SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
Medium right arrow Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow Attach to Form 990.
Medium right arrow Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2022
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

 

No
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
 
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
 
 
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) . . . 		    49,011,370   49,011,370 3.840 %
b Medicaid (from Worksheet 3, column a) . . . . .            
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     13,471,115 8,915,284 4,555,831 0.360 %
d Total Financial Assistance and Means-Tested Government Programs . . . . .     62,482,485 8,915,284 53,567,201 4.200 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     357,264   357,264 0.030 %
f Health professions education (from Worksheet 5) . . .     27,198,419   27,198,419 2.130 %
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     288,333   288,333 0.020 %
j Total. Other Benefits . .     27,844,016   27,844,016 2.180 %
k Total. Add lines 7d and 7j .     90,326,501 8,915,284 81,411,217 6.380 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
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     36,500   36,500 0 %
3 Community support     37,011   37,011 0 %
4 Environmental improvements            
5 Leadership development and
training for community members		            
6 Coalition building     8,925   8,925 0 %
7 Community health improvement advocacy     451,182   451,182 0.040 %
8 Workforce development            
9 Other            
10 Total     533,618   533,618 0.040 %
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 Healthcare 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
6,374,184
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
1,657,783
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
405,105,742
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
428,403,792
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-23,298,050
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) 2022
Schedule H (Form 990) 2022
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) 		Licensed Hospital General Medical and Surgical Children's Hospital Teaching Hospital Critical Access Hospital Research 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) 2022
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Schedule H (Form 990) 2022
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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 21
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 21
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    
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) 2022
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Schedule H (Form 990) 2022
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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 Was widely publicized 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
j
Schedule H (Form 990) 2022
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Schedule H (Form 990) 2022
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Part VFacility Information (continued)

Billing and Collections
UNIVERSITY HEALTH SYSTEM INC
Name of hospital facility or letter of facility reporting group  
Yes No
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 nonpayment?.................................. 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
f
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
e
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
Schedule H (Form 990) 2022
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Schedule H (Form 990) 2022
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Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
UNIVERSITY HEALTH SYSTEM INC
