2020-11-11T12:31:15-06:00 2019-12-31 134008324 PRICEWATERHOUSECOOPERS LLP 600 13TH STREET NW STE 1000 WASHINGTON DC 20005 990 2019-01-01 570360499 Roper St Francis Mt Pleasant Hospital ROPE 8437242958 8536 Palmetto Commerce Pkwy 201 Ladson SC 29456 Anthony Jackson SVP & COO 2020-11-11 true TRAVIS L PATTON P00369623 2124141000 2019 2021-01-29 14:40:06Z Anthony Jackson SVP & COO 8536 Palmetto Commerce Pkwy 201 Ladson SC 29456 94273501 false X www.rsfh.com X 2005 SC Operation of nonprofit hospital facility in Mt. Pleasant, SC. 12 7 316 74 36593 1225 27900 62594 88439109 93805788 -130417 -1012 337557 379111 88674149 94246481 46954 0 0 0 28851610 24694439 0 0 0 45375074 57474855 74273638 82169294 14400511 12077187 141945060 135959666 110328845 109416626 31616215 26543040 Healing all people with compassion, faith, and excellence. false false 66958118 0 93805788 Roper St. Francis Mount Pleasant Hospital opened in November of 2010 and has become a true community hospital. The hospital places an emphasis on comfort, communication and care with a personal touch. In 2019, Roper St. Francis Mount Pleasant Hospital contributed $4.7 million in community benefit. Please visit our website for a detailed community benefit report at http://www.rsfh.com/mission-department. 66958118 true true false false false false false false false 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 0 0 316 true true true false false false false false false false false false false false X 12 7 false false false false true true true true true false false true true true true true true true true false SC X The Finance Department 8437242958 8536 Palmetto Commerce Pkwy Ste 201 Ladson SC 29456 Brian Cuddy MD Chair, Neurosurgeon - RSFPP 0.5 49.5 X X 0 961103 70412 Susan Datta MD Vice-Chairperson, Internist - RSFPP 0.5 49.5 X X 0 301585 70729 Brett Denton Board Member (Beg 6/1/19) 0.5 3.5 X 0 0 0 Edward McKelvey Board Member 0.5 3.5 X 0 0 0 Henry West MD Board Member (Beg 01/19), Surgeon - RSFPP 0.5 49.5 X 0 593280 61811 John B Holloway Jr Board Member, CEO - MSSC 0.5 49.5 X 0 464000 36462 Julie Medich Board Member (7/1/19-10/11/19) 0.5 3.5 X 0 0 0 Katherine Duffy PHD Board Member (End 6/30/19) 0.5 3.5 X 0 0 0 Kent Stock MD Board Member 0.5 3.5 X 0 25028 0 Mark Nantz Board Member 0.5 3.5 X 0 0 0 Mary Thornley Board Member 0.5 3.5 X 0 0 0 Roberta Pinckney Board Member 0.5 3.5 X 0 0 0 Roger Ray MD Board Member (1/1/19-05/31/19) 0.5 3.5 X 0 0 0 Sr Anne Lutz CBS Board Member 0.5 3.5 X 0 0 0 Wills C Geils MD Board Member 0.5 3.5 X 0 9359 0 Anthony Jackson VP and CEO Acute Care Services 10.0 40.0 X 0 574760 91673 Bret D Johnson CFO & SVP / Treasurer 1.0 49.0 X 0 720630 110425 Lorraine Lutton President & CEO 1.0 49.0 X 0 1437023 81309 Stanley Wilson MD Chief Medical Officer 25.0 25.0 X 0 456039 55361 Tavia Buck Chief Administrative Officer and CNO 50.0 0 X 217468 0 24518 John Prentice Pharmacist 40.0 0 X 172180 0 46084 Kimberly Gaillard Medication Safety Coordinator 40.0 0 X 150353 0 25186 Phillip Creger Manager Pharmacy 40.0 0 X 194451 0 35594 Spencer Morris Pharmacist 40.0 0 X 135012 0 14662 Tracy Bishop Clinical Pharmacist 40.0 0 X 154362 0 39352 Pennie Peralta Former Key EE, VP Nursing/Sr. Nurse Exec SFX 0.0 50.0 X 0 467835 36947 Stephanie McKoin Former Key EE, Director of Perioperative Services 15.0 35.0 X 0 214003 40446 Stephen Porter Former Key, VP and CEO, Roper Hospital and Berkeley Hospital 1.0 49.0 X 0 373844 29322 Vanessa Shamrock Former Key EE, Director of Lab Services 15.0 35.0 X 0 169206 21777 1023826 6767695 892070 16 true true false 0 61974 620 62594 Net Patient Service 624100 93805788 93805788 0 0 0 0 93805788 1891 1891 0 0 2903 0 -2903 -2903 -2903 29783 24117 5666 5666 Cafeteria Revenue 722210 261981 261981 Miscellaneous Revenue 900099 111464 36593 74871 0 0 0 0 373445 94246481 93805788 36593 341506 X 241986 205688 36298 19760137 16796116 2964021 888431 755166 133265 2488091 2114877 373214 1315794 1118425 197369 22967866 12591741 10376125 0 2079 1663 416 2412582 1616430 796152 9109 7287 1822 1612277 1289822 322455 9796 7837 1959 15130 12104 3026 4338490 4338490 7740668 7740668 7521 6017 1504 Medical Supplies 16804089 16804089 Sales Tax 1406 1406 Medicaid DSH Tax 1515586 1515586 Physician Recruitment 14586 14586 23670 20120 3550 0 82169294 66958118 15211176 0 2638 188 12994204 12778978 0 0 1547605 1470067 245277 232924 159257751 69374476 95535299 89883275 0 0 31620037 31594234 141945060 135959666 265594 115738 106938887 106668287 0 3124364 2632601 110328845 109416626 X 31616215 26543040 31616215 26543040 141945060 135959666 X 12077187 -17150362 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 16828435 16828435 106959367 43060211 63899156 1929527 1449958 479569 33540422 24864307 8676115 89883275 Third Party Receivable 344592 Intercompany Receivables 31151201 Other Assets 98441 31594234 Due to Affiliates 793526 Third Party Reserve 1734347 Other Liabilities 104728 2632601 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote Roper St. Francis Mt. Pleasant Hospital is a not-for-profit organization as described in Section 501(c)(3) of the Internal Revenue Code and are generally exempt from federal and state income taxes. Accordingly no provision for income taxes is made on the consolidated financial statements. Although Roper St. Francis Healthcare (RSFH), including Roper St. Francis Mt. Pleasant Hospital, is generally exempt from federal and state income taxes, it evaluates whether there are any uncertain tax positions that fail to meet the more-likely-than-not threshold for recognition in the consolidated financial statements. Uncertain tax positions may include the characterization of income, such as a characterization of income as passive, a decision to exclude reporting taxable income in a tax return, or a decision to classify a transaction, entity, or other position in a tax return as tax exempt. The tax benefit from an uncertain tax position is recognized when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, based on the technical merits. RSFH had no unrecognized tax positions as of December 31, 2019 and 2018, and does not expect that unrecognized tax benefits will materially increase within the next 12 months. Interest and