPROVE MENTAL HEALTH THROUGH PREVENTION AND BY ENSURING ACCESS TO APPROPRIATE, QUALITY MENTAL HEALTH SERVICES. REDUCE THE HIGH SUICIDE RATE.STRATEGY 1: DECREASE THE NUMBER OF MENTAL HEALTH DAYS PEOPLE EXPERIENCE IN OUR REGION BY 2022. PROVIDE EDUCATIONAL LEARNING OPPORTUNITIES TO A VARIETY OF AGE GROUPS AND POPULATIONS. HOLD MENTAL HEALTH FIRST AID TRAININGS FOR PROFESSIONALS AND THE COMMUNITY AT LARGE. INCREASECOMMUNITY OUTREACH AND ACCESS TO SUPPORT GROUPS.STRATEGY 2: DECREASE THE SUICIDE RATE BY 5% IN THE REGION BY 2022. PROVIDE EDUCATIONAL LEARNING OPPORTUNITIES TO A VARIETY OF AGE GROUPS AND POPULATIONS. PROVIDE QPR TRAININGS FOR PROFESSIONALS AND THE COMMUNITY AT LARGE. INCREASE COMMUNITY OUTREACH AND ACCESS TO SUPPORT GROUPS.PRIORITY 3: MATERNAL-CHILD HEALTHGOALS: IMPROVE THE HEALTH AND WELL-BEING OF WOMEN AND THEIR UNBORN CHILDREN. PROMOTE HEALTHY SEXUAL BEHAVIORS AND INCREASE ACCESS OF QUALITY SERVICES TO PREVENT STD'S/STI'S AND THEIR COMPLICATIONS. REDUCE THE NUMBER OF TEEN PREGNANCIES AND INCREASE ACCESS TO PRENATAL CARE.STRATEGY 1: REDUCE THE NUMBER OF LOW BIRTH WEIGHT BABIES BORN IN THE REGION BY 5% BY 2022 BY PROMOTING AND SUPPORTING LOCAL PRENATAL AND POSTNATAL CARE SUPPORT SERVICES FOR PREGNANT WOMEN AND TEENS AND DISTRIBUTING PRODUCE VOUCHERS FOR PREGNANT MOMS AND NEW PARENTS.STRATEGY 2: REDUCE THE RATE OF TEENS WITH STD'S/STI'S IN THE REGION BY 5% BY 2022. WE WILL PROVIDE AND FUND LOCAL, ESTABLISHED EDUCATIONAL PROGRAMS FOR STD'S/STI'S.STRATEGY 3: DECREASE THE NUMBER OF TEEN PREGNANCIES BY 10% IN OUR REGION BY 2022. WE WILL PROVIDE AND FUND LOCAL, ESTABLISHED PROGRAMS FOR TEEN PREGNANCY PREVENTION. PART VI, LINE 3: PATIENTS ARE INFORMED OF AVAILABLE ASSISTANCE IN NUMEROUS WAYS. SIGNAGE IS POSTED AND LITERATURE IS HANDED OUT TO THE UNINSURED AT ALL THE REGISTRATION SITES INDICATING TO PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE. ALL UNINSURED PATIENTS WHO ARE SCHEDULED FOR HIGH DOLLAR TESTS AND SURGERIES ARE CONTACTED BY ONE OF THE HOSPITAL'S FINANCIAL COUNSELORS TO DISCUSS THE FINANCIAL ASSISTANCE OPTIONS AVAILABLE TO THEM. THE FINANCIAL ASSISTANCE POLICY IS ALSO DISCLOSED ON THE HOSPITAL WEBSITE, ALONG WITH THE APPLICATION, IN BOTH ENGLISH AND SPANISH. IN ADDITION, ALL INPATIENTS WHO ARE RESIDENTS OF PENNSYLVANIA ARE PROVIDED PERSONAL ASSISTANCE IN THE COMPLETION OF THE MEDICAL ASSISTANCE APPLICATION. AS PART OF THE DISCHARGE PROCESS IN THE EMERGENCY