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UPMC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
UPMC (EIN 24-0795508)
Tax period
2016-07-01 to 2017-06-30
Filed
2018-05-15
IRS object ID
201811359349302371
Schema version
2016v3.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2018-05-15T08:42:06-05:00ReturnTs
Tax Period End2017-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1910 E St Louis Street Suite 200AddressLine1Txt
CitySpringfieldCityNm
State AbbreviationMOStateAbbreviationCd
ZIP65806ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN240795508EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1The Williamsport HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlWILLBusinessNameControlTxt
Phone5703207900PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1700 High StreetAddressLine1Txt
CityWilliamsportCityNm
State AbbreviationPAStateAbbreviationCd
ZIP17701ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonEric D PohjalaPersonNm
Person TitleExecutive Vice President / CFOPersonTitleTxt
Phone5703207900PhoneNum
Signature2018-05-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBrian D ToddPreparerPersonNm
PTINP00422601PTIN
Phone4178658701PhoneNum
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSteven P JohnsonPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1700 High StreetAddressLine1Txt
CityWilliamsportCityNm
State AbbreviationPAStateAbbreviationCd
ZIP17701ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$400,875,093GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.upmcsusquehannahealth.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1873FormationYr
Legal Domicile StatePALegalDomicileStateCd
Activity Or MissionThe Williamsport Hospital (TWH) is a 223 bed acute care community hospital primarily serving Lycoming and surrounding counties. Services provided include, but are not limited to, Acute and Intensive Care, Surgical Services, Heart and Lung Services, Rehabilitation Services, Dialysis, Laboratory, Radiology, Psychology and Emergency Room Services.ActivityOrMissionDesc
Contract TerminationYes (X)ContractTerminationInd
Voting Members Governing Body22VotingMembersGoverningBodyCnt
Voting Members Independent16VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers202TotalVolunteersCnt
Total Gross UBI$666,406TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$61,864NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,563,869PYContributionsGrantsAmt
CY Contributions Grants$5,398,048CYContributionsGrantsAmt
PY Program Service Revenue$324,262,075PYProgramServiceRevenueAmt
CY Program Service Revenue$330,227,037CYProgramServiceRevenueAmt
PY Investment Income$2,166,214PYInvestmentIncomeAmt
CY Investment Income$11,289,147CYInvestmentIncomeAmt
PY Other Revenue$2,319,118PYOtherRevenueAmt
CY Other Revenue$1,772,873CYOtherRevenueAmt
PY Total Revenue$332,311,276PYTotalRevenueAmt
CY Total Revenue$348,687,105CYTotalRevenueAmt
PY Grants And Similar Paid$12,678,222PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$16,185,108CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$129,862,659PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$134,676,730CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$22,826CYTotalFundraisingExpenseAmt
PY Other Expenses$166,540,493PYOtherExpensesAmt
CY Other Expenses$171,346,259CYOtherExpensesAmt
PY Total Expenses$309,081,374PYTotalExpensesAmt
CY Total Expenses$322,208,097CYTotalExpensesAmt
PY Revenues Less Expenses$23,229,902PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$26,479,008CYRevenuesLessExpensesAmt
Total Assets BOY$521,644,871TotalAssetsBOYAmt
Total Assets EOY$357,731,232TotalAssetsEOYAmt
Total Liabilities BOY$330,020,008TotalLiabilitiesBOYAmt
Total Liabilities EOY$44,399,231TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$191,624,863NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$313,332,001NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionThe Williamsport Hospital (TWH) is a subsidiary of UPMC Susquehanna. The mission of UPMC Susquehanna and affiliates is as follows: To extend God's healing love by providing outstanding patient care and shaping tomorrow's health care through clinical and technological innovation and education. Our vision is to create an integrated community health system that delivers world class care. Our values are to carefully place our patients and their families first, share ownership with all of our caregivers and lead with a servant's heart.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$294,641,469ExpenseAmt
Grant$16,185,108GrantAmt
Revenue$331,102,228RevenueAmt
DescThe Williamsport Hospital (TWH) is a 223 bed acute care community hospital primarily serving Lycoming and surrounding counties. Services provided include, but are not limited to, Acute and Intensive Care, Surgical Services, Heart and Lung Services, Rehabilitation Services, Dialysis, Laboratory, Radiology, Psychology and Emergency Room Services. TWH also provides Labor and Delivery Services while maintaining a 20 bed Nursery. During the fiscal year ended June 30, 2017, TWH admitted 11,427 patients rendering 49,415 patient days and registered approximately 223,026 outpatient procedures.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
DescTWH treats all patients without regard to their ability to pay. In addition, the Hospital treats Medicare / Medical Assistance patients and maintains a Medicare / Medical Assistance policy that provides patients enrolled in such programs with access to all covered inpatient, outpatient and diagnostic services that are available to non-Medicare / Medical Assistance patients.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
DescOn an annual basis, TWH devotes a portion of its revenue and assets to community program services. The following reflects the breakout of $53,658,846 in quantifiable community benefits for FY 2017: Charity Care (at cost) $1,071,135; Bad Debt (at cost) $3,574,502; Government-sponsored health care (unpaid cost of Medicare, Medicaid, indigent care programs, SCHIP and other safety net programs) $45,959,000. In addition, various other programs such as Research, Health Professions Education, Community Health Services, Subsidized Health Services, Community Building, Financial and In-kind Contributions and Community Benefit Operations totaling $3,054,209.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$294,641,469TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign ActivitiesYes (1)ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial LiquidationYes (1)PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members22GoverningBodyVotingMembersCnt
Independent Voting Member16IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldPAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Eric D PohjalaBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5703207900PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1700 High StreetAddressLine1Txt
CityWilliamsportCityNm
State AbbreviationPAStateAbbreviationCd
ZIP17701ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Ann S Pepperman
Chair2.0010.00Yes (X)Yes (X)$0$0$0
Davie Jane Gilmour
Vice Chair2.008.00Yes (X)Yes (X)$0$0$0
Sister Teresa Ann Jacobs
Secretary2.008.00Yes (X)Yes (X)$0$0$0
Phillip Johnson
Treasurer2.0010.00Yes (X)Yes (X)$0$0$0
Mark Beyer DO
Director2.002.00Yes (X)$0$0$0
Susan Branton MD
Director2.0042.00Yes (X)$0$477,115$30,846
Jill A Burns MD
Director2.0048.00Yes (X)$0$259,810$33,044
Ronald E DiSimone
Director2.0046.00Yes (X)$0$1,072,681$31,403
Durriya S Esaa MD
Director2.006.00Yes (X)$0$0$0
Kevin W Kist DO
Director2.0042.00Yes (X)$0$421,770$35,537
Daniel A Klingerman
Director2.008.00Yes (X)$0$0$0
Keith S Kuzio
Director2.0010.00Yes (X)$0$0$0
Donald Leathers MD
Director2.006.00Yes (X)$0$0$0
Lynda Livingston
Director2.008.00Yes (X)$0$0$0
J Dennis Murray PhD
Director2.0010.00Yes (X)$0$0$0
Alexander R Nesbitt MD
Director2.0046.00Yes (X)$0$241,117$31,052
Thomas M Owlett Esquire
Director2.0010.00Yes (X)$0$0$0
Shailsh D Patel MD
Director2.008.00Yes (X)$0$0$0
Glenn B Poirier
Director2.0010.00Yes (X)$0$0$0
Peter B Trevouledes MD
Director2.002.00Yes (X)$0$0$0
Patrick Wilson
Director2.008.00Yes (X)$0$0$0
Steven P Johnson
President / CEO40.0010.00Yes (X)Yes (X)$960,096$0$33,271
Eric D Pohjala
Executive VP / CFO40.002.00Yes (X)$430,438$0$32,395
David Lopatofsky MD
Executive VP / CMO2.0040.00$0$593,514$37,048Yes (X)
Jan E Fisher
Executive VP / COO40.002.00$551,981$0$31,238Yes (X)
Kenneth B Young
VP / Legal Services40.00$335,016$0$10,600Yes (X)
Daniel Glunk MD
AVP / Chief Quality Office40.00$302,929$0$32,287Yes (X)
Timothy E Schoener
VP CIO40.00$284,584$0$30,773Yes (X)
Christine A Ballard
VP Human Resources40.00$259,209$0$21,575Yes (X)
Timothy M Douglass
CRNA40.00$229,192$0$29,916Yes (X)
Ronald J Butler
Former Exec VP/CBO (retired)40.00$335,670$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,689,115TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,066,007TotReportableCompRltdOrgAmt
Total Other Compensation$420,985TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K125IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Aramark Healthcare
24863 Network PlaceChicagoIL60673Management / environmental services$25,839,132
Anesthesia Associates
700 High StreetWilliamsportPA17701Anesthesia services$1,569,573
Paris Companies
67 Hoover AveneueDuBoisPA15801Linen services$934,011
Emergency Physician Associates
PO Box 634850CincinnatiOH45263Contracted services$856,314
Cleveland Clinic Foundation
PO Box 931760ClevelandOH44193Cardiology & Cardiovascular services$800,000
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K23CntrctRcvdGreaterThan100KCnt
Related Organizations$3,991,249RelatedOrganizationsAmt
Government Grants$615,848GovernmentGrantsAmt
All Other Contributions$790,951AllOtherContributionsAmt
Total Contributions$5,398,048TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net patient revenue621990$302,591,503$302,591,503
Support from alliance affiliates900099$24,476,689$24,476,689
Affiliate rent income531120$1,427,389$1,427,389
Cafeteria722514$1,398,123$1,398,123
Aramark900099$333,333$333,333
FieldValueIRS element (for citing)
Total Program Service Revenue$330,227,037TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$402,410TotalRevenueColumnAmt
Exclusion$402,410ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$63,073,624SecuritiesAmt
Other$1,101OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$52,187,988SecuritiesAmt
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$10,885,636SecuritiesAmt
Other$1,101OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$10,886,737TotalRevenueColumnAmt
Exclusion$10,886,737ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
Cardiology - consulting physician561000$449,296$449,296
North Penn - management561000$435,324$435,324
Purchase discounts900099$231,276$231,276

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$656,977TotalRevenueColumnAmt
Related Or Exempt Func Income$425,895RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$231,082UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,772,873OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$348,687,105TotalRevenueColumnAmt
Related Or Exempt Func Income$331,102,228RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$666,406UnrelatedBusinessRevenueAmt
Exclusion$11,520,423ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$16,185,108TotalAmt
Program Services$16,185,108ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$2,677,019TotalAmt
Program Services$2,677,019ProgramServicesAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$13,982TotalAmt
Program Services$13,982ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$103,523,237TotalAmt
Program Services$94,663,718ProgramServicesAmt
Management And General$8,841,517ManagementAndGeneralAmt
Fundraising$18,002FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$5,021,920TotalAmt
Program Services$4,602,978ProgramServicesAmt
Management And General$418,091ManagementAndGeneralAmt
Fundraising$851FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$16,045,786TotalAmt
Program Services$14,707,202ProgramServicesAmt
Management And General$1,335,864ManagementAndGeneralAmt
Fundraising$2,720FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$7,394,786TotalAmt
Program Services$6,777,893ProgramServicesAmt
