UPMC CHAUTAUQUA AT WCA: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
UPMC CHAUTAUQUA AT WCA (EIN 16-0743226)
Tax period
2020-01-01 to 2020-12-31
Filed
2021-11-15
IRS object ID
202123199349316217
Schema version
2020v4.1
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2021-11-15T14:26:57-06:00ReturnTs
Tax Period End2020-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN454051133PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1FREED MAXICK CPAS PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1424 MAIN STREET SUITE 800AddressLine1Txt
CityBUFFALOCityNm
State AbbreviationNYStateAbbreviationCd
ZIP142023508ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN160743226EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1UPMC CHAUTAUQUA AT WCABusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlUPMCBusinessNameControlTxt
Phone7164870141PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1207 FOOTE AVENUE PO BOX 840AddressLine1Txt
CityJAMESTOWNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP147020840ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBRIAN DURNIOKPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone7166648421PhoneNum
Signature2021-11-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstBRIANPersonFirstNm
Person LastDURNIOKPersonLastNm
FieldValueIRS element (for citing)
SSNXXX-XX-XXXXSSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMARY MADONIAPreparerPersonNm
PTINP00405803PTIN
Phone7168472651PhoneNum
Preparation2021-11-12PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1UPMC CHAUTAUQUA WCABusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerBRIAN DURNIOKPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1207 FOOTE AVENUE / PO BOX 840AddressLine1Txt
CityJAMESTOWNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP147020840ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$114,415,083GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.UPMCCHAUTAUQUAWCA.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1885FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionTO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE OF CHAUTAUQUA COUNTY AND THE SURROUNDING AREA IN A WAY THAT INCLUDES COMPASSION, DEDICATION, A COMMITMENT TO QUALITY AND PATIENT SAFETY WHILE MAINTAINING ECONOMIC VIABILITY AND A VISION FOR THE 21ST CENTURY.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee1006TotalEmployeeCnt
Total Volunteers79TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,877,074PYContributionsGrantsAmt
CY Contributions Grants$10,093,262CYContributionsGrantsAmt
PY Program Service Revenue$98,921,434PYProgramServiceRevenueAmt
CY Program Service Revenue$102,312,020CYProgramServiceRevenueAmt
PY Investment Income$24,039PYInvestmentIncomeAmt
CY Investment Income$250,412CYInvestmentIncomeAmt
PY Other Revenue$1,174,004PYOtherRevenueAmt
CY Other Revenue$1,750,668CYOtherRevenueAmt
PY Total Revenue$101,996,551PYTotalRevenueAmt
CY Total Revenue$114,406,362CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$54,926,844PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$52,819,306CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$72,860,431PYOtherExpensesAmt
CY Other Expenses$71,710,507CYOtherExpensesAmt
PY Total Expenses$127,787,275PYTotalExpensesAmt
CY Total Expenses$124,529,813CYTotalExpensesAmt
PY Revenues Less Expenses-$25,790,724PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$10,123,451CYRevenuesLessExpensesAmt
Total Assets BOY$109,284,839TotalAssetsBOYAmt
Total Assets EOY$84,859,370TotalAssetsEOYAmt
Total Liabilities BOY$35,585,126TotalLiabilitiesBOYAmt
Total Liabilities EOY$34,449,937TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$73,699,713NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$50,409,433NetAssetsOrFundBalancesEOYAmt
MissionTO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE OF CHAUTAUQUA COUNTY AND THE SURROUNDING AREA IN A WAY THAT INCLUDES COMPASSION, DEDICATION, A COMMITMENT TO QUALITY AND PATIENT SAFETY WHILE MAINTAINING ECONOMIC VIABILITY AND A VISION FOR THE 21ST CENTURY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$91,477,234ExpenseAmt
Revenue$103,912,094RevenueAmt
DescOPERATED A HOSPITAL TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE OF CHAUTAUQUA COUNTY AND THE SURROUNDING AREA. SEE SCHEDULE O FOR ADDITIONAL DETAILS.Desc
Total Program Service Expenses$91,477,234TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee1006EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonBRIAN DURNIOKPersonNm
Phone7166648300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1207 FOOTE AVE PO BOX 840AddressLine1Txt
CityJAMESTOWNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP147020840ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
STEVEN KILBURN
BOARD MEMBER/CHAIR2.00Yes (X)Yes (X)$0$0$0
BRENDA IRELAND
BOARD MEMBER2.00Yes (X)$0$0$0
MICHAEL SULLIVAN
BOARD MEMBER2.00Yes (X)$0$0$0
DAVID GIBBONS
BOARD MEMBER/VICE CHAIR40.00Yes (X)Yes (X)$0$1,003,939$776,266
BRADLEY DINGER
BOARD MEMBER/TREASURER/CFO40.00Yes (X)Yes (X)$0$215,467$34,348
CRISTIE HERBST
BOARD MEMBER2.00Yes (X)$0$0$0
CAMELLIA HERISKO
BOARD MEMBER40.00Yes (X)$0$275,109$43,848
MARK RAIMY
BOARD MEMBER2.00Yes (X)$0$0$0
ANNA DIBBLE
BOARD MEMBER2.00Yes (X)$0$0$0
WILLIAM GEARY MDPHD
BOARD MEMBER2.00Yes (X)$0$0$0
JAMES DONNELLY
BOARD MEMBER40.00Yes (X)$0$294,809$41,960
BRIAN DURNIOK
PRESIDENT40.00Yes (X)$0$480,278$73,469
CECIL M MILLER III
SECRETARY/VP OF OPERATIONS40.00Yes (X)$196,857$0$20,848
GALO GRIJALVA MD
PHYSICIAN40.00$407,709$0$44,449Yes (X)
JONATHAN BLASIUS MD
MEDICAL DIRECTOR-HOSPITALI40.00$305,745$0$62,599Yes (X)
PUJAN SHRESTHA MD
PHYSICIAN40.00$309,770$0$30,992Yes (X)
SALVATORE J BUONAIUTO MD
HOSPITALIST40.00$436,589$0$40,074Yes (X)
SRINIVAS BOMMIREDDIPALLI MD
HOSPITALIST40.00$294,924$0$33,173Yes (X)
BETSY WRIGHT
FORMER PRESIDENT & CEO40.00$360,362$0$17,618Yes (X)
LISA MCCHESNEY
FORMER CIO40.00$0$285,193$44,310Yes (X)
EDWARD KARLOVICH
FORMER DIRECTOR40.00$0$1,415,698$198,467Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,311,956TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,970,493TotReportableCompRltdOrgAmt
Total Other Compensation$1,462,421TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K54IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
PREMIER ANESTHESIA OF NY PC
2655 NORTHWINDS PKWYALPHARETTAGA30009ANESTHESIA PHYSICIAN SERVICES$2,201,833
ASSOCIATED CLINICAL LAB
1526 PEACH STREETERIEPA16501LAB SERVICES$1,962,007
PERRY CONSTRUCTION GROUP INC
1440 WEST 21ST STREETERIEPA16502CONSTRUCTION SERVICES$1,254,850
SOUTHERN TIER SECURITY LLC
125 S UNION STOLEANNY14760SECURITY SERVICES$809,625
LECHASE CONSTRUCTION SERVICES LLC
205 INDIGO CREEK DRIVEROCHESTERNY14626CONSTRUCTION SERVICES$613,890
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K11CntrctRcvdGreaterThan100KCnt
Related Organizations$563,539RelatedOrganizationsAmt
Government Grants$8,453,135GovernmentGrantsAmt
All Other Contributions$1,076,588AllOtherContributionsAmt
Total Contributions$10,093,262TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
HOSPITAL REVENUE621500$101,466,814$101,466,814
EQUITY INVESTMENTS REVENUE621500$845,206$845,206
FieldValueIRS element (for citing)
Total Program Service Revenue$102,312,020TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$246,443TotalRevenueColumnAmt
Exclusion$246,443ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Personal$150,594PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Personal$0PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Personal$150,594PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$150,594TotalRevenueColumnAmt
Exclusion$150,594ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$12,690OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$8,721OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$3,969OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,969TotalRevenueColumnAmt
Exclusion$3,969ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
OTHER MISCELLANEOUS REVENUE900099$1,326,532$1,326,532
CAFETERIA REVENUE621990$161,538$161,538
EDUCATION REVENUE621990$86,109$86,109

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$25,895TotalRevenueColumnAmt
Related Or Exempt Func Income$25,895RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,600,074OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$114,406,362TotalRevenueColumnAmt
Related Or Exempt Func Income$103,912,094RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$401,006ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$196,857TotalAmt
Program Services$196,857ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$38,734,775TotalAmt
Program Services$36,623,896ProgramServicesAmt
Management And General$2,110,879ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$10,928,079TotalAmt
Program Services$2,325,780ProgramServicesAmt
Management And General$8,602,299ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,959,595TotalAmt
Program Services$2,799,125ProgramServicesAmt
Management And General$160,470ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$199,184TotalAmt
Management And General$199,184ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$90,000TotalAmt
Management And General$90,000ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$40,579TotalAmt
Program Services$40,579ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$7,507,182TotalAmt
Program Services$6,143,124ProgramServicesAmt
Management And General$1,364,058ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,316,227TotalAmt
Program Services$1,316,227ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
HOSPITAL AND MEDICAL SU$20,440,658$20,440,658
ENTERPRISE SHARED SERVI$16,105,894$16,105,894
PURCHASED SERVICES$10,780,418$9,818,721$961,697
PHYSICAN FEES$9,761,331$9,701,712$59,619

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$5,469,034TotalAmt
Program Services$2,070,555ProgramServicesAmt
Management And General$3,398,479ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$124,529,813TotalAmt
Program Services$91,477,234ProgramServicesAmt
Management And General$33,052,579ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$548,110BOYAmt
EOY$582,096EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$16,083,121BOYAmt
EOY$16,974,865EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$651,321BOYAmt
EOY$889,592EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$292,396BOYAmt
EOY$582,539EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$137,034,870LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$96,719,946LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$68,583,769BOYAmt
EOY$40,314,924EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$2,479,318BOYAmt
EOY$3,064,192EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$20,646,804BOYAmt
EOY$22,451,162EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$109,284,839BOYAmt
EOY$84,859,370EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$4,329,191BOYAmt
EOY$3,252,293EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$26,297,365BOYAmt
EOY$971,256EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$592,751BOYAmt
EOY$542,617EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,365,819BOYAmt
EOY$29,683,771EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$35,585,126BOYAmt
EOY$34,449,937EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$56,592,491BOYAmt
EOY$31,495,855EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$17,107,222BOYAmt
EOY$18,913,578EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$73,699,713BOYAmt
EOY$50,409,433EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$109,284,839BOYAmt
EOY$84,859,370EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$10,123,451ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$13,166,829OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$15,946,410BeginningYearBalanceAmt
Contributions$73,261ContributionsAmt
Investment Earnings Or Losses$2,657,988InvestmentEarningsOrLossesAmt
Other Expenditures$705,109OtherExpendituresAmt
End Year Balance$17,972,550EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$13,649,391BeginningYearBalanceAmt
Contributions$77,571ContributionsAmt
Investment Earnings Or Losses$2,926,269InvestmentEarningsOrLossesAmt
Other Expenditures$706,821OtherExpendituresAmt
End Year Balance$15,946,410EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$14,973,749BeginningYearBalanceAmt
Contributions$102,059ContributionsAmt
Investment Earnings Or Losses-$721,818InvestmentEarningsOrLossesAmt
Other Expenditures$704,599OtherExpendituresAmt
End Year Balance$13,649,391EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$13,142,333BeginningYearBalanceAmt
Contributions$96,982ContributionsAmt
Investment Earnings Or Losses$2,378,581InvestmentEarningsOrLossesAmt
Other Expenditures$644,147OtherExpendituresAmt
End Year Balance$14,973,749EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$12,729,182BeginningYearBalanceAmt
Contributions$72,452ContributionsAmt
Investment Earnings Or Losses$950,163InvestmentEarningsOrLossesAmt
Other Expenditures$609,464OtherExpendituresAmt
End Year Balance$13,142,333EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.71570BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.28430PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,016,055OtherCostOrOtherBasisAmt
Book Value$2,016,055BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$50,063,285OtherCostOrOtherBasisAmt
Depreciation$40,962,029DepreciationAmt
Book Value$9,101,256BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,131,935OtherCostOrOtherBasisAmt
Depreciation$2,663,386DepreciationAmt
Book Value$468,549BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$81,723,069OtherCostOrOtherBasisAmt
Depreciation$53,094,531DepreciationAmt
Book Value$28,628,538BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$100,526OtherCostOrOtherBasisAmt
Book Value$100,526BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$40,314,924TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
BENEFICIAL INTEREST IN NET ASSETS OF WCA FOUNDATION$17,103,025
OTHER LONG TERM RECEIVABLE$1,475,000
INVESTMENT IN WCA SERVICES CORPORATION$1,400,000
OPERATING LEASE RIGHT OF USE ASSETS$2,473,137
FieldValueIRS element (for citing)
Total Book Value Other Assets$22,451,162TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDescAmtAmt
EST. THIRD PARTY PAYOR SETTLEMENTS$1,432,419
OTHER LONG TERM LIABILITY$7,981,576
RIGHT OF USE LIABILITY$2,473,137
DUE TO RELATED PARTY$3,372,036
AR PAYOR ADVANCES$4,337,717
HHS GRANT FUNDS$10,086,886
FieldValueIRS element (for citing)
Total Liability$29,683,771TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:THE INCOME FROM THE ENDOWMENT FUND IS UNRESTRICTED AND ITS USES ARE DETERMINED BY THE BOARD.
