SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
UNIVERSITY HEALTH SYSTEM INC
 
Employer identification number

31-1626179
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
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.
3
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.
a
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:
3a
Yes
 
%
b
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: . . . . . . . .
3b
Yes
 
%
c
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.
4
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"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
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? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (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) . . . 		    20,083,140   20,083,140 2.640 %
b Medicaid (from Worksheet 3, column a) . . . . .            
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     11,217,661 6,295,802 4,921,859 0.650 %
d Total Financial Assistance and Means-Tested Government Programs . . . . .     31,300,801 6,295,802 25,004,999 3.290 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     381,168   381,168 0.050 %
f Health professions education (from Worksheet 5) . . .     17,785,183   17,785,183 2.340 %
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) .     157,955   157,955 0.020 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     248,085   248,085 0.030 %
j Total. Other Benefits . .     18,572,391   18,572,391 2.440 %
k Total. Add lines 7d and 7j .     49,873,192 6,295,802 43,577,390 5.730 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support     2,038   2,038 0 %
4 Environmental improvements            
5 Leadership development and
training for community members		     43,000   43,000 0.010 %
6 Coalition building     11,871   11,871 0 %
7 Community health improvement advocacy     338,818   338,818 0.040 %
8 Workforce development     2,540   2,540 0 %
9 Other            
10 Total     398,267   398,267 0.050 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
11,338,266
3
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. ......
3
8,200,000
4
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
5
Enter total revenue received from Medicare (including DSH and IME).....
5
253,124,731
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
255,006,598
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-1,881,867
8
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:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
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 .........................

9b

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) 2015
Schedule H (Form 990) 2015
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?1
Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 UNIVERSITY HEALTH SYSTEM
9000 EXECUTIVE PARK DRIVE BLDG
D-240
KNOXVILLE,TN37923
WWW.UTMEDICALCENTER.ORG 		X X   X   X X      
Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
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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)
UNIVERSITY HEALTH SYSTEM INC
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 No
Community Health Needs Assessment
1 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?........................ 1   No
2 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............... 2   No
3 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...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 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 ................. 5 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.................................. 6a   No
b 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. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE DISCLOSURE
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 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   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2015
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Schedule H (Form 990) 2015
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Part VFacility Information (continued)

Financial Assistance Policy (FAP)
UNIVERSITY HEALTH SYSTEM INC
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE DISCLOSURE
b
SEE DISCLOSURE
c
d
e
f
g
h
i
Billing and Collections
17 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 non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
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Part VFacility Information (continued)

UNIVERSITY HEALTH SYSTEM INC
Name of hospital facility or letter of facility reporting group  
Yes No
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 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):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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.
a
b
c
d
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
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Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 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
UNIVERSITY HEALTH SYSTEM, INC. PART V, SECTION B, LINE 5: UTMC USES MULTIPLE COMMUNITY STAKEHOLDER LISTENING POSTS SUCH AS MARKET DATA, STAKEHOLDER PLATFORMS SUCH AS FOCUS GROUPS, SURVEYING IN OUR 21 COUNTY SERVICE AREA AND DATA COLLECTED DURING COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FROM KNOX COUNTY.IN COLLABORATION WITH OUR LOCAL COUNTY HEALTH DEPARTMENT AND COMMUNITY RESOURCE PROGRAMS, A COLLABORATIVE WAS FORMED TO BRING TOGETHER HEALTH CARE PROVIDERS AND ORGANIZATIONS THAT MAKE UP OUR LOCAL PUBLIC HEALTH SYSTEM AND SERVES TO GUIDE OUR COMMUNITY TO IDENTIFY AND TAKE ACTION ON PRIORITY HEALTH ISSUES.