Management And General$615,640ManagementAndGeneralAmt
Fundraising$1,253FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$600TotalAmt
Management And General$600ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$660,171TotalAmt
Program Services$655,947ProgramServicesAmt
Management And General$4,224ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$267,977TotalAmt
Management And General$267,977ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$9,549TotalAmt
Management And General$9,549ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$90,041TotalAmt
Program Services$2,651ProgramServicesAmt
Management And General$87,390ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$34,914,316TotalAmt
Program Services$30,931,845ProgramServicesAmt
Management And General$3,982,471ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$38,200TotalAmt
Program Services$38,200ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$7,328,114TotalAmt
Program Services$6,515,858ProgramServicesAmt
Management And General$812,256ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$5,571,696TotalAmt
Program Services$5,184,679ProgramServicesAmt
Management And General$387,017ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$213,788TotalAmt
Program Services$144,386ProgramServicesAmt
Management And General$69,402ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$5,387,993TotalAmt
Program Services$5,060,641ProgramServicesAmt
Management And General$327,352ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$495,202TotalAmt
Program Services$454,225ProgramServicesAmt
Management And General$40,977ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$386,566TotalAmt
Program Services$355,460ProgramServicesAmt
Management And General$31,106ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,060,969TotalAmt
Program Services$2,060,969ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$23,924,063TotalAmt
Program Services$23,924,063ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$3,567,987TotalAmt
Program Services$3,330,185ProgramServicesAmt
Management And General$237,802ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies$52,268,334$52,266,494$1,840
Bad Debt$13,849,292$13,849,292
Repairs & maintenance$9,563,219$9,442,650$120,569
Inter-entity costs$5,557,385$5,557,385

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$5,190,797TotalAmt
Program Services$796,024ProgramServicesAmt
Management And General$4,394,773ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$322,208,097TotalAmt
Program Services$294,641,469ProgramServicesAmt
Management And General$27,543,802ManagementAndGeneralAmt
Fundraising$22,826FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$38,269,446BOYAmt
EOY$17,625,040EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$32,377,664BOYAmt
EOY$29,555,339EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$4,835,055BOYAmt
EOY$4,916,609EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$6,129,360BOYAmt
EOY$5,388,716EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$485,816,148LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$237,081,989LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$251,078,029BOYAmt
EOY$248,734,159EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$68,344,411BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$120,610,906BOYAmt
EOY$51,511,369EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$521,644,871BOYAmt
EOY$357,731,232EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$42,575,845BOYAmt
EOY$34,784,834EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$1,666,666BOYAmt
EOY$1,333,333EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$163,832,803BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$121,944,694BOYAmt
EOY$8,281,064EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$330,020,008BOYAmt
EOY$44,399,231EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$190,985,560BOYAmt
EOY$312,708,696EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$435,990BOYAmt
EOY$212,029EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$203,313BOYAmt
EOY$411,276EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$191,624,863BOYAmt
EOY$313,332,001EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$521,644,871BOYAmt
EOY$357,731,232EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$26,479,008ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$9,067,875NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$104,296,005OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit Committee0AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other OrganizationsYes (1)GrantsOtherOrganizationsInd
Grants Other Organizations$9,549GrantsOtherOrganizationsAmt
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other Activities0OtherActivitiesInd
Total Lobbying Expenditures$9,549TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationThe Hospital holds memberships in the American Hospital Association, (AHA), of which engage in lobbying as part of their mission to represent the interests of hospitals at both the Federal and the State levels. For the year ended 6/30/17, the amount of dues paid to AHA totaled $43,844, of which 21.78% or $9,549, was used for lobbying purposes.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$22,867,374OtherCostOrOtherBasisAmt
Book Value$22,867,374BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$190,517,974OtherCostOrOtherBasisAmt
Depreciation$90,766,090DepreciationAmt
Book Value$99,751,884BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$278,105OtherCostOrOtherBasisAmt
Depreciation$98,190DepreciationAmt
Book Value$179,915BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$209,949,801OtherCostOrOtherBasisAmt
Depreciation$123,014,869DepreciationAmt
Book Value$86,934,932BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$62,202,894OtherCostOrOtherBasisAmt
Depreciation$23,202,840DepreciationAmt
Book Value$39,000,054BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$248,734,159TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDescBook ValueBookValueAmt
Funds held by others$110,440
Interest in net affiliate$230,540
Other$338,674
Due from affiliates$38,257,915
Other long-term receivables$12,573,800
FieldValueIRS element (for citing)
Total Book Value Other Assets$51,511,369TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
Due to third parties$1,938,957
Estimated medical legal liability costs$907,000
Other liabilities$3,092,040
Due to affiliates, net$2,343,067
FieldValueIRS element (for citing)
Total Liability$8,281,064TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X, Line 2:FormAndLineReferenceDesc
ExplanationManagement has evaluated their income tax positions under the guidance included in ASC 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements.ExplanationTxt

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp

FieldValueIRS element (for citing)
RegionCentral AmericaRegionTxt
Offices0OfficesCnt
Employee1EmployeeCnt
Type Of Activities ConductedProgram servicesTypeOfActivitiesConductedTxt
Specific Services ProvidedCaptive insurance companySpecificServicesProvidedTxt
Region Total Expenditures$1,632,503RegionTotalExpendituresAmt
FieldValueIRS element (for citing)
Subtotal Offices0SubtotalOfficesCnt
Subtotal Employees1SubtotalEmployeesCnt
Continutation Total Office0ContinutationTotalOfficeCnt
Continutation Total Employee0ContinutationTotalEmployeeCnt
Total Office0TotalOfficeCnt
Total Employee1TotalEmployeeCnt
Subtotal Spent$1,632,503SubtotalSpentAmt
Continuation Spent$0ContinuationSpentAmt
Total Spent$1,632,503TotalSpentAmt
Transfer To Foreign Corp0TransferToForeignCorpInd
Interest In Foreign Trust0InterestInForeignTrustInd
Foreign Corp Ownership0ForeignCorpOwnershipInd
Passive Foreign Investmest Co0PassiveForeignInvestmestCoInd
Foreign Partnership0ForeignPartnershipInd
Boycott Countries0BoycottCountriesInd

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,071,135TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,071,135NetCommunityBenefitExpnsAmt
Total Expense0.00350TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$41,648,017TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$21,671,115DirectOffsettingRevenueAmt
Net Community Benefit Expns$19,976,902NetCommunityBenefitExpnsAmt
Total Expense0.06480TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$42,719,152TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$21,671,115DirectOffsettingRevenueAmt
Net Community Benefit Expns$21,048,037NetCommunityBenefitExpnsAmt
Total Expense0.06830TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$500,649TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,382DirectOffsettingRevenueAmt
Net Community Benefit Expns$493,267NetCommunityBenefitExpnsAmt
Total Expense0.00160TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$489,700TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$489,700NetCommunityBenefitExpnsAmt
Total Expense0.00160TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,584,081TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$70,258DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,513,823NetCommunityBenefitExpnsAmt
Total Expense0.00490TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,574,430TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$77,640DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,496,790NetCommunityBenefitExpnsAmt
Total Expense0.00810TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$45,293,582TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$21,748,755DirectOffsettingRevenueAmt
Net Community Benefit Expns$23,544,827NetCommunityBenefitExpnsAmt
Total Expense0.07640TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$71,473TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$71,473NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$453TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$453NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$71,926TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$71,926NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$13,849,292BadDebtExpenseAmt
Bad Debt Expense Attributable$692,465BadDebtExpenseAttributableAmt
Reimbursed By Medicare$111,200,806ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$137,182,948CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$25,982,142MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost Accounting SystemYes (X)CostAccountingSystemInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1The Williamsport HospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1700 High StreetAddressLine1Txt
CityWilliamsportCityNm
State AbbreviationPAStateAbbreviationCd
ZIP17701ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.upmcsusquehannahealth.orgWebsiteAddressTxt
State License234601StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1The Williamsport HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSee Part V, Page 7OwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSee Part V, Page 7StrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSee Part V, Page 7FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSee Part V, Page 7FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSee Part V, Page 7FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Prospective Medicare MedicaidYes (X)ProspectiveMedicareMedicaidInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
The Williamsport HospitalPart V, Section B, Line 5: In conducting its CHNA, the hospital took into account input from representatives of the community served, including those with special knowledge of or expertise in public health. This was accomplished by conducting 9 key informant meetings, with 55 people answering the key informant interview. A web-based tool was utilized to conduct the key informant interview; however, paper questionnaires identical to the electronic version were distributed to those who may not have access to the internet or generationally are more likely to complete a paper questionnaire. For more details concerning the key informant meeting process or the key informant interview process, including a list of those individuals interviewed, a copy of the key informant interview, and results gathered you may view the CHNA and related implementation plan at www.upmcsusquehanna.org/communityhealth.
