2022-05-07T14:05:36-05:00 2021-06-30 470617373 COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2020-07-01 611345363 FLAGET HEALTHCARE INC FLAG 5023505000 4305 NEW SHEPHERDSVILLE ROAD BARDSTOWN KY 40004 CHRISTY SPITSER VP OF FINANCE 5023505000 2022-05-07 1 CHRISTY SPITSER 999009999 MARK STOCKI P00642127 3032989100 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z FLAGET MEMORIAL HOSPITAL JENNIFER NOLAN 4305 NEW SHEPHERDSVILLE ROAD BARDSTOWN KY 40004 79013923 0 0928 X WWW.CHISAINTJOSEPHHEALTH.ORG X 1951 KY THE HOSPITAL'S VISION IS TO BE THE PREMIER, INTEGRATED, COMPREHENSIVE HEALTH SYSTEM IN THE COMMUNITY PROVIDING HIGH QUALITY CARE CLOSE TO HOME, REDUCING THE INCIDENCE OF DISEASE AND ELIMINATING THE INEQUITIES IN ACCESS TO HEALTHCARE. 15 12 459 43 75 0 6227637 1160875 73486785 77437714 18900 21017 229756 394317 79963078 79013923 75454 26495 0 0 22581519 23297635 0 0 0 43631579 50651504 66288552 73975634 13674526 5038289 156536848 173311439 25544712 29808245 130992136 143503194 "AS AN AFFILIATE OF COMMONSPIRIT HEALTH, WE MAKE THE HEALING PRESENCE OF GOD KNOWN IN OUR WORLD BY IMPROVING THE HEALTH OF THE PEOPLE WE SERVE, ESPECIALLY THOSE WHO ARE VULNERABLE, WHILE WE ADVANCE SOCIAL JUSTICE FOR ALL". 0 0 57909391 26495 77437714 SEE SCHEDULE H. 57909391 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 1 0 0 459 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 12 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 KY X CHRISTY SPITSER 6063306016 310 E 9TH ST LONDON KY 40741 LARRY SCHUMACHER DIRECTOR 1.00 50.00 X 0 1962777 220294 BRUCE TASSIN MARKET CEO/DIRECTOR (PARTIAL YEAR) 1.00 50.00 X 0 1109892 99710 MONTE MARTIN MD ONCOLOGIST 0.00 50.00 X 0 1022331 37644 STEVE FRANTZ TREASURER (PARTIAL YEAR) 1.00 50.00 X 0 808042 31940 COLLEEN HOLTON FORMER TREASURER/CFO 0.00 50.00 X 0 679640 19114 JENNIFER NOLAN PRESIDENT FLAGET 5.00 50.00 X 0 523657 44779 SHARON HAGER SECRETARY/DIV VP SR COUNSEL 0.00 50.00 X 0 521533 28400 SHELLEY STANKO MD DIRECTOR 1.00 40.00 X 0 344168 42905 CHRISTY SPITSER TREASURER/MARKET VP OF FINANCE 1.00 40.00 X 0 340834 45048 SCOTT MONTGOMERY PHYSICIST 40.00 1.00 X 6063 237996 20330 PAULA JOHNSON MD INTERNAL MED-GENERAL 0.00 40.00 X 0 221239 12798 WILLIAM GEORGE SECRETARY 1.00 40.00 X 0 210739 18026 MELINDA EVANS FORMER VP FINANCE 0.00 40.00 X 0 196137 19923 KAMI POOLE-WARDER VP-PATIENT CARE SERVICES 40.00 1.00 X 175719 0 38692 MICHELLE MATTINGLY DIRECTOR, PHARMACY 40.00 1.00 X 177007 0 21507 ELIJAH MARTIN PHYSICIST 40.00 1.00 X 35422 131149 10310 MELINDA OBRYAN PHARMACIST 40.00 1.00 X 139544 0 32984 AVICHAI ERES MD DIRECTOR 1.00 4.00 X 0 36348 0 MARTHA JONES CHAIR 5.00 4.00 X X 0 0 0 ROBERT HEWETT VICE CHAIR 5.00 4.00 X X 0 0 0 MICHAEL ADES DIRECTOR 1.00 4.00 X 0 0 0 JANE BURKS DIRECTOR 1.00 4.00 X 0 0 0 JANE CHILES DIRECTOR 1.00 4.00 X 0 0 0 FR NORMAN FISCHER DIRECTOR 1.00 4.00 X 0 0 0 DIANA HAN MD DIRECTOR 1.00 4.00 X 0 0 0 JOHN STEWART II MD DIRECTOR 1.00 4.00 X 0 0 0 SR ELIZABETH WENDELN DIRECTOR 1.00 4.00 X 0 0 0 DANIEL RODRIQUE MD DIRECTOR 1.00 4.00 X 0 0 0 MARY-ALICHA WELDON DIRECTOR 1.00 4.00 X 0 0 0 WINSTON GRIFFIN DIRECTOR 1.00 4.00 X 0 0 0 533755 8346482 744404 9 1 1 0 U OF L HEALTH SYSTEM-LOUISVILLE 530 S JACKSON ST LOUISVILLE KY 40202 REHAB AND PHYSICIAN SERVICES 2167886 SOUND PHYSICIANS 1498 PACIFIC AVE STE 400 TACOMA WA 98402 EMERGENCY PHYSICIAN CALL COVERAGE 1518281 AMN HEALTHCARE 12400 HIGH BLUFF DRIVE SAN DIEGO CA 92130 HEALTHCARE CONSULTING 657354 REALM CONSTRUCTION CO INC 620 S 3RD ST 600 LOUSIVILLE KY 40202 CONSTRUCTION SERVICES 598867 BARTON ASSOCIATES INC 221 W PHILADELPHIA ST YORK PA 17401 STAFFING AND RECRUITING SERVICES 558729 22 1042674 118201 63891 1160875 NET PATIENT SERVICES 900099 77401635 77401635 0 0 RENTAL INCOME 900099 36079 36079 0 0 77437714 12570 75 12495 8447 0 8447 8447 8447 PHARMACY SERVICES 446110 373937 0 0 373937 ONCOLOGY 900099 7858 0 0 7858 ADMINISTRATIVE WORD PR 561000 3331 0 0 3331 9191 9191 394317 79013923 77437714 75 415259 X 26495 26495 18292013 17048156 1243857 777233 752361 24872 2890783 2659520 231263 1337606 1218559 119047 102952 102952 4846 4846 17478211 13232371 4245840 1206904 782074 424830 2967270 2255125 712145 1373082 1039423 333659 20588 14226 6362 2134 553 1581 16376 16376 2233272 2233272 3380473 1315004 2065469 1199193 74350 1124843 MEDICAL SUPPLIES 14299183 14299183 0 0 MISCELLANEOUS EXPENSES 3800788 977266 2823522 0 STATE PROVIDER TAX 898419 718735 179684 0 REPAIRS AND MAINTENANCE 819380 778411 40969 0 848433 696357 152076 73975634 57909391 16066243 0 683 682 112823441 121747213 0 8554854 10420690 0 0 135426 135426 1772110 1964305 95310 95360 69710426 40307480 31173009 29402946 0 0 0 0 1982015 9544817 156536848 173311439 19525226 16425621 0 164538 183096 0 0 0 0 0 5854948 13199528 25544712 29808245 X 130992136 143503194 0 130992136 143503194 156536848 173311439 X 5038289 257286 7215483 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 4846 0 0 0 4846 0 PART II-B, LINE 1: THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: AMERICAN HOSPITAL ASSOCIATION - $1,167 CATHOLIC HEALTH ASSOCIATION - $621 KENTUCKY HOSPITAL ASSOCIATION - $3,058 2846461 2846461 23637553 7925395 15712158 1566748 1101869 464879 37607923 29563061 8044862 4051741 1717155 2334586 29402946 INTERCOMPANY RECEIVABLES 272836 DEPOSITS 500 ROU OPERATING 9271481 9544817 INTERCOMPANY PAYABLES 2341269 LEASE LIABILITIES 9574890 ACCRUED CONTINGENT LIABILITIES 1283369 13199528 X PART X, LINE 2: FLAGET HEALTHCARE, INC.'S FINANCIAL INFORMATION IS INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS, WHICH INCLUDES THE FOLLOWING DISCLOSURE: COMMONSPIRIT REVIEWS ITS TAX POSITIONS QUARTERLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. 