Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2012
Open to Public Inspection
A For the 2012 calendar year, or tax year beginning 07-01-2012 , 2012, and ending 06-30-2013
BCheck if applicable:
CName of organization
Allegheny Specialty Practice Network
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
C/O TAX DEPARTMENT HIGHMARK STE 92
Suite
Room/suite
City or town, state or country, and ZIP + 4
PITTSBURGH, PA15222
D Employer identification number

25-1838458
E Telephone number

G Gross receipts $ 222,042,981
F Name and address of principal officer:
Tony Farah MD
30 ISABELLA STREET
PITTSBURGH,PA15212
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.wpahs.org
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1999
M State of legal domicile: PA
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: Form 990, Page 2, Part III, Question 1
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 2
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 0
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...... 5 1,959
6 Total number of volunteers (estimate if necessary) ............. 6 0
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 0 0
9 Program service revenue (Part VIII, line 2g) ......... 202,144,491 203,802,743
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 312 2,409
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 21,172,443 18,237,829
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 223,317,246 222,042,981
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 4,075 8,675
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 267,605,403 239,379,411
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 67,313,512 92,257,991
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 334,922,990 331,646,077
19 Revenue less expenses. Subtract line 18 from line 12....... -111,605,744 -109,603,096
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 30,682,344 31,203,080
21 Total liabilities (Part X, line 26)............. 89,975,617 108,935,812
22 Net assets or fund balances. Subtract line 21 from line 20..... -59,293,273 -77,732,732
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2012)
Form 990 (2012)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III ...............
1
Briefly describe the organization’s mission: Allegheny Health Network is a team of care givers committed to improving health and promoting wellness in our communities, one person at a time. We pledge to consistently deliver safe, compassionate quality healthcare by treating the whole person - body, mind and spirit.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If “Yes,” describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 298,555,251 including grants of $ 8,675 ) (Revenue $ 203,802,743 )
The purpose of Allegheny Specialty Practice Network is to improve the health of the people in Western Pennsylvania. In order to accomplish this mission, Allegheny Specialty Practice Network provides Medical services to those individuals in need of medical treatment. See Schedule O for additional support.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet298,555,251
Form 990 (2012)
Form 990 (2012)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? ...
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If “Yes,” complete Schedule C, Part II........
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C,
Part III
............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment
...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,” complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If “Yes,” complete Schedule D, Part VI.Click to see attachment
...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part XClick to see attachment.........................
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the United States? If “Yes,” complete Schedule F, Parts II and IV
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the United States? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I (see instructions)....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If “Yes,” complete Schedule H....
20a
 
No
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
Form 990 (2012)
Form 990 (2012)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II... Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I........
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I...................
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highest compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II
..........................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ..........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV
.....................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If “Yes,” complete Schedule L, Part IV...
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I
...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2...
35b
 
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2012)
Form 990 (2012)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V ...............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
196
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
1,959
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes,” to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?............
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?..........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?.......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note.
See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2012)
Form 990 (2012)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI ...............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
2
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
0
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
Yes
 
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
PA
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletMATTHEW PETERSON30 ISABELLA STREETPITTSBURGHPA15212 (412) 330-6090
Form 990 (2012)
Form 990 (2012)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII ...............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) Matthew Peterson........................................................................
Director & Treasurer
1.0
.......................39.0
X   X       0 281,808 0
(2) Tony Farah MD........................................................................
Director & PO President
1.0
.......................39.0
X   X         820,677  
(3) Deborah Olszewski........................................................................
Assistant Secretary
1.0
.......................39.0
    X         181,014  
(4) Robert Brandfass........................................................................
Secretary
1.0
.......................39.0
    X         478,243  
(5) Michael Sirott........................................................................
Secretary
1.0
.......................39.0
    X         193,042  
(6) Donald McNary........................................................................
Service Line Vice President
 
.......................40.0
      X     214,525    
(7) Susan Manzi MD........................................................................
System Chair Dept. of Medicine
 
.......................40.0
      X     422,394    
(8) Patrick Demeo MD........................................................................
Physician
 
.......................40.0
      X     1,040,136    
(9) Barbara Mercadante........................................................................
Vice President
 
.......................40.0
      X     236,658    
(10) Charles Rakaczky........................................................................
Service Line Vice President
 
.......................40.0
      X     180,237    
(11) Allan Klapper MD........................................................................
Physician
 
.......................40.0
      X     643,677    
(12) Christopher Schmidt MD........................................................................
Physician
 
.......................40.0
        X   1,202,441    
(13) Hae Dong Jho MD........................................................................
Physician
 
.......................40.0
        X   1,150,161    
(14) Nicolas Sotereanos MD........................................................................
Physician
 
.......................40.0
        X   1,269,124    
(15) Mark Baratz MD........................................................................
Physician
 
.......................40.0
        X   1,166,650    
(16) Micheal Oh........................................................................
Physician
 
.......................40.0
        X   1,138,929    
(17) Sanford Kurtz MD........................................................................
Director & PO President & CEO
 
.......................0.0
          X   334,768  
Form 990 (2012)
Form 990 (2012)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) Roy Santarella........................................................................
Director & Treasurer
 
.......................0.0
          X   703,046  
(19) Christopher Olivia MD........................................................................
Health System President & CEO
 
.......................0.0
          X   1,261,143  
(20) Diane Dismukes........................................................................
Health System President & CEO
 
.......................0.0
          X   833,367  
(21) David Kiehn........................................................................
Assistant Treasurer
 
.......................0.0
          X   619,128  
(22) Mark Barnhart........................................................................
ASPN Chief Operating Officer
 
.......................0.0
          X   209,230  
















1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 8,664,932 5,915,466 0
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet617
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
HEALTH ASSOCIATION OF WESTERN PA PC, 680 ANDERSON ROADPITTSBURGHPA15220 MEDICAL SERVICES 886,400
ALVAREZ AND MARSAL, 600 LEXINGTON AVENUENEW YORKNY10022 CONSULTING SERVICE 819,929
STAFFASSIST WORKFORCE, 62373 COLLECTION CENTER DRCHICAGOIL60693 STAFFING AGENCY 563,884
LOCUMTENEMSCOM, PO BOX 405547ATLANTAGA303845547 STAFFING AGENCY 392,505
HSS SYSTEMS LLC, PO BOX 550NASHVILLETN37067 CONSULTING 259,179
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet14
Form 990 (2012)
Form 990 (2012)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response to any question in this Part VIII ..............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above
1f
 