The Williamsport HospitalPart V, Section B, Line 6a: The Williamsport Hospital; located in Williamsport, PA is one of four hospitals that comprise the Susquehanna Health System (the System) based in Williamsport, Pennsylvania. For purposes of conducting the CHNA's, three of these hospitals, The Williamsport Hospital (DBA: Williamsport Regional Medical Center), Divine Providence Hospital, and Muncy Valley Hospital, share the same definition of community served, which is Lycoming County, PA. The fourth hospital that is part of the System is Soldiers & Sailors Memorial Hospital located in Wellsboro, PA, and their defined community is Tioga County, PA. The Systems approach to providing community benefit is to leverage the assets and expertise of all four hospitals to meet the needs and improve the health status of those who reside in the communities located in Lycoming and Tioga counties. Accordingly, a certain amount of collaboration between these related hospitals occurred in the development of their CHNA's and related implementation plans. For more details concerning these four hospitals, as well as their definition of community served you may view the CHNA and related Implementation Plans at www. upmcsusquehannahealth.org/communityhealth.
The Williamsport HospitalPart V, Section B, Line 11: Health needs were identified based on information gathered and analyzed through the 2016 CHNA conducted by the Health System. For the health needs prioritization process, the Health System engaged a hospital leadership team to review the most significant health needs reported the prior CHNA using the following criteria, 1) Current area of hospital focus. 2) Established relationships with community partners to address the health need. 3) Organizational capacity and existing infrastructure to address the health need.Based on the criteria outlined above, the leadership team ranked each of the health needs. As a result of the priority setting process, the identified priority areas that will be addressed through the Health System's Implementation Strategy for fiscal years 2017 through 2019 will be, 1) Substance abuse 2) Lack of mental health services 3) Heart disease 4) Financial barriers/poverty/low socioeconomic 5) Cancer 6) Lack of preventative care 7) Lack of health knowledge/education 8) Obesity 9) Lack of primary care physicians.The Health System's next step included developing an Implementation Strategy to address these priority areas which can be found at www.upmcsusquehanna.org/communityhealth.In some cases the hospital does not have the resources and specialty staff that would be required to adequately address all the identified needs. In other words, there may already be other agencies and healthcare providers working to effect change in these areas by providing related community resources and services. For more detailed discussion regarding identified health needs you may view the CHNA and related implementation strategy at www.upmcsusquehanna.org/communityhealth.To date, our progress on the implementation strategies are as follows: (1) Improve access to primary / specialty services and programs available within Lycoming County. Implementing longer office hours, walk-in access and 24/7 to nurse triage and ability to make an appointment in primary care; improve acess to specialty service lines (i.e. Cancer, Heart, Ortho, GI....); working with various organizations to establish a more robust way to connect the community to services within the county and wellness fairs available. (2) Continue to partner in the fight against opiate addiction and support local services/task forces. Authorize implementation of prescription drug monitoring program system wide; access to certified recovery specialist for all Susquehanna Emergency departments; collaborate with organizations to help educate the community. (3) Collaborate with community organizations on health and wellness initiatives, such as routine wellness check-ups and cancer screenings. Promote routine cancer screenings for breast, colon and lung cancer; Susquehanna signed the 80% by 2018 initiative to have 80% of individuals ages 50 or older screened for colon cancer in Lycoming County; continue to partner with River Valley Regional YMCA to suport health and wellness programs for both children and adults; continue to grow and expand the Spirit of Women programs. (4) Support mental health services; Have licensed clinical socal workers available at all primary care offices; ease access into behavioral health specialists. (5) Support transportation options to healthcare for rural areas; establish a stronger connection to STEP; bring wellness clinics to rural area.
The Williamsport HospitalPart V, Section B, Line 16j: Other - Brochure
Part V, line 7ahttps://www.susquehannahealth.org/in-the-community/community-health-nee ds-assessments
Part V, line 10ahttps://www.susquehannahealth.org/in-the-community/community-health-nee ds-assessments
Part V, line 16a, FAP websitehttps://www.susquehannahealth.org/patients-visitors/for-patients/billin g-insurance/financial-assistance-program
Part V, line 16b, FAP application websitehttps://www.susquehannahealth.org/patients-visitors/for-patients/billin g-insurance/financial-assistance-program
Part V, line 16c FAP plain language summary websitehttps://www.susquehannahealth.org/patients-visitors/for-patients/billin g-insurance/financial-assistance-program
Part V, line 16iThere are no groups with limited english proficiency that exceed IRC section 501 (r) thresholds. However, language translations of the financial assistance policy and related documents are available by request at the financial counseling department of the hospital.
FieldValueIRS element (for citing)
Facility2FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - The Medical Center
699 Rural AvenueWilliamsportPA17701Outpatient clinic
2 - The Montoursville Clinic Savoy Plaza
900 Plaza DriveMontoursvillePA17754Outpatient clinic / lab

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 6a:The community benefit report is prepared on a system wide basis under UPMC Susquehanna.
Part I, Line 7g:The Williamsport Hospital has various subsidized services which are included within the Medicare and Medical Assistance unreimbursed costs.
Part I, Line 7, Column (f)The Bad Debt expense included on Form 990, Part IX, Line 25 (b), but subtracted for purposes of calculating the percentage in this column is $13,849,292.
Part II, Community Building Activities:Activities focus on leadership development and training for community members through support to the Patient Advisory Council, as well as a newly developed Heroin Task Force team.The Williamsport Hospital (TWH) supports workforce development through participation on health care career education programs and by providing student observations for nursing and allied health professionals.
Part III, Line 2:Bad debt consists of the actual bad debt written off, plus a reserve calculation based on a progressive percentage for self-pay and other non-contract accounts receivable aging categories. This figure is the amount of bad debt in the audited financial statements.
Part III, Line 3:An estimate of 5% is used based on looking at patients that were in a bad debt status and eventually through the annual bad debt sale, determined they did not have the resources to pay and were really charity care.
Part III, Line 4:The System reports patient accounts receivable for services rendered at net realizable amounts from third-party payers, patients and others. The System provides an allowance for doubtful accounts based upon a review of outstanding receivables, historical collection information and existing economic conditions. As a service to the patient, the System bills third-party payers directly and bills the patient when the patient's liability is determined. Patient accounts receivable are due in full when billed. Accounts are considered delinquent and subsequently written off as bad debts based on individual credit evaluation and specific circumstances of the account.
