2018-05-10T09:00:14-05:00 2017-06-30 350921680 CROWE HORWATH LLP 225 West Wacker Drive Suite 2600 Chicago IL 606061224 990 2016-07-01 370663567 St Elizabeth's Hospital of the Hospital Sisters of the Third Order of St Fr ancis STEL 6182342120 One St Elizabeths Blvd OFallon IL 62269 David Nosacka SID CFO 2018-04-11 true Rachel Spurlock P00520729 3128997000 2016 2022-09-23 18:48:47Z X PEGGY SEBASTIAN CEO One St Elizabeths Blvd OFallon IL 62269 161321169 false 0928 X WWW.STELIZ.ORG X 1875 IL TO REVEAL AND EMBODY CHRIST'S HEALING LOVE FOR ALL PEOPLE THROUGH OUR HIGH QUALITY FRANCISCAN HEALTH CARE MINISTRY. 11 10 1475 174 16375 279410 200229 436281 157855479 158648871 259068 536431 636056 338949 158950832 159960532 0 0 71193590 66617241 0 0 115563187 129098932 186756777 195716173 -27805945 -35755641 183543621 321813837 294165437 473552887 -110621816 -151739050 X SEE SCHEDULE O false false 49691785 0 37848011 Surgical Services HSHS St. Elizabeth's Hospital's highly trained and experienced surgeons perform surgical and non-surgical procedures in a variety of areas and represent a wide range of specialties, including: cardiothoracic, orthopedic, plastic surgery, neurosurgery, podiatry and more. Your surgical team will perform your surgery using the latest technology and least invasive procedures possible in one of our 16 surgery suites. Our board certified anesthesiologists and certified nurse anesthetists provide excellent anesthesia care. During FY 2017, HSHS St. Elizabeth's Hospital had 4,474 surgical cases. 30532943 0 28613503 Cardiac Services HSHS St. Elizabeth's Hospital provides comprehensive cardiovascular services from diagnosis to surgery to rehabilitation and wellness. HSHS St. Elizabeth's is accredited by the Society of Chest Pain Centers, a professional organization focused on improving care for patients with acute coronary syndromes and teaching the public to recognize and react to the early symptoms of a possible heart attack. This accreditation attests that HSHS St. Elizabeth's meets strict criteria for recognizing and treating patients who come to the emergency room with heart attack symptoms. We are also a heart attack receiving center. Our patients benefit from our highly credentialed physicians and state-of-the-art technologies, as well as our commitment to superior patient outcomes. Services provided include cardiac catheterization, stent placement, stress testing, pacemaker, implantable cardioverter defibrillator (ICD), electrocardiography, coronary artery bypass graft (open heart) surgery and cardiac rehabilitation. During FY 2017, HSHS St. Elizabeth's Hospital had 12,404 cardiac cases. 8989982 0 4506155 Mother Child/Obstetric Services HSHS St. Elizabeth's Hospital has been delivering babies for more than 140 years and continues to serve as the hospital of choice for families seeking a family-centered, high quality, maternity experience. At HSHS St. Elizabeth's, we consider it a privilege to be able to assist families with one of the most memorable and intimate moments of their lives. That's why we hold ourselves to higher standards, guided by our Core Values of RESPECT, CARE, COMPETENCE and JOY to give patients region leading, high-quality obstetric care. From the individualized care we provide for mother and baby, to the educational programs we offer expecting families, we offer a wide range of resources, services and special touches to celebrate deliveries including the Delivering Miracles Program This program provides personalized individual counseling sessions, a private facility tour and post-delivery support. For labor and delivery, the Mother-Child Services department provides quality care to pregnant women and their families throughout the birthing process. Our anesthesia providers are available 24 hours a day to provide epidural placement and other pain management, as needed. A hydrotherapy tub is also available for mothers-to-be as a pain relief alternative to epidural treatment. After you and your closest loved ones have welcomed your new baby in your private labor, delivery and recovery room, you will be transferred to your Mother-Child post-partum room. A diverse team, including a childbirth educator and a clinical resource nurse, are available to you after the birth of your baby. Our maternity nurses are skilled at helping new moms and babies learn how to breastfeed, and our lactation counselors provide extra support. We smooth the transition to home with individualized instruction and a customized education program. In FY17, HSHS St. Elizabeth's Hospital had 747 Births and 4,555 Gynecologic and Obstetric cases. 63215028 0 87681202 Other Health Care Services HSHS St. Elizabeth's Hospital delivers a comprehensive array of healthcare services to both inpatients and outpatients. Our accredited programs have consistently demonstrated quality outcomes that positively impact our patients, their families and the entire community. We provide quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of HSHS St. Elizabeth's Hospital, it is recognized that not all individuals possess the ability to purchase essential medical services. It is our mission to serve the sick, especially the poor, with quality healthcare services and healthcare education. We have further defined our mission of identifying those who are at greatest health risk, the elderly, children, those coping with mental illness, and those with less means who are dependent on quality healthcare. HSHS St. Elizabeth's Hospital currently staffs 260 inpatient beds. The hospital employs 1,475 colleagues. Inpatient admissions for Fiscal Year 2017 were 7,990. The Emergency Department had 33,477 visits and admitted 4,804 to inpatient services. The Urgicare Center in O'Fallon, an offsite facility, had 28,358 visits. Total Outpatient visits for the hospital were 186,677. 63215028 87681202 152429738 true true false true false false false true false false true false false false true true false true false false false false false false false false true true false false true false false false false false false false false false false false false true true false false false true 116 0 true 1475 true true true false false false false false false false false false X 11 10 false false false false true true true true true false false true true true true true true true true true true X David Nosacka 6182342120 One St Elizabeths Blvd OFallon IL 62269 Peggy Sebastian PRESIDENT & CEO 60.0 0.0 X X 0 551166 158139 REVEREND JAMES E DEITERS BOARD CHAIRPERSON 2017 1.0 0 X X 0 0 0 WILLIAM S LYKE BOARD CHAIRPERSON 2016 1.0 1.8 X X 0 0 0 RICHARD J THOMAN BOARD VICE CHAIRPERSON 1.0 0 X X 0 0 0 STEPHANIE STRANO-MAINE BOARD SECRETARY 2017 1.0 0 X X 0 0 0 THOMAS M EGAN BOARD SECRETARY 2016 1.0 0 X X 0 0 0 LORRAINE CAVATAIO BOARD MEMBER 1.0 0 X 0 0 0 JIM CLANAHAN MD BOARD MEMBER 1.0 0 X 0 0 0 JACQUELYN M CLEMENT PHD BOARD MEMBER 1.0 0 X 0 0 0 SR MARYBETH CULNAN OSF BOARD MEMBER 1.0 9.3 X 0 0 0 THOMAS DINGES BOARD MEMBER 1.0 0 X 0 0 0 Michael Hall BOARD MEMBER 1.0 0 X 0 0 0 SR Helen Marie Plummer OSF BOARD MEMBER 1.0 3.0 X 0 0 0 ANN M CARR TREASURER 0.3 59.4 X 0 359960 312526 JAMES DOVER CEO SOUTHERN IL DIVISION 24.0 36.0 X 0 688696 133124 CARRIE A ERLINGER INTERIM CHIEF NURSING OFFICER 20.0 40.0 X 0 125367 20666 ELIZABETH GOVERO CHIEF NURSING OFFICER 30.0 30.0 X 3231 152634 29041 GARY A HAGENS CHIEF MEDICAL OFFICER 60.0 0 X 0 0 0 DAVID NOSACKA DIVISION CFO 23.0 38.0 X 359543 0 65543 MARY LOU TATE DIRECTOR OF FINANCE 60.0 0 X 141101 0 42500 AMY M BALLANCE VP BUSINESS DEVELOPMENT SOUTHERN IL DIVISION 29.0 7.8 X 210575 0 102133 SUSAN M HOLLOWAY PROJECT MANAGER, NEW CONSTRUCTION 60.0 0 X 177849 0 157787 MARGARET A LUNA CHIEF PEOPLE OFFICER SOUTHERN IL DIVISION 29.0 4.2 X 239246 0 181062 COREY J HASTINGS DIRECTOR OF FINANCE SOUTHERN IL DIVISION 29.0 0 X 151817 0 54540 JACQUELYNNE N HOLST VP LEGAL AFFAIRS SOUTHERN IL DIVISION / HSHS ASSOCIATE GENERAL COUNSEL 29.0 7.8 X 192733 0 58324 BRIAN D JOHNSON EXECUTIVE DIRECTOR OF SURGICAL SERVICES 60.0 0 X 169373 0 62332 JULIA K SCHIMMELPFENNIG DIRECTOR OF PHARMACY 60.0 0 X 158428 0 44206 PETER K WONG CHIEF PERFORMANCE IMPROVEMENT OFFICER SOUTHERN IL DIVISION 10.0 0 X 325059 0 16316 SHELLEY A HARRIS INTERIM PRESIDENT & CEO - Through 6/25/16 0.0 0 X 304537 0 204686 LAWRENCE SCHUMACHER Former DIVISION CEO - INTERIM 0.0 X 0 622151 0 2433491 2499974 1642925 51 true true false ALBERICI HEALTHCARE 8800 PAGE AVE ST LOUIS MO 63114 CONSTRUCTION SERVICES FOR NEW HOSPITAL CONSTRUCTION 65935634 PROFESSIONAL THERAPY SERVICES INC 2810 FRANK SCOTT PKWY WEST STE 824 BELLEVILLE IL 62223 PHYSICAL THERAPY 3431691 Navigant 4511 Paysphere Circle Chicago IL 60603 AR Outsourcing Projects 1678742 SODEXO OPERATIONS LLC 4880 PAYSHERE CIRCLE CHICAGO IL 60674 FOOD SERVICE 1483960 SLU Care SLU Medical Center Lockbox St Louis MO 631958541 Physician Residency Program 1277182 51 417492 18789 4786 436281 Net Patient Revenue 622110 156823604 156823604 Oncology Center 621999 674729 674729 Health Programs 621999 3750 3750 Rental Income-Affiliates 531120 1146788 1146788 0 0 0 0 158648871 353199 353199 1136282 1279439 -143157 0 -143157 -143157 264430 81198 183232 0 183232 183232 Outside Services 900099 444652 444652 Cafeteria Sales 722210 21079 21079 Laundry Services 812300 16375 16375 0 0 0 0 482106 159960532 158648871 16375 859005 X 2432126 707804 1724322 50039958 43655956 6384002 926682 761148 165534 8876250 7010331 1865919 4342225 3706681 635544 326364 326364 8736 8736 42843620 33604605 9239015 0 687028 687028 1238884 945588 293296 11816665 11816665 4058292 4058292 864202 59300 804902 36474 10618 25856 3343482 3343482 15603281 7056103 8547178 3463746 3463746 Medical Supplies 24950707 24930566 20141 Provision for uncollectible accounts 5863375 5863375 License & Taxes 10495227 10387045 108182 Maintenance & Repairs 2363670 2355265 8405 1135179 509833 625346 0 195716173 152429738 43286435 0 0 0 7487772 4338244 3332078 33975904 30493011 0 0 0 56202 10099 3336841 3014189 964758 1015139 385243792 174085320 130085505 211158472 5776312 60592237 0 4789579 4464307 220276 246533 183543621 321813837 17484778 34663790 219569894 400801815 57110765 38087282 294165437 473552887 X -119041455 -162928038 7995477 10764776 424162 424212 -110621816 -151739050 183543621 321813837 X -35755641 -28836 -5332757 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 30043 30043 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY ST. ELIZABETH'S HOSPITAL ("THE HOSPITAL") IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION ("CHA"), THE ILLINOIS HEALTH ASSOCIATION ("IHA"), THE NATIONAL ASSOCIATION FOR HOME CARE AND HOSPICE, AND THE AMERICAN HEALTH ASSOCIATION ("AHA"). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES, PART OF WHICH ARE ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. THE AMOUNT LISTED IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID. Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY ST. ELIZABETH'S HOSPITAL ("THE HOSPITAL") IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION ("CHA"), THE ILLINOIS HEALTH ASSOCIATION ("IHA"), THE NATIONAL ASSOCIATION FOR HOME CARE AND HOSPICE, AND THE AMERICAN HEALTH ASSOCIATION ("AHA"). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES, PART OF WHICH ARE ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. THE AMOUNT LISTED IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID. 136051 X See Part III, Line 4 false 22952115 22952115 122793098 110725020 12068078 73174 20123 53051 71454339 57524142 13930197 167971066 5816035 162155031 211158472 Retire Obligation Asbestos Accrued Pension Benefit Cash Balance-negative Retire Obligation Asbestos 9013870 Accrued Pension Benefit 29073412 38087282 X Schedule D, Part III, Line 4 Collections of art - description of collections The hospital has received various donations of artwork, which are held and displayed throughout the facility to beautify the hospital and promote healing. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote HSHS and the Foundation are Illinois not-for-profit organizations as described in Section 501 (c) (3) of the Internal Revenue Code (the Code) and are exempt from federal income taxes on related income pursuant to Section 501 (a) of the Code. Kiara, Inc. is an Illinois for-profit corporation that recognizes income taxes under the asset-and-liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the consolidated financial statement carrying amounts of existing assets and liabilities and their respective tax basis and operating loss and tax credit carryforwards. Deferred tax assets and liabilities are measured using the enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. In assessing the realizability of deferred tax assets, management considers whether it is more likely than not that some portion or all of the deferred tax assets will not be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income during the periods in which those temporary differences become deductible. Management considers projected future taxable income and tax planning strategies in making this assessment. Based upon the level of historical taxable losses and projections for future taxable losses over the periods for which the deferred tax assets are deductible, management believes it is more likely than not Kiara, Inc. will not realize the majority of the benefits of these deductible differences. Full valuation allowances have been applied against the deferred tax assets attributable to the net operating loss carryforwards not realized as of June 30, 2017 and 2016 in the accompanying consolidated financial statements due to the uncertainty of realization. Hshs recognizes the tax benefit from an uncertain tax position only if it is more likely than not the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. As of June 30, 2017 and 2016, HSHS does not have any liabilities for unrecognized tax benefits. true true X true X true X 600 true true false true true 4254 3464938 0 3464938 0.0183 18633 46196545 28407630 17788915 0.0937 0 0 0 0 0.0 0 22887 49661483 28407630 21253853 0.1119 11056 565108 461 564647 0.0030 1944 2517412 771075 1746337 0.0092 0 0 0 0 0.0 0 1421 0 1421 0.0000 3428 274772 0 274772 0.0014 0 16428 3358713 771536 2587177 0.0136 0 39315 53020196 29179166 