UPMC Health Post-Acute Network Analysis Report

1 Why This Matters

UPMC Health discharges thousands of Medicare fee-for-service patients to skilled nursing facilities each year. The performance of those SNF relationships — measured through the Facility Hospitalization Rate (FSHR) — directly affects both patient outcomes and UPMC's clinical and financial exposure under value-based care programs.

The central finding of this analysis is not that UPMC has a readmission problem. The central finding is that there is meaningful variation and limited visibility across UPMC's post-acute network. The system FSHR of 31.4% masks a range from 13.3% at UPMC Western Maryland to 66.7% at UPMC Kane. Across the 25 hospitals with available data, this variation is not random — it reflects identifiable, addressable differences in SNF partner selection and network structure.

Limited visibility is the second challenge. Of UPMC's 174 unique SNF destinations, a significant portion lack FSHR data due to CMS volume suppression thresholds. Without systematic visibility into all post-acute partners, UPMC cannot consistently direct patients toward higher-performing facilities or identify underperforming relationships before they generate readmissions at scale.

This report provides the data foundation for UPMC to move from reactive care management to a proactive preferred post-acute network strategy — prioritizing the 15 highest-leverage SNF engagement opportunities identified through CMS Medicare FFS claims analysis.

2 Methodology

Data Source

CMS Medicare Fee-for-Service (FFS) Claims — the same claims data used in CMS star ratings and value-based purchasing programs. Covers discharges from UPMC Health hospitals to SNFs during Q4 2024 – Q3 2025. All metrics in this report are calculated from CMS Medicare FFS Claims.

Facility Hospitalization Rate (FSHR)

FSHR measures the percentage of SNF patient-days resulting in acute hospital readmission, calculated at the SNF-hospital relationship level. FSHR captures rehospitalization across the full SNF stay — not just 30 days — providing a comprehensive performance signal. System FSHR benchmark: 31.4%.

CMS Suppression

CMS suppresses FSHR for SNF-hospital relationships with fewer than 11 patients. Suppressed destinations are counted in total SNF destination figures but are not rated. Three hospitals (Passavant – Cranberry, Greene, Muncy) fall below hospital-level reporting thresholds and are excluded from quantitative analysis.

FSHR Color Coding

Red = FSHR ≥36.5% (+5pp above system); Amber = ≥33.5% (+2pp); Green = ≤28.4% (−3pp below system). Uncolored = within ±2–3pp of system average.

3 Key Findings

1

System FSHR of 31.4% Masks a 53.4pp Range Across UPMC Hospitals

The weighted average FSHR across UPMC's 25 active hospitals is 31.4%, but individual hospital performance varies from 13.3% (UPMC Western Maryland) to 66.7% (UPMC Kane). This 53.4 percentage point spread represents substantial, unexplained variation that cannot be fully attributed to patient acuity differences. It signals meaningful opportunity in SNF partner selection and care transition processes at higher-FSHR hospitals.

2

15 Priority SNF Partners Drive Disproportionate Hospitalization Volume

15 SNF facilities are identified as priority engagement targets based on FSHR magnitude, patient volume, and multi-hospital presence. These facilities collectively serve 748 UPMC patients. The top priority target, Spring Creek Rehabilitation And Nursing Center, carries a 48.5% FSHR — 17.1pp above the system average. Structured preferred network engagement at these 15 facilities represents the highest-leverage near-term intervention available to UPMC.

3

25 Cross-System SNFs Serve 2+ UPMC Hospitals — System-Level Leverage

25 SNFs appear in the post-acute networks of 2 or more UPMC hospitals, creating system-level engagement leverage. A single preferred network conversation at any of these facilities moves FSHR for multiple hospitals simultaneously. The highest-volume cross-system SNF, Vincentian Home, serves 142 patients across 3 UPMC hospitals. These cross-system relationships should be the foundation of UPMC's preferred post-acute network strategy.

4

High FSHR Concentrated at Specific Hospitals — UPMC Kane, Wellsboro, Altoona, Jameson

UPMC Kane (66.7% FSHR), UPMC Wellsboro (44.0%), and UPMC Altoona (42.6%) are the three highest-FSHR active hospitals in the UPMC network. All three are above the system average by 10+ percentage points. SNF-level data for these hospitals identifies specific high-FSHR facilities that should be the first targets of preferred network engagement conversations.

5

174 SNF Destinations Create Monitoring Complexity — Preferred Network Can Reduce This

UPMC's 25 active hospitals collectively discharge to 174 distinct SNF destinations. Monitoring this many facilities for FSHR performance without systematic infrastructure is operationally infeasible. A preferred post-acute network program — designating 10–20 high-performing partners per hospital based on FSHR, volume, and clinical fit — would concentrate volume, improve monitoring capacity, and create the basis for quality partnership agreements that drive measurable FSHR reduction.

