TY 2017 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)	(F) Estimated amount of other compensation from the organization and related organizations
(1) Lisa V Feil Psy D...................................................................... Director	1.00 ................. 1.00	X			0	0	0
(2) Robert PFitzgerald...................................................................... Director	1.00 ................. 1.00	X			0	0	0
(3) Harold F Hoose III...................................................................... Treasurer	1.00 ................. 1.00	X	X		0	0	0
(4) Michael W Lichty...................................................................... Director	1.00 ................. 1.00	X			0	0	0
(5) JDennis Murray PhD...................................................................... Director	1.00 ................. 1.00	X			0	0	0
(6) Thomas M Owlett Esq...................................................................... Chairman	1.00 ................. 1.00	X	X		0	0	0
(7) Glenn BPoirier...................................................................... Vice Chairman	1.00 ................. 1.00	X	X		0	0	0
(8) Wendy SSwartz CPA...................................................................... Director	1.00 ................. 1.00	X			0	0	0
(9) Donna R Wilson...................................................................... Director	1.00 ................. 1.00	X			0	0	0
(10) Kathy J Wright PhD...................................................................... Secretary	1.00 ................. 1.00	X	X		0	0	0
(11) Jill ABurns MD...................................................................... Director	1.00 ................. 41.00	X			0	249,542	29,207
(12) Walter J Laibinis DO...................................................................... Director	1.00 ................. 41.00	X			0	361,408	29,999
(13) Steven P Johnson...................................................................... President/CEO	1.00 ................. 51.00	X	X		0	1,434,188	33,810
(14) Janie M Hilfiger...................................................................... VP/President	40.00 ................. 2.00		X		188,935	0	18,092
(15) Eric Pohjala...................................................................... Executive VP/CFO	0.00 ................. 52.00		X		0	434,880	31,749
(16) Jan E Fisher...................................................................... Executive VP/COO	1.00 ................. 41.00			X	0	480,809	28,165
(17) David Lopatofsky MD...................................................................... Executive VP/CMO	1.00 ................. 41.00			X	0	552,898	35,625

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

Soldiers and Sailors Memorial Hospital

Employer identification number

23-2176963

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 12, 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 (Form 990 or 990-EZ).)

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 agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

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 in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

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

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2019

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 VI.)..
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 section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. 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—2018. 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—2019. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2018. 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 VI 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) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 VI.) ..
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 section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. 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—2018. 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) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2019

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2019

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2019

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2019 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- 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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

If the organization answered "Yes" on 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" on 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" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

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

Name of the organization

Soldiers and Sailors Memorial Hospital

Employer identification number

23-2176963

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 (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

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-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2019

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 separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2016	(b) 2017	(c) 2018	(d) 2019	(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) 2019

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 on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(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? ..........................................................

Yes

4,221

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

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

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

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

4,221

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, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Part II-B, Line 1:	The Hospital holds a membership in the American Hospital Association (AHA) which engages in lobbying as part of their mission to represent the interests of hospitals at both the Federal and State levels. For the year ended June 30, 2018, the amount of dues paid to AHA totaled $18,370, of which 22.98% or $4,221, was used for lobbying purposes.

Schedule C (Form 990 or 990EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on 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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

Soldiers and Sailors Memorial Hospital

Employer identification number

23-2176963

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of 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" on 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 7/25/06, 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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, 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" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB 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 FASB 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)

Revenue included on 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 FASB ASC 958 relating to these items:

Revenue included on 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) 2019

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" on 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


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

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" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(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

Term endowment SchDMd Bullet

The percentages on 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" on 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" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	1,340,122		1,340,122
b	Buildings ....	52,519,034	22,502,147	30,016,887
c	Leasehold improvements	116,316	115,890	426
d	Equipment ....	25,511,639	17,596,665	7,914,974
e	Other .....	3,442,388	1,880,242	1,562,146
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				40,834,555

Schedule D (Form 990) 2019

Page 3

Part VII

InvestmentsOther Securities.
Complete if the organization answered "Yes" on 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
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on 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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)Due from Exempt Affiliates				43,664,358
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				43,664,358

Part X

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

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	1,536,502
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) 2019

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on 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 (losses) 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' on 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

Part X, Line 2:

UPMC has no uncertain tax positions recorded. Tax benefits are recognized when it is more likely than not that a tax position will be sustained upon examination by the tax authorities based on the technical merits of the position. Such tax positions are measured as the largest amount of tax benefit that is greater than 50% likely to be realized upon ultimate settlement with the tax authorities assuming full knowledge of the position and all relevant facts. As of June 30, 2018, UPMC does not have any unrecorded tax benefits. An external audit is completed at a consolidated UPMC system level only, including UPMC and all taxable and tax-exempt subsidiaries.

Schedule D (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization
Soldiers and Sailors Memorial Hospital

Employer identification number

23-2176963

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.

For grantmakers. Does the organization maintain records to substantiate the amount of its grants and

other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used

to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(b) Number of offices in the region	(c) Number of employees, agents, and independent contractors in the region	(d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region)	(e) If activity listed in (d) is a program service, describe specific type of service(s) in the region	(f) Total expenditures for and investments in the region
	Central America	0	1	Program Services	Captive Insurance Company	441,976
















3a	Sub-total ....	0	1			441,976
b	Total from continuation sheets to Part I ...	0	0			0
c	Totals (add lines 3a and 3b)	0	1			441,976

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2019

Schedule F (Form 990) 2019

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name of organization		(b) IRS code section and EIN (if applicable)	(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of noncash assistance	(h) Description of noncash assistance	(i) Method of valuation (book, FMV, appraisal, other)

2	Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) 2019

Schedule F (Form 990) 2019Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance		(b) Region	(c) Number of recipients	(d) Amount of cash grant	(e) Manner of cash disbursement	(f) Amount of noncash assistance	(g) Description of noncash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) 2019

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2019

Page 5

Part V

Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.

ReturnReference	Explanation

Schedule F (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

Soldiers and Sailors Memorial Hospital

Employer identification number

23-2176963

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 25000.0000000000 %

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 criteria used 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? . . . . . . . . . . . . . . . . . . . . . . .

Yes

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? . . . . . . . . .

Yes

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

Yes

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) . . .	312,257	0	312,257	0.490 %
b	Medicaid (from Worksheet 3, column a) . . . . .	8,254,784	6,913,112	1,341,672	2.120 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	8,567,041	6,913,112	1,653,929	2.610 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	6,153		6,153	0.010 %
f	Health professions education (from Worksheet 5) . . .
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	1,006,992		1,006,992	1.590 %
j	Total. Other Benefits . .	1,013,145		1,013,145	1.600 %
k	Total. Add lines 7d and 7j .	9,580,186	6,913,112	2,667,074	4.210 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

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.

		(c) Total community building 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	0
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 Healthcare Financial Management Association Statement No. 15? ..........................

Yes

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

5,618,536

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. ......

280,927

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).....

6,969,670

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

8,265,879

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

-1,296,209

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) 2019

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?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	Soldiers & Sailors Memorial Hospital 32-36 Central Avenue Wellsboro,PA16901 www.upmcsusquehannahealth.org 390043	X	X	X

Schedule H (Form 990) 2019

Page 4

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)

	Soldiers & Sailors Memorial Hospital
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

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 12......................

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 significant 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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 15

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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

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

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

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): See Part V, Page 7

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): See Part V, Page 7

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

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

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, 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) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Soldiers & Sailors Memorial Hospital
Name of hospital facility or letter of facility reporting group

Yes

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 included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 250.000000000000%
and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

WWW/UPMC.com/patients-visitors/paying-bill/services

The FAP application form was widely available on a website (list url):

WWW/UPMC.com/patients-visitors/paying-bill/services

A plain language summary of the FAP was widely available on a website (list url):
WWW/UPMC.com/patients-visitors/paying-bill/services

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	Soldiers & Sailors Memorial Hospital
Name of hospital facility or letter of facility reporting group

Yes

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 all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized 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?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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 Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

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

	Soldiers & Sailors Memorial Hospital
Name of hospital facility or letter of facility reporting group

Yes

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 a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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 Section C.

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 Section C.

