1029 Inpatient hospitals qualifying for Medical Assistance (MA) disproportionate share payments for the period July 1, 1997 through June 30, 1998

Inpatient Hospitals Qualifying for Medical Assistance (MA) Disproportionate Share Payments for the Period July 1, 1997 through June 30, 1998

[28 Pa.B. 2972]

   On July 1, 1988, the Department of Public Welfare (Department) implemented a disproportionate share payment system. Under Pennsylvania regulations, the Department is required to annually publish the names of each inpatient acute care general hospital, psychiatric unit and rehabilitation unit of acute care general hospitals, rehabilitation hospital, and private psychiatric hospital qualifying for a disproportionate share payment and their respective disproportionate share payment percentage.

   A.  Disproportionate Share for Acute Care General Hospitals, Rehabilitation Hospitals and Private Psychiatric Hospitals.

   The following lists identify the inpatient acute care general hospitals, psychiatric units and rehabilitation units of acute care general hospitals, rehabilitation hospitals and private psychiatric hospitals eligible for payment period July 1, 1997 through June 30, 1998, disproportionate share payments and their respective payment percentages. For all inpatient facilities, disproportionate share payments are calculated as a percentage of projected MA inpatient income.

   Payment period July 1, 1997 to June 30, 1998, disproportionate share payment percentages.

Acute Care Hospitals

ALBERT EINSTEIN
5.155%
A. I. dUPONT
9.422%
BARNES KASSON
4.647%
UPMC BRADDOCK MED CENTER
4.374%
CHARLES COLE MEMORIAL
3.192%
CHILDRENS HOSPITAL-PGH
9.292%
CHILDRENS HOSPITAL-PHILA
14.000%
CLARION HOSPITAL
3.855%
CLEARFIELD
1.595%
CROZER CHESTER
4.583%
DUBOIS REGIONAL MED CTR
10.000%
EPISCOPAL
9.873%
FULTON COUNTY MEDICAL CTR
1.881%
GHS-CITY AVENUE
8.016%
GHS-PARKVIEW
6.752%
HAHNEMANN HOSPITAL
6.612%
HIGHLAND HOSPITAL
5.436%
HOSP UNIV OF PENNA
5.054%
INDIANA HOSPITAL
1.000%
J C BLAIR
4.292%
J F KENNEDY MEMORIAL
3.556%
JAMESON MEMORIAL
1.545%
KENSINGTON
9.277%
LGH--SUSQUEHANNA DIVISION
4.773%
LOCK HAVEN
9.000%
MAGEE WOMENS
7.094%
MEADVILLE MEDICAL CENTER
5.930%
MED COLL HOSP-MAIN
11.700%
MEMORIAL HOSPITAL-TOWANDA
2.447%
UPMC BEDFORD
3.996%
MERCY CATHOLIC-FITZGERALD
7.084%
MERCY CATHOLIC-MISERICORDIA
5.379%
MERCY PROVIDENCE-PGH
2.373%
MILLCREEK COMMUNITY
4.721%
MONSOUR
7.421%
MT SINAI
7.683%
NEUMANN MEDICAL CENTER
9.736%
NPHS--GIRARD
7.458%
NPHS--ST. JOSEPHS
8.536%
PRESBYT MED CTR OF UPH
4.082%
PRESBYT UNIV HOSPITAL
4.847%
PUNXSUTAWNEY
4.990%
SOLDIERS AND SAILORS
7.519%
ST CHRISTOPHERS
15.000%
ST FRANCIS-NEW CASTLE
8.700%
TEMPLE HOSPITAL, INC.
9.102%
THOMAS JEFFERSON
4.828%
TITUSVILLE
2.245%
TROY COMMUNITY
1.000%
VALLEY FORGE
5.500%
WAYNE COUNTY MEMORIAL
2.420%
WEST VIRGINIA UNIVERSITY HOSPITAL
6.510%