g Noncash contributions included in lines
1a-1f:$
 
h Total. Add lines 1a-1f.......MediumBullet 0
 Program Service Revenue Business Code
2a PATIENT SERVICE REVENUE 621110 203,802,743 203,802,743    
b
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 203,802,743
 Other Revenue 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 2,409     2,409
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 543,406  
b Less: rental expenses    
c Rental income or (loss) 543,406 0
d Net rental income or (loss).......MediumBullet 543,406     543,406
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory    
b Less: cost or other basis and sales expenses    
c Gain or (loss)    
d Net gain or (loss)..........MediumBullet 0      
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a ADMIN/STIPEND/TEACHING - AFFILIATE REIMBURSEMENT 621110 8,929,727 8,929,727    
b EHR PAYMENTS 621110 3,292,294 3,292,294    
c PLZ SIDE BY SIDE REIMBURSEMENT 621110 2,620,794 2,620,794    
d All other revenue .... 2,851,608 2,851,608    
e Total. Add lines 11a–11d ...... MediumBullet 17,694,423
12 Total revenue. See Instructions......MediumBullet 222,042,981 221,497,166 0 545,815
Form 990 (2012)
Form 990 (2012)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response to any question in this Part IX ...............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21 8,675 8,675
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 2,858,002 2,813,182 44,820  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 204,150,170 200,948,629 3,201,541  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 12,764,889 12,564,706 200,183  
9 Other employee benefits ....... 8,621,018 8,485,820 135,198  
10 Payroll taxes ........... 10,985,332 10,813,056 172,276  
11 Fees for services (non-employees):        
a Management ...... 1,376,456   1,376,456  
b Legal ......... 18,677 18,352 325  
c Accounting ........... 2,038 2,038    
d Lobbying ........... 0      
e Professional fundraising services. See Part IV, line 17 0 0
f Investment management fees ...... 0      
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 8,120,337 5,869,254 2,251,083  
12 Advertising and promotion .... 56,157 51,362 4,795  
13 Office expenses ....... 1,074,283 1,011,792 62,491  
14 Information technology ...... 0      
15 Royalties .. 0      
16 Occupancy ........... 10,718,131 10,287,456 430,675  
17 Travel ............ 1,132,145 1,106,939 25,206  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 562,118 558,698 3,420  
20 Interest ........... 0      
21 Payments to affiliates ....... 23,330,730 777,670 22,553,060  
22 Depreciation, depletion, and amortization ..... 3,366,380 3,346,737 19,643  
23 Insurance .............. 13,698,374 13,616,134 82,240  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a BAD DEBT 15,424,117 15,424,117    
b PATIENT CARE COSTS 5,795,510 5,795,510    
c ORGANIZATIONAL RESTRUCTURING 3,226,671 2,953,049 273,622  
d MEMBERSHIP FEES & DUES 1,411,932 1,411,932    
e All other expenses 2,943,935 690,143 2,253,792  
25 Total functional expenses. Add lines 1 through 24e 331,646,077 298,555,251 33,090,826 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2012)
Form 990 (2012)
Page 11
Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash—non-interest-bearing ............. 5,788 1 6,457
2 Savings and temporary cash investments ......... 780,935 2 1,734,724
3 Pledges and grants receivable, net ........... 0 3 0
4 Accounts receivable, net ............. 16,554,641 4 14,583,866
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
0 6 0
7 Notes and loans receivable, net ............. 0 7 0
8 Inventories for sale or use .............. 37,150 8 20,059
9 Prepaid expenses and deferred charges .......... 2,104,429 9 2,735,311
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 11,557,352
b Less: accumulated depreciation ..... 10b 569,861 10,990,470 10c 10,987,491
11 Investments—publicly traded securities .......... 0 11 0
12 Investments—other securities. See Part IV, line 11 ..... 0 12 0
13 Investments—program-related. See Part IV, line 11 ..... 0 13 0
14 Intangible assets ............... 0 14 0
15 Other assets. See Part IV, line 11 ........... 208,931 15 1,135,172
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 30,682,344 16 31,203,080
Liabilities 17 Accounts payable and accrued expenses ......... 27,643,438 17 40,342,926
18 Grants payable ................. 0 18 0
19 Deferred revenue ................ 2,075,823 19 1,886,234
20 Tax-exempt bond liabilities ............. 0 20 0
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 60,256,356 25 66,706,652
26 Total liabilities. Add lines 17 through 25......... 89,975,617 26 108,935,812
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. -59,294,321 27 -77,733,780
28 Temporarily restricted net assets ........... 1,048 28 1,048
29 Permanently restricted net assets ........... 0 29 0
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... -59,293,273 33 -77,732,732
34 Total liabilities and net assets/fund balances ........ 30,682,344 34 31,203,080
Form 990 (2012)
Form 990 (2012)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI ...............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
222,042,981
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
331,646,077
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-109,603,096
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
-59,293,273
5
Net unrealized gains (losses) on investments ...............
5
-12,342
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
91,175,979
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
-77,732,732
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII ..............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If “Yes,” to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits
3b
 
 
Form 990 (2012)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
Allegheny Specialty Practice Network
 
Employer identification number

25-1838458
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization? ................
11g(i)
 
 
(ii) A family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) A 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (iv) Is the organization in col. (i) listed in your governing document? (v) Did you notify the organization in col. (i) of your support? (vi) Is the organization in col. (i) organized in the U.S.? (vii) Amount of monetary support
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 4
Part IV
Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
INTERNAL REVENUE SERVICE FORM 990, SCHEDULE H IS REQUIRED TO BE COMPLETED BY ALL ORGANIZATIONS THAT MEET THE IRS DEFINITION OF A HOSPITAL AND IN ADDITION, IS REQUIRED TO BE LICENSED, REGISTERED OR SIMILARLY RECOGNIZED BY A STATE AS A HOSPITAL. ALLEGHENY SPECIALTY PRACTICE NETWORK IS CLASSIFIED BY THE INTERNAL REVENUE SERVICE AS A HOSPITAL UNDER IRC SECTION 170(B)(1)9A)(III). ALLEGHENY SPECIALTY PRACTICE NETWORK IS NOT REQUIRED TO BE LICENSED, REGISTERED OR SIMILARLY RECOGNIZED AS A HOSPITAL BY THE STATE OF PENNSYLVANIA. ACCORDINGLY, INTERNAL REVENUE SERVICE FORM 990, SCHEDULE H IS NOT COMPLETED BY ALLEGHENY SPECIALTY PRACTICE NETWORK.
 
 
 
Schedule A (Form 990 or 990-EZ) 2012

Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
Allegheny Specialty Practice Network
 
Employer identification number

25-1838458
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) .....    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance .... 1,048 1,048 1,048 1,048 1,297
b Contributions ........          
c Net investment earnings, gains, and losses          
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........
        249
f Administrative expenses ....          
g End of year balance ...... 1,048 1,048 1,048 1,048 1,048
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet100.000 %
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................      
b Buildings ................   207,507 176,732 30,775
c Leasehold improvements ............   1,254,310 57,900 1,196,410
d Equipment ................   10,095,535 335,229 9,760,306
e Other .................   0   0
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 10,987,491
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes 0
ACCRUED PENSION LIABILITY 57,038,172
INSURANCE LIABILITY 8,255,285
LEASE ESCALATION LIABILITY 1,413,195






Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 66,706,652
2. Fin 48 (ASC 740) Footnote. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII .....................................................
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
ASPN Inclusion in the Consolidated Audit of WPAHS Form 990, Schedule D, Part X Question 2, Part XIII Allegheny Specialty Practice Network (ASPN) does not issue independent audited financial statements. ASPN is a member of a regional healthcare system named West Penn Allegheny Health System. The West Penn Allegheny Health System receives a consolidated audit which includes the operations of ASPN. The following analysis represents the reconciliation between the financial statement net loss and the net loss as reported on Form 990, Page 1, Line 19: Net Loss Per Financial Statements $(109,615,438) Plus: Unrealized Loss on Limited Liability Company Investment Reclassified Through Net Assets 12,342 _____________ Net Loss Per IRS Form 990 $(109,603,096) The following is the footnote to the audited consolidated financial statements of the West Penn Allegheny Health System for FASB ASC 740: WPAHS adopted Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) 740, Income Taxes, which clarifies the accounting for uncertainty in income taxes recognized in an enterprise's financial statements. FASB ASC 740 prescribes a more-likely than-not recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken or expected to be taken. Under FASB ASC 740, tax positions will be evaluated for recognition, derecognition, and measurement using consistent criteria and will provide more information about the uncertainty in income tax assets and liabilities. Based on an analysis prepared by WPAHS, it was determined that the application of FASB ASC 740 had no material effect on the recorded assets and liabilities of WPAHS.
Intended Use of the Organization Endowment Funds Schedule D, Page 2, Part V, Line 4 The intended use of Allegheny Specialty Practice Network term endowments are for but not exclusive to: capital improvements, research, education, departmental needs, operating efficiencies, and overall patient care.
Schedule D (Form 990) 2012

Additional Data


Software ID:  
Software Version:  




Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
Allegheny Specialty Practice Network
 
Employer identification number
25-1838458
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC Code section
if applicable
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
non-cash assistance
(h) Purpose of grant
or assistance






