PART X, LINE 2:THE HOSPITAL IS A NOT-FOR PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C) (3) OF THE INTERNAL REVENUE CODE (THE "CODE"), AND ACCORDINGLY, IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN REFLECTED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE HOSPITAL ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH U.S. GAAP, WHICH REQUIRES THE RECOGNITION AND MEASUREMENT OF UNCERTAIN INCOME TAX POSITIONS THAT THE HOSPITAL HAS TAKEN OR EXPECTS TO TAKE IN THE HOSPITAL'S TAX RETURNS. THE HOSPITAL HAS NOT RECORDED ANY AMOUNTS RELATING TO UNCERTAIN TAX POSITIONS.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other250.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$853,361TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$853,361NetCommunityBenefitExpnsAmt
Total Expense0.00690TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$27,902,111TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$20,066,589DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,835,522NetCommunityBenefitExpnsAmt
Total Expense0.06290TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,411TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,305DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,106NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$28,764,883TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$20,068,894DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,695,989NetCommunityBenefitExpnsAmt
Total Expense0.06990TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$391,795TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$391,795NetCommunityBenefitExpnsAmt
Total Expense0.00310TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$268,155TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$77,544DirectOffsettingRevenueAmt
Net Community Benefit Expns$190,611NetCommunityBenefitExpnsAmt
Total Expense0.00150TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$19,975TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$19,975NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$679,925TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$77,544DirectOffsettingRevenueAmt
Net Community Benefit Expns$602,381NetCommunityBenefitExpnsAmt
Total Expense0.00480TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$29,444,808TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$20,146,438DirectOffsettingRevenueAmt
Net Community Benefit Expns$9,298,370NetCommunityBenefitExpnsAmt
Total Expense0.07470TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$2,668,593BadDebtExpenseAmt
Bad Debt Expense Attributable$346,917BadDebtExpenseAttributableAmt
Reimbursed By Medicare$38,892,573ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$48,590,038CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$9,697,465MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

FieldValueIRS element (for citing)
Business Name Line11 31 SHERMAN STREET INVESTORS LLCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Primary ActivitiesREAL ESTATE PROJECTSPrimaryActivitiesTxt
Org Profit Or Ownership0.50000OrgProfitOrOwnershipPct
Ofcr Etc Profit Or Ownership0.00000OfcrEtcProfitOrOwnershipPct
Physicians Profit Or Ownership0.00000PhysiciansProfitOrOwnershipPct
FieldValueIRS element (for citing)
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1UPMC CHAUTAUQUA AT WCABusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1207 FOOTE AVENUE / PO BOX 840AddressLine1Txt
CityJAMESTOWNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP147020840ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.UPMCCHAUTAUQUAWCA.ORGWebsiteAddressTxt
State License10-65-60StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1UPMC CHAUTAUQUA AT WCABusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted19CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.UPMC.COMOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt19ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLWWW.UPMC.COMStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care250.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWW.UPMC.COMFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLWWW.UPMC.COMFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLWWW.UPMC.COMFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
UPMC CHAUTAUQUA AT WCAPART V, SECTION B, LINE 5: UPMC'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS INCLUDED A PARTNERSHIP WITH EXPERTS AT THE UNIVERSITY OF PITTSBURGH GRADUATE SCHOOL OF PUBLIC HEALTH TO CONDUCT THE CHNA USING A BEST-PRACTICE METHODOLOGY. THE ASSESSMENT BLENDED ANALYSIS OF DOCUMENTED HEALTH AND SOCIOECONOMIC FACTORS WITH A STRUCTURED, COMMUNITY INPUT SURVEY PROCESS. EFFECTIVELY ENGAGING THE COMMUNITY IN A BROAD, SYSTEMATIC WAY, THE SURVEY SOLICITED FEEDBACK FROM COMMUNITY ADVISORY PANELS COMPOSED OF LEADERS OF ORGANIZATIONS THAT REPRESENT PATIENT CONSTITUENCIES, INCLUDING MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY, AND CHRONICALLY ILL POPULATIONS WITHIN THE HOSPITAL'S COMMUNITY. APPENDIX C OF EACH HOSPITAL CHNA REPORT INCLUDES A LIST OF COMMUNITY PARTICIPANTS. WWW.UPMC.COM/ABOUT/COMMUNITY-COMMITMENT/PAGES/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.ASPX
UPMC CHAUTAUQUA AT WCAPART V, SECTION B, LINE 6A: UPMC HOSPITALS CONDUCTED JOINT CHNAS AS FOLLOWS:ERIE, MCKEAN, AND VENANGO COUNTIES IN PA AND CHAUTAUQUA COUNTY, NY HOSPITALS: UPMC HAMOT, UPMC KANE, UPMC NORTHWEST, AND UPMC CHAUTAUQUA.ALLEGHENY COUNTY HOSPITALS: UPMC CHILDREN'S HOSPITAL OF PITTSBURGH, UPMC EAST, UPMC MAGEE-WOMENS HOSPITAL, UPMC MCKEESPORT, UPMC MERCY, UPMC PASSAVANT, UPMC PRESBYTERIAN SHADYSIDE, AND UPMC ST. MARGARET.BEDFORD AND BLAIR COUNTY HOSPITALS: UPMC ALTOONA AND UPMC BEDFORD.LAWRENCE AND MERCER COUNTY HOSPITALS: UPMC JAMESON AND UPMC HORIZON.CLINTON, LYCOMING, NORTHUMBERLAND, POTTER, AND TIOGA COUNTY HOSPITALS: UPMC LOCK HAVEN, UPMC MUNCY, UPMC WILLIAMSPORT, UPMC SUNBURY, UPMC COLE, AND UPMC WELLSBORO.
UPMC CHAUTAUQUA AT WCAPART V, SECTION B, LINE 11: THROUGH A RIGOROUS CHNA METHODOLOGY, UPMC HOSPITALS IDENTIFIED FOUR MAJOR THEMES REPRESENTING THE SIGNIFICANT HEALTH NEEDS IN THEIR COMMUNITIES: CHRONIC DISEASE MANAGEMENT; BEHAVIORAL HEALTH; ACCESS TO CARE AND NAVIGATING RESOURCES; AND PREVENTION AND COMMUNITY-WIDE HEALTHY LIVING. THE HOSPITALS DEVELOPED STRATEGIC IMPLEMENTATION PLANS TO ADDRESS THESE ISSUES, AS OUTLINED IN THEIR CHNA DOCUMENTS AND COMMUNITY HEALTH STRATEGIC PLANS - SEE SECTION IV OF EACH CHNA REPORT. WWW.UPMC.COM/ABOUT/COMMUNITY-COMMITMENT/PAGES/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.ASPX
UPMC CHAUTAUQUA AT WCAPART V, SECTION B, LINE 13B: UPMC CHAUTAUQUA AT WCA RESERVES THE RIGHT TO REVIEW/APPROVE CASES WITH EXCESSIVE MEDICAL EXPENSES WHOSE FAMILY INCOME EXCEED 400% OF THE FPL, ON A CASE BY CASE BASIS.
UPMC CHAUTAUQUA AT WCAPART V, SECTION B, LINE 20E: UPMC'S POLICIES DO NOT PERMIT HOSPITAL FACILITIES OR ANY OTHER AUTHORIZED PARTIES TO ENGAGE INEXTRAORDINARY COLLECTIONS ACTIONS IN ANY CIRCUMSTANCES. THEREFORE, LINE 20 HAS BEEN LEFT BLANK SINCE IT IS NOT APPLICABLE AND UPMC BELIEVES IT WOULD BE MISLEADING TO CHECK ANY OF THE BOXES.