Psychiatric Units of Acute Care Hospitals

ALBERT EINSTEIN
3.040%
UPMC--BRADDOCK MED CENTER
2.591%
CROZER CHESTER
2.711%
DUBOIS REGIONAL MED CTR
3.104%
CITY AVENUE
4.688%
PARKVIEW
3.960%
HAHNEMANN HOSPITAL
3.880%
HIGHLAND HEALTH CENTER
3.202%
HOSP UNIV OF PENNA
2.982%
J C BLAIR
2.137%
MEADVILLE
2.407%
MED COLL HOSP-MAIN
6.811%
MERCY CATHOLIC-FITZGERALD
4.152%
MERCY CATHOLIC-MISERICORDIA
3.169%
MERCY PROVIDENCE-PGH
1.438%
MONSOUR
4.345%
MT SINAI
4.497%
NEUMANN MEDICAL CEN
5.679%
NPHS--GIRARD
4.367%
PRESBYT MED CTR OF U
2.422%
PRESBYT UNIV HOSPITAL
2.863%
SOLDIERS AND SAILORS
2.668%
ST FRANCIS-NEW CASTLE
2.862%
TEMPLE
5.314%
THOMAS JEFFERSON
2.852%

Private Psychiatric Hospitals

CHARTER FAIRMOUNT I
1.922%
CLARION PSYCH CENTER
5.055%
DELAWARE VALLEY M H
9.000%
EDGEWATER
1.260%
EUGENIA HOSPITAL
2.791%
FIRST HOSP. WYOMING
4.037%
HORSHAM HOSPITAL
3.817%
HUNTINGTON
1.000%
KIRKBRIDE CENTER
2.261%
LAKEWOOD PSYCH HOS
3.422%
MEADOWS PSYCH CENT
4.166%
MONTGOMERY COUNTY
1.444%
NAT'L HOSP FOR KIDS IN
8.880%
NORTHWESTERN
1.938%
PHILA CHILD GUIDANCE
10.000%
PHILA PSYCH CENTER
2.167%
PHILHAVEN
2.238%
SOUTHWOOD PSYCH CE
5.781%

Drug and Alcohol Units of Acute Care Hospitals

LGH--SUSQUEHANNA DI
2.508%
MEADVILLE
2.057%
NPHS--ST. JOSEPHS
4.196%
PRESBYT MED CTR OF U
2.074%
VALLEY FORGE
2.965%

Medical Rehab Units of Acute Care Hospitals

ALBERT EINSTEIN
2.748%
CROZER CHESTER
2.389%
DUBOIS REGIONAL MED
2.817%
HOSP UNIV OF PENNA
2.685%
JAMESON MEMORIAL
1.271%
MERCY CATHOLIC-FITZG
3.961%
MERCY PROVIDENCE-P
1.000%
MT SINAI
4.337%
PRESBYT UNIV HOSPITAL
2.555%
ST FRANCIS-NEW CASTLE
2.554%
TEMPLE
5.229%
THOMAS JEFFERSON
2.543%

Freestanding Rehab Hospitals

CHILDRENS HOME-PGH
7.547%
CHILDREN'S REHAB HOS
6.994%
CHILDRENS SEASHORE
10.000%
EAGLEVILLE (D&A)
2.631%
H/S LAKE ERIE INSTITUT
5.720%
MAGEE MEMORIAL
2.379%

   B.  Additional Disproportionate Share Payments

   Additional disproportionate share payments are made to inpatient facilities, with a Medicaid inpatient utilization rate of not less than 1%, which have provided services to persons who have been determined to be low income by meeting the income and resource standards for the State's general assistance program.

   The payment adjustments are paid directly proportional to the payment received for either general assistance recipients for all hospital services or Title XIX recipients age 21--64 for services rendered by institutions for mental diseases under the fee-for-service and capitation programs.

   These are the Pennsylvania hospitals eligible for this payment adjustment.