2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
 
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2012

Schedule I (Form 990) 2012
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients
(c)Amount of
cash grant
(d)Amount of
non-cash assistance
(e)Method of valuation (book,
FMV, appraisal, other)
(f)Description of non-cash assistance












Part IV
Supplemental Information.
Complete this part to provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Identifier Return Reference Explanation
Statement 1   No individual grant for 2013 was in excess of $5,000.
Schedule I (Form 990) 2012


Additional Data


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Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
Allegheny Specialty Practice Network
 
Employer identification number

25-1838458
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all officers,
directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? .......
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
 
No
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2012

Schedule J (Form 990) 2012
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation
reported as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)Sanford Kurtz MDDirector & PO President & CEO (i)
(ii)
 
 
 
 
 
334,768
0
0
0
0
0
334,768
0
334,768
(2)Roy SantarellaDirector & Treasurer (i)
(ii)
 
 
 
 
 
703,046
0
585,817
0
183
0
1,289,046
0
703,046
(3)Matthew PetersonDirector & Treasurer (i)
(ii)
0
231,605
0
50,000
0
203
0
6,250
0
9,353
0
297,411
0
0
(4)Christopher Olivia MDHealth System President & CEO (i)
(ii)
 
 
 
 
 
1,261,143
0
625,000
0
7,325
0
1,893,468
0
1,250,000
(5)Deborah OlszewskiAssistant Secretary (i)
(ii)
 
179,977
 
 
 
1,037
0
10,858
0
1,538
0
193,410
0
0
(6)Robert BrandfassSecretary (i)
(ii)
 
317,358
 
150,717
 
10,168
0
0
0
10,801
0
489,044
0
0
(7)Diane DismukesHealth System President & CEO (i)
(ii)
 
 
 
 
 
833,367
0
0
0
183
0
833,550
0
833,367
(8)Donald McNaryService Line Vice President (i)
(ii)
164,048
 
50,143
 
334
 
8,802
0
9,170
0
232,497
0
0
0
(9)Susan Manzi MDSystem Chair Dept. of Medicine (i)
(ii)
421,842
 
 
 
552
 
10,000
0
10,705
0
443,099
0
0
0
(10)Tony Farah MDDirector & PO President (i)
(ii)
 
820,125
 
 
 
552
0
10,000
0
12,471
0
843,148
0
0
(11)Patrick Demeo MDPhysician (i)
(ii)
864,584
 
175,000
 
552
 
11,019
0
10,371
0
1,061,526
0
0
0
(12)Mark BarnhartASPN Chief Operating Officer (i)
(ii)
 
 
 
 
 
209,230
0
0
0
0
0
209,230
0
209,230
(13)Barbara MercadanteVice President (i)
(ii)
185,915
 
50,000
 
743
 
12,167
0
12,867
0
261,692
0
0
0
(14)Christopher Schmidt MDPhysician (i)
(ii)
871,943
 
330,138
 
360
 
10,000
0
11,553
0
1,223,994
0
0
0
(15)Hae Dong Jho MDPhysician (i)
(ii)
995,130
 
151,983
 
3,048
 
15,000
0
11,361
0
1,176,522
0
0
0
(16)Nicolas Sotereanos MDPhysician (i)
(ii)
962,922
 
305,650
 
552
 
10,000
0
11,763
0
1,290,887
0
0
0
(17)Mark Baratz MDPhysician (i)
(ii)
865,618
 
300,000
 
1,032
 
10,000
0
7,413
0
1,184,063
0
0
0
(18)David KiehnAssistant Treasurer (i)
(ii)
 
13,033
 
100,000
 
506,095
0
0
0
725
0
619,853
0
564,419
(19)Charles RakaczkyService Line Vice President (i)
(ii)
179,535
 
 
 
702
 
7,401
0
9,471
0
197,109
0
0
0
(20)Micheal OhPhysician (i)
(ii)
793,735
 
344,834
 
360
 
8,125
0
11,163
0
1,158,217
0
0
0
(21)Michael SirottSecretary (i)
(ii)
 
192,662
 
 
 
380
0
0
0
9,370
0
202,412
0
0
(22)Allan Klapper MDPhysician (i)
(ii)
493,377
 
150,000
 
300
 
10,000
0
10,751
0
664,428
0
0
0
Schedule J (Form 990) 2012

Schedule J (Form 990) 2012
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Identifier Return Reference Explanation
Additional Compensation Disclosure Form 990, Schedule J, Page 1 The following represents additional disclosure for Schedule J, line 4a pertaining to officers and key employees listed in Form 990, Part VII, Section A, Line 1a receiving severance pay during the calendar year ending within the June 30, 2013 fiscal year end: David Kiehn $464,419 Christopher Olivia, MD $1,250,000 Diane Dismukes $833,367 Roy Santarella $703,046 Sanford Kurtz, MD $334,768 Mark Barnhart $209,230
Deferred Compensation Schedule J, Page 2, Column C Retirement and other deferred compensation reflect amounts accrued to the benefit of the applicable individuals related to qualified pension and severance plans. In this regard, the following individuals have amounts accrued related to future severance payments to be made: Christopher Olivia, MD Roy Santarella
Schedule J (Form 990) 2012

Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
Allegheny Specialty Practice Network
 