UNIVERSITY HEALTH SYSTEM, INC. PART V, SECTION B, LINE 6B: MULTIPLE ORGANIZATIONS PARTICIPATED IN THE CHNA PROCESS. MAJOR PARTICIPANTS INCLUDED CHEROKEE HEALTH SYSTEM, RURAL METRO EMS, KNOX COUNTY OFFICE ON AGING, KNOX COUNTY HEALTH DEPARTMENT, KNOXVILLE AREA RESCUE MISSION, UNIVERSITY OF TENNESSEE AG EXTENSION, INTERFAITH HEALTH CLINIC, AND UNIVERSITY OF TENNESSEE GRADUATE SCHOOL OF MEDICINE.
UNIVERSITY HEALTH SYSTEM, INC. PART V, SECTION B, LINE 11: UTMC IDENTIFIES ITS KEY COMMUNITIES AND DETERMINES AREAS FOR ORGANIZATIONAL INVOLVEMENT BY THE COMMUNITY HEALTH ADVISORY COMMITTEE (CHAC) AND UTMC TEAM MEMBER ANALYSIS OF STATE, LOCAL, AND REGIONAL HEALTH STATISTICAL DATA. UTMC HAS MANY PROGRAMS AND PARTNERSHIPS IN PLACE TO SUPPORT AND BENEFIT HIGH PRIORITY AND KEY COMMUNITIES WHICH INCLUDES: UTMC'S HEALTHY LIVING KITCHEN PROVIDES NUTRITIONALLY BASED EDUCATION CLASSES AND TEACHES INDIVIDUALS HOW TO COOK HEALTHY TO IMPROVE HEALTH STATUS AND MANAGE DIETS WHICH LESSENS IMPACT CHRONIC DISEASE, SUCH AS DIABETES AND CARDIOVASCULAR DISORDERS. COMMUNITY AND WORKSITE BASED HEALTH SCREENINGS AND EDUCATION FOR CANCER, DIABETES, HYPERTENSION, OBESITY, AND HYPERLIPIDEMIA. RESPIRATORY THERAPY PARTNERS WITH COORDINATED SCHOOL HEALTH STAFF TO IMPLEMENT SMOKING CESSATION AND PREVENTION PROGRAMS TO MIDDLE SCHOOL AGED CHILDREN. UTMC BREAST HEALTH OUTREACH PROGRAM (BHOP) WHICH PROVIDES MOBILE BREAST SCREENINGS TO DISADVANTAGED POPULATIONS THROUGH A COLLABORATIVE PARTNERSHIP EFFORT WITH SUSAN G. KOMEN AND AVON FOUNDATIONS. UTMC CANCER INSTITUTE PROVIDES PROSTATE AND SKIN CANCER EDUCATION AND SCREENINGS. REGIONAL INFANT MORTALITY REDUCTION TASK FORCE WHICH IS COMPOSED OF UTMC TEAM MEMBERS, PUBLIC HEALTH ENTITIES, AND COMMUNITY PARTNERS ARE CWORKING ON INITIATIVES TO DECREASE DEATHS RELATED TO SIDS AND BIRTH DEFECTS AND NEONATAL ABSTINENCE SYNDROME. IMPROVED ACCESS TO CARE HAS BEEN ACHIEVED THROUGH PLACING SPECIALTY CARE SERVICES THROUGHOUT OUR REGION FOCUSED ON PRIMARY CARE AND SPECIALTY CARE INITIATIVES. THE COMMUNITY MEMBERS POINTED TO MENTAL HEALTH SERVICES AS A PRIORITY UNMET NEED, AND POINTED TO THE PHYSICAL BLIGHT OF THE COMMUNITY AS A MAJOR PROBLEM. THE COMBINATION OF DATA, MAPPING TECHNOLOGY, AND COMMUNITY INPUT PROVIDED A BASIS FOR DIALOGUE WITH CITY AND LOCAL GOVERNMENT OFFICIALS, WHO USED EXISTING FUNDS TO RID THE COMMUNITY OF ABANDONED HOMES AND TO REDIRECT THOSE PROPERTIES TO MORE EFFECTIVE AND FUNCTIONAL USE. THIS EXAMPLE HIGHLIGHTS THE POTENTIAL RESULTS OF AN APPROACH TO COMMUNITY BENEFIT PROGRAMMING THAT COMBINES THE USE OF DATA, THE LEVERAGING OF RESOURCES, AND THE DIRECT ENGAGEMENT OF COMMUNITY MEMBEA MENTAL HEALTH TASK FORCE IS CONTINUING EFFORTS TO COLLECT DATA AT THE COMMUNITY LEVEL TO EVALUATE THE IMPACT OF LACK OF OF RESOURCESD TO CARE FOR MENTAL HEALTH NEEDS AND DECREASE THE IMPACT OF OVERCROAWDING OF OUR EMERGENCY DEPARTMENTS IN OUR COMMUNITY.