Acute Care General Hospitals

ABINGTON MEMORIAL
ALBERT EINSTEIN
ALIQUIPPA
ALLEGHENY GENERAL
ALLEGHENY UNIVERSITY HOSPITAL/ALLEGHENY
   VALLEY
ALLENTOWN OSTEO HOSP
ALTOONA
AMERICAN ONCOLOGICAL
ARMSTRONG COUNTY MEMORIAL
ASHLAND REG MED CTR
A. I. dUPONT
BARNES KASSON
BERWICK
BLOOMSBURG
UPMC BRADDOCK MED CENTER
BRADFORD REG MED CTR
BRANDYWINE HOSPITAL
BROOKVILLE
BROWNSVILLE
BRYN MAWR
BUCKTAIL MEDICAL CENTER
BUTLER COUNTY MEMORIAL
UPMC CANONSBURG GENERAL
CARLISLE HOSPITAL
CENTRE COMMUNITY
CHAMBERSBURG HOSPITAL
CHARLES COLE MEMORIAL
CHESTER COUNTY
CHESTNUT HILL
CHILDRENS HOSPITAL-PGH
CHILDRENS HOSPITAL-PHILA
CITIZENS GENERAL
CLARION HOSPITAL
CLEARFIELD
COMMUNITY GENERAL OSTEO
COMMUNITY GENERAL-READING
COMMUNITY HOSP OF LANCASTER
COMMUNITY HOSPITAL-KANE
COMMUNITY MEDICAL CENTER
CONEMAUGH VALLEY
CORRY MEMORIAL
CROZER CHESTER
DELAWARE COUNTY
DELAWARE VALLEY
DIVINE PROVIDENCE-WMSPT
DOYLESTOWN
DUBOIS REGIONAL MED CTR
EASTON HOSPITAL
ELK COUNTY GENERAL
ELLWOOD CITY
EPHRATA COMMUNITY
EPISCOPAL
EVANGELICAL COMMUNITY
FORBES METRO HEALTH CNTR
FORBES REG. HEALTH CNTR
FRANKFORD
FULTON COUNTY MEDICAL CNTR
GEISINGER MEDICAL CENTER
GEISINGER WYOMING VALLEY
GERMANTOWN HOSPITAL & MEDICAL CTR
GETTYSBURG-HOSPITAL
CITY AVENUE
PARKVIEW
GNADEN HUETTEN
GOOD SAMARITAN-LEBANON
GOOD SAMARITAN-POTTSVILLE
AGH UNIVERSITY HOSPITALS GRADUATE
GRANDVIEW
GREENE COUNTY MEMORIAL
AGH UNIVERSITY HOSPITAL HAHNEMANN
HAMOT MEDICAL CENTER
HANOVER GENERAL
PINNACLE HEALTH SYSTEM
HAZLETON GENERAL HOSPITAL
HENRY CLAY FRICK
HIGHLAND HOSPITAL
HOLY REDEEMER
HOLY SPIRIT
HORIZON HOSPITAL SYS, INC
HOSP UNIV OF PENNA
INDIANA HOSPITAL
J C BLAIR
J F KENNEDY MEMORIAL
JAMESON MEMORIAL
JEANES HOSPITAL
JEANNETTE DIST MEMORIAL
JEFFERSON HEALTH SERVICES
JERSEY SHORE HOSPITAL
KENSINGTON
LANCASTER GENERAL
LANKENAU
LATROBE AREA
UPMC LEE HOSPITAL
LEHIGH VALLEY
LEWISTOWN
LGH--SUSQUEHANNA DIVISION
LOCK HAVEN
TEMPLE LOWER BUCKS HOSPITAL
MAGEE WOMENS
MARIAN COMMUNITY HOSP
MCKEESPORT
MEADVILLE
MED COLL HOSP-BUCKS
MED COLL HOSP-ELKINS PARK
MED COLL HOSP-MAIN
MEDICAL CTR BEAVER PA, INC
MEMORIAL--YORK
MEMORIAL HOSPITAL-TOWANDA
UPMC BEDFORD
MERCY FITZGERALD HOSPITAL
MCMC MERCY HOSPITAL PHILADLEP
MERCY COMMUNITY HOSPITAL
MERCY HOSP OF NANTICOKE
MERCY HOSPITAL-ALTOONA
MERCY HOSPITAL-PGH
MERCY HOSPITAL-SCRANTON
MERCY HOSPITAL-WILKES-BARRE
MERCY MED CENTER-JOHNSTOWN
MERCY PROVIDENCE-PGH
METHODIST HOSPITAL
METRO HEALTH CENTER
MEYERSDALE
MID VALLEY
MILLCREEK COMMUNITY
HERSHEY MEDICAL CENTER
MINERS HOSPITAL
MINERS MEMORIAL MED CTR
MONONGAHELA VALLEY
MONSOUR
MONTGOMERY
MONTROSE GENERAL
MOSES TAYLOR
MUHLENBERG
MUNCY VALLEY
NASON HOSPITAL
NAZARETH
NEUMANN MEDICAL CENTER
NORTH HILLS PASSAVANT
NORTH PENN
NORTHEASTERN
NORTHWEST MEDICAL CENTER
NPHS--GIRARD
NPHS--ST. JOSEPHS
OHIO VALLEY
PALMERTON
PAOLI MEMORIAL
PENNSYLVANIA HOSPITAL
PHILIPSBURG AREA
PHOENIXVILLE HOSP OF UNIV OF PA
POCONO HOSPITAL
PODIATRY HOSPITAL
POTTSTOWN MEMORIAL
POTTSVILLE HOSPITAL
PRESBYT MED CTR OF UPHS
PRESBYT UNIV HOSPITAL
PUNXSUTAWNEY
QUAKERTOWN
READING HOSPITAL
RIDDLE MEMORIAL
ROBERT PACKER
ROXBOROUGH MEMORIAL
SACRED HEART-ALLENTOWN
SEWICKLEY
SHADYSIDE
SHAMOKIN AREA COMM HOSP
SHARON
SOLDIERS AND SAILORS
SOMERSET COMMUNITY
SOUTHERN CHESTER
ST AGNES
ST CHRISTOPHERS
ST CLAIR MEMORIAL
ST FRANCIS CENTRAL
ST FRANCIS-NEW CASTLE
ST FRANCIS-PITTSBURGH
ST JOSEPH MED CTR
ST JOSEPH-LANCASTER
ST JOSEPH-READING
ST LUKES OF BETHLEHEM
UPMC ST MARGARET
ST MARY-LANGHORNE
ST VINCENT
ST. MARYS MEDICAL CENTER
SUBURBAN GENERAL-NORRISTOWN
SUBURBAN GENERAL-PGH
SUNBURY COMMUNITY
TAYLOR HOSPITAL
TEMPLE UNIVERSITY HOSPITAL
THOMAS JEFFERSON
THOS. JEFFERSON-FORD RD
TITUSVILLE
TYLER MEMORIAL
TYRONE HOSP
U OF PGH MED CTR--SOUTHSIDE
UNION CITY
UNIONTOWN
UNITED COMMUNITY
VALLEY FORGE
WARREN GENERAL
WASHINGTON
WAYNE COUNTY MEMORIAL
WAYNESBORO
WEST VIRGINIA
WESTERN PENN
WESTMORELAND
WILLIAMSPORT
WILLS EYE HOSPITAL
WINDBER
WYOMING VALLEY HEALTH CARE SYS
YORK HOSPITAL

