2021-11-02T13:37:29-05:00 2020-12-31 420714325 RSM US LLP 30 South Wacker Dr Suite 3300 Chicago IL 606063392 990 2020-01-01 356001540 Goshen Hospital Association Inc GOSH 5743642665 200 High Park Avenue Goshen IN 46526 Ben Bontrager CFO 5743642665 2021-11-01 1 Ben Bontrager 356001540 Rebekuh Eley P01247672 3126343400 2021-11-01 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z Goshen Hospital Randal Christophel 200 High Park Avenue Goshen IN 46526 354019126 0 X https://goshenhealth.com X 1946 IN To improve the health of our communities by providing innovative, outstanding care and services. 12 9 1864 275 -13776 0 74602 16773624 248884437 239044458 12346538 12668964 8987067 8724343 270292644 277211389 218614 25829846 0 0 108596248 107723723 0 0 0 163635197 128710172 272450059 262263741 -2157415 14947648 485116293 540424850 124521718 139430343 360594575 400994507 X The mission of Goshen Hospital is to improve the health of our communities by providing innovative, outstanding care and service, through exceptional people doing exceptional work. 0 0 247135985 25829846 245943333 See Schedule O 247135985 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 115 0 1 1864 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 12 9 1 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 IN X Ben Bontrager 5743642665 200 High Park Avenue Goshen IN 46526 Randal Christophel President and CEO 40.00 2.00 X X 923105 0 167971 Ebenezer Kio MD Physician 40.00 0.00 X 0 685446 53860 Leonard Henry MD Physician 40.00 0.00 X 0 648875 54297 Houman Vaghefi MD Physician 40.00 0.00 X 0 643177 52215 Urs Von Holzen MD Physician 40.00 0.00 X 0 575506 57044 Rob Myers Chief Operating Officer 40.00 1.00 X 516707 0 93535 Daniel Nafziger MD Chief Medical Officer 40.00 0.00 X 493405 0 72888 Larry Allen MD Chief Medical Executive/VP Population Health 40.00 0.00 X 471054 0 92325 Irina Sparks MD Physician 40.00 0.00 X 0 482269 57015 Ben Bontrager CFO 40.00 2.00 X 428421 0 82915 Jody Neer MD Director 1.00 40.00 X 0 451038 58128 Mark Podgorski VP of Hospital Operations 40.00 0.00 X 357161 0 77515 Alan Weldy VP of HR and Compliance (until 4/20) 40.00 1.00 X 412176 0 15164 Julie Crossley Chief Nursing Officer 40.00 0.00 X 299902 0 67986 Margaret S Franger VP of Cancer Services 40.00 0.00 X 295704 0 51446 Beau McNeff VP of Goshen Physicians/Cancer Srvs 20.00 20.00 X 220281 0 64617 Chris Hutfless VP of HR and Compliance (as of 8/20) 40.00 1.00 X 184019 0 24545 Andrew Vorhis NP Director 1.00 40.00 X 0 143403 29952 Steve Garboden Former VP Planning and Managed Care 24.00 0.00 X 115665 0 6522 Bruce Hughes MD Chair 1.00 0.00 X X 0 0 0 Brenda Srof Secretary/Treasurer 1.00 0.00 X X 0 0 0 Harshil Bhatt MD Director 1.00 0.00 X 0 0 0 Randy Cripe Director 1.00 0.00 X 0 0 0 Karen Pletcher Director 1.00 0.00 X 0 0 0 Liliana Quintero Director 1.00 1.00 X 0 0 0 Bonita Schrock Director 1.00 0.00 X 0 0 0 Karen Smith Director 1.00 0.00 X 0 0 0 Susan Stiffney RN Director 1.00 0.00 X 0 0 0 4717600 3629714 1179940 83 1 1 0 Hagerman Inc 510 W Washington Blvd Ft Wayne IN 46802 Construction 9746344 DJ Construction Co Inc 3414 Elkhart Road Goshen IN 46526 Construction 5574405 Southeast Anesthesiologists PC 8141 S Emerson Ave Indianapolis IN 46237 Contracted Staffing 2065690 Apogee Medical Management 15059 N Scottsdale Rd Ste 600 Scottsdale AZ 85254 Contracted Staffing 1350426 Quest Diagnostics PO Box 775460 Chicago IL 60677 Medical Services 1305971 49 98230 16675394 16773624 Patient Care 622110 239044458 239044458 239044458 5523647 -13776 5537423 1520108 0 1520108 1520108 1520108 83884766 68288 76807737 0 7077029 68288 7145317 7145317 Food Service Revenue 722514 244075 244075 Other Oncology Rev Misc 621500 127708 127708 Employee Retention Credit 900099 61285 61285 6771167 6771167 7204235 277211389 245943333 -13776 14508208 25829846 25829846 4717600 1264361 3453239 75940203 71327662 4612541 4935293 4441763 493530 16589293 14930364 1658929 5541334 4987200 554134 2357487 2357487 167667 167667 298322 298322 8730 8730 716000 716000 19393894 19393894 2336870 2336870 3517286 3517286 3035860 3035860 2257132 2257132 426749 426749 807177 807177 13218045 13218045 2323217 2323217 Drugs & Medical Supplie 55215569 55215569 Hospital Assessment Fee 9549341 9549341 Repairs & Maintenance 7006314 7006314 Bad Debt Expense 1515872 1515872 4558640 4558640 262263741 247135985 15127756 0 4263451 10387899 2111190 28512016 48681605 32777356 5663726 7055481 6876403 14744882 294711853 141021497 140928622 153690356 271437672 286961017 5153624 6295843 485116293 540424850 33129409 27616537 74946810 74566658 11761913 11762398 4683586 25484750 124521718 139430343 X 360109504 400994507 485071 0 360594575 400994507 485116293 540424850 X 14947648 22952388 2499896 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 8730 8730 0 Part II-B, Line 1: Lobbying expenses represent the portion of dues paid to the American Hospital Association and the Indiana Hospital Association that are specifically allocable to lobbying. 