2020-08-13T08:30:29-05:00 2019-09-30 350921680 CROWE LLP 225 West Wacker Drive Suite 2600 Chicago IL 606061224 990 2018-10-01 362167785 Mendota Community Hospital MEND 8155397461 1201 E 12TH STREET MENDOTA IL 61342 Michael M Allen CFO 2020-08-13 true Jennifer Burke P01342224 3128997000 2018 2020-11-06 18:47:13Z OSF Saint Paul Medical Center Michael Allen 1201 E 12TH STREET MENDOTA IL 61342 36479388 false X www.osfhealthcare.org/practices/44/1217/osf-saint-paul-medical-center X 1944 IL IN THE SPIRIT OF CHRIST AND THE EXAMPLE OF FRANCIS OF ASSISI, THE MISSION OF OSF HEALTHCARE IS TO SERVE PERSONS WITH THE GREATEST CARE AND LOVE IN A COMMUNITY THAT CELEBRATES THE GIFT OF LIFE. 9 7 169 86 2621 110 40196 69087 36040571 36012475 8945 -82892 248927 152771 36338639 36151441 0 0 15432961 15331653 0 0 20355001 17697994 35787962 33029647 550677 3121794 34342051 33074155 33058937 29275455 1283114 3798700 IN THE SPIRIT OF CHRIST AND THE EXAMPLE OF FRANCIS OF ASSISI, THE MISSION OF OSF HEALTHCARE IS TO SERVE PERSONS WITH THE GREATEST CARE AND LOVE IN A COMMUNITY THAT CELEBRATES THE GIFT OF LIFE. false false 26142961 0 36141771 MENDOTA COMMUNITY HOSPITAL PROVIDED 25 BEDS IN FISCAL YEAR 2019. THE HOSPITAL GAVE $1,253,839 IN CHARITY CARE. THE HOSPITAL PROVIDED 1,970 PATIENT DAYS. THE HOSPITAL PROVIDED 33,030 OUTPATIENT VISITS AND THE EMERGENCY ROOM HAD 5,591 PATIENT VISITS. 26142961 true true false true false false false false true true false false true 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 false true false false false true 6 0 true 169 true true true false false false false false false false false false false false X 9 7 false false false false true true true true true true false true true true true true true true true false IL X Michael Allen 8155397461 800 NE GLEN OAK AVE PEORIA IL 61603 Sister Judith Ann Duvall OSF Chairperson 1.0 43.0 X X 0 5280 0 Robert C Sehring Vice Chairperson CEO 1.0 43.0 X X 0 1660098 67133 Sister Diane Marie McGrew OSF President and Treasurer 1.0 43.0 X X 0 5280 0 Sister Theresa Ann Brazeau OSF Secretary 1.0 43.0 X X 0 5280 0 Sister Agnes Joseph Williams OSF Assistant Secretary 1.0 43.0 X X 0 5280 0 Brian Silverstein MD Board Member 1.0 3.0 X 0 45000 0 Gerald J McShane MD Board Member 1.0 42.0 X 0 382453 75243 Sister M Mikela Meidl FSGM Board Member 1.0 43.0 X 0 0 0 Sister Rose Therese Mann OSF Board Member 1.0 43.0 X 0 0 0 Chad E Boore Chief Executive Officer Eastern Region 1.0 41.0 X 0 489065 46488 Divya-Devi Joshi CEO Children SL 1.0 41.0 X 0 654128 27672 Dwight D Stapleton Vice President Clinical Specialty Services 1.0 41.0 X 0 502198 31423 James J Mormann Chief Information Officer 1.0 41.0 X 0 749665 67244 Jeffry M Tillery SVP Chief Transformation Officer 1.0 41.0 X 0 709263 72449 John R Evancho SVP Chief Compliance Officer 1.0 41.0 X 0 334877 48158 John C Horne SVP Chief Supply Chain Officer 1.0 41.0 X 0 445187 62583 Leon A Yeh MD VP CMO Emergency Serv 1.0 41.0 X 0 591246 64894 Lori L Wiegand Chief Nursing Officer 1.0 41.0 X 0 504267 72769 Mark A Nafziger CEO Ambulatory Care 1.0 41.0 X 0 757602 32595 Michael M Allen CFO 1.0 42.0 X 0 783568 60528 Michael A Cruz MD Chief Executive Officer Central Region 1.0 41.0 X 0 776655 78958 Michelle D Conger Chief Strategy Officer 1.0 41.0 X 0 587557 41654 Ralph R Velazquez MD System Chief Medical Officer 1.0 42.0 X 0 611021 71108 Robert L Brandfass SVP Chief Legal Officer 1.0 41.0 X 0 678404 67458 Roxanna Crosser Chief Executive Officer Western Region 1.0 41.0 X 0 475072 50580 Stephen E Hippler MD Chief Clinical Officer 1.0 41.0 X 0 749430 78944 Thomas G Hammerton President OSF Healthcare Foundation Chief Development Officer 1.0 43.0 X 0 460304 60184 Caitlin J Engels-Arteaga Physician Assistant 40.0 0 X 108003 0 19216 Jane A Battles APN 40.0 0 X 136087 0 29739 Katherine R Riva-Foster MD Physician 40.0 0 X 222382 0 29887 Kenneth K Potts MD Physician 40.0 0 X 229849 0 35288 Stacy A Piller Advanced Practice Nurse 40.0 0 X 107012 0 27127 Anthony M Avellino MD Former - CEO NSSL/INI 0.0 0.0 X 0 498495 38364 David A Schertz Former - CEO Northern Region 0.0 0.0 X 0 825174 50342 Kenneth E Berkovitz MD Former - CEO CVSL 0.0 0.0 X 0 489523 42199 Kenneth J Natzke Former CEO East Region 0.0 0.0 X 0 160000 20250 Kevin D Schoeplein Former - Vice Chairperson CEO 0.0 0.0 X 0 2850403 42655 803332 17791774 1513131 5 true true false Emergency Physician Staffing Solutions 1504 Timber Trail Washington IL 61571 Emergency Services Physicians 2241824 1 X 0 0 0 59791 0 9296 0 69087 PATIENT REVENUE 622110 34420534 34420534 0 0 CONTRACTED PHARMACY 622110 1540891 1540891 0 0 MEDICAL DIRECTORSHIPS 624200 51050 51050 0 0 0 0 0 0 36012475 467 0 0 467 8411 0 0 0 8411 0 8411 0 0 8411 0 186995 0 270354 0 -83359 -83359 0 0 -83359 70036 57593 12443 0 0 12443 CAFETERIA 624200 60891 60891 0 0 71026 68405 2621 0 131917 36151441 36141771 2621 -62038 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11964094 9675315 2288779 0 360717 291710 69007 0 2487026 2011243 475783 0 519816 420372 99444 0 0 0 0 0 0 0 0 0 0 0 0 0 14191 0 14191 0 0 0 0 0 0 0 2186842 2144669 42173 0 0 0 0 0 2970596 2269530 701066 0 0 0 0 0 0 0 0 0 321993 52142 269851 0 100007 66641 33366 0 0 0 0 0 25664 11260 14404 0 1289917 1024065 265852 0 5027126 3637490 1389636 0 813737 646026 167711 0 148433 33648 114785 0 CONTRACTS AND REPAIRS 2157507 1277429 880078 0 BAD DEBTS 1713145 1713145 0 0 PROVIDER TAX 818388 818388 0 0 COLLECTION FEES 35414 35414 0 0 75034 14474 60560 0 33029647 26142961 6886686 0 1192506 1262564 127936 57235 0 0 5605973 4066617 0 0 0 0 0 775070 670364 113426 106028 33450948 19295800 13834932 14155148 74420 137723 0 0 0 12617788 12618476 34342051 33074155 2890403 2636171 0 0 0 18750 0 0 0 0 0 0 0 0 0 30168534 26620534 33058937 29275455 X -516803 1998095 1179408 1180096 620509 620509 0 0 0 0 0 0 1283114 3798700 34342051 33074155 X 3121794 -606208 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 14191 14191 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY THE ORGANIZATION'S LOBBYING ACTIVITIES INCLUDE PAYING MEMBERSHIP DUES TO THE ILLINOIS HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION, WHO PARTICIPATE IN LOBBYING ACTIVITIES ON BEHALF OF HEALTHCARE ORGANIZATIONS. 