Freestanding Rehab Hospitals

ALLIED SERVICES
BRYN MAWR REHAB
CHESTNUT HILL-SPRINGFLD CTR
CHILDRENS HOME-PGH
CHILDREN'S REHAB HOSP
CHILDRENS SEASHORE HOUSE
D T WATSON
GOOD SHEPHERD
HARMARVILLE
H/S GREAT LAKES REHAB
H/S LAKE ERIE INSTITUTE
H/S NITTANY VALLEY REHAB
H/S OF MECHANICSBURG REHAB
H/S REHAB OF ALTOONA
H/S REHAB OF GREATER PGH
H/S REHAB OF YORK
JOHN HEINZ REHAB HOSP
MAGEE MEMORIAL
READING REHAB HOSP
REHAB INST OF PGH.

Private Psychiatric Hospitals

CHARTER FAIRMOUNT INSTITUTE
CLARION PSYCH CENTER
DELAWARE VALLEY M H
DEVEREUX MAPLETON
EDGEWATER
EUGENIA HOSPITAL
FIRST HOSP. WYOMING VALLEY
FRIENDS HOSPITAL
HORSHAM HOSPITAL
HUNTINGTON
KIRKBRIDE CENTER
LAKEWOOD PSYCH HOSP
MEADOWS PSYCH CENTER
MONTGOMERY COUNTY MH/MR
NAT'L HOSP FOR KIDS IN CRISIS
NORTHWESTERN
PHILA CHILD GUIDANCE
PHILA PSYCH CENTER (Belmont)
PHILHAVEN
SOUTHWOOD PSYCH CENTER

Freestanding Drug and Alcohol Hospital

EAGLEVILLE

Drug and Alcohol Units of Acute Care

BUTLER COUNTY MEMORIAL
HAMOT MEDICAL CENTER
HORIZON HOSPITAL SYS, INC
LGH--SUSQUEHANNA DIVISION
MEADVILLE
NPHS--ST. JOSEPHS
PRESBYT MED CTR OF UPHS
ST FRANCIS-PITTSBURGH
VALLEY FORGE
WESTMORELAND

