2022-05-13T11:16:19-05:00 2021-06-30 PricewaterhouseCoopers LLP 2001 MARKET ST SUITE 1800 PHILADELPHIA PA 19103 990 2020-07-01 232152662 WISSAHICKON HOSPICE OF UPHS % PATRICK BROWN WISS 6107473409 150 MONUMENT ROAD SUITE 300 BALA CYNWYD PA 19004 KIETH KASPER CONTROLLER 6107473409 2022-05-03 true KIETH KASPER 999009999 ANTONIO C RUSSO P00858539 2673303000 2022-05-03 2 2020 2022-09-23 18:48:47Z JOAN M DOYLE MSN MBA 150 MONUMENT ROAD SUITE 300 BALA CYNWYD PA 19004 33958744 false X WWW.UPHS.UPENN.EDU X 1980 PA PROVISION OF COMPREHENSIVE HOSPICE SERVICES 7 0 351 61 0 0 354482 272985 36117965 33195149 105728 118502 610058 372108 37188233 33958744 0 0 0 0 28096633 27885967 0 0 0 9033534 8941477 37130167 36827444 58066 -2868700 11176770 7765486 9251098 8929611 1925672 -1164125 X PROVISION OF COMPREHENSIVE HOSPICE SERVICES false false 30513764 0 33567257 DURING THE YEAR ENDED JUNE 30, 2021 WISSAHICKON HOSPICE PROVIDED UNCOMPENSATED CARE, COMPRISED OF CHARITY CARE AND THE PROVISION FOR BAD DEBTS, TOTALING $2,226,003 AND $2,253,062 FOR 2021 AND 2020, RESPECTIVELY. WISSAHICKON HOSPICE PROVIDES MUCH NEEDED PROFESSIONAL AND PUBLIC EDUCATIONAL PROGRAMMING. TOPICS INCLUDE ISSUES RELATED TO END OF LIFE CARE WITH ATTENTION TO THE NEEDS OF BOTH PROFESSIONALS AND FAMILY CAREGIVERS. OUTREACH EFFORTS INCLUDE WORKSHOPS, SYMPOSIA, INFORMATIONAL AND REFERRAL SERVICES, WEB BASED RESOURCES, AND AUDIO AND VIDEO PROGRAMMING. DURING THE YEAR ENDED JUNE 30, 2021, WISSAHICKON HOSPICE PROVIDED THE FOLLOWING PROGRAMS TO PROFESSIONALS AND THE PUBLIC AT LITTLE OR NO CHARGE: C0MMUNITY SUPPORT/SERVICES: - VOLUNTEER SUPPORT AND SERVICES > 2000+ MASKS CREATED AND DELIVERED TO PATIENTS/FAMILIES > VETERANS CELEBRATIONS: 139 VETERAN PACKAGES DELIVERED HONORING THOSE WHO HAVE SERVED PUMPKIN DRIVE: VOLUNTEERS DECORATED AND DELIVERED PUMPKINS TO PATIENTS/FAMILIES > PIE DRIVE: VOLUNTEER EFFORT, DELIVERED OVER 200 PIES TO HOSPICE FAMILIES DURING THANKSGIVING > CAKE DRIVE: REMEMBERING PATIENT/FAMILY SPECIAL EVENTS WITH HOMEMADE AND BEAUTIFULLY DECORATED CAKES. 105 CAKES DELIVERED. > HANDMADE GOODS: 825 RECIPIENTS (QUILTS, BLANKETS, FIDGET SQUARES, DINNER SCARVES, CHEMO CAPS) - ESTABLISHED VET TO VET PROGRAM - VOLUNTEER VETERANS VISITING WITH VETERANS RECEIVING HOSPICE CARE. - ACHIEVED LEVEL III, WORKING ON REACHING LEVEL IV OF THE NATIONAL HOSPICE AND PALLIATIVE CARES'S "WE HONOR VETERANS" PROGRAM. THE PROGRAM SEEKS TO SUPPORT VETERANS AT THE END OF LIFE, ACKNOWLEDGE THEIR SERVICE, AND CONNECT THEM TO THE VA TO ACCESS BENEFITS. THE PROGRAM WAS EXPANDED TO PALLIATIVE CARE AND HOME CARE PATIENTS IN AN EFFORT TO HELP VETERANS CONNECT TO ENTITLED SERVICES THROUGH THE VA PRIOR TO END OF LIFE. - COMMUNITY BEREAVEMENT PROGRAM: ESTABLISHED IN 2021 FOR INDIVIDUALS WHO WERE NOT ON SERVICE WITH PENN MEDICINE HOSPICE BUT EXPERIENCED A LOSS AND NEEDED ADDTITIONAL SUPPORT. PROGRAM HAS A DEDICATED COUNSELOR, PARTICIPANTS RECEIVE UP TO 3 ONE ON ONE COUNSELING SERVICES, SUPPORTIVE EFFORT TO CONNECT PARTICIPANTS TO ADDITIONAL COUNSELING SERVICES FOLLOWING INTERVENTIONS IF DESIRED BY PARTICIPANT. PARTICIPANTS RECEIVE ROUTINE MAILINGS WITH COPING STRATEGIES FOLLOWING LOSS, ARE INVITED TO PARTICIPATE IN WEEKLY GROUP SESSIONS, WORKSHOPS, AND MEMORIAL SERVICES. - GRIEF REACH PROGRAMS FOR YOUNG GRIEVING FAMILIES WERE HELD. WITH THE ONSET OF COVID THE ORGANIZATION CREATED APPROPRIATE PROGRAMING TO ACCOUNT FOR SOCIAL DISTANCING. THE ANNUAL GRIEF CAMP AND THE GRIEF REACH PROGRAM WERE COMBINED INTO VIRTUAL PROGRAMS. GRIEVING