2020-05-14T22:02:10-05:00 2019-06-30 350921680 CROWE LLP 225 West Wacker Drive Suite 2600 Chicago IL 606061224 990 2018-07-01 390807060 Sacred Heart Hospital of Hospital Sisters of Third Order of St Francis SACR 7157176122 900 West Clairemont Avenue Eau Claire WI 54701 PATRICIA ALLEN DIVISION CHIEF FINANCIAL OFFICER 2020-05-14 true Mallory Fairless P01321579 3128997000 2018 2020-09-23 17:36:50Z Andy Bagnall 900 West Clairemont Avenue Eau Claire WI 54701 219547181 false 0928 X www.sacredhearteauclaire.org X 1890 WI TO PROVIDE THE MEANS WHEREBY SACRED HEART CAN CONTINUE THEIR APOSTOLIC MISSION TO SERVE THE SICK, THE AGED, THE POOR AND THE TERMINALLY ILL WITHOUT REGARD TO RACE, COLOR, CREED, OR NATIONAL ORIGIN. 11 9 1377 143 906379 0 546433 756633 215686017 203825726 12135535 14528446 881224 436376 229249209 219547181 0 0 0 79444082 103239952 0 0 0 112771823 101190427 192215905 204430379 37033304 15116802 706501742 707962949 98695369 112848357 607806373 595114592 SEE SCHEDULE O - ORGANIZATION'S MISSION false false 159525589 202931229 SEE SCHEDULE O - PART III LINE 4A 159525589 true true false true false false false false false true false false false true true false true false false false false false false false false true true false false true false false false false false false false false false false false false true true false false false true X 862 0 true 1377 true true true false false false false false true false false false false false X 11 9 false false false false true true true true true false false true true true true true true true true true true X Patty Allen 7157176121 900 WEST CLAIREMONT AVENUE EAU CLAIRE WI 54701 ANDREW J BAGNALL PRES/CEO WESTERN WI DIV 20.0 20.0 X X 0 611303 108512 JULIE MANAS PRES / CEO WESTERN WI DIV Through Jan 2018 40.0 20.0 X X 0 929345 1099 CHARISSE OLAND PRESIDENT (through Dec 2018) 20.0 21.0 X X 0 443544 22913 Jeff Halloin 2019 Chair 1.0 1.0 X X 0 0 0 DAVID KIEFER 2018 CHAIR 1.0 1.0 X X 0 0 0 JAMES E DOCKSEY 2018 & 2019 Vice Chair 1.0 1.0 X X 0 0 0 GERALD JACOBSON 2018 & 2019 Secretary 1.0 1.0 X X 0 0 0 LON BLASER DO BOARD MEMBER 1.0 3.0 X 0 0 0 Patti Darley BOARD MEMBER 1.0 1.0 X 0 0 0 SR BERNADINE GUTOWSKI OSF BOARD MEMBER 1.0 1.0 X 0 0 0 GREG HEILER MD BOARD MEMBER 1.0 1.0 X 0 0 0 PETER MANNIX Board Member 1.0 59.0 X 0 499239 158591 Tina Nazier Board Member 1.0 1.0 X 0 0 0 PATRICIA ALLEN DIV CFO 20.0 30.0 X 302742 0 25406 ANN M CARR TREASURER 0.3 59.7 X 0 329829 110463 JOHN WACIUMA PHYSICIAN 40.0 0 X 629877 0 47683 Erik Dickson Chief Physician Executive 40.0 0 X 370700 0 31898 John Folstad VP - STRATEGY DEV IMP - DIV 40.0 0 X 277218 0 20605 Layton Anderson Chief Human Resources Officer - DIV 40.0 0 X 266619 0 26883 LANCE J LEVENDOWSKI PHYSICIAN 40.0 0 X 256859 0 49317 JOAN COFFMAN Former PRESIDENT 0.0 60.0 X 0 393262 61919 2104015 3206522 665289 78 true true false SAMUELS GROUP 311 FINANCIAL WAY WAUSAU WI 54401 CONSTRUCTION 4093073 MARKET AND JOHNSON INC PO BOX 630 2350 GALLOWAY ST EAU CLAIRE WI 54702 CONSTRUCTION 2612359 Oakleaf Clinics - Eau Claire Med Clinic 3802 Oakwood Mall Drive Eau Claire WI 54701 PROVIDER STAFFING 1867051 Compass One Healthcare PO Box 102289 Atlanta GA 30368 Management and Food service 1458074 Medical Staffing Solutions PO Box 101 Rice Lake WI 54868 Staffing services 1349966 35 756633 756633 Net Patient Revenue 621990 201589646 201589646 Departmental Revenue 900099 1341583 1341583 Reference Lab Services 541380 894497 894497 0 0 0 0 203825726 3466402 3466402 222503 222503 0 222503 222503 11062044 11062044 0 11062044 11062044 Gift Shop 453220 179944 179944 Employee & Senior Cafeteria 722514 22047 22047 Clinical Engineering 541300 11882 11882 0 0 0 0 213873 219547181 202931229 906379 14952940 X 328148 328148 81349336 67587714 13761622 -412782 -307729 -105053 17518826 14509042 3009784 4456424 3322264 1134160 34648 34648 2202166 2202166 29573719 14591808 14981911 0 1350884 773201 577683 10790320 10790320 2247073 241112 2005961 220477 58321 162156 498059 476312 21747 840605 840605 9987875 4701810 5286065 600201 165261 434940 Supplies 28588640 28056938 531702 Medicaid Assessment 4758340 4758340 Maintenance and Repairs 3475619 3285168 190451 Provision for Bad Debt 2626719 2626719 3395082 3888988 -493906 0 204430379 159525589 44904790 0 9052244 2218179 21306123 21409398 0 0 0 5339687 5357698 747709 1102998 291715278 176724158 90642561 114991120 566867270 558503324 0 0 12546148 4380232 706501742 707962949 22981211 18345317 48688074 50664995 0 27026084 43838045 98695369 112848357 X 597976430 585800526 3349558 2811395 6480385 6502671 607806373 595114592 706501742 707962949 X 15116802 -2456135 -25352448 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 8124 8124 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY SACRED HEART HOSPITAL (THE HOSPITAL) IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION ("CHA"), THE WISCONSIN HEALTH ASSOCIATION ("WHA"), AND THE AMERICAN HOSPITAL ASSOCIATION ("AHA"). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES, WITH PART OF THESE DUES BEING ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. THE AMOUNT LISTED IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID. THE ASSOCIATIONS THE HOSPITAL PAYS ARE AS FOLLOWS: - AMERICAN HOSPITAL ASSOCIATION ("AHA") AT 22.73 LOBBYING EXPENSE - CATHOLIC HEALTH ASSOCIATION ("CHA") AT 3.52% LOBBYING EXPENSE - WISCONSIN HOSPITAL ASSOCIATION ("WHA") AT 13.60% LOBBYING EXPENSE THE TOTAL AMOUNT OF ANNUAL DUES PAID TO EACH ASSOCIATION IS MULTIPLIED BY THE PERCENTAGE OF DUES ALLOCATED TO LOBBYING EXPENSE TO CALCULATE THE TOTAL LOBBYING EXPENDITURES PAID. 3005334 3005334 155718484 80436338 75282146 5059463 3411379 1648084 118787240 92876441 25910799 9144757 9144757 114991120 OTHER LONG-TERM LIABILITIES 1035361 ACCRUED PENSION LIABILITY 26525366 INTEREST RATE SWAP PROGRAMS 16277318 43838045 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote HSHS and the Foundation are Illinois not-for-profit organizations as described in Section 501 (c) (3) of the Internal Revenue Code (the Code) and are exempt from federal income taxes on related income pursuant to Section 501 (a) of the Code. Kiara, Inc. is an Illinois for-profit corporation that recognizes income taxes under the asset-and-liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the consolidated financial statement carrying amounts of existing assets and liabilities and their respective tax basis and operating loss and tax credit carryforwards. Deferred tax assets and liabilities are measured using the enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. In assessing the realizability of deferred tax assets, management considers whether it is more likely than not that some portion or all of the deferred tax assets will not be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income during the periods in which those temporary differences become deductible. Management considers projected future taxable income and tax planning strategies in making this assessment. Based upon the level of historical taxable losses and projections for future taxable losses over the periods for which the deferred tax assets are deductible, management believes it is more likely than not Kiara, Inc. will not realize the majority of the benefits of these deductible differences. Full valuation allowances have been applied against the deferred tax assets attributable to the net operating loss carryforwards not realized as of June 30, 2019 and 2018 in the accompanying consolidated financial statements due to the uncertainty of realization. HSHS recognizes the tax benefit from an uncertain tax position only if it is more likely than not the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. As of June 30, 2019 and 2018, HSHS does not have any liabilities for unrecognized tax benefits. true true X true X true X true true true false true true 2269973 2269973 0.0126 26141823 17893071 8248752 0.0459 3897005 2925727 971278 0.0054 0 0 32308801 20818798 11490003 0.0639 376039 16987 359052 0.0020 4116306 3557324 558982 0.0031 19767918 14516869 5251049 0.0292 0 0.0 68748 68748 0.0004 0 0 24329011 18091180 6237831 0.0347 0 0 56637812 38909978 17727834 0.0986 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 197441 0 197441 0.0011 0 0 197441 0 197441 0.0011 true 1984315 785000 63960616 95392772 -31432156 X true true 1 1 SACRED HEART HOSPITAL 900 WEST CLAIREMONT AVENUE EAU CLAIRE WI 54701 http://www.sacredhearteauclaire.org 17 X X X X BEHAVIORAL HEALTH DIALYSIS INPATIENT REHAB SACRED HEART HOSPITAL 1 false false true X X X X X X X X X 17 true true true true X https://www.sacredhearteauclaire.org/www-shec/media/SHEC-Documents/Eau-Claire-County-Community-Healt X X true 17 true https://www.sacredhearteauclaire.org/www-shec/media/SHEC-Documents/Eau-Claire-County-Community-Healt false true X 200.0 400.0 X X X X X X true true X X X true X http://www.hshs.org/fap X http://www.hshs.org/fap X http://www.hshs.org/fap X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E Yes, the significant health needs are a prioritized description of the significant health needs of the community and were identified through the CHNA process. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - HSHS Sacred Heart Hospital. The FY2018 Community Health Needs Assessment (CHNA) Partnership Committee was comprised of representatives from nine community organizations in Chippewa and Eau Claire, WI counties. Membership included the chief health officers from both the Chippewa County and Eau Claire County Public Health Departments. Also, on the committee were the Executive Director and the Director of Community Health from the United Way of the Greater Chippewa Valley, along with Directors of Community Health from HSHS Sacred Heart and St. Joseph's Hospitals and Mayo Clinic Health System. In addition, the committee included the Policy and Systems Manager of the Eau Claire County Health Department, the Administrator of Marshfield Clinic Health System and a Community Health Educator from HSHS. The committee also invited input on the CHNA from local health coalitions, Eau Claire Healthy Communities and Chippewa Health Improvement Partnership. These coalitions have membership that represents all twelve community sectors. The CHNA process included a variety of data collection methods to connect with several different demographic groups in the community and to develop a thorough understanding of health issues facing the Chippewa Valley. These methods included primary qualitative data collection through an online and hardcopy community health survey (an abbreviated hard copy survey was created for residents with limited health literacy), survey outreach with underrepresented demographic groups, community conversations (to prioritize health focus areas), and coalition meetings (to further evaluate the top five health focus areas). A translator was present during survey outreach sessions to assist community residents with a language barrier. The link to the web survey was widely distributed through the networks of each of the partner organizations as well as more than 70 community organizations including public and private schools. Community organizations included the Salvation Army, Aging and Disability Resource Center, Boys & Girls Club of the Greater Chippewa Valley, Family Resource Center, Western Dairyland Head Start, local churches and food pantries, University of Wisconsin-Extension, Eau Claire Area Hmong Mutual Assistance Association, Family Promise of the Chippewa Valley, Eau Claire YMCA, Eau Claire Chamber of Commerce, Catholic Charities, Bolton Refuge House, Hope Gospel Mission, and others. The survey launch was announced by a press release and was widely advertised in local newspapers, television media outlets, social media, and flyers throughout the county. Special effort was made to ensure the survey was available to underrepresented groups who can be at the highest risk of suffering from health disparities. Hardcopy surveys were also made available throughout the county by request from the project manager. A total of 1,876 Eau Claire County residents completed the survey, and results are reportable at a 95% confidence level. Survey respondents represented a wide range of county residents, including a variety of income and educational levels, age, and household size. Twenty-five percent of respondents identified as health care providers and 5% emergency services personnel, indicating many residents not employed in a healthcare related field also participated in the survey. Analysis of the survey demographics in Eau Claire County indicated that a low number of responses were received from the over 70 age group, as well as from community members with highest education level designation of some education or high school. Therefore, targeted sessions were held to engage these two groups and gather information on barriers and resources needed for making healthy choices in the community. These sessions were held in December 2017 throughout the county: Chippewa Valley Correctional Treatment Facility, Eau Claire area Hmong Mutual Assistance Association, L.E. Phillips Senior Center, Agnes Table, The Community Table, and WIC clinic in Augusta. A key informant session was also held with an Eau Claire City-County Health Department Public Health nurse who serves the Eau Claire County Amish population. Each session was conducted by at least one community health needs assessment partner organization representative. Session participants had the choice to complete the community health survey online or hardcopy. An abbreviated assessment was offered as an option during the outreach. Overall, 127 surveys were completed through the targeted outreach sessions. Secondary data gathered throughout the CHNA process, insight from the community, and coalition conversations with members of the community health coalitions for Chippewa and Eau Claire counties provided additional perspective on the disparities among populations within Eau Claire County. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - HSHS Sacred Heart Hospital. Yes, the FY2018 CHNA was conducted with sister-hospital HSHS St. Joseph's Hospital, Chippewa Falls, WI, Mayo Clinic Health System and Marshfield Clinic Health System, of Eau Claire, WI. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - HSHS Sacred Heart Hospital. Yes. The hospital's FY2018 CHNA was conducted with Eau Claire Healthy Communities Coalition, Eau Claire County, Wisconsin; Chippewa County Department of Public Health, Chippewa County, Wisconsin; Chippewa Health Improvement Partnership, Chippewa County, Wisconsin; United Way of the Greater Chippewa Valley, Chippewa and Eau Claire County, Wisconsin. Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - HSHS Sacred Heart Hospital. Hard copies of the CHNA are available free of charge through the hospital's Community Health and Marketing departments, as well as through the hospital's community health coalition, Chippewa Health Improvement Partnership. The CHNA results were also announced by the hospital and partnering agencies via a press release and subsequently multiple media interviews followed to discuss the results and potential implementation plans. The CHNA results are frequently discussed by HSHS Community Health colleagues on television news programs and local newspapers as part of stories to explain why the hospital is implementing a program or hosting an event. The CHNA has been utilized by several community partners to guide their Community Health Improvement Plans (CHIP), including the CHIP for Chippewa County Health Department and Chippewa Health Improvement Partnership Coalition. The link for the hospital webpage where the CHNA is located is often requested and sent to area organizations. The CHNA results are also discussed at a variety of events and presentations that the hospital's Community Health department is involved in such as presentations to area service clubs, area mentor clubs, at the onset of Mental Health First Aid, ACEs and QPR trainings, and hospital board and other committee meetings. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - HSHS Sacred Heart Hospital. Based on the FY2018 CHNA planning and development process, the following top three community health needs were identified and have been the primary focus areas for HSHS Sacred Heart Hospital's (SHEC) community benefit in FY2019: * Mental Health * Substance Abuse * High-Risk Alcohol Consumption Mental Health HSHS Sacred Heart Hospital (SHEC) led the implementation and/or continuation of multiple efforts to improve the mental health and emotional wellbeing of residents of the area that the hospital serves. The SHEC Community Benefit Implementation plan includes several evidence-based strategies to positively impact the top identified need for both Chippewa and Eau Claire counties which was mental health. These strategies were selected with the understanding that behavioral health and mental illness are affected by a multitude of factors at the intrapersonal, interpersonal, community, and societal levels, with no factor singly explaining the prevention, care and treatment, or rehabilitation of mental illness. Goal: In partnership with the Eau Claire City-County Public Health Department and other organizations, HSHS Sacred Heart Hospital will continue existing efforts, while enhancing others, to educate/create awareness of mental health and increase access to mental health services in the community, including services offered by the hospital. HSHS Sacred Heart Hospital will also continue to host and support the mental health initiatives of the Eau Claire Healthy Communities Coalition and Chippewa Health Improvement Partnership (CHIP). Strategy 1: Mental Health Awareness and Education HSHS Sacred Heart Hospital will develop, promote, and/or participate in a minimum of five mental health awareness events, activities, and/or educational sessions annually to raise awareness of mental health issues. FY2019 Outcomes On August 29, 2018, SHEC Community Health coordinated an educational program at LE Phillips Senior Center in Eau Claire. Entitled "Mindful Aging," the program was presented by a counselor from HSHS Sacred Heart Hospital's Healing Place and was geared toward senior citizens. Evaluations from 27 participants indicated that 99 percent of attendees gained useful and applicable knowledge from the session. A service of SHEC, The Healing Place is a center that offers free support services and educational programming for anyone experiencing significant life transitions such as death, divorce or separation, illness/disability, unemployment or retirement, and military deployment. Trained counselors help people of all ages become active in their own healing process through individual counseling, support groups and educational opportunities for schools, churches and community organizations. Ongoing support groups are available to help individuals to cope with life adjustment issues and stress. Offerings include daytime and evening spouse loss group; grief group for parents who have lost a child; suicide survivors group; ongoing daytime and evening meditation groups; and gratefulness gatherings. All Healing Place services are offered to the community free of charge. In FY2019, The Healing Place served 3207 people, including 1790 support group attendees, 1333 participants in classes and events both on-site and in the community. Evaluations from the mindfulness class offer the following comments: "It has helped me immensely through my period of grief so far."; "Trying not to worry about the future, sleeping better."; and "Being more compassionate overall. At least trying to live in the moment." HSHS Sacred Heart Hospital along with community partners together form the Prevent Suicide Chippewa Valley Coalition (PSCVC), which is made up of 20 members from area agencies that have a goal of reducing suicide in our communities through suicide prevention education. Members include Eau Claire County and Chippewa County Public Health and Department of Human services, Mayo Health System, Marshfield Clinic Health System, NAMI, local church pastors, University of WI Eau Claire, Northwest Connections Crisis as well as others. In FY2019, PSCVC designed and distributed 1500 posters throughout Eau Claire, Chippewa and Dunn County with suicide warning signs and tear offs with suicide crisis line information. Also distributed throughout the tri-county area was an educational piece on means restriction entitled, Suicide Safe Home. The coalition also purchased 2000 magnetic locker mirrors with positive messages for students in two area schools. To raise awareness of suicide in our community, PSCVC hosts a yearly public walk and remembrance day called Sharing Hope: Walk to Prevent Suicide. In September 2018, the walk was attended by more than 1000 people. The walk is a fundraiser with all proceeds going back into community mental health initiatives. PSCVC also provides grants to area non-profit agencies for initiatives related to improving mental health. In FY2019 PSCVC grantees included The Wellness Shack (peer-led mental health recovery center services); Tandem Mentor (suicide prevention trainings); Nar Anon (supports families of those struggling with drug abuse); and the Eau Claire Police Department (Crisis Intervention training for community law enforcement). According to the American Psychological Association, caregivers are at elevated risk for developing mental health disorders and report higher levels of depressive symptoms than among their non-caregiving peers. On October 3, 2018, SHEC Community Health coordinated a mental health educational session geared toward caregivers entitled, "Commandments for Caregiving." The presenters were a husband and wife team who used the art of improvisation to educate the attendees on how to cope with caregiving for a loved one. Seventy people attended the program. Evaluations from attendees indicated that 99 percent of attendees gained new information and 100 percent of attendees indicated they plan to implement something new in their lives because of the program. Strategy 2: Promote Resilience for Chippewa Valley Youth SHEC will continue to promote resilience and other protective factors in youth through active participation in the Mental Health Matters grant project from Advancing a Healthier Wisconsin Endowment-Medical College of Wisconsin. The hospital's Community Health Department will also assist the area school district in coordinating a Teen Mental Health Summit. FY2019 Outcomes SHEC Community Health is an active participant of a community collaboration that is working to create awareness of the effect of trauma and Adverse Childhood Experiences (ACEs) on brain development and how to create resilience in youth. From October 2018 through June 2019, the collaborative provided 21 community awareness presentations on ACEs/Resilience to approximately 840 youth-serving professionals from education, health care, community-based organizations, and government sectors in Chippewa and Eau Claire counties. Sixty percent of attendees completed the evaluation of the program and results are as follows: * Participants reported an increase in their level of knowledge after the workshop compared to their reported level of knowledge before the workshop for all five workshop learning objectives. * 95 percent of participants agreed the workshop was relevant to their work, would be of immediate use to them, and motivated them to do something different. * 531 workshop participants reported at least one action they plan to take in their work based on what they learned and discussed in the workshop. * 455 workshop participants reported at least one action they would like their organization to take based on what they learned and discussed in the workshop. SJCF Community Health partnered with the Chippewa Falls Area Unified School District to coordinate a Teen Mental Health Summit held at the Chippewa Valley Technical College in Chippewa Falls in August 2018. The keynote speaker presented a program on Artful Inquiry: When Words are Insufficient. Breakout sessions included: Teen Technology Use and Misuse; Talk About It; Healthy Relationships; Strategies for Successful Healthcare Transitions; Anxiety in Youth; Suicide Post-vention; Understanding the Culture of Poverty; Addiction 101; Drug Behaviors; Living Mindfully; Foster Care; and a Hiding in Plain Sight visual display. The summit was attended by 127 people. Evaluation comments included: "This has been an awesome workshop." "Thank you for providing more opportunities to learn and continue to learn about mental health issues in our area." "Very interesting summit." "A lot of good information. I think it is great to offer this at NO COST."" Great job today. Very well organized!" "Super information, very useful." Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - HSHS Sacred Heart Hospital. Strategy 3: Increase Community Access to Mental and Behavioral Health Services The hospital's Behavioral Health Services will continue to provide frontline care to address patients' mental and behavioral health needs by offering psychiatric consultations by a psychiatrist at Sacred Heart Hospital, provide detox, in-patient and out-patient behavioral health services, as well as residential alcohol and other drug treatment at L.E. Phillips Libertas Treatment Center located on the campus of sister hospital HSHS St. Joseph's Hospital in Chippewa Falls, Wisconsin and clinic partner Prevea Health. Goals for the hospital's Behavioral Health Services include: imbed Behavioral Health into primary clinics (placement of a mental health/substance abuse clinician within clinic settings); expand capacity of Inpatient Behavioral Health adolescent unit from eight beds to twelve beds; and expand reach of outpatient behavioral health counseling services by utilizing telehealth equipment. FY2019 Outcomes Behavioral Care has been embedded into the new Prevea Clinics in Rice Lake and Ladysmith. The hospital will be embedding Behavioral Care into the Altoona Clinic and the Menomonie Clinic when opened. Telehealth between Prevea Behavioral Care to Lake Holcombe School District is in final stages prior to deployment. We anticipate delivering counseling services via telehealth to students effective October 2019. SHEC continues to develop plans and secure funding for an increase in inpatient behavioral health adolescent services. Strategy 4: Promote and Support Suicide Prevention Efforts Eau Claire County's suicide crude death rate (2016-WI Vital Records) is 21 per 100,000 population compared to 15 for State (2016-American Foundation for Suicide Prevention) and 13.5 in the United States (2016-American Foundation for Suicide Prevention). The Healthy People 2020 target for the United States is 10.2. 