801256 3961 805217 731914 69342 801256 644870 87044 731914 591555 53315 644870 0 620509 -28954 591555 0.0 0.7706 0.2294 false true true 1927000 1927000 16249923 7334343 8915580 2047602 1677710 369892 13196155 10283747 2912408 30268 0 30268 14155148 GOODWILL 10817871 RESTRICTED FOUNDATION ASSETS 1800605 12618476 ASSET RETIREMENT OBLIGATION 24538 ADVANCES DUE CORP-TERM 25949996 OTHER NOTES - LOANS PAYABLE 646000 26620534 X Schedule D, Part I, Line 1(a) PART 1, LINE 1A Prior year ENDOWMENT Balances Were REDUCED to REMOVE FUNDS Restricted UNDER A MORTGAGE AGREEMENT. THESE FUNDS ARE NOT DONOR-RESTRICTED GIFTS AND WILL NOT BE HELD IN PERPETUITY BY THE HOSPITAL TO FUND A PERMANENT SOURCE OF INCOME and have therefore been adjusted appropriately. Schedule D, Part V, Line 4 Intended uses of endowment funds PROCEEDS OF THE ENDOWMENT, AS DICTATED BY THE DONORS, ARE USED AS BEST DETERMINED BY THE FOUNDATION COUNCIL. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote OSF IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED BY SECTION 501(c)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPTED FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(C)(3) OF THE CODE. UNDER ASC SUBTOPIC 740-10,ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES -AN INTERPRETATION OF FASB STATEMENT NO.109, OSF MUST RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. AS OF SEPTEMBER 30, 2019 AND 2018, OSF AND PCI DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS. ON DECEMBER 22, 2017, THE PRESIDENT SIGNED INTO LAW H.R. 1, ORIGINALLY KNOWN AS THE TAX CUTS AND JOBS ACT. THE NEW LAW (PUBLIC LAW NO. 115-97) INCLUDES SUBSTANTIAL CHANGES TO THE TAXATION OF INDIVIDUALS, BUSINESSES, MULTINATIONAL ENTERPRISES, AND OTHERS. IN ADDITION TO MANY GENERALLY APPLICABLE PROVISIONS, THE LAW CONTAINS SEVERAL SPECIFIC PROVISIONS THAT RESULT IN CHANGES TO THE TAX TREATMENT OF TAX-EXEMPT ORGANIZATIONS AND THEIR DONORS. OSF HAS REVIEWED THESE PROVISIONS AND THE POTENTIAL IMPACT AND CONCLUDED THE ENACTMENT OF H.R. 1 WILL NOT HAVE A MATERIAL EFFECT OF THE OPERATIONS OF THE ORGANIZATION. true true X true X 125 true X true true true false true true 539062 539062 0.0163 4989810 4111667 878143 0.0266 0 0.0 0 0 5528872 4111667 1417205 0.0429 21569 1500 20069 0.0006 106500 106500 0.0032 2008982 1825579 183403 0.0056 0 0.0 6955 6955 0.0002 0 0 2144006 1827079 316927 0.0096 0 0 7672878 5938746 1734132 0.0525 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 true 706501 0 13420368 13462396 -42028 X true true 1 1 MENDOTA COMMUNITY HOSPITAL 1401 E 12TH STREET MENDOTA IL 61342 HTTPS://WWW.OSFHEALTHCARE.ORG/SAINT-PAUL/ IL0005819 X X X X MENDOTA COMMUNITY HOSPITAL 1 false false true X X X X X X X X X 19 true true false true X https://www.osfhealthcare.org/about/community-health/ X true 19 false true false true X 125.0 400.0 X X X X X true true X X X X true X https://www.osfhealthcare.org/billing/financial-assistance/ X https://www.osfhealthcare.org/billing/financial-assistance/ X https://www.osfhealthcare.org/billing/financial-assistance/ X 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 The significant health needs were prioritized as significant health needs of the community and identified through the CHNA. See CHNA for further information. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - MENDOTA COMMUNITY HOSPITAL. FOR THE 2019 CHNA, MENDOTA COMMUNITY HOSPITAL d/b/a SAINT PAUL MEDICAL CENTER SOLICITED AND TOOK INTO ACCOUNT INPUT FROM THE FOLLOWING SOURCES: 1) CURRENT PUBLIC HEALTH ADMINISTRATOR AT THE LASALLE COUNTY HEALTH DEPT. and CURRENT HEALTH EDUCATOR AND PUBLIC INFORMATION FROM THE LASALLE COUNTY HEALTH DEPT. 2) PRIMARY DATA WAS COLLECTED FROM THE AT-RISK AND ECONOMICALLY DISADVANTAGED POPULATION BY COLLECTING A STRATIFIED SAMPLE OF SURVEYS DISTRIBUTED IN ENGLISH AND SPANISH AT ALL HOMELESS SHELTERS, FOOD PANTRIES AND SOUP KITCHENS. 3) THE CHNA WAS MADE WIDELY AVAILABLE TO THE COMMUNITY AND FEEDBACK RECEIVED FROM COMMUNITY SERVICE ORGANIZATIONS WAS TAKEN INTO ACCOUNT. 4) ADDITIONAL SOURCES OF INPUT WAS RECEIVED FROM A COLLABORATIVE TEAM CREATED TO CONDUCT THE 2019 CHNA, WHICH INCLUDED CONSUMER ADVOCATES, REPRESENTATIVES FROM NONPROFIT AND COMMUNITY-BASED ORGANIZATIONS, ACADEMIC EXPERTS AND HEALTH EDUCATORS, LOCAL GOVERNMENT OFFICIALS, ADMINISTRATORS FROM LOCAL SCHOOL DISTRICTS, HEALTH CARE PROVIDERS AND COMMUNITY HEALTH CENTERS, EXECUTIVE DIRECTOR OF IL VALLEY PADS HOMELESS SHELTER PROGRAM, PROGRAM COORDINATOR FOR THE YOUTH SERVICE BUREAU OF IL VALLEY SERVING THE LATINO POPULATION ENROLLED IN PUBLIC BENEFITS, EXECUTIVE DIRECTOR OF UNITED WAY, AND EXECUTIVE DIRECTOR OF MENDOTA AREA SENIOR SERVICES. MEMBERS OF THE COLLABORATIVE TEAM BY NAME, AFFILIATIONS, TITLE AND EXPERTISE ARE LISTED IN APPENDIX 1 OF THE 2019 CHNA. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - MENDOTA COMMUNITY HOSPITAL DBA OSF SAINT PAUL MEDICAL CENTER - MENDOTA, IL. THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR 2019 FOR LASALLE COUNTY WAS A COLLABORATIVE UNDERTAKING BY OTTAWA REGIONAL HOSPITAL AND HEALTHCARE CENTER DBA OSF SAINT ELIZABETH MEDICAL CENTER AND MENDOTA COMMUNITY HOSPITAL DBA OSF SAINT PAUL MEDICAL CENTER. THE CHNA HIGHLIGHTS THE HEALTH NEEDS AND WELL-BEING OF RESIDENTS IN LASALLE COUNTY. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - MENDOTA COMMUNITY HOSPITAL. MENDOTA COMMUNITY HOSPITAL DBA OSF SAINT PAUL MEDICAL CENTER COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") DURING FISCAL YEAR 2019 AS REQUIRED BY INTERNAL REVENUE CODE SECTION 501(R)(3). THE FINAL CHNA FOR THE HOSPITAL WAS APPROVED AND ADOPTED BY THE SYSTEM'S BOARD OF DIRECTORS ON JULY 29, 2019. THIS CHNA IS EFFECTIVE FOR FISCAL YEARS 2020, 2021 AND 2022. THE FOLLOWING INCLUDES A SUMMARY OF EACH FACILITIES ACCOMPLISHMENTS FOR FY19. THE CHNA ACTIVE FOR FY19 WAS APPROVED AND ADOPTED BY THE SYSTEM'S BOARD OF DIRECTORS ON JULY 25, 2016. THIS REPORT HAS BEEN ACTIVE FOR, FISCAL YEAR(S) 2017, 2018 AND 2019. THE LASALLE COUNTY CHNA WAS DONE AS A COLLABORATIVE UNDERTAKING BY OSF SAINT ELIZABETH AND OSF SAINT PAUL MEDICAL CENTERS TO HIGHLIGHT THE HEALTH NEEDS AND WELL BEING OF RESIDENTS IN LASALLE COUNTY. THE COLLABORATIVE TEAM IDENTIFIED THE FOLLOWING SIGNIFICANT COMMUNITY HEALTH NEEDS AS A PRIORITY: HEALTHY BEHAVIORS AND BEHAVIORAL HEALTH. HEALTHY BEHAVIORS IS DEFINED AS ACTIVE LIVING AND HEALTHY EATING AND THEIR IMPACT ON OBESITY. BEHAVIORAL HEALTH INCLUDES MENTAL HEALTH AND SUBSTANCE ABUSE. IN RESPONSE TO THESE PRIORITY HEALTH NEEDS, THE HOSPITALS DEVELOPED AN IMPLEMENTATION STRATEGY DESCRIBING THE ACTIONS THE HOSPITALS INTEND TO TAKE TO ADDRESS BOTH PRIORITY HEALTH NEEDS, THE RESOURCES THE HOSPITALS PLAN TO COMMIT TO ADDRESS THE HEALTH NEEDS, AND ANY PLANNED COLLABORATIONS WITH OTHER ORGANIZATIONS TO ADDRESS THE HEALTH NEEDS. THE HOSPITALS REVIEW THEIR IMPLEMENTATION STRATEGY AT LEAST ANNUALLY AND MAKE REVISIONS AS NEEDED TO MAXIMIZE THE IMPACT ON IDENTIFIED PRIORITY HEALTH NEEDS. A SUMMARY OF HOW THE HOSPITALS HAVE ADDRESSED THE PRIORITY HEALTH NEEDS IS PROVIDED BELOW. FY2017 - 2019 HEALTHY BEHAVIORS DEFINED AS - ACTIVE LIVING, HEALTHY EATING AND