FAMILIES RECEIVED QUARTERLY MAILINGS AND/OR DELIVERIES BY COUNSELORS OF A CAMP ALL YEAR AND A BOX OF SUPPLIES. THE SUPPLIES SUPPORTED VIRTUAL PROGRAMMING, AND PROVIDED FAMILIES WITH TOOLS AND MATERIALS TO SUPPORT FAMILY CONNECTION IN THEIR GRIEF. THE VIRTUAL PROGRAMMING WAS FACILITATED BY CHILD BEREAVEMENT COUNSELORS, AND COMBINED FUN FAMILY ACTIVITIES AND GRIEF INTERVENTIONS. PROGRAMMING WAS SUPPORTED BY VOLUNTEER DONATIONS AND FUNDRAISING EVENTS, THERE WERE NO CHARGES TO FAMILIES TO PARTICIPATE. - SNF PALLIATIVE CARE PROGRAM WAS ESTABLISHED AT THE ONSET OF COVID TO SUPPORT NURSING HOME PARTNERS WITH COVID POSITIVE PATIENTS. THE PROGRAM PROVIDED PHYSICIAN SUPPORT, MEDICATION CONSULTATION, SOCIAL WORK AND CHAPLAIN SUPPORTS. IPADS WERE DELIVERED TO THE FACILITIES AND PSYCHOSOCIAL STAFF HELPED TO FACILITATE VIRTUAL VISITS FOR THE FAMILY AND RESIDENT. FAMILIES WHO LOST A LOVED ONE FROM COVID WERE ALSO ENTERED INTO A SPECIFICALLY DESIGNED BEREAVEMENT PROGRAM THAT FEATURED: EARLY SUPPORT CALLS, MULTIPLE MAIL CORRESPONDENCE, COPING MODULES ON WEBSITE, INCLUDED IN ANNUAL SERVICE OF REMEMBRANCE, AND WERE ELIGIBLE TO PARTICIPATE IN VIRTUAL SUPPORT GROUPS. 124 PATIENTS WERE SUPPORTED IN THIS PROGRAM. - ESTABLISHED A VAN PROGRAM TO BRING NECESSARY PPE TO STAFF VISITING PATIENTS DURING COVID PANDEMIC - PROVIDED BEREAVEMENT SUPPORT FOR LOCAL SCHOOL DISTRICTS - MAINTAINED THE ELDERPAC PROGRAM IN COLLABORATION WITH RALSTON HOUSE, WHICH IS A PROGRAM FOR THE FRAIL ELDERLY CONCENTRATED IN WEST PHILADELPHIA - SUPPORTED CHESTER COUNTY CHALLENGE BIKE RIDE, ANGEL TREE CEREMONY AND DILWORTHTOWN WINE FESTIVAL ALL THROUGH VIRTUAL EVENTS THIS PAST YEAR. - EXPANDED VOLUNTEER SERVICES TO PATIENTS IN THEIR HOMES INCLUDING CELEBRATORY CAKES, ASSISTANCE WITH GARDENING, PLANTS PROVIDED, AND HOMEMADE MASKS TO PROTECT FAMILIES. - COLLABORATED WITH LOCAL RESTAURANT IN A DASH AND DELIVER PROGRAM TO SUPPORT PATIENTS AND FAMILIES. - VIRTUAL MEMORIAL SERVICE: OFFERED OVER A YOUTUBE CHANNEL AND EXTENDED TO HOSPICE, HOMECARE, PALLIAITVE CARE, HOSPITAL AND NURSING HOME FACILITIES. THE MEMORIAL SERVICE PROGRAM REMAINED AVAILABLE FOR VEIWING THROUGHOUT 2021. - THE DAVID BRADLEY CHILDREN'S BEREAVEMENT PROGRAM IS A VALUABLE AND UNIQUE COMMUNITY RESOURCE AVAILABLE TO CHILDREN AND TEENS AT NO COST TO THE FAMILIES. THE PROGRAM'S LICENSED PROFESSIONAL COUNSELOR PROVIDES INDIVIDUAL COUNSELING SERVICES - BEFORE AND AFTER THE DEATH OF THE CHILD'S LOVED ONE. PART OF THE MISSION OF THE DAVID BRADLEY CHILDREN'S BEREAVEMENT PROGRAM IS TO PROVIDE THE COMMUNITY WITH EDUCATIONAL MATERIALS AND SUPPORT SERVICES TO ENCOURAGE DISCUSSION AND PROVIDE METHODS FOR CHILDREN AND TEENS TO UNDERSTAND THEIR EMOTIONS AFTER THE DEATH OF A SPECIAL PERSON IN THEIR LIVES. OUR CHILDREN'S BEREAVEMENT COUNSELOR IS AVAILABLE AS A RESOURCE FOR: TEACHERS AND SCHOOL COUNSELORS, COMMUNITY AND NON PROFIT GROUPS, CHURCHES AND SCHOOL SEMINARS, SPEAKING AND LECTURE PROGRAMS. EDUCATION: - ONLINE COPING MODULES CREATED ON THE PENN MEDICINE BEREAVEMENT PAGE; 10-15 MINUTE MODULES ON COPING STRATEGIES, REFLECTIONS AND SUPPORT - CREATED AND DISTRIBUTED PATIENT EDUCATION ON COVID - CEU PRESENTATIONS PROVIDED THROUGHOUT THE YEAR ON: > HEART FAILURE IN A JIFFY > CANNABIS FOR THE HOSPICE CROWD > EDMONTON SYMPTOM ASSESSMENT SCALE > PPE: COVID 19 AND PERSONAL PROTECTIVE EQUIPMENT > REACH TO TEACH: MEETING THE HEALTH LITERACY NEEDS OF DIVERSE PATIENTS AND FAMLIES > HOSPICE ELIGIBITY AND REGULATORY COMPLIANCE > ROLE OF THE IDT > OPIOD MATH