2016-05-16T17:14:23-05:00 2015-06-30 346565596 Ernst & Young US LLP 2100 One PPG Place Pittsburgh PA 15222 990 2014-07-01 611663540 St Clair Health Corporation Group Return STCL 4129424000 1000 Bower Hill Road Pittsburgh PA 15243 Richard C Chesnos CPA, SVP, CFO, Treasurer 4129424000 2016-05-16 1 James L Ziesche P01264584 4126447800 2014 2016-12-15 16:53:06Z James M Collins 1000 Bower Hill Road Pittsburgh PA 15243 434990174 1 1 5858 X www.stclair.org X St Clair is the region's leading healthcare provider, excelling in quality, service and value. 46 34 2588 623 646536 0 4236851 2405166 277714618 300208524 10787108 8021828 -349498 204285 292389079 310839803 92316 126574 0 0 144776899 146090171 0 0 353007 122112077 138569917 266981292 284786662 25407787 26053141 372954215 384307409 115766293 118095467 257187922 266211942 X St Clair is the region's leading healthcare provider, excelling in quality, service and value. 0 0 222209230 126574 300410070 St Clair Memorial Hospital's primary exempt purpose is to provide healthcare services to the community and operate a 24 hour Emergency Department to meet the medical needs of the community regardless of ability to pay. In the current year,the Hospital provided 71,589 inpatient days of care to the adult and pediatric population of the community, served 16,359 admissions, performed 297,524 occasions of outpatient services and treated 63,852 Emergency room visits. St Clair Memorial Hospital Foundation provides administrative and support functions associated with program services. St. Clair Medical Services, Inc. provides physician and other healthcare services to the community to support, provide assistance, and advance the interests of St. Clair Health Corporation. (Continued on Schedule O)St. Clair Professional Services, Inc., a non-profit subsidiary of St. Clair Medical Services, Inc., provides physician and other healthcare services to the community, regardless of ability to pay, including, but not limited to, pediatric and certain hospitalists and intensivists services to support, assist, and advance the interests of St. Clair Memorial Hospital(exempt) and other corporations or organizations that are affiliated with St. Clair Health Corporation which are exempt from federal income tax under Sections 501 (c) (3) and public charities exempt under 509 (a) (1) or (2) of the Code. St. Clair Anesthesiology Associates, Inc., a non-profit subsidiary of St. Clair Medical Services, Inc. employs Certified Nurse Anesthetists who provide healthcare services to the community, regardless of ability to pay, including, but not limited to, anesthesia services to support, assist, and advance the interests of St. Clair Memorial Hospital(exempt) and other corporations or organizations that are affiliates with St. Clair Health Corporation which are exempt from federal income tax under Sections 501 (c) (3) and public charities exempt under 509 (a) (1) or (2) of the Code. 222209230 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 1 0 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 0 0 1 X 127 0 1 2588 1 1 1 0 0 0 0 1 1 0 0 0 0 X 46 34 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X Richard C Chesnos SR VP & CFO 4129421250 1000 Bower Hill Road Pittsburgh PA 15243 Andrew Aloe Board Member-SCH 2.00 2.00 X 0 0 0 Frank Arcuri ESQ Board Member-SCH 2.00 2.00 X 0 0 0 Joseph Banko Vice Chairman-SCH 5.00 5.00 X X 0 0 0 Stephanie Brown MD Board Member-SCH 2.00 2.00 X 0 0 0 Karl E Bushman MD Board Member-SCH 60.00 2.00 X 234038 0 30442 Louis A Civitarese DO CMIO-SCH through 11/2014 2.00 2.00 X 0 0 0 James M Collins President/CEO/Asst Secy -SCH 60.00 12.00 X X 897394 0 48902 Robert Daley Board Member-SCH as of 1/2015 2.00 2.00 X 0 0 0 Kim Edvardsson Board Member-SCH as of 8/2014 2.00 2.00 X 0 0 0 Mario J Fatigati MD Board Member-SCH 2.00 2.00 X 0 0 0 Gary G Glausser Board Member-SCH 2.00 6.00 X 0 0 0 Andrew R Hays Board Member-SCH 2.00 2.00 X 0 0 0 David R Heilman Chairman-SCH 5.00 3.00 X X 0 0 0 David R Jardini Board Member-SCH 2.00 1.00 X 0 0 0 Donald J Jenkins Board Member-SCH 2.00 1.00 X 0 0 0 Joan L Massella Adm VP/CNO-SCH 60.00 2.00 X X 269054 0 36743 Thomas M Medwig Board Member-SCH 2.00 7.00 X 0 0 0 Donald P Orr MD Board Member-SCH 60.00 5.00 X 10000 0 0 Melvin D Rex Chairman-SCH thru 11/2014 5.00 3.00 X X 0 0 0 Harry E Serene MD Board Member-SCH 2.00 6.00 X 0 0 0 Joseph B Smith Board Member-SCH 2.00 2.00 X 0 0 0 G Alan Yeasted MD Sr VP/CMO-SCH 60.00 12.00 X X 373674 0 47505 Mark Zacur Board Member-SCH as of 11/2014 2.00 2.00 X 0 0 0 Gary J Zentner Board Member-SCH 2.00 6.00 X 0 0 0 Robert L Allman II Board Member-SCF 2.00 2.00 X 0 0 0 Andrew Aloe Board Member-SCF 2.00 2.00 X 0 0 0 Jodi Amos Board Member-SCF 2.00 2.00 X 0 0 0 Joseph Banko Board Member-SCF 2.00 8.00 X 0 0 0 Bryan Hondru Board Member-SCF 2.00 1.00 X 0 0 0 Vicki McKenna Board Member-SCF 2.00 2.00 X 0 0 0 Thomas M Medwig Board Member-SCF 2.00 7.00 X 0 0 0 Jack B Piatt Board Member-SCF 2.00 2.00 X 0 0 0 Stephen F Reich Board Member-SCF 2.00 2.00 X 0 0 0 Andrew F Rodgers Board Member-SCF 2.00 2.00 X 0 0 0 Harry E Serene MD Vice Chairman-SCF 5.00 6.00 X X 0 0 0 C Vaughn Strimlan MD Board Member-SCF 2.00 2.00 X 0 0 0 G Alan Yeasted MD Board Member & Secretary-SCF 2.00 62.00 X X 0 0 0 Gary J Zentner Chairman-SCF 5.00 3.00 X X 0 0 0 Joseph Banko Board Member-SCMS 2.00 8.00 X 0 0 0 James W Barson Board Member-SCMS 2.00 1.00 X 0 0 0 Karl E Bushman MD Board Member-SCMS 2.00 60.00 X 0 0 0 James M Collins President-SCMS 2.00 70.00 X X 0 0 0 Mario J Fatigati MD Board Member-SCMS 60.00 2.00 X 343565 0 30028 Gary G Glausser Chairman-SCMS 5.00 3.00 X X 0 0 0 David R Heilman Board Member-SCMS 2.00 2.00 X 0 0 0 Thomas M Medwig Board Member-SCMS 2.00 7.00 X 0 0 0 Donald P Orr MD Board Member-SCMS 2.00 2.00 X 0 0 0 Melvin D Rex Board Member-SCMS through 11/2014 2.00 6.00 X 0 0 0 Robert N Shogry MD Board Member-SCF 2.00 60.00 X 506084 0 32374 Richard C Chesnos Sr VP/CFO/Treasurer-SCH 60.00 12.00 X 393162 0 42635 Michael J Flanagan Sr VP/COO/Secretary-SCH 60.00 2.00 X 387815 0 36426 Holly M Hampe VP & CQO-SCH thru 7/4/14 60.00 0.00 X 10323 0 15823 Andrea L Kalina VP External Affairs/CHRO-SCH 60.00 2.00 X 253462 0 32681 Eric Luttringer Asst Treasurer-SCH 60.00 12.00 X 174782 0 26262 Charles J Rakaczky VP-Physician Network-SCH 12/2014 60.00 2.00 X 6538 0 0 Richard J Schaffer VP & CIO-SCH 60.00 2.00 X 242305 0 43352 Barry S Zaiser Sr VP Op&SD-SCH 60.00 10.00 X 329698 0 30291 James M Collins Asst Secretary-SCF 2.00 70.00 X 0 0 0 Richard C Chesnos Treasurer-SCF 2.00 72.00 X 0 0 0 Eric Luttringer Asst Treasurer-SCF 2.00 72.00 X 0 0 0 Richard Sieber Exec Dir Mkt/Devl-SCF 60.00 0.00 X 156074 0 26937 Richard C Chesnos Treasurer-SCMS 2.00 72.00 X 0 0 0 Eric Luttringer Asst Treasurer-SCMS 2.00 72.00 X 0 0 0 Barry S Zaiser Secretary-SCMS 2.00 70.00 X 0 0 0 Kevin P Bordeau Physician 60.00 0.00 X 833779 0 29388 John Girod Physician 60.00 0.00 X 538291 0 29427 Mark K Greathouse Physician 60.00 0.00 X 521687 0 32374 Jeffrey Friedel Physician 60.00 0.00 X 499183 0 29427 Arnold Sholder Physician 60.00 0.00 X 479302 0 18200 7460210 0 619217 137 0 1 0 Allscripts Healthcare LLC PO Box 8538-133 Philadelphia PA 191710133 Software Support 5824492 Massaro Corporation 120 Delta Drive Pittsburgh PA 152382806 Construction 3156349 GE Healthcare Services PO Box 96483 Chicago IL 60693 Software Support 1807569 Volpatt Construction Corp 100 Castleview Road Pittsburgh PA 15243 Construction 1764590 MBM Contracting 4999 Old Clairton Road Pittsburgh PA 15236 Construction 1641792 66 222685 25000 1293532 863949 40300 2405166 Net patient service rev 622110 266792908 264527353 2265555 Program service revenue 621990 29942597 29942597 Cafeteria/Cafe 722210 1906022 1906022 Parking 812930 930371 930371 Lablink 621500 636626 636626 300208524 3717048 3717048 1129573 1133835 -4262 -4262 -4262 127016510 2473 122706083 8120 4310427 -5647 4304780 4304780 85794 222685 168496 -82702 -82702 213630 133837 79793 79793 Partnership Activities 561000 201546 201546 Telephone 900002 9910 9910 211456 310839803 294671496 646536 13116605 87181 87181 39393 39393 6815404 5173470 1641934 114301478 92071273 22139413 90792 2467529 1995474 470060 1995 14170009 11269136 2891439 9434 8335751 6728399 1600588 6764 671226 671226 420705 420705 352612 352612 46829 