OBESITY GOALS. GOALS -BRING TOGETHER COMMUNITY ORGANIZATIONS PROVIDING EDUCATION, INCREASING AWARENESS, AND ENGAGING IN HEALTH NUTRITION, INCLUDING EXERCISE DECISIONS, IN ORDER TO BENEFIT COMMUNITY MEMBERS IN THEIR EVERYDAY LIFE AND OVERALL HEALTH. -INCREASE KNOWLEDGE, AWARENESS AND ENGAGEMENT IN HEALTHY BEHAVIORS IN ORDER TO IMPROVE LASALLE COUNTY RESIDENTS' OVERALL HEALTH. HEALTHY BEHAVIORS MEASUREMENT AND KEY ACCOMPLISHMENTS (1) TRACKED NUMBER OF IMMUNIZATIONS PROVIDED AND THE IMPACT ON SCHOOL ABSENCES. DATA FOR OTTAWA/STREATOR/MENDOTA: *8/1/2016-5/31/2017 21,136 IMMUNIZATIONS GIVEN *8/1/2017-4/20/2018 23,231 IMMUNIZATIONS GIVEN *8/1/2018 TO PRESENT 22,536 IMMUNIZATIONS GIVEN NOTE: THIS PROJECT HAS INCREASED THE IMMUNIZATION COMPLIANCE RATES OF 2 YEAR OLDS IN THE OTTAWA/STREATOR PRACTICES FROM 23.2% IN 2/2016 TO 39.02% AS OF 4/2018 TO 52% AS OF 2/2019. (2) TRACKED HOURS SPENT WITH STUDENT ATHLETES AND THE NUMBER OF INJURIES. *2017 STREATOR HIGH SCHOOL - 451 HOURS/58 INJURIES *2017 OTTAWA HIGH SCHOOL - 232 HOURS/32 INJURIES *2018 STREATOR HIGH SCHOOL - 699 HOURS/90 INJURIES *2018 OTTAWA HIGH SCHOOL - 409 HOURS/20 INJURIES *2018 EARLVILLE HIGH SCHOOL - 245 HOURS/20 INJURIES *2019 STREATOR HIGH SCHOOL / 872 HOURS / 40 INJURIES *2019 OTTAWA HIGH SCHOOL / 449 HOURS / 28 INJURIES *2019 EARLVILLE HIGH SCHOOL / 538 HOURS / 6 INJURIES (3) TRACKED NUMBER OF EDUCATIONAL EVENTS AND ATTENDANCE ADDRESSING HEALTH AND WELLNESS. *2017: 74 EVENTS: 4115 ATTENDEES *2018: 114 EVENTS: 7500 ATTENDEES (4) TRACKED NUMBER OF SPORTS PHYSICALS PROVIDED. *2016: STREATOR HIGH SCHOOL - 57; OTTAWA HIGH SCHOOL - 59 *2017: STREATOR HIGH SCHOOL - 51; OTTAWA HIGH SCHOOL - 69 *2018: STREATOR HIGH SCHOOL - 41; OTTAWA HIGH SCHOOL - 79; EARLVILLE HIGH SCHOOL - 11 (5) TRACKING OF SOCIAL MEDIA POSTS. *IN 2017, SAINT ELIZABETH MEDICAL CENTER HAD FACEBOOK POSTS REACHING 1,070,284 RESIDENTS. *CENTER FOR HEALTH'S FACEBOOK POSTS REACHING 441,387 RESIDENTS. *IN 2018, SAINT PAUL MEDICAL CENTER HAD FACEBOOK POSTS REACHING LOCAL RESIDENTS 437,000 TIMES *IN 2018, SAINT ELIZABETH MEDICAL CENTER FACEBOOK POSTS REACHED LOCAL RESIDENTS 752,000 TIMES *CENTER FOR HEALTH'S FACEBOOK POSTS REACHED LOCAL RESIDENTS 305,000 TIMES (6) POUNDS OF FOOD DONATED TO COMMUNITY AGENCIES FROM OUR COMMUNITY GARDEN. *2017 - 1500 POUNDS *2018 - 1500 POUNDS *2019 - 1749 POUNDS (7) TRACKED PARTICIPATION IN OSF4LIFE - INCREASED PARTICIPATION. *2017 - HEALTH RISK ASSESSMENT AT SAINT ELIZABETH MEDICAL CENTER - 39% *2017 - HEALTH RISK ASSESSMENT AT SAINT PAUL MEDICAL CENTER - 63% *WELLNESS CHALLENGE VIRTUE AT SAINT PAUL MEDICAL CENTER HAD 49 PARTICIPANTS *WELLNESS CHALLENGE VIRTUE AT SAINT ELIZABETH MEDICAL CENTER HAD 35 PARTICIPANTS *TAKE THE FIRST STEP CHALLENGE AT SAINT PAUL MEDICAL CENTER HAD 83 PARTICIPANTS *TAKE THE FIRST STEP CHALLENGE AT SAINT ELIZABETH MEDICAL CENTER HAD 53 PARTICIPANTS *2018 HEALTH RISK ASSESSMENT AT SAINT ELIZABETH MEDICAL CENTER - 42% *2018 HEALTH RISK ASSESSMENT AT SAINT PAUL MEDICAL CENTER - 66.5% *2019 HRA : SEMC - 45% SPMC - 69%. (8) TRACKED PARTICIPATION IN POUNDS WITH THE HEALTHY YOU PROGRAM FOR SAINT PAUL MEDICAL CENTER. *2016: 259 PARTICIPANTS; 2300 POUNDS *2017: 251 PARTICIPANTS; 2339 POUNDS *2018: 283 PARTICIPANTS; 2441 POUNDS *2019 CHANGED PROGRAM. **BEGAN COLLABORATIVE/PARTNERSHIP INITIATIVE - LIVE WELL STREATOR; HELD MONTHLY MEETINGS ON HEALTHY EATING, ACTIVITY AND OPIOID USE DISORDER **PARTICIPATES IN ACTION WALK WITH GREENWAY TRAIL IN STREATOR; 100 PARTICIPANTS WALKED 2.8 MILES **COLLABORATED AND ROLLED OUT PIECES IRIS, CASE MANAGEMENT PLATFORM THAT EXTENDS HEALTH SYSTEM AND HEALTHY PLAN NETWORKS TO INCLUDE COMMUNITY BASED ORGANIZATIONS TO ADDRESS HEALTH RELATED SOCIAL NEEDS. PARTICIPATING ORGANIZATIONS INCLUDE: SERVANT'S HEART; SAFE JOURNEY; BEST, INC; OTTAWA/PERU PADS; LASALLE CO. HEALTH DEPT; OTTAWA/STREATOR YMCA; STREATOR ELEMENTARY/HIGH SCHOOL; SALVATION ARMY - STREATOR; TRI-COUNTY OPPORTUNITIES COUNCIL. FY2017 - 2019 BEHAVIORAL HEALTH DEFINED AS - MENTAL HEALTH AND SUBSTANCE ABUSE GOAL GOALS: -INCREASE ACCESS TO AND AWARENESS OF MENTAL HEALTH SERVICES IN LASALLE COUNTY. -INCREASE AWARENESS OF MENTAL HEALTH SERVICES IN THE COMMUNITY. -COMMIT TO TEACHING, EMPOWERING, AND ADVOCATING FOR MENTAL HEALTH ISSUES. -DEVELOP AND IMPLEMENT STRATEGIES TO FACILITATE ACCESS AND IMPROVE COMMUNITY AGENCY ALIGNMENT TO MEET THE BEHAVIORAL HEALTH NEEDS OF THE COMMUNITY. -INCREASE AWARENESS AND ENGAGEMENT TO DECREASE INSTANCES OF RISKY BEHAVIOR AND SUBSTANCE ABUSE IN LASALLE COUNTY. -PROVIDE AWARENESS OF FUTURE POTENTIAL RISKS RELATED TO SUBSTANCE ABUSE. -DEVELOP AND IMPLEMENT STRATEGIES TO FACILITATE SERVICES / ACCESS AND IMPROVE COMMUNITY AGENCY ALIGNMENT IN ADDRESSING ALCOHOL AND ILLICIT SUBSTANCE ABUSE BY YOUTHS WITHIN THE COMMUNITY. BEHAVIORAL HEALTH MEASUREMENT AND KEY ACCOMPLISHMENTS (1) DEVELOPED A STRATEGIC SYSTEM OF CARE PLAN FOR MENTAL HEALTH (STREATOR INITIATIVE). *IMPLEMENTED BEHAVIORAL HEALTH NAVIGATOR, REFERRAL ALGORITHM, AND EMBEDDED BEHAVIORIST IN PRIMARY CARE PRACTICE, TELE-PSYCH, NCBH COLOCATION, LIVE WELL STREATOR SUBSTANCE ABUSE FOCUS. **DRUG TAKE BACK EVENT PRODUCED. 242 POUNDS IN 2019. (2) MONITORED COUNSELING VISITS PROVIDING EARLY INTERVENTION, DEPRESSION SCREENING AND SUPPORT. *EMBEDDED A THERAPIST IN CENTER FOR HEALTH-STREATOR. (3) TRACKED PATIENT WISDOM DATA. A SURVEY TOOL USED TO ASK COMMUNITY MEMBERS QUESTIONS SPECIFIC TO BEHAVIORAL HEALTH. *149 RESPONDENTS GAVE THEIR VIEW ON HOW TO ADDRESS BEHAVIORAL HEALTH IN COMMUNITY. 20% IDENTIFIED SUBSTANCE ABUSE AS NEEDING MORE COMMUNITY ATTENTION. IN 2018 THE DATA USAGE CONTINUES TO VALIDATE STRATEGIES. (4) TRACKED UNIQUE PATIENTS FOR BEHAVIORAL HEALTH SERVICES THROUGH TELE-PSYCH. *236 TELE-PSYCH UNIQUE PATIENTS (5) TRACKED TELE-PSYCH VISITS. *367 TELE-PSYCH OUTPATIENT VISITS *105 ECO SILT PSYCH VISITS *15% OF CHOICES OUTPATIENTS FROM STREATOR-PSYCHIATRY AND THERAPY SERVICES **IN 2018, 939 TELE-PSYCH OUTPATIENT VISITS *99 OF THE VISITS WERE IN CENTER FOR HEALTH TELE-PSYCH FOR A TOTAL OF 939 TELE-PSYCH PATIENTS *ADDED ADDITIONAL HOURS FOR TELE-PSYCH *2019, 1416 OP VISITS. (6) TRACKED THE BEHAVIORAL HEALTH NAVIGATOR CALLS. *BEHAVIORAL HEALTH NAVIGATORS SERVED OVER 300 COMMUNITY MEMBERS. (7) TRACKED SILVER CLOUD (BEHAVIORAL HEALTH APP). *200 COMMUNITY MEMBERS JOINED IN THE PAST TWO YEARS. *2019 ADDED 113. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - MENDOTA COMMUNITY HOSPITAL. CATASTROPHIC FINANCIAL ASSISTANCE IS AVAILABLE WHEN CHARGES EXCEED 25% OF ANNUAL FAMILY INCOME. THE AMOUNT BILLED IS ADJUSTED TO 25% OF FAMILY INCOME WHEN OSF DETERMINES THIS ADJUSTMENT IS THE MOST GENERAL ASSISTANCE. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - MENDOTA COMMUNITY HOSPITAL. PRESUMPTIVE FINANCIAL ASSISTANCE IS AVAILABLE AND PROVIDES FOR A DISCOUNT OF 100% OF BILLED CHARGES FOR MEDICALLY NECESSARY SERVICES PROVIDED TO A PATIENT WITH NO INSURANCE BENEFITS, WHEN THE PATIENT ESTABLISHES FINANCIAL NEED AT TIME OF REGISTRATION BY SATISFYING ONE OF THE FOLLOWING CATEGORIES OF PRESUMPTIVE ELIGIBILITY CRITERIA: HOMELESSNESS; DECEASED WITH NO ESTATE; MENTAL INCAPACITATION WITH NO ONE TO ACT ON THE PATIENT'S BEHALF; AND CURRENT MEDICAID ELIGIBILITY, BUT NOT ON DATE OF SERVICE OR FOR NON-COVERED SERVICE. Schedule H, Part V, Section B, Line 15 Facility , 1 Facility , 1 - MENDOTA COMMUNITY HOSPITAL. THE FINANCIAL ASSISTANCE POLICY DIRECTS PATIENTS TO STAFF IN THE PATIENT FINANCIAL SERVICES AND ADMITTING AREAS AT OSF HOSPITALS FOR ASSISTANCE IN OBTAINING ANSWERS TO QUESTIONS REGARDING THE POLICY. Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - MENDOTA COMMUNITY HOSPITAL. A PLAIN LANGUAGE SUMMARY OF THE FAP IS OFFERED TO PATIENTS AS PART OF THE INTAKE OR DISCHARGE PROCESS, INFORMATION ABOUT FINANCIAL ASSISTANCE AND THE APPLICATION PROCESS IS INCLUDED ON OR WITH THE OSF PATIENT BILLING STATEMENT, AND OSF PROVIDES COPIES OF THE PLAIN LANGUAGE SUMMARY AND THE FAP APPLICATION FORM TO REFERRING STAFF PHYSICIANS. 0 Schedule H, Part I, Line 3c SCH H, PART I, LINE 3C -CATASTROPHIC CHARITY ASSISTANCE REGARDLESS OF INCOME OR ASSET LEVELS FOR MEDICALLY NECESSARY SERVICES WHICH EXCEED 25% OF ANNUAL FAMILY INCOME. THE AMOUNT DUE IS ADJUSTED TO 25% OF FAMILY INCOME WHEN OSF DETERMINES CATASTROPHIC CHARITY IS MORE GENEROUS. -PRESUMPTIVE CHARITY: CHARGES MAY BE ADJUSTED TO PROVIDE FOR A CHARITY DISCOUNT OF 100% OF BILLED CHARGES FOR MEDICALLY NECESSARY SERVICES PROVIDED TO AN UNINSURED PATIENT WHO ESTABLISHES FINANCIAL NEED AT TIME OF REGISTRATION BY SATISFYING ONE OF THE FOLLOWING CATEGORIES OF PRESUMPTIVE ELIGIBILITY CRITERIA. PRESUMPTIVE CHARITY CATEGORIES FOR ALL OSF HOSPITALS: -HOMELESSNESS; - DECEASED WITH NO ESTATE; - MENTAL INCAPACITATION WITH NO ONE TO ACT ON PATIENT'S BEHALF; OR - CURRENT MEDICAID ELIGIBILITY, BUT NOT ON DATE OF SERVICE OR FOR NON-COVERED SERVICE. - ALL PATIENTS RECEIVE THE GREATEST REQUESTED DISCOUNT AVAILABLE UNDER ANY OF THE OSF PROGRAMS. NO ASSET TESTS ARE USED. - EXCEPT AS OTHERWISE NOTED, THESE POLICIES APPLY BOTH TO UNINSURED PATIENTS AND TO INSURED PATIENTS WITH RESPECT TO THE PATIENT RESPONSIBILITY AMOUNT. Schedule H, Part I, Line 7g Subsidized Health Services COSTS REPORTED ON LINE 7G DO NOT INCLUDE PHYSICIAN CLINIC COSTS. THESE COSTS REFLECT A HOSPITAL DEPARTMENT THAT IS ELIGIBLE TO BE CLAIMED BUT HAD NOT BEEN CLAIMED IN PAST RETURNS. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance MEDICARE COST TO CHARGE RATIO Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount IN GENERAL, AND IN ACCORDANCE WITH MEDICARE REGULATIONS, PATIENT ACCOUNT BALANCES ARE WRITTEN OFF TO BAD DEBT EXPENSE AFTER REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED AND THE ACCOUNT HAS BEEN SENT TO A COLLECTION AGENCY OR LAW FIRM. PATIENTS' ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENTS' ACCOUNTS RECEIVABLE, OSF ANALYZES PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, OSF ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH PATIENT RESPONSIBILITY (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND CO-PAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE PATIENTS ARE SCREENED AGAINST THE OSF FINANCIAL ASSISTANCE POLICY AND UNINSURED DISCOUNT POLICY. FOR ANY REMAINING PATIENT RESPONSIBILITY BALANCE, OSF RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. BAD DEBT EXPENSE OF 1,713,145 ON FORM 990, PART IX, LINE 24B IS BASED UPON ACCRUAL ACCOUNTING REQUIRED BY GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. THIS AMOUNT CONSEQUENTLY DIFFERS FROM THE BAD DEBT EXPENSE OF 706,501 ON SCHEDULE H, PART III, LINE 2 WHICH REQUIRES THE ORGANIZATION TO REPORT AGGREGATE BAD DEBT AT COST. BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 IS THEREFORE CALCULATED BY MULTIPLYING GROSS CHARGES WRITTEN OFF TO BAD DEBT EXPENSE TIMES THE MEDICARE COST-TO-CHARGE RATIO DERIVED FROM THE MEDICARE COST REPORT. DISCOUNTS, INCLUDING ANY APPLICABLE THIRD PARTY PAYER CONTRACTUAL ALLOWANCES AND ANY CHARITY CARE DISCOUNTS (VALUED AT GROSS CHARGES), ARE APPLIED TO PATIENT ACCOUNT GROSS CHARGES TO DETERMINE THE ACCOUNT BALANCE BEFORE PATIENT PAYMENTS. THE AGGREGATE AMOUNT OF ALL PATIENT PAYMENTS IS THEN APPLIED TO THE ACCOUNT BALANCE. WHEN DETERMINATION IS MADE THAT NO FURTHER AMOUNTS CAN BE COLLECTED IN ACCORDANCE WITH THE CORPORATION'S BAD DEBT POLICY, THE REMAINING BALANCE IS WRITTEN OFF TO BAD DEBT EXPENSE. PRESUMPTIVE CHARITY: CHARGES MAY BE ADJUSTED TO PROVIDE FOR A CHARITY DISCOUNT OF 100% OF BILLED CHARGES FOR MEDICALLY NECESSARY SERVICES PROVIDED TO AN UNINSURED PATIENT WHO ESTABLISHES FINANCIAL NEED AT TIME OF REGISTRATION BY SATISFYING ONE OF THE FOLLOWING CATEGORIES OF PRESUMPTIVE ELIGIBILITY CRITERIA. PRESUMPTIVE CHARITY CATEGORIES FOR ALL OSF HOSPITALS: -HOMELESSNESS; -DECEASED WITH NO ESTATE; -MENTAL INCAPACITATION WITH NO ONE TO ACT ON PATIENT'S BEHALF; OR -CURRENT MEDICAID ELIGIBILITY, BUT NOT ON DATE OF SERVICE OR FOR NON-COVERED SERVICE. THEREFORE, THE CORPORATION DOES NOT BELIEVE THAT BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 INCLUDES ANY AMOUNTS THAT REASONABLY COULD BE ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY QUALIFY UNDER THE CORPORATION'S FINANCIAL ASSISTANCE POLICY. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote PLEASE SEE PAGE 19 OF NOTES TO CONSOLIDATED FINANCIAL STATEMENTS Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs 100% OF THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. OSF IS COMMITTED TO SERVING PATIENTS, REGARDLESS OF ABILITY TO PAY OR IF THE PAYMENTS TO BE RECEIVED WILL BE LESS THAN THE COST TO PROVIDE THE SERVICE, WHICH IS THE CASE FOR MEDICARE AND MEDICAID PATIENTS. THE MEDICARE ALLOWABLE COSTS ON LINE 6 PART III HAVE BEEN CALCULATED BY USING THE MEDICARE COST TO CHARGE RATIO. THE AMOUNT IS COMPARED TO TOTAL MEDICARE PAYMENTS RECEIVED INCLUDING DSH AND IME PAYMENTS. THIS SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT SINCE IT REFLECTS UN-REIMBURSED COSTS FOR PROVIDING MEDICAL SERVICES TO THE MEDICARE RESIDENTS OF THE COMMUNITY. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance THE CORPORATION HAS A FAIR BILLING/COLLECTION POLICY WHICH APPLIES FOR ALL PATIENTS. THE POLICY INCLUDES: -REQUIRED INFORMATION PROVIDED IN BILLS TO PATIENTS (INCLUDING A REQUIREMENT THAT INFORMATION BE PROVIDED ON HOW THE PATIENT MAY APPLY FOR FINANCIAL ASSISTANCE). -PROCESS FOR PATIENTS TO INQUIRE ABOUT OR DISPUTE A BILL, INCLUDING TOLL-FREE TELEPHONE NUMBER, ADDRESS, CONTACT NAME AND E-MAIL ADDRESS. -REQUIREMENTS FOR TIMELY RESPONSE TO PATIENT INQUIRIES. -CONDITIONS WHICH MUST BE SATISFIED BEFORE PATIENT MAY BE SENT TO A COLLECTION AGENCY OR ATTORNEY. -LEGAL ACTION FOR NON-PAYMENT OF A PATIENT BILL MAY NOT BE INITIATED UNTIL AN AUTHORIZED HOSPITAL OFFICIAL HAS DETERMINED THAT ALL CONDITIONS IN THE CORPORATION'S POLICY (INCLUDING ALL THE FOREGOING POLICY PROVISIONS) HAVE BEEN SATISFIED FOR INITIATING LEGAL ACTION. -LEGAL ACTION MAY NOT BE PURSUED AGAINST UNINSURED PATIENTS WHO HAVE CLEARLY DEMONSTRATED THAT THEY HAVE NEITHER SUFFICIENT INCOME NOR ASSETS TO MEET THEIR FINANCIAL OBLIGATIONS - EVEN IF SUCH PATIENTS DO NOT APPLY FOR FINANCIAL ASSISTANCE. -THE CORPORATION SHALL NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIONS, SUCH AS SUBMITTING REPORTS TO CREDIT AGENCIES BEFORE REASONABLE ATTEMPTS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE HAVE BEEN COMPLETED. -IF A PATIENT RECEIVES AN APPLICATION FOR FINANCIAL ASSISTANCE BUT FAILS TO RETURN IT, OSF WILL TRY TO USE SECONDARY SOURCES TO DETERMINE THE PATIENT'S ELIGIBILITY FOR NON COMPLIANT CHARITY BEFORE PURSUING LEGAL ACTION FOR NONPAYMENT. IF A COMPLETE APPLICATION IS RECEIVED DURING THE APPLICATION PERIOD, OSF WILL SUSPEND EXTRAORDINARY COLLECTION ACTIONS AND MAKE A DETERMINATION OF ELIGIBILITY FOR ASSISTANCE. IF THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE, OSF WILL ISSUE APPROPRIATE REFUNDS AND REVERSE ANY EXTRAORDINARY COLLECTION ACTIONS TAKEN, AS MORE FULLY DESCRIBED IN THE OSF FAIR BILLING - COLLECTION POLICY. Schedule H, Part V, Section B, Line 16a FAP website - MENDOTA COMMUNITY HOSPITAL: Line 16a URL: https://www.osfhealthcare.org/billing/financial-assistance/; Schedule H, Part V, Section B, Line 16b FAP Application website - MENDOTA COMMUNITY HOSPITAL: Line 16b URL: https://www.osfhealthcare.org/billing/financial-assistance/; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - MENDOTA COMMUNITY HOSPITAL: Line 16c URL: https://www.osfhealthcare.org/billing/financial-assistance/; Schedule H, Part VI, Line 2 Needs assessment MENDOTA COMMUNITY HOSPITAL DBA OSF SAINT PAUL MEDICAL CENTER COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") DURING FISCAL YEAR 2019 AS PREVIOUSLY STATED. THE CHNA IS UPDATED EVERY 3 YEARS AND CORRESPONDING IMPLEMENTATION STRATEGY IS REFRESHED YEARLY. NOT ONLY DOES THE PLAN GET REFRESHED YEARLY, BUT EACH ACTION ITEM HAS A RESPONSIBLE PARTY INVOLVED TO GET THE WORK ASSOCIATED WITH THE NEED ACCOMPLISHED. THE NEW CHNA WAS APPROVED AND ADOPTED BY THE OSF BOARD OF DIRECTORS ON JULY 29, 2019 AND THE CORRESPONDING IMPLEMENTATION STRATEGY WAS APPROVED JANUARY 27, 2020. THE ASSOCIATED PLAN GOALS AND ACCOMPLISHMENTS WILL BE IN OUR NEXT FISCAL YEAR 2020 FILING. LEADERSHIP WITHIN OSF SIT ON VARIOUS COMMUNITY ADVISORY BOARDS TO STAY CONNECTED TO THE OTHER AGENCIES WITHIN THE COMMUNITY. THIS WORK ALIGNS WITH OUR MISSION STATEMENT TO SERVE PERSONS WITH THE GREATEST CARE AND LOVE IN A COMMUNITY THAT CELEBRATES THE GIFT OF LIFE. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance THE CORPORATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO ARE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER GOVERNMENT PROGRAMS AND THE CORPORATION'S FINANCIAL ASSISTANCE POLICY, IN ENGLISH AND IN ANY OTHER LANGUAGE SPOKEN BY POPULATIONS WITH LIMITED ENGLISH PROFICIENCY THAT CONSTITUTE THE LESSER OF 1,000 INDIVIDUALS OR 5% OF THE COMMUNITY OF THE HOSPITAL, IN THE FOLLOWING WAYS: -SIGNS ARE POSTED IN PATIENT REGISTRATION AREAS (INCLUDING EMERGENCY DEPARTMENT REGISTRATION) INFORMING PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE, THE AVAILABILITY OF FINANCIAL ASSISTANCE COUNSELORS, AND HOW TO OBTAIN A COPY OF THE OSF FINANCIAL ASSISTANCE POLICY AND APPLICATION. -A PLAIN LANGUAGE SUMMARY OF THE OSF FINANCIAL ASSISTANCE POLICY IS OFFERED TO PATIENTS AS PART OF THE INTAKE OR DISCHARGE PROCESS AND INCLUDED IN THE BILLING STATEMENT MAILED PRIOR TO INITIATING EXTRAORDINARY COLLECTION ACTIONS. IN ADDITION, THE PLAIN LANGUAGE SUMMARY AND APPLICATION ARE PROVIDED TO REFERRING STAFF PHYSICIANS. -OSF MAKES REASONABLE EFFORTS TO ORALLY NOTIFY PATIENTS ABOUT THE FINANCIAL ASSISTANCE POLICY AND HOW TO OBTAIN ASSISTANCE IN APPLYING. -A NOTICE OF AVAILABILITY OF THE CORPORATION'S FINANCIAL ASSISTANCE AND UNINSURED PATIENT DISCOUNT POLICIES IS PROMINENTLY AVAILABLE ON THE CORPORATION'S WEB SITE. THE APPLICATION FORM WITH INSTRUCTIONS AND THE PLAIN LANGUAGE SUMMARY IS AVAILABLE FOR DOWNLOAD. -A NOTE REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE (TOGETHER WITH CONTACT PHONE NUMBERS) APPEARS ON EVERY PATIENT BILLING STATEMENT AS WELL AS THE WEBSITE WHERE COPIES OF THE POLICY, APPLICATION AND PLAIN LANGUAGE SUMMARY MAY BE OBTAINED. -FINANCIAL ASSISTANCE COUNSELORS ARE AVAILABLE IN PERSON AND BY PHONE TO ASSIST PATIENTS IN COMPLETING THE FINANCIAL ASSISTANCE APPLICATION AND IN DETERMINING ELIGIBILITY AND APPLYING FOR GOVERNMENT PROGRAM BENEFITS, INCLUDING MEDICAID. -THE CORPORATION'S FINANCIAL ASSISTANCE POLICY IS FILED WITH THE ILLINOIS ATTORNEY GENERAL AND IS AVAILABLE TO THE PUBLIC. Schedule H, Part VI, Line 4 Community information MENDOTA COMMUNITY HOSPITAL DBA OSF SAINT PAUL MEDICAL CENTER IS LOCATED IN LASALLE COUNTY. DATA ESTABLISHES THAT LASALLE COUNTY IS THE RESIDENCE OF OVER 90% OF ALL PATIENTS RECEIVING SERVICES FROM SAINT PAUL MEDICAL CENTER AND SAINT ELIZABETH MEDICAL CENTER. THE HOSPTIAL IS A CRITICAL ACCESS HOSPTIAL SERVING AN AGING POPULATION. THE HISPANIC POULATION COMPRISES 9.4% OF THE POPULATION. RESIDENTS HAVE A MEDIAN HOUSEHOLD INCOME LOWER THEN THE STATE OF ILLINOIS. UNEMPLOYMENT REMAINS SLIGHTLY HIGHER THEN THE STATE OF ILLINOIS UNEMPLOYMENT RATE. Schedule H, Part VI, Line 5 Promotion of community health THE CORPORATION'S SPONSORING ORGANIZATION IS A RELIGIOUS CONGREGATION OF THE ROMAN CATHOLIC CHURCH KNOWN AS THE SISTERS OF THE THIRD ORDER OF SAINT FRANCIS. IN ACCORDANCE WITH CANON LAW OF THE ROMAN CATHOLIC CHURCH AND FEDERAL TAX LAW APPLICABLE TO SUPPORTING ORGANIZATIONS, A MAJORITY OF THE MEMBERS OF THE BOARD OF DIRECTORS OF THE CORPORATION ARE PROFESSED MEMBERS OF THE SPONSORING RELIGIOUS CONGREGATION. EACH HOSPITAL OPERATED BY THE CORPORATION HAS A COMMUNITY ADVISORY BOARD CONSISTING OF MEMBERS OF THE COMMUNITY WHO ARE NOT DIRECTORS, OFFICERS, OR CONTRACTORS OF THE CORPORATION. THE CORPORATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITIES. THE SURPLUS FUNDS WERE USED DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2019 FOR IMPROVEMENTS IN PATIENT CARE, MEDICAL EDUCATION, AND