4848692 4848513 9697205 124148658 47389900 76758758 158142 36948 116019 79071 133746519 93515578 40230941 26924381 26924381 153690356 Deferred Malpractice 209000 Claims Liability 1045452 Lease Liability 4547668 Deferred Compensation 1457457 Medicare Advance Payments 17925173 Due to Third-Party Payor 300000 25484750 X Part X, Line 2: The Internal Revenue Service has determined that Goshen Health and certain affiliated entities are tax-exempt organizations as defined in Section 501(c)(3) of the Internal Revenue Code. Certain subsidiaries of Goshen Health are taxable entities, the tax expense and liabilities of which are not material to the consolidated financial statements. Goshen Health and its tax-exempt affiliated entities each file a Form 990 (Return of Organization Exempt from Income Tax) annually. When these returns are filed, it is highly certain that some positions taken would be sustained upon examination by the taxing authorities, while others are subject to uncertainty about the merits of the position taken or the amount of the position that would ultimately be sustained. Examples of tax positions common to health systems include such matters as the tax-exempt status of each entity, the continued tax-exempt status of bonds, the nature, characterization and taxability of joint venture income, and various positions relating to potential sources of unrelated business taxable income (reported on Form 990T). As of December 31, 2020 and 2019, there are no unrecognized tax benefits resulting from uncertain tax positions. Forms 990 and 990T filed by Goshen Health and its tax-exempt affiliated entities are subject to examination by the Internal Revenue Service up to three years from the extended due date of each return. Forms 990 and 990T filed by Goshen Health and its tax-exempt affiliated entities are no longer subject to examination for tax year 2017 and prior. 1 1 X 1 X 1 X 1 1 1 0 1 1 4999 2121951 0 2121951 0.00810 7808 39573385 26472493 13100892 0.05000 12807 41695336 26472493 15222843 0.05810 15354 26864120 9470 26854650 0.10240 809 732750 12466 720284 0.00270 12 10779 0 10779 0.00000 16175 27607649 21936 27585713 0.10510 28982 69302985 26494429 42808556 0.16320 16 71877 71877 0.00030 16 71877 71877 0.00030 1 9824899 40786020 49820258 -9034238 X 1 1 1 1 Goshen Hospital Association Inc 200 High Park Avenue Goshen IN 46526 https://goshenhealth.com License #XXX-XX-XXXX X X X Goshen Hospital Association Inc 1 0 0 1 X X X X X X X X X 18 1 0 0 1 X See Part V, Page 8 X 1 18 1 See Part V, Page 8 0 1 X 200.000000000000 400.000000000000 X X 1 1 X X X X 1 X https://goshenhealth.com/patient-information/estimates-financial-assistance X https://goshenhealth.com/patient-information/estimates-financial-assistance X https://goshenhealth.com/patient-information/estimates-financial-assistance X X X X X X 1 X 0 X X X X 1 X 0 0 Goshen Hospital Association, Inc. Part V, Section B, Line 5: In 2018, Goshen Hospital completed an evaluation of the communities' healthcare needs as required by the Patient Protection and Affordable Care Act. The Community Action Council met over multiple months and received input from community representatives, including those with special knowledge or expertise in public health. This process continues Goshen Hospital's long-standing practice of regularly identifying and addressing health needs within the community.In an effort to further identify health needs for the 2018 Community Health Needs Assessment (CHNA), additional data was collected from other sources. These sources include Latino and non-Latino parents and guardians, Amish community leaders, focus groups, key informants from business, not-for-profit organizations, service organizations, health care workers, mental health workers, and vulnerable or medically underserved populations. Goshen Hospital contracted with Indiana University School of Medicine to analyze various existing health, social, and economic data sets. The Bowen Center for Health Workforce Research and Policy provided data related to Indiana's health workforce and medically underserved areas. Elkhart County data was compared with Kosciusko, LaGrange and Noble counties, as well as the State of Indiana. Goshen Hospital Association, Inc. Part V, Section B, Line 11: Health needs were identified after an extensive analysis of primary and secondary data that included surveys, focus groups and key informants. Working with community stakeholders in the Community Action Council, this data was analyzed to identify and prioritize health needs in Goshen Hospital communities. The committee identified 13 needs and ranked accordingly. Prioritized Health Need1. Mental health2. Obesity3. Substance abuse: alcohol, drugs, addiction4. Diabetes5. Mental health providers6. Tobacco use/smoking7. Poverty8. Nutrition9. Physical fitness10. Physicians: primary care and other11. Insurance coverage12. Family support13. Health educationGoshen Hospital reviewed the prioritized list and evaluated based on the following questions:-How much control or influence do we have over each particular category? Can we make a material change in 2-3 years?