Schedule H (Form 990) 2019

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Soldiers & Sailors Memorial Hospital	Part V, Section B, Line 5: In conducting its CHNA, the hospital took into account input from representatives of the community served, including those with special knowledge of or expertise in public health. This was accomplished by conducting 9 Key Informant interviews with 55 people answering the key informant interview. A web-based tool was utilized to conduct the key informant interviews; however, paper questionnaires identical to the electronic version were distributed to populations who may not have had access to the internet or generally are more likely to complete a paper questionnaire. For more details concerning the Key Informant Interview Process or the Community Health Input Questionnaire process, including a list of those individuals interviewed, a copy of the Community Health Input Questionnaire, and results gathered you may view the CHNA and related Implementation Plan at www.upmcsusquehanna.org/community health.
Soldiers & Sailors Memorial Hospital	Part V, Section B, Line 6a: Soldiers and Sailors Memorial Hospital; located in Wellsboro, PA is one of six hospitals that comprise UPMC Susquehanna based in Williamsport, Pennsylvania. For purposes of conducting CHNA's, three of these hospitals, The Williamsport Hospital (DBA:Williamsport Regional Medical Center), Divine Providence Hospital, and Muncy Hospital, share the same definition of community served, which is Lycoming County, PA. The fourth hospital that is part of UPMC Susquehanna is Soldiers and Sailors Memorial Hospital located in Wellsboro, PA and their defined community is Tioga County, PA. Additionally there are two recently acquired hospital entities, Lock Haven Hospital and Sunbury Hospital,whose community health needs are being evaluated. The health systems' approach to providing community benefits is to leverage the assets and expertise of all six hospitals to meet the needs and improve the health status of those who reside in the communities located in Lycoming and Tioga counties. Accordingly, a certain amount of collaboration between these related hospitals occurred in the development of their CHNA's and related Implementation Plans. For more details concerning these four hospitals, as well as their definition of community served you may view the CHNA and related Implementation Plans at www.upmcsusquehanna.org/community health.
Soldiers & Sailors Memorial Hospital	Part V, Section B, Line 11: Health needs were identified based on information gathered and analyzed through the 2016 CHNA conducted by the Health System. For the health needs prioritization process, the Health System engaged a hospital leadership team to review the most significant health needs reported in the CHNA using the following criteria, 1) Current area of hospital focus. 2) Established relationships with community partners to address the health need. 3) Organizational capacity and existing infrastructure to address the health need. Based on the criteria outlined above, the leadership team ranked each of the health needs. As a result of the priority process, the identified priority areas that will be addressed through the Health System's Implementation Strategy for fiscal years 2017 through 2019 will be: Priority 1:Improve access to primary and specialty services.Goal 1: Work with Tioga County Partnership for Community Health on Improvement of transportation for healthcare services. Update as of 7/7/2017: Tioga County Partnership for Community Health received a block grant for transportation which SSMH is using for patients discharged from the Emergency Department and inpatient units, to transport to home at no cost to the patient.Goal 2: Explore non-traditional strategies to provide access to care. Update as of 7/7/2017: Susquehanna Health Internal Medicine office has opened same day appointments to accommodate urgent needs. Laurel Health Center administration is exploring urgent care concept at the Mansfield Laurel Health Center. Visiting specialists from Lycoming provide Cardiology and ENT at Wellsboro and Cardiology, Sports Medicine and Rheumatology at Mansfield.Goal 3: Explore telehealth opportunities and innovative ways to deliver care. Update as of 7/7/2017: the following at now available at SSMH: teleburn, telestroke, telepsychiatry, and teleneurology. A UPMC Susquehanna telehealth committee has been formed.Priority 2: Bring in addiction services and/or task forces to Tioga County.Goal 1: Authorize Implementation of prescription drug monitoring program system wide. Goal 2: Collaborate with Tioga County to share best practices. Update as of 7/7/2017:SSMH actions-Review and reduce Rx when feasible, standardize narcotic formulations, OB task force setup and add ER case managers. Physician offices- monitor of prescribing patterns. County Wide-Project Bald Eagle/Tioga Coalition first mtg 4/27/17, drug drop boxes, National Guard education programs.Priority 3: Collaborate with community organizations on health and wellness initiatives. Goal 1: Promote routine cancer screenings for breast, colon and cervical cancer. Update as of 7/7/2017: Susan G Komen grant received to cover mammograms for the uninsured. Free screening for melanoma provided by Susquehanna Surgical at Wellsboro in May and September. Expansion of mammography to the Mansfield Medical Plaza. Implementation of breast health nurse navigator program in Wellsboro.Goal 2: Collaborate with the PA Department of Health and Tioga County Partnership for Community Health to establish more health screeeings and community events. Update as of 7/7/2017: Community health programs offered throughout the year to include newborn immunization program through SSMH and Tioga Partnership.Goal 3: Continue to partner with River Valley Regional YMCA and Wellsboro Parks and Recreation Department to support health and wellness programs for both children and adults. Update as of 7/7/2017: YMCA offers a variety of programs for youth. The UPMC Wellness program provides a multitude of activities to promote a healthy lifestyle.Goal 4: Continue to grow and expand Spirit of Women program. Update as of 7/7/2017: Multiple programs provided throughout the year by the Spirit of Women program.Priority 4: Support mental health serviceGoal 1: Increase access to behavorial health specialists. Update as of 7/7/2017: Telehealth available at SSMH and pediatric behavorial health through the Penn State telehealth program available at Wellsboro Behavorial Health Office.Priority 5: Support transportation options to healthcare for rural areas.Goal 1: Work with Tioga County Partnership for Community Health on improvement of transportation for healthcare services. Update as of 7/7/2017: Tioga County Partnership received a grant for transportaion which SSMH is using for patients discharged from the ER and inpatient units, to transport to home at no cost to the patient.Goal 2 : Bring routine wellness screenings and programs to rural Tioga areas. Update as of 7/7/2017: PA Department of health no longer employs an RN to assist with programs. UPMC SSMH and Tioga Partnership continue to offer routine Wellness screenings and programs, such as CMBA (community multi-phasic blood analysis).
Soldiers & Sailors Memorial Hospital	Part V, Section B, Line 20e: UPMC Soldiers and Sailors Memorial Hospital engages in no extraordinary collection actions.

Schedule H (Form 990) 2019

Page 9

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?
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2019

