2018-05-12T12:14:21-05:00 2017-06-30 990 2016-07-01 352099320 ST VINCENT FRANKFORT HOSPITAL INC STVI 3147338000 1300 S JACKSON STREET FRANKFORT IN 460410669 Tonya Mershon Tax Officer 2017-10-13 2016 2022-09-23 18:48:47Z KRISTI L BLEDSOE 17367 N State Road 13 Elwood IN 46036 21858430 false X WWW.STVINCENT.ORG X 2000 IN To improve the health and well-being of all people in the communities we serve. X 8 4 124 74 0 0 136257 141394 22056894 21570851 295899 0 248292 146185 22737342 21858430 492 0 0 8270429 7331624 0 0 11791223 14093526 20062144 21425150 2675198 433280 50185575 6442804 3901242 7493625 46284333 -1050821 X Our Mission as part of a Catholic health care system is to further the healing ministry of Jesus by continually improving the health and well-being of all people, especially the poor, in the communities we serve. false true 19064266 0 21582769 St. Vincent Frankfort Hospital (SVFH) is a 25-bed, critical access hospital serving rural Clinton and contiguous counties and providing services without regard to patient race, creed, national origin, economic status, or ability to pay. SVFH provides inpatient and outpatient health care services with a 24 hour emergency department that is staffed with an on-site physician. During fiscal year 2017, SVFH treated 358 adults and children for a total of 1,213 patient days of service. The hospital also provided services for 27,114 outpatient visits, including 180 outpatient surgeries and 26,934 Emergency Room and Minor Care Visits. St. Vincent Frankfort Hospital provides the following hospital services: Diabetes Care, Emergency Medicine, Heart (Cardiovascular), Immediate Care, Laboratory, Maternity (Obstetrics), Pastoral Care, Radiology, Rehabilitation Therapy, Respiratory Care, Surgery, Women's Services. Some of these services operate at a loss in order to ensure that comprehensive services are available to the community. St. Vincent Frankfort transferred net assets to Indiana University Health on 5/31/17 and is in the process of winding up its affairs. 19064266 true true false true false false false false false false true false false true true true false true false false false false false false false false true true false false true false false false false false false false false false false false true false true true true false false true 26 0 true 124 true false false false false false false false false false false X 8 4 false false false false true true true true true false false false true true true true true false false false IN X Wayne R Knight 3174605178 6363 Fairfield St Whitestown IN 46075 KRISTI BLEDSOE INTERIM ADMINISTRATOR - CNO 40.0 0 X X 223230 0 33633 WAYNE R KNIGHT REGIONAL CFO 15.0 32.0 X X 0 238072 36723 JAMES MOORE CHAIRMAN 0.2 0 X X 0 0 0 RANDY RIDGWAY VICE-CHAIRMAN 0.2 0 X X 0 0 0 DON RUSK SECRETARY/TREASURER 0.2 0 X X 0 0 0 JOSEPH D DOMINIK MD DIRECTOR 0.2 55.0 X 0 137027 17330 BRETT EATON MD DIRECTOR 0.2 0 X 0 0 0 MARGARET M JOHNSON DIRECTOR 0.2 40.4 X 0 475368 26087 BRIAN E BRINKLEY Mgr-Imaging Svcs 40.0 0 X 107204 0 25775 DONALD H JACOBY Pharmacist-Staff 40.0 0 X 163473 0 11696 STEPHEN D THARP MD FORMER OFFICER (END 6/2015) 0.0 0.0 X 0 233143 37363 493907 1083610 188607 3 true true false EMCARE PHYSICIANS 7032 COLLECTION CTR DR CHICAGO IL 60693 PHYSICIAN SERVICES 811281 TX TEAM REHAB INC 4625 E STOP 11 RD INDIANAPOLIS IN 462379120 PT/OT SERVICES 725497 MID AMERICA CLINICAL LABORATORIES PO BOX 642263 PITTSBURGH PA 15264 LAB SERVICES 701802 RN SPECIALTIES INC 10333 N Meridian St 225 INDIANAPOLIS IN 46290 NURSING SERVICES 259005 4 16901 124493 141394 Net Patient Revenue 621990 21090126 21090126 Program revenue 621990 313950 313950 intercompany revenue 531120 166775 166775 0 0 0 0 21570851 60205 60205 0 60205 60205 0 0 Cafeteria Revenue 722514 73988 73988 Other Revenue 900099 11918 11918 Pharmacy Revenue 446110 74 74 0 0 0 0 85980 21858430 21582769 0 134267 256863 256863 5540985 4973034 567951 -17745 -15926 -1819 1256730 1127915 128815 294791 264575 30216 8496 7625 871 81500 81500 2012089 1805850 206239 0 9205 8261 944 81143 72826 8317 379 340 39 531180 476734 54446 14618 13120 1498 9094 8162 932 16621 14917 1704 432209 387908 44301 77845 77845 Purchased Services 3534057 3171816 362241 Maintenance and Repair 2549263 2287964 261299 Corporate Expense 2034535 1825995 208540 equipment rent 992379 890660 101719 1708913 1664645 44268 0 21425150 19064266 2360884 0 498642 99 2349333 1283333 0 0 0 372774 0 62896 239 233991 57418 3015506 176573 0 0 43886424 4982560 50185575 6442804 2273794 2170335 1627448 5323290 3901242 7493625 X 46245099 -1090048 39234 39227 46284333 -1050821 50185575 6442804 X 433280 -47768434 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 970 970 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY LOBBYING EXPENSES REPRESENT THE PORTION OF DUES PAID TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS THAT IS SPECIFICALLY ALLOCABLE TO LOBBYING. ST. VINCENT FRANKFORT HOSPITAL, INC. DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTION OR STATEMENTS) ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE. Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY LOBBYING EXPENSES REPRESENT THE PORTION OF DUES PAID TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS THAT IS SPECIFICALLY ALLOCABLE TO LOBBYING. ST. VINCENT FRANKFORT HOSPITAL, INC. DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTION OR STATEMENTS) ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE. 160146 160146 3036979 1203023 1833956 470 470 0 -5001482 -1146075 -3855407 2037878 2037878 176573 Intra/Intercompany AR 413941 Restricted Funds 39227 Miscellaneous Assets 14097 Estimated Settlements from Third-Party Payor 1088451 Other Receivables 3426844 4982560 INTERCOMPANY PAYABLES 2975635 Estimated Settlement to Third-Party Payor 1386690 Other Liabilities 239797 intercompany debt with ascension health alliance 473234 Pension and Other Post retirement Liability 247934 5323290 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote The System accounts for uncertainty in income tax positions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. The System has determined that no material unrecognized tax benefits or liabilities exist as of June 30, 2017. true true X true X 250 true X true true true false true true 1580175 1580175 0.0738 7126671 5226588 1900083 0.0887 0 0.0 0 0 8706846 5226588 3480258 0.1624 8 751 46812 0 46812 0.0022 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 3 2723 8429 0 8429 0.0004 11 3474 55241 0 55241 0.0026 11 3474 8762087 5226588 3535499 0.1650 0 0 0 0 0 0.0 1 180 3486 0 3486 0.0002 1 597 38289 0 38289 0.0018 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 0 0 0 0.0 2 777 41775 0 41775 0.0019 false 265606 79682 7401472 7328190 73282 X true true 1 1 St Vincent Frankfort Hospital Inc 1300 S Jackson Street Frankfort IN 460410669 http://www.stvincent.org 14-005039-1 X X X X St Vincent Frankfort Hospital Inc 1 false false true X X X X X X X X X 15 true true false true X https://www.stvincent.org/How-we-are-Different/Community-Assessment X true 15 true https://www.stvincent.org/How-we-are-Different/Community-Assessment false true X 250.0 400.0 X true true X X X true X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - St. Vincent Frankfort Hospital, Inc.. As federally required by the Affordable Care Act, the following is an overview of the methods and process used to identify and prioritize significant health needs in Clinton County, Indiana. St. Vincent Health contracted Healthy Communities Institute (HCI) to help facilitate their system wide CHNA work and document all efforts. The secondary data included over 100 community health and quality of life indicators covering over 20 topic areas. Health indicators for Clinton County were compared to other counties in Indiana and nationwide to score health topics and compare relative areas of need. Other considerations for health areas of need included trends over time, Healthy People 2020 targets, and disparities by gender and race/ethnicity. The needs assessment was further informed by interviews with community members who have a fundamental understanding of Clinton County's health needs and represent the broad interests of the community. Six key informants provided valuable input on the county's health challenges, the sub-populations most in need, and existing resources for county residents. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - st. vincent frankfort hospital, inc.. The hospital conducted its CHNA in conjunction with Community Health Network, Franciscan Health and Indiana University Health. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - ST. VINCENT FRANKFORT HOSPITAL, INC.. The St. Vincent FY 2017-2019 Implementation Strategy specifically addresses the following three SWHIPs: 1) Access to Health Services St Vincent Frankfort will use the RUAH Pathway Program to increase its reported number of completed pathways (i.e., verification from FSSA) in FY 2015 by 5% each year for FYs 2017-2019. Achieving this goal will contribute to the percentage of people who have health insurance in Clinton County. Specific action steps include the following: HAW assesses for eligibility and educates individuals about coverage options; HAW submits application and works through any issues or delays; and HAW verifies eligibility in order to complete the Pathway. 