1 1 X 1 X 300.000000000000 1 X 1 1 1 0 1 1 1120548 352851 767697 0.01040 14016751 15480757 0 0.00000 15137299 15833608 767697 0.01040 3 1901 127103 127103 0.00170 2 72 90266 90266 0.00120 4 759 66520 66520 0.00090 9 2732 283889 283889 0.00380 9 2732 15421188 15833608 1051586 0.01420 1 16308 16308 0.00020 1 16308 16308 0.00020 1 3086366 14517539 18482776 -3965237 X 1 1 1 1 FLAGET MEMORIAL HOSPITAL 4305 NEW SHEPHERDSVILLE ROAD BARDSTOWN KY 40004 HTTPS://WWW.CHISAINTJOSEPHHEALTH.ORG/F 100348 X X X FLAGET MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X 18 1 0 0 1 X SEE PART V, PAGE 8 X 1 19 1 SEE PART V, PAGE 8 0 1 X 300.000000000000 300.000000000000 X X X X 1 1 X X X 1 X HTTPS://WWW.CHISAINTJOSEPHHEALTH.ORG/FINANCIAL-ASSISTANCE X HTTPS://WWW.CHISAINTJOSEPHHEALTH.ORG/FINANCIAL-ASSISTANCE X HTTPS://WWW.CHISAINTJOSEPHHEALTH.ORG/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 FLAGET MEMORIAL HOSPITAL PART V, SECTION B, LINE 5: CHI SAINT JOSEPH HEALTH (FLAGET MEMORIAL HOSPITAL) CONTRACTED WITH THE COMMUNITY AND ECONOMIC DEVELOPMENT INITIATIVE OF KENTUCKY (CEDIK) TO CONDUCT A CHNA IN ACCORDANCE WITH THE AFFORDABLE CARE ACT AND SECTION 501(R) OF THE INTERNAL REVENUE CODE FOR NONPROFIT TAX-EXEMPT HOSPITALS. CEDIK FACILITATED THE PROCESS OF PRIMARY DATA COLLECTION THROUGH COMMUNITY SURVEYS, FOCUS GROUPS AND KEY INFORMANT INTERVIEWS TO CREATE AN IMPLEMENTATION PLAN TO ADDRESS IDENTIFIED HEALTH NEEDS. IN ADDITION, COUNTY SPECIFIC SECONDARY DATA WAS GATHERED TO HELP EXAMINE THE SOCIAL DETERMINANTS OF HEALTH. THROUGHOUT THE PROCESS, CEDIK AND THE COMMUNITY STEERING COMMITTEE, WHICH INCLUDED A PUBLIC HEALTH REPRESENTATIVE ON EACH COMMUNITY'S COMMITTEE, MADE IT A PRIORITY TO GET INPUT FROM POPULATIONS THAT ARE OFTEN NOT ENGAGED IN CONVERSATIONS ABOUT THEIR HEALTH NEEDS OR GAPS IN SERVICE. CEDIK CONDUCTED KEY INFORMANT INTERVIEWS TO PROBE MORE DEEPLY INTO HEALTH AND QUALITY OF LIFE THEMES WITHIN THE COUNTY. CURRENT COMMUNITY RESOURCES AND POTENTIAL BARRIERS TO ACCESSING RESOURCES WERE ALSO IDENTIFIED IN THESE INTERVIEWS. THIS CHNA REPORT SYNTHESIZES COMMUNITY HEALTH NEEDS SURVEY DATA, FOCUS GROUPS WITH VULNERABLE POPULATIONS, AND KEY INFORMANT INTERVIEW DATA WITH SOCIAL AND ECONOMIC DATA AS WELL AS HEALTH OUTCOMES DATA COLLECTED FROM SECONDARY SOURCES TO HELP PROVIDE CONTEXT FOR THE COMMUNITY. COMMUNITY REPRESENTATION INCLUDED: NELSON COUNTY HEALTH DEPARTMENT, BARDSTOWN AT HOME, GUTHRIE OPPORTUNITY CENTER, NELSON COUNTY COMMUNITY CLINIC, BLACKMON & WALTON DENTISTRY, NELSON COUNTY EMS, NELSON COUNTY SCHOOL DISTRICT, BARDSTOWN CITY SCHOOL, NELSON COUNTY CHAMBER OF COMMERCE, LOCAL NAMI CHAPTER FLAGET MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: ALL STRATEGIES WERE IMPLEMENTED, BUT WERE SEVERELY CURTAILED WITH THE NOVEL CORONAVIRUS BEGINNING MARCH 1, 2020.FLAGET MEMORIAL HOSPITAL'S IDENTIFIED NEEDS GOALS, OBJECTIVES AND STRATEGIES ARE BELOW AND LACK OF RESOURCE KNOWLEDGE WILL BE WOVEN INTO EACH NEED:BEHAVIORAL HEALTH - INCLUDING MENTAL HEALTH AND SUBSTANCE ABUSEGOAL: ADDRESS BEHAVIORAL HEALTH, INCLUDING MENTAL HEALTH AND SUBSTANCE ABUSE, FROM A CHI SAINT JOSEPH HEALTH SYSTEM APPROACH, INCLUDING WORKING UPSTREAM TO ADDRESS ISSUES THAT UNDERLIE MENTAL HEALTH AND SUBSTANCE ABUSE.OUTCOME OBJECTIVE: BY JUNE 2022, INCREASE MENTAL HEALTH RESOURCES, INCLUDING TELEHEALTH, PARTICIPATION AND COLLABORATION WITH COMMUNITY PARTNERS TO ADDRESS BEHAVIORAL HEALTH; DECREASE SUBSTANCE ABUSE AS MEASURED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION.STRATEGIES WILL BE ACCOMPLISHED THROUGH PARTICIPATION AND COLLABORATION WITH COMMUNITY PARTNERS. INFORMATION ABOUT AVAILABLE RESOURCES WILL BE PROVIDED WITH EACH OPPORTUNITY.STRATEGIES - MENTAL HEALTH* SUPPORT LEGISLATION CONSIDERING A HOLISTIC APPROACH TO ADDRESS MENTAL HEALTH, INCLUDING TELEHEALTH.* PURSUE VARIOUS PRIVATE, STATE AND FEDERAL GRANTS TO ADDRESS MENTAL HEALTH NEEDS.* EPIC PROJECT - CONSIDER PARTICIPATING WITH PARTNERS IN PEDIATRIC THERAPY AND THE NELSON COUNTY HEALTH DEPARTMENT TO IDENTIFY INDIVIDUALS WHO HAVE EXPERIENCED CHALLENGING AND ADVERSE SITUATIONS THROUGHOUT THEIR LIFETIME THAT COULD IMPACT THEIR MENTAL AND PHYSICAL HEALTH.* PARTICIPATE AND SUPPORT LOCAL GROUPS AND EVENTS THAT HAVE A MISSION TO PROMOTE MENTAL WELL-BEING.* INCREASE ACCESS TO MENTAL HEALTH SERVICES BY IMPROVING COLLABORATION BETWEEN FLAGET MEMORIAL HOSPITAL, COMMUNITY AND LOCAL MENTAL HEALTH FACILITIES.* LEVERAGE EXPERTISE IN MENTAL HEALTH TO INCREASE ACCESS TO MENTAL HEALTH SERVICES, INCLUDING TELEHEALTH.* COLLABORATE WITH OUR LADY OF PEACE TO PROVIDE PEACE FOR PARENTS SEMINARS ON TOPICS SUCH AS ANXIETY, DEPRESSION, SUICIDE, BULLYING AND SUBSTANCE ABUSE.* UTILIZE TELEHEALTH FOR CONSULTATIONS THROUGH THE EMERGENCY DEPARTMENT.* CONTINUE GREEN DOT PROGRAM TO ADDRESS VIOLENCE IN THE AREA SCHOOLS AND IDENTIFY HIGH RISK KIDS AND CONTINUED LEADERSHIP OF THE VIOLENCE PREVENTION COMMUNITY COALITION. STRATEGIES - SUBSTANCE ABUSE* PARTICIPATE AND SUPPORT KENTUCKY HOSPITAL ASSOCIATION (KHA) AND THE CABINET FOR HEALTH AND FAMILY SERVICES AS PART OF THE KENTUCKY OPIOID RESPONSE EFFORT (KORE) TO LAUNCH THE KENTUCKY STATEWIDE OPIOID STEWARDSHIP (KY SOS) PROGRAM.* ADVANCE CHI SAINT JOSEPH HEALTH'S RECENT NEW POSITION OF OPIOID STEWARDSHIP PHARMACIST AND FORTHCOMING DRUG TASK FORCE.* PARTICIPATE AND SUPPORT THE KENTUCKY CHAMBER OF COMMERCE'S OPIOID TASK FORCE.* PARTICIPATE AND/OR SPONSOR EVIDENCE-BASED SUBSTANCE ABUSE INITIATIVES ADDRESSING THE OPIOID CRISIS.* PROMOTE COLLABORATION BETWEEN THE PUBLIC AND PRIVATE SECTORS.* PROMOTE AND SUPPORT COMMUNITY SUPPORT PROGRAMS SUCH AS ALCOHOLICS ANONYMOUS (AA) AND NARCOTICS ANONYMOUS (NA).* IDENTIFY OPPORTUNITIES TO ADDRESS ALCOHOL AND SUBSTANCE USE.* SUPPORT LOCAL GROUPS AND EVENTS THAT HAVE A MISSION TO PREVENT ALCOHOL AND SUBSTANCE USE AND CARE FOR THOSE WHO ARE EXPERIENCING MENTAL HEALTH ISSUES AND/OR SUBSTANCE ABUSE.