RESEARCH. THE CORPORATION MEETS THE REQUIREMENTS OF REVENUE RULING 69-545 BY: -OPERATING AN EMERGENCY DEPARTMENT WHICH IS STAFFED 24 HOURS PER DAY BY QUALIFIED PHYSICIANS AND OTHER MEDICAL PERSONNEL AND WHICH IS OPEN TO ALL PERSONS WITHOUT REGARD TO ABILITY TO PAY. -HAVING A MEDICAL STAFF WHICH IS OPEN TO ALL QUALIFIED PHYSICIANS, MID-LEVEL PROVIDERS, PODIATRISTS, AND DENTISTS IN THE COMMUNITY (EXCEPT WHERE RESTRICTED IN RARE CASES FOR CLINICAL QUALITY REASONS BY ACTION OF THE MEDICAL STAFF AND THE BOARD OF DIRECTORS). -ACCEPTING MEDICARE, MEDICAID AND OTHER GOVERNMENT PROGRAM PATIENTS. ACCEPTING ALL PATIENTS, INCLUDING UNINSURED PATIENTS, WITHOUT REGARD TO THEIR ABILITY TO PAY. -USING SURPLUS FUNDS TO IMPROVE THEIR FACILITIES, EQUIPMENT, PATIENT CARE, MEDICAL TRAINING, EDUCATION, AND RESEARCH AS DESCRIBED ABOVE. MENDOTA COMMUNITY HOSPITAL DBA OSF SAINT PAUL MEDICAL CENTER IS INVOLVED IN THE PROMOTION OF COMMUNITY HEALTH IN SEVERAL WAYS INCLUDING BUT NOT LIMITIED TO; ADOPTING IMPLEMENTATION STRATEGIES TO ADDRESS SIGNIFCANT HEALTH NEEDS IDENFIED IN THE 2019 CHNA; PROVIDING HEALTH SCREENING BOOTHS AT COMMUNITY EVENTS; PROVIDING BEHAVIORAL HEALTH REFERRALS; PERFORMING WELLNESS SCREENINGS AT VARIOUS BUSINESSES IN THE COMMUNITY; AND PREPARING AND DELIVERING MEALS TO COMMUNITY MEMBERS IN NEED WITH OUR MEALS ON WHEELS PROGRAM. OSF ON CALL OFFERS A 24/7 ONLINE ACCESS TO MEDICAL CARE VIA SMARTPHONE, TABLET OR COMPUTER. Schedule H, Part VI, Line 6 Affiliated health care system The Corporation is part of an affiliated health care system (the "OSF System"), which is an integrated health system that operates acute care hospitals, home health care services, two colleges of nursing, a medical training simulation center, emergency medical transportation, and other health care facilities in Illinois and Michigan. The OSF System includes many other entities which are controlled, directly or indirectly by the Sisters of the Third Order of St. Francis (the "Congregation"). All affiliated entities apply and follow the charity care policies of the Corporation and are operated in furtherance of the mission to provide comprehensive, integrated quality care to the communities served by the Corporation. The OSF System's corporate office in Peoria, Illinois (the "Corporate Office"), provides corporate management services as well as direction, consultation and assistance to the administration of the OSF System's health care facilities and subsidiary corporations. The primary affiliated corporations of the OSF System are the following: The Congregation, which works exclusively in the health care apostolate, holds the assets of the religious congregation and directs all other corporations in the affiliated health care system through board representation and the exercise of reserved powers. OSF Multi-Specialty Group was incorporated in 2011. Virtually all physicians and advance practice providers providing professional services through the OSF System's acute care hospital facilities and ambulatory practice settings (with a few limited exceptions) provide services pursuant to employment agreements or professional service agreements with the Multi-Specialty Group. OSF Medical Group is a d/b/a of Multi-Specialty Group. Pointcore, Inc., formerly known as OSF Saint Francis, Inc., was originally incorporated in 1986 and is engaged in the following lines of business: retail pharmacies, retail shops, a mobile medical system, durable medical equipment, home therapeutics, real estate, equipment technology services, telecommunications, electronic health records, telehealth services, and consulting services. Pointcore, Inc. also participates in various health related joint ventures. OSF Healthcare Foundation was incorporated in 1989 to conduct fundraising and other activities for the benefit of OSF Healthcare System and in support of the mission of the Congregation. Ottawa Regional Hospital & Healthcare Center, formerly known as Community Hospital of Ottawa was incorporated in 1964. OSF Healthcare System became the sole member of Ottawa Regional Hospital & Healthcare Center in 2012, and the hospital was renamed as d/b/a/ OSF Saint Elizabeth Medical Center. Mendota Community Hospital, formerly known as Mendota Hospital Foundation, was incorporated in 1944. OSF Healthcare System became the sole member of Mendota Community Hospital in 2015, and the hospital was renamed as d/b/a/ OSF Saint Paul Medical Center. Schedule H, Part VI, Line 7 State filing of community benefit report IL X true true X X X X false true false false false false false false false Kevin D Schoeplein Former - Vice Chairperson CEO 0 0 0 760000 0 2090403 0 41061 0 1594 0 2893058 0 0 Robert C Sehring Vice Chairperson CEO 0 1198952 0 433312 0 27834 0 44400 0 22733 0 1727232 0 0 Gerald J McShane MD Board Member 0 373046 0 0 0 9407 0 52500 0 22743 0 457696 0 0 Anthony M Avellino MD Former - CEO NSSL/INI 0 497432 0 0 0 1063 0 25763 0 12601 0 536859 0 0 David A Schertz Former - CEO Northern Region 0 522872 0 136072 0 166231 0 34000 0 16342 0 875516 0 0 Kenneth E Berkovitz MD Former - CEO CVSL 0 486977 0 0 0 2546 0 28022 0 14177 0 531722 0 0 Kenneth J Natzke Former CEO East Region 0 160000 0 0 0 0 0 20250 0 0 0 180250 0 0 Chad E Boore Chief Executive Officer Eastern Region 0 375351 0 100633 0 13081 0 17684 0 28804 0 535554 0 0 Divya-Devi Joshi CEO Children SL 0 518376 0 134278 0 1474 0 17800 0 9872 0 681800 0 0 Dwight D Stapleton Vice President Clinical Specialty Services 0 415537 0 86547 0 114 0 21850 0 9573 0 533621 0 0 James J Mormann Chief Information Officer 0 586086 0 154715 0 8864 0 40350 0 26894 0 816909 0 0 Jeffry M Tillery SVP Chief Transformation Officer 0 557443 0 147333 0 4487 0 52069 0 20380 0 781713 0 0 John R Evancho SVP Chief Compliance Officer 0 257513 0 68752 0 8611 0 19430 0 28728 0 383035 0 0 John C Horne SVP Chief Supply Chain Officer 0 344936 0 92045 0 8206 0 36300 0 26283 0 507770 0 0 Leon A Yeh MD VP CMO Emergency Serv 0 490398 0 100800 0 47 0 36300 0 28594 0 656140 0 0 Lori L Wiegand Chief Nursing Officer 0 384623 0 99683 0 19961 0 52500 0 20269 0 577036 0 0 Mark A Nafziger CEO Ambulatory Care 0 593148 0 154190 0 10264 0 21630 0 10965 0 790196 0 0 Michael M Allen CFO 0 600496 0 181366 0 1707 0 33525 0 27004 0 844097 0 0 Michael A Cruz MD Chief Executive Officer Central Region 0 612279 0 161133 0 3243 0 52500 0 26458 0 855613 0 0 Michelle D Conger Chief Strategy Officer 0 457618 0 119634 0 10305 0 15297 0 26356 0 629211 0 0 Ralph R Velazquez MD System Chief Medical Officer 0 474101 0 122124 0 14796 0 52500 0 18608 0 682129 0 0 Robert L Brandfass SVP Chief Legal Officer 0 530487 0 137920 0 9997 0 40350 0 27108 0 