2) Exercise, Nutrition & Weight St. Vincent Frankfort will partner with a school and a food source to provide eligible students with a weekend backpack of nutritious food throughout the school year in order to reduce the school's number of families in FY 2018 who are food insecure (based on survey responses) by 5% at the end of FY 2019 (June 30, 2019). (NOTE: FY 2017 is the planning year for the program.) Specific action steps include the following: complete the Weekend Feeding Program Preparation Checklist; meet with all stakeholders to determine program logistics; plan the specifics of your program's protocol; make final preparations for the program's "go live" date in FY 2018; and distribute and collect surveys, enter survey data into software at the beginning and end of the school year (twice a year in FY 2018 and FY 2019). 3) Behavioral Health St. Vincent Frankfort will offer Rx for Change training at no charge to anyone who works in a health care setting to increase the proportion of training participants who screen and refer to the Indiana Tobacco Quitline by 10% by the end of FY 2019 (June 30, 2019). Achieving this goal will contribute to the percentage of tobacco users who have been screened and referred to the Indiana Tobacco Quitline. Specific action steps include the following: complete the Provider Training Checklist - Action Step #1; plan at least two Rx for Change trainings in your community in FY 2018 and ensure continuing education credits are available, if applicable (See Provider Training Checklist - Action Step #2); develop a strategy to promote trainings to the community; promote and offer at least two Rx for Change trainings at no charge to your community in FY 2018; enter FY 2018 baseline survey data into database within two weeks of each training; for FY 2019 - Repeat Action Steps #2-4 to plan, develop, and promote and offer at least two Rx for Change trainings at no charge to your community in FY 2019; and enter FY 2019 baseline survey data into database within two weeks of each training. Needs That Will Not Be Addressed The hospital is committed to improving community health by directly, and indirectly, addressing prioritized health needs. However, certain factors impact the hospital's ability to fully address all priority health needs. The needs listed below are not included in the hospital's implementation strategy plan for the following reasons: Transportation - This identified health need is not being monitored and evaluated in the Implementation Strategy due to limitations within the hospital's financials and human resources. However, St. Vincent Frankfort supports Healthy Communities of Clinton County Coalition and other organizations that are focusing on this issue. Maternal, Fetal & Infant Health - This issue is being addressed in the Access to Health Services priority. Education - This identified health need is not being monitored and evaluated in the Implementation Strategy because it is outside the scope of the hospital's core mission. However, the hospital provides a clinic site for the certified nurse assistant program in Clinton County. 0 Schedule H, Part I, Line 7 CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST COMMUNITY BENEFIT OVERVIEW St. Vincent Frankfort Hospital is part of St. Vincent Health, a non-profit healthcare system consisting of 20 locally-sponsored ministries serving over 57 counties throughout Central Indiana. Sponsored by Ascension Health, the nation's largest Catholic healthcare system, St. Vincent Health is one of the largest healthcare employers in the state. St. Vincent creates strong partnerships with businesses, community organizations, local, state and federal government. Working with its partners, and utilizing the CHNA completed every three years, St. Vincent Frankfort Hospital is committed to addressing community health needs and developing and executing an implementation strategy to meet identified needs to improve health outcomes within the community. Community benefit is not the work of a single department or group within St. Vincent Frankfort, but is part of the St. Vincent mission and cultural fabric. The hospital leadership team provides direction and resources in developing and executing the Implementation Strategy in conjunction with the St. Vincent Health Community Development & Health Improvement Department, but associates at all levels of the organization contribute to community benefit and health improvement. FINANCIAL ASSISTANCE As part of St. Vincent Health, the St. Vincent Frankfort vision is to deliver a continuum of holistic, high-quality services and improve the health of individuals and communities, with special attention to the poor and vulnerable. This is accomplished through a generous assistance policy which includes financial assistance at cost and unreimbursed cost of public programs. Patient Services for Poor and Vulnerable Hospital and outpatient care is provided to