FOR THE PRACTICING HOSPICE AND PALLIATIVE CARE CLINICIANS > SYMPTOM MANAGEMENT DYSPNEA > IS THIS HOSPICE? STRATEGIES FOR DISCUSSING GOALS OF CARE IN THE FACE OF COMPLEX THERAPIES > HOARDING BEHAVIOR AND INTERVENTIONS > MOTIVATIONAL INTERVIEWING FOR HEALTH CARE PROVIDERS > PARTNERSHIP WITH BOARD OF ELECTIONS TO REGISTER ELIGIBLE VOTERS AND FACILITATED OPPORTUNITIES TO CAST MAIL IN BALLOTS. - ESTABLISHED MANDATORY HOSPICE ELIGIBILTY COMPETENCEY PROGRAM FOR ALL HOSPICE CLINICIANS - DEVELOPED CLINICAL EFFECTIVENESS TEAM FOCUSED ON REDUCING UNPLANNED DISCHARGES FROM HOSPICE AND IMPROVING ACCESS TO CARE AFTER HOURS - PARTNER WITH LOCAL UNIVERSITIES AND PARAMEDIC PROGRAM TO PROVIDE INPATIENT HOSPICE EDUCATION TO STUDENTS - LEADERSHIP PARTICIPATES IN CURRICULUM FOR NURSING STUDENTS ON DEATH AND DYING TOPICS. - PROVIDED LECTURES FOR PENN PHD GRADUATE STUDENTS PROGRAM - PRESENT MODULES AT MONTHLY ELNEC MEETINGS - STAFF MEMBERS PROVIDE REAL LIFE EXPERIENCE TRAINING TO MED STUDENTS ON END OF LIFE CARE (DOC 101) - STAFF MEMBERS PROVIDE MONTHLY CLASSROOM EDUCATION ON UNDERSTANDING THE ROLE OF SPIRITUAL AND PSYCHOSOCIAL DISTRESS ON DISEASE PROGRESSION. - PARTNER WITH THE SCHOOL OF MEDICINE TO PROVIDE MEDICAL STUDENT ROTATION THROUGH PALLIATIVE CARE AND HOSPICE. - FORMULATED ADVANCED BEREAVEMENT PEER TO PEER SOCIAL NETWORK GROUP FOR BEREAVED INDIVIDUALS WHO HAVE GONE THROUGH BEREAVEMENT SUPPORT PROGRAMMING TO MINIMIZE SOCIAL ISOLATION AMOUNG BEREAVED ADULTS. - COMMUNITY OUTREACH PROGRAMS TO SUPPORT GRIEF AND LOSS WERE OFFERED THROUGHOUT THE YEAR TO THE COMMUNITY FREE OF CHARGE. SPECIAL PROGRAMS WERE OFFERED DURING DIFFICULT HOLIDAYS - SUPPORTING GRIEVING CHILDREN AND ADULTS DURING THE HOLIDAYS; ADULT SUPPORT AT MOTHER'S DAY. - PROVIDED "ASK THE EXPERTS" TABLE SIDE CONSULTATIONS TO PATIENTS, FAMILIES AND CAREGIVERS. - MONTHLY PARTICIPATION IN THE UPHS PALLIATIVE CARE SEMINARS - ESTABLISHED TOWN HALL PRESENTATIONS EVERY OTHER WEEK - ESTABLISHED - ONE NOTE, A PHONE APP TO ALLOW CLINICIANS TO ACCESS ON THEIR PHONE IMPORTANT RESOURCES, INFORMATION, CLINICAL SUPPORT, FUNERAL HOME INFORMATION, VETERAN'S BENEFITS, AREA FACILITIES, AND HOW TO COMPLETE CERTAIN ELEMENTS OF DOCUMENTATION. - HELD GOALS OF CARE AND DEATH AND DYING SIMULATIONS FOR HEALTH SYSTEM EMPLOYEES. - PROVIDED GRIEF SUPPORT AND EDUCATION TO COMMUNITY HEALTH WORKERS. - STAFF SUPPORT AT AREA NURSING HOMES FOCUSED ON CAREGIVER AND GRIEF BURNOUT. - EDUCATIONAL LECTURES HELD WITH SOCIAL WORK GRAD STUDENTS, MED STUDENTS AND NURSING STUDENTS. - AGENCY WIDE HEALTH AND WELLNESS COMMITTEE ESTABLISHED TO PROMOTE SELF CARE AMOUNG EMPLOYEES. - COORDINATED WITH FUTURE MEDICAL STUDENTS ON A STUDENT VOLUNTEER PROGRAM THROUGH THE UNIVERSITY OF PENNSYLVANIA (SHOOP). - ESTABLISHED GRIEF REACH WORKSHOP. - PRESENTED CREATIVE ART OF GRIEF AT CHESTNUT HILL FALL FESTIVAL. 30513764 true true false false false false false false false true true false false false true true false true 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 false false false true X 0 0 351 true false false false false false false false false false false false false false false false X 7 0 false false false false false false false true true false false true true true true true true true true false PA X PATRICK BROWN 6107473409 150 MONUMENT ROAD SUITE 300 BALA CYNWYD PA 19004 X KEITH KASPER CHAIR & CONTROLLER(EX-OFFICIO) 1.0 54.0 X X 0 1572045 206973 REGINA S CUNNINGHAM PHD BOARD MEMBER 1.0 54.0 X 0 1274815 166573 MICHAEL M VOLPE BOARD MEMBER 1.0 54.0 X 0 921031 12057 PATRICK J BRENNAN MD BOARD MEMBER 1.0 54.0 X 0 874887 44679 JOAN M DOYLE MSN MBA EXEC. 