2018-05-14T11:31:38-05:00 2017-06-30 346565596 Ernst & Young US LLP 2100 One PPG Place Pittsburgh PA 15222 990 2016-07-01 611663540 St Clair Health Corporation Group Return STCL 4129424000 1000 Bower Hill Road Pittsburgh PA 15243 Richard C Chesnos CPA, SVP, CFO, Treasurer 4129424000 2018-05-14 1 James L Ziesche P01264584 4126447800 2016 2022-09-23 18:48:47Z James M Collins 1000 Bower Hill Road Pittsburgh PA 15243 406618699 1 1 5858 X www.stclair.org X St Clair is the region's leading healthcare provider, excelling in quality, service and value. 45 33 2675 397 800692 0 2167406 2838783 317362670 325394626 5554797 8819797 566979 -642372 325651852 336410834 98516 122860 0 0 152322781 157720281 0 0 339766 145761719 148060878 298183016 305904019 27468836 30506815 386286351 425585475 128220927 108575393 258065424 317010082 X St Clair is the region's leading healthcare provider, excelling in quality, service and value. 0 0 242740015 122860 325347766 St Clair Memorial Hospital's primary exempt purpose is to provide healthcare services to the community and operate a 24 hour Emergency Department to meet the medical needs of the community regardless of ability to pay. In the current year,the Hospital provided 66,984 inpatient days of care to the adult and pediatric population of the community, served 15,988 admissions, performed 264,124 occasions of outpatient services and treated 63,591 Emergency room visits. St Clair Memorial Hospital Foundation provides administrative and support functions associated with program services. St. Clair Medical Services, Inc. provides physician and other healthcare services to the community to support, provide assistance, and advance the interests of St. Clair Health Corporation. (Continued on Schedule O)St. Clair Professional Services, Inc., a non-profit subsidiary of St. Clair Medical Services, Inc., provides physician and other healthcare services to the community, regardless of ability to pay, including, but not limited to, pediatric and certain hospitalists and intensivists services to support, assist, and advance the interests of St. Clair Memorial Hospital(exempt) and other corporations or organizations that are affiliated with St. Clair Health Corporation which are exempt from federal income tax under Sections 501 (c) (3) and public charities exempt under 509 (a) (1) or (2) of the Code. St. Clair Anesthesiology Associates, Inc., a non-profit subsidiary of St. Clair Medical Services, Inc. employs Certified Nurse Anesthetists who provide healthcare services to the community, regardless of ability to pay, including, but not limited to, anesthesia services to support, assist, and advance the interests of St. Clair Memorial Hospital(exempt) and other corporations or organizations that are affiliates with St. Clair Health Corporation which are exempt from federal income tax under Sections 501 (c) (3) and public charities exempt under 509 (a) (1) or (2) of the Code. 242740015 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 1 0 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 1 0 0 1 X 125 0 1 2675 1 1 1 0 0 0 0 1 1 0 0 0 0 X 45 33 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X Richard C Chesnos SR VP & CFO 4129421250 1000 Bower Hill Road Pittsburgh PA 15243 Jodi Amos Board Member-SCH as of 2/17 2.00 2.00 X 0 0 0 Frank Arcuri ESQ Board Member-SCH 2.00 1.00 X 0 0 0 Joseph Banko Board Member-SCH as of 2/2017 2.00 1.00 X 0 0 0 Susan M Bicket ESQ Board Member-SCH as of 1/2017 2.00 0.00 X 0 0 0 Stephanie Brown MD Board Member-SCH 2.00 0.00 X 0 0 0 Karl E Bushman MD Board Member-SCH 2.00 60.00 X 263132 0 33365 James M Collins President/CEO/Asst Secy -SCH 60.00 12.00 X X 976897 0 178148 Robert Daley Board Member-SCH 2.00 0.00 X 0 0 0 Kim Edvardsson Board Member-SCH through 2/2017 2.00 0.00 X 0 0 0 Mario J Fatigati MD Board Member-SCH 2.00 45.00 X 0 0 0 Gary G Glausser Board Member-SCH 2.00 6.00 X 0 0 0 Scott Heeter Board Member-SCH as of 7/2016 2.00 2.00 X 0 0 0 David R Heilman Chairman-SCH 5.00 3.00 X X 0 0 0 Joan L Massella Adm VP/CNO-SCH through 12/2016 60.00 0.00 X X 359456 0 50922 Thomas M Medwig Board Member-SCH 2.00 7.00 X 0 0 0 John P Meegan Board Member-SCH 2.00 3.00 X 0 0 0 Donald P Orr MD Board Member-SCH 60.00 3.00 X 20000 0 0 Harry E Serene MD Board Member-SCH 2.00 3.00 X 0 0 0 Douglas E Shaffer Board Member-SCH as of 11/2016 2.00 0.00 X 0 0 0 Joseph B Smith Vice Chairman-SCH 2.00 3.00 X X 0 0 0 G Alan Yeasted MD Sr VP/CMO-SCH 60.00 2.00 X X 352201 0 52418 Mark Zacur Board Member-SCH 2.00 1.00 X 0 0 0 Gary J Zentner Board Member-SCH 2.00 6.00 X 0 0 0 Jodi Amos Board Member-SCF 2.00 2.00 X 0 0 0 Scott Heeter Board Member-SCF as of 7/2016 2.00 2.00 X 0 0 0 Bryan Hondru Board Member-SCF 2.00 1.00 X 0 0 0 Vicki McKenna Board Member-SCF 2.00 0.00 X 0 0 0 Thomas M Medwig Board Member-SCF 2.00 7.00 X 0 0 0 John P Meegan Board Member-SCF as of 11/2016 2.00 3.00 X 0 0 0 Jack B Piatt Board Member-SCF 2.00 0.00 X 0 0 0 Stephen F Reich Board Member-SCF 2.00 0.00 X 0 0 0 Andrew F Rodgers Board Member-SCF 2.00 0.00 X 0 0 0 Harry E Serene MD Vice Chairman-SCF 5.00 3.00 X X 0 0 0 Robert N Shogry MD Board Member-SCF 2.00 60.00 X 450015 0 34036 C Vaughn Strimlan MD Board Member-SCF 2.00 0.00 X 0 0 0 G Alan Yeasted MD Secretary-SCF 2.00 60.00 X X 0 0 0 Gary J Zentner Chairman-SCF 5.00 3.00 X X 0 0 0 James W Barson Board Member-SCMS 2.00 1.00 X 0 0 0 Kevin Bordeau Board Member-SCMS as of 11/2016 60.00 0.00 X 803506 0 30715 Karl E Bushman MD Board Member-SCMS 60.00 2.00 X 0 0 0 James M Collins President-SCMS 2.00 72.00 X X 0 0 0 Mario J Fatigati MD Board Member-SCMS 45.00 2.00 X 355318 0 31916 Gary G Glausser Chairman-SCMS 5.00 3.00 X X 0 0 0 David R Heilman Board Member-SCMS 2.00 6.00 X 0 0 0 Thomas M Medwig Board Member-SCMS 2.00 7.00 X 0 0 0 Donald P Orr MD Board Member-SCMS 2.00 63.00 X 0 0 0 Joseph B Smith Board Member-SCMS 2.00 3.00 X 0 0 0 Richard C Chesnos Sr VP/CFO/Treasurer-SCH 60.00 12.00 X 448179 0 107053 Michael J Flanagan Sr VP/COO/Secretary-SCH 60.00 0.00 X 447684 0 99095 Andrea L Kalina VP External Affairs/CHRO-SCH 60.00 0.00 X 288432 0 72943 Eric Luttringer Asst Treasurer-SCH 60.00 12.00 X 189410 0 28795 Elizabeth Pittman VP Operations-SCH 60.00 0.00 X 181663 0 43205 Charles J Rakaczky VP Physician Network-SCH 60.00 0.00 X 210752 0 61743 Diane L Pucetti RN Adm VP/CNO-SCH as of 1/2017 2.00 0.00 X 175587 0 30040 Richard J Schaeffer VP & CIO-SCH 60.00 0.00 X 252890 0 77250 Barry S Zaiser Sr VP Op&SD-SCH 60.00 10.00 X 382762 0 83014 James M Collins Asst Secretary-SCF 2.00 70.00 X 0 0 0 Richard C Chesnos Treasurer-SCF 2.00 70.00 X 0 0 0 Eric Luttringer Asst Treasurer-SCF 2.00 70.00 X 0 0 0 Richard Sieber Exec Dir Mkt/Devl-SCF 60.00 0.00 X 164991 0 28861 Richard C Chesnos Treasurer-SCMS 2.00 70.00 X 0 0 0 Eric Luttringer Asst Treasurer-SCMS 2.00 70.00 X 0 0 0 Barry S Zaiser Secretary-SCMS 2.00 68.00 X 0 0 0 John Girod Physician 60.00 0.00 X 493850 0 30714 Mark K Greathouse Physician 60.00 0.00 X 449776 0 33813 Jeffrey M Friedel Physician 60.00 0.00 X 453112 0 30450 Arnold J Sholder Physician 60.00 0.00 X 446076 0 33744 Richard H Maley Physician 60.00 0.00 X 436756 0 33652 8602445 0 1205892 157 0 1 0 ALLSCRIPTS HEALTHCARE LLC PO BOX 8538-133 Philadelphia PA 19171 Software Support 8440900 MBM CONTRACTING 4999 OLD CLAIRTON ROAD Pittsburgh PA 15236 Construction 3801049 G E HEALTHCARE SERVICES PO BOX 96483 Chicago PA 60693 Software Support 2534574 RMP PO BOX 324 Temple PA 19560 AR Collection Services 1317756 NFMDYMUN 200 FIRST AVENUE Minneapolis MN 15222 Corporate Promotions 1266677 93 245920 25000 171269 2396594 6036 2838783 Net patient service rev 622110 288638786 285617633 0 3021153 Program service revenue 621990 32737297 32737297 Cafeteria/Cafe 722514 1998991 1998991 Parking 812930 1231233 1231233 Lablink 621500 788319 788319 325394626 3925517 3925517 1110120 1736494 -626374 -626374 -626374 73096552 5593 68177544 30321 4919008 -24728 4894280 4894280 80467 245920 143095 -62628 -62628 201222 120411 80811 80811 Telephone 561000 12373 12373 Partnership Activities 561000 -46554 -46554 -34181 336410834 318308376 800692 14462983 91349 91349 31511 31511 7994122 6109206 1884916 120428692 99474058 20880518 74116 6464939 5450647 1008637 5655 13974998 11296331 2671626 7041 8857530 7253358 1598823 5349 2294104 2294104 431374 431374 317937 317937 22144 22144 