patients that cannot pay for services, including hospitalizations, surgeries, prescription drugs, medical equipment and medical supplies. Patients with income less than or equal to 250% of the Federal Poverty level (FPL) will be eligible for 100% charity care write off on that portion of the charges for services for which the patient is responsible following payment by an insurer, if any. At a minimum, patients with incomes above 250% of the FPL, but not exceeding 400% of the FPL, will receive a sliding scale discount on that portion of the charges for services provided for which the patient is responsible following payment by an insurer, if any. A patient eligible for the sliding scale discount will not be charged more than the calculated AGB (amounts generally billed) charges. Patients with demonstrated financial needs with income greater than 400% of the FPL may be eligible for consideration under a "Means Test" for some discount of their charges for services from the organization based on a substantive assessment of their ability to pay. Maximum owed by any patient per episode of care or account is 10% of gross household income. Hospital financial counselors and health access workers assist patients in determining eligibility and in completing necessary documentation. St. Vincent Frankfort Hospital is committed to 100% access, and is proactive in providing healthcare that leaves no one behind. Public Program Participation St. Vincent Frankfort Hospital participates in government programs including Medicaid, SCHIP (Hoosier Healthwise), Healthy Indiana Plan (HIP), the Health Insurance Marketplace and Medicare and assists patients in enrolling for programs for which they are eligible. Per Catholic Health Association guidelines and St. Vincent Health's conservative approach, Medicare shortfall is not included as community benefit. Community health improvement efforts must take a comprehensive approach and utilize diverse methods in order to reach intended audiences. As a system, St. Vincent works to improve the health of communities through a variety of approaches, including community health improvement services, health professions education, subsidIZed health services, generalizable research, and cash and in-kind contributions. During fiscal year 2017, St. Vincent Frankfort supported the community in the following ways: Community Health Improvement Services Community Health Education St. Vincent Frankfort Hospital provides health education on a number of topics and issues facing the local community throughout the year. The information is offered to the community through a variety of methods, which include, but are not limited to the following: health fairs, health promotion and wellness programs, lectures, school health education programs, and support groups. Social and Environmental Improvement Activities Programs and activities that improve the health of persons in the community by addressing the determinants of health, which include the social, economic and physical environment, which includes removal of harmful materials in public housing, participation in community coalitions to increase jobs with health insurance, and conducing a separate assessment for community disaster preparedness. Cash and In-Kind Contributions The hospital makes cash and in-kind contributions to a variety of organizations focused on improving the health status in the community. Examples include cash donations to nonprofits in response to natural disasters, event sponsorships focused on addressing an identified community health need, donation of employee time/services to outside organizations, and the representation of the hospital on community boards and committees. Community Benefit Operations Hospital staff dedicates significant time and costs to lead and manage community benefit programs and activities, which include internal tracking and reporting of community benefit. Funds are allocated to conduct a community health needs assessment and develop an implementation strategy. System Wide Health Improvement Priorities NOTE: FY17 will be the only year that this hospital works on this health need. The termination of lease agreement for St. Vincent Frankfort, Inc. was on May 30, 2017. FY17 was the first year of the three year SWHIP implementation strategy (FY17-19). Below is a year 1 update for each SWHIP: 1) Access to Health Services: The health advocate helped 329 people obtain medical insurance (FY17 goal=287; FY17 goal attainment=115%). As of June 30, 2017, the hospital has attained 36% of its overall enrollment goal for this three year cycle (n=904). The total community benefit for this health need in FY17 was $23,305. 