Quarterly Compliance and 45-Day Status Report. Pennsylvania Hospitals and Ambulatory Surgical Facilities

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1 Quarterly Compliance and 45-Day Status Report for Pennsylvania Hospitals and Ambulatory Surgical Facilities 2001Q4 through 2002Q3 Pennsylvania Health Care Cost Containment Council March 2003

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3 Quarterly Compliance and 45-Day Status Report Pennsylvania Health Care Cost Containment Council 225 Market Street, Suite 400 Harrisburg, PA Phone: (717) Fax: (717) Marc P. Volavka Executive Director March 2003

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5 Contents Definitions... 1 No Ambulatory/Outpatient UB92 Submission (Third Quarter 2002)... 2 Ambulatory/Outpatient Facilities Recognized for UB92 Submission Excellence (Third Quarter 2002)... 3 No Inpatient UB92 Submission (Third Quarter 2002)... 4 Inpatient Facilities Recognized for UB92 Submission Excellence (Third Quarter 2002)... 5 Ambulatory/Outpatient Compliance and 45-Day Status Report (Fourth Quarter 2001 through Third Quarter 2002)... 7 Change of Status Information for Ambulatory/Outpatient Facilities (Third Quarter 2002) Inpatient Compliance and 45-Day Status Report (Fourth Quarter 2001 through Third Quarter 2002)...19 Change of Status Information for Inpatient Facilities (Third Quarter 2002) NOTE: UB92 refers to the 1992 version of the modified Uniformed Claims and Billing Form adopted for use by the Council. This specifies data elements, definitions, and standard file format used by data sources for meeting regulatory requirements.

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7 Definitions A facility is deemed compliant when they have met the following criteria: The data submission is received on or before the original due dates as follows: Quarter Ends Submission Due Date March 31 June 30 June 30 September 30 September 30 December 31 December 31 March 31 Passed initial edit process for proper format and readability UB92 error rate is 20% or less Ninety Percent of the Atlas -derived records were received and matched by the original due date All facilities are considered compliant for each quarter denoted with a checkmark ( ). The only exceptions are for those facilities that followed the Request for Exceptions policy under Act-89 and had the request approved by the Council. The following are definitions used in the 45-day status sections of this report. No Data: Failed: E XXX%: E NAIC: XX Days Late: I XXX%: Late: The facility did not submit UB92 discharge data to PHC4. The facility submitted UB92 data to PHC4, but for some reason the media was not properly formatted or otherwise unreadable. The facility submitted UB92 data to PHC4, but had an error rate that exceeded the allowable maximum of 20%. This rate is calculated by dividing the number of records with at least one error by the total number of records submitted. The error rate is displayed. The facility submitted UB92 data to PHC4, but had an excessive percentage of blank NAIC Codes. The facility submitted UB92 data to PHC4 after the original due date. Days late refers to the number of days between the original due date and the date of the acceptable submission. The facility did not submit or match the minimum number of Atlas -derived records by the straggler date. The straggler date, which is approximately six weeks after the original due date, is intended to give facilities an opportunity to correct and/or add records to their original submission. The match rate is displayed. The facility did not submit or match the minimum number of Atlas -derived records by the original due date. Currently, the required number of Atlas -derived records is defined as matching 90% of the UB92 data submission minus MDCs 2, 3, 14, 15, 19, 20, 23 and DRG

8 No Ambulatory/Outpatient UB92 Submission for Third Quarter 2002 (Status 45-Days After Due Date) Endoscopy USA York Center Foundation Surgery Center at Fort Washington Lehigh Plastic Surgery Center Facility Type Ambi-Surg Center Ambi-Surg Center Ambi-Surg Center n=3 Facilities 2

9 Ambulatory/Outpatient Facilities Recognized for UB92 Submission Excellence for Third Quarter 2002 Facility Type Error Rate Digestive Disease Institute Ambi-Surg Center 0.00% Four Seasons Endoscopy Center, Inc Ambi-Surg Center 0.00% Lancaster General Hospital/Susquehanna General Acute 0.00% Mifflin County Community Surgical Center Ambi-Surg Center 0.00% Progressive Surgical Institute Ambi-Surg Center 0.00% Shadyside Surgi-Center Ambi-Surg Center 0.00% Valley View Surgical Center Ambi-Surg Center 0.00% Endoscopy Center of Pennsylvania Ambi-Surg Center 0.09% Laurel Laser and Surgery Center Ambi-Surg Center 0.12% UPMC Braddock General Acute 0.25% HEALTHSOUTH Mt Pleasant Surgery Center Ambi-Surg Center 0.26% Carlisle Endoscopy Center Ambi-Surg Center 0.27% West Shore Endoscopy Center, LLC Ambi-Surg Center 0.27% UPMC South Side General Acute 0.30% Hanover Hospital, Inc General Acute 0.37% UPMC Shadyside General Acute 0.39% UPMC St. Margaret General Acute 0.39% UPMC Presbyterian General Acute 0.40% York Endoscopy Center Ambi-Surg Center 0.46% Elk Regional Health Center General Acute 0.47% Meadville Medical Center General Acute 0.47% UPMC Horizon General Acute 0.50% Facility Type Error Rate Palmerton Hospital General Acute 0.54% UPMC McKeesport General Acute 0.62% Mt Lebanon Surgical Center Ambi-Surg Center 0.74% St. Francis Medical Center General Acute 0.79% Conemaugh Valley Memorial Hospital General Acute 0.81% Sunbury Community Hospital General Acute 0.81% Highlands Hospital General Acute 0.83% Lewistown Hospital General Acute 0.83% Gastrointestinal Specialists Ambi-Surg Center 0.90% Leader Surgical Center Ambi-Surg Center 0.90% UPMC Monroeville Surgery Center Ambi-Surg Center 0.91% Ambulatory Surgery Center/New Kensington Ambi-Surg Center 0.95% SurgiCenter at Ligonier Ambi-Surg Center 0.96% Temple University Hospital General Acute 0.97% DuBois Regional Medical Center General Acute 1.00% Three Rivers Endoscopy Center Ambi-Surg Center 1.06% Pocono Ambulatory Surgery Center, LP Ambi-Surg Center 1.08% Windber Medical Center General Acute 1.11% Sewickley Valley Hospital Surgical Center Ambi-Surg Center 1.12% Sewickley Valley Hospital General Acute 1.24% Tyler Memorial Hospital General Acute 1.30% Guthrie Clinic, Ltd Ambi-Surg Center 1.39% n=44 Facilities Facilities on this list not only met all the compliance criteria, but were also in the top 20% of the lowest initial submission error rates. Additionally, these facilities met all the original due dates without needing any type of extension. 3

