2021-04-29T18:09:39-05:00 2020-06-30 430352985 KERBER ECK & BRAECKEL LLP 3401 OFFICE PARK DRIVE MARION IL 62959 990 2019-07-01 237246265 SAINT FRANCIS MEDICAL CENTER SAIN 5733313000 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 JUSTIN DAVISON CHIEF FINANCIAL OFFICER 5733313000 2021-04-09 1 AMBER HALSTEAD P01343727 6189938724 2021-04-09 2019 2022-09-23 18:48:47Z MARYANN REESE 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 694385855 0 X WWW.SFMC.NET X 1972 MO THE MISSION OF SAINT FRANCIS MEDICAL CENTER IS TO PROVIDE A MINISTRY OF HEALING, WELLNESS, QUALITY AND LOVE INSPIRED BY OUR FAITH IN JESUS CHRIST. 11 8 3558 109 17250011 0 278537 11947487 545808319 499807186 34722756 16966218 4475864 2812411 585285476 531533302 0 0 0 0 244577767 254658134 0 0 0 282843992 243641804 527421759 498299938 57863717 33233364 990506091 1022809384 237532535 242522266 752973556 780287118 X SAINT FRANCIS MEDICAL CENTER IS A 306-BED FACILITY SERVING MORE THAN 650,000 PEOPLE THROUGHOUT MISSOURI, ILLINOIS, KENTUCKY, TENNESSEE, AND ARKANSAS. THE MEDICAL CENTER PROVIDES COMPREHENSIVE INPATIENT ACUTE CARE SERVICES FOR MEDICAL AND SURGICAL PATIENTS SPECIALIZING IN ORTHOPEDICS, NEUROSURGERY, CARDIOVASCULAR SERVICES, ONCOLOGY, DISEASE MANAGEMENT, GASTROENTEROLOGY, MATERNAL-CHILD HEALTH AND NEUROLOGY. 0 0 432012831 496276366 SINCE ITS FOUNDING IN 1875, SAINT FRANCIS MEDICAL CENTER'S (SFMC) MISSION HAS BEEN TO PROVIDE HEALTH CARE SERVICES TO EVERYONE, REGARDLESS OF RACE, CREED, GENDER, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF SFMC, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. IN FULFILLING OUR MISSION TO SERVE RESIDENTS OF CAPE GIRARDEAU AND THE SURROUNDING REGION, SFMC PROVIDES: -FREE AND/OR SUBSIDIZED CARE WHEN NEED AND/OR AN INDIVIDUAL'S INABILITY TO PAY COEXIST. THIS PAST YEAR, SFMC PROVIDED OVER $51.9 MILLION IN FREE AND/OR SUBSIDIZED CARE.-CARE FOR PERSONS COVERED BY GOVERNMENTAL PROGRAMS THAT REIMBURSE BELOW ACTUAL COST.-HEALTH SCREENINGS AND EDUCATIONAL PROGRAMS TO SUPPORT THE HEALTHCARE NEEDS OF THE COMMUNITY. SFMC PROVIDES A VARIETY OF WELLNESS PROGRAMS, COMMUNITY HEALTH EDUCATION ACTIVITIES, SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDER-SERVED AND PARTICIPATES IN A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. SFMC SERVED 9,684 INPATIENTS, 37,725 EMERGENCY PATIENTS AND 176,621 OUTPATIENTS DURING THE FISCAL YEAR (FY) ENDING JUNE 30, 2020. DURING FY 2020, SFMC HAD A TOTAL OF 44,120 PATIENT DAYS IN ITS MEDICAL/SURGICAL, CRITICAL CARE, OBSTETRIC, AND REHABILITATION CARE UNITS. SFMC PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS, FOR WHICH IT IS REIMBURSED BELOW COST. RECOGNIZING ITS MISSION IN THE COMMUNITY, SFMC PROVIDES SERVICES TO BOTH MEDICARE AND MEDICAID PATIENTS. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS IN EXCESS OF $72.7 MILLION IN FY 2020. CHARITY CARE IS PROVIDED IN THE FORM OF MANY REDUCED-PRICE AND FREE SERVICES OFFERED THROUGHOUT THE YEAR. SFMC STRONGLY BELIEVES THESE PROGRAMS AND SERVICES FILL A REAL NEED IN THE COMMUNITY. THESE PROGRAMS AND SERVICES INCLUDE THE FOLLOWING: -PARTICIPATION IN AND/OR SPONSORSHIP OF MANY COMMUNITY HEALTH FAIRS. THESE EVENTS RANGE FROM CHILDREN'S SPECIAL EVENTS TO SENIOR HEALTH FAIRS. THESE EVENTS DRAW SEVERAL THOUSAND ATTENDEES EACH YEAR.-SFMC SPONSORS THE REGIONAL ARTHRITIS CENTER, OFFERING INFORMATION AND ASSISTANCE TO PEOPLE THROUGHOUT SOUTHEAST MISSOURI. -FREE OR DISCOUNTED HEALTH SCREENINGS (CHOLESTEROL, BLOOD PRESSURE, GLAUCOMA, BLOOD SUGAR, ETC.) PROVIDED AT HEALTH FAIRS AND COMMUNITY HEALTH EDUCATION PROGRAMS, AS WELL AS OUR WEEKLY WEDNESDAY MORNING HEART HEALTH SCREENINGS.-COMMUNITY HEALTH FORUMS WERE OFFERED ON TOPICS SUCH AS ARTHRITIS, DIABETES, CARDIOVASCULAR FITNESS, CHILDREN'S HEALTH AND SAFETY, NUTRITION, BREAST CANCER AND OSTEOPOROSIS. OTHER WELLNESS PROGRAMS SUCH AS WEIGHT MANAGEMENT AND SMOKING CESSATION ARE SUBSIDIZED BY SFMC AND OFFERED FOR A NOMINAL FEE.-CHILDBIRTH, SIBLINGS, BREASTFEEDING AND INFANT CARE CLASSES ARE PROVIDED FREE OF CHARGE TO EXPECTANT MOTHERS AND YOUNG FAMILIES.