2021-11-15T16:05:26-06:00 2020-12-31 381357951 PLANTE & MORAN PLLC 250 SOUTH HIGH ST SUITE 100 COLUMBUS OH 43215 990 2020-01-01 340714756 ST VINCENT CHARITY MEDICAL CENTER STVI 2168616200 2351 EAST 22ND STREET CLEVELAND OH 44115 JOHN RUSNACZYK SENIOR VICE PRESIDENT, CFO 2168616200 2021-11-15 1 JOHN RUSNACZYK 999009999 AMY CIMINELLO P00796388 6148493000 2021-11-15 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z JANICE MURPHY 2351 EAST 22ND STREET CLEVELAND OH 44115 151612578 0 0928 X STVINCENTCHARITY.COM X 1926 OH PROVIDER OF HEALTHCARE SERVICES 19 13 1369 130 351851 28162 559716 22718346 134967240 125530765 112918 -66378 4037038 3312043 139676912 151494776 0 0 0 0 75485790 70468237 0 0 0 80734152 81218490 156219942 151686727 -16543030 -191951 63103048 80772646 37155601 54534640 25947447 26238006 X SEE SCHEDULE O 0 0 137434502 125530765 SEE SCHEDULE OST. VINCENT CHARITY MEDICAL CENTER IS CLEVELAND'S FAITH-BASED, HIGH-QUALITY HEALTHCARE PROVIDER. OUR DISTINGUISHED DOCTORS AND CAREGIVERS ARE DEVOTED TO TREATING EVERY PATIENT WITH CLINICAL EXCELLENCE AND COMPASSIONATE CARE. ST. VINCENT CHARITY MEDICAL CENTER IS HOME TO THE RENOWNED SPINE AND ORTHOPEDIC INSTITUTE AND THE CENTER FOR BARIATRIC SURGERY. OWNED BY THE SISTERS OF CHARITY HEALTH SYSTEM, ST. VINCENT CHARITY MEDICAL CENTER PROVIDES CARE BEYOND MEDICINE.MISSION:EXPANDED MEDICAL-LEGAL PARTNERSHIP WITH LEGAL AID SOCIETY OF CLEVELAND FROM BEHAVIORAL HEALTH AND ADDICTION SERVICE LINES TO INCLUDE THE ENTIRE MEDICAL CENTER AND JOSEPH'S HOME. THE PARTNERSHIP PROVIDES FREE, ON-SITE SERVICES TO RESOLVE CIVIL-LEGAL ISSUES THAT ARE TIED TO SOCIAL DETERMINANTS OF HEATH AND ISSUES THAT IMPACT THE OVERALL HEALTH OF PATIENTS. ST. VINCENT CHARITY MEDICAL CENTER CONTINUED A PARTNERSHIP WITH SAINT IGNATIUS HIGH SCHOOL TO ALLOW SOPHOMORE SERVICE STUDENTS TO GAIN MEANINGFUL EXPERIENCES IN CATHOLIC HEALTH CARE. THE PARTNERSIP WAS PLACED ON PAUSE AFTER THE CORONAVIRUS PANDEMIC.ST. VINCENT CHARITY MEDICAL CENTER CAREGIVERS INCLUDING PHYSICIANS, NURSING, PHARMACY, LEGAL, EXTERNAL AFFAIRS, AND GOVERNMENT AFFAIRS CONTINUE TO PARTICIPATE IN THE NORTHEAST OHIO HOSPITAL OPIOID CONSORTIUM, A HOSPITAL SYSTEM-BASED AND PHYSICIAN-LED COLLABORATIVE OF HEALTHCARE ORGANIZATIONS WORKING TOGETHER TO SIGNIFICANTLY REDUCE THE IMPACT OF THE OPIOID EPIDEMIC IN THE REGION BY SHARING AND IMPLEMENTING EVIDENCE-BASED PRACTICES; PROMOTING POLICY CHANGES; AND INCREASING PREVENTION EFFORTS. THE RESILIENT YOUTH PROJECT, FUNDED BY THE WILLIAM J. AND DOROTHY K. O'NEILL FOUNDATION, CONTINUES TO SUPPORT YOUTH IN THE CENTRAL NEIGHBORHOOD. THE RESILIENT YOUTH PROJECT ENROLLS 20 YOUTH AGES 13-15 YEARS FROM THE NEIGHBORHOOD IN WORK AND ACTIVITIES DESIGNED TO TEACH BOTH LIFE AND JOB SKILLS, AS WELL AS PROMOTE EDUCATION AND COMMUNITY IMPACT, ALL WHILE EARNING A SMALL STIPEND. THE PROJECT WAS ABLE TO BE CONTINUED INTO THE CORONAVIRUS PANDEMIC BY BRINGING THE STUDENTS TOGETHER VIA ZOOM.ST. VINCENT WORKS IN CONJUNCTION WITH ST. MARTIN DE PORRES SCHOOL TO PROVIDE FOUR STUDENTS FOR THE SCHOOL YEAR AN EXPERIENCE OF WORKING IN A HOSPITAL SETTING. AT THE HOSPITAL THEY LEARN SKILLS OF PROFESSIONALISM, COMMUNICATION AND SECRETARIAL WORK ALONG WITH INTERACTING WITH PATIENTS, DOCTORS AND FAMILIES. THE STUDENTS WORK 8 HOURS EACH WEEK AND RECEIVE PARTIAL PAYMENT (GOES DIRECTLY TO THE SCHOOL) TOWARD THEIR TUITION. THE PROGRAM WAS PAUSED IN MARCH DUE TO THE CORONAVIRUS PANDEMIC UNTIL DEEMED APPROPRIATE TO RESUME.ST. VINCENT RECEIVED GRANT FUNDING FROM CIGNA HEALTH TO HOST AN OUTDOOR HALLOWEEN HEALTH AND WELLNESS FAIR FOR THE CENTRAL COMMUNITY. THE EVENT INCLUDED BLOOD PRESSURE AND GLUCOSE SCREENINGS, FLU SHOTS, AND DISTRIBUTION OF HOUSEHOLD GOODS AND FOOD AS WELL AS TRICK-OR-TREAT. MORE THAN 200 INDIVIDUALS WERE SERVED. DESPITE THE PANDEMIC, ST. VINCENT CHARITY CONTINUED THE NO TEARS FOR CHRISTMAS PROGRAM. CAREGIVERS PURCHASE AND WRAP GIFTS FOR NEIGHBORHOOD CHILDREN AND THE GIFTS WERE DELIVERED VIA DRIVE-THROUGH AT TWO CENTRAL COMMUNITY PRESCHOOL FACILITIES. MORE THAN 100 CHILDREN RECEIVED CHRISTMAS GIFTS THROUGH THE PROGRAM. THROUGHOUT THE YEAR COMMUNITY OUTREACH TEAM SOUGHT OUT DONATIONS