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:FINANCIAL ASSISTANCE OR CHARITY CARE IS AVAILABLE FOR ELIGIBLE INDIVIDUALS WHO HAVE HEALTH CARE NEEDS AND ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR GOVERNMENT PROGRAMS OR OTHERWISE UNABLE TO PAY FOR THEIR OWN CARE.A PATIENT MAY BE DETERMINED TO HAVE FINANCIAL NEED BASED ON THE FOLLOWING:1. INDIGENCY: IF INCOME FALLS AT OR BELOW 250% OF THE FEDERAL POVERTY GUIDELINES, THE PATIENT WILL HAVE NO FINANCIAL RESPONSIBILITY. THE PATIENT IS APPROVED FOR 100% FREE CARE. 2. LOW INCOME SLIDING SCALE: ASSISTANCE MAY BE A DISCOUNTED OR REDUCED PATIENT LIABILITY DEPENDING ON THE PATIENT'S INCOME: A. IF THE COMBINED FAMILY INCOME IS GREATER THAN 251% AND LESS THAN OR EQUAL TO 400% OF THE FEDERAL POVERTY GUIDELINES AND UNINSURED, THE PATIENT IS ELIGIBLE FOR REDUCED CHARITY CARE. THERE WILL BE AN 88% REDUCTION IN THE PATIENT BILL.THE DISCOUNTED CHARITY CARE SCALE IS BASED ON FAMILY HOUSEHOLD SIZE FOR 2020.3. FINANCIAL HARDSHIP: IF A PATIENT IS APPROVED FOR DISCOUNTED OR REDUCED CHARITY CARE AND CANNOT AFFORD TO PAY THE REMAINING BALANCE, THE PATIENT MAY BE CONSIDERED FOR FINANCIAL HARDSHIP. ASSISTANCE WILL BE PROVIDED IN THE FORM OF AN ADJUSTMENT OF CHARGES TO PREVENT THE PATIENT LIABILITY FROM EXCEEDING THE LESSER OF 15% OF FAMILY INCOME OR THE AGB.4. MEDICAL HARDSHIP/CATASTROPHIC CARE: IF A PATIENT IS DENIED FOR FINANCIAL ASSISTANCE AND CANNOT AFFORD TO PAY THE ACCOUNT BALANCE, THE PATIENT MAY BE CONSIDERED MEDICALLY INDIGENT AND MAY BE CONSIDERED FOR MEDICAL HARDSHIP / CATASTROPHIC CARE. THE PATIENT WILL BE LIABLE TO PAY THE LESSER OF 15% OF THEIR CALCULATED HOUSEHOLD INCOME OR THE AGB TOWARDS THEIR MEDICAL BILL. THIS IS A ONE-TIME FINANCIAL ASSISTANCE ADJUSTMENT FOR EXISTING ACCOUNT BALANCES. THE REMAINING BALANCE WILL BE ADJUSTED TO FREE CARE.
PART I, LINE 7:THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN PART I LINE 7 IS A RATIO OF COSTS TO CHARGES METHOD. THE METHOD EMPLOYED FOR DETERMINING THE RATIO OF COST TO CHARGES IS IN LINE WITH THOSE DESCRIBED IN SCHEDULE H, WORKSHEET 2, "RATIO OF PATIENT COSTS TO CHARGES".
PART I, LN 7 COL(F):THE TOTAL EXPENSES REPORTED ON FORM 990 PART IX LINE 25 COLUMN A ARE INCLUSIVE OF ALL ENTITIES REPORTED WITHIN THE UPMC CHAUTAUQUA AT WCA 990 AND EXCLUDES BAD DEBT EXPENSE FOR THE ENTITY. THE EXPENSE USED TO CALCULATE THE PERCENT OF TOTAL EXPENSE FOR FORM 990 SCHEDULE H PART I LINE 7 COLUMN F ARE THE TOTAL EXPENSES FROM FORM 990 PART IX. THE TOTAL EXPENSE PER PART IX LINE 25 DOES NOT INCLUDE BAD DEBT EXPENSE, AND AS SUCH, IS NOT INCLUDED IN THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE. THE TOTAL EXPENSES USED FOR THIS CALCULATION, EXCLUDING BAD DEBT EXPENSE, IS $127,787,275.
PART I, LINE 6AUPMC PREPARES AN ANNUAL COMMUNITY BENEFITS REPORT. THE REPORT ENCOMPASSES INFORMATION FOR THE ENTIRE INTEGRATED DELIVERY AND FINANCING SYSTEM (IDFS) THAT MAKES UP THE UPMC HEALTH SYSTEM. IT IS POSTED AND AVAILABLE TO THE PUBLIC VIA THE UPMC WEBSITE, WWW.UPMC.COM.
PART I, LINE 4"MEDICALLY INDIGENT" MEANS PERSONS WHO THE ORGANIZATION HAS DETERMINED UNABLE TO PAY SOME OR ALL OF THEIR MEDICAL BILLS BECAUSE THEIR MEDICAL BILLS EXCEED A CERTAIN PERCENTAGE OF THEIR FAMILY HOUSEHOLD'S INCOME.
PART III, LINE 4:PATIENT ACCOUNTS RECEIVABLE IS PRESENTED NET OF AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL COLLECTIONS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION, AND EXISTING ECONOMIC CONDITIONS. PATIENT ACCOUNTS RECEIVABLE ARE DUE 30 DAYS AFTER THE DATE OF DISCHARGE. RECEIVABLES PAST DUE MORE THAN 120 DAYS ARE GENERALLY WRITTEN OFF BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE PATIENT AND OTHER THIRD-PARTY PAYORS.
PART III, LINE 9B:UPMC HAS A DEBT COLLECTION POLICY OUTLINING COLLECTION PRACTICES FOR PATIENTS. IF AT ANY TIME THE PATIENT EXPRESSES AN INABILITY TO PAY, THEY ARE SENT A FINANCIAL ASSISTANCE APPLICATION. INFORMATION REGARDING FINANCIAL ASSISTANCE IS PRINTED ON ALL COLLECTION LETTERS. COLLECTIONS PER POLICY DO NOT APPLY TO ACCOUNT BALANCES KNOWN TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE.
PART III, LINES 2 & 3THE COSTING METHOD USED TO CALCULATE THE AMOUNTS IN SCHEDULE H PART III LINES 2 AND 3 IS A RATIO OF COST TO CHARGES METHOD. DISCOUNTS AND PAYMENTS IN PATIENTS' ACCOUNTS ARE DEDUCTED BEFORE THE COST OF BAD DEBT EXPENSE IS DETERMINED. THE METHOD EMPLOYED IS IN LINE WITH THOSE DESCRIBED IN SCHEDULE H, WORKSHEET 2, "RATIO OF PATIENT COSTS TO CHARGES".THE ORGANIZATION'S BAD DEBT EXPENSE CONSISTS SOLELY OF SELFPAY PATIENTS ACCOUNTS DEEMED UNCOLLECTABLE. IT IS UPMC GROUP'S CONTENTION THAT THE COST OF BAD DEBT SHOULD BE STATED IN PART I LINE 7 OF SCHEDULE H AS THEY REPRESENT THE COSTS FOR PROVISION OF SERVICES TO PATIENTS FOR WHICH THE ENTITY HAS EXHAUSTED ALL RECOURSE FOR REIMBURSEMENT. THE SERVICES PROVIDED TO PATIENTS WHO PRESENT THEMSELVES ARE PROVIDED REGARDLESS OF A PATIENT'S ABILITY TO PAY AND IS IN LINE WITH THE ORGANIZATION'S CHARITABLE MISSION AND SERVICE TO OUR COMMUNITY. THESE EXPENSES ARE INCURRED REGARDLESS OF THE EFFICIENCY OF THE PROVISION OF THE RELATED MEDICAL CARE AND ARE DEEMED TO HAVE BEEN MEDICALLY NECESSARY FOR THE PATIENT.
PART III, LINE 3PROCESS FOR REALLOCATION FROM BAD DEBT TO CHARITY CARE UPMC RECLASSIFIES BAD DEBT ACCOUNTS AS CHARITY CARE BY UTILIZING A PREDICTIVE MODEL CALLED PARO (PAYMENT ASSISTANCE RANK ORDER). PARO WAS BUILT AS A SOCIO-ECONOMIC SCORE THAT IDENTIFIES THOSE PATIENTS THAT ARE MOST LIKELY TO BE THE HIGHEST NEED OF FINANCIAL ASSISTANCE. THIS IS ACCOMPLISHED BY ANALYZING CONSUMER DATA AND ACTIVITY, COURT RECORDS, GOVERNMENT RECORDS, PROPERTY FILES, CENSUS DATA AND IRS DATA. PARO PROVIDES A SYSTEMATIC APPROACH TO FINANCIAL ASSISTANCE: "PREDICTIVE MODEL THAT ENCOMPASSES HEALTHCARE ECONOMICS AND CREDIT POLICIES;" UNIFORM ASSESSMENT MEASURE FOR EVERY PATIENT REGARDLESS OF FINANCIAL STANDING; "ACCOUNTS FOR PATIENTS THAT ARE UNRESPONSIVE, ILLITERATE, OR OTHERWISE CHALLENGED TO APPLY; "ELIMINATES BARRIER TO APPLICATION AND MEETS INCREASED PRESSURE TO PROVIDE ADDITIONAL FINANCIAL RESOURCES TO CONSUMERS; "IDENTIFY AND SUPPORT THOSE COMMUNITY NEEDS EFFORTS TO PROVIDE ASSISTANCE TO THOSE CONSUMERS IN NEED." THERE ARE TWO DATA POINTS RETURNED TO UPMC IN ORDER TO MAKE THE DECISION WHETHER THE PATIENT WOULD QUALIFY FOR CHARITY CARE. THE FIRST IS THE ESTIMATED INCOME LEVEL BASED ON THE FEDERAL POVERTY LEVEL GUIDELINES. THE SECOND IS THE PARO SCORE WHICH UTILIZES AN ALGORITHM BASED APPROACH AND RETURNS A SCORE BASED ON PERSONAL ATTRIBUTES OF THE PATIENT. DATA ELEMENTS WERE COMBINED TO CREATE TWO PRIMARY INDICATORS OF NEED, THE PARO SCORE AND THE FEDERAL POVERTY LEVEL. PARO ANALYZED OUR HISTORICAL CHARITY CARE APPROVALS TO DETERMINE OUR PARO THRESHOLD AND THE FPL THRESHOLD FOR THE HISTORICAL APPROVALS. THE APPROVED CHARITY CARE ACCOUNTS WERE COMPARED AGAINST ACCOUNTS THAT WERE IN ACTIVE ACCOUNTS RECEIVABLE. THIS WAS DONE TO DETERMINE IF THE DISTRIBUTIONS WERE SIMILAR OR IF ANY PATTERN EXISTED BASED ON THE APPROVED ACCOUNTS AND THE UNKNOWN ACCOUNTS. IF THE PATIENT'S ESTIMATED INCOME AND PARO SCORE ARE WITHIN THE SCORES IDENTIFIED BY THE CALIBRATION OF UPMC EXISTING CHARITY CARE PATIENTS, THE ACCOUNT IS RECLASSIFIED FROM BAD DEBT TO CHARITY CARE. EVERY PATIENT IS ABLE TO APPLY FOR CHARITY CARE; HOWEVER, THE AUTOMATED STRATEGY FOCUSES ON PATIENTS THAT DO NOT COMPLETE THE APPLICATIONS PROCESS. THE US DEPARTMENT OF EDUCATION ESTIMATES THAT 1 IN 5 CONSUMERS ARE FUNCTIONALLY ILLITERATE. THIS, COUPLED WITH THE LOW LEVELS OF PARTICIPATION IN TRADITIONAL BANKING METHODS, MAKES THE APPLICATION PROCESS VIRTUALLY IMPOSSIBLE FOR SOME CONSUMERS.
PART III, LINE 8THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS OF CARE IS A RATIO OF COSTS TO CHARGES METHOD. THE METHOD IS IN LINE WITH THOSE DESCRIBED IN SCHEDULE H, WORKSHEET 2, "RATIO OF PATIENT COSTS TO CHARGES". IT IS UPMC GROUP'S CONTENTION THAT ALL AMOUNTS CALCULATED TO BE SHORTFALLS IN REIMBURSEMENT FOR SERVICES PROVIDED TO MEDICARE PATIENTS ARE TRULY UNCOMPENSATED CARE THAT SHOULD BE STATED IN PART I LINE 7 OF SCHEDULE H OF FORM 990 AS THEY REPRESENT COSTS FOR PROVISION OF SERVICES TO PATIENTS FOR WHICH THE ENTITY IS UNABLE TO COLLECT, REGARDLESS OF THE EFFICIENCY OF PROVISION OF THE RELATED CARE COSTS.