46829 28910 28910 20104413 9060019 10954461 89933 1503039 100662 1402377 1687219 1113628 489781 83810 7312207 5854584 1452597 5026 6757426 3787233 2970192 1 168100 56383 111642 75 202742 136408 66265 69 1274053 1274053 18468127 9362059 9084850 21218 4726791 3817952 908839 Patient Care Supplies 59497274 59410013 87261 PA Quality Care Assessm 4178170 4178170 Equipment Rental & Main 2634023 2223064 410959 Food Service 2395330 1035720 1358861 749 6140721 3434956 2662624 43141 284786662 222209230 62224425 353007 16056 16287 5710022 10010708 339621 300777 28338639 30522328 1612609 1252234 4347366 4813130 3382779 5408892 313495103 189172716 123366707 124322387 185026227 189581509 8559807 7563801 4801713 4236591 1296866 1396275 6155803 4882490 372954215 384307409 24158869 28978286 4305633 4210412 48449257 45731675 38852534 39175094 115766293 118095467 X 240382074 249671605 6563211 6825179 10242637 9715158 257187922 266211942 372954215 384307409 X 26053141 -3451184 -13577937 X 0 1 X 1 0 X X 1 St Clair Memorial Hospital 251010303 3 1 0 0 1 0 0 1104721 1900639 1815833 2093727 1111634 8026554 1104721 1900639 1815833 2093727 1111634 8026554 1912143 6114411 253610 263329 302071 318522 360007 1497539 9524093 1315603 0.64200 0.58110 X 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 Schedule A, Part II Reason for Public Charity Status St Clair Health Corp Group Return is comprised of - St Clair Memorial Hospital EIN# 25-1010303 - #3 - St Clair Memorial Hospital Foundation EIN# 25-1407399 - #7 - St Clair Professional Services, Inc EIN# 25-1691194 - #11, Type II - St Clair Anesthesiology Associates, Inc EIN# 71-0875076 - #11, Type II - St Clair Medical Services, Inc EIN# 25-1876056 - #11, Type II RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 1 22949 1 23430 0 1 450 46829 0 Part II-B, Line 1: Form 990, Part IV, Line 4 St. Clair Hospital is engaged in lobbying activities through membership dues paid to the American Hospital Association, The Hospital & Healthsystem Association of Pennsylvania, Healthcare Council of Western PA, and through legal fees paid to Buchanan Ingersoll & Rooney. Additionally, any time spent by paid employees and / or management in lobbying activities are tracked internally and reported. 11373246 6321 -54711 100 548657 10776099 10398985 1358625 100 384264 11373246 9894895 902255 100 398065 10398985 10090921 184795 100 380721 9894895 8926091 1302689 100 137759 10090921 0.09850 0.90150 0.00000 0 0 9082318 9082318 98185724 48663847 49521877 18615504 8035700 10579804 114277159 80627457 33649702 73334398 51845712 21488686 124322387 Due to Third Parties 1390974 Accrued Retirement Benefits 23250487 Accrued Professional Liability 13131309 Other Liabilities 1402324 39175094 X Part V, Line 4: Endowments are designated by donors and/ or the Board. Part X, Line 2: The Corporation, the Hospital, the Foundation, and SCMS are Pennsylvania nonprofit corporations that are described in Section 501(c)(3) of the Internal Revenue Code and are therefore exempt from federal income tax under Section 501(a) and are not subject to the Pennsylvania Corporate Net Income Tax or Pennsylvania Capital Stock Tax. The Corporation and its subsidiaries have adopted Accounting Standards Codification Subtopic 740-10, Accounting for Uncertainty in Income Taxes - an Interpretation of FASB Statement No. 109 (ASC 740-10). ASC 740-10 addresses the determination of how tax benefits claimed or expected to be claimed on a tax return should be recorded in the financial statements. Under ASC 740-10, the Corporation may recognize the tax benefit from an uncertain tax position only if its more likely than not that the tax position will be sustained upon examination by the taxing authorities, based on the technical merits of the position. As of June 30, 2015 and 2014, the Corporation does not have any uncertain tax positions. Central America and Caribbean Investments 7836018 0 0 0 0 0 0 7836018 0 7836018 1 0 1 0 0 0 Golf Outing and Dinner 308479 222685 85794 44463 19635 53667 50731 None 308479 222685 85794 44463 19635 53667 50731 168496 -82702 1 1 X 1 X 1 X 1 1 1 0 1 1 5184149 5184149 0.01820 20775485 13525581 7249904 0.02550 25959634 13525581 12434053 0.04370 593477 593477 0.00210 319313 319313 0.00110 1697466 1697466 0.00600 167736 167736 0.00060 2777992 2777992 0.00980 28737626 13525581 15212045 0.05350 901373 901373 0.00320 901373 901373 0.00320 1 2769323 0 130629195 152284596 -21655401 X 1 1 1 1 St Clair Memorial Hospital 1000 Bower Hill Road Pittsburgh PA 15243 X X X St Clair Memorial Hospital Line 1 1 0 0 1 X X X X X X X X X 12 1 0 0 1 X www.stclair.org/221/about X 1 12 0 1 0 1 X 200.000000000000 300.000000000000 X X X 1 1 X X X 1 X www.stclair.org/191/financial-assistance X See Part V, Line 16a X X X X 1 X 0 1 X 0 0 St Clair Memorial Hospital, Line 1 Part V, Section B, Line 5: St. Clair completed all phases of its Community Health Needs Assessment, publicizing its findings in May 2013. Using primary and secondary data sources, interviews with public health experts, stakeholder input and guidance, and community member feedback, a priority index was developed in order to establish an implementation plan. Key areas of focus included: improving access to care for seniors and the underserved; improving the quality of prenatal care available in the region; reducing the incidence of prevalent cancers such as colon, lung and breast cancer; better education and management of chronic lifestyle conditions and lack of community services for behavioral and mental health patients. Additional and expanded program development is currently underway resulting in new programs being delivered directly in community neighborhoods. St Clair gathered information through interviews and surveys of dozens of persons who are invested in healthcare in the community. Also, St. Clair Hospital interviews were conducted in June and July of 2011. The web-based survey was conducted from September-November of 2011. These included external stakeholders - those not affiliated with St. Clair - as well as members of our medical and Hospital staff. These persons shared their perspectives and experience on community health needs and their ideas for interventions and innovative programs to meet those needs. St. Clair Hospital acknowledges the following leaders for their valuable feedback and ideas:ST. CLAIR HOSPITAL COMMUNITY BENEFIT COMMITTEE MEMBERS at that time:Joseph B. Smith Senior Vice President, Marketing, Dollar Bank Chairman, Community Benefit Committee, St. Clair Hospital Board of DirectorsAndrew Aloe Chair CE 411, Vistage International, St. Clair Hospital Board of DirectorsFrank Arcuri, Esq. Law Office of Frank Arcuri, St. Clair Hospital Board of DirectorsKarl E. Bushman, M.D. Mt. Lebanon Internal Medicine, St. Clair Hospital Board of DirectorsJames M. Collins President & Chief Executive Officer, St. Clair Hospital, St. Clair Hospital Board of DirectorsAndrew R. Hays Managing Director, Strategic Advisors, St. Clair Hospital Board of DirectorsAndrea L. Kalina Executive Liaison, Community Benefit Committee, Vice President - External Affairs and Chief Human Resources Officer, St. Clair HospitalJoan R. Massella Administrative Vice President and Chief Nursing Officer, St. Clair Hospital, St. Clair Hospital Board of DirectorsHarriett M. Rea St. Clair Hospital Board of DirectorsMelvin D. Rex Chairman, St. Clair Hospital Board of DirectorsT.A. Ward President, T.A. Ward Constructors, Inc., St. Clair Hospital Board of DirectorsG. Alan Yeasted, M.D. Sr. Vice President & Chief Medical Officer St. Clair Hospital, St. Clair Hospital Board of DirectorsCOMMUNITY LEADERS AND EXPERTSFrank Aggazio Director, Allegheny County Housing AuthorityBarbara Baulding Resident Services Assistant Director Allegheny County Housing AuthoritySister Ruth Bearer Associate Director Sto-Rox Neighborhood Health Center (Focus on Renewal)James Brophy Former Director of Operations Outreach Teen and Family ServicesVenard Campbell EMS and Emergency Communications Coordinator St. Clair HospitalRichard C. Chesnos Senior Vice President and Chief Financial Officer St Clair HospitalMary Jo Dickson Administrator, Adult Mental Health Services Allegheny County Department of Human ServicesBruce Dixon, M.D. (Now deceased) Former Director, Allegheny County Health