UNIVERSITY HEALTH SYSTEM, INC. PART V, SECTION B, LINE 20E: PATIENTS RECEIVE PRINTED STATEMENTS WHICH INCLUDE REFERENCES TO THE FINANCIAL ASSISTANCE POLICY.
UNIVERSITY HEALTH SYSTEM, INC. PART V, SECTION B, LINE 22D: THE STATE OF TENNESSE ALLOWS A HOSPITAL TO CHARGE NO MORE THAN 185% OF THE MOST RECENTLY SETTLED COST TO CHARGE RATIO IN THE MEDICARE COST REPORT. UHS AUTOMATICALLY EXTENDS A 50% DISCOUNT TO SELF-PAYING PATIENTS. THIS 50% DISCOUNT COMPLIES WITH STATE REGULATIONS.
SCHEDULE H, PART V, FINANCIAL ASSISTANCE POLICY WEBSITES FINANCIAL ASSISTANCE POLICY URLHTTP://WWW.UTMEDICALCENTER.ORG/PATIENTS-VISITORS/GOING-HOME/INSURANCE-AND-BILLING/FINANCIAL-ASSISTANCE/FINANCIAL ASSISTANCE APPLICATION URLHTTP://WWW.UTMEDICALCENTER.ORG/LIB/FILE/MANAGER/PAGES/PATIENTS_AND_VISITORS/LETTER__GUIDELINES_FINANCIALASSISTANCE_APPLICATION_2015.PDFPLAIN LANGUAGE SUMMARY URLHTTPS://UTMEDICALCENTER.PATIENTCOMPASS.COM/HC/GUARANTOR/PREPAREBILLINGOPTION2.DO
PART V, SECTION B, CHNA WEBSITE HTTP://WWW.UTMEDICALCENTER.ORG/ABOUT-US/COMMUNITY-BENEFIT/
PART V, SECTION B, LINE 10A: HTTP://WWW.UTMEDICALCENTER.ORG/LIB/FILE/MANAGER/PAGES/ABOUT-US/COMMUNITY_BENEFIT/COMMUNITY_NEEDS_ASSESSMENT_2012-2015_3.PDF
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
Page 8
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) 2015
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Schedule H (Form 990) 2015
Page 9
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 7: COST IS DERIVED FROM THE ACTUAL EXPENSE DATA ACCUMULATED WITHIN THE UNIVERSITY HEALTH SYSTEM, INC. ("UHS") GENERAL LEDGER WHICH ADDRESSES ALL PATIENT SEGMENTS (INPATIENT, OUTPATIENT, EMERGENCY ROOM, PRIVATE INSURANCE, MEDICAID, MEDICARE, UNINSURED, AND SELF-PAY). UHS ALLOCATES THOSE EXPENSES TO ALL PATIENT SEGMENTS AT THE PROCEDURE LEVEL BASED ON A COST TO CHARGE RATIO AND AGGREGATES THE EXPENSES AT THE PATIENT LEVEL.
PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 55,048,897.
PART II, COMMUNITY BUILDING ACTIVITIES: THE ACTIVITIES REPORT IN PART II SEEK TO ACHIEVE SPECIFICED OBJECTIVES, INCLUDING: IMPROVING ACCESS TO HEALTH SERVICES, ENHANCING PUBLIC HEALTH, AND RELIEF OF GOVERNMENT BURDEN. THE ACTIVITIES ARE AVAILABLE TO THE GENERAL PUBLIC, FOCUSING ON LOW-INCOME CONSUMERS.