Part III, Line 8:The costing methodology is based on a modified cost accounting system. We cost our patient data for the previous fiscal year and then we apply relational factors to the costs based on the change in charges from the prior fiscal year to the current fiscal year.Serving patients with government health benefits, such as Medicare, is a component of the community benefit standard that tax-exempt hospitals are held to. This implies that serving Medicare patients is a community benefit and that the hospital operates to promote the health of the community.
Part III, Line 9b:UPMC Susquehanna will provide financial assistance under the Financial Assistance Program for patients that require medically necessary services during the period in which family income and financial resources meets the defined guidelines, and after all other payment resources have been exhausted. The UPMC Susquehanna Financial Assistance Program is always the coverage of the last resort.Eligible services include inpatient and outpatient hospital services which are medically necessary and are provided directly by UPMC Susquehanna(Hospitals and Susquehanna Physician Services) or by employees of UPMC Susquehanna for the treatment of an illness or injury.All payer resources must be exhausted. Pennsylvania Medical Assistance screening and application must be completed for all considered individuals. All other payment arrangements must be explored. The income guideline source is the annual poverty income published in the Federal Register by the Department of Health and Human Services. The federal poverty guidelines are used to determine four tiers of SHS Financial Assistance Program eligibility. Income guidelines are updated annually according to federal poverty guideline updates. Family income must be at or below the eligibility guidelines for program consideration.It is the responsibility of the patient or guarantor to initiate and complete the SHS Financial Assistance Program by applying.
Part VI, Line 2:The Health System engaged BKD, LLP to conduct a formal CHNA. BKD, LLP is one of the largest CPA and advisory firms in the United States, with approximately 2,000 partners and employees in 34 offices. BKD serves more than 900 hospitals and health care systems across the country. The CHNA was conducted from February 2016 to June 2016.The following steps were conducted as part of the Health System's CHNA, 1) An evaluation of the impact of actions taken to address the significant health needs identified in the tax year 2012 CHNA was completed to understand the effectiveness of the Health System's current strategies and programs. 2) The "community" served by the Health System was defined by utilizing inpatient data regarding patient origin. This process is further described in Community Served by the Health System. 3) 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 the Center for Disease Control and Prevention (Community Health Status Indicators). Health factors with significant opportunity for improvement were noted. 4) Community input was provided through nine key stakeholder meetings and a community health survey. Results and findings are described in the Community Input - Key Stakeholder Interviews and Survey section of the CHNA at www.upmcsusquehanna.org/communityhealth. 5) Information gathered in the above steps 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 weighing method that weighs the size of the problem, the seriousness of the problem, the impact of the issues on vulnerable populations, the prevalence of common themes, how important the issue is to the community, and how the issue aligns with the Hospital's strategic plan. 6) 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 an overall health for the community.To help see the implementation plan come to fruition an implementation team has been formed which is comprised of various individuals from community organization throughout Lycoming and Tioga counties. Such partnered organizations include Lycoming County Health Improvement Coalition, Tioga County Partnership for Community Health, River Valley YMCA, Project Bald Eagle, STEP, YWCA, PA Department of Health, to name a few.
Part VI, Line 3:UPMC Susquehanna will provide financial assistance under the Financial Assistance Program for patients that require medically necessary services during the period in which family income and financial resources meets the defined guidelines, and after all other payment resources have been exhausted. The UPMC Susquehanna Financial Assistance Program is always the coverage of the last resort. The UPMC Susquehanna Financial Assistance program is an income/assets based package designed to meet the healthcare financial needs of eligible individuals and households who receive medically necessary inpatient and outpatient services from TWH, DPH, MVH,or SSMH.The first hospital claim sent to guarantors of uninsured accounts will include a statement to briefly explain the availability and contacts for referral to the Financial Assistance program. Subsequent guarantor billings also reference the availability of The Financial Assistance program.It is the responsibility for the patient or guarantor to initiate the UPMC Susquehanna Financial Assistance Program by applying. It is the responsibility of the UPMC Susquehanna Finance personnel to administrate the program according to this policy.
Part VI, Line 4:The hospitals that comprise UPMC Susquehanna Lycoming county operations are: The Williamsport Hospital (TWH), Divine Providence Hospital (DPH) and Muncy Valley Hospital (MVH). The county is in the north central region of the state, about three and half hours northeast of Pittsburgh and the same distance northwest of Philadelphia. Lycoming County is designated as rural and has small towns nestled within a stunning natural landscape. The City of Williamsport, with the majestic Susquehanna River running through it, is designated as urban, and is the home of Little League World Series. Unfortunately, the City of Williamsport and the surrounding rural area are also home for many individuals and families who cannot afford the primary health and dental care services provided in their county. In addition, Soldiers & Sailors Memorial Hospital (SSMH) located in Wellsboro, PA, Tioga County, is also part of UPMC Susquehanna.For a more detailed discussion regarding the community served, as well as associate socio-economic characteristics, you may view CHNA and related implementation plan at www.upmcsusquehannahealth.org.
Part VI, Line 5:The hospitals of UPMC Susquehanna all have entity specific boards that are composed of persons who reside in Lycoming County.In addition to this UPMC Susquehanna extends medical staff privileges to all qualified physicians in the county in all areas of primary and specialty care according to the UPMC Susquehanna Medical Staff Bylaws. Bylaws excerpts pertaining to this area are as follows:3.1) Nature of Membership - Medical Staff membership is available to qualified physicians, dentists, maxillofacial/oral surgeons, and podiatrists and confers both responsibilities and prerogatives, but only as provided in these Bylaws. No physician, dentist, or podiatrist, including those employed by or otherwise under contract with the Hospital(s), may admit a patient or independently provide patient care services in the Hospital(s) unless he is a Medical Staff member with applicable clinical privileges pursuant to these Bylaws. A member shall have only those clinical privileges, including admitting privileges, as have been granted in accordance with these Bylaws.3.2) Qualifications - No individual shall be considered eligible for appointment on reappointment to the Medical Staff unless he meets each of the following required qualifications/criteria. If any change in personal or professional status occurs which would inhibit practitioner's ability to effectively meet the obligations for patient care and Medical Staff membership under these Bylaws, the practitioner shall immediately notify the Medical Director.3.2-1) Professional Licensure Qualification - A member must be a physician, dentist, or podiatrist and must be duly licensed to practice in the Commonwealth of Pennsylvania.3.2-2) Clinical Privileges Qualification - A member of the Medical Staff must have clinical privileges (or in the case of a new applicant, is granted clinical privileges at the time of the appointment), except those appointed to the Emeritus Staff or as otherwise specified in these Bylaws.3.2-3) Professional Competence - A member must demonstrate sufficient professional education, training, experience, competence, and good judgement to perform Medical Staff responsibilities and clinical privileges requested.3.2-4) Health Status - A member must have sufficient physical and mental health to perform Medical Staff responsibilities and exercise clinical privileges requested.3.2-5) Basic Responsibilities - A member must discharge the basic responsibilities of Medical Staff membership noted in 3.3-2.3.2-6) Board Certification Requirement - All practitioners who are current staff members at UPMC Susquehanna as of 7/1/10 and who have met prior qualifications for membership shall be exempt from board certification requirements.3.2-7) Standing with Federal Payors - A member must not be excluded from participation in federally funded programs such as Medicare and Medicaid.3.2-8) Waiver - The Board Certification requirement described in 3.2-6 may be waived under very special circumstances in which an applicant for Medical Staff membership is capable of providing specific unique expertise presently not available or insufficiently available on the Medical Staff which will fulfill an unmet medical need in the community. Such waiver may be granted by the Board(s) only upon recommendation of the Department Chairman, Credentials Committee, and the Medical Executive Committee (MEC)3.2-9) Prohibited Criteria - Medical Staff membership or assignment to a Medical Staff category shall not be denied, terminated, revoked, suspended, modified, or otherwise restricted based upon:(a) Gender, race, creed, color, national origin, handicap, or disability, if the individual is otherwise qualified under these Bylaws, or(b) Economic considerations as the sole or primary criterion, or(c) Any criterion not set forth as a required qualification in these Bylaws, or(d) Any other criterion lacking professional or ethical justification.3.2-10) Effect of Other Affiliations - No individual shall be granted Medical Staff membership or be assigned to any Medical Staff category merely because he:(a) Holds a certain degree,(b) Is licensed to practice in the Commonwealth of Pennsylvania or any other state,(c) Is a member of any professional organization,(d) Is certified by any clinical Board,(e) Had, or presently has, Medical Staff membership or clinical privileges at another health care facility,(f) Is employed by or is otherwise under contract with the Hospital(s) or(g) Is employed by or otherwise practices with a group composed of one or Medical Staff members. The volunteer program at UPMC Susquehanna supports the services at our 4 campuses, MVH, DPH, TWH, and SSMH as well as our LifeCenter located within the River Valley Regional YMCA in Williamsport, PA. Volunteers, ranging in age from 14, assist staff and patients in almost every department.The volunteers come from Lycoming and surrounding counties to support our services. They provide over 65,000 hours of service in both office, customer service and patient care areas to support our service partners. They become ambassadors for the hospital, make new friends, financially support the hospital, become involved in the auxiliary, remain an active member of society, often stay healthier longer, enjoy the camaraderie with staff and other volunteers, serve on hospital committees, recruit other volunteers, increase their volunteer hours and offer constructive suggestions for improvement. Volunteers are recruited through fairs, internet information and on-line applications, volunteer referrals and presentations to groups. They are a highly regarded, integral part of our operational support system.
