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UPMC Jameson provides health and human services to all individuals regardless of their race, color, religious creed, ancestry, union membership age, gender, sexual orientation, gender identity or expression, national origin, aids or hiv status or disability and promotes health by providing quality inpatient and outpatient medical care to our surrouding area. false false 90889568 SEE SCHEDULE O 90889568 true true false false false false false false true true false false true true false false true false false false false false false true false true true false false true false false false false false false false false false false false false false true false false false true 0 0 true 1098 true false false false false false false false false false false X 13 11 false false false false true true true true true false false true true true true true true true true false PA X BRIAN FRITZ CFO 4127486354 1211 WILMINGTON AVE NEW CASTLE PA 161052595 Frank Mindicino Chairman 1.0 0.0 X X 0 0 0 Frank 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X X X true true X X X true X www.upmc.com (see Part VI) X www.upmc.com (see Part VI) X www.upmc.com (see Part VI) X X X X X X true X false true X false false Part V, Section B Schedule H, Part V, Section B, Line 5-Group A - BKD, LLC worked together with Lawrence County Community Health Needs Steering Committee to develop a broad list of community leaders to interview. These community members were selected based on their involvement within the community and because they provided distinctive backgrounds and a variety of perspective on the state of the community and health care. Interviews were conducted with a number of directors and staff members from the community health centers, members from social service organizations, educational leaders, religious groups and elected officials. The selected participants give an overarching viewpoint of the community and through these interviews the health needs from the perspective of the community were identified. BKD, LLP was engaged to conduct a formal community health needs assessment. The community health needs assessment was conducted from January 2016 through May 2016. Based on current literature and other guidance from the treasury and the IRS, the following steps were conducted as part of the Health System's community health needs assessment. An evaluation of the impact of actions taken to address the significant health needs identified in the prior community health needs assessment was completed and an implementation strategy scorecard was prepared to understand the effectiveness of the Health System's current strategies and programs. The "community" served by the Health System was defined by utilizing inpatient and outpatient data regarding patient origin. This process is further described in Community Served by the Health System. Population demographics and socioeconomic characteristics of the community were gathered and reported utilizing various third parties. The health status of the community was then reviewed. Information on the leading causes of death and morbidity information was analyzed in conjunction with health outcomes and factors reported for the community by CountyHealthRankings.org. Health factors with significant opportunity for improvement were noted. Community input was provided through key informant interviews. Results and findings are described in the Key informant section of the formal report. Information gathered in the steps above was analyzed and reviewed to identify health issues of uninsured persons, low income persons and minority groups and the community as a whole. Health needs were ranked utilizing a weighting method that weighs the following: the size of the problem; the seriousness of the problem; impact of the issues on vulnerable populations; the prevalence of common themes; how important the issue is to the community; how the issue aligns with the Health System's strategic plan. An inventory of health care facilities and other community resources potentially available to address the significant health needs identified through the CHNA was prepared and collaborative efforts were identified. Health needs were then prioritized taking into account the perceived degree of influence the Health System has to impact the need and the health needs impact on overall health for the community. Information gaps identified during the prioritization process have been reported. SCHEDULE H, PART V, SECTION B, LINE 11 GROUP A UPMC JAMESON MADE MEASURABLE PROGRESS ON IMPROVING COMMUNITY HEALTH IN THE PERIOD FROM FISCAL YEAR 2014 THROUGH 2018. PROGRAMS AND INITIATIVES FOCUSED ON ALL OF THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE JUNE 30, 2013 CHNA AND THE JUNE 30, 2016 CHNA, WHICH INCLUDED: OBESITY AND