-SFMC SPONSORS HEALTHCARE SPEAKERS FOR COMMUNITY EVENTS AND CIVIC MEETINGS. SFMC STAFF PRESENTS FREE PROGRAMS ON A VARIETY OF HEALTH AND WELLNESS TOPICS TO VARIOUS COMMUNITY, SCHOOL AND CHURCH GROUPS THROUGHOUT THE YEAR. -SEVERAL SFMC OUTPATIENT CLINICS ARE OFFERED AT REDUCED FEE OR NO COST TO PATIENTS AND THEIR FAMILIES. THE CLINICS ADDRESS DIABETIC FOOT CARE, GENETICS, ORTHOPEDICS AND SPORTS INJURIES. -SFMC PROVIDES FREE FIRST AID SERVICES AT THE WEEKLONG SEMO DISTRICT FAIR IN CAPE GIRARDEAU. MEDICAL CENTER PERSONNEL STAFF THE FIRST AID STATION AND PROVIDE MINOR MEDICAL SERVICES TO HUNDREDS OF PEOPLE DURING THE COURSE OF THE WEEK. SFMC ALSO PROVIDES STAFF AND FIRST AID MATERIALS FOR OTHER CIVIC FUNCTIONS DURING THE FISCAL YEAR. -SFMC PROVIDES FREE MEETING ROOM SPACE AND RELATED ASSISTANCE TO MANY HEALTHCARE SUPPORT GROUPS. SEVERAL HUNDRED PEOPLE REGULARLY PARTICIPATE IN THESE SUPPORT GROUPS FOR DISEASES AND DISORDERS INCLUDING BREAST CANCER, MUSCULAR DYSTROPHY, SLEEP DISTURBANCE, HEAD INJURIES, LARYNGECTOMY, HEART SURGERY, DIGESTIVE DISEASES, PARKINSON'S, ARTHRITIS, MULTIPLE SCLEROSIS AND STROKES, AS WELL AS GRIEF SUPPORT FOR PEOPLE WHO HAVE LOST A LOVED ONE TO ILLNESS, INJURY OR DISEASE. -SFMC PROVIDES FINANCIAL AND IN-KIND SUPPORT FOR ACTIVITIES OF LOCAL CHARITIES SUCH AS THE AMERICAN CANCER SOCIETY, AMERICAN DIABETES ASSOCIATION, THE AMERICAN ARTHRITIS ASSOCIATION, THE MARCH OF DIMES, THE AMERICAN HEART ASSOCIATION AND THE AMERICAN LUNG ASSOCIATION. -SCHOLARSHIPS AND TUITION REIMBURSEMENT ARE AWARDED ANNUALLY BY SFMC TO UNDERGRADUATE AND GRADUATE STUDENTS ENROLLED IN VARIOUS HEALTHCARE CURRICULUMS. THE VALUE OF THIS INVESTMENT IN THE ADVANCEMENT OF EXISTING CARE PROVIDERS AND THE EDUCATION OF FUTURE CARE PROVIDERS WAS $121,471 IN FY 2020. -SFMC SPONSORS MEDICAL MINUTE. THESE WEEKLY EDUCATIONAL PROGRAMS, PRODUCED IN COOPERATION WITH MEMBERS OF THE MEDICAL COMMUNITY, PROVIDES INFORMATION ON NEW TECHNOLOGY AND PROCEDURES, TREATMENT FOR DISEASES AND DISORDERS, AND GENERAL MEDICAL EDUCATION TO AREA PATIENTS. -SFMC PROVIDES FREE INTERNET LIBRARY SEARCHES ON HEALTHCARE TOPICS TO AREA RESIDENTS WHO DO NOT HAVE OTHER ACCESS. HOSPITAL EDUCATION STAFF CONDUCTS THE SEARCH AND FAX OR EMAIL MATERIALS. -SFMC PROVIDES EMERGENCY CARE, CLOTHING AND PHARMACEUTICALS TO CHILDREN IN NEED THROUGH THE SAINT FRANCIS FOUNDATION CHILDREN HELPING CHILDREN FUND. -DURING FY 2020 SFMC VOLUNTEERS CONTRIBUTED APPROXIMATELY 11,804 HOURS OF SERVICE TO OUR PATIENTS, THEIR FAMILIES AND THE COMMUNITY. THE VALUE OF THIS CONTRIBUTION IS ESTIMATED AT OVER $113,000 AND IS GIVEN BACK TO THE COMMUNITY THROUGH LOWER COSTS IN PATIENT CARE SERVICES AND WELLNESS PROGRAMS SUCH AS THOSE DESCRIBED ELSEWHERE IN THIS DOCUMENT. -DURING FY 2020 SFMC PROVIDED 2,650 FREE MAMMOGRAMS AND ULTRASOUNDS TO AREA WOMEN WHO COULD NOT AFFORD THIS POTENTIALLY LIFESAVING SCREENING. THE VALUE OF THIS CONTRIBUTION IS ESTIMATED AT MORE THAN $109,651. 432012831 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 1 1 0 1 0 0 0 0 1 1 0 0 0 1 203 0 1 3558 1 1 1 0 0 0 0 0 0 0 0 0 X 11 8 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X JUSTIN DAVISON 5733313000 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 KEVIN GOVERO CHAIR OF THE BOARD 2.00 4.00 X 0 0 0 DONALD KAVERMAN DIRECTOR 2.00 4.00 X 2027 0 0 WILLIAM STAHR DIRECTOR 2.00 2.00 X 0 0 0 JANET VARNON DIRECTOR 2.00 2.00 X 2297 0 0 JOEY MCLANE DIRECTOR 2.00 2.00 X 0 0 0 GINA RAFFETY DIRECTOR 2.00 2.00 X 2131 0 0 DENNIS VOLLINK SECRETARY/TREASURER OF THE BOARD 2.00 2.00 X 0 0 0 JAMES BOLLINGER JR DIRECTOR 2.00 2.00 X 5858 0 0 ADAM KIDD DIRECTOR 2.00 4.00 X 3000 0 0 STEVEN DIRNBERGER VICE CHAIR OF THE BOARD 2.00 2.00 X 0 0 0 LAURA YOUNGHOUSE DIRECTOR 2.00 4.00 X 15631 0 0 MARYANN REESE PRESIDENT & CEO 40.00 6.00 X 1180483 0 26177 STEVEN OGBURN VP OF SFMP 40.00 X 368274 0 41419 THOMAS S DIEMER MD CHIEF MEDICAL OFFICER 40.00 X 490628 0 21201 GERRY SALTER VP - SPECIALTY PRACTICES 40.00 X 267840 0 39527 STEPHANIE LAPIERRE CHIEF NURSING/CLINICAL OFFICER 40.00 X 243217 0 15328 JAMES WILFERTH VP FOUNDATION 40.00 2.00 X 240578 0 26459 JAMES BURKE CHIEF ADMINISTRATIVE OFFICER/GENERAL COUNSEL 40.00 X 611950 0 41751 LORI STURGILL CHIEF INFORMATION OFFICER 40.00 X 353614 0 21698 JUSTIN DAVISON CFO 40.00 2.00 X 38335 0 2406 CHRISTY SHAWN VP SFMP OPERATIONS SOUTHWEST 40.00 X 70235 0 7530 JASON BANDERMANN VP SFMP OPERATIONS NORTHEAST 40.00 X 171635 0 34308 BRANDON SCOTT DO NEUROSURGEON 40.00 X 1378498 0 24881 KAYWAN GAMADIA DO NEUROSURGEON 40.00 X 1289125 0 32151 CHAD STASIK MD CARDIOTHORACIC SURGEON 40.00 X 1045910 0 27500 RAFID HUSSEIN DO GASTROENTEROLOGIST 40.00 X 790746 0 41751 WILSON PAIS MD GASTROENTEROLOGIST 40.00 X 810886 0 41500 DAVID PRATHER CFO (FORMER) 40.00 2.00 X 435638 0 32858 STEVEN C BJELICH PRESIDENT & CEO (FORMER) 0.00 X 2644180 0 0 JULIE WOODRUFF CNO (FORMER) 40.00 X 270357 0 15143 12733073 0 493588 340 1 1 0 CAPE ANESTHESIA GROUP INC PO BOX 1777 CAPE GIRARDEAU MO 63702 ANESTHESIA SERVICES 8142757 ORTHOPAEDIC ASSOCIATES OF SEMO PC OF SOU 48 DRS PARK CAPE GIRARDEAU MO 63701 ORTHOPEDIC SERVICES 6411711 INTERNAL MEDICINE ASSOC OF SE MO LLC 225 PHYSICIANS PARK DRIVE SUITE 40 POPLAR BLUFF MO 63901 PHYSCIAN SERVICES 4189567 CAPE NEUROSUGICAL ASSOCIATES PC 150 S MT AUBURN ROAD SUITE 320 CAPE GIRARDEAU MO 63703 NEUROLOGICAL SERVICES 628397 