TY 2013 Form 990

(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)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) Nancy Decker........................................................................ Chairman	1.00 .......................1.00	X	X	0	0
(2) Charles Watson........................................................................ Vice Chairman	1.00 .......................1.00	X	X	0	0
(3) Steven Handy........................................................................ Current CEO/Secretary Prior CFO/Asst Sec/Treas	1.00 .......................40.00	X	X	1,465,637	36,606
(4) Barbara Weiss........................................................................ CFO/Treasurer beginning 05/14	1.00 .......................40.00	X	X	99,936	25,711
(5) Robert Garrett........................................................................ Asst Secretary/Treasurer	1.00 .......................1.00	X	X	0	0
(6) Jason Cox........................................................................ Director beginning 05/14	1.00 .......................1.00	X		0	0
(7) Michael George DDS........................................................................ Director	1.00 .......................1.00	X		0	0
(8) John Malone........................................................................ Director	1.00 .......................1.00	X		0	0
(9) Suzanne McMonagle........................................................................ Director	1.00 .......................1.00	X		0	0
(10) Louise Monaghan........................................................................ Director	1.00 .......................1.00	X		0	0
(11) William Smith........................................................................ Director	1.00 .......................1.00	X		0	0
(12) Malcolm Stone DDS........................................................................ Director beginning 05/14	1.00 .......................1.00	X		0	0
(13) William Ulmer........................................................................ Director	1.00 .......................1.00	X		0	0
(14) Paul Hartley MD........................................................................ Director	1.00 .......................	X		0	0
(15) Josef Vanek MD........................................................................ Director	1.00 .......................	X		0	0
(16) Ari Pressman MD........................................................................ Director	1.00 .......................	X		0	0
(17) Cataldo Corrado MD........................................................................ Director end date 04/14	1.00 .......................1.00	X		0	0

(A) Name and business address	(B) Description of services	(C) Compensation
Quest Diagnostics12436 Collections Ctr DrChicagoIL60693	Laboratory Services	1,039,880
Phoenix Health Systems Inc1130 E Arapaho RoadRichardsonTX75081	Information Technology Services	807,114
Executive Health Resources Inc15 Campus Boulevard Suite 200Newtown SquarePA19073	Medical Record Consulting Services	633,461
UPMC Emergency Medicine Inc2 Hot Metal Street - 2nd FloorPittsburghPA15203	Contracted Physicians	631,846
UPMCPO Box 223270PittsburghPA15251	Mgmt Fees/Contracted Services	587,952
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 24

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	0
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 ....	0
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	44,235,064	34,503,350	9,731,714
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	2,694,172	2,101,454	592,718
9	Other employee benefits .......	7,596,367	5,925,166	1,671,201
10	Payroll taxes ...........	3,528,811	2,752,473	776,338
11	Fees for services (non-employees):
a	Management ......	6,835,677	2,734,271	4,101,406
b	Legal .........	41,902		41,902
c	Accounting ...........	93,622		93,622
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	43,594		43,594
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	2,428,767	1,894,438	534,329
12	Advertising and promotion ....	2,395	1,868	527
13	Office expenses .......	1,400,067	1,092,052	308,015
14	Information technology ......	5,861,576	4,572,029	1,289,547
15	Royalties ..	0
16	Occupancy ...........	2,565,183	2,000,843	564,340
17	Travel ............	40,787	31,814	8,973
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	81,841	63,836	18,005
20	Interest ...........	1,861,603	1,452,050	409,553
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	8,778,256	6,847,040	1,931,216
23	Insurance ..............	1,779,586	1,388,077	391,509
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	DRUGS MEDICAL/SURGICAL SUPPLIES	20,924,822	20,924,822
b	BAD DEBT	4,186,825	4,186,825
c	EQUIPMENT RENTAL AND MAINTENANCE	4,921,533	3,838,796	1,082,737
d	MA MOD ASSESSMENT	2,380,818	2,380,818
e	All other expenses	1,488,269	1,364,649	123,620
25	Total functional expenses. Add lines 1 through 24e	123,771,537	100,056,671	23,714,866	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 if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	8,758,104	1	10,653,290
2	Savings and temporary cash investments .........	7,314,649	2	10,084,371
3	Pledges and grants receivable, net ...........		3
4	Accounts receivable, net .............	14,586,596	4	12,779,426
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
			5
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
			6
7	Notes and loans receivable, net .............		7
8	Inventories for sale or use ..............	2,230,912	8	2,172,184
9	Prepaid expenses and deferred charges ..........	1,153,204	9	816,698
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	178,587,579
b	Less: accumulated depreciation .....	10b	111,111,830	73,995,209	10c	67,475,749
11	Investments—publicly traded securities ..........	10,616,854	11	16,007,107
12	Investments—other securities. See Part IV, line 11 .....		12
13	Investments—program-related. See Part IV, line 11 .....	4,466,010	13	4,932,651
14	Intangible assets ...............		14
15	Other assets. See Part IV, line 11 ...........	1,839,296	15	904,433
16	Total assets. Add lines 1 through 15 (must equal line 34)......	124,960,834	16	125,825,909
	17	Accounts payable and accrued expenses .........	28,672,610	17	26,527,268
18	Grants payable .................		18
19	Deferred revenue ................	36,210	19	183,382
20	Tax-exempt bond liabilities .............	44,343,333	20	43,233,333
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
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..........		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ....		24
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....................	16,206,048	25	15,028,872
26	Total liabilities. Add lines 17 through 25.........	89,258,201	26	84,972,855
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	35,498,800	27	40,589,594
28	Temporarily restricted net assets ...........	174,931	28	233,982
29	Permanently restricted net assets ...........	28,902	29	29,478
	Organizations that do not follow SFAS 117 (ASC 958), check here 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 ...........	35,702,633	33	40,853,054
34	Total liabilities and net assets/fund balances ........	124,960,834	34	125,825,909

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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.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.
right arrow

Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

Uniontown Hospital

Employer identification number

25-0965588

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.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Non-functionally integrated

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

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)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(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
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of monetary support


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2013

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)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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).

Gross receipts from related activities, etc. (see instructions) ..................

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

Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f)) .........

0 %

Public support percentage for 2012 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2013. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2012. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2013. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2012. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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) 2013

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)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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.)..

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

Public support percentage for 2013 (line 8, column (f) divided by line 13, column (f)) .........

0 %

Public support percentage from 2012 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f)) ......