745862 0 0 Roxanna Crosser Chief Executive Officer Western Region 0 359201 0 93006 0 22866 0 42212 0 8368 0 525652 0 0 Stephen E Hippler MD Chief Clinical Officer 0 592624 0 152023 0 4782 0 52500 0 26444 0 828373 0 0 Thomas G Hammerton President OSF Healthcare Foundation Chief Development Officer 0 337111 0 88059 0 35134 0 40120 0 20064 0 520487 0 0 Jane A Battles APN 126192 0 8475 0 1419 0 9684 0 20055 0 165825 0 0 0 Katherine R Riva-Foster MD Physician 222336 0 0 0 46 0 9832 0 20055 0 252268 0 0 0 Kenneth K Potts MD Physician 229566 0 0 0 282 0 15851 0 19437 0 265137 0 0 0 Schedule J, Part I, Line 3 SCH J, PART I, LINE 3 THE BOARD OF DIRECTORS HAS ESTABLISHED A BOARD COMMITTEE KNOWN AS THE HUMAN RESOURCES COMMITTEE WHOSE MEMBERS ARE ALL PROFESSED MEMBERS OF THE RELIGIOUS CONGREGATION KNOWN AS THE SISTERS OF THE THIRD ORDER OF SAINT FRANCIS WHO HAVE TAKEN A VOW OF POVERTY. HENCE, THEY DO NOT PERSONALLY BENEFIT FROM DECISIONS OF THE COMMITTEE. THE COMMITTEE DETERMINES WHICH OFFICERS, KEY EMPLOYEES AND OTHER EMPLOYEES ARE ELIGIBLE TO PARTICIPATE IN THE EXECUTIVE COMPENSATION PLAN. BASED ON PERFORMANCE REVIEWS BY THE SUPERVISORS OF SUCH PERSONS, COMPENSATION SURVEY DATA AND RECOMMENDATIONS FROM A NATIONALLY KNOWN INDEPENDENT COMPENSATION CONSULTANT, THE COMMITTEE APPROVES ANY EXECUTIVE COMPENSATION PLAN APPLICABLE TO KEY EMPLOYEES AND ESTABLISHES THE BASE SALARY AND BENEFITS FOR PLAN PARTICIPANTS. PRIOR TO PAYMENT OF ANY BONUS OR INCENTIVE COMPENSATION, THE TOTAL COMPENSATION FOR EACH KEY EMPLOYEE, INCLUDING BASE SALARY, BENEFITS, AND PROPOSED BONUS OR INCENTIVE COMPENSATION, IS AGAIN REVIEWED BY A NATIONALLY RECOGNIZED COMPENSATION CONSULTANT TO ENSURE THAT NO EXCESS BENEFIT AMOUNT IS PAID OR FURNISHED. Schedule J, Part I, Line 1a Health or social club dues or initiation fees THE CORPORATION REIMBURSES CERTAIN EXECUTIVES FOR SOCIAL CLUB DUES PAID BY SUCH EXECUTIVES. ELIGIBILITY FOR CLUB DUES REIMBURSEMENT IS DETERMINED BY THE HUMAN RESOURCES COMMITTEE OF THE BOARD OF DIRECTORS AND IS TAKEN INTO CONSIDERATION BY THE COMMITTEE IN DETERMINING FAIR MARKET COMPENSATION. SEE FORM 990 - SCHEDULE O - PART VI - LINES 15A AND 15B FOR AN EXPLANATION OF THE ROLE OF THE HUMAN RESOURCES COMMITTEE AND THE MANNER IN WHICH FAIR MARKET COMPENSATION IS DETERMINED. CLUB DUES ARE NOT ELIGIBLE FOR REIMBURSEMENT IF THE CLUB IN QUESTION DISCRIMINATES ON THE BASIS OF RACE, RELIGION, SEX, NATIONAL ORIGIN, OR OTHER PROHIBITED FACTORS. DUES REIMBURSEMENT IS TREATED AND REPORTED AS TAXABLE COMPENSATION. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan DURING 2018, OSF HEALTHCARE SYSTEM MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN. THE FOLLOWING REPORTABLE INDIVIDUALS WERE ELIGIBLE TO PARTICIPATE IN THAT PLAN: KEVIN D. SCHOEPLEIN DURING 2018, THE FOLLOWING CONTRIBUTIONS WERE MADE BY OSF HEALTHCARE SYSTEM TO THE PLAN: KEVIN D. SCHOEPLEIN - $-0- DURING 2018, DISTRIBUTIONS WERE MADE BY OSF HEALTHCARE SYSTEM FROM THE PLAN: KEVIN D. SCHOEPLEIN - $2,087,403 Form 990, Part I, Line 1 PART I THE TAX LAW REQUIRES THAT EACH LEGAL ENTITY WITHIN THE OSF HEALTHCARE SYSTEM COMPLETE A SEPARATE TAX RETURN WHICH APPROPRIATELY REFLECTS THE ACTIVITIES AND FINANCIAL POSITION OF THE PARTICULAR ORGANIZATION. THIS REPORTING, HOWEVER, IS NOT REFLECTIVE OF THE OSF HEALTHCARE SYSTEM AS A WHOLE. PLEASE SEE THE ATTACHED AUDITED FINANCIAL STATEMENTS OF OSF HEALTHCARE SYSTEM AND SUBSIDIARIES FOR A COMPLETE OVERVIEW OF THE SYSTEM. Form 990, Part VI, Line 6 Classes of members or stockholders OSF HEALTHCARE SYSTEM IS THE SOLE CORPORATE MEMBER OF MENDOTA COMMUNITY HOSPITAL. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body OSF HEALTHCARE SYSTEM AS A SOLE CORPORATE MEMBER OF MENDOTA COMMUNITY HOSPITAL HAS THE POWER TO ELECT MEMBERS OF THE BOARD. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders RESERVED POWERS: THE FOLLOWING POWERS ARE RESERVED FOR THE MEMBER: A) TO ESTABLISH, APPROVE, OR MODIFY THE PHILOSOPHY, VISION, VALUES, AND MISSION ACCORDING TO WHICH THE CORPORATION OPERATES. (B) TO AMEND THE CORPORATION'S ARTICLES OF INCORPORATION AND BYLAWS. (C) TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE DIRECTORS OF THE CORPORATION. (D) TO MERGE OR CONSOLIDATE THE CORPORATION WITH OTHER ENTITIES OR TO DISSOLVE THE CORPORATION. (E) TO ACQUIRE AN INTEREST IN AN EXISTING ENTITY OR TO ESTABLISH A NEW ENTITY. (F) TO LEASE, SELL, ENCUMBER OR OTHERWISE ALIENATE ANY REAL PROPERTY OR INTEREST IN REAL PROPERTY OF THE CORPORATION. (G) TO APPROVE ANY TRANSFER, LEASE, SALE OR ENCUMBRANCE OF PERSONAL PROPERTY OF THE CORPORATION EXCEPT IN THE ORDINARY COURSE OF BUSINESS. (H) TO APPROVE ANY BORROWING OR DEBT FINANCING ON BEHALF OF THE CORPORATION. (I) TO APPOINT, DISCIPLINE, TERMINATE AND REMOVE THE CORPORATION'S OPERATING DIVISION PRESIDENT. (J) TO APPOINT AND REMOVE THE CORPORATION'S CHAIRPERSON, VICE CHAIRPERSON(S), CHIEF EXECUTIVE OFFICER, PRESIDENT, SECRETARY, AND TREASURER, AND THE ASSISTANT SECRETARY AND ASSISTANT TREASURER, IF ANY. (K) TO APPROVE OR AMEND STRATEGIC PLANS, MANAGEMENT OBJECTIVES, AND CAPITAL AND OPERATING BUDGETS OF THE CORPORATION. (L) TO APPROVE ANY PURCHASE OR OTHER AQUISITION BY THE CORPORATION THAT IS NOT INCLUDED IN ITS CAPITAL BUDGET AND EXCEEDS ONE MILLION DOLLARS ($1,000,000) PER ITEM. (M) TO NAME OR RENAME ANY HOSPITAL OR MEDICAL CENTER OWNED AND OPERATED BY THE CORPORATION. (N) TO REQUIRE A CERTIFIED AUDIT OF FINANCES OF THE CORPORATION AND TO APPOINT THE CERTIFIED PUBLIC ACCOUNTANT TO PERFORM THE AUDIT. (O) TO APPROVE THE ENGAGEMENT OF AND TO DISMISS ANY OUTSIDE LEGAL COUNSEL TO REPRESENT THE CORPORATION ON A REGULAR BASIS OR IN CONNECTION WITH ANY MATTER DEEMED BY THE MEMBER, IN GOOD FAITH, TO HAVE SIGNIFICANCE FOR THE CORPORATION AS A WHOLE. (P) TO GIVE PRELIMINARY APPROVAL PRIOR TO THE DEVELOPMENT OF, AND TO GIVE FINAL APPROVAL PRIOR TO THE EXECUTION OF, ALL DOCUMENTS TO WHICH THE CORPORATION IS OR WILL BE A PARTY AND WHICH RELATE TO THE CREATION, FORMATION, ORGANIZATION, OR TERMINATION OF ANY OTHER LEGAL ENTITY (WHETHER A CORPORATION, LIMITED LIABILITY COMPANY, PARTNERSHIP, OR ANY OTHER ENTITY) IN WHICH THE CORPORATION WILL HAVE ANY OWNERSHIP INTEREST, MEMBERSHIP INTEREST, POWER TO ELECT OR APPOINT BOARD MEMBERS OR OFFICERS, OR ANY OTHER FORMAL PARTICIPATION ARRANGEMENT, WHETHER ACTING ALONE OR IN CONJUNCTION WITH ANY OTHER PERSON OR ENTITY. (Q) TO TAKE ANY AND ALL ACTIONS DEEMED NECESSARY, IN THE SOLE JUDGEMENT OF THE MEMBER BOARD TO PROTECT AND PRESERVE THE TAX-EXEMPT STATUS AND PUBLIC CHARITY STATUS OF THE CORPORATION OR THE MEMBER AND ANY TAX-EXEMPT AFFILIATE OF THE CORPORATION OR THE MEMBER (INCLUDING FEDERAL AND STATE INCOME TAX EXEMPTIONS, PROPERTY