10 No Inpatient UB92 Submission for Third Quarter 2002 (Status 45 Days After Due Date) This is the third time PHC4 has received a readable Inpatient UB92 Data Submission from every facility required to submit data. We want to congratulate every facility on a job well done and hope this continues in the future. 4

11 Inpatient Facilities Recognized for UB92 Submission Excellence for Third Quarter 2002 Facility Type Error Rate Bucktail Medical Center General Acute 0.00% Kensington Hospital Specialty 0.00% UPMC Braddock General Acute 0.12% Windber Medical Center General Acute 0.18% Lewistown Hospital General Acute 0.26% UPMC Shadyside General Acute 0.35% UPMC St. Margaret General Acute 0.37% Washington Hospital General Acute 0.45% UPMC South Side General Acute 0.52% DuBois Regional Medical Center General Acute 0.74% Medical Center, Beaver, PA General Acute 0.75% Sewickley Valley Hospital General Acute 0.79% Fulton County Medical Center General Acute 0.81% St. Luke's Miners Memorial Hospital General Acute 0.81% Conemaugh Valley Memorial Hospital General Acute 0.88% UPMC Presbyterian General Acute 0.88% Palmerton Hospital General Acute 0.90% Facility Type Error Rate Butler Memorial Hospital General Acute 0.92% UPMC Rehabilitation Hospital Rehabilitation 0.97% Gnaden Huetten Memorial Hospital General Acute 1.00% UPMC Horizon General Acute 1.08% Milton S. Hershey Medical Center General Acute 1.11% Tyler Memorial Hospital General Acute 1.12% Charles Cole Memorial Hospital General Acute 1.14% Sunbury Community Hospital General Acute 1.24% Lancaster General Hospital/Susquehanna General Acute 1.30% UPMC Passavant General Acute 1.36% Girard Medical Center Long Term Acute 1.43% Western Psychiatric Institute & Clinic Psychiatric 1.43% Centre Community Hospital General Acute 1.46% Hanover Hospital, Inc General Acute 1.47% Clearfield Hospital General Acute 1.53% Elk Regional Health Center General Acute 1.56% n=33 Facilities Facilities on this list not only met all the compliance criteria, but were also in the top 20% of the lowest initial submission error rates. Additionally, these facilities met all the original due dates without needing any type of extension. 5

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13 Ambulatory/Outpatient Compliance and 45-Day Status Report Fourth Quarter 2001 through Third Quarter

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15 Summary of Ambulatory/Outpatient Facility Compliance (Includes Hospital and Freestanding Facilities) Third Quarter 2002 (n=289) Second Quarter 2002 (n=286) Did Not Meet Criteria 15% Did Not Meet Criteria 10% Met UB92 Criteria 85% Met UB92 Criteria 90% First Quarter 2002 (n=280) Fourth Quarter 2001 (n=276) Did Not Meet Criteria 8% Did Not Meet Criteria 10% Met UB92 Criteria 92% Met UB92 Criteria 90% 9

16 Fourth Quarter 2001 through Third Quarter 2002 Ambulatory/Outpatient Compliance Report Facility Type UB92 Compliant 01Q4 02Q1 02Q2 02Q3 Abington Memorial Hospital General Acute Abington Surgical Center Ambi-Surg Center Aestique Ambulatory Surgical Center Ambi-Surg Center 39 Days Late 27 Days Late Albert Einstein Medical Center General Acute Aliquippa Community Hospital General Acute Alle-Kiski Medical Center General Acute Allegheny General Hospital General Acute Altoona Hospital General Acute Ambulatory Surgery Center at Bucks County Ambi-Surg Center E 33% E 42% E 36% E 47% Ambulatory Surgery Center/New Kensington Ambi-Surg Center Apple Hill Surgical Center Ambi-Surg Center 4 Days Late Armstrong County Memorial Hospital General Acute 8 Days Late Ashland Regional Medical Center General Acute Failed E 26% B Barnes Kasson County Hospital General Acute Berwick Hospital Center General Acute Bloomsburg Hospital General Acute E 27% E 22% Bon Secours Holy Family Regional Health Sys General Acute 22 Days Late Bradford Regional Medical Center General Acute Brandywine Hospital General Acute Brookville Hospital General Acute Brownsville General Hospital General Acute E 100% E 22% Bucci Eye Surgery Center, Inc Ambi-Surg Center N/R N/R E 23% Bucktail Medical Center General Acute 32 Days Late Butler Memorial Hospital General Acute C Canonsburg General Hospital General Acute 18 Days Late Carlisle Endoscopy Center Ambi-Surg Center Carlisle Regional Medical Center General Acute Carlisle Regional Surgery Center Ambi-Surg Center Center for Reproductive Surgery, LLC Ambi-Surg Center N/R Center for Same Day Surgery Ambi-Surg Center N/R N/R N/R 10 Days Late Central Montgomery Medical Center General Acute 31 Days Late Centre Community Hospital General Acute Centre Community Surgical Center Ambi-Surg Center Chambersburg Hospital General Acute Charles Cole Memorial Hospital General Acute Chester County Hospital General Acute N/R: Not Required 10