ACMJ SERVICES LLC PO BOX 1132 CAPE GIRARDEAU MO 63702 PAIN MANAGEMENT SERVICES 620041 27 388322 11559165 11947487 PATIENT SERVICE REVENUE 621400 479447309 479447309 PHARMACY 446110 17048239 17048239 FITNESS CENTER 621400 1636663 1636663 MISC PROGRAM SERVICE REVENUE 621990 1190672 1190672 LAB FEES 621500 277690 94770 182920 206613 187761 18852 499807186 11221381 7974354 3247027 619144 0 619144 619144 619144 168591801 5589 162795422 57131 5796379 -51542 5744837 5744837 CAFETERIA SALES 722514 1161136 1161136 MEDICAL RECORDS 621990 640497 640497 TRAINING AND DEVELOPMENT 900099 223647 223647 167987 167987 2193267 531533302 496276366 17250011 6059438 7386964 7386964 195950834 185038808 10912026 6382231 5740253 641978 32631319 28910782 3720537 12306786 11021657 1285129 708817 708817 96447 96447 24231146 24213254 17892 2450763 22112 2428651 259735 259735 12603980 12603980 4059866 4050684 9182 194840 146825 48015 5644355 5644355 30597220 30597220 4598977 2217284 2381693 MEDICAL SUPPLIES 58505421 58505421 DRUGS 39225142 39225142 OTHER EXPENSE 37155538 24757973 12397565 FRA TAX 18346944 18346944 4962613 4961436 1177 498299938 432012831 66287107 0 43920471 68936720 7607842 41260326 59495424 37979076 11207378 10579478 17561961 16863509 631605914 345956118 294816934 285649796 546780289 558105528 7036768 1509476 2079024 1925475 990506091 1022809384 91377179 100559551 146155356 141962715 237532535 242522266 X 752973556 780287118 752973556 780287118 990506091 1022809384 X 33233364 -1036253 -4883549 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 8386950 8386950 246297579 112751257 133546322 354449746 224145902 130303844 22471639 9058959 13412680 285649796 X 532723104 1036253 153549 1189802 531533302 0 531533302 498299938 0 498299938 0 498299938 PART X, LINE 2: THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED AND RECORDED AS A LIABILITY AT JUNE 30, 2020 OR 2019. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN INTEREST IN NET ASSETS OF SFF $(153,549) PART XIII - SUPPLEMENTAL FINANCIAL INFORMATION THE DIFFERENCE BETWEEN THE REVENUES AND THE NET ASSETS ON THE AUDITED FINANCIAL STATEMENTS AND THOSE REPORTED ON THE 990 REPRESENTS A DECREASE IN AUXILIARY FUNDS OF ($16,108) AND AN INCREASE OF AUXILIARY CASH OF $55,378 1 1 1 X 0 1 1 1 0 1 1 26540431 7623828 18916603 0.03800 83344942 63517692 19827250 0.03980 109885373 71141520 38743853 0.07780 300535 300535 0.00060 1555000 1555000 0.00310 13670928 4377807 9293121 0.01860 437335 437335 0.00090 15963798 4377807 11585991 0.02320 125849171 75519327 50329844 0.10100 776 776 0.00000 17282 17282 0.00000 755 755 0.00000 8074 8074 0.00000 6380 6380 0.00000 316611 316611 0.00060 349878 349878 0.00060 1 3643812 910953 173221902 226114834 -52892932 X 1 1 1 1 SAINT FRANCIS MEDICAL CENTER 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 X X X SAINT FRANCIS MEDICAL CENTER 1 0 0 1 X X X X X X X X X 19 1 1 0 1 X WWW.SFMC.NET X 1 19 1 WWW.SFMC.NET 0 1 X 200.000000000000 X 1 1 X X X 1 X WWW.SFMC.NET X WWW.SFMC.NET X WWW.SFMC.NET X X X X X X X 1 X 0 X X X X 1 X 0 0 SAINT FRANCIS MEDICAL CENTER PART V, SECTION B, LINE 3J: THE IMPACT OF ANY ACTIONS TAKEN TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE HOSPITAL FACILITY'S PRIOR CHNA. SAINT FRANCIS MEDICAL CENTER PART V, SECTION B, LINE 5: INDIVIDUALS REPRESENTING THE BOARD INTERESTS OF BOLLINGER, CAPE GIRARDEAU, SCOTT, AND STODDARD COUNTIES INCLUDED PEOPLE INVOLVED IN SOME OF THE FOLLOWING ORGANIZATIONS: PUBLIC HEALTH DEPARTMENTS RURAL HEALTH CLINICS LOCAL SCHOOL DISTRICTS SOCIAL SERVICE ORGANIZATIONS OTHER HOSPITALS MINORITY ADVOCACY GROUPSSIX FOCUS GROUPS WERE HELD IN THE FOUR DESIGNATED COUNTIES AND THE QUESTIONS ASKED CAN BE FOUND BELOW. 1. WHAT DO PEOPLE IN THIS COMMUNITY DO TO STAY HEALTHY? HOW DO PEOPLE GET INFORMATION ABOUT HEALTH? 2. IN THIS GROUP'S OPINION, WHAT ARE THE SERIOUS HEALTH PROBLEMS IN YOUR COMMUNITY? WHAT ARE SOME OF THE CAUSES OF THESE PROBLEMS? 3. WHAT KEEPS PEOPLE IN YOUR COMMUNITY FROM BEING HEALTHY? 4. WHAT COULD BE DONE TO SOLVE THESE PROBLEMS? 5. IS THERE ANY GROUP NOT RECEIVING ENOUGH HEALTH CARE? IF SO, WHY? 6. OF ALL THE ISSUES WE TALKED ABOUT TODAY, WHAT ISSUES DO YOU THINK ARE THE MOST IMPORTANT TO YOUR COMMUNITY TO ADDRESS? 237 SURVEYS WERE COMPLETED BY RESIDENTS OF THE FOUR DESIGNATED COUNTIES. THE SURVEY DEMOGRAPHICS WERE REPRESENTATIVE OF THE AREA'S POPULATION: 1. DEMOGRAPHICS: MULTIPLE-CHOICE QUESTIONS TO COLLECT INFORMATION ABOUT THE POPULATION OF THE COUNTY 2. SOCIAL AND ECONOMIC FACTORS: MULTIPLE-CHOICE QUESTIONS TO COLLECT INFORMATION REGARDING THE POPULATION'S EDUCATION, EMPLOYMENT AND INCOME STATUS. 3. HEALTH BEHAVIORS: QUESTIONS TO COLLECT INFORMATION ON THE BEHAVIORS CORRELATED TO HEALTH OF ADULTS AND CHILDREN IN THE COUNTRY. 