-Are some of these categories related in a way that we can address more than one with our efforts?-Do we have key community partners we can collaborate with in these efforts?This evaluation process collapsed the original priorities list to the 7 below. Condensed Categories1. Mental Health and Mental Health Provider Access2. Obesity/Nutrition/Physical Fitness3. Substance Abuse4. Diabetes5. Tobacco/Smoking6. PCP Access/Availability7. Insurance CoverageTo accomplish meaningful and measurable change, the decision was made to target interrelated health conditions and behaviors, including obesity, nutrition, health education, physical fitness, and diabetes. Resources may be refocused to best address the needs of the community as they change over time. Goshen Hospital took the following actions in 2020 with respect to the Community Health Needs Assessment conducted in 2018.PRIORITY AREA: Obesity/Physical Fitness/Nutrition/Health EducationGOAL: Reduce the rate of obesity in Goshen Hospital service areas through internal and external programs.LONG TERM INDICATORS OF IMPACT1. Slow or halt the accelerating rate of adult obesity within the community Baseline Values - Elkhart County: 32.8%, 11.2% increase over 4 years2. Reduce the percentage of adults reporting physical inactivity within the community Baseline Values - 25.9% reporting physical inactivity in Elkhart County in 2013 and 26.4% from 2014-20183. Increase engagement in health education related to nutrition, physical fitness, and obesity within the community.STRATEGY #1: Lead a community coalition focused on improving and expanding broad access obesity initiatives with outcomes measures. This group will focus on high risk populations and cultural minorities, leveraging community assets and advancing the role of social determinants of health in programming.2020 ActivityGoshen Hospital planned to assist in achieving the Let's Move citywide designation as an opportunity for our community to support increases in physical activity and slow the acceleration of obesity. This effort, along with the Reducing Obesity Coalition of St. Joseph County and Live Well Kosciusko, were put on hold due to the COVID-19 pandemic. Almost all traditional in-person outreach programs and events were cancelled, including Run the Halls, THRIVE, 4H Fair, Great Inflatable Race, Summer Health Lunch Bunch program, Screen Free Week campaign, blood drives, and other community health events. Goshen Hospital was able to expand partnerships and modify programming to continue to meet the health education needs of the community during the pandemic. Noteworthy partnerships included: Purdue Extension, Elkhart County Food Council, Bushelcraft Farms, Kosciusko Chamber of Commerce Health and Wellness Committee, local parks departments, local school systems, Elkhart County Health Department, Goshen Farmers Market, Elkhart Educational Foundation, Montessori Schools, Goshen Public Library and the Elkhart County Fairgrounds. Modified programs included: THRIVE, Head 2 Toe on the Go Drive by Scavenger Hunt, educational videos in place of Summer Health Lunch Brunch on-site lessons, Move More Campaign, collaborative health education web resource for schools, and Run the Halls to fit multiple learning environments. These programs served a total of 9,848 participants in 2020. STRATEGY #2: Establish a consistent, evidence based pathway for obese patients within the Accountable Care Organization2020 ActivityBMI tracking continued as an indicator throughout our medical homes. Patients with a BMI over 35 are connected with our PAM assessment system for activation. This provides patients with a curriculum to help them move forward on a continuum of success. Progress is recorded as patients show improvement. In 2020, 249 patients completed the PAM assessment and 50% of patients improved their scores after intervention. The PREPARE system has been blended into care coordination. Through targeted medical assistance, vocational training, and transportation support, we are supporting lifestyle changes for individuals in our communities. STRATEGY #3: Establish an evidence-based pathway for overweight or obese pediatric patients while considering social determinants of