17 Fourth Quarter 2001 through Third Quarter 2002 Ambulatory/Outpatient Compliance Report Facility Type UB92 Compliant 01Q4 02Q1 02Q2 02Q3 Chestnut Hill Hospital General Acute Children s Hosp of Philadelphia ASC at Exton Ambi-Surg Center E 45% E 40% E 48% E 50% Children s Hosp Pgh North Outpatient Surgical Ambi-Surg Center Children's Hospital of Philadelphia Specialty Acute E 43% E 42% E 42% E 46% Children's Hospital of Pittsburgh Specialty Acute CHS Ambulatory Surgery Center Ambi-Surg Center E 21% E 21% E 21% Clarion Hospital General Acute Clearfield Hospital General Acute Community Hospital of Lancaster General Acute 2 Days Late 28 Days Late Community Medical Center/Scranton General Acute Conemaugh Valley Memorial Hospital General Acute Corry Memorial Hospital General Acute Crozer-Chester Medical Center General Acute Cumberland Surgery Center Ambi-Surg Center N/R E 100% D E Delaware County Memorial Hospital General Acute Delaware Valley Laser Surgery Institute Ambi-Surg Center Dermatologic Surgi Center/Drexel Hill Ambi-Surg Center Failed Dermatologic Surgi Center/Philadelphia Ambi-Surg Center Failed Dermatology and Cosmetic Surgery Center Ambi-Surg Center Digestive Disease Institute Ambi-Surg Center Digestive Health and Endoscopy Center, Inc Ambi-Surg Center N/R Divine Providence Hospital/Williamsport Specialty 30 Days Late Doylestown Hospital General Acute Doylestown Surgery Center Ambi-Surg Center N/R N/R 32 Days Late DuBois Regional Medical Center General Acute Easton Hospital General Acute Einstein Surgery Center Ambi-Surg Center N/R N/R Elk Regional Health Center General Acute Elkins Park Hospital General Acute Ellwood City Hospital General Acute Endoscopic Associates, Inc Ambi-Surg Center 15 Days Late 10 Days Late Endoscopy Center of Pennsylvania Ambi-Surg Center Endoscopy USA York Center Ambi-Surg Center N/R N/R E 100% Failed Ephrata Community Hospital General Acute Evangelical Community Hospital General Acute Exeter Surgery Center Ambi-Surg Center Eye Surgery Center Ambi-Surg Center N/R: Not Required 11

18 Fourth Quarter 2001 through Third Quarter 2002 Ambulatory/Outpatient Compliance Report Facility Type UB92 Compliant 01Q4 02Q1 02Q2 02Q3 Eye Surgery Center of Chester County, LLC Ambi-Surg Center E 31% F G Fairgrounds Surgical Center Ambi-Surg Center Forbes Regional Hospital General Acute Fort Washington Surgery Center Ambi-Surg Center 4 Days Late No Data No Data Four Seasons Endoscopy Center, Inc Ambi-Surg Center N/R Frankford Hospital General Acute Frick Hospital General Acute Fulton County Medical Center General Acute Gastrointestinal Specialists Ambi-Surg Center Geisinger Medical Center/Danville General Acute Geisinger Wyoming Valley General Acute Gettysburg Hospital General Acute 7 Days Late Gnaden Huetten Memorial Hospital General Acute Good Samaritan Hospital/Lebanon General Acute Good Samaritan Regional Medical Center General Acute Graduate Hospital General Acute Grand View Hospital General Acute Grandview Surgery & Laser Center Ambi-Surg Center Grandview Surgical Center Ambi-Surg Center 27 Days Late Greene County Memorial Hospital General Acute 17 Days Late 3 Days Late Guthrie Clinic, Ltd Ambi-Surg Center N/R H Hahnemann University Hospital General Acute Hamot Medical Center General Acute Hamot Surgery Center, LLC Ambi-Surg Center Hanover Hospital, Inc General Acute Hanover SurgiCenter Ambi-Surg Center Harrisburg Endoscopy & Surgery Center Ambi-Surg Center Hazleton Ambulatory Surgical Center Ambi-Surg Center 31 Days Late 30 Days Late Hazleton Endoscopy Center Ambi-Surg Center N/R N/R N/R Hazleton General Hospital General Acute Hazleton Saint Joseph Medical Center General Acute HEALTHSOUTH Mt Pleasant Surgery Center Ambi-Surg Center HEALTHSOUTH Scranton Surgery & Laser Center Ambi-Surg Center 11 Days Late 16 Days Late HEALTHSOUTH Surgery Center of Lancaster Ambi-Surg Center Highlands Hospital General Acute Hillmont Endoscopy Center Ambi-Surg Center N/R: Not Required 12

19 Fourth Quarter 2001 through Third Quarter 2002 Ambulatory/Outpatient Compliance Report Facility Type UB92 Compliant 01Q4 02Q1 02Q2 02Q3 Holy Redeemer Health System ASC Ambi-Surg Center Holy Redeemer Hospital & Medical Center General Acute Holy Spirit Hospital General Acute Hospital of Fox Chase Cancer Center Specialty Acute Hospital of the University of Pennsylvania General Acute I L Indiana Ambulatory Surgical Associates Ambi-Surg Center Indiana Regional Medical Center General Acute J. C. Blair Memorial Hospital General Acute Jameson Memorial Hospital General Acute Jeanes Hospital General Acute Jeannette District Memorial Hospital General Acute Jefferson Regional Medical Center General Acute Jennersville Regional Hospital General Acute 32 Days Late 3 Days Late 4 Days Late Jersey Shore Hospital General Acute John A. Zitelli Ambulatory Surgery Center Ambi-Surg Center 8 Days Late 2 Days Late Kane Community Hospital General Acute Kingston Ophthalmology ASC, LLC Ambi-Surg Center 3 Days Late E 23% E 24% Lancaster General Hospital General Acute Lancaster General Hospital/Susquehanna General Acute Lancaster Regional Medical Center General Acute Latrobe Area Hospital General Acute Laurel Laser and Surgery Center Ambi-Surg Center Leader Surgical Center Ambi-Surg Center Lebanon Outpatient Surgical Center, LP Ambi-Surg Center Lehigh Plastic Surgery Center Ambi-Surg Center N/R N/R No Data No Data Lehigh Valley Hospital General Acute Lehigh Valley Hospital/Muhlenberg General Acute Lewistown Hospital General Acute Lock Haven Hospital General Acute E 100% E 100% Lowry SurgiCenter Ambi-Surg Center 2 Days Late M Magee Womens Hosp of UPMC Health System Specialty Acute Main Line Hospital Bryn Mawr General Acute Main Line Hospital Lankenau General Acute Main Line Hospital Paoli General Acute Main Line Surgery Center, LLC Ambi-Surg Center Marian Community Hospital General Acute N/R: Not Required 13