PART VI, LINE 3:UPMC COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE TO ITS PATIENTS BY PLACING SIGNAGE AND DISTRIBUTING BROCHURES ABOUT THE FINANCIAL ASSISTANCE PROGRAM IN ITS PROVIDER REGISTRATION AREAS,ADMISSIONS, EMERGENCY DEPARTMENT AND BUSINESS OFFICE LOCATIONS. IN ADDITION, UPMC INCLUDES INFORMATION REGARDING HOW A PATIENT CAN REQUEST FINANCIAL ASSISTANCE ON THE BILLS, FOLLOW-UP CORRESPONDENCE AND COLLECTION LETTERS. PATIENTS ALSO MAY FIND INFORMATION ABOUT FINANCIAL ASSISTANCE THROUGH ACCESS TO THE UPMC WEB SITE (WWW.UPMC.COM). PATIENTS ARE ENCOURAGED TO CONTACT UPMC'S TRAINED FINANCIAL COUNSELORS SHOULD THEY REQUIRE ASSISTANCE WITH COMPLETING APPLICATIONS. CONTACT TELEPHONE NUMBERS ARE POSTED STRATEGICALLY THROUGHOUT THE HOSPITAL FACILITIES SO THAT PATIENTS HAVE A RESOURCE FOR OBTAINING SUPPORT WITH ANY FINANCIAL ASSISTANCE QUESTIONS THEY MAY HAVE. UPMC HAS CREATED A PLAIN LANGUAGE SUMMARY (PLS) TO EXPLAIN, IN SIMPLIFIED TERMS, OUR FINANCIAL ASSISTANCE POLICY (FAP). THIS SUMMARY IS PRINTED AT ALL SAME DAY SURGERY, ER AND INPATIENT LOCATIONS AND GIVEN TO THE PATIENT UPON DISCHARGE. UPMC HAS ALSO TRANSLATED THE PLS, FAP, COLLECTION AND BILLING POLICY, AND FAP APPLICATION INTO THE FOLLOWING LANGUAGES: ARABIC, CHINESE, FRENCH, ITALIAN, NEPALI, RUSSIAN, SPANISH AND BRAILLE. THE DETERMINATION OF LANGUAGES FOR TRANSLATION OF DOCUMENTS WAS DETERMINED BY A STUDY OF ENGLISH PROFICIENCY IN THE COMMUNITIES SERVED AND REVIEW OF PREDOMINANT NATIVE LANGUAGES IN THOSE COMMUNITIES AS PRESCRIBED IN IRC SECTION 501(R). THE PLS IS AVAILABLE ON THE UPMC WEBSITE.UPMC WILL NOTIFY ALL PATIENTS APPROVED VIA PRESUMPTIVE ELIGIBILITY IF NOT RECEIVING THE HIGHEST LEVEL OF ASSISTANCE. A LETTER INFORMING THE PATIENT THAT THEY MAY QUALIFY FOR A HIGHER LEVEL AND A FINANCIAL ASSISTANCE APPLICATION WILL BE SENT TO THE PATIENT UPON DETERMINATION. UPMC HAS WIDELY PUBLICIZED OUR FINANCIAL ASSISTANCE POLICY. UPMC HAS WORKED WITH HOSPITAL LEADERS AND COMMUNITY LIAISONS TO DETERMINE THE MOST APPROPRIATE NON-HEALTHCARE LOCATIONS TO REACH THE POPULATIONS THAT WILL BENEFIT FROM OUR FINANCIAL ASSISTANCE. UPMC HAS PROACTIVELY REACHED OUT IN THESE COMMUNITIES TO WIDELY PUBLICIZE OUR FINANCIAL ASSISTANCE POLICY. FINALLY, UPMC WILL NOW ONLY INCLUDE PATIENT BALANCES FROM ONE YEAR PRIOR TO THE PATIENT'S FINANCIAL ASSISTANCE APPROVAL DATE. AS A RESULT, UPMC WILL ALSO REFUND ANY PATIENT PAYMENTS MADE WITHIN THAT YEAR OF THE PATIENT'S FINANCIAL ASSISTANCE APPROVAL DATE, APPROVED VIA AN APPLICATION.
PART VI, LINE 5:IN 2019, IN KEEPING WITH IRS 501(R) GUIDELINES, UPMC CHAUTAUQUA COLLABORATED WITH OTHER UPMC HOSPITALS IN THE FOUR-COUNTY REGION THAT INCLUDES CHAUTAUQUA COUNTY IN NEW YORK, AND ERIE, MCKEAN, AND VENANGO COUNTIES IN PENNSYLVANIA. THROUGH THE ASSESSMENT PROCESS, UPMC'S HOSPITALS IDENTIFIED THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS, PRIORITIZED THOSE HEALTH NEEDS, ESTABLISHED ACTION PLANS, AND IDENTIFIED RESOURCES TO ADDRESS THOSE NEEDS. THE 2019 DOCUMENT BUILDS UPON PRIOR ASSESSMENTS AND IMPLEMENTATION PLANS DEVELOPED IN 2013 AND 2016. UPMC APPROACHED THE CHNA REQUIREMENT AS AN OPPORTUNITY TO EVALUATE AND ASSESS NEEDS THROUGH A FORMALIZED, RIGOROUS, AND STRUCTURED PROCESS TO ENSURE THAT HEALTH IMPROVEMENT EFFORTS AND RESOURCES ARE ALIGNED WITH THE MOST SIGNIFICANT COMMUNITY HEALTH NEEDS.UPMC ACTIVELY ENGAGED ITS HOSPITAL BOARDS, COMMUNITY STAKEHOLDERS, AND PUBLIC HEALTH EXPERTS TO IDENTIFY COMMUNITY HEALTH NEEDS AND DETERMINE HOW TO COLLABORATE MOST EFFECTIVELY TO ADDRESS THOSE NEEDS. THE ORGANIZATION SOLICITED AND TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY. IN MAY THROUGH JUNE 2018, PITT PUBLIC HEALTH SURVEYED COMMUNITY LEADERS AND STAKEHOLDERS SPECIFIC TO EACH HOSPITAL'S LOCAL COMMUNITY, AS WELL AS A SYSTEM-WIDE PANEL OF REGIONAL STAKEHOLDERS. A TOTAL OF 2,074 COMMUNITY PARTICIPANTS FROM 22 UPMC HOSPITAL COMMUNITIES WERE SURVEYED. PARTICIPANTS INCLUDED: LEADERS OR MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASE; REPRESENTATIVES FROM PUBLIC HEALTH DEPARTMENTS OR GOVERNMENTAL AGENCIES SERVING COMMUNITY HEALTH; MEDICAL STAFF LEADERS WHO HAVE A UNIQUE PERSPECTIVE AND VIEW OF THE COMMUNITY; AND OTHER STAKEHOLDERS IN COMMUNITY HEALTH, SUCH AS CONSUMER ADVOCATES, NONPROFIT AND COMMUNITY-BASED ORGANIZATIONS, LOCAL SCHOOL DISTRICTS, GOVERNMENT ORGANIZATIONS, AND HEALTH CARE PROVIDERS. MORE THAN 800 INDIVIDUALS COMPLETED THE SURVEY, AND GREATER THAN 70 PERCENT OF THOSE PARTICIPANTS SELF-IDENTIFIED AS BEING A REPRESENTATIVE OR MEMBER OF A MEDICALLY UNDERSERVED, MINORITY, OR LOW-INCOME POPULATION.UPMC USED THE COMMUNITY INPUT TO DEVELOP STRATEGIC PLANS FOR EACH OF ITS LICENSED HOSPITALS TO ADDRESS SIGNIFICANT COMMUNITY HEALTH NEEDS. IMPORTANTLY, THESE PLANS ADDRESS LOCAL COMMUNITY NEEDS NOT ONLY AT THE HOSPITAL LEVEL, BUT ALSO INCLUDE EFFORTS UNDERTAKEN IN PARTNERSHIP WITH OTHER UPMC HOSPITALS, EXTERNAL ORGANIZATIONS, AND THE LARGER UPMC SYSTEM. KEY THEMES THAT EMERGED AT UPMC HOSPITALS CAN BE GROUPED INTO FOUR BROAD CATEGORIES - CHRONIC DISEASE MANAGEMENT, BEHAVIORAL HEALTH, ACCESS TO CARE AND NAVIGATING RESOURCES, AND PREVENTION AND COMMUNITY-WIDE HEALTHY LIVING. THE 2019 CHNA REPORTS AND 2019-2022 STRATEGIC PLANS FOR EACH UPMC HOSPITAL CAN BE FOUND ON UPMC'S WEBSITE: HTTPS://WWW.UPMC.COM/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.UPMC HOSPITALS CONTINUE TO BUILD AN EXTENSIVE SUITE OF PROGRAMS AND SERVICES TO ADDRESS THE FOUR SIGNIFICANT HEALTH NEEDS. UPMC HOSPITALS LEVERAGE COMMUNITY-BASED PARTNERSHIPS AND SYSTEM-WIDE RESOURCES TO SUPPORT RESIDENTS IN NEED. UPMC CHAUTAUQUA'S 2019-2022 STRATEGIC PLAN TO IMPROVE COMMUNITY HEALTH INCLUDES THE FOLLOWING:ADDRESSING CHRONIC DISEASE MANAGEMENT: UPMC CHAUTAUQUA IS WORKING TO INCREASE AWARENESS, PREVENTION, AND MANAGEMENT OF CHRONIC DISEASES IN THE COMMUNITY THROUGH INTERVENTIONS TARGETING HEART DISEASE, CANCER, AND DIABETES. THE HOSPITAL CONTINUES TO PROMOTE COMMUNITY EDUCATION AND OUTREACH AND TO OFFER PROGRAMS THAT SUPPORT AND EMPOWER PATIENTS TO MANAGE THEIR HEALTH CONDITIONS.ADDRESSING BEHAVIORAL HEALTH: UPMC CHAUTAUQUA CONTINUES TO ENHANCE EFFORTS TO ADDRESS BEHAVIORAL HEALTH NEEDS IN THE COMMUNITY THROUGH MULTIPLE CHANNELS AND COMMUNITY-BASED PARTNERSHIPS. THE HOSPITAL IS CREATING PROGRAMS TO ADDRESS OPIOID ADDICTION AND SUBSTANCE ABUSE AND CONTINUING TO ENSURE RESIDENTS HAVE ACCESS TO INPATIENT BEHAVIORAL HEALTH SERVICES.ADDRESSING ACCESS TO CARE AND NAVIGATING RESOURCES: UPMC CHAUTAUQUA IS COLLABORATING WITH LOCAL COMMUNITY ORGANIZATIONS, AS WELL AS PIONEERING INNOVATIVE CARE MODELS. THE HOSPITAL IS WORKING TO EXTEND ACCESS TO SPECIALTY CARE THROUGH PHYSICIAN RECRUITMENT AND IS EVALUATING TELEHEALTH CAPABILITIES.ADDRESSING PREVENTION AND COMMUNITY-WIDE HEALTHY LIVING: UPMC CHAUTAUQUA IS PARTNERING WITH LOCAL ORGANIZATIONS TO ENHANCE AND DEVELOP PROGRAMS THAT PROMOTE A HEALTHY AND SAFE ENVIRONMENT FOR THE COMMUNITY. EXAMPLES OF TARGETED INITIATIVES INCLUDE PROMOTING PHYSICAL EXERCISE, PRENATAL EDUCATION, AND BREASTFEEDING EDUCATION.THE BOARD OF DIRECTORS AT EACH UPMC HOSPITAL REGULARLY MONITORS THE PROGRESS OF THE COMMUNITY HEALTH IMPROVEMENT PLANS. UPMC CHAUTAUQUA IS MAKING MEASURABLE PROGRESS IN AREAS IDENTIFIED THROUGH THE CHNA PROCESS, INCLUDING IMPROVING AND EXPANDING EXISTING PROGRAMS - REACHING OUT AND TARGETING PEOPLE WHO COULD BENEFIT MOST.