* EXPLORE THE FEASIBILITY OF EXPANDING TELEHEALTH OPPORTUNITIES FOR ALCOHOL AND DRUG COUNSELING.OBESITY AND DIABETES - INCLUDING WELLNESS & EXERCISEGOAL: ADDRESS OBESITY AND DIABETES, INCLUDING WELLNESS AND EXERCISE, THROUGH EDUCATION AND PREVENTION.OUTCOME OBJECTIVE: TO DECREASE OBESITY AND DIABETES AS MEASURED BY KENTUCKY BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY AND TO INCREASE WELLNESS AND EXERCISE AS MEASURED BY COUNTY HEALTH RANKINGS AND ROADMAPS. (KY RANKS 7TH FOR DIABETES; AND, 8TH FOR OBESITY.)STRATEGIES WILL BE ACCOMPLISHED THROUGH PARTICIPATION AND COLLABORATION WITH COMMUNITY PARTNERS. INFORMATION ABOUT AVAILABLE RESOURCES WILL BE PROVIDED WITH EACH OPPORTUNITY.STRATEGIES - OBESITY AND DIABETES - INCLUDING WELLNESS & EXERCISE* ADVOCATE FOR INITIATIVES THAT ADDRESS THE RISK FACTORS THAT LEAD TO OBESITY AND CHRONIC DISEASE IN CHILDREN.* SUPPORT LEGISLATION TO PROVIDE TAX BREAKS AND OTHER INCENTIVES FOR THE CREATION OF WELLNESS PROGRAMS ENABLING BUSINESSES TO EDUCATE AND ENCOURAGE EMPLOYEES TO ENGAGE IN HEALTHY LIFESTYLES AND OBTAIN PREVENTIVE CARE.* PROMOTE HEALTHY OPTIONS FOR DIET AND EXERCISE.* PROVIDE COMMUNITY SUPPORTED AGRICULTURE PROGRAMS AND/OR FARMERS MARKETS.* PROMOTE HEALTHY FOOD INITIATIVE AND "MINDFUL" PROGRAM.* OFFER ITEMS AND EDUCATIONAL MATERIALS FROM "HARVEST OF THE MONTH" PROGRAM.* PROVIDE NUTRITION LABELING IN CAFETERIA.* ESTABLISH DIABETES EDUCATION CLASSES WITH INDIVIDUAL COUNSELING, ALONG WITH MEDICAL NUTRITION THERAPY.* PURSUE OPPORTUNITIES TO DEVELOP AND/OR EXPAND PARTNERSHIPS TO INCREASE ACCESS TO RESOURCES RELATED TO DIET AND EXERCISE.* PARTICIPATE AND SUPPORT LOCAL GROUPS AND EVENTS THAT HAVE A MISSION TO PROMOTE HEALTHY DIET AND EXERCISE TO PREVENT NEGATIVE HEALTH OUTCOMES.* PROMOTE AND SUPPORT THE AMERICAN DIABETES ASSOCIATION.EDUCATION ABOUT RESOURCESGOAL: ADDRESS LACK OF KNOWLEDGE ABOUT AVAILABLE RESOURCES FOR DISEASES AND SERVICES AT FLAGET MEMORIAL HOSPITAL.OUTCOME OBJECTIVE: BY JUNE 2022, INCREASE KNOWLEDGE ABOUT DISEASES AND SERVICES AT FLAGET MEMORIAL HOSPITAL BY ACCEPTING 85% OF INVITATIONS AND PARTICIPATING IN COMMUNITY AND SCHOOL EVENTS TO PROVIDE EDUCATION MATERIALS AND INFORMATION; HOST A MINIMUM OF TWO EDUCATIONAL SESSIONS AT FACILITY COVERING SERVICES AND/OR DISEASES.STRATEGIES WILL BE ACCOMPLISHED THROUGH PARTICIPATION AND COLLABORATION WITH COMMUNITY PARTNERS. INFORMATION ABOUT AVAILABLE RESOURCES WILL BE PROVIDED WITH EACH OPPORTUNITY.STRATEGIES - EDUCATION ABOUT RESOURCES* PARTICIPATE IN COMMUNITY EVENTS AND SCHOOL EVENTS TO PROVIDE EDUCATION ABOUT DISEASES AND SERVICES AT FLAGET MEMORIAL HOSPITAL.* HOST EDUCATIONAL SESSIONS AT FLAGET MEMORIAL HOSPITAL TO SHARE KNOWLEDGE ABOUT DISEASES AND SERVICES.* CONTINUE ADVISORY COUNCIL TO PROVIDE EDUCATION ABOUT RESOURCES AND ENCOURAGE MEMBERS TO SHARE WITH COMMUNITY.* IDENTIFY SPECIALTY PROVIDERS WHO ARE WILLING TO EXPAND THEIR SERVICES TO THE FLAGET MEMORIAL HOSPITAL SERVICE AREA.SIGNIFICANT HEALTH NEED(S) NOT ADDRESSEDALL TOP PRIORITIES IDENTIFIED AS NEEDS WILL BE ADDRESSED. FLAGET MEMORIAL HOSPITAL PART V, SECTION B, LINE 13H: THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF THIRTY-FIVE DOLLARS ($35.00) WITH THE CHI HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW THIRTY-FIVE DOLLARS ($35) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS. THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION. PATIENT COOPERATION STANDARDS - A PATIENT MUST EXHAUST ALL OTHER PAYMENT OPTIONS, INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD-PARTIES PRIOR TO BEING APPROVED. AN APPLICANT FOR FINANCIAL ASSISTANCE IS RESPONSIBLE FOR APPLYING TO PUBLIC PROGRAMS FOR AVAILABLE COVERAGE. HE OR SHE IS ALSO EXPECTED TO PURSUE PUBLIC OR PRIVATE HEALTH INSURANCE PAYMENT OPTIONS FOR CARE PROVIDED BY A CHI HOSPITAL ORGANIZATION WITHIN A HOSPITAL FACILITY. A PATIENT'S AND, IF APPLICABLE, ANY GUARANTOR'S COOPERATION IN APPLYING FOR APPLICABLE PROGRAMS AND IDENTIFIABLE FUNDING SOURCES, INCLUDING COBRA COVERAGE (A FEDERAL LAW ALLOWING FOR A TIME-LIMITED EXTENSION OF EMPLOYEE HEALTHCARE BENEFITS), SHALL BE REQUIRED. IF A HOSPITAL FACILITY DETERMINES THAT COBRA COVERAGE IS POTENTIALLY AVAILABLE, AND THAT A PATIENT IS NOT A MEDICARE OR MEDICAID BENEFICIARY, THE PATIENT OR GUARANTOR SHALL PROVIDE THE HOSPITAL FACILITY WITH INFORMATION NECESSARY TO DETERMINE THE MONTHLY COBRA PREMIUM FOR SUCH PATIENT, AND SHALL COOPERATE WITH HOSPITAL FACILITY STAFF TO DETERMINE WHETHER HE OR SHE QUALIFIES FOR HOSPITAL FACILITY COBRA PREMIUM ASSISTANCE, WHICH MAY BE OFFERED FOR A LIMITED TIME TO ASSIST IN SECURING INSURANCE COVERAGE. A HOSPITAL FACILITY SHALL MAKE AFFIRMATIVE EFFORTS TO HELP A PATIENT OR PATIENT'S GUARANTOR APPLY FOR PUBLIC AND PRIVATE PROGRAMS. SCHEDULE H, PART V, SECTION B, LINE 3E: THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS IDENTIFIED THROUGH THE CHNA. SCHEDULE H, PART V, SECTION B, LINE 7A: HTTPS://WWW.CHISAINTJOSEPHHEALTH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT-2020-2022 SCHEDULE H, PART V, SECTION B, LINE 10A: HTTPS://WWW.CHISAINTJOSEPHHEALTH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT-2020-2022 PART I, LINE 3C: UNLESS ELIGIBLE FOR PRESUMPTIVE FINANCIAL ASSISTANCE, THE FOLLOWING ELIGIBILITY CRITERIA MUST BE MET IN ORDER FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE: * THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF THIRTY-FIVE DOLLARS ($35.00) WITH THE CHI HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW THIRTY-FIVE DOLLARS ($35) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS. * THE PATIENT'S FAMILY INCOME MUST BE AT OR BELOW 300% OF THE FPG. * THE PATIENT MUST COMPLY WITH PATIENT COOPERATION STANDARDS AS DESCRIBED [IN THE FAP]. * THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION. FOR PATIENTS AND