UPMC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: UPMC (EIN 24-0795508)
Tax period: 2015-07-01 to 2016-06-30
Filed: 2017-05-02
IRS object ID: 201721229349300107
Schema version: 2015v3.0
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule F
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-05-02T07:41:25-05:00	ReturnTs
Tax Period End	2016-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	BKD LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	910 E St Louis Street Suite 200	AddressLine1Txt
City	Springfield	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	65806	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2015-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	240795508	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	The Williamsport Hospital	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	WILL	BusinessNameControlTxt
Phone	5703207900	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	700 High Street	AddressLine1Txt
City	Williamsport	CityNm
State Abbreviation	PA	StateAbbreviationCd
ZIP	17701	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Eric D Pohjala	PersonNm
Person Title	Executive Vice President / CFO	PersonTitleTxt
Phone	5703207900	PhoneNum
Signature	2017-05-02	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Brian D Todd	PreparerPersonNm
PTIN	P00422601	PTIN
Phone	4178658701	PhoneNum

Field	Value	IRS element (for citing)
Tax	2015	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	Steven P Johnson	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	700 High Street	AddressLine1Txt
City	Williamsport	CityNm
State Abbreviation	PA	StateAbbreviationCd
ZIP	17701	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$404,352,567	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.upmcsusquehannahealth.org	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1873	FormationYr
Legal Domicile State	PA	LegalDomicileStateCd
Activity Or Mission	The 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
Voting Members Governing Body	20	VotingMembersGoverningBodyCnt
Voting Members Independent	16	VotingMembersIndependentCnt
Total Employee	1718	TotalEmployeeCnt
Total Volunteers	224	TotalVolunteersCnt
Total Gross UBI	$836,620	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$148,227	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$7,889,752	PYContributionsGrantsAmt
CY Contributions Grants	$3,563,869	CYContributionsGrantsAmt
PY Program Service Revenue	$310,839,784	PYProgramServiceRevenueAmt
CY Program Service Revenue	$324,262,075	CYProgramServiceRevenueAmt
PY Investment Income	$2,735,635	PYInvestmentIncomeAmt
CY Investment Income	$2,166,214	CYInvestmentIncomeAmt
PY Other Revenue	$902,304	PYOtherRevenueAmt
CY Other Revenue	$2,319,118	CYOtherRevenueAmt
PY Total Revenue	$322,367,475	PYTotalRevenueAmt
CY Total Revenue	$332,311,276	CYTotalRevenueAmt
PY Grants And Similar Paid	$11,560,796	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$12,678,222	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$124,266,315	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$129,862,659	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$22,372	CYTotalFundraisingExpenseAmt
PY Other Expenses	$167,509,835	PYOtherExpensesAmt
CY Other Expenses	$166,540,493	CYOtherExpensesAmt
PY Total Expenses	$303,336,946	PYTotalExpensesAmt
CY Total Expenses	$309,081,374	CYTotalExpensesAmt
PY Revenues Less Expenses	$19,030,529	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$23,229,902	CYRevenuesLessExpensesAmt
Total Assets BOY	$409,268,241	TotalAssetsBOYAmt
Total Assets EOY	$521,644,871	TotalAssetsEOYAmt
Total Liabilities BOY	$239,186,118	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$330,020,008	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$170,082,123	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$191,624,863	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	The 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 improving the health of those we serve. 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 Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$277,638,447	ExpenseAmt
Grant	$12,678,222	GrantAmt
Revenue	$325,236,877	RevenueAmt
Desc	The 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, 2016, TWH admitted 11,454 patients rendering 48,370 patient days and registered approximately 227,376 outpatient procedures.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Desc	TWH 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

