2019-05-13T18:02:42-05:00 2018-06-30 990 2017-07-01 731440267 Jane Phillips Nowata Hospital Inc JANE 3147338000 237 South Locust Nowata OK 74048 Tonya Mershon Tax Officer 2019-05-13 2017 2019-02-21 02:37:17Z Nowata Health Center Mike Moore 237 South Locust Nowata OK 74048 5064818 false X https://www.stjohnhealthsystem.com/jane-phillips/services/nowata-health-center X 1946 OK To improve the health and well-being of all people in the communities we serve. 8 6 34 6 0 0 0 0 4932558 5058371 199 -2485 10216 6689 4942973 5062575 0 765 0 2969624 2991899 0 0 0 2052100 1966560 5021724 4959224 -78751 103351 2660998 2692467 531628 2958114 2129370 -265647 Our Mission as part of a Catholic health care system is to further the healing ministry of Jesus by continually improving the health and well-being of all people, especially the poor, in the communities we serve. false false 3909066 765 5057771 Jane Phillips Nowata Hospital, Inc. is a 12-bed hospital campus providing services without regard to patient race, creed, national origin, economic status, or ability to pay. During fiscal year 2018, Jane Phillips Nowata Hospital, Inc. treated 172 adults and children for a total of 1,789 patient days of service. The hospital also provided services for 2,372 outpatient visits, which included 2,372 Emergency Room Visits. See Schedule H for a non-exhaustive list of community benefit programs and descriptions. 3909066 true false false true false false false false false true false false false true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true true false false true 23 0 true 34 true false false false false false false true false false false X 8 6 false false false false true true true true true false false false true true true true true false false false OK X SARA OBRIEN 3147338070 11775 BORMAN DRIVE MARYLAND HEIGHTS MO 63146 STANLEY P DEFEHR MD CHAIR (END 5/2018) 1.0 50.0 X X 0 556493 38884 MERL LINDSTROM VICE CHAIR 1.0 1.0 X X 0 0 0 MICHAEL A MOORE PRESIDENT (EX-OFFICIO) 25.0 25.0 X X 0 293289 27171 DAVID J PYNN SVP AH-MINSTRY MKT EXEC TULSA (END 10/2017) 0.0 50.0 X X 0 1637759 34002 MICHAEL L MULLINS DIRECTOR (START 10/2017) 0.0 50.0 X 0 1365922 41134 MARK HEADLEY DIRECTOR 1.0 1.0 X 0 0 0 DAVID KING DIRECTOR 1.0 1.0 X 0 0 0 SONYA SAYLES DIRECTOR 1.0 1.0 X 0 0 0 SHERRY DOTY DIRECTOR 1.0 1.0 X 0 0 0 LINDEL FIELDS DIRECTOR 1.0 1.0 X 0 0 0 LEX ANDERSON TREASURER/EXEC VP & CFO SJHS (END 10/2017) 5.0 45.0 X 0 410957 29719 ALAN TOWNSEND TREASURER (START 10/2017) 1.0 5.0 X 0 0 0 KEVIN B STECK SECRETARY/VP INTEGRITY & COMPLIANCE 8.0 42.0 X 0 278300 16444 RONALD JAMES BRASEL VP FINANCE 5.0 45.0 X 0 152007 30666 PAUL MCQUILLEN VP PHYSICIAN SERVICE 25.0 25.0 X 0 179860 11346 ALFRED W GARTZKE MD PHYSICIAN 50.0 0 X 302449 0 24296 DEBRA J ROBNETT-BELL PHYSICIAN ASSISTANT 50.0 0 X 153245 0 17079 VICKY S USHER RN I 50.0 0 X 131686 0 10797 MICHELE F FAUGHT RN I 50.0 0 X 110829 0 4431 JEFFREY L GIBSON PHYSICIAN 50.0 0 X 106902 0 25846 SAMUEL C ANDERSON FORMER OFFICER (END 6/2014) 0.0 0.0 X 0 254463 1910 805111 5129050 313725 5 true true false GREEN COUNTRY MEDICAL INC 712 E OSAGE AVE NOWATA OK 74048 MEDICAL SERVICES 160401 1 X 0 Net Patient Service Revenue 621990 5054156 5054156 Rental Income from Affiliates 531120 4215 4215 0 0 0 0 5058371 -242 -242 0 0 0 2243 0 -2243 -2243 -2243 Education Revenue 611430 -600 -600 7289 0 0 7289 6689 5062575 5057771 0 4804 765 765 2561445 2407790 153655 114164 107316 6848 131791 123885 7906 184499 173431 11068 2106 2106 99 99 127191 128717 -1526 0 3275 1825 1450 22390 3426 18964 899 899 78077 263 77814 2899 2778 121 352304 12206 340098 60 60 Purchased Services 688013 365049 322964 Professional Fee to Affiliate 336174 336174 Medical Supplies 147188 109647 37541 Physician Fees to Affiliate 114927 98152 16775 90958 36743 54215 0 4959224 3909066 1050158 0 1246 200 0 164 727401 1094034 0 0 0 0 49146 45958 2435285 1252793 1319637 1182492 0 0 472596 346571 90972 23048 2660998 2692467 283922 227222 0 0 247706 2730892 531628 2958114 X 2129370 -265647 2129370 -265647 2660998 2692467 X 103351 -2498368 X false true X true false X false false false false false false false false true 99 99 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY LOBBYING EXPENSES REPRESENT THE PORTION OF DUES PAID TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS THAT IS SPECIFICALLY ALLOCABLE TO LOBBYING. JANE PHILLIPS NOWATA HOSPITAL, INC. DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTING OF STATEMENTS) ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE. Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY LOBBYING EXPENSES REPRESENT THE PORTION OF DUES PAID TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS THAT IS SPECIFICALLY ALLOCABLE TO LOBBYING. JANE PHILLIPS NOWATA HOSPITAL, INC. DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTING OF STATEMENTS) ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE. 170000 170000 1958409 1043246 915163 251059 186214 64845 55817 23333 32484 1182492 Due to Affiliates 413069 Estimated 3rd Party Payor Settlement 437752 Recovery Tail Liability 3388 Accrued Tax Liability 846 Interest in Investments Held by Ascension Health Alliance 1875837 2730892 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE SYSTEM ACCOUNTS FOR UNCERTAINTY IN INCOME TAX POSITIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE SYSTEM HAS DETERMINED THAT NO MATERIAL UNRECOGNIZED TAX BENEFITS OR LIABILITIES EXIST AS OF JUNE 30, 2018. true true X true X 250 true X true true true false true true 727936 28446 699490 0.1410 1035340 635008 400332 0.0807 0 0.0 0 0 1763276 663454 1099822 0.2218 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 0 0 1763276 663454 1099822 0.2218 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 false 243219 0 4025532 4025532 0 X true true 1 1 Jane Phillips Nowata Health Center 237 South Locust Nowata OK 74084 https://www.stjohnhealthsystem.com/jane-phillips/services/nowata-health-center 2187 X X X Jane Phillips Nowata Health Center 1 false false true X X X X X X X X X 15 true true true true X www.stjohnhealthsystem.com/about/community-health-needs-assessment X true 15 true www.stjohnhealthsystem.com/about/community-health-needs-assessment false true X 250.0 400.0 X X X X true true X X X true X www.stjohnhealthsystem.com/about/payment-for-services X www.stjohnhealthsystem.com/about/payment-for-services X www.stjohnhealthsystem.com/about/payment-for-services 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 To better target community resources on the service area's most pressing health needs, the hospital participated in a group discussion with organizational decision makers and community leaders to prioritize the significant community health needs while considering several criteria: alignment with Ascension Health strategies of healthcare that leaves no one behind; care for the poor and vulnerable; opportunities for partnership; availability of existing programs and resources; addressing disparities of subgroups; availability of evidence-based practices; and community input. The significant health needs are a prioritized description of the significant health needs of the community as identified through the CHNA. See Schedule H, Part V, Line 7 for the link to the CHNA and Schedule H, Part V, Line 11 for how those needs are being addressed. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Jane Phillips Nowata Hospital, Inc.. COMMUNITY INPUT IS A PRIMARY FOCUS OF THE MOST RECENT CHNA THAT WAS ADOPTED AND APPROVED BEFORE JUNE 30, 2016 FOR THE FISCAL YEARS 2017-2019. ACCORDINGLY, INPUT FROM COMMUNITY MEMBERS, COMMUNITY LEADERS AND REPRESENTATIVES, AS WELL AS THE ST. JOHN SYSTEM'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ADVISORY GROUP AND LEADERSHIP WAS OBTAINED TO EXPAND UPON INFORMATION GLEANED FROM THE SECONDARY DATA REVIEW. A CONCERTED EFFORT WAS MADE TO OBTAIN COMMUNITY INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL, INCLUDING THOSE WITH SPECIAL KNOWLEDGE AND EXPERTISE OF PUBLIC HEALTH ISSUES AND POPULATIONS DEEMED VULNERABLE. THIS ASSESSMENT ALSO TOOK IN TO ACCOUNT THE IMPORTANCE OF ENGAGING COMMUNITIES ON AN ONGOING BASIS AND THE PROMOTION OF A CONTINUAL DIALOGUE. THIS INCLUDES DISSEMINATING THE RESULTS OF THE ASSESSMENT WITHIN THE COMMUNITY AND ENGAGING THE COMMUNITY IN MUTUALLY REINFORCING AND COMMUNITY-DRIVEN ACTIVITIES TO IMPROVE THE COMMUNITY HEALTH AND WELL-BEING. THIS ASSESSMENT EMPLOYED SEVERAL METHODS OF COMMUNITY INPUT TO YIELD THE DESIRED RESULTS. FOR THE PURPOSES OF THIS ASSESSMENT, COMMUNITY INPUT WAS OBTAINED THROUGH THE FOLLOWING METHODS: 1) A COMMUNITY INPUT MEETING WITH 15 COMMUNITY MEMBERS, LEADERS, AND REPRESENTATIVES; 2) INPUT FROM THE PUBLIC HEALTH WORKFORCE AND LOCAL PARTNERSHIPS; AND 3) INPUT FROM THE HEALTH SYSTEM'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ADVISORY GROUP AND LEADERSHIP. THE HOSPITAL ENGAGED THE WASHINGTON COUNTY HEALTH DEPARTMENT (OVERSEES NOWATA COUNTY) AS WELL A MULTITUDE OF OTHER COMMUNITY PARTNER ORGANIZATIONS