penalties related to uncertain tax positions, if any, would be recognized in the consolidated financial statements as income tax expense. true true X true X true X true true false true true 3361242 288455 3072787 0.0374 4247269 2666410 1580859 0.0192 0 0.0 0 0 7608511 2954865 4653646 0.0566 8012 8012 0.0001 50023 50023 0.0006 0 0 0.0 0 0 0.0 19418 19418 0.0002 0 0 77453 0 77453 0.0009 0 0 7685964 2954865 4731099 0.0576 1916 1916 0.0000 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 1916 0 1916 0.0000 false 5525793 0 16768706 23715279 -6946573 X true true 1 1 Roper St Francis Mt Pleasant Hospital 3500 Highway 17 North Mt Pleasant SC 29466 https://www.rsfh.com/mount-pleasant-hospital HTL-0909 X X X Roper St Francis Mt Pleasant Hospital 1 false false true X X X X X X X X X 19 true true true true X https://www.rsfh.com/mission-department/ X true 20 true https://www.rsfh.com/mission-department/ false true X 200.0 400.0 X X X X X true true X X X X true X https://www.rsfh.com/billing-financial-assistance/ X https://www.rsfh.com/billing-financial-assistance/ X https://www.rsfh.com/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 5 Facility , 1 Facility , 1 - Roper St. Francis Mt. Pleasant Hospital. In an effort to create a greater impact on the community and address the greatest needs, Roper St. Francis Healthcare participated in and produced a joint Community Health Needs Assessment (CHNA) in collaboration with the Medical University of South Carolina and the Trident United Way. Data for the CHNA was collected from January - February 2019. To gather community input the Community Health Needs Assessment team disseminated a community survey with the purpose of identifying a general overview of the most concerning health topics. The surveys had 5,128 responses which greatly surpassed the number of responses from the previous CHNA of 905 survey responses. This level of engagement is an immediate benefit of collaborating with community partners. Furthermore, the team hosted 19 Interviews with community leaders, elected officials and health care professionals, held 12 focus groups with 57 participants from the community at large, and had 100 participants at the team's community input session. During the 2019 CHNA planning process, specific community groups and organizations, including area schools, churches, and clinics, were included to engage more members from African American, Latino, low socioeconomic and rural communities. Using feedback from the surveys, interviews, focus groups and the community input session a summary of community feedback was created. This summary would be used in the creation of team's priorities and ultimately the implementation strategy. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - Roper St. Francis Mt. Pleasant Hospital. Roper Hospital, Inc. Bon Secours St. Francis Xavier Hospital Roper St. Francis Mt. Pleasant Hospital Roper St. Francis Hospital - Berkeley Inc. Medical University of South Carolina Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - Roper St. Francis Mt. Pleasant Hospital. Trident United Way Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Roper St. Francis Mt. Pleasant Hospital. The Roper St. Francis Healthcare (RSFH) Community Needs Assessment Team developed implementation strategies for each health issue identified as a strategic priority. This implementation plan was rolled out over 3 years. Some strategies may be addressed by more than one RSFH hospital or the system as a whole. The team developed a monitoring method at the conclusion of the implementation planning process to provide status updates to community partners, stakeholders, and the community-at-large. The following are the 2019 strategies and outcomes on the 5 issues identified as priorities in the 2016 Community Health Needs Assessment. Access to Care 2019 Strategies and Outcomes: Strategy (System-wide): Navigate high users of emergency departments to primary care medical homes, and to refer underinsured and uninsured patients to AccessHealth and/or the Transitions Clinic * During 2019, the four local hospital systems actively participated in AccessHealth Tri-County Network in order to collaborate with local healthcare systems to identify Emergency Department (ED) "super utilizers". * RSFH took steps to navigate uninsured ED "super utilizers" to AccessHealth and/or the Transitions Clinic. During 2019, AccessHealth had 3,411 patients, including 1,042 new patients, and Transitions Clinic had 1,321 patients, including 406 new patients. The resulting new patients reduced the number of ED visits by 61%. * RSFH developed a team-based program to create a comprehensive, patient-centered care plan for ED "super utilizers," engaging both RSFH and community resources. During 2019, Bon Secours St. Francis Xavier enrolled 45 patients in the program, and Roper Hospital enrolled 25 patients in the program. Strategy (System-wide): Coordinate and collaborate with safety-net partners for delivery of services, including area Federally Qualified health Centers (FQHC), free clinics, and homeless shelters. * RSFH provides lab work, free supplies, and ancillaries to partner medical clinics and supportive agencies. During 2019, RSFH signed contracts to continue its partnership with these clinics and supportive agencies. * RSFH coordinated with local partners and managed care coordination for eligible patients through the shared care navigation hub through AccessHealth. Strategy (System-wide): Provide in-home care to patients with limited mobility through Home Health and Hospice Care. * RSFH provided high quality care for patients with transportation or mobility issues or those with end-of-life needs through in-home or inpatient Hospice or Home Health Services. During 2019, 5,525 patients received Home Health Services, while 561 patients received In-home Hospice care and 562 patients received Inpatient Hospice care. Clinical Preventative Services 2019 Strategies and Outcomes: Strategy (System-wide): Provide routine, primary care for low-income, uninsured adults that live or work on the Sea Islands of Charleston County. * RSFH provides lab work, free supplies, and ancillaries to partner medical clinics and supportive