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ALL PROCEEDS ARE USED IN FURTHERANCE OF THE DAVID BRADLEY CHILDREN'S BEREAVEMENT PROGRAM (THE "PROGRAM"). THE PROGRAM IS A VALUABLE AND UNIQUE COMMUNITY RESOURCE AVAILABLE TO CHILDREN AND TEENS AT NO COST TO THE FAMILIES. THE PROGRAM'S LICENSED PROFESSIONAL COUNSELOR PROVIDES INDIVIDUAL COUNSELING SERVICES - BEFORE AND AFTER THE DEATH OF THE CHILD'S LOVED ONE. PART OF THE MISSION OF THE PROGRAM IS TO PROVIDE THE COMMUNITY WITH EDUCATIONAL MATERIALS AND SUPPORT SERVICES TO ENCOURAGE DISCUSSION AND PROVIDE METHODS FOR CHILDREN AND TEENS TO UNDERSTAND THEIR EMOTIONS AFTER THE DEATH OF A SPECIAL PERSON IN THEIR LIVES. A CHILDREN'S BEREAVEMENT COUNSELOR IS AVAILABLE AS A RESOURCE FOR: TEACHERS AND SCHOOL COUNSELORS, COMMUNITY AND NON PROFIT GROUPS, CHURCHES AND SCHOOL SEMINARS, SPEAKING AND LECTURE PROGRAMS. ------------------------------ SCHEDULE D, PART X, LINE 1 DETAIL OF OTHER LIABILITIES THE DUE TO AFFILIATES ACCOUNT REPRESENTS AMOUNTS OWED BY THIS ORGANIZATION TO THE TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA ("PENN"), A RELATED ORGANIZATION, BASED UPON PENN'S CENTRAL TREASURY OFFICE MANAGING THE CASH BALANCES OF CERTAIN OF ITS AFFILIATES. ------------------------------ SCHEDULE D, PART X, LINE 2 TEXT OF FIN 48 (ASC 740) FOOTNOTE THIS ORGANIZATION IS AN AFFILIATE OF THE TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA ("UNIVERSITY"). THE FIN 48 (ASC 740) FOOTNOTE BELOW DERIVES FROM THE CONSOLIDATED JUNE 30, 2021 FINANCIAL STATEMENTS OF THE UNIVERSITY: THE UNIVERSITY REGULARLY EVALUATES ITS TAX POSITION AND DOES NOT BELIEVE IT HAS ANY UNCERTAIN TAX POSITIONS THAT REQUIRE DISCLOSURE OR ADJUSTMENT TO THE CONSOLIDATED FINANCIAL STATEMENTS. false true false false false false false true false PATRICK J BRENNAN MD BOARD MEMBER 0 549411 0 254585 0 70891 0 25650 0 19029 0 919566 0 0 JOAN M DOYLE MSN MBA EXEC. DIRECTOR(EX-OFFICIO MBR) 0 374757 0 131108 0 65255 0 0 0 19821 0 590941 0 0 KEITH KASPER CHAIR & CONTROLLER(EX-OFFICIO) 0 929309 0 375766 0 266970 0 180000 0 26973 0 1779018 0 213363 KATHERINE MAJOR DIRECTOR PENN HOME PALLIATIVE 196542 0 0 0 235 0 0 0 18382 0 215159 0 0 0 EVELYN DESMOND DIRECTOR HOSPICE 193228 0 0 0 646 0 0 0 8480 0 202354 0 0 0 SUSAN C FOSTER HOSPICE SYSTEM DIRECTOR 166501 0 0 0 797 0 0 0 17795 0 185093 0 0 0 KRISTIE SMITH NURSE EMERGENCY RESPONSE 140679 0 18131 0 82 0 0 0 27095 0 185987 0 0 0 SARAH GLICK JOHNSON SECRETARY 0 243462 0 54728 0 235 0 0 0 25701 0 324126 0 0 CHARLES SCHNEIDER MD FACP BOARD MEMBER 0 306766 0 1950 0 36522 0 30953 0 34544 0 410735 0 0 JAMES WEINSTEIN CPA CFO, ASST CONTROLLER 0 230019 0 38952 0 2754 0 0 0 17865 0 289590 0 0 ANGELA R COLADONATO DNP RN BOARD MEMBER 0 327400 0 65334 0 21604 0 0 0 17738 0 432076 0 0 REGINA S CUNNINGHAM PHD BOARD MEMBER 0 770211 0 327501 0 177103 0 148800 0 17773 0 1441388 0 151891 CHARMAINE ROCHESTER DHA CPA BOARD MEMBER 0 312569 0 68580 0 2672 0 3167 0 20549 0 407537 0 0 LORI REED NURSE EMERGENCY RESPONSE 132782 0 44449 0 139 0 0 0 17580 0 194950 0 0 0 MICHAEL A POSENCHEG MD BOARD MEMBER - AS OF 6/21 0 365808 0 0 0 96241 0 36450 0 65203 0 563702 0 0 MICHAEL M VOLPE BOARD MEMBER 0 568975 0 242460 0 109596 0 0 0 12057 0 933088 0 0 SCHEDULE J, PART I, LINE 3 TOP MANAGEMENT COMPENSATION AS PROVIDED IN THE FORM 990, SCHEDULE J INSTRUCTIONS, SINCE THE ORGANIZATION RELIES ON A RELATED ORGANIZATION WHICH