Field	Value	IRS element (for citing)
Desc	On an annual basis, TWH devotes a portion of its revenue and assets to community program services. The following reflects the breakout of $49,064,401 in quantifiable community benefits for FY 2016: Charity Care (at cost) $967,782; Bad Debt (at cost) $3,474,317; Government-sponsored health care (unpaid cost of Medicare, Medicaid, indigent care programs, SCHIP and other safety net programs) $41,927,000. 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 $2,695,302.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$277,638,447	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	0	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	Yes (1)	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	1718	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	20	GoverningBodyVotingMembersCnt
Independent Voting Member	16	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	0	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	PA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Management	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	5703207900	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1205 Grampian Boulevard	AddressLine1Txt
City	Williamsport	CityNm
State Abbreviation	PA	StateAbbreviationCd
ZIP	17701	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Chris H Dewald
Chair	2.00	4.00	Yes (X)	Yes (X)	$0	$0	$0
Keith Kuzio
Vice Chair	2.00	6.00	Yes (X)	Yes (X)	$0	$0	$0
Kathleen D Pagana
Secretary	2.00	2.00	Yes (X)	Yes (X)	$1,845	$0	$0
Geneva Peck
Treasurer	2.00	4.00	Yes (X)	Yes (X)	$0	$0	$0
Daniel C Berninger
Director	2.00	2.00	Yes (X)		$0	$0	$0
Mark Beyer DO
Director	2.00	2.00	Yes (X)		$0	$0	$0
Sister Teresa Ann Jacobs
Director	2.00	6.00	Yes (X)		$0	$0	$0
Roger D Jarrett
Director	2.00	4.00	Yes (X)		$0	$0	$0
Kevin W Kist MD
Director	2.00	46.00	Yes (X)		$0	$432,005	$36,767
Patrick Marty
Director	2.00	2.00	Yes (X)		$0	$0	$0
Robert E More
Director	2.00	2.00	Yes (X)		$0	$0	$0
Paul Moulton
Director	2.00	2.00	Yes (X)		$0	$0	$0
Alexander R Nesbitt MD
Director	2.00	46.00	Yes (X)		$0	$222,603	$30,549
Shailesh Patel MD
Director	2.00	2.00	Yes (X)		$0	$0	$0
Kent Trachte PhD
Director	2.00	2.00	Yes (X)		$0	$0	$0
Peter B Trevouledes MD
Director	2.00	2.00	Yes (X)		$0	$0	$0
Patrick Wilson
Director	2.00	2.00	Yes (X)		$0	$0	$0
Mary Wolf
Director	2.00	2.00	Yes (X)		$0	$0	$0
Steven E Yordy MD
Director	2.00	0.00	Yes (X)		$0	$0	$0
Steven P Johnson
President / CEO	42.00	12.00	Yes (X)	Yes (X)	$832,199	$0	$35,182
Eric D Pohjala
Executive VP / CFO	40.00	2.00		Yes (X)	$255,157	$0	$27,349
David Lopatofsky MD
Executive VP / CMO	2.00	42.00			$0	$437,276	$38,887	Yes (X)
Jan E Fisher
Executive VP / COO	40.00	0.00			$459,806	$0	$31,992	Yes (X)
Kenneth B Young
VP / Legal Services	40.00	0.00			$314,279	$0	$10,587		Yes (X)
Daniel Glunk MD
AVP / Chief Quality Office	40.00	0.00			$283,845	$0	$35,435		Yes (X)
Timothy E Schoener
VP CIO	40.00	0.00			$231,039	$0	$36,051		Yes (X)
Teresa A Stackhouse
Mgr. Anesthesia / Chief CRNA	40.00	0.00			$228,828	$0	$27,381		Yes (X)
Glenda L Stroud
CRNA	40.00	0.00			$227,238	$0	$22,224		Yes (X)
Charles J Santangelo
Former Exec VP/CFO (retired 5/2/15)	40.00	0.00			$338,073	$0	$24,988			Yes (X)
William C McCauley MD
Former Exec VP/CMO (retired 1/31/15)	40.00	0.00			$0	$185,372	$4,271			Yes (X)
Ronald J Butler
Former Exec VP/CBO (retired 4/15/15)	40.00	0.00			$518,626	$0	$13,502			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$3,690,935	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$1,277,256	TotReportableCompRltdOrgAmt
Total Other Compensation	$375,165	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	133	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
Aramark Healthcare
24863 Network Place	Chicago	IL	60673	Management / environmental services	$28,827,758
Anesthesia Associates
700 High Street	Williamsport	PA	17701	Anesthesia services	$1,393,999
Paris Companies
67 Hoover Aveneue	DuBois	PA	15801	Linen services	$908,173
Cleveland Clinic Foundation
PO Box 931760	Cleveland	OH	44193	Cardiology & Cardiovascular services	$733,333
Paths LLC
9 Executive Campus	Cherry Hill	NJ	08002	Collection services	$624,958

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	26	CntrctRcvdGreaterThan100KCnt
Related Organizations	$2,483,676	RelatedOrganizationsAmt
Government Grants	$244,811	GovernmentGrantsAmt
All Other Contributions	$835,382	AllOtherContributionsAmt
Total Contributions	$3,563,869	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net patient revenue	621990	$298,521,003	$298,521,003
Support from alliance affiliates	900099	$22,199,165	$22,199,165
Cafeteria	722514	$1,423,865	$1,423,865
Affiliate rent income	531120	$1,317,657	$1,317,657
Meaningful Use Revenue	900099	$467,052	$467,052

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$333,333	TotalRevenueColumnAmt
Related Or Exempt Func Income	$333,333	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$324,262,075	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,074,883	TotalRevenueColumnAmt
Exclusion	$1,074,883	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$73,022,918	SecuritiesAmt
Other	$109,704	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$71,933,334	SecuritiesAmt
Other	$107,957	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$1,089,584	SecuritiesAmt
Other	$1,747	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,091,331	TotalRevenueColumnAmt
Exclusion	$1,091,331	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
North Penn - management	561000	$654,169	$654,169
River Valley ACO	900099	$481,157		$481,157
Cardiology - consulting physician	561000	$338,562		$338,562