GUARANTORS WHO ARE UNABLE TO PROVIDE REQUIRED DOCUMENTATION, A HOSPITAL FACILITY MAY GRANT PRESUMPTIVE FINANCIAL ASSISTANCE BASED ON INFORMATION OBTAINED FROM OTHER RESOURCES. IN PARTICULAR, PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE: * RECIPIENT OF STATE-FUNDED PRESCRIPTION PROGRAMS; * HOMELESS OR ONE WHO RECEIVED CARE FROM A HOMELESS CLINIC; * PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC); * FOOD STAMP ELIGIBILITY; * SUBSIDIZED SCHOOL LUNCH PROGRAM ELIGIBILITY; * ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS (E.G., MEDICAID SPEND-DOWN); * LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; OR * PATIENT IS DECEASED WITH NO KNOWN ESTATE. PART I, LINE 6A: FLAGET HEALTHCARE INC. COMMUNITY BENEFIT REPORT IS CONTAINED IN THE REPORT OF A RELATED ORGANIZATION - CHI SAINT JOSEPH HEALTH. PART III, LINE 2: COSTING METHODOLOGY FOR AMOUNTS REPORTED ON LINE 2 IS DETERMINED USING THE ORGANIZATION'S COST/CHARGE RATIO OF 22.15%. WHEN DISCOUNTS ARE EXTENDED TO SELF-PAY PATIENTS, THESE PATIENT ACCOUNT DISCOUNTS ARE RECORDED AS A REDUCTION IN REVENUE, NOT AS BAD DEBT EXPENSE. PART III, LINE 3: FLAGET HEALTHCARE, INC. DOES NOT BELIEVE THAT ANY PORTION OF BAD DEBT EXPENSE COULD REASONABLY BE ATTRIBUTED TO PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE SINCE AMOUNTS DUE FROM THOSE INDIVIDUALS' ACCOUNTS WILL BE RECLASSIFIED FROM BAD DEBT EXPENSE TO CHARITY CARE WITHIN 30 DAYS FOLLOWING THE DATE THAT THE PATIENT IS DETERMINED TO QUALIFY FOR CHARITY CARE. PART III, LINE 4: FLAGET HEALTHCARE, INC. DOES NOT ISSUE SEPARATE COMPANY AUDITED FINANCIAL STATEMENTS. HOWEVER, THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF COMMONSPIRIT HEALTH. THE CONSOLIDATED FOOTNOTE READS AS FOLLOWS:COMMONSPIRIT RELIES ON THE RESULTS OF DETAILED REVIEWS OF HISTORICAL WRITE-OFFS AND COLLECTIONS IN ESTIMATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE. UPDATES TO THE HINDSIGHT ANALYSIS ARE PERFORMED AT LEAST QUARTERLY USING PRIMARILY A ROLLING EIGHTEEN-MONTH COLLECTION HISTORY AND WRITE-OFF DATA. SUBSEQUENT CHANGES TO ESTIMATES OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO NET PATIENT REVENUE IN THE PERIOD OF THE CHANGE.SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN A THIRD-PARTY PAYOR'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE IN PURCHASED SERVICES AND OTHER IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS. BAD DEBT EXPENSE FOR 2021 AND 2020 WAS NOT SIGNIFICANT. PART III, LINE 8: COMMONSPIRIT HEALTH HOSPITALS PREPARE MEDICARE COST REPORTS IN A MANNER THAT COMPORTS WITH PROVIDER REIMBURSEMENT MANUAL (PRM) 15-1 AND PRM 15-2 CHAPTER 40 (TRANSMITTAL 13). AS SUCH, THE FOLLOWING LANGUAGE PER PRM 15-1 DESCRIBES THE COMPUTATION OF COSTS PER THE MEDICARE COST REPORT: TOTAL ALLOWABLE COSTS OF A PROVIDER ARE APPORTIONED BETWEEN PROGRAM BENEFICIARIES AND OTHER PATIENTS SO THAT THE SHARE BORNE BY THE PROGRAM IS BASED UPON ACTUAL SERVICES RECEIVED BY PROGRAM BENEFICIARIES. THE RATIO OF COVERED BENEFICIARY CHARGES TO TOTAL PATIENT CHARGES FOR THE SERVICES OF EACH ANCILLARY DEPARTMENT IS APPLIED TO THE COST OF THE DEPARTMENT. ADDED TO THIS AMOUNT IS THE COST OF ROUTINE SERVICES FOR PROGRAM BENEFICIARIES, DETERMINED ON THE BASIS OF A SEPARATE AVERAGE COST PER DIEM FOR ALL PATIENTS FOR GENERAL ROUTINE PATIENT CARE AREAS. ANOTHER FACTOR CONSIDERED IS A SEPARATE AVERAGE COST PER DIEM FOR EACH INTENSIVE CARE UNIT, CORONARY CARE UNIT, AND OTHER SPECIAL CARE INPATIENT HOSPITAL UNITS. COMMONSPIRIT HEALTH AND ITS SUBORDINATE CORPORATIONS BELIEVE THAT THE ENTIRE MEDICARE SHORTFALL FOR THE CONSOLIDATED ENTITIES, CONSTITUTES COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY COMMONSPIRIT HEALTH HOSPITALS IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITIES. THE HOSPITALS PROVIDE CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVE THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. FLAGET HEALTHCARE, INC.'S SHORTFALL, AS REPORTED ON PART III, SECTION B, LINE 7, OF $3,965,237 REPRESENTS THE FILING ORGANIZATION'S MEDICARE COST REPORTS. PART III, LINE 9B: THE ORGANIZATION'S BILLING AND COLLECTIONS POLICY APPLIES TO ALL INDIVIDUALS PRESENTING FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. THE POLICY CONTAINS PROVISIONS FOR COLLECTING AMOUNTS DUE FROM THOSE PATIENTS WHO THE ORGANIZATION KNOWS TO QUALIFY FOR FINANCIAL ASSISTANCE EITHER THROUGH THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS OR THROUGH PRESUMPTIVE ELIGIBILITY PROCESSES. BEFORE ENGAGING IN EXTRAORDINARY COLLECTION ACTIONS (ECAS) TO OBTAIN PAYMENT FOR EMCARE, HOSPITAL FACILITIES MUST MAKE REASONABLE EFFORTS THROUGH ITS BILLING AND COLLECTIONS PROCESSES, PURSUANT TO TREAS. REG. 1.501(R)-6(C), TO DETERMINE WHETHER AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE. IN NO EVENT WILL AN ECA BE INITIATED PRIOR TO 120 DAYS FROM THE DATE THE FACILITY PROVIDES THE FIRST POST-DISCHARGE BILLING STATEMENT (I.E., DURING THE NOTIFICATION PERIOD) UNLESS ALL REASONABLE EFFORTS HAVE BEEN MADE.HOSPITAL FACILITIES WILL NOT REFER ACCOUNTS FOR COLLECTION WHERE THE PATIENT HAS INITIALLY APPLIED FOR FINANCIAL ASSISTANCE, AND THE HOSPITAL FACILITY HAS NOT YET MADE REASONABLE EFFORTS WITH RESPECT TO THE ACCOUNT. FOR PATIENTS AND GUARANTORS WHO ARE UNABLE TO PROVIDE REQUIRED DOCUMENTATION, A HOSPITAL FACILITY MAY GRANT PRESUMPTIVE FINANCIAL ASSISTANCE BASED ON INFORMATION OBTAINED FROM OTHER RESOURCES. PATIENTS WHO QUALIFY FOR MEDICAID ARE PRESUMED TO QUALIFY FOR FULL CHARITY WRITE OFF. ANY CHARGES FOR DAYS OR SERVICES WRITTEN OFF (EXCLUDING MEDICAID DENIALS RELATED TO TIMELINESS OF BILLING, INSUFFICIENT MEDICAL RECORD DOCUMENTATION, MISSING INVOICES, AUTHORIZATION, OR ELIGIBILITY ISSUES) AS A RESULT OF A MEDICAID ARE BOOKED AS CHARITY.SOME MEDICAID PLANS OFFER COVERAGE FOR A LIMITED