THROUGHOUT THIS COMMUNITY HEALTH NEEDS ASSESSMENT. THE HEALTH SYSTEM HOSPITAL WORKED CLOSELY WITH THESE PARTNERS TO CONDUCT THIS ASSESSMENT. THROUGHOUT THE ASSESSMENT PROCESS, THE HOSPITAL WORKED TO INITIATE AND STRENGTHEN OUR RELATIONSHIPS WITH THESE COMMUNITY PARTNERS AND WILL CONTINUE TO DO SO TO PROMOTE EFFECTIVE AND COMMUNITY-DRIVEN COMMUNITY HEALTH IMPROVEMENT INITIATIVES WITHIN NOWATA COUNTY. ON MAY 2, 2016, A TOTAL OF 16 COMMUNITY LEADERS AND REPRESENTATIVES PARTICIPATED IN A COMMUNITY INPUT MEETING CONDUCTED AT JANE PHILLIPS NOWATA HOSPITAL, INC. THE PURPOSE OF THIS MEETING WAS TO SOLICIT COMMUNITY INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY, ESPECIALLY THOSE MOST IN NEED. THE MEETING WAS INTENDED TO OBTAIN COMMUNITY INPUT SPECIFIC TO THE HOSPITAL AND SURROUNDING COMMUNITY OF NOWATA COUNTY. THE MEETING TOOK PLACE OVER A TWO-HOUR PERIOD AND CONSISTED OF FOUR MAIN EXERCISES: 1) HOSPITAL ASSESSMENT EXERCISES, 2) NOMINAL GROUP EXERCISE TO VALIDATE AND PRIORITIZE HEALTH NEEDS BASED ON TOP HEALTH NEEDS IDENTIFIED, 3) COMMUNITY PERCEPTION GROUP EXERCISE, AND 4) COMMUNITY CAPACITY ASSESSMENT EXERCISE. THE FOLLOWING COMMUNITY AGENCIES AND ORGANIZATIONS PARTICIPATED IN THE HOSPITAL'S MEETING: ARVEST BANK NOWATA, CHEROKEE NATION - WILL ROGERS HEALTH CENTER, CITY OF NOWATA, DR. JEFFREY GIBSON, DO- FAMILY PRACTICE PHYSICIAN'S OFFICE, ELDER CARE, MORTON COMPREHENSIVE HEALTH SERVICES, NOWATA COMMUNITY ADVANCEMENT NETWORK, NOWATA UNITED METHODIST CHURCH, OKLAHOMA DEPARTMENT OF HUMAN SERVICES, REGENT BANK, AND WASHINGTON COUNTY HEALTH DEPARTMENT (OVERSEES NOWATA COUNTY). A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ADVISORY GROUP WAS FORMED IN THE BEGINNING OF THIS ASSESSMENT PROCESS TO PROVIDE DIRECTION, INPUT, AND GUIDANCE. THIS GROUP MET SEVERAL TIMES DURING THE PROCESS BETWEEN FEBRUARY AND MAY 2016. GROUP MEMBERSHIP CONSISTED OF THIRTEEN KEY REPRESENTATIVES FROM HOSPITAL FACILITIES, ST. JOHN CLINIC, AND DEPARTMENTS THROUGHOUT THE HEALTH SYSTEM. THESE MEMBERS ASSISTED WITH THE DESIGN AND COORDINATION OF THE HOSPITAL COMMUNITY HEALTH INPUT MEETINGS AND HELPED TO COMPILE INFORMATION AND DATA RELATED TO OUR EVALUATION OF IMPACT FROM OUR 2013 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. ADDITIONAL MEMBERS OF HOSPITAL AND HEALTH SYSTEM LEADERSHIP WERE ALSO ENGAGED TO PROVIDE INPUT AND GUIDANCE THROUGHOUT THE PROCESS. A SHORT COMMUNITY HEALTH NEEDS PRIORITIZATION SURVEY WAS EMAILED TO CHNA ADVISORY GROUP MEMBERS AND HOSPITAL/HEALTH SYSTEM LEADERSHIP VIA SURVEYMONKEY IN APRIL 2016. A TOTAL OF FIFTEEN MEMBERS AND LEADERSHIP RESPONDED TO THE SURVEY. COMMUNITY INPUT WAS SOLICITED FROM A DIVERSE SET OF COMMUNITY STAKEHOLDERS SUCH AS COMMUNITY MEMBERS, COMMUNITY ORGANIZATIONS, AND THE PUBLIC HEALTH WORKFORCE. A VARIETY OF SOURCES ENSURED THAT AS MANY DIFFERENT PERSPECTIVES AS POSSIBLE WERE REPRESENTED WHILE SATISFYING THE BROAD INTERESTS OF THE COMMUNITY. SOURCES OF COMMUNITY INPUT FOR THIS ASSESSMENT WERE AS FOLLOWS: - COMMUNITY LEADERS AND REPRESENTATIVES - LOCAL PUBLIC HEALTH WORKFORCE AND COALITIONS/PARTNERSHIPS - MEMBERS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY, AT-RISK, AND OTHERWISE VULNERABLE POPULATIONS, AND - ST. JOHN SYSTEM CHNA ADVISORY GROUP AND LEADERSHIP. COMMUNITY STAKEHOLDERS WHO PROVIDED COMMUNITY INPUT REPRESENTED A VARIETY OF COMMUNITY SECTORS INCLUDING: COMMUNITY MEMBERS, HEALTHCARE PROVIDERS AND SERVICES, EDUCATION AND ACADEMIA, NON-PROFIT AGENCIES, COMMUNITY-BASED ORGANIZATIONS, PRIVATE BUSINESSES, COMMUNITY DEVELOPERS, FAITH COMMUNITIES AND FAITH-BASED ORGANIZATIONS, GOVERNMENT REPRESENTATIVES, SAFETY NET SERVICE PROVIDERS, ECONOMIC AND WORKFORCE DEVELOPMENT, MENTAL HEALTH/BEHAVIORAL HEALTH SERVICES, LAW ENFORCEMENT AND FIRST RESPONDERS, PUBLIC HEALTH WORKFORCE, AND OTHER INTEREST GROUPS WORKING WITH AT-RISK AND VULNERABLE POPULATIONS. THIS ASSESSMENT ESPECIALLY FOCUSED ON COMMUNITY INPUT FROM THOSE WITH SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH AS WELL AS MEMBERS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW INCOME, MINORITY, OR OTHERWISE VULNERABLE POPULATIONS. EACH OFFERED CRITICAL STRENGTHS AND INSIGHTS ON THE HEALTH NEEDS AND ASSETS OF THE COMMUNITY. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - Jane Phillips Nowata Hospital, Inc.. The other hospital facilities, with which the reporting hospital facility conducted its CHNA, include: - St. John Medical Center, Inc. - St. John Broken Arrow, Inc. - Owasso Medical Facility, Inc. - St. John Sapulpa, Inc. - Jane Phillips Memorial Medical Center, Inc. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - Jane Phillips Nowata Hospital, Inc.. The other organizations, with which the reporting hospital facility conducted its CHNA, include: - The Washington County Health Department (oversees Nowata County) Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Jane Phillips Nowata Hospital, Inc.. HOW THE CHNA NEEDS WERE MET IN FY 2018 FOR THE CHNA THAT WAS ADOPTED AND APPROVED BEFORE JUNE 30, 2016 FOR FISCAL YEAR 2017-2019: USING THE CHNA COMPLETED IN 2016, THE ST. JOHN SYSTEM DEVELOPED, ADOPTED, AND WORKED ON EXECUTING A FISCAL YEAR 2017-2019 IMPLEMENTATION STRATEGY TO ADDRESS THE PRIORITY COMMUNITY HEALTH NEEDS IDENTIFIED IN THE COMMUNITY-WIDE COMMUNITY HEALTH NEEDS ASSESSMENT. INPUT FROM COMMUNITY MEMBERS, COMMUNITY LEADERS AND REPRESENTATIVES, AS WELL AS THE ST. JOHN SYSTEM'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ADVISORY GROUP AND LEADERSHIP WAS OBTAINED FOR IDENTIFICATION AND PRIORITIZATION OF NEEDS. A CONCERTED EFFORT WAS MADE TO OBTAIN COMMUNITY INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL, INCLUDING THOSE WITH SPECIAL KNOWLEDGE AND EXPERTISE OF PUBLIC HEALTH ISSUES AND POPULATIONS DEEMED VULNERABLE. THE HOSPITAL COLLABORATED WITH THE WASHINGTON COUNTY HEALTH DEPARTMENT (OVERSEES NOWATA COUNTY) AND A DIVERSE RANGE OF COMMUNITY STAKEHOLDERS IN NOWATA COUNTY ON THIS PROCESS. THE FOLLOWING COMMUNITY HEALTH NEEDS WERE SELECTED AS THE TOP FOUR PRIORITIES IN THE 2016 CHNA FOR ST. JOHN SYSTEM AND THE HOSPITAL TO ADDRESS IN FISCAL YEAR 2017-2019: 1) ACCESS TO CARE 2) BEHAVIORAL HEALTH 3) WELLNESS AND CHRONIC DISEASE PREVENTION 4) HEALTH LITERACY IN FISCAL YEAR 2018, THE FOLLOWING INITIATIVES WERE UNDERTAKEN TO ADDRESS THE PRIORITY NEEDS: 1) ACCESS TO CARE: ACCESS TO SERVICES IN OKLAHOMA IS A SIGNIFICANT CHALLENGE DUE TO THE LIMITED AVAILABILITY OF PRIMARY CARE PHYSICIANS AND STRESS ON HOSPITAL EMERGENCY ROOM ACCESS AND INPATIENT BEDS DUE TO A GROWING NUMBER OF TRANSFERS FROM UNDERSERVED RURAL AREAS IN OKLAHOMA. THE ST. JOHN SYSTEM AND HOSPITAL WORKED TO IMPROVE ACCESS AS NEEDED FOR HEALTHCARE SERVICES IN SOLIDARITY WITH THOSE LIVING IN POVERTY AND/OR DEEMED OTHERWISE VULNERABLE THROUGH THE FOLLOWING ACTIVITIES: HEALTH INSURANCE COVERAGE: THE HOSPITAL AND ST. JOHN SYSTEM PROVIDE TREATMENT TO ALL PEOPLE WHO COME IN NEEDING ASSISTANCE, REGARDLESS OF THEIR ABILITY TO PAY. HOWEVER, ONCE IN THE DOOR, AN ASSOCIATE WILL WORK WITH EACH PATIENT TO SEE IF THEY QUALIFY FOR TRADITIONAL CHARITY CARE AND/OR A GOVERNMENT PROGRAM. IF THEY DO, THE PATIENT IS SIGNED UP STRONGLY ENCOURAGED TO FIND A MEDICAL HOME IF THEY DO NOT CURRENTLY HAVE ONE. IN ADDITION, LOCAL HOSPITAL, ST JOHN SYSTEM AND ASCENSION LEADERSHIP AND ADVOCACY, CONTINUE TO BE STRONG PROPONENTS FOR THE EXPANSION OF MEDICAID IN OKLAHOMA. AFFORDABLE HEALTH CARE, IN OUR CATHOLIC TRADITION, SHOULD BE A RIGHT GIVEN TO ALL, BUT ESPECIALLY FOR THOSE WHO ARE POOR AND VULNERABLE. THE HOSPITAL CONTINUES TO OFFER CHARITY CARE TO THE POOR, TAKES CARE OF THOSE WHO ARE RECIPIENTS OF MEDICAID AND MEDICARE KNOWING THAT THE GOVERNMENT WILL NOT BE PAYING THE FULL COST OF THAT CARE. - PRESCRIPTION ASSISTANCE: THE HOSPITAL SUPPORTS EFFORTS TO INCREASE THE PROPORTION OF PERSONS WHO CAN OBTAIN OR NOT DELAY IN OBTAINING NECESSARY PRESCRIPTION MEDICINES THROUGH THE DISPENSARY OF HOPE (DOH) PROGRAM. THE DOH CONNECTS SURPLUS MEDICATIONS FROM MANUFACTURERS, DISTRIBUTORS, AND PROVIDERS TO CLINICS AND PHARMACIES SERVING THE POOR AND UNINSURED. PHARMACY AND CLINIC PARTNERS PROVIDE DOH MEDICATIONS TO PATIENTS FREE OF CHARGE, TRACK AND SEGREGATE DOH INVENTORY, AND QUALIFY PATIENTS (LESS THAN OR EQUAL TO 200% OF THE FEDERAL POVERTY LEVEL). THE PROGRAM SERVES SAFETY NET CLINICS IN THE GREATER TULSA AREA INCLUDING THE GOOD SAMARITAN MOBILE HEALTH CLINICS. IN 2018, 19,000 THIRTY-DAY PRESCRIPTIONS ($223,000 WORTH) WERE FILLED FOR FREE CLINIC PARTNERS. THE DOH HAS DEMONSTRATED TO BE A POSITIVE FACTOR IN IMPROVING OUTCOMES OF UNINSURED PATIENTS WITH CHRONIC CONDITIONS AND HAS BEEN SHOWN TO DECREASE PREVENTABLE HOSPITAL ENCOUNTERS. IN ADDITION, THE HOSPITAL AND ST. JOHN SYSTEM CONTINUE TO LOOK FOR NEW WAYS TO PROCURE MEDICATION DISCOUNTS FOR ALL PATIENTS WHETHER THEY ARE BEING DISCHARGED FROM ONE OF OUR HOSPITALS OR ARE GETTING OUTPATIENT TREATMENT IN ONE OF OUR CLINICS. -TRANSPORTATION ASSISTANCE: REDUCTION IN BARRIERS TO ACCESSING TO HEALTHCARE SERVICES BY PROVIDING TRANSPORTATION