Part VI, Line 6:The Williamsport Hospital (TWH) is one of four hospitals which are part of UPMC Susquehanna. The mission of SHS is to promote health by acting as the parent of a nonprofit health system in North Central Pennsylvania and by raising funds and otherwise supporting the system. Muncy Valley Hospital (MVH) is a critical access hospital, primarily serving Lycoming and surrounding counties. MVH also provides a full range of outpatient and emergency services, as well as, operates a long-term care facility.Divine Providence Hospital (DPH) is a specialty hospital that offers inpatient psychiatric services and a wide array of outpatient hospital services, as well as, home health and Hospice services.The Williamsport Hospital (TWH) is an acute care community hospital providing diagnostic and treatment facilities, educational and training programs, and a rehabilitation facility.Soldiers & Sailors Memorial Hospital (SSMH) is an acute care community hospital providing diagnostic and treatment facilities, educational and training programs, and a rehabilitation facility.The hospitals treat Medicare and Medical Assistance patients and maintains a Medicare / Medical Assistance policy that provides patients enrolled in such programs with access to all covered inpatient, outpatient and diagnostic services that are available to non-Medicare / Medical Assistance patients.The community benefit report is prepared on a system-wide basis under UPMC Susquehanna. On an annual basis, UPMC Susquehanna devotes a portion of its revenue and assets to community program services. The following reflects the breakout of $98,755,622 in quantifiable community benefits reported for FY 2017: Charity Care (at cost) $1,629,207; Bad Debt (at cost) $7,909,280; Government-sponsored health care (unpaid cost of Medicare, Medicaid, indigent care programs, SCHIP and other safety net programs) $81,482,454. In addition, various other programs such as Research, Health Professions Education, Community Building, Financial and In-Kind Contributions, and Community Benefit Operations totaling $7,734,681.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
Susquehanna Physician Services
1201 Grampian BoulevardWilliamsportPA17701232449454501(c)(3)$15,205,418Support of affiliate
Susquehanna Community Health & Dental Clinic
469-471 Hepburn StreetWilliamsportPA17701208979596501(c)(3)$377,800Financial support
Williamsport Area Ambulance Service Cooperative
700 High StreetWilliamsportPA17701232416166501(c)(3)$500,000Support of affiliate
The Commonwealth Medical College
525 Pine StreetScrantonPA18509260812968501(c)(3)$100,000Financial contribution
FieldValueIRS element (for citing)
Total501c3 Org4Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule I, Part 1, Line 2FormAndLineReferenceDesc
ExplanationSusquehanna Physician Services and Williamsport Area Ambulance Service Cooperative are related organizations and part of the UPMC Susquehanna with consistent management oversight ensuring the use of funds for charitable purposes. Susquehanna Community Health and Dental Clinic is a former service of Susquehanna Health System that is being converted to a Federally Qualified Health Clinic (FQHC). "Look-alike" status was received effective 12/06/11. UPMC Susquehanna continues to support the clinics financially until full FQHC status is obtained and they are able to operate by their own means. All requests for funding are supported by detailed records of cash receipts and disbursements, as well as cash flow projections prepared by an independent accounting firm. UPMC Susquehanna has pledged financial support for the founding of the new medical school in Northeastern Pennsylvania, known as The Commonwealth Medical College. The pledge money will be used to help recruit faculty and students, construct facilities, provide scholarships, and fund other expenses associates with the development of a new medical school.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (1)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsYes (1)CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Susan Branton MD
Director$0$408,412$0$19,117$0$49,586$0$9,950$0$20,896$0$507,961$0$0
Jill A Burns MD
Director$0$224,371$0$34,600$0$839$0$9,950$0$23,094$0$292,854$0$0
Ronald E DiSimone
Director$0$1,007,081$0$27,445$0$38,155$0$9,950$0$21,453$0$1,104,084$0$0
Kevin W Kist DO
Director$0$326,783$0$18,531$0$76,456$0$9,950$0$25,587$0$457,307$0$0
Alexander R Nesbitt MD
Director$0$215,177$0$23,675$0$2,265$0$12,965$0$18,087$0$272,169$0$0
Steven P Johnson
President / CEO$703,292$0$226,453$0$30,351$0$13,925$0$19,346$0$993,367$0$0$0
Eric D Pohjala
Executive VP / CFO$362,196$0$66,436$0$1,806$0$9,950$0$22,445$0$462,833$0$0$0
David Lopatofsky MD
Executive VP / CMO$0$425,773$0$141,731$0$26,010$0$11,275$0$25,773$0$630,562$0$0
Jan E Fisher
Executive VP / COO$401,814$0$138,186$0$11,981$0$9,950$0$21,288$0$583,219$0$0$0
Kenneth B Young
VP / Legal Services$290,909$0$43,477$0$630$0$9,950$0$650$0$345,616$0$0$0
Daniel Glunk MD
AVP / Chief Quality Office$262,196$0$37,558$0$3,175$0$12,600$0$19,687$0$335,216$0$0$0
Timothy E Schoener
VP CIO$241,878$0$37,335$0$5,371$0$11,275$0$19,498$0$315,357$0$0$0
Christine A Ballard
VP Human Resources$221,790$0$35,092$0$2,327$0$9,848$0$11,727$0$280,784$0$0$0
Timothy M Douglass
CRNA$221,113$0$1,115$0$6,964$0$8,770$0$21,146$0$259,108$0$0$0
Ronald J Butler
Former Exec VP/CBO (retired)$0$0$0$0$335,670$0$0$0$0$0$335,670$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 4aRonald J. Butler, former Executive VP/CBO retired on April 15, 2015. His entire reportable compensation, $335,670 paid by a related organization, is a severance payment.
Part I, Line 6In order for the Leadership Team to participate in the annual Variable Compensation Incentive Program (VCIP) a minimum operating margin must be achieved for the most recently completed year on a consolidated system-level basis. Individual goals and objectives related to the VCIP may also include individual entity operating performance. For FY 2017, the minimum threshold was met that would trigger a VCIP payment. In September 2016, President / CEO Steven P. Johnson received variable compensation award in the amount of $226,453.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Richard FisherBusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship DescriptionSon of key employeeRelationshipDescriptionTxt
Transaction$13,982TransactionAmt
TransactionCompensationTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule N IRS990ScheduleN

Disposition Of Assets Detail DispositionOfAssetsDetail

FieldValueIRS element (for citing)
Assets Distri Or Expnss PaidUPMC Susquehanna investments were liquidated and cash was transferred to UPMC (parent).AssetsDistriOrExpnssPaidDesc
Distribution2017-10-01DistributionDt
Fair Market Value Of Asset$62,834,669FairMarketValueOfAssetAmt
Method Of FMV DeterminationCash valueMethodOfFMVDeterminationTxt
EIN251423657EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1UPMCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1700 Grant StreetAddressLine1Txt
CityPittsburghCityNm
State AbbreviationPAStateAbbreviationCd
ZIP15219ZIPCd
FieldValueIRS element (for citing)
IRC Section501 (c)3IRCSectionTxt
FieldValueIRS element (for citing)
Director Of Successor2Yes (1)DirectorOfSuccessor2Ind
Employee Of Successor20EmployeeOfSuccessor2Ind
Owner Of Successor20OwnerOfSuccessor2Ind
Receive Compensation20ReceiveCompensation2Ind

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part II, Line 2e:Person(s) Involved: Ann S. Pepperman
Part II, Line 2e:Explanation of Involvement: Ann S. Pepperman also serves on the UPMC (parent) EIN # 25-1423657 board.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part V, Line 1AAll 1099's are issued by UPMC Susquehanna EIN #23-2751183. All expenses are then allocated back to all related entities.
Form 990, Part VI, Section A, line 6UPMC Susquehanna, EIN # 23-2751183, is the sole member of the governing body.
Form 990, Part VI, Section A, line 7aUPMC Susquehanna, EIN # 23-2751183, may elect or remove members of the governing body.