4. MEDICAL CARE AND SERVICES: MULTIPLE-CHOICE, SHORT ANSWER AND RANKED QUESTIONS TO COLLECT INFORMATION REGARDING HEALTHCARE ACCESS, HEALTH STATUS, INSURANCE COVERAGE, AND OPINIONS ON HEALTH ISSUES. SAINT FRANCIS MEDICAL CENTER PART V, SECTION B, LINE 6A: SAINT FRANCIS HEALTHCARE SYSTEM CONDUCTED THE 2019 CHNA PRIMARY DATA GATHERING IN CONJUNCTION WITH SOUTHEAST HEALTH. SAINT FRANCIS MEDICAL CENTER PART V, SECTION B, LINE 7D: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS PLACED ON THE SAINT FRANCIS MEDICAL CENTER'S WEBSITE. THERE WERE NUMEROUS NEWS STORIES ON THE ASSESSMENT AND WHERE TO LOCATE THE INFORMATION. LOCAL HEALTH AND HUMAN SERVICES AGENCIES WERE INFORMED WHEN THE ASSESSMENT WAS COMPLETED AT LOCAL MEETINGS. PRESENTATION OF THE CHNA FINDINGS WERE PRESENTED TO ALL BOARDS OF SAINT FRANCIS HEALTHCARE SYSTEM. THE CHNA WAS SHARED WITH MISSOURI DELTA MEDICAL CENTER IN SIKESTON, MISSOURI AND THE HEALTH DEPARTMENTS IN EACH COUNTY. HTTPS://WWW.SFMC.NET/CHNA SAINT FRANCIS MEDICAL CENTER PART V, SECTION B, LINE 11: WHILE TREATMENT FOR SUBSTANCE ABUSE AND MENTAL HEALTH CONDITIONS ARE A SIGNIFICANT COMMUNITY HEALTH NEED IDENTIFIED BY THIS ASSESSMENT, SAINT FRANCIS HEALTHCARE SYSTEM WILL NOT BE ADDRESSING THIS NEED AS PART OF ITS 2019-2022 CHNA IMPLEMENTATION PLAN FOR THE FOLLOWING REASONS: 1. CONSIDERABLE SAINT FRANCIS RESOURCES HAVE BEEN ALLOCATED TO ADDRESS THE OTHER TOP-PRIORITY HEALTH NEEDS IDENTIFIED BY THE 2019 CHNA. 2. SOUTHEASTHEALTH, THE OTHER COMMUNITY HOSPITAL IN CAPE GIRARDEAU, RECENTLY OPENED A NEW IMPATIENT BEHAVIORAL HEALTH FACILITY IN STODDARD COUNTY WHICH SERVES SAINT FRANCIS' SERVICE AREA. SOUTHEASTHEALTH ALSO PLANS A NEW $33 MILLION BEHAVIORAL HEALTH HOSPITAL IN CAPE GIRARDEAU FOR TREATING ADULTS AND ADOLESCENTS. MISSOURI DELTA MEDICAL CENTER IN SIKESTON (SCOTT COUNTY) PLANS TO OPEN AN ADOESCENTS BEHAVIORAL HEALTH UNIT. DUPLICATION OF SUCH SERVICES IN THE SAME COMMUNITIES IS NOT THE BEST USE OF SAINT FRANCIS' RESOURCES. 3. THE SIGNIFICANT RESOURCES REQUIRED FOR SAINT FRANCIS HEALTHCARE SYSTEM TO DEVELOP ITS OWN OUTPATIENT SUBSTANCE ABUSE AND/OR BEHAVIORAL HEALTH TREATMENT PROGRAMS FROM THE GROUND UP ARE NOT FEASIBLE IN THE SERVICE AREA. SAINT FRANCIS WILL INSTEAD CONTINUE TO WORK WITH OTHER COMMUNITY PARTNERS THAT OFFER SUCH SERVICES IN THE COMMUNITY BY MAKING APPROPRIATE PATIENT REFFERALS. 4. SAINT FRANCIS HEALTHCARE SYSTEM RECENTLY ACQUIRED A MULTI-SPECIALTY CLINIC IN FERGUSON MEDICAL GROUP, WHICH EMPLOYS A PSYCHOLOGIST AND OTHER BEHAVIORAL HEALTH PROVIDERS. SAINT FRANCIS ALSO PROVIDES PSYCHIATRIC SERVICE IN POPULAR BLUFF THROUGH KNEIBERT CLINIC. BOTH OF THESE CLINICS SERVE A WIDE RANGE OF PATIENTS IN SCOTT, STODDARD AND BUTLER COUNTIES. SAINT FRANCIS MEDICAL CENTER PART V, SECTION B, LINE 13H: ALL UNINSURED PATIENTS RECEIVING SERVICES AT SAINT FRANCIS MEDICAL CENTER WILL RECEIVE A 75% REDUCTION ON ALL GROSS CHARGES AT THE TIME OF BILLING (WITHOUT APPLICATION).ALL SELF-PAY ACCOUNTS WILL BE PROCESSED THROUGH A PRESUMPTIVE SCORING PROGRAM TO DETERMINE IF THEY QUALIFY FOR ASSISTANCE. IF THE PATIENT MEETS THE QUALIFICATIONS, THE PATIENT'S ACCOUNT WILL BE REDUCED TO ZERO. IF THE QUALIFICATIONS ARE NOT MET, COLLECTIONS WILL BE ESCALATED. SAINT FRANCIS MEDICAL CENTER PART V, SECTION B, LINE 16J: ALL PATIENTS ARE NOTIFIED OF THE FINANCIAL ASSISTANCE POLICY VIA THE CONSENT FORM UPON ADMISSION. UNINSURED PATIENTS ARE CONTACTED AFTER ADMISSION AND INFORMED OF THE FINANCIAL ASSISTANCE AVAILABLE THROUGH THE MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY. SAINT FRANCIS MEDICAL CENTER PART V, SECTION B, LINE 20E: IN-HOUSE AND THIRD PARTY REPRESENTATIVES WORK WITH UNINSURED PATIENTS TO HELP THEM QUALIFY FOR MEDICAID BENEFITS THROUGH THEIR STATE OF RESIDENCE. FINANCIAL ASSISTANCE APPLICATIONS ARE OFFERED FOR THOSE THAT DO NOT QUALIFY FOR MEDICAID AND EXPRESS THE INABILITY TO PAY FOR MEDICAL SERVICES. SCHEDULE H PART V, LINE 4 THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN 2019. 