Employer identification number

25-1838458
Identifier Return Reference Explanation
IRS Form 990 - Organizational Comment IRS Form 990 On April 29, 2013, West Penn Allegheny Health System, Inc., the parent organization of the West Penn Allegheny Health System formalized an affiliation with Highmark Health, EIN: 45-3674900, a 501(c)(3) tax exempt organization to become a member of a newly created integrated delivery system named Allegheny Health Network (the "Network"). West Penn Allegheny Health System, Inc. is the sole member of Allegheny Specialty Practice Network. In addition to West Penn Allegheny Health System, the Allegheny Health Network also consists of Jefferson Regional Medical Center, Saint Vincent Health Center and Saint Vincent Health System. In total, the Network consists of 22 different organizations exempt from federal income tax under IRS Section 501(c)(3). The parent organization of the Network is Allegheny Health Network, EIN: 45-3674924, a 501(c)(3) tax exempt organization. Together, these organizations have combined to create a cost-effective health system that raises quality, enhances outcomes and preserves consumer choice for everyone. Allegheny Specialty Practice Network - Board of Director Independence IRS Form 990, Page 1, Part I, Line 4 The appointment of the Allegheny Specialty Practice Network Board of Directors is made by the sole member of the organization, West Penn Allegheny Health System, Inc. The Bylaws of Allegheny Specialty Practice Network provide that the sole member has the exclusive power to fix the number of, and elect, appoint, fill vacancies in and remove, with or without cause, the directors; and elect and remove, with or without cause, the chair and vice chair of the board of directors of the corporation, and the secretary and treasurer of the corporation. The board of directors of the sole member of Allegheny Specialty Practice Network is comprised of a majority of independent board members. The board of directors of Allegheny Specialty Practice Network consists of two members who have voting rights on matters pertinent to the organization. Of these two members, none are deemed to be independent to the organization. Because of the independence of the Board of Directors of the sole member, and the rights and powers of the sole member to appoint and fix the Board of Directors of Allegheny Specialty Practice Network, we deem that the Board of Directors of Allegheny Specialty Practice Network is in fact controlled by a majority of independent Board Members.
Statement of Program Service Accomplishments Form 990, Page 2, Part III, Line 4a INTRODUCTION TO ALLEGHENY SPECIALTY PRACTICE NETWORK (ASPN) ASPN is part of the Allegheny Health Network by virtue of being affiliated with the West Penn Allegheny Health System (WPAHS). Organized in 2000, WPAHS (www.wpahs.org) is comprised of West Penn Allegheny Health System, Inc. (WPAHS, Inc.), Alle-Kiski Medical Center (AKMC), Canonsburg General Hospital (CGH), Allegheny Medical Practice Network (AMPN), Allegheny-Singer Research Institute (ASRI), West Penn Physician Practice Network (WPPPN), West Penn Allegheny Oncology Network (WPAON), Canonsburg General Hospital Ambulance Service, Inc. (CGH Ambulance), Alle-Kiski Medical Center Trust (AKMC Trust), Forbes Health Foundation (FHF), Suburban Health Foundation (SHF) and The Western Pennsylvania Hospital Foundation (WPHF). ASPN is a Pennsylvania non-profit and non-stock corporation that was formed on June 16, 1999 to provide clinical instruction and teaching services. Consisting primarily of physician specialists, ASPN is the sister organization to the primary care network of AMPN, which in combination, function as the faculty practice plan for WPAHS. ASPN employs full time specialty physicians who teach and provide clinical instruction to third and fourth year medical students from Drexel University College of Medicine. This instruction is provided at the hospitals operated by WPAHS, Inc., AKMC, and CGH. The charitable missions (including clinical and educational activities) of the WPAHS hospitals are carried out via the faculty and staff of ASPN. In keeping with its tradition of innovation and research, the Allegheny General Hospital (AGH) campus of WPAHS, Inc. is an affiliate site for the Philadelphia-based Drexel University College of Medicine, and is currently conducting studies in the neurosciences, human oncology, human genetics, cardiovascular and pulmonary disease, allergy and asthma, orthopaedics and trauma. AGH is also host to the headquarters of the National Surgical Adjuvant Breast and Bowel Project, the nation's largest breast cancer study, which is sponsored by the National Cancer Institute. This research activity is all conducted by ASPN physicians. ASPN consists of over 458 specialty and primary care physicians in the western Pennsylvania community, specializing in anesthesiology, cardiology, emergency medicine, neurosurgery, trauma, orthopaedics, neurology, pediatrics, obstetrics/gynecology, and general and specialty surgery at mulitple practice sites throughout the System's service area. In addition, ASPN physician-employees teach medical students, residents, interns and fellows serving at WPAHS, Inc. Instruction is both classroom-based and clinical-based. Clinical instruction refers to teaching medical knowledge, skills and procedures in the course of rendering medical care to patients. It includes performance of medical services by the physician-employees in the presence of medical students, interns, residents and fellows, and patient care by interns, residents and fellows under the supervision of the physician-employees. MISSION, VISION & VALUES Allegheny Health Network is a team of care givers committed to improving health and promoting wellness in our communities, one person at a time. We pledge to consistently deliver safe, compassionate quality healthcare by treating the whole person - body, mind and spirit. UNCOMPENSATED CARE To enhance the health status of the community in which it operates and consistent with its tax-exempt status, ASPN provides needed health care services to individuals regardless of their ability to pay for all or part of the services rendered. These services include both inpatient and outpatient services as well as access to an emergency room that is available 24 hours a day. The components of uncompensated care include charity care and unreimbursed costs of Medicaid. ASPN provided uncompensated care at a cost of $15,496,984 in Fiscal 2013. COMMUNITY ASSESSMENT Community Health Improvement Services and Community Benefit Operations include activities intended to improve community health. They extend beyond patient care activities and are subsidized by AMPN. The programs ranged from community health education to free clinics and screenings. AMPN provided the following community health improvement services and community benefit operations during Fiscal 2013 at an estimated cost of $240,608. Community Health Fairs - During the year, ASPN participated in various community health fairs. At these fairs, educational information is presented and ASPN physicians are present to address questions about health issues. Media Appearances - During the year, ASPN participated in various appearances on radio and television programs providing answers to a number of questions from the audience. Volunteering time to free clinics - During the year, ASPN participated in free clinics and food pantries throughout the area such as the North Side Christian Health Center and the Gluten Free Food Pantry. Health Professions Education - ASPN provides health professionals with educational opportunities to advance their careers in healthcare. ASPN provided the following health professions education during Fiscal 2013. Residents, Interns and Fellowship Training - ASPN's physician-employees teach medical students, residents, interns and fellows serving at WPAHS, Inc. facilities. Instruction is both classroom-based and clinical-based. Clinical instruction refers to teaching medical knowledge, skills and procedures in the course of rendering medical care to patients. It includes performance of medical services by the physician-employees in the presence of medical students, interns, residents and fellows, and patient care by interns, residents and fellows under the supervision of the physician-employees. During fiscal year 2013, ASPN provided $4,895,912 in undergraduate medical education. Financial Contributions - ASPN supports the community through cash contributions made at the discretion of ASPN and its directors, benefiting not only the non-profit recipient but ultimately the community as a whole. ASPN made cash contributions totaling $8,675 including the following: National Kidney Foundation American Heart Association Temple Sinai Western Pennsylvania Humane Society Washington County Co-Habitat for Humanity American Liver Foundation National Pancreas Foundation Quaker Valley High School soccer team Phipps Conservatory Wine Under Glass Event Mon Valley Gala Tabernacle Cosmopolitan Baptist Church Brian Aneurysm Foundation American Diabetes Association American Liver Foundation Community-Building Activities - Community building activities include activities engaged in for the purpose of improving or protecting the health, future and wellbeing of the community. ASPN participated in the following community building activities during the fiscal year at an estimated cost of $117,803 Leadership Development and Training - Several ASPN physicians provided and participated in various community activities providing education and training for mental health professionals, teachers, and guidance counselors involved with children and families on multiple topics including trauma and grief. Board and Committee Membership - Several ASPN physicians sit on community advisory boards and councils. The boards and counsels include various foundations and medical advisory boards. School Career Days - Several ASPN physicians participated in community activities providing education at school functions. activities providing education at school functions.
Operational Oversight By A Third Party Management Company Form 990, Page 6, Part VI, Section A, Line 3 Allegheny Specialty Practice Network (ASPN) is a member of the West Penn Allegheny Health System (System). The System consists of thirteen operational IRC Section 501(c)(3) organizations. The parent organization for ASPN and the other eleven operational IRC Section 501(c)(3) organizations is West Penn Allegheny Health System, Inc. (WPAHS, Inc.). The board of directors of WPAHS, Inc. is comprised of a majority of independent members. Effective November 7, 2011 (Effective Date), the board of directors of WPAHS, Inc. engaged Alvarez and Marsal Healthcare Industry Group, LLC (A&M)to assign an Interim Chief Executive Officer of the System, Interim Chief Operating Officer of the System and Interim Chief Financial Officer of the System. All individuals appointed to their respective positions are under the employment of A&M and have daily oversight of all matters pertinent to the operation of the System as a whole and all organizations on an independent basis. All interim management personnel under the employment of A&M are responsible to and report to the WPAHS, Inc. board of directors. The term of the engagement is to last one year from the effective date with the option to renew the engagement beyond the initial one year term. During the course of the engagement, the WPAHS, Inc. board of directors upon written notice may cause any individual employed by A&M to be removed from their respective position and replaced by another similarly qualified individual. On April 29, 2013 West Penn Allegheny Health System, Inc., the sole member of the Allegheny Specialty Practice Network consummated a formal affiliation to establish a regional integrated health care services delivery system. With the establishment of this formal affiliation, the management team from A & M were removed from their respective positions and ceased to provide management services.