OR RESTRICTED LIST OF SERVICES. IF A PATIENT IS ELIGIBLE FOR MEDICAID, ANY CHARGES FOR DAYS OR SERVICES NOT COVERED BY THE PATIENT'S COVERAGE MAY BE WRITTEN OFF TO CHARITY WITHOUT A COMPLETED APPLICATION. THIS DOES NOT INCLUDE ANY SHARE OF COST (SOC) OR OTHER PATIENT COST-SHARING AMOUNTS SUCH AS DEDUCTIBLES OR COPAYMENTS, AS SUCH COSTS ARE DETERMINED BY THE STATE TO BE AN AMOUNT THAT THE PATIENT MUST PAY BEFORE THE PATIENT IS ELIGIBLE FOR MEDICAID. HEALTH AND HUMAN SERVICES (HSS) USES THE TERM "SPEND DOWN" INSTEAD OF SHARE OF COST.ALL COLLECTION ACTIVITIES CONDUCTED BY THE FACILITY, A DESIGNATED SUPPLIER, OR ITS THIRD-PARTY COLLECTION AGENTS WILL BE IN CONFORMANCE WITH ALL FEDERAL AND STATE LAWS GOVERNING DEBT COLLECTION PRACTICES. ALL THIRD-PARTY AGREEMENTS GOVERNING COLLECTION AND RECOVERY ACTIVITIES MUST INCLUDE A PROVISION REQUIRING COMPLIANCE WITH THE HOSPITAL FACILITIES' FINANCIAL ASSISTANCE AND BILLING AND COLLECTIONS POLICY AND INDEMNIFICATION FOR FAILURES AS A RESULT OF ITS NONCOMPLIANCE. THIS INCLUDES, BUT IS NOT LIMITED TO, AGREEMENTS BETWEEN THIRD PARTIES WHO SUBSEQUENTLY SELL OR REFER DEBT OF THE HOSPITAL FACILITY. PART VI, LINE 2: CHI SAINT JOSEPH HEALTH (FLAGET MEMORIAL HOSPITAL) IS INVOLVED WITH EACH COMMUNITY THROUGH SERVING ON COMMITTEES, BOARDS, ETC. WE ARE ASTUTELY AWARE THAT CONCERNS/CHALLENGES ARISE OUTSIDE THE CHNA AND WE OFTEN ASSIST IN ADDRESSING THESE CHALLENGES SUCH AS COVID EDUCATION FOR THE COMMUNITY. PART VI, LINE 3: NOTIFICATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE FROM CHI HOSPITAL ORGANIZATIONS SHALL BE DISSEMINATED BY VARIOUS MEANS, WHICH MAY INCLUDE, BUT NOT BE LIMITED TO: * CONSPICUOUS PUBLICATION OF NOTICES IN PATIENT BILLS; * NOTICES POSTED IN EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING/REGISTRATION DEPARTMENTS, BUSINESS OFFICES, AND AT OTHER PUBLIC PLACES AS A HOSPITAL FACILITY MAY ELECT; AND * PUBLICATION OF A SUMMARY OF THIS POLICY ON THE HOSPITAL FACILITY'S WEBSITE AND AT OTHER PLACES WITHIN THE COMMUNITIES SERVED BY THE HOSPITAL FACILITY AS IT MAY ELECT. SUCH NOTICES AND SUMMARY INFORMATION SHALL INCLUDE A CONTACT NUMBER AND SHALL BE PROVIDED IN ENGLISH, SPANISH, AND OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVED BY AN INDIVIDUAL HOSPITAL FACILITY, AS APPLICABLE. REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE MAY BE MADE BY ANY MEMBER OF THE CHI HOSPITAL ORGANIZATION NON-MEDICAL OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR ASSISTANCE MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS.IN ADDITION, HOSPITAL REGISTRATION CLERKS ARE TRAINED TO PROVIDE CONSULTATION TO THOSE WHO HAVE NO INSURANCE OR POTENTIALLY INADEQUATE INSURANCE CONCERNING THEIR FINANCIAL OPTIONS INCLUDING APPLICATION FOR MEDICAID AND FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY. COUNSELORS ASSIST MEDICARE ELIGIBLE PATIENTS IN ENROLLMENT BY PROVIDING REFERRALS TO THE APPROPRIATE GOVERNMENT AGENCIES. ONCE IT IS DETERMINED THAT THE PATIENT DOES NOT QUALIFY FOR ANY THIRD PARTY FUNDING, THE PATIENT IS VERBALLY NOTIFIED ABOUT THE EXISTENCE OF FINANCIAL ASSISTANCE APPLICATION AND ADDITIONAL SCREENING TAKES PLACE BY A HOSPITAL EMPLOYEE TO DETERMINE IF THE PATIENT IS ELIGIBLE FOR CHARITY SERVICE PRIOR TO DISCHARGE. UPON REGISTRATION (AND ONCE ALL EMTALA REQUIREMENTS ARE MET), PATIENTS WHO ARE IDENTIFIED AS UNINSURED (AND NOT COVERED BY MEDICARE OR MEDICAID) ARE PROVIDED WITH A PACKET OF INFORMATION THAT ADDRESSES THE FINANCIAL ASSISTANCE POLICY, THE PLAIN LANGUAGE SUMMARY OF THAT POLICY, AND AN APPLICATION FOR ASSISTANCE. HOSPITAL REGISTRATION CLERKS READ THE ORGANIZATION'S MEDICAL ASSISTANCE POLICY TO THOSE WHO APPEAR TO BE INCAPABLE OF READING, AND PROVIDE TRANSLATORS FOR NON-ENGLISH-SPEAKING INDIVIDUALS. PATIENTS THAT HAVE BEEN DISCHARGED PRIOR TO CHARITY SCREENING, SUCH AS EMERGENCY ROOM PATIENTS, RECEIVE A WRITTEN NOTIFICATION OF POSSIBLE ELIGIBILITY FOR SERVICES. IF THE PATIENT IS DETERMINED NOT TO BE ELIGIBLE FOR GOVERNMENT ASSISTANCE, HE/SHE MAY NOTIFY THE HOSPITAL THAT THEY SEEK CHARITY ASSISTANCE. THE APPROPRIATE CHARITY FORM IS SENT TO THE PATIENT/GUARANTOR FOR COMPLETION AND THEN RETURNED TO THE HOSPITAL FOR EVALUATION AND QUALIFICATION. ONCE DETERMINATION OF ELIGIBILITY IS MADE, THE PATIENT IS SENT A NOTICE INFORMING HIM/HER IF THEY QUALIFY FOR FULL, PARTIAL, OR NO CHARITY CARE SERVICES.HOSPITAL FACILITIES MUST MAKE REASONABLE EFFORTS THROUGH ITS BILLING AND COLLECTIONS PROCESSES, PURSUANT TO TREAS. REG. 1.501(R)-6(C), TO DETERMINE WHETHER ANY INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE. PART VI, LINE 4: KENTUCKY COUNTY: NELSON (RURAL) [SEE LINK 1 BELOW]POPULATION: 46,738 [SEE LINK 2 BELOW]AVERAGE MEDIAN HOUSEHOLD INCOME: $60,127 [SEE LINK 2 BELOW]% OF FAMILIES LIVING BELOW POVERTY: 9.2% OR 4,299 [SEE LINK 2 BELOW]% UNINSURED <65 YEARS OLD: 6.3% [SEE LINK 2 BELOW]% OF MEDICAID RECIPIENTS: - 29.45% OR 13,767 [SEE LINK 3 BELOW]# OF HOSPITALS SERVING THE COMMUNITY: 1+FQHC: YES (5) [SEE LINK 4 BELOW][LINK1]: HTTPS://WWW.HRSA.GOV/SITES/DEFAULT/FILES/HRSA/RURALHEALTH/RESOURCES/FORHPELIGIBLEAREAS.PDF[LINK 2]: HTTPS://WWW.CENSUS.GOV/QUICKFACTS/FACT/TABLE/NELSONCOUNTYKENTUCKY,LEXINGTONFAYETTEURBANCOUNTYKENTUCKY/PST045221[LINK 3]: HTTPS://CHFS.KY.GOV/AGENCIES/DMS/STATS/KYDWMMCC122021.PDF[LINK 4]: HTTPS://DATA.HRSA.GOV/DATA/REPORTS/DATAGRID?GRIDNAME=FQHCS PART VI, LINE 5: CHI SAINT JOSEPH HEALTH (FLAGET MEMORIAL HOSPITAL) ENCOURAGES ALL EMPLOYEES, PARTICULARLY LEADERS, TO BE INVOLVED IN THEIR COMMUNITIES. THE MAJORITY OF SENIOR LEADERSHIP SERVE ON A COMMITTEE OR BOARD THAT ADVANCES HEALTH AND IN ACCORD WITH OUR MISSION AND CORE VALUES.CHI SAINT JOSEPH HEALTH (FLAGET MEMORIAL HOSPITAL) PARTNERS WITH SUPPLIES OVER SEAS AND GIFTS SLIGHTLY USED MEDICAL EQUIPMENT AND OTHER SUPPLIES THAT ARE NOT EXPIRED, BUT