Statewide Quality Care Assessment Program Report to the Pennsylvania General Assembly. Act 49 of 2010

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1 Statewide Quality Care Assessment Program Report to the Pennsylvania General Assembly Act 49 of 2010 Commonwealth of Pennsylvania Department of Public Welfare Tom Corbett Governor Beverly Mackereth Acting Secretary of Public Welfare March 4, 2013

2 Purpose/Introduction This report provides the appropriate committees of the Pennsylvania Senate and House of Representatives and other interested parties with the information required to be reported by Act 49 of 2010 regarding the Statewide Quality Care Assessment Program (Assessment). The report analyzes the various components of the Assessment, including the assessment fees paid by each hospital and the amount and types of payments made by the Commonwealth to individual hospitals. Background In 2010, the General Assembly enacted the Act of July 9, 2010 (P. L. 336, No. 49) (Act 49). Act 49 added a new Article VIII-G to the Public Welfare Code (62 P. S G 816-G) to authorize the Department of Public Welfare (Department) to implement the Statewide Quality Care Assessment Program for a 3-year period beginning July 1, 2010 and ending June 30, Under the Assessment program, the Department is required to impose a monetary assessment on all licensed hospitals in the Commonwealth other than certain exempt hospitals. 1 The assessment equals a percentage of the covered hospitals net inpatient revenue. As detailed in the appendixes to this report, since the Assessment was implemented in 2010, the Department has collected two years of Assessment revenue totaling $1.1 billion and used a substantial portion of these funds to increase Medical Assistance (MA) payments to hospitals for inpatient services by $2.2 billion, of which $1.2 billion was paid under the MA Fee for Service Program and $943 million was paid to the MA Managed Care Organizations for distribution to hospitals for inpatient services. Section 814-G of Act 49 requires the Department to submit a report on the Assessment program not later than 180 days prior to June 30, The report is to be submitted to the Chair and Minority Chair of the Public Health and Welfare Committee of the Senate, the Chair and Minority Chair of the Appropriations Committee of the Senate, the Chair and Minority Chair of the Health Committee of the House of Representatives and the Chair and Minority Chair for the Appropriations Committee of the House of Representatives. Assessment Rates: As originally enacted, Article VIII-G specified that the assessment percentage would be 2.69% for State FY and 2.84% for FY and FY (See 62 P. S. 803-G.) The Secretary of Public Welfare (Secretary) was authorized to adjust the 1 Under section 801-G of the code (62 P. S. 801-G), the following hospitals are exempt from the assessment: (1) Federal veterans' affairs hospitals; (2) hospitals that provide care, including inpatient hospital services, to all patients free of charge; (3) private psychiatric hospitals; (4) State-owned psychiatric hospitals; (5) critical access hospitals; and (6) long-term acute care hospitals.

3 assessment percentage for FY and FY after publishing notice in the Pennsylvania Bulletin, allowing for a 30-day comment period and obtaining approval from the Governor. As a result of the loss of enhanced Federal Medical Assistance Percentage (FMAP) in FY , the General Assembly subsequently amended Article VIII-G to authorize the Secretary to adjust the assessment percentage for FY (Act of October 22, 2010 P.L. 829, No 84. Act 84). After publishing an intent notice in the Pennsylvania Bulletin (40 Pa.B 6987) and allowing for a 30-day comment period the Secretary adjusted the assessment percentage for FY to 2.95%. Final notice of the change was published on January 22, 2011 (41 Pa.B 565). In the Act of June 30, 2011 P.L. 89, No. 22 Act 22, the General Assembly subsequently amended Article VIII-G to increase the assessment percentages for FY and FY to 3.22% in order to secure additional needed savings for the Commonwealth and to ensure hospital reimbursement continued at the same levels. To ensure timely receipt of assessment revenues, the General Assembly also eliminated the requirement for the Governor s approval. Assessment Revenues: Article VIII-G directs that revenues derived from the Assessment must be deposited into the Quality Care Assessment Account (Account) and only used for certain purposes. (See 62 PS. 805-G.) More specifically, section 805-G provides that funds in the Account are appropriated for payments to hospitals under the MA Fee-for-Service and Managed Care delivery systems, and for any other purposes approved by the secretary. Section 805-G also limits the amount of assessment funds that may be used for hospital payments, allowing the Department to retain a portion of the funding. Originally in Act 49 of 2010, the Department was able to retain a higher level of $121 million in the first year, subsequently declining in the remaining two years of the assessment to $59 million and $51.5 million respectively. Through Act 22 of 2011, these numbers were changed and the portion of the funding the department is able to retain was increased to at least $121 million in FY and $109 million in each of the remaining two fiscal years for purposes approved by the Secretary. Any additional funds that remain in the account after these amounts are deducted and the hospital payments are made are also designated to be used for purposes approved by the Secretary. Appendixes Supplemental information for the purposes of this report is included in the following appendixes addressing the remaining seven categories of information required under Act 49 of 2010 including: Attachment 1 Includes the name, address, amount of assessment, total amount of revenue assessment collected, the amount paid by each covered hospital,

4 including any interest and penalties paid for each covered hospital subject to the Quality Care Assessment for Fiscal Year Attachment 2 Includes the name, address, amount of assessment, total amount of revenue assessment collected, the amount paid by each covered hospital, including any interest and penalties paid for each covered hospital subject to the Quality Care Assessment for Fiscal Year Attachment 3 Includes the name, address, payment amount and type of supplement payment received by each hospital subject to the Assessment for Fiscal Year Attachment 4 Includes the name, address, payment amount and type of supplement payment received by each hospital subject to the Assessment for Fiscal Year Attachment 5 Total amount of Fee-for-Service inpatient acute care payments made to each hospital for Fiscal Year Attachment 6 Total amount of Fee-for-Service inpatient acute care payments made to each hospital for Fiscal Year Attachment 7 The medical assistance patient days/discharges by hospital for Fiscal Year Attachment 8 The medical assistance patient days/discharges by hospital for Fiscal Year Given that this report is due during the third year of the assessment, the figures included represent the first two years only, FY and FY Figures for the current fiscal year, , will not be available until after the end of the fiscal year. Reauthorization The Department is not proposing any changes to the payment methodologies at this time. The Department is committed to working to reauthorize the Assessment beyond Fiscal Year ; however, a number of changes to the MA program over the life of the Assessment impact the potential reauthorization, including the expansion of the HealthChoices program across the Commonwealth. The Department is currently in discussions with both the Hospital and Healthsystem Association of Pennsylvania (HAP) and the contracted Managed Care Organizations (MCOs), all of whom recognize the benefits of the assessment for the MA population, the hospital community and for the Commonwealth. The Commonwealth recently received HAP s preliminary proposed changes to the Assessment. These continued discussions, along with subsequent conversations with the General Assembly, may result in additional changes to the Assessment. In addition, the state of Medicaid payments varies by year based upon the FMAP. As has been the case over the last few years, the FMAP in FFY 2014 is again projected to decrease, requiring additional revenues in order to maintain hospital reimbursement at existing levels.

5 Conclusion The Assessment, via federal matching funds, has permitted the Commonwealth to increase funding to Pennsylvania hospitals for inpatient services by approximately $2 billion in the first two years of the Assessment It has raised the rates of inpatient Medicaid payments to hospitals by over 30 percent on average. This increase has come at a time when many other programs and providers are struggling financially and facing reductions. Additionally, the Commonwealth has received approximately $230 million in revenue from the first two years of the assessment, This additional revenue has enabled the Department to continue to fulfill one of its core missions, to serve the health care needs of Pennsylvanians; however, these new state dollars represent only 22% of the additional net new funding received by the hospital industry as a result of the Assessment. The Department continues to support the Assessment and is committed to working with the General Assembly to pursue a renewal for the benefit of the Medical Assistance population, Pennsylvania hospitals and the Commonwealth as a whole.

6 FY Attachment 1 Street Address City State Zip Code Assessment Due Penalty Due Interest Due Total Amount Due ABINGTON MEMORIAL HOSPITAL 1200 OLD YORK RD ABINGTON PA $ (13,196,223) $ - $ - $ (13,196,223) $ 13,196,223 $ - ALBERT EINSTEIN MEDICAL CENTER 5501 OLD YORK RD PHILADELPHIA PA (10,555,118) - - (10,555,118) 10,555,118 - ALFRED I DUPONT INSTITUTE 1600 ROCKLAND RD WILMINGTON DE ALLE KISKI MEDICAL CENTER 1301 CARLISLE ST NATRONA HEIGHTS PA (1,663,236) - - (1,663,236) 1,663,236 - ALLIED SERVICES REHABILITATION HOSPITAL 475 MORGAN HWY SCRANTON PA (713,760) - - (713,760) 713,760 - ALTOONA REGIONAL HEALTH SYSTEM 620 HOWARD AVE ALTOONA PA (4,252,519) - - (4,252,519) 4,252,519 - AMERICAN ONCOLOGIC HOSPITAL 7701 BURHOLME AVE PHILADELPHIA PA (1,770,598) - - (1,770,598) 1,770,598 - ARIA HEALTH KNIGHTS RD PHILADELPHIA PA (9,572,147) - (1,180) (9,573,327) 9,573,327 - ARMSTRONG COUNTY MEMORIAL HOSPITAL ONE NOLTE DR KITTANNING PA (833,843) - - (833,843) 833,843 - BARNES KASSON COUNTY HOSPITAL 2872 TURNPIKE ST SUSQUEHANNA PA BELMONT CENTER FOR COMPREHENSIVE TREATMENT 4200 MONUMENT RD PHILADELPHIA PA BERWICK HOSPITAL CENTER 701 E 16TH ST BERWICK PA (912,156) - - (912,156) 912,156 - BRADFORD REGIONAL MEDICAL CENTER 116 INTERSTATE PKWY BRADFORD PA (610,831) - - (610,831) 610,831 - BRANDYWINE HOSPITAL 201 REECEVILLE RD COATESVILLE PA (1,714,800) - - (1,714,800) 1,714,800 - BROOKE GLEN BEHAVIORAL HOSPITAL 7170 LAFAYETTE AVE FORT WASHINGTON PA BROOKVILLE HOSPITAL 100 HOSPITAL RD BROOKVILLE PA BRYN MAWR HOSPITAL 130 S BRYN MAWR AVE BRYN MAWR PA (5,543,588) - - (5,543,588) 5,543,588 - BRYN MAWR REHABILITATION HOSPITAL 414 PAOLI PIKE MALVERN PA (1,716,614) - - (1,716,614) 1,716,614 - BUCKTAIL MEDICAL CENTER 1001 PINE ST RENOVO PA BUTLER MEMORIAL HOSPITAL ONE HOSPITAL WAY BUTLER PA (2,202,928) - - (2,202,928) 2,202,928 - CANONSBURG GENERAL HOSPITAL 100 MEDICAL BLVD CANONSBURG PA (705,840) - - (705,840) 705,840 - CARLISLE REGIONAL MEDICAL CENTER 361 ALEXANDER SPRING RD CARLISLE PA (1,443,935) - - (1,443,935) 1,443,935 - CHAMBERSBURG HOSPITAL 112 N SEVENTH ST CHAMBERSBURG PA (3,228,466) - - (3,228,466) 3,228,466 - CHARLES COLE MEMORIAL HOSPITAL 1001 E SECOND ST COUDERSPORT PA CHESTER COUNTY HOSPITAL 701 E MARSHALL ST WEST CHESTER PA (3,211,520) - - (3,211,520) 3,211,520 - CHESTNUT HILL HOSPITAL 8835 GERMANTOWN AVE PHILADELPHIA PA (1,708,387) - - (1,708,387) 1,708,387 - CHILDRENS HOME OF PITTSBURGH, THE 5324 PENN AVE PITTSBURGH PA (93,237) - (13) (93,250) 93,250 - CHILDRENS HOSPITAL OF PHILADELPHIA 34TH ST AND CIVIC CENTER BLVD PHILADELPHIA PA (17,703,560) - - (17,703,560) 17,703,560 - CHILDRENS HOSPITAL OF PITTSBURGH OF UPMC 45TH ST AND PENN AVE PITTSBURGH PA (6,627,226) - - (6,627,226) 6,627,226 - CHILDRENS INSTITUTE OF PITTSBURGH, THE 1405 SHADY AVE PITTSBURGH PA (408,650) - - (408,650) 408,650 - CLARION HOSPITAL ONE HOSPITAL DR CLARION PA (419,215) - - (419,215) 419,215 - CLARION PSYCHIATRIC CENTER TWO HOSPITAL DR CLARION PA CLEARFIELD HOSPITAL 809 TURNPIKE AVE CLEARFIELD PA (567,815) - - (567,815) 567,815 - CONEMAUGH VALLEY MEMORIAL HOSPITAL 1086 FRANKLIN ST JOHNSTOWN PA (5,285,936) - - (5,285,936) 5,285,936 - COORDINATED HEALTH ORTHOPEDIC HOSPITAL LLC 2310 HIGHLAND AVE BETHLEHEM PA (409,734) - - (409,734) 409,734 - CORRY MEMORIAL HOSPITAL 612 W SMITH ST CORRY PA CROZER CHESTER MEDICAL CENTER ONE MEDICAL CENTER BLVD UPLAND PA (10,086,451) - - (10,086,451) 10,086,451 - DELAWARE COUNTY MEMORIAL HOSPITAL 501 N LANSDOWNE AVE DREXEL HILL PA (3,340,658) - - (3,340,658) 3,340,658 - DEVEREUX CHILDRENS BEHAVIORAL HEALTH CENTER 655 SUGARTOWN RD MALVERN PA DIVINE PROVIDENCE HOSPITAL 1100 GRAMPIAN BLVD WILLIAMSPORT PA (71,343) - - (71,343) 71,343 - DOYLESTOWN HOSPITAL 595 W STATE ST DOYLESTOWN PA (2,908,094) - - (2,908,094) 2,908,094 - DUBOIS REGIONAL MEDICAL CENTER 100 HOSPITAL AVE DUBOIS PA (2,044,122) - - (2,044,122) 2,044,122 - EAGLEVILLE HOSPITAL 100 EAGLEVILLE RD EAGLEVILLE PA (246,006) - - (246,006) 246,006 - EASTERN REGIONAL MEDICAL CENTER 1331 E WYOMING AVE PHILADELPHIA PA (1,639,476) - - (1,639,476) 1,639,476 - EASTON HOSPITAL 250 S 21ST ST EASTON PA (3,484,548) - - (3,484,548) 3,484,548 - EDGEWOOD SURGICAL HOSPITAL 239 EDGEWOOD DRIVE EXT TRANSFER PA (35,679) - - (35,679) 35,679 - ELK REGIONAL HEALTH CENTER 763 JOHNSONBURG RD ST MARYS PA (415,862) - - (415,862) 415,862 - ELLWOOD CITY HOSPITAL 724 PERSHING ST ELLWOOD CITY PA (306,860) - - (306,860) 306,860 - ENDLESS MOUNTAINS HEALTH SYSTEMS 25 GROW AVE MONTROSE PA EPHRATA COMMUNITY HOSPITAL 169 MARTIN AVE EPHRATA PA (1,726,095) - - (1,726,095) 1,726,095 - EVANGELICAL COMMUNITY HOSPITAL ONE HOSPITAL DR LEWISBURG PA (1,152,932) - - (1,152,932) 1,152,932 - FAIRMOUNT BEHAVIORAL HEALTH SYSTEM 561 FAIRTHORNE AVE PHILADELPHIA PA FIRST HOSPITAL WYOMING VALLEY 562 WYOMING AVE KINGSTON PA FOREST HEALTH MEDICAL CENTER OF BUCKS COUNTY 280 MIDDLETOWN BLVD LANGHORNE PA (299,850) - (2,341) (302,191) 302,191 - FOUNDATIONS BEHAVIORAL HEALTH 833 E BUTLER AVE DOYLESTOWN PA FRICK HOSPITAL 508 S CHRUCH ST MT PLEASANT PA (486,596) - - (486,596) 486,596 - FRIENDS HOSPITAL 4641 ROOSEVELT BLVD PHILADELPHIA PA FULTON COUNTY MEDICAL CENTER 214 PEACH ORCHARD RD MCCONNELLSBURG PA GEISINGER BLOOMSBURG HOSPITAL 549 FAIR ST BLOOMSBURG PA (435,518) - - (435,518) 435,518 - GEISINGER COMMUNITY MEDICAL CENTER 1822 MULBERRY ST SCRANTON PA (3,093,497) - - (3,093,497) 3,093,497 - GEISINGER MEDICAL CENTER 100 N ACADEMY AVE DANVILLE PA (9,632,756) - - (9,632,756) 9,632,756 - GEISINGER WYOMING VALLEY MEDICAL CENTER 1000 E MOUNTAIN DR WILKES-BARRE PA (3,362,055) - - (3,362,055) 3,362,055 - GETTYSBURG HOSPITAL 147 GETTYS ST GETTYSBURG PA (866,642) - - (866,642) 866,642 - Total Payment Received Overages/ Underages Page 1 of 36

