2012-05-15T11:56:48-05:00 2011-06-30 990 2010-07-01 250965387 UPMC HAMOT UPMC 8148776000 600 Grant Street 58th Floor C/O Corporate Tax Dept Pittsburgh PA 15219 STEPHEN M DANCH 2012-05-15 2010 2016-02-24 21:20:13Z X JOHN T MALONE 201 STATE STREET PITTSBURGH PA 16550 460629956 false X www.upmchamot.com X 1881 PA UPMC HAMOT IS A PREMIER PROVIDER OF INPATIENT AND OUTPATIENT MEDICAL SERVICES TO RESIDENTS OF WESTERN PENNSYLVANIA, WESTERN NEW YORK AND NORTHEASTERN OHIO. UPMC HAMOT'S GOAL TO SERVE THE RESIDENTS OF 25 19 3071 139 289171 -76662 1579814 5420233 316609103 349576725 2133057 6419401 4018085 0 324340059 361416359 20562936 0 0 131456189 139343889 0 0 170314133 203215097 322333258 342558986 2006801 18857373 340648399 585209974 221436050 324012641 119212349 261197333 X UPMC HAMOT'S MISSION IS TO SERVE OUR PATIENTS AND COMMUNITY IN THE HAMOT TRADITION OF QUALITY, HEALTH, HEALING AND EDUCATION. TO PUT SIMPLY, "TO SERVE." false false 320970783 346782951 SEE SCHEDULE O 320970783 true true false true false false false false false true true true true true false false true false false false false false false false false true true false false true true false false false false false false false true true true false false false false false true true true false false true 400 0 true 3071 true true true true CJ false false false false false false false false X 25 19 false false true false true true true true true false false true true true true true true true true false PA X JUDITH L JOHNSON 8148773896 300 STATE STREET SUITE 100 ERIE PA 16507 Scott B Kern 5.0 X X 0 0 0 Desmond J McDonald 5.0 X 0 0 0 Nancy J Anderson 2.0 X 0 0 0 Gregory S Baldwin Esq 2.0 X 0 0 0 Jeffrey E Beach CPA 2.0 X 0 0 0 Mary C Bula 2.0 X 0 0 0 Elizabeth Concordia 1.0 X 0 0 0 George M Currie 2.0 X 0 0 0 Leslie Davis 1.0 X 0 0 0 Robert DeMichiei 1.0 X 0 0 0 Robert J Ferraro MD 2.0 X 0 0 0 Richard E Griffith 2.0 X 0 0 0 Richard S Hamilton 1.0 X 0 0 0 C Talbot Heppenstall Jr 1.0 X 0 0 0 Margaret Joy 1.0 X 0 0 0 Carolynn Masters PhD 2.0 X 0 0 0 Philip Garcia 2.0 X 0 0 0 Linda Myers 2.0 X 0 0 0 Mark H Raimy 5.0 X 0 0 0 Nicholas N Scott 2.0 X 0 0 0 Dennis Scully MD 2.0 X 0 0 0 Thomas A Tupitza Esq 2.0 X 0 0 0 Joseph Walton 1.0 X 0 0 0 Gail Welch 2.0 X 0 0 0 John T Malone 50.0 X X 746017 0 92826 Donald K Inderlied 50.0 X 240986 0 36313 Stephen M Danch 50.0 X 381710 0 58016 V James Fiorenzo 50.0 X 478352 0 64362 John Lyons MD 40.0 X 259574 0 3702 Richard Long MD 40.0 X 371221 0 60291 Debbie Burbules 40.0 X 211959 0 33608 Gary Maras 40.0 X 240097 0 39114 Joseph Butler 40.0 X 231578 0 29449 3161494 0 417681 133 false true false PERRY CONTRUCTION GROUP 1440 W 21ST STREET ERIE PA 16512 17263297 MEDICOR ASSOCIATES INC 120 EAST 2ND STREET ERIE PA 16507 15313256 CLINICAL PATHOLOGY INSTITUTE 1526 PEACH STREET ERIE PA 16501 11016653 NORTH AMERICAN PARTNERS IN ANESTHES 68 SOUTH SERVICE ROAD SUITE 350 MELVILLE NY 11747 2442293 SODEXHO RT 532 GENERAL SULLIVAN ROAD WASHINGTON CROSSING PA 18977 1673723 46 5420233 5420233 NET PATIENT SERVICE REVENUE 621990 344796073 344796073 RENTAL INCOME 621110 1044513 1044513 JOINT VENTURE REVENUE 900099 888300 888300 TEACHING INCOME 611710 661235 661235 CLINICAL TRIALS RESEARCH 900099 437343 437343 1749261 289171 1460090 349576725 5945773 5945773 0 0 99665922 21303 99014021 199576 651901 -178273 473628 0 0 0 0 361416359 346782951 289171 8450376 0 0 0 0 2098574 2098574 0 105470854 96396449 9074405 0 5734728 5244145 490583 18248154 16525993 1722161 0 7791579 7106699 684880 0 441887 24613 417274 155490 155490 12046 12046 0 267996 267996 43694053 40368438 3325615 796741 796741 4194835 3792127 402708 4040462 3232370 808092 0 8821601 7419849 1401752 605912 534596 71316 0 654023 175867 478156 4633402 4633402 0 14181694 14181694 5555172 5520804 34368 MEDICAL/PATIENT SUPPLIES 51874195 51874195 PROVISION FOR BAD DEBTS 37555625 37555625 DRUGS 15937288 15937288 MA MODERNIZATION ASSESS 5938276 5938276 LAUNDRY & LINEN SERVICE 773696 773696 3080703 2669920 410783 342558986 320970783 21588203 0 3039 3239 25493660 13169387 35964226 35464443 114375 79375 7322470 3333585 11420274 9343803 206213131 65422753 142160893 140790378 89198489 86542573 9740050 43281062 223088806 19230923 30113323 340648399 585209974 35814385 32893765 260341 370121 102088633 102945653 16233754 4995904 67038937 182807198 221436050 324012641 X 117684531 259625147 50774 38279 1477044 1533907 119212349 261197333 340648399 585209974 X 18857373 123127611 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 12046 false false false 12046 false PART II-B, LINE 1(I), OTHER LOBBYING ACTIVITIES THE ORGANIZATION PAYS MEMBERSHIP DUES TO THE HOSPITAL & HEALTHSYSTEM ASSOCIATION OF PENNSYLVANIA ("HAP"). A PORTION OF THE DUES PAID TO HAP ARE USED FOR LOBBYING PURPOSES BY HAP. THIS AMOUNT REPRESENTS THE PORTION OF MEMBERSHIP DUES USED BY HAP FOR LOBBYING PURPOSES. 4979701 4979701 112978203 -9078035 122056238 283251 142957 140294 100808642 75319308 25489334 -12836666 -961477 -11875189 140790378 CASH & CASH EQUIVALENTS 26885512 C U.S. GOVERNMENT & AGENCY OBLIG 13974348 C GUARANTEED INVESTMENT CONTRACT 2155586 C ALTERNATIVE INVESTMENTS 265616 C 43281062 EMERGYCARE, INC. 248 C ASSOCIATED CLINICAL LAB, LLP 1366378 C HAMOT SURGERY CENTER, LLC 3989221 C REGIONAL AMBULATORY SURGERY CT 951523 C VHA 148000 C BAYFRONT REGIONAL DEVELOPMENT 15465000 C CLINICAL PATHOLOGY INSTITUTE 512636 C GREAT LAKES HOME HEALTHCARE 100 C HAMOT-KCH REAL ESTATE VENTURE 35700 C HAMOT COLE VENTURES 620000 C UPMC NOTE RECEIVABLE 200000000 C 223088806 BENEFICIAL INTEREST IN HHF 19659609 INTERCOMPANY RECEIVABLE -14829 COMMUNITY HEALTH ALLIANCE ADV 5324354 THIRD PARTY PAYORS SETTLEMENTS 3034546 DEFERRED FINANCING COSTS 2102143 OTHER ASSETS 7500 30113323 0 INTERCOMPANY PAYABLES 137473796 DEFERRED COMPENSATION 18728955 PENSION LIABILITY 11854037 ESTIMATED MEDICAL MALPRACTICE RESERVE LIABILITY 14371661 OTHER LIABILITY 378749 182807198 true true true X true X true true true false true true 1121654 1121654 0.00360 42403762 33064323 9339439 0.02980 43525416 33064323 10461093 0.03340 190000 190000 0.00010 5829943 2793941 3036002 0.00970 1489608 17450 1472158 0.00470 540992 452341 88651 0.00030 1184731 1184731 0.00380 9235274 3263732 5971542 0.01860 52760690 36328055 16432635 0.05200 413043 413043 0.00130 531861 531861 0.00170 944904 944904 0.00300 true 7276781 2647011 129746163 143531679 -13785516 X true true HAMOT SURGERY CENTER OUTPATIENT SURGERY CENTER 0.51000 0.49000 1 1 UPMC HAMOT

201 STATE STREET ERIE PA 16550

X X X X X UPMC HAMOT 1 PART I FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST LINE 6B, LINE 7, LINE 7G, LINE 7 COLUMN F LINE 6B - THE ORGANIZATIONS COMMUNITY BENEFIT REPORT IS CONTAINED IN A REPORT PREPARED BY THE HAMOT HEALTH FOUNDATION. LINE 7 - The costing methodology used to calculate the amounts reported in Part 1 Line 7 is a combination of direct costs as well as indirect costs where obtainable. Where appropriate, to determine cost a ratio of costs to charges method is employed. The method is in line with those described in Schedule H, Worksheet 2, "Ratio of Patient Costs to Charges". LINE 7G - The organization includes as subsidized health services costs attributable to a physician clinic in the amount of $377,158. LINE 7 COLUMN F - The Bad Debt expense of $37,555,625 from line 24(b) of Part IX is subtracted from the total expenses of $346,022,980 per line 25 Column A of Part IX in order to calculate the percentages in part I Line 7 Column f. PART III BAD DEBT, MEDICARE, & COLLECTION PRACTICES LINE 4, LINE 8 AND LINE 9B LINE 4 - COSTING METHODOLOGY USED TO DETERMINE THE AMOUNTS REPORTED IN PART III LINE 2 AND 3: The 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 patient's 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". RATIONALE FOR INCLUDING BAD DEBT AMOUNTS IN COMMUNITY BENEFIT: The organization's bad debt expense consists solely