OF PERSONAL PROTECTIVE EQUIPMENT AND PURCHASED SUPPLIES AS WELL AND DISTRIBUTED THE PERSONAL PROTECTIVE EQUIPMENT TO COMMUNITY ORGANIZATIONS AND INDIVIDUALS. ST. VINCENT CHARITY MEDICAL CENTER PARTICIPATES IN THE CAPUCHIN LAY MISSIONARY PROGRAM. AS A FRANCISCAN COMMUNITY, THEY INVITE MEN AND WOMEN TO GIVE A YEAR OF SERVICE TO A NUMBER OF DIFFERENT SOCIAL JUSTICE NEEDS. ONE OF THE LAY MINISTERS SERVES AT SVCMC IN OUR EMERGENCY DEPARTMENT. THAT PERSON EXPERIENCED ALL KINDS OF MEDICAL NEEDS AND DIAGNOSIS AND HAS A FIRST HAND OPPORTUNITY TO DECIDE IF MEDICINE, DOCTOR, NURSE OR PHYSICIAN ASSISTANT IS THEIR FUTURE CALLING. PROGRAMS AND SERVICES ST. VINCENT CHARITY MEDICAL CENTER CONVERTED AN INTENSIVE CARE UNIT INTO A RESPIRATORY CARE UNIT TO SPECIFICALLY CARE FOR COVID-19 PATIENTS. THE MEDICAL CENTER ALSO OFFERED COVID-19 TESTING THROUGH ITS EMERGENCY DEPARTMENT AND PHYSICIAN OFFICES THROUGHOUT THE PANDEMIC. ON DEC. 23 2020, ST. VINCENT CHARITY RECEIVED NOTICE THAT IT WAS AN APPROVED COVID-19 VACCINE DISTRIBUTION PROVIDER AND THE ORGANIZATION BEGAN TO OPERATIONALIZE A STAFF AND COMMUNITY VACCINE CLINIC. EXPANDED MENTAL HEALTH SERVICES WITH OPENING OF NEW OUTPATIENT BEHAVIORAL HEALTH CLINIC IN DECEMBER 2020. DIABETES EDUCATION PROVIDED 353 INDIVIDUAL SCREENINGS OF BLOOD PRESSURE AND BLOOD GLUCOSE. THE INDIVIDUALS RECEIVED EDUCATION REGARDING THE RESULTS ALONG WITH RESOURCES FOR HEALTH CARE AND SOCIAL SERVICE NEEDS. THE SCREENINGS WERE PERFORMED AT 14 DIFFERENT EVENTS IN THE CENTRAL NEIGHBORHOOD, NEAR WESTSIDE, AND NEAR EASTSIDE. MANY EVENTS WERE PAUSED DUE TO THE PANDEMIC. DIABETES EDUCATION ALSO PROVIDED EDUCATION TO 208 PARTICIPANTS AT TWELVE EDUCATION PROGRAMS CONDUCTED VIRTUALLY. AWARDS AND ACCOMPLISHMENTS CATHY KOPINSKY, OUTREACH MISSION DIRECTOR, WAS ONE OF 60 FINALIST NOMINATED FOR THE HEALTH CARE WORKER IN THE STATE OF OHIO.SVCMC WAS WITHIN THE WINDOW FOR A JOINT COMMISSION SURVEY IN 2020, HOWEVER THE SURVEY WAS DELAYED DUE TO COVID-19. 137434502 1 1 0 1 0 0 0 1 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 1 180 0 1 1369 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 19 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X WILLIAM BOTCH 2168616200 2351 EAST 22ND STREET CLEVELAND OH 44115 STRAUSS THOMAS DIRECTOR 2.00 48.00 X 0 1032155 67942 ROGERS MELISSA DIRECTOR 2.00 48.00 X 0 458924 74092 MURPHY JANICE PRESIDENT/CEO, DIRECTOR 49.00 1.00 X X 0 373693 53913 BASTULLI JOHN MD DIRECTOR 12.00 0.00 X 75000 0 0 CHMIELEWSKI RICHARD MD DIRECTOR 12.00 0.00 X 51875 0 0 FRANTZ MICHAEL SECRETARY 3.00 0.00 X X 0 0 0 STRICKLIN MARY LOU VICE CHAIR 3.00 0.00 X X 0 0 0 VARLEY ROBERT W CHAIR 5.00 0.00 X X 0 0 0 WEAVER JEFFERY J TREASURER 3.00 0.00 X X 0 0 0 BEDELL JACK DIRECTOR 2.00 0.00 X 0 0 0 CHAPMAN TIMOTHY DIRECTOR 2.00 0.00 X 0 0 0 COYNE ANTHONY DIRECTOR 2.00 0.00 X 0 0 0 DUNN CYNTHIA DIRECTOR 2.00 0.00 X 0 0 0 ISAKOV GARY DIRECTOR 2.00 0.00 X 0 0 0 KARAM CSA SR JUDITH ANN DIRECTOR 2.00 0.00 X 0 0 0 KAVALEC JAMES DIRECTOR 2.00 0.00 X 0 0 0 PANZICA TIMOTHY DIRECTOR 2.00 0.00 X 0 0 0 PLATO WILLIAM DIRECTOR 2.00 0.00 X 0 0 0 WONG MARGARET JD DIRECTOR 2.00 0.00 X 0 0 0 RUSNACZYK JOHN SR. V.P. & CHIEF FINANCIAL 50.00 0.00 X 0 465703 48542 RITCHIE SHANNAN CHIEF OPERATING OFFICER 50.00 0.00 X 298742 0 32845 TAHIR MD ADNAN SR. V.P. & CHIEF CLINICAL AND ADMIN OFFICER 50.00 0.00 X 0 280750 44694 RAUH BRADLEY EXECUTIVE DIRECTOR STRATEGIC PROJECTS 50.00 0.00 X 131757 119862 18286 BISCARO MICHAEL CHIEF CLINICAL OFFICER 50.00 0.00 X 237337 0 11561 MONCZEWSKI THEODORE V.P. OF HUMAN RESOURCES 50.00 0.00 X 175892 0 19137 MORAN BARBARA CHIEF NURSING OFFICER 50.00 0.00 X 181155 0 9412 ERB SR MIRIAM V.P. OF MISSION & MINISTRY 50.00 0.00 X 0 0 0 FRIEDHOFF GEORGE PHYSICIAN 50.00 0.00 X 472941 0 47650 COOPER MD KEVIN PHYSICIAN 50.00 0.00 X 333727 0 29589 HENSLEY LESLIE MEDICAL DIRECTOR 50.00 0.00 X 295228 0 22151 HAYES EILEEN DIRECTOR OF SUPPORT & PROFESSIONAL SERVICES 50.00 0.00 X 197987 0 56687 VOLENIK FIOVDALIZA NURSE PRACTITIONER 50.00 0.00 X 212549 0 22016 PERSE DAVID MD FORMER PRESIDENT/CEO, DIRECTOR 0.00 50.00 X 0 1023709 5130 LOZAR BEVERLY FORMER SR. V.P. & C.O.O. 0.00 0.00 X 