Form 990, Part VI, Section A, line 7bAll the business and affairs of the corporation shall be managed and controlled by the Board of Directors, subject to the oversight of the Member of the management and operation of the corporation, except that the following powers are reserved exclusively to the sole Member of the corporation, and no attempted exercise of any such powers by anyone other than the sole Member shall be valid of any force or effect whatsoever. The sole Member shall exercise its powers through its Board of Directors. The Member shall have the exclusive authority to exercise the following powers: A) To approve the appointment and removal of the President of the corporation. B) To elect and remove, with or without cause, a Director of the corporation. C) To establish the overall policy and long range plans of the corporation, determine or change the mission of the corporation, approve the programs and services of the corporation and the termination of any programs or services of the corporation, and monitor and maintain the philosophy, goals and purposes for which the corporation was formed and exists. D) To adopt, amend or repeal the Articles of Incorporation or these bylaws. E) To establish requirements for a unified budget, the approval of new capital debt, any increments to any existing capital debt, and/or any change in capital debt obligations of the corporation. F) To establish requirements for the approval of the acquisition, purchase, sale, leasing outside the ordinary course of business, transfer outside the ordinary course of business of land or buildings and the construction or demolition of building owned by the corporation. G) To require a certified audit of corporate funds at any time. H) To approve any guaranty of the indebtedness of any person, the granting of any security interest in or the creation of any encumbrance on any assets of the corporation outside of the ordinary course of business, or any transfer of any assets of the corporation outside the ordinary course of business, except transfers between or among affiliated corporations. I) To approve any merger, consolidation, organization, reorganization, joint venture or other modification of corporate structure or affiliations affecting the autonomy, governance, or operations of the corporation. J) To dissolve or terminate the existence of the corporation and determine the distribution of assets upon the termination or dissolution, as provided in these bylaws. K) To appoint annually the external fiscal auditor of the corporation. L) To approve the nominees for elected officers of the Board of Directors of the corporation, and to return the list of approved nominees to the Board of Directors for election. M) To remove any elected officer of the corporation; N) To approve the annual capital and operating budget of the corporation; O) To coordinate managed care plans, including decisions concerning entry into or renewal of any contract or agreement relating thereto.
Form 990, Part VI, Section B, line 11bA high-level overview of Forms 990 is presented to the parent Board of Directors (UPMC Susquehanna, #23-2751183) before filing and complete drafts of all returns made available to all Board Members through the CEO's and CFO's office.
Form 990, Part VI, Section B, line 12cAs required by law, Hospital policy states that all members of the Board of Managers must sign a statement each year disclosing any conflict of interest that may arise and agree to abstain when issues involving those parties with conflicting interests are called to motion. Any conflicts of interest are reviewed by the Hospital's attorneys.
Form 990, Part VI, Section B, line 15The Board of Directors, through the Executive Compensation Committee, retains an independent outside consultant to provide guidance with respect to the annual establishment of the rebuttable presumption or reasonableness relative to executive compensation and benefits. The consultant annually provides detailed market information from its annual Executive Compensation Survey for Health Systems. In addition, other regional survey data is provided in order to supply the health system with a "national" picture of compensation. With this process established, the Executive Compensation Committee takes the proper steps to educate the Board of Directors to understand all of the above mentioned oversight and to appropriately prepare them for community or media inquiry. In addition, the Board is made aware of the Form 990 and its role in the communication of information to the public.
Form 990, Part VI, Section C, line 19The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request.
Form 990, Part IX, line 11gOther - Aramark: Program service expenses 30,931,845. Management and general expenses 3,982,471. Fundraising expenses 0. Total expenses 34,914,316.
Form 990, Part XI, line 9:Change in fair value interest sweep 361,940. Transfer of debt to UPMC 147,748,033. Barclay loan payoff 13,139,368. Transfer of liquidated investments to UPMC -62,834,669. Inter-Entity 5,881,333.
Form 990, Part XII, Lince 2cUPMC, the sole member of UPMC Susquehanna, has assumed the responsibility for oversight of the audited financial statements at a system level for FY 2017.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (51 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
UPMC SENIOR COMMUNITIES INC
600 GRANT STREETPITTSBURGHPA15219251574736SR. LIVINGPA501(c)(3)Line 10UPMCYes (1)
PITTSBURGH LIFETIME CARE COMMUNITY
600 GRANT STREETPITTSBURGHPA15219251335247CCRCPA501(c)(3)Line 10UPMC SR COMMYes (1)
CANTERBURY PLACE
600 GRANT STREETPITTSBURGHPA15219250965334SR. LIVINGPA501(c)(3)Line 10UPMC SR COMMYes (1)
SENECA PLACE
600 GRANT STREETPITTSBURGHPA15219721562844SR. LIVINGPA501(c)(3)Line 10UPMC SR COMMYes (1)
SHADYSIDE HOSPITAL SUPPORTING FOUNDATION
600 GRANT STREETPITTSBURGHPA15219260303394FOUNDATIONPA501(c)(3)Line 12a, IUPMCYes (1)
UPMC LEE
600 GRANT STREETPITTSBURGHPA15219250613830INACTIVEPA501(c)(3)Line 3UPMCYes (1)
PITTSBURGH CARE PARTNERSHIP INC
600 GRANT STREETPITTSBURGHPA15219251753852ADULTDAYCAREPA501(c)(3)Line 10UPMCYes (1)
UPMC CENTER FOR HIGH VALUE HEALTHCARE
600 GRANT STREETPITTSBURGHPA15219452178782RESEARCHPA501(c)(3)Line 7UPMCYes (1)
SHADYSIDE HOSPITAL FOUNDATION