25143 25143 21117728 10154853 10864113 98762 1686345 91961 1594384 1904271 1240358 579001 84912 7789098 6046672 1737501 4925 6190657 3631418 2559238 1 306035 152049 153470 516 134828 101203 33365 260 1139877 1132961 6916 20656090 11287240 9339339 29511 1809339 1638575 170764 Patient Care Supplies 66001519 65967889 33630 PA Quality Care Assessm 4813978 4813978 Food Service 2527963 1047720 1479765 478 Equipment Rental & Main 2335176 1984554 350622 6557272 3742124 2786908 28240 305904019 242740015 62824238 339766 16442 16508 5291469 19890761 288261 987546 32620700 31320008 878282 477405 5098237 6713467 5763745 6359732 328470754 206363278 122659492 122107476 194185583 217386002 9743510 9618778 4212345 4499161 371268 1043040 5157017 5165591 386286351 425585475 32082493 27489114 3864826 3553419 42975816 39829585 49297792 37703275 128220927 108575393 X 242015771 297227169 6996398 10446256 9053255 9336657 258065424 317010082 386286351 425585475 X 30506815 11197198 17240645 X 0 1 X 1 0 X X 1 St Clair Memorial Hospital 251010303 3 1 0 0 1 0 0 1815833 2093727 1111634 1380441 2161478 8563113 1815833 2093727 1111634 1380441 2161478 8563113 1817752 6745361 302071 318522 360007 364451 359123 1704174 10267287 1537732 0.65700 0.65800 X 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 Schedule A, Part II Reason for Public Charity Status St Clair Health Corp Group Return is comprised of - St Clair Memorial Hospital EIN# 25-1010303 - #3 - St Clair Memorial Hospital Foundation EIN# 25-1407399 - #7 - St Clair Professional Services, Inc EIN# 25-1691194 - #12, Type II - St Clair Anesthesiology Associates, Inc EIN# 71-0875076 - #12, Type II - St Clair Medical Services, Inc EIN# 25-1876056 - #12, Type II RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 1 25392 1 22144 0 0 47536 0 Part II-B, Line 1: Form 990, Part IV, Line 4 St. Clair Hospital is engaged in lobbying activities through membership dues paid to the American Hospital Association, The Hospital & Healthsystem Association of Pennsylvania, Healthcare Council of Western PA, and through legal fees paid to Buchanan Ingersoll & Rooney. Additionally, any time spent by paid employees and / or management in lobbying activities are tracked internally and reported. 10036805 855742 100 548724 10343723 10776099 6136 -179895 100 565435 10036805 11373246 6321 -54711 100 548657 10776099 10398985 1358625 100 384264 11373246 9894895 902255 100 398065 10398985 0.09740 0.90260 0.00000 0 0 9100869 9100869 99195816 57081407 42114409 22296885 11396961 10899924 120323839 82967974 37355865 77553345 54916936 22636409 122107476 Due to Third Parties 1533332 Accrued Retirement Benefits 20880358 Accrued Professional Liability 14204763 Other Liabilities 1084822 37703275 X Part V, Line 4: Endowments are designated by donors and/ or the Board. Part X, Line 2: The Corporation, the Hospital, the Foundation, and SCMS are Pennsylvania nonprofit corporations that are described in Section 501(c)(3) of the Internal Revenue Code and are therefore exempt from federal income tax under Section 501(a) and are not subject to the Pennsylvania Corporate Net Income Tax or Pennsylvania Capital Stock Tax. The Corporation and its subsidiaries have adopted Accounting Standards Codification Subtopic 740-10, Accounting for Uncertainty in Income Taxes - an Interpretation of FASB Statement No. 109 (ASC 740-10). ASC 740-10 addresses the determination of how tax benefits claimed or expected to be claimed on a tax return should be recorded in the financial statements. Under ASC 740-10, the Corporation may recognize the tax benefit from an uncertain tax position only if its more likely than not that the tax position will be sustained upon examination by the taxing authorities, based on the technical merits of the position. As of June 30, 2017 and 2016, the Corporation does not have any uncertain tax positions. Central America and Caribbean Investments 19247308 0 0 0 0 0 0 19247308 0 19247308 1 0 1 1 0 0 Golf Outing and Dinner 326387 245920 80467 20525 10960 65619 45991 None 326387 245920 80467 20525 10960 65619 45991 143095 -62628 1 1 X 1 X 1 X 1 1 1 0 1 1 3829066 3829066 0.01250 25165732 17610683 7555049 0.02470 28994798 17610683 11384115 0.03720 502549 502549 0.00160 357767 357767 0.00120 1682569 1682569 0.00550 168464 168464 0.00060 2711349 2711349 0.00890 31706147 17610683 14095464 0.04610 914122 914122 0.00300 914122 914122 0.00300 1 4194099 133502657 160930872 -27428215 X 1 1 1 1 St Clair Memorial Hospital 1000 Bower Hill Road Pittsburgh PA 15243 X X X St Clair Memorial Hospital Line 1 1 0 0 1 X X X X X X X X X 15 1 0 0 1 X www.stclair.org/221/about X 1 15 0 1 0 1 X 200.000000000000 300.000000000000 X X X 1 1 X X X 1 X http://www.stclair.org/191 X See Part V, Line 16a X See Part V, Line 16a X X X X X X X 1 X 0 1 X X 0 0 St Clair Memorial Hospital, Line 1 Part V, Section B, Line 5: St. Clair completed all phases of its Community Health Needs Assessment (CHNA), publicizing its findings from the most recent assessment in June 2016 (Tax Year 2015). Using primary and secondary data sources, interviews with public health experts, stakeholder input and guidance, and community member feedback, a priority index was developed in order to establish an implementation plan. Key areas of focus included: improving access to care for seniors and underserved populations (underserved defined as those located within federally qualified designated areas; those without health insurance; the foreign-born population with limited english-speaking skills; and those at or below the poverty threshold); better education for behavioral and mental health patients; combating health behaviors, such as addiction, with the implementation of a Narcan program; improving the quality of prenatal care available in the region; reducing the incidence of prevalent cancers such as skin, prostate and breast cancer; and better education and management of chronic lifestyle conditions and lack of community. Additional and expanded program development is currently underway resulting in new programs being delivered directly in community neighborhoods.St. Clair gathered information through interviews and surveys of dozens of persons who are invested in healthcare in the community. Also, St. Clair Hospital interviews were conducted in August 2015. The web-based survey was conducted from October - December of 2015. These included external stakeholders - those not affiliated with St. Clair - as well as members of our medical and Hospital staff. These persons shared their perspectives and experience on community health needs and their ideas for interventions and innovative programs to meet those needs. St. Clair Hospital acknowledges the following leaders for their valuable feedback and ideas:ST. CLAIR HOSPITAL COMMUNITY BENEFIT COMMITTEE MEMBERS at that time:Joseph B. SmithSenior Vice President, Marketing,Dollar Bank Chairman,Community Benefit CommitteeBoard of Directors, St. Clair HospitalFrank Arcuri, Esq.Law Office of Frank ArcuriBoard of Directors, St. Clair HospitalKarl E. Bushman, M.D.Mt. Lebanon Internal MedicineBoard of Directors, St. Clair HospitalJames M. CollinsPresident & Chief Executive Officer,St. Clair HospitalBoard of Directors, St. Clair HospitalAndrew R. HaysSenior Director, Elk Lake CapitalEmeritus, Board of Directors, St. Clair HospitalDavid R. HeilmanChairman, St. Clair Hospital Board of DirectorsAndrea L. KalinaExecutive Liaison,Community Benefit CommitteeVice President of Human Resources and Organizational Development,St. Clair HospitalJoan R. MassellaFormer Administrative Vice Presidentand Chief Nursing Officer, St. Clair HospitalBoard of Directors, St. Clair HospitalJohn P. MeeganExecutive Vice Presidentand Chief Operating Officer,Heffren-Tillotson, Inc.Board of Directors, St. Clair HospitalMelvin D. RexFormer Chairman, St. Clair Hospital Board of DirectorsG. Alan Yeasted, M.D.Sr. Vice President & ChiefMedical Officer, St. Clair HospitalBoard of Directors, St. Clair HospitalMark ZacurVice President and General ManagerThermo Fisher Scientific,Fisher HealthcareBoard of Directors, St. Clair HospitalCOMMUNITY LEADERS AND EXPERTS WHO CONTRIBUTED THEIR EXPERTISE:Michael Bowersox, LPCProgram Director, Our ClubhouseRachael BurdetteOutreach Specialist,Greenbriar Treatment CenterVenard CampbellEMS and EmergencyCommunications