NUTRITION, HEART DISEASE, BEHAVIORAL HEALTH (INCLUDING SUBSTANCE ABUSE), AND ACCESS TO PRIMARY CARE AND SPECIALTY CARE. IMPLEMENTATION PLANS DEVELOPED BY UPMC JAMESON DRAW SUPPORT FROM AN ARRAY OF ACTIVE AND ENGAGED COMMUNITY PARTNERS, AS WELL AS FROM THE LARGER UPMC SYSTEM, AND INCLUDE NUMEROUS INITIATIVES, UTILIZING BOTH EVIDENCE-BASED, NATIONALLY RECOGNIZED PROGRAMS AND INTERNALLY DESIGNED PILOT PROGRAMS. THE BOARD OF DIRECTORS AT UPMC JAMESON REGULARLY MONITORS THE PROGRESS OF THE COMMUNITY HEALTH IMPROVEMENT PLANS. DURING FISCAL YEARS 2014 THROUGH 2018, UPMC JAMESON MADE MEASURABLE PROGRESS IN ALL AREAS IDENTIFIED THROUGH THE CHNA PROCESS. IN SOME CASES, UPMC IMPOVED AND EXPANDED EXISTING PROGRAMS - REACHING OUT NOT ONLY TO MORE PEOPLE, BUT ALSO TARGETING PEOPLE WHO COULD BENEFIT MOST. UPMC ALSO DEVELOPED NEW PROGRAMS AND INITIATIVES, WHICH REQUIRED THE CREATION OF OPERATING INFRASTRUCTURE, AND ESTABLISHMENT OF GOALS AND ASSOCIATED ASSESSMENT TOOLS. UPMC JAMESON DEVELOPED AND ENHANCED PARTNERSHIPS WITH OTHER COMMUNITY ORGANIZATIONS TO BETTER COORDINATE RESOURCES. EXAMPLES OF UPMC JAMESONS PROGRESS DURING FISCAL YEARS 2014 THROUGH 2018 INCLUDE: PROMOTED HEALTHY EATING AND EXERCISE TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITY THROUGH EDUCATION INITIATIVES, DEVELOPMENT OF SPECIALIZED PROGRAMS, AND USE OF TECHNOLOGY TOOLS. UPMC JAMESON OFFERED VARIOUS NUTRITION EDUCATION PROGRAMS TO SCHOOL-AGE CHILDREN, ADULTS, AND SENIORS. THE HOSPITAL COLLABORATES WITH LOCAL ORGANIZATIONS TO ACHIEVE THIS GOAL. FOR EXAMPLE, UPMC JAMESON PARTNERS WITH MEALS ON WHEELS AND CHALLENGES: OPTIONS IN AGING TO HELP EDUCATE THE COMMUNITY ABOUT NUTRITION AND HEALTHY EATING, REACHING OUT THROUGH INDIVIDUAL COUNSELING, HEALTH FAIRS, AND AFTER-SCHOOL PROGRAMS. OVER THE LAST THREE YEARS, MORE THAN 4,600 COMMUNITY MEMBERS HAVE PARTICIPATED IN NUTRITION EDUCATION PROGRAMS. ADDITIONALLY, UPMC JAMESON OFFERS WEIGHT MANAGEMENT AND WEIGHT LOSS SERVICES TO EMPLOYEES AND COMMUNITY MEMBERS THROUGH THE MYPATH PROGRAM. THIS FLEXIBLE PROGRAM IS TAILORED BY A REGISTERED DIETITION TO HELP PARTICIPANTS REACH THEIR WEIGHT LOSS GOALS. THE MYPATH PROGRAM CONNECTS PARTICIPANTS TO WEIGHT LOSS SUPPORT AND TRACKING ASSISTANCE THROUGH IN-PERSON SESSIONS WITH A DIETITION OR VIA AN ONLINE OR SMARTPHONE APP. IMPROVED MANAGEMENT AND PREVENTION OF HEART DISEASE BY EXPANDING LOCAL ACCESS TO EXPERT CARDIOVASCULAR CARE AND PROVIDING COMMUNITY EDUCATION. IN JULY 2017, THE HOSPITAL OPENED THE UPMC HEART AND VASCULAR INSTITUTE (HVI) AT UPMC JAMESON TO SERVE AS A REGIONAL HUB ACROSS MERCER AND LAWRENCE COUNTIES. HVI PROVIDES COMPREHENSIVE CARDIOVASCULAR SERVICES TO THE LOCAL COMMUNITY, INCLUDING ADVANCED DIAGNOSTIC TESTING AND INTERVENTIONAL CARDIAC CATHETERIZATIONS. ADDITIONALLY, UPMC JAMESON CONTINUES TO RAISE AWARENESS ABOUT HEART DISEASE THROUGH A RANGE OF COMMUNITY PROGRAMS, SUCH AS OFFERING ROUTINE BLOOD PRESSURE SCREENINGS AT CHALLENGES: OPTIONS IN AGING; HOSTING THE HEALTHY LIVING EDUCATION SERIES; AND PROVIDING UPMC EMPLOYEES, AREA BUSINESSES, AND SCHOOLS WITH CPR TRAINING THAT INCORPORATES CURRICULUM ABOUT HEART DISEASE FROM THE AMERICAN HEART ASSOCIATION. EXPANDED ACCESS TO BEHAVIORAL HEALTH SERVICES WITH A FOCUS ON SUBSTANCE USE DISORDERS THROUGH THE PARTIAL HOSPITALIZATION PROGRAM, CONSULT AND LIAISON SERVICES, AND THE PEER NAVIGATOR PROGRAM. THE UPMC JAMESON PARTIAL HOSPITALIZATION PROGRAM IS A STRUCTURED, INTENSIVE MENTAL HEALTH TREATMENT SERVICE FOR ADULTS. THIS PROGRAM COMBINES INDIVIDUAL, GROUP, AND FAMILY THERAPY SESSIONS. IN 2017, 133 PATIENTS DEVELOPED THE SKILLS TO MANAGE THEIR SYMPTOMS, TRANSITION BACK TO THEIR HOMES, AND REINTEGRATE INTO THEIR COMMUNITIES. UPMC JAMESON, IN PARTNERSHIP WITH UPMC HORIZON, PROVIDED CONSULT AND LIAISON SERVICES TO HOSPITALIZED AND EMERGENCY DEPARTMENT PATIENTS. SERVICES OFFERED INCLUDED ASSESSMENTS, REFERRALS, CONNECTIONS TO RESOURCES, SUPPORT, AND TELEMEDICINE CONSULTATIONS WITH UPMC WESTERN PSYCHIATRIC HOSPITAL. IN DECEMBER 2017, UPMC JAMESON BEGAN USING TELEMEDICINE TECHNOLOGY FOR BEHAVIORAL HEALTH CONSULTS. USING TELEPSYCHIATRY, THE HOSPITAL QUICKLY CONNECTED PATIENTS WITH A UNIVERSITY OF PITTSBURGH PHYSICIANS PSYCHIATRIST. THIS NEW SERVICE IMPROVED PATIENTS LEVEL OF ACCESS TO A FACE-TO-FACE CONSULTATION WITH A PHYSICIAN, AND BRINGS THE EVIDENCE-BASED, EXPERT CARE OF UPMC WESTERN PSYCHIATRIC HOSPITAL TO LOCAL PATIENTS. LASTLY, UPMC JAMESON PARTICIPATES IN THE PEER NAVIGATOR PROGRAM, WHICH OFFERS PATIENTS WITH MENTAL HEALTH DISORDERS AND SUBSTANCE USE DISORDERS AN OPPORTUNITY TO ENGAGE WITH AN INDIVIDUAL IN RECOVERY WHO HAS EXPERIENCED ADDICTION. PEER NAVIGATORS SUPPORT THE INDIVIDUAL ON THEIR JOURNEY TO WELLNESS BY OFFERING PATIENT-CENTERED, RECOVERY-ORIENTED, AND EVIDENCE-BASED SERVICES, SUCH AS WELLNESS COACHING, REFERRALS TO COMMUNITY RESOURCES, AND HELP WITH REACHING