0 %

Investment income percentage from 2012 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2013. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ........ right arrow

33 1/3% support tests—2012. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2013

Page 4

Part IV

Supplemental Information. 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

Schedule A (Form 990 or 990-EZ) 2013

Additional Data

Software ID:	13000230
Software Version:	13.6.0.0

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Name of the organization

Uniontown Hospital

Employer identification number

25-0965588

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi) and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not total more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year ......................... Arrow Bullet

Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 2

Name of organization Uniontown Hospital

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTEDRESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 3

Name of organization Uniontown Hospital

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 4

Name of organization
Uniontown Hospital

Employer identification number

25-0965588

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

$
Use duplicate copies of Part III if additional space is needed.

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Additional Data

Software ID:	13000230
Software Version:	13.6.0.0

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

See separate instructions. SchCMd Bullet

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35c (Proxy Tax), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

Uniontown Hospital

Employer identification number

25-0965588

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ................................... SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b.. SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2013

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......
c	Total lobbying expenditures (add lines 1a and 1b) ...................
d	Other exempt purpose expenditures ........................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2013

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? ..........................

Yes

18,338

Total. Add lines 1c through 1i ...............................

18,338

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members .....................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ............................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
II-B 1i	The Uniontown Hospital is a member of the Hospital Association of PA HAP, the American Hospital Association AHA, and the Hospital Council of Western PA HCWP. All of these organizations engage in lobbying activities. As a member of these organizations we have been instructed to include certain percentages of yearly dues as lobbying expenses.

Schedule C (Form 990 or 990EZ) 2013

Additional Data

Software ID:	13000230
Software Version:	13.6.0.0

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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. SchDMd Bullet

Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

Uniontown Hospital

Employer identification number

25-0965588

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 ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

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)? .......................................

Yes No

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.

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.

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

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:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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) 2013

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?........

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIII and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

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 ....
b	Contributions ........
c	Net investment earnings, gains, and losses
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	1,879,567		1,879,567
b	Buildings ................	89,611,198	42,974,283	46,636,915
c	Leasehold improvements ............	1,863,517	1,405,171	458,346
d	Equipment ................	78,722,481	63,897,613	14,824,868
e	Other .................	6,510,816	2,834,763	3,676,053
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				67,475,749

Schedule D (Form 990) 2013

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. 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
(3)Other (A) Financial derivatives and other financial products
(B) Closely-held equity interests







Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment		(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.)

Part IX

Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. 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.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability		(b) Book value
Federal income taxes
Federal income taxes
Est. Malpractice Cost		2,025,640
Other Long Term Liabilities		4,791,760
Estimated Third Party Settlement		2,132,723
Interest Rate Swap Agreement		6,078,749




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		15,028,872
2. Liability for uncertain tax positions 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) 2013

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
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

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.

Return Reference	Explanation
X 2	The organization adopted the provisions of Financial Accounting Standards Board FASB Interpretation No. 48 ASC 740, Accounting for Uncertainty in Income Taxes. Because no material uncertain tax positions were identified, a disclosure was not included in the footnotes to the financial statements.

Schedule D (Form 990) 2013

Additional Data

Software ID:	13000230
Software Version:	13.6.0.0

- TIN:

SCHEDULE G (Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrow

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.
right arrow

Information about Schedule G (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization
Uniontown Hospital

Employer identification number

25-0965588

Part I

Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

Yes

If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










Total .................

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

For Paperwork Reduction Act Notice, see the Instructions for Form 990or 990-EZ.

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2013

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

			(a) Event #1 (event type)	(b) Event #2 (event type)	(c) Other events (total number)	(d) Total events (add col. (a) through col. (c))
	1	Gross receipts . . .
	2	Less: Contributions . .
	3	Gross income (line 1 minus line 2) . . .
	4	Cash prizes . . .
	5	Noncash prizes . .
	6	Rent/facility costs . .
	7	Food and beverages .
	8	Entertainment . . .
	9	Other direct expenses .
	10	Direct expense summary. Add lines 4 through 9 in column (d) ...........
	11	Net income summary. Subtract line 10 from line 3, column (d)...........

Part III

Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

(a) Bingo

(b) Pull tabs/Instant
bingo/progressive bingo

(c) Other gaming

(d) Total gaming (add col.(a) through col.(c))

Gross revenue . . . .

Cash prizes . . . .

Non-cash prizes . . .

Rent/facility costs . . .

Other direct expenses . .

Volunteer labor . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d) ......... right arrow

Enter the state(s) in which the organization operates gaming activities:

Is the organization licensed to operate gaming activities in each of these states? ............

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2013

Page 3

Does the organization operate gaming activities with nonmembers? .................

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? ..........................

YesNo

Indicate the percentage of gaming activity operated in:

The organization's facility ......................

13a

An outside facility ........................

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? ......................................

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? ............................

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v), and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).

Return Reference	Explanation

Schedule G (Form 990 or 990-EZ) 2013

Additional Data

Software ID:	13000230
Software Version:	13.6.0.0

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

Uniontown Hospital

Employer identification number

25-0965588

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...

Yes

If "Yes," was it a written policy? .......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: .........

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............

Did the organization prepare a community benefit report during the tax year? ..........

If "Yes," did the organization make it available to the public? ..............

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) ..	2,798,248	230,546	2,567,702	2.150 %
b	Medicaid (from Worksheet 3, column a) ....	27,118,808	20,922,552	6,196,256	5.180 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .
d	Total Financial Assistance and Means-Tested Government Programs .	29,917,056	21,153,098	8,763,958	7.330 %
Other Benefits		235,741		235,741	0.200 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	235,741		235,741	0.200 %
f	Health professions education (from Worksheet 5) ..	181,486		181,486	0.150 %
g	Subsidized health services (from Worksheet 6) ..	6,603,429	5,031,230	1,572,199	1.310 %
h	Research (from Worksheet 7)
i	Cash and in-kind contributions for community benefit (from Worksheet 8)
j	Total. Other Benefits ..	7,020,656	5,031,230	1,989,426	1.660 %
k	Total. Add lines 7d and 7j .	36,937,712	26,184,328	10,753,384	8.990 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2013

Schedule H (Form 990) 2013

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

4,186,826

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

242,836

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

24,306,937

Enter Medicare allowable costs of care relating to payments on line 5.....

24,065,099

Subtract line 6 from line 5. This is the surplus (or shortfall)........

241,838

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2013

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?1 Name, address, primary website address, and state license number						Facility reporting group
1	Uniontown Hospital 500 W Berkeley Street Uniontown,PA15401 uniontownhospital.com 470901	X	X	X	X	A

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	A
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9....................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ....................