USES ONE OR MORE OF THE METHODS DESCRIBED IN LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION, THIS QUESTION HAS BEEN LEFT UNANSWERED. REFER TO SCHEDULE O FOR A DESCRIPTION OF THE COMPENSATION REVIEW AND APPROVAL PROCESS. ------------------------------ SCHEDULE J, PART I, LINE 4B PARTICIPATION IN A SUPP NONQUALIFIED PLAN CERTAIN TRUSTEES, OFFICERS AND/OR KEY EMPLOYEES OF THIS ORGANIZATION ARE COMPENSATED BY A RELATED ORGANIZATION, THE TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA ("UNIVERSITY"). THE UNIVERSITY OF PENNSYLVANIA HEALTH SYSTEM ("HEALTH SYSTEM") MAINTAINS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") DESIGNED FOR SENIOR ADMINISTRATORS OF THE HEALTH SYSTEM, AS DESIGNATED BY THE BOARD OF TRUSTEES, WHO ARE ACTIVELY EMPLOYED BY THE HEALTH SYSTEM WHEN THE CONTRIBUTIONS ARE MADE. VESTING IN THE SERP OCCURS AFTER EACH THREE YEARS OF PARTICIPATION AND UPON THE OCCURRENCE OF CERTAIN EVENTS (ATTAINMENT OF AGE 65, DEATH, DISABILITY, OR INVOLUNTARY TERMINATION WITHOUT "CAUSE"). CONTRIBUTIONS FOR THOSE WHO HAVE REACHED AGE 65 WILL BE FULLY VESTED WHEN MADE. UPON REACHING A VESTING DATE, PARTICIPANTS WILL AUTOMATICALLY RECEIVE A FULL DISTRIBUTION WHICH IS TAXABLE AS EARNED INCOME. PARTICIPANTS WHO VOLUNTARILY TERMINATE BEFORE VESTING WILL FORFEIT THE BALANCE IN THEIR ACCOUNTS. THE FOLLOWING INDIVIDUALS LISTED ON FORM 990, PART VII, SECTION A, LINE 1A PARTICIPATED IN THE UNIVERSITY/HEALTH SYSTEM SERP PLAN DURING THE YEAR: DOYLE, JOAN M.- $44,670 KASPER, KEITH - $213,363 CUNNINGHAM, REGINA S. - $151,891 MICHELE VOLPE -$82,620 THE HEALTH SYSTEM ALSO MAINTAINS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN DESIGNED FOR SENIOR FACULTY OF THE SCHOOL OF MEDICINE OF THE UNIVERSITY, AS DESIGNATED BY THE BOARD OF TRUSTEES, WHO ARE ACTIVELY EMPLOYED BY THE UNIVERSITY WHEN THE CONTRIBUTIONS ARE MADE (THE "MED SERP"). VESTING IN THE MED SERP OCCURS AFTER EVERY TEN YEARS OF PARTICIPATION AND UPON THE OCCURRENCE OF CERTAIN EVENTS (ATTAINMENT OF AGE 60, DEATH, DISABILITY, OR INVOLUNTARY TERMINATION WITHOUT "CAUSE"). CONTRIBUTIONS FOR THOSE WHO HAVE REACHED AGE 60 (WITH 2 OR MORE YEARS OF PARTICIPATION) WILL BE FULLY VESTED WHEN MADE. UPON REACHING A VESTING DATE, TAXES OWED WILL BE WITHDRAWN FROM THE PLAN, AND THE REMAINING AFTER-TAX BALANCE WILL REMAIN IN THE PLAN. PARTICIPANTS WILL AUTOMATICALLY RECEIVE A FULL DISTRIBUTION THE SUMMER AFTER THE YEAR IN WHICH THEY TERMINATE EMPLOYMENT, AT WHICH TIME ANY EARNINGS NOT YET TAXED WILL BE TREATED AS TAXABLE INCOME. PARTICIPANTS WHO VOLUNTARILY TERMINATE BEFORE VESTING WILL FORFEIT THE NON-VESTED BALANCE IN THEIR ACCOUNTS. THE FOLLOWING INDIVIDUALS LISTED ON FORM 990, PART VII, SECTION A, LINE 1A PARTICIPATED IN THE MED SERP PLAN DURING THE YEAR: BRENNAN, PATRICK J. - NO DISTRIBUTION SCHNEIDER, CHARLES J. - NO DISTRIBUTION ------------------------------ SCHEDULE J, PART I, LINE 7 PROVISION OF NON-FIXED PAYMENTS WISSAHICKON HOSPICE PROVIDES DISCRETIONARY BONUS AND/OR INCENTIVE COMPENSATION PAYMENTS TO ELIGIBLE EMPLOYEES. PAYMENTS MADE TO ANY DISQUALIFIED PERSON IS APPROVED BY THE COMPENSATION COMMITTEE THROUGH THE PROCESS DESCRIBED IN FORM 990, PART VI, SECTION B, LINE 15. ------------------------------ FORM 990, PART V, LINE 1A FORMS 1099 THIS ORGANIZATION IS AN AFFILIATE OF THE TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA ("TRUSTEES"). THE FORMS 1099 DISTRIBUTED AS PART OF THIS ENTITY'S ACTIVITIES ARE DONE SO THROUGH THE UNIVERSITY HEALTH SYSTEM AND CONSOLIDATED WITH THE