4A (Expenses $ 111651413 including grants of $ 0) (Revenue $ 119303851)
OPERATED 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.

UPMC CHAUTAUQUA AT WCA
PART 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 WCA
PART 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 WCA
PART 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 WCA
PART 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 WCA
PART 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.

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 89% REDUCTION IN THE PATIENT BILL. THE DISCOUNTED CHARITY CARE SCALE IS BASED ON FAMILY HOUSEHOLD SIZE FOR 2021.3. 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 $131,360,176.

PART I, LINE 6A
UPMC 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 & 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 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 8
"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 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 7, REPORTS FILED WITH STATES
NY

PART III, LINE 3
"PROCESS 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 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 5
PART 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. IN 2021, THE HOSPITAL STARTED PROVIDING CHF KITS TO PATIENTS AS NEEDED INCLUDING A BLOOD PRESSURE CUFF, A SCALE, A DAILY WEIGHT LOG, A WATER BOTTLE FOR FLUID MANAGEMENT, A PILL ORGANIZER, AND CHF EDUCATIONAL MATERIALS. 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, AND IN 2021 A NEW PHYSICIAN ASSISTANT JOINED THE TEAM. 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. SINCE JULY 2019, MORE THAN 2,000 PATIENTS WERE SERVED THROUGH THE INPATIENT BEHAVIORAL HEALTH UNITS.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. OVER THE PAST THREE YEARS, THE HOSPITAL RECRUITED 12 SPECIALISTS TO THE REGION INCLUDING AN ENT SPECIALIST, AN ORTHOPEDIC SURGEON, AND A FAMILY MEDICINE PHYSICIAN. IN ADDITION, UPMC CHAUTAUQUA PARTNERS WITH UPMC HAMOT TO INCREASE LOCAL ACCESS TO SPECIALTY PROVIDERS. WHEN A SPECIALIST IS NOT AVAILABLE IN CHAUTAUQUA COUNTY, UPMC CHAUTAUQUA OFFERS TELEMEDICINE TO INCREASE LOCAL ACCESS TO CARE. MORE THAN 24,000 VIRTUAL VISITS WERE CONDUCTED SINCE JULY 2019.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. OVER THE LAST THREE YEARS, UPMC CHAUTAUQUA HAS CONTINUED TO OFFER EDUCATION AND SUPPORT TO PREGNANT WOMEN AND HAS DELIVERED MORE THAN 1200 BABIES.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. SINCE JULY 2019, THE HOSPITAL'S THREE EMPLOYEE EXERCISE ROOMS LOGGED MORE THAN 550 VISITS, EVEN THOUGH THE FACILITIES WERE TEMPORARILY CLOSED DUE TO COVID-19.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