DEPARTMENT, ALL UNINSURED PATIENTS ARE SCREENED FOR CHARITY CARE ELIGIBILITY UNDER THE HOSPITAL POLICY AND, IF APPROPRIATE, PROVIDED ASSISTANCE IN APPLYING FOR MEDICAID OR OBTAINING INSURANCE THROUGH HEALTHCARE.GOV. LASTLY, INFORMATION ABOUT FINANCIAL ASSISTANCE IS INCLUDED ON THE PATIENT BILLING STATEMENTS. PROGRAMS DISCUSSED INCLUDE THE PENNSYLVANIA STATE MEDICAID PROGRAM (MEDICAL ASSISTANCE), HOSPITAL CHARITY CARE PROGRAM, AND FUNDS AVAILABLE THROUGH HOSPITAL ENDOWMENT FUNDS. IN INSTANCES WHEN AN UNINSURED PATIENT MAY APPEAR ELIGIBLE FOR A CHARITY CARE/FINANCIAL ASSISTANCE DISCOUNT, BUT LACKS DOCUMENTATION TO SUPPORT IT, CONSIDERATION WILL BE GIVEN BASED ON CIRCUMSTANCES PRESENTED OR CREDIT AGENCY INCOME DATA FOR PRESUMPTIVE CHARITY CARE/FINANCIAL ASSISTANCE. THIS WILL INCLUDE, BUT IS NOT LIMITED TO, HOMELESSNESS, NO INCOME, PARTICIPATION IN WOMEN INFANTS AND CHILDREN PROGRAMS (WIC) FOOD STAMP ELIGIBILITY AND OTHER STATE OR LOCAL ASSISTANCE THAT ARE UNFUNDED (E.G. MEDICAID SPEND-DOWN), INFORMATION FROM FAMILY OR FRIENDS, LOW INCOME HOUSING PROVIDED AS A VALID ADDRESS, PATIENT DECEASED WITH NO KNOWN ESTATE, ELIGIBLE FOR STATE FUNDED PRESCRIPTION PROGRAM, AND CREDIT BUREAU SOFT CREDIT CHECKS THAT ARE ONLY SEEN BY THE PATIENT/ GUARANTOR. PART VI, LINE 4: UPMC HANOVER IS LOCATED IN YORK COUNTY. YORK COUNTY IS 904.2 SQUARE MILES WITH A POPULATION OF 448,273 WHICH EQUATES TO 495.8 PEOPLE PER SQUARE MILE. THE MEDIAN AGE IS 40.9. APPROXIMATELY 8.7% OF RESIDENTS FALL BELOW THE POVERTY LINE WITH 13% COMPRISED OF CHILDREN BELOW 18 AND 4% ARE SENIORS (ABOVE 65).YORK COUNTY RANKS 19 OUT OF 67 COUNTIES IN HEALTH OUTCOMES AND 13 OUT OF 67 COUNTIES IN HEALTH FACTORS. COMPARED TO OTHER COUNTIES IN THE STATE, YORK SHOWS HIGH RATES OF OBESITY, LOW BIRTH WEIGHT BABIES, TEEN BIRTHS, AND LOW RATES OF MENTAL HEALTH PROVIDERS. YORK ALSO HAS RELATIVELY HIGH RATES OF SEXUALLY TRANSMITTED INFECTIONS AND VIOLENT CRIME. YORK COUNTY DOES RELATIVELY WELL ON HAVING LOW RATES OF CHILDREN IN POVERTY AND PREVENTABLE HOSPITAL STAYS. YORK COUNTY'S PHYSICAL ENVIRONMENT SCORES HAVE DECLINED SIGNIFICANTLY OVER TIME RELATIVE TO OTHER COUNTIES IN THE STATE, DUE TO POOR AIR QUALITY AND PROBLEMS RELATED TO HOUSING AND TRANSPORTATION. PART VI, LINE 5: UPMC HANOVER FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF ITS COMMUNITY THROUGH THE FOLLOWING: UPMC HANOVER UTILIZES APPROXIMATELY 90 VOLUNTEERS OFFERING SUPPORT TO THE