Medical Rehab Units of Acute Care Ho

ABINGTON MEMORIAL
ALBERT EINSTEIN
BUCKS CO HOSP
CHAMBERSBURG HOSPITAL
COMMUNITY HOSP OF LANCASTER
CONEMAUGH VALLEY
CROZER CHESTER
DELAWARE COUNTY
DIVINE PROVIDENCE-WMSPT
DOYLESTOWN
DUBOIS REGIONAL MED CTR
EASTON HOSPITAL
ELKINS PARK HOSP
FORBES METRO HEALTH CNTR
FRANKFORD
GEISINGER MEDICAL CENTER
GEISINGER WYOMING VALLEY
GOOD SAMARITAN-LEBANON
HARRISBURG-POLYCLINIC MED CTR
HORIZON HOSPITAL SYS, INC
HOSP UNIV OF PENNA
JAMESON MEMORIAL
JEANNETTE DIST MEMORIAL
JEFFERSON HEALTH SERVICES
LANCASTER GENERAL
LEE HOSPITAL
MCKEESPORT
MERCY CATHOLIC-FITZGERALD
BON SECOURS
MERCY HOSPITAL-PGH
MERCY PROVIDENCE-PGH
HERSHEY MEDICAL CENTER
MONONGAHELA VALLEY
MT SINAI
NAZARETH
NORTHWEST MEDICAL CENTER
POTTSVILLE HOSPITAL
PRESBYT UNIV HOSPITAL
SEWICKLEY
ST AGNES
ST FRANCIS CENTRAL
ST FRANCIS-NEW CASTLE
ST FRANCIS-PITTSBURGH
ST JOSEPH-LANCASTER
UPMC--ST MARGARET-PGH
ST MARY-LANGHORNE
ST VINCENT
SUBURBAN GENERAL-PGH
TAYLOR HOSPITAL
TEMPLE
THOMAS JEFFERSON
U OF PGH MED CTR--SOUTHSIDE
WESTMORELAND
WILLIAMSPORT

Psychiatric Units of Acute Care Hospitals

ABINGTON MEMORIAL
ALBERT EINSTEIN
ALIQUIPPA
ALLEGHENY GENERAL
ALLEGHENY VALLEY
ALTOONA
ARMSTRONG COUNTY MEMORIAL
BLOOMSBURG
UPMC--BRADDOCK MED CENTER
BRADFORD REG MED CTR
BRANDYWINE HOSPITAL
BROWNSVILLE
BRYN MAWR
BUCKS CO HOSP
BUTLER COUNTY MEMORIAL
CARLISLE HOSPITAL
CENTRE COMMUNITY
CHAMBERSBURG HOSPITAL
COMMUNITY HOSP OF LANCASTER
COMMUNITY MEDICAL CENTER
CONEMAUGH VALLEY
CORRY MEMORIAL
CROZER CHESTER
DELAWARE VALLEY
DIVINE PROVIDENCE-WMSPT
DOYLESTOWN
DUBOIS REGIONAL MED CTR
ELK COUNTY GENERAL
EPHRATA COMMUNITY
FORBES METRO HEALTH CNTR
FORBES REG. HEALTH CNTR
GEISINGER MEDICAL CENTER
CITY AVENUE
PARKVIEW
GNADEN HUETTEN
GRANDVIEW
GREENE COUNTY MEMORIAL
HAHNEMANN HOSPITAL
HAMOT MEDICAL CENTER
HANOVER GENERAL
HARRISBURG-POLYCLINIC MED CTR
HAZLETON GENERAL HOSPITAL
HIGHLAND HEALTH CENTER
HOLY SPIRIT
HOSP UNIV OF PENNA
J C BLAIR
JEFFERSON HEALTH SERVICES
LANCASTER GENERAL
LATROBE AREA
LEHIGH VALLEY
LEWISTOWN
LOWER BUCKS
MARIAN COMMUNITY HOSP
MCKEESPORT
MEADVILLE
MED COLL HOSP-MAIN
MEDICAL CTR BEAVER PA, INC
MEMORIAL--YORK
MERCY CATHOLIC-FITZGERALD
MERCY CATHOLIC-MISERICORDIA
MERCY SPECIAL CARE
BON SECOURS
MERCY HOSPITAL-PGH
MERCY HOSPITAL-WILKES-BARRE
MERCY MED CENTER-JOHNSTOWN
MERCY PROVIDENCE-PGH
HERSHEY MEDICAL CENTER
MONONGAHELA VALLEY
MONSOUR
MONTGOMERY
MOSES TAYLOR
MT SINAI
MUHLENBERG
NAZARETH
NEUMANN MEDICAL CENTER
NORTHWEST MEDICAL CENTER
NPHS--GIRARD
PAOLI MEMORIAL
PENNSYLVANIA HOSPITAL
POCONO HOSPITAL
POTTSTOWN MEMORIAL
POTTSVILLE HOSPITAL
PRESBYT MED CTR OF UPHS
PRESBYT UNIV HOSPITAL
READING HOSPITAL
ROBERT PACKER
SEWICKLEY
SHARON
SOLDIERS AND SAILORS
SOMERSET COMMUNITY
ST CLAIR MEMORIAL
ST FRANCIS-NEW CASTLE
ST FRANCIS-PITTSBURGH
ST JOSEPH-LANCASTER
ST JOSEPH-READING
ST LUKES OF BETHLEHEM
ST LUKES-QUAKERTOWN
ST VINCENT
TEMPLE
THOMAS JEFFERSON
U OF PGH MED CTR--SOUTHSIDE
WARREN GENERAL
WASHINGTON
WESTERN PENN
WESTMORELAND
WILLS EYE HOSPITAL
WYOMING VALLEY HEALTH CARE SY
YORK HOSPITAL