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): uniontownhospital.com

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2013

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Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 0000000002.000000000000% If "No," explain in Part VI the criteria the hospital facility used.
11	Used FPG to determine eligibility for providing discounted care?.................	11	Yes
	If "Yes," indicate the FPG family income limit for eligibility for discounted care: 0000000002.500000000000% If "No," explain in Part VI the criteria the hospital facility used.
12	Explained the basis for calculating amounts charged to patients?.................	12	Yes
	If "Yes," indicate the factors used in determining such amounts (check all that apply):
a	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14	Yes
	If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......	15	Yes
16	Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
17	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?..........	17		No
	If "Yes," check all actions in which the hospital facility or a third party engaged:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines 1j, 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptions for each facility in a facility reporting group, designated by "Facility A," "Facility B," etc.
Form and Line Reference	Explanation
Group Uniontown Hospital	Part V, Section B, Line 1i - The Uniontown Hospital did not encounter any information gaps that limited the hospital facilitys ability to assess the communitys health needs.
Group Uniontown Hospital Line Part V, Section B, Line 3	Tripp Umbach facilitated and managed a comprehensive community health needs assessment on behalf of the Uniontown Hospital. The process included input from key community stakeholders collected through a series of 21 interviews that were completed between April and May, 2012. The following is a complete list of those consulted Albert Gallatin, Laurel Highlands, Brownsville Area, Uniontown Area, and Connellsville area school districts Pennsylvania State University Fayette/Eberly Campus United Way of Fayette PA Department of Health California University of Social Work Fayette County Children Youth Fayette Chamber of Commerce Fayette County Commissioners Fayette County Office of Human Services Fayette County CHIP Fayette County Drug Alcohol Commission Fayette County Behavior Health Administration Fayette County Community Action Agency Fay-Penn Economic Development Council Southwest Pennsylvania Area Agency on Aging Uniontown Hospital Diabetes Center and Career Link Fayette.
Group Uniontown Hospital Line Part V, Section B, Line 7	Three needs identified as not being met 1. Lifestyle choices of consumers While hospital leaders are interested in this issue, there is a Healthy Lifestyles Committee that is participating in the planning process from the Fayette County CHIP Program. The Hospital collaborates and works closely with the CHIP program, which has chosen to take responsibility for addressing the choices of residents that impact health. Additionally, the hospital will study and identify methods for addressing substance abuse issues among pregnant women, which is as a component of lifestyle choices and an area the hospital may have a measure of influence. 2. Dental Care The hospital does not have access to the resources needed to provide dental care to residents in Fayette County. The hospital does not offer dental care and has limited leverage to influence dental providers in the community. 3. Socio-economic barriers The hospital does not have access to the resources needed to address the socia-economic issues in Fayette County. The hospital has helped facilitate the formulation of a community development committee, which has chosen to address the socio-economic issues in Fayette County. A seperate community development plan was developed during this planning process and may begin to address some of these issues.
Group Uniontown Hospital Line Part V, Section B, Line 14g	The Financial Assistance Policy FAP is publicized to the community in various ways. There is a link posted on the Hospital website giving instructions on how to get a copy the FAP. There is a paragraph on the patient bill discussing free or discounted services and directing patients to the proper location to see the FAP. Brochures are available in the emergency waiting room, Patient Financial Services and admissions office which discuss the FAP.
Group Uniontown Hospital Line Part V, Section B, Line 20d	Charges are established using cost as the principle basis. A relevant cost basis is established for each service on an annual basis. The charge will be initially established based upon 150 of the cost of the service. Prior to eligibility for financial assistance, a patient will be billed gross charges. Individuals eligible for assistance under the Hospitals financial assistance program will not be charged more than the amount generally billed to individuals having insurance coverage. Charges for emergency and other medically necessary care will not be charged more than amounts generally billed to individuals having insurance coverage. Financial assistance free or discounted adjusted amounts will be applied to gross charges. Based on the poverty income guidelines, free assistance will be provided at 100 for incomes less than 200 of the poverty income guidelines. Discounted assistance will be provided at 66 for incomes greater than 200 but less than 250 and 33 for incomes greater than 250 but less than 300. There will be a minimum patient liability amount required for each service. Payment of the following minimum patient liability amounts will be required for each service 10 Outpatient diagnostic testing 25 Emergency department 50 Same Day Surgery 100 Observation and Inpatient services.
Group Uniontown Hospital Line Part V, Section B, Line 6i	The Uniontown Hospitals full Community Health Needs Assessment and Implementation Plan can be found at www.uniontownhospital.com. Community Health Needs Assessment Implementation Plan Progress Year 1 FYE 6/30/14. Topic Decrease the percentage of uninsured residents in the community. Measurement There has been a 7 decrease in self-pay patients from FY13 to FY14. There has been a 33 increase in the number of patients we have successfully helped apply for Medical Assistance from FY13 to FY14. The FQHC navigators helped 29 patients successfully apply for healthcare coverage. They spoke with approximately 200 patients. There was a 48 increase in charity care applications from FY13 to FY14. Applicants are required to apply for Medical Assistance. Actions One Financial Care Services Department located on the main floor is our designated Financial Care Resource Center. Financial Care Services Department with the hospital consists of three Financial Care Consultants and four full-time and two part-time Financial Care Associates. Financial Care Consultants are available to all patients to discuss their healthcare financial needs. Financial Access/Registration developed 24/7 Financial Access Associate positions in addition to the staff in the Financial Care Services Department. Staff speak with, direct, and counsel patients that have difficulty meeting their financial obligations for healthcare provided at Uniontown Hospital. All uninsured patients are referred to the Department of Public Welfare in conjunction with the charity care application. All uninsured patients that are inpatient, observation, Emergency Department and surgical patients are referred to outside agencies to encourage and help the patient apply for Medical Assistance. Two contracted agencies help patients with the Medical Assistance application process and follow through if necessary. Scheduled self-pay patients are contacted by a Financial Care Consultant prior to their service to offer help applying for Medical Assistance or any other financial options that may be available to them. Coordinated with the local Department of Public Welfare county office a method to identify, process, and determine hospitals referred applications in a timely and consistent manner.