4 System Metrics

31.4%

System FSHR
(Wtd Avg)

5,998

FFS SNF Patients
Q4 2024 – Q3 2025

25

Hospitals
Analyzed

174

Unique SNF
Destinations

15

Priority Intervention
Targets

25

Cross-System
SNFs

66.7%

Peak Hospital
FSHR

13.3%

Lowest Hospital
FSHR

Data: CMS Medicare FFS Claims, Q4 2024 – Q3 2025. 3 hospitals (Passavant – Cranberry, Greene, Muncy) excluded from quantitative analysis due to CMS reporting thresholds.

Patient Risk Mix

Distribution across CMS risk categories

Very Low 4%

Low 18%

Medium 62%

High 15%

Very High 2%

Facility Risk Mix

SNF-level facility risk across rated relationships

Very Low 0%

Low 1%

Medium 19%

High 30%

Very High 23%

Not Rated 27%

5 Priority Intervention Targets

The following 15 SNF facilities are identified as the highest-priority engagement targets for UPMC's post-acute network program. Priority score combines FSHR above system average, total patient volume, and multi-hospital presence. Red rows indicate FSHR ≥36.5% (5+ pp above system). Download full Excel workbook for complete SNF-level data.

Rank	SNF Facility	Hospital(s)	Patients	FSHR	Est. Prev. Admits	Hospitals
1	SPRING CREEK REHABILITATION AND NURSING CENTER	UPMC Pinnacle (Harrisburg)	117	48.5%	56	1H
2	JAMC OPCO LLC	UPMC Presbyterian Shadyside (incl. Montefiore); UPMC Jameson; UPMC Horizon (Greenville / Shenango Valley)	77	50.7%	39	3H
3	LUTHERAN HOME AT KANE PENNSYLVANIA	UPMC Hamot; UPMC Kane	34	66.7%	22	2H
4	HANOVER HALL FOR NURSING AND REHABILITATION	UPMC Hanover	52	52.1%	27	1H
5	MIDTOWN OAKS HEALTH & REHAB CENTER, LLC	UPMC Altoona	29	68.2%	19	1H
6	PRESBYTERIAN HOME OF HOLLIDAYSBURG	UPMC Altoona	45	52.9%	23	1H
7	HERITAGE PARK REHAB & SKILLED NURSING	UPMC Hamot; UPMC Chautauqua	107	39.1%	41	2H
8	NORTH HILLS SKILLED NURSING AND REHABILITATION CENTER	UPMC Passavant – McCandless	28	60.0%	16	1H
9	ERIE SNF OPERATIONS LLC	UPMC Hamot	49	47.4%	23	1H
10	BROAD ACRES HEALTH & REHABILITATION CENTER	UPMC Wellsboro	42	50.0%	21	1H
11	VALLEY VIEW HEALTH AND REHABILITATION CENTER	UPMC Altoona	57	43.8%	24	1H
12	WASHINGTON OPERATING LLC	UPMC Washington	36	50.6%	18	1H
13	GOLDEN HILL NURSING AND REHAB LP	UPMC Jameson	23	61.0%	14	1H
14	CAPITAL HEALTH & REHAB CENTER, LLC	UPMC Pinnacle (Harrisburg)	32	51.4%	16	1H
15	EDISON MANOR NURSING AND REHABILITATION	UPMC Jameson	20	63.0%	12	1H

Priority score: composite of FSHR excess above 31.4% system average, patient volume, and multi-hospital appearance. Est. Preventable Admits: patients × FSHR. Data: CMS Medicare FFS Claims, Q4 2024 – Q3 2025.

6 Cross-System SNFs

25 SNF facilities serve patients from 2 or more UPMC hospitals. These facilities represent the most efficient system-level engagement opportunities — a single preferred network conversation at any of these SNFs can move FSHR performance across multiple hospitals simultaneously. Sorted by total patient volume.