36 1 - ADVANCED ORTHOPEADIC SPECIALISTS 48 DOCTORS PARK CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 2 - CAPE PHYSICIAN ASSOCIATES 3250 GORDONVILLE ROAD CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 3 - CAPE CARDIOLOGY GROUP 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 4 - KNEIBERT CLINIC 686 LESTER STREET POPLAR BLUFF MO 63901 PHYSICIAN PRACTICE 5 - CAPE CARE FOR WOMEN 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 6 - FERGUSON MEDICAL GROUP - SIKESTON 1012 NORTH MAIN STREET SIKESTON MO 63801 PHYSICIAN PRACTICE 7 - PHYSICIANS PARK PRIMARY CARE 225 PHYSICIANS PARK DRIVE SUITE 40 POPLAR BLUFF MO 63901 PHYSICIAN PRACTICE 8 - CAPE SPINE AND NEUROSURGERY 150 S MOUNT AUBURN ROAD CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 9 - CAPE GASTROENTEROLOGY SPECIALISTS 28 S MOUNT AUBURN ROAD CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 10 - FARMINGTON PHYSICIAN ASSOCIATES 515 MAPLE VALLEY DRIVE FARMINGTON MO 63640 PHYSICIAN PRACTICE 11 - CAPE ENT GROUP 150 S MOUNT AUBURN ROAD CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 12 - HOSPICE 14 C DOCTORS PARK CAPE GIRARDEAU MO 63703 HOSPICE 13 - PIEDMONT PHYSICIAN ASSOCIATES RT 4 BOX 4515 PIEDMONT MO 63957 PHYSICIAN PRACTICE 14 - CAPE MEDICAL ONCOLOGY 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 15 - CAPE THORACIC & CARDIOVASCULAR SURGERY 3250 GORDONVILLE ROAD CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 16 - POPULAR BLUFF PEDIATRICS 2210 BARRON ROAD SUITE 120-122 POPLAR BLUFF MO 63901 PHYSICIAN PRACTICE 17 - POPLAR BLUFF NEUROLOGY SPECIALISTS 2210 BARRON ROAD SUITE 112 POPLAR BLUFF MO 63901 PHYSICIAN PRACTICE 18 - SAINT FRANCIS OUTPATIENT CENTER - DEXTER 1212 SAINT FRANCIS DRIVE DEXTER MO 63841 PHYSICIAN PRACTICE 19 - CAPE PRIMARY CARE 1702 N KINGSHIGHWAY CAPE GIRARDEAU MO 63701 PHYSICIAN PRACTICE 20 - CAPE NEUROLOGY SPECIALISTS 3004 GORDONVILLE ROAD CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 21 - IMMEDIATE CONVENIENT CARE - CAPE 1702 N KINGSHIGHWAY CAPE GIRARDEAU MO 63701 PHYSICIAN PRACTICE 22 - FERGUSON MEDICAL GROUP - EAST PRAIRIE 320 NORTH LINCOLN EAST PRAIRIE MO 63845 PHYSICIAN PRACTICE 23 - SAINT FRANCIS OUTPATIENT CENTER - POPLAR 225 PHYSICIANS PARK DRIVE SUITE 400 POPLAR BLUFF MO 63901 PHYSICIAN PRACTICE 24 - SAINT FRANCIS HOME HEALTH 14 DOCTORS PARK CAPE GIRARDEAU MO 63703 HOME HEALTH 25 - PHYSICIANS PARK GENERAL SURGERY 225 PHYSICIANS PARK DRIVE SUITE 301 POPLAR BLUFF MO 63901 PHYSICIAN PRACTICE 26 - CAPE PULMONARY AND SLEEP MEDICINE 24 S MOUNT AUBURN ROAD CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 27 - CAPE NEUROSURGICAL ASSOCIATES 150 S MOUNT AUBURN ROAD CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 28 - JACKSON FAMILY CARE 545 BROADRIDGE DRIVE JACKSON MO 63755 PHYSICIAN PRACTICE 29 - FERGUSON MEDICAL GROUP - CHARLESTON 112 WEST COMMERCIAL CHARLESTON MO 63834 PHYSICIAN PRACTICE 30 - CAPE DIABETES & ENDOCRINOLOGY 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 31 - FITNESS PLUS 150 S MOUNT AUBURN ROAD CAPE GIRARDEAU MO 63703 FITNESS CENTER 32 - CAPE GYNECOLOGIC ONCOLOGY 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 PHYSICIAN PRACTICE 33 - CHARLESTON FAMILY CARE 400 S MAIN STREET CHARLESTON MO 63834 PHYSICIAN PRACTICE 34 - FERGUSON MEDICAL GROUP - SCOTT CITY 100 EAST OUTER ROAD SCOTT CITY MO 63780 PHYSICIAN PRACTICE 35 - JACKSON PHYSICIAN ASSOCIATES 2130 E JACKSON BLVD JACKSON MO 63755 PHYSICIAN PRACTICE 36 - FITNESS PLUSS - DEXTER 1212 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63841 FITNESS CENTER PART I, LINE 3C: ALL UNINSURED PATIENTS RECEIVING SERVICES AT SAINT FRANCIS MEDICAL CENTER WILL RECEIVE A 75% REDUCTION ON ALL GROSS CHARGES AT THE TIME OF BILLING (WITHOUT APPLICATION). ALL SELF-PAY ACCOUNTS WILL BE PROCESSED THROUGH A PRESUMPTIVE SCORING PROGRAM TO DETERMINE IF THEY QUALIFY FOR ASSISTANCE. IF THE PATIENT MEETS THE QUALIFICATIONS, THE PATIENT'S ACCOUNT WILL BE REDUCED TO ZERO. IF THE QUALIFICATIONS ARE NOT MET, COLLECTIONS WILL BE ESCALATED. PART I, LINE 7: A COST-TO-CHARGE RATIO WAS USED IN ACCORDANCE WITH THE CALCULATION IN WORKSHEET 2, "RATIO OF PATIENT CARE COST TO CHARGES." PART I, LINE 7G: COSTS FOR SUBSIDIZED HEALTH SERVICES INCLUDE COSTS ASSOCIATED WITH PROVIDED NEONATOLOGY, TRAUMA, AND HOSPITALIST PHYSICIAN CLINICAL SERVICES WHERE OPERATIONS RESULT IN LOSSES. TOTAL EXPENSES IN THE AMOUNT OF $13,670,928 ARE INCLUDED. PART II, COMMUNITY BUILDING ACTIVITIES: SAINT FRANCIS MEDICAL CENTER'S COMMUNITY BUILDING ACTIVITIES ARE TARGETED TO KEEP GOOD HEALTH IN THE FOREFRONT THROUGH NON-TRADITIONAL CHANNELS. THESE ACTIVITIES ARE USED TO DELIVER HEALTHCARE INFORMATION AND EDUCATION DIRECTLY TO CITIZENS OF THE COMMUNITY. COMMUNITY FORUMS OR MEETINGS ALLOW REPRESENTATIVES OF THE MEDICAL CENTER TO PRESENT POTENTIALLY LIFE-SAVING INFORMATION TO AN AUDIENCE NOT TYPICALLY REACHED BY COMMUNITY HEALTH AGENCIES OR SCREENINGS. PART III, LINE 2: A COST-TO-CHARGE RATIO WAS USED IN ACCORDANCE WITH THE CALCULATION IN WORKSHEET 2, "RATIO OF PATIENT CARE COST TO CHARGES" TO DEVELOP COSTS ASSOCIATED WITH BAD DEBT EXPENSE. PATIENT PAYMENTS AND DISCOUNTS ARE APPLIED TO THE PATIENT'S ACCOUNT BEFORE BAD DEBT DETERMINATION IS MADE. PART III, LINE 3: AN ESTIMATE OF BAD DEBT EXPENSE AT COST ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY WAS CALCULATED BASED ON A STUDY OF POVERTY RATES IN THE UNITED STATES