Page 10

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
Part I, Line 3c:	Financial Assistance or Charity care is available for eligible individuals who have health care needs and are uninsured, underinsured, inelgible for government programs or otherwise unable to pay for their own care.A patient may be determined to have financial needs based on the following:1. Indigency: if income falls at or below 250% of the Federal Poverty guidelines, the patient will have no financial responsibilty. The patient is approved for 100% free care. 2. Low income sliding scale: Assistance may be a discounted or reduced patient liability depending on the patient's income:A. If the combined family income is greater than 251% and less than or equal to 400% of the Federal poverty guidelines and uninsured, the patient is eligible for reduced charity care.There will be an 87% reduction in the patient bill. The discounted charity care scale is listed below:F/S=Family Size 2018Family Size Category 1-100% Category 2-87%1 $30,350 $48,5602 $41,150 $65,8403 $51,950 $83,1204 $62,750 $100,4005 $73,550 $117,6806 $84,350 $134,9607 $95,150 $152,2408 $105,950 $169,520Each Additional $10,800 $17,2803. Financial hardship: If a patient is approved for discounted or reduced charity care and cannot afford to pay the remaining balance, the patient may be considered for financial hardship. Assistance will be provided in the form of an adjustment of charges to prevent the patient liability from exceeding the lesser of 15% of family income or the AGB. 4. Medical Hardship/catastrophic care: If a patient is denied financial assistance and cannot afford to pay the account balance, the patient may be considered medically indigent and may be considered for medical hardship/catastrophic care. The patient will be liable to pay the lesser of 15% of their calculated household income or the AGB towards their medical bill. This is a one time financial assistance adjustment for existing account balances. The remaining balance will be adjusted to free care.Part 1 Line 4"Medically indigent" means persons who the organization has determined unable to pay some or all of their medical bills because their medical bills exceed a certain percntage of their family household's income.
Part I, Line 6a:	The community benefit report is prepared on a system wide basis under UPMC Susquehanna.
Part I, Line 7:	Part I Line 7 Column (F): The Bad Debt expense included on Form 990, Part IX, Line 25 (A) but subtracted for purposes of calculating the percentage in this column is $5,618,536.
Part II, Community Building Activities:	Soldiers & Sailors Memorial Hospital participates in community building through various means such as making parts of the building (conference rooms cafeteria, etc) available for public meetings, blood drives, CPR classes, expectant parent classes, and EMS education among others. The hospital has a large group of volunteers from the community who donate time to assist the organization providing care and well being to the community it serves. For fiscal year 2018, SSMH had 91 volunteers donate approximately 6,865 hours of their time.
Part III, Line 2:	Bad Debt expense consists of the actual bad debts written off, plus a reserve calculation based on a progressive percentage for self pay and other non-contract accounts receivable aging categories. This figure is the amount of bad debt in the audited financial statements.
Part III, Line 3:	Process for reallocation from Bad Debt to Charity Care UPMC reclassifies bad debt accounts as charity care by utilizing a predictive model called PARO (Payment Assistance Rank Order). PARO was built as a socio-economic score that identified those patients that are most likely to be the highest need of financial assistance. This is accomplished by analyzing comsumer data and IRS data. PARO provides a systematic approach to financial assistance: "Predictive model that encompasses health care economics and credit policies; Uniform assessment measure for every patient regardless of financial standing. "Accounts for patients that are unresponsive, illiterate, or otherwise challenged to apply, "Eliminates barrier to application and meets increased pressure to provide additional financial resources to consumers; "Identify and support those community needs efforts to provide assistance to those consumers in need." There are two data points returned to UPMC in order to make the decision whether the patient would qualify for charity care. The first is the estimated income level based on the Federal poverty level guidelines. The second is the PARO score which utilizes an algorithm based approach and returns a score based on personal attributes of the patient. Data elements were combined to create two primary indicators of need, the PARO score and the Federal poverty level. PARO analyzed our historical charity care approvals to determine our PARO threshold and the FPL threshold for historical approvals. The approved charity care accounts were compared against accounts that were inactive accounts receivable. This was done to determine if the distributions were similar or if any pattern existed based on the approved accounts and the unknown accounts. If the patient's estimated income and PARO score are within the scores identified by the calibration of UPMC exisitng charity care patients, the account is reclassified from bad debt to charity care, however, the automated strategy focuses on patients that do not complete the application process. The US Department of Education estimates that 1 in 5 consumers are functionally illiterate. This, coupled with the low levels of participation in traditional banking methods, makes the appliation process virtually impossible for consumers.
Part III, Line 4:	The System reports patient accounts receivable for services rendered at net realizable amounts from third-party payers, patients and others. The System provides an allowance for doubtful accounts based upon a review of outstanding receivables, historical collection information and existing economic conditions. As a service to the patient, the System bills third-party payers directly and bills the patient when the patient's liability is determined. Patient accounts receivable are due in full when billed. Accounts are considered delinquent and subsequently written off as bad debts based on individual credit evaluation and specific circumstances of the account.
Part III, Line 8:	The Medicare cost report uses a cost per day for the routine service costs times the number of Medicare days. Ancillary costs are calculated based on the cost to charge ratio by department. The Medicare cost report does not capture all charges and reimbursements provided to the facility under Medicare. For the fiscal year ended June 30, 2018, the facility had approximately $7 million in Medicare charges provided at a cost of approximately $8 million. This resulted in a $1 million shortfall for the fiscal year.Serving patients with government health benefits, such as Medicare, is a component of the community benefit standard that tax-exempt hospitals are held to. This implies that serving Medicare patients is a community benefit and that the hospital operates to promote the health of the community.
Part III, Line 9b:	UPMC has a debt collection policy outlining collection practices for patients. If at any time the patient expresses an inability to pay, they are sent a financial assistance application. Information regarding financial assistance is printed on all collection letters. Collections per policy do not apply to account balances known to be eligible for financial assistance.
Part VI, Line 2:	The Health System engaged BKD, LLP to conduct a formal CHNA. BKD, LLP is one of the largest CPA and advisory firms in the United States, with approximately 2,000 partners and employees in 34 offices. BKD serves more than 900 hospitals and health care systems across the country. The CHNA was conducted from February 2016 to June 2016.The following steps were conducted as part of the Health System's CHNA 1) An evaluation of the impact of actions taken to address the significant health needs identified in the tax year 2012 CHNA was completed to understand the effectiveness of the Health System's current strategies and programs. 2) The "community" served by the Health System was defined by utilizing inpatient data regarding patient origin. This process is further described in the Community Served by the Health System. 3) Population demographics and socioeconomic characteristics of the community were gathered and reported utilizing various third parties. The health status of the community was then reviewed. Information on the leading causes of death and morbidity information was analyzed in conjunction with health outcomes and factors reported for the community by the Center for Disease Control and Prevention (Community Health Status Indicators). Health factors with significant opportunity for improvement were noted. 4) Community input was provided through nine key stakeholder meetings and a community health survey. Results and findings are described in the Community Input Key Stakeholder Interviews and Survey section of the CHNA at www.upmcsusquehanna.org/community health. 5) Information gathered in the above steps was analyzed and reviewed to identify health issues of uninsured persons, low income persons and minority groups and the community as a whole. Health needs were ranked utilizing a weighing method that weighs the size of the problem, the seriousness of the problem, the impact of the issues on vulnerable populations, the prevalence of common themes, how important the issue is to the community, and how the issue aligns with the Hospital's strategic plan. 6) An inventory of health care facilities and other community resources potentially available to address the significant health needs identified through the CHNA was prepared and collaborative efforts were identified. Health needs were then prioritized taking into account the perceived degree of influence the Health System has to impact the need and the health needs impact on overall health for the community.To help see the implementation plan come to fruition an implementation team has been formed which is comprised of various individuals from community organizations throughout Lycoming and Tioga counties. Such partnered organizations include Lycoming County Health Improvement Coalition, Tioga County Partnership for Community Health, River Valley YMCA, Project Bald Eagle, STEP, YWCA, PA Department of Health , just to name a few.
Part VI, Line 3:	UPMC communicates the availability of financial assistance to its patients by placing signage and distributing brochures about the financial assistance program in its provider registration areas, admissions, emergency department and business office locations. In addition, UPMC includes information regarding how a patient can request financial assistance on the bills, follow-up correspondence and collection letters.Patients may also find information about financiai assistance through access to the UPMC website (WWW.UPMC.COM).Patients are encouraged to contact UPMC's trained financial counselors should they require assistance with completing applications. Contact telephone numbers are posted strategically throughout the hospital facilities so that patients have a resource for obtaining support with any financial assistance questions they may have. UPMC has created a plain language summary (PLS) to explain, in simplified terms, our financial assistance policy (FAP). This summary is printed at all same day surgery, ER and inpatient locations and given to the patient upon discharge. UPMC has also translated the PLS, FAP, collection and billing policy, and FAP application into the following languages; Arabic, Chinese, French, Italian, Nepali, Russian, Spanish, and Braille. The determination of languages for translation of documents was determined by a study of English proficiency in the communities served and review of predominant native languages in those communities as prescribed in IRC Section 501 (R). The PLS is available on the UPMC website.UPMC will notify all patients approved via presumptive eligibility if not receiving the highest level of assistance. A letter informing the patient that they may qualify for a higher level and a financial assitance application will be sent to the patient upon determination. UPMC has widely publicized our financial assistance policy. UPMC has worked with hospital leaders and community liasons to determine the most appropriate non-healthcare locations to reach the populations that will benefit from our financial assistance. UPMC has proactively reached out in these communities to widely publicize our financial assistance policy. Finally, UPMC will now only include patient balances from one year prior to the patient's financial assistance approval date. As a result, UPMC will also refund any patient payments made within that year of the patient's financial assistance approval date, approved via an application.
Part VI, Line 4:	The hospitals that comprise UPMC Susquehanna Lycoming county operations are: The Williamsport Hospital (TWH), Divine Providence Hospital (DPH) and Muncy Valley Hospital (MVH). The county is in the north central region of the state, about three and half hours northeast of Pittsburgh and the same distance northwest of Philadelphia. Lycoming County is designated as rural and has small towns nestled within a stunning natural landscape. The City of Williamsport, with the majestic Susquehanna River running through it, is designated as urban, and is home of the Little League World Series. Unfortunately, the City of Williamsport and the surrounding rural area are also home for many individuals and families who cannot afford the primary health and dental care services provided in the county. In addition, Soldiers and Sailors Memorial Hospital (SSMH)located in Wellsboro, PA, Tioga County, is also part of UPMC Susquehanna. Tioga County is located in rural North Central Pennsylvania and has a population of approximately 42,000 as of the 2010 census. The median household income was $44,000 with 15.3% of the residents below two times the Federal Poverty level. Also part of UPMC Susquehanna are Lock Haven Hospital (LHH) located in Clinton County and Sunbury Community Hospital located in Northumberland County. For a more detailed discussion regarding the community served, as well as associate socio-economic characteristics, you may view the CHNA and related Implementation plan at www.upmcsusquehannahealth.org.
Part VI, Line 5:	The hospitals of UPMC Susquehanna all have entity specific boards that are composed of persons who reside in Lycoming and Tioga Counties.In addition to this UPMC Susquehanna extends medical staff privileges to all qualified physicians in the county in all areas of primary and specialty care according to the UPMC Susquehanna Medical Staff Bylaws. Bylaws excerpts pertaining to this area are as follows:3.1) Nature of Membership - Medical Staff membership is available to qualified physicians, dentists, maxillofacial/oral surgeons, and podiatrists and confers both responsibilities and prerogatives, but only as provided in these Bylaws. No physician, dentist, or podiatrist, including those employed by or otherwise under contract with the Hospital(s), may admit a patient or independently provide patient care services in the Hospital(s) unless he is a Medical Staff member with applicable clinical privileges pursuant to these Bylaws. A member shall have only those clinical privileges, including admitting privileges, as have been granted in accordance with these Bylaws.3.2) Qualifications - No individual shall be considered eligible for appointment or reappointment to the Medical Staff unless he meets each of the following required qualifications/criteria. If any change in personal or professional status occurs which would inhibit practitioner's ability to effectively meet the obligations for patient care and Medical Staff membership under these Bylaws, the practitioner shall immediately notify the Medical Director.3.2-1) Professional Licensure Qualification - A member must be a physician, dentist, or podiatrist and must be duly licensed to practice in the Commonwealth of Pennsylvania.3.2-2) Clinical Privileges Qualification - A Member of the Medical Staff must have clinical privileges(or in the case of a new applicant, is granted privileges at the time of the appointment), except those appointed to the Emeritus Staff or as otherwise specified in these Bylaws. 3.2-3) Professional Competence - A member must demonstrate sufficient professional education, training, experience, competence, and good judgement to perform Medical Staff responsibilities and clinical privileges requested.3.2-4) Health Status - A member must have sufficient physical and mental health to perform Medical Staff responsibilities and exercise clinical privileges requested.3.2-5) Basic Responsibilities - A member must discharge the basic responsibilities of Medical Staff membership noted in 3.3-2.3.2-6) Board Certification Requirement - All practitioners who are current staff members at UPMC Susquehanna as of 7/1/10 and who have met prior qualifications for membership shall be exempt from board certification requirements.3.2-7) Standing with Federal Payors - A member must not be excluded from participation in federally funded programs such as Medicare and Medicaid.3.2-8) Waiver - The Board Certification requirement described in 3.2-6 may be waived under very special circumstances in which an applicant for Medical Staff membership is capable of providing specific unique expertise presently not available or insufficiently available on the Medical Staff which will fulfill an unmet medical need in the community. Such waiver may be granted by the Board(s) only upon recommendation of the Department Chairman, Credentials Committee, and the Medical Executive Committee (MEC).3.2-9) Prohibited Criteria - Medical Staff membership or assignment to a Medical Staff category shall not be denied, terminated, revoked, suspended, modified or otherwise restricted based upon:(a) Gender, race, creed, color, national origin, handicap, or disability, if the individual is otherwise qualified under these Bylaws, or(b) Economic considerations as the sole or primary criterion, or (c) Any criterion not set forth as a required qualification in these Bylaws, or(d) Any other criterion lacking professional or ethical justification.3.2-10) Effect of Other Affiliations - No individual shall be granted Medical Staff membership or be assigned to any Medical Staff category merely because he:(a) Holds a certain degree,(b) Is licensed to practice in the Commonwealth of Pennsylvania or any other state,(c) Is a member of any professional organization,(d) Is certified by any Clinical Board,(e) Had, or presently has, Medical Staff membership or clinical privileges at another health care facility,(f) Is employed by or is otherwise under contract with the Hospital(s) or,(g) Is employed by or otherwise practices with a group composed of one or more Medical Staff members.The volunteer program at UPMC Susquehanna supports the services at our 6 campuses, SSMH, MVH, DPH, TWH, LHH and SCH as well as our Life Center located within the River Valley Regional YMCA in Williamsport, PA. Volunteers ranging in age from 14, assist staff and patients in almost every department. The volunteers come from Tioga and surrounding counties to support our services. They provide over 65,000 hours of service in both office, customer service and patient care areas to support our service partners. They become ambassadors for the hospital, make new friends, financially support the hospital, become involved in the auxiliary, remain active members of society, often stay healthier longer, enjoy the camaraderie with staff and other volunteers, serve on hospital committees, recruit other volunteers, increase their volunteer hours and offer constructive suggestions for improvement. Volunteers are recruited through fairs, internet information and on-line applications, volunteer referrals and presentations to groups. They are a highly regarded, integral part of our operational support system.
Part VI, Line 6:	Soldiers and Sailors Memorial Hospital (SSMH) is one of six hospitals which are part of UPMC Susquehanna. The mission of UPMC Susquehanna is to promote health by acting as the parent of a nonprofit health system in North Central Pennsylvania and by raising funds and otherwise supporting the system.SSMH is a critical access hospital providing diagnostic and treatment facilities, educational and training programs and a rehabilitation facility.Divine Providence Hospital (DVH) is a specialty hospital that offers inpatient psychiatric services and a wide array of outpatient hospital services, as well as, home health and hospice services.Muncy Valley Hospital (MVH) is a critical access hospital, primarily serving Lycoming and surrounding counties. MVH also provides a full range of outpatient and emergency services, as well as, operates a long-term care facility. The Williamsport Hosital (TWH)is an acute care community hospital providing diagnostic and treatment facilities, educational and training programs, and a rehabilitation facility.Sunbury (SCH) is an acute care community hospital as well as offers inpatient psychiatric services.Lock Haven (LHH)is an acute care community hospital providing diagnostic and treatment facilities. LHH also operates a long-term care facility.The hospitals treat Medicare and Medical Assistance patients and maintains a Medicare/Medical Assistance policy that provides patients enrolled in such programs with access to all covered inpatient, outpatient and diagnostic services that are available to non-Medicare/Medical Assistance patients.The community benefit report is prepared on a system-wide basis under UPMC Susquehanna. On an annual basis, UPMC Susquehanna devotes a portion of its revenue and assets to community program services. The following reflects the breakout of $108,814,429 in quantifiable community benefits reported for FY 2018: Charity Care (at cost) $1,975,767; Bad Debts (at cost) $10,179,193; Government sponsored health care (unpaid cost of Medicare, Medicaid, indigent care programs, SCHIP and other safety net programs)$90,988,959. In addition, various other programs such as Research, Health Professions Education, Community Building, Financial and In-Kind contributions, and Community Benefit Operations totaling $5,670,510.