20 Fourth Quarter 2001 through Third Quarter 2002 Ambulatory/Outpatient Compliance Report Facility Type UB92 Compliant 01Q4 02Q1 02Q2 02Q3 Meadville Medical Center General Acute Medical Center, Beaver, PA General Acute Medical College of Pennsylvania General Acute Memorial Hospital Inc/Towanda General Acute Memorial Hospital York General Acute Mercy Community Hospital General Acute Closed Closed Mercy Fitzgerald Hospital General Acute Mercy Hospital of Philadelphia General Acute Mercy Hospital of Pittsburgh General Acute 4 Days Late Mercy Hospital/Scranton General Acute Mercy Hospital/Wilkes-Barre General Acute Mercy Providence Hospital General Acute 21 Days Late Mercy Suburban Hospital General Acute Mercy Surgery Center Ambi-Surg Center E 63% E 69% E 22% E 22% Methodist Hospital General Acute Metro Health Center General Acute Meyersdale Community Hospital General Acute Mid-Valley Hospital General Acute Mifflin County Community Surgical Center Ambi-Surg Center Millcreek Community Hospital General Acute 17 Days Late 21 Days Late 16 Days Late Milton S. Hershey Medical Center General Acute Miners Hospital General Acute Monongahela Valley Hospital General Acute Monsour Medical Center General Acute E 57% E 43% 3 Days Late 7 Days Late Montgomery Hospital General Acute Montrose General Hospital General Acute 35 Days Late Moses Taylor Hospital General Acute 22 Days Late Mt Lebanon Surgical Center Ambi-Surg Center Muncy Valley Hospital General Acute 30 Days Late N R Nason Hospital General Acute Nazareth Hospital General Acute NEI Ambulatory Surgery, Inc, PC Ambi-Surg Center 28 Days Late North Shore Surgi Center Ambi-Surg Center 7 Days Late 25 Days Late Northwood Surgery Center Ambi-Surg Center 1 Day Late Ohio Valley General Hospital General Acute Ophthalmology Surgery Center Ambi-Surg Center Palmerton Hospital General Acute N/R: Not Required 14

21 Fourth Quarter 2001 through Third Quarter 2002 Ambulatory/Outpatient Compliance Report Facility Type UB92 Compliant 01Q4 02Q1 02Q2 02Q3 Paoli Surgery Center Ambi-Surg Center Parkview Hospital General Acute Penn Surgery Institute Ambi-Surg Center Pennsylvania Eye Surgery Center Ambi-Surg Center Pennsylvania Hospital Univ PA Hlth Sys General Acute Philadelphia Surgi-Center, Inc Ambi-Surg Center Philipsburg Area Hospital General Acute Phoenixville Hospital Univ PA Hlth Sys General Acute Pinnacle Health Hospitals General Acute Pittsburgh Specialty Hospital Specialty 10 Days Late Closed Pocono Ambulatory Surgery Center, LP Ambi-Surg Center Pocono Medical Center General Acute Pottstown Memorial Medical Center General Acute Pottsville Hospital and Warne Clinic General Acute Presbyterian Medical Center Univ PA Hlth Sys General Acute Progressive Surgical Institute Ambi-Surg Center Punxsutawney Area Hospital, Inc General Acute Reading Hospital and Medical Center General Acute Reading Surgery Center, LP Ambi-Surg Center N/R N/R N/R Riddle Memorial Hospital General Acute Riverview Ambulatory Surgical Center Ambi-Surg Center Robert Packer Hospital General Acute Roxborough Memorial Hospital General Acute S Sacred Heart Hospital/Allentown General Acute Saint Agnes Medical Center General Acute Saint Christopher's Hospital for Children Specialty Acute 35 Days Late E 21% E 25% E 32% Saint Francis Hospital/Cranberry General Acute Saint Joseph Medical Center/Reading General Acute Saint Joseph's Hospital/Philadelphia General Acute Saint Vincent Health Center General Acute Saint Vincent Surgery Center Ambi-Surg Center 3 Days Late Sally Balin Ambulatory Surgical Center Ambi-Surg Center 3 Days Late Scranton Endoscopy Center Ambi-Surg Center 13 Days Late Sewickley Valley Hospital General Acute Sewickley Valley Hospital Surgical Center Ambi-Surg Center Shadyside Surgi-Center Ambi-Surg Center Shamokin Area Community Hospital General Acute N/R: Not Required 15

22 Fourth Quarter 2001 through Third Quarter 2002 Ambulatory/Outpatient Compliance Report Facility Type UB92 Compliant 01Q4 02Q1 02Q2 02Q3 Sharon Regional Health System General Acute Soldiers and Sailors Memorial Hospital General Acute Somerset Hospital Center for Health General Acute Southwestern Ambulatory Surgery Center Ambi-Surg Center 16 Days Late 27 Days Late Southwestern Pennsylvania Eye Surgery Center Ambi-Surg Center 2 Days Late St. Clair Memorial Hospital General Acute 4 Days Late St. Francis Hospital of New Castle General Acute St. Francis Medical Center General Acute St. Luke's Hospital/Bethlehem General Acute St. Luke s Miners Memorial Hospital General Acute St. Luke's Quakertown Hospital General Acute St. Mary Medical Center General Acute Suburban General Hospital/Pittsburgh General Acute Summit Surgery Center Ambi-Surg Center Sunbury Community Hospital General Acute Surgery & Laser Center Ambi-Surg Center Surgery Center of Chester County Ambi-Surg Center Surgical Center of York Ambi-Surg Center Surgical Specialty Center of Northeastern PA Ambi-Surg Center N/R N/R N/R SurgiCenter at Ligonier Ambi-Surg Center Susquehanna Valley Surgical Center Ambi-Surg Center 25 Days Late T U Temple East, Inc General Acute Temple Lower Bucks Hospital General Acute Temple University Children's Medical Center General Acute E 23% E 23% Temple University Hospital General Acute Thomas Jefferson University Hospital General Acute Three Rivers Endoscopy Center Ambi-Surg Center Titusville Area Hospital General Acute Tri County Outpatient Surgical Facility Ambi-Surg Center Troy Community Hospital General Acute Twin Rivers Endoscopy Center Ambi-Surg Center 9 Days Late Tyler Memorial Hospital General Acute Tyrone Hospital General Acute 16 Days Late Union City Memorial Hospital General Acute Closed Closed Closed Uniontown Hospital General Acute 14 Days Late United Community Hospital General Acute UPMC Bedford General Acute N/R: Not Required 16