ORGANIZATION, FROM THE BOARD OF DIRECTORS TO THOSE WHO DELIVER FLOWERS AND TRANSPORT PATIENTS. THESE VOLUNTEERS ARE ALSO ACTIVE COMMUNITY MEMBERS LIVING IN THE HOSPITAL'S PRIMARY SERVICE AREA. THROUGH THEIR INVOLVEMENT AT THE HOSPITAL, THEY ARE ABLE TO COMMUNICATE ITS PROGRAMS AND SERVICES THAT BENEFIT THE WELFARE OF THE COMMUNITY.THROUGH RELATED PARTIES, THE HOSPITAL IS ABLE TO OFFER PHYSICIAN SERVICES TO OUR COMMUNITY, WITH SPECIALTIES INCLUDING FAMILY MEDICINE, INTERNAL MEDICINE, PEDIATRICS , GERIATRICS, GENERAL SURGERY, LUNG AND SLEEP MEDICINE, NEUROLOGY, NEUROSURGERY , ENDOCRINOLOGY, UROLOGY, UROGYNECOLOGY , GASTROENTEROLOGY, CARDIOLOGY, GYNECOLOGIC ONCOLOGY , AND OB-GYN. THROUGH ANOTHER PARTY, THE HOSPITAL IS ALSO ABLE TO OFFER ORTHOPAEDICS SERVICES. OUR PHYSICIANS WORK WITH THOUSANDS OF FAMILIES, PROVIDING EXCEPTIONAL CARE.FINALLY, UPMC HANOVER APPLIES ITS SURPLUS FUNDS BY REINVESTING IN THE ORGANIZATION. MOST RECENTLY, THE HOSPITAL OPENED THE UPMC OUTPATIENT CENTER AT 2201 BRUNSWICK DRIVE, IN HANOVER. THIS LOCATION EXPANDS SERVICES IN THE SOUTHERN END OF YORK COUNTY AND NORTHERN MARYLAND COMMUNITIES. SOME SERVICES WERE CONSOLIDATED FROM OTHER BUILDINGS, BUT MANY ARE NEW TO THIS PART OF TOWN. PROVIDER SERVICES INCLUDE EXPRESS CARE, PRIMARY CARE, OB-GYN, CARDIOLOGY, ENDOCRINOLOGY, AND GENERAL SURGERY. CARDIAC DIAGNOSTICS, PULMONARY DIAGNOSTICS, LAB, AND IMAGING ARE AVAILABLE IN THIS SPACE AS WELL. SELECT PHYSICAL THERAPY ALSO LEASES A SPACE. A COMMUNITY CONFERENCE/EDUCATION SPACE IS AVAILABLE IN THE BUILDING AND WAS USED REGULARLY FOR COVID-19 VACCINE CLINICS AND BLOOD DRIVES DURING THE PANDEMIC.THROUGH OUR MOST VALUABLE ASSETS, OUR VOLUNTEERS AND EMPLOYEES, ALONG WITH OUR ONGOING COMMITMENT TO OUR COMMUNITY, UPMC HANOVER HAS FURTHERED ITS EXEMPT PURPOSE. PART VI, LINE 6: UPMC HANOVER IS PART OF UPMC PINNACLE, A FULLY INTEGRATED, AFFILIATED HEALTH CARE SYSTEM. THE SYSTEM IS COMPRISED OF ELEVEN WHOLLY OWNED ENTITIES AS WELL AS A VARIETY OF AFFILIATED JOINT VENTURES. THE ORGANIZATION'S MISSION IS TO MAINTAIN AND IMPROVE THE HEALTH AND QUALITY OF LIFE FOR EVERYONE IN CENTRAL PENNSYLVANIA. UPMC PINNACLE IS ENGAGED IN AND CONDUCTS CHARITABLE, EDUCATIONAL, AND SCIENTIFIC ACTIVITIES THROUGH THE SUPPORT AND BENEFIT OF PINNACLE HEALTH FOUNDATION, AND PROVIDES MANAGEMENT AND CONSULTATIVE SERVICES TO AFFILIATED ENTITIES. UPMC PINNACLE MEDICAL SERVICES AND REGIONAL PHYSICIANS ARE PRIMARILY