7 FY Attachment 1 Street Address City State Zip Code Assessment Due Penalty Due Interest Due Total Amount Due GNADEN HUETTEN MEMORIAL HOSPITAL 211 N 12TH ST LEHIGHTON PA (533,220) - - (533,220) 533,220 - GOOD SAMARITAN HOSPITAL 4TH AND WALNUT STS LEBANON PA (2,403,187) - - (2,403,187) 2,403,187 - GOOD SHEPHERD REHABILITATION HOSPITAL 850 S 5TH ST ALLENTOWN PA (725,935) - - (725,935) 725,935 - GRAND VIEW HOSPITAL 700 LAWN AVE SELLERSVILLE PA (2,133,683) - - (2,133,683) 2,133,683 - GROVE CITY MEDICAL CENTER 631 N BROAD ST GROVE CITY PA (282,258) - - (282,258) 282,258 - HAHNEMAN UNIVERSITY HOSPITAL 230 N BROAD ST PHILADELPHIA PA (9,124,758) - - (9,124,758) 9,124,758 - HANOVER HOSPITAL INC 300 HIGHLAND AVE HANOVER PA (1,263,178) - - (1,263,178) 1,263,178 - HAVEN BEHAVIORAL HOSPITAL OF EASTERN PENNSYLVANIA 145 N 6TH ST READING PA HAZLETON GENERAL HOSPITAL 700 E BROAD ST HAZLETON PA (1,409,475) - - (1,409,475) 1,409,475 - HEALTHSOUTH REHABILITATION HOSPITAL-ALTOONA 2005 VALLEY VIEW BLVD ALTOONA PA (540,267) - - (540,267) 540,267 - HEALTHSOUTH REHABILITATION HOSPITAL-ERIE 143 E SECOND ST ERIE PA (513,322) - (158) (513,480) 513,480 - HEALTHSOUTH REHABILITATION HOSPITAL-GEISINGER 2 REHAB LANE DANVILLE PA (277,916) - - (277,916) 277,916 - HEALTHSOUTH REHABILITATION HOSPITAL-HARMARVILLE 320 GUYS RUN RD PITTSBURGH PA (887,786) - - (887,786) 887,786 - HEALTHSOUTH REHABILITATION HOSPITAL-MECHANICSBURG 175 LANCASTER BLVD MECHANICSBURG PA (437,907) - - (437,907) 437,907 - HEALTHSOUTH REHABILITATION HOSPITAL-NITTANY VALLEY 550 W COLLEGE AVE PLEASANT GAP PA (337,559) - - (337,559) 337,559 - HEALTHSOUTH REHABILITATION HOSPITAL-READING 1623 MORGANTOWN RD READING PA (380,234) - - (380,234) 380,234 - HEALTHSOUTH REHABILITATION HOSPITAL-SEWICKLEY 303 CAMP MEETING RD SEWICKLEY PA (225,925) - - (225,925) 225,925 - HEALTHSOUTH REHABILITATION HOSPITAL-YORK 1850 NORMANDIE DR YORK PA (488,013) - - (488,013) 488,013 - HEART OF LANCASTER REGIONAL MEDICAL CENTER 1500 HIGHLANDS DR LITITZ PA (562,865) - - (562,865) 562,865 - HERITAGE VALLEY BEAVER 1000 DUTCH RIDGE RD BEAVER PA (2,981,294) - - (2,981,294) 2,981,294 - HERITAGE VALLEY SEWICKLEY 720 BLACKBURN RD SEWICKLEY PA (1,597,011) - - (1,597,011) 1,597,011 - HIGHLANDS HOSPITAL 401 E MURPHY AVE CONNELLSVILLE PA (346,179) - (57) (346,236) 346,236 - HOLY REDEEMER HOSPITAL 1648 HUNTINGDON PIKE MEADOWBROOK PA (3,023,319) - - (3,023,319) 3,023,319 - HOLY SPIRIT HOSPITAL 503 N 21ST ST CAMP HILL PA (4,082,930) - - (4,082,930) 4,082,930 - HORSHAM CLINIC 722 E BUTLER PIKE AMBLER PA HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA 3400 SPRUCE ST PHILADELPHIA PA (25,113,779) - - (25,113,779) 25,113,779 - INDIANA REGIONAL MEDICAL CENTER 835 HOSPITAL RD INDIANA PA (1,203,415) - - (1,203,415) 1,203,415 - J C BLAIR MEMORIAL HOSPITAL 1225 WARM SPRINGS AVE HUNTINGDON PA (338,333) - - (338,333) 338,333 - JAMESON MEMORIAL HOSPITAL 1211 WILMINGTON AVE NEW CASTLE PA (1,530,223) - - (1,530,223) 1,530,223 - JEANES HOSPITAL 7600 CENTRAL AVE PHILADELPHIA PA (1,963,359) - - (1,963,359) 1,963,359 - JEFFERSON REGIONAL MEDICAL CENTER 565 COAL VALLEY RD PITTSBURGH PA (3,790,566) - - (3,790,566) 3,790,566 - JENNERSVILLE REGIONAL HOSPITAL 1015 W BALTIMORE PIKE WEST GROVE PA (542,824) - - (542,824) 542,824 - JERSEY SHORE HOSPITAL 1020 THOMPSON ST JERSEY SHORE PA JOHN HEINZ INSTITUTE 150 MUNDY ST WILKES-BARRE PA (575,822) - - (575,822) 575,822 - KANE COMMUNITY HOSPITAL 4372 ROUTE 6 KANE PA (181,766) - (71) (181,837) 181,837 - KENSINGTON HOSPITAL 136 W DIAMOND ST PHILADELPHIA PA (140,739) - - (140,739) 140,739 - KIDSPEACE CHILDRENS HOSPITAL 5300 KIDSPEACE DR OREFIELD PA KIRKBRIDE PSYCHIATRIC HOSPITAL TH ST PHILADELPHIA PA LANCASTER GENERAL HOSPITAL 555 N DUKE ST LANCASTER PA (13,364,442) - - (13,364,442) 13,364,442 - LANCASTER REGIONAL MEDICAL CENTER 250 COLLEGE AVE LANCASTER PA (1,317,534) - - (1,317,534) 1,317,534 - LANCASTER REHABILITATION HOSPITAL 675 GOOD DR LANCASTER PA (380,468) - - (380,468) 380,468 - LANKENAU MEDICAL CENTER 100 LANCASTER AVE WYNNEWOOD PA (7,144,900) - - (7,144,900) 7,144,900 - LANSDALE HOSPITAL 100 MEDICAL CAMPUS DR LANSDALE PA (1,060,837) - - (1,060,837) 1,060,837 - LATROBE HOSPITAL ONE MELLON WAY LATROBE PA (1,435,555) - - (1,435,555) 1,435,555 - LEHIGH VALLEY HOSPITAL 1200 S CEDAR CREST BLVD ALLENTOWN PA (15,337,220) - - (15,337,220) 15,337,220 - LEHIGH VALLEY HOSPITAL MUHLENBERG 2545 SCHOENERSVILLE RD BETHLEHEM PA (3,029,432) - - (3,029,432) 3,029,432 - LEWISTOWN HOSPITAL 400 HIGHLAND AVE LEWISTOWN PA (891,136) - - (891,136) 891,136 - LIFE CARE HOSPITALS OF PITTSBURGH 225 PENN AVE PITTSBURGH PA LOCK HAVEN HOSPITAL 24 CREE DR LOCK HAVEN PA (262,891) - - (262,891) 262,891 - LOWER BUCKS HOSPITAL 501 BATH RD BRISTOL PA (1,965,958) - (1,170) (1,967,128) 1,967,128 - MAGEE REHABILITATION HOSPITAL 1513 RACE ST PHILADELPHIA PA (1,399,787) - - (1,399,787) 1,399,787 - MAGEE WOMENS HOSPITAL OF UPMC 300 HALKET ST PITTSBURGH PA (3,698,998) - - (3,698,998) 3,698,998 - MARIAN COMMUNITY HOSPITAL 100 LINCOLN AVE CARBONDALE PA (383,753) - - (383,753) 383,753 - MEADOWS PSYCHIATRIC CENTER 132 THE MEADOWS DR CENTRE HALL PA MEADVILLE MEDICAL CENTER 751 LIBERTY ST MEADVILLE PA (1,241,703) - - (1,241,703) 1,241,703 - MEMORIAL HOSPITAL 325 S BELMONT ST YORK PA (1,143,042) - - (1,143,042) 1,143,042 - MEMORIAL HOSPITAL INC OF TOWANDA PA 91 HOSPITAL DR TOWANDA PA (182,322) - - (182,322) 182,322 - MERCY FITZGERALD HOSPITAL 1500 LANSDOWNE AVE DARBY PA (3,181,987) - - (3,181,987) 3,181,987 - MERCY PHILADELPHIA HOSPITAL 501 SOUTH 54TH ST PHILADELPHIA PA (2,710,582) - - (2,710,582) 2,710,582 - MERCY SUBURBAN HOSPITAL 2701 DEKALB PIKE EAST NORRITON PA (1,874,729) - - (1,874,729) 1,874,729 - MEYERSDALE COMMUNITY HOSPITAL 200 HOSPITAL DRIVE MEYERSDALE PA MID VALLEY HOSPITAL 1400 MAIN ST PECKVILLE PA MILLCREEK COMMUNITY HOSPITAL 5515 PEACH ST ERIE PA (485,915) - - (485,915) 485,915 - Total Payment Received Overages/ Underages Page 2 of 36