TREATMENT GOALS. EXPANDED LOCAL ACCESS TO PRIMARY AND SPECIALTY CARE THROUGH RECRUITMENT AND TELEMEDICINE SERVICES. UPMC JAMESON COMPLETED AN ASSESSMENT OF PHYSICIAN NEEDS ACROSS MERCER AND LAWRENCE COUNTIES. AFTER IDENTIFYING AREAS OF PHYSICIAN NEED, THE HOSPITAL DEVELOPED A RECRUITMENT PLAN AND HAS SUCCESSFULLY RECRUITED MORE THAN 20 PHYSICIANS TO PRACTICE IN THE REGION. ADDITIONALLY, UPMC JAMESON DEVELOPED A TELEMEDICINE PROGRAM IN 2017 THAT ENABLES PATIENTS TO MEET, BY VIDEO CONFERENCE, WITH UPMC SPECIALISTS IN PITTSBURGH. THE TELEMEDICINE PROGRAM HELPS OVERCOME DISTANCE 3 Jameson & UPMC Cancer Center 2602 Wilmington Road New Castle PA 16105 Outpatient Cancer Treatment Lawrence County MRI 2526 Wilmington Road New Castle PA 16105 Outpatient Radiology Center Jameson at College Fields 130 Enclave Drive New Castle PA 16101 Outpatient Radiology Center Schedule H, Part I, Line 3c PART I LINE 3C FINANCIAL ASSISTANCE OR CHARITY CARE IS AVAILABLE FOR ELIGIBLE INDIVIDUALS WHO HAVE HEALTH CARE NEEDS AND ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR GOVERNMENT PROGRAMS OR OTHERWISE UNABLE TO PAY FOR THEIR OWN CARE. A PATIENT MAY BE DETERMINED TO HAVE FINANCIAL NEED BASED ON THE FOLLOWING: 1. INDIGENCY: IF INCOME FALLS AT OR BELOW 250% OF THE FEDERAL POVERTY GUIDELINES, THE PATIENT WILL HAVE NO FINANCIAL RESPONSIBILITY. THE PATIENT IS APPROVED FOR 100% FREE CARE. 2. LOW INCOME SLIDING SCALE: ASSISTANCE MAY BE A DISCOUNTED OR REDUCED PATIENT LIABILITY DEPENDING ON THE PATIENT'S INCOME: A. IF THE COMBINED FAMILY INCOME IS GREATER THAN 251% AND LESS THAN OR EQUAL TO 400% OF THE FEDERAL POVERTY GUIDELINES AND UNINSURED, THE PATIENT IS ELIGIBLE FOR REDUCED CHARITY CARE. THERE WILL BE AN 87% REDUCTION IN THE PATIENT BILL.THE DISCOUNTED CHARITY CARE SCALE IS LISTED BELOW: F/S= FAMILY SIZE 2018 2018 Family Size Category 1-100% Category 2-87% 1 $30,350 $48,560 2 $41,150 $65,840 3 $51,950 $83,120 4 $62,750 $100,400 5 $73,550 $117,680 6 $84,350 $134,960 7 $95,150 $152,240 8 $105,950 $169,520 Each Additional $10,800 $17,280 3. FINANCIAL HARDSHIP: IF A PATIENT IS APPROVED FOR DISCOUNTED OR REDUCED CHARITY CARE AND CANNOT AFFORD TO PAY THE REMAINING BALANCE, THE PATIENT MAY BE CONSIDERED FOR FINANCIAL HARDSHIP. ASSISTANCE WILL BE PROVIDED IN THE FORM OF AN ADJUSTMENT OF CHARGES TO PREVENT THE PATIENT LIABILITY FROM EXCEEDING THE LESSER OF 15% OF FAMILY INCOME OR THE AGB. 4. MEDICAL HARDSHIP/CATASTROPHIC CARE: IF A PATIENT IS DENIED FOR FINANCIAL ASSISTANCE AND CANNOT AFFORD TO PAY THE ACCOUNT BALANCE, THE PATIENT MAY BE CONSIDERED MEDICALLY INDIGENT AND MAY BE CONSIDERED FOR MEDICAL HARDSHIP/CATASTROPHIC CARE. THE PATIENT WILL BE LIABLE TO PAY THE LESSER OF 15% OF THEIR CALCULATED HOUSEHOLD INCOME OR THE AGB TOWARDS THEIR MEDICAL BILL. THIS IS A ONE-TIME FINANCIAL ASSISTANCE ADJUSTMENT FOR EXISTING ACCOUNT BALANCES. THE REMAINING BALANCE WILL BE ADJUSTED TO FREE CARE. Schedule H, Part I Part 1, Line 4 "Medically Indigent" means persons who the organization has determined unable to pay some or all of their medical bills because their medical bills exceed a certain percentage of their family household's income. Part 1, Line 7 THE COSTING METHODOLOGY USED TO CALCULATE THE AMTS REPORTED IN PART I LINE 7 The costing methodology used to calculate the amounts reported in Part I Line 7 is a ratio of costs to charges method. The method employed for determining the ratio of cost to charges is in line with those described in Schedule H, Worksheet 2, "Ratio of Patient Costs to Charges". Part 1, Line 7, Column F The expense used to calculate the percent of total expense for Form 990 Schedule H Part I Line 7 Column f are the total expenses from Form 990 Part IX. From this total expense per Part IX Line 25 the amount related to bad debt expense has been removed from the denominator when calculating the percent of total expense. The total expenses used for this calculation, net of bad debt expense, is $111,286,461. Schedule H, Part III Part III, Lines 2 & 3 COSTING METHODOLOGY USED TO DETERMINE THE AMTS REPORTED IN PT III LINE 2 & 3 The costing method used to calculate the amounts in Schedule H Part III lines 2 and 3 is a ratio of cost to charges method. Discounts and payments in patients' accounts are deducted before the cost of bad debt expense is determined. The method employed is in line with those described in Schedule H, Worksheet 2, "Ratio of Patient Costs to Charges". Part III, Line 3 RATIONALE FOR INCLUDING BAD DEBT AMOUNTS IN COMMUNITY BENEFIT The organization's bad debt expense consists solely of self-pay patients accounts deemed uncollectable. It is UPMC Jameson's contention that the cost of bad debt should be stated in Part I Line 7 of Schedule H as they represent the costs for provision of services to patients for which the entity has exhausted all recourse for reimbursement. The