of self pay patients accounts deemed uncollectable. It is UPMC Hamot'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 is in line with the organizations 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. METHOD THE ORGANIZATION USES TO DETERMINE THE ESTIMATED AMOUNT OF THE ORGANIZATIONS BAD DEBT EXPENSE AT COST ATTRIBUTABLE TO PATIENTS ELIGIBILITY UNDER THE ORGANIZATIONS CHARITY CARE POLICY: The method that the organization uses to determine the amount of the cost of bad debts that reasonably could be attributable to patients who likely would qualify for financial assistance under the hospital's charity care policy if sufficient information had been available to make a determination of their true eligibility is based on a statistical model applied to a sampling of inpatient accounts. The predictive model takes into consideration consumer activity and data, court records, government records, census data and encompasses healthcare economics, local demographics and credit policies. LINE 8 - COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS OF CARE AND AS REPORTED IN THE ORGANIZATIONS MEDICARE COST REPORT: The 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 Hamot'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 has no recourse for reimbursement, regardless of the efficiency of provision of the related care costs. LINE 9B - COLLECTION PRACTICES SET FORTH IN THE ORGANIZATIONS COLLECTION POLICY THAT APPLY TO PATIENTS QUALIFYING FOR CHARITY CARE OR FINANCIAL ASSISTANCE: If determined at any point prior to or during the patients stay that the patient is medically indigent, credit personnel will assist the patient, patient's family or guarantor in completing an application for state medical assistance and may suspend certain admission and in house payment requirements pending final determination as to medical assistance eligibility. Patients may request charity care post discharge by either calling or visiting the hospital and speaking with the patient accounting office. Personnel in patient accounting are designated to handle charity care applications. PART VI SUPPLEMENTAL INFORMATION LINE 2, LINE 3, LINE4, LINE 5, LINE 6 AND LINE 7 LINE 2 - Hamot Medical Center assesses the health care needs of the community as part of the regular strategic planning cycle. Periodically a comprehensive assessment is done of the environment, including health care needs of the communities served. The assessment is then updated annually and presented to the strategic planning committee of the Board of Directors for use in the strategic plan. Assessment includes evaluating current environmental, demographic, and economic factors both globally and locally, as well as industry specific factors. Sources we regularly reference are The Pennsylvania Department of Health's Behavioral Risk Factor Survey, Healthy People Statistics, health status indicators, and cancer incidence and mortality reports. These are all available at the county level. We also use consumer surveys regarding health care utilization and access administrated by National Research Corporation. There are also various industry publications we consult. We have also worked actively with partners in our community. We are currently working collaboratively with our local Department of Health, the Erie Community Foundation, as well as other hospital providers in Erie County to develop a more formal community health needs assessment. LINE 3 - The charity care policy is posted throughout the medical center including postings at each registration window. Charity care applications are provided to all uninsured patients. Patients are also given information regarding financial assistance in their information packet and it is reviewed during the admission process. LINE 4 - UPMC Hamot's primary service area is Erie county, Pennsylvania and it secondary service area encompasses Crawford, Warren and McKean counties in Pennsylvania, Ashtabula