It looks like UPMC has some 'splainin' to do.

Actually, they're 'splainin' as fast as they can; it's just that their explanations don't add up.

And since this isn't a sitcom -- real lives and communities are at stake -- let's ditch the Lucy-and-Desi reference and borrow a phrase from UPMC's inescapable TV ads: "The conversation continues ..." and if we're lucky, maybe at some point it will include the truth.

When UPMC officials announced two weeks ago that they would be closing their Braddock facility, they cited both continuing financial losses and declining patient admissions.

Last week hospital officials were downplaying the red ink and insisting it was primarily the low number of "Braddock" residents using the hospital that made it no longer viable. "General utilization by area residents determines the success or failure of any community hospital," a UPMC spokesman said Saturday.

Really? Doesn't that depend on how you define "community"? UPMC defined it -- very loosely -- by geography, lumping in the six ZIP codes around Braddock to determine that 4 out of 5 patients go to other facilities such as UPMC Presbyterian and UPMC Shadyside.

But a county ZIP code map shows that the six adjacent to Braddock (15104) include some relatively upscale neighborhoods like Regent Square (15218) and huge swaths such as Wilkinsburg (15221). It's hard not to wonder whether UPMC was gaming its numbers: Many residents of those two ZIP codes live closer to UPMC Shadyside than they do to UPMC Braddock -- and that's assuming the Braddock facility offers the same services patients can get elsewhere. It does not.

UPMC Presby is a renowned, state-of-the-art research hospital. UPMC Shadyside is a "tertiary care" facility offering both primary medical care and "a broad range of specialties that include cardiology, oncology ... obstetrics and gynecology," among others.

As previous Post-Gazette coverage noted, Braddock doesn't provide oncology or obstetrics. Having cancer and having a baby are two reasons low-income people to seek medical care that they often must otherwise forgo; those in Braddock always had to find it outside their community.

UPMC officials decide which services to offer where. Punishing Braddock residents for not using their local hospital for services it doesn't even offer is a particularly heartless case of blaming the victim.

There's a different way to define community than by ZIP code -- defining it by need. And need can overlap with geography in fascinating ways.

Although the beds in the general medical portion of the Braddock hospital are not as full as UPMC honchos would like, the beds devoted to drug and alcohol, sober living and detoxification are well-used. This not only boosts the hospital's overall utilization rate to a quite healthy level, it means there's a significant community, defined by need, that still could be served.

Relocating such a facility could be a public relations nightmare -- for an organization with a talent for creating them -- since rehab centers tend to depress property values in more affluent neighborhoods, but locating them in distressed neighborhoods like, um, Braddock has the opposite effect.

If they'd wanted to, UPMC officials could have reconfigured the percentage of beds devoted to such purposes and thereby served two communities -- the "community of need" and the community of Braddock which desperately needs this large business and its money-producing ripple effect.

Which brings us back to the money. Utilization rates aside, experts defended UPMC's decision solely on economic grounds. As one professor commented in the Post-Gazette, "With any business, you have to cover your costs."

But UPMC isn't "any business." It's a gigantic nonprofit that gets huge tax breaks -- money made up for by us taxpayers -- in return for serving needs that for-profit businesses cannot and doing so in a more efficient way than government bureaucracies can.

And in recent years, UPMC The Nonprofit has done a spectacular job of raking in profits that ought to cover the relatively minor losses in Braddock -- as assessed at the bottom of a recession, at that!

Critics of the closing increasingly believe that UPMC minds were made up when they decided to open a new outpost in the much more affluent Monroeville. But their insight is more damning than they realize: A more profitable facility in Monroeville should, in the long term, have made it easier, not harder, to subsidize and reimagine a tiny community outpost.

Braddock Mayor John Fetterman's distinctive mug graces the current cover of The Atlantic as one of "27 Brave Thinkers Who Are Shaping the Future." Maybe he could have helped UPMC's shallow thinkers. As he said in the PG this weekend, they "could have found a way to make it work, but they don't want to make it work."

It's hard to reach any different conclusion. UPMC may technically be a nonprofit, but judging from its leaders' decisions, you really can't call it charitable.

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