Coordinator, St. Clair HospitalRichard ChesnosSenior Vice President and Chief Financial Officer,St. Clair HospitalSusan CoyleChief Executive Officer,Chartiers Community Mental HealthKatie DevineDirector of Human Resources, Mt. Lebanon School DistrictMary DurantiLibrarian, Heritage Public LibraryMichael FlanaganSenior Vice Presidentand Chief Operating Officer, St. Clair HospitalHarry FruechtPolice Chief, Peters Township PoliceJim GuffeyExecutive Director, South Hills Interfaith MovementNora HelfrichEMS Director, Tri-Community South EMSChristina Hostutler, LCSWClinical Director, Outreach Teen and Family ServicesDavid KishExecutive Director, Emergency Services,St. Clair HospitalJanice KleinDirector of Business, Mt. Lebanon School DistrictMichelle Kurta, PhD, MPHEpidemiology Research Associate,Allegheny County Health DepartmentTracy LahewPublic Health Nurse, Washington CountyAaron LauthChief of Police, Mt. Lebanon PoliceHeather MartorellaOncology Nurse Specialist, St. Clair HospitalLinda McIntyreDirector, Women and Children's Services,St. Clair HospitalCasey Monroe, MSWExecutive Policy Advisor,Allegheny County Health DepartmentGrace MullerNavigator, Casa San JoseKathe NiznikDirector, Psychiatry and Mental Health,St. Clair HospitalMarianne OlscheskyCommunity Outreach & Marketing Specialist, St. Clair HospitalTodd R. PritchardOperations Director, Medical Rescue Team South AuthorityCasey RichService Coordinator, South Hills Interfaith MovementTom Salerno Jr.Director of Operations/EMS Chief,Scott Township EMSStephanie Samolovitchm, MSWDirector of Support Services, Cancer Caring CenterJames SecretePolice Chief, Scott Township PoliceRichard SieberExecutive Director, Marketing & Development,St. Clair HospitalLiz StyleProject Coordinator for Safer Together,City of PittsburghDenis ValentineDirector, Southbridge EMSBrian WhiteSuperintendent, Chartiers Valley School DistrictRebecca WhitlingerExecutive Director, Cancer Caring CenterJoseph Wissel Jr.EMS Chief, Kirwan Heights EMS St Clair Memorial Hospital, Line 1 Part V, Section B, Line 11: See Part VI and the CHNA Implementation Strategy (attached). Implementation progress is reported quarterly to the Community Benefit Committee and Board of Directors. There are two primary health needs identified in the 2016 (Tax Year 2015) CHNA that St. Clair will not address in its implementation strategy. Specifically, St. Clair Hospital will not address the physical environment or social and economic factors. The Hospital does not have sufficient resources to effectuate a significant change in these areas, and believes resources devoted to its implementation strategy should focus on the other identified pervasive community health needs. St Clair Memorial Hospital, Line 1 Part V, Section B, Line 16j: St. Clair has a service for Limited English Proficiency (LEP) patients where patients can call and have the St. Clair Financial Assistance Policy translated. A simplified PLS for FAP and Collections is provided on the back of every statement and is available on our website http://www.stclair.org/191. This simplified FAP listed on St. Clair website also applies for lines 16C (plain language FAP widely available on the St. Clair Website) as well as for line 16F (Plain language FAP is available upon request and without charge). St Clair Memorial Hospital, Line 1 Part V, Section B, Line 20e: and 20f: St. Clair's Financial Assistance/Charity Care policy includes presumptive charity care as an addition to the regular financial assistance discount process. Patients that do not complete a formal charity care application are screened for presumptive charity care prior to being placed in the regular collection process and qualify for charity care if the patient's credit score is below St. Clair's threshold credit score or their estimated income is within the policy guidelines. Presumptive charity care is extended to a single account. Line 20 is left blank because none of the actions in Line 19 are permitted under St. Clair's policy. Part V, Section B, Line 13 All patients without insurance are billed services at a discount regardless of income. Inpatient and outpatient services are discounted to a level approximating the average of Medicare and all commercial payment rates. In addition to Federal Poverty Guidelines, St. Clair utilizes a presumptive charity care determination process. Patients that do not complete a formal charity care application qualify for presumptive charity care if the patients' credit score is below St. Clair's threshold credit score or their estimated income is within the policy guidelines. Presumptive charity care is extended to a single account. Part V, Section B, Line 10b See attached copy of St. Clair's CHNA Implementation Strategy 35 1 - SCMS So Hills Cardiology Associates 2000 Oxford Drive Suite 305 Bethel Park PA 15102 Physician Office 2 - SCMS Sholder and Bordeau Urologic Asoc 1145 Bower Hill Road Mt Lebanon PA 15243 Physician Office 3 - SCMS Fatigati Nalin Associates 733 Washington Rd Suite 401 Pittsburgh PA 15228 Physician Office 4 - SCMS Fatigati Nalin Associates 1025 Washington Pike Bridgeville PA 15017 Physician Office 5 - SCMS Fatigati Nalin Associates 5187 Library Road Bethel Park PA 15102 Physician Office 6 - SCMS Fatigati Nalin Associates 3928 Washington Road Suite 280 McMurray PA 15317 Physician Office 7 - SCMS Fatigati Nalin Associates 601 McMillan Street Bridgeville PA 15017 Physician Office 8 - SCMS Mt Lebanon Internal Medicine 2000 Oxford Drive Suite 420 Bethel Park PA 15102 Physician Office 9 - SCMS Colorectal Surgical Associates 1050 Bower Hill Road POB Suite 208 Pittsburgh PA 15243 Physician Office 10 - SCMS Zubritzky & Christy OGGYN 1050 Bower Hill Road POB Suite 205 Pittsburgh PA 15243 Physician Office 11 - SCMS Zubritzky & Christy OGGYN 1767 Pine Hollow Road McKees Rocks PA 15136 Physician Office 12 - SCMS Zubritzky & Christy OGGYN 6000 Steubenville Pike Suite 105 McKees Rocks PA 15136 Physician Office 13 - SCMS Zubritzky & Christy OGGYN 2000 Oxford Drive Suite 415 Bethel Park PA 15102 Physician Office 14 - SCMS Urgent Care Center 2000 Oxford Drive Bethel Park PA 15102 Urgent Care Center 15 - SCMS St Clair Orthopedic Associates 1082 Bower Hill Road Suite 100 Pittsburgh PA 15243 Physician Office 16 - SCMS St Clair Orthopedic Associates 3928 Washington Road Suite 270 McMurray PA 15317 Physician Office 17 - SCMS Dobkin & Ricelli Associates 250 Mt Lebanon Boulevard Suite 306 Pittsburgh PA 15234 Physician Office 18 - SCMS Dobkin & Ricelli Associates 5301 Grove Road Pittsburgh PA 15236 Physician Office 19 - SCMS DeGiovanni & Montini Associates 717 Washington Road Pittsburgh PA 15228 Physician Office 20 - SCMS Ripepi Surgical Associates 2000 Oxford Drive Suite 216 Bethel Park PA 15102 Physician Office 21 - SCMS Ripepi Surgical Associates 3928 Washington Road Suite 270 McMurray PA 15317 Physician Office 22 - SCMS Budway Surgical Associates 2000 Oxford Drive Bethel Park PA 15102 Physician Office 23 - SCMS Budway Surgical Associates 3928 Washington Road Suite 270 McMurray PA 15317 Physician Office 24 - SCMS Evron Endocrinology Associates 2000 Oxford Drive Suite 302 Bethel Park PA 15102 Physician Office 25 - SCMS Maley Thoracic Surgery Associates 1050 Bower Hill Road Suite 204 Pittsburgh PA 15243 Physician Office 26 - SCMS Maley Thoracic Surgery Associates 3928 Washington Road Suite 270 McMurray PA 15317 Physician Office 27 - SCMS Maley Thoracic Surgery Associates 27 Heckel Road Suite 106 McKees Rocks PA 15136 Physician Office 28 - SCMS John E Love Family Practice 1626 Potomac Avenue Dormont PA 15216 Physician Office 29 - SCMS Johnston Internal Medicine 2000 Oxford Drive Suite 302 Bethel Park PA 15102 Physician Office 30 - SCMS Basheda Pulmonary Associates 1050 Bower Hill Road Suite 304 Pittsburgh PA 15243 Physician Office 31 - SCMS Basheda Pulmonary Associates 3928 Washington Road Suite 270 McMurray PA 15317 Physician Office 32 - SCMS Basheda Pulmonary Associates 27 Heckel Road Suite 104 McKees Rocks PA 15136 Pysician Office 33 - SCMS Robinson 5482 Campbells Run Road Pittsburgh PA 15205 Physician Office 34 - SCMS Popovich Internal Medicine 2000 Oxford Drive Suite 302 Bethel Park PA 15102 Physician Office 35 - SCMS Gobao Internal Medicine 1145 Bower Hill Road Suite 206 Pittsburgh PA 15243 Physician Office Part I, Line 3c: In