ASSISTANCE TO COMMUNITY-DWELLING PERSONS SERVED BY ST. JOHN SYSTEM AND THE HOSPITAL WHO ARE LIVING IN POVERTY AND/OR ARE OTHERWISE DEEMED VULNERABLE. THROUGH AN AGREEMENT WITH MORTON COMPREHENSIVE COMMUNITY HEALTH CENTER (FQHC) FOR THEIR BUS SERVICES, ST. JOHN SYSTEM PROVIDES TRANSPORTATION TO THOSE IN NEED IN THE COMMUNITY WHO MEET SPECIFIC CRITERIA. IN FY18, 2,102 RIDES WERE PROVIDED AND OVER $165,000 WAS PROVIDED IN FUNDING FOR THIS INITIATIVE. AN AGREEMENT WITH LYFT WAS ALSO SECURED TO BEGIN PROVIDING ADDITIONAL TRANSPORTATION ASSISTANCE TO PATIENTS IN NEED. IN FY18, 2,006 RIDES WERE PROVIDED AND OVER $31,000 WAS PROVIDED IN FUNDING FOR LYFT ASSISTANCE. -INCREASING PRIMARY CARE ACCESS: THE ST. JOHN SYSTEM AND THE HOSPITAL WORKED TO INCREASE RECRUITMENT AND HIRING OF PROVIDERS TO IMPROVE ACCESS TO PRIMARY CARE AND SPECIALTY SERVICES IN THE COMMUNITIES SERVED. THIS STRATEGY INCLUDED THE EXPLORATION OF METHODS TO EXTEND HOURS AMONG ST. JOHN CLINIC PRIMARY CARE PROVIDERS AND ADOPT PLANS TO UTILIZE VARIOUS HOURS IN PRIMARY CARE CLINICS. MANY COMMUNITIES SERVED BY ST. JOHN SYSTEM AND THE HOSPITAL INCLUDE PARTIAL OR TOTAL IDENTIFIED HEALTHCARE SHORTAGE AREAS. IMPROVING ACCESS TO CARE THROUGH PROVIDER RECRUITMENT ADDRESSES THESE SHORTAGE AREAS, REDUCES HEALTH DISPARITIES, AND PROMOTES HEALTH EQUITY AMONG PERSONS DEEMED VULNERABLE. -SUPPORT OF MEDICAL EDUCATION: THE HOSPITAL AND THE ST. JOHN SYSTEM CONTINUE TO INVEST IN MEDICAL EDUCATION TO SUPPORT THE EXPANSION OF PHYSICIANS, NURSES AND ALLIED HEALTH PROFESSIONALS THAT WILL SERVE THE CURRENT AND FUTURE GENERATIONS OF PATIENTS IN THE SERVICE AREA. THE HOSPITALS PARTICIPATE IN ST. JOHN SYSTEM'S COORDINATED EFFORT TO ASSESS COMMUNITY NEED COLLABORATIVELY WITH OTHER INTERESTED PARTIES IN THE COMMUNITY AND TO ALLOCATE CAPITAL AND HUMAN RESOURCES TO ADDRESS THE NEEDS OF THE ENTIRE SERVICE AREA. -SUPPORT OF SEXUAL ASSAULT NURSE EXAMINER PROGRAM: THE HOSPITAL AND JANE PHILLLIPS MEMORIAL MEDICAL CENTER, INC. PROVIDED $10,000 IN COMMUNITY BENEFIT SUPPORT TO THE SAFE-NOW, SEXUAL ASSAULT NURSE EXAMINER (SANE) PROGRAM IN FY18. THIS AGENCY PROVIDES SEXUAL ASSAULT EXAMS AND SUPPORT SERVICES TO VICTIMS OF SEXUAL ASSAULT IN NOWATA, OSAGE, AND WASHINGTON COUNTIES IN OKLAHOMA AS WELL AS TO THE RAY OF HOPE CHILD ADVOCACY CENTER. -HUMAN TRAFFICKING PREVENTION/EDUCATION: HUMAN TRAFFICKING IS THE FASTEST-GROWING CRIMINAL INDUSTRY IN THE WORLD TODAY. TRAFFICKERS USE FORCE, FRAUD OR COERCION TO ENSLAVE THEIR VICTIMS INTO SITUATIONS INVOLVING SEXUAL EXPLOITATION OR FORCED LABOR. DURING FY18, THIS HOSPITAL AND THE ST. JOHN SYSTEM WORKED TO DEVELOP A LOCAL PROGRAM BASED ON A NATIONAL MODEL FOR ASCENSION HEALTH TO ADDRESS HUMAN TRAFFICKING. THIS LOCAL HUMAN TRAFFICKING EDUCATION AND RESPONSE PROGRAM WILL SERVE TRAIN ALL ASSOCIATES ON INTERNAL PROTOCOL FOR IDENTIFYING AND RESPONDING TO THE NEEDS OF HUMAN TRAFFICKING VICTIMS AND SURVIVORS IN A TRAUMA-INFORMED MANNER, INCLUDING ASSISTANCE WITH REFERRALS TO RESOURCES AS NEEDED. THE HOSPITAL AND ST. JOHN SYSTEM WORKED TO ENGAGE LAW ENFORCEMENT, SOCIAL SERVICE AGENCIES, AND OTHER ORGANIZATIONS TO COLLABORATE ON EFFORTS TO SPREAD AWARENESS AND COMBAT HUMAN TRAFFICKING IN OUR COMMUNITY. TRAINING OF KEY ASSOCIATES WAS PILOTED IN FY18 EARLY FY19 WITH PLANS FOR ROLL-OUT OF EDUCATION TO ALL ASSOCIATES LATER IN FY19. Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - Jane Phillips Nowata Hospital, Inc.. 2) BEHAVIORAL HEALTH: ST. JOHN SYSTEM AND THE HOSPITAL ARE ADDRESSING BEHAVIORAL HEALTH THROUGH EFFORTS TO IMPROVE ACCESS TO BEHAVIORAL HEALTH SERVICES TO PROMOTE A REDUCTION OF SUICIDE RATES IN TULSA COUNTY AND SURROUNDING AREAS THROUGHOUT THE FOLLOWING ACTIVITIES: - PROMOTION OF ACCESS TO BEHAVIORAL HEALTH SERVICES FOR AT-RISK POPULATIONS THROUGH EARLY IDENTIFICATION AND INTERVENTION VIA AN INTEGRATED MODEL OF BEHAVIORAL HEALTH IN PRIMARY CARE: THIS WAS ACCOMPLISHED THROUGH THE IMPLEMENTATION OF CLINIC-WIDE PHQ9 DEPRESSION SCREENINGS, FULL SUICIDE RISK ASSESSMENTS FOR HIGH/POSITIVE SCORES ON PHQ9 DEPRESSION SCREENINGS, AND EXPANSION OF THE NUMBER OF BEHAVIORAL HEALTH THERAPISTS EMBEDDED IN CLINICS. - INCREASED ACCESS TO BEHAVIORAL HEALTH SERVICES FOR COMMUNITY-DWELLING PERSONS IN NEED OF OUTPATIENT PSYCHIATRY SERVICES IN WASHINGTON COUNTY: THIS WAS ACHIEVED THROUGH THE ADDITION OF AN APRN TO THE OUTPATIENT PSYCHIATRIC CLINIC AT JANE PHILLIPS MEMORIAL MEDICAL CENTER, INC. - PROMOTION OF ADDITIONAL CAPACITY FOR HUMANIZED BEHAVIORAL HEALTH CRISIS AND ACUTE CARE THROUGH INCREASED ACCESS TO BEHAVIORAL HEALTH PROFESSIONALS AND SERVICES AS WELL AS INCREASED ASSESSMENT AND RECOGNITION OF SUICIDE RISKS AT THE COMMUNITY LEVEL: THIS INCLUDED COLLABORATION WITH THE CITY OF TULSA, TULSA FIRE DEPARTMENT, THE MENTAL HEALTH ASSOCIATION OF OKLAHOMA, AND OTHER COMMUNITY PARTNERS ON A MULTIDISCIPLINARY EMERGENCY RESPONSE SYSTEM THAT FOCUSES ON DE-ESCALATING MENTAL HEALTH CRISES OF INDIVIDUALS WHO FREQUENTLY USE HOSPITAL EMERGENCY DEPARTMENTS AND REDIRECTS THEM TO IMMEDIATE BEHAVIORAL HEALTH SERVICES. ADDITIONALLY, THIS INCLUDED SUICIDE RISK ASSESSMENT TRAINING FOR ASSOCIATES AND COMMUNITY MEMBERS AND THE IMPLEMENTATION OF A SYSTEMATIC APPROACH IN HEALTH SYSTEM TO SUPPORT EFFORTS TO HUMANIZE CRISIS AND ACUTE CARE AT A COMMUNITY LEVEL. Schedule H, Part V, Section B, Line 11 Facility , 3 Facility , 3 - Jane Phillips Nowata Hospital, Inc.. 3) WELLNESS AND CHRONIC DISEASE PREVENTION: ST. JOHN SYSTEM AND THE HOSPITAL ADDRESSED WELLNESS AND CHRONIC DISEASE PREVENTION THROUGH THE FOLLOWING ACTIVITIES: - EFFORTS TO IMPROVE HEALTH OUTCOMES FOR INDIVIDUALS WHO ARE IN A PRE-CONDITION STATE OR WHO HAVE BEEN DIAGNOSED WITH A CHRONIC DISEASE: THE ST. JOHN SYSTEM AND HOSPITAL HAVE WORKED TO PROMOTE HEALTHY DIET, PHYSICAL ACTIVITY, AND PREVENTION-ORIENTED WELLNESS THROUGH HEALTH SYSTEM SUPPORT OF COMMUNITY-BASED INITIATIVES IN PARTNERSHIP WITH LOCAL HEALTH DEPARTMENTS, COALITIONS, COMMUNITY-BASED ORGANIZATIONS, AND SCHOOLS; PARTICIPATION IN LOCAL ACTIVITIES, EDUCATION CLASSES, LUNCH AND LEARNS, EVENTS, AND HEALTH FAIRS; AND CHRONIC DISEASE MANAGEMENT SUPPORT. -HEALTH AND WELLNESS PROMOTION/EDUCATION: THE ST. JOHN HEALTH SYSTEM AND ITS HOSPITALS SPONSORED AND PARTICIPATED OVER 100 COMMUNITY EVENTS AND WELLNESS ACTIVITIES THROUGHOUT THE FY 2018. HOSPITAL ASSOCIATES PROMOTED HEALTH AND WELLNESS THROUGH HEALTH SCREENINGS AND PUBLIC EDUCATION AT THESE EVENTS. THE HEALTH SYSTEM AND HOSPITAL ALSO HOSTED A MULTITUDE OF PUBLIC HEALTH EDUCATION SEMINARS, CLASSES, LUNCH AND LEARNS, AND SYMPOSIUMS ON A VARIETY OF WELLNESS TOPICS INCLUDING, BUT NOT LIMITED TO: DIABETES, HEART HEALTH, STROKE, SAFETY AND PREVENTION, TRAUMA, MATERNAL AND CHILD HEALTH, JOINT CARE, CANCER CARE, HEALTHY DIET AND NUTRITION, AND THE PROMOTION OF PHYSICAL ACTIVITY. THE HOSPITAL ANNUALLY HOSTS ON-SITE BLOOD DRIVES IN SUPPORT OF THE AMERICAN RED CROSS. THE ST. JOHN SYSTEM AND THE HOSPITAL SPONSORED AND PARTICIPATED IN SEVERAL LOCAL HEALTH PROMOTION WALKS AND RUNS DURING FY 18 INCLUDING, BUT NOT LIMITED TO THE: AMERICAN CANCER SOCIETY'S RELAY FOR LIFE EVENTS, AMERICAN HEART AND AMERICAN STROKE ASSOCIATIONS' HEART WALK, SUSAN G. KOMEN'S RACE FOR THE CURE, PARKINSON'S FOUNDATION OF OKLAHOMA'S TULSA PARKINSON'S WALK & 5K, THE OKLAHOMA CHAPTER OF THE ALZHEIMER'S ASSOCIATION'S WALK TO END ALZHEIMER'S, THE COLON CANCER COALITION'S GET YOUR REAR IN GEAR TULSA EVENT, THE LEUKEMIA AND LYMPHOMA SOCIETY'S LIGHT THE NIGHT WALK, THE ST. JOHN ZOO RUN, MARCH OF DIMES' MARCH FOR BABIES, PATHWAYS TO HEALTH TOUR DE TULSA, AMERICAN DIABETES ASSOCIATION'S TOUR DE CURE, AND THE ARTHRITIS FOUNDATION'S JINGLE BELL RUN. - PARTICIPATION IN COMMUNITY COALITION TO PROMOTE HEALTH AND WELLNESS: THE HOSPITAL ACTIVELY PARTICIPATES IN THE COMMUNITY-WIDE COALITION, THE NOWATA COMMUNITY ADVANCEMENT NETWORK (NOWATA CAN). NOWATA CAN IS A COALITION OF INDIVIDUALS AND GROUPS DEDICATED TO IMPROVING THE OVERALL HEALTH OF THE CITIZENS OF NOWATA COUNTY. NOWATA CAN AND PARTNERS WORK TO SUPPORTING OUR COMMUNITY BY PROVIDING EDUCATION THE PREVENTION OF DISEASE AND DRUG ABUSE AND IMPROVING THE HEALTH AND WELL-BEING OF RESIDENTS THROUGH HEALTHY LIFESTYLE CHOICES. THE HOSPITAL SPONSORS NOWATA CAN'S "DOUBLE BUCKS" AND "VEGGIE VOUCHERS" PROGRAMS IN CONJUNCTION WITH THE NOWATA AREA FARMERS MARKET EACH SPRING. 