county in Ohio, and Chautauqua County in New York. Erie County has a population of approximately 280,000 and the secondary service area has a population of approximately 410,000. While Erie County is largely urban and suburban the secondary service area is largely rural. Median household income in Erie County is $42,341 and 15.6% of the residents fall below the federal poverty level with over 22% of the population being Medicaid recipients. Of the 314,000 residents in the Pennsylvania and New York secondary service areas over 65,000 are Medicaid. Median household income in the secondary service area counties ranges between $38,300 and $41,000 and the percent of residents below the federal poverty level ranges from 12.2% in Warren County up to 17.1% in Chautauqua County. Erie County has 13 federally designated Medically Underserved Areas ("MUAS") while Crawford and McKean counties have 25 MUAS together. Chautauqua County has 1 MUA. LINE 5 - Through UPMC Hamot's financial support, organizations and communities can provide health services without otherwise having the means. Without these sponsored programs, the community could not otherwise financially support them. UPMC Hamot supports the community by subsidizing the local emergency transportation entity. Without Hamot's support the transportation entity could not remain financially viable. Though tax exempt, UMC Hamot pays property taxes exceeding $1 million though its PILOT program entered into with local, school district and county taxing authorities. UPMC Hamot has an open medical staff extending privileges to all qualified physicians for all departments. The Board of Directors of UPMC Hamot are made up in the majority of community members who are independent to UPMC Hamot. Surplus funds of UPMC Hamot are all reinvested in the hospital and the surrounding communities to promote the health of all served. LINE 6 - The delivery system of entities affiliated with UPMC Hamot is able to provide patients with all medically necessary services. These services include ambulatory surgery, durable medical equipment, home care services, medical transportation, physicians in all specialties to provide healthcare services, and all types of outpatient and ambulatory diagnostic services. UPMC Hamot's mission is to promote healthcare for the benefit of all its services and to provide the highest quality of patient care in a dignified environment without regard to a patient's ability to pay. LINE 7 - STATES RECEIVING COMMUNITY BENEFIT REPORT Pennsylvania X X X X false true false false false false false false false Donald K Inderlied 171545 0 33265 0 36176 0 22517 0 13796 0 277299 0 0 0 John T Malone 460573 0 185908 0 99536 0 77313 0 15513 0 838843 0 0 0 Stephen M Danch 266572 0 69396 0 45742 0 40844 0 17172 0 439726 0 0 0 V James Fiorenzo 321836 0 99310 0 57206 0 49676 0 14686 0 542714 0 0 0 John Lyons MD 258600 0 0 0 974 0 2259 0 1443 0 263276 0 0 0 Richard Long MD 310053 0 56930 0 4238 0 45867 0 14424 0 431512 0 0 0 Debbie Burbules 180889 0 30380 0 690 0 17640 0 15968 0 245567 0 0 0 Gary Maras 171744 0 37014 0 31339 0 22252 0 16862 0 279211 0 0 0 Joseph Butler 183162 0 30951 0 17465 0 12084 0 17365 0 261027 0 0 0 PART I, LINE 4B RETIREMENT PLAN THE FOLLOWING OFFICERS, KEY EMPLOYEES, AND 5 HIGHEST PAID EMPLOYEES PARTICIPATED IN THE ORGANIZATION'S SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN, AND HAD THE FOLLOWING AMOUNTS INCLUDED IN THEIR TAXABLE INCOME FOR 2010: JOHN T. MALONE - $62,613 DONALD K. INDERLIED - $11,195 STEPHEN M. DANCH - $26,144 V. JAMES FIORENZO - $34,976 DEBBIE BURBULES - $9,865 GARY MARAS - $10,942 RICHARD LONG MD - $36,067 ERIE COUNTY HOSPITAL AUTHORITY 232302072 295200523 2006-04-06 23921150 SERIES 2006 SEE SCHEDULE O false false false ERIE COUNTY HOSPITAL AUTHORITY 232302072 295200TA7 2007-07-31 30141552 SERIES 2007 SEE SCHEDULE O false false false ERIE COUNTY HOSPITAL AUTHORITY 232302072 295200TKS 