23841030 0.1256 0 0 0 0 0.0 0 0 0 0 0.0 408 2655 0 2655 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 0 0 0.0 0 0 0 0 0.0 0 408 2655 0 2655 0.0000 true 5863375 0 44905179 51701769 -6796590 X true true 1 1 ST ELIZABETH'S HOSPITAL 211 SOUTH 3RD STREET BELLEVILLE IL 62220 http://www.steliz.org/ 00002345 X X X X ST ELIZABETH'S HOSPITAL 1 false false true X X X X X X X X X 14 true false true true X http://www.steliz.org/www-seb/media/SEB-PDF-Documents/Community-Health-Needs-Assessment-(CHNA)_St_El X true 14 true http://www.steliz.org/www-seb/media/SEB-PDF-Documents/Community-Health-Needs-Assessment-(CHNA)_St_El false true X 200.0 600.0 X X X X X X true true X X X true X http://www.steliz.org/Patient-Guest/Financial-Assistance X http://www.steliz.org/Patient-Guest/Financial-Assistance X http://www.steliz.org/Patient-Guest/Financial-Assistance X X X X X X true X false X X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - HSHS St. Elizabeth's Hospital. HSHS St. Elizabeth Hospital undertook a nine-month planning and implementation effort to develop the CHNA, identify and prioritize community health needs for its service area and formulate an implementation plan to guide ongoing population health initiatives with like-missioned partners and collaborators. HSHS St. Elizabeth's senior leadership engaged Southern Illinois School of Medicine's Center for Clinical Research and Office of Community Health and Service to provide quantitative and secondary data and community health data on the four county service areas. In addition, the team along with members of the Community Benefit Committee identified additional data sets to review and discuss with focus groups. Internal data collected consisted of the top 10 diagnosis of patients admitted to the hospital from the Emergency Department and the top 10 diagnosis of patients discharged from the Emergency Department. The FY12 Community Health Needs Assessment was also included in the data review. A core group of HSHS St. Elizabeth's colleagues and our physician partners provided valuable input for this CHNA. This focus group discussed the data, shared insights from their perspective and identified their top three health care focus areas. HSHS St. Elizabeth's Hospital also leveraged existing relationships that provided diverse input for a comprehensive review and analysis of community health needs in the hospital's service area. These external component steps included conducting a survey at the Regional Health Policy Summit, leading focus groups, and utilizing the expertise of the existing Community Benefit Committee members. Community members were invited based on their awareness and expertise in the needs of our community. There was attention afforded to those who work with the underserved, low income, and minority populations as well as populations with chronic disease. In addition, a special focus group was conducted with the homeless in their environment. Local focus groups were sponsored by community partners, which further demonstrate HSHS St. Elizabeth's integration with the community. Members include: director, St. Clair County Public Health Commission; retired nurse, St. Clair Mental Health Board (mental health); the Carla Smith Foundation (families of the mentally ill); USAF Nurse, Scott Air Force Base (Population Health); local clergy; community based hospice; BEACON ministries (social services agency for the poor and underserved); Health Visions East social worker for low income, medically underserved, and the elderly; local mental health agencies; representatives from senior living; a university professor; agency for domestic violence prevention; legal and financial services that represent low income population; and a member of the local Federally Quantified Healthcare Agency. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - HSHS St. Elizabeth's Hospital. St. Clair County Public Health Commission, Southern Illinois Health Foundation, Health Visions East, Lindenwood University, Southern Illinois University School of Medicine Office of Community Health and Service, Eastside Health District and BEACON Ministries. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - HSHS St. Elizabeth's Hospital. Identifying and prioritizing the areas of focus was completed using LEAN Principles. The charter, the first step in the LEAN process, consisted of identifying the primary customers, the scope of the project, the primary goal and the metrics selected for the CHNA. HSHS St. Elizabeth's listened to the voice of the customer and collaborated with our community partners. Individuals included the Community Benefit team, social agencies such as BEACON ministries, the executive medical staff, and SIU School of Medicine. The key drivers selected included the SIU secondary data analysis, focus groups, surveys, and Emergency Department (ED) data. These key drivers were further delineated into critical to quality requirements that provided measureable specifications. Data collected and measured included focus group members' top three health needs, survey results of the top three health needs, and the top 10 ED diagnoses for both admitted and discharged patients. The data was collected and analyzed using a pareto chart. A pareto chart measures data in decreasing order of occurrence. The pareto chart identified poverty as the largest area of need followed by access to health care, obesity, food scarcity, diabetes and substance abuse as the top six community health needs. As a health care organization, HSHS St. Elizabeth's expertise and resources are best used addressing a health care need with measureable outcomes. Noting the association among some of the topics, the data was categorized using an affinity diagram, which organizes a large amount of data into natural relationships. Using the data in the affinity diagram, a new pareto chart was created. The priority areas that rose to the top were nutrition, mental health/substance abuse, access to care, and cardiac disease. As part of the identification and prioritization of health needs, HSHS St. Elizabeth's senior leadership team and the CHNA Steering Committee considered the estimated feasibility and effectiveness of possible interventions by the hospital to impact these health priorities; the burden, scope, severity, or urgency of the health need; the health disparities associated with the health needs; the importance the community places on addressing the health need; and other community assets and resources that could be leveraged through strategic collaboration in the hospital's service area to address the health need. Based on the CHNA planning and development process described, the following community health needs were identified: 1. Nutrition and Wellness 2. Access to Care 3. Cardiac Disease Implementation Plan to Address Identified Needs HSHS St. Elizabeth's Hospital partnered with other organizations to develop, implement, monitor and evaluate both new and ongoing initiatives that address the identified priority community health needs. The set of implementation strategies and interventions are contained in the Implementation Plan, which was approved and adopted by an authorized body of the hospital. The implementation strategies and interventions will include, but are not limited to, the following initiatives: Wellness related to Nutrition a. Goal: To partner with Cosgrove's Kitchen to provide a series of education classes on nutrition and provide free health screening services. Measure: Conduct quarterly classes at Cosgrove's Kitchen. b. Goal: To provide support and information to individuals with diabetes to help with diabetes self-management. Measure: Continue to provide diabetes support. Measure: Provide health screenings/glucose test and education to the community. Measure: Refer and track pre-diabetes patients for classes to our partner, the YMCA. c. Goal: To provide the services of a dietitian to organizations free of charge for education about nutrition and healthy eating. Measure: Registered dietitian will make presentations during the year in partnership with local agencies. Access to Health Care a. Goal: To continue providing financial assistance programs for patients who cannot pay for services received. To determine eligibility, a scale based upon the Federal Poverty Guidelines (FPG) will be used. Measure: Information about financial assistance programs will be communicated in registration areas and through patient accounting representatives. Eligibility will be based upon the Federal Poverty Guidelines (FPG) established by the U.S. Department of Health & Human Service b. Goal: To increase enrollment in the health insurance exchange (HIE). Measure: During the period of open enrollment on the HIE, November 1, 2015 and end January 31, 2016, HSHS St. Elizabeth's Hospital will distribute one news release to the local media about open enrollment and place information on the hospital's website. The services of an enrollment counselor will be funded by the hospital as the level of need is determined for the county and in coordination with the local/regional public health departments. c. Goal: To further assess the need for non-emergency medical transportation and identify other organizations for possible collaboration. Measure: Assessment will be completed and one action taken as identified to improve transportation access and/or reduce costs for low income residents. Collaboration will be completed with current public transportation provider, as appropriate. d. Goal: To address to the needs of eligible patients that require medications and services to safely transition patients to an appropriate level of care. Measure: Collaborate with other organizations that support the continuum of care for eligible patients and can provide needed services. Heart Disease/Cerebrovascular Disease a. Goal: To promote heart health awareness, education about cardiovascular disease, and healthy eating and lifestyle choices. Measure: During the month of February, nationally recognized as Heart Health month, one activity will be held for community health education. Measure: Conduct/participate in quarterly community health programs. Measure: Meet with outside agencies and hospitals and provide cardiac and stroke education. Measure: Participate in a division wide diabetes/cardiac campaign in partnership with Walmart and create a cohort of patients that we can measure and track physical behavioral changes. In addition to the above activities HSHS St. Elizabeth's continues to engage the community in many other activities that provide support to the poor and underserved. Colleagues mentor students in a variety of disciplines to include a family practice residency program, pharmacy, nursing and multiple ancillary departments. As an outcome of the prioritization process, the following community health needs were also identified and will not be addressed directly by the hospital for the reasons indicated: Mental Health and Substance Abuse was listed as the second health care priority. HSHS St. Elizabeth's will continue to partner with local and state agencies to assist when feasible with mental health and substance abuse. HSHS St. Elizabeth's transitioned of our mental health resources and expertise to a local community partner. HSHS St. Elizabeth's lacks necessary resources to pursue this priority. Tobacco Use is addressed by the County Health Department smoking cessation classes. Due the complexity of this issue, the hospital will not take lead on poverty. There are several agencies that are addressing this issue. HSHS St. Elizabeth's partners with agencies such as East-Side Aligned, Catholic Urban Programs, St. Vincent DePaul, and BEACON ministries, where we can provide support. The hospital will not take lead on violent crime because it is not an area of expertise for HSHS St. Elizabeth's, however an active partnership exists with the Violence Prevention Center and a positive working relationship exists between HSHS St Elizabeth's and local law enforcement. Sexually Transmitted Diseases are addressed by the local health department. The hospital did not take the lead on available healthy food and food scarcity. These needs are addressed by groups including local food pantries, East Side Health District, and East Side Aligned. The hospital supports these efforts by donating health food to the local food pantry through our food drives. The hospital has a special care nursery and a pediatrician on staff but lacks the resources to further enhance programs for maternal and child health at this time. It is part of the St Clair County IPLAN. Lung Cancer is being addressed in the IPLAN and HSHS St. Elizabeth's does offer new technology to screen for lung cancer. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - St. Elizabeth's Hospital. Presumptive eligibility provides individuals participating in one of the following categories with a 100% write off. These programs are granted by outside organizations based on screening criteria of less than 200% of the FPG. 1. Homelessness 2. Deceased with no estate 3. Mental incapacitation with no one to act on patient's behalf 4. Medicaid eligibility, but not on date of service or for non-covered services 5. Incarceration in a penal institution 6. Enrollment in the following assistance programs for low-income individuals: 6a. Temporary Assistance for Needy Families (TANF) 6b. Illinois Housing Development Authority's Rental Housing Support Program 7. Wisconsin Department of Health Services Housing Assistance Program 8. Participation in Women, Infants and Children programs (WIC); 9. Supplemental Nutrition Assistance Program (SNAP) eligibility; 10. Illinois Free Lunch and Breakfast Program; 11. Wisconsin Free Lunch Program; 12. Low Income Home Energy Assistance Program (LIHEAP); 13. Wisconsin Home Energy Assistance Program (WHEAP); 14. Enrollment in an organized community-based program providing access to medical care that assesses and documents limited low-income financial status as criteria; 15. Receipt of grant assistance for medical services 0 Schedule H, Part VI, Line 5 Promotion of community health (continued A) HSHS St. Elizabeth's also devotes significant resources to improve access to health care for patients who cannot afford care, in addition to other Community Benefit. In FY2017, HSHS St. Elizabeth's provided more than $23.8 million in Community Benefit, including financial assistance at cost, unpaid costs of Medicaid and other public programs, and a range of diverse programs designed to enhance access improve community health. Additionally, in 2017 HSHS St. Elizabeth's provided $17.7 million (at cost) in uncompensated care to patients who did not qualify for charity care to public assistance and more than $6.7 million (at cost) in excess of Medicare payment for health care services. HSHS St. Elizabeth's provides a range of Community Benefit activities and programs that furthers our mission and long-standing commitment to our community. In many cases, these Community Benefit initiatives would not exist without the leadership role played by HSHS St. Elizabeth's and they often relieve a burden that would otherwise be carried by government. The hospital's FY2015 Community Health Needs Assessment (CHNA) surfaced the following health focus areas to be addressed by the hospital in collaboration with other hospitals and community organizations: nutrition and wellness, access to care and cardiac disease. Implementation strategies were developed to maximize resources and impact the community. Access to health care Over the past three years, HSHS St. Elizabeth's has been committed to providing and assisting eligible patients to enroll in health care plans. Attending to the needs of the poor and vulnerable, HSHS St. Elizabeth's continues to contract with Med-Data, formerly Cardon Outreach, to screen all self-pay patients that present in inpatient or outpatient. Once screened and eligibility criteria met, patients are assisted with enrollment in Medicaid. In FY2017, more than 3,200 patients were screened and 74% were enrolled in Medicaid. For other patients, financial assistance is offered. For example, a patient was being discharged but needed outpatient infusions. However, the patient did not have the resources to obtain this needed service. A colleague facilitated a financial assistance referral. With this help, the patient completed the necessary paperwork and was able to receive the outpatient infusion. Access to health care goes beyond seeing a provider. Assisting patients with medication, durable medical equipment and transportation is another way that HSHS St. Elizabeth's ensures that the underserved are treated with respect and dignity. HSHS St. Elizabeth's provides funding to purchase medication or equipment for those patients who have no ability to pay. By doing so, the patient maintains their dignity and can help themselves. Occasionally, a patient who was hospitalized or seen in the Emergency Department (ED) has no transportation home. Supervisors have the authority to assess the situation and determine if a patient needs a bus pass, cab or ambulance ride to their home. In FY2017, HSHS St Elizabeth's provided more than $5,600 in cab and bus tickets for patients and more than $6,000 in medications for those in need. The hospital contributed more than $14,000 for patients who needed to be transported by ambulance. In collaboration with our physician partners, the hospital hosted a community resource fair to address education gaps with our patients regarding their new health care coverage. HSHS St. Elizabeth's initiated the resource fair concept last year, and many local agencies that had surfaced similar education gaps united to help those in need by providing education based on areas of expertise. HSHS St. Elizabeth's focused on cardiovascular and cardiac education, while other agencies provided education on health care coverage and benefits by plan. Routinely, he hospital participates in events and programs in our communities to serve the poor and vulnerable. Chronic disease; cardiac and cardiovascular Although great health care advances have been made in cardiac and cardiovascular disease, these conditions continue to plague our communities, especially the underserved or poor. The poor are still likely to have high blood pressure, to smoke and have other risk factors for heart disease and stroke as they did 15 or 20 years ago. With this in mind, HSHS St. Elizabeth's continues to provide monthly blood pressure screenings and 1:1 education at East St. Louis's Cosgrove's Kitchen. Cosgrove's Soup Kitchen has been an important ministry serving those suffering from the effects of poverty. It is the only facility in the East St. Louis area that offers a free noon meal six days a week. Each month, two hospital colleagues engage with the clients at the Kitchen, treating them with dignity and respect while checking their blood pressure, offering health information and providing hygiene kits. Over the past two years, the clients have become more comfortable with hospital colleagues and now ask questions about their health. Although it is difficult to measure the impact of this ministry, it is easy to recognize the positive impact that personal interaction has on the community when we are present. Now, some clients bring their medications with them and ask questions to understand what and why they are taking the medication. One client approached a "familiar face" at a local East St. Louis church health fair. He asked the nurse if she knew him, and she did recognize him from the Kitchen. He proceeded to explain his symptoms and she directed him to the nearest Emergency Department because his symptoms resembled a stroke. He followed her instructions and sought medical care. The following month at the Kitchen, the client eagerly approached the nurse asking "Do you remember me?" After acknowledging him, he said, "Look, I'm okay! They told me I caught it in time!" Due to relationship and trust established at the Kitchen, the man did not suffer a stroke. To provide ongoing health care education, HSHS St. Elizabeth's participates in health fair events throughout the community. Connecting with residents in shelters, participating in East St. Louis corner grocery store initiatives, and attending church-sponsored events are some of the examples of events where the hospital takes took our mission outside of our walls. Annually, HSHS St. Elizabeth's colleagues provide blood pressure screens and education on cardiovascular risk factors and signs and symptoms of a heart attack to hundreds of community members. Hospital colleagues also taught hands only CPR in area grade schools. As a result of her participation in the hands only CPR class, a 5th grader recognized that her father was not feeling well and asked if she should call 911 since her mother was not at home. The father did not want her to call 911 but based on the information she learned at school, she called anyway. The ambulance came and father had a cardiac arrest on the way to the hospital. Had it not been for the hospital's school-based education and the bravery of this young girl, her father would not be alive. Happily, he made a full recovery and the family shared their story publicly through a testimonial video used on the hospital's website and on social media. HSHS St. Elizabeth's also collaborates with the YMCA to provide the Lifefit program to meet the complex needs of 15 YMCA underserved families. Through monthly meetings, educational offerings, and bi-weekly check-ins, Lifefit provided the families with opportunity, connections and information to lead healthier lives. Lifefit concluded last summer, however, the success of the program resulted in partnership with the YMCA to sponsor a bike and ride program for the citizens of our local community to promote healthy physical activity. HSHS St Elizabeth's continues to provide education classes to our military and civilian partners in the community through courses such as Advanced Cardiac Life Support, Pediatric Advanced Life support and Neonatal Resuscitation courses. Wellness, Nutrition and Access to Healthy Food The East St. Louis Make Health Happen partnership consists of local community organizations working together to change policy, improve food access, and increase consumption of healthy foods in East St. Louis, Illinois. The Corner Store Initiative increased access to healthy food while building demand in the community through education and promotion of healthy food options. Community partners improved access to nutrition information through healthy cooking demonstrations and an ongoing nutrition-based education series. HSHS St. Elizabeth's participated in community events in East St Louis including a church health fair, a Corner Store event, and a community center event to support Make Health Happen, and to provided blood pressure screenings, healthy recipes and cardiac health education. Schedule H, Part VI, Line 6 DESCRIPTION OF AFFILIATED GROUP (continued A) HSHS Good Shepherd Hospital in Shelbyville, Illinois increases access to mammograms, diagnostic screenings and breast cancer treatments for women through the hospital's Pink Ribbon Program and Vicky Wagner Breast Cancer Assistance Fund. The Pink Ribbon Program covers the costs of mammograms or diagnostic screenings for women living in rural areas who are under or uninsured. The Vicky Wagner Breast Cancer Assistance Fund assists women living in Shelby County who are receiving treatment for breast cancer with out of pocket expenses such as wigs, transportation to treatment appointments, child care, meals or other expenses that insurance doesn't cover. In southwest Illinois, HSHS St. Joseph's Hospital in Highland provides enhanced offerings for senior population based on their CHNA. "Senior Renewal" is an outpatient counseling program for senior adults who may be facing emotional and physical problems unique to the aging process such as feelings of loneliness, isolation and anxiety. Clients receive a comprehensive level of treatment without inpatient hospitalization through counseling strategies and education. In addition, St. Joseph's Hospital is the lead collaborator in the Highland Area Meals on Wheels Program. In April 1977, the hospital partnered with the now defunct Highland Area Council of Churches to introduce the Meals on Wheels program. Today, St. Joseph's partners with the civic organization Highland Area Meals on Wheels Program to prepare and deliver nutritious meals to the elderly, those who are recuperating from illness or hospital stays, or anyone wishing to participate in the program within a 15-mile radius (cumulative population 20,000+) of the hospital. Annually, approximately 16,896 meals are delivered in eight communities. In addition to programs designed to increase access to care, HSHS makes sure that those who need financial assistance receive it. HSHS's Financial Assistance (Charity Care) policy was modified effective January 1, 2014 to offer a 25 percent self-pay discount to all patients who register without insurance. HSHS Financial Assistance programs have a sliding scale, in some instances providing up to a 55 percent reduction off billed charges if an uninsured patient's family income level is determined to be above 500 percent but equal to our less than 600 percent of the current Federal Poverty Guidelines. HSHS hospitals waive all charges for patients below 200 percent of the Federal Poverty Levels. Counselors are available in our hospitals to explain our financial assistance policy to patients, provide them with assistance in filling out a simple application form, or help them enroll in publicly funded health care programs. Enhance community health As part of our mission to embody Christ's healing love for all people, we understand that we have a responsibility to improve the overall quality of life in our communities by supporting initiatives that promote health and wellness. We recognize we are most successful when we work together with a wide array of public and private organizations that share our commitment to improving lives. By doing so, we maximize our efforts and reduce the duplication of services. To ensure the health care needs of all are being met, HSHS hospitals also understand we need to listen closely to the residents of the communities we serve. In turn, 13 HSHS hospitals conducted Community Health Needs Assessments (CHNAs) in FY2015. HSHS St. Clare Memorial Hospital in Oconto Falls, Wisconsin, who affiliated with HSHS in September 2015, and HSHS Holy Family Hospital in Greenville, Illinois, who affiliated with HSHS in May 2016, both completed their CHNAs in FY2014. HSHS Good Shepherd Hospital in Shelbyville, Illinois who affiliated with HSHS in January 2017, conducted its most recent CHNA in FY2016. HSHS hospitals are using the information gathered from their most recent CHNAs to develop new, and enhance existing, programs and services that best address the needs of the community. Priority health care needs were identified in the FY2015 CHNAs including access to health care services; alcohol, tobacco, and other drug abuse; chronic disease prevention and management; nutrition/wellness; mental health; and oral health. HSHS hospitals are addressing these and other needs by proactively offering educational opportunities, preventative screenings, and new or enhanced clinical services. In many cases, the hospitals collaborate with other hospital facilities, local departments of public health and community organizations to address identified needs. In western Wisconsin, HSHS Sacred Heart Hospital in Eau Claire and HSHS St. Joseph's Hospital in Chippewa Falls are taking the lead to educate the public about mental health issues and treatment, the stigma associated with mental health, and the recognition of mental health issues. Under the umbrella of 3D Community Health, the hospitals led suicide prevention activities across multiple sectors in collaboration with the Chippewa Health Improvement Partnership in FY2017. Strategies included community trainings of an evidence-based suicide prevention program, QPR (question, persuade & refer), and a variety of events, activities and displays pertaining to suicide prevention. Efforts are measured by the county suicide rate, inventory of change in community knowledge, stigma and behaviors, as well as participation in the county suicide death review team to monitor for potential trends and respond accordingly. 