ENGAGED IN THE PROVISION OF PHYSICIAN SERVICES TO SUPPORT AND ENHANCE THE SERVICES WITHIN UPMC PINNACLE. THE UPMC PINNACLE CARDIOVASCULAR INSTITUTE IS ENGAGED IN PROVIDING COMPREHENSIVE CARDIAC CARE, INCLUDING TECHNOLOGICAL ADVANCES IN ORDER TO PROVIDE THE BEST CLINICAL OUTCOMES TO THE COMMUNITY. COMMUNITY LIFE TEAM IS ENGAGED IN PROVIDING COMMUNITY BASED, EFFICIENT AND COST EFFECTIVE MEDICAL TRANSPORT SERVICES AND PRE-HOSPITAL EMERGENCY MEDICAL SERVICES FOR THE RESIDENTS AND COMMUNITIES OF THE CENTRAL PENNSYLVANIA YORK REGIONS.PINNACLE HEALTH VENTURES, INC. WAS FORMED IN 2012 TO CONSOLIDATE VARIOUS ENTITIES THAT FUNCTION IN SUPPORT OF THE UPMC PINNACLE NETWORK. CURRENTLY INCLUDED IN VENTURES ARE PINNACLE HEALTH IMAGING, MEDCARE SUSQUEHANNA VALLEY, PINNACLE HEALTH ALLBETTERCARE, AND MEDICAL ARTS BUILDING. UNITED CENTRAL PENNSYLVANIA RECIPROCAL RISK RETENTION GROUP IS A WHOLLY OWNED, FOR-PROFIT, VERMONT CAPTIVE INSURANCE COMPANY OPERATING FOR THE BENEFIT OF UPMC PINNACLE. UPMC PINNACLE AND ITS AFFILIATES ARE ACTIVELY INVOLVED IN THE CENTRAL PENNSYLVANIA REGION THROUGH VARIOUS CHARITY AND COMMUNITY BENEFIT ACTIVITIES. PART VI, LINE 7, REPORTS FILED WITH STATES PA 1 NEW HOPE MINISTRIES PO BOX 448 DILLSBURG PA 17019 232223120 501(C)(3) 18000 SPONSORSHIP THE BRETHREN HOME INC 2990 CARLISLE PIKE NEW OXFORD PA 17350 232454835 501(C)(3) 10000 SPONSORSHIP PINK POWER 10 BENTZEL MILL RD YORK PA 17404 822668598 501(C)(3) 5000 SPONSORSHIP CULTURAL ALLIANCE OF YORK COUNTY 14 W MARKET ST YORK PA 17401 232992925 501(C)(3) 37500 SPONSORSHIP SWEET CHARITIES 1150 CARLISLE ST HANOVER PA 17331 113662416 501(C)(3) 10000 SPONSORSHP 5 0 PART I, LINE 2: DONATIONS ARE MADE TO 501(C)(3) PUBLIC CHARITIES FOR USE IN EXEMPT ACTIVITIES RELATED TO HEALTHCARE. 1 0 0 0 0 0 0 0 0 PHILIP W GUARNASCHELLI BD MBR/PRESIDENT AND CEO 0 803155 0 460142 0 133982 0 14250 0 26699 0 1438228 0 0 MICHAEL W GASKINS PRESIDENT/SR. VP, HANOVER & MEMORIAL 475103 0 185924 0 0 0 14250 0 33590 0 708867 0 0 0 CHRISTOPHER P MARKLEY ESQ BD MBR(UNTIL 4/21)/SR VP/GEN COUNSEL 0 420513 0 167946 0 47054 0 14250 0 18745 0 668508 0 0 LOUIS BAVERSO BOARD MEMBER 0 272500 0 229000 0 14022 0 13350 0 25776 0 554648 0 0 DOUGLAS C DYER BD MBR(UNTIL 9/20)/SVP, PLAN & BUS. 0 238528 0 133308 0 137221 0 12950 0 27125 0 549132 0 0 SUSAN COMP BD MBR/SVP, NURSING OPS & CNO 0 308353 0 125712 0 41099 0 14250 0 851 0 490265 0 0 MICHAEL A HOCKENBERRY VP & COO 235783 