SNF Facility	Parent Organization	# UPMC Hospitals	Total Patients	Wtd FSHR
VINCENTIAN HOME	VINCENTIAN COLLABORATIVE SYSTEM	3 hospitals	142	31.4%
CONCORDIA AT REBECCA RESIDENCE	CONCORDIA CARE NETWORK	4 hospitals	115	31.6%
HERITAGE PARK REHAB & SKILLED NURSING	GERRY HOMES	2 hospitals	107	39.1%
HERITAGE GREEN REHAB & SKILLED NURSING	HERITAGE MINISTRIES CHARITABLE CARE NETWORK	2 hospitals	90	32.0%
THE WILLOWS OF PRESBYTERIAN MEDICAL CENTER	PRESBYTERIAN SENIORCARE	2 hospitals	79	21.5%
JAMC OPCO LLC	EMSIR	3 hospitals	77	50.7%
HARMONY PHYSICAL REHABILITATION	CONCORDIA CARE NETWORK	2 hospitals	70	21.5%
CLAREMONT NURSING & REHABILITATION CENTER LLC	—	2 hospitals	65	28.4%
HOMEWOOD LIVING MARTINSBURG, INC.	—	2 hospitals	62	24.8%
EAST END HEALTH & REHAB CENTER, LLC	WIW DYNASTY	2 hospitals	59	25.6%
UPMC MAGEE-WOMENS HOSPITAL	UPMC	2 hospitals	59	36.6%
CONCORDIA AT THE CEDARS	CONCORDIA LUTHERAN MINISTRIES OF PITTSBURGH	2 hospitals	51	34.9%
YORK NORTH SKILLED NURSING AND REHABILITATION CENTER	GENESIS HEALTHCARE	2 hospitals	51	29.3%
FP 700 OPERATIONS LLC	PA 3 OPCO	2 hospitals	49	43.0%
SENECA PLACE	OAKDALE SENIORS ALLIANCE	3 hospitals	47	—
WARREN MANOR	JOANN C UNVERFERTH 12 29 04 REVOCABLE TRUST	2 hospitals	39	24.3%
CONCORDIA LUTHERAN MINISTRIES OF PITTSBURGH	CONCORDIA CARE NETWORK	2 hospitals	38	26.9%
LUTHERAN HOME AT KANE PENNSYLVANIA	—	2 hospitals	34	66.7%
CONCORDIA LUTHERAN HEALTH AND HUMAN CARE	CONCORDIA CARE NETWORK	2 hospitals	31	41.7%
SHENANGO PRESBYTERIAN SENIORCARE	PRESBYTERIAN SENIORCARE	2 hospitals	31	47.1%
THE GROVE AT GREENVILLE	LME FAMILY HOLDINGS	2 hospitals	31	20.0%
TRANSITIONS HEALTHCARE NORTH HUNTINGDON	TRANSITIONS HEALTHCARE	2 hospitals	30	—
CHURCH OF GOD HOME INC	STONERIDGE RETIREMENT LIVING COMMUNITIES	2 hospitals	29	23.9%
THE REHABILITATION & NURSING CENTER AT GREATER PITTSBURGH	HEALTHBRIDGE MANAGEMENT	2 hospitals	27	52.5%
PENNKNOLL VILLAGE	CONSULATE MANAGEMENT COMPANY III	2 hospitals	25	29.1%

FSHR = weighted average across all UPMC hospital relationships. Data: CMS Medicare FFS Claims, Q4 2024 – Q3 2025.

7 Per-Hospital Roll-Up

All 25 active UPMC hospitals with CMS Medicare FFS data, sorted by FSHR descending. FSHR is color-coded relative to the system average of 31.4%. Three hospitals below CMS reporting thresholds are shown at the bottom. Download full Excel workbook for per-hospital SNF-level detail.