Group Uniontown Hospital Line Part V, Section B, Line 6i	Two - partnered with Cornerstone Care and Centerville Clinics to provide resources for self-pay patients to apply for affordable healthcare plans during open enrollment. Both are FQHC clinics. Both provide certified navigators to help the patient understand the website, health plan options, opportunity for discounts, determine eligibility for Medical Assistance, Social Security Disability income, and CHIPS. For the patients ease, navigators will meet with them at the hospital or at the agencies. They offer many scheduling opportunities to accommodate the patients schedule. A mass mailing was sent to all self-pay patients that presented to our facility within the last 12 months notifying them of the services Cornerstone and Centerville Clinic can provide to them. A mass mailing was sent to all self-pay patients announcing a UPMC on-site representative to discuss any questions they have regarding affordable health plans with UPMC. Three - Financial Care Services Center and Financial Access Associates engaged in best practices as identified by organization.
Group Uniontown Hospital Line Part V, Section B, Line 6i	Topic Increase the appropriate use of available healthcare resources increasing the use of affordable primary care clinics and FQHC whereby reducing the use of the Emergency Departments for non-emergent and/or ongoing primary care purposes. Measurement There were 11 less non emergent ED visits from FY 13 to FY 14. Actions One Partnered with Wesley Healthcare Center to provide free or discounted care for uninsured patients Information for Wesley Healthcare Center provided to all self-pay patients that present to our facility. Two At the end of a visit to the Emergency Department a handout listing healthcare reasons to visit an Emergency Department. The handout also includes multiple sources for non-urgent care outside of the Emergency Department. Partnered with two FQHC clinics to promote better access for consistent healthcare needs, Cornerstone and Centerville. Also, partnered to provide assistance with the Healthcare Market place. Partnered with two Urgent Care Centers to coordinate care needs with the hospital. Three Partnered with Wesley Healthcare Center, Cornerstone and Centerville Clinics, MedExpress and Cherry Tree Urgent Centers to reduce the use of the Emergency Department for non-emergent services and provide educational information to the population on where and when to seek alternative provider setting. Also, have physician offices listed as open to new patients. Four The Fayette Physician Network, the Preferred Primary Care Physicians and the Centerville Clinics are currently working with the UPMC Health Plans and Highmark. In this Medical home model, Nurses and Social Workers are present in the physician offices and work to close gaps in care and provide patients with support and referrals for a vast number of services. Another goal of the Medical Home Model is to have patients seen within 3 days of discharge from acute care hospitals. The Social Work staff is proactively calling these physician practices to secure follow up appointments within this time frame which is mutually beneficial to the patient, the Health Plan and the Physician Practice. Patients who are seen by their physician for post-acute visits are less likely to be readmitted to the hospital and are more likely to become more engaged in the medical home partnership. The Social Work staff is also linking patients to primary care physicians and is providing them with a list of practices and FQHC clinics as mentioned above. Patients who are seen in the ED or the acute hospital and who are identified as not having a primary care physician are educated on the options for care in their community.
Group Uniontown Hospital Line Part V, Section B, Line 6i	This includes Wesley Health Center, Centerville Clinics and Cornerstone Care as well as other local physicians. The Home Line 724-430-4633 is a dedicated line for callers who are seeking help in locating a Primary Care Physician or specialist. Many patients have successfully been linked to Physicians in their community through this basic service. Topic - To improve the health and birth outcome for women with chemical dependency. Actions - Attended several webinars/seminars regarding Neonatal Abstinence Syndrome neonatal withdrawal regarding prevalence and best evidence based treatment. Networked nationally regarding prevalence and policies. Developed a parent/family education board regarding drug/alcohol use and pregnancy outside the nursery viewing window. Conducted a one month detailed chart review of every birth to determine that approximately 30 of our population of pregnant woman is taking either illicit or rehabilitative drugs/alcohol. Collated data to determine that 50 of the pregnant women are smoking cigarettes throughout the pregnancy. Began members of the Drug/Alcohol Task Force Lea Walls, Nancy Brown, and Mary Jul Phillips along with politicians, education administrators and agencies. Our goal was to influence the politicians for a law to screen 100 of women in labor to determine neonates needing treatment at birth. We currently use a policy with red flags that determine who is tested and potentially leaving a newborn to begin withdrawal at home on day 4-5. Added Subutex testing to our urine drug screening, as this is a widely used rehabilitative medication for drug addicted pregnant women. Initiate a laboratory test called CORDSTAT where a portion of the umbilical cord at birth is tested for 13 drugs and alcohol. The specimen is considered a chain of custody and performed by an outside laboratory. When positive results are received after discharge, the pediatrician office is notified by the laboratory along with Social Work who follows up. Met with the Methadone Clinic administrators and determined that they are an excellent resource to the Medicaid patient but costly otherwise. Methadone is the longest accepted rehabilitative treatment for drug addicted pregnant woment and breastfeeding is permitted. Met with Drug and Alcohol who assured us that a pregnant woman is the highest priority for care.
Group Uniontown Hospital Line Part V, Section B, Line 6i	Met with Axiom who offered to start treatment with Subutex on our patients within 24 hours. This was communicated to the OB/GYN physicians for immediate referral as needed. Prior to this company we had patients traveling to Greensburg for treatment and not following through. Babies can breastfeed when the mother is treated with Subutex also for rehabilitation. Care of the newborn withdrawing policy was changed to increase mother baby interaction and education. Involvement of the parents better prepares them for a difficult baby once discharged and enhances bonding. Began a CUDDLING OUR BABIES program for neonatal comfort using volunteers. Began July 2014 monitoring babies who are withdrawing and using the Finnegan scoring system for severity. This does not give us the number of babies exposed and not withdrawing or mothers who used marijuana where the baby does not withdraw. Transfer statistics readily available through our risk monitoring system of babies transfer to tertiary care for medication treatment of withdrawal per month.