addition to Federal Poverty Guidelines, St. Clair utilizes a presumptive charity care determination process. Patients that do not complete a formal charity care application qualify for presumptive charity care if the patients' credit score is below St. Clair's threshold credit score or their estimated income is within the policy guidelines. Presumptive charity care is extended to a single account. Additionally, all patients without insurance are billed services at a discount regardless of income. Inpatient and outpatient services are discounted to a level approximating the average of Medicare and all commercial payment rates. Part I, Line 7: The Hospital's ratio of cost to charges was applied to the total charges for accounts written off to charity care of $4,122,118 in order to determine a reasonable approximation of the cost of providing services for those patients. Costs were then prorated between payments and charity care write-offs on the accounts to calculate the cost amount disclosed.The cost of Medicaid accounts utilized to calculate the Medicaid Community Benefit expense was derived from St. Clair's internal cost accounting system. All other items in Part I, Line 7 represents actual costs. Part I, Ln 7 Col(f): Actual Provision for Bad Debts expense totaling $4,588,500 and St. Clair Memorial Hospital Foundation expenses totaling $983,278 have been excluded from the denominator in the calculation of percentage of total expense. Part II, Community Building Activities: St. Clair Hospital, St. Clair Medical Services and St. Clair HospitalFoundation are Pennsylvania non-profit corporations, exempt from taxesunder Section 501(c)(3) of the Internal Revenue Code of 1986, as amended(the "Code"), which own and operate an acute care hospital providing acomprehensive range of general and specialized care along with physicianpractices supporting the hospital and surrounding communities and aFoundation, the purpose of which is to support health and welfareinitiatives.St. Clair Hospital is a national leader in quality care, patient safety, patient satisfaction, and value. As a member of the Mayo Clinic Care Network, St. Clair is driven by its 2,500 employees and a culture of continuous improvement. The Hospital recently earned its eighth consecutive A grade for Hospital Safety, placing St. Clair in the top 3% in the nation. The Hospital has been honored by Truven Health Analytics for excellent culture, an award that signifies we deliver higher quality, higher satisfaction and lower cost to patients. St. Clair has also been recognized by independent evaluators as having the highest patient satisfaction in the Pittsburgh region and among the top 10% in the nation. St. Clair has also been named among the top 100 hospitals by Watson Health.The Hospital is committed to improving the health status of patients in our region without regard to their ability to pay. A comprehensive offering of programs and services is made available on and off campus ( to include partnering with other local healthcare agencies) and encompasses health education and screenings, prenatal education, smoking cessation, psychiatry and mental health services, cancer care, nutrition and weight control, and the management of cronic diseases such as diabetes, congestive heart failure, COPD and asthma. In most cases these programs are provided at no cost to participants, and are generally fully subsidized. Among its other charitable works, St. Clair supports numerous community based programs including a subsidized cardiac rehabiliation program, well-baby programs, CPR training for schools and non-profit organizations, provision of Narcan supplies and training to first responders on usage, flu and pneumonia vaccinations for local EMS workers, a needle disposal program for diabetics and other individuals who self administer medications, and mentoring opportunities for young adults interested in healthcare careers.The Foundation funds the Hospital's courtesy van-service transportation program, a free need-based service available to local residents who require rides to and from the Hospital and its affiliate locations. During the year ended June 30, 2017 the van service provided nearly 13,000 trips to area residents in need. In addition nearly 150 community outreach eduction programs were sponsored by St. Clair, encompassing nearly every clinical service.St. Clair has established a coordinated program with the nursing schools of surrounding communities and St. Clair's nursing staff serves as preceptors to the nursing students. As many as 288 nursing students were served and more than 3,000 hours were spent on this program in the nurturing of the future healtcare givers of the region. Additionally, St. Clair serves as a clinical site for post-secondary advanced clinical degree programs for medical imaging students in multiple modalities, CRNA students and 5th and 6th year doctoral students in Pharmacy. Its medical school preceptor program hosts between 6 to 8 students for 8 week rotations througout the year. Job shadowing programs are also coordinated for high-school students.St. Clair is actively involved with the clinical training of over 125 Emergency Medical Technicians and Paramedics. Approximately 2,800 hours of training were devoted for their education in order to strengthen the quality of care given by these professionals. The following is a sample of other ways in which St. Clair supports thecommunity:Since its inception, St. Clair Hospital has remained focused on the needs of the community. St. Clair envisions our community as a place where healthful lifestyles are the norm, where residents of any neighborhood have access to health education, disease prevention, screening and primary care. By engaging in partnerships with established nonprofit agencies and charitable organizations who share our values and goals, St. Clair expands its reach into the community, building on existing strengths and enhancing services to improve health and quality of life. St. Clair June 2016 CHNA (Tax Year 2015) identified five key areas the Hospital will build programs and initiatives around:access,behavioral health,health behaviors,health conditions,infant and maternal health and mortality rates.Access - When access is problematic for residents, health problems go untreated; chronic conditions worsen and complications develop, leading to emergencies and hospital admissions. To address the lack of access to care, St. Clair will continue to provide free van transportation services to the hospital and its outpatient centers. It will market the van to seniors and areas of high need. Additionally, St. Clair is also collaborating with other nonprofits in the region that provide health and human services. St. Clair will help to facilitate coordination to ensure residents' health needs are being met.Behavioral Health - With the closing of mental health facilities over the past two decades, families are turning to police and the emergency department to respond to mental health crises. To combat this, St. Clair will continue to provide community-based mental health support groups in collaboration with other nonprofit mental health providers. The Hospital is also integrating mental health services into primary care and obstetrics and gynecology physician offices. Lastly, to better meet the demand for more mental health services, St. Clair recruited additional clinical providers. Health Behaviors - Substance abuse and addiction have reached epidemic proportions across St. Clair Hospital's service area. To address this need, St. Clair will continue to provide training and funding for the Narcan opioid reversal program. The Hospital developed resource cards listing the contact information for drug and rehab partners in the region. St. Clair is also collaborating with first responders in a forum setting to discuss the best way to address this issue. Health Conditions - St. Clair Hospital will continue to participate in community health fairs and senior expos, providing free health education and screenings to the community. Additionally, St. Clair Hospital is expanding its efforts, by doing monthly outreach at the South Hills Interfaith Movement and Salvation Army Carnegie food pantries. Infant and Maternal Health - Insufficient access to prenatal care was shown to be a key concern for St. Clair Hospital's service area. To address the need, St. Clair Hospital created prenatal education videos, posted them on its YouTube channel and promotes them regularly via social media and digital marketing. St. Clair is currently writing curriculum to add to this online education video collection. Additionally, St. Clair is subsidizing prenatal education classes for low-income families. Mortality Rates - In St. Clair Hospital's service area, high mortality exists for prostate, breast, ovarian, and colon cancers. Realizing that early detection provides the best chances for survival, St. Clair is providing free cancer screenings to the community for prostate, breast and skin cancer. The Hospital is also providing information to the community on the HPV vaccination, which prevents the deadly forms of ovarian, head and neck cancers associated with HPV. In addition to CHNA initiatives, St. Clair also expands its reach into the community in the following ways: -St. Clair regularly makes donations to partnering agencies in the form of monetary donations and in-kind contributions.