TRUSTEES. ------------------------------ FORM 990, PART VI, SECTION B, LINE 11 FORM 990 REVIEW PROCESS INFORMATION RELATED TO THIS ORGANIZATION'S FORM 990 FILING IS GATHERED BY FINANCE STAFF AND PROVIDED TO PRICEWATERHOUSECOOPERS LLP FOR REVIEW AND RETURN PREPARATION. A DRAFT COPY OF THE 2020 FORM 990 WAS REVIEWED BY VARIOUS SENIOR FINANCIAL MANAGEMENT OFFICIALS BEFORE IT WAS SUBMITTED TO THE BOARD FOR THEIR REVIEW. A COPY OF THE FINAL 2020 FORM 990 WAS THEN MADE AVAILABLE TO EACH BOARD MEMBER PRIOR TO THE FILING DEADLINE. ------------------------------ FORM 990, PART VI, SECTION A, LINE 12C CONFLICT OF INTEREST POLICY THIS ORGANIZATION IS AN AFFILIATE OF THE TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA ("UNIVERSITY"). EACH COVERED PERSON* ANNUALLY SHALL COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE PROVIDED BY THE UNIVERSITY AND SHALL UPDATE SUCH QUESTIONNAIRE PROMPTLY AS NECESSARY TO REFLECT CHANGES DURING THE COURSE OF THE YEAR. FORMER BOARD MEMBERS WHO ARE NOT TRUSTEE EMERITI ARE ENCOURAGED BUT NOT REQUIRED TO COMPLETE THE QUESTIONNAIRE DURING THE FIVE-YEAR PERIOD FOLLOWING COMPLETION OF THEIR TERMS. COMPLETED QUESTIONNAIRES SHALL BE RETURNED TO THE OFFICE OF THE SECRETARY AND SHALL BE SUBJECT TO REVIEW BY SUCH OFFICE AND THE OFFICE OF THE GENERAL COUNSEL, AS WELL AS BY ANY OUTSIDE LEGAL COUNSEL AND/OR AUDITORS WHO MAY BE APPOINTED TO ADVISE THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES APPOINTED TO OVERSEE THIS POLICY. COMPLETED QUESTIONNAIRES ALSO SHALL BE AVAILABLE FOR INSPECTION BY ANY BOARD MEMBER. *COVERED PERSONS INCLUDE: (1) VOTING MEMBERS OF THE BOARD OF TRUSTEES (INCLUDING CHARTER TRUSTEES, TERM TRUSTEES, ALUMNI TRUSTEES, AND COMMONWEALTH TRUSTEES); (2) TRUSTEE EMERITI WHO HAVE SERVED IN THAT CAPACITY FOR FIVE YEARS OR LESS; (3) OTHER FORMER VOTING TRUSTEES FOR A PERIOD OF FIVE YEARS FROM THE END OF THEIR TERM AS SUCH; (4) OFFICERS AS DEFINED IN THE STATUTES; AND (5) MEMBERS OF THE INVESTMENT BOARD. EACH COVERED PERSON (EXCEPT FORMER BOARD MEMBERS WHO ARE NOT TRUSTEE EMERITI) SHALL BE REQUIRED TO ACKNOWLEDGE, NOT LESS THAN ANNUALLY, THAT HE OR SHE HAS READ AND IS IN COMPLIANCE WITH THIS POLICY. ------------------------------ FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION PROCESS THIS ORGANIZATION IS AN AFFILIATE OF THE TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA ("UNIVERSITY"). COMPENSATION ARRANGEMENTS INVOLVING ANY OF OUR OFFICERS AND/OR KEY EMPLOYEES ARE ESTABLISHED BY THE UNIVERSITY PURSUANT TO A PROCESS THAT SATISFIES THE REBUTTABLE PRESUMPTION PROCEDURE AVAILABLE FOR SECTION 4958 EXCESS BENEFIT TRANSACTION TAX PURPOSES (WHICH REQUIRES A REVIEW OF COMPENSATION DETERMINATIONS BY DISINTERESTED PERSONS, USE OF APPROPRIATE COMPARABILITY DATA, AND CONTEMPORANEOUS DOCUMENTATION OF THE PROCESS). ------------------------------ FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS AVAILABILITY TO PUBLIC OUR FORMS 1023 AND 990, GOVERNING DOCUMENTS, AUDITED FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. ------------------------------ FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS TRANSFER TO AFFILIATE ($157,185) ------------------------------ AFFILIA HOME HEALTH 1811 OLDE HOMESTEAD LANE LANCASTER PA 17601 231352572 HOME HEALTH PA 501(c)(3) 7 LG HEALTH false CARL V S PATTERSON 19 UN OF PA C/O PNC BANK 620 LIBERTY AVE 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HEALTH COLUMBIA CENTER 306 NORTH 7TH STREET COLUMBIA PA 17512 230485650 FACILITY MGMT PA 501(C)(3) 