agencies. During 2019, RSFH signed contracts to continue its partnership with these clinics and supportive agencies. * RSFH also provided financial support for clinical staff and infrastructure at Our Lady of Mercy Outreach. Strategy (System-wide): Provide early intervention services for patients diagnosed with HIV/AIDS. * During 2019, RSFH enrolled HIV positive patients into the federally funded Ryan White program. The Ryan White Wellness Center provided comprehensive HIV and primary care for 869 HIV positive patients. * During 2019, RSFH worked with the Ryan White Wellness Center to ensure continued health insurance coverage for 267 HIV positive adult patients using federal and employer insurance programs. * RSFH sought grant funding to expand primary prevention services for high risk HIV negative adults and prevent the rate of transmission for HIV positive patients. Partially due to RSFH's support, the Ryan White Wellness Center invested over $105,000 in transportation assistance to reduce barriers to accessing services and provided HIV prevention to 123 HIV negative patients. * During 2019, RFSH provided 44 free HIV testing at community events and 311 HIV tests in the clinic. Strategy (System-wide): Provide evidence-based outpatient care for diabetic patients and expand access to free annual breast health screenings for all women, particularly African-American women. * Through its affiliated physician entity, Roper St. Francis Physician Partners (RSFPP), the system tracked the percentage of patients who receive evidence-based outpatient care for diabetes. In 2019, 92.6% of all RSFPP with a diagnosis of diabetes received A1c testing. * RSFPP hosted the annual "Family Wellness Night" and other screening events for underserved men and women to get breast and colorectal screenings. In 2019, 79 clinical breast exams were provided and resulted in 72 referrals for additional screening. 55 colorectal screenings were also provided no resulting referrals. * RSFPP hosted an annual skin cancer screening event and offered 119 screenings in 2019 resulting in 31 referrals for biopsy. Mental Health 2019 Strategies and Outcomes: Strategy (System-wide): Coordinate services between Emergency Departments and regional mental health agencies. * During 2019, RSFH continued to participate and collaborate in the Charleston/Dorchester Mental Health Department's community task force. * During 2019, RSFH continued to coordinate care of behavioral health patients, using local agencies and resources for support. * RSFH continued to collaborate with mental health providers to engage community members in highest need areas to direct appropriate services. * During 2019, RSFH added Charleston County Public Library to the list of collaborators. RSFH continues to work with other agencies to broaden the scope of the project. Strategy (System-wide): Provide services and education to combat the opioid epidemic. * RSFH has continued work to develop partnerships with local law enforcement to create an alliance for holding Drug Take Back events. During 2019, RSFH expanded the initiative and created relationships with the North Charleston Police Depart and Berkeley County Sheriff's Dept. * RSFH organized Drug Take Back events with local law enforcement throughout the tri-county area. During 2019, RSFH successfully applied for two grants to increase the reach of the take back events with education and awareness around the opioid epidemic. 755 pounds of drugs were collected at 11 drug take back events in 2019. Strategy (System-wide): Provide mental health screenings at wellness and postpartum OB/GYN visits. * RSFH incorporates depression screenings at primary care wellness visits and postpartum OB/GYN patient visits. In 2019, 79.8% of all patients received a depression screening during primary care wellness checks and 90.6% of all patients received a depression screening during the follow-up postpartum visit. Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - Roper St. Francis Mt. Pleasant Hospital. Obesity, Nutrition, and Physical Activity 2019 Strategies and Outcomes: Strategy (System-wide): increase opportunities for comprehensive wellness. * RSFH requires all system employees to have an annual primary care screening. In 2019, RSFH had 3,463 employees with PCP visits. * RSFH promotes employee participation in disease-specific events to increase health awareness and advocacy. In 2019, RSFH employees recorded 7,859 hours of staff time supporting initiatives while serving 19,373 community residents. * In 2019, RSFH hosted informative and interactive tables/booths and participated in over 100 local community and health fairs, screenings, and events. Strategy (System-wide): Collaborate with local partners to increase healthy food options in underprivileged communities. * RSFH engaged community members in highest need areas to promote wellness and nutrition. In 2019, over 2,000 bags of fresh produce was distributed to families in need. * RSFH collaborates with Lowcountry Food Bank and East Cooper Meals on Wheels to provide home-delivered meals in low-income communities. In 2019, 3,000 meals were provided to 400 homebound residents in Charleston County. Strategy (System-wide): Host evidence-based health and wellness community programs for older adults. * RSFH offered physical wellness classes specifically targeting older adults. In 2019, 1,789 seniors were enrolled as members at Lowcountry Senior Center and 1,619 seniors enrolled at Waring Senior Center. There were 76,882 visits to fitness centers and exercise activities in 2019. Maternal, Infant, and Child Health 2019 Strategies and Outcomes: Strategy (Bon Secours St. Francis Xavier Hospital (BSSF)): Offer specialized services for high risk pregnancies. * BSSF offered specialized care teams for high risk pregnant women to include a board-certified maternal fetal medicine specialist during 2019. * BSSF supports a Maternal Fetal Medicine program that includes medical management, counseling, biophysical profiles, diagnosis and management of birth defects as well as other highly specialized services. During 2019, this program had 5,761 patient visits with 1,930 total patients served. Strategy (BSSF): Provide