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$845,230	TotalRevenueColumnAmt
Related Or Exempt Func Income	$155,083	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$182,451	UnrelatedBusinessRevenueAmt
Exclusion	$507,696	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$2,319,118	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$332,311,276	TotalRevenueColumnAmt
Related Or Exempt Func Income	$325,236,877	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$836,620	UnrelatedBusinessRevenueAmt
Exclusion	$2,673,910	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$12,678,222	TotalAmt
Program Services	$12,678,222	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$2,165,760	TotalAmt
Program Services	$2,165,760	ProgramServicesAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$65,929	TotalAmt
Program Services	$65,929	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$98,218,315	TotalAmt
Program Services	$89,414,982	ProgramServicesAmt
Management And General	$8,786,028	ManagementAndGeneralAmt
Fundraising	$17,305	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$4,928,616	TotalAmt
Program Services	$4,496,677	ProgramServicesAmt
Management And General	$431,090	ManagementAndGeneralAmt
Fundraising	$849	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$17,429,083	TotalAmt
Program Services	$15,901,616	ProgramServicesAmt
Management And General	$1,524,464	ManagementAndGeneralAmt
Fundraising	$3,003	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$7,054,956	TotalAmt
Program Services	$6,436,667	ProgramServicesAmt
Management And General	$617,074	ManagementAndGeneralAmt
Fundraising	$1,215	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$600	TotalAmt
Management And General	$600	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$676,335	TotalAmt
Management And General	$676,335	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$261,937	TotalAmt
Management And General	$261,937	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$23,133	TotalAmt
Management And General	$23,133	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$257,141	TotalAmt
Program Services	$2,735	ProgramServicesAmt
Management And General	$254,406	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$30,717,645	TotalAmt
Program Services	$26,908,722	ProgramServicesAmt
Management And General	$3,808,923	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$1,077,367	TotalAmt
Program Services	$1,070,765	ProgramServicesAmt
Management And General	$6,602	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$7,642,988	TotalAmt
Program Services	$6,776,566	ProgramServicesAmt
Management And General	$866,422	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$5,935,047	TotalAmt
Program Services	$4,450,766	ProgramServicesAmt
Management And General	$1,484,281	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$91,831	TotalAmt
Program Services	$91,386	ProgramServicesAmt
Management And General	$445	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$5,144,013	TotalAmt
Program Services	$5,082,642	ProgramServicesAmt
Management And General	$61,371	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$485,648	TotalAmt
Program Services	$419,313	ProgramServicesAmt
Management And General	$66,335	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$333,375	TotalAmt
Program Services	$98,363	ProgramServicesAmt
Management And General	$235,012	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$7,568,062	TotalAmt
Program Services	$7,568,062	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$22,811,159	TotalAmt
Program Services	$22,811,159	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$3,358,124	TotalAmt
Program Services	$3,358,124	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Medical Supplies	$46,377,813	$46,377,237	$576
Bad Debt	$12,592,668	$12,592,668
Repairs & maintenance	$8,550,743	$8,463,045	$87,698
Inter-entity costs	$7,651,655		$7,651,655

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$4,983,209	TotalAmt
Program Services	$407,041	ProgramServicesAmt
Management And General	$4,576,168	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$309,081,374	TotalAmt
Program Services	$277,638,447	ProgramServicesAmt
Management And General	$31,420,555	ManagementAndGeneralAmt
Fundraising	$22,372	FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$28,999,345	BOYAmt
EOY	$38,269,446	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$25,217,181	BOYAmt
EOY	$32,377,664	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$4,608,396	BOYAmt
EOY	$4,835,055	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$6,997,018	BOYAmt
EOY	$6,129,360	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$466,553,580	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$215,475,551	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$240,715,763	BOYAmt
EOY	$251,078,029	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$63,877,980	BOYAmt
EOY	$68,344,411	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$38,852,558	BOYAmt
EOY	$120,610,906	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$409,268,241	BOYAmt
EOY	$521,644,871	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$40,774,929	BOYAmt
EOY	$42,575,845	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$2,000,000	BOYAmt
EOY	$1,666,666	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$158,749,775	BOYAmt
EOY	$163,832,803	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$37,661,414	BOYAmt
EOY	$121,944,694	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$239,186,118	BOYAmt
EOY	$330,020,008	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$169,436,838	BOYAmt
EOY	$190,985,560	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$434,173	BOYAmt
EOY	$435,990	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$211,112	BOYAmt
EOY	$203,313	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$170,082,123	BOYAmt
EOY	$191,624,863	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$409,268,241	BOYAmt
EOY	$521,644,871	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$23,229,902	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$1,627,975	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$59,187	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	Yes (1)	GrantsOtherOrganizationsInd
Grants Other Organizations	$23,133	GrantsOtherOrganizationsAmt
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	0	OtherActivitiesInd
Total Lobbying Expenditures	$23,133	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part II-B, Line 1:	FormAndLineReferenceDesc
Explanation	The Hospital holds memberships in the American Hospital Association, (AHA), and the Hospital Association of Pennsylvania, (HAP), both 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 6/30/16, the amount of dues paid to HAP totaled $54,633, of which 24.94% or $13,625, was used for lobbying purposes. Dues paid to AHA totaled $42,984, of which 22.12% or $9,508, was used for lobbying purposes. On occasion, HAP requests the help of member providers to communicate concerns to legislators regarding pending legislation which could impact hospitals. This can involve direct contact with legislators or letter-writing. This occurs infrequently, and the cost to the Hospital in negligible.	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