Changes to the Organizational Governing Documents Form 990, Page 6, Part VI, Section A, Line 4 The bylaws of Allegheny Specialty Practice Network (ASPN) were amended effective May 17, 2013 to reflect an affiliation with Highmark Health, EIN: 45-3674900 and the creation of a regional integrated healthcare delivery system, the parent organization of which is Allegheny Health Network, EIN: 45-3674924. In accordance with the affiliation, Highmark Health assumed certain reserve powers over Allegheny Specialty Practice Network. Among the reserve powers given to Highmark Health includes the right to approve the election, re-election and removal of all officers of the corporation; to amend, revise and restate the corporation's Articles of Incorporation and Bylaws; adopt or change the mission, purpose, philosophy or objective of the corporation; to change the general structure of the corporation; to dissolve or liquidate, consolidate or merge and sell or acquire assets in excess of certain thresholds; approve the capital, operating plan and budget of the corporation; approve the incurrence of debt by the corporation and the making of capital expenditures in excess of certain thresholds; to approve donations or other transfers in excess of certain thresholds; approve the strategic plan and mission statement; approve investment policies; approve the closure or relocation of a licensed healthcare facility; approve the creation of or dissolution of subsidiary corporations, partnerships or other joint ventures in excess of certain thresholds; manage the corporations program for compliance with all legal requirements; selection of auditors and the designation of the fiscal year of the corporation.
Form 990 Review Process Form 990, Page 6, Part VI, Section B, Line 11b The IRS Form 990 of the Allegheny Specialty Practice Network was prepared by the Highmark Health Tax Department. Prior to filing the final tax return with the Internal Revenue Service, members of senior management reviewed components of the tax return and the voting members of the governing body received a copy of the tax return.
Monitoring and Enforcement of the Conflict of Interest Policy Form 990, Page 6, Part VI, Section B, Line 12c Allegheny Specialty Practice Network is a member of the West Penn Allegheny Health System (WPAHS). WPAHS has a corporate compliance department that monitors and oversees compliance with the conflict of interest policy of all organizations in the health system. The following describes the manner in which the corporate compliance department monitors and oversees compliance with the conflict of interest policy for Allegheny Specialty Practice Network. Conflict of Interest disclosure forms are completed on an annual basis by all board members, officers, employees who have a title of Manager and above, physicians in leadership roles, Pharmacy and Therapeutic Committee members, all employees of the System's Compliance and Internal Audit Department as well as personnel involved with contracting in the Corporate Purchasing Department. Upon completion of the above disclosure statement by all applicable individuals, a report is generated listing all individuals that have reported a conflict. The System Compliance Officer and General Counsel review the conflicts disclosed. Those that require additional information or clarification receive a letter from the Compliance Officer requesting such. Once received, all additional information is added to the report and again reviewed by the Compliance Officer and General Counsel. Those conflicts that require a mitigation plan are sent to the respective organization's senior management for development of the mitigation plan. The organization's senior management is responsible to discuss the mitigation plan with the individual as needed and monitor compliance with the mitigation plan. Once mitigation is received, a final report is reviewed with the System Executive Compliance Council with the Legal Department and the Allegheny Health Network(AHN)senior management and finally the AHN Audit & Compliance Committee of the Board.
Process Used To Determine Executive Compensation Form 990, Page 6, Part VI, Section B, Line 15b The West Penn Allegheny Health Systems (WPAHS) process for determining compensation for executive positions (including officers, key employees and other management positions) within Allegheny Specialty Practice Network is covered by the WPAHS Executive Compensation Policy. This policy was approved by the West Penn Allegheny Health System, Inc. Board of Directors. It is the policy of WPAHS and its Board of Directors to compensate its executives in accordance with the market and in relation to the experience, service and accomplishments of the individual both prior to and during their service with WPAHS. The Compensation Committee of the West Penn Allegheny Health System, Inc. Board of Directors approves the compensation for WPAHS senior executives. The Compensation Committee approves the initial compensation for newly hired senior executives, which shall include all compensation components, including without limitation, base compensation, incentive compensation, deferred compensation, fringe and other benefits, as well as the total compensation. It shall also approve all base compensation adjustments and all incentive compensation awards, as well as material changes to deferred compensation, fringe, or other benefits. The Compensation Committee uses comparability data provided by the System Human Resources Department, which may include industry surveys, expert compensation studies, documented compensation of persons holding similar positions, or other comparable data in approving any executive compensation. The Compensation Committee shall periodically retain the services of an independent compensation consultant to provide an expert opinion report as to the reasonableness of total compensation of Allegheny Specialty Practice Network officers and key employees. Each Compensation Committee member voting on a senior executive's compensation arrangement ensures that he or she has no conflict of interest, including that he or she (a) does not economically benefit from the proposed employment; (b) does not receive compensation subject to the approval of the proposed employee; and (c) has no material financial interest affected by the transaction. The Compensation Committee consists of five independent Board Members of West Penn Allegheny Health System, Inc. All decisions of the Compensation Committee regarding executive compensation matters are documented.
Public Availability of Organizational Documents Form 990, Page 6, Part VI, Section C, Line 19 Allegheny Specialty Practice Network (ASPN) does not make its governing documents available to the public. ASPN is a member of the West Penn Allegheny Health System (WPAHS). The WPAHS makes available their annual and quarterly financial statements through the use of a dissemination agent. These financial statements are on a consolidated basis with ASPN being one of the consolidated entities. In addition, the WPAHS annual report and quarterly financial results are available on the WPAHS website. WPAHS has adopted a conflict of interest policy that is uniformly applied to all organizations of the health system, including ASPN. A condensed version of this conflict of interest policy is available on the WPAHS website. List of Officers, Directors or Key Employees of ASPN Form 990, Part VII, Section A The following list represents Officers, Directors or Key Employees of Allegheny Specialty Practice Network listed on Form 990, Part VII who did not serve a full consecutive twelve month tenure during the year ended June 30, 2013 along with the dates served: Robert Brandfass 07-01-2012 - 11-16-2012 Michael Sirott 02-28-2013 - 06-30-2013
Officer, Director and Key Employee Hour Allocation Form 990, Page 7, Part VII, Section A, Column B Allegheny Specialty Practice Network (ASPN) is part of an integrated healthcare delivery system named West Penn Allegheny Health System. Individuals employed by one organization may be assigned to provide management for an affiliated organization. As such, many individuals play key roles or serve as officers or directors on multiple affiliated organizations. Each individual will be assigned forty hours to the organization of their actual employment. If the individual is employed by one organization and appointed as an officer, director or key employee of affiliated organizations the hour allocation on Form 990, Part VII, Page 7, Column (B) takes various factors into account when attempting to assign hours in a reasonable manner. Thus, it is possible for a single individual to have hours assigned in excess of forty hours per week if all affiliated organization IRS Forms 990 is taken into account. The actual time served for all individuals disclosed in IRS Form 990 can vary based upon the need of the organization.
Rental Expense Form 990, Page 9, Part VIII, Line 6b Allegheny Specialty Practice Network does not account for rental expenses in a manner that would allow us to reflect the expense as a direct offset to rental income. The components of rental expense are reflected on Form 990, Page 10, Statement of Functional Expenses.
Health System Tax Exempt Bond Issuance Form 990, Page 10, Part X, Line 20 Allegheny Specialty Practice Network is a member of the West Penn Allegheny Health System obligated group in regards to 2007 Allegheny County Hospital Development Authority tax-exempt bonds. The purpose of the issue of the Allegheny County Hospital Development Authority (ACHDA) Hospital Revenue Bonds, Series 2007 A is to refund the outstanding ACHDA Series 2000A and B Bond Issues, refund the Dauphin County General Authority (DCGA) Series 1992A and B Hospital Bonds, the Pennsylvania Higher Education Facility Authority (PHEFA) Series 1991A Revenue Bonds, the Monroeville Hospital Authority (MHA) Series 1992 and 1995 Revenue Bonds, the funding of a project fund for certain prior and future capital expenditures and to pay the cost of issuing Series 2007A Debt. No internal allocation of debt has been made to Allegheny Specialty Practice Network, however, the organization's assets are security for purposes of this bond issue.
Other Changes in Net Assets Form 990, Page 12, Part XI, Line 9 The following represents a reconciliation of the other changes in net assets of Allegheny Specialty Practice Network for the year ended June 30, 2013: Net Transfers From Affiliated Organizations $ 98,170,170 Change in Minimum Pension Liability 70,654,634 Purchase Accounting Adjustment (77,649,873) Temporarily Restricted Net Assets 1,048 ____________ Other Changes In Net Assets $ 91,175,979
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2012