23 Fourth Quarter 2001 through Third Quarter 2002 Ambulatory/Outpatient Compliance Report Facility Type UB92 Compliant 01Q4 02Q1 02Q2 02Q3 UPMC Braddock General Acute UPMC Horizon General Acute UPMC Lee Regional Hospital General Acute UPMC McKeesport General Acute UPMC Monroeville Surgery Center Ambi-Surg Center UPMC Northwest General Acute UPMC Passavant General Acute UPMC Presbyterian General Acute UPMC Shadyside General Acute UPMC South Side General Acute UPMC St. Margaret General Acute V Z Valley Surgery Center, Inc Ambi-Surg Center N/R N/R Valley View Surgical Center Ambi-Surg Center Village SurgiCenter Ambi-Surg Center Warminster Hospital General Acute Warren General Hospital General Acute 10 Days Late Washington Hospital General Acute Wayne Memorial Hospital General Acute 6 Days Late Waynesboro Hospital General Acute West Shore Endoscopy Center, LLC Ambi-Surg Center West Shore Surgery Center Ambi-Surg Center E 100% E 99% 25 Days Late Western PA Surgery Center Ambi-Surg Center N/R N/R Western Pennsylvania Hospital General Acute Westfield Surgery Center Ambi-Surg Center 10 Days Late Westmoreland Regional Hospital General Acute Williamsport Hospital and Medical Center General Acute 31 Days Late Wills Eye Hospital Specialty Acute 28 Days Late 11 Days Late 14 Days Late Wills Eye Surgery Center of Plymouth Meeting Ambi-Surg Center No Data Wills Eye Surgery Center of South Phila Ambi-Surg Center 10 Days Late 8 Days Late Wills Surgery Center of Bucks County Ambi-Surg Center Wills Surgery Center of the Northeast Ambi-Surg Center Windber Medical Center General Acute 14 Days Late WVHCS Hospital General Acute York Endoscopy Center Ambi-Surg Center York Hospital General Acute 37 Days Late Zitelli South Ambulatory Surgical Center Ambi-Surg Center 8 Days Late 2 Days Late N/R: Not Required 17

24 Change of Status Information for Ambulatory/Outpatient Facilities Information Bucci Eye Surgery Center, Inc Opened on August 1, 2001 Center for Reproductive Surgery, LLC Opened on November 14, 2000 Center for Same Day Surgery Opened on September 11, 2001 Cumberland Surgery Center Opened on April 9, 2001 Digestive Health and Endoscopy Center, Inc Opened on May 15, 2001 Doylestown Surgery Center Opened on June 6, 2001 Einstein Surgery Center Opened on August 6, 2001 Endoscopy USA York Center Opened on July 10, 2001 Foundation Surgery Center at Fort Washington Current Name: Fort Washington Surgery Center Four Seasons Endoscopy Center, Inc Opened on May 3, 2001 Guthrie Clinic, Ltd Opened on March 7, 2001 Hazleton Endoscopy Center Opened on September 20, 2001 Lehigh Plastic Surgery Center Opened on August 20, 2001 Mercy Community Hospital Closed on February 2, 2002 Methodist Hospital Merged with Thomas Jefferson University Hospital effective September 1, 1996, but reports data separately Pittsburgh Specialty Hospital Closed on May 30, 2002 Reading Surgery Center, LP Opened on October 12, 2001 Surgery Center of Bucks County Current Name: Wills Surgery Center of Bucks County Surgical Specialty Center of Northeastern PA Opened on September 28, 2001 Temple East/Northeastern Division Merged with Temple East/Neumann Division to become Temple East, Inc Union City Memorial Hospital Closed on November 30, 2001 Valley Surgery Center, Inc Opened on July 27, 2001 Western PA Surgery Center Opened on October 20,

25 Inpatient Compliance and 45-Day Status Report Fourth Quarter 2001 through Third Quarter

26 Summary of Inpatient Acute Care Facility Compliance Third Quarter 2002 (n=187) Second Quarter 2002 (n=187) Met UB92 and Atlas Criteria 86% Neither Criteria Met 2% Met Atlas Criteria Only 8% Met UB92 Criteria Only 4% Met UB92 and Atlas Criteria 88% Neither Criteria Met 1% Met Atlas Criteria Only 5% Met UB92 Criteria Only 6% First Quarter 2002 (n=188) Fourth Quarter 2001 (n=189) Met UB92 and Atlas Criteria 87% Neither Criteria Met Atlas Met Criteria Only 1% 6% Met UB92 Criteria Only 6% Met UB92 and Atlas Criteria 91% Neither Criteria Met Met Atlas 2% Criteria Only 4% Met UB92 Criteria Only 3%.20

27 Summary of Inpatient Non-Acute Care Facility Compliance Third Quarter 2002 (n=59) Second Quarter 2002 (n=61) Did Not Meet Criteria 27% Did Not Meet Criteria 30% Met UB92 Criteria 73% Met UB92 Criteria 70% First Quarter 2002 (n=59) Fourth Quarter 2001 (n=58) Did Not Meet Criteria 24% Did Not Meet Criteria 28% Met UB92 Criteria 76% Met UB92 Criteria 72%.21