0 60909 0 0 0 12824 0 17404 0 326920 0 0 0 DONNA L MULLER ASST. TREASURER/VP FINANCE 197703 0 47447 0 537 0 12212 0 830 0 258729 0 0 0 MARIA FINNEY SUPERVISOR CHIEF PHARMACIST 153294 0 9510 0 0 0 6923 0 16526 0 186253 0 0 0 ANDREW RINEHART CLINICAL STAFF PHARMACIST 158103 0 0 0 0 0 8023 0 19260 0 185386 0 0 0 JODI LAFFERTY CLINICAL DIR. OF SURGICAL SERVICES 134057 0 25691 0 0 0 7295 0 13639 0 180682 0 0 0 NANCY ESCHRICH CLINICAL STAFF PHARMACIST 158559 0 0 0 0 0 8115 0 13434 0 180108 0 0 0 TERRI CORBIN DIRECTOR QUALITY MANAGEMENT 130191 0 19667 0 0 0 8068 0 11754 0 169680 0 0 0 PART I, LINE 3 UPMC HANOVER RELIES ON UPMC PINNACLE, A RELATED ORGANIZATION, TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO. METHODS USED TO ESTABLISH COMPENSATION BY THE RELATED ORGANIZATION INCLUDE: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE COMPENSATION COMMITTEE OF THE BOARD PART I, LINE 4A DOUGLAS DYER, SVP, PLANNING & BUSINESS DEVELOPMENT, RECEIVED A SEVERANCE PAYMENT OF $105,454 DURING THE 2020 CALENDAR YEAR, UPON HIS DEPARTURE FROM THE ORGANIZATION. A GENERAL AUTHORITY OF SOUTHCENTRAL PENNSYLVANIA 232982233 84129NGT0 2013-04-30 17348592 REFINANCE 2002 SERIES BOND ISSUE 0 0 0 B GENERAL AUTHORITY OF SOUTHCENTRAL PENNSYLVANIA 232982233 84129NJV2 2015-12-01 26665698 REFINANCE 2005 SERIES BOND ISSUE 0 0 0 A 8945000 17348592 2767975 358734 16989859 2013 1 0 1 1 B 2600000 26665698 434774 515888 26142000 2015 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 1 0.15600 1 0 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 1 0 0 0 0 0 0 B 0 0 1 0 0 0 0 0 0 A 0 B 0 SCHEDULE K. PART III, LINE 9, PART IV, LINE 7, PART V: THE ORGANIZATION UNDERSTANDS ITS OBLIGATIONS TO ENSURE THAT IT STAYS WITHIN SAFE HARBOR REGULATIONS AND IS VERY PRUDENT IN ITS POST-BOND ISSUANCE RESPONSIBLITIES. THE ORGANIZATION HAS NOT ESTASLISHED WRITTEN PROCEDURES TO DATE AS BOTH BOND ISSUANCES ARE CURRENT REFUNDINGS AND SHOULD MEET EXCEPTIONS TO REBATE. THE ORGANIZATION WILL, HOWEVER, WORK TO ESTABLISH WRITTEN PROCEDURES AS ADDITIONAL SAFEGUARDS. FORM 990, PART V, LINE 1: UPMC (EIN 25-1423657), ULTIMATE PARENT ENTITY OF UPMC PINNACLE AND THE PARENT ENTITY OF A GROUP OF TAX-EXEMPT ORGANIZATIONS, IS THE COMMON REPORTING AGENT FOR THE GROUP AND FILES ALL 1099 FORMS FOR UPMC HANOVER. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS HANOVER HEALTHCARE PLUS, INC., A FEDERALLY TAX EXEMPT, STATE NONPROFIT ENTITY (EIN 22-2658574). IN SEPTEMBER 2017 UPMC PINNACLE AFFILIATED WITH UPMC, A WORLD-RENOWNED INTEGRATED HEALTHCARE DELIVERY AND FINANCING SYSTEM, THAT IS AN INTERNATIONAL LEADER IN PROVIDING CLINICAL CARE, GROUND BREAKING RESEARCH AND TREATMENTS WITH LOCATIONS IN WESTERN AND CENTRAL PENNSYLVANIA, MARYLAND, NEW YORK AND AROUND THE WORLD. FORM 990, PART VI, SECTION A, LINE 7A DURING THE PERIOD OF INTEGRATION, UPMC PINNACLE SHALL APPOINT TWO-THIRDS OF THE VOTING MEMBERS OF THE UPMC HANOVER BOARD. FORM 990, PART VI, SECTION A, LINE 7B CERTAIN GOVERNANCE DECISIONS OF THE ORGANIZATION REQUIRE THE APPROVAL OF BOTH THE HANOVER HEALTHCARE PLUS, INC. BOARD AND THE UPMC PINNACLE BOARD, AS THE PARENT OF BOTH THE FILING ORGANIZATION AND ITS SOLE MEMBER. FORM 990, PART VI, SECTION B, LINE 11B DURING THE PERIOD OF INTEGRATION, UPMC PINNACLE AND UPMC HANOVER BOARDS HAVE JOINT AUTHORITY AND RESPONSIBILITY FOR THE REVIEW OF THE FORM 990. EACH BOARD HAS DELEGATED THIS RESPONSIBILITY TO THEIR RESPECTIVE FINANCE COMMITTEES. IN ORDER TO ACCOMPLISH THIS, ALL MEMBERS OF EACH FINANCE COMMITTEE ARE PROVIDED WITH A REASONABLE OPPORTUNITY TO REVIEW AND COMMENT TO EXECUTIVE LEADERSHIP ON THE FORM 990 OF UPMC HANOVER. IN ADDITION, EACH MEMBER OF EACH RESPECTIVE BOARD OF DIRECTORS WILL BE GIVEN ACCESS TO VIEW THEIR INDIVIDUAL FORM 990 VIA A SHARED, PASSWORD-PROTECTED WEBSITE BEFORE THE RETURNS ARE FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C IN THE PERFORMANCE OF THEIR DUTIES TO UPMC PINNACLE, COVERED PERSONS SHALL SEEK TO ACT IN THE BEST INTERESTS OF UPMC PINNACLE, AND SHALL EXERCISE GOOD FAITH, LOYALTY, DILIGENCE AND HONESTY. A COVERED PERSON IS ANY INDIVIDUAL WHO SERVES IN A FIDUCIARY CAPACITY TO, OR WHO HAS LEGAL AUTHORITY TO REPRESENT OR OBLIGATE, UPMC PINNACLE OR ANY OF ITS AFFILIATED ORGANIZATIONS INCLUDING, BUT NOT LIMITED TO, DIRECTORS, OFFICERS, EMPLOYEES, AND AGENTS. COVERED PERSONS ALSO INCLUDE A) IMMEDIATE FAMILIES (SPOUSES, CHILDREN, SIBLINGS, PARENTS, OR SPOUSE'S PARENTS), B) ANY ORGANIZATION IN WHICH THEY OR THEIR IMMEDIATE FAMILIES DIRECTLY OR INDIRECTLY I) HAVE A MATERIAL FINANCIAL OR BENEFICIAL INTEREST, OR II) SERVE AS A DIRECTOR, OFFICER, EMPLOYEE, AGENT, ATTORNEY OR SIMILAR CAPACITY. A COVERED PERSON SHALL DISCLOSE ANY BUSINESS OR PERSONAL INTERESTS OR RELATIONSHIPS WHICH MAY BE IN CONFLICT WITH THE INTERESTS OF UPMC PINNACLE, INCLUDING, BUT NOT LIMITED TO (A) ENGAGING IN OR SEEKING TO BE