3 LG HOSPITAL false LANCASTER GENERAL HEALTH FOUNDATION 555 NORTH DUKE STREET LANCASTER PA 17604 205767147 FUNDRAISING PA 501(C)(3) 7 NA false LANCASTER GENERAL HEALTH HOLDINGS 555 NORTH DUKE STREET LANCASTER PA 17604 204943109 HEALTHCARE PA 501(C)(3) 3 LG HEALTH false LANCASTER GENERAL HOSPITAL 555 NORTH DUKE STREET LANCASTER PA 17604 231365353 HEALTHCARE PA 501(C)(3) 3 LG HEALTH false LANCASTER GENERAL MEDICAL GROUP 1030 NEW HOLLAND AVENUE LANCASTER PA 17601 232777286 HEALTHCARE PA 501(C)(3) 3 LG HEALTH false MORRIS EST LYDIA T DECD TW 1525 W WT HARRIS BLVD CHARLOTTE NC 28262 236210940 SUPPORT TRUST PA 501(C)(3) 12, III-FI NA false NEIGHBORHOOD HEALTH AGENCIES INC 795 E MARSHALL STREET WEST CHESTER PA 19380 232324782 NURSING PA 501(C)(3) 12, I CCH&HS false NEIGHBORHOOD LEAGUE HEALTH SERVICES 795 E MARSHALL STREET WEST CHESTER PA 19380 232324787 HEALTH SRVCS PA 501(C)(3) 10 CCH&HS false NEIGHBORHOOD VISITING NURSE ASSOCIATION 795 E MARSHALL STREET WEST CHESTER PA 19380 231352243 NURSING PA 501(C)(3) 7 CCH&HS false OAP INC 3451 WALNUT STREET ROOM 748 PHILADELPHIA PA 19104 231986931 SUPPORT ORG PA 501(c)(3) 12, I TRUSTEES false PENN CENTER FOR REHAB AND CARE 3609 CHESTNUT STREET PHILADELPHIA PA 19104 232422635 HEALTHCARE PA 501(c)(3) 3 PMC false PENN CLUB OF NEW YORK INC 30 WEST 44TH STREET NEW YORK NY 10036 232726687 CLUB NY 501(c)(7) N/A NA false PENN PRAXIS INC 210 SOUTH 34TH STREET PHILADELPHIA PA 19104 752974931 SUPPORT ORG PA 501(c)(3) 12, I TRUSTEES false PENN PRESS INC 3905 SPRUCE STREET PHILADELPHIA PA 19107 231876142 PUBLISHING PA 501(c)(3) 12, I TRUSTEES false PENNSYLVANIA COLLEGE OF HEALTH SCIENCES 850 GREENFIELD ROAD LANCASTER PA 17601 061645496 HEALTH EDU PA 501(C)(3) 2 LG HOSPITAL false PENNSYLVANIA HOSPITAL OF UPHS 800 SPRUCE STREET PHILADELPHIA PA 19107 311538725 HEALTHCARE PA 501(C)(3) 3 TRUSTEES false PGH DEVELOPMENT CORP 426 CURIE BLVD PHILADELPHIA 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TRUST PA 501(c)(3) 8 NA false THE HEART GROUP OF LANCASTER GEN HEALTH 217 HARRISBURG AVENUE LANCASTER PA 17603 300634510 CARDIOLOGY PA 501(C)(3) 3 LG HEALTH false THE LEONARD AND MADLYN ABRAMSON INST 421 CURIE BLVD 450 BRB II/III PHILADELPHIA PA 19104 232929823 MED RESEARCH PA 501(c)(3) 4 NA false TRUSTEES OF THE UNIVERSITY OF PENN 3451 WALNUT STREET ROOM 305 PHILADELPHIA PA 19104 231352685 EDUCATION PA 501(c)(3) 2 NA false UNIVERSITY CITY ASSOCIATES INC 3451 WALNUT STREET ROOM 329 PHILADELPHIA PA 19104 233021159 SUPPORT ORG PA 501(c)(3) 12, I TRUSTEES false UNIVERSITY CLUB AT PENN INC 3611 WALNUT STREET PHILADELPHIA PA 19104 236299508 FAC. CLUB PA 501(c)(3) 12, I TRUSTEES false UPENN INTERNATIONAL 3451 WALNUT STREET SUITE 731 PHILADELPHIA PA 19104 454985731 SUPPORT ORG PA 501(C)(3) 12, I TRUSTEES false UPENN MASTER RETIREMENT TRUST 3451 WALNUT STREET ROOM 305 PHILADELPHIA PA 19104 043574136 RETIRE TRUST PA 501(A) N/A TRUSTEES false UPENN RETIREE BENEFITS TRUST 3451 WALNUT STREET ROOM 329 PHILADELPHIA PA 19104 232769744 BENEFITS PA 501(c)(3) 12, I TRUSTEES false WOMEN'S AND CHILDREN'S HEALTH SERVICES 700 SPRUCE STREET PHILADELPHIA PA 19106 232248956 HEALTHCARE PA 501(c)(3) 3 PA HOSPITAL false PENN MEDICINE-PMA 5 ATRIUM 3400 CIVIC CTR BLVD PHILADELPHIA PA 19104 863800365 HEALTHCARE PA 501(C)(3) 10 CCA false ARI 1740 FUND N SETSON AVE STE 5500 CHICAGO IL 60601 320472404 INVESTMENT IL NA false CYRUS 1740 FUND LP 65 E 55TH STREET 35TH FLOOR NEW YORK NY 10022 821211542 INVESTMENT NY NA false CYRUS 1740 MASTER FUND LP 89 NEXUS WAY