Schedule H (Form 990) 2013

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Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?1
Name and address		Type of Facility (describe)
1	Uniontown Hospital Outpatient Diagnostic Center 150 Wayland Smith Drive Suite B Uniontown,PA15401	Outpatient Center
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2013

Page

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
Group Uniontown Hospital	Part V, Section B, Line 1i - The Uniontown Hospital did not encounter any information gaps that limited the hospital facilitys ability to assess the communitys health needs.
Group Uniontown Hospital Line Part V, Section B, Line 3	Tripp Umbach facilitated and managed a comprehensive community health needs assessment on behalf of the Uniontown Hospital. The process included input from key community stakeholders collected through a series of 21 interviews that were completed between April and May, 2012. The following is a complete list of those consulted Albert Gallatin, Laurel Highlands, Brownsville Area, Uniontown Area, and Connellsville area school districts Pennsylvania State University Fayette/Eberly Campus United Way of Fayette PA Department of Health California University of Social Work Fayette County Children Youth Fayette Chamber of Commerce Fayette County Commissioners Fayette County Office of Human Services Fayette County CHIP Fayette County Drug Alcohol Commission Fayette County Behavior Health Administration Fayette County Community Action Agency Fay-Penn Economic Development Council Southwest Pennsylvania Area Agency on Aging Uniontown Hospital Diabetes Center and Career Link Fayette.
Group Uniontown Hospital Line Part V, Section B, Line 7	Three needs identified as not being met 1. Lifestyle choices of consumers While hospital leaders are interested in this issue, there is a Healthy Lifestyles Committee that is participating in the planning process from the Fayette County CHIP Program. The Hospital collaborates and works closely with the CHIP program, which has chosen to take responsibility for addressing the choices of residents that impact health. Additionally, the hospital will study and identify methods for addressing substance abuse issues among pregnant women, which is as a component of lifestyle choices and an area the hospital may have a measure of influence. 2. Dental Care The hospital does not have access to the resources needed to provide dental care to residents in Fayette County. The hospital does not offer dental care and has limited leverage to influence dental providers in the community. 3. Socio-economic barriers The hospital does not have access to the resources needed to address the socia-economic issues in Fayette County. The hospital has helped facilitate the formulation of a community development committee, which has chosen to address the socio-economic issues in Fayette County. A seperate community development plan was developed during this planning process and may begin to address some of these issues.
Group Uniontown Hospital Line Part V, Section B, Line 14g	The Financial Assistance Policy FAP is publicized to the community in various ways. There is a link posted on the Hospital website giving instructions on how to get a copy the FAP. There is a paragraph on the patient bill discussing free or discounted services and directing patients to the proper location to see the FAP. Brochures are available in the emergency waiting room, Patient Financial Services and admissions office which discuss the FAP.
Group Uniontown Hospital Line Part V, Section B, Line 20d	Charges are established using cost as the principle basis. A relevant cost basis is established for each service on an annual basis. The charge will be initially established based upon 150 of the cost of the service. Prior to eligibility for financial assistance, a patient will be billed gross charges. Individuals eligible for assistance under the Hospitals financial assistance program will not be charged more than the amount generally billed to individuals having insurance coverage. Charges for emergency and other medically necessary care will not be charged more than amounts generally billed to individuals having insurance coverage. Financial assistance free or discounted adjusted amounts will be applied to gross charges. Based on the poverty income guidelines, free assistance will be provided at 100 for incomes less than 200 of the poverty income guidelines. Discounted assistance will be provided at 66 for incomes greater than 200 but less than 250 and 33 for incomes greater than 250 but less than 300. There will be a minimum patient liability amount required for each service. Payment of the following minimum patient liability amounts will be required for each service 10 Outpatient diagnostic testing 25 Emergency department 50 Same Day Surgery 100 Observation and Inpatient services.
Group Uniontown Hospital Line Part V, Section B, Line 6i	The Uniontown Hospitals full Community Health Needs Assessment and Implementation Plan can be found at www.uniontownhospital.com. Community Health Needs Assessment Implementation Plan Progress Year 1 FYE 6/30/14. Topic Decrease the percentage of uninsured residents in the community. Measurement There has been a 7 decrease in self-pay patients from FY13 to FY14. There has been a 33 increase in the number of patients we have successfully helped apply for Medical Assistance from FY13 to FY14. The FQHC navigators helped 29 patients successfully apply for healthcare coverage. They spoke with approximately 200 patients. There was a 48 increase in charity care applications from FY13 to FY14. Applicants are required to apply for Medical Assistance. Actions One Financial Care Services Department located on the main floor is our designated Financial Care Resource Center. Financial Care Services Department with the hospital consists of three Financial Care Consultants and four full-time and two part-time Financial Care Associates. Financial Care Consultants are available to all patients to discuss their healthcare financial needs. Financial Access/Registration developed 24/7 Financial Access Associate positions in addition to the staff in the Financial Care Services Department. Staff speak with, direct, and counsel patients that have difficulty meeting their financial obligations for healthcare provided at Uniontown Hospital. All uninsured patients are referred to the Department of Public Welfare in conjunction with the charity care application. All uninsured patients that are inpatient, observation, Emergency Department and surgical patients are referred to outside agencies to encourage and help the patient apply for Medical Assistance. Two contracted agencies help patients with the Medical Assistance application process and follow through if necessary. Scheduled self-pay patients are contacted by a Financial Care Consultant prior to their service to offer help applying for Medical Assistance or any other financial options that may be available to them. Coordinated with the local Department of Public Welfare county office a method to identify, process, and determine hospitals referred applications in a timely and consistent manner.
Group Uniontown Hospital Line Part V, Section B, Line 6i	Two - partnered with Cornerstone Care and Centerville Clinics to provide resources for self-pay patients to apply for affordable healthcare plans during open enrollment. Both are FQHC clinics. Both provide certified navigators to help the patient understand the website, health plan options, opportunity for discounts, determine eligibility for Medical Assistance, Social Security Disability income, and CHIPS. For the patients ease, navigators will meet with them at the hospital or at the agencies. They offer many scheduling opportunities to accommodate the patients schedule. A mass mailing was sent to all self-pay patients that presented to our facility within the last 12 months notifying them of the services Cornerstone and Centerville Clinic can provide to them. A mass mailing was sent to all self-pay patients announcing a UPMC on-site representative to discuss any questions they have regarding affordable health plans with UPMC. Three - Financial Care Services Center and Financial Access Associates engaged in best practices as identified by organization.
Group Uniontown Hospital Line Part V, Section B, Line 6i	Topic Increase the appropriate use of available healthcare resources increasing the use of affordable primary care clinics and FQHC whereby reducing the use of the Emergency Departments for non-emergent and/or ongoing primary care purposes. Measurement There were 11 less non emergent ED visits from FY 13 to FY 14. Actions One Partnered with Wesley Healthcare Center to provide free or discounted care for uninsured patients Information for Wesley Healthcare Center provided to all self-pay patients that present to our facility. Two At the end of a visit to the Emergency Department a handout listing healthcare reasons to visit an Emergency Department. The handout also includes multiple sources for non-urgent care outside of the Emergency Department. Partnered with two FQHC clinics to promote better access for consistent healthcare needs, Cornerstone and Centerville. Also, partnered to provide assistance with the Healthcare Market place. Partnered with two Urgent Care Centers to coordinate care needs with the hospital. Three Partnered with Wesley Healthcare Center, Cornerstone and Centerville Clinics, MedExpress and Cherry Tree Urgent Centers to reduce the use of the Emergency Department for non-emergent services and provide educational information to the population on where and when to seek alternative provider setting. Also, have physician offices listed as open to new patients. Four The Fayette Physician Network, the Preferred Primary Care Physicians and the Centerville Clinics are currently working with the UPMC Health Plans and Highmark. In this Medical home model, Nurses and Social Workers are present in the physician offices and work to close gaps in care and provide patients with support and referrals for a vast number of services. Another goal of the Medical Home Model is to have patients seen within 3 days of discharge from acute care hospitals. The Social Work staff is proactively calling these physician practices to secure follow up appointments within this time frame which is mutually beneficial to the patient, the Health Plan and the Physician Practice. Patients who are seen by their physician for post-acute visits are less likely to be readmitted to the hospital and are more likely to become more engaged in the medical home partnership. The Social Work staff is also linking patients to primary care physicians and is providing them with a list of practices and FQHC clinics as mentioned above. Patients who are seen in the ED or the acute hospital and who are identified as not having a primary care physician are educated on the options for care in their community.
Group Uniontown Hospital Line Part V, Section B, Line 6i	This includes Wesley Health Center, Centerville Clinics and Cornerstone Care as well as other local physicians. The Home Line 724-430-4633 is a dedicated line for callers who are seeking help in locating a Primary Care Physician or specialist. Many patients have successfully been linked to Physicians in their community through this basic service. Topic - To improve the health and birth outcome for women with chemical dependency. Actions - Attended several webinars/seminars regarding Neonatal Abstinence Syndrome neonatal withdrawal regarding prevalence and best evidence based treatment. Networked nationally regarding prevalence and policies. Developed a parent/family education board regarding drug/alcohol use and pregnancy outside the nursery viewing window. Conducted a one month detailed chart review of every birth to determine that approximately 30 of our population of pregnant woman is taking either illicit or rehabilitative drugs/alcohol. Collated data to determine that 50 of the pregnant women are smoking cigarettes throughout the pregnancy. Began members of the Drug/Alcohol Task Force Lea Walls, Nancy Brown, and Mary Jul Phillips along with politicians, education administrators and agencies. Our goal was to influence the politicians for a law to screen 100 of women in labor to determine neonates needing treatment at birth. We currently use a policy with red flags that determine who is tested and potentially leaving a newborn to begin withdrawal at home on day 4-5. Added Subutex testing to our urine drug screening, as this is a widely used rehabilitative medication for drug addicted pregnant women. Initiate a laboratory test called CORDSTAT where a portion of the umbilical cord at birth is tested for 13 drugs and alcohol. The specimen is considered a chain of custody and performed by an outside laboratory. When positive results are received after discharge, the pediatrician office is notified by the laboratory along with Social Work who follows up. Met with the Methadone Clinic administrators and determined that they are an excellent resource to the Medicaid patient but costly otherwise. Methadone is the longest accepted rehabilitative treatment for drug addicted pregnant woment and breastfeeding is permitted. Met with Drug and Alcohol who assured us that a pregnant woman is the highest priority for care.
Group Uniontown Hospital Line Part V, Section B, Line 6i	Met with Axiom who offered to start treatment with Subutex on our patients within 24 hours. This was communicated to the OB/GYN physicians for immediate referral as needed. Prior to this company we had patients traveling to Greensburg for treatment and not following through. Babies can breastfeed when the mother is treated with Subutex also for rehabilitation. Care of the newborn withdrawing policy was changed to increase mother baby interaction and education. Involvement of the parents better prepares them for a difficult baby once discharged and enhances bonding. Began a CUDDLING OUR BABIES program for neonatal comfort using volunteers. Began July 2014 monitoring babies who are withdrawing and using the Finnegan scoring system for severity. This does not give us the number of babies exposed and not withdrawing or mothers who used marijuana where the baby does not withdraw. Transfer statistics readily available through our risk monitoring system of babies transfer to tertiary care for medication treatment of withdrawal per month.