265989 0 4579 2930179 3754796 568226 48 1 1 0 XTEND HEALTHCARE LLC 90 VOLUNTEER DR STE 200 HENDERSONVILLE TN 37075 BILLING & COLLECTION SERVICES 2571261 CLEVELAND ANESTHESIA GROUP INC 6701 ROCKSIDE RD STE 200 INDEPENDENCE OH 44131 HEALTHCARE SERVICES 1976342 M&M MANAGEMENT & CONSULTING 6701 ROCKSIDE RD STE 200 INDEPENDENCE OH 44131 MANAGEMENT SERVICES 1140631 METZ CULINARY MANAGEMENT INC TWO WOODLAND DRIVE DALLAS PA 18162 MANAGEMENT SERVICES 975695 EMERGENCY PROFESSIONAL SERVICE INC PO BOX 634850 CINCINNATI OH 45263 HEALTHCARE SERVICES 686363 38 21145090 1573256 817700 22718346 NET PATIENT REVENUE 623000 122033870 122033870 PROGRAM RENTAL INCOME 532000 1840265 1840265 PHYSICIAN PRACTICE REVENUE 621300 573827 573827 DIAG REVENUE 900099 180781 180781 RESIDENT & INTERN DEVELOPMENT 611430 117000 117000 785022 785022 125530765 51424 51424 117802 -117802 -117802 -117802 PHYSICIAN BILLING REVENUE 900099 1660734 88351 1572383 CAFETERIA REVENUE 722514 829128 829128 OUTPATIENT LAB SERVICES 621500 263500 263500 558681 558681 3312043 151494776 125530765 351851 2893814 X 2630157 126875 2503282 53718284 49211686 4506598 2039712 1806133 233579 7520832 6642773 878059 4559252 4076520 482732 132615 132615 120844 120844 18437250 15802796 2634454 552643 552643 6803381 6092563 710818 2006168 1841954 164214 4394211 4326235 67976 62269 33975 28294 22626 20373 2253 301665 301665 6017459 5440320 577139 2105812 2105812 UBIT TAXES 3150 1575 1575 SUPPLIES-MEDICAL 26569928 26569928 STATE FRANCHISE TAX 3369207 3369207 COLLECTION FEES 2831019 2831019 7488243 6280450 1207793 151686727 137434502 14252225 0 4130 4130 2893927 21347127 16024836 14167939 3705545 3629679 472235 822081 150246904 121992912 28655341 28253992 9558286 10320009 1788748 2227689 63103048 80772646 24376841 24800123 3110543 3945395 9668217 25789122 37155601 54534640 X 14777277 13920148 11170170 12317858 25947447 26238006 63103048 80772646 X -191951 482510 X X 0 1 X 1 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2598 2598 0 PART II-B, LINE 1: DURING THE YEAR, THE REPORTING ORGANIZATION WAS A MEMBER OF THE OHIO HOSPITAL ASSOCIATION (OHA). DUES OF $44,417 WERE PAID OHA, AND OHA REPORTED THAT 5.85% OF DUES RECEIVED FROM THE MEMBER ORGANIZATION WERE ALLOCATED TO LOBBYING ACTIVITIES OF THE ASSOCIATION. 147700 147700 1 2577611 0 366645 6950 1295 2936010 2159797 5000 381466 5049 8603 2577611 2225951 67542 -125717 7979 2159797 1893629 35 339164 6877 2225951 500850 1350000 45043 2264 1893629 1.00000 0 1 1 1183998 1183998 53318956 44718959 8599997 3193717 3140080 53637 90523390 72961554 17561836 2026843 1172319 854524 28253992 MALPRACTICE CAPTIVE 1135244 DEFERRED GRANTS & OTHER 520603 MEDICAL STAFF FUNDS 685323 LINE OF CREDIT FROM SISTERS OF CHARITY HEALTH SYSTEM 7100000 DEFERRED PAYROLL TAXES 2314190 MMO ADVANCE 1283386 CMS ADVANCE 12750376 25789122 X PART III, LINE 4: ST. VINCENT CHARITY MEDICAL CENTER RECEIVED SEVEN SUBJECT OIL PAINTINGS, THREE LITHOGRAPHS, ONE CAST SILVER SCULPTURE, AND ONE CAST BRONZE SCULPTURE. THESE PIECES OF ART WERE DONATED IN 2020 FOR THE PRIMARY PURPOSE FOR THE VALUE OF THE ASSET. THE ART IS CURRENTLY ON DISPLAY IN THE WARREN OFFICE. PART V, LINE 4: TO PROVIDE GRANTS TO CURRENTLY ENROLLED STUDENTS WHO ARE PURSUING AN EDUCATION IN NURSING, REGARDLESS OF AGE, SEX, RACE, COLOR, RELIGION, ACADEMIC STATUS OR NEED. PART X, LINE 2: ST. VINCENT CHARITY MEDICAL CENTER AND ITS SUBSIDIARY ST. VINCENT CHARITY DEVELOPMENT FOUNDATION ARE NONPROFIT, TAX-EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AND, ACCORDINGLY, NO TAX PROVISION IS REFLECTED IN THE CONSOLIDATED FINANCIAL STATEMENTS. INDEPENDENT PHYSICIAN SOLUTIONS IS CONSIDERED A DISREGARDED ENTITY, AND ITS OPERATIONS ARE INCLUDED IN THE TAX FILINGS OF ST. VINCENT CHARITY MEDICAL CENTER. WITH FEW EXCEPTIONS, THE SYSTEM IS NO LONGER SUBJECT TO U.S. FEDERAL, STATE, AND LOCAL OR NON-U.S. INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2017. ST. VINCENT MEDICAL GROUP IS A FOR-PROFIT ENTITY. THE ENTITY IS A C CORPORATION THAT FILES A CONSOLIDATED FEDERAL TAX RETURN AND HAS NET OPERATING LOSSES OF APPROXIMATELY $9,942,400 AND $10,075,200 FOR THE YEARS ENDED DECEMBER 31, 2020 AND 2019, RESPECTIVELY. ANY POTENTIAL DEFERRED TAX ASSET ATTRIBUTABLE TO THE NET OPERATING LOSS CARRYFORWARDS HAS BEEN FULLY OFFSET BY A VALUATION ALLOWANCE, AS SVMG DOES NOT EXPECT TO REALIZE A BENEFIT FROM THE LOSSES. INCOME TAXES ON ST. VINCENT MEDICAL GROUP, IF ANY, ARE NOT SIGNIFICANT. BRAINARD ENTITIES ARE TREATED AS PARTNERSHIPS FOR INCOME TAX PURPOSES. INCOME AND LOSSES FOR BRAINARD ENTITIES ARE PASSED TO THEIR MEMBERS. 