Schedule H (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
Soldiers and Sailors Memorial Hospital

Employer identification number
23-2176963

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) Penn College of Technology 1 College Avenue Williamsport,PA17701	11-1111111	Government		670,000	Appraisal	Donation of Building	Donated a building to be used for educational purposes by expanding its nursing program in Wellsboro Pa.

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) 2019

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference	Explanation

Schedule I (Form 990) 2019

Additional Data

Software ID:
Software Version:

- 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" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

Soldiers and Sailors Memorial Hospital

Employer identification number

23-2176963

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 on 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 on 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 on 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 on 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? .........

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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on 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," on line 5a or 5b, describe in Part III.

For persons listed on 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," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported on 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" on 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) 2019

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 on 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 in column (B) reported as deferred on 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)
1Jill ABurns MD Director	(i) (ii)	0 ------------- 225,123	0 ------------- 23,580	0 ------------- 839	0 ------------- 9,668	0 ------------- 19,539	0 ------------- 278,749	0 ------------- 0
2Walter J Laibinis DO Director	(i) (ii)	0 ------------- 228,709	0 ------------- 103,398	0 ------------- 29,301	0 ------------- 10,100	0 ------------- 19,899	0 ------------- 391,407	0 ------------- 0
3Steven P Johnson President/CEO	(i) (ii)	0 ------------- 727,745	0 ------------- 665,835	0 ------------- 40,608	0 ------------- 14,150	0 ------------- 19,660	0 ------------- 1,467,998	0 ------------- 0
4Janie M Hilfiger VP/President	(i) (ii)	163,771 ------------- 0	15,107 ------------- 0	10,057 ------------- 0	7,651 ------------- 0	10,441 ------------- 0	207,027 ------------- 0	0 ------------- 0
5Eric Pohjala Executive VP/CFO	(i) (ii)	0 ------------- 375,558	0 ------------- 46,874	0 ------------- 12,448	0 ------------- 10,100	0 ------------- 21,649	0 ------------- 466,629	0 ------------- 0
6Jan E Fisher Executive VP/COO	(i) (ii)	0 ------------- 410,810	0 ------------- 54,316	0 ------------- 15,683	0 ------------- 10,100	0 ------------- 18,065	0 ------------- 508,974	0 ------------- 0
7David Lopatofsky MD Executive VP/CMO	(i) (ii)	0 ------------- 440,444	0 ------------- 75,201	0 ------------- 37,253	0 ------------- 11,450	0 ------------- 24,175	0 ------------- 588,523	0 ------------- 0
8Enrico Doganiero Physician	(i) (ii)	515,989 ------------- 0	0 ------------- 0	11,902 ------------- 0	10,100 ------------- 0	25,766 ------------- 0	563,757 ------------- 0	0 ------------- 0
9Stephen Bortz Supervisor Chief Pharmaci	(i) (ii)	142,383 ------------- 0	5,181 ------------- 0	106 ------------- 0	6,462 ------------- 0	7,451 ------------- 0	161,583 ------------- 0	0 ------------- 0
10Toni Burch RN Supervisor	(i) (ii)	143,859 ------------- 0	2,468 ------------- 0	343 ------------- 0	6,437 ------------- 0	8,005 ------------- 0	161,112 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2019

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

UPMC Susquehanna EIN# 23-2751183, a related organization, uses the following resources to establish the compensation of the top management officials: compensation committee, independent compensation consultant, written employment contract, compensation survey or study, and approval by the board.

Part I, Line 7

In order for the Leadership Team to participate in the annual Variable Compensation Incentive Program (VCIP) a minimum operating margin must be achieved for the most recently completed year on a consolidated system-wide basis. Individual goals and objectives related to the VCIP may also include individual entity operating performance. For FY 2018, the minimum threshold was met that would trigger a VCIP payment. In October 2017, CEO Steven P Johnson received a variable compensation award in the amount of $665,835.

Schedule J (Form 990) 2019

Additional Data

Software ID:
Software Version:

- 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 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