ENGAGED IN (I) THE DELIVERY OF HEALTH CARE SERVICES OR (II) THE DELIVERY OF GOODS OR SERVICES TO UPMC PINNACLE, OR (B) ANY TRANSACTION OR ARRANGEMENT WITH UPMC PINNACLE WHICH WOULD RESULT IN BENEFIT TO COVERED PERSONS. IF A POTENTIAL CONFLICT IS IDENTIFIED REGARDING A SPECIFIC UPMC ACTIVITY, THE UPMC CORPORATE COMPLIANCE DEPARTMENT, WITH THE ASSISTANCE OF THE LEGAL DEPARTMENT, EITHER DEVELOPS A WRITTEN PLAN DESIGNED TO PREVENT THE CONFLICT FROM INFLUENCING DECISIONS RELATED TO THAT ACTIVITY, OR REQUIRES THAT THE CONFLICTING RELATIONSHIP BE DIVESTED, AS APPROPRIATE. COVERED PERSONS WITH A DOCUMENTED CONFLICT OF INTEREST SHALL NOT VOTE ON THE MATTER, AND THE UPMC PINNACLE BOARD OR COMMITTEE MUST APPROVE, AUTHORIZE, OR RATIFY THE TRANSACTION OR ARRANGEMENT BY A MAJORITY VOTE OF THE NON-INTERESTED DIRECTORS OR COMMITTEE MEMBERS PRESENT AT A MEETING THAT HAS A QUORUM. VIOLATIONS OF THIS STATEMENT OF POLICY MAY SUBJECT COVERED PERSONS TO APPROPRIATE SANCTIONS, INCLUDING REMOVAL FROM THEIR POSITIONS WITH UPMC PINNACLE. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE OF THE UPMC PINNACLE BOARD HAS THE AUTHORITY TO DEVELOP AND MAINTAIN EXECUTIVE COMPENSATION TO BE APPROVED BY THE UPMC PINNACLE BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE WILL FOLLOW A DILIGENT PROCESS THAT MEETS REGULATORY REQUIREMENTS FOR A REBUTTABLE PRESUMPTION OF REASONABLENESS AND PROMOTES EFFECTIVE GOVERNANCE OF EXECUTIVE COMPENSATION, CONSISTENT WITH THE UPMC PINNACLE COMPENSATION PHILOSOPHY. 1. FOLLOW A PROCESS THAT ESTABLISHES AND MAINTAINS A REBUTTABLE PRESUMPTION OF REASONABLENESS FOR ALL EXECUTIVES POTENTIALLY SUBJECT TO INTERMEDIATE SANCTIONS. 2. PREPARE MINUTES FOR EACH MEETING TO RECORD THE TERMS OF THE COMMITTEE'S DECISIONS AND THE PROCESS FOLLOWED IN REACHING THOSE DECISIONS. THESE MINUTES MUST INCLUDE INDICATIONS THAT THE COMMITTEE IS FOLLOWING GOOD PRACTICES IN DEALING WITH CONFLICTS OF INTEREST AND IN OBTAINING AND RELYING ON APPROPRIATE COMPARABILITY DATA ON TOTAL COMPENSATION. 3. SELECT AND DIRECTLY ENGAGE AND SUPERVISE ANY CONSULTANT HIRED BY UPMC PINNACLE TO ADVISE THE COMMITTEE ON EXECUTIVE COMPENSATION. 4. PERIODICALLY EVALUATE THE APPROPRIATENESS OF THIS CHARTER AND THE EFFECTIVENESS OF THE PROCESS THE COMMITTEE USES IN GOVERNING EXECUTIVE COMPENSATION AND REPORT THIS EVALUATION TO THE UPMC PINNACLE BOARD. 