-In the interest of safety and disease prevention, St. Clair has a needle disposal program for those who utilize needles, syringes and other sharps in managing conditions such as diabetes. This free service enables people to exchange containers of contaminated needles for new empty ones.-St. Clair opens its doors to health professions students from the region's many training programs and universities, who come to the Hospital to gain clinical experience. Medical students, residents, nursing students and others rotate through our clinical departments as they prepare for careers in healthcare, and often times, returning to communities in need.-St. Clair Hospital regularly sponsors Youth Programs in the community, including those offered by the 14 school districts within our service area. These programs provide opportunities for children and teens to socialize with their peers and participate in arts and sports. Part III, Line 2 The Hospital's ratio of cost to charges was applied to the total charges for accounts written off in order to determine a reasonable approximation of the cost of providing services for those patients. Costs were then prorated between payments and bad debt write-offs on the accounts to calculate the cost amount disclosed in Part III section A. Part III, Line 3 St. Clair's Financial Assistance/Charity Care policy includes presumptive charity care as an addition to the regular financial assistance discount process. Patients that do not complete a formal charity care application are screened for presumptive charity care prior to being placed in the regular collection process and qualify for charity care if the patients' credit score is below St. Clair's threshold credit score or their estimated income is within the policy guidelines. Presumptive charity care is extended to a single account. As such, St. Clair expects the amount of bad debt expense attributable to patients eligible under the financial assistance policy to be negligible. Part III, Line 4: St. Clair's audited financial statements, Note 2, pages 14-17 describe bad debt expense and uncompensated care. Part III, Line 8: The Hospital provides services regardless of the level of reimbursement to be received from the patient or its insurer. Reimbursement from the government-sponsored programs including Medicare and state Medical Assistance and indigent care programs are often less than the cost of providing these services and therefore should be treated as community benefit. The Hospital's ratio of cost to charges was utilized to estimate this shortfall. Part III, Line 9b: St. Clair provides quality medical health care regardless of race, creed, sex, national origin, age, sexual orientation, or the ability to pay. The care include both inpatient and outpatient services as well as maintaining an emergency department that is available twenty-four (24) hours a day and treats approximately 64,000 patients annually. St. Clair provides free or discounted care to patients who meet certain criteria under St. Clair's Financial Assistance and Charity Care Program. St. Clair ensures that its financial assistance program is easily accessible to patients in need and the policy is posted in all key public areas, all registration areas and in all ancillary departments. The policy extends free or discounted services to low-income, uninsured or underinsured, patients with extraordinary medical expenses and indigent individuals who do not otherwise have the ability to pay fully for medically necessary health care. All patients without insurance are billed services at a discount regardless of income. Inpatient and outpatient services are discounted to a level approximating the average of Medicare and all commercial payment rates. Once St. Clair determines that a patient has qualified for formal charity care or free care, based on a sliding scale of 200%, 250% or 300% of federal poverty guidelines an additional adjustment of 100%, 30% or 20%, respectively, is applied to all accounts reviewed in the charity care/financial assistance application process. Those patients that do not complete a formal charity care application are screened for presumptive charity care prior to being placed in the regular collection process and qualify for charity care if the patients' credit score is below St. Clair's threshold credit score or if their estimated income is within the policy guidelines. Presumptive charity care is extended to a single account. No further collection efforts are made on those qualifying for the 100% discount. For the patients qualifying for the 20% or 30% discount, the balance due is adjusted by the applicable percentage and the remaining balance continues through the regular collection process. During the year ended June 30, 2017, $4,048,000 of uninsured discounts were provided. Part VI, Line 2: St. Clair completed all phases of its Community Health Needs Assessment (CHNA), publicizing its findings from the most recent assessment in June 2016 (Tax Year 2015). Using primary and secondary data sources, interviews with public health experts, stakeholder input and guidance, and community member feedback, a priority index was developed in order to establish an implementation plan. Key areas of focus included: improving access to care for seniors and the underserved; better education for behavioral and mental health patients; combating health behaviors, such as addiction, with the implementation of a Narcan program; improving the quality of prenatal care available in the region; reducing the incidence of prevalent cancers such as skin, prostate and breast cancer; and better education and management of chronic lifestyle conditions and lack of community. Additional and expanded program development is currently underway resulting in new programs being delivered directly in community neighborhoods. St. Clair has regular dialogue with regional healthcare experts, government officials, partnering agencies and community members regarding the health status of the community. That feedback is used to supplement the CHNA action plan as appropriate. Part VI, Line 3: The Hospital's process for educating patients about the Charity Care/Financial Assistance Policy is as follows:All uninsured patients who are registered through the emergency department are given a handout with information about the Hospital's Charity Care/Financial Assistance Policy. All patients who are admitted as inpatients receive a Patient Handbook and one section of the Handbook describes the Charity Care/Financial Assistance Policy. All self-pay patients are mailed the charity care letter and application.The Hospital's customer service representatives discuss the charity care policy when patients call the customer service line.All Self-pay patients who are admitted are seen by an outside consulting firm for a Medical Assistance qualification screening process. The firm also handles high-dollar outpatient accounts. The Hospital strives to be as helpful as possible in discussing charity care for our scheduled and unscheduled patient population.All patient statements notify patients that the hospital offers financial assistance/charity care, the customer service