prenatal care for uninsured patients that are not eligible for Medicaid. * BSSF provided prenatal care for eligible uninsured and immigrant patients of Our Lady of Mercy Outreach. During 2019, this support resulted in 103 annual exams, 25 deliveries, and 60 GYN patients. * During 2019, BSSF signed contracts to continue partnerships that provide routine lab work, radiology services, prenatal education classes, and Maternal Fetal Medicine services for Spanish speaking patients. Strategy (BSSF, Roper St. Francis Mt. Pleasant Hospital (MPH), and Roper St. Francis Hospital - Berkeley, Inc. (BH)): Host expectant parent education classes and tours, and Safe Sitter classes. * During 2019, BSSF, MPH, and BH facilitated regularly scheduled expectant parent education classes and hospital tours as well as Safe Sitter classes. The total classes facilitated during the year total 251, including 134 free classes, and had 2,582 participants. This was the first year of expanding to the BH campus. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - Roper St. Francis Mt. Pleasant Hospital. Full charity care will be provided to patients with income 200% or less of FPG. Patients with an FPG of 201% - 400% will receive a discount based upon a sliding scale. Patients who qualify and are receiving benefits from the following programs may be presumed eligible for 100 percent financial assistance - food stamps, county and state relief programs, homelessness, deceased patients, and religious organizations. Patients who meet presumptive eligibility criteria may be granted financial assistance without completing the financial assistance application. In order to determine the appropriate level of financial assistance to apply to a patient's account, the facility will utilize a scoring mechanism, with the assistance of a third party vendor that provides a patient profile, or require the patient to complete a financial assistance application. Household income, as defined for federal tax guidelines, will be considered in determining whether a patient is eligible for financial assistance. Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - Roper St. Francis Mt. Pleasant Hospital. The patient handbook provided with registration references the Policy and includes contact information for patients who need assistance. In addition, signs are posted at all Hospital registration sites that reference our financial assistance policies and how they are accessed. 0 Schedule H, Part I, Line 3c Roper St. Francis Mt. Pleasant Hospital In addition to using the FPG to determine eligibility for free or discounted care, the system offers a 35% discount for patients who are uninsured. A 10% prompt payment discount is offered to all self-pay or self-pay-after-insurance patients who pay the balance at one time. Medical indigency adjustments are available to those that meet the established guidelines. Schedule H, Part V, Section B, Line 9 Roper St. Francis Mt. Pleasant Hospital The hospital adopted its Community Health Needs Assessment (CHNA) in August 2019. Both the hospital's CHNA and its implementation strategy to address the needs identified in the CHNA were posted to the hospital's website and made publicly available as required by the IRS. The hospital's implementation strategy was adopted by the Board in October 2020. The hospital is eligible for and is relying on the relief provided in Notice 2020-56, and should not be treated as failing to meet the requirements of Section 501(r)(3) prior to December 31, 2020. Although the hospital's implementation strategy was not formally adopted by the fifteenth day of the fifth month following the hospital's tax year end, the hospital had documented its strategies to address the prioritized health needs identified in its CHNA, had posted those strategies on the hospital's website, and began taking actions towards those strategies as required by the IRS. Schedule H, Part I, Line 6a Community benefit report prepared by related organization Roper St. Francis Healthcare dba CareAlliance Health Services Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance A cost to charge ratio was used to report financial assistance costs and actual expenses were used to report other community benefit costs. Schedule H, Part II Community Building Activities Roper St. Francis Healthcare addresses various community concerns including health improvement, poverty, workforce development, and access to health care. Roper St. Francis Healthcare hospitals conduct community health education and support groups, health fairs and screenings for the communities served. Roper St. Francis Healthcare hospitals work with state and local leadership to address community needs and provide healthcare services to the poor and underserved. Roper St. Francis Healthcare hospitals provide programs to improve the physical surroundings and housing in the communities served. Inadequate housing has a negative impact on the health of residents in the area by leading to violence in the neighborhoods. A robust economy positively impacts residents covered by health insurance and improves the capacity of the community to support health services. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. NET PATIENT ACCOUNTS ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL RECEIVABLES BASED UPON MERCY HEALTH'S HISTORICAL COLLECTION EXPERIENCE ADJUSTED FOR CURRENT ENVIRONMENTAL RISKS AND TRENDS FOR EACH MAJOR PAYOR SOURCE. SIGNIFICANT PROVISION IS MADE FOR SELF-PAY PATIENT ACCOUNTS IN THE PERIOD OF SERVICE BASED ON PAST COLLECTION EXPERIENCE. MERCY HEALTH'S CONCENTRATION OF CREDIT RISK RELATED TO NET PATIENT ACCOUNTS IS LIMITED DUE TO THE DIVERSITY OF PATIENTS AND PAYORS. NET PATIENT ACCOUNTS CONSIST OF AMOUNTS DUE FROM GOVERNMENTAL PROGRAMS (PRIMARILY MEDICARE AND MEDICAID), PRIVATE INSURANCE COMPANIES, MANAGED CARE PROGRAMS AND PATIENTS THEMSELVES. NET PATIENT SERVICE REVENUE FOR SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY PAYOR COVERAGE IS RECOGNIZED BASED ON CONTRACTUAL RATES FOR SERVICES RENDERED. MERCY HEALTH RECOGNIZES A SIGNIFICANT AMOUNT OF PATIENT SERVICE REVENUE AT THE TIME SERVICES ARE RENDERED EVEN THOUGH IT DOES NOT ASSESS THE PATIENT'S ABILITY TO PAY. AS A RESULT, THE PROVISION FOR BAD DEBTS IS PRESENTED AS A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL PROVISIONS AND DISCOUNTS). AMOUNTS RECOGNIZED ARE SUBJECT TO ADJUSTMENT UPON REVIEW BY THIRD-PARTY PAYORS. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, MERCY HEALTH RECOGNIZES REVENUE WHEN SERVICES ARE PROVIDED. BASED ON HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF MERCY HEALTH'S ININSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR SERVICES PROVIDED. THUS, MERCY HEALTH RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. ANY DISCOUNTS APPLIED TO SELF-PAY PATIENTS WOULD BE DEEMED EITHER CHARITY OR A CONTRACTUAL ADJUSTMENT. BAD DEBT WOULD BE BASED ON THE BALANCE AFTER THE CHARITY OR CONTRACTUAL ADJUSTMENT THAT IS DEEMED UNCOLLECTABLE FOLLOWING A REASONABLE COLLECTION EFFORT. Schedule H, Part III, Line 3 Bad Debt Expense Methodology For patients who do not turn in a signed charity care application, after 120 days of collection efforts, Roper St. Francis Healthcare uses the Health Care Advisory Board's self pay compass program to automatically qualify patients for charity care through the use of an electronic scoring technique. The data received through this software is believed to err on the side of denying charity. The estimate of bad debt that could have been charity is based on the system error rate. Please note that patients who complete a full charity care application and qualify for charity under our policy are granted charity regardless of the score in the self-pay compass system. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote From the consolidated audited financial statements of Roper St. Francis Healthcare (RSFH) dba CareAlliance Health Services (CareAlliance) which includes the activity of Roper St. Francis Mt. Pleasant Hospital: The process of estimating the allowance for doubtful accounts requires CareAlliance to estimate the collectibility of patient accounts receivable, which is primarily based on collection history, adjusted for expected recoveries. CareAlliance collects substantially all of its third-party insured receivables, which include receivables from governmental agencies. Collections are impacted by the economic ability of patients to pay and the effectiveness of collection efforts. Significant changes in payor mix, business office operations, economic conditions, or trends in federal and state governmental healthcare coverage could affect the collection of accounts receivable. CareAlliance also continually reviews overall reserve adequacy by monitoring historical cash collections as a percentage of trailing net revenue, as well as by analyzing current-period gross charges and admissions by payor classification, aged accounts receivable by payor, and days revenue outstanding. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs The entire amount of Medicare shortfall qualifies as community benefit. Our treatment of Medicare patients, as described in IRS Rev. Rul. 69-545, indicates that Roper St. Francis Mt. Pleasant Hospital operates to promote the health of the community. By Taking Medicare patients, the hospital promotes access to healthcare services, which is a community benefit. The organization uses the Medicare cost report to determine the costs reported on Part III, Line 5 and 6. Had we included revenues and costs from all Medicare programs including Medicare Part C this would have resulted in an additional shortfall of $4,284,588. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance Roper St. Francis Mt. Pleasant Hospital uses the same reasonable efforts and follows the same reasonable process for collecting amounts due for services provided to all patients, including insured, underinsured or uninsured patients. Collection activities may occur during the pre-registration process and will continue until account resolution, a determination the account is uncollectible, or determination of eligibility for financial assistance. The collection process may include the use of deposits, the implementation of payment plans or discretionary settlements. The collection process may involve the use of outside collection agencies. The collection process is documented in the patient's account files accessible to the Hospital and its business associates involved in the collection process. Collection will not, however, be pursued against patients who fall within populations exempt from collection action by law. Schedule H, Part V, Section B, Line 16a FAP website - Roper St. Francis Mt. Pleasant Hospital: Line 16a URL: https://www.rsfh.com/billing-financial-assistance/; Schedule H, Part V, Section B, Line 16b FAP Application website - Roper St. Francis Mt. Pleasant Hospital: Line 16b URL: https://www.rsfh.com/billing-financial-assistance/; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - Roper St. Francis Mt. Pleasant Hospital: Line 16c URL: https://www.rsfh.com/billing-financial-assistance/; Schedule H, Part VI, Line 2 Needs assessment The CHNA team used surveys sent out to the community at large and asked respondents to rank the top 10 topics areas from Health People 2020 that impact the communities where they live and/or work from 1 (most concerning) to 10 (least concerning). The top five health topic areas prioritized by the community were then used as the focus of health improvement efforts going forward. Additionally, secondary sources of data in the assessment process came from interviews with community leaders, elected officials and health care professionals, health focus groups with the community at large, and feedback from participants at the CHNA team's community input session. Healthy People 2020 is consistently recognized as a national benchmark for healthcare goals and standards. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Statements to patients from the Hospital outline our charity care policy and our charity care policy is posted on our website. If patients indicate they are not able to pay their bill, we will provide the patient with a charity care application. The Hospital shall send anyone who requests information on the Hospital's financial assistance program a letter outlining required information and a financial assistance application form. Requests for financial assistance may be proposed by sources other than the patient, such as the patient's physician, family members, social service organizations, community or religious groups, or Hospital personnel. Patients can also meet with a member or our financial counseling department to learn about their financial assistance options. Brochures are printed in English and Spanish telling patients to contact the financial counseling department. The Hospital wants its patients focus to be on health and recovery and not financial worry. There is absolutely no additional cost for our financial counseling assistance. Additionally, patients can meet with staff of the Medicaid program. The program staff will meet with patients individually to help them apply for publicly supported programs such as Medicaid, Medicare, and disability. Counselors meet with patients in the Hospital as well as making home visits as appropriate. The staff can also help identify resources to help pay for medication. All of this information is posted on our website with the appropriate contact information. Schedule H, Part VI, Line 4 Community information The primary service area for Roper St. Francis Healthcare and its four hospitals (collectively referred to as RSFH) consists of Charleston, Berkeley, and Dorchester counties. These counties include the major municipalities of Charleston, North Charleston, Mount Pleasant, and Summerville. The tri-county area that makes up the primary service area has a population of approximately 750,000 residents and is expected to grow based on the results of the most recently completed Community Health Needs Assessment (CHNA). These residents are 47% Male and 53% Female with a majority between the ages of 18 and 64. The average annual household income of the tri-county area is between $50,000 - $75,000 with the average level of education being an Associates degree. The race/ethnicity of these residents is approximately 66% White (non-Hispanic), 27% African American, and 6% Hispanic/Latinx. Based on the respondents from the CHNA the average amount of individuals with no health insurance is between 6.8% in Dorchester County, 7.5% in Berkeley County, and 10.6% in Charleston County. Accordingly to national health rankings, South Carolina struggles with high rates of premature death, obesity, violent crime, poverty, and diabetes. However, County Health Rankings and Roadmaps ranks the Tri-County region high in overall health compared to the other 43 counties in South Carolina. Additional detail regarding the community served by RSFH can be found in the CHNA at the following link: https://www.rsfh.com/mission-department/ Schedule H, Part VI, Line 5 Promotion of community health In keeping with our mission of healing all people with compassion, faith, and excellence, Roper St. Francis Healthcare strives to enrich the health of our community. We do this by offering charity care to those in need, reaching out to our neighbors with health fairs and educational materials, sponsoring organizations and events that promote wellness and community well-being, and marshaling our resources to advance the health and dignity of each person with whom we come in contact. We are the Low Country's only non-governmental, not for profit healthcare system. With this distinction, we believe it is our responsibility to advocate for and respond to our neighbors needs through community benefit. Surplus funds are returned to our community through the development of new facilities to serve population growth, the expansion of existing facilities, subsidizing care for those who are unable to pay, sponsorship of healthcare related activities including outreach clinics and programs for the uninsured, and investing in technology to improve the quality of patient care. The Organization is committed to the enrichment of healthcare in our community as evidenced by the composition of our Board of Directors and Open Medical Staff. Our governing body is comprised of a 13-member Board of Directors. At least nine directors must have their primary residence in a community served by the System. Five directors must be physicians actively engaged in the full time practice of medicine. The hospital extends medical staff privileges to all qualified physicians in the area for most of our departments. Schedule H, Part VI, Line 6 Affiliated health care system Roper St. Francis Healthcare (RSFH) dba CareAlliance Health Services is a charitable health care delivery system based in Charleston, South Carolina. The 657-bed health system provides services at 90 facilities and doctors' offices conveniently located throughout our region. RSFH was formed effective August 1, 1998, through the execution of an affiliation agreement between the following founding members: - The Medical Society of South Carolina (MSSC), - Bon Secours Mercy Health, Inc. (BSMH), and - Atrium Health (formerly Carolinas Healthcare System). During the year Atrium redeemed its 10% interest in RSFH and its membership interest was terminated. As of December 31, 2019, MSSC's membership percentage was 70% and BSMH's membership percentage was 30%. RSFH is the sole corporate member and, through its by-laws, has the power to control the financial and business affairs of Bon SEcours Mt. Pleasant Hospital. System leadership provides strategic vision and management oversight in support of the system by directing resources, providing access to lower cost debt financing, improving clinical outcomes and reducing operating costs. System-wide community benefit for 2019 per the 2019 Community Benefit Report is as follows: Total 2019 Community Benefit: $54.1 Million Charity Care: $40.5 million Unreimbursed Care for Those Who Are Poor and Qualify for Medicaid: $11.8 million Community Outreach and Community Sponsorship Programs: $1.8 million Community Benefit as Percent of Net Operating Expense: 5.7 percent. Schedule H, Part VI, Line 7 State filing of community benefit report SC false true false false false false false true false Brian Cuddy MD Chair, Neurosurgeon - RSFPP 0 896742 0 24960 0 39401 0 35942 0 34470 0 1031515 0 0 Susan Datta MD Vice-Chairperson, Internist - RSFPP 0 