8 FY Attachment 1 Street Address City State Zip Code Assessment Due Penalty Due Interest Due Total Amount Due MINERS HOSPITAL OF NORTHERN CAMBRIA 280 HAIDA AVE HASTINGS PA (91,853) - - (91,853) 91,853 - MONONGAHELA VALLEY HOSPITAL INC 1163 COUNTRY CLUB RD MONONGAHELA PA (1,573,891) - - (1,573,891) 1,573,891 - MONTGOMERY COUNTY EMERGENCY SERVICE INC 50 BEECH DR NORRISTOWN PA MONTGOMERY HOSPITAL MEDICAL CENTER 1301 POWELL ST NORRISTOWN PA (1,370,374) - - (1,370,374) 1,370,374 - MOSES TAYLOR HOSPITAL 700 QUINCY AVE SCRANTON PA (1,760,262) - - (1,760,262) 1,760,262 - MOUNT NITTANY MEDICAL CENTER 1800 E PARK AVE STATE COLLEGE PA (2,606,367) - - (2,606,367) 2,606,367 - MUNCY VALLEY HOSPITAL 215 E WATER ST MUNCY PA NASON HOSPITAL 105 NASON DR ROARING SPRING PA (260,094) - - (260,094) 260,094 - NAZARETH HOSPITAL 2601 HOLME AVE PHILADELPHIA PA (2,715,729) - - (2,715,729) 2,715,729 - NPHS-GIRARD MEDICAL CENTER 8TH AND GIRARD AVE PHILADELPHIA PA NPHS-ST JOSEPH'S HOSPITAL 16TH ST AND GIRARD AVE PHILADELPHIA PA (1,565,590) - (1,801) (1,567,391) 1,567,391 - OHIO VALLEY GENERAL HOSPITAL 25 HECKLE RD MCKEES ROCKS PA (752,524) - (160) (752,684) 752,684 - PALMERTON HOSPITAL 135 LAYFAYETTE AVE PALMERTON PA (273,418) - - (273,418) 273,418 - PAOLI HOSPITAL 255 W LANCASTER AVE PAOLI PA (3,655,546) - - (3,655,546) 3,655,546 - PENN PRESBYTERIAN MEDICAL CENTER 39th AND MARKET STS PHILADELPHIA PA (7,766,728) - - (7,766,728) 7,766,728 - PENN STATE HERSHEY REHABILITATION-ADULT 1135 OLD W CHOCOLATE AVE HUMMELSTOWN PA (180,257) - (70) (180,327) 180,327 - PENN STATE MILTON S HERSHEY MEDICAL CENTER 500 UNIVERSITY DR HERSHEY PA (11,405,573) - - (11,405,573) 11,405,573 - PENNSYLVANIA HOSPITAL 800 SPRUCE ST PHILADELPHIA PA (9,187,885) - - (9,187,885) 9,187,885 - PENNSYLVANIA PSYCHIATRIC INSTITUTE 2501 N THIRD ST HARRISBURG PA PHILHAVEN 283 S BUTLER RD MT GRETNA PA PHOENIXVILLE HOSPITAL 140 NUTT RD PHOENIXVILLE PA (2,325,682) - - (2,325,682) 2,325,682 - PINNACLE HEALTH HOSPITALS 409 S SECOND ST HARRISBURG PA (10,611,524) - - (10,611,524) 10,611,524 - POCONO MEDICAL CENTER 206 E BROWN ST EAST STROUDSBURG PA (2,945,191) - - (2,945,191) 2,945,191 - POTTSTOWN MEMORIAL MEDICAL CENTER 1600 E HIGH ST POTTSTOWN PA (2,085,159) - - (2,085,159) 2,085,159 - PUNXSUTAWNEY AREA HOSPITAL 81 HILLCREST DR PUNXSUTAWNEY PA (238,821) - - (238,821) 238,821 - READING HOSPITAL AND MEDICAL CENTER 6TH AVE AND SPRUCE ST READING PA (9,694,359) - - (9,694,359) 9,694,359 - REGIONAL HOSPITAL OF SCRANTON 746 JEFFERSON AVE SCRANTON PA (2,369,682) - - (2,369,682) 2,369,682 - RIDDLE HOSPITAL 1068 W BALTIMORE PIKE MEDIA PA (2,813,515) - - (2,813,515) 2,813,515 - ROBERT PACKER HOSPITAL ONE GUTHRIE SQUARE SAYRE PA (3,028,280) - - (3,028,280) 3,028,280 - ROXBOROUGH MEMORIAL HOSPITAL 5800 RIDGE AVE PHILADELPHIA PA (1,276,954) - (9,285) (1,286,239) 1,286,239 - ROXBURY PSYCHIATRIC HOSPITAL 601 ROXBURY RD SHIPPENSBURG PA SACRED HEART HOSPITAL 421 CHEW ST ALLENTOWN PA (1,523,344) - (250) (1,523,594) 1,523,594 - SAINT CATHERINE HEALTHCARE CENTER 101 BROAD ST ASHLAND PA (181,892) - - (181,892) 181,892 - SAINT MARY MEDICAL CENTER 1201 LANGHORNE-NEWTOWN RD LANGHORNE PA (5,965,435) - - (5,965,435) 5,965,435 - SAINT VINCENT HEALTH CENTER 232 W 25TH ST ERIE PA (3,840,209) - - (3,840,209) 3,840,209 - SCHUYLKILL MEDICAL CENTER-EAST NORWEGIAN STREET 700 E NORWEGIAN ST POTTSVILLE PA (1,024,587) - - (1,024,587) 1,024,587 - SCHUYLKILL MEDICAL CENTER-SOUTH JACKSON STREET 420 S JACKSON ST POTTSVILLE PA (1,101,156) - - (1,101,156) 1,101,156 - SHAMOKIN AREA COMMUNITY HOSPITAL 4200 HOSPITAL RD COAL TOWNSHIP PA (395,612) - - (395,612) 395,612 - SHARON REGIONAL HEALTH SYSTEM 740 E STATE ST SHARON PA (1,772,007) - - (1,772,007) 1,772,007 - SOLDIERS AND SAILORS MEMORIAL HOSPITAL CENTRAL AVE WELLSBORO PA (365,132) - - (365,132) 365,132 - SOMERSET HOSPITAL 225 S CENTER AVE SOMERSET PA (581,041) - - (581,041) 581,041 - SOUTHWEST REGIONAL MEDICAL CENTER 350 BONAR AVE WAYNESBURG PA (380,131) - (31) (380,162) 380,162 - SOUTHWOOD PSYCHIATRIC HOSPITAL 2575 BOYCE PLAZA RD PITTSBURGH PA SPECIAL CARE HOSPITAL 128 W WASHINGTON ST NANTICOKE PA ST CHRISTOPHER'S HOSPITAL FOR CHILDREN ERIE AVE AT FRONT ST PHILADELPHIA PA (4,332,254) - - (4,332,254) 4,332,254 - ST CLAIR MEMORIAL HOSPITAL 1000 BOWER HILL ROAD PITTSBURGH PA (2,854,626) - - (2,854,626) 2,854,626 - ST JOSEPH MEDICAL CENTER 2500 BERNVILLE RD READING PA (2,621,508) - - (2,621,508) 2,621,508 - ST LUKE'S HOSPITAL 801 OSTRUM ST BETHLEHEM PA (11,291,907) - - (11,291,907) 11,291,907 - ST LUKE'S MINERS MEMORIAL HOSPITAL 360 W RUDDLE ST COALDALE PA (473,984) - - (473,984) 473,984 - ST LUKE'S QUAKERTOWN HOSPITAL 1021 PARK AVE QUAKERTOWN PA (709,518) - - (709,518) 709,518 - SUNBURY COMMUNITY HOSPITAL 350 N 11TH ST SUNBURY PA (351,925) - - (351,925) 351,925 - SURGICAL INSTITUTE OF READING LP 2752 CENTURY BLVD WYOMISSING PA (292,391) - - (292,391) 292,391 - TEMPLE UNIVERSITY HOSPITAL BROAD AND ONTARIO ST PHILADELPHIA PA (16,581,540) - - (16,581,540) 16,581,540 - THOMAS JEFFERSON UNIVERSITY HOSPITAL 111 S 11TH ST PHILADELPHIA PA (24,223,962) - (1,493) (24,225,455) 24,225,455 - TITUSVILLE AREA HOSPITAL 406 W OAK ST TITUSVILLE PA (245,369) - - (245,369) 245,369 - TROY COMMUNITY HOSPITAL 101 ELMIRA ST TROY PA TYLER MEMORIAL HOSPITAL 5950 STATE ROUTE 6 TUNKHANNOCK PA (249,119) - - (249,119) 249,119 - TYRONE HOSPITAL 187 HOSPITAL DR TYRONE PA UNIONTOWN HOSPITAL 500 W BERKELEY ST UNIONTOWN PA (1,616,248) - - (1,616,248) 1,616,248 - UPMC BEDFORD LINCOLN HWY EVERETT PA (315,967) - - (315,967) 315,967 - UPMC HAMOT 201 STATE ST ERIE PA (5,938,276) - - (5,938,276) 5,938,276 - UPMC HORIZON 110 N MAIN ST GREENVILLE PA (1,309,823) - - (1,309,823) 1,309,823 - UPMC MCKEESPORT 1500 FIFTH AVE MCKEESPORT PA (1,781,658) - - (1,781,658) 1,781,658 - Total Payment Received Overages/ Underages Page 3 of 36

9 FY Attachment 1 Street Address City State Zip Code Assessment Due Penalty Due Interest Due Total Amount Due UPMC MERCY 1400 LOCUST ST PITTSBURGH PA (6,512,692) - - (6,512,692) 6,512,692 - UPMC NORTHWEST 100 FAIRFIELD DR SENECA PA (1,043,263) - - (1,043,263) 1,043,263 - UPMC PASSAVANT 9100 BABCOCK BLVD PITTSBURGH PA (4,055,515) - - (4,055,515) 4,055,515 - UPMC PRESBYTERIAN SHADYSIDE 200 LOTHROP ST PITTSBURGH PA (33,688,648) - - (33,688,648) 33,688,648 - UPMC ST MARGARET 815 FREEPORT RD PITTSBURGH PA (3,255,126) - - (3,255,126) 3,255,126 - VALLEY FORGE MEDICAL CENTER AND HOSPITAL 1033 W GERMANTOWN PIKE NORRISTOWN PA (314,711) - (39) (314,750) 314,750 - WARREN GENERAL HOSPITAL 2 CRESCENT PARK W WARREN PA (461,457) - - (461,457) 461,457 - WASHINGTON HOSPITAL 155 WILSON AVE WASHINGTON PA (3,282,098) - - (3,282,098) 3,282,098 - WAYNE MEMORIAL HOSPITAL 601 PARK ST HONESDALE PA (745,902) - (107) (746,009) 746,009 - WAYNESBORO HOSPITAL 501 E MAIN ST WAYNESBORO PA (659,200) - - (659,200) 659,200 - WEST PENN-ALLEGHENY GENERAL HOSPITAL 320 E NORTH AVE PITTSBURGH PA (10,859,159) - - (10,859,159) 10,859,159 - WEST VIRGINIA UNIVERSITY HOSPITAL ONE MEDICAL CENTER DR MORGANTOWN WV WESTERN PENNSYLVANIA HOSPITAL 4800 FRIENDSHIP AVE PITTSBURGH PA (5,832,868) - - (5,832,868) 5,832,868 - WESTERN PENNSYLVANIA HOSPITAL-FORBES REGIONAL CAMPUS 2570 HAYMAKER RD MONROEVILLE PA (2,549,121) - - (2,549,121) 2,549,121 - WESTFIELD HOSPITAL 4815 W TILGHMAN ST ALLENTOWN PA (110,984) - - (110,984) 110,984 - WESTMORELAND HOSPITAL 532 W PITTSBURGH ST GREENSBURG PA (3,008,669) - - (3,008,669) 3,008,669 - WILKES-BARRE GENERAL HOSPITAL 534 WYOMING AVE KINGSTON PA (3,621,373) - - (3,621,373) 3,621,373 - WILLIAMSPORT HOSPITAL 700 HIGH ST WILLIAMSPORT PA (2,766,735) - - (2,766,735) 2,766,735 - WINDBER HOSPITAL 600 SOMERSET AVE WINDBER PA (298,507) - - (298,507) 298,507 - YORK HOSPITAL 1001 S GEORGE ST YORK PA (9,097,907) - - (9,097,907) 9,097,907 - Total Payment Received Overages/ Underages Total $ (542,178,974) $ - $ (18,227) $ (542,197,201) $ 542,197,201 $ - Page 4 of 36