Hospital	City, State	Region	SNF Patients	FSHR	vs. System	Rated/Total SNFs	Top-5 Conc.
UPMC Kane	Kane, PA	Western/Northern PA	22	66.7%	+35.2pp	1/11	4.8%
UPMC Jameson	New Castle, PA	Western/Northern PA	302	54.3%	+22.9pp	10/30	55.1%
UPMC Wellsboro	Wellsboro, PA	Northern Tier PA	72	44.0%	+12.6pp	2/10	10.4%
UPMC Altoona	Altoona, PA	Western/Northern PA	283	42.6%	+11.2pp	9/30	59.5%
UPMC Northwest	Seneca, PA	Western/Northern PA	292	38.0%	+6.5pp	8/30	93.2%
UPMC Harrisburg	Harrisburg, PA	Central/Eastern PA	587	36.2%	+4.8pp	17/30	51.1%
UPMC Hamot	Erie, PA	Western/Northern PA	462	36.1%	+4.7pp	22/30	32.3%
UPMC East	Monroeville, PA	Pittsburgh Metro	163	35.1%	+3.6pp	8/25	46.0%
UPMC Washington	Washington, PA	Western/Northern PA	292	33.3%	+1.9pp	9/30	72.1%
UPMC Passavant – McCandless	McCandless, PA	Pittsburgh Metro	357	33.1%	+1.7pp	11/25	52.4%
UPMC Williamsport	Williamsport, PA	Northern Tier PA	253	33.0%	+1.5pp	9/25	67.6%
UPMC Hanover	Hanover, PA	Central/Eastern PA	285	33.0%	+1.5pp	9/30	75.0%
UPMC Presbyterian Shadyside	Pittsburgh, PA	Pittsburgh Metro	431	32.9%	+1.4pp	20/21	17.4%
UPMC Carlisle	Carlisle, PA	Central/Eastern PA	378	32.3%	+0.8pp	11/30	67.8%
UPMC McKeesport	McKeesport, PA	Pittsburgh Metro	28	31.9%	+0.4pp	1/25	32.2%
UPMC Mercy	Pittsburgh, PA	Pittsburgh Metro	121	30.9%	-0.5pp	7/25	19.4%
UPMC Somerset	Somerset, PA	Western/Northern PA	51	30.5%	-1.0pp	2/21	11.3%
UPMC Magee-Womens Hospital	Pittsburgh, PA	Pittsburgh Metro	30	30.3%	-1.1pp	1/25	31.3%
UPMC Bedford	Everett, PA	Western/Northern PA	44	29.6%	-1.8pp	3/11	13.9%
UPMC Memorial	York, PA	Central/Eastern PA	152	27.5%	-3.9pp	6/30	67.0%
UPMC St. Margaret	Pittsburgh, PA	Pittsburgh Metro	158	27.5%	-4.0pp	6/25	60.9%
UPMC Chautauqua	Jamestown, NY	New York	201	27.4%	-4.0pp	5/25	36.3%
UPMC Horizon – Greenville	Greenville, PA	Western/Northern PA	203	26.5%	-5.0pp	10/30	61.0%
UPMC Lititz	Lititz, PA	Central/Eastern PA	111	25.2%	-6.3pp	6/30	62.1%
UPMC Western Maryland	Cumberland, MD	Maryland	720	13.3%	-18.2pp	11/25	45.0%
UPMC Passavant – Cranberry	Cranberry Township, PA	Pittsburgh Metro	Insufficient FFS claim volume — below CMS reporting threshold
UPMC Greene	Waynesburg, PA	Western/Northern PA	Insufficient FFS claim volume — below CMS reporting threshold
UPMC Muncy	Muncy, PA	Northern Tier PA	Insufficient FFS claim volume — below CMS reporting threshold

FSHR: Facility Hospitalization Rate from CMS Medicare FFS Claims. vs. System: FSHR minus 31.4% system average. Top-5 Conc.: percentage of SNF patients flowing to top 5 destinations. 3 hospitals shown in grey are below CMS reporting thresholds. Data period: Q4 2024 – Q3 2025.

8 Recommendations

1

Immediate: Launch Priority Engagement at Top 15 FSHR Facilities

Initiate clinical liaison outreach to the 15 priority target SNFs within 30 days. For each facility, develop a tailored engagement plan anchored to FSHR data, shared clinical expectations, and a preferred network designation pathway. Focus first on Spring Creek Rehabilitation And Nursing Center (48.5% FSHR), Jamc Opco Llc (50.7% FSHR), and Lutheran Home At Kane Pennsylvania (66.7% FSHR) — the three highest-impact opportunities in the UPMC system.

2

Near-Term: Build a UPMC Preferred Post-Acute Network Around Cross-System SNFs

Designate a preferred post-acute network of 10–20 high-performing SNFs per hospital, anchored to the 25 cross-system facilities that already serve multiple UPMC hospitals. Establish shared quality expectations, quarterly FSHR review cadences, and preferred referral protocols. A preferred network at Vincentian Home (142 patients, 3 hospitals) alone can move FSHR across multiple hospital P&Ls simultaneously.

3

Hospital Focus: Prioritize UPMC Kane, Wellsboro, Altoona, and Jameson

These four hospitals carry FSHRs 10+ percentage points above the system average. A structured network rationalization — identifying which SNF destinations are driving elevated FSHR and redirecting volume to lower-risk alternatives — will produce the fastest measurable impact on system-wide FSHR. Begin with SNF-level preferred network conversations at each hospital's top-3 volume destinations.

4

Infrastructure: Implement FSHR-Based SNF Scorecards Across All Active Hospitals

Deploy quarterly SNF scorecards — anchored to FSHR, volume share, and facility risk — for all 25 active UPMC hospitals. Scorecards give discharge planners and care coordinators a consistent, data-driven signal for every post-acute partner. Puzzle Healthcare's preferred network platform can automate scorecard generation and surface real-time FSHR alerts, enabling proactive rather than reactive network management.

5

Data: Close the Reporting Gap at Passavant – Cranberry, Greene, and Muncy

Supplement CMS Medicare FFS data with UPMC internal utilization data for the three hospitals below CMS reporting thresholds. Integrate these sites into the preferred network program from launch so that, as FFS volume grows, performance management is already in place. Establish internal FSHR tracking at these sites now to detect performance issues before they appear in federal data.

Post-Acute NetworkAnalysis Report

Post-Acute Network
Analysis Report