PART VI, LINE 7, REPORTS FILED WITH STATESNY
PART VI, LINE 5PART VI, LINE 5 (CONTINUED)BEGINNING IN MARCH 2020, THE COVID-19 PANDEMIC DISRUPTED NEW YORK'S COMMUNITIES, ECONOMY, AND HEALTH CARE ORGANIZATIONS. TO HELP SLOW THE SPREAD OF COVID-19 THROUGHOUT THE REGION, STATE AND LOCAL GOVERNMENTS ISSUED COMMUNITY MITIGATION AND SOCIAL DISTANCING MEASURES, IMPACTING UPMC CHAUTAUQUA'S ABILITY TO IMPLEMENT PLANNED COMMUNITY HEALTH IMPROVEMENT INITIATIVES. AS A RESULT, UPMC CHAUTAUQUA TEMPORARILY SUSPENDED OR MODIFIED IN-PERSON PROGRAMS TO PROMOTE SOCIAL DISTANCING, EDUCATED THE COMMUNITY ABOUT THE HEALTH RISKS OF COVID-19, INCREASED ACCESS TO TELEHEALTH SERVICES, ESTABLISHED COVID-19 TESTING AND VACCINE SITES, AND WORKED WITH STATE AND LOCAL LEADERS TO DELIVER COVID-19 VACCINES. WHILE UPMC CHAUTAUQUA NAVIGATED THE COMPLEXITIES OF THE PANDEMIC, THE HOSPITAL CONTINUED TO ADDRESS IDENTIFIED HEALTH NEEDS BY DEVELOPING INNOVATIVE APPROACHES AND STRATEGIES TO ENGAGE WITH ITS COMMUNITIES. EXAMPLES OF PROGRESS OVER THE PAST THREE YEARS INCLUDES:ADDRESSING CHRONIC DISEASE MANAGEMENT:UPMC CHAUTAUQUA IS WORKING TO ADDRESS HEART DISEASE, DIABETES, AND CANCER. TO PROMOTE HEART HEALTH AND TO HELP REDUCE READMISSIONS FOR PATIENTS WITH HEART DISEASE, UPMC CHAUTAUQUA'S CARDIAC NURSE NAVIGATOR HELPS TO SUPPORT AND GUIDE PATIENTS THROUGH THEIR INPATIENT OR OUTPATIENT HEART CARE, SERVING AS A LIAISON BETWEEN PATIENTS, THEIR CAREGIVERS, AND HEALTH CARE PROVIDERS. THE CARDIAC NURSE NAVIGATOR COUNSELS CARDIOVASCULAR AND CONGESTIVE HEART FAILURE (CHF) PATIENTS ABOUT RISK FACTORS AND EDUCATES PATIENTS ABOUT SELF-MANAGEMENT OF THEIR DISEASE TO HELP REDUCE READMISSIONS TO THE HOSPITAL. IN 2020, THE HOSPITAL BEGAN OFFERING LOW-INCOME PATIENTS WITH UNCONTROLLED HEART DISEASE DIGITAL SCALES AND BLOOD PRESSURE CUFFS TO HELP WITH SELF-MANAGEMENT OF THEIR DISEASE. THE HOSPITAL ALSO DEVELOPED A LEARNING MODULE FOR USE ON INPATIENT TELEVISIONS AND ADOPTED A QUESTIONNAIRE FOR USE WITH PATIENTS WHO WERE READMITTED WITHIN 7-30 DAYS. TO HELP PREVENT AND MANAGE DIABETES, UPMC CHAUTAUQUA CONTINUES TO ENCOURAGE HEALTHY EATING - OFFERING A GRAB AND GO HEALTHY FOOD OPTION IN THE CAFETERIA, WHICH INCORPORATES LOCAL, SEASONAL, FRESH FRUITS AND VEGETABLES IN 300-500 CALORIE MEALS, AS WELL AS WATER, LOW SUGAR, AND LOW CALORIE BEVERAGE CHOICES. UPMC CHAUTAUQUA ALSO REMAINS COMMITTED TO CANCER SUPPORT AND TREATMENT. TO SUPPORT THOSE NEWLY DIAGNOSED WITH BREAST CANCER, THE HOSPITAL PROVIDES A NURSE NAVIGATOR, WHO HELPS PATIENTS SCHEDULE APPOINTMENTS AND CONNECTS PATIENTS WITH RESOURCES AND SUPPORT GROUPS. TO INCREASE LOCAL ACCESS TO TREATMENT, THE UPMC HILLMAN CANCER CENTER AT UPMC CHAUTAUQUA ADDED ONE MEDICAL ONCOLOGIST AND ONE HEMATOLOGIST IN 2020. THESE SPECIALISTS ARE AVAILABLE FIVE DAYS PER WEEK - UP FROM ONE DAY PER WEEK WHEN THE CANCER CENTER FIRST OPENED.FILLING A GAP FOR RESIDENTIAL ADDICTION SERVICES:UPMC CHAUTAUQUA OFFERS ACCESS TO INPATIENT BEHAVIORAL HEALTH SERVICES, WITH 65 BEDS DEDICATED TO MENTAL HEALTH AND SUBSTANCE USE DISORDER. IN SEPTEMBER 2019, UPMC CHAUTAUQUA OPENED A 20-BED, LONG-TERM RESIDENTIAL ADDICTION SERVICES PROGRAM AT UPMC CHAUTAUQUA'S JONES MEMORIAL HEALTH CENTER CAMPUS. THIS FACILITY IS THE FIRST LONG-TERM RESIDENTIAL ADDICTION SERVICES PROGRAM IN CHAUTAUQUA COUNTY - INCREASING LOCAL ACCESS TO BEHAVIORAL HEALTH CARE. THE PROGRAM OFFERS THREE LEVELS OF CARE: STABILIZATION, REHABILITATION, AND COMMUNITY REINTEGRATION. THESE PHASES ALLOW INDIVIDUALS WHO MAY RELAPSE WHILE IN TREATMENT TO REMAIN IN THE RESIDENCE, RATHER THAN CHANGE LOCATIONS. THIS MODEL OF CARE OFFERS THE ABILITY TO ADAPT TREATMENT PLANS AND PROGRAMMING AROUND A PATIENT, INCREASING SUPPORTS AND SERVICES AS NEEDED. IN ADDITION, UPMC CHAUTAUQUA'S ADOLESCENT AND ADULT MENTAL HEALTH INPATIENT UNITS OFFER TEN BEDS DEDICATED FOR CHILDREN AND ADOLESCENTS AND 20 BEDS DEDICATED FOR ADULTS. THESE NEW UNITS PROVIDE A RECOVERY-ORIENTED ENVIRONMENT - WITH PRIVATE ROOMS AND A GYM FOR RECREATION THERAPY - AND IMMEDIATE ACCESS TO HOSPITAL SERVICES THROUGH A DIRECT CONNECTION FROM THE EMERGENCY DEPARTMENT. INCREASING ACCESS TO CARE THROUGH PHYSICIAN RECRUITMENT:UPMC CHAUTAUQUA CONTINUES EFFORTS TO RECRUIT NEW PHYSICIANS - HELPING TO INCREASE ACCESS TO SPECIALTY AND PRIMARY CARE PROVIDERS. IN 2020, THE HOSPITAL RECRUITED AN ORTHOPEDIC SURGEON AND A FAMILY MEDICINE PHYSICIAN. IN ADDITION, UPMC CHAUTAUQUA PARTNERS WITH UPMC HAMOT TO INCREASE LOCAL ACCESS TO SPECIALTY PROVIDERS.CARING FOR NEW MOMS AND INFANTS:UPMC CHAUTAUQUA CONTINUES TO OFFER EXCELLENT MATERNITY CARE TO THE COMMUNITY. IN 2019, THE HOSPITAL EXPANDED ITS WOMENS AND MATERNITY CARE CENTER - ADDING LABOR AND DELIVERY SUITES, TRIAGE ROOMS, AND POSTPARTUM PRIVATE ROOMS. THE HOSPITAL ALSO CONTINUES TO OFFER INDIVIDUALIZED BREASTFEEDING SUPPORT TO ALL MOMS, WITH FOUR NURSES SERVING AS LACTATION COUNSELORS. PROMOTING EMPLOYEE WORKSITE WELLNESS:UPMC CHAUTAUQUA CONTINUES TO PROMOTE HEALTH AND WELLNESS AMONG EMPLOYEES. THE HOSPITAL OFFERS EMPLOYEES THE OPPORTUNITY TO SPEAK WITH A HEALTH COACH FROM UPMC HEALTH PLAN FOR INDIVIDUALIZED HEALTH ADVICE AND SUPPORT. THESE COACHES HELP EMPLOYEES SET GOALS, CREATE WORK OUT PLANS, LEARN ABOUT NUTRITION, DECREASE STRESS, AND MOTIVATE EMPLOYEES TO ADOPT HEALTHY HABITS. TO CONTINUE TO SUPPORT EMPLOYEES DURING THE COVID-19 PANDEMIC, HEALTH COACHES ADAPTED THEIR CONSULTATIONS TO A VIRTUAL PLATFORM. FOR MORE DETAILED INFORMATION ON UPMC'S COMMUNITY BENEFITS EFFORT, SEE THE ORGANIZATION'S COMMUNITY BENEFITS REPORT, AVAILABLE AT:HTTPS://WWW.UPMC.COM/ABOUT/COMMUNITY-COMMITMENT/BENEFITS-REPORT

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DAVID GIBBONS
BOARD MEMBER/VICE CHAIR$0$442,513$0$365,000$0$196,426$0$766,446$0$9,820$0$1,780,205$0$0
EDWARD KARLOVICH
FORMER DIRECTOR$0$587,542$0$738,000$0$90,156$0$171,696$0$26,771$0$1,614,165$0$0
BRIAN DURNIOK
PRESIDENT$0$275,198$0$179,134$0$25,946$0$67,285$0$6,184$0$553,747$0$0
SALVATORE J BUONAIUTO MD
HOSPITALIST$435,908$0$0$0$681$0$20,427$0$19,647$0$476,663$0$0$0
GALO GRIJALVA MD
PHYSICIAN$406,809$0$0$0$900$0$20,686$0$23,763$0$452,158$0$0$0
BETSY WRIGHT
FORMER PRESIDENT & CEO$336,596$0$0$0$23,766$0$17,618$0$0$0$377,980$0$0$0
JONATHAN BLASIUS MD
MEDICAL DIRECTOR-HOSPITALI$297,111$0$7,500$0$1,134$0$27,920$0$34,679$0$368,344$0$0$0
PUJAN SHRESTHA MD
PHYSICIAN$299,332$0$10,000$0$438$0$16,607$0$14,385$0$340,762$0$0$0
JAMES DONNELLY
BOARD MEMBER$0$188,006$0$104,150$0$2,653$0$20,688$0$21,272$0$336,769$0$0
LISA MCCHESNEY