services provided to patients who present themselves are provided regardless of a patient's ability to pay AND IS IN line with the organization's charitable mission and service to our community. These expenses are incurred regardless of the efficiency of the provision of the related medical care and are deemed to have been medically necessary for the patient. PROCESS FOR REALLOCATION FROM BAD DEBT TO CHARITY CARE UPMC RECLASSIFIES BAD DEBT ACCOUNTS AS CHARITY CARE BY UTILIZING A PREDICTIVE MODEL CALLED PARO (PAYMENT ASSISTANCE RANK ORDER). PARO WAS BUILT AS A SOCIO-ECONOMIC SCORE THAT IDENTIFIES THOSE PATIENTS THAT ARE MOST LIKELY TO BE THE HIGHEST NEED OF FINANCIAL ASSISTANCE. THIS IS ACCOMPLISHED BY ANALYZING CONSUMER DATA AND ACTIVITY, COURT RECORDS, GOVERNMENT RECORDS, PROPERTY FILES, CENSUS DATA AND IRS DATA. PARO PROVIDES A SYSTEMATIC APPROACH TO FINANCIAL ASSISTANCE: " PREDICTIVE MODEL THAT ENCOMPASSES HEALTHCARE ECONOMICS AND CREDIT POLICIES;" UNIFORM ASSESSMENT MEASURE FOR EVERY PATIENT REGARDLESS OF FINANCIAL STANDING; " ACCOUNTS FOR PATIENTS THAT ARE UNRESPONSIVE, ILLITERATE, OR OTHERWISE CHALLENGED TO APPLY; " ELIMINATES BARRIER TO APPLICATION AND MEETS INCREASED PRESSURE TO PROVIDE ADDITIONAL FINANCIAL RESOURCES TO CONSUMERS; " IDENTIFY AND SUPPORT THOSE COMMUNITY NEEDS EFFORTS TO PROVIDE ASSISTANCE TO THOSE CONSUMERS IN NEED." THERE ARE TWO DATA POINTS RETURNED TO UPMC IN ORDER TO MAKE THE DECISION WHETHER THE PATIENT WOULD QUALIFY FOR CHARITY CARE. THE FIRST IS THE ESTIMATED INCOME LEVEL BASED ON THE FEDERAL POVERTY LEVEL GUIDELINES. THE SECOND IS THE PARO SCORE WHICH UTILIZES AN ALGORITHM BASED APPROACH AND RETURNS A SCORE BASED ON PERSONAL ATTRIBUTES OF THE PATIENT. DATA ELEMENTS WERE COMBINED TO CREATE TWO PRIMARY INDICATORS OF NEED, THE PARO SCORE AND THE FEDERAL POVERTY LEVEL. PARO ANALYZED OUR HISTORICAL CHARITY CARE APPROVALS TO DETERMINE OUR PARO THRESHOLD AND THE FPL THRESHOLD FOR THE HISTORICAL APPROVALS. THE APPROVED CHARITY CARE ACCOUNTS WERE COMPARED AGAINST ACCOUNTS THAT WERE IN ACTIVE ACCOUNTS RECEIVABLE. THIS WAS DONE TO DETERMINE IF THE DISTRIBUTIONS WERE SIMILAR OR IF ANY PATTERN EXISTED BASED ON THE APPROVED ACCOUNTS AND THE UNKNOWN ACCOUNTS. IF THE PATIENT'S ESTIMATED INCOME AND PARO SCORE ARE WITHIN THE SCORES IDENTIFIED BY THE CALIBRATION OF UPMC EXISTING CHARITY CARE PATIENTS, THE ACCOUNT IS RECLASSIFIED FROM BAD DEBT TO CHARITY CARE. EVERY PATIENT IS ABLE TO APPLY FOR CHARITY CARE; HOWEVER, THE AUTOMATED STRATEGY FOCUSES ON PATIENTS THAT DO NOT COMPLETE THE APPLICATIONS PROCESS. THE US DEPARTMENT OF EDUCATION ESTIMATES THAT 1 IN 5 CONSUMERS ARE FUNCTIONALLYILLITERATE. THIS, COUPLED WITH THE LOW LEVELS OF PARTICIPATION IN TRADITIONAL BANKING METHODS, MAKES THE APPLICATION PROCESS VIRTUALLY IMPOSSIBLE FOR SOME CONSUMERS. Part III, Line 4 Reference UPMC's, December 31, 2017, consolidated Audited Financial Statements page 8. Part III, Line 8 ALLOWABLE COSTS OF CARE AND AS REPORTED IN THE ORGS MEDICARE COST REPORT The costing methodology used to determine the Medicare allowable costs of care is a ratio of costs to charges method. The method is in line with those described in Schedule H, Worksheet 2, "Ratio of Patient Costs to Charges". It is UPMC Jameson's contention that all amounts calculated to be shortfalls in reimbursement for services provided to Medicare patients are truly uncompensated care that should be stated in Part I Line 7 of Schedule H of Form 990 as they represent costs for provision of services to patients for which the entity is unable to collect, regardless of the efficiency of provision of the related care costs. Part III, Line 9A and B UPMC has a debt collection policy outlining collection practices for patients. If at any time the patient expresses an inability to pay, they are sent a Financial Assistance application. Information regarding Financial Assistance is printed on all collection letters. Collections per policy do not apply to account balances known to be eligible for financial assistance. Schedule H, Part V PART V SECTION B LINE 16: www/upmc.com/patients-visitors/paying-bill/services PART VI LINE 3 COMMUNICATION OF FINANCIAL ASSISTANCE UPMC COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE TO ITS PATIENTS BY PLACING SIGNAGE AND DISTRIBUTING BROCHURES ABOUT THE FINANCIAL ASSISTANCE PROGRAM IN ITS PROVIDER REGISTRATION AREAS, ADMISSIONS, EMERGENCY DEPARTMENT AND BUSINESS OFFICE LOCATIONS. IN ADDITION, UPMC INCLUDES INFORMATION REGARDING HOW A PATIENT CAN REQUEST FINANCIAL ASSISTANCE ON THE BILLS, FOLLOW-UP CORRESPONDENCE AND COLLECTION LETTERS. PATIENTS ALSO MAY FIND INFORMATION ABOUT FINANCIAL ASSISTANCE THROUGH ACCESS TO THE UPMC WEB SITE (WWW.UPMC.COM). PATIENTS ARE ENCOURAGED TO CONTACT UPMC'S TRAINED FINANCIAL COUNSELORS SHOULD THEY REQUIRE ASSISTANCE WITH COMPLETING APPLICATIONS. CONTACT TELEPHONE