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

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$183,479,603	OtherCostOrOtherBasisAmt
Depreciation	$86,679,034	DepreciationAmt
Book Value	$96,800,569	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$278,105	OtherCostOrOtherBasisAmt
Depreciation	$67,715	DepreciationAmt
Book Value	$210,390	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$191,602,216	OtherCostOrOtherBasisAmt
Depreciation	$108,517,632	DepreciationAmt
Book Value	$83,084,584	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$68,326,282	OtherCostOrOtherBasisAmt
Depreciation	$20,211,170	DepreciationAmt
Book Value	$48,115,112	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$251,078,029	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (6 entries)

DescDesc	Book ValueBookValueAmt
Other receivables	$1,414,618
Funds held by others	$101,724
Interest in net affiliate	$230,540
Other	$705,859
Due from affiliates	$105,584,365
Other long-term receivables	$12,573,800

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$120,610,906	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDesc	AmtAmt
Due to third parties	$2,140,888
Estimated medical legal liability costs	$861,000
Other liabilities	$3,233,840
Due to affiliates, net	$115,347,026
Interest rate swap agreement	$361,940

Field	Value	IRS element (for citing)
Total Liability	$121,944,694	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$315,586,459	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	-$1,627,975	NetUnrealizedGainsInvstAmt
Other Revenue	-$11,763,187	OtherRevenueAmt
Revenue Not Reported	-$13,391,162	RevenueNotReportedAmt
Revenue Subtotal	$328,977,621	RevenueSubtotalAmt
Other Revenues Not Included	$3,333,655	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$3,333,655	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$332,311,276	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$284,793,927	TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported	$0	ExpensesNotReportedAmt
Expenses Subtotal	$284,793,927	ExpensesSubtotalAmt
Other Expenses Not Included	$24,287,447	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$24,287,447	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$309,081,374	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part X, Line 2:	Management 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.
Part XI, Line 2d - Other Adjustments:	Bad debt expense -12,592,668. Net assets released 829,481.
Part XI, Line 4b - Other Adjustments:	Temporary restricted contributions 857,778. Permanently restricted investment contributions -7,799. Transfer from affiliates - UPMC Susquehanna 75,000. Transfer from affiliates - SHF 2,408,676.
Part XII, Line 4b - Other Adjustments:	Bad debt expense 12,592,668. Transfer to affiliate - SHMG 11,694,779.

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp

Field	Value	IRS element (for citing)
Region	Central America	RegionTxt
Offices	0	OfficesCnt
Employee	1	EmployeeCnt
Type Of Activities Conducted	Program services	TypeOfActivitiesConductedTxt
Specific Services Provided	Captive insurance company	SpecificServicesProvidedTxt
Region Total Expenditures	$1,757,860	RegionTotalExpendituresAmt

Field	Value	IRS element (for citing)
Subtotal Offices	0	SubtotalOfficesCnt
Subtotal Employees	1	SubtotalEmployeesCnt
Continutation Total Office	0	ContinutationTotalOfficeCnt
Continutation Total Employee	0	ContinutationTotalEmployeeCnt
Total Office	0	TotalOfficeCnt
Total Employee	1	TotalEmployeeCnt
Subtotal Spent	$1,757,860	SubtotalSpentAmt
Continuation Spent	$0	ContinuationSpentAmt
Total Spent	$1,757,860	TotalSpentAmt
Transfer To Foreign Corp	0	TransferToForeignCorpInd
Interest In Foreign Trust	0	InterestInForeignTrustInd
Foreign Corp Ownership	0	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	0	PassiveForeignInvestmestCoInd
Foreign Partnership	0	ForeignPartnershipInd
Boycott Countries	0	BoycottCountriesInd

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent150	Yes (X)	Percent150Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (1)	ExpensesExceedBudgetInd
Unable To Provide Care	0	UnableToProvideCareInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$967,857	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$967,857	NetCommunityBenefitExpnsAmt
Total Expense	0.00330	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$39,476,728	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$22,537,617	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$16,939,111	NetCommunityBenefitExpnsAmt
Total Expense	0.05710	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$40,444,585	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$22,537,617	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$17,906,968	NetCommunityBenefitExpnsAmt
Total Expense	0.06040	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$485,518	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$10,185	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$475,333	NetCommunityBenefitExpnsAmt
Total Expense	0.00160	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$430,889	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$430,889	NetCommunityBenefitExpnsAmt
Total Expense	0.00150	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

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

Research ResearchGrp

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

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,341,442	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,341,442	NetCommunityBenefitExpnsAmt
Total Expense	0.00450	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,257,849	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$10,185	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,247,664	NetCommunityBenefitExpnsAmt
Total Expense	0.00760	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$42,702,434	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$22,547,802	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$20,154,632	NetCommunityBenefitExpnsAmt
Total Expense	0.06800	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$49,351	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$49,351	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,715	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,715	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$51,066	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$51,066	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$12,592,669	BadDebtExpenseAmt
Bad Debt Expense Attributable	$629,633	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$104,898,715	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$129,887,152	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$24,988,437	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost Accounting System	Yes (X)	CostAccountingSystemInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	The Williamsport Hospital	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	700 High Street	AddressLine1Txt
City	Williamsport	CityNm
State Abbreviation	PA	StateAbbreviationCd
ZIP	17701	ZIPCd