NO LONGER IN CIRCULATION AT A FACILITY.CHI SAINT JOSEPH HEALTH FACILITIES ARE OPEN TO ACCEPTING STUDENTS IN ROTATIONS IN ALL AREAS, WITH A MAJORITY BEING IN THE NURSING FIELD.CHI SAINT JOSEPH HEALTH HAS A COMMUNITY RELATIONS COMMITTEE THAT MEETS ONCE A MONTH TO REVIEW AND DECIDE ON REQUESTED DONATIONS THAT AGAIN, REFLECTS OUR MISSION, CORE VALUES AND ADDRESS SOME ASPECT OF OUR COMMUNITY HEALTH NEEDS ASSESSMENT. PART VI, LINE 6: THE ORGANIZATION IS AFFILIATED WITH COMMONSPIRIT HEALTH. COMMONSPIRIT HEALTH WAS CREATED BY THE ALIGNMENT OF CATHOLIC HEALTH INITIATIVES AND DIGNITY HEALTH IN EARLY 2019. COMMONSPIRIT HEALTH, A NONPROFIT, FAITH-BASED HEALTH SYSTEM IS COMMITTED TO BUILDING HEALTHIER COMMUNITIES, ADVOCATING FOR THOSE WHO ARE POOR AND VULNERABLE, AND INNOVATING HOW AND WHERE HEALING CAN HAPPEN BOTH INSIDE ITS HOSPITALS AND OUT IN THE COMMUNITY. COMMONSPIRIT HEALTH OWNS AND OPERATES HEALTH CARE FACILITIES IN 21 STATES AND IS THE SOLE CORPORATE MEMBER (PARENT CORPORATION) OF OTHER PRIMARILY NONPROFIT CORPORATIONS THAT ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES. COMMONSPIRIT HEALTH IS COMPRISED OF MORE THAN 1,500 CARE SITES, CONSISTING OF 140 HOSPITALS, INCLUDING ACADEMIC HEALTH CENTERS, MAJOR TEACHING HOSPITALS, AND CRITICAL ACCESS FACILITIES, COMMUNITY HEALTH SERVICES ORGANIZATIONS, ACCREDITED NURSING COLLEGES, HOME HEALTH AGENCIES, LIVING COMMUNITIES, A MEDICAL FOUNDATION AND OTHER AFFILIATED MEDICAL GROUPS, AND OTHER FACILITIES AND SERVICES THAT SPAN THE INPATIENT AND OUTPATIENT CONTINUUM OF CARE. IN FISCAL YEAR 2021, COMMONSPIRIT HEALTH PROVIDED MORE THAN $2.5 BILLION IN FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT FOR PROGRAMS AND SERVICES FOR THE POOR, FREE CLINICS, EDUCATION AND RESEARCH. FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT TOTALED MORE THAN $5.1 BILLION WITH THE INCLUSION OF THE UNPAID COSTS OF MEDICARE. THE HEALTH SYSTEM, WHICH GENERATED OPERATING REVENUES OF $33.25 BILLION IN FISCAL YEAR 2021, HAS TOTAL ASSETS OF APPROXIMATELY $54.87 BILLION.COMMONSPIRIT HEALTH PROVIDES STRATEGIC PLANNING AND MANAGEMENT SERVICES AS WELL AS CENTRALIZED SERVICES FOR ITS DIVISIONS. THE PROVISION OF CENTRALIZED MANAGEMENT AND SHARED SERVICES INCLUDING AREAS SUCH AS ACCOUNTING, HUMAN RESOURCES, PAYROLL AND SUPPLY CHAIN PROVIDES ECONOMIES OF SCALE AND PURCHASING POWER TO THE DIVISIONS. THE COST SAVINGS ACHIEVED THROUGH COMMONSPIRIT HEALTH'S CENTRALIZATION ENABLE DIVISIONS TO DEDICATE ADDITIONAL RESOURCES TO HIGH-QUALITY HEALTH CARE AND COMMUNITY OUTREACH SERVICES TO THE MOST VULNERABLE MEMBERS OF OUR SOCIETY. SCHEDULE H, PART VI, LINE 7: NA KENTUCKY DOES NOT REQUIRE FILING OF A COMMUNITY BENEFIT REPORT, BUT IT IS AVAILABLE ONLINE AT HTTPS://WWW.CHISAINTJOSEPHHEALTH.ORG/HEALTHYCOMMUNITIES 1 BARDSTOWN MAINSTREET PROGRAM ONE COURT SQUARE BARDSTOWN KY 40004 611332010 501(C)(6) 10400 SPONSORSHIP NELSON CO SCHOOLS COMM SUPPORT 288 WILDCAT LANE BARDSTOWN KY 40004 202903210 501(C)(3) 6250 SPONSORSHIP 1 1 PART I, LINE 2: THE ORGANIZATION MADE GRANTS TO 501(C)(3) AND 501(C)(6) ORGANIZATIONS. UPON PROVIDING SATISFACTORY WRITTEN EVIDENCE THAT THE FUNDS WERE USED FOR THE PURPOSE THE GRANT WAS MADE, THE HOSPITAL RELEASES THE RESTRICTION AND THE FUNDS ARE TRANSFERRED. THE ORGANIZATION ALSO PROVIDES FINANCIAL ASSISTANCE IN ACCORDANCE WITH THE CHI FINANCIAL ASSISTANCE POLICY TO INDIVIDUALS WHO ARE ELIGIBLE FOR FREE OR DISCOUNTED CARE. 1 1 0 0 0 0 0 0 0 LARRY SCHUMACHER DIRECTOR 0 1053841 0 748629 0 160307 0 197895 0 22399 0 2183071 0 140400 BRUCE TASSIN MARKET CEO/DIRECTOR (PARTIAL YEAR) 0 651174 0 383221 0 75497 0 79143 0 20567 0 1209602 0 59148 MONTE MARTIN MD ONCOLOGIST 0 1020325 0 0 0 2006 0 16674 0 20970 0 1059975 0 0 STEVE FRANTZ TREASURER (PARTIAL YEAR) 0 254730 0 110753 0 442559 0 14486 0 17454 0 839982 0 0 COLLEEN HOLTON FORMER TREASURER/CFO 0 93516 0 71081 0 515043 0 10593 0 8521 0 698754 0 0 JENNIFER NOLAN PRESIDENT FLAGET 0 377675 0 118277 0 27705 0 19093 0 25686 0 568436 0 0 SHARON HAGER SECRETARY/DIV VP SR COUNSEL 0 380020 0 137905 0 3608 0 18514 0 9886 0 549933 0 0 SHELLEY STANKO MD DIRECTOR 0 343028 0 0 0 1140 0 16837 0 26068 0 387073 0 0 CHRISTY SPITSER TREASURER/MARKET VP OF FINANCE 0 285137 0 54775 0 922 0 16908 0 28140 0 385882 0 0 SCOTT MONTGOMERY PHYSICIST 6063 236838 0 625 0 533 7163 0 341 12826 13567 250822 0 0 PAULA JOHNSON MD INTERNAL MED-GENERAL 0 220107 0 0 0 1132 0 12762 0 36 0 234037 0 0 WILLIAM GEORGE SECRETARY 0 176177 0 34233 0 329 0 9377 0 8649 0 228765 0 0 MELINDA EVANS FORMER VP FINANCE 0 176067 0 19503 0 567 0 9189 0 10734 0 216060 0 0 KAMI POOLE-WARDER VP-PATIENT CARE SERVICES 155748 0 19213 0 758 0 11258 0 27434 0 214411 0 0 0 MICHELLE MATTINGLY DIRECTOR, PHARMACY 163665 0 12247 0 1095 0 4553 0 16954 0 198514 0 0 0 ELIJAH MARTIN PHYSICIST 35422 130384 0 0 0 765 2016 0 1729 6565 39167 137714 0 0 MELINDA OBRYAN PHARMACIST 138813 0 625 0 106 0 8466 0 24518 0 172528 0 0 0 PART I, LINE 3 DURING THE CALENDAR YEAR 2020, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY ST. JOSEPH HEALTH SYSTEM, INC., A RELATED ORGANIZATION. ST. JOSEPH HEALTH SYSTEM, INC. USED THE FOLLOWING TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) INDEPENDENT COMPENSATION CONSULTANT; (2) COMPENSATION SURVEY OR STUDY; (3) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINES 4A-B LINE 4A FOR REPORTABLE INDIVIDUALS EMPLOYED PRIOR TO 2019, POST-TERMINATION PAYMENTS ARE ADDRESSED IN EXECUTIVE EMPLOYMENT AGREEMENTS FOR EMPLOYEES AT THE LEVEL OF VICE PRESIDENT AND ABOVE. THESE EMPLOYMENT AGREEMENTS REQUIRE THAT IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT AGREEMENT. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. OFFICERS, KEY EMPLOYEES AND CERTAIN HIGHLY COMPENSATED EMPLOYEES WHO BEGAN EMPLOYMENT AFTER NOVEMBER 1ST OF 2019 ARE COVERED BY THE COMMONSPIRIT HEALTH EXECUTIVE SEVERANCE POLICY. THIS POLICY PROVIDES FOR SEVERANCE PAY WHICH VARIES BASED UPON THE EXECUTIVE'S POSITION LEVEL, IN THE EVENT OF A POSITION ELIMINATION OR OTHER QUALIFYING EVENT, IN ACCORDANCE WITH THE GUIDELINES OF THE EXECUTIVE SEVERANCE POLICY. AN EXECUTIVE'S WRITTEN EMPLOYMENT OR SEVERANCE AGREEMENT SHALL CONTROL WHERE THE SEVERANCE PAY AMOUNTS IN THE POLICY CONFLICT WITH THE EXECUTIVE'S WRITTEN EMPLOYMENT OR SEVERANCE AGREEMENT. IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT OF CLAIMS. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS FROM COMMONSPIRIT HEALTH (A RELATED ORGANIZATION) DURING THE 2020 CALENDAR YEAR, AND THESE SEVERANCE PAYMENTS WERE INCLUDED IN THE INDIVIDUALS' W-2 INCOME AND REPORTABLE COMPENSATION ON PART VII AND SCHEDULE J, PART II, COLUMN (B)(III): COLLEEN HOLTON, $510,876; STEVEN FRANTZ, $438,115. LINE 4B DURING THE 2020 CALENDAR YEAR, COMMONSPIRIT HEALTH ("COMMONSPIRIT") MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR DIVISION CEOS/PRESIDENTS AND OTHER DESIGNATED COMMONSPIRIT EXECUTIVES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. DURING 2020 THE FOLLOWING DISTRIBUTIONS WERE MADE BY COMMONSPIRIT FROM THE DEFERRED COMPENSATION PLAN: BRUCE TASSIN, $71,414; LARRY SCHUMACHER, $142,712. DUE TO THE "SUPER" VESTING RULES UNDER COMMONSPIRIT'S DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS INVOLUNTARY TERMINATION WITHOUT CAUSE, AGE, AGE AND YEARS OF SERVICE, OR MORE THAN 5 YEARS OF PLAN PARTICIPATION ARE ELIGIBLE TO RECEIVE THEIR 2020 CONTRIBUTIONS IN CASH. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION ON SCHEDULE J PART II. DURING 2020, THE FOLLOWING PAYMENTS WERE MADE PURSUANT TO THE SUPER VESTING RULES: JENNIFER NOLAN, $22,894. X VARIOUS ITEMS FROM EVENING OF HOPE EVENT 31 38539 FMV X VENTILATOR 1 25352 FMV 0 1 0 FORM 990, PART VI, SECTION A, LINE 1 PURSUANT TO SECTION 7.1 OF THE BYLAWS OF FLAGET HEALTHCARE, INC., THE BOARD OF DIRECTORS MAY, BY RESOLUTION ADOPTED BY A MAJORITY OF THE DIRECTORS THEN IN OFFICE, ESTABLISH ONE OR MORE COMMITTEES, AS NEEDED OR REQUIRED TO CONDUCT AND TRANSACT THE BUSINESS OF THE CORPORATION. EXCEPT AS OTHERWISE PROVIDED IN THESE BYLAWS, THE BOARD OF DIRECTORS MAY SET THE QUALIFICATIONS FOR MEMBERSHIP ON ANY COMMITTEE IT MAY ESTABLISH; PROVIDED THAT EACH COMMITTEE SHALL CONSIST OF AT LEAST TWO (2) DIRECTORS OF THE CORPORATION. COMMITTEES MAY INCLUDE PERSONS OTHER THAN DIRECTORS, EXCEPT THAT A COMMITTEE THAT HAS THE AUTHORITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS MUST INCLUDE ONLY DIRECTORS OF THE CORPORATION. MINUTES OF ALL COMMITTEE MEETINGS SHALL BE RECORDED AND COPIES OF SUCH MINUTES SHALL BE PROVIDED TO THE BOARD OF DIRECTORS. ACTIONS OF COMMITTEES SHALL BE REPORTED TO THE FULL BOARD OF DIRECTORS, BUT ACTIONS OF COMMITTEES WHICH INCLUDE PERSONS OTHER THAN DIRECTORS SHALL BE SUBJECT TO RATIFICATION BY THE FULL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 ACCORDING TO THE BYLAWS OF FLAGET HEALTHCARE INC., THE ENTITY'S SOLE MEMBER IS KENTUCKYONE HEALTH INC., A KENTUCKY NONPROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS SHALL BE APPOINTED OR REFUSED BY THE CORPORATE MEMBER. THE CORPORATE MEMBER MAY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS, AND MAY AT ANY TIME REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS. ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS OF THE CORPORATION SHALL BE APPOINTED BY THE CORPORATE MEMBER NO LATER THAN JUNE 30 OF EACH YEAR. THE NAMES AND QUALIFICATIONS OF EACH INDIVIDUAL ACCEPTED BY THE BOARD OF DIRECTORS SHALL BE SUBMITTED TO THE CORPORATE MEMBER, WHO SHALL APPOINT OR REFUSE EACH NOMINEE IN ACCORDANCE WITH THE CORPORATE MEMBER'S BYLAWS. THE CORPORATE MEMBER MAY UNILATERALLY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS SHOULD THE BOARD FAIL TO FURNISH THE CORPORATE MEMBER WITH A LIST OF INDIVIDUALS QUALIFIED TO SERVE ON THE BOARD OF DIRECTORS OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B FLAGET HEALTHCARE, INC'S CORPORATE MEMBER IS KENTUCKYONE HEALTH, INC. PURSUANT TO SECTION 4.4.1 OF THE ORGANIZATION'S BYLAWS, NEITHER THE BOARD NOR ANY OFFICER OR EMPLOYEE OF THE CORPORATION NOR ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION SHALL TAKE ANY ACTION EITHER IN CONTRADICTION OF ANY OF THE FOREGOING POWERS, OR WITHOUT FIRST HAVING SECURED THE NECESSARY APPROVALS OR GIVEN THE APPROPRIATE NOTIFICATIONS AS MAY BE REQUIRED BY THESE BYLAWS. IN ADDITION, PURSUANT TO SECTION 4.4.2 OF THE ORGANIZATION'S BYLAWS, IN EXERCISE OF ITS APPROVAL POWERS, THE CORPORATE MEMBER MAY GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND THE PRESIDENT OF THE CORPORATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE. FORM 990, PART VI, SECTION B, LINE 11B ONCE THE RETURN IS PREPARED, IT IS REVIEWED BY THE VP OF FINANCE AND AN ELECTRONIC COPY IS PROVIDED TO EACH BOARD MEMBER. AFTER THE RETURN IS REVIEWED BY THE VP OF FINANCE, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NONSUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RESUBMITTED TO THE BOARD. SUBSEQUENT TO THE RETURN BEING FILED, THE PRESIDENT/CEO OF THE KENTUCKYONE HEALTH, INC., THE SOLE MEMBER OF THE ORGANIZATION, PRESENTS THE RETURN AT A SAINT JOSEPH HEALTH SYSTEM, INC. BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICTS OF INTEREST ("COI") POLICY (THE "POLICY") IN PLACE TO PROTECT THE INTERESTS OF COMMONSPIRIT HEALTH ("COMMONSPIRIT") IN CIRCUMSTANCES THAT MAY RESULT IN A CONFLICT BETWEEN PERSONAL INTERESTS OF A PERSON AND THE INTERESTS OF THE ORGANIZATION AND THOSE IT SERVES. THE POLICY WAS LAST UPDATED DURING THE TAX YEAR ENDED 6/30/2021. COMMONSPIRIT'S COI POLICY APPLIES TO COMMONSPIRIT, ITS DIRECT AFFILIATES AND SUBSIDIARIES AND ANY RELATED ENTITY THE GOVERNING DOCUMENTS OF WHICH