Name of hospital facility or letter of facility reporting group  
Yes No
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) 2022
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Schedule H (Form 990) 2022
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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, 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
UNIVERSITY HEALTH SYSTEM, INC. PART V, SECTION B, LINE 5: IN 4 Q 2021- 1 Q 2022, A NEW COMMUNITY NEEDS ASSESSMENT AND SURVEY WAS CONDUCTED BY UTMC TO COMPARE STATISTICS, HEALTH INITIATIVE OUTCOMES, AND ALIGN STRATEGY WITH THE STATE AND LOCAL INITIATIVES TO ADDRESS PUBLIC HEALTH CONCERNS. OUR PARTNERSHIPS INCLUDE THE GOVERNOR'S FOUNDATION FOR HEALTH AND WELLNESS FOR A HEALTHIER TENNESSEE AND KNOX COUNTY HEALTH COUNCIL.UTMC ALSO COLLABORATED WITH A PARTNERSHIP FOCUSED ON PROVIDING A COMMUNITY WIDE HEALTH NEEDS ASSESSMENT AND ACTION PLAN TO ADDRESS THE HEALTH NEEDS OF KNOX COUNTY RESIDENTS. KNOX COUNTY COMMUNITY HEALTH COUNCIL PROVIDES A FRAMEWORK FOR BRINGING TOGETHER THE INDIVIDUALS, GROUPS AND ORGANIZATIONS THAT MAKE UP OUR LOCAL PUBLIC HEALTH SYSTEM, AND GUIDES OUR COMMUNITY TO IDENTIFY AND TAKE ACTION ON PRIORITY HEALTH ISSUES. THE CHC ASSESSES AND EVALUATES HEALTH, THE PERCEPTION OF HEALTH, THE PERFORMANCE OF THE LOCAL PUBLIC HEALTH SYSTEM, AND FUTURE CONDITIONS RELATING TO HEALTH IN KNOX COUNTY, THE CITY OF KNOXVILLE AND THE TOWN OF FARRAGUT. THE PURPOSE OF THE ASSESSMENT IS TO PROVIDE A SNAPSHOT OF THE HEALTH STATUS OF KNOX COUNTY RESIDENTS; TO PROVIDE USEFUL INFORMATION FOR LOCAL PROGRAMMATIC AND FISCAL DECISION MAKING; AND TO INFORM THE DEVELOPMENT OF A STRATEGIC COMMUNITY HEALTH IMPROVEMENT PLAN. IN 2021-2022, UTMC PARTNERED WITH THE KNOX COUNTY HEALTH DEPARTMENT AND OTHER LOCAL COMMUNITY HEALTH AND EDUCATION ORGANIZATIONS TO CONDUCT A COUNTY-WIDE ASSESSMENT OF OUR POPULATION. THE RESULTS FROM THIS ASSESSMENT WAS SHARED WITH COMMUNITY AND HEALTH SYSTEM LEADERS IN MARCH 2022 TO ALIGN INITIATIVES AND STRATEGIES TO ADDRESS THE MOST PRESSING HEALTH ISSUES FACING KNOX COUNTY AND THE 21 COUNTY REGION THAT WE SERVE.IN 2020, UTMC PARTNERED WITH OTHER ORGANIZATIONS MENTIONED ABOVE IN ADDITION TO THE KNOXVILLE BOARD OF HEALTH TO ALIGN STRATEGIES TO MITIGATE THE COVID-19 VIRUS AND PLAN FOR SURGE OF OF POSSIBLE CRITICALLY ILL PATIENTS THAT WOULD CRIPPLE OUR HEALTHCARE SYSTEM STRUCTURE FOR OUR REGION AND COMMUNITY WE SERVE. IMMUNIZATION EFFORTS BEGAN COMMUNITY WIDE IN DECEMBER 2020 WITH BOOSTERS AVAILABLE IN 2021. UTMC SERVED AS AN APPROVED COVID VACCINATION PROVIDER AND ADMINISTERED OVER 50,000 COVID VACCINATIONS TO FIRST RESPONDERS, TEACHERS, TEAM MEMBERS, AND UNDERSERVED POPULATIONS WITHIN KNOX COUNTY.
UNIVERSITY HEALTH SYSTEM, INC. PART V, SECTION B, LINE 6B: COLLABORATION AND DATA SHARING WAS CONDUCTED WITH KNOX COUNTY HEALTH DEPARTMENT AND THE TENNESSEE DEPARTMENT OF HEALTH.
UNIVERSITY HEALTH SYSTEM, INC. PART V, SECTION B, LINE 11: UTMC IS CONTINULLAY ANALYZING DATA AND FOCUSING ON POPULATIONS WITHIN OUR SERVICE REGION FOR INEQUALITIES RELATED TO HEALTHCARE ACCESS AND SERVICES. IN RESPONSE TO THE MOST SIGNIFICANT NEEDS IDENTIFIED, UTMC HAS INCREASED THE NUMBER OF REGIONAL HEALTH CENTERS AND HAVE PLANS TO OPEN ADDITIONAL SERVICES IN AREAS THAT HAVE LOST HEALTHCARE CARE SERVICES AND LICENSED PRACTIONERS AND PHYSICIAN PROVIDERS ACCESS DUE TO A MYRIAD OF FACTORS.
UNIVERSITY HEALTH SYSTEM, INC. PART V, SECTION B, LINE 16J: PATIENT STATEMENTS ALSO INCLUDE VERBIAGE REGARDING FAP.SOME STATEMENTS HAVE FAP APPLICATIONS MAILED WITH SELF ADDRESSED STAMP ENVELOPES.
UNIVERSITY HEALTH SYSTEM, INC. PART V, SECTION B, LINE 18E: LEGAL ACTION MAY BE FILED BY OUTSIDE THIRD PARTY LEGAL COUNSEL WHEN THE PATIENT HAS NOT COOPERATED AND HAS THE FINANCIAL MEANS TO PAY. THE HOSPITAL MAY PURSUE THE FILING OF LIENS BUT WILL NOT FORCE THE SALE OF PROPERTY.