phone number, and hours of operation for additional information.The hospital's website notifies patients that the hospital offers financial assistance and provides access to the financial assistance/charity care application.Financial assistance notification is posted in all registration and other high volume patient areas. Part VI, Line 4: St. Clair is located in the municipality of Mt. Lebanon, in the southwestsuburban quadrant of metropolitan Pittsburgh, Pennsylvania, approximatelysix miles from the downtown proper. St. Clair considers its service areato include thirty-four zip codes within six regions in southwesternAllegheny and northern Washington County, along with three other communityhospitals. In 2017, the total population of this community was 485,000,with 18% of all households having incomes below $25,000. St. Clair alsomaintains a comprehensive outpatient center located in Bethel Park,approximately three miles from the main hospital, and a second outpatientcenter located in Peters Township, Washington County, approximately tenmiles from the Hospital, as well as two smaller outpatient centers withinsimilar proximity. The Hospital is licensed for 328 beds of which 301were set up and staffed during the year ended June 30, 2017. Part VI, Line 5: St. Clair is the region's leading healthcare provider, excelling in quality, service and value. St. Clair's values are demonstrated through performance, integrity, compassion, pride and innovation. With more than 2,500 employees, St. Clair is the largest employer in southern Allegheny County. St. Clair's board of directors is comprised of members of the local community so that community needs can be properly determined and addressed. Subsidized Health ServicesIn addition to charity care and costs not covered by Medicaid payments, another community benefit provided by St. Clair is subsidized health services. These services yield low or negative margins, but are necessary to serve the community. $1,682,569 of subsidized health services were provided for the year ended June 30, 2017.Healthcare ServicesSt. Clair offers a comprehensive array of inpatient and outpatient services, including: advanced cardiovascular services; specialized care for women, children and infants; diabetes treatment; oncology services; emergency care; general surgery services; primary care; psychiatry and mental health services; and pulmonary care. In addition to the high quality, broad range of clinical services offered, St. Clair is equally committed to capital improvements and purchases of new technology to enhance its services to meet the community's health needs. To that end,the Hospital has invested, approximately $115,000,000 over the past five years.Each of these areas is staffed by a team of skilled physicians, nurses and other clinicians. St. Clair considers requests for clinical privileges and medical staff membership based upon the needs of the community and Medical Staff Development Plan.St. Clair provides state-of-the-art facilities and a full continuum of diagnostic, treatment, and rehabilitation procedures, including:Cardiovascular Services - From diagnosis to treatment to rehabilitation and wellness, our multidisciplinary team of caregivers at St. Clair offers a full range of cardiac care services. Our highly skilled professionals have, helped St. Clair achieve industry-leading treatment times for heart attack victims arriving at our Emergency Department, resulting in better outcomes than some of the most recognized hospitals in the United States. St. Clair excels in a host of other cardiac performance measurements as well, having been named a Blue Distinction Center for Cardiac Care for its best practices and standards of care. Our cardiologists and cardiac surgeons are available 24 hours a day, seven days a week to provide scheduled and emergency cardiac care, seamlessly delivered with St. Clair's longtime reputation for quality, compassionate, personalized care. Additionally, Cardiovascular Services provides a comprehensive offering of screening, prevention, cardiac rehabilitation and educational programs to the community. St. Clair subsidizes one of the busiest Cardiac Rehabilitation programs in southwestern Pennsylvania, with more than 24,000 annual visits. St. Clair offers a full range of cardiac diagnostic testing, including ECG, holter monitoring, event recording, echocardiogram, cardiac CT angiography, and stress tests at multiple locations.Psychiatry and Mental Health Services - St. Clair provides comprehensive diagnosis, treatment and follow-up care for persons suffering from mental illness. The Psychiatry and Mental Health Services program offers a safe compassionate treatment environment where patients can learn to understand their illness and begin the recovery process. It engages a multi-disciplinary team of caring professionals (physicians, nurses, therapists and social workers) to develop individual treatment plans to best meet the specific needs of each patient. As one of the few remaining area hospitals to provide this much-needed care, the program offers services to nearly 5,000 patients annually. (Inpatient unit, Outpatient Services, Mental Health Consultation-Liaison Program, Community Outreach)Orthopedics - St. Clair's Orthopedics program includes a variety of services focused on the prevention, diagnosis and treatment of disorders of the musculoskeletal system. From diagnostic testing to arthroscopic and minimally invasive surgery to elective surgery to rehabilitation, St. Clair provides access to leading edge technologies in a compassionate and caring setting. Our multidisciplinary team of physicians, nurses, and therapists develop coordinated treatment plans for each patient to ensure that each individual receives personalized attention and comprehensive care with the ultimate goals of better results and fewer complications. St. Clair also was recognized as a Blue Distinction Center for Spine Surgery and for Knee and Hip Replacement by the Blue Cross and Blue Shield Association. Additionally, St. Clair offers an extensive host of orthopedic education and prevention programs to the community.Women and Children Services - Women and Children Services provides a comprehensive continuum of care, spanning from pre-natal, obstetrics, newborn and pediatric services to complete gynecological and urological services. The state-of-the-art Family Birth Center includes 23 Labor, Delivery, Recovery and Post-Partum (LDRP) beds, a Level II neonatal intensive care unit and an 9 bed Pediatric unit. As one of six hospitals in the service area providing Obstetric services, St. Clair performed 1,512 deliveries during the year ended June 30, 2017. Additionally, it provides an extensive offering of education and support programs. A board-certified pediatrician is on-site 24 hours a day.Cancer Care - Cancer Care provides comprehensive inpatient and outpatient services to patients diagnosed with cancer, and their families. The focus is to treat the physical, emotional, spiritual and psychological needs of patients throughout all stages of the cancer continuum, from diagnosis to treatment, recovery and rehabilitation. Additionally, Cancer Care provides a significant number of cancer screening, education and wellness programs to the community.St. Clair's Sipe Infusion Center is used by patients being treated with chemotherapy, blood transfusions and injections for various ailments. The experienced Infusion Center team consists of registered nurses who have received specialized education and training in cancer care, including certifications in oncology, infusion therapy, critical care and medical-surgical care. Services include: chemotherapy; blood/blood products and IV solutions/medications administration; PICC and mid-line insertions for both inpatients and outpatients; maintenance, care, repair and de-clotting of central IV lines/ports; and therapeutic phlebotomies.The UPMC/St. Clair Hospital Cancer Center, located on the Hospital's main campus, provides a full spectrum of radiation treatment services, which are designed to help treat cancerous tumors while preserving healthy surrounding tissue. The Center is a joint venture between UPMC CancerCenters, a partner with University of Pittsburgh Cancer Institute, and St. Clair Hospital. The