PART III, LINE 4: TO DETERMINE THE AMOUNTS REPORTED IN PART III, LINES 2 AND 3, UHS USES ACTUAL EXPENSE DATA ACCUMULATED BY PATIENT WITHIN THE TRENDSTAR SYSTEM BASED ON A COST TO CHARGE RATIO.THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER UHS'S CHARITY CARE POLICY CONSISTS OF ALL BAD DEBT ACCOUNTS WHEREBY THE PATIENTS:1. DID NOT FOLLOW THROUGH WITH THE APPROPRIATE TNCARE OR CHARITY CARE APPLICATIONS (IF THEY FOLLOWED THROUGH CHARITY MAY HAVE BEEN GRANTED).2. HAD TNCARE COVERAGE BUT NOT AT THE TIME OF SERVICE. (A MAJORITY WERE PATIENTS DISRENROLLED BY THE TNCARE PROGRAM. THESE PATIENTS NEVER FOLLOWED THROUGH WITH REAPPLYING FOR TNCARE OR CHARITY CARE).3. LIABILITY AMOUNTS REMAINED UNPAID AFTER THEIR LOCAL GOVERNMENTAL ASSISTANCE PROGRAM PAID AND THEY NEVER FOLLOWED THROUGH WITH CHARITY APPLICATION.THE TEXT OF THE UHS AND SUBSIDIARIES CONSOLIDATED FINANCIAL STATEMENTS READS: "NET PATIENT SERVICE REVENUE IS REPORTED AT ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED AND INCLUDES ESTIMATED RETROACTIVE REVENUE ADJUSTMENTS DUE TO FUTURE AUDITS, REVIEWS, AND INVESTIGATIONS. RETROACTIVE ADJUSTMENTS ARE CONSIDERED IN THE RECOGNITION OF REVENUE ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED, AND SUCH AMOUNTS ARE ADJUSTED IN FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN OR AS YEARS ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS, AND INVESTIGATIONS. ON THE BASIS OF HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF UHS' UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THEREFORE, UHS RECORDS A SIGNIFICANT PROVISION FOR DOUBTFUL ACCOUNTS RELATED TO UNINSURED PATIENTS. THIS PROVISION FOR DOUBTFUL ACCOUNTS IS PRESENTED ON THE CONSOLIDATED STATEMENTS OF OPERATIONS AS A COMPONENT OF NET PATIENT REVENUE."UHS PROVIDES CARE TO PATIENTS WHO MEET CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. UHS DOES NOT REPORT AS NET REVENUE THE CHARGES THAT QUALIFY AS CHARITY CARE BECAUSE UHS DOES NOT PURSUE COLLECTION OF THOSE AMOUNTS.
PART III, LINE 8: THE MEDICARE ALLOWABLE COST REPORTED IN THE UHS MEDICARE COST REPORT, AS REFLECTED IN THE AMOUNT REPORTED IN PART III, LINE 6, IS DERIVED FROM THE ACTUAL EXPENSE DATA FROM THE UHS GENERAL LEDGER. UHS ALLOCATES THOSE EXPENSES TO PATIENTS AT THE PROCEDURE LEVEL BASED ON A COST TO CHARGE RATIO.THE SHORTFALL OF $1,881,697 AS REPORTED IN PART III, LINE 7, SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE, ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALITY FOR CHARITY CARE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS. BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUSALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPTIAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. ALSO, THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS, AND THE AMOUNT SPENT TO COVER THE MEDICARE SHORTALL IS MONEY NOT AVAILABLE TO COVER CHARITY CARE AND OTHER COMMUNITY BENEFIT NEEDS.