2008-07-01 8210000 SERIES 2008 SEE SCHEDULE O false false false ERIE COUNTY HOSPITAL AUTHORITY 232302072 2010-05-06 35000000 SERIES 2010ABC SEE SCHEDULE O true false false 25307118 2155586 277420 535160 22338951 2010 false false true true 31252910 328700 500770 30423440 2010 false false true true 690000 8210000 150656 2008 true false true true 2085000 35000000 9107354 522137 10527255 2010 true true true true false false true false true 0.01700 0.00000 0.01700 true false false true false true 0.04100 0.00000 0.04100 true false false true false true 0.01700 0.00000 0.01700 true false false true false true 0.01900 0.00000 0.01900 true false false false true IXIS FUNDING CORP 10. true true false false false false false false false false true false false false false false false false false false false SCHEDULE K PART V SUPPLEMENTAL INFORMATION SERIES 2006, 2007, 12/12/2006 FINANC, 7/16/2009 FINANC, 8/31/2010 FINANCI SERIES 2006 $1,385,967.79 WAS EARNED IN THE CONSTRUCTION FUND DURING CONSTRUCTION AND SPENT ACCORDING TO THE PURPOSE OF THE BONDS SERIES 2007 $1,111,358.09 WAS EARNED IN THE CONSTRUCTION FUND DURING CONSTRUCTION AND SPENT ACCORDING TO THE PURPOSE OF THE BONDS. 12/12/2006 FINANCING $203,327.61 WAS EARNED IN THE CONSTRUCTION FUND DURING CONSTRUCTION AND SPENT ACCORDING TO THE PURPOSE OF THE BONDS. $688,519.03 WAS USED FOR PRINCIPAL AND INTEREST PAYMENTS. 7/16/2009 FINANCING $879.78 WAS EARNED IN THE CONTRUCTION FUND DURING CONSTRUCTION AND SPENT ACCORDING TO THE PURPOSE OF THE BONDS. 8/31/2010 FINANCING $480.05 WAS EARNED IN THE CONSTRUCTION FUND DURING CONSTRUCTION AND SPENT ACCORDING TO THE PURPOSE OF THE BONDS. SEE SCHEDULE O PART I SUMMARY LINE 1 PART I, LINE 1 CONTINUED - WESTERN PENNSYLVANIA, WESTERN NEW YORK AND NORTHEASTERN OHIO. UPMC HAMOT'S GOAL TO SERVE THE COMMUNITY IS ACCOMPLISHED THROUGH A COMMITMENT TO PATIENT-FOCUSED CARE AND OUTCOMES MANAGEMENT, OUTSTANDING CUSTOMER SERVICE, STRONG REGIONAL PARTNERSHIPS, RESEARCH, AND COMMUNITY EDUCATION AND PROGRAMS. UPMC HAMOT IS DEDICATED TO SERVICE ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. PART III STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS LINE 4D OTHER PROGRAM SERVICES INPATIENT SERVICES: UPMC HAMOT IS A 412 BED TERTIARY HOSPITAL WITH MEDICAL SPECIALTIES THAT INCLUDE CARIOLOGY, NEUROSCIENCE, GASTROINTESTINAL CARE, CRITICAL CARE, ORTHPAEDICS AND WOMAN'S HEALTH SERVICES. DURING FISCAL YEAR 2011, UPMC HAMOT'S ADMISSIONS WERE APPROXIMATELY 18,200 AND HAD APPROXIMATELY 86,000 PATIENT DAYS. UPMC HAMOT IS ACCREDITED BY THE JOINT COMMISSION AND ALSO HAS AN ADVANCED CERTIFICATION FROM THEM AS A PRIMARY STROKE CENTER. SOME OF THE OTHER MOST CURRENT ACCOLADES INCLUDE: THOMSON REUTERS "100 TOP HOSPITALS" IN BOTH TOP NATIONAL HOSPITALS AND CARDIOVASCULAR CARE; A THREE YEAR ACCREDITATION (WITH COMMENDATION) FROM THE AMERICAN COLLEGE OF SURGEONS' COMMISSION ON CANCER CARE; AMERICAN HEART ASSOCIATION "GET WITH THE GUIDELINES"; STROKE GOLD PLUS PERFORMANCE AWARD; JOINT COMMISSION ADVANCED CERTIFICATION IN STROKE CARE AND HEART FAILURE PROGRAM; U.S. NEWS & WORLD REPORT - AMERICA'S BEST HOSPITALS PULMONARY; HIGHMARK BLUE DISTINCTION CENTER FOR CARDIAC, BARIATRIC, KNEE AND HIP REPLACEMENT; NATIONAL RESEARCH CORPORATION CONSUMER CHOICE AWARD; AND THE AMERICAN COLLEGE OF RADIOLOGY BREAST IMAGING CENTER OF EXCELLENCE. UPMC HAMOT ALSO MAINTAINS AN ORTHOPAEDIC CLINIC THAT SERVES PRIMARILY THE INDIGENT OF THE COMMUNITY. OUTPATIENT SERVICES: UPMC HAMOT OUTPATIENT SERVICES INCLUDE OUTPATIENT SURGERY, EMERGENCY ROOM VISITS, HOME HEALTH VISITS, OUTPATIENT CARDIOLOGY PROCEDURES, RADIOLOGY PROCEDURES, ORTHOPAEDIC PROCEDURES, AND PHYSICIAL REHABILITATION. THE TOTAL OUTPATIENT VOLUME WAS APPROXIMATELY 351,000. MEDICAL EDUCATION AND RESEARCH: TO FURTHER UPMC HAMOT'S GOAL TO PROVIDE OUTSTANDING PATIENT CARE, UPMC HAMOT HAS ESTABLISHED THE FOLLOWING GRADUATE PROGRAMS: PHARMACY RESIDENCY, NEUROLOGY RESIDENCY, ORTHOPAEDIC