256943 0 38014 0 6628 0 33765 0 36964 0 372314 0 0 John B Holloway Jr Board Member, CEO - MSSC 0 339000 0 125000 0 0 0 16942 0 19520 0 500462 0 0 Henry West MD Board Member (Beg 01/19), Surgeon - RSFPP 0 491911 0 100775 0 594 0 35942 0 25869 0 655091 0 0 Lorraine Lutton President & CEO 0 837453 0 220326 0 379244 0 45036 0 36273 0 1518332 0 218986 Bret D Johnson CFO & SVP / Treasurer 0 460454 0 113613 0 146563 0 71967 0 38458 0 831055 0 137301 Anthony Jackson VP and CEO Acute Care Services 0 410968 0 76554 0 87238 0 54790 0 36883 0 666433 0 53200 Pennie Peralta Former Key EE, VP Nursing/Sr. Nurse Exec SFX 0 264787 0 55871 0 147177 0 14120 0 22827 0 504782 0 117649 Stephen Porter Former Key, VP and CEO, Roper Hospital and Berkeley Hospital 0 219311 0 103345 0 51188 0 8352 0 20970 0 403166 0 16403 Stephanie McKoin Former Key EE, Director of Perioperative Services 0 192153 0 20163 0 1687 0 12724 0 27722 0 254449 0 0 Vanessa Shamrock Former Key EE, Director of Lab Services 0 149170 0 19442 0 594 0 9321 0 12456 0 190983 0 0 Tavia Buck Chief Administrative Officer and CNO 175496 0 21642 0 20330 0 21903 0 2615 0 241986 0 20195 0 Stanley Wilson MD Chief Medical Officer 0 417226 0 38325 0 488 0 31565 0 23796 0 511400 0 0 Phillip Creger Manager Pharmacy 176072 0 14155 0 4224 0 8574 0 27020 0 230045 0 0 0 John Prentice Pharmacist 165855 0 0 0 6325 0 9302 0 36782 0 218264 0 0 0 Tracy Bishop Clinical Pharmacist 153975 0 0 0 387 0 8534 0 30818 0 193714 0 0 0 Kimberly Gaillard Medication Safety Coordinator 147771 0 0 0 2582 0 8335 0 16851 0 175539 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation A related organization of Roper St. Francis Mount Pleasant Hospital determined the compensation of the Organization's CEO using the following methods: Compensation Committee Independent Compensation Consultant Compensation Survey or Study Approval by the Board or Compensation Committee Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan The Roper St. Francis Healthcare 457(f) Plan's purpose is to offer eligible employees of the employer deferred compensation benefits to supplement Eligible Employees' retirement income. The Plan is intended to be a top-hat plan (i.e. an unfunded deferred compensation plan maintained for certain members of a select group of management or highly compensated employees). INDIVIDUALS THAT PARTICIPATED OR RECEIVED A DISTRIBUTION INCLUDE: Bret D. Johnson, $51,320; Pennie Peralta, $92,610; Anthony Jackson, $0; Tavia Buck, $20,195; Lorraine Lutton, $142,112. Schedule J, Part I, Line 7 Non-fixed payments Goals are developed each year to support the Organization's strategic initiatives for people, quality, financial, growth and service. The Ad Hoc Compensation Committee approves the system goals annually and reports it to the full Board of Directors. Progress on each metric is reported to the Board each month on the corporate scorecard. At year-end, the Ad Hoc Compensation Committee approves the final scorecard number and reports results to the full Board. Annual incentives for the executives are based 60% on the corporate scorecard and 40% on individual performance. Executives maintain an individual scorecard on the leader evaluation manager and discuss results monthly with the President/CEO. The President/CEO approves the individual executive scorecard. Form 990, Part VI, Line 6 Classes of members or stockholders The sole member of the Corporation is Roper St. Francis Healthcare (RSFH), a South Carolina nonprofit, nonstock Corporation. RSFH is in turn governed by a Board of Directors appointed by the "founding members". Please see the response to Line 7a below. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body RSFH is governed by a 13-member board of directors (the "Board of Directors") appointed by the Founding Members. Subject to certain Nominating Committee approvals, six directors are appointed by each of the Medical Society of South Carolina (MSSC) and Bon Secours Mercy Health (BSMH) and one director is appointed by Atrium. It is the Founding Members' intent that the members of RSFH's Board of Directors are appointed to such positions because they have a willingness to serve the needs of RSFH as a whole and not the needs of any individual Founding Member. During the year Atrium redeemed its 10% interest in RSFH and its membership interest was terminated. As of December 31, 2019, MSSC's membership percentage was 70% and BSMH's membership percentage was 30%. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders The following actions shall require the unanimous affirmative approval of all of the founding members: (a) to amend the Articles of Incorporation or By-laws, including without limitation, any change in the Corporation's purposes; provided, however, that, subject to the procedures and voting requirements with respect to the admission of non-founding members, Schedule 3.1 may be amended with the approval of two (2) of the founding members to reflect the admission of a non-founding member; (b) to dissolve or liquidate the Corporation and to determine the distribution of assets upon dissolution; (c) to merge or consolidate the Corporation or to sell, convey, transfer, lease, or otherwise dispose of all or substantially all of its assets; (d) to appoint the President and Chief Executive Officer of the Corporation in a manner other than that established within the By-laws; (e) to alter or amend the Corporation's ethical performance standards (defined below); or (f) to enter into any material agreement whereby a third party will: (i) become an equity owner in any joint venture with the Corporation or any System participant and will not be legally obligated to support the Corporation's ethical performance standards; or (ii) manage a substantial part of the facilities, assets, or operations of the system and will not be legally obligated to comply with and support the Corporation's ethical performance standards. Form 990, Part VI, Line 11b Review of form 990 by governing body The Form 990 was prepared by the BSMH Tax Department with assistance and oversight by management and was reviewed by an independent accounting firm. Reviews were then conducted by senior management. Upon review, the Form 