PART III, LINE 9B: IT IS THE POLICY OF UHS TO PURSUE COLLECTION OF PATIENT BALANCES FROM PATIENTS WHO HAVE THE ABILITY TO PAY FOR THESE SERVICES. IF ADDITIONAL ASSISTANCE IS APPROVED, THE PATIENT ACCOUNT REPRESENTATIVE WILL SUBMIT A LETTER TO THE PATIENT TO INFORM HIM/HER OF APPROVAL OR PROVIDE OTHER INSTRUCTIONS. IF APPROVED FOR AN ADJUSTMENT, THE PATIENT ACCOUNT REPRESENTATIVE WILL SUBMIT THE INFORMATION TO PATIENT ACCOUNTS, WHO WILL PROCESS THE WRITE-OFF OR OTHER DISCOUNTS. THE ORGANIZATION'S COLLECTION POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTIES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. THE ORGANIZATION MAINTAINS COLLECTION PRACTIES THAT APPLY TO ALL PATIENTS, CHARITY CARE AND NON-CHARITY CARE PATIENTS, CONSITENTLY AND FAIRLY REGARDLESS OF INSURANCE STATUS. THE UNIVERSITY OF TENNESSEE MEDICAL CENTER ("MEDICAL CENTER"), AS A TRAUMA CENTER, OFTEN TREATS PATIENTS WHO HAVE HAD AN UNPLANNED CATASTROPHIC HEALTHCARE OCCURRENCE. PATIENTS MAY HAVE THE MEANS TO PAY ONLY A PORTION OF THE ENTIRE COST. ALLOWANCES ARE MADE TO ADJUST THEIR HIGH BALANCES TO A MORE MANAGEABLE PAYOFF AMOUNT. WE UTILIZE AN INCOME CRITERION TO ADJUST A SIGNIFICANT PORTION OF THE BALANCE AS A CHARITY DISCOUNT. PATIENT ACCOUNT REPRESENTATIVES DILIGENTLY WORK WITH PATIENTS AND EVALUATE NEW INFORMATION LEARNED DURING THE COLLECTION PROCESS TO DETERMINE IF COLLECTION ACTIVITIES SHOULD BE CEASED OR IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE.
PART VI, LINE 2: UHS SUPPORTS AND STRENGTHENS OUR KEY COMMUNITIES THROUGH DELIVERING NEEDED SERVICES BY LEADING AND PARTNERING WITH OTHER ORGANIZATIONS TO POSITIVELY IMPACT HIGH PRIORITY HEALTH ISSUES. THE COMMUNITY HEALTH ADVISORY COMMITTEE ("CHAS") ANALYZES MULTIPLE SOURCES OF HEALTH STATUS, DEMOGRAPHIC, AND SOCIOECONOMIC INFORMATION TO IDENTIFY KEY COMMUNITIES, PRIORITIZE SPECIFIC POPULATION NEEDS, AND DETERMINE THE FOCUS FOR UHS INVOLVEMENT. THE CHAC REVIEWS AND FORMULATES RECOMMENDATIONS FOR ORGANIZATIONAL INVOLVEMENT FOR IDENTIFIED NEEDS. THE CHAC TEAM LEVERAGES OUR CORE COMPETENCIES TO DESIGN AND IMPLEMENT STRATEGIC INITIATIVES AND ACTION PLANS TO ADDRESS THESE PRIORITIES. THE CHAC MONITORS PROGRESS THROUGH ACTION PLANS AND PERFORMANCE MEASURES AND REPORTS RESULTS QUARTERLY TO SENIOR LEADERS AND TO THE CHAC.IN COLLBORATION WITH OUR LOCAL COUNTY HEALTH DEPARTMENT AND COMMUNITY RESOURCE PROGRAMS, A COLLABORATION WAS FORMED TO BRING TOGETHER HEALTH CARE PROVDERS AND ORGANIZATIONS THAT MAKE UP OUR LOCAL PUBLIC HEALTH SYSTEM AND SERVICES TO GUIDE OUR COMMUNITY IDENTIFY AND TAKE ACTION ON PRIORITY HEALTH ISSUES. TOGETHER HEALTHY KNOX PROVIDES A FRAMEWORK FOR LOCAL PROGRAMMATIC AND FISCAL DECISION-MAKING AND INFORMS THE DEVELOPMENT OF A STRATEGIC COMMUNITY HEALTH IMPROVEMENT PLAN. UHS UTILIZES DATA OBTAINED DURING THIS ASSESSMENT INITIATIVE TO IMPROVE DELIVERY OF SELECT SERVICES TO MEET THE NEEDS OF THE COMMUNITY IT SERVES. UHS' IMPACT OF SUPPORT IS DETERMINED THROUGH A COMMUNITY BENEFIT DATABASE ANALYSIS OF DISBURSEMENTS AND ANNUAL PROCESS REVIEW.