SURGERY RESIDENCY, ORTHOPAEDIC HAND SURGERY FELLOWSHIPS, AND EMERGENCY MEDICINE. THE CONTINUING MEDICAL EDUCATION DEPARTMENT IS ACCREDITED BY THE PENNSYLVANIA MEDICAL SOCIETY AND ENABLES PHYSICIANS OUTSIDE OF HAMOT TO RECEIVE REQUIRED EDUCATIONAL CREDITS. THE DEPARTMENT'S MOST RECENT ANNUAL REPORT SHOWED THAT MORE THAN 3,000 DOCTORS ATTENDED THESE COURSES. UPMC HAMOT HOUSES A SCHOOL OF ANESTHESIA IN CONJUNCTION WITH A LOCAL UNIVERSITY. THE ANESTHESIA PROGRAM IS ACCREDITED BY THE COUNCIL ON ACCREDITATION OF NURSE ANESTHESIA. LAST YEAR, 20 STUDENTS GRADUATED FROM THE PROGRAM. VARIOUS RESEARCH ACTIVITIES SUPPORT MEDICAL EDUCATION AND ADVANCEMENTS IN PATIENT CARE. UPMC HAMOT PARTICIPATES IN CLINICAL TRIALS FOR DRUGS AND DEVICES IN THE FINAL TESTING STAGES AS WELL AS BASIC SCIENCE RESEARCH. COMMUNITY EDUCATION AND SUPPORT PROGRAMS: UPMC HAMOT WORKS IN CLOSE PARTNERSHIP WITH THE COMMUNITY TO PROVIDE SERVICES. UPMC HAMOT PARTICIPATES IN THE "PILOT" (PAYMENT IN LIEU OF TAXES) PROGRAM WHICH WAS APPROXIMATELY $1,173,000 IN FISCAL YEAR 2011, AND SUBSIDIZES THE LOCAL EMERGENCY TRANSPORTATION FOR APPROXIMATELY $400,000 ANNUALLY. IN ADDITION, UPMC HAMOT PROVIDES MANY OTHER EDUCATIONAL AND SUPPORT SERVICES TO THE COMMUNITY INCLUDING SUPPORT TO BUILD UP THE DOWNTOWN DISTRICT WITHIN WHICH UPMC HAMOT'S CAMPUS RESIDES. UPMC HAMOT ALSO CONDUCTS VARIOUS FREE HEALTH SCREENINGS AND EDUCATION SESSIONS AT LOCATIONS THROUGHOUT THE CITY INCLUDING CAR SEAT SAFETY, COMMUNITY VACCINATION PROGRAMS, UPMC HAMOT HEART FOR WOMEN, ATV SAFETY TRAINING, SPEAKERS BUREAU AND LECTURE SERIES, LET ME CALL YOU SWEETHEART, HEART AND SOLES, AND WEAR RED FOR WOMEN. PART VI GOVERNANCE, MANAGEMENT, AND DISCLOSURE SECTION A, LINE 2,4 ; SECTION B, LINE 11; LINE 12C; SECTION C, LINE 19 PART VI SECTION A LINE 4 - ON FEBRUARY 1, 2011, UPMC, HAMOT MEDICAL CENTER ('HAMOT') AND THE HAMOT HEALTH FOUNDATION ("FOUNDATION") EXECUTED AN INTEGRATION AND AFFILIATION AGREEMENT (THE "AGREEMENT") PROVIDING FOR AN AFFILIATION BETWEEN UPMC AND HAMOT. ON THE DATE OF THE AFFILIATION, THE ARTICLES OF INCORPORATION AND BYLAWS OF HAMOT WERE AMENDED SUCH THAT UPMC BECAME THE SOLE CORPORATE MEMBER OF HAMOT. AS A RESULT OF THE AFFILIATION, UPMC ACQUIRED $406,664,000 OF TOTAL ASSETS, CONSISTING PRIMARILY OF PROPERTY, PLANT AND EQUIPMENT AND INVESTMENTS, AND ASSUMED $255,631,000 OF HAMOT'S LIABILITIES CONSISTING PRIMARILY OF LONG-TERM DEBT OBLIGATIONS. SECTION B LINE 11 - A COPY OF THE FORM 990 IS POSTED TO A SECURE WEBSITE FOR ALL BOARD MEMBERS TO REVIEW. THE CFO PROVIDES FORM 990 HIGHLIGHTS TO THE AUDIT COMMITTEE OF THE BOARD, AND THE CHAIR OF THE AUDIT COMMITTEE RECEIVES AN ENTIRE COPY OF THE FORMS 990 AND 990-t. ALSO, THE COMPLIANCE OFFICER REVIEWS THE OFFICERS' COMPENSATION WITH THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THE CHAIR OF THE COMPENSATION COMMITTEE REVIEWS THE OFFICER AND KEY EXECUTIVE COMPENSATION WITH THE FULL BOARD. THE EXECUTIVE COMPENSATION AND AUDIT COMMITTEE MEMBERSHIPS CONSIST OF ONLY "INDEPENDENT" TRUSTEES AS DEFINED BY THE GOVERNANCE POLICY. LINE 12C - BOARD MEMBERS, OFFICERS, KEY EMPLOYEES AND OTHER SENIOR EXECUTIVES ARE REQUIRED TO SUBMIT FORMAL CONFLICT OF INTEREST STATEMENTS ON AT LEAST AN ANNUAL BASIS AND WHENEVER THE PERSON FIRST BECOMES SUBJECT TO THE POLICY OR THERE HAS BEEN ANY MATERIAL CHANGES IN THE PERSON'S RESPONSES TO THE PREVIOUSLY PROVIDED STATEMENT. THE STATEMENTS ARE PROVIDED TO, REVIEWED BY AND MAINTAINED BY THE CORPORATION'S CHIEF GOVERNANCE OFFICER. CONFLICTS OF INTEREST MUST BE DISCLOSED TO THE BOARD OF DIRECTORS OR COMMITTEE CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. IN ORDER TO MONITOR CONFLICTS OF INTEREST ARISING OUT OF TRANSACTIONS THAT WOULD NOT IN THE ORDINARY COURSE BE PRESENTED TO THE BOARD OR A COMMITTEE WITH BOARD DELEGATED POWERS, THE CHIEF GOVERNANCE OFFICER REVIEWS THE CONFLICT. QUARTERLY, THE CORPORATIONS'S ACCOUNTS PAYABLE DEPARTMENT WILL PROVIDE A COMPREHENSIVE