1 1 X 1 X 1 X 1 1 0 0 0 1731 1016828 486593 530235 0.00350 0 34961 49685751 38104073 11581678 0.07640 36692 50702579 38590666 12111913 0.07990 9 8767 508831 183750 325081 0.00210 3 1089 285208 0 285208 0.00190 2 347 1130 0 1130 0.00000 14 10203 795169 183750 611419 0.00400 14 46895 51497748 38774416 12723332 0.08390 1 17 23984 23984 0.00020 1 2019 13488 120 13368 0.00010 2 31 15513 15513 0.00010 2 737 14302 14302 0.00010 6 2804 67287 120 67167 0.00050 1 2725290 136265 16362017 21184056 -4822039 X 1 1 1 1 ST VINCENT CHARITY MEDICAL CENTER 2351 EAST 22ND STREET CLEVELAND OH 44115 X X X X ST VINCENT CHARITY MEDICAL CENTER 1 0 0 1 X X X X X X X X X 19 1 1 1 1 X HTTPS://WWW.STVINCENTCHARITY.COM/ABOUT/COMMUNITY-BENEFIT/ X 1 17 1 HTTPS://WWW.STVINCENTCHARITY.COM/ABOUT-ST-VINCENT-CHARITY-MEDICAL-CENTER 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X 1 X HTTPS://WWW.STVINCENTCHARITY.COM/POLICIES/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.STVINCENTCHARITY.COM/POLICIES/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.STVINCENTCHARITY.COM/POLICIES/FINANCIAL-ASSISTANCE/ X X X X X X 1 X 0 X X X X 1 X 0 0 ST. VINCENT CHARITY MEDICAL CENTER PART V, SECTION B, LINE 5: QUANTITATIVE DATA INCLUDED A RANDOM SAMPLE SURVEY TO ADULTS AND CHILDREN IN CUYAHOGA COUNTY WITH AN OVERSAMPLING OF AFRICAN AMERICAN AND HISPANIC RESIDENTS TO ASSURE REPRESENTATION OF THESE COMMUNITIES. A CONVENIENCE SAMPLE WAS ALSO CONDUCTED TO SUPPLEMENT THE RANDOM SAMPLE SURVEYS BY COMMUNITY HEALTH WORKERS WHO DISSEMINATED AND ASSISTED WITH SURVEY COMPLETION IN UNDER-RESOURCED NEIGHBORHOODS.QUALITATIVE DATA INCLUDED KEY STAKEHOLDER INTERVIEWS AND A FOCUS GROUP WITH COMMUNITY AGENCIES. INTERVIEWS WERE CONDUCTED WITH INDIVIDUALS FROM A VISION OF CHANGE, ALCOHOL, DRUG ADDICTION, AND MENTAL HEALTH SERVICES (ADAMHS) BOARD OF CUYAHOGA COUNTY, BENJAMIN ROSE INSTITUTE ON AGING, CALVARY HILL CHURCH OF GOD IN CHRIST, CLEVELAND CITY PLANNING COMMISSION, CLEVELAND DEPARTMENT OF PUBLIC HEALTH, CUYAHOGA COUNTY BOARD OF HEALTH, CUYAHOGA COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES, CUYAHOGA COUNTY MEDICAL EXAMINER, LGBT COMMUNITY CENTER, NEIGHBORHOOD CONNECTIONS, NEIGHBORHOOD FAMILY PRACTICE, THE CENTER OF COMMUNITY SOLUTIONS, THE METROHEALTH SYSTEM, ST. VINCENT CHARITY MEDICAL AND UNITED WAY OF GREATER CLEVELAND. THE MAJORITY OF THESE ORGANIZATIONS REPRESENT UNDER-RESOURCED, MEDICALLY VULNERABLE, LOW-INCOME, COMMUNITY MEMBERS AND POPULATIONS PROVIDING UNIQUE PERSPECTIVES ON HEALTH NEEDS IN CUYAHOGA COUNTY. FOCUS GROUP PARTICIPANTS INCLUDED REPRESENTATIVES FROM WESTERN RESERVE AREA AGENCY ON AGING, NORTHEAST OHIO AREAWIDE COORDINATING AGENCY, COUNCIL FOR ECONOMIC OPPORTUNITIES IN GREATER CLEVELAND, ENTERPRISE COMMUNITY PARTNERS, CLEVELAND RAPE CRISIS CENTER, CUYAHOGA METROPOLITAN HOUSING AUTHORITY, CHN HOUSING PARTNERS, HUNGER NETWORK OF GREATER CLEVELAND AND THE FOOD TRUST. FOCUS GROUP PARTICIPANTS SHARED THEIR PERSPECTIVES REGARDING THE MOST PRESSING ISSUES FACING THE PEOPLE THEY SERVE, HEALTH DISPARITIES, AND THE ROLE HOSPITALS AND HEALTH DEPARTMENTS SHOULD PLAY IN COMMUNITY HEALTH ISSUES. ST. VINCENT CHARITY MEDICAL CENTER PART V, SECTION B, LINE 6A: 1.) THE METROHEALTH SYSTEM2.) UNIVERSITY HOSPITALS3.) SOUTHWEST GENERAL HEALTH CENTER ST. VINCENT CHARITY MEDICAL CENTER PART V, SECTION B, LINE 6B: THE HOSPITAL'S 2019 CHNA WAS COMPLETED BY THE CENTER FOR HEALTH AFFAIRS WORKING WITH THE HOSPITAL. THE CHNA WAS ADOPTED BY THE ST. VINCENT CHARITY MEDICAL CENTER BOARD OF DIRECTORS ON OCTOBER 2, 2019. ST. VINCENT CHARITY MEDICAL CENTER PART V, SECTION B, LINE 7D: CHNA WAS POSTED TO OUR WEBSITE AND PROMOTED VIA SOCIAL MEDIA CHANNELS, INCLUDING FACEBOOK, TWITTER AND