7 In partnership with the Eau Claire City-County Health Department and other organizations, HSHS Sacred Heart Hospital's Community Health will provide/promote local QPR and Mental Health First Aid training as a means of suicide prevention. FY2019 Outcomes SHEC's Community Health department is leading suicide prevention activities across multiple sectors and settings in collaboration with the Public Health Department of Chippewa County, Eau Claire Healthy Communities, and Eau Claire City- County Health Department, Eau Claire and Chippewa County School Districts and multiple other community partners to promote awareness that suicide is a preventable public health problem. Strategies include community trainings of an evidence-based suicide prevention program, QPR (question, persuade & refer). One of the strategies was to "blanket" the area with QPR gatekeeper training - the three simple steps anyone can learn to help prevent suicide. Per the surgeon general's national strategy for suicide prevention, a gatekeeper is someone in a position to recognize a crisis and the warning signs that someone may be contemplating suicide. In FY2019, SHEC Community Health provided 11 gatekeeper trainings to 203 adults as well as 22 sessions to 620 youth in the same period. Eighty-five percent of attendees indicated an increased knowledge of community resources. In FY2019, SHEC Community Health department provided 15, eight-hour Mental Health First Aid classes to 363 participants. The types of classes included five regular adult classes, six youth classes, one class geared for military, veterans and their families, and four classes focused on the rural population. The classes focusing on rural populations were a new offering in FY2019 in response to the increasing suicide rate of farmers, ranchers and foresters. West central Wisconsin is an area with a high population of dairy farmers and training on how to recognize when someone is struggling with mental health issues and what to do was an identified need among this population. Attendees at Mental Health First Aid classes gave the class an average score of 4.67 on a 5-point Likert-type scale for improvement of knowledge when reaching out and helping a person with a mental health need. The following is a comment from a Youth Mental Health First Aid attendee. "I came here to get help for my family and I will also be able to share what I know with my daughter. My husband and I can now work together with the skills we have learned together. Thank you so much for having a youth mental health class to help us." Substance Use According to the national Office of Disease Prevention and Health Promotion substance abuse has a major impact on individuals, families, and communities resulting in teenage pregnancy, HIV/AIDS, other STDs, domestic violence, child abuse and neglect, motor vehicle crashes, physical fights, escalation of crime, homicide and suicide. Goal: In partnership with the Eau Claire City-County Health Department and other organizations, HSHS Sacred Heart Hospital will educate/create awareness of substance abuse issues and increase awareness of and access to substance abuse services in the community, including services offered by the hospital and affiliates. Strategy 1: Increase Community Access to Substance Abuse Services HSHS Sacred Heart Hospital will enhance community access to substance abuse services-illicit drugs. Behavioral Health hospital colleagues will participate in a state-wide project to expand access to treatment around opioid addiction. SHEC will have developed/implemented a Medication Assisted Treatment (MAT) Program for opioid addiction for WWD HSHS/Prevea - Behavioral Health program. FY2019 Outcomes Five HSHS Sacred Heart, HSHS St. Joseph's, and Prevea Health colleagues including a physician, are involved in the statewide NiaTx project aimed at expanding access to treatment for Opioid Use Disorders. As a result of involvement in the NiaTx project, colleagues received training on best-practices, access to treatment protocols, and access to experts in the field. This project continues to date. In September 2018, HSHS Sacred Heart, HSHS St. Joseph's, and Prevea Health opened a Medication Assisted Treatment Program, which has served more than 300 people to date. HSHS Sacred Heart reviewed and revised the curriculum at the hospital's LE Phillips Treatment Center and have moved to utilizing Dialectic Behavioral Therapy as our foundation for treatment, an evidence-based treatment. The hospital recently purchased new curriculum for the Residential Treatment Program at L.E. Phillips and are presently beginning integration of this into the program. The new evidence-based curriculum fits our patient population very well and is designed for those with co-occurring disorders. Strategy 2: Substance Abuse Awareness and Education HSHS Sacred Heart Hospital will develop, coordinate, promote, and/or participate in a minimum of four Substance Abuse awareness, education events, and/or activities to raise awareness and educate about substance abuse issues. FY2019 Outcomes On February 25, 2019, SHEC Community Health coordinated BROKEN: My Story of Addiction & Redemption, a community conversation with William C. Moyers at a conference Center in Eau Claire. The community conversation focused on addiction prevention and stigma reduction education. The presenter was William C. Moyers, the public advocate for the Hazelden Betty Ford Foundation. Three hundred and fifty people attended the event. Evaluations from attendees indicated 92 percent of attendees gained useful and applicable knowledge from the session and 92 percent indicated that because of the program they plan to change something about their daily routine for better health. Comments from the program evaluation included: "Great speaker, thank you." "Loved the talk about opening up your heart, wonderful thank you from the bottom of my heart." Loved it, glad you had this program." "Stunning presentation, relevant & personal, I will apply what I learned." SHEC and SJCF Community Health sponsors and leads Chippewa Health Improvement Partnership (CHIP), a 100-member community health coalition. In January 2019 CHIP hosted an educational event entitled RISE TOGETHER for area school districts. The event featured nationally known speaking team, RISE TOGETHER, which exists to ignite a youth-led movement to save lives by encouraging students to stand up and speak out on issues such as suicide, bullying, mental illness, drugs and alcohol. RISE TOGETHER educates, engages and empowers youth primarily through storytelling, high-quality educational content, programs, workshops and training to help build strong advocates and leaders. The program was provided to middle and high school aged students at six area schools over three days; a parent program was also offered. The program reached approximately 1500 students and 100 adults. Schedule H, Part V, Section B, Line 11 Facility , 3 Facility , 3 - HSHS Sacred Heart Hospital. Based on the student evaluation question, "After seeing a RISE TOGETHER presentation, are you more comfortable asking for help with substance abuse," 67 percent of respondents said "yes." SHEC and SJCF Community Health sponsors and leads Chippewa Health Improvement Partnership (CHIP), a 100-member community health coalition. Since the early 2000s, Wisconsin has experienced a surge in opioid abuse and its related harmful consequences. Since the start of this increase, the age-adjusted death rate from opioid overdose has increased over fivefold. Over the last decade alone, the number of opioid-related deaths in Wisconsin has nearly doubled (Wisconsin Office of Health Informatics). Chippewa Health Improvement Partnership (CHIP) developed a strategy aimed at reducing the availability of and access to opioids for nonmedical purposes and to prevent the consequences of opioid abuse. The team purchased prescription drug deactivation units and prescription lock boxes. They worked with all the pharmacies in Chippewa County to distribute these items to their customers with literature on the safe storage and disposal of prescription drugs. Four hundred deactivation units and 50 lock boxes were distributed. SHEC Community Health department provided 15, eight-hour Mental Health First Aid (MHFA) classes in FY2019 to 363 participants. Part of the curriculum of MHFA is a two-hour section about substance use disorder. Effective in 2019, a required addition to the curriculum of this class is a chapter specifically on opioid response, including how to use Narcan. Strategy 3: Reduce the Stigma Associated with Addiction HSHS Sacred Heart Hospital will develop, coordinate, promote, and/or participate in Substance Abuse awareness/education events/activities to reduce the stigma associated with addiction. FY2019 Outcomes SHEC and SJCF Community Health sponsors and leads Chippewa Health Improvement Partnership (CHIP), a 100-member community health coalition. CHIP uses social media to educate the public about addiction to reduce the associated stigma and encourage more people to seek treatment. CHIP messages eight to 10 educational posts per month. Examples of posts include: Recovery month information, "What if They Won't Seek Help" and "Addiction can Happen to Anyone, Anywhere, Anytime." High-Risk Alcohol Consumption The misuse and abuse of alcohol, over-the-counter medications, illicit drugs, and tobacco affect the health and well-being of millions of Americans (SAMHSA 2018). SAMHSA's National Survey on Drug Use and Health (NSDUH) - 2014 (PDF | 3.4 MB) reports that in 2014 there were 139.7 million current alcohol users aged 12 or older, with 23% classified as binge drinkers and 6.2% as heavy drinkers. About 17 million of these, or 6.4%, met criteria for an alcohol use disorder in the past year. Excessive alcohol use, including underage drinking and binge drinking (drinking 5 or more drinks on a single occasion for men or 4 or more drinks on an occasion for women), can increase a person's risk of developing serious health problems, including brain and liver damage, heart disease, hypertension, and fetal damage in pregnant women. According to the Centers for Disease Control and Prevention (CDC), alcohol use causes 88,000 deaths a year. Eau Claire County has a higher rate of high-risk drinking than the state or national average. The city of Eau Claire recently earned the unfavorable distinction of being the second drunkest city in the nation (Wall Street 24/7 -2018). Goal: In partnership with the Eau Claire City-County Health Department and other organizations, HSHS Sacred Heart Hospital will educate and/or create awareness of issues related to alcohol misuse and create awareness of and access to Alcohol and Other Drug Abuse services in the community, including services offered by the hospital and affiliates. HSHS Sacred Heart Hospital will promote a healthy substance use culture in Eau Claire. Strategy 1: Non-Alcoholic Events/Activities The hospital will support and/or fund area events and activities which are alcohol-free to curb underage drinking and increase the number of alcohol-free events in the community. FY2019 Outcomes SHEC participated as a sponsor of alcohol-free after prom and post-graduation parties at six area high schools as well the Boys and Girls Club and Big Brothers/Big Sisters in FY2019. Strategy 2: Alcohol Misuse Community Awareness and Education The hospital will coordinate/host/actively participate in a minimum of five events/activities where education related to high-risk drinking is provided. FY2019 Outcomes SHEC distributed the SAMSHA community information flyer "Underage Drinking Myths vs. Facts" at many educational events in FY2019 including: National Night Out, Youth Mental Health Conference, Sharing Hope Walk, School District Prevention event, Rise Together and Broken: My Story of Addiction & Redemption. 