health.2020 ActivityWhile this has a natural connection to the first strategy, the focus of this strategy is the health needs of children. A team was formed in 2020 to develop the evidence based pathway for pediatric patients. This team will determine metrics to monitor the patient population. Goshen Hospital adjusted programming, including Run the Halls and Summer Foods in order to meet COVID restrictions. These programs served a total of 1,061 participants in 2020. PRIORITY AREA: Diabetes/Nutrition/Health EducationGOAL: Reduce the rate of uncontrolled diabetics within the ACO population.LONG TERM INDICATORS OF IMPACTSlow or halt the accelerating rate of diabetes in our communityBaseline Values - 10.4% in Elkhart County, with an increase of 11.8% over 4 years.STRATEGY #1: Establish primary care driven intervention platform for uncontrolled diabetes.2020 ActivityReferred 725 patients to diabetes education in 2020.SUMMARYIn 2020, Goshen Hospital addressed prioritized health needs by: - Informing 10,666 participants through community health education events - Serving 498 individuals with community based clinical services - Expanding access to care by educating 809 doctors, nurses, and other health professional students - Partnering with 12 other organizations across the community in support of their health-building initiatives Goshen Hospital Association, Inc. Part V, Section B, Line 13h: Family size is another factor in determining discounts granted to patients. Goshen Hospital Association, Inc. Part V, Section B, Line 7, CHNA Policy Website:https://goshenhealth.com/health-library/community-health-needsGoshen Hospital Association, Inc.Part V, Section B, Line 10, Implementation Strategy Website:https://goshenhealth.com/health-library/community-health-needs 5 1 - Goshen Hospital 200 High Park Avenue Goshen IN 46526 Clinic 2 - The Retreat Women's Health Center 1135 Professional Drive Goshen IN 46526 Clinic 3 - Indiana Lakes Accountable Care 2018 South Main Street Goshen IN 46526 ACO: Ambulatory Care Coordination 4 - Indiana Lakes Managed Care 2018 South Main Street Goshen IN 46526 Health Care Management 5 - New Paris Medical Clinic 200 High Park Avenue Goshen IN 46526 Clinic Part I, Line 6a: Goshen Hospital Association, Inc. reports community benefit information as part of the Goshen Health, Inc. annual community benefit report (EIN: 35-1955872). Part I, Line 7: Goshen Hospital calculated the cost of financial assistance and means-tested government programs, using the cost-to-charge ratio derived from Schedule H, Worksheet 2, and ratio of patient care cost-to-charges. Other benefits amounts reported on line 7 were calculated using costs charged directly to the individual programs via the financial accounting system. An indirect cost allocation factor for shared services is also calculated and included in applicable programs listed in other benefits. Part II, Community Building Activities: Goshen Hospital promoted the health of the community by supporting various local organizations that engage in community building activities. Part III, Line 2: Goshen Hospital's analysis and assessment of the allowance for doubtful accounts and related bad debt expense uses a receipts "look-back" method utilizing historical payment data on accounts, including contractual adjustments for payer discounts, as well as patient payments, such as co-pays and deductibles, to establish anticipated collectability rates for accounts receivable within each payer category. Part III, Line 3: Goshen Hospital estimated the possible amount of charity care within bad debt expense by reviewing accounts that were internally coded as having been provided a financial assistance application, but that was not completed by the patient or guarantor, in which the account was subsequently written off to bad debt. Part III, Line 4: Refer to page 15 of the attached audited financial statements for the footnote related to bad debt expense. Part III, Line 8: Actual month and year to date revenue, contractuals, accounts receivable balances, ratios and statistics are compared to prior years on a monthly basis. Variances are reviewed and analyzed by finance representatives, hospital directors and the CFO. Additionally, actual contractual allowance as a percentage of gross accounts receivable and contractual provision as a percentage of gross patient charges are compared to prior years. This is done as part of the hospital's monthly close process. Explanations to variances (or non-variances when expected) are researched and provided by the appropriate personnel and reviewed with management of the hospital. The finance department also considers these key performance indicators when developing their estimates of contractual allowances to ensure recorded amounts appear