LINKEDIN. IT WAS ALSO SHARED WITH ALL INTERNAL STAKEHOLDERS, INCLUDING BOARD, PHYSICIANS AND CAREGIVERS, VIA EMAIL. ST. VINCENT CHARITY MEDICAL CENTER PART V, SECTION B, LINE 11: ST. VINCENT CHARITY MEDICAL CENTER IDENTIFIED FIVE PRIORITY AREAS TO FOCUS ON AS PART OF OUR COMMUNITY HEALTH NEEDS ASSESSMENT IMPLEMENTATION PLAN. THE FIVE AREAS ARE:1.) ELIMINATING STRUCTURAL RACISM2.) ENHANCING TRUST AND TRUSTWORTHINESS ACROSS SECTORS, PEOPLE, COMMUNITIES3.) ADDRESSING COMMUNITY CONDITIONS, SUCH AS REDUCING POVERTY AND ITS EFFECTS4.) ENHANCING MENTAL HEALTH AND REDUCING SUBSTANCE ABUSE5.) REDUCING CHRONIC ILLNESS AND ITS EFFECTS ST. VINCENT CHARITY MEDICAL CENTER PART V, SECTION B, LINE 16J: HTTPS://WWW.STVINCENTCHARITY.COM/POLICIES/FINANCIAL-ASSISTANCE/ SCHEDULE H PART V SECTION B LINE 7A HTTPS://WWW.STVINCENTCHARITY.COM/ABOUT/COMMUNITY-BENEFIT/ 9 1 - ST VINCENT - ROCKSIDE OP SURGERY CENTER 6701 ROCKSIDE RD INDEPENDENCE OH 44131 OUTPATIENT SURGERY CENTER 2 - ST VINCENT - ROCKSIDE 4400 ROCKSIDE RD INDEPENDENCE OH 44131 IMAGING/RADIOLOGY 3 - ST VINCENT - MEDICAL OFFICE BUILDING 2475 EAST 22ND ST CLEVELAND OH 44115 OCCUPATIONAL MED THERAY, LAB, RADIOLOGY, URGENT CARE & MEDICAL OFFICE BLDG 4 - ST VINCENT - ROCKY RIVER 20220 CENTER RIDGE RD STE 120 ROCKY RIVER OH 44116 DIAGNOSTIC SERVICES 5 - ST VINCENT - ROCKSIDE 6701 ROCKSIDE RD INDEPENDENCE OH 44131 MEDICAL OFFICE BUILDING 6 - ST VINCENT SHAKER MEDICAL OFFICE BLG 11201 SHAKER BLVD CLEVELAND OH 44104 MEDICAL OFFICE BUILDING 7 - ST VINCENT - SOLON MEDICAL OFFICE BLDG 33001 SOLON RD SOLON OH 44139 LAB, RADIOLOGY, URGENT CARE & OCCUPATIONAL HEALTH SERVICES 8 - ST VINCENT - MEDICAL OFFICE BUILDING 2322 EAST 22ND ST CLEVELAND OH 44115 MEDICAL OFFICE BUILDING 9 - ST VINCENT - WARREN OFFICE 2614 EAST MARKET ST WARREN OH 44483 MEDICAL OFFICE BUILDING PART I, LINE 3C: NA PART I, LINE 7: THE ORGANIZATION USES ITS CURRENT YEAR COST-TO-CHARGE RATIO TO DETERMINE THE COSTS ASSOCIATED WITH CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $2,725,290. PART III, LINE 4: AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS CALCULATED ON AN AGGREGATE BASIS BY USING HISTORICAL WRITE-OFF FACTORS BY FINANCIAL CLASS AND AGING CATEGORY APPLIED TO UNPAID ACCOUNTS BASED ON AGING. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. THE BAD DEBT EXPENSE IS BASED ON OUR AUDITED FINANCIAL STATEMENTS. ESTIMATE EXPENSE ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY QUALIFY FOR ASSISTANCE IS BASED ON DATA GATHERED ON ACCOUNTS INITIALLY WRITTEN OFF TO BAD DEBT THAT SUBSEQUENTLY WERE DETERMINED TO HAVE QUALIFIED FOR CHARITY CARE AFTER SECURING PATIENT COOPERATION IN THE FINANCIAL ASSISTANCE APPLICATION PROCESS.THE MEDICAL CENTER IS LOCATED IN A COMMUNITY WHERE 44% OF THE POPULATION'S INCOME FALLS BELOW THE FEDERAL POVERTY LEVEL. SOME PATIENTS DO NOT FULLY COMPLETE THE FINANCIAL ASSISTANCE (CHARITY) APPLICATION PROCESS OFFERED BY ST. VINCENT MEDICAL CENTER. GIVEN THE COMMUNITY DEMOGRAPHICS, ST. VINCENT MEDICAL CENTER REASONABLY ASSUMES THAT A PORTION OF THESE BAD DEBT ACCOUNTS WOULD OTHERWISE QUALIFY FOR ST. VINCENT MEDICAL CENTER'S FINANCIAL ASSISTANCE (CHARITY) PROGRAM IF PATIENTS COMPLETED THE CHARITY APPLICATIONS. ACCORDINGLY, A PORTION OF THESE AMOUNTS ARE CONSIDERED A COMMUNITY BENEFIT. PART III, LINE 8: MEDICARE COST REPORT ALLOWABLE COSTS WERE USED TO ARRIVE AT THE AMOUNT REPORTED ON PART III, LINE 6. PART III, LINE 9B: OUR POLICIES CONTAIN DETAILED INSTRUCTIONS AS TO THE PROCESS TO FOLLOW AS TO INFORMATION NEEDED AND FINANCIAL ASSISTANCE TO BE PROVIDED FOR ANY PATIENT THAT QUALIFIES FOR CHARITY CARE OR FINANCIAL ASSISTANCE. WHEN PATIENTS QUALIFY FOR FINANCIAL/CHARITY ASSISTANCE, THEIR ACCOUNT BALANCE IS EITHER WRITTEN OFF OR REDUCED USING A CHARITY ADJUSTMENT CODE. ANY RESIDUAL ACCOUNT BALANCE AFTER CHARITY ADJUSTMENTS ARE SUBJECT TO THE SAME COLLECTION PROCEDURES AS ALL OTHER PATIENTS. PART VI, LINE 2: COMMUNITY BOARD MEETS REGULARLY AT THE MEDICAL CENTER TO HELP ASSESS COMMUNITY NEEDS AND MAKE DETERMINATIONS ON THE NEED TO EXPAND OR RETRACT SERVICES OFFERED TO PATIENTS RELATIVE TO OUR MISSION AND MINISTRY. UNDER THE UMBRELLA OF THE SISTERS