FORMER CIO$0$174,568$0$109,000$0$1,625$0$20,799$0$23,511$0$329,503$0$0
SRINIVAS BOMMIREDDIPALLI MD
HOSPITALIST$284,412$0$10,000$0$512$0$20,172$0$13,001$0$328,097$0$0$0
CAMELLIA HERISKO
BOARD MEMBER$0$167,675$0$105,000$0$2,434$0$20,773$0$23,075$0$318,957$0$0
BRADLEY DINGER
BOARD MEMBER/TREASURER/CFO$0$173,898$0$40,000$0$1,569$0$18,884$0$15,464$0$249,815$0$0
CECIL M MILLER III
SECRETARY/VP OF OPERATIONS$144,608$0$51,000$0$1,249$0$15,049$0$5,799$0$217,705$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINES 4A-BBETSY WRIGHT (FORMER PRESIDENT & CEO) RECEIVED SEVERANCE COMPENSATION TOTALING $360,362 DURING THE YEAR ENDED DECEMBER 31, 2020. ALL PERSONS PARTICIPATING IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN ARE DISCLOSED IN SCHEDULE J WITH CORRESPONDING AMOUNTS DISCLOSED WITHIN THE TOTAL AMOUNT IN SCHEDULE J COLUMN C "RETIREMENT AND OTHER DEFERRED COMPENSATION". DUE TO RESTRICTIONS IMPOSED BY THE INTERNAL REVENUE CODE ("CODE"), CERTAIN OFFICERS AND KEY EMPLOYEES ARE LIMITED IN THE AMOUNT OF BENEFITS WHICH MAY BE RECEIVED UNDER A TAX QUALIFIED RETIREMENT PROGRAM. LIKE MANY EMPLOYERS, UPMC CHAUTAUQUA AT WCA SUPPLEMENTS ITS RETIREMENT BENEFITS THROUGH A SUPPLEMENTAL RETIREMENT PROGRAM. THE SUPPLEMENTAL RETIREMENT PROGRAM IS SUBJECT TO MULTI YEAR VESTING WHICH PLACES THE OFFICERS AND KEY EMPLOYEES' RETIREMENT BENEFIT AT RISK OF FORFEITURE OF THE VESTING REQUIREMENTS ARE NOT SATISFIED. ONCE VESTED HOWEVER, PROVISIONS OF THE CODE REQUIRE THAT THE VESTED AMOUNTS BE REPORTED ON THE FORM 990 AND THE VESTED OFFICER OR KEY EMPLOYEE INCLUDE IN CURRENT INCOME THE VALUE OF HER OR HIS SUPPLEMENTAL RETIREMENTS BENEFIT. NOTWITHSTANDING, THE TAX REQUIREMENT TO RECOGNIZE THE VESTED AMOUNT OF THE SUPPLEMENTAL RETIREMENT BENEFIT AS CURRENT INCOME FOR FICA TAXATION AND REPORTING PURPOSES, THIS BENEFIT, WHICH GENERALLY HAS BEEN EARNED OVER HER OF HIS ENTIRE CAREER, HAS NOT AND WILL NOT BE DISTRIBUTED UNTIL THE OFFICER OR KEY EMPLOYEE RETIRES OR SEPARATES FROM SERVICE FROM THE ORGANIZATION. THE SUPPLEMENTAL RETIREMENT PROGRAM PROVIDES FOR THE CURRENT LIABILITY RESULTING FROM THE VESTING CURING ACTIVE EMPLOYMENT. FINALLY, IT SHOULD BE NOTED THAT IN ACCORDANCE WITH IRS INSTRUCTIONS, A SUBSTANTIAL PORTION OF THE AMOUNT REPORTED ON THE FORM 990 ATTRIBUTABLE TO SUPPLEMENTAL RETIREMENT PROGRAM VESTING HAS BEEN REPORTED IN PREVIOUSLY FILED FORMS 990.
PART I, LINE 7UPMC PROVIDES INCENTIVE COMPENSATION AS PART OF ITS TOTAL COMPENSATION PROGRAM FOR OFFICERS AND KEY EMPLOYEES. THIS COMPONENT IS BASED UPON THE ACCOMPLISHMENT OF PREDETERMINED PERFORMANCE GOALS AND OBJECTIVES WHICH FOCUS ON THE ACHIEVEMENT OF MULTIPLE ANNUAL AND THREE YEAR INDIVIDUAL AND GROUP PERFORMANCE CRITERIA IN THE CONTEXT OF APPROPRIATE RISK TAKING. THESE CRITERIA DIRECTLY SUPPORT UPMC'S MISSION AND INCLUDE: PATIENT QUALITY AND SATISFACTION, COMMUNITY BENEFITS, OPERATIONAL AND FINANCIAL STRENGTH, LEADERSHIP DEVELOPMENT, AND STRATEGIC BUSINESS INITIATIVES AMONG OTHERS.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1ALL BOARD MEMBERS HAVE A VOTE EXCEPT THE PRESIDENT ELECT OF THE MEDICAL STAFF WHO IS A BOARD MEMBER WITHOUT VOTING RIGHTS.
FORM 990, PART VI, SECTION A, LINE 6UPMC CHAUTAUQUA SERVICES INC. A NY STATE NON-PROFIT, FEDERALLY TAX EXEMPT ENTITY, IS AN ACTIVE PARENT HOLDING COMPANY AND IS THE SOLE MEMBER OF THE FILING ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7AUPMC CHAUTAUQUA SERVICES, INC., THE PARENT ENTITY, ELECTS DIRECTORS OF THE GOVERNING BODY. UPMC HAMOT APPOINTS 6 OF THE 12 BOARD MEMBERS FROM AMONG REPRESENTATIVES OF UPMC AND UPMC HAMOT.
FORM 990, PART VI, SECTION A, LINE 7BDECISIONS OF THE GOVERNING BODY RELATIVE TO A MAJOR TRANSFER OF ASSETS ARE SUBJECT TO APPROVAL BY THE PARENT ENTITY, UPMC CHAUTAUQUA SERVICES, INC.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM. THE 990 IS REVIEWED BY MANAGEMENT AND IS MADE AVAILABLE TO THE FULL BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CUPMC CHAUTAUQUA AT WCA REQUIRES KEY EMPLOYED AND NON-EMPLOYED PERSONNEL TO COMPLY WITH ITS CONFLICT OF INTEREST POLICIES WHEN THEY ENGAGE IN UPMC CHAUTAUQUA AT WCA-RELATED BUSINESS. PERSONS COVERED BY THE POLICIES INCLUDE: - UPMC CHAUTAUQUA AT WCA BOARD MEMBERS, BOARD COMMITTEE MEMBERS, CORPORATE OFFICERS, AND KEY EMPLOYEES - UPMC CHAUTAUQUA AT WCA PHYSICIANS AND NON-PHYSICIAN EMPLOYEES WHO HOLD A POSITION OF INFLUENCE IDENTIFIED NON-EMPLOYED MEMBERS OF THE UPMC CHAUTAUQUA AT WCA MEDICAL STAFF WHO HOLD A POSITION OF INFLUENCE OR TRUST-INDIVIDUALS CONDUCTING CLINICAL RESEARCH AT THE UPMC CHAUTAUQUA AT WCA, WHETHER OR NOT THEY ARE EMPLOYED BY UPMC CHAUTAUQUA AT WCA. THESE PEOPLE ARE REQUIRED TO COMPLETE A QUESTIONNAIRE AT LEAST ANNUALLY, WHICH ALONG WITH OTHER DATA IS USED TO IDENTIFY POSSIBLE INDIVIDUAL AND INSTITUTIONAL CONFLICTS OF INTEREST. IF A POTENTIAL CONFLICT IS IDENTIFIED REGARDING A SPECIFIC UPMC CHAUTAUQUA AT WCA ACTIVITY, THE CORPORATE COMPLIANCE DEPARTMENT, WITH THE ASSISTANCE OF THE LEGAL DEPARTMENT, EITHER DEVELOPS A WRITTEN PLAN DESIGNED TO PREVENT THE CONFLICT FROM INFLUENCING DECISIONS RELATED TO THAT ACTIVITY, OR REQUIRES THAT THE CONFLICTING RELATIONSHIP BE DIVESTED, AS APPROPRIATE. FOR EMPLOYED PERSONNEL AND NON-BOARD MEMBER, NON-EMPLOYED PERSONNEL, THE CONFLICT OF INTEREST IDENTIFICATION AND MANAGEMENT PROCESS IS ULTIMATELY OVERSEEN BY AN ETHICS AND COMPLIANCE COMMITTEE OF THE UPMC CHAUTAUQUA AT WCA BOARD OF DIRECTORS ON BEHALF OF UPMC CHAUTAUQUA AT WCA AND ALL OF ITS RELATED ENTITES. POTENTIAL CONFLICT OF INTEREST TRANSACTIONS INVOLVING UPMC CHAUTAUQUA AT WCA BOARD MEMBERS AND ENTITIES WITH WHICH THEY ARE AFFILIATED ARE MONITORED AND SUBJECT TO PRE-APPROVAL BY THE GOVERNANCE AND NOMINATING COMMITTEE OF THE UPMC CHAUTAUQUA AT WCA BOARD OF DIRECTORS. IN ADDITION TO THE GENERAL CORPORATE AND BOARD POLICIES DESCRIBED ABOVE, UPMC CHAUTAUQUA AT WCA HAS ALSO DEVELOPED AND IMPLEMENTED A SEPARATE TAX QUESTIONNAIRE DISTRIBUTED TO OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES ANNUALLY THAT SPECIFICALLY ADDRESSES DISCLOSURE REQUIREMENTS OF FORM 990.
FORM 990, PART VI, SECTION B, LINE 15UPMC CHAUTAUQUA ENGAGES AN INDEPENDENT FIRM TO EVALUATE THE COMPENSATION OF THE CEO AND THE CFO.
FORM 990, PART VI, SECTION C, LINE 19UPMC (THE PARENT COMPANY OF UPMC CHATAUQUA AT WCA) PUBLIC WEBSITE (WWW.UPMC.COM) MAKES ITS FINANCIAL RESULTS, CONFLICT OF INTEREST PROCESS, AND VARIOUS INFORMATION ABOUT THE GOVERNANCE AND OVERSIGHT AVAILABLE TO THE PUBLIC. ADDITIONAL INFORMATION MAY BE SUPPLIED UPON SPECIFIC REQUEST FOR DATA NO POSTED TO THE WEB SITE.