10 FY Attachment 2 Street Address City State Zip Code Assessment Due Penalty Due Interest Due Total Amount Due ABINGTON MEMORIAL HOSPITAL 1200 OLD YORK RD ABINGTON PA $ (14,404,013) $ - $ - $ (14,404,013) $ 14,404,013 $ - ADVANCED SURGICAL HOSPITAL 100 TRICH DR WASHINGTON PA (46,741) - (12) (46,753) 46,753 - ALBERT EINSTEIN MEDICAL CENTER 5501 OLD YORK RD PHILADELPHIA PA (11,521,180) - - (11,521,180) 11,521,180 - ALFRED I DUPONT INSTITUTE 1600 ROCKLAND RD WILMINGTON DE ALLE KISKI MEDICAL CENTER 1301 CARLISLE ST NATRONA HEIGHTS PA (1,815,465) - - (1,815,465) 1,815,465 - ALLIED SERVICES REHABILITATION HOSPITAL 475 MORGAN HWY SCRANTON PA (779,087) - - (779,087) 779,087 - ALTOONA REGIONAL HEALTH SYSTEM 620 HOWARD AVE ALTOONA PA (4,641,733) - - (4,641,733) 4,641,733 - AMERICAN ONCOLOGIC HOSPITAL 7701 BURHOLME AVE PHILADELPHIA PA (1,932,653) - - (1,932,653) 1,932,653 - ARIA HEALTH KNIGHTS RD PHILADELPHIA PA (10,448,242) - (1,503) (10,449,745) 10,449,745 - ARMSTRONG COUNTY MEMORIAL HOSPITAL ONE NOLTE DR KITTANNING PA (910,161) - - (910,161) 910,161 - BARNES KASSON COUNTY HOSPITAL 2872 TURNPIKE ST SUSQUEHANNA PA BELMONT CENTER FOR COMPREHENSIVE TREATMENT 4200 MONUMENT RD PHILADELPHIA PA BERWICK HOSPITAL CENTER 701 E 16TH ST BERWICK PA (995,641) - - (995,641) 995,641 - BRADFORD REGIONAL MEDICAL CENTER 116 INTERSTATE PKWY BRADFORD PA (666,738) - (1,132) (667,870) 667,870 - BRANDYWINE HOSPITAL 201 REECEVILLE RD COATESVILLE PA (1,871,747) - - (1,871,747) 1,871,747 - BROOKE GLEN BEHAVIORAL HOSPITAL 7170 LAFAYETTE AVE FORT WASHINGTON PA BROOKVILLE HOSPITAL 100 HOSPITAL RD BROOKVILLE PA BRYN MAWR HOSPITAL 130 S BRYN MAWR AVE BRYN MAWR PA (6,050,967) - - (6,050,967) 6,050,967 - BRYN MAWR REHABILITATION HOSPITAL 414 PAOLI PIKE MALVERN PA (1,873,728) - - (1,873,728) 1,873,728 - BUCKS COUNTY SPECIALTY HOSPITAL 3300 TILLMAN DR BENSALEM PA (202,858) - (75) (202,933) 202,933 - BUCKTAIL MEDICAL CENTER 1001 PINE ST RENOVO PA BUTLER MEMORIAL HOSPITAL ONE HOSPITAL WAY BUTLER PA (2,404,551) - (593) (2,405,144) 2,405,144 - CANONSBURG GENERAL HOSPITAL 100 MEDICAL BLVD CANONSBURG PA (770,442) - - (770,442) 770,442 - CARLISLE REGIONAL MEDICAL CENTER 361 ALEXANDER SPRING RD CARLISLE PA (1,576,092) - - (1,576,092) 1,576,092 - CH HOSPITAL OF ALLENTOWN LLC 1503 NORTH CEDAR CREST BLVD ALLENTOWN PA (246,741) - (15) (246,756) 246,756 - CHAMBERSBURG HOSPITAL 112 N SEVENTH ST CHAMBERSBURG PA (3,523,953) - - (3,523,953) 3,523,953 - CHARLES COLE MEMORIAL HOSPITAL 1001 E SECOND ST COUDERSPORT PA CHESTER COUNTY HOSPITAL 701 E MARSHALL ST WEST CHESTER PA (3,505,456) - - (3,505,456) 3,505,456 - CHESTNUT HILL HOSPITAL 8835 GERMANTOWN AVE PHILADELPHIA PA (1,864,748) - - (1,864,748) 1,864,748 - CHILDRENS HOME OF PITTSBURGH, THE 5324 PENN AVE PITTSBURGH PA (101,770) - (8) (101,778) 101,778 - CHILDRENS HOSPITAL OF PHILADELPHIA 34TH ST AND CIVIC CENTER BLVD PHILADELPHIA PA (19,323,886) - (4,368) (19,328,254) 19,328,254 - CHILDRENS HOSPITAL OF PITTSBURGH OF UPMC 45TH ST AND PENN AVE PITTSBURGH PA (7,233,785) - - (7,233,785) 7,233,785 - CHILDRENS INSTITUTE OF PITTSBURGH, THE 1405 SHADY AVE PITTSBURGH PA (446,052) - - (446,052) 446,052 - CLARION HOSPITAL ONE HOSPITAL DR CLARION PA (457,584) - - (457,584) 457,584 - CLARION PSYCHIATRIC CENTER TWO HOSPITAL DR CLARION PA CLEARFIELD HOSPITAL 809 TURNPIKE AVE CLEARFIELD PA (619,785) - - (619,785) 619,785 - CONEMAUGH VALLEY MEMORIAL HOSPITAL 1086 FRANKLIN ST JOHNSTOWN PA (5,769,734) - (830) (5,770,564) 5,770,564 - COORDINATED HEALTH ORTHOPEDIC HOSPITAL LLC 2310 HIGHLAND AVE BETHLEHEM PA (447,235) - (28) (447,263) 447,263 - CORRY MEMORIAL HOSPITAL 612 W SMITH ST CORRY PA CROZER CHESTER MEDICAL CENTER ONE MEDICAL CENTER BLVD UPLAND PA (11,009,618) - - (11,009,618) 11,009,618 - DELAWARE COUNTY MEMORIAL HOSPITAL 501 N LANSDOWNE AVE DREXEL HILL PA (3,646,413) - - (3,646,413) 3,646,413 - DEVEREUX CHILDRENS BEHAVIORAL HEALTH CENTER 655 SUGARTOWN RD MALVERN PA DIVINE PROVIDENCE HOSPITAL 1100 GRAMPIAN BLVD WILLIAMSPORT PA (77,872) - (14) (77,886) 77,886 - DOYLESTOWN HOSPITAL 595 W STATE ST DOYLESTOWN PA (3,174,258) - - (3,174,258) 3,174,258 - DUBOIS REGIONAL MEDICAL CENTER 100 HOSPITAL AVE DUBOIS PA (2,231,211) - - (2,231,211) 2,231,211 - EAGLEVILLE HOSPITAL 100 EAGLEVILLE RD EAGLEVILLE PA (268,522) - - (268,522) 268,522 - EASTERN REGIONAL MEDICAL CENTER 1331 E WYOMING AVE PHILADELPHIA PA (1,789,529) - - (1,789,529) 1,789,529 - EASTON HOSPITAL 250 S 21ST ST EASTON PA (3,803,472) - - (3,803,472) 3,803,472 - EDGEWOOD SURGICAL HOSPITAL 239 EDGEWOOD DRIVE EXT TRANSFER PA (38,945) - (6) (38,951) 38,951 - ELK REGIONAL HEALTH CENTER 763 JOHNSONBURG RD ST MARYS PA (453,924) - (37) (453,961) 453,961 - ELLWOOD CITY HOSPITAL 724 PERSHING ST ELLWOOD CITY PA (334,946) - - (334,946) 334,946 - ENDLESS MOUNTAINS HEALTH SYSTEMS 25 GROW AVE MONTROSE PA EPHRATA COMMUNITY HOSPITAL 169 MARTIN AVE EPHRATA PA (1,884,077) - - (1,884,077) 1,884,077 - EVANGELICAL COMMUNITY HOSPITAL ONE HOSPITAL DR LEWISBURG PA (1,258,455) - - (1,258,455) 1,258,455 - FAIRMOUNT BEHAVIORAL HEALTH SYSTEM 561 FAIRTHORNE AVE PHILADELPHIA PA FIRST HOSPITAL WYOMING VALLEY 562 WYOMING AVE KINGSTON PA FOREST HEALTH MEDICAL CENTER OF BUCKS COUNTY 280 MIDDLETOWN BLVD LANGHORNE PA (265,743) - (988) (266,731) 266,731 - FOUNDATIONS BEHAVIORAL HEALTH 833 E BUTLER AVE DOYLESTOWN PA FRICK HOSPITAL 508 S CHRUCH ST MT PLEASANT PA (531,132) - - (531,132) 531,132 - FRIENDS HOSPITAL 4641 ROOSEVELT BLVD PHILADELPHIA PA FULTON COUNTY MEDICAL CENTER 214 PEACH ORCHARD RD MCCONNELLSBURG PA GEISINGER BLOOMSBURG HOSPITAL 549 FAIR ST BLOOMSBURG PA (475,379) - - (475,379) 475,379 - GEISINGER COMMUNITY MEDICAL CENTER 1822 MULBERRY ST SCRANTON PA (3,376,630) - (626) (3,377,256) 3,377,256 - Total Payment Received Overages/ Underages 5 of 36

11 FY Attachment 2 Street Address City State Zip Code Assessment Due Penalty Due Interest Due Total Amount Due GEISINGER MEDICAL CENTER 100 N ACADEMY AVE DANVILLE PA (10,514,398) - - (10,514,398) 10,514,398 - GEISINGER WYOMING VALLEY MEDICAL CENTER 1000 E MOUNTAIN DR WILKES-BARRE PA (3,669,768) - - (3,669,768) 3,669,768 - GETTYSBURG HOSPITAL 147 GETTYS ST GETTYSBURG PA (945,961) - - (945,961) 945,961 - GNADEN HUETTEN MEMORIAL HOSPITAL 211 N 12TH ST LEHIGHTON PA (582,024) - - (582,024) 582,024 - GOOD SAMARITAN HOSPITAL 4TH AND WALNUT STS LEBANON PA (2,623,140) - (539) (2,623,679) 2,623,679 - GOOD SHEPHERD REHABILITATION HOSPITAL 850 S 5TH ST ALLENTOWN PA (792,377) - - (792,377) 792,377 - GRAND VIEW HOSPITAL 700 LAWN AVE SELLERSVILLE PA (2,328,970) - - (2,328,970) 2,328,970 - GROVE CITY MEDICAL CENTER 631 N BROAD ST GROVE CITY PA (308,091) - - (308,091) 308,091 - HAHNEMAN UNIVERSITY HOSPITAL 230 N BROAD ST PHILADELPHIA PA (9,959,905) - (1,842) (9,961,747) 9,961,747 - HANOVER HOSPITAL INC 300 HIGHLAND AVE HANOVER PA (1,378,790) - (113) (1,378,903) 1,378,903 - HAVEN BEHAVIORAL HOSPITAL OF EASTERN PENNSYLVANIA 145 N 6TH ST READING PA HAZLETON GENERAL HOSPITAL 700 E BROAD ST HAZLETON PA (1,538,478) - - (1,538,478) 1,538,478 - HEALTHSOUTH REHABILITATION HOSPITAL-ALTOONA 2005 VALLEY VIEW BLVD ALTOONA PA (589,715) - - (589,715) 589,715 - HEALTHSOUTH REHABILITATION HOSPITAL-ERIE 143 E SECOND ST ERIE PA (560,304) - - (560,304) 560,304 - HEALTHSOUTH REHABILITATION HOSPITAL-GEISINGER 2 REHAB LANE DANVILLE PA (303,352) - (56) (303,408) 303,408 - HEALTHSOUTH REHABILITATION HOSPITAL-HARMARVILLE 320 GUYS RUN RD PITTSBURGH PA (969,041) - - (969,041) 969,041 - HEALTHSOUTH REHABILITATION HOSPITAL-MECHANICSBURG 175 LANCASTER BLVD MECHANICSBURG PA (477,986) - (88) (478,074) 478,074 - HEALTHSOUTH REHABILITATION HOSPITAL-NITTANY VALLEY 550 W COLLEGE AVE PLEASANT GAP PA (368,454) - - (368,454) 368,454 - HEALTHSOUTH REHABILITATION HOSPITAL-READING 1623 MORGANTOWN RD READING PA (415,035) - - (415,035) 415,035 - HEALTHSOUTH REHABILITATION HOSPITAL-SEWICKLEY 303 CAMP MEETING RD SEWICKLEY PA (246,603) - - (246,603) 246,603 - HEALTHSOUTH REHABILITATION HOSPITAL-YORK 1850 NORMANDIE DR YORK PA (532,679) - - (532,679) 532,679 - HEART OF LANCASTER REGIONAL MEDICAL CENTER 1500 HIGHLANDS DR LITITZ PA (614,381) - - (614,381) 614,381 - HERITAGE VALLEY BEAVER 1000 DUTCH RIDGE RD BEAVER PA (3,254,158) - - (3,254,158) 3,254,158 - HERITAGE VALLEY SEWICKLEY 720 BLACKBURN RD SEWICKLEY PA (1,743,179) - - (1,743,179) 1,743,179 - HIGHLANDS HOSPITAL 401 E MURPHY AVE CONNELLSVILLE PA (377,864) - - (377,864) 377,864 - HOLY REDEEMER HOSPITAL 1648 HUNTINGDON PIKE MEADOWBROOK PA (3,300,030) - - (3,300,030) 3,300,030 - HOLY SPIRIT HOSPITAL 503 N 21ST ST CAMP HILL PA (4,456,621) - - (4,456,621) 4,456,621 - HORSHAM CLINIC 722 E BUTLER PIKE AMBLER PA HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA 3400 SPRUCE ST PHILADELPHIA PA (27,412,328) - - (27,412,328) 27,412,328 - INDIANA REGIONAL MEDICAL CENTER 835 HOSPITAL RD INDIANA PA (1,313,559) - - (1,313,559) 1,313,559 - J C BLAIR MEMORIAL HOSPITAL 1225 WARM SPRINGS AVE HUNTINGDON PA (369,299) - (341) (369,640) 369,640 - JAMESON MEMORIAL HOSPITAL 1211 WILMINGTON AVE NEW CASTLE PA (1,670,277) - - (1,670,277) 1,670,277 - JEANES HOSPITAL 7600 CENTRAL AVE PHILADELPHIA PA (2,143,056) - - (2,143,056) 2,143,056 - JEFFERSON REGIONAL MEDICAL CENTER 565 COAL VALLEY RD PITTSBURGH PA (4,137,499) - (291) (4,137,790) 4,137,790 - JENNERSVILLE REGIONAL HOSPITAL 1015 W BALTIMORE PIKE WEST GROVE PA (592,506) - - (592,506) 592,506 - JERSEY SHORE HOSPITAL 1020 THOMPSON ST JERSEY SHORE PA JOHN HEINZ INSTITUTE 150 MUNDY ST WILKES-BARRE PA (628,524) - - (628,524) 628,524 - KANE COMMUNITY HOSPITAL 4372 ROUTE 6 KANE PA (198,403) - (98) (198,501) 198,501 - KENSINGTON HOSPITAL 136 W DIAMOND ST PHILADELPHIA PA (153,621) - (9) (153,630) 153,630 - KIDSPEACE CHILDRENS HOSPITAL 5300 KIDSPEACE DR OREFIELD PA KIRKBRIDE PSYCHIATRIC HOSPITAL TH ST PHILADELPHIA PA LANCASTER GENERAL HOSPITAL 555 N DUKE ST LANCASTER PA (14,587,628) - - (14,587,628) 14,587,628 - LANCASTER REGIONAL MEDICAL CENTER 250 COLLEGE AVE LANCASTER PA (1,438,122) - - (1,438,122) 1,438,122 - LANCASTER REHABILITATION HOSPITAL 675 GOOD DR LANCASTER PA (543,371) - - (543,371) 543,371 - LANKENAU MEDICAL CENTER 100 LANCASTER AVE WYNNEWOOD PA (7,798,840) - - (7,798,840) 7,798,840 - LANSDALE HOSPITAL 100 MEDICAL CAMPUS DR LANSDALE PA (1,228,465) - - (1,228,465) 1,228,465 - LATROBE HOSPITAL ONE MELLON WAY LATROBE PA (1,566,945) - - (1,566,945) 1,566,945 - LEHIGH VALLEY HOSPITAL 1200 S CEDAR CREST BLVD ALLENTOWN PA (16,740,965) - - (16,740,965) 16,740,965 - LEHIGH VALLEY HOSPITAL MUHLENBERG 2545 SCHOENERSVILLE RD BETHLEHEM PA (3,306,702) - - (3,306,702) 3,306,702 - LEWISTOWN HOSPITAL 400 HIGHLAND AVE LEWISTOWN PA (972,698) - - (972,698) 972,698 - LIFE CARE HOSPITALS OF PITTSBURGH 225 PENN AVE PITTSBURGH PA LOCK HAVEN HOSPITAL 24 CREE DR LOCK HAVEN PA (286,952) - - (286,952) 286,952 - LOWER BUCKS HOSPITAL (**See note at the end of this attachment) 501 BATH RD BRISTOL PA (2,145,893) - (6,361) (2,152,254) 2,011,567 (140,687) MAGEE REHABILITATION HOSPITAL 1513 RACE ST PHILADELPHIA PA (1,527,903) - - (1,527,903) 1,527,903 - MAGEE WOMENS HOSPITAL OF UPMC 300 HALKET ST PITTSBURGH PA (4,037,550) - - (4,037,550) 4,037,550 - MARIAN COMMUNITY HOSPITAL 100 LINCOLN AVE CARBONDALE PA (278,106) - - (278,106) 278,106 - MEADOWS PSYCHIATRIC CENTER 132 THE MEADOWS DR CENTRE HALL PA MEADVILLE MEDICAL CENTER 751 LIBERTY ST MEADVILLE PA (1,355,351) - (139) (1,355,490) 1,355,490 - MEMORIAL HOSPITAL 325 S BELMONT ST YORK PA (1,247,660) - (77) (1,247,737) 1,247,737 - MEMORIAL HOSPITAL INC OF TOWANDA PA 91 HOSPITAL DR TOWANDA PA (199,009) - - (199,009) 199,009 - MERCY FITZGERALD HOSPITAL 1500 LANSDOWNE AVE DARBY PA (3,473,220) - - (3,473,220) 3,473,220 - MERCY PHILADELPHIA HOSPITAL 501 SOUTH 54TH ST PHILADELPHIA PA (2,958,669) - - (2,958,669) 2,958,669 - MERCY SUBURBAN HOSPITAL 2701 DEKALB PIKE EAST NORRITON PA (2,046,315) - - (2,046,315) 2,046,315 - Total Payment Received Overages/ Underages 6 of 36