CAMANA BAY GR CJ KY1-9009 981361754 INVESTMENT CJ NA false DVG 1740 FUND LP ONE FAWCETT PLACE GREENWICH CT 06830 800961539 INVESTMENT CT NA false EAST MARSHALL STREET PARTNERSHIP LP 701 E MARSHALL STREET WEST CHESTER PA 19380 232902742 INVESTMENT PA NA false FERN HILL PARTNERSHIP III LP 701 E MARSHALL STREET WEST CHESTER PA 19380 300409614 RENTAL PA NA false FERN HILL LLC 701 E MARSHALL STREET WEST CHESTER PA 19380 233005147 RENTAL PA NA false GALLOPAVO LP 2000 McKINNEY AVE STE 2125 DALLAS TX 75201 464621967 INVESTMENT TX NA false JOG V C LIMITED PARTNERSHIP STE 2370 440 2ND AVE SW CALGARY AL CA T2P5E9 INVESTMENT CA NA false JOG VI C LIMITED PARTNERSHIP STE 2370 440 2ND AVE SW CALGARY AL CA T2P5E9 INVESTMENT CA NA false KINGSTOWN 1740 FUND LP 34 EAST 51ST STREET NEW YORK NY 10022 843119908 INVESTMENT NY NA false LANCASTER PET PARTNERSHIP LLP PO BOX 4216 LANCASTER PA 17604 233102793 MEDICAL SERVICES PA NA false LG HEALTH COMM CARE COLLAB II 555 NORTH DUKE STREET LANCASTER PA 17604 823809581 ACO PA NA false LG HEALTH COMMUNITY CARE COLLABORATIVE 555 NORTH DUKE STREET LANCASTER PA 17604 455542179 ACO PA NA false LIFT REAL ESTATE PARTNERS FUND I LP 180 SUTTER STREET SUITE 400 SAN FRANCISCO CA 94104 831339929 INVESTMENT CA NA false MRI GROUP LLP PO BOX 4216 LANCASTER PA 17604 331011386 MEDICAL SERVICES PA NA false NEIGHBRHD PRES & DEV FUND LP 240 NEW YORK DR STE 1 FORT WASHINGTON PA 19034 233037919 RENTAL PA NA false OAKLANDS WAY MEDICAL BUILDING ASSOCIATES 701 E MARSHALL STREET WEST CHESTER PA 19380 830490251 RENTAL PA NA false SRP INVESTORS FUND A LP 2001 ROSS AVE SUITE 400 DALLAS TX 75201 611748291 INVESTMENT TX NA false TURK'S HEAD SURGERY CENTER 915 OLD FERN HILL ROAD BLDG B STE WEST CHESTER PA 19380 200184603 MEDICAL SERVICES PA NA false ST-TO RIBBIT OPPORTUNITY V LLC 364 UNIVERSITY AVENUE PALO ALTO CA 94301 841814102 INVESTMENTS CA NA false UNIVERSA BLACK SWAN PROTECTION PROTOCOL 2601 S BAYSHORE DR SUITE 2030 MIAMI FL 33133 852143048 INVESTMENT FL N/A false AXIS UKA GP LLC 240 NEW YORK DRIVE SUITE 1 FORT WASHINGTON PA 19034 273617178 INVESTMENT PA N/A false LIFT REAL ESTATE PARTNERS FUND II LP 180 SUTTER STREET SUITE 400 SAN FRANCISCO CA 94104 844983190 INVESTMENT CA N/A false ARCM 1740 LTD 27 HOSPITAL ROAD CJ KY1-9008 INVESTMENTS CJ TRUSTEES C-CORP false CIRCLE MEDICAL ASSURANCE CO 2929 WALNUT STREET STE 460 PHILADELPHIA PA 19104 833556286 INSURANCE PA TRUSTEES C-CORP false CLINICAL HEALTH CARE ASSOC OF NJ PC 250 KING OF PRUSSIA RD 4TH FL RADNOR PA 19087 232865181 PHYS MGMT PA CCA C-CORP false DELANCEY CORPORATION 800 SPRUCE STREET PHILADELPHIA PA 19106 232060159 RENTAL PA PA HOSPITAL C-CORP false FRANKLIN CASUALTY INSURANCE CO PO BOX 530 BURLINGTON VT 05402 043378984 INSURANCE VT TRUSTEES C-CORP false LANCASTER GENERAL 457 DEFERRED COMP PLAN 555 NORTH DUKE STREET LANCASTER PA 17604 232250941 TRUST PA LG HEALTH TRUST false LANCASTER GENERAL INSURANCE COMPANY PO BOX 1109 GT GRAND CAYMAN CJ KYI-1102 980176655 INSURANCE CJ LG HEALTH C-CORP false LANCASTER GENERAL SERVICES INC 555 NORTH DUKE STREET LANCASTER PA 17604 232250128 PROPERTY SVCS PA LG HEALTH C-CORP false NAYA 1740 FUND LTD PO BOX 309 UGLAND HOUSE CJ KY1-1104 INVESTMENTS CJ TRUSTEES C-CORP false PENN MEDICINE LONDON LIMITED RADIUS COMMERCIAL SERVICES LTD 11T WHITEFRIARS LEWINS MEAD UK BS1 2NT HEALTHCARE UK UPENN INT'L LIMITED COMPANY false PENN WHARTON CONSULTING (BEIJING) CO LTD CHINA WORLD TOWER 1 14F CHAOYANG DIST CH 100004 BUS. 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