FORM 990, PART VI, SECTION B, LINE 16B:UPMC CHAUTAUQUA AT WCA HAS A FORMAL WRITTEN POLICY PERTAINING TO JOINT VENTURES BETWEEN UPMC CHAUTAUQUA AT WCA TAX-EXEMPT ENTITIES AND TAXABLE ENTITIES. THE POLICY EMPLOYS AN INTERNAL PROCEDURE FOR REVIEW OF ALL TRANSACTIONS INVOLVING POTENTIAL PARTICIPATION IN JOINT VENTURES AND SIMILAR ARRANGEMENTS TO ENSURE THAT SUCH ENTITIES OPERATE IN ACCORDANCE WITH APPLICABLE IRS POLICIES AND WITHIN UPMC CHAUTAUQUA AT WCA'S CHARITABLE PURPOSES.
FORM 990, PART XI, LINE 9:CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF W.C.A. FOUNDATION 1,926,247. BOOK TO TAX ADJUSTMENT - PARTNERSHIP INTERESTS -132,338. EQUITY TRANSFER FROM EXEMPT RELATED PARTY -14,960,738.
FORM 990, PART XII, LINE 2C:UPMC CHAUTAUQUA AT WCA'S FINANCIAL STATEMENTS ARE AUDITED ON A CONSOLIDATED AND SEPARATE BASIS. THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED AUDIT OF UPMC CHAUTAUQUA SERVICES INC. AND SUBSIDIARIES AS WELL AS THE CONSOLIDATED UPMC SYSTEM LEVEL AUDIT WHICH INCLUDES ALL UMPC TAXABLE AND TAX-EXEMPT SUBSIDIARIES OF UPMC. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1WCA 31 SHERMAN LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line14 CENTRE DRIVEAddressLine1Txt
CityORCHARD PARKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14127ZIPCd
FieldValueIRS element (for citing)
EIN454867695EIN
Primary ActivitiesREAL ESTATEPrimaryActivitiesTxt
Legal Domicile StateNYLegalDomicileStateCd
Total Income$0TotalIncomeAmt
End Of Year Assets$0EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1UPMC CHAUTAUQUA AT WCABusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (72 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
WCA FOUNDATION INC
PO BOX 214JAMESTOWNNY147020214222393584PROMOTE/SUPPORT COMMUNITY HEALTH THROUGH SUPPORT OF WCA HOSP & AFFILIATENY501(C)(3)7UPMC CHAUTAUQUA AT WCA0
STARFLIGHT INC
PO BOX 840JAMESTOWNNY147020840161557878MEDICAL AVIATION SERVICE SUBSIDIARYNY501(C)(3)7UPMC CHAUTAUQUA AT WCAYes (1)
UPMC SENIOR COMMUNITIES INC
600 GRANT STREETPITTSBURGHPA15219251574736SR. LIVINGPA501(C)(3)10UPMC0
PITTSBURGH LIFETIME CARE COMMUNITY
600 GRANT STREETPITTSBURGHPA15219251335247CCRCPA501(C)(3)10UPMC SR COMM0
CANTERBURY PLACE
600 GRANT STREETPITTSBURGHPA15219250965334SR. LIVINGPA501 (C) 310UPMC SR COMM0
SENECA PLACE
600 GRANT STREETPITTSBURGHPA15219721562844SR. LIVINGPA501 (C) 310UPMC SR COMM0
SHADYSIDE HOSPITAL SUPPORTING FOUNDATION
600 GRANT STREETPITTSBURGHPA15219260303394FOUNDATIONPA501 (C) 312(A) IUPMC0
UPMC LEE
600 GRANT STREETPITTSBURGHPA15219250613830INACTIVEPA501 (C) 33UPMC0
PITTSBURGH CARE PARTNERSHIP INC
600 GRANT STREETPITTSBURGHPA15219251753852ADULTDAYCAREPA501 (C) 310UPMC0
UPMC CENTER FOR HIGH VALUE HEALTHCARE
600 GRANT STREETPITTSBURGHPA15219452178782RESEARCHPA501 (C) 37UPMC0
SHADYSIDE HOSPITAL FOUNDATION
532 SOUTH AIKEN AVENUEPITTSBURGHPA15232251290546FOUNDATIONPA501 (C) 312 (C) IIIUPMC PRESBY0
PASSAVANT HOSPITAL FOUNDATION
9100 BABCOCK BLVDPITTSBURGHPA15237251407815FOUNDATIONPA501 (C) 312 (B) IIUPMC PASSAVANT0
NORTHWEST HOSPITAL FOUNDATION
100 FARFIELD DRIVESENECAPA16346251483624FOUNDATIONPA501 (C) 312 (D) IIIUPMC NORTHWEST0
ST MARGARET FOUNDATION
600 GRANT STREETPITTSBURGHPA15219251520340FOUNDATIONPA501 (C) 37UPMC ST MARGARET0
CHILDREN'S HOSPITAL OF PITTSBURGH FND
600 GRANT STREETPITTSBURGHPA15219251865744FOUNDATIONPA501 (C) 37UPMC CHP0
MAGEE-WOMEN RES INST AND FOUNDATION
600 GRANT STREETPITTSBURGHPA15219251462312FOUNDATIONPA501 (C) 370N/A
WESLEY HILLS
600 GRANT STREETPITTSBURGHPA15219251507472INDEPENDENT LIVINGPA501 (C) 3N/AUPMC HAMOT0
GREAT LAKES PHYSICIAN PRACTICE PC
600 GRANT STREET 58TH FLOORPITTSBURGHPA15219464186362PHYSICIANSNY501 (C) 33REGNL HEALTH0
HAMOT HEALTH FOUNDATION
302 FRENCH STERIEPA16507251400999FOUNDATIONPA501 (C) 312 (B) IIUPMC HAMOT0
REGIONAL CANCER CENTER FOUNDATION
2500 WEST 12TH STREETERIEPA16505251631855FOUNDATIONPA501 (C) 312 (A)(I)REGIONAL CAN0
UPMC
600 GRANT STREETPITTSBURGHPA15219251423657SUPPORTING ORGPA501 (C) 312 (C) III0N/A
UPMC JAMESON CANCER CENTER
600 GRANT STREET 58TH FLOORPITTSBURGHPA15219201459415ONCOLOGY SVCPA501 (C) 310UPMC JAMESON0
JAMESON CARE CENTER INC
1211 WILMINGTON AVENEW CASTLEPA16105232871396HEALTHCAREPA501 (C) 310UPMC SR COMM0
UPMC SUSQUEHANNA
700 HIGH STREETWILLIAMSPORTPA17701232751183HEALTHCAREPA501 (C) 33UPMC0
MUNCY VALLEY HOSPITAL
215 EAST WATER STREETMUNCYPA17756240806023HEALTHCAREPA501 (C) 33UPMC SUSQUEH0
DIVINE PROVIDENCE HOSPITAL OF THE SISTER
1100 GRAMPAIN BOULEVARDWILLIAMSPORTPA17701240799343HEALTHCAREPA501 (C) 33UPMC SUSQUEH0
SUSQUEHANNA PHYSICIAN SERVICES
1201 GRAMPAIN BOULEVARDWILLIAMSPORTPA17701232449454PHYSICIAN SVCPA501 (C) 33UPMC SUSQUEH0
SUSQUEHANNA HEALTH SYSTEM INNOVATION CTR
700 HIGH STREETWILLIAMSPORTPA17701471600873FUNDRAISINGPA501 (C) 312(A) IUPMC SUSQUEH0
SUSQUEHANNA HEALTH FOUNDATION
1100 GRAMPAIN BOULEVARDWILLIAMSPORTPA17701232743470FUNDRAISINGPA501 (C) 312(A) IUPMC SUSQUEH0
THE WILLIAMSPORT HOSPITAL
700 HIGH STREETWILLIAMSPORTPA17701240795508HOSPITALPA501 (C) 33UPMC SUSQUEH0
LAUREL REALTY INC
15 MEADE STREET NO U-6WELLSBOROPA16901231403678RENTAL REAL EPA501 (C) 2N/AUPMC SUSQUEH0
LAUREL MANAGEMENT SERVICES INC
22 WALNUT STREETWELLSBOROPA16901251644910MANAGEMENT SVPA501 (C) 312 (B) IIUPMC SUSQUEH0
LAUREL HEALTH SYSTEM
22 WALNUT STREETWELLSBOROPA16901240795488HEALTHCAREPA501 (C) 312 (B) IIUPMC SUSQUEH0
SOLDIERS AND SAILORS MEMORIAL HOSPITAL
32-36 CENTRAL AVENUEWELLSBOROPA16901232176963HEALTHCAREPA501 (C) 33UPMC SUSQUEH0
THE GREEN HOME
37 CENTRAL AVENUEWELLSBOROPA16901240804365ASSISTED LIVINGPA501 (C) 310UPMC SUSQUEH0
TIOGA HEALTH CARE PROVIDERS
22 WALNUT STREETWELLSBOROPA16901251765538HEALTHCAREPA501 (C) 312 (B) IIUPMC SUSQUEH0
WILLIAMSPORT AREA AMBULANCE SERVICE COOP
700 HIGH STREETWILLIAMSPORTPA17701232416166AMBULANCE SVCPA501 (C) 310WILLIAM HOSP0
UPMC SUSQUEHANNA LOCK HAVEN
700 HIGH STREETWILLIAMSPORTPA17701821600494HOSPITALPA501 (C) 33UPMC SUSQUEH0
UPMC SUSQUEHANNA SUNBURY
700 HIGH STREETWILLIAMSPORTPA17701821592230HOSPITALPA501 (C) 33UPMC SUSQUEH0
SOUTH CENTRAL ALPHA HOUSING AND HEALTH
3410 W PITTSBURG ROADNEW CASTLEPA16101251701701SKILLED NURSINGPA501 (C) 310UPMC SR COMM0
SOUTH WESTERN ALPHA HOUSING AND HEALTH
745 GREENVILLE ROADMERCERPA16137251701700SKILLED NURSINGPA501 (C) 310UPMC SR COMM0
KANE COMMUNITY HOSPITAL FOUNDATION
4372 ROUTE 6KANEPA16735263906925FOUNDATIONPA501 (C) 370N/A
JUNIOR GUILD OF THE JAMESON MEMORIAL HOS
1211 WILMINGTON AVENUENEW CASTLEPA16105256005313SUPPORTPA501 (C) 312 (D) III0N/A
LAUREL HEALTH FOUNDATION
15 MEADE STREET NO U-6WELLSBOROPA16901251810488FOUNDATIONPA501 (C) 312 (B) II0N/A
VENANGO VNA FOUNDATION
491 ALLEGHENY BOULEVARDFRANKLINPA16323251472179FOUNDATIONPA501 (C) 312 (D) III0N/A
CHARLES E COLE MEMORIAL HOSPITAL
1001 EAST SECOND STREETCOUDERSPORTPA16915240802108HOSPITALPA501 (C) 33UPMC0
COLE FOUNDATION INC
1001 EAST SECOND STREETCOUDERSPORTPA16915455417308FOUNDATIONPA501 (C) 312 (A)(I)C COLE MEM H0
COMMUNITY LIFE TEAM INC
409 SOUTH SECOND STREETHARRISBURGPA17104231890444MEDICAL TRANSPORTPA501 (C) 37UPMC PINNACLE0