DepartmentMichael J. Flanagan Sr. Vice President and Chief Operating Officer St Clair HospitalHarry Fruecht Police Chief, Peters TownshipJames Guffey Executive Director, South Hills Interfaith MinistriesNora Helfrich EMS Director, Tri-Community South EMSKeith Kanel Chief Medical and Learning Officer Pittsburgh Regional Health InitiativeTim Kimmel Director, Washington County Department of Human ServicesChad King Chief of Police, BridgevilleDave Kish Executive Director, St. Clair Hospital Emergency ServicesSue Martone Assistant Deputy Director, Office of Behavioral Health Allegheny County Department of Human ServicesColeman McDonough Police Chief, Mt. LebanonJenny Michaux Director of Community Impact United Way of Allegheny CountyMildred Morrison Director, Area Agency on Aging, Allegheny County Department of Human ServicesBarbara Murphy President, United Way of Washington CountyMarianne K. Olschesky Community Outreach and Marketing Coordinator St. Clair HospitalKathe Niznik Director, St. Clair Hospital Behavioral HealthMichael Panka Former Superintendent, Sto-Rox School DistrictTodd Pritchard Director, Medical Rescue Team SouthNan Rees Former Director, St. Clair Hospital Care ManagementFather Regis Ryan Former Executive Director, Sto-Rox Neighborhood Health Center (Focus on Renewal)Tom Salerno Director of Operations, Scott TownshipAndrea Schachner Program Director Angel's PlaceJames Secrete Chief of Police, Scott TownshipMary Sedore Administrative Services Coordinator, Chartiers Community Mental HealthScott Seltzer Assistant Superintendent, Mt. Lebanon School DistrictRichard M. Sieber Director of Marketing and Development St. Clair HospitalMary Lynn Spilak Director of Aging Services, Washington County Department of Human ServicesTimothy Steinhauer Superintendent, Mt. Lebanon School DistrictKay Stepp Executive Director, Compassion ConnectionMichelle Tipton Executive Director Angel's PlaceDenis Valentine Director, Southbridge EMSJoe Wissel Director, Kirwan Heights EMSReginald Young Deputy Director, Office of Community Services Allegheny County Department of Human ServicesJanet Yuhasz Health Services Coordinator, Pittsburgh Public SchoolsPatricia Zurawski Medical Services Director, Sto-Rox Neighborhood Health Center St Clair Memorial Hospital, Line 1 Part V, Section B, Line 11: See Part VI and the CHNA Implementation Strategy (attached). Implementation progress is reported quarterly to the Community Benefits Committee and Board of Directors. There were three primary health needs identified in the most recent CHNA that St. Clair did not address in its implementation strategy. Specifically the need for improved dental care among the underserved population was not included as it is not a core competency of the hospital. Two other areas of need, addiction services and insufficient food sources were also not addressed directly. However, recognizing the importance and value of collaboration among community agencies we are partnering with organizations better equipped to address these issues. With respect to addiction services, St. Clair is not licensed to provide this treatment however we are partnering with community agencies such as Greenbriar Treatment Center and Outreach Teen to facilitate services for residents in need. Additionally we have a strong relationship with all of the local food banks and partner with them to meet the food shortage needs of the region. St Clair Memorial Hospital, Line 1 Part V, Section B, Line 20e: and 20f: St. Clair's Financial Assistance/Charity Care policy includes presumptive charity care as an addition to the regular financial assistance discount process. Patients that do not complete a formal charity care application are screened for presumptive charity care prior to being placed in the regular collection process and qualitfy for charity care if the patient's credit score is below St. Clair's threshold credit score or their estimated income is within the policy guidelines. Presumptive charity care is extended to a single account. Line 20 is left blank because none of the actions in Line 19 are permitted St. Clair's policy. St Clair Memorial Hospital, Line 1 Part V, Section B, Line 22d: In accordance with Internal Revenue Code Section 501(r) Regulations, the Hospital facility used the average of Medicare and all commercial payment rates when calculating the maximum amounts that can be charged. Part V, Section B, Line 13 All patients without insurance are billed services at a discount regardless of income. Inpatient and outpatient services are discounted to a level approximating the average of Medicare and all commercial payment rates. In addition to Federal Poverty Guidelines, St. Clair utilizes a presumptive charity care determination process. Patients that do not complete a formal charity care application and qualify for charity care if the patients' credit score is below St. Clair's threshold credit score or their estimated income is within the policy guidelines. Presumptive charity care is extended to a single account. Part V, Section B, Line 10b See attached copy of St. Clair's CHNA Implementation Strategy Part V, Section B, Line 16 Financial Assistance Policy Website Availability St Clair Memorial Hospital, Line 1 Part V, Section B, line 16a website: www.stclair.org/191/financial-assistance St Clair Memorial Hospital, Line 1 Part V, Section B, line 16b website: See Part V, Line 16a 27 SCMS So Hills Cardiology Associates 2000 Oxford Drive Suite 305 Bethel Park PA 15102 Physician Office SCMS Sholder and Bordeau Urologic Asoc 1145 Bower Hill Road Mt Lebanon PA 15243 Physician Office SCMS Mt Lebanon Internal Medicine 300 Cedar Boulevard Pittsburgh PA 15228 Physician Office SCMS Colorectal Surgical Associates 1050 Bower Hill Road POB Suite 208 Pittsburgh PA 15243 Physician Office SCMS Zubritzky & Christy OGGYN 1050 Bower Hill Road POB Suite 205 Pittsburgh PA 15243 Physician Office SCMS DeGiovanni & Montini Associates 717 Washington Road Pittsburgh PA 15228 Physician Office SCMS Dobkin & Ricelli Associates 250 Mt Lebanon Boulevard Suite 306 Pittsburgh PA 15234 Physician Office SCMS Fatigati Nalin Associates 733 Washington Rd Suite 401 Pittsburgh PA 15228 Physician Office SCMS Fatigati Nalin Associates 1025 Washington Pike Bridgeville PA 15017 Physician Office SCMS Fatigati Nalin Associates 5187 Library Road Bethel Park PA 15102 Physician Office SCMS Budway Surgical Associates 2000 Oxford Drive Bethel Park PA 15102 Physician Office SCMS Tucker Orthopedics Division 1082 Bower Hill Road Pittsburgh PA 15243 Physician Office SCMS Maley Thoracic Surgery Associates 1050 Bower Hill Road Pittsburgh PA 15243 Physician Office SCMS Urgent Care Center 2000 Oxford Drive Bethel Park PA 15102 Urgent Care Center SCMS Robinson 5482 Campbells Run Road Pittsburgh PA 15205 Physician Office SCMS Evron Endocrinology Associates 2000 Oxford Drive Bethel Park PA 15102 Physician Office SCMS Fatigati Nalin Associates 3928 Washington Road Suite 280 McMurray PA 15317 Physician Office SCMS John E Love Family Practice 1626 Potomac Avenue Dormont PA 15216 Physician Office SCMS Johnston Internal Medicine 2000 Oxford Drive Suite 302 Bethel Park PA 15102 Physician Office SCMS Zuckerman Family Practice 2500 Baldwick Road Pittsburgh PA 15205 Physician Office SCMS Sholder and Bordeau Urologic Aso 3928 Washington Road Suite 270 McMurray PA 15317 Physician Office SCMS Colorectal Surgical Associates 3928 Washington Road Suite 270 McMurray PA 15317 Physician Office SCMS Zubritzky & Christy OGGYN 1767 Pine Hollow Road McKees Rocks PA 15136 Physician Office SCMS Zubritzky & Christy OGGYN 6000 Steubenville Pike Suite 105 McKees Rocks PA 15136 Physician Office SCMS Maley Thoracic Surgery Associates 3928 Washington Road Suite 270 McMurray PA 15317 Physician Office SCMS Maley Thoracic Surgery Associates 27 Heckel Road Suite 106 McKees Rocks PA 15136 Physician Office SCMS Fatigati Nalin Associates 601 McMillan Street Bridgeville PA 15017 Physician Office Part I, Line 3c: In addition to Federal Poverty Guidelines, St. Clair utilizes a presumptive charity care determination process. Patients that do not complete a formal charity care application and qualify for charity care if the patients' credit score is below St. Clair's threshold credit score or their estimated income is within the