3D formed a suicide death review team in both Eau Claire and Chippewa Counties. These teams review details of each suicide to look for trends and key pieces of information that may guide efforts in targeting certain geographic areas, certain age or gender, etc. 3D is also focused on increasing community awareness and knowledge of the factors that offer protection from suicidal behaviors and that promote wellness and recovery in collaboration with multiple community partners on an ongoing basis. One strategy is to promote effective programs and practices i.e. adverse childhood experiences (ACEs) that increase protection from suicidal risk and promote connectedness among residents of Chippewa and Eau Claire Counties. At the Children, Health and Family Summit that 3D Community Health coordinated in partnership with the County Department of Human Services in FY2017, 99 of the 190 attendees took a pre-and- post-event survey about ACEs and brain development. There was a 24% increase in the percentage who strongly agreed that exposing infants to stress can actually cause them to develop a smaller brain post-event compared to pre-event survey. HSHS Holy Family Hospital in Greenville, Illinois has sponsored a multi-faceted health fair for decades, one of the largest Health Fairs in the east St. Louis metropolitan area. The event provides many free health tests in addition to five, low-cost comprehensive blood tests. In FY2017, more than 2,000 blood tests were performed as part of the hospital's annual Health Fair. Participants could choose from a comprehensive blood test, prostate specific antigen blood test (PSA), Hemoglobin A1-C, Vitamin D blood test, Colovantage or a combination of the five blood tests. The cost incurred by HSHS Holy Family Hospital for offering these discounted services was $1,431,105. In addition to the services provided on the day of the Health Fair, the hospital also performs the low-cost blood tests at several off-site locations including area schools, businesses, and manufacturers. Through the years, life-threatening and serious medical conditions have been discovered through testing performed in association with the Health Fair. Mary's Garden is a community teaching garden located on the campus of HSHS St. Mary's Hospital in Decatur, Illinois. The goals of the community garden are to improve community health and food accessibility for those in need, teach the younger generation sustainable gardening and offer a comprehensive, place-based approach to community health improvement. In FY2017 Mary's Garden became a living classroom for Eisenhower High School students who use the garden for interactive instruction on health and nutrition, science, mathematics, ecology and agriculture. Mary's Garden also provided opportunities for two apprentices to develop competencies and self-confidence to move into rural and urban farming/gardening leadership roles and launched a community-supported agriculture (CSA) program for colleagues. This created two jobs and is providing a model for turning dilapidated city lots into urban gardens. The hospital has engaged City officials about a job creation program and neighborhood revitalization. Schedule H, Part VI, Line 6 DESCRIPTION OF AFFILIATED GROUP (continued B) The Make Health Happen partnership is transitioning to a non-profit organization. The partnership was a result of a grant that ended last fiscal year. However, the community partners remain committed. Therefore, to increase our visibility and presence in the community, the coalition sought non-profit status and a HSHS St. Elizabeth's colleague serves on the Board of Directors, which is working with city officials to create a strategic plan that incorporates both short and long-term strategies. Understanding the importance of nutrition, HSHS St. Elizabeth's is providing nutritional education in senior centers in East St Louis. Under the advice of a hospital dietician, one local senior center will receive additional instruction hon how to create healthier meals for seniors. Other Community Benefit Activities and Programs Breast Health Awareness October is Breast Health Awareness month. Annually, HSHS St. Elizabeth's Hospital connects with the community to educate and raise awareness of the importance of breast health. In FY2017, the hospital partnered with the local newspaper, our regional FQHC, a local business, and the HSHS Southern Illinois Division to host a community Health Fair at the local mall. A member of the Illinois Breast and Cervical Cancer program was present to share information about their programs for qualified individuals. Nearly 70 women participated. The community Health Fair included breast health information, mammography scheduling, bone density screenings, cardiac and stroke information, blood pressure and BMI screenings, diabetes information and a diabetes risk assessment, and an on-demand glucose screening. In- Kind donations for the community, the poor, and the vulnerable HSHS St. Elizabeth's provides in-kind donations to social and educational organizations. For example, space is donated to a variety of organizations that are aligned with our mission and values including support groups, blood drives and the county morgue. HSHS St. Elizabeth's donates printing services and office supplies for two small local non-profit organizations. Education HSHS St. Elizabeth's is a strong proponent of education and provides mentoring to individuals in the clinical disciples as well those outside of the clinical setting. In conjunction with St Louis University, Southern Illinois Health Foundation (FQHC), and Scott Air Force Base, the hospital supports a Family Practice Residency. Other disciplines that receive on site education and mentoring include nursing, pharmacy, pharmacy informatics, respiratory, radiology, occupational, physical, and speech therapies. Non-clinical education includes administrative secretary, medical records, and a masters of health administration. Immunization Clinic for the Underserved Flu vaccines were provided to community members who are homeless or clients of Cosgrove's Kitchen. Schedule H, Part VI, Line 5 Promotion of community health (continued B) Pregnancy Loss Support Group: The Share Program Pregnancy loss affects families of all races, all socioeconomic groups, and all ages. It is important to for those who experience pregnancy or infant loss to be supported and surrounded by those who understand the devastating emotional, physical, and long lasting effects pregnancy loss creates. Unfortunately, in the community served by St. Elizabeth's Hospital, support for grieving families has been limited. Share is a pregnancy and infant loss program dedicated to supporting mothers and families experiencing this heartbreaking tragedy. Two colleagues on the Obstetrics unit, embraced the challenge of establishing a Share Chapter at St. Elizabeth's to help support those facing loss during a period of life that is usually exciting and celebrated-the birth of a child. HSHS St Elizabeth's continues to serve as the chapter leader for this organization in our community. Mothers interact with our Share leader both in person and through social media. She makes accommodations to meet the needs of the mother through the bi-monthly meetings or through email. This year she interacted with 15 different mothers who experienced fetal loss. In- Kind donations for the community, the poor, and the vulnerable HSHS St Elizabeth's provides and donates a plethora of donations to various social and educational agencies. For example seven agencies received 137 computer devices to support students in the classroom and computers to facilitate and manage social agencies. Conference room space is donated to a variety of organizations that are aligned with our mission and principles. An example of such space includes providing meeting space for support groups, blood drives, and also housing the county morgue. HSHS St Elizabeth's provides printing services for two small small local non-profit organizations. Education HSHS St Elizabeth's is a strong supporter of education and provides mentoring to individuals in the clinical disciples as well those outside of the clinical setting. In conjunction with St Louis University, Southern Illinois Health Foundation (FQHC), and Scott Air Force Base, the hospital supports a Family Practice Residency. Other disciplines that receive on site education and mentoring include nursing, pharmacy, pharmacy informatics, respiratory, radiology, occupational, physical, and speech therapies. Non clinical education includes administrative secretary, medical records, and a master of health administration to name a few. Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 5863375 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance TO DETERMINE THE ACTUAL COST OF THESE SERVICES, THE HOSPITAL USES A COST-TO-CHARGE RATIO BASED ON OUR AUDITED FINANCIAL STATEMENTS TO CALCULATE THE AMOUNTS REPORTED ON LINES 7A THROUGH 7I. THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) WAS SUBTRACTED PRIOR TO AND FOR THE PURPOSE OF CALCULATING THE PERCENTAGE IN PART I, LINE 7, COLUMN (F) IS $5,863,375. Schedule H, Part II Community Building Activities Workforce (non-hospital) development: HSHS St Elizabeth's Replacement Hospital working with minority groups. HSHS St. Elizabeth's honors the over 140 year tradition of the Sisters in the Belleville and surrounding communities by ensuring it can sustain the Sisters' mission well into the future. One way HSHS St. Elizabeth's is able to sustain its mission is through the effective development and utilization of the hospital's financial resources in its policies and practices. HSHS St. Elizabeth's purposefully and diligently planned careful utilization of its financial resources in the construction and planning of the replacement hospital and medical office building in O'Fallon, Illinois. First, HSHS St. Elizabeth's made a commitment to the community to ensure representation on the project from minority and women owned businesses in the construction of the building. In addition, local subcontractors are used whenever possible to support the local community and continue the partnership between the hospital and community. Workforce (non-hospital) development: Bridges Connections District 201 Bridges Connections District 201 is designed to help special needs students learn marketable skills through on the job training. Up to three students receive two hours of supervised job training for each day during the school year. Each student progresses through a three-phase program. Bridges enhances this high-risk population's ability to be productive members of our community. Environmental improvements: Sanitary Pump Station Throughout the process of construction, the neighbors to the new hospital in Misty Valley subdivision have been kept informed. Misty Valley residents experienced many issues relative to their current sanitary pump station. When the new hospital construction team identified the need for a new sanitary pump station on the campus, the hospital built the pump station in a location that would also serve the Misty Valley neighborhood. This demonstrated our commitment to work with the community, improve the environment and be good stewards of our resources. Leadership Development: Leadership Belleville Partnerships with community business leaders is an important part of furthering positive perceptions of HSH St. Elizabeth's as a healing and caring organization. One of HSHS St. Elizabeth's leaders participated in community functions to further convey our message of commitment to southwestern Illinois, and completed Leadership Belleville is a nine-month commitment and unique training program for individuals who have demonstrated high leadership qualities. Coalition Building: BASIC Initiative (Belleville Achieves Strength in Character) BASIC is a partnership of schools, the City of Belleville, and the business community to strengthen character in our youth and in the community. BASIC encourages youth and adults to be productive citizens in our community. HSHS St Elizabeth's is an active member of this organization. Coalition Building: St. Clair County Health Commission HSHS St. Elizabeth's Hospital initiated practices that later became part of the health department when they formed in 1985. A member of HSHS St. Elizabeth's participates in the Health Care Commission. The Health Care Commission, founded in 1991, is a 20 plus organization that serves as a public health system to establish priority health issues, mobilize resources to meet identified needs, and promote the health and well-being of the county residents. This year, HSHS St. Elizabeth's was a lead sponsor for the 8th annual policy summit. The summit launched further discussion and advancement toward agencies working together for collective impact to improve the health of the county. The county is in the middle of the IPLAN process and HSHS St Elizabeth's co-chaired one aspect of the plan in collaboration with another local hospital. Coalition Building: East Side Aligned HSHS St. Elizabeth's joined East Side Aligned, a collective impact model for children and youth within East St Louis that is led by the United Way. As a member of the health care strategy team, we align our Community Health Needs Assessment and partner with other agencies that have similar goals. For example, Eastside Health District's Make Health Happen coalition sponsored by the CDC (Center of Disease Control) and WIC (Women, Infants, and Children) focused on policy change and increasing healthy foods in the area. Although the grant ended, the coalition remains and is transitioning into a separate non-profit agency in which a HSHS St. Elizabeth's colleague will serve on the board. Community Support: Emergency Management and Disaster Preparedness HSHS St. Elizabeth's is a community leader for emergency management. The hospital's EMS coordinator is on the Advisory Council for two counties and is a certified National Incident Management System (NIMS) and Incident Command Structure (ICS). In conjunction with HSHS St. Elizabeth's colleagues, the EMS coordinator taught 42 community partners NIMS