Soldiers and Sailors Memorial Hospital

Employer identification number

23-2176963

Return Reference	Explanation
Form 990, Part VI, Section A, line 6	UPMC Susquehanna, EIN #23-2751183, is the sole member of the governing body.
Form 990, Part VI, Section A, line 7a	UPMC Susquehanna may elect or remove members of the governing body.
Form 990, Part VI, Section A, line 7b	All the business and affairs of the corporation shall be managed and controlled by the Board of Directors, subject to the oversight of the sole Member of the management and operation of the corporation, except that the following powers are reserved exclusively to the sole Member of the corporation, and no attempted exercise of any such powers by anyone other than the sole Member shall be valid of any force or effort whatsoever. The sole Member shall exercise its power through its Board of Directors. The sole Member shall have the exclusive authority to exercise the following powers: A.)To approve the appointment and removal of the President of the corporation subject to all applicable provisions of the Creation agreement. B.) To elect and remove, with or without cause, a Director of the corporation. C.) To establish the overall policy and long range plans of the corporation, determine or change the mission of the corporation, approve the programs and services of the corporation and the termination of any programs or services of the corporation, monitor and maintain the philosophy, goals and purposes for which the corporation was formed and exists, subject to and in accordance with the provisions of the Creation agreement. D.) To adopt, amend or repeal the Articles of Incorporation or these Bylaws. E.) To establish requirements for a unified budget, the approval of new capital debt, any increment to any existing capital debt, and/or any change in capital debt obligations of the corporation. F.) To establish requirements for the approval of the acquisition, purchase, sale, leasing outside the ordinary course of business, transfer outside the ordinary course of business or encumbrance outside the ordinary course of business of land or buildings and the construction or demolition of buildings owned by the corporation. G.) To require a certified audit of corporate funds at any time. H.) To approve any guaranty of the indebtedness of any person, the granting of any security interest in or the creation of any encumbrance on any assets of the corporation outside the ordinary course of business, or any transfers of any assets of the corporation outside the ordinary course of business, except transfers between or among corporations. I.) To approve any merger, consolidation, organization, reorganization, joint venture or other modification of corporate structure or affiliations affecting the autonomy, governance, or operations of the corporation. J.) To dissolve or terminate the existence of the corporation and determine the distribution of assets upon such termination or dissolution, as provided in these Bylaws. K.) To appoint annually the external fiscal auditor of the corporation. L.) To approve the nominees for elected officers of the Board of Directors of the corporation, and to return the list of approved nominees to the Board of Directors for election. M.) To remove any elected officer of the corporation. N.) To approve the annual capital and operating budget of the corporation. O.) To coordinate managed care plans, including decisions concerning entry into or renewal of any contract or agreement relating thereto.
Form 990, Part VI, Section B, line 11b	A copy of the full IRS Form 990 is available for all board members to review prior to filing.
Form 990, Part VI, Section B, line 12c	UPMC, as a system-wide practice, requires key employed and non-employed personnel to comply with its conflict of interest policies when they engage in UPMC-related business. Individuals covered by the policies include: UPMC Board Members, Corporate Officers, and key employees. UPMC Physicians and non-physician employees who hold a position of influence, identified non-employed members of the UPMC medical staff who hold a position of influence, and individuals conducting clinical research at UPMC, whether or not they are employed by UPMC. These individuals are required to complete a questionnaire at least annually, which along with other data is used to identify possible individual and institutional conflicts of interest. If a potential conflict is identified regarding a specific UPMC activity, the corporate compliance department, with the assistance of the legal department, either develops a written plan designed to prevent the conflict from influencing decisions related to that activity, or requires that the conflicting relationship be divested, as appropriate. For employed personnel and non-board members, non-employed personnel, the conflict of interest identification and management process is ultimately overseen by an ethics and compliance committee of the UPMC Board of Directors on behalf of UPMC and all of its subsidiaries. Potential conflicts of interest transactions involving UPMC entity Board members and entities with which they are affiliated are monitored and subject to pre-approval by the governance and nominating committee of the UPMC Board of Directors.
Form 990, Part VI, Section B, line 15	All top management officials are paid by UPMC Susquehanna, EIN #23-2751183. The Board of Directors, through the Executive Compensation Committee, retains an independent outside consultant to provide guidance with respect to the annual establishment of the rebuttable presumption or reasonableness relative to executive compensation and benefits. The consultant annually provides detailed market information from its annual Executive Compensation Survey for Health Systems. In addition, other regional survey data is provided in order to supply the health system with a "national" picture of compensation. With this process established, the Executive Compensation Committee takes the proper steps to educate the Board of Directors to understand all of the above mentioned oversight and to appropriately prepare them for the community or media inquiry. In addition, the Board is made aware of the Form 990 and its role in the communication of information to the public.
Form 990, Part VI, Section C, line 19	The organization makes its governing documents, conflict of interest policies and financial statements available upon request from the person listed as possessor of the information on line 20.
Form 990, Part IX, line 11g	Other Purchased Services: Program service expenses 5,699,844. Management and general expenses 637,758. Fundraising expenses 0. Total expenses 6,337,602. Housekeeping: Program service expenses 3,353,558. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,353,558. Physician Services: Program service expenses 920,404. Management and general expenses 0. Fundraising expenses 0. Total expenses 920,404. Catering and Food Services: Program service expenses 83,584. Management and general expenses 0. Fundraising expenses 0. Total expenses 83,584. Contracted Medical: Program service expenses 632,115. Management and general expenses 0. Fundraising expenses 0. Total expenses 632,115.
Form 990, Part XI, line 9:	Transfers between related entities 2,523,104.
Form 990 Part XII Line 2c	UPMC, the sole member of UPMC Susquehanna, has assumed the responsibility for oversite of the audited financials at a system-wide level for FY 2018.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- 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.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