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
Allegheny Specialty Practice Network
 
Employer identification number

25-1838458
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" to Form 990, Part IV, line 33.)
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity











Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1) Highmark Health

120 Fifth Ave Suite 922

Pittsburgh,PA15222
45-3674900
Healthcare PA 501(c)(3) 11-I NA
 
 
No
(2) Allegheny Health Network

120 Fifth Ave Suite 922

Pittsburgh,PA15222
45-3674924
Healthcare PA 501(c)(3) 11-I Highmark Hea
 
 
No
(3) Allegheny Medical Practice Network

4800 Friendship Ave

Pittsburgh,PA15224
25-1838457
Healthcare PA 501(c)(3) 3 WPAHS Inc
 
 
No
(4) Allegheny Singer Research Institute

320 East North Ave

Pittsburgh,PA15212
25-1320493
Sci Research PA 501(c)(3) 4 WPAHS Inc
 
 
No
(5) Alle-Kiski Medical Center

1301 Carlisle Street

Pittsburgh,PA15065
25-1875178
Healthcare PA 501(c)(3) 3 WPAHS Inc
 
 
No
(6) Alle-Kiski Medical Center Trust

1301 Carlisle Street

Pittsburgh,PA15065
20-5855753
Fundraising PA 501(c)(3) 11-I AKMC
 
 
No
(7) Canonsburg General Hospital

100 Medical Blvd

Canonsburg,PA15317
25-1737079
Healthcare PA 501(c)(3) 3 WPAHS Inc
 
 
No
(8) Canonsburg General Hospital Ambulance Se

100 Medical Blvd

Canonsburg,PA15317
23-2939715
ER Response PA 501(c)(3) 9 CGH
 
 
No
(9) Canonsburg Hospital & Health Foundation

100 Medical Blvd

Canonsburg,PA15317
25-1818505
Inactive PA 501(c)(3) 11-I NA
 
 
No
(10) Forbes Health Foundation

2570 Haymaker Rd

Monroeville,PA15146
25-1798379
Fundraising PA 501(c)(3) 7 WPAHS Inc
 
 
No
(11) Greater Canonsburg Health System

100 Medical Blvd

Canonsburg,PA15317
25-1488089
Inactive PA 501(c)(3) 11-I NA
 
 
No
(12) Suburban Health Foundation

100 South Jackson Ave

Pittsburgh,PA15202
25-1472073
Fundraising PA 501(c)(3) 11-I WPAHS Inc
 
 
No
(13) The Western Pennsylvania Hospital Founda

4800 Friendship Ave

Pittsburgh,PA15224
25-1470766
Fundraising PA 501(c)(3) 11-I WPAHS Inc
 
 
No
(14) West Allegheny Hospital

100 Medical Blvd

Pittsburgh,PA15317
25-1054206
Inactive PA 501(c)(3) 3 NA
 
 
No
(15) West Penn Allegheny Health System Inc

Two Allegheny Ctr

Pittsburgh,PA15212
25-0969492
Healthcare PA 501(c)(3) 3 AHN
 
 
No
(16) West Penn Allegheny Oncology Network

4800 Friendship Ave

Pittsburgh,PA15224
11-3683376
Healthcare PA 501(c)(3) 11-III FL WPAHS Inc
 
 
No
(17) West Penn Physician Practice Network

4800 Friendship Ave

Pittsburgh,PA15224
25-1494317
Healthcare PA 501(c)(3) 9 WPAHS Inc
 
 
No
(18) JRMCUPMC Cancer Associates

565 Coal Valley Rd

Jefferson Hills,PA15236
20-1634783
Healthcare PA 501(c)(3) 3 NA
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


Yes No Yes No
(1) Employee Benefit Data Services Company

120 Fifth Ave Suite 922
Pittsburgh,PA15222
25-1824465
Data Services PA  
NONE 0 0   No 0   No 0 %
(2) Gateway Health Plan LP

444 Liberty Avenue Suite 2100
Pittsburgh,PA15222
25-1691945
Insurance PA  
NONE 0 0   No 0   No 0 %
(3) Jenkins Empire Associates

120 Fifth Ave Suite 922
Pittsburgh,PA15222
25-1524682
Property Mgmt PA  
NONE 0 0   No 0   No 0 %
(4) Silver Rain LP

120 Fifth Ave Suite 922
Pittsburgh,PA15222
27-3035436
Property Mgmt PA  
NONE 0 0   No 0   No 0 %
(5) Provider PPI LLC

120 Fifth Ave Suite 922
Pittsburgh,PA15222
32-0429947
Facilities Suppor PA  
NONE 0 0   No 0   No 0 %
(6) Chartwell Pennsylvania LP

120 Fifth Ave Suite 922
Pittsburgh,PA15222
Medical Practice PA  
NONE 0 0   No 0   No 0 %
(7) Waterfront Surgery Assoc

120 Fifth Ave Suite 922
Pittsburgh,PA15222
Medical Practice PA  
NONE 0 0   No 0   No 0 %
(8) Waterfront Medical Assoc

120 Fifth Ave Suite 922
Pittsburgh,PA15222
Medical Practice PA  
NONE 0 0   No 0   No 0 %
(9) Upper Midwest Consol Services Ctr LLC

120 Fifth Ave Suite 922
Pittsburgh,PA15222
Medical Practice PA  
NONE 0 0   No 0   No 0 %
(10) UPMC VNA Home Health

120 Fifth Ave Suite 922
Pittsburgh,PA15222
25-1844485
Medical Practice PA  
NONE 0 0   No 0   No 0 %
(11) 5148 Liberty Avenue Associates

4800 Friendship Ave
Pittsburgh,PA15224
Medical Practice PA  
NONE 0 0   No 0   No 0 %
(12) Allegheny Imaging of McCandless

4800 Friendship Ave
Pittsburgh,PA15224
Medical Practice PA  
NONE 0 0   No 0   No 0 %
(13) Forbes Regional Urologic

4800 Friendship Ave
Pittsburgh,PA15224
Medical Practice PA  
NONE 0 0   No 0   No 0 %
(14) McCandless Endoscopy Center

4800 Friendship Ave
Pittsburgh,PA15224
Medical Practice PA  
NONE 0 0   No 0   No 0 %
(15) North Shore Endoscopy Center

4800 Friendship Ave
Pittsburgh,PA15224
Medical Practice PA  
NONE 0 0   No 0   No 0 %
(16) West Penn Ambulatory Center

15305 Dallas Parkway
Pittsburgh,PA15224
27-2344847
Medical Practice PA  
NONE 0 0   No 0   No 0 %
(17) Peters Ambulatory Surgery Ctr LLC

4800 Friendship Ave
Pittsburgh,PA15224
Medical Practice PA  
NONE 0 0   No 0   No 0 %
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) Delaware Ancillary Insurance Agency