4) HEALTH LITERACY: THE ST. JOHN SYSTEM AND HOSPITAL ARE ADDRESSING HEALTH LITERACY TO THE HELP PERSONS OF DIVERSE BACKGROUNDS NAVIGATE HEALTH SERVICES AND GAIN EMPOWERMENT IN TAKING CHARGE OF THEIR OWN HEALTH THROUGH THE FOLLOWING ACTIVITIES: -EARLY CHILDHOOD LITERACY/HEALTH LITERACY PROMOTION: ST. JOHN SYSTEM, THE HOSPITAL, AND CLINICS HAVE PARTNERED WITH A NATIONAL NON-PROFIT ORGANIZATION, REACH OUT AND READ, TO INCORPORATE BOOKS WITH PEDIATRIC CARE. DURING ROUTINE PEDIATRIC VISITS, HEALTHCARE PROVIDERS GIVE BRAND-NEW BOOKS AND RESOURCES TO FAMILIES TO PROMOTE HEALTHY CHILDHOOD DEVELOPMENT. PROVIDERS ARE ABLE SEE HOW WHETHER CHILDREN INTERACT WITH THE BOOK ON A DEVELOPMENTALLY APPROPRIATE LEVEL AND DISCUSS WITH PARENTS FAMILIES THE IMPORTANCE OF INTERACTING AND READING WITH CHILDREN TO INCREASE LANGUAGE SKILLS, EMOTIONAL RESILIENCE, AND EARLY LITERACY. INTERACTIONS BETWEEN PARENTS OR CAREGIVERS AND CHILDREN RIGHT FROM INFANCY AND EARLY LITERACY ARE CRITICALLY IMPORTANT IN THE CHILD'S HEALTHY DEVELOPMENT. ACCORDINGLY, THE AMERICAN ACADEMY OF PEDIATRICS AND THE AMERICAN ACADEMY OF FAMILY PHYSICIANS HAVE DEVELOPED POLICIES RECOMMENDING EARLY CHILDHOOD LITERACY AS IMPORTANT HEALTHCARE INTERVENTIONS. THE ST. JOHN SYSTEM AND HOSPITAL DONATED $35,000 FOR NEARLY 5,000 BOOKS IN ENGLISH AND SPANISH AS PART OF ITS COMMUNITY BENEFIT EFFORTS IN FY18. Schedule H, Part V, Section B, Line 11 Facility , 4 Facility , 4 - Jane Phillips Nowata Hospital, Inc.. COMMUNITY ENGAGEMENT AND COMMUNITY BENEFIT SPONSORSHIPS: IN ADDITION TO THE ABOVE, THE ST. JOHN SYSTEM HAS ESTABLISHED A PROCESS FOR SUPPORTING COMMUNITY REQUESTS FOR SPONSORSHIPS THAT ALIGN WITH THE 4 PRIORITY COMMUNITY HEALTH NEEDS AS AFOREMENTIONED. EACH YEAR A BUDGET IS ESTABLISHED FOR THIS PURPOSE AND IS EXCEEDED THROUGH IDENTIFICATION OF ADDITIONAL COMMUNITY REQUESTS. A COMMUNITY ENGAGEMENT COMMITTEE CONSISTING OF KEY ST. JOHN SYSTEM LEADERSHIP HAS BEEN ESTABLISHED TO IMPROVE THE COORDINATION, PROCESS, AND TRACKING FOR THIS CATEGORY OF COMMUNITY BENEFIT SPEND. IN FY 18, A TOTAL OF $182,403 WAS PROVIDED TO SUPPORT ACTIVITIES LED COMMUNITY-BASED ORGANIZATIONS TO ADDRESS THE 4 PRIORITY COMMUNITY HEALTH NEEDS. THE ST. JOHN SYSTEM DONATED COMMUNITY BENEFIT FUNDING/SPONSORED ACTIVITIES LED BY THE FOLLOWING ORGANIZATIONS IN FY18: TULSA DAY CENTER FOR THE HOMELESS, GOOD SAMARITAN HEALTH SERVICES, TULSA CHARITY FLIGHT NIGHT INC., CREEK COUNTY COMMUNITY PARTNERSHIP, WASHINGTON-NOWATA COUNTY SANE, PREGNANCY RESOURCE CENTER OF OWASSO, ARTHRITIS FOUNDATION, CLAREHOUSE INC., TULSA ZOO MANAGEMENT INC., REACH OUT AND READ, INC., TULSA AFFILIATE - SUSAN G. KOMEN BREAST CANCER FOUNDATION, BISHOP KELLEY HIGH SCHOOL, UNIVERSITY OF TULSA, TRI COUNTY TECH ENDOWMENT FUND INC., ALZHEIMERS ASSOCIATION, SUSAN G. KOMEN, PATHWAYS TO HEALTH COMMUNITY PARTNERSHIP, KENDALL WHITTIER MAIN STREET, INC., OKLAHOMA CENTER FOR COMMUNITY AND JUSTICE, AMERICAN CANCER SOCIETY INC., THE PARENT CHILD CENTER OF TULSA, INC., COMMUNITY HEALTH CONNECTION, INC., CHILD ABUSE NETWORK, INC., MENTAL HEALTH ASSOCIATION OKLAHOMA, HIV RESOURCE CONSORTIUM INC./TULSA CARES, TULSA COUNTY MEDICAL SOCIETY FOUNDATION, THE FOUNDATION FOR TULSA SCHOOLS, CARING COMMUNITY FRIENDS INC., AMERICAN HEART ASSOCIATION, OPERATION AWARE OF OKLAHOMA, DOMESTIC VIOLENCE INTERVENTION SERVICES INC., JUVENILE DIABETES RESEARCH (JDRF), COMMUNITY FOOD BANK OF EASTERN OKLAHOMA, COLON CANCER COALITION, AMERICAN DIABETES ASSOCIATION, MUSCULAR DYSTROPHY ASSOCIATION, TULSA HUB, SAND SPRINGS COMMUNITY SERVICES INC., TULSA DREAM CENTER, INC., BRADY CRAFT INC./108 CONTEMPORARY, ABILITY RESOURCES, INC., GOODWILL INDUSTRIES OF TULSA, HOSPITALITY HOUSE OF TULSA, JOY IN THE CAUSE COMPANY, RETIRED SENIOR VOLUNTEER PROGRAM OF TULSA, PARKINSON FOUNDATION OF OKLAHOMA, LIFESHARE FOUNDATION, PORTA CAELI HOUSE CORPORATION, AND RIVER PARKS AUTHORITY FOUNDATION. NEEDS NOT ADDRESSED: THE COMMUNITY HEALTH NEEDS ASSESSMENT COMPLETED BY JUNE 30, 2016, INEVITABLY IDENTIFIED MORE SIGNIFICANT HEALTH NEEDS THAN THE HOSPITAL, ST. JOHN SYSTEM, AND COMMUNITY PARTNERS CAN OR SHOULD ADDRESS AS PRIORITY HEALTH NEEDS. IT WOULD NOT BE PRUDENT TO SPREAD HOSPITAL AND COMMUNITY RESOURCES ACROSS TOO MANY INITIATIVES. ACCORDINGLY, THE HOSPITAL, ST. JOHN SYSTEM, AND COMMUNITY PARTNERS INSTEAD DECIDED TO FOCUS ATTENTION ON PRIORITY AREAS TO HELP ENSURE SUFFICIENT RESOURCES ARE AVAILABLE. SOME REASONS FOR NOT ADDRESSING CERTAIN NEEDS INCLUDE: 1) NEED BEING ADDRESSED BY OTHERS 2) INSUFFICIENT RESOURCES (FINANCIAL AND PERSONNEL) TO ADDRESS THE NEED 3) ISSUE IS NOT A PRIORITY FOR COMMUNITY MEMBERS AND THEREFORE APPROACH IS UNLIKELY TO SUCCEED 4) LACK OF EVIDENCE-BASED APPROACH FOR ADDRESSING THE PROBLEM 5) NEED IS NOT AS PRESSING AS OTHER PROBLEMS 6) NEED IS NOT AS LIKELY TO BE RESOLVED AS OTHER PROBLEMS 7) HOSPITAL AND/OR HEALTH SYSTEM DOES NOT HAVE EXPERTISE TO EFFECTIVELY ADDRESS THE NEED THE FOLLOWING SIGNIFICANT HEALTH NEED WAS IDENTIFIED, BUT WILL NOT BE ADDRESSED DIRECTLY BY THE HOSPITAL AND ST. JOHN SYSTEM AS A PRIORITY HEALTH NEED: - TOBACCO USE AND CESSATION: THE COMMUNITY IDENTIFIED THIS NEED AS ONE THAT WAS ALREADY BEING SUFFICIENTLY ADDRESSED AT THE TIME AND DID NOT FEEL ISSUE WAS AS PRESSING OTHER NEEDS IDENTIFIED (THIS WAS A CHANGE IN PERSPECTIVE FROM OUR PREVIOUS COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS IN 2013 WHEN THE NEED WAS IDENTIFIED AS A PRIORITY NEED). IT IS IMPORTANT THAT NOTE THAT, ALTHOUGH NOT A PRIORITY HEALTH NEED FOR THE PURPOSES OF THIS PROCESS, THE HOSPITAL AND ST. JOHN SYSTEM WILL CONTINUE EXISTING ACTIVITIES REGARDING TOBACCO USE AND CESSATION. WHILE NOT NECESSARILY NOTED AS ONE OF OUR FOUR PRIORITY HEALTH NEEDS, THE REMAINDER OF SIGNIFICANT COMMUNITY HEALTH NEEDS IDENTIFIED WERE CLOSELY INTER-RELATED WITH THE PRIORITY NEEDS. SO, WHILE, THEY MAY NOT BE EXPLICITLY LISTED AS A PRIORITY HEALTH NEED, THE HOSPITAL AND ST. JOHN SYSTEM DO FEEL CONFIDENT THAT THE NEEDS ARE BEING ADDRESSED BY ADDRESSING THE FOUR SELECTED PRIORITY HEALTH NEEDS. Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - Jane Phillips Nowata Hospital, Inc.. SIGNS ARE POSTED IN WAITING ROOMS AND AT THE ADMISSIONS OFFICES TO NOTIFY PATIENTS THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY. IN ADDITION, EVERY BILLING STATEMENT, THE HOSPITAL'S WEBSITE, AND ADMISSION PACKETS INCLUDE INFORMATION REGARDING THE FINANCIAL ASSISTANCE POLICY. THE POLICY IS PROVIDED AT THE REQUEST OF THE PATIENT. 0 Schedule H, Part VI, Line 5 Promotion of Community Health: Part B PART B (CONTINUED FROM PART A): THE "MEDICAL ACCESS PROGRAM" ("MAP"): CONSISTENT WITH OUR MISSION AND VALUES, THE ST. JOHN SYSTEM HAS CREATED PROGRAMS TO SEEK OUT BETTER WAYS TO SERVE THE UNINSURED AND VULNERABLE. THE ST. JOHN SYSTEM AND HOSPITAL HAVE CONTINUED WORK ON AN OUTREACH PROJECT TO IMPROVE ACCESS TO MEDICAL CARE TO THE POOR THAT IS REFERRED TO AS THE "MEDICAL ACCESS PROGRAM" ("MAP"). SUPPORTED IN PART BY FUNDING FROM THE CHAPMAN TRUSTS (A COLLECTION OF PRIVATE TRUSTS OF WHICH THE MEDICAL CENTER IS ONE OF THE BENEFICIARIES), THE PROGRAM IS A COMPREHENSIVE EFFORT TO PROVIDE INCREASED ACCESS TO MEDICAL SERVICES ACROSS A BROAD CONTINUUM OF CARE TO THE POOR AND DISADVANTAGED IN THE TULSA METROPOLITAN AREA. THE PROGRAM IS A COLLABORATIVE EFFORT LED BY THE MEDICAL CENTER THAT INCLUDES FINANCIAL SUPPORT FOR NEW AND EXISTING COMMUNITY OUTREACH ACTIVITIES. KEY ELEMENTS OF THE PROGRAM INCLUDE: - EXPANDED ACCESS TO FREE PRIMARY CARE CLINIC VISITS PROVIDED PRIMARILY THROUGH DIRECT FUNDING TO THE UNIVERSITY OF OKLAHOMA'S FREE CLINICS AND GOOD SAMARITAN MOBILE CLINICS. - INCLUDING THE ABOVE TWO FREE ACCESS POINTS TO PRIMARY CARE, THE MAP PROGRAM SUPPORTS A TOTAL OF 8 FREE AND 2 SLIDING SCALE CLINICS THROUGH THE "VOUCHER" PROGRAM, WHICH PROVIDES PATIENTS OF THE PRIMARY CARE PROVIDERS FREE ACCESS TO: - DIAGNOSTIC AND SPECIALTY TESTING; - DIAGNOSTIC IMAGING SERVICES, INCLUDING BASIC X-RAY, CT, ULTRASOUND AND MRI; - 23 SPECIALTY MEDICAL SERVICES AVAILABLE THRU ST. JOHN EMPLOYED PROVIDERS, UNIVERSITY OF OKLAHOMA PROVIDERS, AND OTHER SPECIALTY MEDICAL SERVICE PROVIDERS IN THE COMMUNITY; - THE DELIVERY OF SPECIALIZED CARE IN BOTH AN OUTPATIENT AND INPATIENT SETTING; I.E., ALL EXPENSES RELATING TO THAT EPISODE OF CARE IS FREE TO THE PATIENT: THE SPECIALIST FEE, FACILITY CHARGES, LAB, RADIOLOGY, ANESTHESIOLOGY; UNTIL THE PATIENT IS DISCHARGED FROM THE SPECIALIST BACK TO THE PATIENT'S PRIMARY CARE PROVIDER AT THEIR MEDICAL HOME; -EXPANSION OF ACCESS TO FREE PRESCRIPTIONS AND OTHER MEDICATIONS IN COLLABORATION WITH THE DISPENSARY OF HOPE (DOH) PHARMACY OPERATED BY ST. JOHN MEDICAL CENTER. IT IS HOPED THAT MAP CAN CONTINUE TO GROW AND SERVE AS A MODEL FOR COLLABORATION AND OUTREACH THAN CANNOT ONLY BE USED TO PROVIDE MORE EFFECTIVE HEALTH CARE IN TULSA TO ITS MOST NEEDY CITIZENS, BUT ALSO SERVE AS A MODEL FOR OTHER COMMUNITIES. ST. JOHN HOSPITALS ALSO PARTICIPATED IN A PROGRAM SPONSORED BY THE TULSA MEDICAL SOCIETY TO PROVIDE FREE SURGICAL SERVICES TO CERTAIN PATIENTS. SUPPORT FOR MEDICAL EDUCATION: THE HOSPITALS CONTINUE TO INVEST IN MEDICAL EDUCATION TO SUPPORT THE EXPANSION OF PHYSICIANS, NURSES AND ALLIED HEALTH PROFESSIONALS THAT WILL SERVE THE CURRENT AND FUTURE GENERATIONS OF PATIENTS IN THE SERVICE AREA. THE HOSPITALS PARTICIPATE IN ST. JOHN SYSTEM'S COORDINATED EFFORT TO ASSESS COMMUNITY NEED COLLABORATIVELY WITH OTHER INTERESTED PARTIES IN THE COMMUNITY AND TO ALLOCATE CAPITAL AND HUMAN RESOURCES TO ADDRESS THE NEEDS OF THE ENTIRE SERVICE AREA. OTHER PROMOTION OF COMMUNITY HEALTH: EACH ST. JOHN SYSTEM HOSPITAL PROVIDES SUBSIDIZED VITAL EMERGENCY SERVICES IN ITS COMMUNITY. THE ST. JOHN SYSTEM IS ATTEMPTING TO PROMOTE COMMUNITY HEALTH IN SEVERAL