1000 handouts were distributed. SHEC is an active member of Eau Claire Healthy Communities High Risk Drinking Prevention Action Team. The High- Risk Drinking Prevention Action Team helps the community understand and avoid the high-risk uses of alcohol, including binge, heavy, and underage drinking, as well as drinking during pregnancy. FY2019 activities included: Getting an ordinance enacted that will enable law enforcement to act on public excessive intoxication and advocating for the city council to review criteria for alcohol license to include prevention best practices. Other CHNA Identified Needs SJCF is always concerned with the prevention and management of chronic disease and continues to incorporate this focus area into community awareness and education events/activities. An example is an educational program provided by SJCF Community Health focused on Cancer prevention. The event was held in partnership with a local beauty salon and featured education by HSHS Sacred Heart Center Colleagues. Thirty people attended the event which started in the BRAVO Salon where participants were invited to visit cancer prevention information tables. On hand was a registered dietician, community health educators, cancer center nurses and a skin care specialist to provide educational materials and answer questions. Guests were then guided to the Cafe where there were presentations. Presentation topics were as follows: Critical Role on the Front Line presented by a Skin Care Specialist; Heads Up! Trust Your Intuition presented by a Cancer Survivor; Lifestyle for Cancer Prevention presented by a Nurse Practitioner; and Cancer Isn't a Dirty Word Oncology presented by a Nurse Navigator Twenty evaluations were returned: Twenty people rated the overall program excellent or good; Nineteen people answered yes to experiencing the hands-on activities prior; Twenty people said that as a result of this program, they are aware of information that they were unaware of prior to attending; and eighteen people said as a result of this program, they plan to implement something new into their daily routine to reduce their risk of cancer. Also, in response to chronic disease prevention, SHEC hosted a Cardiac/ Stroke Screening in May 2019. The free screening for community members included blood pressure, cholesterol and glucose levels, carotid bruits, heart rate/rhythm, diabetes questionnaire and BMI. Individual counseling was provided as well as medication education. Eighty-two people participated in the screenings. Obesity SHEC and SJCF Community Health supports and actively participates in the Chippewa Health Improvement action team - Challenge Chippewa, which works to positively impact physical fitness and overall wellbeing. This team hosted a four-week series of nutrition events in October that promoted families cooking together and eating together. The classes were held in the local Middle School food labs. The classes sold out with 12 families participating each week. HSHS Sacred Heart Hospital partnered with local agencies that make up the Chippewa Valley Healthy Retail Team, a collaborative effort of nutrition and community health professionals from Eau Claire, Dunn and Chippewa Counties. The team hosted a Wavemaker Rally in August 2018 in Eau Claire to bring area food environment leaders together to spark movement in changing the food environment in the Chippewa Valley. The event was attended by 90 participants. Physical Activity SHEC supports the community need of physical activity by providing financial and in-kind support to area efforts including the Altoona Bike Rodeo, Eau Claire Heart Walk, YMCA Kids Expo and support of area school athletics. Healthy Growth and Development The hospital supports the Infant Mental Health Action Team of Chippewa Health Improvement Partnership (CHIP) whose work impacts this focus area. Schedule H, Part V, Section B, Line 11 Facility , 4 Facility , 4 - HSHS Sacred Heart Hospital. SHEC will continue its coordination and support of its First Connections program which is a partnership between SHEC and the Family Support Center, Chippewa Falls that provide a visit by a family services case worker to all parents in SHEC's Birth Center to evaluate risk factors and provide information/referral. Monthly data is collected as to number of families seen, the degree of risk is assessed, and referrals made to community services for the families who are assessed to have heightened risk. In FY2019, 132 new parent visits were made with referrals as follows: 128 Dad gift vouchers and 113 swaddler vouchers given to parents (Referrals to Public Health Department to redeem these gifts); 46 referrals to Baby & Me - First Time Parents Playgroup; 31 referrals to other supportive services including WIC, Public Health Department car seat safety, Dolly Parton Imagination Library, Rural Playgroups, Chippewa Falls Playgroups, Head Start, Public Health Department Immunization clinics; and 4 referrals to Home visiting program - Bright Starts SMILE Program. Three families enrolled into Bright Starts SMILE Program. Injury & Violence The community has a well-established, well- respected community sexual assault and domestic violence agency that is the lead on this area; the hospital provides financial support. SHEC hosted a community education event on Human Trafficking Awareness in December 2018. Presenters included the Eau Claire Police Department, Wisconsin Department of Justice and Fierce Freedom. The event was attended by approximately 75 people. As an outcome of the prioritization process, the following community health needs were also identified to a lesser degree and were not addressed directly by the hospital for the reasons indicated: Reproductive/Sexual Health. SHEC does not take the lead in this area as it is best served by the Eau Claire County Health Department and other agencies with expertise in the area. Environmental/Occupational Health. Eau Claire County Health Department leads activities for environmental/occupational health as they have expertise in this area. Tobacco Use and Exposure. SHEC is a smoke-free campus and advocates for smoking cessation. Efforts in the community are best led through the Eau Claire County Health Department and other community agencies with expertise in this area. Communicable Disease Prevention and Control. The Eau Claire County Health Department leads activities for communicable disease prevention as they have expertise in this area. Oral Health. The Eau Claire County Health Department leads activities for oral disease prevention as well as the Marshfield Clinic Dental Center provides dental care to the community regardless of payment ability. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - Sacred Heart Hospital. Presumptive eligibility provides individuals participating in one of the following categories with a 100% write off. These programs are granted by outside organizations based on screening criteria of less than 200% of the FPG. 1. Homelessness 2. Deceased with no estate 3. Mental incapacitation with no one to act on patient's behalf 4. Medicaid eligibility, but not on date of service or for non-covered services 5. Incarceration in a penal institution 6. Enrollment in the following assistance programs for low-income individuals: 6a. Temporary Assistance for Needy Families (TANF) 6b. Illinois Housing Development Authority's Rental Housing Support Program 7. Wisconsin Department of Health Services Housing Assistance Program 8. Participation in Women, Infants and Children programs (WIC); 9. Supplemental Nutrition Assistance Program (SNAP) eligibility; 10. Illinois Free Lunch and Breakfast Program; 11. Wisconsin Free Lunch Program; 12. Low Income Home Energy Assistance Program (LIHEAP); 13. Wisconsin Home Energy Assistance Program (WHEAP); 14. Enrollment in an organized community-based program providing access to medical care that assesses and documents limited low-income financial status as criteria; 15. Receipt of grant assistance for medical services 0 Schedule H, Part I, Line 7f Bad Debt Expense excluded from financial assistance calculation THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) WAS SUBTRACTED PRIOR TO AND FOR THE PURPOSE OF CALCULATING THE PERCENTAGE IN PART I, LINE 7, COLUMN (F) IS $1,984,315. Schedule H, Part I, Line 7g Subsidized Health Services THE HOSPITAL USES LYON SOFTWARE (CBISA: COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY) TO DETERMINE SUBSIDIZED SERVICES. PHYSICIAN CLINICS WERE NOT INCLUDED IN THE SUBSIDIZED HEALTH SERVICES. Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 1984315 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance THE HOSPITAL USES A COST-TO-CHARGE RATIO AS CALCULATED ON IRS SCHEDULE H - WORKSHEET 2 BASED ON OUR AUDITED FINANCIAL STATEMENTS TO CALCULATE THE AMOUNTS REPORTED ON LINES 7A THROUGH 7I. Schedule H, Part II Community Building Activities HSHS SACRED HEART HOSPITAL (SHEC) HAS A 130 YEAR HISTORY OF GIVING BACK TO THE COMMUNITY AND ADDRESSING COMMUNITY NEED AT THE MOST BASIC LEVELS. THE HOSPITAL WAS FOUNDED ON THE FRANCISCAN PRINCIPLES OF CARING FOR THE POOR AND MOST VULNERABLE AND WORKING TIRELESSLY TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES. SHEC INVESTED $197,441 AND SERVED 133 INDIVIDUALS THROUGH ITS COMMUNITY BUILDING INITIATIVES. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Self-pay patients are screened for verification of no insurance coverage. Once verification of no coverage has been completed, the guarantors will be screened for charity or uninsured discounts based on income levels. Those guarantors who do not qualify for charity through the screening process will be asked to provide proof of income in the form of a recent pay stub and/or recent tax return to determine the level of uninsured discounting. If no proof of income is provided or a guarantor's income is greater than 201% of the federal poverty level, the appropriate discount according to the established criteria up to 400% of the federal poverty level will be applied. The amount of money not collected from those self-pay patients who are not eligible for charity care is reported as bad debt. Allowances for Doubtful Accounts have been recorded based on an historical matrix, using collectability percentages by payor and aging category in accordance with HSHS Executive Policy #F-23, Valuation of Net Accounts Receivable. Percentages are based on historical experience at the hospital and adjusted for known limitations. The hospital reports bad debt in accordance with Generally Accepted Accounting Principles (GAAP). Schedule H, Part III, Line 3 Bad Debt Expense Methodology The hospital strongly believes that its charity care, and the related community benefit obtained from such care, is understated because of those patients who potentially qualify for charity care but do not wish to apply for it. In addition, some care is not classified as charity because of missing documentation on patient resources. Thus, the hospital's bad debt includes a portion that could be classified as charity care if application for such care was sought and/or completed. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE TEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE CAN BE FOUND ON PAGE 19 OF THE HSHS CONSOLIDATED AUDIT REPORT. PLEASE ALSO REFERENCE FOOTNOTE 2Q ON PAGE 14 FOR AN EXPLANATION OF HOW THE FINANCIALS ACCOUNT FOR BAD DEBT. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE HOSPITAL CONTINUALLY STRIVES TO PROVIDE EXCELLENT PATIENT CARE IN THE MOST COST EFFECTIVE FASHION. NONETHELESS, THE MEDICARE PROGRAM, IN MANY CASES, DOES NOT PROVIDE PAYMENT THAT COVERS THE FULL COST OF THE CARE PROVIDED. SINCE IT IS THE MISSION OF THE HOSPITAL TO RESPOND TO COMMUNITY NEED, HOSPITAL MANAGEMENT CONTINUALLY ADVOCATES FOR IMPROVED MEDICARE PAYMENT SO THAT THE COST OF QUALITY CARE TO THOSE PATIENTS WHO ARE NOT ABLE TO AFFORD IT IS NOT COMPROMISED AND IS FAIRLY SUBSIDIZED BY ALL PAYERS. WHILE THIS SHORTFALL IN MEDICARE PAYMENTS IS NOT CLASSIFIED AS COMMUNITY BENEFIT BY THE IRS, WE NONETHELESS BELIEVE IT IS AN IMPORTANT CONTRIBUTION MADE BY THE HOSPITAL TO THE HEALTH AND WELL-BEING OF THE COMMUNITY. IF THE MEDICARE PROGRAM DID NOT EXIST, MANY MEDICARE PATIENTS WOULD BE ELIGIBLE FOR CHARITY CARE OR OTHER MEANS-TESTED GOVERNMENT PROGRAMS. FURTHER, BY ABSORBING THIS PAYMENT SHORTFALL AND PROVIDING CARE BELOW COST TO THESE INDIVIDUALS, HSHS SACRED HEART HOSPITAL IS RELIEVING THE BURDENS OF THE GOVERNMENT. ACCORDINGLY, THIS SHORTFALL RESTRICTS HSHS SACRED HEART HOSPITAL'S ABILITY TO MAKE FUNDS AVAILABLE TO PROVIDE FOR CHARITY CARE AND OTHER COMMUNITY BENEFITS. THE HOSPITAL MEDICARE SHORTFALL AT COST FOR FISCAL YEAR 2019 WAS $31,432,156. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance EVERY EFFORT IS MADE PRIOR TO, DURING AND AFTER THE PROVISION OF MEDICAL CARE SERVICES TO DETERMINE IF A PATIENT IS ELIGIBLE FOR CHARITY/COMMUNITY CARE AND TO ASSIST THE PATIENT IN COMPLETING THE APPLICATION AND PROVIDING ADEQUATE DOCUMENTATION. IF THE PATIENT QUALIFIES FOR CHARITY/COMMUNITY CARE FOR THE FULL BALANCE OF THEIR ACCOUNT, THE ENTIRE AMOUNT IS WRITTEN OFF TO CHARITY/COMMUNITY CARE AND HENCE NO DEBT COLLECTION IS PURSUED. IF THE PATIENT QUALIFIED FOR CHARITY/COMMUNITY CARE FOR A PORTION OF THEIR ACCOUNT BALANCE, THAT PORTION IS WRITTEN OFF TO CHARITY/COMMUNITY CARE WITH THE PATIENT BEING RESPONSIBLE FOR THE REMAINDER OF THE BALANCE. ADDITIONALLY, REASONABLE EFFORT WILL BE MADE TO OBTAIN THIRD-PARTY OR GOVERNMENT PAYER REIMBURSEMENT ON BEHALF OF THE PATIENT. IF THOSE EFFORTS ARE NOT FRUITFUL, AN OFFER WILL BE EXTENDED TO THE PATIENT TO MAKE INSTALLMENT PAYMENT ON THEIR BALANCE. ONLY AT SUCH POINT THAT THE PATIENT DEFAULTS ON INSTALLMENT PAYMENTS OR REFUSES TO COOPERATE WITH THE HOSPITAL EFFORTS TO BE REIMBURSED WILL THE ACCOUNT BE SENT TO COLLECTIONS. The hospital will make reasonable efforts to determine whether a patient is eligible under the financial assistance policy before it engages in an ECA. To the extent a patient is determined to be eligible for financial assistance under the FAP, the hospital will take all reasonably available measures to reverse any ECA taken against the patient to obtain payment for the care. Schedule H, Part V, Section B, Line 16a FAP website - SACRED HEART HOSPITAL: Line 16a URL: http://www.hshs.org/fap; Schedule H, Part V, Section B, Line 16b FAP Application website - SACRED HEART HOSPITAL: Line 16b URL: http://www.hshs.org/fap; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - SACRED HEART HOSPITAL: Line 16c URL: http://www.hshs.org/fap; Schedule H, Part VI, Line 2 Needs assessment In addition to the triennial CHNA, HSHS Sacred Heart Hospital (SHEC) uses many approaches to continually assess the health care needs of the community. SHEC uses Press Ganey Patient Experience Solutions to collect patient feedback to understand patient preferences and develop improvement plans. SHEC also utilizes face to face opportunities with patients to gauge community perception through regular leader rounding. SHEC engages in quarterly discussions about community health needs with the hospital's board of directors and advisory council. Membership consists of community members who represent varying sectors of the Chippewa Valley including non-profit agencies, schools, and businesses. SHEC has a robust Volunteer Partners program whose members are a valuable source of feedback from the community to the hospital and back to the community. SHEC leadership and Community Health staff participates in community groups and coalitions that address the needs of the underserved and minority populations. These groups include the Eau Claire YMCA, the Free Clinic, the Family Resource Center, Big Brothers/Big Sisters, the Mission Coalition, Eau Claire Healthy Communities and Feed My People Food Bank. SHEC Community Health staff continually seeks to improve and refine community education efforts through program evaluations. For example, after offering Youth Mental Health First Aid classes, many people indicated they wanted to learn more about Adverse Childhood Experiences (ACEs) and Resiliency. Because of these evaluation comments, SHEC started offering ACEs and Resiliency classes for the community. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Financial Assistance Program brochures are accessible by patients in all predominate waiting areas/rooms at Sacred Heart Hospital (SHEC). They are also provided to the public at a variety of community events/presentations and health fairs that the hospital is involved in or coordinates. All patient billing statements and financial letters/payment reminder letters reference the hospital's financial assistance program and how to contact the patient financial services office for an application. Hardcopy financial assistance applications are also available in the registration areas, including the hospital Emergency Department. In addition, our hospital websites provide detailed information about our financial assistance program and provides a link to the application so that the patient can fill it out at their convenience and submit it to our Patient Financial Services office. Website example: https://www.sacredhearteauclaire.org/patients-guests/payment-billing Link to the application: http://www.hshs.org/fap Whenever needed, language translators are available to translate both written and verbal communication. SHEC has partnered with MedData who assist patients on site to apply for eligible payer sources (i.e. Wi Medicaid) and assist patients with completing any necessary application(s) for the payer sources. MedData representatives will also make house calls to patients who are immobile or have limited resources to travel to the hospital or who need assistance finding supplemental documentation to accompany the Medicaid applications (i.e. pay stubs, taxes, etc.) SJCF has a financial planner available by phone during peak business hours Monday through Friday, to assist patients with any questions while applying for financial assistance. The financial planner also partners with MedData to proactively review inpatient self-pay accounts and connects with patients to start exploring payment sources, including financial assistance. This is done before the patient leaves the hospital to help put their mind at ease and assure them that the hospital will assist them with their financial questions and concerns. Another way that one-on-one conversations occur with patients is after they receive a financial statement letter. At this point, the customer service representatives within the patient financial services office will explain the patient's payment options including the option of applying for financial assistance. Once all attempts to work out a payment arrangement with the patient have been exhausted, HSHS utilizes a nationally recognized system to determine presumptive financial assistance eligibility. A Pay Nav credit review occurs on the system to determine the probability of the patient being able to pay for their hospital services based on their credit information. After assessing the information, HSHS determines whether to grant full financial assistance, based on a score of below 200% of the FPL, or continue collection efforts. Schedule H, Part VI, Line 4 Community information HSHS Sacred Heart Hospital (SHEC) serves a population of approximately 400,000 people in western Wisconsin. The hospital's service area includes urban and rural areas and encompasses Eau Claire, Chippewa and Rusk Counties, as well as portions of Barron, Buffalo, Clark, Dunn, and Jackson, Pepin, Sawyer, Trempealeau, and Washburn counties. Approximately 40% of the population lives in Eau Claire and Chippewa counties (51% with the addition of Dunn County). The population in the remaining counties is significantly less, with 10 out of 12 service area counties considered rural by the U.S. Department of Agriculture. The majority (approximately 45%) of all inpatient admissions at SHEC originate from Eau Claire County. Eau Claire County has a population of approximately 103,671. The city of Eau Claire is located 90 miles east of the twin cities and is the ninth largest city in the state of Wisconsin, with a population of just over 65,800. SHEC does not exclude medically underserved areas (MUAS), low income or minority populations from its service area. Though western Wisconsin is less diverse than the nation (92.2% White/Non-Hispanic), there are several unique minority populations found within the hospital's service area, including Amish, Mennonite and Hmong communities. Wisconsin has the fourth highest Amish population in the nation. SHEC serves as a "disproportionate share hospital" due to the high rate of Medicaid patients served by the hospital. In fact, 65 percent of SHEC's hospital patients are either Medicare or Medicaid recipients. Sacred Heart's service area mean household income is approximately $50,538, roughly $5,000 lower than the national average with approximately 13% of the population living below 100% of the federal poverty level (FPL); and an additional 1.14% living below 200% of the FPL. Socioeconomics is one of the most influential determinants in an individual's level of access to health care (i.e., individuals with a lower socioeconomic status in the U.S. have lower levels of general health, insurance coverage, in addition to less access to care) (American Journal of Public Health, 2000). Insurance coverage in the counties of SHEC's service area is far lower than that of the U.S. (6.1% for Eau Claire County compared to 10.2% nationally). Insurance coverage is strongly related to better health outcomes for both children and adults when it makes health care services affordable and helps individuals and families use care appropriately. Uninsured individuals generally receive much less care, either preventive or for acute and chronic conditions, than insured individuals. Uninsured adults report lower levels of self-perceived wellness and functioning. The hospital's service area population is aging, much like the rest of the nation. The largest segment of growth from 2000 to 2010 occurred in the 18 to 64-year old age category with a growth rate of 16.9 percent followed by a 10.3 percent growth rate in the 65+ year old age category. The number of 0 to 18 years olds is declining. Combined population growth for these six counties was approximately 6.6 percent between 2000 and 2010. Along with the aging population come increased health care costs with chronic disease. Studies indicate that the health of the aging population can be maintained, and chronic diseases can be reduced by promoting healthy behaviors and expanding preventive health services. Eau Claire County is federally-designated as a medically underserved area even though there are two acute-care hospitals offering tertiary level services including cardiovascular surgery, neurosurgery, oncology and trauma level II in Eau Claire: SHEC and Mayo Clinic Health System - Eau Claire, as well as Oakleaf Surgical Hospital and Marshfield Clinic Hospital-Eau Claire. Schedule H, Part VI, Line 5 Promotion of community health As a healing ministry of the Catholic Church and an affiliate of Hospital Sisters Health System (HSHS), HSHS Sacred Heart Hospital is committed to delivering high quality, compassionate, and cost-effective health care services to all. Founded in 1889, the hospital brings a healing presence and improves the health of our community, especially those persons who are sick, poor, and disadvantaged. Because of the hospital's mission and heritage, the hospital is dedicated to promoting the health of Eau Claire and surrounding areas. The hospital is governed by a Board of Directors, most of whom reside in the hospital's primary service area and are neither employees nor independent contractors of the hospital (nor family members thereof). The Board ensures that Sacred Heart Hospital is responding to community need. In FY2018, for example, the board reviewed the Community Health Needs Assessment and approved an implementation plan for addressing the selected health focus areas of mental health, alcohol misuse and substance use. The Director of HSHS Sacred Heart Hospital's Community Health department provided written and verbal updates to the Hospital Board of Directors (BOD) throughout FY2019 regarding the hospital's various community benefit initiatives and any new needs that may have arisen. Multiple board members routinely seek out and engage in conversation with the Community Health Director about community need and how the hospital board might best serve the hospital and meet community need. There are also other bodies that connect Sacred Heart Hospital to the community, such as the hospital Advisory Council, Patient and Family Advisory Council, The Foundation of HSHS Sacred Heart Hospital, and Volunteer Partners Board. Consistent with its exempt purpose, HSHS Sacred Heart Hospital has an open medical staff with privileges available to all qualified physicians in the area. The hospital also operates an Emergency Department that is open 24 hours to all persons regardless of their ability to pay. As a not-for-profit hospital, HSHS Sacred Heart Hospital reinvests surplus funds to support the mission of the organization and promote the health of the community rather than distributing surplus funds as profits to shareholders or individuals. Funds not committed to ongoing operations are generally used to upgrade facilities, secure new technologies, improve patient care, and support initiatives designed to promote health and ensure access for all. For example, SHEC continues to partner with Prevea Health, a multi-specialty health care organization based in Green Bay, Wisconsin that has been a part of the western Wisconsin region since 2015. Prevea Health works extensively with SHEC and sister hospital HSHS St. Joseph's Hospital in Chippewa Falls. In partnership with SHEC, Prevea opened clinics in Menomonie, Chippewa Falls, Altoona and Ladysmith in FY2019. On September 4, 2019, HSHS and Prevea Clinic opened the Prevea Cancer Center at HSHS Sacred Heart Hospital. The center features eight exam rooms, 11 infusion rooms, a gathering room, and an expanded healing garden. HSHS Sacred Heart Hospital also expanded the C-section suite in the Women and Infants Center. This expansion completed a three-phase renovation of the hospital's Women and Infants Center, which now features all-in-one birthing suites for labor, delivery, recovery and postpartum care; a centrally-located nurses' station; private special care nursery bays with enhanced infant monitoring capabilities; expanded C-section operating rooms; and added birthing options and amenities. HSHS Sacred Heart Hospital also devotes significant resources to access for patients who cannot afford care, along with other Community Benefits. In FY2019, HSHS Sacred Heart Hospital provided more than $17.9 million in Community Benefit, including financial assistance at cost, unpaid costs of Medicaid and other public programs, and a range of diverse programs designed to enhance access and improve community health. Additionally, in FY2019, HSHS Sacred Heart Hospital provided $785 thousand (at cost) in uncompensated care to patients who did not qualify for charity care or public assistance and more than $31.4million (at cost) in excess of Medicare payment for health care services. HSHS Sacred Heart Hospital provides a range of Community Benefit initiatives and programs that further our mission and long-standing commitment to our community. In many cases, these Community Benefits