800 Delaware Avenue
Wilmington,DE198011368
51-0383213
Insurance Service DE Highmark Inc
 
C Corporation          
(2) The Gateway Group LTD

800 Delaware Avenue
Wilmington,DE198011368
51-0293417
Benefit Administr DE Highmark Inc
 
C Corporation          
(3) Highmark BCBSD Inc

800 Delaware Avenue
Wilmington,DE198011368
51-0020405
Insurance DE Highmark Inc
 
C Corporation          
(4) Davis Vision Inc

175 East Houston Street
San Antonio,TX78205
11-3051991
Vision Service TX Highmark Inc
 
C Corporation          
(5) Davis Vision IPA Inc

175 East Houston Street
San Antonio,TX78205
11-2958041
TPA TX Highmark Inc
 
C Corporation          
(6) Visionworks Distribution Services Inc

175 East Houston Street
San Antonio,TX78205
04-3742989
Optical Retail TX Highmark Inc
 
C Corporation          
(7) Visionworks Enterprises Inc

175 East Houston Street
San Antonio,TX78205
35-2196998
Trademarks TX Highmark Inc
 
C Corporation          
(8) ECCA Managed Vision Care Inc

175 East Houston Street
San Antonio,TX78205
74-2759084
Physician Service TX Highmark Inc
 
C Corporation          
(9) Empire Vision Center Inc

175 East Houston Street
San Antonio,TX78205
14-1586016
Retail Sales TX Highmark Inc
 
C Corporation          
(10) Eye Drx Retail Management Inc

175 East Houston Street
San Antonio,TX78205
74-2924030
Office Administra TX Highmark Inc
 
C Corporation          
(11) Visionworks Inc

175 East Houston Street
San Antonio,TX78205
02-0677066
Optical Retail TX Highmark Inc
 
C Corporation          
(12) Gateway Health Plan Inc

444 Liberty Avenue Suite 2100
Pittsburgh,PA15222
25-1505506
Insurance PA Highmark Inc
 
C Corporation          
(13) Gateway Health Plan of Ohio Inc

444 Liberty Avenue Suite 2100
Pittsburgh,PA15222
30-0282076
Insurance PA Highmark Inc
 
C Corporation          
(14) HM Broker Services Inc

120 Fifth Ave Suite 922
Pittsburgh,PA15222
23-2384777
Marketing Agent PA Highmark Inc
 
C Corporation          
(15) HCI Inc

120 Fifth Ave Suite 922
Pittsburgh,PA15222
75-3002215
Finance & Insuran PA Highmark Inc
 
C Corporation          
(16) Highmark Casualty Insurance Company

120 Fifth Ave Suite 922
Pittsburgh,PA15222
25-1334623
Insurance PA Highmark Inc
 
C Corporation          
(17) HM Health Insurance Company

120 Fifth Ave Suite 922
Pittsburgh,PA15222
54-1637426
Insurance Sales PA Highmark Inc
 
C Corporation          
(18) Highmark Inc

120 Fifth Ave Suite 922
Pittsburgh,PA15222
23-1294723
Insurance PA Highmark Inc
 
C Corporation          
(19) HM Casualty Insurance Company

120 Fifth Ave Suite 922
Pittsburgh,PA15222
87-0807723
Insurance Sales PA Highmark Inc
 
C Corporation          
(20) HM Benefits Administrators Inc

120 Fifth Ave Suite 922
Pittsburgh,PA15222
25-1128451
Funds Administrat PA Highmark Inc
 
C Corporation          
(21) HM Captive Insurance Company

120 Fifth Ave Suite 922
Pittsburgh,PA15222
65-1274122
Insurance PA Highmark Inc
 
C Corporation          
(22) HM Insurance Group

120 Fifth Ave Suite 922
Pittsburgh,PA15222
25-1646315
Management Servic PA Highmark Inc
 
C Corporation          
(23) Highmark West Virginia

PO Box 1948
Parkersburg,WV26102
55-0624615
Insurance Sales WV Highmark Inc
 
C Corporation          
(24) HM Life Insurance Company

120 Fifth Ave Suite 922
Pittsburgh,PA15222
06-1041332
Insurance Sales PA Highmark Inc
 
C Corporation          
(25) HM Life Insurance Company of New York

120 Fifth Ave Suite 922
Pittsburgh,PA15222
25-1800302
Insurance Sales PA Highmark Inc
 
C Corporation          
(26) Highmark Senior Resources

120 Fifth Ave Suite 922
Pittsburgh,PA15222
20-2353206
Insurance Sales PA Highmark Inc
 
C Corporation          
(27) HVHC Inc

175 East Houston Street
San Antonio,TX78205
25-1801124
Holding Company TX Highmark Inc
 
C Corporation          
(28) Highmark Ventures Inc

120 Fifth Ave Suite 922
Pittsburgh,PA15222
25-1645888
Holding Company PA Highmark Inc
 
C Corporation          
(29) JEA Inc

120 Fifth Ave Suite 922
Pittsburgh,PA15222
25-1712017
Management Servic PA Highmark Inc
 
C Corporation          
(30) Keystone Health Plan West Inc

120 Fifth Ave Suite 922
Pittsburgh,PA15222
25-1522457
Insurance Sales PA Highmark Inc
 
C Corporation          
(31) Miracle Optics Inc

3140 Route 22 West
Somerville,NJ08876
95-4481411
Trading NJ Highmark Inc
 
C Corporation          
(32) Parker Benefits

PO Box 1948
Parkersburg,WV26102
55-0625743
TPA WV Highmark Inc
 
C Corporation          
(33) South Shore Optometrists PC

2921 Erie Boulevard
Syracuse,NY13224
04-3429510
Health Care NY Highmark Inc
 
C Corporation          
(34) Standard Property Corporation

120 Fifth Ave Suite 922
Pittsburgh,PA15222
25-1668093
Real Estate Opera PA Highmark Inc
 
C Corporation          
(35) Union Benefit Management Inc

120 Fifth Ave Suite 922
Pittsburgh,PA15222
25-1845908
Benefit Plan Mgmt PA Highmark Inc
 
C Corporation          
(36) United Concordia Companies Inc

4401 Deer Path Road
Harrisburg,PA17110
25-1687586
Dental Insurance PA Highmark Inc
 
C Corporation          
(37) United Concordia Dental Corporation of

4401 Deer Path Road
Harrisburg,PA17110
63-1028262
Dental Insurance PA Highmark Inc
 
C Corporation          
(38) United Concordia Dental Plans of Califor

4401 Deer Path Road
Harrisburg,PA17110
23-7328765
Dental Insurance PA Highmark Inc
 
C Corporation          
(39) United Concordia Dental Plans of Florida

4401 Deer Path Road
Harrisburg,PA17110
65-0243292
Dental Insurance PA Highmark Inc
 
C Corporation          
(40) United Concordia Dental Plans Inc

4401 Deer Path Road
Harrisburg,PA17110
52-1542269
Dental Insurance PA Highmark Inc
 
C Corporation          
(41) United Concordia Dental Plans of Kentuck

4401 Deer Path Road
Harrisburg,PA17110
61-1012900
Dental Insurance PA Highmark Inc
 
C Corporation          
(42) United Concordia Dental Plans of the Mid

4401 Deer Path Road
Harrisburg,PA17110
38-2289438
Dental Insurance PA Highmark Inc
 
C Corporation          
(43) United Concordia Dental Plans of Pennsyl

4401 Deer Path Road
Harrisburg,PA17110
23-2541529
Dental Insurance PA Highmark Inc
 
C Corporation          
(44) United Concordia Dental Plans of Texas

4401 Deer Path Road
Harrisburg,PA17110
74-2489037
Dental Insurance PA Highmark Inc
 
C Corporation          
(45) United Concordia Insurance Company

4401 Deer Path Road
Harrisburg,PA17110
86-0307623
Dental Insurance PA Highmark Inc
 
C Corporation          
(46) United Concordia Insurance Company of Ne

4401 Deer Path Road
Harrisburg,PA17110
11-3008245
Dental Insurance PA Highmark Inc
 
C Corporation          
(47) United Concordia Life and Health Insuran

4401 Deer Path Road
Harrisburg,PA17110
23-1661402
Dental Insurance PA Highmark Inc
 
C Corporation          
(48) Visionworks Lab Services Inc

175 East Houston Street
San Antonio,TX78205
04-3742977
Optical Retail TX Highmark Inc
 
C Corporation          
(49) Visionary Properties Inc