Field	Value	IRS element (for citing)
Website Address	www.upmcsusquehannahealth.org	WebsiteAddressTxt
State License	234601	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	The Williamsport Hospital	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Information Gaps	Yes (X)	InformationGapsInd
CHNA Conducted	15	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	0	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	See Part V, Page 7	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	15	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	See Part V, Page 7	StrategyWebsiteURLTxt
Strategy Attached	0	StrategyAttachedInd
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	150.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.000000000000	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	See Part V, Page 7	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	See Part V, Page 7	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	See Part V, Page 7	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
FAP Notice Displayed	Yes (X)	FAPNoticeDisplayedInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified Before Discharge	Yes (X)	FAPNotifiedBeforeDischargeInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
The Williamsport Hospital	Part 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 Hospital	Part 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 Hospital	Part 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.
The Williamsport Hospital	Part V, Section B, Line 16i: Other - Brochure
The Williamsport Hospital	Part V, Section B, Line 22d: They may also be eligible for discounts of 50%, 60%, 80%, and 100% of charges following application to our Financial Assistance Program which is a greater discount than what has been computed as amounts generally billed utilizing a look back method.
Part V, line 7a	https://www.susquehannahealth.org/in-the-community/community-health-nee ds-assessments
Part V, line 10a	https://www.susquehannahealth.org/in-the-community/community-health-nee ds-assessments
Part V, line 16a, FAP website	https://www.susquehannahealth.org/patients-visitors/for-patients/billin g-insurance/financial-assistance-program
Part V, line 16b, FAP application website	https://www.susquehannahealth.org/patients-visitors/for-patients/billin g-insurance/financial-assistance-program
Part V, line 16c FAP plain language summary website	https://www.susquehannahealth.org/patients-visitors/for-patients/billin g-insurance/financial-assistance-program

Field	Value	IRS element (for citing)
Facility	2	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - The Medical Center
699 Rural Avenue	Williamsport	PA	17701	Outpatient clinic
2 - The Montoursville Clinic Savoy Plaza
900 Plaza Drive	Montoursville	PA	17754	Outpatient clinic / lab

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 24(B), but subtracted for purposes of calculating the percentage in this column is $12,592,668.
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.upmcsusquehannahealh.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 70,000 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 $94,467,383 in quantifiable community benefits reported for FY 2016: Charity Care (at cost) $1,524,334; Bad Debt (at cost) $8,097,385; Government-sponsored health care (unpaid cost of Medicare, Medicaid, indigent care programs, SCHIP and other safety net programs) $78,563,849. In addition, various other programs such as Research, Health Professions Education, Community Building, Financial and In-Kind Contributions, and Community Benefit Operations totaling $6,281,815.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (5 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
Susquehanna Physician Services
1201 Grampian Boulevard	Williamsport	PA	17701	232449454	501(c)(3)	$11,694,779	Support of affiliate
Susquehanna Community Health & Dental Clinic
469-471 Hepburn Street	Williamsport	PA	17701	208979596	501(c)(3)	$357,503	Financial support
Williamsport Area Ambulance Service Cooperative
700 High Street	Williamsport	PA	17701	232416166	501(c)(3)	$500,000	Support of affiliate
Project Bald Eagle Inc
One College Avenue DIF 17	Williamsport	PA	17701	473821707	501(c)(3)	$25,000	Financial contribution
The Commonwealth Medical College
525 Pine Street	Scranton	PA	18509	260812968	501(c)(3)	$100,000	Financial contribution

Field	Value	IRS element (for citing)
Total501c3 Org	5	Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule I, Part 1, Line 2	FormAndLineReferenceDesc
Explanation	Susquehanna 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 partnered with Project Bald Eagle a 501(c)(3) exempt organization to help combat the opioid issues that our area is currently facing. 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