reasonable based on actual data available.Financial representatives prepare and update the contractual allowance model as a basis for all third party payors based on actual statistics (e.g. discharges, days, etc.) and on current reimbursement rates. The model analyzes patient receivables and contractual allowance by payor and by patient status. The model estimates the collectability of patient accounts based on historical collection rates. Finance colleagues also update the model to account for changes in reimbursement rules. After the model is prepared, it is reviewed by the CFO for appropriateness and reasonableness.Contractual allowance calculations are reconciled to the general ledger on a monthly basis. Once the calculation is prepared, the finance department adjusts the general ledger accounts. Part III, Line 9b: Financial assistance is granted to those patients unable to pay all or a portion of their bill and who are unable to qualify for assistance through federal and state government assistance programs. If after insurance reimbursement additional assistance is needed, all patients may obtain financial assistance if the income criteria are met. All financial assistance applications are based on policy guidelines. Uninsured patients are required to provide documentation and an application. When approved, the adjustment is applied to the patient's account. For patients who do not qualify for financial assistance, payment plans and lump sum settlements are available. Goshen Hospital also partners with a local financing institution to provide a flexible and affording financing solution. Part VI, Line 2: As a community hospital, Goshen Hospital is dedicated to meeting the specific health care needs of our community. The hospital has 122 patient beds and over 250 physicians on its medical staff in 31 specialties. These physicians, together with other dedicated professionals, provide a wide range of services including the following: acute medical & surgical, emergency, home health, radiology, laboratory, cancer care, bariatrics, women's health, pain management, sleep studies, rehabilitation, patient and community health education and professional education.The Center for Cancer Care is a leader in innovative cancer treatment. We were among the first to adopt a comprehensive, multidisciplinary approach to cancer treatment. We offer holistic programs for strengthening minds as well as bodies, place a premium on family involvement and spiritual needs, and encourage patients to play a decision-making role in treatment selection. The Center for Cancer Care has specifically trained surgical oncologists, breast surgeons, medical oncologist, radiation oncologist, naturopathic practitioners and highly distinguished magnet designated nurses.Goshen Hospital improves the health and well-being of its communities by providing community wellness and education programs. Through local partnerships, the hospital identifies health issues and creates programs to ensure our community is the healthiest place to live, work and raise a family. The first of these programs cover CPR, EMS, diabetes, childbirth, fitness, nutrition, community education and health screenings the Elkhart County childhood obesity initiative. The CPR class is for anyone - professionals or private citizens - who want to know how to perform life-saving cardiopulmonary resuscitation; first aid classes are also offered. EMS training is available for persons interested in becoming emergency medical technicians or paramedics. The diabetes education helps people delay the onset and slow the progression of complications from this disease. It includes seminars, support groups, consultations and screenings. Childbirth education prepares expectant mothers and their families during this significant time in their life. Part VI, Line 3: Uninsured patients are screened during the pre-registration process for eligibility in the Healthy Indiana Plan and offer any other known sources of financial assistance. All registration locations have financial assistance forms available for self-pay patients to complete and will have information on the criteria and process for applying for financial assistance. Applications are also provided to any patients with a balance due who may qualify for financial assistance. Counselors are available to patients to aid in the application process including the collection of information to complete the application. Payment options and information on financial assistance is available on the hospital's website. Patients may download a preliminary application, and the patient agreement associated with financial assistance form the website, this information is available in English and Spanish. Part VI, Line 4: Goshen Hospital serves the northern