ADDITIONAL WAYS. MOST OF THE AFFILIATED PRIMARY CARE PHYSICIANS HAVE OR ARE ESTABLISHING ADVANCED PRIMARY CARE MODELS OF CARE THAT ARE ATTEMPTING TO IMPROVE HEALTH STATUS OF THEIR PATIENTS BY BETTER EMPHASIZING PREVENTIVE CARE AND HEALTH SCREENING AND BY BETTER MANAGEMENT OF CHRONIC DISEASE. THIS INCLUDES PARTICIPATION IN THE MEDICARE COMPREHENSIVE PRIMARY CARE PLUS MODEL AND OKLAHOMA'S FIRST MEDICARE SHARED SAVINGS PROGRAM ACCOUNTABLE CARE ORGANIZATION (ACO). THE AFFILIATED PRIMARY CARE PHYSICIANS UTILIZE A SOPHISTICATED ELECTRONIC MEDICAL RECORD THAT HELPS PROVIDE REAL TIME INFORMATION TO MAKE IT EASIER TO MANAGE PATIENTS' CARE. THE HOSPITALS AND THE OTHER HOSPITALS IN THE SYSTEM HAVE INVESTED HEAVILY IN CLINICAL INFORMATION SYSTEMS AND ELECTRONIC MEDICAL RECORDS AS TO BETTER MANAGE PATIENT CARE DURING EACH EPISODE OF ACUTE CARE. THE ST. JOHN SYSTEM SUPPORTS AND PARTICIPATES IN A REGIONAL HEALTH INFORMATION EXCHANGE WHICH FURTHER PROMOTES THE EXCHANGE OF HEALTH DATA IN AN EFFORT TO IMPROVE QUALITY AND REDUCE COST OF CARE FOR THE COMMUNITY. ST. JOHN IS INVESTING IN NEW SYSTEMS OF CARE TO PROVIDE BETTER COORDINATION OF CARE BETWEEN ALL THE DIFFERENT PROVIDERS RESPONSIBLE FOR PORTIONS OF EACH PATIENT'S CARE WITH AN EMPHASIS ON PREVENTION, SCREENING AND COORDINATION OF CHRONIC CARE. THE HOSPITALS AND THE ST. JOHN HEALTH SYSTEM HAVE INVESTED IN TERTIARY SERVICES THAT ARE NEEDED BY THE COMMUNITY. EXAMPLES OF WHICH INCLUDE DEVELOPMENT OF OKLAHOMA'S ONLY ACS LEVEL II TRAUMA CENTER (THE HIGHEST ACCREDITED CENTER IN TULSA), NORTHEASTERN OKLAHOMA'S ONLY JOINT COMMISSION ACCREDITED STROKE CENTER, NEONATAL INTENSIVE CARE, SOPHISTICATED MEDICAL TECHNOLOGY INCLUDING ALL-DIGITAL DIAGNOSTIC RADIOLOGY, CYBERKNIFE, AND OTHER FORMS OF RADIATION THERAPY, A KIDNEY TRANSPLANT CENTER, DAVINCI ROBOTIC SURGERY, AN ENDOVASCULAR OPERATING SUITE, ORTHOPEDIC AND NEUROSURGICAL CENTERS OF EXCELLENCE, SOPHISTICATED CARDIOVASCULAR CARE THAT EMPHASIZES RAPID AND EFFECTIVE INTERVENTION FOR HEART ATTACK VICTIMS AND PREVENTIVE CARE FOR THOSE WITH CHRONIC HEART CONDITIONS. THE ST. JOHN SYSTEM IS ALSO ACCREDITED AS A PARTICIPANT IN THE MD ANDERSON CANCER NETWORK BRINGING EXPERTISE IN SUB-SPECIALTY CANCER CARE TO RESIDENTS OF OUR COMMUNITY. THE HOSPITALS HAVE AN OPEN MEDICAL STAFF AND HAVE COMMUNITY, RELIGIOUS AND PHYSICIAN REPRESENTATIVES SERVING ON ITS BOARD. THE MEDICARE SHARED SAVINGS PROGRAM ACCOUNTABLE CARE ORGANIZATION INCLUDES COMMUNITY REPRESENTATIVES ON THE BOARD AND A HEALTH DEPARTMENT REPRESENTATIVE ON AN ACTIVE COMMITTEE. THE ST. JOHN SYSTEM HAS CREATED AND IS CONTINUING TO CREATE SYSTEMS AND POLICIES TO PROMOTE BETTER COORDINATION OF CARE AND ALLOCATION OF RESOURCES THROUGHOUT THE SYSTEM. THE HOSPITALS PARTICIPATE IN MANY COMMUNITY-WIDE HEALTH SCREENING AND HEALTH EDUCATION EVENTS AS WELL AS HOSTING MANY SUCH EVENTS THAT ARE OPEN TO THE PUBLIC. DURING THIS FISCAL YEAR, THE ORGANIZATION PARTICIPATED IN OVER 100 DOCUMENTED EVENTS SYSTEM-WIDE. THE THOUSANDS OF ASSOCIATES, PHYSICIANS AND VOLUNTEERS THAT MAKE UP ST. JOHN HEALTH SYSTEM, INC. TOUCH THE LIVES OF THOUSANDS OF PATIENTS EVERY DAY AND MILLIONS OF PATIENTS EVERY YEAR. AS WE SEEK TO TRANSFORM HEALTH CARE IN OKLAHOMA AND THE U.S., ST. JOHN IS CHALLENGED BY MANY FACTORS INCLUDING: LACK OF PUBLIC RESOURCES IN OKLAHOMA THAT ARE DEVOTED TO BOTH CARE FOR THE POOR; REDUCTIONS IN REIMBURSEMENT DUE TO A STRUGGLING OIL INDUSTRY; HEALTH CARE INFRASTRUCTURE, AND MEDICAL EDUCATION; COMPETITION FROM INVESTOR-OWNED HEALTH CARE FACILITIES THAT DO NOT SHARE ST. JOHN'S MISSION OF SERVICE AND EMPHASIS ON SERVICE TO THE POOR AND POWERLESS BUT WHICH SEEK TO GAIN MARKET SHARE IN COMMERCIALLY INSURED PATIENTS; POOR ECONOMIC AND HEALTH CARE DEMOGRAPHIC FACTORS CONTRIBUTING TO GENERALLY POOR HEALTH STATUS AND HIGH RATES OF POVERTY AND UNINSURED IN OKLAHOMA; AND THE CHALLENGE OF TRANSITION TO PAYMENT FOR VALUE. FINALLY, AS ONE OF ONLY TWO MAJOR TAX-EXEMPT HEALTH SYSTEMS IN OUR SERVICE AREA, THE ST. JOHN SYSTEM REINVESTS PROFITS GENERATED INTO NEW OR EXPANDED SERVICES FOR THE COMMUNITY. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The cost of providing charity care, means-tested government programs, and other community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a cost accounting system that addresses all patient segments (for example, inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table. For the information in the table, a cost-to-charge ratio was calculated and applied. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Corporation follows established guidelines for placing certain past-due patient balances within collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Corporation's policies. After applying the cost-to-charge ratio, the share of the bad debt expense in fiscal year 2018 was $412,235 at charges, ($243,219 at cost). Schedule H, Part III, Line 3 Bad Debt Expense Methodology The provision for doubtful accounts is based upon management's assessment of expected net collections considering historical experience, economic conditions, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote The organization is part of the Ascension Health Alliance's consolidated audit in which the footnote that discusses the bad debt expense is located on page 21. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs A cost to charge ratio is applied to the organization's Medicare Expense to determine the Medicare allowable costs reported in the organization's Medicare Cost Report. Ascension Health and its related health ministries follow the Catholic Health Association (CHA) guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance The organization has a written debt collection policy that also includes a provision on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance. If a patient qualifies for charity or financial assistance certain collection practices do not apply and the financial assistance program is followed. Schedule H, Part V, Section B, Line 16a FAP website - Jane Phillips Nowata Health Center: Line 16a URL: www.stjohnhealthsystem.com/about/payment-for-services; Schedule H, Part V, Section B, Line 16b FAP Application website - Jane Phillips Nowata Health Center: Line 16b URL: www.stjohnhealthsystem.com/about/payment-for-services; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - Jane Phillips Nowata Health Center: Line 16c URL: www.stjohnhealthsystem.com/about/payment-for-services; Schedule H, Part VI, Line 2 Needs assessment FOLLOWING THE 2016 CHNA, THE ST. JOHN SYSTEM AND HOSPITAL HAVE CONTINUED DIALOGUE WITH THE COMMUNITY AND PARTICIPATE IN ADDITIONAL ONGOING COMMUNITY-BASED NEEDS ASSESSMENTS. THE ST. JOHN SYSTEM AND THE HOSPITAL ACTIVELY PARTICIPATE IN THE COMMUNITY-WIDE COALITION, THE NOWATA COMMUNITY ADVANCEMENT NETWORK (NOWATA CAN). NOWATA CAN IS A COALITION OF INDIVIDUALS AND GROUPS DEDICATED TO IMPROVING THE OVERALL HEALTH OF THE CITIZENS OF NOWATA COUNTY. NOWATA CAN AND PARTNERS WORK TO SUPPORTING OUR COMMUNITY BY PROVIDING EDUCATION THE PREVENTION OF DISEASE AND DRUG ABUSE AND IMPROVING THE HEALTH AND WELL-BEING OF RESIDENTS THROUGH HEALTHY LIFESTYLE CHOICES. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance THE ST. JOHN SYSTEM IS COMMITTED TO DELIVERING EFFECTIVE, SAFE, PERSON-CENTRIC, HEALTH CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A NONPROFIT HOSPITAL (OR HEALTH SYSTEM), IT IS OUR MISSION AND PRIVILEGE TO PLAY THIS IMPORTANT ROLE IN OUR COMMUNITY. STAFF SCREEN UNINSURED PATIENTS AND IF FOUND POTENTIALLY ELIGIBLE FOR A GOVERNMENT FUNDING SOURCE, PROVIDE ASSISTANCE AND/OR RESOURCES TO THE PATIENT AND THEIR FAMILY. IF A PATIENT IS NOT ELIGIBLE FOR A PAYMENT SOURCE, THE ST. JOHN SYSTEM'S FINANCIAL ASSISTANCE POLICY COVERS PATIENTS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR ALL OR PART OF THEIR BILLS. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED UPON THE ANNUAL FEDERAL POVERTY GUIDELINES; THE ST. JOHN SYSTEM PROVIDES FINANCIAL ASSISTANCE FOR THOSE WHO EARN UP TO 400% OF THE FEDERAL POVERTY LEVEL. THE ST. JOHN SYSTEM WIDELY PUBLICIZES ITS: - FINANCIAL ASSISTANCE POLICY - FINANCIAL ASSISTANCE APPLICATION - FINANCIAL ASSISTANCE POLICY SUMMARY - LIST OF PROVIDERS COVERED BY THE FINANCIAL ASSISTANCE POLICY VIA THE HOSPITAL FACILITY'S WEBSITE - https://www.stjohnhealthsystem.com/about/payment-for-services THE ST. JOHN SYSTEM MAKES PAPER COPIES OF THE: - FINANCIAL ASSISTANCE POLICY - FINANCIAL ASSISTANCE APPLICATION - FINANCIAL ASSISTANCE POLICY SUMMARY - LIST OF PROVIDERS COVERED BY THE FINANCIAL ASSISTANCE POLICY - AMOUNT GENERALLY BILLED CALCULATION. THE PAPER COPIES ARE MADE READILY AVAILABLE AS PART OF THE INTAKE, DISCHARGE AND CUSTOMER SERVICE PROCESSES. UPON REQUEST, PAPER COPIES CAN ALSO BE OBTAINED BY MAIL. THE ST. JOHN SYSTEM INFORMS ITS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY VIA A NOTICE ON PATIENT BILLING STATEMENTS, INCLUDING THE PHONE NUMBER AND WEB ADDRESS WHERE MORE INFORMATION MAY BE FOUND. THE ST. JOHN SYSTEM INFORMS ITS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY VIA SIGNAGE DISPLAYED IN THE EMERGENCY ROOM AND ADMISSIONS AREAS. Schedule H, Part VI, Line 4 Community information AS DESCRIBED ABOVE, THE HOSPITAL IS PART OF ST. JOHN HEALTH SYSTEM, INC. ("ST. JOHN SYSTEM"). ALTHOUGH THE ST. JOHN SYSTEM PROVIDES A FULL SPECTRUM OF HEALTH-RELATED SERVICES THROUGHOUT EASTERN OKLAHOMA AND SOUTHEASTERN KANSAS, ITS TERTIARY OPERATIONS AND A LARGE PART OF ITS OTHER SERVICES ARE CONCENTRATED IN THE TULSA METROPOLITAN STATISTICAL AREA (THE "TULSA MSA"). ACCORDING TO THE 2010 CENSUS, THE STATE OF OKLAHOMA HAD A RESIDENT POPULATION OF 3,751,351 PERSONS COMPARED TO 3,450,654 PERSONS IN 2000. THIS IS AN 8.7% INCREASE. IT HAD AN ESTIMATED RESIDENT POPULATION OF 3,923,561 PERSONS IN 2016; 4.6% INCREASE FROM 2010. THE U.S. CENSUS BUREAU ESTIMATED THAT IN 2009 13.5% OF THE OKLAHOMA RESIDENT POPULATION WAS ELIGIBLE FOR MEDICARE, COMPARED TO 14.7% IN 2000 (17% IN 2015). TULSA COUNTY, OKLAHOMA AND THE COUNTIES THAT MAKE UP THE TULSA MSA, ACCORDING TO THE 2010 CENSUS, HAD POPULATIONS OF 603,403 AND 1,008,460, RESPECTIVELY. THIS COMPARES TO POPULATIONS OF 563,299 AND 803,235 PERSONS, RESPECTIVELY IN 2000 AND REPRESENTS POPULATION GROWTH OF 7.1% AND 25.5%, RESPECTIVELY. NOWATA COUNTY, SERVED BY JANE PHILLIPS NOWATA HOSPITAL, INC. HAD A POPULATION OF 10,536 IN 2010. THE 2010 COMBINED POPULATION OF PRIMARY SERVED BY THE ST. JOHN SYSTEM, INC. COUNTIES (WASHINGTON, NOWATA, CREEK, AND TULSA COUNTIES) WAS 1,139,939. THE AREA SERVED APPEARS TO BE FOLLOWING THE STATE AND NATIONAL TREND OF A DECLINING SHARE OF YOUNG PEOPLE AND A GROWING PROPORTION OF THE OLDER POPULATION. THIS EVOLVING POPULATION AGE COMPOSITION PRESENTS NEW CHALLENGES AND OPPORTUNITIES FOR THE COMMUNITY AS A WHOLE. THE ESTIMATED PER CAPITA INCOME FOR NOWATA COUNTY IN 2013 WAS $20,523. THERE WAS CLEAR RACIAL INEQUALITY AMONG MEDIAN HOUSEHOLD INCOMES. ADDITIONALLY, MEDIAN HOUSEHOLD INCOMES INCREASED WITH AGE UNTIL THE 65 AND OLDER AGE GROUP. THIS IS MOST LIKELY ATTRIBUTABLE TO LOWER INCOMES AFTER RETIREMENT. ESTIMATES FOR 2013 STATED THAT THE POVERTY RATE (BELOW 100%) WAS 18.7 PERCENT FOR NOWATA COUNTY. ACCORDING TO THE OKLAHOMA STATE DEPARTMENT OF HEALTH'S 2014 STATE OF THE STATE'S HEALTH REPORT, ONE IN SIX PEOPLE IN CREEK COUNTY, NOWATA COUNTY, AND WASHINGTON COUNTY LIVED IN POVERTY AND ONE IN SEVEN PEOPLE IN TULSA COUNTY LIVED IN POVERTY. RACIAL AND AGE DISPARITY AMONG THOSE LIVING IN POVERTY IS EVIDENT IN THE AREA SERVED. SINCE 2013, OKLAHOMA IS PARTICIPATING IN THE FEDERALLY-FACILITATED HEALTH INSURANCE MARKETPLACE. IN 2013, BEFORE THE FIRST OPEN ENROLLMENT PERIOD FOR THE HEALTH INSURANCE MARKETPLACE, OKLAHOMA'S UNINSURED RATE OF 20.5 PERCENT AND WAS 4.1 PERCENT GREATER THAN THE NATIONAL UNINSURED RATE. IN 2015, OKLAHOMA'S UNINSURED RATE IMPROVED AS IT DECREASED TO 15.4%. THE 2015 OKLAHOMA UNINSURED RATE IS A 5.1 PERCENT DECREASE SINCE 2013 PRIOR TO THE FIRST OPEN ENROLLMENT PERIOD. OKLAHOMA'S RATE OF UNINSURED WAS 4.7 PERCENT GREATER THAN THE NATIONAL RATE. THE 2015 RATE OF UNINSURED WAS 16 PERCENT IN NOWATA COUNTY. DESPITE SOME RECENT ATTENTION TO MEDICAID EXPANSION IN STATE LEGISLATURE IN 2016 AFTER YEARS OF NO TRACTION, AS OF 2017 OKLAHOMA HAS NOT EXPANDED MEDICAID COVERAGE TO LOW-INCOME ADULTS. NOWATA COUNTY HAD 10,351 UNDUPLICATED MEDICAID ENROLLEES DURING 2011-2015 WHICH REPRESENTS 22.95 PERCENT OF THE TOTAL POPULATION. THERE IS SIGNIFICANT DISPARITY IN THE GENERAL HEALTH OF POPULATIONS WITHIN THE SERVICE AREA DEPENDING UPON WHERE AN INDIVIDUAL LIVES AND TO WHAT SOCIOECONOMIC AND ETHNIC GROUP THEY BELONG. GEOGRAPHIC HEALTH DISPARITIES SUCH AS THIS EXIST ACROSS THE AREA SERVED. MEMBERS OF MINORITY GROUPS (MANY OF WHOM RESIDE IN THE GEOGRAPHIC AREAS DESCRIBED ABOVE) SHARE THESE SAME HEALTH CHARACTERISTICS. IT HAS BEEN DEMONSTRATED THAT THESE INDIVIDUALS HAVE LESS ACCESS TO REGULAR HEALTH CARE SERVICES, INCLUDING SPECIALTY CARE AND MANY SEEK EVEN THEIR PRIMARY CARE IN HOSPITAL EMERGENCY ROOMS, INCLUDING ALL OF THE ST. JOHN HEALTH SYSTEM, INC. HOSPITALS. SOME SIGNIFICANT MINORITY GROUPS IN THE HOSPITAL AND ST. JOHN HEALTH SYSTEM, INC.'S PRINCIPAL SERVICE AREA INCLUDES NATIVE AMERICANS, HISPANICS AND AFRICAN AMERICANS. EACH OF THESE GROUPS SHARES COMMON SOCIOECONOMIC CHALLENGES MAKING THEM MORE LIKELY TO EXPERIENCE HEALTH DISPARITIES. EACH OF THESE GROUPS HAS UNIQUE ETHNIC HEALTH RISK FACTORS THAT CONTRIBUTE TO HEALTH STATUS THAT IS GENERALLY POORER THAN THEIR WHITE COUNTERPARTS. HOWEVER, EVEN AMONG THE WHITE POPULATION IN THE HOSPITALS SERVICE AREA, THERE IS SIGNIFICANT ADVERSE HEALTH CARE STATUS. OKLAHOMA (INCLUDING THE HOSPITAL SERVICE AREA) RANKS NEAR THE BOTTOM IN MANY IF NOT MOST MEASURES OF HEALTH STATUS IN THE U.S. THE ST. JOHN HEALTH SYSTEM AND HOSPITALS SERVE A DIVERSE REPRESENTATION OF HEALTH DISPARITIES IN ONE OF THE LOWEST RANKED STATES IN THE UNITED STATES FOR HEALTH STATUS (46TH IN 2016). WITHIN THE STATE OF OKLAHOMA, COUNTIES SERVED BY THE HEALTH SYSTEM RANK FROM 16TH OUT OF 77 TO 63RD OUT OF 77. NOWATA COUNTY RANKS 34 OUT OF 77. THIS RANKING IS BASED ON EACH STATE'S PERFORMANCE ON THE CORE MEASURES WHICH INCLUDE BEHAVIORS, COMMUNITY AND ENVIRONMENTAL FACTORS, HEALTH POLICY, CLINICAL CARE, AND OUTCOMES. AMONG HEALTH DETERMINANTS, OKLAHOMA RANKS NUMBER 47, AND AMONG HEALTH OUTCOMES, NUMBER 44. AMONG SENIORS, OKLAHOMA RANKS NUMBER 49, AND AMONG WOMEN AND CHILDREN, NUMBER 46. OKLAHOMA'S MOST EXTREME CHALLENGES INCLUDE RISKY HEALTH BEHAVIORS SUCH AS HIGH LEVELS OF SMOKING, HIGH LEVELS OF UNINSURED, HIGH LEVELS OF POVERTY, LIMITED ACCESS TO PRIMARY CARE AND BEHAVIORAL HEALTH SERVICES, INADEQUATE PRENATAL CARE, AND HIGH RATES OF PREMATURE DEATH. THERE ARE HIGH RATES OF INFANT MORTALITY, DEATHS BY SUICIDE AND DRUG OVERDOSE, DIABETES, OBESITY, UPPER RESPIRATORY ILLNESS, CHRONIC HEART CONDITIONS, AND MANY OTHER FACTORS. ACCESS TO SERVICES IN OKLAHOMA IS A SIGNIFICANT CHALLENGE DUE TO THE LIMITED AVAILABILITY OF PRIMARY CARE PHYSICIANS AND STRESS ON HOSPITAL EMERGENCY ROOM ACCESS AND INPATIENT BEDS DUE TO A GROWING NUMBER OF TRANSFERS FROM UNDERSERVED RURAL AREAS IN OKLAHOMA. INA ADDITION, THERE ARE FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS PRESENT IN THE COMMUNITY. THESE FACTORS AMONG INDIVIDUALS AND FAMILIES IN THE COMMUNITIES AND GEOGRAPHIES SERVED BY THE HOSPITAL WHICH CREATE MANY CHALLENGES IN MEETING THE DEMAND FOR BASIC SERVICES AND IN IMPROVING THE HEALTH STATUS OF THE POPULATION. Schedule H, Part VI, Line 5 Promotion of community health PART A: THE ST. JOHN SYSTEM IS A GROWING INTEGRATED DELIVERY SYSTEM THAT SERVES EASTERN OKLAHOMA, SOUTHEASTERN KANSAS, AND THE SURROUNDING AREA. IT HAS GROWN SIGNIFICANTLY IN RECENT YEARS, WITH INCREASING REVENUES FROM OUTPATIENT AND PHYSICIAN PROFESSIONAL SERVICES AS WELL AS OTHER POST-ACUTE SERVICES. ACUTE CARE SERVICES ARE PROVIDED ON SIX HOSPITAL CAMPUSES THAT ARE OWNED BY THE ST. JOHN SYSTEM. THE OWNED HOSPITALS ARE ST. JOHN MEDICAL CENTER, INC. (THE TERTIARY CENTER IN TULSA, OKLAHOMA), JANE PHILLIPS MEMORIAL MEDICAL CENTER INC. IN BARTLESVILLE, OWASSO MEDICAL FACILITY, INC. IN OWASSO, OKLAHOMA, ST. JOHN BROKEN ARROW, INC. IN BROKEN ARROW, OKLAHOMA, AND ST. JOHN NOWATA HOSPITAL, INC., A CRITICAL ACCESS HOSPITAL IN NOWATA, OKLAHOMA, AND ST. JOHN SAPULPA, INC., A CRITICAL ACCESS HOSPITAL IN SAPULPA, OKLAHOMA. ACUTE CARE SERVICES ARE ALSO PROVIDED AT AN ADDITIONAL RURAL CRITICAL ACCESS HOSPITAL WHICH IS OWNED OR MANAGED BY JANE PHILLIPS. DIAGNOSTIC SERVICES AND CERTAIN ACUTE CARE SERVICES ARE ALSO PROVIDED IN A VARIETY OF FREE-STANDING (INCLUDING HOSPITAL-BASED) SETTINGS. SERVING OKLAHOMA FOR MORE THAN 90 YEARS, THE ST. JOHN SYSTEM NOW INCLUDES OVER 500 EMPLOYED PHYSICIANS AND "MID-LEVEL PROVIDERS", AND SEVERAL URGENT CARE CLINICS. COMMUNITY BENEFIT REPORT: ST. JOHN HEALTH SYSTEM, INC.'S (THE "ST. JOHN SYSTEM" OR "ST. JOHN") MISSION IS TO IMPROVE THE HEALTH STATUS OF THE INDIVIDUALS WHO LIVE IN THE COMMUNITIES WE SERVE WITH A SPECIAL EMPHASIS ON THOSE LIVING IN POVERTY AND THOSE WHO ARE VULNERABLE AMONG US; FAITHFUL TO THE TEACHING OF JESUS CHRIST AND THE VALUES OF OUR SPONSORS AND THE CATHOLIC CHURCH. OUR PROMISE TO OUR PATIENTS AND TO OUR COMMUNITIES IS TO PROVIDE MEDICAL EXCELLENCE AND COMPASSIONATE CARE. WE STRIVE TO PROVIDE HEALTHCARE THAT WORKS, HEALTHCARE THAT IS SAFE, AND HEALTHCARE THAT LEAVES NO ONE BEHIND. TO MEET THIS MISSION THE ST. JOHN SYSTEM HAS OPERATED SINCE THE 1920'S; GROWING FROM A FLEDGLING COMMUNITY HOSPITAL IN WHAT WAS THEN THE SOUTHERN EDGE OF TULSA, OKLAHOMA TO AN INTEGRATED HEALTH CARE DELIVERY SYSTEM SERVING NORTHEASTERN OKLAHOMA AND SURROUNDING STATES. THE ST. JOHN SYSTEM INCLUDES: THOUSANDS OF ASSOCIATES (8,000 IN FY 2017), EMPLOYED PHYSICIANS, AND ADVANCED PRACTICE PROVIDERS, HUNDREDS MORE INDEPENDENT PHYSICIANS, AND DOZENS OF VOLUNTEERS. THEY SERVE PATIENTS IN THE SIX OWNED HOSPITALS OPERATING NEARLY 800 BEDS; DOZENS OF PHYSICIAN OFFICES, CLINICS, AND URGENT CARE CENTERS, A REFERENCE LABORATORY, AND