PART VI, LINE 3: TO COMMUNICATE THE HOSPITAL'S FINANCIAL POLICY TO THE PATIENT, THE "UNDERSTANDING YOUR HOSPITAL BILL" BROCHURE IS MADE AVAILABLE AT ALL POINTS OF REGISTRATION (INTAKE AND PROCESS) AND FINANCIAL COUNSELORS ALONG WITH CUSTOMER SERVICE REPRESENTATIVES ARE AVAILABLE TO DISCUSS SPECIFIC CASES. THE BROCHURE INSTRUCTS THE PATIENT TO CONTACT THE FINANCIAL COUNSELOR OR PATIENT ACCOUNTS FOR MORE INFORMATION ON CHARITY AND OTHER APPLICABLE DISCOUNTS. FINANCIAL COUNSELORS VISIT PATIENT ROOMS WHEN POSSIBLE TO EXPLAIN THE UHS BILLING PROCESS, PAYMENT PLANS AND SCREENS FOR ASSISTANCE SUCH AS TENNCARE, VICTIM OF CRIME OR CHARITY WRITE-OFF. FINANCIAL COUNSELORS SCREEN ADMISSIONS FOR TRUE HARDSHIP CASES THAT SHOULD BE REVIEWED FOR CHARITY AND CLEARLY STATE THE ELIGIBILITY REQUIREMENTS TO THE PATIENT. THE ORGANIZATION'S CHARITY CARE POLICY (A PATIENT-FRIENDLY SUMMARY) AND FINANCIAL ASSISTANCE CONTACT INFORMATION IS POSTED IN THE ADMISSIONS AREAS, EMERGENCY AREAS, AND OTHER AREAS OF THE ORGANIZATION'S FACILITIES IN WHICH ELIGIBLE PATIENTS MAY BE PRESENT, AS WELL AS ON OUR WEBSITE. POLICIES ARE ALSO POSTED IN SPANISH DUE TO THE HIGH VOLUMES OF SPANISH-SPEAKING PATIENTS. THE MAJORITY OF STAFF ASSOCIATED WITH PATIENT CONTACT ARE KNOWLEDGEABLE ABOUT THE CHARITY CARE POLICY.
PART VI, LINE 4: UHS' KEY COMMUNITIES ARE DEFINED BY OUR DEMOGRAPHIC LOCATIONS WITHIN A 21 COUNTY REGIONAL SERVICE AREA. KNOX COUNTY IS CONSIDERED OUR PRIMARY SERVICE AREA WHERE OUR ACADEMIC MEDICAL CENTER RESIDES. SURROUNDING COUNTIES, SUCH AS ANDERSON, SEVIER, BLOUNT, LOUDON, JEFFERSON, AND HAMBLEN COUNTIES ARE SUPPORTED BY OUR NETWORK OF PRIMARY CARE PHYSICIANS, SPECIALISTS, AND OTHER CLINICAL SERVICES. UHS' KEY COMMUNITIES INCLUDE THE UNDERSERVED AND DISADVANTAGED POPULATIONS, PRIORITIZED BY THOSE WITH THE GREATEST NEED FOR SERVICES.UHS IDENTIFIES ITS KEY COMMUNITIES AND DETERMINES AREAS FOR ORGANIZATIONAL INVOLVEMENT BY THE CHAC AND UHS TEAM MEMBER ANALYSIS OF STATE, LOCAL, AND REGIONAL HEALTH STATISTICAL DATA. UHS HAS MANY PROGRAMS AND PARTNERSHIPS IN PLACE TO SUPPORT AND BENEFIT HIGH PRIORITY AND KEY COMMUNITEIS WHICH INCLUDES:-HEALTH LIVING KITCHEN PROVIDES NUTRIONAALLY BASED EDUCATION CLASSES AND TEACHES INDIVIDUALS HOW TO COOK HEALTHY TO IMPROVE HEALTH STATUS AND MANAGE DIETS WHICH LESSENS THE IMPACT OF CHRONIC DISEASE, SUCH AS DIABETES AND CARDIOVASCULAR DISORDERS.