and ICS. However, it is this colleague's involvement in the Local Emergency Planning Committees (LEPC) that integrates and prepares HSHS St. Elizabeth's to respond effectively in a disaster. Two of HSHS St Elizabeth's colleagues who are trained in emergency management served as evaluators at a local mock tornado drill. HSHS St. Elizabeth's was the only hospital involved in this county-wide exercise. In addition, HSHS St. Elizabeth's continues as an assessing hospital for EBOLA Community Support: Pregnancy Care Center The hospital's Mother Child Department coordinates donation drives for the Pregnancy Care Center, which is located on the Belleville campus in space donated by the hospital. The Center provides free services including pregnancy tests, referrals for medical care, WIC and other resource information; these resources are also provided by the hospital. The Pregnancy Care Center also provides clothing and supplies to those with financial needs. Community Support: Social Agency Donations Food, clothing, and school supply drives, as well as electronics recycling events were conducted in collaboration with local social agencies such as St. Vincent DePaul, Catholic Urban Programs, and local food pantries to meet the needs of the underserved and reduce the burden of government In FY2017, colleagues donated 56 food baskets weighing approximately pounds 70 each for colleagues in need, and donated an additional 230 pounds of food to Cathedral Food Pantry. More than 75 pounds of clothing supported a local church ministry and backpacks and school supplies were donated to the Violence Prevention Center and hospital colleagues in need. HSHS St. Elizabeth's partners with the local blood services and provides a location to blood donation and contributes to incentives to encourage colleagues and the public to participate. A hospital colleague also serves on the board for the Center of Autism. Community Health improvement and advocacy: Behavioral Health Care In January of 2016, the Behavioral Healthcare Unit at HSHS St. Elizabeth's Hospital closed after working closely with Touchette Regional Hospital to create a Mental Health Center of Excellence. We met with our counterparts from Touchette regularly during the planning stages in order to make this transition of facilities a smooth and effortless process. Both hospitals are members of the Metro-east Behavioral Health Network Council. This is a group of agencies within our community that share resources and implement new treatment strategies for our patients with psychiatric needs. Even though HSHS St. Elizabeth's no longer offers this type of treatment, it is aligned with area facilities and specialists that accommodate our patient population. To facilitate the care of mental health patients at HSHS St Elizabeth's, a mental health nurse practitioner is on staff to assess the needs of this patient population. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Self-pay patients are screened for verification of no insurance coverage. Once verification of no coverage has been completed, the guarantors will be screened for charity or uninsured discounts based on income levels. Those guarantors that do not qualify for charity through the screening process will be asked to provide proof of income in the form of a recent pay stub and/or recent tax return to determine the level of uninsured discounting. If no proof of income is provided or a guarantor's income is greater than 201% of the federal poverty level, the appropriate discount according to the established criteria up to 600% of the federal poverty level will be applied. The amount of money not collected from those self-pay patients who are not eligible for charity care is reported as bad debt. Allowances for Doubtful Accounts have been recorded based on an historical matrix, using collectability percentages by payor and aging category in accordance with HSHS Executive Policy #F-23, Valuation of Net Accounts Receivable. Percentages are based on historical experience at the hospital and adjusted for known limitations. HSHS ST. ELIZABETH'S HOSPITAL REPORTS BAD DEBT IN ACCORDANCE WITH HEALTHCARE FINANCIAL\ MANAGEMENT ASSOCIATION STATEMENT 15, AS MODIFIED AND CONSISTENT WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP). Schedule H, Part III, Line 3 Bad Debt Expense Methodology The hospital strongly believes that its charity care, and the related community benefit obtained from such care, is understated because of those patients who potentially qualify for charity care but do not wish to apply for it. In addition, some care is not classified as charity because of missing documentation on patient resources. Thus, the hospital's bad debt includes a portion that could be classified as charity care if application for such care was sought and/or completed. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote The text of the footnote to the organization's financial statements that describes bad debt expense can be found on page 21 of the HSHS Consolidated Audit Report. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs HSHS St. Elizabeth's Hospital continually strives to provide excellent patient care in the most cost effective fashion. Nonetheless, the Medicare program, in many cases, does not provide payment that covers the full cost of the care provided. Since it is the mission of the hospital to respond to community need, hospital management continually advocates for improved Medicare payment so that the cost of quality care to those patients who are not able to afford it is not compromised and is fairly subsidized by all payers. While this shortfall in Medicare payments is not classified as community benefit by the IRS, we nonetheless believe it is an important contribution made by the hospital to the health and well-being of the community. If the Medicare program did not exist, many Medicare patients would be eligible for charity care or other means-tested government programs. Further, by absorbing this payment shortfall and providing care below cost to these individuals, HSHS St Elizabeth's is relieving the burdens of the government. Accordingly, this shortfall restricts HSHS St Elizabeth's ability to make funds available to provide for charity care and other community benefits. The hospital Medicare shortfall at cost for fiscal year 2017 was $6,796,590. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance The hospital makes reasonable efforts to determine a patient's eligibility for the Financial Assistance Program before utilizing any extraordinary collection actions. Upon admission, a patient receives information about the Financial Assistance Program and how to fill out an application, along with a phone number to contact for further help. Inpatients that are uninsured and not eligible for Medicaid are given a Financial Assistance Application. Each patient will then receive a minimum of three bills with information on how to apply for Financial Assistance. Accounts of patients who have not responded to any of these inquiries will be recommended for bad debt. However, before submitting accounts to a collection agency, the guarantor is screened (using an external program) for charity qualification. If the guarantor qualifies for a full adjustment, the account is settled. We do offer a sliding scale discount for charity. If they qualify for less than 100%, the discount will be posted and the account transferred to the collection agency. The collection agency will do further screening based on their credit score and propensity to pay. Based on this screening, the collection agency may return the account with a recommendation of charity. Schedule H, Part V, Section B, Line 16a FAP website - ST. ELIZABETH'S HOSPITAL: Line 16a URL: http://www.steliz.org/Patient-Guest/Financial-Assistance; Schedule H, Part V, Section B, Line 16b FAP Application website - ST. ELIZABETH'S HOSPITAL: Line 16b URL: http://www.steliz.org/Patient-Guest/Financial-Assistance; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - ST. ELIZABETH'S HOSPITAL: Line 16c URL: http://www.steliz.org/Patient-Guest/Financial-Assistance; Schedule H, Part VI, Line 2 Needs assessment As indicated in Part V, Section C, the hospital conducted a Community Health Needs Assessment in FY2015. In addition to conducting a Community Health Needs Assessment (CHNA) triennially per the provisions in the Affordable Care Act, the hospital routinely assesses the health care needs of the communities it serves in a variety of ways, including reviewing the health needs assessments of other health care organizations in our service area as well our local and state health departments and the United Way. We continually review primary data such as hospital and emergency department utilization and patient surveys as well as secondary data from our county and state public health departments, the Centers for Disease Control, County Health Rankings, and the Behavioral Risk FS Survey to name a few. On occasion, we will also collect primary data through telephone and electronic survey instruments. In addition to ongoing primary and secondary data collection and analysis, the hospital regularly assesses the health care needs of the communities it serves through feedback received from its internal assessment team, assessment advisory team, hospital leadership, Strategy department and hospital Board members. As part of the three-year Implementation Plan, the hospital shares its progress toward achieving its short and long term indicators in various community venues such as town hall meetings, community forums, and Chamber of Commerce. Also through volunteer and board service with other local health care, social service agencies, law enforcement task forces, and area schools, hospital colleagues gather ongoing information on the health care needs of the communities it serves. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance The Registration Department informs all patients about the Financial Assistance Policy and provides applications and brochures upon request. They are printed and readily available. This packet contains a letter identifying financial assistance opportunities offered to our patients as well as a financial assistance application. At the time of registration, a brochure is provided to self-pay patients upon registration regarding the Financial Assistance Program available to them at HSHS St. Elizabeth's. The brochures are also supplied in waiting and ancillary areas for easy access by the patient. The hospital has onsite advocates to assist patients with enrollment in several federal, state and local government programs. These Advocates visit patients while in the hospital or contact them by phone once discharged. The advocates will also make home visits as needed to assist patients with enrollment as well as gathering necessary documents for application. We also offer an online business office portal that provides information on how to read and understand HSHS St. Elizabeth's billing information. HSHS St. Elizabeth's website provides an explanation of Medicare forms at www.steliz.org. Each statement that a patient receives contains information about our Financial Assistance Program and a phone number for assistance with applying. Any patient visiting the onsite financial counselor as well as contacting us via phone are given information about payment options including our financial assistance options. Even after an account is sent to a collection agency and/or anytime in the process they believe a patient may be eligible for financial assistance, the account is returned to the hospital for evaluation. HSHS St. Elizabeth's makes their financial assistance application and standard response letters available in Spanish, as well as English. Patients are also provided a Fair Billing Act notification at the point of registration regarding separate physician billing they can expect to receive, plus information about the patient's financial responsibility if their insurance plan is out of network. A system called Payment Navigator is now being utilized after failed attempts have been made by the hospital to receive payment, but before sending to a collection agency. That system accesses credit and other information and allows us to see the probability of a patient being able to pay their bill. After assessing that information, the hospital determines whether to grant charity care or continue collection efforts. Schedule H, Part VI, Line 4 Community information HSHS St. Elizabeth's Hospital service area is comprised of approximately 1955 square miles with a population of approximately 610,057 and a population density of 312 per square mile. The service area consists of the following communities: St. Clair, Monroe, Madison, and Clinton counties. The population of these counties is 270,056, 32,957, 269,282, and 37,762 respectively. The population increased in the service area by 5.51% between 2000 and 2010. The population in HSHS St. Elizabeth's service area had a similar age distribution as the state as a whole. Belleville, the county seat of St. Clair county, has median household income is $49,634 compared to the national median income of $53,271. More than 85,000 residents (14.0%) in the service area live below poverty. Thirty percent of the area's population lives below 200% of the poverty level. The population in Clinton County that is uninsured is 6.9%, Madison County is 9.5%, Monroe County is 5.9%, and St. Clair County is 11.4%. Hospitals that also provide service include five hospitals in Madison County, one hospital in Clinton County, three hospitals in St. Clair County with one being a FQHC, and no hospitals in Monroe county. The hospital does not exclude Medically Underserved Areas (MUAs), low income or minority populations from its service area. Schedule H, Part VI, Line 5 Promotion of community health As a healing ministry of the Catholic Church and an affiliate of Hospital Sisters Health System (HSHS), HSHS St. Elizabeth's is committed to delivering high quality, compassionate, and cost-effective health care services to all. Founded in 1875, the hospital brings a healing presence and improves the health of our community, especially for those persons who are