SCHEDULE H, PART V, FINANCIAL ASSISTANCE POLICY WEBSITES FINANCIAL ASSISTANCE POLICY URLHTTPS://UTMEDICALCENTER.PATIENTCOMPASS.COM/RA/CONTENT/IMAGES/UTMEDICALCENTER/PRODUCTION/COMPLETE-FINANCIAL-ASSISTANCE-POLICY.PDFFINANCIAL ASSISTANCE APPLICATION URLHTTPS://UTMEDICALCENTER.PATIENTCOMPASS.COM/RA/CONTENT/IMAGES/UTMEDICALCENTER/PRODUCTION/FINANCIAL-ASSISTANCE-APP.PDFPLAIN LANGUAGE SUMMARY URLHTTPS://UTMEDICALCENTER.PATIENTCOMPASS.COM/RA/GENERAL/BILLINGPOLICIES/_FINANCIALASSISTANCE
PART V, SECTION B, CHNA WEBSITE HTTPS://WWW.UTMEDICALCENTER.ORG/ABOUT/OUR-STORY/COMMUNITY-BENEFIT/
PART V, SECTION B, LINE 10A: HTTPS://WWW.UTMEDICALCENTER.ORG/ABOUT/OUR-STORY/COMMUNITY-BENEFIT/
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2022
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Schedule H (Form 990) 2022
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) 2022
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Schedule H (Form 990) 2022
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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 $ 28,666,622.
PART II, COMMUNITY BUILDING ACTIVITIES: THE ACTIVITIES REPORTED IN PART II SEEK TO ACHIEVE SPECIFIED 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 2: WE SCORE ALL PATIENTS ON THEIR ABILITY TO PAY 1-4 WITH 4 BEING CHARITY ELIGIBLE.
PART III, LINE 3: WE SCORE ALL PATIENTS ON THEIR ABILITY TO PAY 1-4 WITH 4 BEING CHARITY ELIGIBLE.
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' 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 DISENROLLED 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.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.
PART III, LINE 9B: WE NOTIFY PATIENTS OF THE AVAILIBILITY OF FAP VIA STATEMENTS, POSTED NOTICES THROUGHOUT THE HOSPITAL INCLUDING WEBSITE, AND SEND CUSTOMIZED STATEMENTS WITH APPLICATIONS ATTACHED FOR ASSISTING PATIENTS TO APPLY. IF THE PATIENT REQUESTS FAP WE WILL SEND THEM AN APPLICATION UP TO 240 DAYS FROM THE DATE OF THEIR FIRST STATEMENT THIS INCLUDES IF THE PATIENT IS IN BAD DEBT. WE MAKE ALL REASONABLE ATTEMPTS TO HAVE A DECISION MADE WITHIN 10 DAYS UPON RECEIPT OF THE APPLICATION.
PART VI, LINE 2: FOR THE MEDICAL CENTER TO SERVE ITS REGION MOST EFFECTIVELY, IT IS ESSENTIAL TO UNDERSTAND EACH COMMUNITY'S NEEDS. THE MEDICAL CENTER HAS CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO UNDERSTAND THE HEALTH OF THE RESIDENTS WITHIN THE LOCAL REGION. THE ASSESSMENT FOCUSES ON THE MEDICAL CENTER'S NINE CORE COUNTIES WHERE UHS HAS FACILITIES OR PROVIDES SERVICES. OUR COMMITMENT IS ALSO TO OFFER SERVICES TO COUNTIES WITHOUT HEALTHCARE FACILITIES AND PARTNERING WITH LOCAL HEALTHCARE PROVIDERS TO ENSURE ACCESS TO QUALITY AND SPECIALIZED SERVICES. ACTIVITIES ASSOCIATED WITH DEVELOPING THIS ASSESSMENT HAVE TAKEN PLACE DURING 2021-2022, INCLUDING STATE, REGIONAL, AND COUNTY-SPECIFIC SECONDARY DATA COLLECTION AND PRIMARY DATA OBTAINED THROUGH 406 SURVEYS WITH INDIVIDUALS FROM KNOX COUNTY, TN, AND SURROUNDING COUNTIES. THROUGHOUT THE ASSESSMENT, HIGH PRIORITY WAS GIVEN TO DETERMINING EACH COMMUNITY'S HEALTH STATUS AND AVAILABLE RESOURCES. UTMC EXAMINED LOCAL, NATIONAL, AND STATE DATA AND IDENTIFIED THAT IN 2021, TENNESSEE RANKED 41ST FOR OVERALL HEALTH OUTCOMES. TENNESSEE HAD HIGH RATES OF ADULT OBESITY, CANCER DEATHS, INFANT MORTALITY, AND DIABETES. KNOX COUNTY RANKED 6TH OUT OF 95 COUNTIES IN TENNESSEE FOR COMBINED HEALTH FACTORS, INCLUDING HEALTH BEHAVIORS, CLINICAL CARE, PHYSICAL ENVIRONMENT, AND SOCIAL AND ECONOMIC FACTORS THAT INFLUENCE THE COUNTY'S HEALTH. ADDITIONAL DATA SOURCES CONSULTED FOR THE CHNA WERE THE TENNESSEE HEALTH RANKINGS AND THE COMMUNITY NEEDS INDEX (CNI). ALSO, COMMUNITY AND ORGANIZATION MEMBERS MEET WITH THE MEDICAL CENTER TO DISCUSS CURRENT HEALTH PRIORITIES AND IDENTIFY POTENTIAL SOLUTIONS. THE INFORMATION GATHERED FROM A LOCAL PERSPECTIVE, PAIRED WITH REGIONAL, STATE, AND NATIONAL DATA, HELPS TO EVALUATE THE REGION'S HEALTH SITUATION IN ORDER TO BEGIN FORMULATING SOLUTIONS FOR IMPROVEMENT. AFTER COMPILING THE VARIOUS SOURCES OF INFORMATION, FOUR TOP HEALTH PRIORITIES WERE IDENTIFIED BY THE CHNA: CANCER, SUBSTANCE USE, MENTAL HEALTH/DEPRESSION/ANXIETY, AND OBESITY.