-COMMUNITY AND WORKSITE BASED HEALTH SCREENINGS AND EDUCATION FOR CANCER, DIABETES, HYPERTENSION, OBESITY, AND HYPERLIPIDEMIA.-RESPIRATORY THERAPY PARTNERS WITH COORDINATED SCHOOL HEALTH STAFF TO IMPLEMENT SMOKING CESSATION AND PREVENTATION PROGRAMS TO MIDDLE SCHOOL AGED CHILDREN.-BREAST HEALTH OUTREACH PROGRAM (BHOP) WHICH PROVIDES MOBILE BREAST SCREENINGS TO DISADVANTAGED POPULATIONS THROUGH A COLLABORATIVE PARTNERSHIP EFFORT WITH SUSAN G. KOMEN AND AVON FOUNDATIONS.-CANCER INSTITUTE PROVIDES PROSTATE AND SKIN CANCER EDUCATION AND SCREENINGS.-REGIONAL INFANT MORTALITY REDUCTION TASK FORCE WHICH IS COMPOSED OF THE MEDICAL CENTER TEAM MEMBERS, PUBLIC HEALTH ENTITIES, AND COMMUNITY PARTNERS.
PART VI, LINE 5: UHS USES MULTIPLE STAKEHOLDERS AND ATA TO SUPPORT SOCIETAL WELL-BEING FOR OUR COMMUNITY. OUR CORE COMPETENCIES ARE PARTNERING WITH COMMUNITY ORGANIZATIONS AND INNOVATION, WHILE ALSO CONTRIBUTING TO OUR ENVIRONMENT, SOCIAL, AND ECONOMIC SYSTEMS. UHS CONSIDERS ENVIRONMENTAL IMPACT IN PROJECT ANALYSIS AND DAILY OPERATIONS. SEVERAL STRATEGIES TO CONSERVE ENERGY AND RECYCLE PAPER ARE IMPLEMENTED AND EVIDENCED THROUGHOUT OUR CAMPUS AND DAILY ACTIVITIES.UHS ACTIVITY PARTICIPATES IN KNOXVILLE AREA PROJECT ACCESS ("KAPA"), AN INNOVATIVE COMMUNITY APPROACH THROUGH WHICH THE MEDICAL CENTER'S PHYSICIANS AND SPECIALISTS PROVIDE CARE FOR THOSE IN OUR SERVICE AREA WHO ARE WITHOUT THE ABILITY TO PAY. KAPA IS A PHYSICIAN-LED COMMUNITY EFFORT AND WAS CREATED AS A COMPREHENSIVE HEALTHCARE PLAN TO HELP PATIENTS WHO STRUGGLE EVERYDAY WITH THE CHALLNEGES OF POVERTY, HAVE NO ACCESS TO EMPLOYER-SPONSORED OR GOVERNMENT-SPONSORED INSURANCE PROGRAMS, AND HAVE AN INCOME OF 200% OF THE POVERTY LEVEL OR BELOW.THE INTERFAITH HEALTH CLINIC PROVIDES PRIMARY CARE SERVICES TO A SEGMENT OF THE COMMUNITY THAT IS IN NEED - THE WORKING UNINSURED. THEY SERVE THE NEEDS OF OUR RESIDENTS THAT DO NOT QUALIFY FOR TENNCARE AND CANNOT AFFORD TO PURCHASE PRIVATE HEALTH INSURANCE. UHS IS PROUD TO HAVE PARTNERED WITH INTERFAITH HEALTH CLINIC SINCE THE BEGINNING OF THIS INNOVATIVE COMMUNITY EFFORT WHICH BEGAN IN 1991. WE HAVE OFFERED OUR SUPPORT BOTH FINANCIALLY AND THROUGH GIFTS OF IN-KIND SERVICES.IN KEEPING WITH OUR MISSION