NUMBERS ARE POSTED STRATEGICALLY THROUGHOUT THE HOSPITAL FACILITIES SO THAT PATIENTS HAVE A RESOURCE FOR OBTAINING SUPPORT WITH ANY FINANCIAL ASSISTANCE QUESTIONS THEY MAY HAVE.UPMC HAS CREATED A PLAIN LANGUAGE SUMMARY (PLS) TO EXPLAIN, IN SIMPLIFIED TERMS, OUR FINANCIAL ASSISTANCE POLICY (FAP). THIS SUMMARY IS PRINTED AT ALL SAME DAY SURGERY, ER AND INPATIENT LOCATIONS AND GIVEN TO THE PATIENT UPON DISCHARGE. UPMC HAS ALSO TRANSLATED THE PLS, FAP, COLLECTION AND BILLING POLICY, AND FAP APPLICATION INTO THE FOLLOWING LANGUAGES: ARABIC, CHINESE, FRENCH, ITALIAN, NEPALI, RUSSIAN, SPANISH AND BRAILLE. THE DETERMINATION OF LANGUAGES FOR TRANSLATION OF DOCUMENTS WAS DETERMINED BY A STUDY OF ENGLISH PROFICIENCY IN THE COMMUNITIES SERVED AND REVIEW OF PREDOMINANT NATIVE LANGUAGES IN THOSE COMMUNITIES AS PRESCRIBED IN IRC SECTION 501(R). THE PLS IS AVAILABLE ON THE UPMC WEBSITE. UPMC WILL NOTIFY ALL PATIENTS APPROVED VIA PRESUMPTIVE ELIGIBILITY IF NOT RECEIVING THE HIGHEST LEVEL OF ASSISTANCE. A LETTER INFORMING THE PATIENT THAT THEY MAY QUALIFY FOR A HIGHER LEVEL AND A FINANCIAL ASSISTANCE APPLICATION WILL BE SENT TO THE PATIENT UPON DETERMINATION. UPMC HAS WIDELY PUBLICIZED OUR FINANCIAL ASSISTANCE POLICY. UPMC HAS WORKED WITH HOSPITAL LEADERS AND COMMUNITY LIAISONS TO DETERMINE THE MOST APPROPRIATE NON-HEALTHCARE LOCATIONS TO REACH THE POPULATIONS THAT WILL BENEFIT FROM OUR FINANCIAL ASSISTANCE. UPMC HAS PROACTIVELY REACHED OUT IN THESE COMMUNITIES TO WIDELY PUBLICIZE OUR FINANCIAL ASSISTANCE POLICY. FINALLY, UPMC WILL NOW ONLY INCLUDE PATIENT BALANCES FROM ONE YEAR PRIOR TO THE PATIENT'S FINANCIAL ASSISTANCE APPROVAL DATE. AS A RESULT, UPMC WILL ALSO REFUND ANY PATIENT PAYMENTS MADE WITHIN THAT YEAR OF THE PATIENT'S FINANCIAL ASSISTANCE APPROVAL DATE, APPROVED VIA AN APPLICATION. Part VI Line 6 See Schedule O Line 7 STATES RECEIVING COMMUNITY BENEFIT REPORT: Pennsylvania true true false false false false false true false Tulio Estrada-Quintero MD Director 0 521435 0 7220 0 8011 0 18900 0 20169 0 575735 0 0 Donald Owery President 0 264036 0 181000 0 83780 0 81998 0 20753 0 631567 0 82470 Thomas Newman R 8617 Chief Financial Officer 0 143452 0 0 935 0 11884 0 15482 0 171753 0 0 Brian Fritz J 10117 Chief Financial Officer 0 149550 0 56500 0 272 0 12777 0 17900 0 236999 0 0 Albert Boland Chief Operating Officer 0 129612 0 20000 0 378 0 10827 0 17838 0 178655 0 0 Douglas Danko President 0 258412 0 75478 0 168945 0 26191 0 16786 0 545812 0 54320 James Aubel Former CFO 0 -1000 0 0 0 151053 0 0 0 0 0 150053 0 0 Angel Toca MD Physician 326448 0 0 0 3153 0 18900 0 17757 0 366258 0 0 0 Bienvenido Ong MD Physician 321062 0 0 0 6786 0 19038 0 16270 0 363156 0 0 0 Kenneth Molinero MD Physician 288222 0 0 0 672 0 8100 0 10015 0 307009 0 0 0 Majed Sarouf Maalouf MD Physician 210471 0 36506 0 486 0 0 0 9795 0 257258 0 0 0 Steven Hand MD Physician 192147 0 329238 0 671 0 16200 0 6545 0 544801 0 0 0 SCHEDULE J, PART 1, Question 4 SCHEDULE J, PART 1, Question 4A Douglas Danko, President, Severance $83,173 James Aubel, Former CFO, Severance $150,053 SCHEDULE J, PART 1, Question 4B ALL PERSONS PARTICIPATING IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN ARE DISCLOSED IN SCHEDULE J WITH CORRESPONDING AMOUNTS DISCLOSED WITHIN THE TOTAL AMOUNT IN SCHEDULE J COLUMN C "RETIREMENT AND OTHER DEFERRED COMPENSATION". Due to restrictions imposed by the Internal Revenue Code ("Code"), certain officers and key employees are limited in the amount of benefits which may be received under a tax qualified retirement program. Like many employers, Jameson Health Services, Inc. supplements its retirement benefits through a supplemental retirement program. The supplemental retirement program is subject to multi year vesting which places the officers and key employees' retirement benefit at risk of forfeiture if the vesting requirements are not satisfied. Once vested however, provisions of the Code require that the vested amounts be reported on the Form 990 and the vested officer or key employee include in current income the value of her or his supplemental retirement benefit. Notwithstanding the tax requirement to recognize the vested amount of the supplemental retirement benefit as current income for FICA purposes, this benefit, which generally has been earned over her or his entire career, has not and will not be distributed until the officer or key employee retires or separates from service from UPMC Jameson. The supplemental retirement program provides for the CURRENT distribution of only the amount necessary to satisfy any income tax liability resulting from the vesting during active employment. Finally, it should be noted that in accordance with IRS instructions, a substantial portion of the amount reported on the Form 990 attributable to supplemental retirement program vesting has been reported in