PARTNERSHIPS AND VENTURES THAT INCLUDE A HEALTH INSURANCE COMPANY, SEVERAL AMBULATORY SURGERY CENTERS, AND OTHER HEALTHCARE ACTIVITIES. TOGETHER OUR ASSOCIATES, PHYSICIANS, AND VOLUNTEERS TOUCH THE LIVES OF THOUSANDS OF PATIENTS EVERY DAY, INCLUDING THOSE LIVING IN POVERTY AND/OR DEEMED OTHERWISE VULNERABLE. THE ST. JOHN SYSTEM IS COMMITTED TO CONTINUE THE LEGACY OF HEALTH CARE EXCELLENCE AND SERVICE STARTED BY OUR ORIGINAL FOUNDERS AND SPONSORS THE SISTERS OF THE SORROWFUL MOTHER BY CONTINUING TO PROVIDE VITAL SERVICES TO THE COMMUNITIES WITH CONTINUED EMPHASIS ON SERVICE TO THE THOSE LIVING IN POVERTY AND/OR WHO MAY OTHERWISE BE DEEMED VULNERABLE OR POWERLESS. WE ENDEAVOR TO ESTABLISH TRUSTED RELATIONSHIPS WITH OUR PATIENTS OVER THEIR ENTIRE LIVES: SEEKING TO IMPROVE THEIR HEALTH AND WORKING TO HEALTH THEIR MINDS AND BODIES WHEN AFFLICTED BY INJURY OR ILLNESS. OUR ENABLING STRENGTHS: WE USE OUR ENABLING STRENGTHS TO ACHIEVE OUR MISSION AND VISION. THOSE STRENGTHS INCLUDE: A MODEL COMMUNITY OF INSPIRED PEOPLE WORKING TO PROVIDE OUR SERVICES AND ACHIEVE OUR MISSION; EMPOWERING KNOWLEDGE - CLINICAL AND BUSINESS INFORMATION SYSTEMS THAT PROVIDE OUR ASSOCIATES ACTIONABLE, TIMELY DATA AND INFORMATION UPON WHICH THEY CAN MAKE INFORMED DECISIONS; THE CREATION OF TRUSTED PARTNERSHIPS WITH EXTERNAL PARTNERS TO EXPAND OUR CAPABILITIES, COMPLEMENT OUR SERVICE OFFERINGS AND FULFILL OUR MISSION; AND ACHIEVING VITAL PRESENCE IN THE COMMUNITIES WE SERVE. THIS VITAL PRESENCE CONTEMPLATES CREATION AND CONTINUATION OF IMPORTANT SAFETY NET SERVICES, WORLD-CLASS CENTERS OF CLINICAL EXCELLENCE AND CREATION OF MEDICAL HOMES THAT PROMOTE EACH INDIVIDUAL'S PARTICIPATION IN THEIR OWN HEALTH AND WELL-BEING AND WHICH CREATE AND SUSTAIN THE INFRASTRUCTURE FOR PROMOTING HEALTH COMMUNITIES. OUR POINT OF VIEW: HEALTH CARE DELIVERY AND FINANCING IN THE U.S. MUST CHANGE. THE COST OF THE CURRENT SYSTEM RELATIVE TO THE VALUE THAT COMMUNITIES AND INDIVIDUALS ARE RECEIVING IS NOT SUSTAINABLE. IN ORDER TO MEET THE HEALTH CARE NEEDS AND CONTRIBUTE TO ECONOMIC VITALITY OF COMMUNITIES, WITH SPECIAL ATTENTION TO THE POOR AND VULNERABLE, HEALTH CARE PROVIDERS MUST FUNDAMENTALLY RECONFIGURE DELIVERY SYSTEMS, CARE PROCESSES AND COST STRUCTURES. DELIVERING SAFE, HIGH-QUALITY CARE THAT IS LOW COST WITH AN EXCEPTIONAL PATIENT EXPERIENCE WILL INCREASINGLY REQUIRE PROVIDERS TO HAVE A STRONG REGIONAL PRESENCE, INTEGRATED PHYSICIAN RELATIONSHIPS AND CAPABILITIES ACROSS THE CARE CONTINUUM. SUSTAINING THE ST. JOHN MISSION INTO THE FUTURE WILL REQUIRE A MORE CONTINUOUS, DYNAMIC RELATIONSHIP WITH THOSE WE SERVE AND THE ABILITY TO SHARE RISK WITH HEALTHCARE PURCHASERS, AS OPPORTUNITIES FOR INPATIENT GROWTH OR COMMERCIAL RATE INCREASES WILL BE LIMITED. THE MOVEMENT TO MANAGING HEALTH OF DEFINED POPULATIONS DEMANDS MASSIVE TRANSFORMATIONAL CHANGE. THIS REQUIRES RAPID ASSESSMENT, ASSEMBLY AND DEPLOYMENT OF THE NECESSARY CAPABILITIES. WE BELIEVE THE ST. JOHN SYSTEM IS WELL POSITIONED TO LEAD THIS TRANSFORMATION. COMMUNITY BENEFIT: THE COMMUNITY BENEFIT PROVIDED BY THE ST. JOHN SYSTEM INCLUDES: UNCOMPENSATED CARE FOR THE POOR, SUPPORT FOR THE EDUCATION OF MEDICAL PROFESSIONALS, PROVISION OF SUBSIDIZED HEALTH SERVICES, SUPPORT FOR OTHER COMMUNITY ORGANIZATIONS, INITIATIVES TO IMPROVE COMMUNITY HEALTH, AND MEDICAL RESEARCH TO BE SOME OF THE KEY AREAS OF FOCUS FOR PROVIDING COMMUNITY BENEFIT. THE ST. JOHN SYSTEM DOES NOT INCLUDE AMOUNTS RECORDED AS BAD DEBT; PAYMENT OF PROPERTY, SALES, USE, INCOME, PAYROLL, AND OTHER TAXES; CONSIDERABLE ECONOMIC VALUE PROVIDED TO THE LOCAL COMMUNITIES IN WHICH WE OPERATE AS COMPONENTS OF COMMUNITY BENEFIT. THE ST. JOHN SYSTEM DOES INCLUDE MEDICARE SHORTFALLS. CARE FOR THE POOR: "CARE FOR THE POOR" (WHICH INCLUDES THE ESTIMATED COST OF SERVICES PROVIDED TO PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE (CHARITY) AND THE UNCOMPENSATED COST OF CARE PROVIDED TO MEDICAID BENEFICIARIES) IS THE LARGEST FINANCIAL CATEGORY OF COMMUNITY BENEFIT. SUPPORT FOR GRADUATE AND ALLIED HEALTH MEDICAL EDUCATION IS THE SECOND LARGEST. ST. JOHN PROVIDES DISCOUNTS OF AT LEAST 50% TO ALL UNINSURED PATIENTS AND ADDITIONAL DISCOUNTS OF AT LEAST 10% TO UNINSURED PATIENTS WHO MAKE THE AGREED UPON TIMELY PAYMENTS FOR SERVICES THEY RECEIVE. ALL UNINSURED INDIVIDUALS LIVING IN HOUSEHOLDS WITH INCOMES AT OR BELOW 400% OF THE FEDERAL POVERTY LIMIT QUALIFY FOR FREE CARE FOR MEDICALLY NECESSARY SERVICES. INSURED PATIENTS AND OTHERS WHO ARE FACED WITH FINANCIALLY CATASTROPHIC MEDICAL BILLS ARE ALSO ELIGIBLE FOR AND ENCOURAGED TO SEEK FINANCIAL ASSISTANCE. (CONTINUED PART B) Schedule H, Part VI, Line 6 Affiliated health care system ST. JOHN HEALTH SYSTEM, INC., HEADQUARTERED IN TULSA, OKLAHOMA, AND WITH FACILITIES LOCATED THROUGHOUT EASTERN OKLAHOMA AND SOUTHEASTERN KANSAS, IS AN OKLAHOMA NONPROFIT HEALTH SYSTEM. IT OWNS AND OPERATES AN INTEGRATED TERTIARY HEALTH CARE DELIVERY SYSTEM THAT PROVIDES SERVICES EASTERN OKLAHOMA AND SOUTHEASTERN KANSAS. ST. JOHN HEALTH SYSTEM, INC. AND ITS SUBSIDIARIES, AFFILIATES, AND EMPLOYED AND AFFILIATED PHYSICIANS, PROVIDE HEALTH CARE SERVICES FOR PATIENTS OF ALL AGES ACROSS A BROAD CONTINUUM OF CARE, FROM PHYSICIAN PRIMARY CARE AND SPECIALTY SERVICES TO AMBULATORY, AND INPATIENT ACUTE AND POST-ACUTE SERVICES. THE HEALTH MINISTRY IS RELATED TO ASCENSION HEALTH'S OTHER SPONSORED ORGANIZATIONS THROUGH COMMON CONTROL. SUBSTANTIALLY ALL EXPENSES OF THE HEALTH MINISTRY ARE RELATED TO PROVIDING HEALTH CARE SERVICES. ASCENSION HEALTH ALLIANCE, D/B/A ASCENSION (ASCENSION), IS A MISSOURI NONPROFIT CORPORATION FORMED ON SEPTEMBER 13, 2011. ASCENSION IS THE SOLE CORPORATE MEMBER AND PARENT ORGANIZATION OF ASCENSION HEALTH, A CATHOLIC NATIONAL HEALTH SYSTEM CONSISTING PRIMARILY OF NONPROFIT CORPORATIONS THAT OWN AND OPERATE LOCAL HEALTHCARE FACILITIES, OR HEALTH MINISTRIES, LOCATED IN 23 STATES AND THE DISTRICT OF COLUMBIA. ASCENSION IS SPONSORED BY ASCENSION SPONSOR, A PUBLIC JURIDIC PERSON. THE PARTICIPATING ORGANIZATIONS/ENTITIES OF ASCENSION SPONSOR ARE THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL, ST. LOUISE PROVINCE; THE CONGREGATION OF ST. JOSEPH; THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF CARONDELET; THE CONGREGATION OF ALEXIAN BROTHERS OF THE IMMACULATE CONCEPTION PROVINCE, INC. - AMERICAN PROVINCE; AND THE SISTERS OF THE SORROWFUL MOTHER OF THE THIRD ORDER OF ST. FRANCIS OF ASSISI - US/CARIBBEAN PROVINCE. MISSION: THE ST. JOHN SYSTEM DIRECTS ITS GOVERNANCE AND MANAGEMENT ACTIVITIES TOWARD STRONG, VIBRANT, CATHOLIC HEALTH MINISTRIES UNITED IN SERVICE AND HEALING, AND DEDICATES ITS RESOURCES TO SPIRITUALLY CENTERED CARE WHICH SUSTAINS AND IMPROVES THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES IT SERVES. IN ACCORDANCE WITH THE ST. JOHN SYSTEM'S MISSION OF SERVICE TO THOSE PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS, EACH HEALTH MINISTRY ACCEPTS PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE ST. JOHN SYSTEM USES FIVE CATEGORIES TO IDENTIFY THE RESOURCES UTILIZED FOR THE CARE OF PERSONS LIVING IN POVERTY AND COMMUNITY BENEFIT PROGRAMS: - TRADITIONAL CHARITY CARE INCLUDES THE COST OF SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTHCARE BECAUSE OF INADEQUATE RESOURCES AND/OR WHO ARE UNINSURED OR UNDERINSURED. - UNPAID COST OF PUBLIC PROGRAMS, EXCLUDING MEDICARE, REPRESENTS THE UNPAID COST OF SERVICES PROVIDED TO PERSONS COVERED BY PUBLIC PROGRAMS FOR PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS. - COST OF OTHER PROGRAMS FOR PERSONS LIVING IN POVERTY (OTHER PROGRAMS FOR PERSONS WHO ARE POOR) INCLUDES UNREIMBURSED COSTS OF PROGRAMS INTENTIONALLY DESIGNED TO SERVE THE PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS OF THE COMMUNITY, INCLUDING SUBSTANCE ABUSERS, THE HOMELESS, VICTIMS OF CHILD ABUSE, AND PERSONS WITH ACQUIRED IMMUNE DEFICIENCY SYNDROME. - COMMUNITY BENEFIT (OTHER PROGRAMS FOR THE GENERAL COMMUNITY) CONSISTS OF THE UNREIMBURSED COSTS OF COMMUNITY BENEFIT PROGRAMS AND SERVICES FOR THE GENERAL COMMUNITY, NOT SOLELY FOR THE PERSONS LIVING IN POVERTY, INCLUDING HEALTH PROMOTION AND EDUCATION, HEALTH CLINICS AND SCREENINGS, AND MEDICAL RESEARCH. DISCOUNTS ARE PROVIDED TO ALL UNINSURED PATIENTS, INCLUDING THOSE WITH THE MEANS TO PAY. DISCOUNTS PROVIDED TO THOSE PATIENTS WHO DID NOT QUALIFY FOR ASSISTANCE UNDER CHARITY CARE GUIDELINES ARE NOT INCLUDED IN THE COST OF PROVIDING CARE OF PERSONS LIVING IN POVERTY AND OTHER COMMUNITY BENEFIT PROGRAMS. THE COST OF PROVIDING CARE TO PERSONS LIVING IN POVERTY AND OTHER COMMUNITY BENEFIT PROGRAMS IS ESTIMATED BY REDUCING CHARGES FORGONE BY A FACTOR DERIVED FROM THE RATIO OF EACH ENTITY'S TOTAL OPERATING EXPENSES TO THE ENTITY'S BILLED CHARGES FOR PATIENT CARE. CERTAIN COSTS SUCH AS GRADUATE MEDICAL EDUCATION AND CERTAIN OTHER ACTIVITIES ARE EXCLUDED FROM TOTAL OPERATING EXPENSES FOR PURPOSES OF THIS COMPUTATION. - MEDICARE SHORTFALL CONSISTS OF THE CALCULATED UNREIMBURSED COSTS OF SERVICES PROVIDED TO MEDICARE PATIENTS. Schedule H, Part VI, Line 