Center includes Intensity-Modulated Radiation Therapy (IMRT) capabilities. IMRT gives radiation oncologists the ability to more precisely "custom sculpt" the shape of a tumor, delivering the right amount of radiation with more accuracy and helping to preserve healthy tissue around the tumor. This partnership offers area residents access to convenient, advanced, comprehensive, and high-quality care close to home.Emergency Services - St. Clair is home to the region's largest Emergency Department, with approximately 64,000 annual visits in the year ended June 30, 2017. The Emergency Department is open 24 hours a day and accessible by all patients, providing emergency care ranging from minor injuries and illness to life-threatening accidents or illnesses. The Emergency Department is fully integrated with all of the other service areas of St.Clair to ensure that, should patients require additional specialized treatment, it is provided in a coordinated environment. St. Clair's throughput processes better serve our community as evidenced by a patients-left-without-being-seen rate of 0.48%, which is well below the national average of approximately 2.0%. Door-to-room times averaged five minutes and door-to-doctor times averaged 19 minutes during the year ended June 30, 2017. Patient satisfaction scores for St. Clair's Emergency Department were in the 93rd percentile nationwide for the year ended June 30, 2017.See Additional Information for other services. Part VI, Line 7, Reports Filed With States PA Additional Information Surgical Services - St. Clair's Surgical Services Department performs a wide range of operative procedures, including: endoscopy; gynecological surgery; ear; nose and throat surgery; orthopedic surgery; pediatric surgery; oral/maxillofacial surgery; minimally invasive surgery; podiatric surgery; open chest (heart) surgery; urological surgery; ophthalmologic surgery; pain control services; laser surgery; general surgery; vascular surgery; plastic and reconstructive surgery; lithotripsy; and thoracic surgery. Through the use of its da Vinci Si robotic surgical system, St. Clair is a leader in minimally-invasive surgical procedures. Medical Imaging - Physicians at St. Clair use the most sophisticated imaging and diagnostic equipment available to ensure that their patients are receiving the fastest and most accurate readings to determine their conditions and to serve as the foundation to developing a course of treatment. A full-service Medical Imaging Department offers a variety of diagnostic and interventional studies in four locations using the modalities of general radiology, nuclear medicine, ultrasound, mammography, CT scanning, MRI, PET scanning and special procedures.Laboratory Services - St. Clair's full-service Laboratory operates 24 hours a day, seven days a week to provide quick and accurate test results. The Lab is equipped with leading-edge technology and analyzers, offering comprehensive testing in the specialties of Hematology, Chemistry, Microbiology, Histology, Cytology and Blood Banking. St. Clair's outreach program operates six community-based service centers and provides services to more than 90 physician offices and 11 long-term care facilities.Physical and Occupational Therapy - St. Clair's Physical Therapy Department offers comprehensive rehabilitation services to inpatients and outpatients. Licensed Physical Therapists and Physical Therapist Assistants focus their treatment on restoring patients' loss of motion, strength and function. Physical Therapy works as a treatment for existing problems and prevention of complications. The goal is to return patients to their optimum level of function through exercise, walking therapy, heat and cold treatments, and tissue mobilization. The health care professionals within St. Clair's Occupational Therapy Department help individuals who are suffering from an illness, injury or disability return to a healthy way of living. With a personalized plan of care, patients are assisted in resuming activities they need or want to participate in, including independent self-care, home and work-related skills, and leisure activities. Utilizing purposeful activity to maximize independence, prevent disability and maintain health, the department promotes safety at home, work or school.Respiratory Care/Respiratory Therapy - The Respiratory Care Department at St. Clair delivers comprehensive, consistent, state-of-the-art pulmonary services to patients. The department treats patients of all ages, offering a full continuum of care, ranging from diagnostic testing, Emergency Department care, inpatient and outpatient pulmonary rehabilitation, and education. Services include: Respiratory Care; Sleep Disorders Center; Intensive Care Unit; 22-Bed Pulmonary/Telemetry; Inpatient Unit; Pulmonary Rehabilitation Program; Pulmonary Health Education and Smoking Cessation classes. 1 St Clair Memorial Hospital Foundation 1000 Bower Hill Road Pittsburgh PA 15243 251407399 501(c)(3) 25000 Employee Assistance 1 0 Employee Assistance - expenses 19 19169 0 Patient Assistance 10 12242 0 Scholarship - Nursing Student 1 100 0 Part I, Line 2: Funds are budgeted and approved by St. Clair Memorial Foundation Board on an annual basis. St. Clair Memorial Hospital Social Service department identifies employees and patients in need, from a care perspective and makes recommendations to senior management. Based on established criteria and need senior management forwards approved recommendations to St. Clair Memorial Foundation for disbursement of approved funding. X 1 1 X X X X X X 0 1 0 0 0 0 0 0 0 Karl E Bushman MD Board Member-SCH 227797 0 34556 0 779 0 18550 0 14815 0 296497 0 0 0 James M Collins President/CEO/Asst Secy -SCH 576841 0 400000 0 56 0 144431 0 33717 0 1155045 0 0 0 Joan L Massella Adm VP/CNO-SCH through 12/2016 270245 0 80500 0 8711 0 41476 0 9446 0 410378 0 0 0 G Alan Yeasted MD Sr VP/CMO-SCH 277118 0 75000 0 83 0 31111 0 21307 0 404619 0 0 0 Robert N Shogry MD Board Member-SCF 247827 0 201438 0 750 0 18550 0 15486 0 484051 0 0 0 Kevin Bordeau Board Member-SCMS as of 11/2016 776438 0 27039 0 29 0 15900 0 14815 0 834221 0 0 0 Mario J Fatigati MD Board Member-SCMS 269247 0 86071 0 0 0 18550 0 13366 0 387234 0 0 0 Richard C Chesnos Sr VP/CFO/Treasurer-SCH 315371 0 126000 0 6808 0 78223 0 28830 0 555232 0 0 0 Michael J Flanagan Sr VP/COO/Secretary-SCH 314876 0 126000 0 6808 0 74408 0 24687 0 546779 0 0 0 Andrea L Kalina VP External Affairs/CHRO-SCH 215832 0 61600 0 11000 0 63016 0 9927 0 361375 0 0 0 Eric Luttringer Asst Treasurer-SCH 169041 0 13971 0 6398 0 11505 0 17290 0 218205 0 0 0 Elizabeth Pittman VP Operations-SCH 155817 0 24000 0 1846 0 26095 0 17110 0 224868 0 0 0 Charles J Rakaczky VP Physician Network-SCH 172178 0 35190 0 3384 0 40190 0 21553 0 272495 0 0 0 Diane L Pucetti RN Adm VP/CNO-SCH as of 1/2017 154171 0 14108 0 7308 0 12360 0 17680 0 205627 0 0 0 Richard J Schaeffer VP & CIO-SCH 195751 0 53190 0 3949 0 57882 0 19368 0 330140 0 0 0 Barry S Zaiser Sr VP Op&SD-SCH 275714 0 103125 0 3923 0 66311 0 16703 0 465776 0 0 0 Richard Sieber Exec Dir Mkt/Devl-SCF 157213 0 4607 0 3171 0 11714 0 17147 0 193852 0 0 0 John Girod Physician 256380 0 237470 0 0 0 15900 0 14814 0 524564 0 0 0 Mark K Greathouse Physician 246695 0 203081 0 0 0 18550 0 15263 0 483589 0 0 0 Jeffrey M Friedel Physician 257016 0 196096 0 0 0 15900 0 14550 0 483562 0 0 0 Arnold J Sholder Physician 429615 0 16432 0 29 0 18550 0 15194 0 479820 0 0 0 Richard H Maley Physician 436756 0 0 0 0 0 18550 0 15102 0 470408 0 0 0 Part I, Line 1a Duquesne Club: Membership dues are paid for James M. Collins at the Duquesne Club. The Duquesne Club is a social club where local leaders meet to conduct business and accepts only individual memberships. The Hospital conducts business meetings at the facility. The accountable plan rules are met. Part I, Line 3 A subcommittee of the Board of Directors of St. Clair Health Corporation (whose Board members are also members of the St Clair Memorial Hospital Board), the parent of St. Clair Memorial Hospital, St. Clair Memorial Foundation and St. Clair Medical Services, serves as the executive compensation committee and is charged annually with evaluating, determining and approving the annual compensation of executives. Salary survey information and 