Soldiers and Sailors Memorial Hospital

Employer identification number

23-2176963

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)Laurel Health System 32-36 Central Ave Wellsboro,PA16901 24-0795488	Healthcare	PA	501(c)(3)	Line 12b, II	UPMC Susquehanna	Yes
(2)Laurel Realty 32-36 Central Ave Wellsboro,PA16901 23-1403678	Rental Real Estate	PA	501(c)(2)	NA	UPMC Susquehanna	Yes
(3)Laurel Management Services 32-36 Central Ave Wellsboro,PA16901 25-1644910	Inactive	PA	501(c)(3)	Line 12b, II	UPMC Susquehanna	Yes
(4)The Green Home 37 Central Avenue Wellsboro,PA16901 24-0804365	Skilled nursing	PA	501(c)(3)	Line 10	UPMC Susquehanna	Yes
(5)Tioga Health Care Providers 1201 Grampian Blvd Williamsport,PA17701 25-1765538	Physician Services	PA	501(c)(3)	Line 12b, II	UPMC Susquehanna	Yes
(6)Divine Providence Hospital of the Sister 1100 Grampian Blvd Williamsport,PA17701 24-0799343	Hospital	PA	501(c)(3)	Line 3	UPMC Susquehanna	Yes
(7)Muncy Valley Hospital 215 East Water Street Muncy,PA17756 24-0806023	Hospital	PA	501(c)(3)	Line 3	UPMC Susquehanna	Yes
(8)The Williamsport Hospital 700 High Street Williamsport,PA17701 24-0795508	Hospital	PA	501(c)(3)	Line 3	UPMC Susquehanna	Yes
(9)Susquehanna Health Foundation 1100 Grampian Blvd Williamsport,PA17701 23-2743470	Fundraising	PA	501(c)(3)	Line 12a, I	UPMC Susquehanna	Yes
(10)Susquehanna Physician Services 1201 Grampian Blvd Williamsport,PA17701 23-2449454	Physician Services	PA	501(c)(3)	Line 3	UPMC Susquehanna	Yes
(11)Williamsport Area Ambulance Services 700 High Street Williamsport,PA17701 23-2416166	Ambulance transport	PA	501(c)(3)	Line 10	Williamsport Hospital	Yes
(12)Laurel Health Foundation 32-36 Central Ave Wellsboro,PA16901 25-1810488	Foundation	PA	501(c)(3)	Line 12b, II	Laurel Health System		No
(13)Susquehanna Health Innovation Center Inc 700 High Street Williamsport,PA17701 47-1600873	Fundraising	PA	501(c)(3)	Line 12a, I	UPMC Susquehanna	Yes
(14)UPMC Susquehanna 1205 Grampian Blvd Williamsport,PA17701 23-2751183	management Services	PA	501(c)(3)	Line 3	UPMC	Yes
(15)UPMC Senior Communities Inc 600 Grant Street Pittsburgh,PA15219 25-1574736	Senior Living	PA	501(c)(3)	Line 10	UPMC	Yes
(16)Pittsburgh Lifetime Care Community 600 Grant Street Pittsburgh,PA15219 25-1335247	CCRC	PA	501(c)(3)	Line 10	UPMC SR Comm	Yes
(17)Canterbury Place 600 Grant Street Pittsburgh,PA15219 25-0965334	Senior Living	PA	501(c)(3)	Line 10	UPMC SR Comm	Yes
(18)Seneca Place 600 Grant Street Pittsburgh,PA15219 72-1562844	Senior Living	PA	501(c)(3)	Line 10	UPMC SR Comm	Yes
(19)Shadyside Hospital Supporting Foundation 600 Grant Street Pittsburgh,PA15219 26-0303394	Foundation	PA	501(c)(3)	Line 12a, I	UPMC	Yes
(20)UPMC Lee 600 Grant Street Pittsburgh,PA15219 25-0613830	Inactive	PA	501(c)(3)	Line 3	UPMC	Yes
(21)Pittsburgh Care Partnership Inc 600 Grant Street Pittsburgh,PA15219 25-1753852	Adult Daycare	PA	501(c)(3)	Line 10	UPMC	Yes
(22)UPMC Center for High Value Healthcare 600 Grant Street Pittsburgh,PA15219 45-2178782	Research	PA	501(c)(3)	Line 7	UPMC	Yes
(23)Shadyside Hospital Foundation 532 South Aiken Avenue Pittsburgh,PA15232 25-1290546	Foundation	PA	501(c)(3)	Line 12c, III-FI	UPMC Presby	Yes
(24)Passavant Hospital Foundation 9100 Babcock Blvd Pittsburgh,PA15237 25-1407815	Foundation	PA	501(c)(3)	Line 12b, II	UPMC Pass	Yes
(25)UPMC Northwest Foundation 100 Farfield Drive Seneca,PA16346 25-1483624	Foundation	PA	501(c)(3)	Line 12d, III-O	UPMC Northwe	Yes
(26)St Margaret Foundation 600 Grant Street Pittsburgh,PA15219 25-1520340	Foundation	PA	501(c)(3)	Line 7	UPMC St Marg	Yes
(27)Children's Hospital of Pittburgh Fnd 600 Grant Street Pittsburgh,PA15219 25-1865744	Foundation	PA	501(c)(3)	Line 7	UPMC CHP	Yes
(28)Magee-Women Res Inst and Foundation 600 Grant Street Pittsburgh,PA15219 25-1462312	Foundation	PA	501(c)(3)	Line 7	N/A		No
(29)Great Lakes Physician Practice 600 Grant Street 58th Floor Pittsburgh,PA15219 46-4186362	Physician Services	NY	501(c)(3)	Line 3	Regnl Health	Yes
(30)HAMOT Health Foundation 302 French Street Erie,PA16507 25-1400999	Foundation	PA	501(c)(3)	Line 12b, II	UPMC HAMOT	Yes
(31)Safe Harbor Behavorial Health of UPMC HA 1330 W 26TH Street Erie,PA16508 25-1317492	Behavorial	PA	501(c)(3)	Line 7	UPMC HAMOT	Yes
(32)UPMC Jameson 1211 Wilmington Avenue New Castle,PA16105 25-0965406	Healthcare	PA	501(c)(3)	Line 3	UPMC	Yes
(33)Jameson Healthcare Foundation 1211 Wilmington Avenue New Castle,PA16105 25-1536037	Foundation	PA	501(c)(3)	Line 12b, II	UPMC Jameson	Yes
(34)Jameson Health Services Inc 1211 Wilmington Avenue New Castle,PA16105 03-0486993	Supporting Organization	PA	501(c)(3)	Line 12b, II	UPMC Jameson	Yes
(35)Children's Advocacy Center of Lawrence 1107 Wilmington Avenue New Castle,PA16105 25-1581304	Support Sys	PA	501(c)(3)	Line 7	UPMC Jameson	Yes
(36)UPMCJameson Cancer Center 600 Grant Street 58th Floor Pittsburgh,PA15219 20-1459415	Oncology Svc	PA	501(c)(3)	Line 10	UPMC Jameson	Yes
(37)Jameson Medical Care Inc 1211 Wilmington Avenue New Castle,PA16105 26-0462696	Healthcare	PA	501(c)(3)	Line 10	UPMC Jameson	Yes
(38)Jameson Care Center Inc 1211 Wilmington Avenue New Castle,PA16105 23-2871396	Healthcare	PA	501(c)(3)	Line 10	UPMC SR Comm	Yes
(39)Venango VNA Foundation 491 Alleghany Boulevard Franklin,PA16323 25-1472179	Foundation	PA	501(c)(3)	Line 12d, III-O	N/A		No
(40)UPMC Susquehanna Lock Haven 700 High Street Williamsport,PA17701 82-1600494	Hospital	PA	501(c)(3)	Line 3	UPMC Susquehanna	Yes
(41)UPMC Susquehanna Sunbury 700 High Street Williamsport,PA17701 82-1592230	Hospital	PA	501(c)(3)	Line 3	UPMC Susquehanna	Yes
(42)UPMC Chautauqua at WCA 207 Foote Avenue Jamestown,NY14701 16-0743226	Hospital	NY	501(c)(3)	Line 3	UPMC Chautau	Yes
(43)WCA Group Inc 207 Foote Avenue Jamestown,NY14701 22-2392582	Holding Company	NY	501(c)(3)	Line 12b, II	UPMC Chautau	Yes
(44)Starflight Inc 135 Allen Street Jamestown,NY14701 16-1557878	Air Ambulance	NY	501(c)(3)	Line 7	UPMC Chautau	Yes
(45)South Central Alpha Housing and Healthcare 3410 West Pittsburg Road New Castle,PA16101 25-1701701	Skilled Nursing	PA	501(c)(3)	Line 10	UPMC Sr Comm	Yes
(46)South Western Alpha Housing and Health Care 745 Greenville Road Mercer,PA16137 25-1701700	Skilled Nursing	PA	501(c)(3)	Line 10	UPMC Sr Comm	Yes
(47)Kane Community Hospital Foundation 4372 Route 6 Kane,PA16735 26-3906925	Foundation	PA	501(c)(3)	Line 12b, II	N/A		No
(48)Junior Guild of the Jameson Memorial Hospital 1211 Wilmington Avenue New Castle,PA16105 25-6005313	Support Sys	PA	501(c)(3)	Line 12d, III-O	N/A		No
(49)WCA Foundation Inc 300 Foote Avenue PO Box 840 Jamestown,NY14702 22-2393584	Foundation	PA	501(c)(3)	Line 12c, III-FI	N/A		No
(50)UPMC 600 Grant Street Pittsburgh,PA15219 25-1423657	Supporting Organization	PA	501(c)(3)	Line 12c, III-FI	N/A		No
(51)UPMC Pinnacle 409 South Second Street Harrisburg,PA17104 25-1778658	Supporting Organization	PA	501(c)(3)	Line 12b, II	UPMC	Yes
(52)UPMC Pinnacle Carlisle 361 Alexander Spring Road Carlisle,PA17105 82-0880337	hospital	PA	501(c)(3)	Line 3	UPMC Pinnacle	Yes
(53)UPMC Pinnacle Lancaster 250 College Avenue Lancaster,PA17603 82-0896436	hospital	PA	501(c)(3)	Line 3	UPMC Pinnacle	Yes
(54)UPMC Pinnacle Lititz 1500 Highlands Avenue Lititz,PA17543 82-0844453	hospital	PA	501(c)(3)	Line 3	UPMC Pinnacle	Yes
(55)UPMC Pinnacle Memorial 325 South Belmont Street York,PA17405 82-0912090	hospital	PA	501(c)(3)	Line 3	UPMC Pinnacle	Yes
(56)Pinnacle Health Regional Physicians 409 South Second Street Harrisburg,PA17104 82-0947698	Physician Services	PA	501(c)(3)	Line 3	UPMC Pinnacle	Yes
(57)Pinnacle Health Foundation 409 South Second Street Harrisburg,PA17104 22-2691718	Foundation	PA	501(c)(3)	Line 12b, II	UPMC Pinnacle	Yes
(58)Community Life Team Inc 409 South Second Street Harrisburg,PA17104 23-1890444	Ambulance transport	PA	501(c)(3)	Line 7	UPMC Pinnacle	Yes
(59)Hanover Healthcare Plus Inc 300 Highland Avenue Hanover,PA17331 22-2658574	supporting Organization	PA	501(c)(3)	Line 12a, I	UPMC PInnacle	Yes
(60)UPMC Pinnacle Hanover 300 Highland Avenue Hanover,PA17331 23-1360851	hospital	PA	501(c)(3)	Line 3	Hanover Health	Yes
(61)UPMC Pinnacle Hospitals 409 South Second Street Harrisburg,PA17104 25-1778644	hospital	PA	501(c)(3)	Line 3	UPMC Pinnacle	Yes
(62)Pinnacle Health Medical Services 409 South Second Street HArrisburg,PA17104 25-1709054	Physician Services	PA	501(c)(3)	Line 3	UPMC Pinnacle	Yes
(63)Charles E Cole Memorial Hospital 1001 East Second Street Coudersport,PA16915 24-0802108	hospital	PA	501(c)(3)	Line 3	UPMC	Yes
(64)Cole Foundation Inc 1001 East Second Street Coudersport,PA16915 45-5417308	foundation	PA	501(c)(3)	Line 12a, I	Charles Cole Memorial Hospital	Yes
(65)Hamot Cole Ventures 1001 East Second Street Coudersport,PA16915 27-3172100	offsite Clinics	PA	501(c)(3)	Line 12a, I	Charles Cole Memorial Hospital	Yes
(66)Hendorn Inc 1001 East Second Street Coudersport,PA16915 23-1972659	Respite Care	PA	501(c)(3)	Line 12a, I	Charles Cole Memorial Hospital	Yes
(67)Asbury Heights of UPMC 600 Grant Street Pittsburgh,PA15219 25-1555687	Supporting Organization	PA	501(c)(3)	Line 12b, II	UPMC Sr Comm	Yes
(68)Asbury Health Center 600 Grant Street Pittsburgh,PA15219 25-0969472	CCRC	PA	501(c)(3)	Line 10	Asbury Heights	Yes
(69)Asbury Villas 600 Grant Street Pittsburgh,PA15219 25-1819952	Personal Care	PA	501(c)(3)	Line 10	Asbury Heights	Yes
(70)Asbury Place 600 Grant Street Pittsburgh,PA15219 25-1729266	Personal Care	PA	501(c)(3)	Line 10	Asbury Heights	Yes
(71)Wesley Hills 600 Grant Street Pittsburgh,PA15219 25-1507472	Independent Living	PA	501(c)(1)	PF	Asbury Heights	Yes
(72)Asbury Foundation 600 Grant Street Pittsburgh,PA15219 25-1555688	Foundation	PA	501(c)(3)	Line 7	Asbury Heights	Yes
(73)UPMC Home Care Management Services 600 Grant Street Pittsburgh,PA15219 83-0857507	Home Health	PA	501(c)(3)	Line 10	UPMC Comm Prov	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2019