BY THE UNITED STATES CENSUS BUREAU. THE PERCENTAGE OF THE POPULATION WITH INCOME LEVELS AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES WAS OBTAINED AND THAT PERCENTAGE WAS THEN APPLIED TO THE ESTIMATED BAD DEBT EXPENSE TO OBTAIN THE ESTIMATED AMOUNT IN BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSITANCE POLICY. THE COST-TO-CHARGE RATIO WAS THEN APPLIED TO CONVERT TO COST. THE MEDICAL CENTER ESTIMATES THAT $910,953 AT COST IS FINANCIAL ASSISTANCE ELIGIBLE AND IS INCLUDED IN BAD DEBT EXPENSE. PART III, LINE 4: THE FOLLOWING IS FROM FOOTNOTE B OF THE AUDITED FINANCIAL STATEMENTS FOR SAINT FRANCIS MEDICAL CENTER FOR THE YEAR ENDED JUNE 30, 2020:THE MEDICAL CENTER ALSO PROVIDES A SIGNIFICANT AMOUNT OF UNCOMPENSATED CARE FOR PATIENTS WHICH IS NOT INCLUDED IN COMMUNITY BENEFIT EXPENSE BUT IS REPORTED ON THE STATEMENT OF OPERATIONS AS A PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANY OF THOSE PATIENTS ARE UNINSURED OR UNDERINSURED, BUT DID NOT APPLY FOR OR QUALIFY FOR CHARITY CARE. DURING THE YEAR ENDED JUNE 30, 2020, THE MEDICAL CENTER REPORTED BAD DEBT EXPENSE; AT COST, OF $3,643,812. PART III, LINE 8: THE COSTING METHODOLOGY USED FOR PART III, LINE 6, IS A COST-TO-CHARGE RATIO DERIVED FROM THE PRIOR YEAR'S MEDICARE COST REPORT WHICH USES ONLY MEDICARE ALLOWABLE COSTS.IRS REV. RUL. 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THIS IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT.**FOR-PROFIT SPECIALTY HOSPITALS HAVE BEEN CARVING OUT CERTAIN HIGH-MARGIN SERVICES (SUCH AS CARDIAC, ORTHOPEDICS, AND ONCOLOGY), LEAVING GENERAL ACUTE CARE HOSPITALS WITH LOWER-MARGIN MEDICARE SERVICES. THIS INDICATES THAT MEDICARE LOSSES CAN BE A RESULT OF RENDERING THESE LOWER-MARGIN SERVICES (WHICH BENEFIT THE COMMUNITY) RATHER THAN INEFFICIENT OPERATIONS.**IN SOME COMMUNITIES, MEDICARE IS THE LARGEST PAYER, AND HOSPITALS MUST ACCEPT THESE PATIENTS REGARDLESS OF WHETHER THEY MAKE A SURPLUS OR DEFICIT FROM PROVIDING SUCH SERVICES. IF THE MEDICARE PARTICIPATION IS PREMISED ON THIS FACT, THEN PROVIDING MEDICARE SERVICES PROMOTES ACCESS TO HEALTHCARE SERVICES WHICH IS A COMMUNITY BENEFIT.**THERE ARE A NUMBER OF LOW-INCOME CONSUMERS RECEIVING MEDICARE BENEFITS.**THE ELDERLY ARE OFTEN AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE SERVICES, CMS WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY.**MEDICARE PAYMENT ANOMALIES MAY BE PRESENT IN SOME STATES SO EVEN VERY EFFICIENT HOSPITALS ARE UNABLE TO AVOID LOSSES. THUS, LOSSES MAY NOT BE INDICATIVE OF INEFFICIENCY BUT RATHER PROVISION OF A COMMUNITY BENEFIT. PART III, LINE 9B: IF A PATIENT EXPRESSES FINANCIAL INABILITY TO PAY, THE REPRESENTATIVE OF THE MEDICAL CENTER WILL OFFER A FINANCIAL ASSISTANCE APPLICATION TO THE PATIENT. THE PATIENT THEN RETURNS THE APPLICATION TO THE BUSINESS OFFICE FOR REVIEW. AFTER REVIEW, THE BUSINESS OFFICE WILL NOTIFY THE PATIENT IN WRITING OF THE DECISION. IF APPROVED, THE BUSINESS OFFICE WILL WRITE OFF THE REMAINING BALANCES. IF DENIED, THE BUSINESS OFFICE WILL CONTACT THE PATIENT TO MAKE PAYMENT ARRANGEMENTS. PART VI, LINE 2: SAINT FRANCIS IS PROACTIVE IN ASSESSING THE HEALTHCARE NEEDS OF ITS SERVICE AREA THROUGH GATHERING INFORMATION OR STUDIES FROM COMMUNITY HEALTHCARE AGENCIES, DEVELOPING AND SUPPORTING COMMUNITY HEALTH EDUCATORS, AND FOLLOWING UP ON INFORMATION FROM PATIENTS AND FAMILIES. SAINT FRANCIS IS REACTIVE IN ASSESSING THE HEALTHCARE NEEDS OF ITS SERVICE AREA BY PROVIDING SUPPORT AND ASSISTANCE THROUGH LOCAL AND NATIONAL AGENCIES, WHICH PROVIDE DIRECT HEALTHCARE SERVICES TO THE MEDICAL CENTER'S SERVICE AREA. PART VI, LINE 3: HOSPITAL PERSONNEL, INCLUDING NURSES, PHYSICIANS, SOCIAL WORKERS AND OTHERS, MAY IDENTIFY AND REQUEST AN APPLICATION FOR A PATIENT WHEN DEEMED APPROPRIATE. PATIENTS AND PERSONS WHO MAY BE BILLED RECEIVE AN APPLICATION FOR ASSISTANCE WHEN A NEED IS EXPRESSED. REQUEST FOR ASSISTANCE IS USUALLY MADE WHEN THE PATIENT RECEIVES THE BILL, OR WHEN THE CUSTOMER SERVICE REPRESENTATIVE CONTACTS THE PATIENT FOR PAYMENT OF ACCOUNT. AT THE TIME NEED IS EXPRESSED, THE APPLICATION IS GIVEN PERSONALLY OR MAILED TO THE PATIENT. CUSTOMER SERVICE REPRESENTATIVES THEN WORK WITH THE PATIENT TO COMPLETE ASSISTANCE REQUEST AND FORWARD APPLICATION FOR APPROVAL. ANY PATIENTS WHO RETURN TO THE MEDICAL CENTER TO PAY A BILL HAVE ACCESS TO ASSISTANCE EDUCATION DOCUMENTATION AT THE BILLING OFFICE. PART VI, LINE 4: SAINT FRANCIS MEDICAL CENTER IS A LEADING TERTIARY CARE PROVIDER SERVING PORTIONS OF A FIVE-STATE REGION - MISSOURI, ARKANSAS, TENNESSEE, KENTUCKY AND ILLINOIS. THE SYSTEM PROVIDES TO A POPULATION OF MORE THAN 740,000 PEOPLE. THE PRIMARY SERVICE AREA CONSISTS OF CAPE GIRARDEAU COUNTY THAT HAS AN