sick, poor, and disadvantaged. Because of the hospital's mission and heritage, the hospital is dedicated to promoting the health of St. Clair County and the surrounding counties of Madison, Clinton, and Monroe. The hospital is governed by a Board of Directors, at least a majority of whom reside in the hospital's primary service area and who are neither employees nor independent contractors of the hospital (nor family members thereof). The Board ensures that HSHS St. Elizabeth's is responding to community need. In FY2017, for example, the board reviewed the Community Benefit implementation plan and was especially impressed by the work at Cosgrove's Kitchen. In addition, the Hospital Advisory/Community Benefit Committee expanded membership to complement the CHNA priority needs. Along with this committee, the Foundation and our volunteer auxiliary group advocate on behalf of the hospital in the community. Consistent with its exempt purpose, HSHS St. Elizabeth's has an open medical staff with privileges available to all qualified physicians in the area. The hospital also operates an Emergency Department that is open 24 hours to all persons regardless of their ability to pay. As a not-for-profit hospital, HSHS St. Elizabeth's reinvests surplus funds to support the mission of the organization and health of the community rather than distributing surplus funds as profits to shareholders or individuals. Funds not committed to ongoing operations are generally used to upgrade facilities, secure new technologies, improve patient care, and support initiatives designed to promote health and ensure access for all along with providing medical education and research. Replacement Hospital HSHS St. Elizabeth's largest capital investment is the replacement hospital. With the support of the Hospital Sisters and HSHS, HSHS St. Elizabeth's began the journey years ago, and it will soon be a reality. With the expected patient move date on November 4, 2017, the investment in the new hospital is not merely an investment in bricks and mortar, but in state-of-the-art equipment and patient care. The 144-bed, patient centered facility is built on a 120-acre campus with an adjoining ambulatory care center. The new campus will enhance HSHS St. Elizabeth's ability to develop an integrated care delivery model that will serve residents from across southwestern Illinois for decades to come. The new hospital will offer the latest technology in nearly every department. For example, the lab will be automated, dramatically saving the precious Medical Laboratory Scientists (MLS) resources to complete the more advanced testing; pharmacy will have an automatic dispensing unit; and ultrasound will offer 4D capability. Throughout the process, identifying capital purchases for the new hospital was also balanced with the need for equipment to care for our patients on our current campus. A prime example of this is that HSHS St. Elizabeth's had initially planned to take the existing ventilators to the new hospital due to budgetary constraints. While the existing ventilators were functional, they were starting to show their age. With the savings realized from negotiating other equipment, HSHS St. Elizabeth's purchased new ventilators that allow for a common platform to treat neonates to adults with one ventilator, as well as the ability to interface with EPIC, our new electronic health care record (EHR). HSHS St. Elizabeth's will also start up a new electronic medical record (EHR) on the day of the move to the new campus. Along with this interface, we will obtain the ability to track and monitor all quality metrics with the ventilators in any area of the hospital. Capital Purchasing HSHS St. Elizabeth's utilizes a multi-disciplinary task force to prioritize capital projects. The team reviewed every desired asset and prioritized the list, both clinical and non-clinical to determine which assets to purchase during the year. The criteria used in the evaluation process include: patient and colleague safety, regulatory requirements, infection prevention, equipment age and usage, physician needs and financial information. One example was the purchase and standardization of new defibrillators and crash carts to ensure patient safety and compliance. The Imaging department procured new equipment for several areas including mammography, ultrasound, and nuclear medicine. A new stereotactic biopsy machine was purchased and allows for a more definitive diagnosis. The ultrasound machine increased the scope of testing and the nuclear medicine scanner was obsolete and needed replacement. The additional benefit of purchasing this equipment before the move allows colleagues to train and be proficient which will decrease training time at the new facility. Reinvestment of support services for the community Since 2013, HSHS St. Elizabeth's has utilized telehealth technology to enhance access to health care. We continue to be an Emergent Stroke Ready hospital but we also expanded our services to include pediatrics. In July 2016, HSHS St. Elizabeth's and SSM Health Cardinal Glennon Children's Hospital partnered to bring region leading expertise on pediatric care to Belleville, O'Fallon, and many other communities throughout St. Clair County. Board-certified pediatric physicians are available 24/7 in the Emergency Department and they are readily available to support the newborn nursery in our Mother Child Center. With the support of our telehealth project manager, HSHS St. Elizabeth's further expanded its telehealth services to include pediatrics at our sister facilities of HSHS St. Joseph's Hospital in Breese and HSHS St. Joseph's Hospital in Highland. Through telehealth technology, children that present at either hospital can be quickly connected with SSM Health Cardinal Glennon pediatricians who are at HSHS St. Elizabeth's. The high-resolution video and audio communication provides an interactive experience with the consulting physician who is connected in real-time. The benefit of tele-pediatrics is to prevent delay of care when time is of the essence, especially in an emergency. Children are observed and treated, often without the need for transfer. Other service lines include cardiology and neurology. A cardiologist at HSHS St. Elizabeth's can remote into HSHS St. Joseph's Hospital in Highland when a cardiologist is not readily available. The robot also assists with neurology cases at all three hospitals for Inpatient and Emergency Department care. The benefits of telehealth medicine include faster access to board-certified specialists close to home and near their support systems. It also encourages utilization of local community resources, such as rehabilitation services. HSHS St. Elizabeth's Hospital strives to keep people who suffer from cancer in their community, close to their support systems, and most importantly, actively involved in decisions about their care and treatment. As a recent recipient of Cancer Accreditation through the Commission on Cancer, HSHS St. Elizabeth's provides patients with guaranteed access to important components of treatment recommended by the Health and Medicine Division, National Cancer Comprehensive Network, and the American Society of Clinical Oncology. Patients are treated by a multidisciplinary oncology team and informed about clinical research studies and trial options. As part of the accreditation process, HSHS St. Elizabeth's also implemented an Oncology Wellness Program. The Oncology Wellness Program assists those undergoing cancer treatments to receive the full spectrum of quality care and quality of life care from cancer diagnosis, before, during, and after treatment. Pre-treatment consists of a functional assessment, education, and a home exercise program. During and after treatment, the team evaluates and creates a plan to assist with physical, occupational and speech therapy. A chaplain is also on the care team to assist with emotional and spiritual care. HSHS St. Elizabeth's added the services of a Nurse Navigator to further support and advocate for our cancer patients and their care givers. The Nurse Navigator is a liaison for newly diagnosed cancer patients by providing information and resources to facilitate informed decision making and timely access to health care. The Nurse Navigator helps patients keep track of appointments; educate, guide and empower their decision-making during treatment; and identify and connect patients to other resource in the community. Schedule H, Part VI, Line 6 Affiliated health care system HSHS St. Elizabeth's Hospital is an affiliate of Hospital Sisters Health System (HSHS), a health care ministry that includes 15 hospitals, numerous community-based health centers and clinics, and hundreds of physician partners across Illinois and Wisconsin. The mission of HSHS is "to reveal and embody Christ's healing love for all people through our high-quality Franciscan health care ministry." We live our mission by providing holistic healing to all who seek our care, as well as through Community Benefit. In tandem with others in the communities we serve, our Community Benefit initiatives are strategically increasing access to care, improving the health status of residents, and increasing medical education and knowledge. In FY2017, our hospitals responded to the top needs identified in each of their most recent Community Health Needs Assessments (CHNAs). The information gathered from these assessments was used to develop or enhance Community Benefit programs and services to best address community health needs. Among the priority needs identified in the most recent CHNA process were access to care; alcohol, tobacco, and other drug abuse; chronic disease prevention and management; nutrition/wellness; mental health; and oral health. HSHS hospitals are proactively addressing these and other needs through patient, provider and community education, preventative screenings, self-management classes, and new or enhanced clinical services. In FY2017, HSHS collectively provided $197.6 million in Community Benefit (9.2% of total hospital expenses). This amount included $26.0 million provided for Financial Assistance (a.k.a. Charity Care) and $128.6 million for unreimbursed care provided as part of the Medicaid program. In addition, HSHS hospitals committed significant resources to treat Medicare patients. The cost of providing services to primarily elderly beneficiaries of the Medicare program - in excess of governmental and managed care contract payments - was $205.9 million. HSHS hospitals also recorded $40.9 million in uncollectible accounts. While HSHS does not count the latter two amounts as Community Benefit, they nonetheless reflect our commitment to serving all persons in need of care. In addition to the dollars invested in our Community Benefit programs, HSHS continues to reinvest any surplus revenue from operations and investments into new medical technology, facility infrastructure and health care services in our communities. By doing so, we ensure our ability to meet the ongoing demand for high quality, efficient and easily accessible health care. Improve access to health care As a Franciscan health care ministry, HSHS is deeply committed to serving those who are most in need with a special focus on the poor and vulnerable. We not only provide care to every patient who walks through our doors, but also reach out beyond the walls of our hospitals and clinics to care for those in our communities. Our efforts to ensure residents in the communities we serve receive the right care, at the right time, and in the right setting involve collaborating with others to achieve this goal. Across our two-state System, there are numerous examples of partnerships with departments of public health, other health care facilities and community and social service organizations to enhance access to care for those in need. In FY2017, HSHS and our 15 hospitals dedicated Community Benefit resources to educate uninsured persons about enrollment opportunities in affordable health care coverage and to facilitate the enrollment process. Studies have shown that people without insurance are more likely to postpone care and develop more severe and expensive conditions than their insured counterparts. It is for this reason that the Catholic Church, Catholic health care and HSHS have long promoted "coverage and access for all." HSHS and our 15 hospitals in partnership with local health departments, social service agencies and other health care providers played a vital role in educating eligible people in their service areas, by referring people to Certified Application Counselors and/or in enrolling them in the health insurance exchanges, or by helping them to obtain coverage through Medicaid expansion. In southern Illinois, HSHS St. Elizabeth's Hospital in Belleville is committed to improving access to health care services by assisting eligible patients to enroll in health care plans. In FY2017, more than 3,200 patients were screened and 74% met eligibility criteria and were enrolled in Medicaid. Access to health care is not limited to insurance coverage and access to primary care providers. In FY2017, the hospital assisted patients with access to medications, durable medical equipment, and transportation including more than $5,600 in cab and bus tickets for patients and $14,000 for patients who needed transfer by ambulance. In response to its FY2015 CHNA, HSHS St. John's Hospital in Springfield, Illinois established a community health worker program to increase access to health care and coordination of care for residents of the Enos Park Neighborhood. The hospital also helped establish an Enos Park Neighborhood Advisory Council and Providers Alliance as part of the access collaborative to drive behavior changes and improve health outcomes. In the first three years, the program has realized 93% engagement of 300 clients. Services rendered include basic needs and health care access. Sixteen formally homeless individuals or families were placed in affordable, safe housing. Of the 35 parolees in the program, the recidivism rate was only 18% compared to 60% nationwide. The only reason participating parolees went back to prison was because of lack of a job or