990 along with a summary memo is forwarded to the governing body for approval. After approval by the governing body the final version is filed with the Internal Revenue Service. Form 990, Part VI, Line 12c Conflict of interest policy The HR policy requires COI disclosures from "every RSFH senior leader, employed physicians and non-physician practitioners, all directors and all Value Analysis Team members". The governing board policies define covered persons as "directors and to all officers (as defined by the President/CEO) and all persons who serve in a position functionally equivalent to that of a corporate officer". All covered persons shall complete and return to the Secretary an annual statement that each of them: (a) has received a copy of the Conflict of Interest Policy; (b) has read and understands the Policy; (c) agrees to comply with this Policy; (d) understands that the Policy applies to all committees; and (e) understands that the Organization is a charitable organization and must continuously engage primarily in activities which accomplish one or more of its tax-exempt purposes. Form 990, Part VI, Line 15a Process to establish compensation of top management official An independent company, Towers Watson, provides research, advice and guidance to the Compensation Committee and senior leadership to ensure the Organization's compensation programs for executives covered by the "Intermediate Sanctions Legislation" (IRC Section 4958) are aligned with its stated philosophy: Base salaries are targeted at the 50th percentile of the established comparator market; Total cash compensation (base salary plus annual incentive payments) are targeted at the 75th percentile of the established comparator market; Total direct compensation (total cash compensation plus long term incentive payments) will not exceed the 90th percentile of the established comparator market; Benefits are targeted at market median; and In aggregate, base salary, total cash compensation, total direct compensation and benefits comprise total compensation for executives. The Compensation Committee ensures that executive total compensation is reflective of the Organization's stated compensation philosophy. The committee, in this process, authorizes and supports an annual three step process utilizing Towers Watson's resources: 1) Salary levels, annual bonus targets/payments and long term incentive grants are compared rigorously each year with market data based on comparable positions and organizations. A. Comparable organizations are typically not-for-profit healthcare systems with similar operating revenues. Private sector employer data, when available, are also included in the analysis for "transferable skills positions". B. Historically, performance incentive payouts generally track with a normal bonus payout distribution. Incentive goals are primarily based on formally defined quantitative goals approved by the ad hoc Compensation Committee of the RSFH Board of Directors. 2) All recommended pay decisions are tested against these data and the organization's stated compensation philosophy. 3) A formal opinion letter is prepared by Towers Watson, representing that senior executives are compensated within the reasonableness standards mandated by the IRS. A similar process is performed by Towers Watson for the CEO and CFO positions. This letter provides a "safe harbor" for the organization's "directors" relative to the reasonableness of total executive compensation consistent with IRC Section 4958. Form 990, Part VI, Line 15b Process to establish compensation of other employees See explanation for 15A. 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 IX, Line 11g Other Fees Purchased Services - Total Expense: 4960712, Program Service Expense: 3621320, Management and General Expenses: 1339392, Fundraising Expenses: ; Professional Fees - Total Expense: 3433782, Program Service Expense: 3433782, Management and General Expenses: , Fundraising Expenses: ; Administration Fees - Total Expense: 12030786, Program Service Expense: 3248312, Management and General Expenses: 8782474, Fundraising Expenses: ; Other - Total Expense: 2542586, Program Service Expense: 2288327, Management and General Expenses: 254259, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Pension - -99213; Equity Transfer - -17051149; Roper St Francis Healthcare 8536 Palmetto Commerce Pkwy Ste 201 Ladson SC 29456 570831165 HEALTHCARE SYSTEM PARENT SC 501(c)(3) 3 NA false Roper Hospital Inc 8536 Palmetto Commerce Pkwy Ste 201 Ladson SC 29456 570828733 Healthcare SC 501(c)(3) 3 Roper St Francis Healthcare false Bon Secours St Francis Xavier Hospital 8536 Palmetto Commerce Pkwy Ste 201 Ladson SC 29456 571067254 Healthcare SC 501(c)(3) 3 Roper St Francis Healthcare false Roper St Francis Mt Pleasant Hospital 8536 Palmetto Commerce Pkwy Ste 201 Ladson SC 29456 570360499 Healthcare SC 501(c)(3) 3 Roper St Francis Healthcare false Roper St Francis Hospital - Berkeley 8536 Palmetto Commerce Pkwy Ste 201 Ladson SC 29456 263710229 Healthcare SC 501(c)(3) 3 Roper St Francis Healthcare false Roper St Francis Physicians Network 8536 Palmetto Commerce Pkwy Ste 201 Ladson SC 29456 262946628 Healthcare SC 501(c)(3) 3 Roper St Francis Healthcare false Roper St Francis Foundation 8536 Palmetto Commerce Pkwy Ste 201 Ladson SC 29456 571068509 Fundraising SC 501(c)(3) Type I Roper St Francis Healthcare false The Medical Society of South Carolina 69-B Barre St Charleston SC 29401 570288358 Supporting Org/Founding Member SC 501(c)(3) Type III-FI NA false Clinical Biotechnology Research Institute at RSFH 8536 Palmetto Commerce Pkwy Ste 201 Ladson SC 29456 475407453 Healthcare SC 501(c)(3) 4 Roper St Francis Healthcare false LOWCOUNTY SURGERY CENTER (DBA ROPER ST FRANCIS EYE SURGERY CENTER) 8536 PALMETTO COMMERCE PKY LADSON SC 29456 581693021 EYE SURGERY SC NA N/A RSFH - ATI PHYSICAL THERAPY 125 DOUGHTY ST STE 760 CHARLESTON SC 29403 474797980 PHYSICAL THERAPY SC NA N/A CAREALLIANCE MEDICAL SERVICES ORGANIZATION 8536 PALMETTO COMMERCE PKWY STE 201 LADSON SC 29546 571012837 INACTIVE SC NA C Corporation false false false true true true false false false true true true true true true true true true false false