ESTIMATED POPULATION OF 78,871 AS OF 2019. ACCORDING TO THE MISSOURI OFFICE OF ADMINISTRATION, BUDGET AND PLANNING, CAPE GIRARDEAU COUNTY'S POPULATION IS EXPECTED TO INCREASE TO 84,612 BY 2030. THE SECONDARY SERVICE AREA HAS A POPULATION OF NEARLY 169,000 AND INCLUDES THE COUNTIES OF ALEXANDER (5,761), PULASKI (5,335) AND UNION (16,653) IN ILLINOIS; AND BOLLINGER (12,133), MISSISSIPPI (13,180), NEW MADRID (17,076), PERRY (19,136), SCOTT (38,280), AND STODDARD (29,025) IN MISSOURI. THE TERTIARY SERVICES AREA HAS A POPULATION OF MORE THAN 493,000 AND INCLUDES THE COUNTIES OF BUTLER (42,478), CARTER (5,982), DUNKLIN (19,131), IRON (10,125), MADISON (12,088), PEMISCOT (15,805), REYNOLDS (6,270), RIPLEY (13,288), ST. FRANCOIS (67,215), STE. GENEVIEVE (17,894) AND WAYNE (12,873) IN MISSOURI; JACKSON (56,750), JOHNSON (12,417), RANDOLPH (31,782) AND WILLIAMSON (66,597) IN ILLINOIS; CLAY (14,551) AND RANDOLPH (17,958) IN ARKANSAS; LAKE (7,016) AND OBION (30,069) IN TENNESSEE; AND BALLARD (7,888), CARLISLE (4,760), FULTON(5,969) AND HICKMAN (4,380) IN KENTUCKY. THE SOUTHEAST REGION OF MISSOURI IS DECLINING IN POPULATION AND EVERY COUNTY HAS A HIGHER THAN AVERAGE PERCENTAGE OF RETIREE-AGED PEOPLE AS COMPARED WITH THE U.S. THIS REGION IS 89.8 PERCENT CAUCASIAN, 7.0 PERCENT AFRICAN-AMERICAN AND 2.4 PERCENT HISPANIC. PER CAPITA INCOME FOR CAPE GIRARDEAU COUNTY WAS $28,267. OF THE ENTIRE SOUTHEAST MISSOURI REGION POPULATION AGED 25 OR OLDER, 16 PERCENT DID NOT OBTAIN A HIGH SCHOOL DIPLOMA. APPROXIMATELY 84 PERCENT GRADUATED FROM HIGH SCHOOL OR HIGHER, 24 PERCENT EARNED A COLLEGE DEGREE OR HIGHER AND 6 PERCENT COMPLETED A GRADUATE OR PROFESSIONAL DEGREE.ACCORDING TO EMPLOYMENT STATISTICS IN DECEMBER 2020, THE SOUTHEAST REGION HAD AN UNEMPLOYMENT RATE OF 6.0 PERCENT. STATISTICS ARE FROM THE MISSOURI ECONOMIC RESEARCH AND INFORMATION CENTER AND THE U.S. CENSUS BUREAU. PART VI, LINE 5: SAINT FRANCIS MEDICAL CENTER FURTHERS ITS EXEMPT PURPOSE BY PROVIDING FOR AN OPEN MEDICAL STAFF COMPRISED OF PHYSICIANS IN ITS PRIMARY SERVICE AREA. THE BOARD OF DIRECTORS IS COMPRISED OF LOCAL COMMUNITY MEMBERS WITH A VESTED INTEREST IN PROMOTING AND IMPROVING THE HEALTH OF THE POPULATION SERVED BY SAINT FRANCIS MEDICAL CENTER. IN ADDITION, SURPLUS FUNDS GENERATED BY THE OPERATINS OF THE MEDICAL CENTER ARE REINVESTED IN EQUIPMENT AND FACILITIES SO THAT SAINT FRANCIS MEDICAL CENTER CAN PROVIDE CUTTING EDGE HEALTHCARE TO THE RESIDENTS OF ITS COMMUNITY. PART VI, LINE 6: SAINT FRANCIS HEALTHCARE SYSTEM IS A HOLDING COMPANY WHICH IS THE SOLE MEMBER OF SAINT FRANCIS MEDICAL CENTER. SAINT FRANCIS MEDICAL CENTER OPERATES A 306-BED ACUTE CARE HOSPITAL LOCATED IN CAPE GIRARDEAU, MISSOURI. ADMITTING PHYSICIANS ARE PRIMARILY PRACTITIONERS IN THE LOCAL AREA. SAINT FRANCIS HEALTH DEVELOPMENT SERVICES, INC. WAS ORGANIZED BY SAINT FRANCIS HEALTHCARE SYSTEM. SAINT FRANCIS HEALTH DEVELOPMENT SERVICES, INC. FORMED IN 2002, OWNS A 51% INTEREST IN PHYSICIANS ALLIANCE SURGERY CENTER, LLC, A 67% INTEREST IN BLACK RIVER REAL ESTATE, LLC (F/K/A POPULAR BLUFF MEDICAL PARTNERS, LLC), A 30% INTEREST IN LANDMARK HOSPITAL OF CAPE GIRARDEAU, LLC, A 100% INTEREST IN SAINT FRANCIS HEALTH DEVELOPMENT REAL ESTATE, LLC (F/K/A SIKESTON HEALTHCARE PROPERTY, LLC), A 100% INTEREST IN BLACK RIVER AMBULATORY SURGERY CENTER, LLC AND A 30% INTEREST IN UC CLINIC 001, LLC (F/K/A AFC CLINIC 001, LLC), WHICH OPERATES AFC URGENT CARE CENTER. PART VI, LINE 7, REPORTS FILED WITH STATES MO X X 1 1 X X X X X 0 1 0 0 0 1 0 0 0 MARYANN REESE PRESIDENT & CEO 792787 0 204406 0 183290 0 14000 0 12177 0 1206660 0 0 0 STEVEN OGBURN VP OF SFMP 266350 0 30342 0 71582 0 14000 0 27419 0 409693 0 0 0 THOMAS S DIEMER MD CHIEF MEDICAL OFFICER 401346 0 43811 0 45471 0 14000 0 7201 0 511829 0 0 0 GERRY SALTER VP - SPECIALTY PRACTICES 234673 0 24432 0 8735 0 12494 0 27033 0 307367 0 0 0 STEPHANIE LAPIERRE CHIEF NURSING/CLINICAL OFFICER 216938 0 22604 0 3675 0 5107 0 10221 0 258545 0 0 0 JAMES WILFERTH VP FOUNDATION 183214 0 20680 0 36684 0 10575 0 15884 0 267037 0 0 0 JAMES BURKE CHIEF ADMINISTRATIVE OFFICER/GENERAL 464630 0 76440 0 70880 0 14000 0 27751 0 653701 0 0 0 LORI STURGILL CHIEF INFORMATION OFFICER 317027 0 31850 0 4737 0 2919 0 18779 0 375312 0 0 0 JASON BANDERMANN VP SFMP OPERATIONS NORTHEAST 152373 0 10303 0 8959 0 8311 0 25997 0 205943 0 0 0 BRANDON SCOTT DO NEUROSURGEON 687610 0 653199 0 37689 0 14000 0 10881 0 1403379 0 0 0 KAYWAN GAMADIA DO NEUROSURGEON 728518 0 541912 0 18695 0 5600 0 26551 0 1321276 0 0 0 CHAD STASIK MD CARDIOTHORACIC SURGEON 922941 0 84779 0 38190 0 14000 0 13500 0 1073410 0 0 0 RAFID HUSSEIN DO GASTROENTEROLOGIST 750055 0 3065 0 37626 0 14000 0 27751 0 832497 0 0 0 WILSON PAIS