12 FY Attachment 2 Street Address City State Zip Code Assessment Due Penalty Due Interest Due Total Amount Due MEYERSDALE COMMUNITY HOSPITAL 200 HOSPITAL DRIVE MEYERSDALE PA MID VALLEY HOSPITAL 1400 MAIN ST PECKVILLE PA MILLCREEK COMMUNITY HOSPITAL 5515 PEACH ST ERIE PA (530,388) - - (530,388) 530,388 - MINERS HOSPITAL OF NORTHERN CAMBRIA 280 HAIDA AVE HASTINGS PA (100,260) - (14) (100,274) 100,274 - MONONGAHELA VALLEY HOSPITAL INC 1163 COUNTRY CLUB RD MONONGAHELA PA (1,717,942) - - (1,717,942) 1,717,942 - MONTGOMERY COUNTY EMERGENCY SERVICE INC 50 BEECH DR NORRISTOWN PA MONTGOMERY HOSPITAL MEDICAL CENTER 1301 POWELL ST NORRISTOWN PA (1,495,798) - - (1,495,798) 1,495,798 - MOSES TAYLOR HOSPITAL 700 QUINCY AVE SCRANTON PA (1,921,371) - - (1,921,371) 1,921,371 - MOUNT NITTANY MEDICAL CENTER 1800 E PARK AVE STATE COLLEGE PA (2,844,916) - - (2,844,916) 2,844,916 - MUNCY VALLEY HOSPITAL 215 E WATER ST MUNCY PA NASON HOSPITAL 105 NASON DR ROARING SPRING PA (283,899) - - (283,899) 283,899 - NAZARETH HOSPITAL 2601 HOLME AVE PHILADELPHIA PA (2,964,288) - - (2,964,288) 2,964,288 - NPHS-GIRARD MEDICAL CENTER 8TH AND GIRARD AVE PHILADELPHIA PA NPHS-ST JOSEPH'S HOSPITAL 16TH ST AND GIRARD AVE PHILADELPHIA PA (1,708,881) - (8,883) (1,717,764) 1,717,764 - OHIO VALLEY GENERAL HOSPITAL 25 HECKLE RD MCKEES ROCKS PA (821,399) - (72) (821,471) 821,471 - OSS ORTHOPAEDIC HOSPITAL 1861 POWDER MILL RD YORK PA (354,833) - (139) (354,972) 354,972 - PALMERTON HOSPITAL 135 LAYFAYETTE AVE PALMERTON PA (298,443) - - (298,443) 298,443 - PAOLI HOSPITAL 255 W LANCASTER AVE PAOLI PA (3,990,122) - - (3,990,122) 3,990,122 - PENN PRESBYTERIAN MEDICAL CENTER 39th AND MARKET STS PHILADELPHIA PA (8,477,581) - - (8,477,581) 8,477,581 - PENN STATE HERSHEY REHABILITATION-ADULT 1135 OLD W CHOCOLATE AVE HUMMELSTOWN PA (259,328) - (266) (259,594) 259,594 - PENN STATE MILTON S HERSHEY MEDICAL CENTER 500 UNIVERSITY DR HERSHEY PA (12,449,472) - - (12,449,472) 12,449,472 - PENNSYLVANIA HOSPITAL 800 SPRUCE ST PHILADELPHIA PA (10,028,810) - - (10,028,810) 10,028,810 - PENNSYLVANIA PSYCHIATRIC INSTITUTE 2501 N THIRD ST HARRISBURG PA PHILHAVEN 283 S BUTLER RD MT GRETNA PA PHOENIXVILLE HOSPITAL 140 NUTT RD PHOENIXVILLE PA (2,538,541) - - (2,538,541) 2,538,541 - PHYSICIANS CARE SURGICAL HOSPITAL 454 ENTERPRISE DR ROYERSFORD PA (12,096) - - (12,096) 12,096 - PINNACLE HEALTH HOSPITALS 409 S SECOND ST HARRISBURG PA (11,582,748) - - (11,582,748) 11,582,748 - POCONO MEDICAL CENTER 206 E BROWN ST EAST STROUDSBURG PA (3,214,751) - - (3,214,751) 3,214,751 - POTTSTOWN MEMORIAL MEDICAL CENTER 1600 E HIGH ST POTTSTOWN PA (2,276,004) - - (2,276,004) 2,276,004 - PUNXSUTAWNEY AREA HOSPITAL 81 HILLCREST DR PUNXSUTAWNEY PA (260,680) - - (260,680) 260,680 - READING HOSPITAL AND MEDICAL CENTER 6TH AVE AND SPRUCE ST READING PA (10,581,639) - - (10,581,639) 10,581,639 - REGIONAL HOSPITAL OF SCRANTON 746 JEFFERSON AVE SCRANTON PA (2,586,568) - - (2,586,568) 2,586,568 - RIDDLE HOSPITAL 1068 W BALTIMORE PIKE MEDIA PA (3,071,023) - - (3,071,023) 3,071,023 - ROBERT PACKER HOSPITAL ONE GUTHRIE SQUARE SAYRE PA (3,305,445) - - (3,305,445) 3,305,445 - ROXBOROUGH MEMORIAL HOSPITAL 5800 RIDGE AVE PHILADELPHIA PA (1,393,828) - (1,921) (1,395,749) 1,395,749 - ROXBURY PSYCHIATRIC HOSPITAL 601 ROXBURY RD SHIPPENSBURG PA SACRED HEART HOSPITAL 421 CHEW ST ALLENTOWN PA (1,662,769) - - (1,662,769) 1,662,769 - SAINT CATHERINE HEALTHCARE CENTER 101 BROAD ST ASHLAND PA (131,094) - - (131,094) 131,094 - SAINT MARY MEDICAL CENTER 1201 LANGHORNE-NEWTOWN RD LANGHORNE PA (6,511,424) - (15,724) (6,527,148) 6,527,148 - SAINT VINCENT HEALTH CENTER 232 W 25TH ST ERIE PA (4,191,686) - - (4,191,686) 4,191,686 - SCHUYLKILL MEDICAL CENTER-EAST NORWEGIAN STREET 700 E NORWEGIAN ST POTTSVILLE PA (1,118,363) - - (1,118,363) 1,118,363 - SCHUYLKILL MEDICAL CENTER-SOUTH JACKSON STREET 420 S JACKSON ST POTTSVILLE PA (1,201,940) - - (1,201,940) 1,201,940 - SHAMOKIN AREA COMMUNITY HOSPITAL 4200 HOSPITAL RD COAL TOWNSHIP PA (431,821) - (373) (432,194) 432,194 - SHARON REGIONAL HEALTH SYSTEM 740 E STATE ST SHARON PA (1,934,191) - - (1,934,191) 1,934,191 - SOLDIERS AND SAILORS MEMORIAL HOSPITAL CENTRAL AVE WELLSBORO PA (398,551) - - (398,551) 398,551 - SOMERSET HOSPITAL 225 S CENTER AVE SOMERSET PA (634,221) - - (634,221) 634,221 - SOUTHWEST REGIONAL MEDICAL CENTER 350 BONAR AVE WAYNESBURG PA (414,923) - - (414,923) 414,923 - SOUTHWOOD PSYCHIATRIC HOSPITAL 2575 BOYCE PLAZA RD PITTSBURGH PA SPECIAL CARE HOSPITAL 128 W WASHINGTON ST NANTICOKE PA ST CHRISTOPHER'S HOSPITAL FOR CHILDREN ERIE AVE AT FRONT ST PHILADELPHIA PA (4,728,765) - (2,332) (4,731,097) 4,731,097 - ST CLAIR MEMORIAL HOSPITAL 1000 BOWER HILL ROAD PITTSBURGH PA (3,115,896) - - (3,115,896) 3,115,896 - ST JOSEPH MEDICAL CENTER 2500 BERNVILLE RD READING PA (2,861,443) - - (2,861,443) 2,861,443 - ST LUKE'S HOSPITAL 801 OSTRUM ST BETHLEHEM PA (12,325,404) - - (12,325,404) 12,325,404 - ST LUKE'S MINERS MEMORIAL HOSPITAL 360 W RUDDLE ST COALDALE PA (517,365) - - (517,365) 517,365 - ST LUKE'S QUAKERTOWN HOSPITAL 1021 PARK AVE QUAKERTOWN PA (774,457) - - (774,457) 774,457 - SUNBURY COMMUNITY HOSPITAL 350 N 11TH ST SUNBURY PA (384,135) - - (384,135) 384,135 - SURGICAL INSTITUTE OF READING LP 2752 CENTURY BLVD WYOMISSING PA (319,153) - (26) (319,179) 319,179 - TEMPLE UNIVERSITY HOSPITAL BROAD AND ONTARIO ST PHILADELPHIA PA (18,099,173) - - (18,099,173) 18,099,173 - THOMAS JEFFERSON UNIVERSITY HOSPITAL 111 S 11TH ST PHILADELPHIA PA (26,441,071) - (5,976) (26,447,047) 26,447,047 - TITUSVILLE AREA HOSPITAL 406 W OAK ST TITUSVILLE PA (267,827) - - (267,827) 267,827 - TROY COMMUNITY HOSPITAL 101 ELMIRA ST TROY PA TYLER MEMORIAL HOSPITAL 5950 STATE ROUTE 6 TUNKHANNOCK PA (271,920) - - (271,920) 271,920 - TYRONE HOSPITAL 187 HOSPITAL DR TYRONE PA Total Payment Received Overages/ Underages 7 of 36