28 Fourth Quarter 2001 through Third Quarter 2002 Inpatient Compliance Report Facility Type UB92 Compliant Atlas Compliant 01Q4 02Q1 02Q2 02Q3 01Q4 02Q1 02Q2 02Q3 Abington Memorial Hospital General Acute Albert Einstein Medical Center General Acute Aliquippa Community Hospital General Acute E 62% E 73% E 39% I 81% Alle-Kiski Medical Center General Acute Allegheny General Hospital General Acute Allied Services Institute of Rehab Medicine Rehabilitation N/R N/R N/R N/R Altoona Hospital General Acute Armstrong County Memorial Hospital General Acute E 31% Ashland Regional Medical Center General Acute Failed E 22% 15 Days Late I 0% I 84% I 80% I 82% B Barnes Kasson County Hospital General Acute Belmont Center for Comprehensive Treatment Psychiatric N/R N/R N/R N/R Berwick Hospital Center General Acute Bloomsburg Hospital General Acute Late Late Late Late Bon Secours Holy Family Regional Health Sys General Acute 22 Days Late Bradford Regional Medical Center General Acute Brandywine Hospital General Acute Brookville Hospital General Acute Brownsville General Hospital General Acute E 100% 43 Days Late I 0% I 0% I 0% Late Bryn Mawr Rehabilitation Hospital Rehabilitation N/R N/R N/R N/R Bucktail Medical Center General Acute Butler Memorial Hospital General Acute C Canonsburg General Hospital General Acute Carlisle Regional Medical Center General Acute 17 Days Late Central Montgomery Medical Center General Acute 24 Days Late 35 Days Late 24 Days Late 43 Days Late Centre Community Hospital General Acute Chambersburg Hospital General Acute 43 Days Late Charles Cole Memorial Hospital General Acute Chester County Hospital General Acute Chestnut Hill Hospital General Acute Chestnut Hill Rehabilitation Hospital Rehabilitation N/R N/R N/R N/R Children's Home of Pittsburgh Specialty N/R N/R N/R N/R Children's Hospital of Philadelphia Specialty Acute E 38% E 35% E 35% E 41% Children's Hospital of Pittsburgh Specialty Acute Children's Institute of Pittsburgh Rehabilitation E 27% 7 Days Late N/R N/R N/R N/R Children's Seashore House of the CHOP Rehabilitation E 100% E 100% E 100% E 100% N/R N/R N/R N/R N/R: Not Required 22

29 Fourth Quarter 2001 through Third Quarter 2002 Inpatient Compliance Report Facility Type UB92 Compliant Atlas Compliant 01Q4 02Q1 02Q2 02Q3 01Q4 02Q1 02Q2 02Q3 Clarion Hospital General Acute Clarion Psychiatric Center Psychiatric E 32% N/R N/R N/R N/R Clearfield Hospital General Acute Community Hospital of Lancaster General Acute 15 Days Late 25 Days Late E 25% Community Medical Center/Scranton General Acute Conemaugh Valley Memorial Hospital General Acute Corry Memorial Hospital General Acute Crozer-Chester Medical Center General Acute D - E Delaware County Memorial Hospital General Acute Late Late Divine Providence Hospital/Williamsport Specialty 24 Days Late N/R N/R N/R N/R Doylestown Hospital General Acute DuBois Regional Medical Center General Acute Eagleville Hospital Specialty N/R N/R N/R N/R Easton Hospital General Acute Elk Regional Health Center General Acute Elkins Park Hospital General Acute Ellwood City Hospital General Acute Ephrata Community Hospital General Acute Eugenia Hospital Psychiatric 22 Days Late 15 Days Late N/R N/R N/R N/R Evangelical Community Hospital General Acute F G Fairmount Behavioral Health Systems Psychiatric E 53% E 48% N/R N/R N/R N/R First Hospital of Wyoming Valley Psychiatric 18 Days Late N/R N/R N/R N/R Forbes Regional Hospital General Acute Foundations Behavioral Health Psychiatric N/R N/R N/R N/R Frankford Hospital General Acute Frick Hospital General Acute Friends Hospital Psychiatric E 75% E 96% N/R N/R N/R N/R Fulton County Medical Center General Acute Geisinger HEALTHSOUTH Rehabilitation Hospital Rehabilitation N/R N/R N/R N/R Geisinger Medical Center/Danville General Acute Geisinger Wyoming Valley General Acute Gettysburg Hospital General Acute Girard Medical Center Long Term Acute N/R N/R N/R N/R Gnaden Huetten Memorial Hospital General Acute Good Samaritan Hospital/Lebanon General Acute N/R: Not Required 23

30 Fourth Quarter 2001 through Third Quarter 2002 Inpatient Compliance Report Facility Type UB92 Compliant Atlas Compliant 01Q4 02Q1 02Q2 02Q3 01Q4 02Q1 02Q2 02Q3 Good Samaritan Regional Medical Center General Acute Good Shepherd Rehabilitation Hospital Rehabilitation N/R N/R N/R N/R Good Shepherd Specialty Hospital/Allentown Long Term Acute 24 Days Late N/R N/R N/R N/R Graduate Hospital General Acute Grand View Hospital General Acute Greene County Memorial Hospital General Acute 17 Days Late 3 Days Late H Hahnemann University Hospital General Acute Hamot Medical Center General Acute Hanover Hospital, Inc General Acute Hazleton General Hospital General Acute Hazleton St. Joseph Medical Center General Acute HEALTHSOUTH Harmarville Rehabilitation Rehabilitation N/R N/R N/R N/R HEALTHSOUTH Nittany Valley Rehab Hospital Rehabilitation 1 Day Late N/R N/R N/R N/R HEALTHSOUTH Reading Rehabilitation Hospital Rehabilitation N/R N/R N/R N/R HEALTHSOUTH Rehab Hospital of Greater Pgh Rehabilitation 4 Days Late N/R N/R N/R N/R HEALTHSOUTH Rehab Hospital of Sewickley Rehabilitation 30 Days Late N/R N/R N/R N/R HEALTHSOUTH Rehabilitation Hosp Mechanicsburg Rehabilitation N/R N/R N/R N/R HEALTHSOUTH Rehabilitation Hosp of Altoona Rehabilitation 35 Days Late N/R N/R N/R N/R HEALTHSOUTH Rehabilitation Hosp Special Svcs Rehabilitation N/R N/R N/R N/R HEALTHSOUTH Rehabilitation Hospital of Erie Rehabilitation 43 Days Late N/R N/R N/R N/R HEALTHSOUTH Rehabilitation Hospital of York Rehabilitation N/R N/R N/R N/R Highlands Hospital General Acute Holy Redeemer Health System General Acute 32 Days Late Holy Spirit Hospital General Acute Horsham Clinic Psychiatric E 36% N/R N/R N/R N/R Hospital of Fox Chase Cancer Center Specialty Acute Hospital of the University of Pennsylvania General Acute I - L Indiana Regional Medical Center General Acute J. C. Blair Memorial Hospital General Acute Jameson Memorial Hospital General Acute I 29% Jeanes Hospital General Acute Jeannette District Memorial Hospital General Acute Jefferson Regional Medical Center General Acute Jennersville Regional Hospital General Acute 18 Days Late 3 Days Late 3 Days Late Jersey Shore Hospital General Acute N/R: Not Required 24