policy guidelines. Presumptive charity care is extended to a single account. Additionally, all patients without insurance are billed services at a discount regardless of income. Inpatient and outpatient services are discounted to a level approximating the average of Medicare and all commercial payment rates. Part I, Line 7: The Hospital's ratio of cost to charges was applied to the total charges for accounts written off to charity care of $5,541,443 in order to determine a reasonable approximation of the cost of providing services for those patients. Costs were then prorated between payments and charity care write-offs on the accounts to calculate the cost amount disclosed.The cost of Medicaid accounts utilized to calculate the Medicaid Community Benefit expense was derived from St. Clair's internal cost accounting system. All other items in Part I, Line 7 represents actual costs. Part I, Ln 7 Col(f): Actual Provision for Bad Debts expense totaling $3,134,859 and St. Clair Memorial Hospital Foundation expenses totaling $998,285 have been excluded from the denominator in the calculation of percentage of total expense. Part II, Community Building Activities: St. Clair Hospital, St. Clair Medical Services and St. Clair Hospital Foundation are Pennsylvania non-profit corporations, exempt from taxes under Section 501(c)(3) of the Internal Revenue Code of 1986, as amended (the "Code"), which own and operate an acute care hospital providing a comprehensive range of general and specialized care along with physician practices supporting the hospital and surrounding communities and a Foundation, the purpose of which is to support health and welfare initiatives at St. Clair and other organizations that service communities within the footprint of the hospital. St. Clair is committed to improving the health status of patients in our region without regard to their ability to pay. A comprehensive offering of programs and services is made available both on and off campus (to include partnering with other local healthcare agencies) and encompasses health education and screenings, prenatal education, smoking cessation, mental and behavioral health support programs, addiction, cancer care, nutrition and weight control, and the management of chronic diseases such as diabetes, congestive heart failure, COPD and asthma. In most cases these programs are provided at no cost to participants, and are generally fully subsidized. Among its other charitable works, St. Clair supports numerous community based programs including a subsidized cardiac rehabilitation program, well-baby programs, CPR training for schools and non-profit organizations, annual flu and pneumonia vaccinations for local EMS workers, a needle disposal program for diabetics and other individuals who self-administer medications, and mentoring opportunities for young adults interested in healthcare careers. Among its most well received services is the Hospital's van-service program. Intended to improve access to care for the elderly and poor, transportation is provided on a scheduled basis to and from the hospital and its outpatient centers, at no cost, helping to ensure that health related appointments are kept and that the care process is not negatively impacted as a result of lack of transportation. During the year ended June 30, 2015, the van service provided over 13,000 trips to area residents in need and nearly 200 community outreach education programs were sponsored by St. Clair encompassing nearly every clinical service. St. Clair has established a coordinated program with the nursing schools of surrounding communities and St. Clair's nursing staff serves as preceptors to the nursing students. As many as 347 nursing students were served and more than 3,300 hours were spent on this program in nurturing the future healthcare givers of the region.Additionally, St. Clair serves as a clinical site for post-secondary advanced clinical degree programs for medical imaging students in multiple modalities, CRNA students and 5th and 6th year doctoral students in pharmacy. Its medical school preceptor program hosts between 6 to 8 students for 8 week rotations throughout the year. Job shadowing programs are also coordinated for high-school students. St. Clair is actively involved with the clinical training of over 100 Emergency Medical Technicians and Paramedics. Approximately 2,400 hours of training were devoted for their education in order to strengthen the quality of care given by these professionals.St. Clair's website (www.stclair.org) provides consumers of healthcare with robust health information. Nearly 450,000 visitors utilize the website each year.St. Clair has a very active volunteer program including over 250 junior and 400 senior volunteers. Approximately 60,000 volunteer hours of service are provided in numerous areas covering a broad range of services from clerical duties to patient assistance and supportive visiting.The following is a sample of other ways in which St. Clair supports the community: - St. Clair's Community Health Needs Assessment identified that 10 percent of expectant moms in the region do not receive prenatal care in their first trimester. With the goal of reaching those with the greatest need, St. Clair is providing subsidized prenatal education for low-income families and families who lack insurance coverage. Vouchers were distributed to OB/GYNs affiliated with St. Clair so they can be distributed to their patients with the greatest needs.- St. Clair maintains a supportive relationship with The Sto-Rox Neighborhood Family Health Center, a non-profit organization that has been a beacon of hope in the Sto-Rox community for more than 40 years. The Health Center is located within St Clair's service area and was identified as underserved in St. Clair's Community Health Needs Assessment. The federally qualified health care facility provides a broad spectrum of services, including general medicine for adults and children; -obstetric and gynecologic care; -podiatry; -optometry; -dental medicine; and counseling and social services to the residents of Stowe Township and McKees Rocks. St. Clair partners with Tobacco Free Allegheny and the Health Center in the delivery of programs and services aimed at improving the overall health status of moms and babies and the smoking cessation of mothers in neighborhoods like Stowe, Ingram and McKees Rocks. Additionally, St. Clair is partnering with Women, Infants & Children (WIC) to aid prenatal efforts to expectant mothers in the McKees Rocks and Carnegie areas.- -St. Clair Hospital has expanded its relationship with Focus on Renewal (FOR), a comprehensive community social service organization that helps more than 15,000 economically disadvantaged individuals and families annually. This organization previously encompassed the Sto-Rox Neighborhood Family Health Center, but the two organizations have become separate nonprofits. St. Clair conducted a Wellness Day at FOR to promote healthy lifestyles. St. Clair clinicians provided health-related education and performed free health screenings, including glucose, cholesterol, bone density, and stroke. The wellness day was held on a Food Pantry distribution day, in order to reach the individuals with the greatest needs.- Annually, St. Clair Hospital participates in the Boy Scouts of America Scouting for Food Drive. Donations gathered were donated to the Focus on Renewal food pantry and the South Hills Interfaith Ministries food pantry.- St. Clair partners with other local nonprofit organizations like Our Clubhouse, South Hills Interfaith Ministry, Brookline 3For1, Bridgeville Public Library, Cancer Caring Center, American Cancer Society, Adagio and Susan B. Komen to provide cancer support and education. Additionally, St. Clair's Community Health Needs Assessment identified high rates of breast and lung cancer. To address the high incidence rate, St. Clair will provide Free Mammography Screenings for uninsured women over 40 and free lung cancer screenings to community members. The planning phase of these projects began in FY14. Several departments, physicians, hospital management leaders and Community Benefit Committee Board of Directors have been involved in the planning phase. The breast and lung cancer screening events were executed in FY15.