TAX EXEMPTIONS, AND SALES TAX EXEMPTIONS); PROVIDED THE MEMBER BOARD HAS GIVEN A WRITTEN REQUEST TO THE BOARD TO TAKE ACTION OR REFRAIN FROM TAKING ACTION, WHICH WOULD HAVE SUFFICIENTLY PROTECTED AND PRESERVED SUCH TAX-EXEMPT AND PUBLIC CHARITY STATUS, AND THE BOARD HAS FAILED TO PROMPTLY TAKE SUCH ACTION OR REFRAIN FROM TAKING SUCH ACTION. Form 990, Part VI, Line 9 Interested person not at organization's address BRIAN SILVERSTEIN, M.D. 711 APPLE TREE LANE GLENCOE, IL 60022 Form 990, Part VI, Line 11b Review of form 990 by governing body THE PROPOSED FINAL VERSION OF THE 990 IS SENT VIA E-MAIL TO ALL OFFICERS AND MEMBER OF THE BOARD OF DIRECTORS FOR THEIR REVIEW PRIOR TO FILING. ANY APPROPRIATE CHANGES REQUESTED BY THE OFFICERS AND DIRECTORS ARE THEN INCORPORATED INTO THE FINAL FORM 990 AND ALL SCHEDULES FOR FILING. Form 990, Part VI, Line 12c Conflict of interest policy DISCLOSURES BY OFFICERS, DIRECTORS AND TRUSTEES, AS WELL AS KEY EMPLOYEES AND EMPLOYEES CHARGED WITH PURCHASING, PROCUREMENT AND CONTRACTION DECISION-MAKING ARE MADE THROUGH AN ELECTRONIC REPORTING SYSTEM ON AN ANNUAL BASIS. DISCLOSURES ARE RECEIVED AND REVIEWED BY THE CORPORATE COMPLIANCE DIVISION ON AN ANNUAL BASIS. IF A POTENTIAL CONFLICT OF INTEREST IS IDENTIFIED, THEN THE DISCLOSING EMPLOYEE IS NOTIFIED OF THE POTENTIAL CONFLICT AND MAY BE ASKED FOR ADDITIONAL INFORMATION ABOUT THE INTEREST. THE CORPORATE COMPLIANCE DIVISION DETERMINES WHETHER A PLAN TO MANAGE A POSSIBLE OR ACTUAL CONFLICT OF INTEREST IS NEEDED, DISCUSSES THE MANGEMENT PLAN WITH THE EMPLOYEE AND MONITORS THE EMPLOYEE'S COMPLIANCE WITH THE PLAN. PLANS TO MANAGE CONFLICTS ARE TRACKED THROUGH THE ELECTRONIC DISCLOSURE SYSTEM. Form 990, Part VI, Line 15a Process to establish compensation of top management official THE BOARD OF DIRECTORS HAS ESTABLISHED A BOARD COMMITTEE KNOWN AS THE HUMAN RESOURCES COMMITTEE WHOSE MEMBERS ARE ALL PROFESSED MEMBERS OF THE RELIGIOUS CONGREGATION KNOWN AS THE SISTERS OF THE THIRD ORDER OF SAINT FRANCIS WHO HAVE TAKEN A VOW OF POVERTY. HENCE, THEY DO NOT PERSONALLY BENEFIT FROM DECISION OF THE COMMITTEE. THE PERFORMANCE OF THE CEO AND HIS ACHIEVEMENT OF ANNUAL GOALS IS EVALUATED EACH YEAR BY THE FULL BOARD OF DIRECTORS, AND THIS PERFORMANCE REVIEW IS PROVIDED TO THE COMMITEE. THE COMMITEE ALSO OBTAINS COMPENSATION SURVEY DATA AND RECOMMENDATION FROM A NATIONALLY RECOGNIZED INDEPENDENT COMPENSATION CONSULTANT. BASED ON ALL OF THESE FACTORS, THE COMMITTEE SETS BASE SALARY AND BENEFITS OF THE CEO AND APPROVES THE EXECUTIVE COMPENSATION PLAN APPLICABLE TO THE CEO. PRIOR TO PAYMENT OF ANY BONUS OR INCENTIVE COMPENSATION, THE TOTAL COMPENSATION FOR THE CEO, INCLUDING BASE SALARY, BENEFITS, AND PROPOSED BONUS OR INCENTIVE COMPENSATION, IS AGAIN REVEIWED BY A NATIONALLY RECOGNIZED COMPENSATION CONSULTANT TO ENSURE THAT NO EXESS BENEFIT AMOUNT IS PAID OR FURNISHED. THE COMPENSATION REVIEW IS DONE ANNUALLY IN NOVEMBER. Form 990, Part VI, Line 15b Process to establish compensation of other employees THE BOARD OF DIRECTORS HAS ESTABLISHED A BOARD COMMITTEE KNOWN AS THE HUMAN RESOURCES COMMITTEE WHOSE MEMBERS ARE ALL PROFESSED MEMBER OF THE RELIGIOUS CONGREGATION KNOWN AS THE SISTERS OF THE THIRD ORDER OF SAINT FRANCIS WHO HAVE TAKEN A VOW OF POVERTY. HENCE, THEY DO NOT PERSONALLY BENEFIT FROM DECISIONS OF THE COMMITTEE. THE COMMITTEE DETERMINES WHICH OFFICERS, KEY EMPLOYEES AND OTHER EMPLOYEES ARE ELIGIBLE TO PARTICIPATE IN THE EXECUTIVE COMPENSATION PLAN. BASED ON PERFORMANCE REVIEWS BY THE SUPERVISORS OF SUCH PERSONS AND COMPENSATION SURVEY DATA AND RECOMMENDATIONS FROM A NATIONALLY KNOWN INDEPENDENT COMPENSATION CONSULTANT, THE COMMITTEE APPROVES ANY EXECUTIVE COMPENSATION PLAN APPLICABLE TO KEY EMPLOYEES AND ESTABLISHED THE BASE SALARY AND BENEFITS FOR PLAN PARTICIPANTS. PRIOR TO PAYMENT OF ANY BONUS OR INCENTIVE COMPENSATION, THE TOTAL COMPENSATION FOR EACH KEY EMPLOYEE, INCLUDING BASE SALARY, BENEFITS, AND PROPOSED BONUS OR INCENTIVE COMPENSATION, IS AGAIN REVIEWED BY A NATIONALLY RECOGNIZED COMPENSATION CONSULTANT TO ENSURE THAT NO EXCESS BENEFIT AMOUNT IS PAID OR FURNISHED. THE COMPENSATION REVIEW IS DONE ANNUALLY IN NOVEMBER. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue OTHER - Total Revenue: 71026, Related or Exempt Function Revenue: 68405, Unrelated Business Revenue: 2621, Revenue Excluded from Tax Under Sections 512, 513, or 514: 0; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Inter-company Contributions - -8065; Net assets Released from Restrictions - 687; Equity Transfers - -598830; SISTERS OF THE THIRD ORDER OF ST FRANCIS 800 NE GLEN OAK AVE PEORIA IL 61603 371259286 PARENT/SU ORG IL 501(c)(3) Type II NA false OSF HEALTHCARE FOUNDATION 800 NE GLEN OAK AVE PEORIA IL 61603 371259284 SUPPORT ORG IL 501(c)(3) Type II NA false OTTAWA REGIONAL HOSP & HEALTHCARE CTR 1100 EAST NORRIS DRIVE OTTAWA IL 61350 362604009 HOSPITAL IL 501(c)(3) 3 OSF false OTTAWA REGIONAL HOSPITAL FOUNDATION 1100 EAST NORRIS DRIVE OTTAWA IL 61350 364007569 SUPPORT ORG IL 501(c)(3) Type I ORHHC false OSF MULTI-SPECIALTY GROUP 800 NE GLEN OAK AVE PEORIA IL 61603 383852646 HLTHCARE SVCS IL 501(c)(3) Type I OSF false OSF HEALTHCARE SYSTEM 800 NE GLEN OAK AVE PEORIA IL 61603 370813229 HOSPITAL IL 501(c)(3) 3 SIS 3RD OSF false OTTAWA REGIONAL HOSPITAL AUXILIARY 1100 EAST NORRIS DRIVE OTTAWA IL 61350 363854788 SUPPORT ORG IL 501(c)(3) Type I OSF false OSF College of Health Sciences 800 NE Glen Oak Avenue Peoria IL 61603 364868939 COLLEGE OF NURSING IL 501(c)(3) 2 OSF false St Francis Community Clinic 530 NE Glen Oak Ave Peoria IL 61637 370661235 Free clinic IL 501(c)(3) 7 Sis 3rd osf false CENTER FOR HEALTH AMBULATORY 8800 RTE 91 N PEORIA IL 61615 205557171 SURGICAL CENTER IL OSF Related false true 0 EASTLAND MEDICAL PLAZA 1505 EASTLAND DRIVE Bloomington IL 61701 371400643 SURGICAL CENTER IL OSF Related false true 0 FORT JESSE IMAGING CENTER LLC 2200 FT JESSE ROAD NORMAL IL 61761 460515604 MEDICAL IMAGING IL OSF Related false true 0 SAINT CLARE'S VILLA 915 EAST 5TH STREET ALTON IL 62002 371397289 LOW INC HOUSING IL OSF Related false true 0 FOX RIVER CANCER CENTER 1211 STARFISH DRIVE OTTAWA IL 61350 870805865 ONCOLOGY IL ORHHC Related false true 0 POINTCORE INC 800 NE GLEN OAK AVE PEORIA IL 61603 363484677 HLTHCARE SVCS IL OSF C Corporation false ILLINOIS PATHOLOGIST SERVICES LLC 5666 EAST STATE STREET ROCKFORD IL 61108 800439081 PATHOLOGY SVCS IL OSF C Corporation false Lakeview Medical Office Building 812 N Logan Ave Danville IL 61832 371100761 Condominium Association IL OSF C Corporation false false false true false false false false false false true true true true true true true false false false