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	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(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
(1) Community Basket LLC 1205 Grampian Blvd Williamsport,PA17701 20-1195739	Rents real estate	PA	N/A	N/A				No			No
(2) Seneca Hills Assisted Living 600 Grant Street Pittsburgh,PA15219 23-2873106	Assisted Living	PA	N/A	N/A				No			No
(3) St Margaret Medical Arts Association 600 Grant Street Pittsburgh,PA15219 25-1786655	Med Office BL	PA	N/A	N/A				No			No
(4) Core Network LLC 600 Grant Street Pittsburgh,PA15219 25-1786209	Healthcare	PA	N/A	N/A				No			No
(5) Life Home Care LP 600 Grant Street Pittsburgh,PA15219 25-1847839	Homecare	PA	N/A	N/A				No			No
(6) Shadyside Medical Center Association 600 Grant Street Pittsburgh,PA15219 25-1608318	Med Office BL	PA	N/A	N/A				No			No
(7) Chartwell PA LP 600 Grant Street Pittsburgh,PA15219 25-1729714	Homehealth	PA	N/A	N/A				No			No
(8) Life Care Home Srv of NW PA 1647 Sassafras Street Erie,PA16507 25-1536879	Homehealth	PA	N/A	N/A				No			No
(9) HAMOT-KCH Real Estate Venture 300 State Street Erie,PA16507 26-3691782	Med Office BL	PA	N/A	N/A				No			No
(10) HAMOT Surgery Center LLC 200 State Street Erie,PA16507 25-1863661	Ambulatory Srv	PA	N/A	N/A				No			No
(11) EPN-HAMOT Urgent Care LLC 600 Grant Street Pittsburgh,PA15219 27-2147949	Urgent Care	PA	N/A	N/A				No			No
(12) Mountain View Medical Oncology 600 Grant Street 58th Floor Pittsburgh,PA15219 46-1449241	Healthcare	PA	N/A	N/A				No			No
(13) Lawrence County MRI & Diagnostic 2526 Wilmington Avenue New Castle,PA16105 27-0219891	Imaging Center	PA	N/A	N/A				No			No
(14) Hanover Surgicenter Real Estate LP 300 Highland Avenue Hanover,PA17331 35-2342993	Inactive	PA	N/A	N/A				No			No
(15) Medcare Susquehanna Valley LLC 409 South Second Street Harrisburg,PA17104 82-1673688	DME	PA	N/A	N/A				No			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) Tyoga Carenet 32-36 Central Avenue Wellsboro,PA16901 25-1810967	Inactive	PA	N/A	C				No
(2) Susquehanna Ventures Inc 1201 Grampian Blvd Williamsport,PA17701 23-2470263	Pharmacy	PA	N/A	C				No
(3) Susquehanna Health System Insurance Network LTD PO Box 1159 Grand Caymans CJ	Insurance	CJ	N/A	C				No
(4) HC Pharmacy Central Inc 600 Grant Street Pittsburgh,PA15219 25-1364192	Pharmacy co-op	PA	N/A	C				No
(5) Children's Community Care 600 Grant Street Pittsburgh,PA15219 25-1781887	Pediatric Svc	PA	N/A	C				No
(6) UPMC Cancer Centers Ireland Limited 6th Floor Beacon Hospital Sandyford,Dublin EI	Cancer Treatment	EI	N/A	C				No
(7) UPMC Physician Services Holding Company 600 Grant Street Pittsburgh,PA15219 25-1877017	Holding Company	PA	N/A	C				No
(8) Hematology Oncology Associates 600 Grant Street Pittsburgh,PA15219 42-1648357	Physician Services	PA	N/A	C				No
(9) Oncology Hematology Associates 600 Grant Street Pittsburgh,PA15219 25-1762980	Physician Services	PA	N/A	C				No
(10) Tri-State Neurosurgical Associates 600 Grant Street Pittsburgh,PA15219 25-1458655	Physician Services	PA	N/A	C				No
(11) Renaissance Family Practice - UPMC Inc 600 Grant Street Pittsburgh,PA15219 26-2942406	Physician Services	PA	N/A	C				No
(12) UPMC Holding Company Inc 600 Grant Street Pittsburgh,PA15219 25-1777713	Holding Company	PA	N/A	C				No
(13) UPMC Coverage Products Inc 600 Grant Street Pittsburgh,PA15219 25-1777710	Holding Company	PA	N/A	C				No
(14) Freedom Insurance Company 600 Grant Street Pittsburgh,PA15219 03-0308944	Insurance	VT	N/A	C				No
(15) Tri-Century Insurance Comp 600 Grant Street Pittsburgh,PA15219 25-1500739	Insurance	PA	N/A	C				No
(16) UPMC DNA Inc 600 Grant Street Pittsburgh,PA15219 25-1883237	Insurance	PA	N/A	C				No
(17) UPMC Health Benefits Inc 600 Grant Street Pittsburgh,PA15219 25-1844144	Health Insurance	PA	N/A	C				No
(18) UPMC Health Network Inc 600 Grant Street Pittsburgh,PA15219 72-1527566	Health Insurance	PA	N/A	C				No
(19) UPMC Health Plan Inc 600 Grant Street Pittsburgh,PA15219 23-2813536	Health Insurance	PA	N/A	C				No
(20) UPMC Benefit Management Services Inc 600 Grant Street Pittsburgh,PA15219 25-1769564	Worker's Comp	PA	N/A	C				No
(21) UPMC Diversified Services Inc 600 Grant Street Pittsburgh,PA15219 25-1778454	Holding Company	PA	N/A	C				No
(22) Monroeville Specialty Clinic 600 Grant Street Pittsburgh,PA15219 25-1666087	Amb Surgery	PA	N/A	C				No
(23) Medical Archival Systems Inc 600 Grant Street Pittsburgh,PA15219 23-2912501	Software Dev	DE	N/A	C				No
(24) Presby Health Resource Mgnt 600 Grant Street Pittsburgh,PA15219 25-1422155	Inactive	PA	N/A	C				No
(25) RX Partners Inc 600 Grant Street Pittsburgh,PA15219 25-1801966	Retail Pharmacy	PA	N/A	C				No
(26) Biotronics Inc 600 Grant Street Pittsburgh,PA15219 25-1843500	Equip Maint	PA	N/A	C				No
(27) Medical Center Properties Inc 600 Grant Street Pittsburgh,PA15219 25-1796940	Real Estate	PA	N/A	C				No
(28) Askesis Development Group Inc 600 Grant Street Pittsburgh,PA15219 54-1625585	Software Dev	DE	N/A	C				No
(29) Panther Reinsurance Company Inc PO Box 1109 Grand Cayman,Cayman Islands CJ 98-1402742	Insurance	CJ	N/A	C				No
(30) Forbes Reinsurance Compnay LTD PO Box 1109 Grand Cayman,Cayman Islands CJ 98-1400710	Insurance	CJ	N/A	C				No
(31) Cathedral (RE) Insurance Co PO Box 1109 Grand Cayman,Cayman Islands CJ 98-1400837	Insurance	CJ	N/A	C				No
(32) UPMC International Health Initiatives 600 Grant Street Pittsburgh,PA15219 84-1706741	Inactive	PA	N/A	C				No
(33) UPMC Ireland Limited 6th Floor Beacon Hospital Sandyford,Dublin EI	Healthcare Srv	EI	N/A	C				No
(34) UPMC United Kingdom LTD C/O Nair Co 11th Floor Whitefriar Lewins Mead,Bristol UK 98-0571026	Software LICE	UK	N/A	C				No
(35) Bayfront Regional Development Corp 300 State Street Erie,PA16507 25-1401388	Holding Company	PA	N/A	C				No
(36) Bayside Development Corp 300 State Street Erie,PA16507 25-1401386	Real Estate	PA	N/A	C				No
(37) UPMC Work Alliance Inc 600 Grant Street Pittsburgh,PA15219 45-2825053	Insurance	PA	N/A	C				No
(38) UPMC Canada Technologies Limited 600 Grant Street Pittsburgh,PA15219	Software	CA	N/A	C				No
(39) Allied Orthopedics Appliances Inc 335 East 3rd Street Jamestown,NY14701 16-1092951	Inactive	PA	N/A	C				No
(40) UPMC Health Coverage Inc 600 Grant Street Pittsburgh,PA15219 46-2824537	Insurance	PA	N/A	C				No
(41) UPMC Health Options Inc 600 Grant Street Pittsburgh,PA15219 46-2824626	Insurance	PA	N/A	C				No
(42) UPMC Complete Care Inc 5215 Centre Avenue Pittsburgh,PA15232 46-3605753	Physician Services	PA	N/A	C				No
(43) American Home Health Services 868 Corporate Way Westlake,OH44145 31-1521422	Home Health C	OH	N/A	C				No
(44) Health Fidelity Inc 210 South B Street San Mateo,CA94401 45-2538963	Technology Sv	CA	N/A	C				No
(45) Fluence Health Inc 6425 Penn Avenue Pittsburgh,PA15206 47-2684174	Software	DE	N/A	C				No
(46) Curavi Health Inc 6425 Penn Avenue Pittsburgh,PA15206 81-1217377	Healthcare	DE	N/A	C				No
(47) Pensiamo Inc 600 Grant Street 59th Floor Pittsburgh,PA15219 81-2069236	Supply Chain	DE	N/A	C				No
(48) Altoona Family Inc 620 Howard Avenue Altoona,PA16601 25-1444935	Mgmt Serv	PA	N/A	C				No
(49) Lexington Holdings Inc 620 Howard Avenue Altoona,PA16601 25-1794386	Holding Company	PA	N/A	C				No
(50) Lexington One Inc 620 Howard Avenue Altoona,PA16601 25-1468889	Rental	PA	N/A	C				No
(51) Lexington Two Inc Howard Avenue 7th Street Altoona,PA16601 25-1555689	DME	PA	N/A	C				No
(52) Lexington Four Inc 620 Howard Avenue Altoona,PA16601 25-1793736	Holding Company	DE	N/A	C				No
(53) Allegheny Healthcare Staffing Inc 620 Howard Avenue Altoona,PA16601 27-1657362	Inactive	PA	N/A	C				No
(54) UPMC Altoona Regional Health Services 1414 9th Avenue Altoona,PA16602 25-1219302	Physician Services	PA	N/A	C				No
(55) Lexington Anesthesia Associates Inc 620 Howard Avenue Altoona,PA16601 25-1897765	Physician Services	PA	N/A	C				No
(56) Northern Cambria Medical Center Inc 620 Howard Avenue Altoona,PA16601 25-1530860	Inactive	PA	N/A	C				No
(57) Patton Family Medical Center Inc 620 Howard Avenue Altoona,PA16601 25-1793735	Inactive	PA	N/A	C				No
(58) MEDCPU 100 Wall Street Suite 2202 New York,NY10005 38-3805381	Software Dev	DE	N/A	C				No
(59) UPMC Excess PL TR 600 Grant Street Pittsburgh,PA15219 82-6254351	Trust	PA	N/A	T				No
(60) RXANTE Inc 511 Congress Street 803 Portland,ME04101 45-4040219	Medication Mgnt	DE	N/A	C				No
(61) Vincent Payment Solutions Inc Bakery Square 6425 Penn Avenue Suit pittsburgh,PA15219 82-1101143	Payment System	DE	N/A	C				No
(62) J Health Ventures Inc 1211 Wilmington Avenue New Castle,PA16105 25-1607893	Inactive	PA	N/A	C				No
(63) JER Medical Associates Inc 1211 Wilmington Avenue New Castle,PA16105 25-1609398	Inactive	PA	N/A	C				No
(64) WCA Service Corporation Inc 207 Foote Avenue Jamestown,NY14701 16-1151438	Support Services	NY	N/A	C				No
(65) ITTCCO I Inc 600 Grant Street Pittsburgh,PA15219 82-2590699	Inactive	DE	N/A	C				No
(66) ITTCCO II Inc 600 Grant Street Pittsburgh,PA15219 82-2597388	Inactive	DE	N/A	C				No
(67) Pinnacle Health Cardiovascular Institute Inc 409 South Second Street Harrisburg,PA17104 32-0321362	Physician Services	PA	N/A	C				No
(68) Hanover Health Corporation 300 Highland Avenue Hanover,PA17331 90-0498067	Holding Company	PA	N/A	C				No
(69) Hanover Apothecary Inc 310 Stock Street Suite 1 Hanover,PA17331 90-0498067	Pharmacy	PA	N/A	C				No
(70) United Central PA Reciprocal Risk Retention Group 76 Saint Paul Street Suite 500 Burlington,VT05401 13-4224033	Insurance	VT	N/A	C				No
(71) Pinnacle Health Ventures Inc 409 South Second Street Harrisburg,PA17104 61-1677624	Holding Company	PA	N/A	C				No
(72) Pinnacle Health Imaging Inc 409 South Second Street Harrisburg,PA17104 23-1718571	Imaging Services	PA	N/A	C				No
(73) Cole Care Inc 1001 East 2nd Street Coudersport,PA16915 25-1497347	DME	PA	N/A	C				No
(74) UPMC Italy Health Services SR L VIA Discesa DEI Giudici 4 Palermo IT	Health Services	IT	N/A	C				No
(75) UPMC Investments LTD C/O UPMC Whitfield Cork Road Butler Waterford EI	Holding Company	EI	N/A	C				No
(76) UPMC Property LTD C/O UPMC Whitfield Cork Road Butler Waterford EI	Property	EI	N/A	C				No
(77) UPMC Property II LTD C/O UPMC Whitfield Cork Road Butler Waterford EI	Property	EI	N/A	C				No
(78) Euro Care Infrastructure LTD C/O UPMC Whitfield Cork Road Butler Waterford EI	Property Management	EI	N/A	C				No
(79) Euro Care Property Managment LTD C/O UPMC Whitfield Cork Road Butler Waterford EI	Property Management	EI	N/A	C				No
(80) Euro Care Healthcare LTD C/O UPMC Whitfield Cork Road Butler Waterford EI	Hospital	EI	N/A	C				No
(81) Waterford Oncology Associates LTD C/O UPMC Whitfield Cork Road Butler Waterford EI	Oncology Services	EI	N/A	C				No
(82) United Health Risk LTD PO Box HM 2450 Hamilton BD	Insurance	BD	N/A	C				No