- Mental and behavioral concerns were found to be critical issues impacting the entire St. Clair community, specifically a lack of support services and outreach programs. In previous years, St. Clair held one Mental Health Support Group. As part of the Hospital's Community Health Needs Assessment initiatives, St. Clair expanded its support groups, adding two Mental Health Support Group classes in areas identified to be high-need within St Clair's service area. Additionally, St. Clair management has been active with the Mt. Lebanon Drug Task Force, helping to educate the community and combat addiction problems that are often coupled with mental health issues. St. Clair has also started a Narcam (opiod reversal drug) program to help combat the number of deaths caused by overdoses in the St. Clair service area. St. Clair trains the EMS, fire and police departments on how to use Narcam and provides the initial supplies. - Consistent with St. Clair's Community Health Needs Assessment and in order to combat high rates of obesity and diabetes, often linked to poor diet and physical inactivity, St. Clair offers a diabetes support group for those newly diagnosed with the condition. St. Clair also conducts health fairs with free glucose, cholesterol and blood pressure screenings to make residents aware of their levels before they could potentially become a health crisis. - Monetary and in-kind donations were made by St. Clair to support various non-profit health and human services agencies that provide support to underserved residents in our region. Part III, Line 2 The Hospital's ratio of cost to charges was applied to the total charges for accounts written off in order to determine a reasonable approximation of the cost of providing services for those patients. Costs were then prorated between payments and bad debt write-offs on the accounts to calculate the cost amount disclosed in Part III section A. Part III, Line 3 St. Clair's Financial Assistance/Charity Care policy includes presumptive charity care as an addition to the regular financial assistance discount process. Patients that do not complete a formal charity care application are screened for presumptive charity care prior to being placed in the regular collection process and qualify for charity care if the patients' credit score is below St. Clair's threshold credit score or their estimated income is within the policy guidelines. Presumptive charity care is extended to a single account. As such, St. Clair expects the amount of bad debt expense attributable to patients eligible under the financial assistance policy to be negligible. Part III, Line 4: St. Clair's audited financial statements, Note 2, pages 14-17 describe bad debt expense and uncompensated care. Part III, Line 8: The Hospital provides services regardless of the level of reimbursement to be received from the patient or its insurer. Reimbursement from the government-sponsored programs including Medicare and state Medical Assistance and indigent care programs are often less than the cost of providing these services and therefore should be treated as community benefit. The Hospital's ratio of cost to charges was utilized to estimate this shortfall. Part III, Line 9b: St. Clair provides quality medical health care regardless of race, creed, sex, national origin, age, sexual orientation, or the ability to pay. The care include both inpatient and outpatient services as well as maintaining an emergency department that is available twenty-four (24) hours a day and treats nearly 64,000 patients annually. St. Clair provides free or discounted care to patients who meet certain criteria under St. Clair's Financial Assistance and Charity Care Program. St. Clair ensures that its financial assistance program is easily accessible to patients in need and the policy is posted in all key public areas, all registration areas and in all ancillary departments. The policy extends free or discounted services to low-income, uninsured or underinsured, patients with extraordinary medical expenses and indigent individuals who do not otherwise have the ability to pay fully for medically necessary health care. All patients without insurance are billed services at a discount regardless of income. Inpatient and outpatient services are discounted to a level approximating the average of Medicare and all commercial payment rates. Once St. Clair determines that a patient has qualified for formal charity care or free care, based on a sliding scale of 200%, 250% or 300% of federal poverty guidelines an additional adjustment of 100%, 30% or 20%, respectively, is applied to all accounts reviewed in the charity care/financial assistance application process. Those patients that do not complete a formal charity care application are screened for presumptive charity care prior to being placed in the regular collection process and qualify for charity care if the patients' credit score is below St. Clair's threshold credit score or if their estimated income is within the policy guidelines. Presumptive charity care is extended to a single account. No further collection efforts are made on those qualifying for the 100% discount. For the patients qualifying for the 20% or 30% discount, the balance due is adjusted by the applicable percentage and the remaining balance continues through the regular collection process. During the year ended June 30, 2015, $5,646,000 of uninsured discounts were provided. Part VI, Line 2: St. Clair completed all phases of its Community Health Needs Assessment, publicizing its findings in May 2013. Using primary and secondary data sources, interviews with public health experts, stakeholder input and guidance, and community member feedback, a priority index was developed in order to establish an implementation plan. Key areas of focus included: improving access to care for seniors and the underserved; improving the quality of prenatal care available in the region; reducing the incidence of prevalent cancers such as colon, lung and breast cancer; better education and management of chronic lifestyle conditions and lack of community services for behavioral and mental health patients. Additional and expanded program development is currently underway resulting in new programs being delivered directly in community neighborhoods. St. Clair has regular dialogue with regional healthcare experts, government officials, partnering agencies and community members regarding the health status of the community. That feedback is used to supplement the CHNA action plan as appropriate. Part VI, Line 3: The Hospital's process for educating patients about the Charity Care/Financial Assistance Policy is as follows:All uninsured patients who are registered through the emergency department are given a handout with information about the Hospital's Charity Care/Financial Assistance Policy. All patients who are admitted as inpatients receive a Patient Handbook and one section of the Handbook describes the Charity Care/Financial Assistance Policy. All self-pay patients are mailed the charity care letter and application.The Hospital's customer service representatives discuss the charity care policy when patients call the customer service line.All Self-pay patients who are admitted are seen by an outside consulting firm for a Medical Assistance qualification screening process. The firm also handles high-dollar outpatient accounts. The Hospital strives to be as helpful as possible in discussing charity care for our scheduled and unscheduled patient population.All patient statements notify patients that the hospital offers financial assistance/charity care, the customer service phone number, and hours of operation for additional information.The hospital's website notifies patients that the hospital offers financial assistance and provides access to the financial assistance/charity care application.Financial assistance notification is posted in all registration and other high volume patient areas. Part VI, Line 4: St. Clair is located in the municipality of Mt. Lebanon, in the southwest suburban quadrant of metropolitan Pittsburgh, Pennsylvania, approximately six miles from the downtown proper. St. Clair considers its service area to include thirty-four zip codes within six