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	Yes (1)	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	Yes (1)	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Kevin W Kist MD
Director	$0	$333,862	$0	$10,206	$0	$87,937	$0	$9,950	$0	$26,817	$0	$468,772	$0	$0
Alexander R Nesbitt MD
Director	$0	$219,808	$0	$0	$0	$2,795	$0	$12,116	$0	$18,433	$0	$253,152	$0	$0
Steven P Johnson
President / CEO	$668,195	$0	$133,858	$0	$30,146	$0	$15,925	$0	$19,257	$0	$867,381	$0	$0	$0
Eric D Pohjala
Executive VP / CFO	$252,402	$0	$0	$0	$2,755	$0	$9,720	$0	$17,629	$0	$282,506	$0	$0	$0
David Lopatofsky MD
Executive VP / CMO	$0	$412,757	$0	$18,458	$0	$6,061	$0	$11,275	$0	$27,612	$0	$476,163	$0	$0
Jan E Fisher
Executive VP / COO	$409,956	$0	$36,987	$0	$12,863	$0	$9,950	$0	$22,042	$0	$491,798	$0	$0	$0
Kenneth B Young
VP / Legal Services	$283,890	$0	$29,746	$0	$643	$0	$9,950	$0	$637	$0	$324,866	$0	$0	$0
Daniel Glunk MD
AVP / Chief Quality Office	$262,900	$0	$19,157	$0	$1,788	$0	$12,600	$0	$22,835	$0	$319,280	$0	$0	$0
Timothy E Schoener
VP CIO	$205,698	$0	$20,521	$0	$4,820	$0	$10,167	$0	$25,884	$0	$267,090	$0	$0	$0
Teresa A Stackhouse
Mgr. Anesthesia / Chief CRNA	$214,422	$0	$13,638	$0	$768	$0	$10,107	$0	$17,274	$0	$256,209	$0	$0	$0
Glenda L Stroud
CRNA	$217,005	$0	$0	$0	$10,233	$0	$10,784	$0	$11,440	$0	$249,462	$0	$0	$0
Charles J Santangelo
Former Exec VP/CFO (retired 5/2/15)	$186,916	$0	$71,895	$0	$79,262	$0	$9,950	$0	$15,038	$0	$363,061	$0	$0	$0
William C McCauley MD
Former Exec VP/CMO (retired 1/31/15)	$0	$108,272	$0	$45,384	$0	$31,716	$0	$0	$0	$4,271	$0	$189,643	$0	$0
Ronald J Butler
Former Exec VP/CBO (retired 4/15/15)	$112,293	$0	$32,105	$0	$374,228	$0	$9,950	$0	$3,552	$0	$532,128	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part I, Line 6	FormAndLineReferenceDesc
Explanation	In 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 2016, the minimum threshold was met that would trigger a VCIP payment. In December 2015, President / CEO Steven P. Johnson received variable compensation award in the amount of $133,858.	ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
Lycoming County Authority
A	236760375	550804AH1	2009-10-22	$147,688,732	See Part VI	0	0	0
Lycoming County Authority
B	236760375	NoneAvail	2011-11-21	$25,000,000	See Part VI	0	0	0
Lycoming County Authority
C	236760375	NoneAvail	2015-06-18	$24,400,000	See Part VI	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)

Bond ReferenceBondReferenceCd	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Capitalized InterestCapitalizedInterestAmt	Refunding EscrowRefundingEscrowAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Capital ExpendituresCapitalExpendituresAmt	Substantial CompletionSubstantialCompletionYr	Current RefundingCurrentRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	UnspentUnspentAmt
A	$153,692,252	$10,568,333	$11,118,563	$53,252,545	$2,696,993	$76,055,818	2012	Yes (1)	Yes (1)	Yes (1)
B	$25,000,000					$25,000,000	2012	0	Yes (1)	Yes (1)
C	$24,400,000				$207,869	$12,622,679		0	0	Yes (1)	$11,569,452

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	Yes (1)	Yes (1)	Yes (1)
B	Yes (1)	Yes (1)	Yes (1)
C	Yes (1)	Yes (1)	Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd	Business Name Line2HedgeProviderName/BusinessNameLine2Txt	Term Of HedgeTermOfHedgePct	Superintegrated HedgeSuperintegratedHedgeInd	Hedge TerminatedHedgeTerminatedInd
(no name)
A	0	0	0	Yes (1)	0	0	0	0	Yes (1)
Manufacturers And
B	0	0	Yes (1)	0	Yes (1)	Yes (1)	0	0	Yes (1)	Traders Trust	7.000000000000	0	0
(no name)
C	0	0	Yes (1)	0	Yes (1)	0	0	0	Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (1)
B	Yes (1)
C	Yes (1)