Schedule H (Form 990) 2013

Additional Data

Software ID:	13000230
Software Version:	13.6.0.0

- TIN:

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, line 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

Uniontown Hospital

Employer identification number

25-0965588

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

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....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? ................

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

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 ............

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 .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2013

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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable 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
(1)Steven HandyCurrent CEO/Secretary Prior CFO/Asst Sec/Treas	(i) (ii)	251,817		1,213,820	17,572	29,686	1,512,895	773,527
(2)Paul BacharachPrior CEO end date 12/1/13	(i) (ii)	367,406		2,207,221	26,516	28,449	2,629,592	1,471,681
(3)William JohnsonPharmacy Director	(i) (ii)	142,866		605	6,561	3,648	153,680

Schedule J (Form 990) 2013

Page 3

Part III

Supplemental Information

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.

Return Reference	Explanation
Part I Line 3	Uniontown Hospital relied on Fayette Regional Health System EIN25-1451183 a related organization that used the following methods to establish the top management officials compensation a Compensation Committee, independent compensation consultant, compensation survey or study and approval by the board or compensation committee.
Part 1 Line 4b	Participation in the Fayette Regional Health System 457 f Plan the Plan was limited to Paul Bacharach and Steve Handy Participants. During the calendar year 2013, the Plan was terminated and 1,471,681 was distributed to Paul Bacharach and 773,527 was distributed to Steve Handy in a lump sum payment in accordance to planned documents. FRHS held Split Dollar Life Insurance Plans in the name of Paul Bacharach and Steve Handy. During calendar year 2013, the ownership of those plans were transferred to Paul Bacharach and Steve Handy. This made the current value of those plans immediately taxable in the amount of 595,421 to Paul Bacharach and 393,069 to Steve Handy respectively. Accordingly, these amounts were included in Medicare wages for calendar year 2013.
Part II Line 1 2 Column F	Compensation is reported on the Form 990 in the year that the compensation is earned by or awarded to an individual, even if the compensation is not paid to the individual, is not fully vested, or is subject to substantial risk of forfeiture. If compensation is earned or awarded in one year but paid in a later year, then the compensation is reported a second time on the Form 990 in the year the compensation is vested or paid to the individual. Amounts reported in Column F include these prior contributions which are inclusive of earnings due to the cost basis being undeterminable.

Schedule J (Form 990) 2013

Additional Data

Software ID:	13000230
Software Version:	13.6.0.0

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.
SchKMediumBullet

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization
Uniontown Hospital

Employer identification number
25-0965588

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	Fayette County Hospital Authority	25-1512681	312468BP5	09-27-2007	50,000,000	Constructing New Inpatient Tower Refunding previous issue, Series 1996		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .
2 Amount of bonds legally defeased . . . . . . . . . . .
3 Total proceeds of issue . . . . . . . . . . . . . .	50,000,000
4 Gross proceeds in reserve funds . . . . . . . . . . . .
5 Capitalized interest from proceeds . . . . . . . . . . .
6 Proceeds in refunding escrows . . . . . . . . . . . .	11,074,301
7 Issuance costs from proceeds . . . . . . . . . . . .	450,208
8 Credit enhancement from proceeds . . . . . . . . . . .	37,500
9 Working capital expenditures from proceeds . . . . . . . . .
10 Capital expenditures from proceeds . . . . . . . . . . .	38,437,991
11 Other spent proceeds . . . . . . . . . . . . . .
12 Other unspent proceeds . . . . . . . . . . . . . .
13 Year of substantial completion . . . . . . . . . . . .	2010
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .	X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X
16 Has the final allocation of proceeds been made? . . . . . . . .	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2013

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .
6 Total of lines 4 and 5 . . . . . . . . . . . . .
7 Does the bond issue meet the private security or payment test? . . . . .		X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? . . . . . . .