2) Exercise, Nutrition & Weight: FY17 was structured as a planning year to increase the likelihood of program sustainability and success. In the first year of implementation, the hospital: * Completed a program checklist, which assisted in identifying a school (completed by 9/30/16). * Met with stakeholders to determine logistics (completed by 12/31/16). * Developed protocol describing how the weekend feeding program works and the hospital's role/contribution to the program over the three year cycle (completed by 3/31/17). The hospital's described its role/contribution as: - Partnered with the DECA club in the Frankfort School System to enhance the existing backpack program. Donated over $4,000 from both associates and the hospital ($1:$1 match up to $2,000) - Reported that these funds extend DECA's annual budget (~$12,000) & serve ~135 students * Sent a partner commitment letter to the school's principal outlining the hospital's contribution to the weekend feeding program in FY18 and FY19. This letter was signed by the hospital administrator then emailed and mailed via US Postal Service (completed by 5/31/17). The total community benefit for this health need in FY17 was $419; Staff time=11 hours. 3) Behavioral Health: The first year of this implementation cycle was designated as a planning year to increase the likelihood of program sustainability and success. During FY17, the hospital: * Completed a training checklist, which facilitated in identifying associates to become formally trained Rx for Change Trainers (completed by 9/30/16). * Sent an associate to attend an in-person Rx for Change "Train-the-Trainer" session. The associates can deliver the Rx for Change curriculum to any health care professional (completed by 2/16/17). * Developed a distribution list of possible training participants (completed by 3/31/17). The total community benefit for this health need in FY17 was $507; Staff time=10 hours. Schedule H, Part I, Line 1b MEDICAID OFFSETTING REVENUE Because St. Vincent Frankfort provides care for a significant share of individuals covered by Medicaid and other Government Means-Tested programs, it qualifies for state reimbursement (DSH payments) that helps to subsidize this care. In FY 17, St. Vincent Frankfort received DSH payments of $3,543,506. Had DSH payments of $3,543,506 not been received in FY 17, St. Vincent Dunn's Government Means-Tested Healthcare would be $5,443,589 and the total community benefit contribution for FY 17 would be $7,079,005. Schedule H, Part V, Section B, Line 17 Billing and Collection Policy During tax year 2017, the organization learned via verbal comments of IRS agents at public events that the IRS intends that the "readily obtainable" standard in the 501(r) regulations for the AGB calculation and billing and collection policy is only met if those items are posted to the organization's web site. The organization had interpreted that web posting standard to be a safe harbor after consulting with external counsel and tax advisors, and timely took other steps to make the information readily obtainable. Consequently, the organization does not believe its decision to not post these documents to its web site rises to the level of a failure, nor does it believe the circumstances were either willful or egregious, having otherwise timely taken the steps necessary to attain and continue to maintain compliance with the other requirements related to the billing and collection policy and the AGB, as part of its policies and procedures for ensuring compliance with all aspects of 501(r). However, the organization is making this voluntary disclosure in order to communicate to the IRS the changes it is undertaking in response to the recent IRS informal guidance on this specific point concerning the "readily obtainable" standard, and the fact that the organization has started the work necessary to post its AGB information and billing and collection policy to its web site and will complete those additional postings as soon as reasonably possible. The other web postings required under 501(r) (i.e., those related to the community health needs assessment and the financial assistance policy) were timely completed and continue to remain in place as required. The organization believes its safeguards worked as intended in this case (i.e., the organization has regular communications with a number of external law firms and tax consultants and the timely attention to the recent guidance was supported by the framework of regular access to subject matter experts). These changes are in the process of being incorporated into corporate policies and procedures that apply to the organization. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The cost of providing charity care, means tested government programs, and community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a cost accounting system that addresses all patient segments (for example, inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table. For the information in the table, a cost-to-charge ratio was calculated and applied. Schedule H, Part II Community Building Activities Extensive research has shown that social determinants, such as poverty level, education level, employment and housing, have significant impact on health outcomes, equal to or greater than the impact of health care, health education and direct health behaviors. Efforts to improve health within our communities must include both traditional community benefit activities that directly address health outcomes as well as community building activities that address some of the underlying factors that help to determine the overall health and well-being of individuals and communities served. An example of community building is the Back to School Program which provides school supplies and back packs for children. Purchasing school items can be a financial burden which affects the mental and physical health of families. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Corporation follows established guidelines for placing certain past-due patient balances within collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Corporation's policies. After applying the cost-to-charge ratio, the share of the bad debt expense in fiscal year 2017 was $761,703 at charges, ($265,606 at cost). Schedule H, Part III, Line 3 Bad Debt Expense Methodology The provision for doubtful accounts is based upon management's assessment of expected net collections considering economic conditions, historical experience, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote The organization is part of the Ascension Health Alliance's consolidated audit in which the footnote that discusses the bad debt expense is located on page 19. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs A cost to charge ratio is applied to the organization's Medicare Expense to determine the Medicare allowable costs reported in the organization's Medicare Cost Report. Ascension Health and its related health ministries follow the Catholic Health Association ("CHA") guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance The organization has a written debt collection policy that also includes a provision on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance. If a patient qualifies for charity or financial assistance certain collection practices do not apply. Schedule H, Part VI, Line 2 Needs assessment St. Vincent Frankfort Hospital uses reliable, third party reports, including data from government sources to assess the health care needs of the communities it serves. These reports provide information about key health, socioeconomic and demographic indicators that point to area of need and include but are not limited to reports from Indiana State Department of Health, Indiana Business Research Center at Indiana University, U.S. Census Bureau, Alliance for a Healthier Indiana, Tobacco Prevention & Cessation Commission and Indiana Hospital Association. St. Vincent Frankfort Hospital utilizes information from these secondary sources to develop programs and provide services throughout the region. In addition, St. Vincent Frankfort Hospital considers the health care needs of the overall community when evaluating internal financial and operational decisions. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance St. Vincent Frankfort Hospital communicates with patients in multiple ways to ensure that those who are billed for services are aware of the hospital's financial assistance program as well as their potential eligibility for local, state or federal programs. Signs are prominently posted in each service area, and bills contain a formal notice explaining the hospital's charity care program. In addition, the hospital employs financial counselors, health access workers, and enrollment specialists who consult with patients about their eligibility for financial assistance programs and help patients in applying for any public programs for which they may qualify. Schedule H, Part VI, Line 4 Community information St. Vincent Frankfort Hospital is located in Frankfort, Indiana. St. Vincent Frankfort serves Clinton and contiguous counties, in Northwest Central Indiana. Clinton is a rural county with an estimated population of 32,800. The most common industry in Clinton County is manufacturing. According to the 2015 County Health Rankings, Clinton County ranks 53rd out of 92 Indiana counties. Clinton County demographics are similar but slightly more diverse than the overall Indiana state population. Approximately 15% of Clinton County residents are Hispanic or Latino, compared with only 6.7% in