would not exist without the leadership role played by HSHS Sacred Heart Hospital and they often relieve a burden that would otherwise be carried by government. Schedule H, Part VI, Line 6 Affiliated health care system Headquartered in Springfield, Illinois, Hospital Sisters Health System (HSHS) is a highly integrated, multi-institutional health care system comprised of 16 hospitals and more than 200 physician practice sites in Illinois and Wisconsin. HSHS is sponsored by Hospital Sisters Ministries (HSM), which is a public juridic person of the Roman Catholic Church. HSHS continues the health care ministries begun by its founders, the Hospital Sisters of St. Francis, more than 140 years ago, in rural and midsized communities throughout Illinois and Wisconsin. HSHS provides compassionate, holistic, high quality, and cost-effective health care through its acute care hospitals, physician practices, home health programs, palliative and hospice programs, and community outreach services. In addition, HSHS affiliated hospitals include critical access facilities that offer essential health services that otherwise would not be available in many communities. Our mission calls us to reveal and embody Christ's healing love for all people, and we extend our high quality Franciscan health care ministry beyond the walls of our hospitals by providing community health improvement services with special emphasis on the poor and vulnerable. In addition to providing community health improvement services to the broader community, HSHS cares for everyone who comes to its facilities, regardless of their ability to pay. In tandem with a variety of cross sector community partners, HSHS's Community Benefit initiatives are strategically planned and professionally implemented to improve access to health care services; enhance the health of the community; advance medical or general health care knowledge; and relieve or reduce the burden of government to improve health. In FY2019, HSHS collectively provided $211.7 million in Community Benefit (9.2% of total hospital expenses). This amount included $27.7 million provided for Financial Assistance (a.k.a. Charity Care) and $142.3 million for unreimbursed care provided as part of the Medicaid program. In addition, HSHS hospitals committed significant resources to treat Medicare patients. The cost of providing services to primarily elderly beneficiaries of the Medicare program - in excess of governmental and managed care contract payments - was $279.9 million. HSHS hospitals also recorded $41.1 million in uncollectible accounts. While HSHS does not count the latter two amounts as Community Benefit, they nonetheless reflect our commitment to serving all persons in need of care. In addition to the dollars invested in our Community Benefit programs, HSHS continues to reinvest any surplus revenue from operations and investments into new medical technology, facility infrastructure and health care services in our communities. By doing so, we ensure our ability to meet the ongoing demand for high quality, efficient and easily accessible health care. Schedule H, Part VI, Line 7 State filing of community benefit report WI X X X X X true true false false false false false false false JOAN COFFMAN Former PRESIDENT 0 170268 0 0 0 222994 0 48373 0 13546 0 455181 0 81755 ANDREW J BAGNALL PRES/CEO WESTERN WI DIV 0 398881 0 15779 0 196643 0 77839 0 30673 0 719815 0 51004 JULIE MANAS PRES / CEO WESTERN WI DIV Through Jan 2018 0 32644 0 0 0 896701 0 0 0 1099 0 930444 0 203625 CHARISSE OLAND PRESIDENT (through Dec 2018) 0 259983 0 7293 0 176268 0 0 0 22913 0 466457 0 0 PETER MANNIX Board Member 0 385199 0 8843 0 105197 0 122337 0 36254 0 657830 0 97302 PATRICIA ALLEN DIV CFO 279886 0 4250 0 18606 0 5049 0 20357 0 328148 0 0 0 ANN M CARR TREASURER 0 268272 0 4360 0 57197 0 89873 0 20590 0 440292 0 28431 JOHN WACIUMA PHYSICIAN 398141 0 0 0 231736 0 41820 0 5863 0 677560 0 0 0 Erik Dickson Chief Physician Executive 364742 0 5178 0 780 0 6154 0 25744 0 402598 0 0 0 John Folstad VP - STRATEGY DEV IMP - DIV 15703 0 0 0 261515 0 0 0 20605 0 297823 0 0 0 Layton Anderson Chief Human Resources Officer - DIV 206358 0 1248 0 59013 0 6026 0 20857 0 293502 0 0 0 LANCE J LEVENDOWSKI PHYSICIAN 230733 0 6601 0 19525 0 23112 0 26205 0 306176 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation PLEASE SEE RESPONSE TO FORM 990, PART VI, LINE 15A IN SCHEDULE O. Schedule J, Part I, Line 4a Severance or change-of-control payment ORGANIZATION: HOSPITAL SISTERS HEALTH SYSTEM, INC. EIN: 37-1058692 INTERESTED PERSON: JULIE MANAS AMOUNT: $526,733 TERMS: COMPENSATION PAID AS A RESULT OF A SEVERANCE FROM THE POSITION OF PRESIDENT/CEO WESTERN WI DIVISION. ORGANIZATION: HOSPITAL SISTERS HEALTH SYSTEM, INC. EIN: 37-1058692 INTERESTED PERSON: CHARISSE OLAND AMOUNT: $10,941 TERMS: COMPENSATION PAID AS A RESULT OF A SEVERANCE FROM THE POSITION OF PRESIDENT. Organization: Sacred Heart Hospital EIN: 39-0807060 INTERESTED PERSON: JOHN FOLSTAD AMOUNT: $191,654 TERMS: COMPENSATION PAID AS A RESULT OF A SEVERANCE FROM THE POSITION OF VP OF STRATEGY. Organization: Sacred Heart Hospital EIN: 39-0807060 INTERESTED PERSON: JOHN WACIUMA AMOUNT: $30,000 TERMS: COMPENSATION PAID AS A RESULT OF A SEVERANCE FROM THE POSITION OF PHYSICIAN. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan HSHS EXECUTIVES ELIGIBLE TO PARTICIPATE IN SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) ARE DEFINED IN THE SERP PLAN DOCUMENTS. THE SERP WAS ESTABLISHED TO PROVIDE ADDITIONAL RETIREMENT BENEFITS TO ENSURE REASONABLE MARKET COMPETITIVE BENEFITS IN ACCORDANCE WITH THE HSHS EXECUTIVE COMPENSATION PHILOSOPHY ESTABLISHED BY THE HSHS COMPENSATION COMMITTEE. THE PLAN PROVIDES A DEFINED RETIREMENT CONTRIBUTION TO PARTICIPANTS COMMENCING ON JANUARY 1, 2008, EQUAL TO A PERCENTAGE OF COMPENSATION AS DEFINED IN THE SERP PLAN DOCUENTS FOR THE PLAN YEAR. PARTICIPANTS CONSTRUCTIVELY RECEIVE A DISTRIBUTION FROM THE PLAN NO LATER THAN MARCH 15TH OF THE CALENDAR YEAR FOLLOWING THE CALENDAR YEAR IN WHICH AN AMOUNT IS VESTED AND TAXABLE PURSUANT TO A VESTING SCHEDULE AS SPECIFIED IN THE PLAN DOCUMENT. THE ACTUAL DISTRIBUTION OF THE VESTED BENEFIT UNDER THE PLAN IS PAID IN A SINGLE LUMP SUM TO THE PARTICIPANT OR THE PARTICIPANT'S BENEFICIARY UPON THE EARLIER OF THE PARTICIPANT'S TERMINATION OF EMPLOYMENT, DEATH, OR TOTAL AND PERMANENT DISABILITY. THE FOLLOWING INTERESTED PERSONS CONSTRUCTIVELY RECEIVED DEFERRALS TO THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2018 THESE DEFERRALS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). Andy Bagnall -- $52,032 Ann Carr -- $29,653 Peter Mannix -- $48,406 THE FOLLOWING INTERESTED PERSONS RECEIVED DISTRIBUTIONS FROM THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2018 THESE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III) AND SCHEDULE J, PART II, COLUMN (F), AS APPLICABLE. Andy Bagnall -- $51,004 Ann Carr -- $28,431 Julie Manas -- $203,625 Peter Mannix -- $97,302 Joan Coffman -- $81,755 Form 990, Part III, Line 1 ORGANIZATION'S MISSION THE PRIMARY PURPOSE OF SACRED HEART HOSPITAL IS TO PROVIDE A STRUCTURE AND THE MEANS WHEREBY THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS CAN CONTINUE THEIR APOSTOLIC MISSION TO SERVE THE SICK, THE AGED, THE POOR AND THE TERMINALLY ILL WITHOUT REGARD TO RACE, COLOR, CREED OR NATIONAL ORIGIN. THE PRIMARY CONCERN OF SACRED HEART HOSPITAL AND THE HOSPITAL SISTERS IS THE PATIENT'S WELL BEING... SPIRITUALLY, PHYSICALLY, PSYCHOLOGICAL AND SOCIAL. Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS SACRED HEART HOSPITAL PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF SACRED HEART HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES, AND FURTHER THAT OUR MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY ARE CONSIDERED WHERE THERE IS A DEMONSTRATED NEED. THESE ACTIVITIES INCLUDE BEHAVIORAL HEALTH SERVICES, WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, SPECIAL PROGRAMS FOR THE ELDERLY, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. SACRED HEART HOSPITAL PROVIDED 35,118 ADULT AND PEDIATRIC DAYS OF CARE AND 70,155 OUTPATIENT VISITS DURING FISCAL YEAR ENDED JUNE 30, 2019. SACRED HEART HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT OR BELOW COST. RECOGNIZING OUR MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS. IN ACCORDANCE WITH STANDARDS DEFINED BY THE CATHOLIC HEALTH ASSOCIATION USA (CHAUSA), SACRED HEART HOSPITAL HAS RECOGNIZED AN UNREIMBURSED COST OF COMMUNITY BENEFIT OF $17,925,275. THE COST OF SERVICING THE PEOPLE QUALIFYING FOR PUBLIC INDIGENT PROGRAMS (INCLUDING MEDICAID AND OTHER PUBLIC PROGRAMS) WAS $9,220,030. THE COST OF OUR HOSPITAL BASED COMMUNITY CARE PROGRAM WAS $2,269,973. SACRED HEART ALSO PROVIDED BENEFITS OF $6,435,272 TO THE COMMUNITY THROUGH MANY REDUCED PRICE SERVICES AND FREE PROGRAMS OFFERED THROUGHOUT THE YEAR BASED UPON ACTIVITIES AND SERVICES THAT SACRED HEART HOSPITAL BELIEVES WILL SERVE A BONA FIDE COMMUNITY HEALTH NEED. THESE INCLUDE: * SUPPORT GROUPS INCLUDING: - THE HEALING PLACE: A CENTER FOR LIFE'S JOURNEYS IS SACRED HEART HOSPITAL'S FREE GRIEF AND HOLISTIC HEALING CENTER FOR INDIVIDUALS WHO HAVE EXPERIENCED A LOSS OR ARE DEALING WITH A MAJOR LIFE TRANSITION. SUPPORT INCLUDES: GRIEF SUPPORT GROUPS, COUNSELING, WORKSHOPS, PRESENTATIONS TO GRIEVING INDIVIDUALS AND FAMILIES SUCH AS: 1. EVENING AND DAYTIME SPOUSE LOSS GROUPS FOR THOSE WHO HAVE LOST A SPOUSE 2. SHARE SUPPORT GROUP FOR MISCARRIAGE, STILLBIRTH AND EARLY INFANT DEATH 3. PARENTS GRIEF GROUP FOR PARENTS WHO HAVE LOST A CHILD 4. ADULT LOSS OF A PARENT FOR THOSE WHO HAVE LOST A PARENT 5. CHILDREN'S GRIEF GROUP FOR CHILDREN AGES 6-12 WHO HAVE LOST A SPECIAL PERSON 6. SUICIDE SURVIVOR'S GROUP FOR THOSE WHO HAVE LOST A LOVED ONE TO SUICIDE 7. WORKSHOPS AND PRESENTATIONS TO HEALTHCARE, RELIGIOUS, EDUCATIONAL AND MENTAL HEALTH INSTITUTIONS ON TOPICS RELATED TO GRIEF AND LOSS. 8. SPECIAL PROGRAMS AND WORKSHOPS INCLUDING GRIEF IN THE WORKPLACE AND GRIEF AND THE HOLIDAYS 9. NEW SUPPORT SERVICES, SHORT-TERM COUNSELING, CLASSES AND WORKSHOPS PROVIDE SUPPORT FOR THOSE COPING WITH NON-DEATH-RELATED LIFE TRANSITIONS INCLUDING: DIVORCE OR SEPARATION, ILLNESS, DISABILITY, JOB CHANGES, MILITARY DEPLOYMENT AND RETIREMENT - SEVERAL CANCER CARE RELATED PROGRAMS, INCLUDING: "REACH TO RECOVERY" AND "LIVING WITH CANCER" AND WIG LOAN CLOSET SUPPORT GROUPS FOR DISEASES/DISORDERS SUCH AS; ALZHEIMER'S, AMPUTEE CLINIC, MULTIPLE SCLEROSIS, SPINAL CORD INJURY, AND OTHERS - BREASTFEEDING SUPPORT GROUP *3D COMMUNITY HEALTH AND OTHER EDUCATIONAL CLASSES AND RESOURCES INCLUDING: - PREPARED CHILDBIRTH (LAMAZE, PRENATAL, SIBLING CLASSES AND LACTATION CONSULTING) - EMT AND OTHER PROFESSIONAL TRAINING SUCH AS ACLS - ADULT, INFANT AND CHILD CPR CLASSES - BABYSITTING/SMARTER SITTER SEMINARS - ARTHRITIS, PARKINSON'S DISEASE, OSTEOPOROSIS AND OTHERS - PEDIATRIC HEALTH FAIR WITH HANDS-ON ACTIVITIES IN HEALTH, WELLNESS AND SAFETY. - WELLNESS PROGRAMS, SERVICES AND RETREATS - PARTICIPATION IN HEALTH FAIRS - CARING FOR THE CAREGIVER - CENTER FOR MEDICAL EXCELLENCE COMMUNITY HEALTH INFORMATION ROOM WITH ACCESS TO PRINT AND ELECTRONIC MEDICAL JOURNALS AND OTHER HEALTH RESOURCES FOR PATIENT, FAMILY, AND COMMUNITY USE - ANNUAL "WOMAN TO WOMAN" HEALTHCARE EXPO - INDOOR SPORTS CENTER "GET HOOKED ON HEALTH" KIDS EXPO (SAFETY EDUCATION, HEALTH & WELLNESS) - CENTER FOR SPIRITUAL CARE SPEAKERS' BUREAU * MEAL PROGRAMS & SUPPORT INCLUDING: - MEALS FOR SENIOR CITIZENS AND CONGREGATE SITE MEALS - THANKSGIVING ST. FRANCIS FOOD PANTRY FOOD DRIVE COLLECTION PROGRAM FOR NEEDY FAMILIES - COAT, MITTEN, LINEN AND BLANKET DRIVE - CHRISTMAS SPONSOR-A-FAMILY DRIVE - ESSENTIALS (TOILETRIES) DRIVE * HEALTH SCREENINGS INCLUDING: - REDUCED FEE MAMMOGRAMS - PROSTATE (PSA) SCREENINGS - BLOOD PRESSURE SCREENINGS - STROKE PREVENTION CLINIC/SCREENINGS * SERVICES TO THE COMMUNITY, INCLUDING: - CENTER FOR SPIRITUAL CARE PASTORAL CARE CHAPLAIN & VOLUNTEER ASSISTANCE WITH OVER 650 POWER OF ATTORNEY FOR HEALTH CARE (ADVANCE DIRECTIVE) FORMS - A VARIETY OF STUDENT INTERN PROGRAMS, WORK SHADOWING, AND TOURS - OVERNIGHT ACCOMMODATIONS FOR FAMILIES OF CRITICALLY ILL PATIENTS - PATIENT FOLLOW-UP POST DISCHARGE CALLS PROGRAM - MEDICAL EQUIPMENT, SUPPLIES, LABORATORY SERVICES, IMAGING SERVICES DONATED TO THE CHIPPEWA VALLEY FREE CLINIC AND ITS PATIENTS BELOW THE FEDERAL POVERTY LEVEL - ANNUAL BIOETHICS SYMPOSIUM - SYMPOSIUM SUPPORT AND SPONSORSHIP FOR THE CATHOLIC MEDICAL ASSOCIATION - DISASTER PREPAREDNESS PLANNING - INFLUENZA/H1N1 COMMUNITY EDUCATION - SYMPOSIUM SPONSORSHIP ON FINANCIAL MANAGEMENT DURING CHALLENGING ECONOMIC TIMES Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED) * HOSTING MEETINGS, DRIVES AND SPONSORSHIPS FOR: - RED CROSS BLOOD DRIVES - CATHOLIC CHARITIES EVENTS AND EDUCATION - DIOCESE OF LA CROSSE OFFICE OF FAMILY LIFE - UNITED WAY EVENTS - RELAY FOR LIFE - AMERICAN CANCER SOCIETY - SPECIAL OLYMPICS POLAR PLUNGE - AMERICAN HEART ASSOCIATION HEART WALK - BRAIN INJURY ASSOCIATION OF WISCONSIN - BREAKFAST IN THE VALLEY - RED CROSS REAL HEROES BANQUET - PRODUCERS & BUYERS CO-OP: LINKING LOCAL FARMS AND INSTITUTIONS, ORGANIZATIONAL SUPPORT FOR MEETINGS AND ORGANIZATIONAL AND SECRETARIAL SUPPORT TO ENCOURAGE LOCAL FOOD SOURCING BY INSTITUTIONS TO BENEFIT