TO SERVE THROUGH HEALING, EDUCATION, AND DISCOVERY, WE ALSO VALUE THE IMPORTANCE OF PREVENTION STRATEGIES TO IMPEDED CHRONIC DISEASE DEVELOPMENT. UHS USES NATIONAL AND STATE HEALTH POLICY AND LOCAL COUNTY STATISTICAL DATA WHEN AVAILABLE TO IDENTIFY COMMUNITY SPECIFIC HEALTH PRIORITIES WITHIN THE REGION SUCH AS HIGH SMOKING LEVELS, CANCER RATES, HEART DISEASE, AND DIABETES. WE REVALIDATE OUR COMMUNITY INVOLVEMENT BASED ON MARKET INFORMATION, FOCUS GROUPS, STRATEGIC PLANNING PROCESS, AND COMMUNITY NEEDS ASSESSMENT TO ALIGN OUR CRITERIA THAT WILL BE USED TO SUPPORT OUR INVOLVEMENT. UTILIZING THE INFORMATION AND DATA COLLECTED FROM NUMEROUS SOURCES, UHS IDENTIFIES RESOURCES AND ORGANIZATONAL ALLIANCES LOCALLY TO FORM RESOURCE PARTNERSHIPS TO INITIATE A PROCESS TO ADDRESS THE PRIORITIES OF NEED. WE SOLICIT REQUESTS FROM SERVICE LINE LEADERS TO ENSURE THAT WE IDENTIFY WHAT WE AS AN ORGANIZATION DESIRE TO SUPPORT AND EVALUATE ADDITIONAL REQUEST FOR SUPPORT FROM THE COMMUNITY WHEN A NEED IS IDENTIFIED.THE MEDICAL CENTER HAS POSITIONED ITSELF TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITIES WE SERVE BY OUR ORGANIZATIONAL STRUCTURE, SUBDIVISIONS OF RESPONSBILITY, AND ALIGNMENT OF OUR MISSION, VISION, AND VALUES, OUR CORE COMPETENCIES, OUR CENTS OF EXCELLENCE FOCUSED PRIORITIES, AND INTEGRATION OF OUR SUPPORT INTO THE COMMUNITY THROUGH COLLBORATION AND PARTNERSHIPS.SENIOR LEADERS AND TEAM MEMBERS CONTRIBUTE TO IMPROVING COMMUNITIES AND BUILDING COMMUNITY HEALTH BY ACTIVELY PARTICIPATING IN COMMUNITY SERVICE PROGRAMS AND PARTNERSHIPS. SENIOR LEADERS PERSONALLY SERVE ON COMMUNITY SERVICE BOARDS AND LEAD COLLABORATIVE PARTNERSHIP INITIATIVES INCLUDING GOVERNMENT, COMPETITORS, NOT-FOR PROFIT ORGANIZATIONS, AND FOUNDATION.ADDITIONALLY, PLEASE REFER TO THE STATEMENT OF COMMUNITY BENEFIT AS PROVIDED IN SCHEDULE O FOR FURTHER DOCUMENTATION REGARDING UHS' COMMITTMENT WITHIN ITS COMMUNITY.
PART VI, LINE 6: UHS IS CURRENTLY AFFILIATED WITH EAST TENNESSEE CHILDREN'S HOSPITAL IN PROVIDING JOINT HEALTHCARE SERVICES FOR THE PEDIATRIC POPULATION OF OUR REGION. UHS PARTNERS WITH SEVERAL LOCAL ORGANIZATIONS IN SUPPORT OF CHILDREN'S HEALTH AND WELLBEING
PART VI, LINE 7, REPORTS FILED WITH STATES TN
Schedule H (Form 990) 2015
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