OF CHARITY OF ST. AUGUSTINE, THE COMMUNITY BOARD STRIVES TO MEET EVER-CHANGING COMMUNITY NEEDS, CLINICAL PRACTICES AND TECHNOLOGY WITH A SHARED COMMITMENT TO REPRESENT THE COMPASSION AND EXCELLENCE THAT DISTINGUISHES CATHOLIC HEALTH CARE. PART VI, LINE 3: NOTICES ARE POSTED THROUGHOUT THE MEDICAL CENTER OF ELIGIBILITY FOR FINANCIAL ASSISTANCE. IN PARTICULAR, THEY ARE POSTED IN REGISTRATION, SCHEDULING AND CASHIER LOCATIONS. THE MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY IS ALSO AVAILABLE ON THE MEDICAL CENTER'S WEBSITE. ADDITIONALLY, FINANCIAL COUNSELORS ARE AVAILABLE TO MEET WITH PATIENTS OR THEIR DESIGNATED FAMILY MEMBERS. BILLING REPRESENTATIVES ARE WELL AWARE OF OUR FINANCIAL ASSISTANCE POLICIES AND DISCUSS WITH PATIENTS AS NEEDED. FINALLY, STATEMENTS SENT TO PATIENT DISCLOSE THAT FINANCIAL ASSISTANCE IS AVAILABLE IF PATIENTS MEET THE GUIDELINES AND INSTRUCTS PATIENTS HOW TO CONTACT OUR OFFICES TO APPLY FOR FINANCIAL ASSISTANCE. PART VI, LINE 4: THE PROVISION OF QUALITY HEALTH CARE, ESPECIALLY TO PEOPLE LIVING IN POVERTY, IS A SISTERS OF CHARITY HEALTH SYSTEM HALLMARK. IN KEEPING WITH THE MISSION OF ST. VINCENT CHARITY MEDICAL CENTER AND ITS FOUNDERS, THE SISTERS OF CHARITY OF ST. AUGUSTINE, THIS URBAN DISPROPORTIONATE SHARE HOSPITAL DELIVERS HIGH-QUALITY, INNOVATIVE MEDICAL CARE TO EVERY PATIENT, REGARDLESS OF THEIR FAITH OR THEIR ABILITY TO PAY. ITS EMPLOYEES, PHYSICIANS, AND VOLUNTEERS SERVE APPROXIMATELY 109,800 HEALTHCARE VISITS ANNUALLY BY PROVIDING PRIMARY, SPECIALTY, AND SURGICAL CARE AT ST. VINCENT CHARITY MEDICAL CENTER AND ITS SATELLITE FACILITIES. THE MEDICAL CENTER'S SURROUNDING DOWNTOWN NEIGHBORS, INCLUDING RESIDENTS FROM CLEVELAND'S MOST IMPOVERISHED CENTRAL NEIGHBORHOOD, ARE ALSO SERVED BY THE HOSPITAL. THE POPULATION OF THE CENTRAL NEIGHBORHOOD IS APPROXIMATELY 12,740 WITH AN AVERAGE ANNUAL MEDIAN HOUSEHOLD INCOME OF $17,700, WHICH IS 33.2% BELOW THE FEDERAL POVERTY LEVEL. AS A TEACHING INSTITUTION, ST. VINCENT CHARITY IS COMMITTED TO TRAINING CAREGIVERS OF THE FUTURE THROUGH AN AFFILIATION WITH NORTHEAST OHIO MEDICAL UNIVERSITY, TEACHING MORE THAN 60 RESIDENT TRAINEES AND FELLOWS IN POST-GRADUATE TRAINING FOR INTERNAL MEDICINE, PODIATRY, DENTISTRY, AND CLINICAL ADDICTION. PART VI, LINE 5: SEE SCHEDULE O - PROGRAM ACCOMPLISHMENTS & MISSION PART VI, LINE 6: THE MEDICAL CENTER IS OWNED BY THE SISTERS OF CHARITY OF ST. AUGUSTINE (SCHS). SCHS OPERATES MEDICAL CENTERS IN OHIO. THE SCHS HOSPITALS INCLUDE ST. VINCENT CHARITY MEDICAL CENTER (IN CLEVELAND, OH) AND MERCY MEDICAL CENTER (IN CANTON, OH). THE SCHS HAS NUMEROUS OTHER PROGRAMS AIMED AT IDENTIFYING AND ANSWERING UNMET AND EMERGING COMMUNITY NEEDS. FOR EXAMPLE, OUR ELDER CARE PROGRAMS OFFER COMPASSIONATE, QUALITY HEALTH CARE AND SOCIAL SERVICES IN RESPONSE TO THE SPECIAL NEEDS OF SENIORS. THESE ORGANIZATIONS HAVE EVOLVED TO MEET EVER-CHANGING COMMUNITY NEEDS, CLINICAL PRACTICES AND TECHNOLOGY WITH A SHARED COMMITMENT TO REPRESENT THE COMPASSION AND EXCELLENCE THAT DISTINGUISHES CATHOLIC HEALTH CARE.THE MEDICAL CENTER HAS A FOR PROFIT PHYSICIAN GROUP ST.VINCENT MEDICAL GROUP THAT EMPLOYS PRIMARY CARE AND SPECIALIST PHYSICIANS, MANY WHO HAVE OFFICES IN UNDERSERVED AREAS OF GREATER CLEVELAND. THE MEDICAL CENTER FUNDED THE $10.3 MILLION LOSS THIS PHYSICIAN GROUP INCURRED IN 2020. X 1 1 X 1 1 0 0 0 0 0 1 0 STRAUSS THOMAS DIRECTOR 0 1009207 0 0 0 22948 0 48192 0 19750 0 1100097 0 0 PERSE DAVID MD FORMER PRESIDENT/CEO, DIRECTOR 0 447810 0 0 0 575899 0 5130 0 0 0 1028839 0 0 ROGERS MELISSA DIRECTOR 0 456494 0 0 0 2430 0 48192 0 25900 0 533016 0 0 FRIEDHOFF GEORGE PHYSICIAN 472027 0 0 0 914 0 32159 0 15491 0 520591 0 0 0 RUSNACZYK JOHN SR. V.P. & CHIEF FINANCIAL 0 357987 0 104015 0 3701 0 28692 0 19850 0 514245 0 0 MURPHY JANICE PRESIDENT/CEO, DIRECTOR 0 366678 0 0 0 7015 0 51513 0 2400 0 427606 0 0 COOPER MD KEVIN PHYSICIAN 331232 0 0 0 2495 0 20116 0 9473 0 363316 0 0 0 RITCHIE SHANNAN CHIEF OPERATING OFFICER 295044 0 0 0 3698 0 17354 0 15491 0 331587 0 0 0 TAHIR MD ADNAN SR. V.P. & CHIEF CLINICAL AND ADMIN 0 277863 0 0 0 2887 0 34344 0 10350 0 325444 0 0 HENSLEY LESLIE MEDICAL DIRECTOR 288480 0 