previously filed Forms 990. SCHEDULE J, PART 1, QUESTION 7 UPMC JAMESON PROVIDES INCENTIVE COMPENSATION AS PART OF ITS TOTAL COMPENSATION PROGRAM FOR OFFICERS AND KEY EMPLOYEES. THE COMPONENTS ARE BASED UPON THE ACCOMPLISHMENT OF PREDETERMINED PERFORMANCE GOALS AND OBJECTIVES WHICH FOCUS ON THE ACHIEVEMENT OF MULTIPLE ANNUAL AND THREE YEAR INDIVIDUAL AND GROUP PERFORMANCE CRITERIA IN THE CONTEXT OF APPROPRIATE RISK TAKING. THESE CRITERIA DIRECTLY SUPPORT UPMC JAMESON'S MISSION AND INCLUDE: PATIENT QUALITY AND SATISFACTION, COMMUNITY BENEFITS, OPERATIONAL AND FINANCIAL STRENGTH, LEADERSHIP DEVELOPMENT AND STRATEGIC BUSINESS INITIATIVES, AMONG OTHERS. PART III STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS UPMC JAMESON EIN: 25-0965406 FISCAL YEAR ENDING JUNE 30, 2018 Form 990, Part III - Statement of Program Service Accomplishments UPMC Jameson (Jameson) is a 133-bed hospital located in Lawrence County, Pennsylvania. Jamesons mission is as a full-service hospital including educational opportunities in nursing and other health related professions. UPMC Jameson provides health and human services to all individuals regardless of their race, color, religious creed, ancestry, union membership, age, gender, sexual orientation, gender identity or expression, national origin, AIDS or HIV status or disability, and promotes health by providing quality inpatient and outpatient medical care to the surrounding area. In furtherance of its mission to provide exemplary health care services, Jameson provides patient-centered, quality health care in a cost-effective manner, adhering to the values of excellence, compassion, and the respect for human dignity, regardless of a patient's ability to pay. UPMC Jameson provides a full range of health care services, including inpatient, outpatient, and emergency care, as well as highly specialized diagnostic and treatment procedures. The combination of high-tech medicine and compassionate care touches every one of the thousands of patients who enter UPMC Jameson each year. Services include breast health, cancer treatment, endocrinology, general surgery, nutritional services, pain management, primary care, rehabilitation services, stroke care, and wound care. Jameson is a strong partner in the communities it serves. The Hospital provides medication and transportation to indigent patients. Staff promotes health living with education on good nutrition, reading food labels, and lifestyle changes to manage weight. CPR and first aid courses were offered to educate the community, and staff attended career fairs to inform students of and to promote different medical and health professions. Presentations on diabetes and high cholesterol were held at various health fairs, as well as blood pressure screenings. During fiscal year 2018, Jameson had 5,459 inpatient admissions which contributed to over 26,397 inpatient days. There were 35,274 emergency department visits, and Jameson performed over 5,674 surgeries. Jameson had a total of 137,105 outpatient visits during fiscal year 2018. Of the patients that Jameson serves, 72% are participants in the federal Medicare and state Medicaid programs. Jameson provided in excess of $13,000,000 in uncompensated care at cost during fiscal year 2018 for inclusive of shortfalls from government programs. They also provided community benefit programs and services and donations valued at over $6,900,000 which directly benefited the communities they serve. Part VI Governance, Management, and Disclosure Section A: Governing Body and Management Question 6: UPMC Jameson has one sole member, the exempt entity UPMC. Part VI Governance, Management, and Disclosure Section B: Policies Question 11 B - The Board of Directors members of the filing entity have been provided a copy of the Form 990 prior to filing. Question 12 C - UPMC requires key employed and non-employed personnel to comply with its conflict of interest policies when they engage in UPMC related business. Persons covered by the policies included UPMC board members, board committee members, corporate officers, key employees, UPMC physicians and non physicians employees who hold a position of influence, non employed members of the UPMC medical staff who hold a position of influence or trust, individuals conducting clinical research at UPMC whether or not they are employed by UPMC. These people are required to complete a questionnaire at least annually, which along with other data is used to identify possible individual and institutional conflicts of interest. If a potential conflict is identified regarding a specific UPMC activity, the 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. For employed personnel and non Board members, non employed personnel, the conflict of interest identification and management process is ultimately overseen by an Ethics and