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T? . . . . .		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .		X
b Exception to rebate? . . . . . . . .		X
c No rebate due? . . . . . . . .	X
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .	X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?	X
b Name of provider . . . . . . . . .	PNC BANK NA
c Term of hedge . . . . . . . . . .	0000000029.700000000000
d Was the hedge superintegrated? . . . .		X
e Was the hedge terminated? . . . . . .		X

Schedule K (Form 990) 2013

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .		X
b Name of provider . . . . . . . . .
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?		X

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation
Part IV Line 2a	The last rebate computation was performed 6/25/12 and showed no rebate due. The next rebate computation is due June 2017.

Schedule K (Form 990) 2013

Additional Data

Software ID:	13000230
Software Version:	13.6.0.0

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.
MediumBullet

Information about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

Uniontown Hospital

Employer identification number

25-0965588

Part I

Excess Benefit Transactions (section 501(c)(3) and section 501(c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No






Total ...... $

Part III

Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2013

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person	(c) Amount of transaction	(d) Description of transaction	Yes	No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2013

Additional Data

Software ID:	13000230
Software Version:	13.6.0.0

- TIN:

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.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

Uniontown Hospital

Employer identification number

25-0965588

Return Reference	Explanation
Form 990, Part III, Line 4d	Program Service Expenses 182,051, Grants and allocations 0, Revenue 219,000 The Uniontown Hospital received rent income from Fayette Regional Health System, Inc. an affiliated organization for office space used by various Fayette Regional Health System, Inc. departments.
Form 990, Part III, Line 3	The Progressive Care Center PCC and Behavior Health Unit BHU were closed in mid-November 2014 as part of a Repositioning Plan implemented during FY14.
Form 990, Part VI, Section A, Line 6	The sole member of Uniontown Hospital is the Hospitals parent company, Fayette Regional Health System, a PA non-profit corporation.
Form 990, Part VI, Section A, Line 7a 7b	The sole member has power to a elect all of the Directors except ex-officio Directors of the Hospital b remove at any time one or more of the Directorsexcept for ex-officio Directors and/or officers of the Corporation without cause capprove all capital and operating budgets of the Corporation and amendments thereto d approve all fundamental transactions of the Corporation, including without limitation, any amendments to articles of the Corporation and any merger, consolidation, division, transfer of all or substantially all assets, dissolution, or liquidation of the Corporation and e approve any and all amendments of the bylaws of the Corporation. The Sole Member of the Corporation may initiate any such action and/or amendments listed in c - e above, as applicable, provided that any such actions and/or amendments must be approved by the Corporation and Sole Member prior to implementation. The Corporation shall not unreasonably withhold its approval for any action and/or change recommended by the Sole Member.
Form 990, Part VI, Section B, Line 11b	The 990 was presented to all voting members of the Finance and Audit Committee of the organizations parent for review at the April 2015 Board Meeting. After review by the Finance and Audit Committee, a full copy of the 990 was made available to the entire Board of the Uniontown Hospital.
Form 990, Part VI, Section B, Line 12c	The Business Ethics department of the organization periodically reviews all potential conflicts, transactions and relationships to see if substantive. All potential new conflicts are reviewed by the Business Ethics department and the concept is covered at annual training. The department will report actual or possible conflicts to the FRHS Executive Committee of the Board for evaluation. The Committee shall determine whether a conflict exists. The Committee is empowered to take corrective action as necessary, including refraining from participation in certain Board decisions.
Form 990, Part VI, Section B, Line 15a 15b	The FRHS Executive Committee of the Board is responsible for the organizations overall compensation, philosophy and establishes the guidelines, rules and procedures necessary for the proper and efficient administration of the Executive Compensation Program which covers the CEO, and Executive Directors Executive Council. This Executive Committee is independent from management and reviews, deliberates over, and approves Executive compensation.
Form 990, Part VI, Section C, Line 19	The organizations governing documents, conflicts of interest policy, and financial statements are available by contacting the CEOs office or the General Accounting department. A copy will be mailed upon request.
Form 990, Part XI, Line 9	Other changes in net assets is comprised of change in fair value of interest rate swap 35,565 change in defined benefit acturial valuation 1,818,160 change in permanently restricted net assets 576 change in temporarily restricted net assets 118,781 and transfer in of Uniontown Hospital Auxilary net assets 167,832.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2013

Additional Data

Software ID:	13000230
Software Version:	13.6.0.0

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
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Attach to Form 990. MediumBullet

See separate instructions.
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Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

Uniontown Hospital

Employer identification number

25-0965588

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on 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" on 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?
(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	Yes	No
(1) Fayette Regional Health System 500 W Berkeley Street Uniontown,PA15401 25-1451183	Healthcare Management	PA	501c3	11b II	N/A		No
(2) Uniontown Hospital Auxiliary 500 W Berkeley Street Uniontown,PA15401 25-6040505	Fundraising	PA	501c3	11b II	N/A		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2013

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on 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	(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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on 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	(i) Section 512(b)(13) controlled entity?
(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	Yes	No
(1) Fayette Physician Hospital Organization 500 W Berkeley Street Uniontown,PA15401 25-1844471	Healthcare	PA	N/A	C Corp				No

Schedule R (Form 990) 2013

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on 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

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 . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

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 related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2013

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on 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)	(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?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V?UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2013

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2013

Additional Data

Software ID:	13000230
Software Version:	13.6.0.0

1	Briefly describe the organization’s mission or most significant activities: The Uniontown Hospital is a 190 bed community hospital whose activities include, inpatient acute care, outpatient ancillary services and inpatient rehab. services.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	15
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	14
5	Total number of individuals employed in calendar year 2013 (Part V, line 2a) ......	5	1,436
6	Total number of volunteers (estimate if necessary) .............	6	99
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

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,622,702	903,694
9	Program service revenue (Part VIII, line 2g) .........	126,517,219	120,363,820
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	347,529	303,504
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	3,350,786	5,412,422
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	131,838,236	126,983,440
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...		0
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	64,411,609	58,054,414
16a	Professional fundraising fees (Part IX, column (A), line 11e).....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	71,763,917	65,717,123
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	136,175,526	123,771,537
19	Revenue less expenses. Subtract line 18 from line 12.......	-4,337,290	3,211,903
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	124,960,834	125,825,909
21	Total liabilities (Part X, line 26).............	89,258,201	84,972,855
22	Net assets or fund balances. Subtract line 21 from line 20.....	35,702,633	40,853,054

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 55,786,570 including grants of $ ) (Revenue $ 63,880,174 )
	Inpatient Services - The Uniontown Hospital is a 179 bed comminity hospital that delivered state-of-the art primary inpatient services to approx. 8,700 inpatients during the FYE 6/30/14. Since 1903, the Hospital has been serving the greater Uniontown and Fayette County area, providing quality healthcare regardless of the persons ability to pay. The Hospital has earned several recognitions from HealthGrades, the nations leading independent healthcare ratings organizaion. The Hospital draws the majority of its patients from Fayette County. Although the population of Fayette County has been decreasing, the demand for the Hospitals services remain due to the downsizing and service cuts at nearby facilities, the growth in the regions uninsured population, and the increase in the regions elderly population. The Uniontown Hospital offers lines of services that are unavailable elsewhere in Fayette County. In addition to being the primary source of orthopedic care, it is the only hospital to offer obstetrics, interventional cardiology and radiation oncology services.