0 0 6748 0 15711 0 6440 0 317379 0 0 0 LOZAR BEVERLY FORMER SR. V.P. & C.O.O. 0 0 0 0 265989 0 0 0 4579 0 270568 0 0 0 RAUH BRADLEY EXECUTIVE DIRECTOR STRATEGIC PROJECT 130179 119521 0 0 1578 341 0 0 9168 9118 140925 128980 0 0 HAYES EILEEN DIRECTOR OF SUPPORT & PROFESSIONAL S 187465 0 0 0 10522 0 50247 0 6440 0 254674 0 0 0 BISCARO MICHAEL CHIEF CLINICAL OFFICER 217151 0 20000 0 186 0 0 0 11561 0 248898 0 0 0 VOLENIK FIOVDALIZA NURSE PRACTITIONER 202471 0 10000 0 78 0 11075 0 10941 0 234565 0 0 0 MONCZEWSKI THEODORE V.P. OF HUMAN RESOURCES 173384 0 0 0 2508 0 12697 0 6440 0 195029 0 0 0 MORAN BARBARA CHIEF NURSING OFFICER 181155 0 0 0 0 0 9292 0 120 0 190567 0 0 0 PART I, LINE 3 THE REVIEW AND APPROVAL OF EXECUTIVE COMPENSATION IS THE RESPONSIBILITY OF THE BOARD. THIS THEN IS SUBJECT TO REVIEW BY THE MEMBER SISTERS OF CHARITY HEALTH SYSTEM. THE BOARD USES REPORTS FROM INDEPENDENT COMPENSATION CONSULTANTS, SURVEYORS OR STUDIES TO ASSIST IN THE REVIEW. IN MOST CASES, THESE REPORTS ARE OBTAINED FROM THE SAME SOURCES USED BY THE MEMBER. PART I, LINES 4A-B DAVID PERSE M.D. AGREED TO A TWO YEAR SEVERANCE IN 2019 WITH AN ESTIMATED VALUE OF $1,109,139. THE SEVERANCE PAYMENTS CONTINUE INTO 2021. BEVERLY LOZAR AGREED TO A 18 MONTH SEVERANCE IN 2019 WITH AN ESTIMATED VALUE OF $458,983. THE SEVERANCE PAYMENTS CONTINUE INTO 2021. EILEEN HAYES AGREED TO A 16 WEEK SEVERANCE IN 2020 WITH AN ESTIMATED VALUE OF $56,493. THE SEVERANCE PAYMENTS CONTINUE INTO 2021. SUPPLEMENTAL EXECUTIVE RETIREMENT PAYMENTS (SERP) OF $19,500 WERE MADE BY THE RELATED ORGANIZATION TO MELISSA ROGERS, JANICE MURPHY, AND THOMAS STRAUSS. PART I, LINE 7 DURING THE TERM OF DR. FRIEDHOFF'S EMPLOYMENT AGREEMENT, SO LONG AS PHYSICIAN REMAINS IN COMPLIANCE WITH THE TERMS OF THE AGREEMENT AND SO LONG AS THE AGREEMENT REMAINS IN EFFECT, PHYSICIAN SHALL BE ENTITLED TO A ONE-HUNDRED PERCENT PRODUCTION COMPENSATION AFTER ALL DIRECT AND INDIRECT EXPENSES ARE PAID. MICHAEL BISCARO AND FIOVDALIZA VOLENIK RECEIVED A SIGN ON BONUS. JOHN RUSNACZYK'S BONUS WAS DETERMINED AT THE BOARD'S DISCRETION. X 12 147700 THIRD PARTY APPRAISAL X 1 670000 THIRD PARTY APPRAISAL 2 0 0 0 SCHEDULE M PART I LINE 31 ST VINCENT CHARITY MEDICAL CENTER (SVCMC) DOES NOT HAVE A GIFT ACCEPTANCE POLICY. SVCMC PRIMARILY RECEIVES GIFTS AS CASH. NONCASH GIFTS ARE RECEIVED VERY INFREQUENTLY. THE NONCASH GIFTS THAT SVCMC DOES RECEIVE ARE REVEIWED ON A CASE BY CASE BASIS BY THE EXECUTIVE TEAM BEFORE ACCEPTING THE GIFT. FORM 990, PART III, LINE 1 OUR MISSION: IN THE SPIRIT OF THE SISTERS OF CHARITY OF ST. AUGUSTINE, THE ST. VINCENT CHARITY MEDICAL CENTER FAMILY IS DEDICATED TO THE HEALING MISSION OF JESUS. AS CAREGIVERS, WE SERVE WITH A DEEP RESPECT FOR THE DIGNITY AND VALUE OF ALL PERSONS; WE ARE FOCUSED ON QUALITY CARE; DEDICATED TO THE POOR; AND COMMITTED TO CONTINUING EDUCATION. OUR VISION: ST. VINCENT CHARITY MEDICAL CENTER, WITH THE COMMITMENT OF ITS CAREGIVERS AND PHYSICIANS, WILL BE A LEADING MODEL FOR HEALTHCARE DELIVERY IN NORTHEAST OHIO BASED ON ITS FAITH-BASED MISSION, DEDICATION TO EDUCATION, COMMITMENT TO THE COMMUNITIES IT SERVES, EXCELLENCE IN THE PATIENT EXPERIENCE IT PROVIDES, FOCUS ON SURGICAL SERVICES, AND PARTNERSHIPS WITH PHYSICIANS AND OTHER CONSTITUENCIES. OUR VALUES RESPECT: WE SERVE IN AN ATMOSPHERE OF MUTUAL RESPECT AND FAIRNESS, TREATING EACH PERSON WITH REVERENCE AND DIGNITY THAT RECOGNIZES EACH INDIVIDUAL'S CONTRIBUTION. INTEGRITY: WE HOLD OURSELVES ACCOUNTABLE FOR OUR ACTIONS AND ARE HONEST AND ETHICAL IN ALL OUR DEALINGS. QUALITY: WE ARE COMMITTED TO CONTINUOUS IMPROVEMENT OF OUR SERVICES TO BETTER EACH LIFE AS IF IT WERE OUR OWN. TEAM WORK: WE CELEBRATE THE OPPORTUNITY TO COME TOGETHER AS CAREGIVERS IN AN INCLUSIVE WORKPLACE WHERE DIVERSITY AND OPEN COMMUNICATIONS ARE VALUED. ACCOUNTABILITY: WE TAKE OWNERSHIP OF OUR WORK AND DO WHAT IS BEST FOR THE ORGANIZATION. DIVERSITY VISION: ST. VINCENT CHARITY MEDICAL CENTER IS COMMITTED TO CREATING, ADVOCATING FOR AND MAINTAINING AN INCLUSIVE ENVIRONMENT THAT SUPPORTS, RESPECTS AND VALUES THE UNIQUENESS OF EACH INDIVIDUAL. AS CAREGIVERS, WE CONTRIBUTE OUR UNIQUE TALENTS, EXPERIENCES AND PERSPECTIVES TO ENRICH THE QUALITY AND DELIVERY OF CARE TO OUR PATIENTS. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS ONE CORPORATE MEMBER: SISTER OF CHARITY OF ST. AUGUSTINE HEALTH SYSTEM, INC. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S MEMBER MAY ELECT MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B CERTAIN DECISIONS OF THE GOVERNING BODY, SUCH AS APPROVAL OF BUDGETS, CAPITAL EXPENDITURES AND ACQUISITION OF LAND, MUST BE APPROVED BY THE BOARD OF THE MEMBER ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B AFTER THE 990 RETURN IS REVIEWED INTERNALLY; IT IS SUBMITTED FOR REVIEW TO OUR TAX ADVISOR. THEY REVIEW FOR COMPLETENESS AND COMMUNICATE ANY CONCERNS THAT THEY IDENTIFY WITHIN THE DOCUMENTS AND WORKSHEETS OF THE TAX RETURN. ITEMS IDENTIFIED ARE REVIEWED BY STAFF AND ANY NEEDED CORRECTIONS ARE MADE. THE RETURN IS THEN PROVIDED TO THE CFO FOR REVIEW AND APPROVAL. IT IS THEN PROVIDED TO THE BOARD MEMBERS FOR THEIR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS IN PLACE A CONFLICT OF INTEREST POLICY AS WELL AS A NON-RETALIATION POLICY (WHISTLE-BLOWER). THE CONFLICT OF INTEREST FORMS ARE SENT OUT ANNUALLY TO ADMINISTRATION AND OTHER LEADERSHIP EMPLOYEES AS WELL AS BOARD MEMBERS. THE FORMS ARE RETURNED TO ADMINISTRATION. ONCE RETURNED, THEY ARE REVIEWED BY THE COMPLIANCE OFFICER AND CEO TO DETERMINE IF ANYTHING WOULD BE DEEMED A POTENTIAL CONFLICT OF INTEREST. IF THERE IS A CONFLICT, THE CEO, COMPLIANCE OFFICER AND EMPLOYEE/INDIVIDUAL MEET TO DISCUSS. THE RESULTS OF THOSE MEETINGS ARE AN AGENDA ITEM AT THE ORGANIZATION'S ADMINISTRATIVE COMPLIANCE COMMITTEE MEETING AND IT IS FURTHER DISCUSSED THERE. ONCE A DECISION IS MADE REGARDING THE CONFLICT, FOLLOW-UP IS MADE BY THE COMPLIANCE OFFICER/CEO WITH THE EMPLOYEE, IF APPROPRIATE. THE ORGANIZATION ALSO DISCUSSES THE RESULTS OF THE CONFLICT OF INTERESTS AT THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 15 THE REVIEW AND APPROVAL OF EXECUTIVE COMPENSATION IS THE RESPONSIBILITY OF THE BOARD. THIS THEN IS SUBJECT TO REVIEW BY THE MEMBER SISTERS OF CHARITY HEALTH SYSTEM. THE BOARD USES REPORTS FROM INDEPENDENT COMPENSATION CONSULTANTS, COMPENSATION SURVEYORS OR STUDIES TO ASSIST IN THE REVIEW. IN MOST CASES, THESE REPORT ARE OBTAINED FROM THE SAME SOURCES USED BY THE MEMBER. INFORMATION PROVIDED TO THE COMMITTEE INCLUDES SALARY, BONUS, INCENTIVE COMPENSATION, DEFERRED COMPENSATION AND OTHER BENEFITS. FORM 990, PART VI, SECTION C, LINE 18 FORMS 990, 990-T, AND 1023 ARE AVAILABLE TO PUBLIC UPON REQUEST AT THE MEDICAL CENTER. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, THE FINANCIAL STATEMENTS, AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE TO PUBLIC UPON REQUEST AT THE MEDICAL CENTER. FORM 990, PART IX, LINE 11G CONTRACT LABOR/AGENCY: PROGRAM SERVICE EXPENSES 1,291,537. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,291,537. PROFESSIONAL SERVICE PHYSICIANS: PROGRAM SERVICE EXPENSES 9,931,802. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,931,802. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 4,579,457. MANAGEMENT AND GENERAL EXPENSES 2,634,454. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,213,911. FORM 990, PART XI, LINE 9: ASSET TRANSFER TO ST. VINCENT MEDICAL GROUP -9,896,483. PREVIOUSLY REPORTED DONOR CONTRIBUTIONS 779,268. ASSETS RELEASED FROM RESTRICTION -1,056,349. MARKET VALUE TRUST 761,655. MARKET VALUE/INTEREST ON TEMP RESTRICTED FUNDS 148,431. ASSET TRANSFER FROM SISTERS OF CHARITY HEALTH SYSTEM 8,450,000. ASSET TRANSFER FROM ST. VINCENT CHARITY DEVELOPMENT FOUNDATION 1,241,577. CAPITAL CONTRIBUTIONS 54,411. FORM 990 PART XII, LINE 2C: THE ORGANIZATION HAS AN AUDIT AND COMPLIANCE COMMITTEE THAT HAS BEEN CHARGED WITH OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTING FIRM. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990 PART XII, LINE 3B: THE REQUIRED SINGLE AUDIT AS SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133 HAS NOT YET BEEN COMPLETED. PLANS HAVE BEEN MADE TO HAVE THE REQUIRED SINGLE AUDIT COMPLETED BY THE EXTENDED DUE DATE AS ESTABLISHED IN OMB M-20-26. 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