housing. One-hundred percent of our clients saw a primary care provider and 84% were connected to a medical home. This program is being replicated in a second location in Sangamon County's eastside where our most vulnerable, low-income and underserved populations exist. Through the support of HSHS St. Mary's Hospital Medical Center and St. Vincent Hospital in Green Bay, the Oral Health Partnership (OHP) continues to expand to communities throughout Brown County, providing dental care to 0 - 19 year olds who are uninsured or underinsured. In FY2017, more than 12,000 general dentistry procedures, including exams, X-rays, cleanings, fillings, and crowns, were completed for youth in Brown County's smaller, less urban communities, and more than 1,300 preventative sealants were applied. OHP serves more than 9,000 kids each year through three fixed-site clinics and the traveling school-based program. In January 2017, OHP's West location was opened in response to data showing an unmet need of medical assistance children in the Ashwaubenon area. This clinic, along with the traveling school-based team, will help OHP and HSHS reach the goal of expanding services to a wider population of Brown County children in need. HSHS St. Francis Hospital in Litchfield, Illinois collaborated with Lewis & Clark Community College and local dental providers to bring the College's mobile dental health unit to the Litchfield area; the unit provides free or low cost dental exams and screenings, x-rays and hygiene services. In addition, three local dental providers also participated by opening their offices and donating time, staff and supplies to provide either a free filling, extraction or hygiene services. Beginning in 2015, the hospital collaborated with Catholic Charities to launch a dental voucher program. Five dentists in Macoupin and Montgomery counties participate in the program, which covers an initial exam and x-rays, one tooth extraction and up to three fillings per year per individual. The percentage of total emergency department visits related to dental issues has decreased from 2.2% in 2011 to .95% in 2016 because of this collaboration. In southeast Illinois, area residents can get help filling a prescription through the long-term collaboration between HSHS St. Anthony's Memorial Hospital in Effingham and Catholic Charities. In FY2017, St. Anthony's Memorial Hospital helped to underwrite the cost of prescription medications for 246 residents. St. Anthony's Memorial Hospital and Catholic Charities believe no one should be without prescriptions because of the inability to pay. Schedule H, Part VI, Line 7 State filing of community benefit report IL X true true X X X X X true true false false false false false false false Peggy Sebastian PRESIDENT & CEO 0 294759 0 113216 0 143191 0 141997 0 16142 0 709305 0 29062 SHELLEY A HARRIS INTERIM PRESIDENT & CEO - Through 6/25/16 119009 0 2080 0 183448 0 183421 0 21265 0 509223 0 0 0 LAWRENCE SCHUMACHER Former DIVISION CEO - INTERIM 0 0 0 0 0 622151 0 0 0 0 0 622151 0 0 ANN M CARR TREASURER 0 251800 0 39616 0 68544 0 291816 0 20710 0 672486 0 31485 JAMES DOVER CEO SOUTHERN IL DIVISION 0 550475 0 96529 0 41692 0 95620 0 37504 0 821820 0 0 ELIZABETH GOVERO CHIEF NURSING OFFICER 3231 121633 0 30221 0 780 20879 0 0 8162 24110 160796 0 0 DAVID NOSACKA DIVISION CFO 325821 0 28676 0 5046 0 42252 0 23291 0 425086 0 0 0 MARY LOU TATE DIRECTOR OF FINANCE 140321 0 0 0 780 0 19591 0 22909 0 183601 0 0 0 AMY M BALLANCE VP BUSINESS DEVELOPMENT SOUTHERN IL DIVISION 197978 0 11660 0 937 0 80787 0 21346 0 312708 0 0 0 SUSAN M HOLLOWAY PROJECT MANAGER, NEW CONSTRUCTION 177145 0 0 0 704 0 149115 0 8672 0 335636 0 0 0 MARGARET A LUNA CHIEF PEOPLE OFFICER SOUTHERN IL DIVISION 225316 0 13226 0 704 0 164454 0 16608 0 420308 0 0 0 COREY J HASTINGS DIRECTOR OF FINANCE SOUTHERN IL DIVISION 151817 0 0 0 0 0 34079 0 20461 0 206357 0 0 0 JACQUELYNNE N HOLST VP LEGAL AFFAIRS SOUTHERN IL DIVISION / HSHS ASSOCIATE GENERAL COUNSEL 181474 0 10869 0 390 0 39026 0 19298 0 251057 0 0 0 BRIAN D JOHNSON EXECUTIVE DIRECTOR OF SURGICAL SERVICES 168983 0 0 0 390 0 41704 0 20628 0 231705 0 0 0 JULIA K SCHIMMELPFENNIG DIRECTOR OF PHARMACY 158428 0 0 0 0 0 43262 0 944 0 202634 0 0 0 PETER K WONG CHIEF PERFORMANCE IMPROVEMENT OFFICER SOUTHERN IL DIVISION 139001 0 16677 0 169381 0 0 0 16316 0 341375 0 0 0 Schedule J, Part I, Line 1a Tax indemnification and gross-up payments TAX GROSS-UPS WERE PAID TO THE FOLLOWING: AMY BALLANCE IN THE AMOUNT OF $57.23. SUSAN HOLLOWAY IN THE AMOUNT OF $114.47. MARGARET LUNA IN THE AMOUNT OF $114.47. PEGGY SEBASTIAN IN THE AMOUNT OF $75,651. THE FAIR VALUE OF THESE BENEFITS WAS INCLUDED IN THE INDIVIDUALS' ANNUAL REPORTED INCOME. Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation PLEASE SEE RESPONSE TO FORM 990, PART VI, LINE 15A IN SCHEDULE O. Schedule J, Part I, Line 4a Severance or change-of-control payment Interested Person: Shelley Harris Organization: St. Elizabeth's Hospital of the Hospital Sisters of the Third Order of St. Francis EIN: 37-0663567 Amount: $123,781 Terms: Compensation paid as a result of a severance from the position of Interim President & CEO. Interested Person: Peter Wong Organization: St. Elizabeth's Hospital of the Hospital Sisters of the Third Order of St. Francis EIN: 37-0663567 Amount: $136,251 Terms: Compensation paid as a result of a severance from the position of Chief Performance Improvement Officer. ORGANIZATION: HOSPITAL SISTERS HEALTH SYSTEM, INC. EIN: 37-1058692 INTERESTED PERSON: LAWRENCE SCHUMACHER AMOUNT: $619,080 TERMS: COMPENSATION PAID AS A RESULT OF A SEVERANCE FROM THE POSITION OF COO. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan HSHS EXECUTIVES ELIGIBLE TO PARTICIPATE IN SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) ARE DEFINED IN THE SERP PLAN DOCUMENTS. THE SERP WAS ESTABLISHED TO PROVIDE ADDITIONAL RETIREMENT BENEFITS TO ENSURE REASONABLE MARKET COMPETITIVE BENEFITS IN ACCORDANCE WITH THE HSHS EXECUTIVE COMPENSATION PHILOSOPHY ESTABLISHED BY THE HSHS COMPENSATION COMMITTEE. THE PLAN PROVIDES A DEFINED RETIREMENT CONTRIBUTION TO PARTICIPANTS COMMENCING ON JANUARY 1, 2008, EQUAL TO A PERCENTAGE OF COMPENSATION AS DEFINED IN THE SERP PLAN DOCUENTS FOR THE PLAN YEAR. PARTICIPANTS CONSTRUCTIVELY RECEIVE A DISTRIBUTION FROM THE PLAN NO LATER THAN MARCH 15TH OF THE CALENDAR YEAR FOLLOWING THE CALENDAR YEAR IN WHICH AN AMOUNT IS VESTED AND TAXABLE PURSUANT TO A VESTING SCHEDULE AS SPECIFIED IN THE PLAN DOCUMENT. THE ACTUAL DISTRIBUTION OF THE VESTED BENEFIT UNDER THE PLAN IS PAID IN A SINGLE LUMP SUM TO THE PARTICIPANT OR THE PARTICIPANT'S BENEFICIARY UPON THE EARLIER OF THE PARTICIPANT'S TERMINATION OF EMPLOYMENT, DEATH, OR TOTAL AND PERMANENT DISABILITY. THE FOLLOWING INTERESTED PERSONS CONSTRUCTIVELY RECEIVED DEFERRALS TO THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2016 THESE DEFERRALS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). Ann Carr -- $31,564 James Dover -- $85,408 Peggy Sebastian -- $34,153 THE FOLLOWING INTERESTED PERSONS RECEIVED DISTRIBUTIONS FROM THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2016 THESE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III) AND SCHEDULE J, PART II, COLUMN (F), AS APPLICABLE. Ann Carr -- $31,485 Peggy Sebastian -- $29,062 Form 990, Part III, Line 1 ORGANIZATION'S MISSION THE MISSION OF HSHS ST. ELIZABETH'S HOSPITAL IS TO REVEAL AND EMBODY CHRIST'S HEALING LOVE FOR ALL PEOPLE THROUGH OUR HIGH QUALITY FRANCISCAN HEALTH CARE MINISTRY. IN THE PERFORMANCE OF ITS MISSION, HSHS ST. ELIZABETH'S HOSPITAL WILL FOSTER THE VALUES OF RESPECT, CARE, COMPETENCE AND JOY. RESPECT IS THE FRANCISCAN RESPECT FOR LIFE FROM CONCEPTION TO DEATH AND FOR THE DIGNITY OF EACH INDIVIDUAL PERSON. IT IS A COMMITMENT TO FREEING AND EMPOWERING EACH PERSON TO DEVELOP TO HIS OR FULL POTENTIAL. CARE EMBODIES THE CONCERN, COMPASSION, AND SENSITIVITY WITH WHICH WE CARE FOR PATIENTS, CLIENTS, EMPLOYEES AND CO-WORKERS. MANY TIMES IT IS THOUGHT OF AS BEDSIDE BEHAVIOR, BUT IT BELONGS IN BUSINESS OFFICES, CAFETERIAS AND BOARDROOMS. COMPETENCE MEANS THAT OUR WORK IS PERFORMED AND ST. ELIZABETH'S IS MANAGED WITH THE HIGHEST LEVEL OF SKILL AND ABILITY. WE ARE COMMITTED TO RECRUITING AND DEVELOPING PEOPLE WHO ARE COMPETENT IN THEIR WORK AND WHOSE VALUES REFLECT OUR OWN. OUR VALUES ARE AN INTEGRAL PART OF OUR SYSTEM'S STRATEGIC PLAN, WHICH PROVIDES THE OVERALL FRAMEWORK FOR LOCAL ACTIVITIES. JOY IS THE MANNER IN WHICH OUR EMPLOYEES AND ALL WHO JOIN US IN OUR MINISTRY SEEK TO PERFORM THEIR WORK -- THE PERSONAL FULFILLMENT OF CARING FOR OTHERS. IT IS AN ESSENTIAL INGREDIENT IN BRINGING A SENSE OF HOPE TO THOSE WHO SUFFER. Form 990, Part III, Line 4d Description of other program services (Expenses $ 63,215,028 including grants of $ 0)(Revenue $ 87,681,202) Other Health Care Services HSHS St. Elizabeth's Hospital delivers a comprehensive array of healthcare services to both inpatients and outpatients. Our accredited programs have consistently demonstrated quality outcomes that positively impact our patients, their families and the entire community. We provide quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of HSHS St. Elizabeth's Hospital, it is recognized that not all individuals possess the ability to purchase essential medical services. It is our mission to serve the sick, especially the poor, with quality healthcare services and healthcare education. We have further defined our mission of identifying those who are at greatest health risk, the elderly, children, those coping with mental illness, and those with less means who are dependent on quality healthcare. HSHS St. Elizabeth's Hospital currently staffs 260 inpatient beds. The hospital employs 1,475 colleagues. Inpatient admissions for Fiscal Year 2017 were 7,990. The Emergency Department had 33,477 visits and admitted 4,804 to inpatient services. The Urgicare Center in O'Fallon, an offsite facility, had 28,358 visits. Total Outpatient visits for the hospital were 186,677. Form 990, Part IV, Line 24a TAX EXEMPT BONDS ST. ELIZABETH'S HOSPITAL HOLDS A LIABILITY ON ITS BOOKS FOR TAX-EXEMPT BONDS, WHICH IS AN ALLOCATION FROM ITS SOLE CORPORATE MEMBER, HOSPITAL SISTERS SERVICES, INC. AS A RESULT, THIS QUESTION WAS ANSWERED NO, AND SCHEDULE K WILL BE COMPLETED ON THE HOSPITAL SISTERS SERVICES, INC. FORM 990. Form 990, Part VI, Line 13 WHISTLEBLOWER POLICY PROVISIONS WITHIN THE CORPORATE COMPLIANCE HOTLINE AND CONFLICT OF INTEREST POLICY PROVIDE PROTECTIONS FOR WHISTLEBLOWER TYPE ACTIVITIES. Form 990, Part VI, Line 16b JOINT VENTURES HOSPITAL SISTERS HEALTH SYSTEM ADOPTED A JOINT VENTURE COMPLIANCE PROGRAM POLICY EFFECTIVE ON JANUARY 1, 2012 FOR ALL SYSTEM HOSPITALS, INCLUDING ST. ELIZABETH'S HOSPITAL. THE OVERALL PURPOSE OF THE POLICY IS TO PROVIDE PRACTICAL GUIDELINES FOR ETHICAL BUSINESS CONDUCT, TO ACHIEVE COMPLIANCE, AND TO DETECT AND PREVENT VIOLATIONS OF APPLICABLE LAWS. THE POLICY REQUIRES ST. ELIZABETH'S HOSPITAL, AND ALL HSHS HOSPITALS, TO EVALUATE THEIR PARTICIPATION IN JOINT VENTURE ARRANGEMENTS, INCLUDING UNDER APPLICABLE FEDERAL TAX LAWS, AND TO SAFEGUARD ST. ELIZABETH'S HOSPITAL'S TAX EXEMPT STATUS WITH RESPECT TO ANY JOINT VENTURE ARRANGEMENTS. Form 990, Part VI, Line 6 Classes of members or stockholders THE SENIOR GOVERNING BODY OF HSHS ST. ELIZABETH'S HOSPITAL (THE CORPORATION) IS THE MEMBER OF THE CORPORATION, WHICH IS HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body PURSUANT TO SECTION 2.3 OF THE CORPORATION'S BYLAWS, THE ORGANIZATION'S MEMBER, HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, HAS THE RIGHT TO APPOINT AND REMOVE THE CORPORATION'S BOARD OF DIRECTORS, CHAIRPERSON OF THE BOARD AND PRESIDENT. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders RESPONSIBILITY FOR THE POLICY AND OPERATIONS OF HSHS ST. ELIZABETH'S HOSPITAL (THE "CORPORATION") IS VESTED IN ITS BOARD OF DIRECTORS, EXCEPT WITH RESPECT TO SPECIFIC POWERS RESERVED IN THE CORPORATION'S BYLAWS TO THE CORPORATION'S MEMBER, HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBER OF HSSI IS HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE GOVERNANCE AND OPERATIONS OF THE CORPORATION ARE SUBJECT TO HSSI'S RIGHT TO EXERCISE THESE RESERVED POWERS WITH RESPECT TO THE CORPORATION AND ORGANIZATIONS OF WHICH THE CORPORATION IS EITHER, DIRECTLY OR INDIRECTLY, A CONTROLLING MEMBER OR A CONTROLLING SHAREHOLDER ("AFFILIATES"). HSSI'S RIGHT TO EXERCISE CERTAIN OF THESE RESERVED POWERS IS, IN TURN, SUBJECT TO THE APPROVAL OF HSHS AND HSHS' MEMBERS. THE RESERVED POWERS INCLUDE ALL RIGHTS GRANTED TO HSSI BY LAW AND THE RIGHT TO: (A) ADOPT, APPROVE AMENDMENTS TO, OR AMEND ANY STATEMENT OF PHILOSOPHY, MISSION, MISSION INTEGRATION OR VALUES OR ANY NAME, LOGO, OR MARK OF THE CORPORATION OR OF ANY AFFILIATE; (B) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE ARTICLES OF INCORPORATION OF THE CORPORATION OR OF ANY AFFILIATE; (C) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE BYLAWS OF THE CORPORATION OR OF ANY AFFILIATE; (D) APPOINT AND REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE OF THE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, AND THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE; (E) APPROVE THE RECOMMENDATION OF THE BOARD OF DIRECTORS TO APPOINT OR REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, OR THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE. (F) WITH RESPECT TO THE CORPORATION OR ANY AFFILIATE, APPROVE THE PURCHASE, SALE, ALIENATION, EXCHANGE, LEASE OR ENCUMBRANCE OF ANY REAL PROPERTY OF THE CORPORATION OR OF ANY AFFILIATE, WHICH PROPERTY HAS A VALUE IN EXCESS OF LIMITS SET FROM TIME TO TIME BY HSSI; (G) APPROVE THE OPERATING AND CAPITAL BUDGETS OF THE CORPORATION OR OF ANY AFFILIATE, AND ANY DEVIATIONS BY THE CORPORATION OR OF ANY AFFILIATE FROM SUCH BUDGETS IN AN AMOUNT OR PERCENTAGE SPECIFIED BY HSSI FROM TIME TO TIME; (H) APPROVE THE STRATEGIC PLAN AND GOALS OF THE CORPORATION OR OF ANY AFFILIATE; (I) APPROVE THE SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF THE (II) CORPORATION OR OF ANY AFFILIATE; (J) APPROVE THE MERGER OR DISSOLUTION OF THE CORPORATION OR OF ANY AFFILIATE; (K) ADOPT OR AMEND THE PLAN FOR MINISTRY EDUCATION AND GOVERNANCE FOR THE CORPORATION AND ITS AFFILIATES; (L) APPROVE