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: THE UTMC'S SERVICE AREA IS COMPRISED OF 21 COUNTIES, INCLUDING SMALL AND MID-SIZED CITIES AND RURAL COUNTIES, REPRESENTING DIVERSE POPULATIONS WITH ADVERSE HEALTH OUTCOMES AND SOCIOECONOMIC CONDITIONS. THESE COUNTIES FACE DISTINCTIVE SOCIAL RISK FACTORS THAT VARY DEPENDING ON THEIR RURAL/URBAN DESIGNATION, RACIAL AND ETHNIC MAKEUP, INCOME, UNEMPLOYMENT, EDUCATION RATES, LIVING WAGES, AND MEDIAN INCOME. ACCESS TO HEALTHCARE IS DETERMINED BY A MYRIAD OF FACTORS, AMONG THEM ARE HEALTH INSURANCE AND ACCESS TO MEDICAL PROVIDERS AND FACILITIES IN THE REGION. THE RATE OF UNINSURED ADULTS IS HIGHER THAN THE STATE (15%) FOR 52% OF ALL COUNTIES, AND THE POPULATION RATIO TO PRIMARY CARE PHYSICIANS IS HIGHER THAN THE STATE FOR ALL COUNTIES EXCEPT FOR KNOX. FOR INSTANCE, MORGAN COUNTY HAD ONE PRIMARY CARE PHYSICIAN PER 7,130. ACCESS TO MEDICAL CARE PROVIDERS AND HEALTH FACILITIES IS ALSO A CHALLENGE IN THE REGION. ACCORDING TO THE SYCAMORE INSTITUTE, "AS OF APRIL 2019, 20 TENNESSEE COUNTIES HAD NO HOSPITAL 17 OF WHICH ALSO HAD NO EMERGENCY DEPARTMENT". THE UTMC CATCHMENT AREA HAS BEEN DRAMATICALLY AFFECTED BY THE CLOSURE OF FOUR HOSPITALS, TWO OF THEM LOCATED IN KNOXVILLE AND TWO ADDITIONAL ONES IN RURAL AREASFENTRESS AND MCMINN COUNTIES. UTMC SERVES DIVERSE POPULATIONS WHOSE NEEDS VARY FROM COUNTY TO COUNTY, CONSIDERING VARIOUS DEMOGRAPHIC AND SOCIOECONOMIC FACTORS, PARTICULARLY INCOME AND EDUCATION, BOTH CRUCIAL DETERMINANTS OF HEALTH OUTCOMES. FOR INSTANCE, 17 OUT OF 21 COUNTIES IN THE SERVICE AREA HAVE A POVERTY RATE HIGHER THAN THE STATE'S (13.6%); HOWEVER, IT IS ESSENTIAL TO NOTE AREAS IN KNOXVILLE WITH POVERTY RATES AS HIGH AS 68%. ALTHOUGH THE UNEMPLOYMENT RATES ARE LOW FOR MOST COUNTIES, THE LIVING WAGE IS SIGNIFICANTLY LOWER THAN THE STATE'S AVERAGE FOR 80% OF THE COUNTIES, AS IS THE MEDIAN HOUSEHOLD INCOME. STATISTICS RELATED TO HIGH SCHOOL COMPLETION RATES ARE LOWER THAN THE STATE'S (88%) FOR 15 COUNTIES. HOWEVER, WHEN EXAMINING SUB-COUNTY DATA, KNOXVILLE INCLUDES SOME AREAS WITH HIGH SCHOOL COMPLETION RATES AS LOW AS 65%. WHILE THE MAJORITY OF THE POPULATION IN THE CATCHMENT AREAS IS PREDOMINANTLY NON-HISPANIC WHITE, SEVERAL COUNTIES ARE EXPERIENCING RAPID GROWTH IN THEIR HISPANIC/LATINO POPULATIONS: THAT'S THE CASE FOR HAMBLEN (12%), LOUDON (9%), AND SEVIER (7%) COUNTIES. THERE IS A GREATER CONCENTRATION OF BLACK COMMUNITIES IN ZIP CODES INCLUDED IN KNOX (56%), MORGAN (17%)*, AND BLOUNT (14%) COUNTIES. THE RURAL POPULATION IS ABOVE 50% FOR 16 OF 21 COUNTIES, WHILE FOUR OUT OF 21 COUNTIES ARE CONSIDERED 100% RURAL. THE REGION HAS A SIGNIFICANT PORTION OF INDIVIDUALS AGED 65 OR OLDER, WITH 20 COUNTIES HAVING A HIGHER RATE THAN THE STATE, REPRESENTING A SIGNIFICANT CAPACITY DEMAND FOR THE HEALTHCARE SYSTEM.
PART VI, LINE 5: UTMC CONDUCTS ONGOING INVENTORIES REGARDING THE HOSPITAL'S ASSETS TO MEET THE COMMUNITY'S ONGOING NEEDS. IN COLLABORATION WITH COMMUNITY PARTNERS, UTMC ENGAGES OTHERS TO IDENTIFY ASSETS AND GAPS BY UTILIZING LOCAL, STATE, AND NATIONAL DATA REPOSITORIES AND REPORTING AGENCIES. WE ALSO SURVEY OUR COMMUNITY TO IDENTIFY THE ASSETS AND THE GAPS IN HEALTH AND HUMAN SERVICES. MAJOR INITIATIVES FOCUSED ON INCREASING ACCESS TO HEALTH SERVICES FOR THE UNDERSERVED THROUGH PARTNERSHIPS; PREVENTING INJURIES AND TREATING TRAUMATIC BRAIN INJURIES; IMPROVING HEALTH ACCESS FOR WOMEN'S HEALTH; CANCER SCREENING SERVICES; EARLY DETECTION OF DISEASE PROCESSES AND MANAGEMENT; AND COMMUNITY-BUILDING ACTIVITIES.THROUGH THEBREAST HEALTH OUTREACH PROGRAM (BHOP),UTMC PROVIDES FREE EDUCATION, PREVENTION, DIAGNOSTICS, AND TREATMENT FOR UNINSURED WOMEN. THE MOBILE MAMMOGRAPHY UNIT (MMU) PROVIDES FREE AND LOW-COST SCREENINGS TO WOMEN IN OUR 21 COUNTY AREA.OPIOID/SUBSTANCE ABUSE:UTMC HAS PARTNERED WITH THE METRO DRUG COALITION AND OTHER STATE AGENCIES TO IDENTIFY INNOVATIVE PROCESSES TO ADDRESS THE OPIOID EPIDEMIC. TO ASSIST WITH COMPLIANCE OF WITHDRAWAL FROM OPIOIDS, SEVERAL PHYSICIANS HAVE LED RESEARCH EFFORTS TO ASSIST INDIVIDUALS IN WITHDRAWING SAFELY FROM CHEMICAL DEPENDENCY. FROM PERINATAL WITHDRAWAL TO IMPLEMENTING PATHWAYS FOR INDIVIDUALS WHO ARE ADMITTED WITH MEDICAL ISSUES ASSOCIATED WITH OPIOID MISUSE, UTMC IS PIONEERING RESEARCH EFFORTS IN THIS FIELD TO ASSIST IN COMBATING CHEMICAL DEPENDENCY FROM OPIOIDS.EMERGENCY AND TRAUMA SERVICES PREVENTION AND EDUCATION-"STOP THE BLEED"- A STATEWIDE INITIATIVE FOCUSED ON DECREASING MORTALITY RATES ASSOCIATED WITH HEMORRHAGE.EDUCATION FOR ALLIED HEALTH PROFESSIONALS FOR ADVANCED TRAUMA LIFE SUPPORT (ATLS), ADVANCED TRAUMA CERTIFIED NURSE (ATCN), TRAUMA NURSE CORE CURRICULUM (TNCC), FUNDAMENTALS OF CRITICAL