THE LOCAL ECONOMY (IN PARTNERSHIP WITH RIVER COUNTRY RC&D AND LOCAL FAMILY FARMS) - LOGISTICAL SUPPORT AND MEETING SPACE FOR THE CHIPPEWA VALLEY INTERNETWORKING CONSORTIUM TO HELP EXPAND FIBER BROADBAND INFRASTRUCTURE AND SERVICE TO THE COMMUNITY AND TO RURAL AND UNDERSERVED AREAS TO SUPPORT TELEMEDICINE AND OTHER HEALTH PROJECTS, ALONG WITH CITY/COUNTY GOVERNMENTS, EMS, LIBRARIES AND SCHOOLS/EDUCATION - LOCAL "GREEN" AND ENVIRONMENTAL SUSTAINABILITY EDUCATIONAL EVENTS * FIRST AID BOOTHS FOR COMMUNITY EVENTS/FESTIVALS, INCLUDING: - BUCKSHOT RUN - COUNTRY JAM - FESTIVAL IN THE PINES - INTERNATIONAL FALL FESTIVAL * "GREEN" ENVIRONMENTAL STEWARDSHIP AND SUSTAINABILITY EFFORTS (RECYCLING AND REUSING) INCLUDING: - MORE THAN 5 TONS OF FOOD SCRAP PRODUCE WERE DONATED TO A LOCAL RANCH FOR ANIMAL FEED - THE HOSPITAL DONATED MORE THAN 4.5 TONS OF LEFTOVER FOOD TO THE ST. FRANCIS FOOD PANTRY - DONATED 11.5 TONS OF USED EQUIPMENT (8,400 ITEMS) TO THIRD WORLD COUNTRIES VIA THE HOSPITAL SISTERS MISSION OUTREACH: MEDICAL EQUIPMENT WENT TO NEEDY HOSPITALS AND CLINICS IN THIRD WORLD COUNTRIES SUCH AS MONGOLIA AND UKRAINE AND TO U.S. NAVY PROJECT HANDCLASP. EQUIPMENT INCLUDED BEDS, WHEELCHAIRS, EXAM LIGHTS, WALKERS, X-RAY APRONS, MEDICAL CARTS, SURGICAL INSTRUMENTS, STRETCHERS, LINENS AND VARIOUS OTHER ITEMS SACRED HEART HOSPITAL HAS PREPARED THE FINANCIAL INFORMATION IN THIS REPORT IN ACCORDANCE WITH CHAUSA COMMUNITY BENEFIT REPORTING GUIDELINES. THESE GUIDELINES RECOMMEND THE FOLLOWING: * REPORT COMMUNITY CARE AT COST, NOT CHARGES. * DO NOT INCLUDE BAD DEBT, CONTRACTUAL ALLOWANCES, AND QUICK PAY DISCOUNTS AS PART OF CHARITY CARE EXPENSE. * DO NOT COUNT MEDICARE SHORTFALL AS A COMMUNITY BENEFIT. * REPORT THE NET EXPENSE FOR COMMUNITY BENEFIT SERVICES, I.E., THE TOTAL COMMUNITY BENEFIT EXPENSE MINUS ANY ASSOCIATED REVENUE FROM PATIENTS, PAYERS, AND OTHER EXTERNAL SOURCES. THE CATHOLIC HEALTH ASSOCIATION'S REPORTING GUIDELINES REFLECT A CONSERVATIVE APPROACH TO REPORTING QUANTIFIABLE COMMUNITY BENEFIT. THE GOAL OF THE REPORTING GUIDELINES IS TO PRODUCE COMMUNITY BENEFIT FINANCIAL REPORTS THAT REFLECT TRUE COSTS AND THAT DESCRIBE COMMUNITY BENEFIT ACTIVITIES THAT INCREASE ACCESS TO HEALTH CARE AND IMPROVE COMMUNITY HEALTH. IN SUMMARY SACRED HEART HOSPITAL FINANCIALLY CONTRIBUTED TO THE COMMUNITY $17,925,275 FISCAL YEAR ENDED JUNE 30, 2019 AS FOLLOWS: CHARITY CARE - AT COST, NOT INCLUDING BAD DEBT $2,269,973 GOVERNMENT SPONSORED HEALTH CARE - NET EXPENSES UNPAID COST OF PUBLIC INDIGENT CARE PROGRAMS (INCLUDES MEDICAID AND OTHER PUBLIC PROGRAMS) $9,220,030 COMMUNITY BENEFIT PROGRAMS - NET EXPENSE $6,435,272 TOTAL QUANTIFIABLE COMMUNITY BENEFITS $17,925,275 IN ADDITION TO THE AMOUNTS REPORTED ABOVE, SACRED HEART HOSPITAL COMMITTED SIGNIFICANT RESOURCES TO SERVICE THE MEDICARE POPULATION. THE COST (AS DETERMINED USING THE COST TO CHARGE RATIO) OF PROVIDING SERVICES TO PRIMARILY ELDERLY BENEFICIARIES OF THE MEDICARE PROGRAM IN EXCESS OF GOVERNMENTAL AND MANAGED CARE CONTRACT PAYMENTS WAS $31,432,156 FOR THE YEAR ENDED JUNE 30, 2019. Form 990, Part IV, Line 24a TAX-EXEMPT BONDS SACRED HEART HOSPITAL HOLDS A LIABILITY ON ITS BOOKS FOR TAX-EXEMPT BONDS, WHICH IS AN ALLOCATION FROM ITS SOLE CORPORATE MEMBER, HOSPITAL SISTERS SERVICES, INC. AS A RESULT, THIS QUESTION WAS ANSWERED NO, AND SCHEDULE K WILL BE COMPLETED ON THE HOSPITAL SISTERS SERVICES, INC. FORM 990. Form 990, Part IV, Line 10 Endowment Funds The organization maintains temporarily and permanently restricted net assets on its balance sheet. Such funds are held by Hospital Sisters of St. Francis Foundation, Inc., a related tax-exempt organization. While these funds are held to further one or more exempt purposes of the filing organization, they are not maintained exclusively for the filing organization. The board of directors of Hospital Sisters of St. Francis Foundation, Inc. maintains ownership and ultimately authority and discretion over the use of these funds. Based on the above, the related amounts have not been reported as endowment funds on Part V of Schedule D. Form 990, Part V, Line 1a Number reported in box 3 of Form 1096 THE FORM 1096, ANNUAL SUMMARY AND TRANSMITTAL OF U.S. INFORMATION RETURN IS FILED BY THE ORGANIZATION'S PARENT, HOSPITAL SISTERS HEALTH SYSTEM (HSHS) ON THE ORGANIZATION'S BEHALF TO TRANSMIT TO THE IRS FORMS 1099, 1098, 5498, AND W-2G. THE ORGANIZATION IS UNABLE TO DETERMINE THE NUMBER OF FORMS 1099, 1098, 5498 AND W-2G FILED BY HSHS, ON THEIR BEHALF. HOWEVER, AS THE PARENT ORGANIZATION, HSHS ENSURES THAT THE FILING ORGANIZATION COMPLIES WITH ALL INFORMATION RETURN REPORTING REQUIREMENTS AND BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND REPORTABLE GAMING WINNINGS TO PRIZE WINNERS, AS APPLICABLE. Form 990, Part VI, Line 13 WHISTLEBLOWER POLICY PROVISIONS WITHIN THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY PROVIDE PROTECTIONS FOR WHISTLEBLOWER TYPE ACTIVITIES. Form 990, Part VI, Line 16b JOINT VENTURES HOSPITAL SISTERS HEALTH SYSTEM ADOPTED A JOINT VENTURE COMPLIANCE PROGRAM POLICY EFFECTIVE ON JANUARY 1, 2012 FOR ALL SYSTEM HOSPITALS, INCLUDING SACRED HEART HOSPITAL. THE OVERALL PURPOSE OF THE POLICY IS TO PROVIDE PRACTICAL GUIDELINES FOR ETHICAL BUSINESS CONDUCT, TO ACHIEVE COMPLIANCE, AND TO DETECT AND PREVENT VIOLATIONS OF APPLICABLE LAWS. THE POLICY REQUIRES SACRED HEART HOSPITAL, AND ALL HSHS HOSPITALS, TO EVALUATE THEIR PARTICIPATION IN JOINT VENTURE ARRANGEMENTS, INCLUDING UNDER APPLICABLE FEDERAL TAX LAWS, AND TO SAFEGUARD SACRED HEART HOSPITAL'S TAX EXEMPT STATUS WITH RESPECT TO ANY JOINT VENTURE ARRANGEMENTS. Form 990, Part VI, Line 1a GOVERNING BODY DELEGATED BROAD AUTHORITY TO AN EXECUTIVE COMMITTEE PER ARTICLE 5.5 OF THE ORGANIZATION'S BY-LAWS, THE GOVERNING BODY DELEGATES BROAD AUTHORITY TO AN EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL BE VESTED WITH AND MAY IN ITS DISCRETION EXERCISE THE FULL POWERS, DUTIES, RESPONSIBILITIES, AND AUTHORITY OF THE BOARD EXCEPT WHERE PROHIBITED BY LAW AND SUBJECT TO LIMITATIONS IMPOSED BY THE BYLAWS OR THE BOARD OF DIRECTORS. AS PROVIDED IN THE BYLAWS, THE EXECUTIVE COMMITTEE SHALL CONSIST OF FIVE TO SIX MEMBERS, INCLUDING THE CHAIRPERSON OF THE BOARD, THE VICE CHAIRPERSON, THE PRESIDENT AND OTHER MEMBERS SELECTED FROM AMONG THE DIRECTORS BY THE BOARD. Form 990, Part VI, Line 6 Classes of members or stockholders THE SOLE CORPORATE MEMBER OF SACRED HEART HOSPITAL (THE CORPORATION) IS HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body PURSUANT TO SECTION 2.3 OF THE CORPORATION'S BYLAWS, THE ORGANIZATION'S MEMBER, HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, HAS THE RIGHT TO APPOINT AND REMOVE THE CORPORATION'S BOARD OF DIRECTORS. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders RESPONSIBILITY FOR THE POLICY AND OPERATIONS OF SACRED HEART HOSPITAL (THE "CORPORATION") IS VESTED IN ITS BOARD OF DIRECTORS, EXCEPT WITH RESPECT TO SPECIFIC POWERS RESERVED IN THE CORPORATION'S BYLAWS TO THE CORPORATION'S MEMBER, HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBER OF HSSI IS HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE GOVERNANCE AND OPERATIONS OF THE CORPORATION ARE SUBJECT TO HSSI'S RIGHT TO EXERCISE THESE RESERVED POWERS WITH RESPECT TO THE CORPORATION AND ORGANIZATIONS OF WHICH THE CORPORATION IS EITHER, DIRECTLY OR INDIRECTLY, A CONTROLLING MEMBER OR A CONTROLLING SHAREHOLDER ("AFFILIATES"). HSSI'S RIGHT TO EXERCISE CERTAIN OF THESE RESERVED POWERS IS, IN TURN, SUBJECT TO THE APPROVAL OF HSHS AND HSHS' MEMBERS. THE RESERVED POWERS INCLUDE ALL RIGHTS GRANTED TO HSSI BY LAW AND THE RIGHT TO: (A) ADOPT, APPROVE AMENDMENTS TO, OR AMEND ANY STATEMENT OF PHILOSOPHY, MISSION, MISSION INTEGRATION OR VALUES, OR ANY NAME, LOGO, OR MARK OF THE CORPORATION OR OF ANY AFFILIATE; (B) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE ARTICLES OF INCORPORATION OF THE CORPORATION OR OF ANY AFFILIATE; (C) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE BYLAWS OF THE CORPORATION OR OF ANY AFFILIATE; (D) APPOINT AND REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE OF THE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, AND THE PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE; (E) APPROVE THE RECOMMENDATION OF THE BOARD OF DIRECTORS TO APPOINT OR REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, OR THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE. (F) WITH RESPECT TO THE CORPORATION OR ANY AFFILIATE, APPROVE THE PURCHASE, SALE, ALIENATION, EXCHANGE, LEASE, OR ENCUMBRANCE OF ANY REAL PROPERTY OF THE CORPORATION OR OF ANY AFFILIATE, WHICH PROPERTY HAS A VALUE IN EXCESS OF LIMITS SET FROM TIME TO TIME BY HSSI; (G) APPROVE DEBT INCURRED BY THE CORPORATION OR ANY AFFILIATE IN AN AMOUNT IN EXCESS OF LIMITS SET FROM TIME TO TIME BY THE MEMBER. (H) APPROVE THE OPERATING AND CAPITAL BUDGETS OF THE CORPORATION OR OF ANY AFFILIATE, AND ANY DEVIATIONS BY THE CORPORATION OR OF ANY AFFILIATE FROM SUCH BUDGETS IN AN AMOUNT OR PERCENTAGE SPECIFIED BY HSSI FROM TIME TO TIME; (I)APPROVE THE STRATEGIC PLAN AND ANNUAL GOALS OF THE CORPORATION OR OF ANY AFFILIATE; (J) APPROVE THE SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR OF ANY AFFILIATE; (K) APPROVE THE MERGER OR DISSOLUTION OF THE CORPORATION OR OF ANY AFFILIATE; (L) ADOPT OR AMEND THE PLAN FOR MINISTRY EDUCATION AND GOVERNANCE FOR THE CORPORATION AND ITS AFFILIATES; (M) APPROVE THE CORPORATION'S MISSION ACCOUNTABILITY REPORTS AND THOSE OF ANY AFFILIATE; (N) APPROVE THE FINANCIAL POLICIES AND PROCEDURES OF THE CORPORATION OR OF ANY AFFILIATE, AND APPROVE ANY DEVIATIONS FROM SUCH POLICIES AND PROCEDURES BY THE CORPORATION OR ANY AFFILIATE; AND (O) ADOPT POLICIES TO IMPLEMENT THE RESERVED POWERS OF HSSI. Form 990, Part VI, Line 11b Review of form 990 by governing body THE HOSPITAL EMPLOYS CROWE LLP TO ASSIST IN THE OVERALL REVIEW AND ELECTRONIC SUBMISSION OF ITS FORM 990. CROWE LLP PROVIDES GUIDANCE IN IDENTIFYING CRITICAL ERRORS IN THE RETURN SUBMISSION AND FEEDBACK ON QUANTITATIVE AND QUALITATIVE RESPONSES. ADDITIONALLY, THE HOSPITAL CFO PERFORMS A THOROUGH REVIEW OF THE RETURN AND REVIEWS IT WITH THE HOSPITAL CEO AND/OR SENIOR LEADERS BEFORE PRESENTING IT IN ITS ENTIRETY TO THE HOSPITAL BOARD FOR QUESTIONING AND REVIEW PRIOR TO THE RETURN'S SIGNING AND SUBMISSION TO THE IRS. Form 990, Part VI, Line 12c Conflict of interest policy THE ORGANIZATION IS SUBJECT TO THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY ("POLICY") OF HOSPITAL SISTERS HEALTH SYSTEM, AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. A REVISED CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY HAVE BEEN IMPLEMENTED SINCE JANUARY 2009 TO MANAGE CONFLICTS OF INTEREST USING A SYSTEM-WIDE PROTOCOL FOR DISCLOSURE STATEMENTS. IN ACCORDANCE WITH THE ORGANIZATON'S CONFLICT OF INTEREST POLICY, ALL COVERED PERSONS HAVE A DUTY TO COMPLY WITH THE CONFLICT OF INTEREST POLICY FOR ANY CONTRACT, TRANSACTION, RELATIONSHIP, OR ACTIVITY CONTEMPLATED, ENTERED INTO, OR CONDUCTED AT HSHS OR ITS AFFILIATES. THE POLICY DEFINES COVERED PERSONS AS BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS, BOARD DESIGNEES, SENIOR MANAGEMENT, MEMBERS OF ANY COMMITTEE THAT OVERSEES THE APPROVAL OF PHARMACEUTICALS AND MEDICAL DEVICES, AND ANY OTHER INDIVIDUAL WHO HOLDS A POSITION OF TRUST. ON AN ANNUAL BASIS, HOSPITAL SISTERS HEALTH SYSTEM, ("HSHS") DISCLOSES A COPY OF THE CONFLICT OF INTEREST POLICY (AND ALL CORRESPONDING PROCEDURES, GUIDELINES, FORMS, AND TOOLS) TO ALL COVERED PERSONS, AND ADVISES ALL COVERED PERSONS IN WRITING OF ANY SUBSTANTIVE CHANGES TO THIS POLICY AND SUCH RELATED MATERIALS. COVERED PERSONS ARE REQUIRED TO REVIEW AND COMPLETE THE CORRESPONDING CONFLICT OF INTEREST STATEMENT. THE SYSTEM OFFICE VICE PRESIDENT, SYSTEM RESPONSIBILITY OR MEMBERS OF THE AUDIT AND INTEGRITY COMMITTEE ("COMMITTEE") ARE AVAILABLE TO ANSWER ANY QUESTIONS A COVERED PERSON MAY HAVE. IN ADDITION, IF, AT ANY TIME AFTER SUBMITTING AN ANNUAL CONFLICT OF INTEREST STATEMENT, A COVERED PERSON BECOMES AWARE OF AN INTEREST THAT HE OR SHE WOULD HAVE HAD TO DISCLOSE AT THE ANNUAL INTERVAL, THE COVERED PERSON IS REQUIRED PROMPTLY TO DISCLOSE THE INTEREST TO THE COMMITTEE USING THE HSHS CONFLICT OF INTEREST DISCLOSURE STATEMENT. COMPLETED CONFLICT OF INTEREST STATEMENTS ARE SUBMITTED TO THE COMMITTEE, WHICH IS RESPONSIBLE FOR IDENTIFYING, ASSESSING, AND MANAGING CONFLICTS OF INTEREST THAT ARISE IN THE COURSE OF CONDUCTING THE AFFAIRS OF HSHS AND ITS AFFILIATES. IF THE COMMITTEE DETERMINES THAT A CONFLICT OF INTEREST EXISTS, THE CONFLICT OF INTEREST POLICY REQUIRES HSHS NOT TO ENGAGE IN, OR ENTER INTO, A PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY UNLESS THE COMMITTEE OR, WHERE NECESSARY, THE BOARD OF DIRECTORS (ACTING THROUGH ITS DISINTERESTED MEMBERS), HAS INVESTIGATED ALTERNATIVES TO THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY AND, IN THE ABSENCE OF ALTERNATIVES THAT ARE IN THE BEST INTERESTS OF HSHS, HAS DETERMINED: 1. THAT, REGARDLESS OF WHETHER THE COVERED PERSON PARTICIPATES IN THE IMPLEMENTATION OF THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY; 2. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS IN THE BEST INTERESTS OF HSHS; 3. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS FAIR AND REASONABLE FROM THE PERSPECTIVE OF HSHS; AND 4. HSHS CANNOT OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION, ARRANGEMENT OR ACTIVITY WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. IN DETERMINING WHETHER A CONTRACT, TRANSACTION OR ARRANGEMENT IS FAIR AND REASONABLE TO HSHS, THE COMMITTEE SHALL CONSIDER, WHERE APPLICABLE: 1. APPRAISALS OR OTHER INDEPENDENT VALUATIONS OF THE FAIR MARKET VALUE OF THE CONTRACT, TRANSACTION, OR ARRANGEMENT; 2. INFORMATION REGARDING COMPARABLE CONTRACTS, TRANSACTIONS, OR ARRANGEMENTS BETWEEN UNRELATED PARTIES; 3. OFFERS FROM COMPARABLE COMPETING ENTITIES; AND/OR 4. STUDIES OF COMPARABLE COMPENSATION ARRANGEMENTS. IN ANY CASE IN WHICH THE COMMITTEE FINDS, AFTER TAKING THE STEPS DESCRIBED ABOVE, THAT HSHS SHOULD PARTICIPATE IN A PROPOSED TRANSACTION OR ARRANGEMENT DESPITE THE EXISTENCE OF A CONFLICT OF INTEREST, THE COMMITTEE SHALL DEVELOP, IMPLEMENT, MONITOR, AND ENFORCE COMPLIANCE WITH, A CONFLICT MANAGEMENT PLAN FOR MANAGING THE CONFLICT OF INTEREST AS IT CONSIDERS NECESSARY FOR SUCH FINDINGS TO REMAIN VALID THROUGHOUT THE LIFE OF THE CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY. ALL CONFLICT MANAGEMENT PLANS SHALL: 1. STATE THAT THE COMMITTEE WILL OVERSEE, MONITOR, AND ENFORCE COMPLIANCE WITH THE PLAN THROUGHOUT THE COURSE OF THE STUDY AND SPECIFY MEANS FOR DOING SO, INCLUDING, WITHOUT LIMITATION, THAT THE APPROPRIATE INDIVIDUALS MUST PROVIDE THE COMMITTEE WITH WRITTEN REPORTS PERTAINING TO COMPLIANCE WITH THE CONFLICT MANAGEMENT PLAN, THAT THE COMMITTEE SHALL HAVE THE RIGHT TO AUDIT THE STUDY FOR SUCH COMPLIANCE, AND THE RIGHT TO IMPOSE SANCTIONS FOR NON-COMPLIANCE; 2. STATE THAT THE PLAN MUST BE SHARED WITH COVERED PERSON WHOSE INTERESTS IT WAS DEVELOPED TO MANAGE; 3. STATE THAT THE PLAN MUST BE SHARED WITH, AND PERIODIC REPORTS ON COMPLIANCE WITH THE PLAN MUST BE PROVIDED TO, THE BOARD, SENIOR MANAGEMENT AND/OR GOVERNMENT AGENCIES; AND 4. PROVIDE FOR SUCH OTHER MANAGEMENT STEPS AND MECHANISMS THE COMMITTEE CONSIDERS NECESSARY AND APPROPRIATE. IN ADDITION TO THE COMMITTEE, THE SYSTEM OFFICE VICE PRESIDENTS OF SYSTEM RESPONSIBILITY AND RISK & COMPLIANCE MAY RETAIN SUCH INDEPENDENT ADVISORS OR EXPERTS AS DEEMED NECESSARY TO ASSIST IN MAKING ITS DETERMINATIONS AND DECISIONS. IF THE COMMITTEE DETERMINES THAT THE CONTEMPLATED TRANSACTION, RELATIONSHIP ARRANGEMENT, OR ACTIVITY CANNOT PROCEED DUE TO A CONFLICT OF INTEREST, THE COMMITTEE SHALL INFORM THE APPLICABLE COVERED PERSON OR DECISION-MAKING BODY OF SUCH DETERMINATION WITHIN ONE WEEK OF THE COMMITTEE MEETING AT WHICH THE CONTEMPLATED TRANSACTION WAS DISCUSSED. THE COMMITTEE SHALL DOCUMENT ITS REJECTION OF THE CONTEMPLATED TRANSACTION IN THE COMMITTEE'S MEETING MINUTES. Form 990, Part VI, Line 15a Process to establish compensation of top management official THE COMPENSATION COMMITTEE (COMMITTEE) IS COMPRISED OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE DEVELOPS A COMPENSATION PHILOSOPHY FOR THE SYSTEM AND ALL AFFILIATES. THE COMMITTEE SELECTS AND HIRES THE INDEPENDENT COMPENSATION CONSULTANT TO DEVELOP COMPARABILITY DATA AND ADVISE THE COMMITTEE DURING ITS DELIBERATIONS REGARDING ALL ELEMENTS OF TOTAL COMPENSATION FOR ALL HSHS EXECUTIVES, (the top management official, other officers and key employees). INTEGRATED HEALTHCARE STRATEGIES ("IHS"), THE CONSULTANTS UTILIZED BY THE COMMITTEE, USE DATA FROM MULTIPLE TAX-EXEMPT PEER GROUP SOURCES (derived from a full market review conducted every other year) TO DETERMINE SALARY RANGES, INCENTIVE OPPORTUNITY RANGES AND BENEFITS FOR THE HSHS executives. IHS THEN ASSISTS THE COMMITTEE IN PREPARING CONTEMPORANEOUS DOCUMENTATION OF ALL ACTIONS. EACH COMMITTEE MEETING IS CONDUCTED WITH THE INTENT TO CREATE A REBUTTABLE PRESUMPTION OF REASONABLENESS FOR ALL ELEMENTS OF EXECUTIVE TOTAL COMPENSATION. THE CHAIRMAN MAKES THIS DECLARATION AND ALSO INQUIRES IF THERE ARE ANY CONFLICTS OF INTEREST BY ANY ATTENDEES. ANY CONFLICTS ARE DISCLOSED AND THE COMMITTEE THEN ACTS IN A MANNER TO AVOID ANY CONFLICTED INDIVIDUAL PARTICIPATING IN ANY MANNER WHERE A CONFLICT MIGHT EXIST. AT THE END OF THE MEETING, THE COMMITTEE PREPARES CONTEMPORANEOUS MINUTES THAT RECORD ALL ACTIONS TAKEN DURING THE MEETING. The process for reviewing compensation by the compensation committee is completed each fiscal year. Form 990, Part VI, Line 15b Process to establish compensation of other employees PLEASE SEE RESPONSE TO FORM 990, PART VI, LINE 15A. Form 990, Part VI, Line 19 Required documents available to the public BOARD-APPROVED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC AT THIS TIME. Form 990, Part IX, Line 11g Other Fees Professional Fees - Total Expense: 6725663, Program Service Expense: 2304911, Management and General Expenses: 4420752, Fundraising Expenses: ; Purchased Service Medical - Total Expense: 5418212, Program Service Expense: 5435396, Management and General Expenses: -17184, Fundraising Expenses: ; SSC Management Fee - Total Expense: 4551131, Program Service Expense: , Management and General Expenses: 4551131, Fundraising Expenses: ; Contracted Services - Total Expense: 8352884, Program Service Expense: 2325672, Management and General Expenses: 6027212, Fundraising Expenses: ; Purchased Service General - Total Expense: 4283627, Program Service Expense: 4283627, Management and General Expenses: , Fundraising Expenses: ; Physician Recruiting - Total Expense: 242202, Program Service Expense: 242202, Management and General Expenses: , Fundraising Expenses: ; Form 990, Part X, Line 11 POOLED INVESTMENT ACCOUNT SACRED HEART HOSPITAL USES ITS POOLED INVESTMENTS TO CARRY ON ITS MISSION OF CARING FOR THE SICK. THE HOSPITAL'S CASH RESERVES ARE INVESTED IN A POOLED INVESTMENT ACCOUNT MAINTAINED BY HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"). PARTICIPATION IN THE POOLED FUND IS LIMITED TO THE 501(C)(3) HOSPITALS AND HEALTH SERVICES ORGANIZATIONS SPONSORED BY HSHS. THE POOLED ACCOUNT CONSISTS OF CASH, EQUITY AND DEBT SECURITIES THAT ARE PUBLICLY TRADED. IN ACCORDANCE WITH THE PROVISIONS OF STATEMENT OF FINANCIAL ACCOUNTING STANDARDS ("SFAS") NO. 124 "ACCOUNTING FOR CERTAIN INVESTMENTS HELD BY NOT-FOR-PROFIT ORGANIZATIONS", INVESTMENTS IN EQUITY SECURITIES WITH READILY DETERMINABLE FAIR VALUES, AND ALL INVESTMENTS IN DEBT SECURITIES, ARE REPORTED AT FAIR VALUE ON THE BALANCE SHEET. READILY DETERMINABLE FAIR VALUES AND ALL INVESTMENTS IN DEBT SECURITIES ARE REPORTED AT FAIR VALUE ON THE BALANCE SHEET. INCOME, REALIZED AND UNREALIZED GAINS AND LOSSES ARE POOLED AND ALLOCATED TO THE PARTICIPANTS. INDIVIDUAL COMPONENTS OF ASSETS AND REVENUE ARE NOT IDENTIFIED TO THE INDIVIDUAL HOSPITAL PARTICIPANTS. Form 990, Part XI, Line 9 Other changes in net assets or fund balances Pension Mark to Market Adjustment - -19778004; Transfer to Affiliates - 1665076; Change in Temporarily Restricted Net Assets - -538163; Change in Permenant Restricted Net Assets - 22286; Change in fair value of the interest rate SWAPS - -5601227; SWAP payments - -1122416; KIARA CLINICAL INTEGRATION NETWORK LLC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 261417684 HEALTHCARE IL -1945270 3230896 HSSI PHYSICIAN CLINICAL INTEGRATION NETWORK LLC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371668647 HEALTHCARE IL 563783 11970191 KCIN HSHS ACO LLC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 320465666 HEALTHCARE & SOCIAL ASSISTANCE IL -381285 458242 KCIN HOSPITAL SISTERS HEALTH SYSTEM 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371058692 HEALTHCARE IL 501(c)(3) Type III-FI NA false HOSPITAL SISTERS OF ST FRANCIS FOUNDATION 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371186514 HEALTHCARE IL 501(c)(3) 7 HSHS true HOSPITAL SISTERS HEALTHCARE WEST INC 2661 COUNTY HIGHWAY 1 CHIPPEWA FALLS WI 54729 510157933 HEALTHCARE WI 501(c)(3) Type I HSSI true ST ANTHONY'S HOSPITAL 503 N MAPLE STREET EFFINGHAM IL 62401 370661233 HEALTHCARE IL 501(c)(3) 3 HSSI true ST ELIZABETH'S HOSPITAL ONE ST ELIZABETHS BLVD OFALLON IL 62269 370663567 HEALTHCARE IL 501(c)(3) 3 HSSI true ST NICHOLAS HOSPITAL 3100 SUPERIOR AVENUE SHEBOYGAN WI 53081 390808480 HEALTHCARE WI 501(c)(3) 3 HSSI true ST JOHN'S HOSPITAL 800 EAST CARPENTER STREET SPRINGFIELD IL 62769 370661238 HEALTHCARE IL 501(c)(3) 3 HSSI true ST JOSEPH'S HOSPITAL 9515 HOLY CROSS LANE BREESE IL 62230 371208459 HEALTHCARE IL 501(c)(3) 3 HSSI true ST JOSEPH'S HOSPITAL 2661 COUNTY HIGHWAY 1 CHIPPEWA FALLS WI 54729 390810545 HEALTHCARE WI 501(c)(3) 3 HSSI true ST MARY'S HOSPITAL 1800 E LAKE SHORE DRIVE DECATUR IL 62521 370661244 HEALTHCARE IL 501(c)(3) 3 HSSI true ST MARY'S HOSPITAL 111 SPRING STREET STREATOR IL 61364 362169181 HEALTHCARE IL 501(c)(3) 3 HSSI true ST MARY'S MEDICAL CENTER 1762 SHAWANO AVENUE GREEN BAY WI 54303 390818682 HEALTHCARE WI 501(c)(3) 3 HSSI true ST VINCENT HOSPITAL 835 S VAN BUREN GREEN BAY WI 51301 390817529 HEALTHCARE WI 501(c)(3) 3 HSSI true ST JOSEPH'S HOSPITAL 12866 TROXLER AVENUE HIGHLAND IL 62249 370663568 HEALTHCARE IL 501(c)(3) 3 HSSI true ST FRANCIS HOSPITAL 1215 FRANCISCAN DRIVE LITCHFIELD IL 62056 370661236 HEALTHCARE IL 501(c)(3) 3 HSSI true HOSPITAL SISTERS SERVICES INC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371163402 HEALTHCARE IL 501(c)(3) Type III-FI HSHS true HSHS MEDICAL GROUP INC 3215 EXECUTIVE PARK DRIVE SPRINGFIELD IL 62703 263956318 HEALTHCARE IL 501(c)(3) Type III-FI HSSI true HSHS WISCONSIN MEDICAL GROUP INC 3215 EXECUTIVE PARK DRIVE SPRINGFIELD IL 62703 264515959 HEALTHCARE WI 501(c)(3) Type III-FI HSSI true ORANGE CROSS AMBULANCE INC 919 ASHLAND AVENUE SHEBOYGAN WI 53081 391860942 HEALTHCARE WI 501(c)(3) 10 ST NICHOLAS true UNITY LIMITED PARTNERSHIP 2366 OAK RIDGE CIRCLE DE PERE WI 54115 391750729 HEALTHCARE WI 501(c)(3) 10 HSSI true PRAIRIE EDUCATION & RESEARCH COOPERATIVE 317 NORTH 5TH STREET SPRINGFIELD IL 62701 371157915 HEALTHCARE IL 501(c)(3) 4 HSSI true ST CLARE MEMORIAL HOSPITAL 855 S MAIN STREET OCONTO FALLS WI 54154 390848401 HEALTHCARE WI 501(c)(3) 3 HSSI true HSHS HOLY FAMILY HOSPITAL 200 HEALTHCARE DRIVE GREENVILLE IL 62246 370792770 HEALTHCARE IL 501(c)(3) 3 HSSI true UTLAUT MEMORIAL FOUNDATION 200 HEALTHCARE DRIVE GREENVILLE IL 62246 371140166 FUNDRAISING IL 501(c)(3) Type II HSSI true HSHS GOOD SHEPHERD HOSPITAL INC 200 SOUTH CEDAR STREET SHELBYVILLE IL 62565 370512290 HEALTHCARE IL 501(c)(3) 3 HSSI true SHELBY MEMORIAL HOSPITAL EMPLOYEE BENEFIT TRUST 200 SOUTH CEDAR STREET SHELBYVILLE IL 62565 371778753 TRUST IL 501(a) GSS true PAIN CENTER OF WISCONSIN 4131 W LOOMIS ROAD SUITE 300 GREENFIELD WI 53221 263155343 HEALTHCARE WI ST VINCENT Related 742948 556009 false false 0.5 PAIN CENTER OF WISCONSIN - OCONTO FALLS LLC 4131 W LOOMIS ROAD SUITE 300 GREENFIELD WI 53221 364717036 HEALTHCARE WI ST CLARE Related 26375 142266 false false 0.5 CARPENTER STREET HOTEL LLC 525 NORTH SIXTH STREET SPRINGFIELD IL 62702 364128127 HOTEL IL LASANTE INC N/A 0 SPRINGFIELD URGENT CARE REAL ESTATE LLC PO BOX 19456 SPRINGFIELD IL 627949456 030413258 RENTAL REAL ESTATE IL LASANTE INC N/A 0 PRAIRIE HEART INSTITUTE MANAGEMENT COMPANY LLC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 261479945 MEDICAL IL HSHS Related -6697 9753 false true 1 SOUTHWEST ILLINOIS HEALTH SERVICES REAL ESTATE LLP 4000 NORTH ILLINOIS STREET SWANSEA IL 62226 823633320 REAL ESTATE IL ST ELIZABETH'S Related 337078 1174120 false false 0.5 PRAIRIE HEART INSTITUTE ST JOHN'S 800 EAST CARPENTER STREET SPRINGFIELD IL 62769 371321197 HEALTHCARE IL HSHS Related 0 0 false false 1 KIARA INC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371163401 HEALTHCARE IL HSHS C Corporation -42394446 28694534 1 true LASANTE WISCONSIN INC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 391572196 HEALTHCARE IL KIARA INC C Corporation true LASANTE INC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371163400 HEALTHCARE IL KIARA INC C Corporation true PRAIRIE CARDIOVASCULAR 619 EAST MASON SUITE 4P57 SPRINGFIELD IL 62701 371071858 HEALTHCARE IL KIARA INC C Corporation true PREVEA HEALTH SERVICES INC 2710 EXECUTIVE DRIVE GREEN BAY WI 54304 391839351 HEALTHCARE WI HSSI C Corporation -830459 45532956 0.5 true PREVEA CLINIC INC 2710 EXECUTVE DRIVE GREEN BAY WI 54304 391839349 HEALTHCARE WI PHSI C Corporation true RENAISSANCE QUALITY INSURANCE LTD PO BOX 1159 GRAND CAYMAN CJ KY11102 980669953 SELF-INSURANCE CJ HSSI C Corporation 0 136781581 1 true OJV INC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 460873384 HEALTHCARE IL LASANTE INC C Corporation true false false true true true false true false false true true false false true true true true false false Schedule R, Part V, Line 2 TRANSACTIONS WITH RELATED ENTITIES ANY TRANSACTIONS LISTED ON SCHEDULE R, PART V, LINE 1 AND NOT ON SCHEDULE R, PART V, LINE 2 ARE BETWEEN RELATED 501(C)(3) AND DO NOT REQUIRE REPORTING ON THIS SECTION. Schedule R, Part VII Related Organizations Due to the increasingly complex organization structure of Hospital Sisters Health System and Affiliates, the filing organization has elected to report all organizations within Hospital Sisters Health System as related, regardless of ownership interest or "control" as defined by the instructions to Schedule R. The intent of this reporting is to promote transparency and increase consistency across the numerous Form 990 submissions by Hospital Sisters Health System and Affiliates.