Great Lakes Physician Practice PC

“Section A: Governing Body and Management Question 6: GREAT LAKES PHYSICIAN PRACTICE, P.C. has one Shareholder, Francis P. Foti, M.D. Question 7A and B: The share of the Corporation may be issued only to an individual who (a) is duly licensed or otherwise legally authorized in the State of New York to render the same professional service as that for which the Corporation was incorporated, (b) is employed by Regional Health Services, Inc. (RHS) or an affiliate thereof, and (c) executes an agreement in a form approved by RHS relating to transfer of the shares. A stock agreement between Francis P. Foti, M.D. and RHS, requires RHS approval for certain actions and provides RHS and ultimately UPMC the 501(c)(3) supporting parent organization of the UPMC health system, with exclusive authority over certin matters. The specific transactions that are subject to the approval of the members are stipulated in the By-laws.”

“Section B: Policies Question 11: A full copy of the form 990 is provided to each Board of Directors member prior to filing. Question 12c: Great Lakes Physician Practice, P.C. requires all of its key employees and non-employed personnel to comply with its conflict of interest (COI) policies when they engage in Great Lakes Physician Practice, P.C. related business. This COI policy is that of RHS and UPMC. Persons covered by the policies include: -Great Lakes Physician Practice, P.C. entity board members, board committee members, and corporate officers. -Great Lakes Physician Practice, P.C. physicians and non-physician employees who hold a position of influence.These people are required to complete a questionnaire at least annually. An electronic form has been developed to capture the data from the questionnaire and to monitor completion. The information, along with other data, is used to capture individual and institutional relationships so that potential conflicts of interest can be identified. If a potential conflict is identified regarding a specific activity the corporate compliance department, with the assistance of the legal department of UPMC, would evaluate the activity in relation to the potential conflict. If a perceived or actual conflict is determined to exist and a decision is made to proceed with the activity, a written plan designed to prevent the conflict from influencing decisions related to the activity is developed. Question 15A and B: Great Lakes Physician Practice, P.C. establishes a Practice Management Committee responsible for establishing the methodology for the distribution of annual compensation among employees. All compensation is based on the premise of required reasonable compensation per Internal Revenue Code requirements.”

“Section B: Policies Question 11: A full copy of the form 990 is provided to each Board of Directors member prior to filing. Question 12c: Great Lakes Physician Practice, P.C. requires all of its key employees and non-employed personnel to comply with its conflict of interest (COI) policies when they engage in Great Lakes Physician Practice, P.C. related business. This COI policy is that of RHS and UPMC. Persons covered by the policies include: -Great Lakes Physician Practice, P.C. entity board members, board committee members, and corporate officers. -Great Lakes Physician Practice, P.C. physicians and non-physician employees who hold a position of influence. These people are required to complete a questionnaire at least annually. An electronic form has been developed to capture the data from the questionnaire and to monitor completion. The information, along with other data, is used to capture individual and institutional relationships so that potential conflicts of interest can be identified. If a potential conflict is identified regarding a specific activity the corporate compliance department, with the assistance of the legal department of UPMC, would evaluate the activity in relation to the potential conflict. If a perceived or actual conflict is determined to exist and a decision is made to proceed with the activity, a written plan designed to prevent the conflict from influencing decisions related to the activity is developed. Question 15A and B: Great Lakes Physician Practice, P.C. establishes a Practice Management Committee responsible for establishing the methodology for the distribution of annual compensation among employees. All compensation is based on the premise of required reasonable compensation per Internal Revenue Code requirements.”

“Section a, officers, directors, trustees, key employees and highest compensatied employees: all salaries and benefits reported are based on individuals' operational positions and are not for services performed as directors or board members. Board positions are all volunteer and unpaid.”

“GREAT LAKES PHYSICIAN PRACTICE, P.C. EIN: 46-4186362 FORM 990 FOR THE FISCAL YEAR ENDED JUNE 30, 2019 Part III, Statement of Program Service Accomplishments Great Lakes Physician Practice, P.C. (GLPP) is a New York professional corporation formed on October 16, 2013 which has at all times since its formation been organized and operated for charitable purposes within the meaning of Internal Revenue Code Section 501(c)(3). GLPP is a subsidiary of Regional Health Services, Inc. (RHS), an organization that is recognized as exempt from federal income tax under Section 501(a) as an organization described in Section 501(c)(3) and which is recognized as a public charity under Section 509(a)(2). RHS provides physician and outpatient healthcare and health education services to the Northwestern Pennsylvania tri-state region community. GLPP is organized and operated to promote access to high quality healthcare services to residents of the underserved area of Chautauqua County, New York and surrounding areas through the recruitment and employment of physicians to meet community needs. The majority of GLPP's patients are from Chautauqua County, New York, with additional patients from Cattaraugus County, NY and Bradford County in Pennsylvania, all rural areas with limited access to health care services. Chautauqua County contains four Health Professional Shortage Areas as designated by HHS, and the neighboring county of Bradford, Pennsylvania contains an additional six designated Health Professional Shortage Areas. Further, Chautauqua and Bradford Counties each include a federally-designated Medically Underserved Area. With physician offices in both Jamestown and Dunkirk, New York, and its physicians traveling to see patients in several local hospitals throughout these counties, GLPP also provides necessary specialty medical services that are not widely available in communities that are designated as medically underserved and have a shortage of health professionals. GLPP physicians provide specialty medical services in the following practice areas: cardiology, gastroenterology, general surgery, internal medicine, nephrology, neurology, neurosurgery, orthopedics, pulmonary and sleep medicine, and women's health. Services are offered to residents throughout Chautauqua County in order to relieve conditions relating to, and to promote the interests of, the health of Chautauqua County's various communities. In order to ensure that all residents of these communities are served regardless of their ability to pay, GLPP provides discounted and free care for patients who demonstrated financial need. GLPP regularly hosts medical students for shadowing experiences with its physicians. In addition to furthering students' education, this program serves the important purpose of introducing future physicians to Chautauqua County, a rural area which traditionally lacks incentives to attract such professionals as demonstrated by its status as a federally-designated Health Professional Shortage Area. In addition to providing education opportunities to medical students, GLPP also provides shadowing experiences for other students in the medical professions in fields such as medical assistant, health care administration, and phlebotomy. GLPP also fulfills its exempt charitable and educational mission through participation in community benefit and research programs. GLPP regularly provides education to community members at health fairs and job fairs. GLPP is also active in promoting healthy behaviors in the communities that it serves by sponsoring youth sports programs and offering free space to various types of support groups for community residents dealing with serious health issues. Further, GLPP has been involved in formal research studies to improve outcomes for patients with atrial fibrillation. The willingness of GLPP's physicians to participate in such studies brings the opportunity for new and innovative treatments to the patients of Chautauqua County.”

“Reconciliation of Net Assets Line 9: Other Changes in Net Assets. Prior Period Adjustment 62,866 Joint Venture Activity 89,434 Total 152,300”

“QUESTION 2B and C: An external audit is completed at a consolidated UPMC system level only, including UPMC and all taxable and tax-exempt subsidiaries. UPMC has an Audit Committee that is established to assist the Board of Directors in fulfilling its oversight responsibilities by monitoring UPMC consolidated financial reports and other financial information provided by UPMC to governmental bodies, the public or other external entities. The UPMC's system of internal controls regarding finance, accounting, legal compliance and ethics that management and the Board have established and UPMC's internal auditing, accounting and financial reporting processes also provided oversight.”