regions in southwestern Allegheny and northern Washington County, along with three other community hospitals. In 2015, the total population of this community was 483,000, with 19% of all households having incomes below $25,000. St. Clair also maintains a comprehensive outpatient center located in Bethel Park, approximately three miles from the main hospital, and a second outpatient center located in Peters Township, Washington County, approximately ten miles from the Hospital, as well as two smaller outpatient centers within similar proximity. The Hospital is licensed for 328 beds of which 303 were set up and staffed during the year ended June 30, 2015. Part VI, Line 5: St. Clair is the region's leading healthcare provider, excelling in quality, service and value. St. Clair's values are demonstrated through performance, integrity, compassion, pride and innovation. With more than 2,500 employees, St. Clair is the largest employer in southern Allegheny County. St. Clair's board of directors is comprised of members of the local community so that community needs can be properly determined and addressed. Subsidized Health ServicesIn addition to charity care and costs not covered by Medicaid payments, another community benefit provided by St. Clair is subsidized health services. These services yield low or negative margins, but are necessary to serve the community. $1,697,466 of subsidized health services were provided for the year ended June 30, 2015.Healthcare ServicesSt. Clair offers a comprehensive array of inpatient and outpatient services, including advanced cardiovascular services; specialized care for women, children and infants; diabetes treatment; oncology services; emergency care; general surgery services; primary care; behavioral health services; and pulmonary care. In addition to the high quality, broad range of clinical services offered, St. Clair is equally committed to capital improvements and purchases of new technology, to enhance its services to meet the community's health needs, investing in excess of $117,000,000 over the past five years.Each of these areas is staffed by a team of skilled physicians, nurses and other clinicians. St. Clair considers requests for clinical privileges and medical staff membership based upon the needs of the community and Medical Staff Development Plan.In addition, each area is attractive, modern, and fully equipped for a full continuum of diagnostic, treatment, and rehabilitation procedures.Cardiovascular Services - From diagnosis to treatment to rehabilitation and wellness, our multidisciplinary team of caregivers at St. Clair offers a full range of cardiac care services. Our highly skilled professionals have, in fact, helped St. Clair achieve industry-leading treatment times for heart attack victims arriving at our Emergency Department, resulting in better outcomes than some of the most recognized hospitals in the United States. St. Clair excels in a host of other cardiac performance measurements as well, having been named a Blue Distinction Center for Cardiac Care for its best practices and standards of care. Our cardiologists and cardiac surgeons are available 24 hours a day, seven days a week to provide scheduled and emergency cardiac care, seamlessly delivered with St. Clair's longtime reputation for quality, compassionate, personalized care. Additionally, Cardiovascular Services provides a comprehensive offering of screening, prevention, cardiac rehabilitation and educational programs to the community. St. Clair subsidizes one of the busiest Cardiac Rehabilitation programs in southwestern Pennsylvania, with more than 16,000 annual visits.Behavioral and Mental Health Services - St. Clair provides comprehensive diagnosis, treatment and follow-up care for persons suffering from mental illness and substance abuse. The Behavioral and Mental Health program offers a safe compassionate treatment environment where patients can learn to understand their illness and begin the recovery process. It engages a multi-disciplinary team of caring professionals (physicians, nurses, therapists and social workers) to develop individual treatment plans to best meet the specific needs of each patient. As one of the few remaining area hospitals to provide this much needed care, the program offers services to nearly 4,000 patients annually. (Inpatient unit, Outpatient Services, Mental Health Consultation-Liaison Program, Community Outreach)Orthopedics - St. Clair's orthopedics program includes a variety of services focused on the prevention, diagnosis and treatment of disorders of the musculoskeletal system. From diagnostic testing to arthroscopic and minimally invasive surgery to elective surgery to rehabilitation, St. Clair provides access to leading edge technologies in a compassionate and caring setting. Our multidisciplinary team of physicians, nurses, and therapists develop coordinated treatment plans for each patient to ensure that each individual receives personalized attention and comprehensive care with the ultimate goals of better results and fewer complications. St. Clair also was recognized as a Blue Distinction Center for Spine Surgery and for Knee and Hip Replacement by the Blue Cross and Blue Shield Association. Additionally, it offers an extensive variety of community education and prevention programs monthly, aimed at improving the health status of orthopedic patients.Women's and Children's Services - Women's and Children's Services provides a comprehensive continuum of care, spanning from pre-natal, obstetrics, newborn and pediatric services to complete gynecological and urological services. The state-of-the-art Family Birth Center includes 23 Labor, Delivery, Recovery and Post-Partum (LDRP) beds, a Level II neonatal intensive care unit and an 9 bed Pediatric unit. As one of 6 hospitals in the service area providing Obstetric services, St. Clair performed 1,346 deliveries during the year ended June 30, 2015. Additionally, it provides an extensive offering of education and support programs. A board certified pediatrician is on-site 24 hours a day.Cancer Care- Cancer Care provides comprehensive inpatient and outpatient services to patients diagnosed with cancer, and their families. The focus is to treat the physical, emotional, spiritual and psychological needs of patients throughout all stages of the cancer continuum, from diagnosis to treatment, recovery and rehabilitation. Additionally, Cancer Care provides a significant number of cancer screening, education and wellness programs to the community.St. Clair's Sipe Infusion Center is used by patients being treated with chemotherapy, blood transfusions and injections for various ailments. The experienced Infusion Center team consists of registered nurses who have received specialized education and training in cancer care, including certifications in oncology, infusion therapy, critical care and medical-surgical care. The staff consistently receives high satisfaction ratings from patients and their families for their excellent care. Services include: chemotherapy, blood/blood products and IV solutions/medications administration; PICC and mid-line insertions for both inpatients and outpatients; maintenance, care, repair and de-clotting of central IV lines/ports; and therapeutic phlebotomies.The UPMC/St. Clair Hospital Cancer Center, located on the Hospital campus, provides a full spectrum of radiation treatment services, which are designed to help treat cancerous tumors while preserving healthy surrounding tissue. The Center is a joint venture between UPMC CancerCenters, a partner with University of Pittsburgh Cancer Institute, and St. Clair Hospital. The Center recently expanded and now includes Intensity-Modulated Radiation Therapy (IMRT) capabilities. IMRT gives radiation oncologists the ability to more precisely "custom sculpt" the shape of a tumor, delivering the right amount of radiation with more accuracy and helping to preserve healthy tissue around the tumor. Located at St. Clair, this partnership offers area residents access to convenient, advanced, comprehensive, and high-quality care close to home.Emergency Services - St. Clair is home to the region's largest Emergency Department, with nearly 64,000 annual visits in the year ended June 30, 2015. The Emergency