Compliance committee of the UPMC Board of Directors on behalf of UPMC and all of its subsidiaries. Potential conflict of interest transactions involving UPMC Board members and entities with which they are affiliated are monitored and subject to pre-approval by the Governance and Nominating Committee of the UPC Board of Directors. In addition to the general corporate and Board policies described above, UPMC has also developed and implemented a separate tax questionnaire distributed to Officers, Directors, Trustees and Key Employees annually that specifically addresses disclosure requirements of Form 990. Part VI Governance, Management, and Disclosure Section B: Policies Question 15 - To support UPMC's mission as set forth in the UPMC Bylaws, the Board of Directors has formed an Executive Compensation Committee ("Committee") and delegated to it the responsibility for establishment and implementation of officer and key employee total compensation programs. As part of this responsibility the Committee reports regularly to the Board of Directors. With Board of Directors approval, the Committee has adopted a formal Charter, which includes the establishment of a compensation philosophy and related policies with respect to the total compensation paid by UPMC to its officers and key employees. The UPMC total compensation program for officers and key employees is predicated upon an incentive compensation component. This component is based upon the accomplishment of predetermined performance goals and objectives which focus on the achievement of multiple annual and three year individual and group performance criteria in the context of appropriate risk taking. These criteria directly support UPMC's mission and include patient quality and satisfaction, community benefits, operational and financial strength, leadership development, and strategic business initiatives among others. The total compensation program is integrated with and reinforces the UPMC business planning cycle as well as management development and succession planning processes. It is the Committee's judgment that the structure of the total compensation program is vital to, and strongly supportive of, the high level of ongoing success of UPMC and fosters the retention of critical officer and key employment talent. The total compensation determination process utilized by the Committee is intended to satisfy the "rebuttable presumption of reasonableness" as set forth in the regulations to Section 4958 of the Internal Revenue Code ("Code").This means that compensation programs and levels are approved in advance by the Committee which is composed entirely of outside Directors who do not have a conflict of interest, as defined by the relevant regulations, with respect to the compensation program and levels. The Committee obtains and relies upon a broad range of appropriate data as to comparability prior to making its determinations. The Committee then contemporaneously documents, in formal meeting minutes, the basis and reasons for its determinations. The total compensation program is designed and administered in accordance with the UPMC Bylaws, sound business practices, the tenets of common law business judgment and fiduciary responsibility as well as adherence to all relevant federal, state and local laws. In addition to Code Section 4958, as set forth above, this includes but is not limited to Code Section 501(c)(3) and the applicable regulations thereunder as well as all laws and regulations prohibiting private inurement, private benefit transactions and discrimination. Further, the Committee has identified and adopted as appropriately modified for UPMC, compensation program "best practices" from the business world (e.g. Sarbanes Oxley, SEC, etc.). The Committee believes that while these practices are not required in the tax exempt sector, they are in the best interests of the organization and further support UPMC's nonprofit mission. In accordance with the above, determination of total compensation for the CEO is made exclusively by the Committee. Determination of total compensation for other officers and key employees is recommended by the CEO and subject to review and approval by the Committee. The Committee, which meets at least four times a year, obtains professional advice from its own experts, including accountants, executive compensation consultants and legal counsel. Part VI Governance, Management, and Disclosure Section C: Disclosure Question 19 FORM 990 IS AVAILABLE TO THE PUBLIC UPON REQUEST. OTHER GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS MAY BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. Part XI Reconciliation of Net Assets Net Transfers from Exempt Parent 110,279,460 Net Restricted/SPF Activity -40,168 Other Increases/Decreases in Fund Balance 171,872 Change in Beneficial Interest 