LIST OF ANY TRANSACTIONS WITH A MEMBER OF THE BOARD, THEIR COMPANY/ORGANIZATION OR IMMEDIATE FAMILY MEMBER. QUARTERLY OR MORE FREQUENTLY IF CURCUMSTANCES WARRANT, THE TRANSACTION LIST WILL BE REVIEWED BY THE GOVERNANCE AND NOMINATING COMMITTEE. LINE 15 - AN INDEPENDENT NATIONAL CONSULTING FIRM IS RETAINED BY THE HAMOT BOARD OF TRUSTEES AND REPORTS DIRECTLY TO THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD, WHICH IS COMPRISED OF "INDEPENDENT" TRUSTEES. THE BOARD MONITORS A LIST OF PERFORMANCE METRICS AND EVALUATES THE EXECUTIVE TEAM ANNUALLY BASED ON THE QUALITY OF PATIENT CARE, PATIENT SATISFACTION, FINANCIAL PERFORMANCE, AND COMMUNITY STEWARDSHIP. tHE CONSULTANT'S STUDY INCLUDES: UNDERSTANDING THE TARGET COMPETITIVE MARKET THROUGH DISCUSSION WITH HAMOT EXECUTIVES AND COMPENSATION COMMITTEE, REVIEWING THE DUTIES AND RESPONSIBILITIES FOR EACH POSITION UNDER THE SCOPE OF THE STUDY, SELECTING CREDIBLE PUBLISHED SURVEY SOURCES, ANALYZING MARKET DATA, AND COMPARING HAMOT COMPENSATION LEVELS BY EACH COMPONENT OF THE EXECUTIVE TOTAL COMPENSATION TO THE COMPETITIVE MARKET PRACTICES. AN OFFICIAL OPINION IS RENDERED BY THE CONSULTANT IN ACCORDANCE WITH TREASURY REGULATION SECTION 53.4958-6(2) AND 53.4958-1(D)(4)(III). THEY ALSO CERTIFY THEIR INDEPENDENCE. THE STUDY IS PERFORMED ANNUALLY WITH THE MOST RECENT STUDY CONDUCTED IN 2011. THE SCOPE OF THIS STUDY IS FOR POSITIONS HELD WITH UPMC HAMOT AND REGIONAL HEALTH SERVICES. THE POSITIONS UNDER THE SCOPE OF THIS STUDY ARE: CEO, COO, CFO, CMO, CNO, SVP OF CORP SERVICE/CORPORATE COMPLIANCE, SVP OF BUSINESS DEVELOPMENT, VP OF OUTPATIENT SERVICES, VP OF SUPPORT SERVICES, VP OF STRATEGIC RESOURCES, VP OF PATIENT ACCOUNTING, VP OF GENERAL SERVICES, VP OF HAMOT PHYSICIAN NETWORK, VP OF PHARMACY, AND THE PRESIDEDNT OF REGIONAL HEALTH SERVICES. SECTION C LINE 19 - THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. PART X BALANCE SHEET SCHEDULE K TAX EXEMPT BONDS - DESCRIPTION OF PURPOSE SERIES 2006 - CONSTRUCTION AND EQUIPPING OF A NEW TWO-STORY GENERATOR BUILDING TO PROVIDE EMERGENCY AND STANDBY ELECTRICAL POWER FOR THE MEDICAL CENTER AND RELATED FACILITIES, EXPANSION AND RENOVATION OF THE FACILITIES HOUSING THE IMAGING CENTER, EXPANSION OF THE RESOURCE CENTER TO HOUSE ADDITIONAL FACILITIES, RENOVATION AND CONSTRUCTION OF THE WOMEN'S AND BABIES INPATIENT SERVICES FACILITIES, AND FINANCING VARIOUS EQUIPMENT AND RENOVATION PROJECTS FOR THE MEDICAL CENTER. SERIES 2007 - CONSTRUCTION AND EQUIPPING OF A NEW HOSPTIAL AND HEALTH CENTER FOCUSED ON WOMEN'S AND BABIES' HEALTH CARE NEEDS. SERIES 2008 - REFUNDED ERIE COUNTY HOSPITAL AUTHORITY'S VARIABLE RATE DEMAND REVENUE SERIES 1998B BONDS ISSUED 6/30/1998. SERIES 2010ABC - REFUNDED ERIE COUNTY HOSPITAL AUTHORITY'S REVENUE SERIES 1998A BONDS ISSUED 6/30/1998; ADVANCE REFUNDED ERIE COUNTY HOSPITAL AUTHORITY'S REVENUE SERIES 2002 BONDS ISSUED 12/5/2002; CONSTRUCTED, RENOVATED, EQUIPPED INPATIENT AND OUTPATIENT HOSPITAL AND HEALTH CARE FACILITIES TO BE OWNED AND OPERATED BY THE MEDICAL CENTER, INCLUDING THE HAMOT WOMEN'S HOSPITAL. 12/12/2006 FINANCING - FINANCE CAPITAL EXPENDITURES OR REIMBURSE FOR PREVIOUSLY INCURRED CAPITAL EXPENDITURES FOR HOSPITAL AND/OR HEALTH CARE FACILITIES. 7/16/2009 FINANCING - FINANCE CAPITAL EXPENDITURES OR REIMBURSE FOR PREVIOUSLY INCURRED CAPITAL EXPENDITURES FOR HOSPITAL AND/OR HEALTH CARE FACILITIES 8/31/2010 FINANCING - FINANCE CAPITAL EXPENDITURES OR REIMBURSE FOR PREVIOUSLY INCURRED CAPITAL EXPENDITURES FOR HOSPITAL AND/OR HEALTH CARE FACILITIES PART XI RECONCILIATION OF ASSETS LINE 5 RECONCILIATION OF NET ASSETS TRANSFER OF ASSETS FROM HAMOT HEALTH FOUNDATION 26,962,986 ELIMINATION OF INTERCOMPANY DEBT (22,448,725) PLEDGE RECEIVABLE FROM UPMC 200,000,000 CHANGE IN PENSION LIABILITY 6,068,060 CHANGE IN BENEFICIAL INTEREST 19,659,609 WRITE OFF OF KANE A/R (438,511) OPENING BALANCE SHEET ADJUSTMENTS (23,077,842) WRITEOFF OF THE PHYSICIAN & KANE INVESTMENT (869,073) INHERENT CONTRIBUTION FROM HAMOT ACQUISITION (63,201,000) EMERGYCARE INVESTMENT WRITEOFF (1,805,782) COMPLIANCE OF INVENTORY RESERVE POLICY (9,281,000) PPE EQUIPMENT WRITEUP RELATING TO UPMC ACQUISITION (10,000,000) DOL 8/80 LIABILITY (208,000) PENSION DISCOUNT RATE CONFORMITY 1,800,000 OTHER MISCELLANEOUS ADJUSTMENTS (33,111) TOTAL 123,127,611 SCHEDULE L TRANSACTIONS WITH INTERESTED PERSONS PART IV BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS A NAME OF INTERESTED PERSON BALDWIN BROTHERS, INC. B RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION BOARD MEMBER GREGORY S. BALDWIN IS AN OFFICER AND DIRECTOR OF INTERESTED PERSON C AMOUNT OF TRANSACTION 212,205 D DESCRIPTION OF TRANSACTION REAL ESTATE E SHARING OF ORGANIZATIONS REVENUES NO A NAME OF INTERESTED PERSON SCOTTS COURT-PEACH INC B RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION INTERESTED PERSON ENTITY MORE THAN 35% OWNED BY BOARD MEMBER NICHOLAS SCOTT C AMOUNT OF TRANSACTION 111,325 D DESCRIPTION OF TRANSACTION SPACE RENTAL E SHARING OF ORGANIZATIONS REVENUES NO A NAME OF INTERESTED PERSON KNOX MCLAUGHLIN GORNALL & SENNETT PC B RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION BOARD MEMBER THOMAS TUPITZA ESQ. IS A SHAREHOLDER AND DIRECTOR OF INTERESTED PERSON C AMOUNT OF TRANSACTION 332,341 D DESCRIPTION OF TRANSACTION LEGAL SERVICES E SHARING OF ORGANIZATIONS REVENUES NO A NAME OF INTERESTED PERSON GERALD GARCIA M.D. B RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION FAMILY MEMBER OF BOARD MEMBER PHILIP A. GARCIA C AMOUNT OF TRANSACTION 60,000 D DESCRIPTION OF TRANSACTION CONSULTING SERVICES E SHARING OF ORGANIZATIONS REVENUES NO A NAME OF INTERESTED PERSON MEDICOR ASSOCIATES, INC B RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION BOARD MEMBER ROBERT J. FERRARO M.D. IS > 5% OWNER OF INTERESTED PERSON C AMOUNT OF TRANSACTION 20,411,074 D DESCRIPTION OF TRANSACTION CARDIOLOGY SERVICES E SHARING OF ORGANIZATIONS REVENUES NO A NAME OF INTERESTED PERSON MARY JERGE B RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION FAMILY MEMBER OF CFO STEPHEN DANCH C AMOUNT OF TRANSACTION 18,083 D DESCRIPTION OF TRANSACTION COMPENSATION E SHARING OF ORGANIZATIONS REVENUES NO KANE COMMUNITY HOSPITAL 4372 ROUTE 6 KANE PA 16735 250998168 HOSPITAL PA 501(C)(3) 3 UPMC HAMOT REGIONAL HEALTH SERVICES INC 300 STATE STREET NO 100A ERIE PA 19103 251403958 OUTPATIENT SV PA 501(C)(3) 9 UPMC HAMOT UPMC 600 GRANT STREET PITTSBURGH PA 15219 251423657 HEALTHCARE PA 501(C)(3) 11 TYPE III NA HAMOT-KCH REAL ESTATE VENTURE LLC 300 STATE ST ERIE PA 16501 263691782 MEDICAL OFFICE BL PA UPMC HAMOT RELATED HAMOT SURGERY CENTER LLC 200 STATE ST ERIE PA 16550 251863661 AMBULATORY SURGER PA UPMC HAMOT RELATED 1230149 3747111 false 0 false 0.50940 LIFE CARE HOME SERVICES OF NW PA 1647 SASSAFRAS ST ERIE PA 16502 251536879 HOME HEALTH SVCS PA NA N/A 0 0 0 0.00000 HAMOT PROFESSIONAL BUILDING CONDOMINIUM 2950 WEST 12TH ST ERIE PA 16505 251761211 REAL ESTATE PA N/A INVESTMENT -78099 215772 false 0 true 0.93860 KANE ANESTHESIA PROFESSIONAL SERVICES 4372 ROUTE 6 KANE PA 16735 050555457 ANESTHESIA SVCS PA KANE COMMUNITY C CORP 365999 98894 1.00000 BAYFRONT REGIONAL DEVELOPMENT CORP 300 STATE STREET SUITE 100 ERIE PA 16507 251401388 RE HOLDINGS CO PA UPMC HAMOT C CORP 339578 25327188 1.00000 BAYSIDE DEVELOPMENT CORP 300 STATE STREET SUTIE 100 ERIE PA 16507 251401386 REAL ESTATE/PHARM PA BAYFRONT REG DE C CORP 7554023 27183883 1.00000 true true true true true true true REGIONAL HEALTH SERVICES INC B 22107465 REGIONAL HEALTH CENTRAL LLC B 341260 KANE COMMUNITY HOSPITAL C 2515845 HAMOT SURGERY CENTER I 113867 REGIONAL HEALTH SERVICES INC I 382677 BAYFRONT REGIONAL DEVELOPMENT J 97284 BAYSIDE DEVELOPMENT CORP J 98702 HAMOT SURGERY CENTER LLC K 339164 REGIONAL HEALTH SERVICES INC K 147112 KANE COMMUNITY HOSPITAL K 536822 REGIONAL HEALTH SERVICES INC O 3378000 HAMOT SURGERY CENTER LLC R 1147373 UPMC R 200000000