175 East Houston Street
San Antonio,TX78205
74-2849554
Leasing TX Highmark Inc
 
C Corporation          
(50) Visionary Retail Management Inc

175 East Houston Street
San Antonio,TX78205
74-2849552
Office Administra TX Highmark Inc
 
C Corporation          
(51) Viva Europa Inc

3140 Route 22 West
Somerville,NJ08876
22-3390239
Investing NJ Highmark Inc
 
C Corporation          
(52) Viva International Inc

3140 Route 22 West
Somerville,NJ08876
22-3106453
Wholesale Distrib NJ Highmark Inc
 
C Corporation          
(53) Viva IP Corp

3140 Route 22 West
Somerville,NJ08876
22-3841079
Holding Company NJ Highmark Inc
 
C Corporation          
(54) Viva Optique Inc

3140 Route 22 West
Somerville,NJ08876
22-2192365
Wholesale Distrib NJ Highmark Inc
 
C Corporation          
(55) Visionworks of America Inc

175 East Houston Street
San Antonio,TX78205
74-2337775
Retail Sales TX Highmark Inc
 
C Corporation          
(56) West Virginia Family Health Plan Inc

1219 Virginia Street East
Charleston,WV25301
45-2763165
Insurance WV Highmark Inc
 
C Corporation          
(57) Prime Medical Group PCG 1

1200 Brooks Ln 110
Clairton,PA15025
26-4194208
Medical Practice PA JRMC
 
C Corporation          
(58) Primary Care Group 2 Inc

6011 Baptist Rd Ste 220
Pittsburgh,PA15236
90-0451375
Medical Practice PA JRMC
 
C Corporation          
(59) Primary Care Group 3 Inc

5426 Mifflin Rd
Pittsburgh,PA15227
90-0451380
Medical Practice PA JRMC
 
C Corporation          
(60) Primary Care Group 4 Inc

1907 Lebanon Church Rd
West Mifflin,PA15122
80-0403090
Medical Practice PA JRMC
 
C Corporation          
(61) Primary Care Group 5 Inc

624 Monongahela Ave
Glassport,PA15045
80-0403100
Medical Practice PA JRMC
 
C Corporation          
(62) Primary Care Group 6 Inc

PO Box 333
West Mifflin,PA15122
45-3684432
Medical Practice PA JRMC
 
C Corporation          
(63) Primary Care Group 7 Inc

575 Coal Valley Rd
Jefferson Hills,PA15025
90-0503600
Medical Practice PA JRMC
 
C Corporation          
(64) Primary Care Group 8 Inc

803 Miller Ave
Clairton,PA15025
01-0927360
Medical Practice PA JRMC
 
C Corporation          
(65) Primary Care Group 9 Inc

1200 Brooks Ln 270
Clairton,PA15025
01-0929359
Medical Practice PA JRMC
 
C Corporation          
(66) Primary Care Group 10 Inc

3726 Brownsville Rd
Pittsburgh,PA15227
38-3807173
Medical Practice PA JRMC
 
C Corporation          
(67) Primary Care Group 11 Inc

455 Valley Brook Rd Ste 300
McMurray,PA15317
80-0494617
Medical Practice PA JRMC
 
C Corporation          
(68) Primary Care Group 12 Inc

17 Arentzen Blvd Ste 101
Charleroi,PA15022
90-0614054
Medical Practice PA JRMC
 
C Corporation          
(69) Park Cardiothoracic & Vascular Inst

565 Coal Valley Rd
Jefferson Hills,PA15236
72-1529328
Medical Practice PA JRMC
 
C Corporation          
(70) Family Practice Medical Associates South

2414 Lytle Rd Ste 300
Bethel Park,PA15102
25-1684735
Medical Practice PA JRMC
 
C Corporation          
(71) Health System Services Corp & Subs

565 Coal Valley Rd
Jefferson Hills,PA15236
25-1403745
Medical Office Bl PA JRMC
 
C Corporation          
(72) JRMC Health Pavilion

565 Coal Valley Rd
Jefferson Hills,PA15236
25-1203449
Medical Practice PA JRMC
 
C Corporation          
(73) HSSC Diversified Services Inc

565 Coal Valley Rd
Jefferson Hills,PA15236
25-1770047
Medical Practice PA JRMC
 
C Corporation          
(74) Specialty Group Practice 1 Inc

575 Coal Valley Rd Ste 365
Jefferson Hills,PA15025
35-2367818
Medical Practice PA JRMC
 
C Corporation          
(75) Grandis Rubin Shanahan & Assoc

565 Coal Valley Rd
Jefferson Hills,PA15236
45-3355906
Medical Practice PA JRMC
 
C Corporation          
(76) Steel Valley Orthopedics & Sports Medici

1200 Brooks Ln 240
Clairton,PA15025
45-3540378
Medical Practice PA JRMC
 
C Corporation          
(77) Jefferson Hills Surgical Specialists PA

1200 Brooks Ln 150
Clairton,PA15025
30-0477313
Medical Practice PA JRMC
 
C Corporation          
(78) JRMC Specialty Group Practice

565 Coal Valley Rd
Jefferson Hills,PA15236
72-1529332
Medical Practice PA JRMC
 
C Corporation          
(79) JRMC Physician Service Corp

565 Coal Valley Rd
Jefferson Hills,PA15236
86-1159658
Medical Practice PA JRMC
 
C Corporation          
(80) Pace Re Ltd

565 Coal Valley Rd
Jefferson Hills,PA15236
98-1109020
Medical Practice PA JRMC
 
C Corporation          
(81) Pittsburgh Bone Joint and Spine Inc

565 Coal Valley Rd
Jefferson Hills,PA15236
25-1203449
Medical Practice PA JRMC
 
C Corporation          
(82) West Penn Corporate Medical Services In

4800 Friendship Avenue
Pittsburgh,PA15224
25-1437405
Medical Practice PA WPAHS Inc
 
C Corporation          
(83) West Penn Neurosurgery PC

4800 Friendship Avenue
Pittsburgh,PA15224
25-1630719
Medical Practice PA WPAHS Inc
 
C Corporation          
(84) Burn Care Associates Ltd

4800 Friendship Avenue
Pittsburgh,PA15224
23-2899534
Medical Practice PA WPAHS Inc
 
C Corporation          
(85) Medical Center Clinic PC

4800 Friendship Avenue
Pittsburgh,PA15224
23-2894939
Medical Practice PA WPAHS Inc
 
C Corporation          
(86) Optima Imaging

4800 Friendship Avenue
Pittsburgh,PA15224
25-1652874
Medical Practice PA WPAHS Inc
 
S Corporation          
(87) HMPG Inc

120 Fifth Ave Suite 922
Pittsburgh,PA15222
45-3444325
Holding Company PA Highmark Inc
 
C Corporation          
(88) Physician Landing Zone PC

120 Fifth Ave Suite 922
Pittsburgh,PA15222
45-3913973
Health Care PA HMPG Inc
 
C Corporation          
(89) Lake Erie Medical Group PC

120 Fifth Ave Suite 922
Pittsburgh,PA15222
45-3444157
Health Care PA HMPG Inc
 
C Corporation          
(90) Premier Medical Associates PC

120 Fifth Ave Suite 922
Pittsburgh,PA15222
25-1742869
Health Care PA HMPG Inc
 
C Corporation          
(91) Beam Medical Associates PC

120 Fifth Ave Suite 922
Pittsburgh,PA15222
28-1816080
Health Care PA HMPG Inc
 
C Corporation          
(92) Palladium Risk Retention Group

120 Fifth Ave Suite 922
Pittsburgh,PA15222
46-3476730
Health Care PA HMPG Inc
 
C Corporation          
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
 
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved





Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under section 512-514)

(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V—UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Transactions with Affiliated Organizations Schedule R, Part V, Line 2 Allegheny Specialty Practice Network has chosen not to complete Schedule R, Part V, line 2. The disclosure of this information is only required for organizations listed in Schedule R, Part V, line 2 that are controlled entities within the meaning of section 512(b)(13). No organization listed in Schedule R, Part V, line 2 is a controlled entity within the meaning of section 512(b)(13) for Allegheny Specialty Practice Network.

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