31 Fourth Quarter 2001 through Third Quarter 2002 Inpatient Compliance Report Facility Type UB92 Compliant Atlas Compliant 01Q4 02Q1 02Q2 02Q3 01Q4 02Q1 02Q2 02Q3 John Heinz Institute of Rehab Medicine Rehabilitation N/R N/R N/R N/R Kane Community Hospital General Acute Kensington Hospital Specialty 7 Days Late N/R N/R N/R N/R Kindred Hospital/Delaware County Long Term Acute Failed 1 Day Late 30 Days Late N/R N/R N/R N/R Kindred Hospital/Philadelphia Long Term Acute 29 Days Late 30 Days Late E 28% E 26% N/R N/R N/R N/R Kindred Hospital/Pittsburgh Long Term Acute E 31% E 100% E 41% N/R N/R N/R N/R Kirkbride Center Psychiatric N/R N/R N/R N/R Lancaster General Hospital General Acute Lancaster General Hospital/Susquehanna General Acute Lancaster Regional Medical Center General Acute Latrobe Area Hospital General Acute Lehigh Valley Hospital General Acute Lehigh Valley Hospital/Muhlenberg General Acute Lewistown Hospital General Acute LifeCare Hospitals of Pittsburgh, Inc Long Term Acute N/R N/R N/R N/R Lock Haven Hospital General Acute E 100% Failed Late M Magee Rehabilitation Hospital Rehabilitation E 23% N/R N/R N/R N/R Magee-Womens Hosp of UPMC Health System Specialty Acute Main Line Hospital Bryn Mawr General Acute Main Line Hospital Lankenau General Acute Main Line Hospital Paoli General Acute 24 Days Late Malvern Institute Specialty 15 Days Late N/R N/R N/R N/R Marian Community Hospital General Acute Meadows Psychiatric Center Psychiatric E 21% N/R N/R N/R N/R Meadville Medical Center General Acute Medical Center, Beaver, PA General Acute Medical College of Pennsylvania General Acute Late Late I 56% Memorial Hospital Inc/Towanda General Acute Memorial Hospital York General Acute Mercy Community Hospital General Acute Closed Closed Closed Closed Mercy Fitzgerald Hospital General Acute Mercy Hospital of Philadelphia General Acute Mercy Hospital of Pittsburgh General Acute 4 Days Late Mercy Hospital/Scranton General Acute I 11% Mercy Hospital/Wilkes-Barre General Acute Mercy Providence Hospital General Acute 21 Days Late N/R: Not Required 25

32 Fourth Quarter 2001 through Third Quarter 2002 Inpatient Compliance Report Facility Type UB92 Compliant Atlas Compliant 01Q4 02Q1 02Q2 02Q3 01Q4 02Q1 02Q2 02Q3 Mercy Special Care Hospital Long Term Acute N/R N/R N/R N/R Mercy Suburban Hospital General Acute Methodist Hospital General Acute Metro Health Center General Acute Meyersdale Community Hospital General Acute Late Late Late Late Mid-Valley Hospital General Acute Millcreek Community Hospital General Acute 17 Days Late 21 Days Late 16 Days Late Late Late Late Late Milton S. Hershey Medical Center General Acute Miners Hospital General Acute I 83% Monongahela Valley Hospital General Acute Monsour Medical Center General Acute E 58% E 63% E 25% E 30% Late Montgomery County MH/MR Emergency Service Psychiatric 18 Days Late N/R N/R N/R N/R Montgomery Hospital General Acute I 88% I 63% Montrose General Hospital General Acute 31 Days Late 3 Days Late Moses Taylor Hospital General Acute Moss Rehabilitation Hospital Rehabilitation N/R N/R N/R N/R Muncy Valley Hospital General Acute 24 Days Late N R Nason Hospital General Acute National Hospital for Kids in Crisis Psychiatric 15 Days Late N/R N/R N/R N/R Nazareth Hospital General Acute Northwestern Institute of Psychiatry Psychiatric 3 Days Late N/R N/R N/R N/R Ohio Valley General Hospital General Acute Palmerton Hospital General Acute Parkview Hospital General Acute Pennsylvania Hospital Univ PA Hlth Sys General Acute Philhaven Hospital Psychiatric N/R N/R N/R N/R Philipsburg Area Hospital General Acute I 83% I 83% Phoenixville Hospital Univ PA Hlth Sys General Acute Late Pinnacle Health Hospitals General Acute Pittsburgh Specialty Hospital Specialty Closed N/R N/R N/R Closed Pocono Medical Center General Acute Pottstown Memorial Medical Center General Acute Pottsville Hospital and Warne Clinic General Acute Presbyterian Medical Center Univ PA Hlth Sys General Acute Punxsutawney Area Hospital, Inc General Acute Reading Hospital and Medical Center General Acute N/R: Not Required 26