100,547 TOTAL 110,511,711 Part XII Financial Statements and Reporting Question 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 organizations 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 31,2017. Schedule R - Related Organizations and Unrelated Partnerships There are organizations included in the UPMC Group Form 990 tax return for fiscal year 2018 which are related to UPMC Jameson. These organizations are not required to be listed in Schedule R. The related organizations have direct and indirect control. FORM 990 PART IX LINE 24 - OTHER EXPENSES DESCRIPTION:PURCHASED LAB SERVICES TOTAL EXPENSES:1347046 PROGRAM SERVICES:1347046 MANAGEMENT AND GENERAL: FORM 990 PART IX LINE 24 - OTHER EXPENSES DESCRIPTION:PURCHASED SERVICES TOTAL EXPENSES:2069387 PROGRAM SERVICES:1913698 MANAGEMENT AND GENERAL:155689 FORM 990 PART IX LINE 24 - OTHER EXPENSES DESCRIPTION:ENTERPRISE SHARED SERVICES TOTAL EXPENSES:11617536 MANAGEMENT AND GENERAL:11617536 FORM 990 PART IX LINE 24 - OTHER EXPENSES DESCRIPTION:OTHER EXPENSE TOTAL EXPENSES:6847650 PROGRAM SERVICES:4184331 MANAGEMENT AND GENERAL:2663319 FUNDRAISING: UPMC SENIOR COMMUNITIES INC 600 GRANT STREET PITTSBURGH PA 15219 251574736 SR LIVING PA 501(C)(3) 10 UPMC true PITTSBURGH LIFETIME CARE COMMUNITY 600 GRANT STREET PITTSBURGH PA 15219 251335247 CCRC PA 501(C)(3) 10 UPMC SR COMM true CANTERBURY PLACE 600 GRANT STREET PITTSBURGH PA 15219 250965334 SR LIVING PA 501(C)(3) 10 UPMC SR COMM true SENECA PLACE 600 GRANT STREET PITTSBURGH PA 15219 721562844 SR LIVING PA 501(C)(3) 10 UPMC SR COMM true SHADYSIDE HOSPITAL SUPPORTING FOUNDATION 600 GRANT STREET PITTSBURGH PA 15219 260303394 FOUNDATION PA 501(C)(3) 12(A) I UPMC true UPMC LEE 600 GRANT STREET PITTSBURGH PA 15219 250613830 INACTIVE PA 501(C)(3) 3 UPMC true PITTSBURGH CARE PARTNERSHIP INC 600 GRANT STREET PITTSBURGH PA 15219 251753852 SR CARE MGMT PA 501(C)(3) 10 UPMC true UPMC CENTER FOR HIGH VALUE HEALTHCARE 600 GRANT STREET PITTSBURGH PA 15219 452178782 RESEARCH PA 501(C)(3) 7 UPMC true SHADYSIDE HOSPITAL FOUNDATION 532 SOUTH AIKEN AVENUE PITTSBURGH PA 15232 251290546 FOUNDATION PA 501(C)(3) 12(C)III UPMC PRESBY true PASSAVANT HOSPITAL FOUNDATION 9100 BABCOCK BLVD PITTSBURGH PA 15237 251407815 FOUNDATION PA 501(C)(3) 12(B)II UPMC PASS true UPMC NORTHWEST FOUNDATION 100 FARFIELD DRIVE SENECA PA 16346 251483624 FOUNDATION PA 501(C)(3) 12(D)III UPMC NORTHWE true ST MARGARET FOUNDATION 600 GRANT STREET PITTSBURGH PA 15219 251520340 FOUNDATION PA 501(C)(3) 7 UPMC ST MARG true CHILDREN'S HOSPITAL OF PITTSBURGH FND 600 GRANT STREET PITTSBURGH PA 15219 251865744 FOUNDATION PA 501(C)(3) 7 UPMC CHP true MAGEE-WOMEN RES INST AND FOUNDATION 600 GRANT STREET PITTSBURGH PA 15219 251462312 FOUNDATION PA 501(C)(3) 7 NA false Great Lakes Physician Practice PC 600 Grant Street 58th Floor PITTSBURGH PA 15219 464186362 PHYSICIAN SRV NY 501(C)(3) 3 Regnl Health true Hamot Health Foundation 302 FRENCH STREET ERIE PA 16507 251400999 FOUNDATION PA 501(C)(3) 12(B)II UPMC HAMOT true Safe Harbor Behavioral Health of UPMC Ha 1330 W 26th STREET ERIE PA 16508 251317492 BEHAVIOR HLTH PA 501(C)(3) 7 UPMC HAMOT true JAMESON HEALTHCARE FOUNDATION 1211 WILMINGTON AVE NEW CASTLE PA 16105 251536037 FOUNDATION PA 501(C)(3) 12(B)II UPMC Jameson true JAMESON HEALTH SERVICES INC 1211 WILMINGTON AVE NEW CASTLE PA 16105 030486993 SUPPORTING OR PA 501(C)(3) 12(b)II UPMC Jameson true CHILDREN'S ADVOCACY CENTER OF LAWRENCE 1107 WILMINGTON AVE NEW CASTLE PA 16105 251581304 COORD SRVS PA 501(C)(3) 7 UPMC Jameson true UPMCJAMESON CANCER CENTER 600 GRANT STREET 58TH FL PITTSBURGH PA 15219 201459415 ONCOLOGY SVC PA 501(C)(3) 10 UPMC Jameson true JAMESON MEDICAL CARE INC 1211 WILMINGTON AVE NEW CASTLE PA 16105 260462696 PHYSICIAN SRV PA 501(C)(3) 10 UPMC Jameson true JAMESON CARE CENTER INC 1211 WILMINGTON AVE NEW CASTLE PA 16105 232871396 SR SERVICES PA 501(C)(3) 10 UPMC SR COMM true UPMC SUSQUEHANNA 700 HIGH STREET WILLIAMSPORT PA 17701 232751183 MGMT SUPPORT PA 501(C)(3) 3 UPMC true MUNCY VALLEY HOSPITAL 215 EAST WATER STREET MUNCY PA 17756 240806023 HOSPITAL PA 501(C)(3) 3 UPMC SUSQUEH true DIVINE PROVIDENCE HOSPITAL OF THE SISTER 1100 GRAMPIAN BOULEVARD WILLIAMSPORT PA 17701 240799343 HOSPITAL PA 501(C)(3) 3 UPMC SUSQUEH true SUSQUEHANNA PHYSICIAN SERVICES 1201 GRAMPIAN BOULEVARD WILLIAMSPORT PA 17701 232449454 PHYSICIAN SRV PA 501(C)(3) 3 UPMC SUSQUEH true SUSQUEHANNA HEALTH SYSTEM INNOVATION CTR 700 HIGH STREET WILLIAMSPORT PA 17701 471600873 SUPPORT SRV PA 501(C)(3) 12(a)(I) UPMC SUSQUEH true SUSQUEHANNA HEALTH FOUNDATION 1100 GRAMPIAN BOULEVARD WILLIAMSPORT PA 17701 232743470 FOUNDATION PA 501(C)(3) 12(A)(I) UPMC SUSQUEH true THE WILLIAMSPORT HOSPITAL 700 HIGH STREET WILLIAMSPORT PA 17701 240795508 HOSPITAL PA 501(C)(3) 3 UPMC SUSQUEH true LAUREL REALTY INC 32 - 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