990 comparative evaluations are considered along with the written performance evaluation for each executive. In addition, data provided by an independent compensation consultant is used to validate and support executive compensation. Part I, Line 4b These officers participated in the Hospital's Supplemental Nonqualified Retirement Plan Richard Chesnos $ 59,673 James M. Collins $125,881 Michael Flanagan $ 55,858 Andrea Kalina $ 33,866 Joan Massella $ 37,405 Elizabeth Pittman $ 16,911 Charles J. Rakaczky $ 25,341 Richard Schaeffer $ 30,048 Alan Yeasted $ 9,912 Barry S. Zaiser $ 47,761 A Mt Lebanon Hosp Authority 256189519 621820C09 2007-12-01 10000000 Finance Capital Improvements 0 0 0 B Mt Lebanon Hosp Authority 256189519 000000000 2010-12-23 20000000 Finance Capital Improvements 0 0 0 C Mt Lebanon Hosp Authority 256189519 621820CS6 2012-08-22 24746452 2002 Bond Refinancing 0 0 0 A 3750000 10000000 16980 9983020 2009 0 0 1 1 B 6318720 20139725 29457 20110268 2013 0 0 1 1 C 3230000 24746452 510468 24235984 2013 1 0 1 1 A 1 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 1 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 C 1 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 1 0 0 0 1 B 0 0 1 0 0 0 0 0 1 C 0 1 1 0 0 0 0 0 1 A 1 B 1 C 1 Part II, Line 3, column B The Series 2010 Revenue Note Project Fund variance between the issue price and the total proceeds of issue represents investments earnings on the project fund. Project Fund was established to fund costs over construction period. SH Radiology D Orr Pres SHR Brd Mbr-SCH, SCMS 841162 Interpretation of Radiology Exams 0 Nina Fatigati Daughter of Board Member 209457 Physician Salary 0 Sch L, Part IV Business Transactions involving interested Persons: Form 990, Part V, Line 3a St. Clair Memorial Hospital recorded more than $1,000 in unrelated gross business income. Form 990, Part V, Line 3b St. Clair Memorial Hospital has filed a 990-T to report all unrelated gross business income. Form 990, Part V, Line 7a St. Clair Memorial Hospital Foundation provided goods or services in exchange for a contribution more than $75. The Foundation notified the donor of the value. Form 990, Part VI, Section A, line 2 Board members Don Jenkins, Gary Zentner and Bryan Hondru each hold greater than 10% of interest in the same non-St Clair related real estate investment partnership. Form 990, Part VI, Section A, line 6 - St. Clair Memorial Hospital, St. Clair Memorial Hospital Foundation, and St. Clair Medical Services do not have members or stockholders. St. Clair Medical Services is the sole member of St. Clair Anesthesiology Associates and St. Clair Professional Services. Form 990, Part VI, Section A, line 7a - According to the governing documents of St. Clair Memorial Hospital, St. Clair Memorial Hospital Foundation, and St. Clair Medical Services, St. Clair Health Corporation, as the parent company, has the power to approve the election or nomination of the board of directors of such organizations. St. Clair Anesthesiology Associates and St. Clair Professional Services are governed by the board of directors of St. Clair Medical Services. Form 990, Part VI, Section A, line 7b According to the governing documents of St. Clair Memorial Hospital and St. Clair Memorial Hospital Foundation, St. Clair Medical Service, St. Clair Health Corporation, as the parent company of such organizations, has the power to make or approve certain decisions of such organizations including approval of the sale or encumberance of a substantial amount of assets, the approval of annual operating and capital budgets, and the approval of strategic plans. St. Clair Anesthesiology Associates and St. Clair Professional Services are governed by the board of directors of St. Clair Medical Services. Form 990, Part VI, Section B, line 11b (b) - This Form 990 is prepared internally, reviewed by management, and reviewed by a third-party accounting firm, Ernst & Young LLP. The draft Form 990 is provided to each board member for review via a secure website prior to filing. Form 990, Part VI, Section B, line 12c Conflicts are monitored through an annual survey completed by Board Members and Officers. Enforcements of the corporations policies are managed by the CEO and Board Members, to whom all conflicts are reported. The Corporate Compliance Officer also manages enforcement of St. Clair Hospital policies. To the extent any conflicts are identified, such Board members or Officers are excluded from participating in the relative decision making process. Form 990, Part VI, Section B, line 15 (a & b) - A subcommittee of the Board of Directors of St. Clair Health Corporation, the parent of St. Clair Memorial Hospital, St. Clair Memorial Foundation and St. Clair Medical Services, serves as the executive compensation committee and is charged with annually evaluating, determining and approving the annual compensation of executives. Salary survey information and 990 comparative evaluations are considered along with the written performance evaluations for each executive. In addition, data provided by an independent compensation consultant is used to validate and support executive compensation. Form 990, Part VI, Section C, line 19 Governing documents, conflict of interest policy and financial statements are made available to the public upon request. Form 990, Part XI, line 9: Change in pension liability 15,929,470. Transfer (to)/from affiliates 216,746. Investment income 1,241. Contributions 101,517. Grants received 1,492,071. Assets released from restriction for operations -51,625. Other increases / (decreases) -448,775. Form 990, Part IV, Line 2 St. Clair Memorial Hospital and St. Clair Medical Services receives and reports amounts exceeding $5,000 from any one contributor, and St. Clair Memorial Hospital Foundation receives and reports amounts exceeding the 2% special rule threshold from any one contributor. Form 990, Part IV, Line 4 St. Clair Hospital is engaged in lobbying activities and has properly reported the allowable costs on Schedule C. Form 990, Part IV, Line 10 St. Clair Memorial Hospital and St. Clair Memorial Hospital Foundation hold assets in term, permanent, or endowments and have properly reported on Schedule D, Part V. Form 990, Part IV, Line 18 St. Clair Foundation's gross receipts from fundraising events exceeded $15,000 and have been properly included in Schedule G, Part II. Form 990, Part IV, Line 20 St. Clair Memorial Hospital operates one hospital and has properly completed Schedule H. Form 990, Part IV, Line 24a St. Clair Hospital has tax-exempt bond issues exceeding $100,000 issued after December 31, 2002 and have properly reported on Schedule K. Schedule B, Contributions covered by General or Special Rule The organizations comprising St. Clair Health Corp Group return are covered by both the General Rule and Special Rule. - St. Clair Memorial Hospital - General Rule - St. Clair Professional Services, Inc. - General Rule - St. Clair Anesthesiology Associates, Inc. - General Rule - St. Clair Medical Services, Inc. - General Rule - St. Clair Memorial Hospital Foundation - Special Rule St Clair HospitalUPMC Cancer Center PETCT 1000 Bower Hill Road Pittsburgh PA 15243 202814053 Community Healthcare Provider PA 501(c)(3) 12(A) Type I St Clair Health Corporation 1 St Clair Professional Office Building 1050 Bower Hill Road Pittsburgh PA 15243 251545786 Real Estate PA 0 0 SCNSC Properties 1000 Bower Hill Road Pittsburgh PA 15243 262004682 Real Estate PA N/A C 0 0 0 1 0 0 0 0 0 1 1 0 0 0 0 1 0 1 1 1 St Clair HospitalUPMC Cancer Center PETCT O 204773 Actual St Clair HospitalUPMC Cancer Center PETCT Q 2275331 Actual St Clair Memorial Hospital Foundation O 473442 Actual St Clair Memorial Hospital Foundation Q 576943 Actual St Clair Professional Services Inc O 4199028 Actual St Clair Professional Services Inc Q 663892 Actual St Clair Professional Services Inc S 2586357 Actual St Clair Anesthesiology Associates Inc O 6318621 Actual St Clair Anesthesiology Associates Inc Q 739598 Actual St Clair Anesthesiology Associates Inc S 3112906 Actual St Clair Medical Services Inc O 27042484 Actual St Clair Medical Services Inc Q 7538274 Actual St Clair Medical Services Inc S 606142 Actual St Clair Medical Services Inc I 129124 Actual St Clair Medical Services Inc J 985852 actual