13 FY Attachment 2 Street Address City State Zip Code Assessment Due Penalty Due Interest Due Total Amount Due UNIONTOWN HOSPITAL 500 W BERKELEY ST UNIONTOWN PA (1,764,176) - - (1,764,176) 1,764,176 - UPMC BEDFORD LINCOLN HWY EVERETT PA (344,886) - - (344,886) 344,886 - UPMC HAMOT 201 STATE ST ERIE PA (6,481,779) - - (6,481,779) 6,481,779 - UPMC HORIZON 110 N MAIN ST GREENVILLE PA (1,429,705) - - (1,429,705) 1,429,705 - UPMC MCKEESPORT 1500 FIFTH AVE MCKEESPORT PA (1,944,725) - - (1,944,725) 1,944,725 - UPMC MERCY 1400 LOCUST ST PITTSBURGH PA (7,108,769) - - (7,108,769) 7,108,769 - UPMC NORTHWEST 100 FAIRFIELD DR SENECA PA (1,138,748) - - (1,138,748) 1,138,748 - UPMC PASSAVANT 9100 BABCOCK BLVD PITTSBURGH PA (4,426,698) - - (4,426,698) 4,426,698 - UPMC PRESBYTERIAN SHADYSIDE 200 LOTHROP ST PITTSBURGH PA (36,772,016) - - (36,772,016) 36,772,016 - UPMC ST MARGARET 815 FREEPORT RD PITTSBURGH PA (3,553,052) - - (3,553,052) 3,553,052 - VALLEY FORGE MEDICAL CENTER AND HOSPITAL 1033 W GERMANTOWN PIKE NORRISTOWN PA (343,515) - (367) (343,882) 343,882 - WARREN GENERAL HOSPITAL 2 CRESCENT PARK W WARREN PA (503,692) - - (503,692) 503,692 - WASHINGTON HOSPITAL 155 WILSON AVE WASHINGTON PA (3,582,493) - - (3,582,493) 3,582,493 - WAYNE MEMORIAL HOSPITAL 601 PARK ST HONESDALE PA (814,171) - - (814,171) 814,171 - WAYNESBORO HOSPITAL 501 E MAIN ST WAYNESBORO PA (719,533) - - (719,533) 719,533 - WEST PENN-ALLEGHENY GENERAL HOSPITAL 320 E NORTH AVE PITTSBURGH PA (11,853,049) - - (11,853,049) 11,853,049 - WEST VIRGINIA UNIVERSITY HOSPITAL ONE MEDICAL CENTER DR MORGANTOWN WV WESTERN PENNSYLVANIA HOSPITAL 4800 FRIENDSHIP AVE PITTSBURGH PA (6,366,724) - - (6,366,724) 6,366,724 - WESTERN PENNSYLVANIA HOSPITAL-FORBES REGIONAL CAMPUS 2570 HAYMAKER RD MONROEVILLE PA (2,782,430) - - (2,782,430) 2,782,430 - WESTFIELD HOSPITAL 4815 W TILGHMAN ST ALLENTOWN PA (120,775) - - (120,775) 120,775 - WESTMORELAND HOSPITAL 532 W PITTSBURGH ST GREENSBURG PA (3,284,039) - - (3,284,039) 3,284,039 - WILKES-BARRE GENERAL HOSPITAL 534 WYOMING AVE KINGSTON PA (3,952,821) - - (3,952,821) 3,952,821 - WILLIAMSPORT HOSPITAL 700 HIGH ST WILLIAMSPORT PA (3,019,961) - (559) (3,020,520) 3,020,520 - WINDBER HOSPITAL 600 SOMERSET AVE WINDBER PA (325,828) - (67) (325,895) 325,895 - YORK HOSPITAL 1001 S GEORGE ST YORK PA (9,930,597) - - (9,930,597) 9,930,597 - Total Payment Received Overages/ Underages Total $ (592,656,462) $ - $ (56,906) $ (592,713,368) $ 592,572,681 $ (140,687) **Note: Lower Bucks Hospital underage amount (-$140,687) is as of this report run date This amount is currently being recovered from MA claims payments. 8 of 36

14 FY Attachment 3 Inpatient DSH Outpatient Supplemental Medical Education Community Access Fund Enhanced Payment to Certain DSH Hospitals MA Dependency MA Rehabilitation Adjustment MA Small and Sole Community ABINGTON MEMORIAL HOSPITAL $ - $ - $ 1,262,745 $ 67,747 $ - $ - $ - $ - $ 2,305,382 $ 3,703,210 $ 7,339,085 ALBERT EINSTEIN MEDICAL CENTER 1,456, ,645 6,163, , ,419,942 24,412,349 37,981,273 ALFRED I DUPONT INSTITUTE - 1, , ,385 1,692,005 2,341,149 ALLE KISKI MEDICAL CENTER , , , ,818 1,919,411 ALLIED SERVICES REHABILITATION HOSPITAL , ,326 ALTOONA REGIONAL HEALTH SYSTEM ,274-1,462, ,211, ,510 4,156,090 AMERICAN ONCOLOGIC HOSPITAL , , , ,108 ARIA HEALTH ,831 76,482 1,392, ,133,221 8,376,082 12,504,370 ARMSTRONG COUNTY MEMORIAL HOSPITAL - 31,699 2, , ,608 1,053,663 AUMC-CANONSBURG , , ,715 BARNES KASSON COUNTY HOSPITAL 15,971 27,121-6, , ,990 BELMONT CENTER FOR COMPREHENSIVE TREATMENT 218, ,690 BERWICK HOSPITAL CENTER , ,009 28, ,049 BLOOMSBURG HOSPITAL THE , ,691 38, ,606 BRADFORD REGIONAL MEDICAL CENTER 202,147 50,741 1, , ,142 BRANDYWINE HOSPITAL , , ,488 1,387,735 BROOKE GLEN BEHAVIORAL HOSPITAL BROOKVILLE HOSPITAL - 15, ,934 6,858 77,423 BRYN MAWR HOSPITAL , , ,623 2,992,248 3,789,325 BRYN MAWR REHABILITATION HOSPITAL ,397, ,397,258 BUCKTAIL MEDICAL CENTER - 2, ,154-5,272 BUTLER MEMORIAL HOSPITAL , ,005 1,587,248 2,813,392 CARLISLE REGIONAL MEDICAL CENTER , , ,074 1,510,679 CHAMBERSBURG HOSPITAL - 44, ,693, ,758 2,098,210 CHARLES COLE MEMORIAL HOSPITAL 19,707 45,344-9, , ,592 CHESTER COUNTY HOSPITAL ,442 3,085,500 3,810,943 CHESTNUT HILL HOSPITAL , , ,484 1,646,719 CHILDREN'S HOME OF PITTSBURGH, THE 569, , , ,305,343 CHILDRENS HOSPITAL OF PHILADELPHIA 1,890, ,858 1,473, , ,849 43,706,802 48,818,888 CHILDRENS HOSPITAL OF PITTSBURGH OF UPMC 2,291,147 1,148,957 1,695, ,144,261 18,610,733 25,890,120 CHILDRENS INSTITUTE OF PITTSBURGH, THE 627, ,675, ,302,960 CLARION HOSPITAL - 19,185 25,527 20, , , , ,198 CLARION PSYCHIATRIC CENTER CLEARFIELD HOSPITAL 34,058 40,694 1,833 22, ,955 68, ,548 COMMUNITY MEDICAL CENTER , , ,328, ,651 2,709,729 CONEMAUGH VALLEY MEMORIAL HOSPITAL ,180-1,098, ,339,512 1,403,559 7,059,688 COORDINATED HEALTH ORTHOPEDIC HOSPITAL LLC ,286 43,286 CORRY MEMORIAL HOSPITAL , ,765 20, ,718 CROZER CHESTER MEDICAL CENTER 560, ,729 1,889, , ,000,861 11,971,120 18,101,015 DELAWARE COUNTY MEMORIAL HOSPITAL 311, , ,126 4,080,126 5,494,544 DEVEREAUX CHILDREN'S BEHAVIORAL HEALTH CENTER 165, ,131 DIVINE PROVIDENCE HOSPITAL 22, , ,416 DOYLESTOWN HOSPITAL , , ,455 1,328,329 DUBOIS REGIONAL MEDICAL CENTER 205, ,241-46, ,847,250 36,869 2,400,538 EAGLEVILLE HOSPITAL 54, , , ,047,582 EASTERN REGIONAL MEDICAL CENTER EASTON HOSPITAL ,882 57, ,541 1,308,026 2,598,828 EDGEWOOD SURGICAL HOSPITAL ,039-11,039 ELK REGIONAL HEALTH CENTER , , ,337 ELLWOOD CITY HOSPITAL ,485 43, , ,547 ENDLESS MOUNTAIN HEALTH SYSTEMS - 5, ,602 7,115 80,895 EPHRATA COMMUNITY HOSPITAL ,949, , ,256 2,760,661 EVANGELICAL COMMUNITY HOSPITAL , ,771 8, ,378 FAIRMOUNT BEHAVIORAL HEALTH SYSTEM FIRST HOSPITAL WYOMING VALLEY 140, ,299 FOREST HEALTH MEDICAL CENTER OF BUCKS COUNTY FOUNDATIONS BEHAVIORAL HEALTH FRICK HOSPITAL , ,061 97, ,091 1,473,871 FRIENDS HOSPITAL 706, ,931 FULTON COUNTY MEDICAL CENTER - 9,510-3, ,638-51,510 GEISINGER MEDICAL CENTER 3,137,513-2,273, , ,524,251 1,028,153 13,075,344 Hospital MA Stability Managed Care Organization Enhanced Payment Total Page 9 of 36

15 FY Attachment 3 Inpatient DSH Outpatient Supplemental Medical Education Community Access Fund Enhanced Payment to Certain DSH Hospitals MA Dependency MA Rehabilitation Adjustment MA Small and Sole Community GEISINGER WYOMING VALLEY MEDICAL CENTER ,519-1,348, ,304,586 1,982, ,524 6,256,482 GETTYSBURG HOSPITAL - - 4, , , ,622 GNADEN HUETTEN MEMORIAL HOSPITAL , ,015 91, ,747 GOOD SAMARITAN HOSPITAL , ,826, ,576 1,370,646 6,583,315 GOOD SHEPHERD REHABILITATION HOSPITAL ,168, , ,670,590 GRAND VIEW HOSPITAL , , ,939 1,474,650 GROVE CITY MEDICAL CENTER , ,207 72, ,262 HAMOT MEDICAL CENTER ,868 71, , ,257,808 1,584,435 4,635,059 HANOVER HOSPITAL INC ,374,634 23, ,220 1,770,511 HAVEN BEHAVIORAL HOSPITAL OF EASTERN PENNSYLVANIA HAZLETON GENERAL HOSPITAL , ,531,491 1,165, ,121 3,362,708 HEALTHSOUTH REHABILITATION HOSPITAL-ALTOONA ,038, ,038,892 HEALTHSOUTH REHABILITATION HOSPITAL-ERIE ,107, ,107,890 HEALTHSOUTH REHABILITATION HOSPITAL-GEISINGER , ,000 HEALTHSOUTH REHABILITATION HOSPITAL-HARMARVILLE ,820, ,820,706 HEALTHSOUTH REHABILITATION HOSPITAL-MECHANICSBURG , , ,195 HEALTHSOUTH REHABILITATION HOSPITAL-NITTANY VALLEY ,820 14, ,801 HEALTHSOUTH REHABILITATION HOSPITAL-READING , ,889 HEALTHSOUTH REHABILITATION HOSPITAL-SEWICKLEY , ,493 HEALTHSOUTH REHABILITATION HOSPITAL-YORK ,571 62, ,335 HEART OF LANCASTER REGIONAL MEDICAL CENTER , ,852 61, , ,550 HERITAGE VALLEY SEWICKLEY , ,279, , ,503 2,288,451 HIGHLANDS HOSPITAL 46, , , , ,195 HOLY REDEEMER HOSPITAL - - 6, ,965 2,676,420 3,367,432 HOLY SPIRIT HOSPITAL - - 9, ,427, ,467 1,540,776 3,770,026 HORSHAM CLINIC INDIANA REGIONAL MEDICAL CENTER 40,769 53,349-81, , , ,609 1,532,413 J C BLAIR MEMORIAL HOSPITAL 97,579 52,615-15, , , ,211 JAMESON MEMORIAL HOSPITAL 13,793 99,559 66,415 54, ,232 1,279,919 1,933,657 JEANES HOSPITAL , ,552 1,738,518 2,094,924 JEFFERSON REGIONAL MEDICAL CENTER ,679, ,938 1,621,608 3,964,582 JENNERSVILLE REGIONAL HOSPITAL , , ,896 JERSEY SHORE HOSPITAL ,783-92,783 JOHN HEINZ INSTITUTE , ,083 KANE COMMUNITY HOSPITAL - 7, ,000 54, ,421 KENSINGTON HOSPITAL 144, , , ,769 1,061,220 KIDSPEACE CHILDRENS HOSPITAL 379, ,303 KIRKBRIDE PSYCHIATRIC HOSPITAL 410, , ,070 LANCASTER GENERAL HOSPITAL , ,690,333 6,087,611 8,263,606 LANCASTER REGIONAL MEDICAL CENTER , , ,289 1,220,381 2,402,885 LANCASTER REHABILITATION HOSPITAL , ,132 LANKENAU MEDICAL CENTER ,331 49, ,469 2,804,730 4,174,624 LANSDALE HOSPITAL , , , ,771 LATROBE HOSPITAL ,578-1,275, , , ,594 2,325,526 LEHIGH VALLEY HOSPITAL , , ,952,347 10,701,294 15,979,796 LEHIGH VALLEY HOSPITAL MUHLENBERG , ,681, , ,427 2,592,003 LEWISTOWN HOSPITAL , ,147 8, ,005 LIFE CARE HOSPITALS OF PITTSBURGH LOCK HAVEN HOSPITAL 28,457 23,331-9, ,108 5, ,922 M.C.M.C. FITZGERALD MERCY DV 509, , , , ,053,731 5,983,074 8,996,316 MAGEE REHABILITATION HOSPITAL ,567, , ,810,627 MAGEE WOMENS HOSPITAL OF UPMC 230, , , , ,199,083 12,313,297 15,428,623 MARIAN COMMUNITY HOSPITAL , ,120 7, ,555 MEADOWS PSYCHIATRIC CENTER MEADVILLE MEDICAL CENTER - 365,688 69,599 60, , , ,268 2,077,610 MEMORIAL HOSPITAL , ,071, ,916 1,149,987 3,403,168 MEMORIAL HOSPITAL INC OF TOWANDA PA 18,801 29,175-7, ,192 66, ,521 MERCY HOSPITAL , ,406, , ,134 2,245,084 MERCY PHILADELPHIA HOSPITAL 627,136 87, , , ,407,891 4,976,792 8,740,174 MERCY HOSPITAL OF PITTSBURGH 593, , , , ,984,453 6,300,204 10,675,798 MERCY SPECIAL CARE HOSPITAL , ,731 Hospital MA Stability Managed Care Organization Enhanced Payment Total Page 10 of 36