Indiana area in Elkhart County. According to the 2019 census, the population of Elkhart County is 206,341. The median income for a household in Elkhart County is $57,021. Approximately 9.6% of the population were below the poverty line. The racial makeup of the county was about 74.1% White, 6.1% African-American, and 16.8% Hispanic or Latino. The remaining 3.0% of the population is a makeup of all other races. Part VI, Line 5: All of the Hospital's governing body is comprised of persons who reside in the organization's primary or secondary service areas. A majority of the board members are independent of the organization. The governing body approves medical staff privileges as indicated in the organization's credentialing and privileging policies and as recommended by the medical executive committee of the hospital. The hospital's governing body approves the annual operating budget for the hospital and the expenditure of capital funds above certain dollar amounts. The governing body also participates in strategic planning initiatives to determine goals objectives focused on patient care for the community. Part VI, Line 6: Hospital management provides Goshen Health with the hospital's annual operating budget and key strategic objectives. In addition, the hospital management provides Goshen Hospital with various key metrics involving patient satisfaction, patient quality and colleague satisfaction. Goshen Hospital reviews the data to ensure key initiatives are focused towards the promoting and meeting the healthcare needs of the communities. In addition, the hospital collaborates with Goshen Health to provide necessary nursing education and physician recruitment to assist in meeting the health needs of the community. Part VI, Line 7, Reports Filed With States IN 1 Goshen Health System Inc 200 High Park Avenue Goshen IN 46526 351974765 501(c)(3) 25521309 0 Operating Support Goshen Health Foundation Inc 200 High Park Avenue Goshen IN 46526 462565300 501(c)(3) 302996 0 Operating Support 2 0 Part I, Line 2: The Organization's Procedures for monitoring the use of grant funds in the U.S. consists of requiring the completion of a follow-up report form with subsequent grant fund applications. X X 0 1 X X X X 0 1 0 0 0 0 0 1 0 Randal Christophel President and CEO 602169 0 305755 0 15181 0 138069 0 29902 0 1091076 0 0 0 Ebenezer Kio MD Physician 0 613823 0 71623 0 0 0 28978 0 24882 0 739306 0 0 Leonard Henry MD Physician 0 528078 0 120797 0 0 0 27627 0 26670 0 703172 0 0 Houman Vaghefi MD Physician 0 565889 0 77288 0 0 0 24974 0 27241 0 695392 0 0 Urs Von Holzen MD Physician 0 455060 0 112946 0 7500 0 27730 0 29314 0 632550 0 0 Rob Myers Chief Operating Officer 390791 0 115854 0 10062 0 68171 0 25364 0 610242 0 0 0 Daniel Nafziger MD Chief Medical Officer 389469 0 98392 0 5544 0 62844 0 10044 0 566293 0 0 0 Larry Allen MD Chief Medical Executive/VP Populatio 353250 0 104332 0 13472 0 67535 0 24790 0 563379 0 0 0 Irina Sparks MD Physician 0 440277 0 41992 0 0 0 30261 0 26754 0 539284 0 0 Ben Bontrager CFO 333221 0 94360 0 840 0 64912 0 18003 0 511336 0 0 0 Jody Neer MD Director 0 412602 0 16375 0 22061 0 29971 0 28157 0 509166 0 0 Mark Podgorski VP of Hospital Operations 254410 0 75660 0 27091 0 48687 0 28828 0 434676 0 0 0 Alan Weldy VP of HR and Compliance (until 4/20) 199093 0 154321 0 58762 0 5968 0 9196 0 427340 0 0 0 Julie Crossley Chief Nursing Officer 231358 0 66242 0 2302 0 48219 0 19767 0 367888 0 0 0 Margaret S Franger VP of Cancer Services 165664 0 109497 0 20543 0 43776 0 7670 0 347150 0 0 0 Beau McNeff VP of Goshen Physicians/Cancer Srvs 191326 0 28955 0 0 0 43103 0 21514 0 284898 0 0 0 Chris Hutfless VP of HR and Compliance (as of 8/20) 132454 0 0 0 51565 0 18039 0 6506 0 208564 0 0 0 Andrew Vorhis NP Director 0 96475 0 46928 0 0 0 11174 0 18778 0 173355 0 0 Steve Garboden Former VP Planning and Managed Care 115665 0 0 0 0 0 3333 0 3189 0 122187 0 0 0 Part I, Line 1a Goshen Hospital grossed up the taxable value of automobiles for 2 of the officers listed on Form 990, Part VII and included the amount in the employees' W-2 as additional compensation. Goshen Hospital paid for country club dues for 1 of the officers listed in Form 990, Part VII. All reimbursements are considered taxable income to employees. Part I, Line 1b Goshen Hospital does not have a specific written policy for the use of automobiles, but does gross up the taxable value of automobiles to include in the employees' W-2 as additional compensation. Part I, Line 4b Eligible executives participate in various non-qualified deferred compensation plans organized under code Section 457(f). The exact purpose of each plan varies, but they include: compensation limitation make-up plans, voluntary deferral plans, deferral of a portion of incentive bonus type plans, etc. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. The following individuals participate in the plan: Randal Christophel Rob Myers Larry Allen, MD Julie Crossley Margaret S. Franger Mark Podgorski Ben Bontrager Daniel Nafziger, MD Beau McNeff Chris Hutfless Alan Weldy No non-qualified plan payments were made during the year to any listed persons in Part VII. A Indiana Finance Authority - 2019A 351602316 45471ATA0 2019-07-31 50630944 Campus improvement project 0 0 0 B Indiana Finance Authority - 2019B 351602316 45471ATA0 2019-07-31 25360000 Campus improvement project 0 0 0 A 50630944 628854 31844330 18157759 2022 0 0 0 1 B 25360000 359751 25000249 2022 0 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 0 B 0 1 0 0 1 0 0 0 0 A 1 B 1 Form 990, Part III, Line 4a, Program Service Description: The mission of Goshen Hospital is to improve the health of our communities by providing innovative, outstanding care and service, through exceptional people doing exceptional work. The hospital's values include: -Compassion - and commitment to service with empathy. -Accountability - with integrity and action. -Respect - through treating others as you wish to be treated. -Excellence - in all we do. The organization created the current three year strategic plan during 2019 to run from 1/1/2020 through 12/31/2022. The current strategic priorities for 2023 are as follows: 1. Access & Consumerism: Provide more access to convenient health services than any competitor in order to grow and secure our market position. 2. Provider Network: Attract and retain the highest-quality providers through a variety of alignment mechanisms. 3. Service Complement: Selectively grow and deepen our service offerings to meet the evolving needs of our community. 4. Value-Based Care: Build new and leverage our existing population health management capabilities as we prepare for value-based care to become increasingly prevalent. As a community hospital, Goshen Hospital is dedicated to meeting the specific health care needs of our communities. As a community leader, the hospital is committed to providing care in an innovating and dynamic environment. The hospital has 122 patient beds and over 250 physicians on its medical staff in 31 specialties. These physicians, together with other dedicated professionals, provide a wide range of services including the following: acute medical & surgical, emergency, home health, radiology, laboratory, cancer care, bariatrics, women's health, pain management, sleep studies, rehabilitation, patient and community health education and professional education. The American Nurses Credentialing Center's (ANCC) magnet recognition program for excellence in nursing services has designated Goshen Hospital as a magnet hospital since 2004. Designated hospitals have successfully created a work environment that nurses find both personally and professionally rewarding, advancing the practice of nursing and improving patient outcomes. Research shows that magnet hospitals are more effective at attracting and keeping quality nurses. Goshen Hospital is among an elite group of hospitals in the nation to be re-designated as a magnet facility. The Goshen Center for Cancer Care is accredited by the Commission on Cancer of the American College of Surgeons (COC). Receiving care at a COC-approved center for cancer care assures that patients will have access to: -quality care close to home. -comprehensive care offering a range of state-of-the art services and equipment. -a multidisciplinary team approach to coordinate the best treatment options available to cancer patients. -participation in cancer clinical trials, education and support. -lifelong patient follow-up through a cancer registry that collects data on type and stage of cancers and treatment results. -ongoing monitoring and improvement in care. The Center for Cancer Care is a leader in innovative cancer treatment. We were among the first to adopt a comprehensive, multidisciplinary approach to cancer treatment. We offer holistic programs for strengthening minds as well as bodies, place a premium on family involvement and spiritual needs, and encourage patients to play a decision-making role in treatment selection. The Center for Cancer Care has specifically trained surgical oncologists, breast surgeons, medical oncologist, radiation oncologist, naturopathic practitioners and highly distinguished magnet designated nurses. Goshen Hospital improves the health and well-being of its communities by providing community wellness and education programs. Through local partnerships, the hospital identifies health issues and creates programs to ensure our community is the healthiest place to live, work and raise a family. The first of these programs cover