CARE (FCCS), AND CERTIFIED EMERGENCY NURSE (CEN) PREPARATION COURSEWOMEN'S AND INFANT'S OUTREACH EFFORTS FOR PRENATAL CARE, HIGH RISK OBSTETRICS, AND CARE OF THE PRE-TERM NEWBORN.KAPA PROJECT ACCESS-UT MEDICAL CENTER PARTNERS WITH KAPA TO PROVIDE FREE OR DISCOUNTED MEDICAL SERVICES AND TREATMENT TO INDIVIDUALS WHO ARE NOT INSURED OR MEDICALLY UNDERSERVED.VOLUNTEER MISSION SERVICE ACTIVITIESBLOOD DRIVES:UTMC PARTNERS WITH MEDIC REGIONAL BLOOD CENTER TO PROVIDE AN OPPORTUNITY FOR EMPLOYEES TO GIVE BACK TO THEIR COMMUNITY. UTMC IS THE REGION'S LARGEST CONSUMER OF BLOOD PRODUCTS DUE TO THE COMPLEXITY OF THE SERVICES WE PROVIDE TO THE COMMUNITY, INCLUDING SERVING AS THE ONLY LEVEL I TRAUMA CENTER IN OUR REGION. IN 2022, THE HOSPITAL DONATED OVER 256 UNITS OF BLOOD.EMPTY STOCKING FUND: UTMC PROVIDES OPPORTUNITIES TO VOLUNTEER WITHIN THE COMMUNITY. AS AN ORGANIZATION, UTMC PARTNERS WITH THE KNOXVILLE NEW SENTINEL TO PROVIDE FOOD AND TOYS TO DISADVANTAGED EAST TENNESSEANS DURING THE HOLIDAYS.COMMUNITY COLLABORATIONS:TO REDUCE HEALTH DISPARITIES AND TO PROVIDE MEDICAL CARE AT FREE MEDICAL CENTER AMERICANOW THE KIM HEALTH CENTER FOR ITS AT-RISK PATIENT POPULATION, UT MEDICAL CENTER, GRADUATE SCHOOL OF MEDICINE, AND UNIVERSITY PHYSICIANS' ASSOCIATION HAVE COMMITTED GRANT FUNDING, TRAINEE PARTICIPATION, AND MANAGEMENT SERVICES. THE KIM HEALTH CENTER PARTNERS WITH KNOXVILLE AREA PROJECT ACCESS, KNOXVILLE OUTPATIENT DIAGNOSTIC CENTER, AND LABCORP, AND WITH COMMUNITY AGENCIES TRAINED TO ADDRESS SOCIAL AND ENVIRONMENTAL FACTORS IMPACTING OUR COMMUNITY'S HEALTH. ADDITIONALLY, ON-SITE PREVENTIVE AND RESTORATIVE DENTAL SERVICES STARTED TO BE OFFERED IN 2022.ADDITIONAL ACCOMPLISHMENTSUT MEDICAL CENTER HIRED ITS INAUGURAL COMMUNITY HEALTH EQUITY DIRECTOR IN JANUARY 2022; CREATED THE COMMUNITY HEALTH EQUITY ADVISORY COUNCIL, AND HIRED ITS FIRST COMMUNITY HEALTH EQUITY DATA ANALYST.UTMC INTENSIFIED ITS COLLABORATION WITH THE KNOXVILLE AREA URBAN LEAGUE (KAUL) TO INCREASE ACCESS TO HEALTH CARE IN EAST KNOXVILLE. IT ALSO PARTNERED WITH THE EMERALD YOUTH FOUNDATION AND THE WELL LONSDALE INITIATIVE.UTMC DEMONSTRATED SIGNIFICANT PROGRESS BY INCLUDING HEALTH EQUITY AS PART OF THE LONG-TERM KEY STRATEGIC OBJECTIVES.
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) 2022
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