16 FY Attachment 3 Inpatient DSH Outpatient Supplemental Medical Education Community Access Fund Enhanced Payment to Certain DSH Hospitals MA Dependency MA Rehabilitation Adjustment MA Small and Sole Community MERCY SUBURBAN HOSPITAL , ,002 1,170,608 2,033,901 MERCY TYLER HOSPITAL , , ,274 31, ,703 MEYERSDALE COMMUNITY HOSPITAL ,674 4,073 12,747 MID VALLEY HOSPITAL ,565 1,985 13,550 MILLCREEK COMMUNITY HOSPITAL , , ,635,137 79,405 1,981,739 MINERS HOSPITAL OF NORTHERN CAMBRIA ,000 41,529 22, ,206 MONONGAHELA VALLEY HOSPITAL INC , ,224, , ,522 3,654,950 MONTGOMERY COUNTY EMERGENCY SERVICE INC 95, ,486 MONTGOMERY HOSPITAL MEDICAL CENTER , ,185 1,270,214 2,101,587 MOSES TAYLOR HOSPITAL , ,505, ,712 3,195,958 MOUNT NITTANY MEDICAL CENTER - - 3, ,375,953 1,259,273 5,090 2,643,685 MUNCY VALLEY HOSPITAL ,529-41,529 NASON HOSPITAL , ,250 76, ,287 NAZARETH HOSPITAL - - 2, ,945 1,786,928 2,141,625 NPHS-GIRARD MEDICAL CENTER 92, , , , ,679 NPHS-ST. JOSEPH'S HOSPITAL 706, , , ,014 87, ,796,188 2,287,653 6,468,132 OHIO VALLEY GENERAL HOSPITAL , , , , ,014 PALMERTON HOSPITAL , ,085 96,200 19, ,006 PAOLI HOSPITAL , ,766 73, ,254 PENN PRESBYTERIAN MEDICAL CENTER 249,531 93, , , ,951 5,725,944 7,869,390 PENN STATE HERSHEY REHABILITATION-ADULT , ,993 PENN STATE MILTON S HERSHEY MEDICAL CTR - - 3,050,970 77, ,904,924 16,941,198 22,975,072 PENNSYLVANIA HOSPITAL 1,065,401-1,805, , ,073,031 9,584,701 14,983,469 PENNSYLVANIA PSYCHIATRIC INSTITUTE PHILHAVEN 108, ,441 PHOENIXVILLE HOSPITAL ,851, ,040 1,047,358 4,477,547 PINNACLE HEALTH HOSPITALS , ,564,807 7,798,893 10,678,394 POCONO MEDICAL CENTER , ,000 1,179, ,154 2,735,056 POTTSTOWN MEMORIAL MEDICAL CENTER ,014 1,016,315 1,354,329 PUNXSUTAWNEY AREA HOSPITAL 22,421 70,368-13, , , ,810 READING HOSPITAL AND MEDICAL CENTER - - 1,265, ,119 1,563, ,892,721 6,092,495 10,914,181 RIDDLE HOSPITAL , , ,870 1,907,486 ROBERT PACKER HOSPITAL , , ,666 ROXBOROUGH MEMORIAL HOSPITAL , , ,078 1,104,021 ROXBURY PSYCHIATRIC HOSPITAL 31, ,881 SACRED HEART HOSPITAL , , ,365 1,034,971 2,739,433 SAINT CATHERINE HEALTHCARE CENTER , ,149 19, ,627 SAINT MARY MEDICAL CENTER - - 2, , ,866 2,642,059 3,681,073 SAINT VINCENT HEALTH CENTER , , ,613,170 2,116,159 5,546,898 SCHUYLKILL MEDICAL CENTER-EAST NORWEGIAN STREET , ,893 73,004 1,124,005 SCHUYLKILL MEDICAL CENTER-SOUTH JACKSON STREET 333,227-73, ,240, ,238 1,971,623 SHAMOKIN AREA COMMUNITY HOSPITAL ,234 93,309 1, ,634 SHARON REGIONAL HEALTH SYSTEM ,799-1,027, , ,384 2,242,395 SOLDIERS AND SAILORS MEMORIAL HOSPITAL 142,187 46,438-21, , , ,386 SOMERSET HOSPITAL , , , ,883 1,117,461 SOUTHWEST REGIONAL MEDICAL CENTER - 22, , , ,337 SOUTHWOOD PSYCHIATRIC HOSPITAL ST CLAIR MEMORIAL HOSPITAL , , ,113 1,521,072 ST JOSEPH MEDICAL CENTER ,003-2,065, ,639 2,636,767 5,567,358 ST LUKE'S HOSPITAL - - 1,230,090 88,350 1,937, ,994,178 7,459,577 12,709,489 ST LUKE'S MINERS MEMORIAL HOSPITAL , ,925 36, ,216 ST LUKE'S QUAKERTOWN HOSPITAL , , , ,379 SUNBURY COMMUNITY HOSPITAL 145, , , ,571 7, ,596 SURGICAL INSTITUTE OF READING LP TEMPLE LOWER BUCKS HOSPITAL , ,640, ,260 1,792,389 4,226,147 TEMPLE UNIVERSITY HOSPITAL 3,002,080 2,658,688 5,264, ,318-5,704, ,555,903 42,971,020 67,455,266 THE MEDICAL CENTER BEAVER PA , ,943 2,538,665 3,179,081 THOMAS JEFFERSON UNIVERSITY HOSPITAL 518, ,845 4,343, ,093-2,968, ,696,602 21,333,111 33,727,273 THS - ST CHRISTOPHER'S HOSPITAL - 595,462 1,315, ,075,022 25,596,301 28,582,446 THS-HAHNEMAN UNIV HOSP 1,129, ,972 2,349,524 53, ,060,151 15,057,035 21,041,579 TITUSVILLE AREA HOSPITAL 27,675 42,478-16, , ,443 30, ,673 Hospital MA Stability Managed Care Organization Enhanced Payment Total Page 11 of 36

17 FY Attachment 3 Inpatient DSH Outpatient Supplemental Medical Education Community Access Fund Enhanced Payment to Certain DSH Hospitals MA Dependency MA Rehabilitation Adjustment MA Small and Sole Community TROY COMMUNITY HOSPITAL 3, ,342-25,859 TYRONE HOSPITAL , ,991 2, ,082 UNIONTOWN HOSPITAL 200, ,041, ,481 2,528,418 3,938,626 UNIVERSITY OF PENNA HOSPITAL 1,000, ,962 7,913, ,891, ,638,777 25,191,674 41,112,939 UPMC BEDFORD 41,126 61,993-15, , ,437 96, ,973 UPMC HORIZON , , , ,821 2,024,464 UPMC MCKEESPORT , , ,110, ,731 1,655,724 3,769,201 UPMC NORTHWEST ,507 21, ,425 UPMC PASSAVANT , , ,220 1,640,234 UPMC PRESBYTERIAN SHADYSIDE 869, ,758 2,741, ,536,341 19,101,117 29,645,124 UPMC ST.MARGARET , ,171, ,775 1,285,489 3,126,036 VALLEY FORGE MEDICAL CENTER AND HOSPITAL 163, , ,010 42, ,121 WARREN GENERAL HOSPITAL , , ,376 WASHINGTON HOSPITAL , , ,348, ,656 3,490,340 12,357,912 WAYNE MEMORIAL HOSPITAL 59,804 20,858-19, , ,005 WAYNESBORO HOSPITAL ,011 49, ,901 WEST PENN-ALLEGHENY GENERAL HOSPITAL 592,398-1,081, , ,877,739 5,722,031 9,704,590 WEST VIRGINIA UNIVERSITY HOSPITAL 219,974 97, ,242 63, ,294 1,397,470 2,060,524 WESTERN PENNSYLVANIA HOSPITAL 749,524-1,800, , ,598 6,789,034 10,358,303 WESTERN PENNSYLVANIA HOSPITAL-FORBES REGIONAL CAMPUS , , ,420 1,355,639 2,456,548 WESTFIELD HOSPITAL ,714 2,714 WESTMORELAND HOSPITAL , ,729 3,419,856 4,775,617 WILKES-BARRE GENERAL HOSPITAL , ,540, ,668 3,066,647 WILLIAMSPORT HOSPITAL , , ,757,095 5,359 2,303,021 WINDBER HOSPITAL , ,711 44, ,831 YORK HOSPITAL , , ,555,345 7,327,561 10,644,926 Hospital MA Stability Managed Care Organization Enhanced Payment Total Total $ 27,341,989 $ 11,615,260 $ 61,110,913 $ 7,453,357 $ 24,661,003 $ 11,564,170 $ 18,618,816 $ 57,893,044 $ 151,443,991 $ 474,944,400 $ 846,646,943 Note: Portion of the $542,197,201 in assessment revenues collected in FY were used as state share for Medicaid payments which are matched with federal funds. Amounts above represent total state and federal funds. Page 12 of 36

18 FY Attachment 4 Inpatient DSH Outpatient Supplemental Medical Education Community Access Fund Enhanced Payment to Certain DSH Hospitals MA Dependency MA Rehabilitation Adjustment MA Small and Sole Community ABINGTON MEMORIAL HOSPITAL $ - $ - $ 1,262,745 $ 67,747 $ - $ - $ - $ - $ 2,305,382 $ 4,550,706 $ 8,186,581 ALBERT EINSTEIN MEDICAL CENTER 1,415, ,645 6,163, , ,419,942 23,381,223 36,909,051 ALFRED I DUPONT INSTITUTE - 1, ,094 87, ,385 4,571,099 5,307,913 ALLE KISKI MEDICAL CENTER , , , ,673 1,771,266 ALLIED SERVICES REHABILITATION HOSPITAL , ,326 ALTOONA REGIONAL HEALTH SYSTEM - - 5,807-1,462, ,211, ,301 4,081,414 AMERICAN ONCOLOGIC HOSPITAL , , , ,568 ARIA HEALTH ,831 76,482 1,392, ,133,221 9,212,107 13,340,395 ARMSTRONG COUNTY MEMORIAL HOSPITAL - 31,699 2, , ,954 1,046,009 AUMC-CANONSBURG , , ,526 BARNES KASSON COUNTY HOSPITAL - 27,121-6, , ,019 BELMONT CENTER FOR COMPREHENSIVE TREATMENT 199, ,000 BERWICK HOSPITAL CENTER , ,009 32, ,922 BLOOMSBURG HOSPITAL THE , ,691 36, ,383 BRADFORD REGIONAL MEDICAL CENTER 202,147 50,741 1, ,347 1, ,749 BRANDYWINE HOSPITAL , , ,462 1,188,063 BROOKE GLEN BEHAVIORAL HOSPITAL BROOKVILLE HOSPITAL - 15, ,934 12,686 83,251 BRYN MAWR HOSPITAL , , ,623 1,184,011 1,979,310 BRYN MAWR REHABILITATION HOSPITAL ,397, ,397,258 BUCKTAIL MEDICAL CENTER - 2, ,154-5,272 BUTLER MEMORIAL HOSPITAL , ,005 1,599,663 2,825,806 CARLISLE REGIONAL MEDICAL CENTER , , ,452 1,567,057 CH HOSPITAL OF ALLENTOWN LLC ,239 70,239 CHAMBERSBURG HOSPITAL - 44, ,693, ,390 2,106,842 CHARLES COLE MEMORIAL HOSPITAL - 45,344-9, ,784 4, ,068 CHESTER COUNTY HOSPITAL ,442 2,806,886 3,532,328 CHESTNUT HILL HOSPITAL , , ,588 1,544,823 CHILDREN'S HOME OF PITTSBURGH, THE 569, , , ,305,343 CHILDRENS HOSPITAL OF PHILADELPHIA 1,446, ,858 1,273, , ,849 44,704,356 49,172,930 CHILDRENS HOSPITAL OF PITTSBURGH OF UPMC 2,291,147 1,148,957 1,695, ,144,261 19,344,266 26,623,653 CHILDRENS INSTITUTE OF PITTSBURGH, THE 627, ,675, ,302,960 CLARION HOSPITAL - 19,185 25,527 20, , ,612 63, ,516 CLARION PSYCHIATRIC CENTER CLEARFIELD HOSPITAL - 40,694-22, ,955 59, ,133 COMMUNITY MEDICAL CENTER , ,328, ,835 2,726,183 CONEMAUGH VALLEY MEMORIAL HOSPITAL ,180-1,098, ,339,512 1,481,054 7,137,183 COORDINATED HEALTH ORTHOPEDIC HOSPITAL LLC ,620 52,620 CORRY MEMORIAL HOSPITAL , ,765 13, ,331 CROZER CHESTER MEDICAL CENTER 559, ,729 1,889, , ,000,861 12,008,623 18,137,657 DELAWARE COUNTY MEMORIAL HOSPITAL 311, , ,126 4,322,605 5,737,023 DEVEREAUX CHILDREN'S BEHAVIORAL HEALTH CENTER 165, ,131 DIVINE PROVIDENCE HOSPITAL 5, , ,529 DOYLESTOWN HOSPITAL , ,803 1,048,988 1,430,862 DUBOIS REGIONAL MEDICAL CENTER 116, ,241-46, ,847,250 48,784 2,322,624 EAGLEVILLE HOSPITAL , , ,074 EASTERN REGIONAL MEDICAL CENTER EASTON HOSPITAL ,882 57, ,541 1,432,941 2,723,743 EDGEWOOD SURGICAL HOSPITAL ,039-11,039 ELK REGIONAL HEALTH CENTER , , ,337 ELLWOOD CITY HOSPITAL ,485 43, , ,230 ENDLESS MOUNTAIN HEALTH SYSTEMS - 5, ,602 5,251 79,031 EPHRATA COMMUNITY HOSPITAL ,949, , ,851 2,819,256 EVANGELICAL COMMUNITY HOSPITAL , ,771 5, ,200 FAIRMOUNT BEHAVIORAL HEALTH SYSTEM FIRST HOSPITAL WYOMING VALLEY 65, ,843 FOREST HEALTH MEDICAL CENTER OF BUCKS COUNTY FOUNDATIONS BEHAVIORAL HEALTH FRICK HOSPITAL , ,061 97, ,074 1,439,854 FRIENDS HOSPITAL 530, ,198 FULTON COUNTY MEDICAL CENTER - 9,510-3, ,638-51,510 Hospital MA Stability Managed Care Organization Enhanced Payment Total Page 13 of 36