REQUIRE THE ENTITY TO COMPLY WITH COMMONSPIRIT POLICY (COLLECTIVELY THE "SYSTEM ENTITIES"). THE FOLLOWING PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AT LEAST ANNUALLY (VIA A FORMAL SYSTEM-ADMINISTERED SURVEY) IF THE PERSON'S AFFILIATION WITH COMMONSPIRIT CONTINUES: - MEMBERS OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF COMMITTEES OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF THE EXECUTIVE LEADERSHIP TEAM ("ELT") OF COMMONSPIRIT - CORPORATE OFFICERS OF SYSTEM ENTITIES - KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES AS SPECIFIED BY THE INTERNAL REVENUE SERVICE FOR FORM 990 PURPOSES WHO ARE NOT OTHERWISE INCLUDED IN THE CATEGORIES ABOVE - EMPLOYEES OF SYSTEM ENTITIES AT THE VICE PRESIDENT LEVEL AND ABOVE - ALL INDIVIDUALS ENGAGED IN RESEARCH AT INSTITUTIONS OWNED OR OPERATED BY A SYSTEM ENTITY - SELECT EMPLOYEES AS DETERMINED FROM TIME TO TIME BY LEADERSHIP DISCLOSURE, REVIEW, AND MANAGEMENT OF PERCEIVED, POTENTIAL, OR ACTUAL CONFLICTS OF INTEREST ARE ACCOMPLISHED THROUGH A DEFINED COI DISCLOSURE REVIEW PROCESS. EACH PERSON IS REQUIRED TO PROMPTLY AND FULLY DISCLOSE ANY SITUATION OR CIRCUMSTANCE THAT MAY CREATE A CONFLICT OF INTEREST AS SOON AS SHE/HE BECOMES AWARE OF IT. IN ADDITION, AT THE INCEPTION OF AN INDIVIDUAL'S RELATIONSHIP WITH COMMONSPIRIT (E.G. HIRING, BOARD APPOINTMENT), AND FOR CERTAIN POSITIONS, ANNUALLY THEREAFTER, WRITTEN CONFLICT OF INTEREST DISCLOSURE FORMS MUST BE COMPLETED. A FAILURE TO DISCLOSE MAY RESULT IN DISCIPLINARY OR CORRECTIVE ACTIONS. REPORTED POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE INITIALLY REVIEWED BY LEGAL, CORPORATE RESPONSIBILITY OR RESEARCH INTEGRITY STAFF. IF NECESSARY, A CONFLICT OF INTEREST MANAGEMENT PLAN IS DEVELOPED, WHICH PLAN SHALL BE SUBJECT TO ACCEPTANCE BY THE APPROPRIATE DIRECT MANAGER, SUPERVISOR, MEDICAL STAFF OFFICE, BOARD OR BOARD COMMITTEE (FOR BOARD, BOARD COMMITTEE, ELT OR CORPORATE OFFICER CONFLICTS), OR OTHER APPROPRIATE INDIVIDUAL OR BODY. ONCE ACCEPTED, THE CONFLICT OF INTEREST MANAGEMENT PLAN IS COMMUNICATED TO THE PERSON WITH THE ACTUAL OR POTENTIAL CONFLICT AND THE INDIVIDUAL MUST CONDUCT THEMSELVES IN CONFORMITY WITH THE PLAN. IN THE EVENT THAT A TRANSACTIONAL CONFLICT INTEREST ARISES IN CONNECTION WITH A SYSTEM ENTITY BOARD MEETING, THE CONFLICTED INDIVIDUAL MUST DISCLOSE THAT CONFLICT PRIOR TO OR AT THE BEGINNING OF THE MEETING IN WHICH THE MATTER IS TO BE CONSIDERED. THE CONFLICTED INDIVIDUAL IS EXCLUDED FROM VOTING ON THE TRANSACTION AND IS PROHIBITED FROM USING PERSONAL INFLUENCE WITH RESPECT TO THE MATTER, BUT IS NOT PROHIBITED FROM PROVIDING INPUT IF REQUESTED TO DO SO. FORM 990, PART VI, SECTION B, LINE 15 LINE 15A THE ORGANIZATION'S CEO IS PAID BY ST. JOSEPH HEALTH SYSTEM, INC., A RELATED ORGANIZATION. ST. JOSEPH HEALTH SYSTEM, INC'S EXECUTIVE LEADERSHIP COMPENSATION IS REVIEWED BY THE EXECUTIVE COMMITTEE TO THE BOARD. AN OUTSIDE CONSULTANT PROVIDED COMPARATIVE DATA BASED ON BASE COMPENSATION, TOTAL COMPENSATION, AND EXECUTIVE BENEFITS. LINE 15B DURING THE TAX YEAR ENDED 6/30/2021, NO OFFICERS, DIRECTORS OR TRUSTEES RECEIVED COMPENSATION FROM THE ORGANIZATION. ANY EXECUTIVE COMPENSATION PAID TO OFFICERS, DIRECTORS OR TRUSTEES BY RELATED ORGANIZATIONS WAS SET BY THE RELATED ORGANIZATION'S COMPENSATION COMMITTEE UTILIZING BOTH AN INDEPENDENT CONSULTANT AND COMPARABILITY STUDIES TO DETERMINE COMPENSATION. THEREFORE, THESE QUESTIONS ARE MORE APPROPRIATELY ANSWERED AS N/A. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.COMMONSPIRIT.ORG. FORM 990, PART IX, LINE 11G OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 4,063,606. MANAGEMENT AND GENERAL EXPENSES 1,599,186. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,662,792. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 564,517. MANAGEMENT AND GENERAL EXPENSES 162,953. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 727,470. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 5,824,844. MANAGEMENT AND GENERAL EXPENSES 1,681,398. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,506,242. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,760,605. MANAGEMENT AND GENERAL EXPENSES 796,876. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,557,481. CONSULTING: PROGRAM SERVICE EXPENSES 18,799. MANAGEMENT AND GENERAL EXPENSES 5,427. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 24,226. FORM 990, PART XI, LINE 9: OTHER CHANGES 2,056. INTERCOMPANY CLEARING ADJUSTMENT 7,290,288. REALLOCATION OF CARES ACT REVENUE -76,861. FORM 990, PART XI, LINE 8: PRIOR PERIOD ADJUSTMENT: CENTRALIZED TRANSACTIONS: TRANSFERS FOR JOURNAL ENTRIES RECORDED CENTRALLY AT COMMONSPIRIT TO STANDARDIZE CONTRACTUAL ALLOWANCE METHODOLOGY ACROSS ALL COMMONSPIRIT AFFILIATES AND SUBSIDIARIES. RECORDED CENTRALLY AT YEAR END AND TRANSFERRED TO FACILITIES IN THE FOLLOWING YEAR. FLAGET RADIATION ONCOLOGY LLC 4305 NEW SHEPHERDSVILLE ROAD BARDSTOWN KY 40004 000000000 ONCOLOGY KY 0 0 FH ALEGENT CREIGHTON CLINIC 12809 W DODGE RD OMAHA NE 68154 470765154 HOSPITAL NE 501(C)(3) LINE 3 ACH 0 ALEGENT CREIGHTON HEALTH 12809 W DODGE RD OMAHA NE 68154 470757164 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM 7500 MERCY RD OMAHA NE 68124 470484764 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - COMM MEM HOSP OF MO VALLEYIA 631 N 8TH ST MISSOURI VALLEY IA 51555 420776568 HOSPITAL IA 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - IMMANUEL MEDICAL CENTER 6901 N 72ND ST OMAHA NE 68122 470376615 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER 104 W 17TH ST SCHUYLER NE 68661 470399853 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA PO BOX 368 CORNING IA 50841 420782518 HOSPITAL IA 501(C)(3) LINE 3 CHI NEBRASKA 0 ALVERNA APARTMENTS 300 SE 8TH AVE 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