HAMOT COLE VENTURES
1001 EAST SECOND STREETCOUDERSPORTPA16915273172100CLINIC SITESPA501 (C) 312 (A)(I)C COLE MEM H0
HANOVER HEALTHCARE PLUS INC
300 HIGHLAND AVENUEHANOVERPA17331222658574SUPPORTPA501 (C) 312 (A)(I)UPMC PINNACLE0
HENDORN INC
1001 EAST SECOND STREETCOUDERSPORTPA16915231972659RESIDENTIAL CAREPA501 (C) 312 (A)(I)C COLE MEM H0
PINNACLE HEALTH FOUNDATION
409 SOUTH SECOND STREETHARRISBURGPA17104222691718FOUNDATIONPA501 (C) 312 (B) IIUPMC PINNACLE0
PINNACLE HEALTH MEDICAL SERVICES
409 SOUTH SECOND STREETHARRISBURGPA17104251709054PHYSICIAN SVCPA501 (C) 33UPMC PINNACLE0
PINNACLE HEALTH REGIONAL PHYSICIANS
409 SOUTH SECOND STREETHARRISBURGPA17104820947698PHYSICIAN SVCPA501 (C) 33UPMC PINNACLE0
UPMC PINNACLE
409 SOUTH SECOND STREETHARRISBURGPA17104251778658SUPPORTPA501 (C) 312 (B) IIUPMC0
UPMC PINNACLE CARLISLE
361 ALEXANDER SPRING ROADCARLISLEPA17105820880337HOSPITALPA501 (C) 33UPMC PINNACLE0
UPMC PINNACLE HANOVER
300 HIGHLAND AVENUEHANOVERPA17331231360851HOSPITALPA501 (C) 33HANNOVER HEALTH0
UPMC PINNACLE HOSPITALS
409 SOUTH SECOND STREETHARRISBURGPA17104251778644HOSPITALPA501 (C) 33UPMC PINNACLE0
UPMC PINNACLE LANCASTER
250 COLLEGE AVENUELANCASTERPA17603820896436HOSPITALPA501 (C) 33UPMC PINNACLE0
UPMC PINNACLE LITITZ
1500 HIGHLANDS AVENUELITITZPA17543820844453HOSPITALPA501 (C) 33UPMC PINNACLE0
UPMC PINNACLE MEMORIAL
325 SOUTH BELMONT STREETYORKPA17405820912090HOSPITALPA501 (C) 33UPMC PINNACLE0
ASBURY FOUNDATION
600 GRANT STREETPITTSBURGHPA15219251555688FOUNDATIONPA501 (C) 37ASBURY HEIGH0
ASBURY HEALTH CENTER
600 GRANT STREETPITTSBURGHPA15219250969472CCRCPA501 (C) 310ASBURY HEIGH0
ASBURY HEIGHTS OF UPMC
600 GRANT STREETPITTSBURGHPA15219251555687SUPPORTPA501 (C) 312 (B) IIUPMC SR COMM0
ASBURY PLACE
600 GRANT STREETPITTSBURGHPA15219251729266PERSONAL CAREPA501 (C) 310ASBURY HEIGH0
ASBURY VILLAS
600 GRANT STREETPITTSBURGHPA15219251819952PERSONAL CAREPA501 (C) 310ASBURY HEIGH0
UPMC SOMERSET
225 SOUTH CENTER AVENUESOMERSETPA15501250965570HOSPITALPA501 (C) 33UPMC0
TWIN LAKES CENTER INC
225 SOUTH CENTER AVENUESOMERSETPA15501232910318DRUG TREATMENPA501 (C) 33UPMC SOMERSET0
SOMERSET COMMUNITY HOSPITAL FOUNDATION
225 SOUTH CENTER AVENUESOMERSETPA15501251441863FOUNDATIONPA501 (C) 312(C)IIIUPMC SOMERSET0
SOMERSET HEALTH SERVICES INC
225 SOUTH CENTER AVENUESOMERSETPA15501251441920PHYSICIAN SRVPA501 (C) 33UPMC SOMERSET0
UPMC WESTERN MARYLAND CORPORATION
PO BOX 539CUMBERLANDMD21501520591531HOSPITALMD501 (C) 33UPMC0
WESTERN MARYLAND HEALTH SYSTEM FOUNDATIO
PO BOX 539CUMBERLANDMD21501352289841FOUNDATIONMD501 (C) 312 (C) IIIUPMC WESTERN0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (18 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerIndOwnershipOwnershipPctDirect Controlling NADirectControllingNACd
31 SHERMAN STREET INVESTORS LLC
4 CENTRE DRIVEORCHARD PARKNY14127264629631REAL ESTATENY31 SHERMAN STREET LLCUNRELATED$102,998$1,410,9980Yes (1)0.50000
CHAUTAUQUA INTEGRATED DELIVERY SYSTEM IPA LLC
200 HARRISON STREET 2ND FLOORJAMESTOWNNY14701161542139INTEGRATED DELIVERY SYSTEMNYSTAND ALONEUNRELATED$446,033$854,109Yes (1)00.33700
SENECA HILLS ASSISTED LIVING LP
600 GRANT STREETPITTSBURGHPA15219232873106ASSISTED LIVINGPA00N/A
ST MARGARET MEDICAL ARTS ASSOCIATION
600 GRANT STREETPITTSBURGHPA15219251786655MED OFFICE BLPA00N/A
CORE NETWORK LLC
600 GRANT STREETPITTSBURGHPA15219251786209HEALTHCAREPA00N/A
LIFE HOME CARE LP
600 GRANT STREETPITTSBURGHPA15219251847839HOMECAREPA00N/A
SHADYSIDE MEDICAL CENTER ASSOCIATES INC
600 GRANT STREETPITTSBURGHPA15219251608318MED OFFICE BLPA00N/A
CHARTWELL PA LP
600 GRANT STREETPITTSBURGHPA15219251729714HOME HEALTH SPA00N/A
LIFE CARE HOME SRV OF NW PA 25
1647 SASSAFRAS STREETERIEPA16501251536879HOME HEALTH SPA00N/A
HAMOT-KCH REAL ESTATE VENTURE
300 STATE STREETERIEPA16507263691782MEDICAL OFFICEPA00N/A
HAMOT SURGERY CENTER LLC
200 STATE STREETERIEPA16507251863661AMBULATORYPA00N/A
EPN-HAMOT URGENT CARE LLC
600 GRANT STREETPITTSBURGHPA15219272147949URGENT CAREPA00N/A
LAWRENCE COUNTY MRI AND DIAGNOSTIC IMAGING CENTER LLC
2526 WILMINGTON AVENUENEW CASTLEPA16105270219891IMAGING CENTERPA00N/A
COMMUNITY BASKET LLC
1205 GRAMPAIN BOULEVARDWILLIAMSPORTPA17701201195736REAL ESTATE RENTALPA00N/A
HANOVER SURGICENTER REAL ESTATE LP
300 HIGHLAND AVEHANOVERPA17331352342993INACTIVEPA00N/A
MEDCARE SUSQUEHANNA VALLEY LLC
409 SOUTH SECOND STREETHARRISBURGPA17104821673688DMEPA00N/A
OMICELO RE I LP
2525 LIBERITY AVENUEPITTSBURGHPA15222475603393REAL ESTATEDE00N/A
UPMC LEADER SURGERY CENTER LLC
1703 INNOVATION DRIVEYORKPA17408233035083SURGERY CENTERPA00N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (92 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACdAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCdForeign PostalForeignAddress/ForeignPostalCd
WCA SERVICES CORPORATION
28 MAPLE STREETJAMESTOWNNY14701161151438PATIENT TRANSPORTATION & MEDICAL BILLING; SUBSIDIARYNYUPMC CHAUTAUQUA AT WCAC$5,823,040$4,142,9921.00000Yes (1)
HC PHARMACY CENTRAL INC
600 GRANT STREETPITTSBURGHPA15219251364192PHARMACY CO-OPAC0N/A
CHILDREN'S COMMUNITY CARE
600 GRANT STREETPITTSBURGHPA15219251781887PEDIATRIC SVCPAC0N/A
UPMC CANCER CENTERS IRELAND LIMITED
CANCER TREATMENTC0N/A6TH FLOOR BEACON HOSPITAL SANDYFORDDUBLINEIEI
UPMC PHYSICIAN SERVICES HOLDING COMPANY
600 GRANT STREETPITTSBURGHPA15219251877017HOLDINGS COPAC0N/A
HEMATOLOGY ONCOLOGY ASSOCIATION INC
600 GRANT STREETPITTSBURGHPA15219421648357HEALTHCAREPAC0N/A
ONCOLOGY HEMATOLOGY ASSOCIATION INC
600 GRANT STREETPITTSBURGHPA15219251762980HEALTHCAREPAC0N/A
TRI-STATE NEUROSURGICAL ASSOCIATES
600 GRANT STREETPITTSBURGHPA15219251458655HEALTHCAREPAC0N/A
RENAISSANCE FAMILY PRACTICE - UPMC INC
600 GRANT STREETPITTSBURGHPA15219262942406HEALTHCAREPAC0N/A
UPMC HOLDING COMPANY INC
600 GRANT STREETPITTSBURGHPA15219251777713HOLDING CORPPAC0N/A
UPMC COVERAGE PRODUCTS INC
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FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
WCA FOUNDATION INC
C$563,539ACCOUNTING RECORDS
WCA SERVICES CORPORATION
P$43,616ACCOUNTING RECORDS

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceFORM 990 - SCHEDULE R - PART II THROUGH PART IVFormAndLineReferenceDesc
ExplanationENTITIES REPORTED IN PARTS I THROUGH IV THAT ARE MARKED WITH AN * ARE NOT TECHNICALLY "RELATED ORGANIZATIONS", AS DEFINED IN THE FORM 990 INSTRUCTIONS AS THE REQUISITE "CONTROL" DID NOT EXIST DURING THE FISCAL YEAR ENDED JUNE 30, 2020. HOWEVER, BECAUSE THESE ENTITIES ARE AFFILIATED WITH UPMC AND THE UPMC PARENT ORGANIZATION HOLDS CERTAIN POWERS WITH RESPECT TO SUCH ENTITIES WE ARE ELECTING TO DISCLOSE THE ENTITIES AS RELATED ORGANIZATIONS IN SCHEDULE R IN THE INTEREST OF TRANSPARENCY. RELATED ORGANIZATIONS AN UNRELATED PARTNERSHIPS - THERE ARE ORGANIZATIONS INCLUDED IN THE UPMC GROUP FORM 990 TAX RETURN FOR CALENDAR YEAR 2020 WHICH ARE RELATED TO UPMC CHAUTAUQUA AT WCA (SEE PRIOR NOTE). THESE ORGANIZATIONS ARE NOT REQUIRED TO BE LISTED IN SCHEDULE R.ExplanationTxt

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