THE CORPORATION'S MISSION ACCOUNTABILITY REPORTS AND THOSE OF ANY AFFILIATE; (M) APPROVE THE FINANCIAL POLICIES AND PROCEDURES OF THE CORPORATION OR OF ANY AFFILIATE AND APPROVE ANY DEVIATIONS FROM SUCH POLICIES AND PROCEDURES BY THE CORPORATION OR ANY AFFILIATE; AND (N) ADOPT POLICIES TO IMPLEMENT THE RESERVED POWERS OF HSSI. Form 990, Part VI, Line 11b Review of form 990 by governing body THE HOSPITAL EMPLOYS CROWE HORWATH TO ASSIST IN THE OVERALL PREPARATION, REVIEW AND ELECTRONIC SUBMISSION OF ITS FORM 990. CROWE HORWATH PROVIDES GUIDANCE IN IDENTIFYING CRITICAL ERRORS IN THE RETURN SUBMISSION AND FEEDBACK ON QUANTITATIVE AND QUALITATIVE RESPONSES. ADDITIONALLY, THE HOSPITAL DIRECTOR OF FINANCE PERFORMS A THOROUGH REVIEW OF THE RETURN AND REVIEWS IT WITH THE HOSPITAL CEO AND/OR SENIOR LEADERS BEFORE PRESENTING IT IN ITS ENTIRETY TO THE HOSPITAL BOARD FOR QUESTIONING AND REVIEW PRIOR TO THE RETURN'S SIGNING AND SUBMISSION TO THE IRS. Form 990, Part VI, Line 12c Conflict of interest policy THE ORGANIZATION IS SUBJECT TO THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY ("POLICY") OF HOSPITAL SISTERS HEALTH SYSTEM, AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. A REVISED CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY HAVE BEEN IMPLEMENTED SINCE JANUARY, 2009 TO MANAGE CONFLICTS OF INTEREST USING A SYSTEM-WIDE PROTOCOL FOR DISCLOSURE STATEMENTS. IN ACCORDANCE WITH THE ORGANIZATON'S CONFLICT OF INTEREST POLICY, ALL COVERED PERSONS HAVE A DUTY TO COMPLY WITH THE CONFLICT OF INTEREST POLICY FOR ANY CONTRACT, TRANSACTION, RELATIONSHIP, OR ACTIVITY CONTEMPLATED, ENTERED INTO, OR CONDUCTED AT HSHS OR ITS AFFILIATES. THE POLICY DEFINES COVERED PERSONS AS BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS, BOARD DESIGNEES, SENIOR MANAGEMENT, MEMBERS OF ANY COMMITTEE THAT OVERSEES THE APPROVAL OF PHARMACEUTICALS AND MEDICAL DEVICES, AND ANY OTHER INDIVIDUAL WHO HOLDS A POSITION OF TRUST. ON AN ANNUAL BASIS, HSHS DISCLOSES A COPY OF THE CONFLICT OF INTEREST POLICY (AND ALL CORRESPONDING PROCEDURES, GUIDELINES, FORMS, AND TOOLS) TO ALL COVERED PERSONS AND ADVISES ALL COVERED PERSONS IN WRITING OF ANY SUBSTANTIVE CHANGES TO THIS POLICY AND SUCH RELATED MATERIALS. COVERED PERSONS ARE REQUIRED TO REVIEW AND COMPLETE THE CORRESPONDING CONFLICT OF INTEREST STATEMENT. THE SYSTEM OFFICE VICE PRESIDENT - SYSTEM RESPONSIBILITY, VICE PRESIDENT - RISK & COMPLIANCE, OR MEMBERS OF THE AUDIT AND INTEGRITY COMMITTEE ("COMMITTEE") ARE AVAILABLE TO ANSWER ANY QUESTIONS A COVERED PERSON MAY HAVE. IN ADDITION, IF, AT ANY TIME AFTER SUBMITTING AN ANNUAL CONFLICT OF INTEREST STATEMENT, A COVERED PERSON BECOMES AWARE OF AN INTEREST THAT HE OR SHE WOULD HAVE HAD TO DISCLOSE AT THE ANNUAL INTERVAL, THE COVERED PERSON IS REQUIRED PROMPTLY TO DISCLOSE THE INTEREST TO THE COMMITTEE USING THE HSHS CONFLICT OF INTEREST DISCLOSURE STATEMENT. COMPLETED CONFLICT OF INTEREST STATEMENTS ARE SUBMITTED TO THE COMMITTEE, WHICH IS RESPONSIBLE FOR IDENTIFYING, ASSESSING, AND MANAGING CONFLICTS OF INTEREST THAT ARISE IN THE COURSE OF CONDUCTING THE AFFAIRS OF HSHS AND ITS AFFILIATES. IF THE COMMITTEE DETERMINES THAT A CONFLICT OF INTEREST EXISTS, THE CONFLICT OF INTEREST POLICY REQUIRES HSHS NOT TO ENGAGE IN, OR ENTER INTO A PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY UNLESS THE COMMITTEE OR, WHERE NECESSARY, THE BOARD OF DIRECTORS (ACTING THROUGH ITS DISINTERESTED MEMBERS), HAS INVESTIGATED ALTERNATIVES TO THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY AND, IN THE ABSENCE OF ALTERNATIVES THAT ARE IN THE BEST INTERESTS OF HSHS, HAS DETERMINED: 1. THAT, REGARDLESS OF WHETHER THE COVERED PERSON PARTICIPATES IN THE IMPLEMENTATION OF THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY; 2. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS IN THE BEST INTERESTS OF HSHS; 3. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS FAIR AND REASONABLE FROM THE PERSPECTIVE OF HSHS; AND 4. HSHS CANNOT OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. IN DETERMINING WHETHER A CONTRACT, TRANSACTION OR ARRANGEMENT IS FAIR AND REASONABLE TO HSHS, THE COMMITTEE SHALL CONSIDER, WHERE APPLICABLE: 1. APPRAISALS OR OTHER INDEPENDENT VALUATIONS OF THE FAIR MARKET VALUE OF THE CONTRACT, TRANSACTION, OR ARRANGEMENT; 2. INFORMATION REGARDING COMPARABLE CONTRACTS, TRANSACTIONS, OR ARRANGEMENTS BETWEEN UNRELATED PARTIES; 3. OFFERS FROM COMPARABLE COMPETING ENTITIES; AND/OR 4. STUDIES OF COMPARABLE COMPENSATION ARRANGEMENTS. IN ANY CASE IN WHICH THE COMMITTEE FINDS, AFTER TAKING THE STEPS DESCRIBED ABOVE, THAT HSHS SHOULD PARTICIPATE IN A PROPOSED TRANSACTION OR ARRANGEMENT DESPITE THE EXISTENCE OF A CONFLICT OF INTEREST, THE COMMITTEE SHALL DEVELOP, IMPLEMENT, MONITOR, AND ENFORCE COMPLIANCE WITH A CONFLICT MANAGEMENT PLAN FOR MANAGING THE CONFLICT OF INTEREST AS IT CONSIDERS NECESSARY FOR SUCH FINDINGS TO REMAIN VALID THROUGHOUT THE LIFE OF THE CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY. ALL CONFLICT MANAGEMENT PLANS SHALL: 1. STATE THAT THE COMMITTEE WILL OVERSEE, MONITOR, AND ENFORCE COMPLIANCE WITH THE PLAN THROUGHOUT THE COURSE OF THE STUDY AND SPECIFY MEANS FOR DOING SO, INCLUDING, WITHOUT LIMITATION, THAT THE APPROPRIATE INDIVIDUALS MUST PROVIDE THE COMMITTEE WITH WRITTEN REPORTS PERTAINING TO COMPLIANCE WITH THE CONFLICT MANAGEMENT PLAN, THAT THE COMMITTEE SHALL HAVE THE RIGHT TO AUDIT THE STUDY FOR SUCH COMPLIANCE AND THE RIGHT TO IMPOSE SANCTIONS FOR NON-COMPLIANCE; 2. STATE THAT THE PLAN MUST BE SHARED WITH COVERED PERSON WHOSE INTERESTS IT WAS DEVELOPED TO MANAGE; 3. STATE THAT THE PLAN MUST BE SHARED WITH, AND PERIODIC REPORTS ON COMPLIANCE WITH THE PLAN MUST BE PROVIDED TO, THE BOARD, SENIOR MANAGEMENT, AND/OR GOVERNMENT AGENCIES; AND 4. PROVIDE FOR SUCH OTHER MANAGEMENT STEPS AND MECHANISMS THE COMMITTEE CONSIDERS NECESSARY AND APPROPRIATE. IN ADDITION TO THE COMMITTEE, THE SYSTEM OFFICE VICE PRESIDENTS OF SYSTEM RESPONSIBILITY AND RISK & COMPLIANCE MAY RETAIN SUCH INDEPENDENT ADVISORS OR EXPERTS AS DEEMED NECESSARY TO ASSIST IN MAKING ITS DETERMINATIONS AND DECISIONS. IF THE COMMITTEE DETERMINES THAT THE CONTEMPLATED TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY CANNOT PROCEED DUE TO A CONFLICT OF INTEREST, THE COMMITTEE SHALL INFORM THE APPLICABLE COVERED PERSON OR DECISION-MAKING BODY OF SUCH DETERMINATION WITHIN ONE WEEK OF THE COMMITTEE MEETING AT WHICH THE CONTEMPLATED TRANSACTION WAS DISCUSSED. THE COMMITTEE SHALL DOCUMENT ITS REJECTION OF THE CONTEMPLATED TRANSACTION IN THE COMMITTEE'S MEETING MINUTES. Form 990, Part VI, Line 15a Process to establish compensation of top management official THE COMPENSATION COMMITTEE (COMMITTEE) IS COMPRISED OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE DEVELOPS A COMPENSATION PHILOSOPHY FOR THE SYSTEM AND ALL AFFILIATES. THE COMMITTEE SELECTS AND HIRES THE INDEPENDENT COMPENSATION CONSULTANT TO DEVELOP COMPARABILITY DATA AND ADVISE THE COMMITTEE DURING ITS DELIBERATIONS REGARDING ALL ELEMENTS OF TOTAL COMPENSATION FOR ALL DISQUALIFIED INDIVIDUALS. INTEGRATED HEALTHCARE STRATEGIES ("IHS"), THE CONSULTANTS UTILIZED BY THE COMMITTEE, USE DATA FROM MULTIPLE TAX-EXEMPT PEER GROUP SOURCES TO DETERMINE SALARY RANGES, INCENTIVE OPPORTUNITY RANGES AND BENEFITS FOR THE DISQUALIFIED INDIVIDUALS. IHS THEN ASSISTS THE COMMITTEE IN PREPARING CONTEMPORANEOUS DOCUMENTATION OF ALL ACTIONS. EACH COMMITTEE MEETING IS CONDUCTED WITH THE INTENT TO CREATE A REBUTTABLE PRESUMPTION OF REASONABLENESS FOR ALL ELEMENTS OF EXECUTIVE TOTAL COMPENSATION FOR THE DISQUALIFIED INDIVIDUALS. THE CHAIRMAN MAKES THIS DECLARATION AND ALSO INQUIRES IF THERE ARE ANY CONFLICTS OF INTEREST BY ANY ATTENDEES. ANY CONFLICTS ARE DISCLOSED AND THE COMMITTEE THEN ACTS IN A MANNER TO AVOID ANY CONFLICTED INDIVIDUAL PARTICIPATING IN ANY MANNER WHERE A CONFLICT MIGHT EXIST. AT THE END OF THE MEETING, THE COMMITTEE PREPARES CONTEMPORANEOUS MINUTES THAT RECORD ALL ACTIONS TAKEN DURING THE MEETING. Form 990, Part VI, Line 15b Process to establish compensation of other employees PLEASE SEE RESPONSE TO FORM 990, PART VI, LINE 15a. Form 990, Part VI, Line 19 Required documents available to the public BOARD-APPROVED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC AT THIS TIME. Form 990, Part IX, Line 11g Other Fees Purchased Services - Total Expense: 29510731, Program Service Expense: 26900034, Management and General Expenses: 2610697, Fundraising Expenses: ; Professional Fees - Total Expense: 6890104, Program Service Expense: 2244983, Management and General Expenses: 4645121, Fundraising Expenses: ; Contract Labor - Total Expense: 4517644, Program Service Expense: 4459588, Management and General Expenses: 58056, Fundraising Expenses: ; HSHS Shared Services Fee - Total Expense: 1925141, Program Service Expense: , Management and General Expenses: 1925141, Fundraising Expenses: ; Form 990, Part X, Line 11 POOLED INVESTMENT ACCOUNT THE ORGANIZATION'S CASH RESERVES ARE INVESTED IN A POOLED INVESTMENT ACCOUNT MAINTAINED BY HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"). PARTICIPATION IN THE POOLED INVESTMENT FUND IS LIMITED TO THE 501(C)(3) HOSPITALS AND HEALTH SERVICES ORGANIZATIONS SPONSORED BY HSHS. THE POOLED ACCOUNT CONSISTS OF CASH, EQUITY AND DEBT SECURITIES THAT ARE PUBLICLY TRADED. IN ACCORDANCE WITH THE PROVISIONS OF STATEMENT OF FINANCIAL ACCOUNTING STANDARDS ("SFAS") NO. 124, "ACCOUNTING FORCERTAIN INVESTMENTS HELD BY NOT-FOR-PROFIT ORGANIZATIONS", INVESTMENTS IN EQUITY SECURITIES WITH READILY DETERMINABLE FAIR VALUES AND ALL INVESTMENTS IN DEBT SECURITIES ARE REPORTED AT FAIR VALUE ON THE BALANCE SHEET. INCOME, REALIZED AND UNREALIZED GAINS AND LOSSES ARE POOLED AND ALLOCATED TO THE PARTICIPANTS. INDIVIDUAL COMPONENTS OF ASSETS AND REVENUE ARE NOT IDENTIFIED TO THE INDIVIDUALHOSPITAL PARTICIPANTS. Form 990, Part XI, Line 9 Other changes in net assets or fund balances Pension - 5317548; Affiliate Transfer - -13488344; Change in Fair Value Interest Rate Swaps - 62348; Change in Temporarily Restricted Net Assets - 2779179; Change in Permanently Restricted Net Assets - 50; Swap Payment - -3538; KIARA CLINICAL INTEGRATION NETWORK LLC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 261417684 HEALTHCARE IL -1762307 6257513 HSSI PHYSICIAN CLINICAL INTEGRATION NETWORK LLC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371668647 HEALTHCARE IL -950689 8580781 KCIN HSHS ACO LLC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 320465666 HEALTHCARE & SOCIAL ASSISTANCE IL -515297 146855 KCIN HOSPITAL SISTERS HEALTH SYSTEM 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371058692 HEALTHCARE IL 501(c)(3) Type III-FI NA false HOSPITAL SISTERS OF ST FRANCIS FOUNDATION 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371186514 HEALTHCARE IL 501(c)(3) 7 HSHS true HSHS SELF INSURANCE TRUST 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371120626 INSURANCE IL 501(c)(3) Type I HSHS true HOSPITAL SISTERS HEALTHCARE WEST INC 2661 COUNTY HIGHWAY 1 CHIPPEWA FALLS WI 54729 510157933 HEALTHCARE WI 501(c)(3) Type I HSSI true SACRED HEART HOSPITAL 990 WEST CLAIREMONT AVENUE EAU CLAIRE WI 54701 390807060 HEALTHCARE WI 501(c)(3) 3 HSSI true ST ANTHONY'S HOSPITAL 503 N MAPLE STREET EFFINGHAM IL 62401 370661233 HEALTHCARE IL 501(c)(3) 3 HSSI true ST NICHOLAS HOSPITAL 3100 SUPERIOR AVENUE SHEBOYGAN WI 53081 390808480 HEALTHCARE WI 501(c)(3) 3 HSSI true ST JOHN'S HOSPITAL 800 EAST CARPENTER STREET SPRINGFIELD IL 62769 370661238 HEALTHCARE IL 501(c)(3) 3 HSSI true ST JOSEPH'S HOSPITAL 9515 HOLY CROSS LANE BREESE IL 62230 371208459 HEALTHCARE IL 501(c)(3) 3 HSSI true ST JOSEPH'S HOSPITAL 2661 COUNTY HIGHWAY 1 CHIPPEWA FALLS WI 54729 390810545 HEALTHCARE WI 501(c)(3) 3 HSSI true ST MARY'S HOSPITAL 1800 E LAKE SHORE DRIVE DECATUR IL 62521 370661244 HEALTHCARE IL 501(c)(3) 3 HSSI true ST MARY'S HOSPITAL 111 SPRING STREET STREATOR IL 61364 362169181 HEALTHCARE IL 501(c)(3) 3 HSSI true ST MARY'S MEDICAL CENTER 1762 SHAWANO AVENUE GREEN BAY WI 54303 390818682 HEALTHCARE WI 501(c)(3) 3 HSSI true ST VINCENT HOSPITAL 835 S VAN BUREN GREEN BAY WI 51301 390817529 HEALTHCARE WI 501(c)(3) 3 HSSI true ST JOSEPH'S HOSPITAL 12866 TROXLER AVENUE HIGHLAND IL 62249 370663568 HEALTHCARE IL 501(c)(3) 3 HSSI true ST FRANCIS HOSPITAL 1215 FRANCISCAN DRIVE LITCHFIELD IL 62056 370661236 HEALTHCARE IL 501(c)(3) 3 HSSI true HOSPITAL SISTERS SERVICES INC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371163402 HEALTHCARE IL 501(c)(3) Type III-FI HSHS true HSHS MEDICAL GROUP INC 3215 EXECUTIVE PARK DRIVE SPRINGFIELD IL 62703 263956318 HEALTHCARE IL 501(c)(3) Type III-FI HSSI true HSHS WISCONSIN MEDICAL GROUP INC 3215 EXECUTIVE PARK DRIVE SPRINGFIELD IL 62703 264515959 HEALTHCARE WI 501(c)(3) Type III-FI HSSI true ORANGE CROSS AMBULANCE INC 919 ASHLAND AVENUE SHEBOYGAN WI 53081 391860942 HEALTHCARE WI 501(c)(3) 10 ST NICHOLAS true UNITY LIMITED PARTNERSHIP 2366 OAK RIDGE CIRCLE DE PERE WI 54115 391750729 HEALTHCARE WI 501(c)(3) 10 HSSI true PRAIRIE EDUCATION & RESEARCH COOPERATIVE 317 NORTH 5TH STREET SPRINGFIELD IL 62701 371157915 HEALTHCARE IL 501(c)(3) 4 HSSI true ST CLARE MEMORIAL HOSPITAL 855 S MAIN STREET OCONTO FALLS WI 54154 390848401 HEALTHCARE WI 501(c)(3) 3 HSSI true HSHS HOLY FAMILY HOSPITAL 200 HEALTHCARE DRIVE GREENVILLE IL 62246 370792770 HEALTHCARE IL 501(c)(3) 3 HSSI true UTLAUT MEMORIAL FOUNDATION 200 HEALTHCARE DRIVE GREENVILLE IL 62246 371140166 FUNDRAISING IL 501(c)(3) Type II HSSI true SHELBY MEMORIAL HOSPITAL FOUNDATION INC 200 SOUTH CEDAR STREET SHELBYVILLE IL 62565 371294401 FUNDRAISING IL 501(c)(3) Type I HSSI true HSHS GOOD SHEPHERD HOSPITAL INC 200 SOUTH CEDAR STREET SHELBYVILLE IL 62565 370512290 HEALTHCARE IL 501(c)(3) 3 HSSI true MEMORIAL AND ST ELIZABETH'S HEALTHCARE CANCER TREATMENT CENTER 4000 NORTH ILLINOIS STREET SWANSEA IL 62226 371312961 HEALTHCARE IL ST ELIZABETH'S Related 674729 4464307 false false 0.5 PRAIRIE HEART INSTITUTE ST JOHN'S 800 EAST CARPENTER STREET SPRINGFIELD IL 62769 371321197 HEALTHCARE IL HSHS Related 0 8000 false false 1 PAIN CENTER OF WISCONSIN 4131 W LOOMIS ROAD SUITE 300 GREENFIELD WI 53221 263155343 HEALTHCARE WI ST VINCENT Related 527290 608459 false false 0.5 PAIN CENTER OF WISCONSIN - 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