Department is open 24 hours a day and accessible by all patients, providing emergency care ranging from minor injuries and illness to life-threatening accidents or illnesses. The Emergency Department is fully integrated with all of the other service areas of St. Clair to ensure that, should patients require additional specialized treatment, it is provided in a coordinated environment. To accommodate the growing needs of the community, St. Clair completed a two-phase, $13.5 million construction project in 2009 to accommodate up to 80,000 patient visits per year. St. Clair has made improvements in our throughput processes to better serve our community as evidenced by a patients-left-without-being-seen rate of 0.27%, which is well below the national average of between 2.5%-3%. Door-to-room times averaged 3 minutes and door-to-doctor times averaged 15 minutes during the year ended June 30, 2015. Patient satisfaction scores for St. Clair's Emergency Department were in the 96th percentile nationwide for the year ended June 30, 2015. See Additional Information for other Services Part VI, Line 7, Reports Filed With States PA Additional Information Surgical Services - St. Clair's Surgical Services Department performs a wide range of operative procedures, including: endoscopy, gynecological surgery, ear, nose and throat surgery, orthopedic surgery, pediatric surgery, oral/maxillofacial surgery, minimally invasive surgery, podiatric surgery, open chest (heart) surgery, urological surgery, ophthalmologic surgery, pain control services, laser surgery, general surgery, vascular surgery, plastic and reconstructive surgery, lithotripsy, and thoracic surgery. In the year ended June 30, 2011, St. Clair also initiated a robotic-assisted, minimally-invasive surgical program, for which it acquired the da Vinci Si robotic surgical system. This system benefits our patients by using the most advanced technology to enable surgeons to perform delicate and complex operations through a few tiny incisions with increased vision, precision, dexterity and control, resulting in less pain and blood loss, a shorter hospital stay, and quicker recovery and return to everyday activities. Other ServicesInpatient Rehabilitation Unit - St. Clair's Inpatient Rehabilitation Unit (IRU) provides therapy programs that help patients reach the maximum independence in living skills, mobility, and communication. The IRU provides acute, individualized rehabilitative services for patients with conditions such as stroke, brain injuries, spinal cord injuries, burns, fractures, and neurological disorders. Medical Imaging - Physicians at St. Clair use the most sophisticated imaging and diagnostic equipment available to ensure that their patients are receiving the fastest and most accurate readings to determine their conditions and to serve as the foundation to developing a course of treatment. A full-service Medical Imaging Department offers a variety of diagnostic and interventional studies in four locations in southern Allegheny County using the modalities of general radiology, nuclear medicine, ultrasound, mammography, CT scanning, MRI, PET scanning and special procedures. Laboratory Services - St. Clair's full-service Laboratory is staffed by a team of professionals operating 24 hours a day, seven days a week to provide quick and accurate test results. The lab is equipped with leading-edge technology and analyzers, offering comprehensive testing in the specialties of hematology, chemistry, microbiology, histology, cytology and blood banking. St. Clair's outreach program operates four community-based service centers and provides services to more than 90 physician offices and eleven long-term care facilities. Physical and Occupational Therapy - St. Clair's Physical Therapy Department offers comprehensive rehabilitation services to inpatients and outpatients. Licensed Physical Therapists and Physical Therapist Assistants focus their treatment on restoring patients' loss of motion, strength and function. Physical Therapy works as a treatment for existing problems and prevention of complications. The goal is to return patients to their optimum level of function through exercise, walking therapy, heat and cold treatments, and tissue mobilization. The health care professionals within St. Clair's Occupational Therapy Department help individuals who are suffering from an illness, injury or disability return to a healthy way of living. With a personalized plan of care, patients are assisted in resuming activities they need or want to participate in, including independent self-care, home and work-related skills, and leisure activities. Utilizing purposeful activity to maximize independence, prevent disability and maintain health, the department promotes safety at home, work or school. Respiratory Care/Respiratory Therapy - The Respiratory Care Department at St. Clair delivers comprehensive, consistent, state-of-the art pulmonary services to patients. The department treats patients of all ages, offering a full continuum of care, ranging from diagnostic testing, Emergency Department care, inpatient and outpatient pulmonary rehabilitation, and education. Services include:-Respiratory Care-Sleep Disorders Center-Intensive Care Unit-22-Bed Pulmonary/Telemetry-Inpatient Unit-Pulmonary Rehabilitation Program-Pulmonary Health Education-Smoking Cessation ClassesHeart Testing - St. Clair offers a full range of diagnostic testing, including ECG, holter monitoring, event recording, echocardiogram, cardiac CT angiography, and stress tests at multiple locations. 1 St Clair Memorial Hospital Foundation (paid by SCH) 1000 Bower Hill Road Pittsburgh PA 15243 251407399 501(c)(3) 15000 Employee Assistance 1 0 Employee assistance-expenses 29 31618 Patient Assistance 18 5690 Education Assistance 2 1985 Scholarship-Nursing Student 1 100 Part I, Line 2: Funds are budgeted and approved by St. Clair Memorial Foundation Board on an annual basis. St. Clair Memorial Hospital Social Service department identifies employees and patients in need, from a care perspective and makes recommendations to senior management. Based on established criteria and need senior management forwards approved recommendations to St. Clair Memorial Foundation for disbursement of approved funding. X 1 1 X X X X X X 0 1 0 0 0 0 0 0 0 Karl E Bushman MD Board Member-SCH 179363 0 54675 0 0 0 16710 0 13732 0 264480 0 0 0 James M Collins President/CEO/Asst Secy -SCH 546819 0 350575 0 0 0 26618 0 22284 0 946296 0 0 0 Joan L Massella Adm VP/CNO-SCH 200992 0 68062 0 0 0 28686 0 8057 0 305797 0 0 0 G Alan Yeasted MD Sr VP/CMO-SCH 280920 0 86110 0 6644 0 30433 0 17072 0 421179 0 0 0 Mario J Fatigati MD Board Member-SCMS 238402 0 105163 0 0 0 17700 0 12328 0 373593 0 0 0 Robert N Shogry MD Board Member-SCF 346678 0 159406 0 0 0 18200 0 14174 0 538458 0 0 0 Richard C Chesnos Sr VP/CFO/Treasurer-SCH 274417 0 118745 0 0 0 24289 0 18346 0 435797 0 0 0 Michael J Flanagan Sr VP/COO/Secretary-SCH 272706 0 115109 0 0 0 18430 0 17996 0 424241 0 0 0 Andrea L Kalina VP External Affairs/CHRO-SCH 192482 0 60980 0 0 0 27886 0 4795 0 286143 0 0 0 Eric Luttringer Asst Treasurer-SCH 163844 0 10938 0 0 0 10777 0 15485 0 201044 0 0 0 Richard J Schaffer VP & CIO-SCH 184860 0 57445 0 0 0 26868 0 16484 0 285657 0 0 0 Barry S Zaiser Sr VP Op&SD-SCH 237833 0 91865 0 0 0 20397 0 9894 0 359989 0 0 0 Richard Sieber Exec Dir Mkt/Devl-SCF 146281 0 9793 0 0 0 11070 0 15867 0 183011 0 0 0 Kevin P Bordeau Physician 833779 0 0 0 0 0 15600 0 13788 0 863167 0 0 0 John Girod Physician 256149 0 282142 0 0 0 15600 0 13827 0 567718 0 0 0 Mark K Greathouse Physician 246268 0 275419 0 0 0 18200 0 14174 0 554061 0 0 0 Jeffrey Friedel Physician 353947 0 145236 0 0 0 15600 0 13827 0 528610 0 0 0 Arnold Sholder Physician 479302 0 0 0 0 0 18200 0 0 0 497502 0 0 0 Part I, Line 1a Duquesne Club: Membership dues are paid for James M. Collins at the Duquesne Club. The Duquesne Club is a social club where local leaders meet to conduct business and accepts only individual memberships. The Hospital conducts business meetings at the facility. The accountable plan rules are met. Part I, Line 3 A subcommittee of the Board of Directors of St. Clair Health Corporation (whose Board members are also members of the St Clair Memorial Hospital