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Schedule K, Part I, Bond A, (e) and (f)	The total issue price per Form 8038, Part III (b) is $165,134,534. Of this total, $147,688,732 was allocated to The Williamsport Hospital at the time of issue, while the balance of $17,445,802 was allocated to Divine Providence Hospital (EIN #24-0799343). The proceeds of the Lycoming County Authority, Series 2009A bonds were used, together with other available funds, to undertake a project consisting of (i) construction at Williamsport Hospital of a new energy services center that will allow the hospital to meet current energy demands, provide capacity to support further growth, including hot and cold water, steam, electricity, heat and air conditioning, and installation of cogeneration equipment, constuction of a new patient service tower that will expand and remodel the hospital's Emergency Department, Diagnostic Imaging Center, and surgical suites, renovation of existing duel-occupancy patient rooms into private patient rooms, and provision of new private room patient nursing unit: (ii) refunding of the outstanding amount of the issuer's hospital revenue bonds (The Williamsport Hospital Project) Series of 2008, the proceeds of which were used to provide interim financing for certain of the construction projects; (iii) refunding of the outstanding amount of issuer's hospital revenue bonds (The Williamsport Hospital Obligated Group) 1995 series, the proceeds of which were used (a) for the advance refunding of the outstanding portion of the issuer's hospital revenue bonds, Series B of 1986 and (b) to finance certain capital facilities, including reimbursement of capital expenditures.
Form 990, Schedule K, Part II, Bond A, Line 3	The difference between Total Proceeds of Issue and the amount reflected in Part I, (e) is due to investment earnings of $503,521 and deposit of State RACP grant funds into the Project fund in the amount of $5,500,000. In 2007, The Williamsport Hospital applied to the Commonwealth of Pennsylvania for RACP grant money in order to pay a portion of the costs of the Project more fully noted above, which included the construction of a new energy services center. On December 6, 2011, The Williamsport Hospital was informed that the RACP Grant was approved in the amount of $5,500,000 to cover the costs of the Energy Services Center and would be distributed upon execution of the RACP Grant Agreement with the State. The Hospital received $5,362,500 of the RACP Grant Funds on December 12, 2012 and deposited them into the Project account held by the trustee for the 2009 bonds. The Hospital received the remaining $137,500 of RACP Grant Funds on May 5, 2014 and also deposited them into the Project account held by the trustee for the 2009 bonds.
Form 990, Schedule K, Part IV, Bond A, Line 2c	Rebate computations are performed annually, the most recent being from the issue date of October 22, 2009 to October 21, 2015.
Form 990, Schedule K, Part I, Bond B, (f)	The proceeds of the Lycoming County Authority, Series 2011, Revenue Note was used together with other available funds to undertake a project consisting of the architectural and planning expenses of a new patient service tower, replacement of the Emergency Department and Diagnostic Imaging Center, replacement of surgical suites, replacement of the Nursery and OB/GYN areas, and the addition of new private patient rooms.
Form 990, Schedule K, Part II, Bond B, Line 3	The note is a draw-down obligation which was fully drawn in the amount of $25,000,000 on October 29, 2012.
Form 990, Schedule K, Part IV, Bond B, Line 2c	As a draw-down obligation with no funds held in investments, rebate calculation requirements are not applicable.
Form 990, Schedule K, Part I, Bond C, (e) and (f)	The total issue price per Form 8038, Part III (b) is $40,000,000. Of this total, $24,400,000 was allocated to The Williamsport Hospital at the time of issue, while $11,200,000 was allocated to Muncy Valley Hospital (EIN #24-0806023) and $4,400,000 was allocated to Divine Providence Hospital (EIN #24-0799343). The proceeds of the financing will be used to finance all, or a portion of projects consisting of (i) construction at Williamsport Hospital, Patient Tower 4th Floor of three (3) Operating Rooms, four (4) Cardiology procedural rooms, and related clinical equipment; (ii) renovation at Williamsport Hospital, East Building 2nd Floor of existing entrance and interior hallway space to improve patient throughput; create a new Pre-Admission Testing area; and expand clinical staff locker area; (iii) installation at Williamsport Hospital, Energy Services Center, of 1,000 ton chiller and cooling tower creating new capacity to support the added demand from the Health Innovation Center and Patient Tower and creating additional back-up capacity; (iv) replacement at Williamsport Hospital, West Building and Energy Center, of the hot water system with hot water sourced from the Energy Services Center, thus providing more efficient hot water and heating to the West Building; (v) construction of Muncy Valley Hospital, Emergency Room expansion and renovation of a 5,400 square foot addition and 11,000 square feet of renovation to upgrade and expand the Emergency Department, installing eight (8) private bed rooms and five (5) specialty rooms, upgraded Radiology; and site-work to relocate Shady Lane, and create a new walk-in entrance, parking lot, and helipad; (vi) renovation at Divine Providence Hospital, Health Sciences Building 2nd Floor, to accommodate the relocation of Sports Medicine from the hospital, creating additional examination rooms and offices to accommodate seven (7) clinical providers and two (2) additional Radiology rooms, with related clinical equipment; (vii) renovation at Divine Providence Hospital, 1st Floor, to accommodate the expansion of the Work Center and relocation of Radiology services; (viii)renovation at Divine Providence Hospital, 1st Floor, to accommodate expansion of the Cancer Center to provide twelve (12) additional examination rooms, physician and management offices and nurse stations; (ix) the funding of any necessary reserves, and (x) the payment of all or a portion of the costs of the Financing.
Form 990, Schedule K, Part II, Bond C, Line 3	This issue is a draw-down obligation from which funds are not requested and drawn until capital expenditures have been incurred.
Form 990, Schedule K, Part IV, Bond C, Line 2c	As a draw-down obligation with no funds held in investments, rebate calculation requirements are not applicable.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Richard Fisher	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Relationship Description	Son of key employee	RelationshipDescriptionTxt
Transaction	$65,929	TransactionAmt
Transaction	Compensation	TransactionDesc
Sharing Of Revenues	0	SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part V, Line 2A & 2B	UPMC Susquehanna EIN #23-2751183 utilizes a common paymaster which includes the following entities: Divine Providence Hospital EIN #24-0799343 Muncy Valley Hospital EIN #24-0806023 The Williamsport Hospital EIN #24-0795508 Susquehanna Health Foundation EIN #23-2743470 Susquehanna Physician Services EIN #23-2449454 Susquehanna Ventures, Inc. EIN #23-2470263 Williamsport Are Ambulance Services EIN #23-2416166 Laurel Management Services EIN #25-1644910 Laurel Realty EIN #23-1403678 Soldiers & Sailors Memorial Hospital EIN #23-2176963 The Green Home EIN #24-0804365 Tioga Health Care Providers EIN #25-1765538 Tyoga Carenet EIN #25-1810967 The total number of employees reported on Form W-3 would be 3,871 for UPMC Susquehanna EIN #23-2751183. Of that total, 1,718 employees payroll expenses were recorded by The Williamsport Hospital.
Form 990, Part VI, Section A, line 6	UPMC Susquehanna, EIN # 23-2751183, is the sole member of the governing body.
Form 990, Part VI, Section A, line 7a	UPMC Susquehanna, EIN # 23-2751183, may elect or remove members of the governing body.
Form 990, Part VI, Section A, line 7b	All 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 11	A 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 12c	As 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 15	The 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 19	The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request.
Form 990, Part XI, line 9:	Change in fair value interest swap -59,187.
Form 990, Part XII, Line 2C	The organization did not change it oversight process or selection process.
Form 990, Part V, Line 1A	All 1099's are issued by UPMC Susquehanna EIN #23-2751183. All expenses are then allocated back to all related entities.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (14 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd
Divine Providence Hospital of the Sisters of Christian Charity
1100 Grampian Boulevard	Williamsport	PA	17701	240799343	Hospital	PA	501(c)(3)	3	UPMC Susquehanna	0
Muncy Valley Hospital
215 East Water Street	Muncy	PA	17756	240806023	Hospital	PA	501(c)(3)	3	UPMC Susquehanna	0
Susquehanna Health Foundation
1100 Grampian Boulevard	Williamsport	PA	17701	232743470	Fundraising for affiliated entities	PA	501(c)(3)	11 A I	UPMC Susquehanna	0
UPMC Susquehanna
1205 Grampian Boulevard	Williamsport	PA	17701	232751183	Coordinate & manage the delivery of healthcare	PA	501(c)(3)	11 A I		0	N/A
Susquehanna Physician Services
1201 Grampian Boulevard	Williamsport	PA	17701	232449454	Physician services & MRI services	PA	501(c)(3)	3	UPMC Susquehanna	0
Williamsport Area Ambulance Service Cooperative
700 High Street	Williamsport	PA	17701	232416166	Ambulance transports	PA	501(c)(3)	9		0	N/A
Soldiers & Sailors Memorial Hospital
32-36 Central Avenue	Wellsboro	PA	16901	232176963	Hospital	PA	501(c)(3)	3	UPMC Susquehanna	0
The Green Home
37 Central Avenue	Wellsboro	PA	16901	240804365	Skilled nursing & assisted living	PA	501(c)(3)	9	UPMC Susquehanna	0
Tioga Health Care Providers
15 Meade Street	Wellsboro	PA	16901	251765538	Physician services	PA	501(c)(3)	11 B II	UPMC Susquehanna	0
Laurel Management Services
15 Meade Street	Wellsboro	PA	16901	251644910	Mgmt consulting & supervisory svcs	PA	501(c)(3)	11 B II	UPMC Susquehanna	0
Laurel Realty
15 Meade Street	Wellsboro	PA	16901	231403678	Own & manage real estate	PA	501(c)(2)	N/A	UPMC Susquehanna	0
Laurel Health Systems
15 Meade Street	Wellsboro	PA	16901	240795488	Coordinate & manage the delivery of healthcare	PA	501(c)(3)	11 B II	UPMC Susquehanna	0
Laurel Health Foundation
15 Meade Street	Wellsboro	PA	16901	251810488	Fundraising for affiliated entities	PA	501(c)(3)	11 A I	Laurel Health System	0
Susquehanna Health Innovation Center Inc
700 High Street	Williamsport	PA	17701	471600873	Supporting organization of affiliated entities	PA	501(c)(3)	11 A I	UPMC Susquehanna	0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	Community Basket LLC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1205 Grampian Boulevard	AddressLine1Txt
City	Williamsport	CityNm
State Abbreviation	PA	StateAbbreviationCd
ZIP	17701	ZIPCd