33 Fourth Quarter 2001 through Third Quarter 2002 Inpatient Compliance Report Facility Type UB92 Compliant Atlas Compliant 01Q4 02Q1 02Q2 02Q3 01Q4 02Q1 02Q2 02Q3 Riddle Memorial Hospital General Acute Robert Packer Hospital General Acute Roxborough Memorial Hospital General Acute S Sacred Heart Hospital/Allentown General Acute Saint Agnes Medical Center General Acute Saint Christopher's Hospital for Children Specialty Acute Saint Francis Hospital/Cranberry General Acute Saint Joseph Medical Center/Reading General Acute Saint Joseph's Hospital/Philadelphia General Acute Saint Vincent Health Center General Acute SCCI Hospital/Easton Long Term Acute 37 Days Late N/R N/R N/R N/R SCCI Hospital/Harrisburg Long Term Acute 37 Days Late N/R N/R N/R N/R Select Specialty Hosp/Central PA/Camp Hill Long Term Acute N/R N/R E 43% E 46% N/R N/R N/R N/R Select Specialty Hospital/Erie Long Term Acute E 100% E 26% E 31% E 30% N/R N/R N/R N/R Select Specialty Hospital/Greensburg Long Term Acute N/R E 54% E 37% E 35% N/R N/R N/R N/R Select Specialty Hospital/Johnstown Long Term Acute E 71% 14 Days Late E 27% N/R N/R N/R N/R Select Specialty Hospital/Philadelphia AEMC Long Term Acute E 95% E 37% E 48% E 63% N/R N/R N/R N/R Select Specialty Hospital/Pittsburgh, Inc Long Term Acute E 79% E 40% E 38% E 22% N/R N/R N/R N/R SemperCare Hospital of Lancaster Long Term Acute N/R N/R No Data E 100% N/R N/R N/R N/R Sewickley Valley Hospital General Acute Shamokin Area Community Hospital General Acute Sharon Regional Health System General Acute Soldiers and Sailors Memorial Hospital General Acute Somerset Hospital Center for Health General Acute Southwood Psychiatric Hospital Psychiatric N/R N/R N/R N/R St. Clair Memorial Hospital General Acute 4 Days Late St. Francis Hospital of New Castle General Acute St. Francis Medical Center General Acute St. Luke's Hospital/Bethlehem General Acute St. Luke s Miners Memorial Hospital General Acute St. Luke's Quakertown Hospital General Acute St. Mary Medical Center General Acute Suburban General Hospital/Pittsburgh General Acute I 66% I 11% Sunbury Community Hospital General Acute T U Temple East, Inc General Acute N/R: Not Required 27

34 Fourth Quarter 2001 through Third Quarter 2002 Inpatient Compliance Report Facility Type UB92 Compliant Atlas Compliant 01Q4 02Q1 02Q2 02Q3 01Q4 02Q1 02Q2 02Q3 Temple East/Northeastern Division Specialty Merged N/R N/R N/R Merged Temple Lower Bucks Hospital General Acute Temple University Children's Medical Center Specialty Acute E 28% E 24% E 26% E 29% Temple University Hospital General Acute Thomas Jefferson University Hospital General Acute Titusville Area Hospital General Acute Troy Community Hospital General Acute Tyler Memorial Hospital General Acute Tyrone Hospital General Acute 16 Days Late Union City Memorial Hospital General Acute Closed Closed Closed Closed Closed Closed Uniontown Hospital General Acute 35 Days Late United Community Hospital General Acute UPMC Bedford General Acute UPMC Braddock General Acute UPMC Horizon General Acute UPMC Lee Regional Hospital General Acute 17 Days Late UPMC McKeesport General Acute Late Late Late UPMC Northwest General Acute UPMC Passavant General Acute UPMC Presbyterian General Acute UPMC Rehabilitation Hospital Rehabilitation N/R N/R N/R N/R UPMC Shadyside General Acute UPMC South Side General Acute UPMC St. Margaret General Acute V Z Valley Forge Medical Center and Hospital Specialty N/R N/R N/R N/R Warminster Hospital General Acute Warren General Hospital General Acute 10 Days Late Washington Hospital General Acute Wayne Memorial Hospital General Acute 6 Days Late Late Waynesboro Hospital General Acute E 20% Western Pennsylvania Hospital General Acute Western Psychiatric Institute & Clinic Psychiatric 1 Day Late N/R N/R N/R N/R Westmoreland Regional Hospital General Acute Williamsport Hospital and Medical Center General Acute Wills Eye Hospital Specialty Acute I - 75% Late Late Windber Medical Center General Acute 14 Days Late N/R: Not Required 28

35 Fourth Quarter 2001 through Third Quarter 2002 Inpatient Compliance Report Facility Type UB92 Compliant Atlas Compliant 01Q4 02Q1 02Q2 02Q3 01Q4 02Q1 02Q2 02Q3 WVHCS Hospital General Acute York Hospital General Acute 34 Days Late N/R: Not Required 29

36 Change of Status Information for Inpatient Facilities Information Allentown Specialty Hospital Current Name: Good Shepherd Specialty Hospital/Allentown Mercy Community Hospital Closed on February 2, 2002 Methodist Hospital Merged with Thomas Jefferson University Hospital effective September 1, 1996, but reports data separately Moss Rehabilitation Hospital Merged with Albert Einstein Medical Center effective July 1, 1992, but reports data separately Pittsburgh Specialty Hospital Closed on May 30, 2002 Select Specialty Hosp/Central PA/Camp Hill Opened on June 11, 2001 Select Specialty Hospital/Greensburg Opened on July 25, 2000 SemperCare Hospital of Lancaster Opened on June 26, 2001 Temple East/Northeastern Division Merged with Temple East/Neumann Division to become Temple East, Inc Union City Memorial Hospital Closed on November 30, 2001 Western Psychiatric Institute & Clinic Merged with UPMC Presbyterian effective July 1, 1992, but reports data separately 30