CPR, EMS, diabetes, childbirth, fitness, nutrition, community education and health screenings the Elkhart County childhood obesity initiative. The CPR class is for anyone - professionals or private citizens - who want to know how to perform life-saving cardiopulmonary resuscitation; first aid classes are also offered. EMS training is available for persons interested in becoming emergency medical technicians or paramedics. The diabetes education helps people delay the onset and slow the progression of complications from this disease. It includes seminars, support groups, consultations and screenings. Childbirth education prepares expectant mothers and their families during this significant time in their life. The Goshen Health Community Benefit Fund is one example of how Goshen Health re-invests money into the communities we serve. Any nonprofit organization with a mission consistent with that of Goshen Health and works toward meeting the needs of the community are encouraged to apply. Since its inception in 1998, the Community Benefit Grant Committee of Goshen Health's Board of Directors has awarded more than $6 million in grants to community organizations and projects that meet the health needs of our community. Goshen Hospital provides health care services to all members of the communities regardless of their ability to pay. The hospital offers financial assistance to those patients unable to pay all or a portion of their bill and who are unable to qualify for assistance through federal and state government assistance programs. Patients are asked to complete a financial aid application to determine their eligibility for financial assistance. The hospital provides the assistance of a financial advocate to help patients complete this application and to investigate other forms of available assistance including enrollment in marketplace plans. In 2020, the hospital extended charity care to 4,999 accounts totaling $8 million. Goshen Hospital also partners with a financial institution to provide flexible and affordable financing solutions for a patient's medical care. Goshen Hospital first received the beacon award for excellence from the American Association of Critical Care Nurses in 2010. This is a three-year accreditation and 2019 marks the fourth time Goshen has won the award and the third time Goshen has achieved the highest status, gold. Goshen Hospital has been named an accredited heart failure institute by the National Healthcare Accreditation Colloquium. The National Accreditation Program for Breast Centers (NAPBC) has awarded three-year, full accreditation to Goshen Health Retreat Women's Health Center. Press Ganey has awarded Goshen Health with 7 summit awards. In addition, Goshen Health has received the H&V Platinum Performance Achievement Award (NCDR) and the WHO baby-friendly designation. Form 990, Part VI, Section A, line 2 The following officers, board members, and key employees are employees of Goshen Hospital or its related organizations, and serve on other related taxable boards: Randal Christophel, Alan Weldy, Rob Myers, Larry Allen, MD, Ben Bontrager, Mark Podgorski, and Beau McNeff. Form 990, Part VI, Section A, line 6 The sole member of Goshen Hospital Association, Inc. is Goshen Health System, Inc. an Indiana not-for-profit corporation that serves as the corporate parent of the health system. Form 990, Part VI, Section A, line 7a Goshen Health System, Inc., a section 501(c)(3) exempt organization and the parent of the exempt healthcare system, is the sole corporate member of the filing organization. Directors shall be appointed as provided in the Bylaws by the member to a term as designated at the time of appointment. Form 990, Part VI, Section B, line 11b A full copy of the Form 990 is provided to the board of directors and the audit committee in November for review and questions before the return is filed with the IRS. Form 990, Part VI, Section B, line 12c Each board member completes an annual disclosure of known or potential conflicts. Each disclosure is reviewed by the VP-legal. Additionally when agenda items are discussed at meetings it is asked if there are any known or potential conflicts of interest, and conflicted parties must recuse themselves. Form 990, Part VI, Section B, line 15 An independent committee approves the compensation which is determined to be reasonable based upon independent comparability data provided by an independent consultant. Approval of amounts are documented in the minutes. Form 990, Part VI, Section C, line 19 Goshen Hospital will provide any documents open to public inspection upon request for the same period of disclosure as set forth in IRC Section 6104(d). Form 990, Part XI, line 9: Equity Transfer 2,499,896. 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