7 State filing of community benefit report OK true true false false false false false false false STANLEY P DEFEHR MD CHAIR (END 5/2018) 0 448496 0 93930 0 14067 0 16200 0 22684 0 595377 0 0 MICHAEL A MOORE PRESIDENT (EX-OFFICIO) 0 253251 0 26060 0 13978 0 16729 0 10442 0 320460 0 0 DAVID J PYNN SVP AH-MINSTRY MKT EXEC TULSA (END 10/2017) 0 637938 0 771396 0 228425 0 15099 0 18903 0 1671761 0 0 MICHAEL L MULLINS DIRECTOR (START 10/2017) 0 620466 0 543869 0 201587 0 13500 0 27634 0 1407056 0 0 SAMUEL C ANDERSON FORMER OFFICER (END 6/2014) 0 0 0 0 0 254463 0 0 0 1910 0 256373 0 0 LEX ANDERSON TREASURER/EXEC VP & CFO SJHS (END 10/2017) 0 279255 0 95484 0 36218 0 15400 0 14319 0 440676 0 0 KEVIN B STECK SECRETARY/VP INTEGRITY & COMPLIANCE 0 237849 0 24212 0 16239 0 13874 0 2570 0 294744 0 0 RONALD JAMES BRASEL VP FINANCE 0 146656 0 150 0 5201 0 9254 0 21412 0 182673 0 0 PAUL MCQUILLEN VP PHYSICIAN SERVICE 0 166154 0 0 0 13706 0 9655 0 1691 0 191206 0 0 ALFRED W GARTZKE MD PHYSICIAN 302051 0 0 0 398 0 6700 0 17596 0 326745 0 0 0 DEBRA J ROBNETT-BELL PHYSICIAN ASSISTANT 152751 0 0 0 494 0 9564 0 7515 0 170324 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation ASCENSION HEALTH, AN AFFILIATE ORGANIZATION OF JANE PHILLIPS NOWATA HOSPITAL, INC., USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT & CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE Schedule J, Part I, Line 4a Severance or change-of-control payment The following individual(s) received severance payments from the organization or a related organization: David J Pynn - $87,446 Samuel C Anderson - $74,918 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. No payments were made to listed persons in Part VII under the non-qualified retirement plan during the year. Form 990, Part VI, Line 15b COMPENSATION OF OTHER OFFICERS IN DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS, THE PROCESS PERFORMED BY ST. JOHN HEALTH SYSTEM, INC., A RELATED ORGANIZATION OF Jane Phillips Nowata Hospital, Inc., INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE ST. JOHN HEALTH SYSTEM, INC. EXECUTIVE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OFFICERS' SALARIES WERE COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE MINUTES. INDIVIDUALS WERE NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. Form 990, Part VI, Line 15a COMPENSATION OF THE CEO In determining compensation of the organization's PRESIDENT & CEO, the process, performed by Ascension Health, a related organization of St. John Nowata Hospital, Inc., included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The compensation committee reviewed and approved the compensation. In the review of the compensation, the PRESIDENT & CEO was compared to individuals at other organizations in the area who hold the same title. During the review and approval of the compensation, documentation was recorded in the compensation committee minutes. The individual was not present when his compensation was decided. Form 990, Part VI, Line 6 Classes of members or stockholders JANE PHILLIPS NOWATA HOSPITAL, INC. HAS A SINGLE CORPORATE MEMBER, ST. JOHN HEALTH SYSTEM, INC. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body JANE PHILLIPS NOWATA HOSPITAL, INC. HAS A SINGLE CORPORATE MEMBER, ST. JOHN HEALTH SYSTEM, INC., WHO HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF JANE PHILLIPS NOWATA HOSPITAL, INC. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders All decisions that have a material impact to Jane Phillips Nowata Hospital, Inc. financial information or corporation as a whole are subject to approval by its sole corporate member, ST. JOHN HEALTH SYSTEM, INC. Form 990, Part VI, Line 11b Review of form 990 by governing body DURING THE RETURN PREPARATION PROCESS, THE TAX DEPARTMENT WORKS WITH OTHER FUNCTIONAL AREAS INCLUDING FINANCE, ACCOUNTING, TREASURY, LEGAL, HUMAN RESOURCES, AND CORPORATE COMPLIANCE FOR ADVICE, INFORMATION AND ASSISTANCE IN ORDER TO PREPARE A COMPLETE AND ACCURATE RETURN. UPON COMPLETION, THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S INTERNAL TAX DEPARTMENT WHICH CONSISTS OF ATTORNEYS AND CPAS. A COMPLETE FINAL COPY OF THE RETURN IS PROVIDED TO THE ORGANIZATION'S PRESIDENT, FINANCIAL OFFICER, AND/OR OTHER KEY OFFICERS IN LIEU OF THE FULL BOARD. Form 990, Part VI, Line 12c Conflict of interest policy The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Line 19 Required documents available to the public The Organization will provide any documents open to public inspection upon request. Form 990, Part VII, Section A Related Entities The organization utilizes an affiliate as the common pay agent. Employees reported in Part VII may have duties that impact multiple related entities. Total average hours worked and compensation and benefits paid are reported. In doing so, if available, a common law employer analysis is used to determine whether the hours and compensation/benefits are reportable as attributable directly to the filing organization or another entity; otherwise, the best available information has been used as the basis for allocations utilized in the reporting. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Miscellaneous Revenue - Total Revenue: 7289, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 7289; Form 990, Part XI, Line 9 Other changes in net assets or fund balances TRANSFERS WITH ALPHA FUND - -5226547; NET TRANSFERS WITH AFFILIATES - 2728179; Form 990, Part XII, Line 2b AUDITED FINANCIAL STATEMENTS THE ACTIVITY OF JANE PHILLIPS NOWATA HOSPITAL, INC. IS REPORTED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF ASCENSION HEALTH ALLIANCE. NO INDIVIDUAL AUDIT OF JANE PHILLIPS NOWATA HOSPITAL, INC. IS COMPLETED. THEREFORE, THE ATTACHED AUDITED FINANCIAL STATEMENTS ARE OF ASCENSION HEALTH ALLIANCE AND AFFILIATES, WHICH INCLUDE THE ACTIVITY OF JANE PHILLIPS NOWATA HOSPITAL, INC.. Form 990, Part XII, Line 2c AUDIT COMMITTEE JANE PHILLIPS NOWATA HOSPITAL, INC.is included in the consolidated financial statements of Ascension Health Alliance. The Finance and Audit committee of Ascension Health Alliance's Board assumes responsibility for the consolidated organization as a whole. ASCENSION HEALTH ALLIANCE PO BOX 45998 ST LOUIS MO 631455998 453358926 NATIONAL HEALTH SYSTEM MO 501(c)(3) Type I NA false ASCENSION HEALTH PO BOX 45998 ST LOUIS MO 631455998 311662309 NATIONAL HEALTH SYSTEM MO 501(c)(3) Type I ASCENSION HEALTH ALLIANCE false ST JOHN HEALTH SYSTEM INC 1923 SOUTH UTICA AVENUE TULSA OK 74104 731215174 SYSTEM PARENT OK 501(c)(3) Type I ASCENSION HEALTH false ST JOHN SAPULPA INC 1923 SOUTH UTICA AVENUE TULSA OK 74104 730662663 HEALTH CARE OK 501(c)(3) 3 ST JOHN HEALTH SYSTEM INC true JANE PHILLIPS MEMORIAL MEDICAL CENTER 3500 E FRANK PHILLIPS BLVD BARTLESVILLE OK 74006 730606129 HEALTH CARE OK 501(c)(3) 3 ST JOHN HEALTH SYSTEM INC true ST JOHN HEALTH SYSTEM FOUNDATION INC 1923 SOUTH UTICA AVENUE TULSA OK 74104 731133139 HEALTH CARE OK 501(c)(3) 7 ST JOHN HEALTH SYSTEM INC true ST JOHN MEDICAL CENTER INC 1923 SOUTH UTICA AVENUE TULSA OK 74104 730579286 HEALTH CARE OK 501(c)(3) 3 ST JOHN HEALTH SYSTEM INC true OWASSO MEDICAL FACILITY INC 1923 SOUTH UTICA AVENUE TULSA OK 74104 203700131 HEALTH CARE OK 501(c)(3) 3 ST JOHN HEALTH SYSTEM INC true ST JOHN BROKEN ARROW INC 1923 SOUTH UTICA AVENUE TULSA OK 74104 383833117 HEALTH CARE OK 501(c)(3) 3 ST JOHN HEALTH SYSTEM INC true ST JOHN AUXILIARY INC 1923 SOUTH UTICA AVENUE TULSA OK 74104 730999759 HEALTH CARE OK 501(c)(3) 10 ST JOHN HEALTH SYSTEM INC true ST JOHN BUILDING CORPORATION 1923 SOUTH UTICA AVENUE TULSA OK 74104 611659782 REAL ESTATE OK 501(c)(2) ST JOHN HEALTH SYSTEM INC true Oklahoma Cancer Specialists Real Estate Company LLC 12697 E 51st St South TULSA OK 74146 473843491 REAL ESTATE HOLDING OK NA N/A SJFI LLC 1923 SOUTH UTICA AVENUE TULSA OK 74104 462713285 ACCOUNTABLE CARE ORGANIZATION OK NA N/A UTICA SERVICES INC 1923 SOUTH UTICA AVENUE TULSA OK 74104 731057650 MEDICAL SERVICES OK NA C Corporation true REGIONAL MEDICAL LABORATORIES INC 1923 SOUTH UTICA AVENUE TULSA OK 74104 731131608 MEDICAL SERVICES OK NA C Corporation true PHYSICIAN SUPPORT SERVICES INC 1923 SOUTH UTICA AVENUE TULSA OK 74104 731437252 MEDICAL SERVICES OK NA C Corporation true OMNI MEDICAL GROUP INC 1923 SOUTH UTICA AVENUE TULSA OK 74104 731335536 MEDICAL SERVICES OK NA C Corporation true ST JOHN URGENT CARE CLINICS INC 1923 SOUTH UTICA AVENUE TULSA OK 74104 204990275 MEDICAL SERVICES OK NA C Corporation true ST JOHN ANESTHESIA SERVICES INC 1923 SOUTH UTICA AVENUE TULSA OK 74104 203690446 MEDICAL SERVICES OK NA C Corporation true ST JOHN PHYSICIANS INC 1923 SOUTH UTICA AVENUE TULSA OK 74104 731321032 MEDICAL SERVICES OK NA C Corporation true false false false false false false false false false true false true false false true true true true true REGIONAL MEDICAL LABORATORIES INC L 336174 FAIR MARKET VALUE ST JOHN PHYSICIANS INC L 98152 FAIR MARKET VALUE JANE PHILLIPS MEMORIAL MEDICAL CENTER Q 67348 FAIR MARKET VALUE