532 SOUTH AIKEN AVEPITTSBURGHPA15232251290546FOUNDATIONPA501(c)(3)Line 12c, III-FIUPMC PRESBYYes (1)
PASSAVANT HOSPITAL FOUNDATION
9100 BABCOCK BLVDPITTSBURGHPA15237251407815FOUNDATIONPA501(c)(3)Line 12b, IIUPMC PASSYes (1)
UPMC NORTHWEST FOUNDATION
100 FAIRFIELD DRIVESENECAPA16346251483624FOUNDATIONPA501(c)(3)Line 12d, III-OUPMC NORTHWEYes (1)
ST MARGARET FOUNDATION
600 GRANT STREETPITTSBURGHPA15219251520340FOUNDATIONPA501(c)(3)Line 7UPMC ST MARGYes (1)
CHILDREN'S HOSPITAL OF PITTSBURGH FND
600 GRANT STREETPITTSBURGHPA15219251865744FOUNDATIONPA501(c)(3)Line 7UPMC CHPYes (1)
MAGEE-WOMEN RES INST AND FOUNDATION
600 GRANT STREETPITTSBURGHPA15219251462311FOUNDATIONPA501(c)(3)Line 70N/A
UPMC KANE
4372 ROUTE 6KANEPA16735250998168HOSPITALPA501(c)(3)Line 3UPMC HAMOT0
GREAT LAKES PHYSICIAN PRACTICE
600 GRANT STREETPITTSBURGHPA15219464186362PHYSICIANSNY501(c)(3)Line 3REGNL HEALTHYes (1)
HAMOT HEALTH FOUNDATION
302 FRENCH STERIEPA16507251400999FOUNDATIONPA501(c)(3)Line 12b, IIUPMC HAMOTYes (1)
SAFE HARBOR BEHAVIORAL HEALTH OF UPMC HA
1330 W 26TH STERIEPA16508251317492BEHAVIORALPA501(c)(3)Line 7UPMC HAMOTYes (1)
UPMC JAMESON
1211 WILMINGTON AVENEW CASTLEPA16105250965406HEALTHCAREPA501(c)(3)Line 3UPMCYes (1)
JAMESON HEALTHCARE FOUNDATION
1211 WILMINGTON AVENEW CASTLEPA16105251536037FOUNDATIONPA501(c)(3)Line 12b, IIUPMC JAMESONYes (1)
JAMESON HEALTH SERVICES INC
1211 WILMINGTON AVENEW CASTLEPA16105030486993HEALTHCAREPA501(c)(3)Line 12b, IIUPMC JAMESONYes (1)
CHILDREN'S ADVOCACY CENTER OF LAWRENCE
1107 WILMINGTON AVENEW CASTLEPA16105251581304SUPPORT SYSPA501(c)(3)Line 7UPMC JAMESONYes (1)
UPMCJAMESON CANCER CENTER
600 GRANT STREETPITTSBURGHPA15219201459415ONCOLOGY SVCPA501(c)(3)Line 10UPMC JAMESONYes (1)
JAMESON MEDICAL CARE INC
1211 WILMINGTON AVENEW CASTLEPA16105260462696HEALTHCAREPA501(c)(3)Line 10UPMC JAMESONYes (1)
JAMESON CARE CENTER INC
1211 WILMINGTON AVENEW CASTLEPA16105232871396HEALTHCAREPA501(c)(3)Line 10UPMC SR COMMYes (1)
UPMC SUSQUEHANNA
700 HIGH STREETWILLIAMSPORTPA17701232751183HEALTHCAREPA501(c)(3)Line 12b, IIUPMCYes (1)
VENANGO VNA FOUNDATION
491 ALLEGHENY BLVDFRANKLINPA16323251472179FOUNDATIONPA501(c)(3)Line 12d, III-OUPMC VISITINYes (1)
DIVINE PROVIDENCE HOSPITAL OF THE SISTERS
1100 GRAMPIAN BLVDWILLIAMSPORTPA17701240799343HEALTHCAREPA501(c)(3)Line 3UPMC SUSQUEHANNAYes (1)
SUSQUEHANNA PHYSICIAN SERVICES
1201 GRAMPIAN BLVDWILLIAMSPORTPA17701232449454PHYSICIANSPA501(c)(3)Line 3UPMC SUSQUEHANNAYes (1)
SUSQUEHANNA HEALTH SYSTEM INNOVATION CTR
700 HIGH STREETWILLIAMSPORTPA17701471600873HEALTHCAREPA501(c)(3)Line 12a, IUPMC SUSQUEHANNAYes (1)
SUSQUEHANNA HEALTH FOUNDATION
1100 GRAMPIAN BLVDWILLIAMSPORTPA17701232743470FUNDRAISINGPA501(c)(3)Line 12a, IUPMC SUSQUEHANNAYes (1)
MUNCY VALLEY HOSPITAL
215 EAST WATER STMUNCYPA17756240806023HEALTHCAREPA501(c)(3)Line 3UPMC SUSQUEHANNAYes (1)
LAUREL REALTY INC
15 MEADE STREETWELLSBOROPA16901231403678RENTAL REAL ESTATEPA501(c)(2)N/AUPMC SUSQUEHANNAYes (1)
LAUREL MANAGEMENT SERVICES INC
32-36 CENTRAL AVEWELLSBOROPA16901251644910MANAGEMENT SVCPA501(c)(3)Line 12b, IIUPMC SUSQUEHANNAYes (1)
LAUREL HEALTH SYSTEM
32-36 CENTRAL AVEWELLSBOROPA16901240795488HEALTHCAREPA501(c)(3)Line 12b, IIUPMC SUSQUEHANNAYes (1)
SOLDIERS AND SAILORS MEMORIAL HOSPITAL
32-36 CENTRAL AVEWELLSBOROPA16901232176963HEALTHCAREPA501(c)(3)Line 3UPMC SUSQUEHANNAYes (1)
THE GREEN HOME
37 CENTRAL AVEWELLSBOROPA16901240804365ASSISTED LIVINGPA501(c)(3)Line 10UPMC SUSQUEHANNAYes (1)
TIOGA HEALTH CARE PROVIDERS
22 WALNUT STWELLSBOROPA16901251765538HEALTHCAREPA501(c)(3)Line 12b, IIUPMC SUSQUEHANNAYes (1)
WILLIAMSPORT AREA AMBULANCE
700 HIGH STREETWILLIAMSPORTPA17701232416166AMBULANCE SERVICEPA501(c)(3)Line 10UPMC SUSQUEHANNAYes (1)
UPMC SUSQUEHANNA LOCK HAVEN
700 HIGH STREETWILLIAMSPORTPA17701821600494HOSPITALPA501(c)(3)Line 3UPMC SUSQUEHANNAYes (1)
UPMC SUSQUEHANNA SUNBURY
700 HIGH STREETWILLIAMSPORTPA17701821592230HOSPITALPA501(c)(3)Line 3UPMC SUSQUEHANNAYes (1)
UPMC CHAUTAUQUA AT WCA
207 FOOTE AVEJAMESTOWNNY14701160743226HOSPITALNY501(c)(3)Line 3UPMC CHAUTAUYes (1)
WCA GROUP INC
207 FOOTE AVEJAMESTOWNNY14701222392582HOLDING CONY501(c)(3)Line 12b, IIUPMC CHAUTAUYes (1)
STARFLIGHT INC
135 ALLEN STREETJAMESTOWNNY14701161557878STAT MEDVACNY501(c)(3)Line 7UPMC CHAUTAUYes (1)
SOUTH CENTRAL ALPHA HOUSING AND HEALTH
3410 W PITTSBURGH RDNEW CASTLEPA16101251701701SKILLED NURSINGPA501(c)(3)Line 10UPMC SR COMMYes (1)
SOUTH WESTERN ALPHA HOUSING AND HEALTH
745 GREENVILLE RDMERCERPA16137251701700SKILLED NURSINGPA501(c)(3)Line 10UPMC SR COMMYes (1)
KANE COMMUNITY HOSPITAL FOUNDATION
4372 ROUTE 6KANEPA16735263906925FOUNDATIONPA501(c)(3)Line 7UPMC KANEYes (1)
JUNIOR GUILD OF THE JAMESON MEMORIAL HOS
1211 WILMINGTON AVENEW CASTLEPA16105256005313SUPPORTPA501(c)(3)Line 12d, III-OUPMC JAMESONYes (1)
LAUREL HEALTH FOUNDATION
15 MEADE STREETWELLSBOROPA16901251810488FOUNDATIONPA501(c)(3)Line 12b, IILAUREL HEALTH SYSTEM0
WCA FOUNDATION INC
300 FOOTE AVEJAMESTOWNNY14702222393584FOUNDATIONPA501(c)(3)Line 12c, III-FIUPMC CHAUTAUYes (1)
UPMC
600 GRANT STREETPITTSBURGHPA15219251423657SUPPORTING ORGANIZATIONPA501(c)(3)Line 12c, III-FIYes (1)N/A

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (13 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdPredominant Income TypePredominantIncomeTypeTxtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerInd
SENECA HILLS ASSISTED LIVING
600 GRANT STREETPITTSBURGHPA15219232873106ASSISTED LIVINGPAN/AN/A00
ST MARGARET MEDICAL ARTS ASSOC
600 GRANT STREETPITTSBURGHPA15219251786655MED OFFICE BLPAN/AN/A00
CORE NETWORK KKC
600 GRANT STREETPITTSBURGHPA15219251786209HEALTHCAREPAN/AN/A00
LIFE HOME CARE LP
600 GRANT STREETPITTSBURGHPA15219251847839HOMECAREPAN/AN/A00
SHADYSIDE MEDICAL CENTER ASSOC
600 GRANT STREETPITTSBURGHPA15219251608318MED OFFICE BLPAN/AN/A00
CHARTWELL PA LP
600 GRANT STREETPITTSBURGHPA15219251729714HOMEHEALTHPAN/AN/A00
LIFE CARE HOME SRV OF NW PA
1647 SASSAFRAS STERIEPA16507251536879HOME HEALTHPAN/AN/A00
HAMOT-KCH REAL ESTATE VENTURE
300 STATE STERIEPA16507263691782MEDICAL OFFICEPAN/AN/A00
HAMOT SURGERY CENTER LLC
200 STATE STREETERIEPA16507251863661AMBULATORY SURGPAN/AN/A00
EPN-HAMOT URGENT CARE LLC
600 GRANT STREETPITTSBURGHPA15219272147949URGENT CAREPAN/AN/A00
MOUNTAIN VIEW MEDICAL ONCOLOGY
600 GRANT STREETPITTSBURGHPA15219461449241HEALTHCAREPAN/AN/A00