Board), the parent of St. Clair Memorial Hospital, St. Clair Memorial Foundation and St. Clair Medical Services, serves as the executive compensation committee and is charged annually with evaluating, determining and approving the annual compensation of executives. Salary survey information and 990 comparative evaluations are considered along with the written performance evaluation for each executive. In addition, data provided by an independent compensation consultant is used to validate and support executive compensation. Part I, Line 4b These officers participated in the Hospital's Supplemental Nonqualified Retirement Plan James M. Collins $8,418 Richard Chesnos $6,089 Barry S. Zaiser $2,197 Alan Yeasted $9,633 Michael Flanagan $2,830 Andrea Kalina $ 28 Joan Massella $ 86 A Mt Lebanon Hosp Authority 256189519 621820C09 2007-12-01 10000000 Finance Capital Improvements 0 0 0 B Mt Lebanon Hosp Authority 256189519 2010-12-23 20000000 Finance Capital Improvements 0 0 0 C Mt Lebanon Hosp Authority 256189519 621820CS6 2012-08-22 24746452 2002 Bond Refinancing 0 0 0 A 2750000 10000000 16980 9983020 2009 0 0 1 1 B 3901060 20139725 29457 20110268 2013 0 0 1 1 C 1565000 24746452 510468 24235984 2013 1 0 1 1 A 1 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 1 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 C 1 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 1 0 0 0 1 B 0 1 0 0 0 0 0 0 1 C 0 1 1 0 0 0 0 0 1 A 1 B 1 C 1 Part II, Line 3, column B The Series 2010 Revenue Note Project Fund variance between the issue price and the total proceeds of issue represents investments earnings on the project fund. Project Fund was established to fund costs over construction period. SH Radiology D Orr Pres SHR Brd Mbr-SCH, SCMS 960834 Interpretation of Radiology Exams 0 PPCP L Civitarese PPCP shrhlder Brd Mbr-SCH 303398 Professional Services 0 X 5 40300 Market Value 0 1 0 Form 990, Part VI, Section A, line 2 Board members Don Jenkins, Gary Zentner and Bryan Hondru each hold greater than 10% of interest in the same non-St Clair related real estate investment partnership. Form 990, Part VI, Section A, line 6 - St. Clair Memorial Hospital, St. Clair Memorial Hospital Foundation, and St. Clair Medical Services do not have members or stockholders. St. Clair Medical Services is the sole member of St. Clair Anesthesiology Associates and St. Clair Professional Services. Form 990, Part VI, Section A, line 7a - According to the governing documents of St. Clair Memorial Hospital, St. Clair Memorial Hospital Foundation, and St. Clair Medical Services, St. Clair Health Corporation, as the parent company, has the power to approve the election or nomination of the board of directors of such organizations. St. Clair Anesthesiology Associates and St. Clair Professional Services are governed by the board of directors of St. Clair Medical Services. Form 990, Part VI, Section A, line 7b According to the governing documents of St. Clair Memorial Hospital and St. Clair Memorial Hospital Foundation, St. Clair Medical Service, St. Clair Health Corporation, as the parent company of such organizations, has the power to make or approve certain decisions of such organizations including approval of the sale or encumberance of a substantial amount of assets, the approval of annual operating and capital budgets, and the approval of strategic plans. St. Clair Anesthesiology Associates and St. Clair Professional Services are governed by the board of directors of St. Clair Medical Services. Form 990, Part VI, Section B, line 11 (b) - This Form 990 is prepared internally, reviewed by management, and reviewed by a third-party accounting firm, Ernst & Young LLP. The draft Form 990 is provided to each board member for review via a secure website prior to filing. Form 990, Part VI, Section B, line 12c Conflicts are monitored through an annual survey completed by Board Members and Officers. Enforcements of the corporations policies are managed by the CEO and Board Members, to whom all conflicts are reported. The Corporate Compliance Officer also manages enforcement of St. Clair Hospital policies. To the extent any conflicts are identified, such Board members or Officers are excluded from participating in the relative decision making process. Form 990, Part VI, Section B, line 15 (a & b) - A subcommittee of the Board of Directors of St. Clair Health Corporation, the parent of St. Clair Memorial Hospital, St. Clair Memorial Foundation and St. Clair Medical Services, serves as the executive compensation committee and is charged with annually evaluating, determining and approving the annual compensation of executives. Salary survey information and 990 comparative evaluations are considered along with the written performance evaluations for each executive. In addition, data provided by an independent compensation consultant is used to validate and support executive compensation. Form 990, Part VI, Section C, line 19 Governing documents, conflict of interest policy and financial statements are made available to the public upon request. Form 990, Part XI, line 9: Change in pension liability -13,243,092. Transfer (to)/from affiliates -56,623. Investment income 72. Contributions 103,595. Grants received -181,524. Assets released from restriction for operations -131,859. Other increases / (decreases) -68,506. Form 990, Part IV, Line 2 St. Clair Memorial Hospital receives and reports amounts exceeding $5,000 from any one contributor, and St. Clair Memorial Hospital Foundation receives and reports amounts exceeding the 2% special rule threshold from any one contributor. Form 990, Part IV, Line 4 St. Clair Hospital is engaged in lobbying activities and has properly reported the allowable costs on Schedule C. Form 990, Part IV, Line 10 St. Clair Memorial Hospital and St. Clair Memorial Hospital Foundation hold assets in term, permanent, or endowments and have properly reported on Schedule D, Part V. Form 990, Part IV, Line 18 St. Clair Foundation's gross receipts from fundraising events exceeded $15,000 and have been properly included in Schedule G, Part II. Form 990, Part IV, Line 20 St. Clair Memorial Hospital operates one hospital and has properly completed Schedule H. Form 990, Part IV, Line 24a St. Clair Hospital has tax-exempt bond issues exceeding $100,000 issued after December 31, 2002 and have properly reported on Schedule K. Form 990, Part V, Line 3a. St. Clair Memorial Hospital recorded more than $1,000 in unrelated gross business income. Form 990, Part V, Line 3b. St. Clair Memorial Hospital has filed a 990-T to report unrelated gross business income. Form 990, Part V, Line 7a. St. Clair Memorial Hospital Foundation provided goods or services in exchange for a contribution more than $75. The Foundation notified the donor of the value. Schedule B, Contributions covered by General or Special Rule The organizations comprising St. Clair Health Corp Group return are covered by both the General Rule and Special Rule. - St. Clair Memorial Hospital - General Rule - St. Clair Professional Services, Inc. - General Rule - St. Clair Anesthesiology Associates, Inc. - General Rule - St. Clair Medical Services, Inc. - General Rule - St. Clair Memorial Hospital Foundation - Special Rule St Clair HospitalUPMC Cancer Center PETCT 1000 Bower Hill Road Pittsburgh PA 15243 202814053 Community Healthcare Provider PA 501(c)(3) 11 St Clair Health Corporation 1 SCNSC Properties 1000 Bower Hill Road Pittsburgh PA 15243 262004682 Real Estate PA NA C 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 St Clair HospitalUPMC Cancer Center PETCT B 966000 Actual St Clair HospitalUPMC Cancer Center PETCT O 211735 Actual St Clair HospitalUPMC Cancer Center PETCT P 897727 Actual St Clair Memorial Hospital Foundation O 498526 Actual St Clair Memorial Hospital Foundation Q 567024 Actual St Clair Professional Services Inc O 3612584 Actual St Clair Professional Services Inc Q 54596 Actual St Clair Professional Services Inc S 2140344 Actual St Clair Anesthesiology Associates Inc O 5711194 Actual St Clair Anesthesiology Associates Inc Q 674150 Actual St Clair Anesthesiology Associates Inc S 2270798 Actual St Clair Medical Services Inc O 23328508 Actual St Clair Medical Services Inc Q 6898283 Actual St Clair Medical Services Inc S 453704 Actual