19 FY Attachment 4 Inpatient DSH Outpatient Supplemental Medical Education Community Access Fund Enhanced Payment to Certain DSH Hospitals MA Dependency MA Rehabilitation Adjustment MA Small and Sole Community GEISINGER MEDICAL CENTER 3,137,513-2,273, , ,117 6,570,905 1,233,027 13,560,989 GEISINGER WYOMING VALLEY MEDICAL CENTER ,519-1,348, ,304,586 1,982, ,376 6,333,334 GETTYSBURG HOSPITAL - - 4, , , ,039 GNADEN HUETTEN MEMORIAL HOSPITAL , ,015 32, ,645 GOOD SAMARITAN HOSPITAL , ,826, ,576 1,153,563 6,366,233 GOOD SHEPHERD REHABILITATION HOSPITAL ,168, , ,670,590 GRAND VIEW HOSPITAL , , ,932 1,521,642 GROVE CITY MEDICAL CENTER , , , ,853 HAMOT MEDICAL CENTER ,868 71, , ,257,808 1,295,597 4,346,220 HANOVER HOSPITAL INC ,374,634 23, ,476 1,757,766 HAVEN BEHAVIORAL HOSPITAL OF EASTERN PENNSYLVANIA HAZLETON GENERAL HOSPITAL , ,531,491 1,165, ,325 3,344,912 HEALTHSOUTH REHABILITATION HOSPITAL-ALTOONA ,038, ,038,892 HEALTHSOUTH REHABILITATION HOSPITAL-ERIE ,107, ,107,890 HEALTHSOUTH REHABILITATION HOSPITAL-GEISINGER , ,000 HEALTHSOUTH REHABILITATION HOSPITAL-HARMARVILLE ,820, ,820,706 HEALTHSOUTH REHABILITATION HOSPITAL-MECHANICSBURG , , ,414 HEALTHSOUTH REHABILITATION HOSPITAL-NITTANY VALLEY ,820 14, ,801 HEALTHSOUTH REHABILITATION HOSPITAL-READING , ,889 HEALTHSOUTH REHABILITATION HOSPITAL-SEWICKLEY , ,493 HEALTHSOUTH REHABILITATION HOSPITAL-YORK ,571 62, ,335 HEART OF LANCASTER REGIONAL MEDICAL CENTER ,852 61, , ,551 HERITAGE VALLEY SEWICKLEY ,279, , ,606 2,302,917 HIGHLANDS HOSPITAL 46, , , , ,846 HOLY REDEEMER HOSPITAL - - 6, ,965 2,958,502 3,649,514 HOLY SPIRIT HOSPITAL - - 9, ,427, ,467 1,347,662 3,576,912 HORSHAM CLINIC INDIANA REGIONAL MEDICAL CENTER - 53,349-81, , , ,886 1,344,920 J C BLAIR MEMORIAL HOSPITAL 97,579 52,615-15, , , ,728 JAMESON MEMORIAL HOSPITAL - 99,559 37,606 54, ,232 1,414,747 2,025,884 JEANES HOSPITAL , ,552 1,929,052 2,285,458 JEFFERSON REGIONAL MEDICAL CENTER ,679, ,938 2,150,155 4,493,129 JENNERSVILLE REGIONAL HOSPITAL , , ,349 JERSEY SHORE HOSPITAL , ,717 JOHN HEINZ INSTITUTE , ,083 KANE COMMUNITY HOSPITAL - 7, ,000 54, ,421 KENSINGTON HOSPITAL 144, , , , ,582 KIDSPEACE CHILDRENS HOSPITAL 39, ,571 KIRKBRIDE PSYCHIATRIC HOSPITAL 410, , ,070 LANCASTER GENERAL HOSPITAL , ,690,333 5,345,310 7,521,304 LANCASTER REGIONAL MEDICAL CENTER , , ,289 1,009,935 2,192,440 LANCASTER REHABILITATION HOSPITAL , ,132 LANKENAU MEDICAL CENTER ,331 49, ,469 4,569,833 5,939,727 LANSDALE HOSPITAL , , , ,428 LATROBE HOSPITAL ,578-1,275, , , ,754 2,645,685 LEHIGH VALLEY HOSPITAL , , ,952,347 10,222,605 15,501,107 LEHIGH VALLEY HOSPITAL MUHLENBERG , ,681, , ,286 2,844,862 LEWISTOWN HOSPITAL , ,147 8, ,341 LIFE CARE HOSPITALS OF PITTSBURGH LOCK HAVEN HOSPITAL 28,457 23,331-9, ,108 14, ,114 M.C.M.C. FITZGERALD MERCY DV 509, , , , ,053,731 4,539,290 7,470,524 MAGEE REHABILITATION HOSPITAL ,567, , ,810,627 MAGEE WOMENS HOSPITAL OF UPMC 1,201, , , , ,199,083 12,404,517 16,490,776 MARIAN COMMUNITY HOSPITAL , , ,596 MEADOWS PSYCHIATRIC CENTER MEADVILLE MEDICAL CENTER - 365,688 69,599 60, , , ,628 1,935,970 MEMORIAL HOSPITAL ,071, , ,318 3,101,568 MEMORIAL HOSPITAL INC OF TOWANDA PA - 29,175-7, , , ,882 MERCY HOSPITAL , ,406, , ,689 2,275,638 MERCY PHILADELPHIA HOSPITAL - 87, , , ,407,891 6,132,627 9,481,895 MERCY HOSPITAL OF PITTSBURGH 593, , , , ,984,453 5,851,926 10,133,782 Hospital MA Stability Managed Care Organization Enhanced Payment Total Page 14 of 36

20 FY Attachment 4 Inpatient DSH Outpatient Supplemental Medical Education Community Access Fund Enhanced Payment to Certain DSH Hospitals MA Dependency MA Rehabilitation Adjustment MA Small and Sole Community MERCY SPECIAL CARE HOSPITAL , ,731 MERCY SUBURBAN HOSPITAL , ,002 1,156,159 2,019,452 MERCY TYLER HOSPITAL , , ,274 12, ,635 MEYERSDALE COMMUNITY HOSPITAL ,674 1,951 10,625 MID VALLEY HOSPITAL ,565 2,633 14,199 MILLCREEK COMMUNITY HOSPITAL 214,799-92, , ,635,137 91,349 2,208,482 MINERS HOSPITAL OF NORTHERN CAMBRIA ,000 41,529 20, ,902 MONONGAHELA VALLEY HOSPITAL INC , ,224, ,527 1,118,034 3,913,461 MONTGOMERY COUNTY EMERGENCY SERVICE INC 94, ,852 MONTGOMERY HOSPITAL MEDICAL CENTER , ,185 1,123,977 1,955,350 MOSES TAYLOR HOSPITAL , ,505, ,963 3,221,209 MOUNT NITTANY MEDICAL CENTER - - 3, ,375,953 1,259,273 3,531 2,642,127 MUNCY VALLEY HOSPITAL ,529-41,529 NASON HOSPITAL , ,250 47, ,036 NAZARETH HOSPITAL ,945 1,841,629 2,193,574 NPHS-GIRARD MEDICAL CENTER 92, ,091 NPHS-ST. JOSEPH'S HOSPITAL 652, , , , , ,988,658 2,548,951 7,118,609 OHIO VALLEY GENERAL HOSPITAL , , , , ,215 PALMERTON HOSPITAL , ,085 96,200 28, ,082 PAOLI HOSPITAL , , , ,359 PENN PRESBYTERIAN MEDICAL CENTER - 93, , , ,951 6,579,551 8,473,467 PENN STATE HERSHEY REHABILITATION-ADULT , ,993 PENN STATE MILTON S HERSHEY MEDICAL CTR - - 3,050,970 77, ,904,924 17,915,135 23,949,009 PENNSYLVANIA HOSPITAL 1,065,401-1,805, , ,073,031 9,690,442 15,089,210 PENNSYLVANIA PSYCHIATRIC INSTITUTE PHILHAVEN 18, ,224 PHOENIXVILLE HOSPITAL ,851, ,040 1,091,054 4,521,242 PINNACLE HEALTH HOSPITALS , ,564,807 6,213,882 9,093,383 POCONO MEDICAL CENTER , ,000 1,179, ,238 2,718,139 POTTSTOWN MEMORIAL MEDICAL CENTER ,014 1,081,927 1,419,941 PUNXSUTAWNEY AREA HOSPITAL - 70,368-13, ,454 88, ,254 READING HOSPITAL AND MEDICAL CENTER - - 1,265, ,119 1,563, ,892,721 6,134,173 10,955,859 RIDDLE HOSPITAL , ,018 1,295,937 2,284,553 ROBERT PACKER HOSPITAL , ,818 8,932 1,004,598 ROXBOROUGH MEMORIAL HOSPITAL , , ,260 1,376,203 ROXBURY PSYCHIATRIC HOSPITAL 31, ,881 SACRED HEART HOSPITAL , , , ,829 2,675,291 SAINT CATHERINE HEALTHCARE CENTER , ,589 7, ,033 SAINT MARY MEDICAL CENTER - - 2, , ,866 3,002,049 4,041,062 SAINT VINCENT HEALTH CENTER , , ,613,170 2,274,885 5,705,624 SCHUYLKILL MEDICAL CENTER-EAST NORWEGIAN STREET , ,893 39,454 1,090,455 SCHUYLKILL MEDICAL CENTER-SOUTH JACKSON STREET 333,227-73, ,240, ,685 2,001,069 SHAMOKIN AREA COMMUNITY HOSPITAL ,117 46,654 6, ,002 SHARON REGIONAL HEALTH SYSTEM ,799-1,027, , ,685 2,279,697 SOLDIERS AND SAILORS MEMORIAL HOSPITAL 142,187 46,438-21, , , ,984 SOMERSET HOSPITAL , , , ,894 1,113,471 SOUTHWEST REGIONAL MEDICAL CENTER - 22, , , ,674 SOUTHWOOD PSYCHIATRIC HOSPITAL ST CLAIR MEMORIAL HOSPITAL , ,123 1,005,793 1,845,753 ST JOSEPH MEDICAL CENTER ,003-2,065, ,639 2,546,051 5,476,641 ST LUKE'S HOSPITAL - - 1,230,090 88,350 1,937, ,994,178 6,277,691 11,527,603 ST LUKE'S MINERS MEMORIAL HOSPITAL , ,925 31, ,772 ST LUKE'S QUAKERTOWN HOSPITAL , , , ,431 SUNBURY COMMUNITY HOSPITAL 145, , , ,571 6, ,912 SURGICAL INSTITUTE OF READING LP ,418 17,418 TEMPLE LOWER BUCKS HOSPITAL , ,640, ,260 1,651,942 4,085,700 TEMPLE UNIVERSITY HOSPITAL 4,230,668 2,658,688 5,264, ,318-5,704, ,555,903 35,315,584 61,028,418 THE MEDICAL CENTER BEAVER PA , ,943 2,276,718 2,870,538 THOMAS JEFFERSON UNIVERSITY HOSPITAL 488, ,845 4,343, ,093-2,968, ,696,602 22,954,135 35,318,755 THS - ST CHRISTOPHER'S HOSPITAL - 595,462 1,315, ,075,022 23,477,211 26,463,356 THS-HAHNEMAN UNIV HOSP 1,126, , ,156 53, ,060,151 14,748,828 18,966,113 Hospital MA Stability Managed Care Organization Enhanced Payment Total Page 15 of 36

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