Schedule R (Form 990) 2019

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) .......................

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) .................

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

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

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

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

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) 2019

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) 2019

Page 5

Part VII

Supplemental Information

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

Return Reference	Explanation
Form 990 Schedule R Part II to Part IV	The entities marked with an asterick are not technically "related parties", as defined by the IRS Form 990 instructions, of the filing organization. However, they are listed on Schedule R to reflect that they are part of the UPMC system of entities, as they all share UPMC as their ultimate parent corporation.

Schedule R (Form 990) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: Soldiers & Sailors Memorial Hospital (SSMH) is a 50 bed, critical access hospital, primarily serving Tioga and surrounding counties. SSMH provides a full range of outpatient, inpatient and emergency services.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	13
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	10
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	91
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 39 .........	7b	2,166

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	26,046	6,700
9	Program service revenue (Part VIII, line 2g) .........	71,932,539	77,632,614
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	117,624	165,238
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	552,462	698,851
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	72,628,671	78,503,403
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	7,675	686,928
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	26,207,312	24,679,469
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	35,013,948	37,835,804
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	61,228,935	63,202,201
19	Revenue less expenses. Subtract line 18 from line 12.......	11,399,736	15,301,202
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	85,842,590	97,443,370
21	Total liabilities (Part X, line 26).............	13,713,473	7,489,947
22	Net assets or fund balances. Subtract line 21 from line 20.....	72,129,117	89,953,423

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 58,342,208 including grants of $ 686,928 ) (Revenue $ 77,632,614 )
	The hospital is an 50 bed critical access hospital, which provides care to patients who meet certain criteria without charge or at amounts less than its established rates. The hospital does not pursue collection of amounts determined to qualify as charity care, nor are such amounts reported as revenue. The charity care charges foregone amounted to $1,264,200 in 2018. The following is a summary of the services provided to patients in 2018;Inpatient admissions 1,707Outpatient visits 94,776Newborn deliveries 206Emergency department visits 15,677Surgeries performed 5,842Laboratory tests 256,094CAT Scans 7,357Ultrasound tests 6,598Radiology tests 17,670MRI tests 1,822Nuclear Medicine tests 742Rehab 11,186Oncology Procedures 2,420

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	SSMH treats all patients without regard to their ability to pay. In addition, the Hospital treats Medicare and Medical Assistance patients and maintains a Medicare/Medical Assistance policy that provides patients enrolled in such programs with access to all covered inpatient, outpatient and diagnostic services that are available to non-Medicare/Medical Assistance patients.

4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	On an annual basis, SSMH devotes a portion of its revenue and assets to community program services. The following reflects the breakout of $13,738,000 in quantifiable community benefits reported for FY 2018. Charity care (at cost) $315,000; Bad Debt (at cost) 5,619,000; Government-sponsored health care (unpaid cost of Medicare, Medicaid, indigent care programs, and other safety net programs) $7,129,000. In addition, various other programs such as Community Building, Community Wellness and recreation, Financial and InKind Contributions and Community Benefit Operations totaling $675,000.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses58,342,208

(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) Enrico Doganiero........................................................................ Physician	40.00 .......................	X	527,891	0	35,866
(19) Candy Klotz........................................................................ Pharmacist	40.00 .......................	X	141,877	0	6,773
(20) Stephen Bortz........................................................................ Supervisor Chief Pharmaci	40.00 .......................	X	147,670	0	13,913
(21) Toni Burch........................................................................ RN Supervisor	40.00 .......................	X	146,670	0	14,442

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	1,153,043	3,513,725	277,641

(A) Name and business address	(B) Description of services	(C) Compensation
Aramark Healthcare 24863 Network Place Chicago,IL60673	Management Services/Environment	6,086,909
Oracle (People Soft) 500 Oracle Parkway Redwood Shores,CA94065	Software support	1,931,084



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 2

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	6,700

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		6,700

		Business Code
2a	Patient service revenue	621990	75,558,570	75,558,570
b	Employee Pharmacy revenue	446110	830,040	830,040
c	Paramedic revenue	621910	541,618	541,618
d	Other Miscellaneous income	621990	469,123	469,123
e	Cafeteria revenue	722210	216,943	216,943
f	All other program service revenue.		16,320	16,320
g	Total. Add lines 2a–2f .....		77,632,614

3 Investment income (including dividends, interest, and othersimilar amounts) ......
4 Income from investment of tax-exempt bond proceeds			7,395			7,395
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		698,851	6a
b	Less: rental expenses		0	6b
c	Rental income or (loss)		698,851	6c
d	Net rental income or (loss).......			698,851			698,851
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	484,609		7a
b	Less: cost or other basis and sales expenses	326,766		7b
c	Gain or (loss)	157,843		7c
d	Net gain or (loss).........			157,843			157,843
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See instructions.....			78,503,403	77,632,614	0	864,089

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	686,928	686,928
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	1,153,043	964,108	188,935
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	18,805,107	17,064,119	1,740,988
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	75,013	67,512	7,501
9	Other employee benefits .......	3,234,989	2,911,490	323,499
10	Payroll taxes ...........	1,411,317	1,270,185	141,132
11	Fees for services (non-employees):
a	Management ......	1,548,232		1,548,232
b	Legal .........	1,073		1,073
c	Accounting ...........	3,885		3,885
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	11,327,263	10,689,505	637,758
12	Advertising and promotion ....	194	194
13	Office expenses .......	574,566	506,729	67,837
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	884,739	860,236	24,503
17	Travel ............	120,845	120,845
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	34,566	34,566
20	Interest ...........	603,478	603,478
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	3,777,208	3,777,208
23	Insurance ...	498,698	498,698
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	Medical Supplies and Dr	9,597,398	9,588,825	8,573
b	Bad Debt Expenses	5,618,536	5,618,536
c	Repairs and Maintenance	2,240,310	2,233,232	7,078
d	Laundry and Linen	216,172	216,172
e	All other expenses	788,641	629,642	158,999
25	Total functional expenses. Add lines 1 through 24e	63,202,201	58,342,208	4,859,993	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).

1	Cash–non-interest-bearing ........			6,393,504	1	210,423
2	Savings and temporary cash investments .........			34,558	2	24,622
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			7,621,953	4	9,121,333
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........			867,555	7	3,191,543
8	Inventories for sale or use ............			684,327	8	368,486
9	Prepaid expenses and deferred charges ......			171,922	9	28,050
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	82,929,499
b	Less: accumulated depreciation	10b	42,094,944	42,107,777	10c	40,834,555
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			27,960,994	15	43,664,358
16	Total assets. Add lines 1 through 15 (must equal line 33)...			85,842,590	16	97,443,370

17	Accounts payable and accrued expenses .....	10,446,129	17	3,547,740
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	257,624	23	173,952
24	Unsecured notes and loans payable to unrelated third parties ..	2,349,399	24	2,231,753
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	660,321	25	1,536,502
26	Total liabilities. Add lines 17 through 25..	13,713,473	26	7,489,947

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........		27
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	72,129,117	32	89,953,423
33	Total liabilities and net assets/fund balances ........	85,842,590	33	97,443,370

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No