MD GASTROENTEROLOGIST 766678 0 0 0 44208 0 14000 0 27500 0 852386 0 0 0 DAVID PRATHER CFO (FORMER) 345267 0 38320 0 52051 0 14000 0 18858 0 468496 0 0 0 STEVEN C BJELICH PRESIDENT & CEO (FORMER) 2644180 0 0 0 0 0 0 0 0 0 2644180 0 0 0 JULIE WOODRUFF CNO (FORMER) 221272 0 24085 0 25000 0 12178 0 2965 0 285500 0 0 0 PART I, LINE 1A EXECUTIVE MEMBERS RECEIVE TRAVEL FOR THEIR SPOUSES. SPOUSAL TRAVEL IS ADDED TO W-2'S FOR EXECUTIVES. PART I, LINE 4B STEVEN A OGBURN - NONQUALIFIED - $19,907 PART I, LINE 6 ALL EXECUTIVE BONUSES ARE BASED ON ATTAINMENT OF STRATEGIC GOALS. A IND DEV AUTH OF CAPE GIRARDEAU 431193901 139404FH5 2013-05-01 131833295 CAPITAL EXPENDITURES 0 0 0 B IND DEV AUTH OF CAPE GIRARDEAU 431193901 139404GB7 2016-11-16 34876270 ADVANCED REFUNDING 0 0 0 A 131833295 3393406 1380910 75003510 2015 1 1 1 1 B 34876270 35254267 178601 2016 0 1 1 1 A 0 1 0 0 0 0 0 B 0 1 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 B 0 0 0 0 1 0 0 0 0 A 0 B 0 DON KAVERMAN BOARD OF DIRECTORS 2027 DISCOUNTED HEAL JAMES BOLLINGER JR BOARD OF DIRECTORS 5858 DISCOUNTED HEAL GINA RAFFERTY BOARD OF DIRECTORS 2131 DISCOUNTED HEAL JANET VARON BOARD OF DIRECTORS 2297 DISCOUNTED HEAL LAURA YOUNGHOUSE BOARD OF DIRECTORS 15631 DISCOUNTED HEAL ADAM KIDD BOARD OF DIRECTORS 3000 DISCOUNTED HEAL D VOLLINK - DRURY SOUTHWEST PRES DIRECTOR 188666 SFMC LEASES BILLBOARD 0 FORM 990, PART VI, SECTION A, LINE 2 A BUSINESS RELATIONSHIP IS CONSIDERED TO EXIST AMONGST OFFICERS AND/OR DIRECTORS OF SAINT FRANCIS MEDICAL CENTER (SFMC) WHO ALSO SERVE AS OFFICERS AND/OR DIRECTORS OF SAINT FRANCIS HEALTH DEVELOPMENT SERVICES, INC., WHICH IS A RELATED TAXABLE ENTITY OF SAINT FRANCIS MEDICAL CENTER. THE FOLLOWING OFFICERS AND/OR DIRECTORS SERVE ON BOTH THE SAINT FRANCIS MEDICAL CENTER AND SAINT FRANCIS HEALTH DEVELPMENT SERVICES, INC. BOARD OF DIRECTORS: MARYANN REESE - PRESIDENT AND CEO AT SFMC DON KAVERMAN - MEMBER OF SFMC BOARD OF DIRECTORS LAURA YOUNGHOUSE - MEMBER OF SFMC BOARD OF DIRECTORS KEVIN GOVERO - CHAIRMAN OF SFMC BOARD OF DIRECTORS ADAM KIDD - MEMBER OF SFMC BOARD OF DIRECTORS FORM 990, PART VI, SECTION A, LINE 6 SAINT FRANCIS HEALTHCARE SYSTEM IS THE SOLE MEMBER OF THE SAINT FRANCIS MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 7A SAINT FRANCIS HEALTHCARE SYSTEM, AS THE SOLE MEMBER OF SAINT FRANCIS MEDICAL CENTER HAS THE POWER TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE DIRECTORS, THE CHAIRMAN OF THE BOARD, THE VICE CHAIRMAN OF THE BOARD AND THE SECRETARY/TREASURER OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS ARE SUBJECT TO THE BISHOP'S APPROVAL. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 IS PROVIDED TO ALL THE MEMBERS OF THE BOARD OF DIRECTORS FOR REVIEW PRIOR TO BEING FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE MEDICAL CENTER REQUIRES ALL OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES TO COMPLETE A CONFLICT OF INTEREST STATEMENT EACH YEAR. OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES ARE EDUCATED EACH YEAR ON THE DEFINITION OF A CONFLICT OF INTEREST AND HOW TO AVOID THEM. FORM 990, PART VI, SECTION B, LINE 15 AN OUTSIDE CONSULTANT IS ENGAGED TO PROVIDE BENCHMARK DATA FOR COMPARABLE POSITIONS IN COMPARABLY SIZED MEDICAL CENTERS. BASED ON THE DATA, THE CONSULTANT MAKES A RECOMMENDATION TO THE COMPENSATION COMMITTEE OF THE BOARD. THE BOARD DISCUSSES THE RECOMMENDATIONS AND MAKES A DECISION AS TO WHAT WILL BE PROVIDED FOR THE YEAR. THE PRESIDENT OF THE BOARD PROVIDES THE INFORMATION TO THE CHIEF FINANCIAL OFFICER TO IMPLEMENT. BASED ON DATA PROVIDED BY CONSULTANTS, THE BOARD OF DIRECTORS ESTABLISH PAY TARGETS FOR THE EXECUTIVE TEAM. THE PRESIDENT GRANTS THE VICE PRESIDENTS THEIR PAY INCREASES BASED ON PERFORMANCE IN THE PRECEEDING YEAR. FORM 990, PART VI, SECTION C, LINE 19 COPIES OF THE MEDICAL CENTERS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND FEDERAL FORM 990 ARE AVAILABLE AT THE ADMINISTRATIVE OFFICE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN NET ASSETS OF SFF -153,549. TRANSFER TO SAINT FRANCIS HEATHCARE SYSTEM -4,730,000. FORM 990, PART XII, LINE 2C: NO CHANGES IN PROCESS DURING FY20 SAINT FRANCIS MEDICAL PARTNERS LLC 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 431869973 PHYS. PRACTICE MO SFMC SAINT FRANCIS HEALTHCARE SYSTEM 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 430662499 HOLDING COMPANY MO 501(C)(3) LINE 12B, II N/A 0 SAINT FRANCIS FOUNDATION 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 431111276 FUND DEV. MO 501(C)(3) LINE 12B, II N/A 0 SAINT FRANCIS HEALTH DEVELOP SRVS 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU MO 63703 470849798 HOLDING COMPANY MO N/A C 0 0 0 1 0 0 0 0 0 0 0 1 0 1 1 1 1 1 0 0