5. MONITOR CHANGES IN LAWS AND REGULATIONS PERTAINING TO EXECUTIVE COMPENSATION AND BENEFITS TO SEE THAT UPMC PINNACLE COMPLIES WITH THEM. 6. SEEK OUTSIDE REVIEW OF COMMITTEE OPERATIONS TO ENSURE COMPLIANCE WITH THE IRS REBUTTABLE PRESUMPTION OF REASONABLENESS. 7. REVIEW ACTUAL EXECUTIVE COMPENSATION AND BENEFITS PROVIDED TO CONFIRM CONSISTENCY WITH COMPENSATION AND BENEFITS APPROVED BY THE COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE FOR PUBLIC INSPECTION. THE ORGANIZATION INCLUDES A COPY OF ITS FINANCIAL STATEMENTS WITH THE STATE REGISTRATION FILED WITH THE PENNSYLVANIA DEPARTMENT OF STATE, BUREAU OF CHARITABLE ORGANIZATIONS. THESE DOCUMENTS ARE A MATTER OF PUBLIC RECORD AND CAN BE VIEWED AT THE BUREAU OFFICE. FORM 990, PART XI, LINE 9: TRANSFERS TO EXEMPT AFFILIATES -19,831,604. TRANSFER FROM UPMC PINNACLE FOUNDATION 897,166. JV EQUITY EARNINGS -64,917. FORM 990, PART XII, LINE 2C: UPMC HAS AN AUDIT COMMITTEE THAT IS ESTABLISHED TO ASSIST THE BOARD OF DIRECTORS IN FULFILLING ITS OVERSIGHT RESPONSIBILITIES BY MONITORING UPMC CONSOLIDATED FINANCIAL REPORTS AND OTHER FINANCIAL INFORMATION PROVIDED BY UPMC TO GOVERNMENTAL BODIES, THE PUBLIC OR OTHER EXTERNAL ENTITIES. THE UPMC'S SYSTEM OF INTERNAL CONTROLS REGARDING FINANCE, ACCOUNTING, LEGAL COMPLIANCE AND ETHICS THAT MANAGEMENT AND THE BOARD HAVE ESTABLISHED AND UPMC'S INTERNAL AUDITING, ACCOUNTING AND FINANCIAL REPORTING PROCESSES ALSO PROVIDED OVERSIGHT. PART XII, LINE 2B: THE ORGANIZATION'S FINANCIAL STATEMENTS ARE PART OF A CONSOLIDATED FINANCIAL STATEMENT AUDIT PERFORMED BY EY FOR UPMC AND ALL SUBSIDIARIES. THE ENTIRE SYSTEM'S FINANCIAL STATEMENTS, OF WHICH THIS ORGANIZATION IS PART OF, ARE POSTED ON THE UPMC WEBSITE. (WWW.UPMC.COM) THE FINANCIAL STATEMENT AUDIT DURING THE 990 FILING PERIOD IS FOR THE CALENDAR YEAR ENDED DECEMBER 31,2020. 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15219 826254351 TRUST PA N/A T 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 FORM 990, SCHEDULE R, PARTS I THROUGH IV: ENTITIES REPORTED IN PARTS I THROUGH IV THAT ARE MARKED WITH AN * ARE NOT TECHNICALLY "RELATED ORGANIZATIONS", AS DEFINED IN THE FORM 990 INSTRUCTIONS AS THE REQUISITE "CONTROL" DID NOT EXIST DURING THE FISCAL YEAR ENDED JUNE 30, 2021. HOWEVER, BECAUSE THESE ENTITIES ARE AFFILIATED WITH UPMC AND THE UPMC PARENT ORGANIZATION HOLDS CERTAIN POWERS WITH RESPECT TO SUCH ENTITIES WE ARE ELECTING TO DISCLOSE THE ENTITIES AS RELATED ORGANIZATIONS IN SCHEDULE R IN THE INTEREST OF TRANSPARENCY.