Field	Value	IRS element (for citing)
EIN	201195739	EIN
Primary Activities	Rents real estate	PrimaryActivitiesTxt
Legal Domicile State	PA	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	UPMC Susquehanna & Susquehanna Health Foundation	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Predominant Income Type	excluded from tax	PredominantIncomeTypeTxt
Disproportionate Allocations	0	DisproportionateAllocationsInd
General Or Managing Partner	0	GeneralOrManagingPartnerInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	CountryForeignAddress/CountryCd	Foreign PostalForeignAddress/ForeignPostalCd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd
Susquehanna Ventures Inc
1201 Grampian Boulevard	Williamsport	PA	17701	232470263	Pharmacy & infusion services	PA	UPMC Susquehanna	C	0
Susquehanna Health System Insurance Network LTD
				980458722	Captive insurance company		UPMC Susquehanna		0	PO Box 1159	Grand Caymans	CJ	KY1-1102	CJ
Tyoga Carenet
15 Meade Street	Wellsboro	PA	16901	251810967	Integrate health care	PA	UPMC Susquehanna	C	0

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (1)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (1)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (1)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (1)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (1)	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Form 990, Schedule R, Part IV	FormAndLineReferenceDesc
Explanation	Susquehanna Health System Insurance Network, LTD (SHSIN) EIN #98-0458722, is a foreign corporation, incorporated under the laws of the Cayman Islands. There are no income, capital, or premium taxes levied in the Cayman Islands and SHSIN has been granted an exemption until September 2022 for any such taxes that might be introduced. SHSIN's sole shareholder, UPMC Susquehanna EIN #23-2751183, is a 501 (c)(3) organization exempt from federal income taxes. SHSIN conducts no business in the United States. It files an 1120F protective filing which implies that its income is not subject to US Federal Income tax.	ExplanationTxt