   C.  New Class of Disproportionate Share Payments

   Effective March 1, 1998, the Department established a new class of disproportionate share payments to hospitals which render uncompensated care and which the Department has determined are experiencing significant revenue loss as a result of recent Medical Assistance Program revisions under Act No. 1996-35.

   These are the hospitals which qualify for this new class of disproportionate share payments:

   Albert Einstein
Allegheny General
Barnes Kasson
Braddock Medical Center
Charles Cole Memorial
Clarion Osteopathic
Clearfield
Crozer Chester Medical Center
Dubois Regional Medical Center
Eagleville
Episcopal
Fulton County Medical Center
Graduate Hospital
Indiana Hospital
JC Blair
Jameson Memorial
Lehigh Valley
Lockhaven
Meadville Medical Center
Memorial Hospital Bedford
Memorial Hospital Towanda
Mercy Catholic-Fitzgerald
Mercy Catholic-Misericordia
Mercy Hospital-Pittsburgh
North Philadephia Health System
Pennsylvania Hospital
Presbyterian Medical Center of Philadelphia
Punxsutawney
Soldiers and Sailors
St. Francis New Castle
St. Francis Pittsburgh
Titusville
Valley Forge
Wayne County Memorial

Contact Person

   A copy of this notice is available for review at local county assistance offices. Interested persons are invited to submit written comments to this notice within 30 days of this publication. These comments should be sent to the Department of Public Welfare, Office of Medical Assistance Programs, c/o Deputy Secretary's Office, Attention: Regulations Coordinator, Room 515 Health and Welfare Building, Harrisburg, PA 17120.

   Persons with a disability may use the AT&T Relay Service by calling 1 [phone] (TDD users) or 1 [phone] (voice users). Persons who require an alternate format should contact Thomas Vracarich at [phone].

FEATHER O. HOUSTOUN,   
Secretary

   Fiscal Note:  14-NOT-171. (1) General Fund; (2) Implementing Year 1997-98 is $19,000,000; (3) 1st Succeeding Year 1998-99 is $6,000,000; 2nd Succeeding Year 1999-00 is $0; 3rd Succeeding Year 2000-01 is $0; 4th Succeeding Year 2001-02 is $0; 5th Succeeding Year 2002-03 is $0; (4) FY 1996-97 $437,000,000; FY 1995-96 $452,000,000; FY 1994-95 $552,000,000; (7) Medical Assistance--Inpatient; (8) recommends adoption. This increased cost is included in the Department's 1998-99 budget.

[Pa.B. Doc. No. 98-1029. Filed for public inspection June 26, 1998, 9:00 a.m.]