LAWRENCE COUNTY MRI & DIAGNOST
2526 WILMINGTON AVENEW CASTLEPA16105270219891IMAGING CENTERPAN/AN/A00
COMMUNITY BASKET LLC
1205 GRAMPIAN BLVDWILLIAMSPORTPA17701201195739REAL ESTATE RENTALPAN/AN/A00

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (65 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
HC PHARMACY CENTRAL INC
600 GRANT STREETPITTSBURGHPA15219251364192PHARMACY CO-OPPAN/AC0
CHILDREN'S COMMUNITY CARE
600 GRANT STREETPITTSBURGHPA15219251781887PEDIATRIC SVCPAN/AC0
UPMC CANCER CENTERS IRELAND LIMITED
CANCER TREATMENTN/AC06TH FLOOR BEACON HOSPITALSANDYFORDDUBLINEIEI
UPMC PHYSICIAN SERVICES HOLDING COMPANY
600 GRANT STREETPITTSBURGHPA15219251877017HOLDING COPAN/AC0
HEMATOLOGY ONCOLOGY ASSOC
600 GRANT STREETPITTSBURGHPA15219421648357HEALTHCAREPAN/AC0
ONCOLOGY HEMATOLOGY ASSOC
600 GRANT STREETPITTSBURGHPA15219251762980HEALTHCAREPAN/AC0
TRI-STATE NEUROSURGICAL ASSOC
600 GRANT STREETPITTSBURGHPA15219251458655HEALTHCAREPAN/AC0
RENAISSANCE FAMILY PRACTICE-UPMCINC
600 GRANT STREETPITTSBURGHPA15219262942406HEALTHCAREPAN/AC0
UPMC HOLDING COMPANY INC
600 GRANT STREETPITTSBURGHPA15219251777713HOLDING COPAN/AC0
UPMC COVERAGE PRODUCTS INC
600 GRANT STREETPITTSBURGHPA15219251777710HOLDING COPAN/AC0
FREEDOM INSURANCE COMPANY
600 GRANT STREETPITTSBURGHPA15219030308944INSURANCEVTN/AC0
TRI-CENTURY INSURANCE CO
600 GRANT STREETPITTSBURGHPA15219251500739INSURANCEPAN/AC0
UPMC DNA INC
600 GRANT STREETPITTSBURGHPA15219251883237INSURANCEPAN/AC0
UPMC HEALTH BENEFITS INC
600 GRANT STREETPITTSBURGHPA15219251844144HEALTH INSURANCEPAN/AC0
UPMC HEALTH NETWORK INC
600 GRANT STREETPITTSBURGHPA15219721527566HEALTH INSURANCEPAN/AC0
UPMC HEALTH PLAN INC
600 GRANT STREETPITTSBURGHPA15219232813536HEALTH INSURANCEPAN/AC0
UPMC BENEFIT MANAGEMENT SERVICES INC
600 GRANT STREETPITTSBURGHPA15219251769564WORKER'S COMPPAN/AC0
UPMC DIVERSIFIED SERVICES INC
600 GRANT STREETPITTSBURGHPA15219251778454HOLDING COPAN/AC0
MONROEVILLE SPECIALTY CLINIC
600 GRANT STREETPITTSBURGHPA15219251666087HEALTHCAREPAN/AC0
MEDICAL ARCHIVAL SYSTEMS INC
600 GRANT STREETPITTSBURGHPA15219232912501SOFTWARE DEVEDEN/AC0
PRESBY HEALTH RESOURCE MGMT
600 GRANT STREETPITTSBURGHPA15219251422155HEALTHCAREPAN/AC0
RX PARTNERS INC
600 GRANT STREETPITTSBURGHPA15219251801966RETAIL PHARMPAN/AC0
BIOTRONICS INC
600 GRANT STREETPITTSBURGHPA15219251843500EQUIP MAINTENPAN/AC0
MEDICAL CENTER PROPERTIES INC
600 GRANT STREETPITTSBURGHPA15219251796940REAL ESTATEPAN/AC0
ASKESIS DEVELOPMENT GROUP INC
600 GRANT STREETPITTSBURGHPA15219541625585SOFTWARE DEVEDEN/AC0
PANTHER REINSURANCE COMPANY LTD
INSURANCEN/AC0PO Box 1109GRAND CAYMANCJCJ
FORBES REINSURANCE COMPANY LTD
INSURANCEN/AC0PO Box 1109GRAND CAYMANCJCJ
CATHEDRAL (RE) INSURANCE CO
INSURANCEN/AC0PO Box 1109GRAND CAYMANCJCJ
UPMC INTERNATIONAL HEALTH INITIATIVES
600 GRANT STREETPITTSBURGHPA15219841706741INACTIVEPAN/AC0
UPMC IRELAND LIMITED
HEALTHCARE SUN/AC06TH FLOOR BEACON HOSPITALSANDYFORDDUBLINEIEI
UPMC UNITED KINGDOM LTD
980571026SOFTWARE LICEN/AC0C/O NAIRCO 11TH FLOORWHITEFRIARS LEWINS MEADBRISTOLUKUK
BAYFRONT REGIONAL DEVELOPMENT CORP
300 STATE STREETERIEPA16507251401388RE HOLDING COPAN/AC0
BAYSIDE DEVELOPMENT CORP
300 STATE STREETERIEPA16507251401386REAL ESTATEPAN/AC0
UPMC WORK ALLIANCE INC
600 GRANT STREETPITTSBURGHPA15219452825053INSURANCEPAN/AC0
UPMC CANADA TECHNOLOGIES LIMITED
600 GRANT STREETPITTSBURGHPA15219SOFTWAREN/AC0CA
ALLIED ORTHOPEDICS APPLIANCES INC
335 E 3RD STJAMESTOWNNY14701161092951MED APPLIANCEPAN/AC0
UPMC HEALTH COVERAGE INC
600 GRANT STREETPITTSBURGHPA15219462824537INSURANCEPAN/AC0
UPMC HEALTH OPTIONS INC
600 GRANT STREETPITTSBURGHPA15219462824626INSURANCEPAN/AC0
UPMC COMPLETE CARE INC
5215 CENTRE AVEPITTSBURGHPA15232463605753HEALTHCAREPAN/AC0
AMERICAN HOME HEALTH SERVICES
868 CORPORATE WAYWESTLAKEOH44145311521422HOME HEALTHOHN/AC0
HEALTH FIDELITY INC
210 S B STSAN MATEOCA94401452538963TECHNOLOGYCAN/AC0
FLUENCE HEALTH INC
6425 PENN AVEPITTSBURGHPA15206472684174SOFTWAREDEN/AC0
CURAVI HEALTH INC
6425 PENN AVEPITTSBURGHPA15206811217377HEALTHCAREDEN/AC0
PENSIAMO INC
600 GRANT STREETPITTSBURGHPA15219812069236SUPPLY CHAINDEN/AC0
ALTOONA FAMILY INC
620 HOWARD AVEALTOONAPA16601251444935MGMT SVCSPAN/AC0
LEXINGTON HOLDINGS INC
620 HOWARD AVEALTOONAPA16601251794386MEDICAL SVCSPAN/AC0
LEXINGTON ONE INC
620 HOWARD AVEALTOONAPA16601251468889RENTALPAN/AC0
LEXINGTON TWO INC
HOWARD AVE 7TH STALTOONAPA16601251555689RENTAL EQPTPAN/AC0
LEXINGTON FOUR INC
620 HOWARD AVEALTOONAPA16601251793736HOLDING COPAN/AC0
ALLEGHENY HEALTHCARE STAFFING INC
620 HOWARD AVEALTOONAPA16601271657362EMPLOYMENT SVCPAN/AC0
UPMC ALTOONA REGIONAL HEALTH SERVICES
1414 9TH AVEALTOONAPA16602251219302MEDICAL SVCSPAN/AC0
LEXINGTON ANESTHESIA ASSOCIATES INC
620 HOWARD AVEALTOONAPA16601251897765MEDICAL SVCSPAN/AC0
NORTHERN CAMBRIA MEDICAL CENTER INC
620 HOWARD AVEALTOONAPA16601251530860MEDICAL SVCSPAN/AC0
PATTON FAMILY MEDICAL CENTER INC
620 HOWARD AVEALTOONAPA16601251793735MEDICAL SVCSPAN/AC0
MEDCPU
100 WALL STREETNEW YORKNY10005383805381SOFTWARE DEVEDEN/AC0
UPMC EXCESS PL TR
600 GRANT STREETPITTSBURGHPA15219826254351TRUSTPAN/AT0
RXANTE INC
511 CONGRESS STREETPORTLANDME04101454040219MEDICATION MGTDEN/AC0
VINCENT PAYMENT SOLUTIONS INC
6425 PENN AVEPITTSBURGHPA15219821101143PAYMENT SYSTEMDEN/AC0
J HEALTH VENTURES INC
1211 WILMINGTON AVENEW CASTLEPA16105251607893INACTIVEPAN/AC0
JER MEDICAL ASSOCIATES INC
1211 WILMINGTON AVENEW CASTLEPA16105251609398INACTIVEPAN/AC0
SUSQUEHANNA HEALTH SYSTEM INSURANCE NETWORK LTD
980458722INSURANCEC0PO Box 1159CAYMAN ISLANDSCJCJUPMC SUSQUEHANNA
SUSQUEHANNA VENTURES INC
1201 GRAMPIAN BLVDWILLIAMSPORTPA17701232470263PHARMACYPAC0UPMC SUSQUEHANNA
TYOGA CARENET
114 EAST AVEWELLSBOROPA16901251810967INTEGRATE HEALTHCAREPAC0UPMC SUSQUEHANNA
WCA SERVICE CORPORATION INC
207 FOOTE AVEJAMESTOWNNY14701161151438NYN/AC0
FRIENDS OF ALTOONA HOSPITAL
620 HOWARD AVEALTOONAPA16601861140504FUNDRAISINGPAN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceForm 990, Schedule R, Part II, III, & IVFormAndLineReferenceDesc
ExplanationAll entities marked with an asterisk * are not related parties of the filing organization. However, they are listed on Schedule R to reflect that they are part of the UPMC system of entities, as they all share UPMC as their ultimate parent corporation.ExplanationTxt