4b	(Code: ) (Expenses $ 42,420,556 including grants of $ ) (Revenue $ 51,030,082 )
	Outpatient Services - The Health Systems hospital based services are complemented by a full spectrum of outpatient services. These services include a state-of-the-art Outpatient Diagnostic Facility that opened in 2006. The outpatient center offers convenient services, including x-rays, bone density scans, ultrasounds, and digital mammography. The Hospital is the primary source of emergency care in the County with approximately 51,000 patient visits during the fiscal year ended June 30, 2014. Other traditional outpatient services include Laboratory, Radiology, and Same Day Surgery which accounted for 1,058,200 patient visits.

4c	(Code: ) (Expenses $ 1,667,494 including grants of $ ) (Revenue $ 5,234,564 )
	PCC/IRU//BHU - The PCC Progressive Care Center was the Hospitals sub-acute unit and had a 24 bed capacity. The PCC served Medicare patients no longer requiring acute care, but not ready for traditional skilled nursing facilities. There were 181 patients in the PCC that stayed a total of 2,635 days prior to its closure in mid-November 2013. The IRU has an 11 bed capacity. The IRU Inpatient Rehabilitation Unit provides rehabilitation services principally for Medicare patients who have been hospitalized due to reasons such as a stroke or an orthopedic procedure. The number of patients in the IRU was 238 with total patient days of 2,939. The BHU Behavioral Health Unit was an 18 bed secured unit principally for older adult and geriatric patients in and around Fayette County. The goal of treatment is to achieve diversion and re-integration of the patient back into the community or to a lower level of care. The BHU had 172 patients that stayed a total of 1,155 days prior to its closure in mid-November 2013.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 182,051 including grants of $ ) (Revenue $ 219,000 )
4e	Total program service expenses100,056,671

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)			(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
(A) Name and Title
(18) Paul Bacharach........................................................................ Prior CEO end date 12/1/13	1.00 .......................40.00	X		0	2,574,627	44,662
(19) William Johnson........................................................................ Pharmacy Director	40.00 .......................		X	143,471	0	10,209
(20) Patrick Bator........................................................................ Oper Mgr. Pharmacy	40.00 .......................		X	116,382	0	24,350
(21) Megan Hanzes........................................................................ Pharmacist	40.00 .......................		X	109,304	0	8,298
(22) Kimberly Zimcosky........................................................................ Pharmacist	40.00 .......................		X	109,187	0	20,428
(23) Cheryl Kramer........................................................................ Director Physical Rehab/Wound Care	40.00 .......................		X	107,919	0	19,054

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	586,263	4,140,200	189,318

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512-514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d
e	Government grants (contributions)1e		687,422

f	All other contributions, gifts, grants, and similar amounts not included above1f		216,272

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			903,694
			Business Code
2a	Inpatient Revenue		900099	63,880,174	63,880,174
b	Outpatient Revenue		900099	51,030,082	51,030,082
c	PCC/IRU/BHU Revenue		900099	5,234,564	5,234,564
d	Gross Rent/Misc Affiliated Organization		900099	219,000	219,000
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			120,363,820
3	Investment income (including dividends, interest, and other similar amounts).......			334,958			334,958
4	Income from investment of tax-exempt bond proceeds..
5	Royalties...........
		(i) Real	(ii) Personal
6a	Gross rents	193,392
b	Less: rental expenses	151,212
c	Rental income or (loss)	42,180
d	Net rental income or (loss).......			42,180			42,180
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	5,230,622	26,675
b	Less: cost or other basis and sales expenses	5,217,933	70,818
c	Gain or (loss)	12,689	-44,143
d	Net gain or (loss)..........			-31,454			-31,454
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..
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...
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..
Miscellaneous Revenue			Business Code
11a	Meaningful Use Initiative		900099	2,777,475	2,777,475
b	Income from Equity Investment		900099	813,326			813,326
c	Pharmacy Copays/Ins. Reimbursements		900099	909,554	909,554
d	All other revenue ....			869,887	869,887
e	Total. Add lines 11a–11d ......			5,370,242
12	Total revenue. See Instructions......			126,983,440	124,920,736		1,159,010


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			8,758,104	1	10,653,290
2	Savings and temporary cash investments .........			7,314,649	2	10,084,371
3	Pledges and grants receivable, net ...........				3
4	Accounts receivable, net .............			14,586,596	4	12,779,426
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
					5
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
					6
7	Notes and loans receivable, net .............				7
8	Inventories for sale or use ..............			2,230,912	8	2,172,184
9	Prepaid expenses and deferred charges ..........			1,153,204	9	816,698
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	178,587,579
b	Less: accumulated depreciation .....	10b	111,111,830	73,995,209	10c	67,475,749
11	Investments—publicly traded securities ..........			10,616,854	11	16,007,107
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 .....			4,466,010	13	4,932,651
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			1,839,296	15	904,433
16	Total assets. Add lines 1 through 15 (must equal line 34)......			124,960,834	16	125,825,909
17	Accounts payable and accrued expenses .........			28,672,610	17	26,527,268
18	Grants payable .................				18
19	Deferred revenue ................			36,210	19	183,382
20	Tax-exempt bond liabilities .............			44,343,333	20	43,233,333
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
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..........				22
23	Secured mortgages and notes payable to unrelated third parties ..				23
24	Unsecured notes and loans payable to unrelated third parties ....				24
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....................			16,206,048	25	15,028,872
26	Total liabilities. Add lines 17 through 25.........			89,258,201	26	84,972,855
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			35,498,800	27	40,589,594
28	Temporarily restricted net assets ...........			174,931	28	233,982
29	Permanently restricted net assets ...........			28,902	29	29,478
	Organizations that do not follow SFAS 117 (ASC 958), check here 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 ...........			35,702,633	33	40,853,054
34	Total liabilities and net assets/fund balances ........			124,960,834	34	125,825,909