Indiana state, and 11.8% of Clinton County residents speak Spanish at home. The median household income is on par with the state at about $49,000 annually, and roughly 11% of Clinton county families are living in poverty, which is slightly lower than the state. Clinton County's uninsured rate is 15% which is higher than the state's rate of 14%. By the Indiana State Department of Health and U.S. Department of Health and Human Services, Clinton County is not designated as a Medically Underserved Area (MUA) and Population (MUP) as of December, 2016. Schedule H, Part VI, Line 5 Promotion of community health St. Vincent Frankfort Hospital's governing body is comprised of persons representing diverse aspects and interests of the community. Many members of St. Vincent Frankfort Hospital's governing body reside in the organization's primary service area; who are neither employees nor independent contractors of the organization, nor family members thereof. The organization extends medical staff privileges to all qualified physicians in its community for some or all of its departments or specialties and applies surplus funds to improvements in patient care, medical education, and research. Schedule H, Part VI, Line 6 Affiliated health care system St. Vincent Frankfort Hospital is an affiliate of St. Vincent Health system and Ascension Health. St. Vincent Frankfort affiliates are large multi-faceted, integrated, not-for-profit ministries including hospital and non-hospital ministries (physician group practices, hospital organizations, research, home health, durable medical equipment and senior facilities). These ministries work together to care for patients, joined by common systems and a philosophy of serving as a healing presence with special concern for our neighbors especially those who are vulnerable. This community benefit happens through its focus on patient care, education and research. The organizations work together to serve their communities at the local, regional, state, and national level. Ascension Health Alliance, D/B/A Ascension (Ascension), is a Missouri nonprofit corporation formed on September 13, 2011. Ascension is the sole corporate member and parent organization of Ascension Health. A Catholic national health system consisting primarily of nonprofit corporations that own and operate local healthcare facilities, or health ministries, located in 23 of the United States and the District of Columbia. Ascension is sponsored by Ascension Sponsor, a public juridic person. The participating ORGANIZATIONS/ENTITIES of Ascension sponsor are the Daughters of Charity of St. Vincent De Paul, St. Louise Province; The Congregation of St. Joseph; The Congregation of the Sisters of St. Joseph of Carondelet; The Congregation of Alexian Brothers of the Immaculate Conception Province, Inc. - American Province; and the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi - US/Caribbean Province. As part of St. Vincent Health, St. Vincent Frankfort Hospital is dedicated to improving the health status and quality of life for the communities it serves. While designated associates at St. Vincent Frankfort Hospital devote time to leading and administering local community-based programs and partnerships, associates throughout the organization are active participants in community outreach. They are assisted and supported by designated St. Vincent Health Community Development & Health Improvement associates and other support staff who work with each of its healthcare facilities to advocate for and provide technical assistance for community outreach, needs assessments and partnerships as well as to support regional and state-wide programs, community programs sponsored by St. Vincent Health in which St. Vincent Frankfort Hospital participates. false true false false false false false false false KRISTI BLEDSOE INTERIM ADMINISTRATOR - CNO 151848 0 70508 0 874 0 14711 0 18922 0 256863 0 0 0 WAYNE R KNIGHT REGIONAL CFO 0 174300 0 61221 0 2551 0 13341 0 23382 0 274795 0 0 JOSEPH D DOMINIK MD DIRECTOR 0 76099 0 58886 0 2042 0 7781 0 9549 0 154357 0 0 MARGARET M JOHNSON DIRECTOR 0 318261 0 149912 0 7195 0 16574 0 9513 0 501455 0 0 STEPHEN D THARP MD FORMER OFFICER (END 6/2015) 0 207100 0 23529 0 2514 0 15124 0 22239 0 270506 0 0 DONALD H JACOBY Pharmacist-Staff 140080 0 19900 0 3493 0 9229 0 2467 0 175169 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation St. Vincent Health, Inc., a related organization of St. Vincent Frankfort Hospital, Inc., uses the following to establish the compensation of the organization's CEO/Executive Director: - Compensation committee - Independent compensation consultant - Compensation survey or study - Approval by the board or compensation committee Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Eligible executives participate in various non-qualified deferred compensation plans organized under Code Section 457(f). The exact purpose of each plan varies but they include: compensation limitation make-up plans, voluntary deferral plans, deferral of a portion of incentive bonus type plans, etc. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. No payments were made to listed persons in Part VII under the various non-qualified deferred compensation plans during the year. CASH ACCOUNTS TRANSFERRED TO PARENT'S BALANCE SHEET 2016-07-01 43600548 FMV 453358926 ASCENSION HEALTH ALLIANCE PO BOX 45998 ST LOUIS MO 63145 501(C)(3) false false false false Schedule N, Part II CASH TRANSFER ST. VINCENT FRANKFORT HOSPITAL, INC. TRANSFERRED ITS BEGINNING HSD CASH BALANCES TO ASCENSION HEALTH ALLIANCE (45-3358926) AS OF JULY 1, 2016. Form 990, Part III, Line 3 Significant changes in program services St. Vincent Frankfort transferred net assets to Indiana University Health on 5/31/17 and is in the process of winding up its affairs. Tax Exempt Bond Issuance St. Vincent Frankfort Hospital, Inc. is a health facility that is part of Ascension Health System. Ascension Health is the borrower for tax exempt hospital revenue bonds. St. Vincent Frankfort Hospital, Inc. holds an intercompany note payable with Ascension Health, and this information is reported on the balance sheet. Form 990, Part IV, Line 20b Audited financial statements The activity of ST. VINCENT FRANKFORT HOSPITAL, INC is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of ST. VINCENT FRANKFORT HOSPITAL, INC is completed. Therefore, the attached audited financial statements are of Ascension Health Alliance and Affiliates, which include the activity of ST. VINCENT FRANKFORT HOSPITAL, INC. Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL THE PROCESS OF DETERMINING THE AMOUNT OF COMPENSATION PAID TO THE ORGANIZATION'S CEO, EXECUTIVE DIRECTOR OR TOP MANAGEMENT OFFICIAL IS PERFORMED BY ST. VINCENT HEALTH, INC. AND ITS SUBSIDIARY ORGANIZATIONS. ST. VINCENT HEALTH, INC. IS THE SOLE CORPORATE MEMBER OF ST. VINCENT FRANKFORT HOSPITAL INC. THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE ORGANIZATION'S CEO, EXECUTIVE DIRECTOR OR TOP MANAGEMENT OFFICIAL'S SALARY WAS COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE MINUTES. THE INDIVIDUAL WAS NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. Form 990, Part VI, Line 15b PROCESS TO ESTABLISH COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES THE PROCESS OF DETERMINING THE AMOUNT OF COMPENSATION PAID TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES IS PERFORMED BY ST. VINCENT HEALTH, INC. AND ITS SUBSIDIARY ORGANIZATIONS. ST. VINCENT HEALTH, INC. IS THE SOLE CORPORATE MEMBER OF ST. VINCENT FRANKFORT HOSPITAL, INC. THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OFFICERS' SALARIES WERE COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE MINUTES. INDIVIDUALS WERE NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. Form 990, Part VI, Line 6 Classes of members or stockholders St. Vincent Frankfort Hospital, Inc. has a single corporate member, St. Vincent Health, Inc. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body St. Vincent Frankfort Hospital, Inc. has a single corporate member, St. Vincent Health, Inc. who has the ability to elect members to the governing body of St. Vincent Frankfort Hospital, Inc. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders All decisions that have a material impact to St. Vincent Frankfort Hospital, Inc.'s financial information or corporation as a whole are subject to approval by its sole corporate member, St. Vincent Health, Inc. Form 990, Part VI, Line 11b Review of form 990 by governing body DURING THE RETURN PREPARATION PROCESS, THE TAX DEPARTMENT WORKS WITH OTHER FUNCTIONAL AREAS INCLUDING FINANCE, ACCOUNTING, TREASURY, LEGAL, HUMAN RESOURCES, AND CORPORATE COMPLIANCE FOR ADVICE, INFORMATION AND ASSISTANCE IN ORDER TO PREPARE A COMPLETE AND ACCURATE RETURN. UPON COMPLETION, THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S INTERNAL TAX DEPARTMENT WHICH CONSISTS OF ATTORNEYS AND CPAS. A COMPLETE FINAL COPY OF THE RETURN IS PROVIDED TO THE ORGANIZATION'S PRESIDENT, FINANCIAL OFFICER, AND/OR OTHER KEY OFFICERS IN LIEU OF THE FULL BOARD. Form 990, Part VI, Line 12c Conflict of interest policy The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Line 19 Required documents available to the public The organization will provide any documents open to public inspection upon request. Form 990, Part XI, Line 9 Other changes in net assets or fund balances FAS 158 PENSION LIABILITY - -263577; TRANSFER TO AFFILIATES - -3904309; TRANSFER TO ALPHA FUND AS OF 7/1/2016 - -43600548; Form 990, Part XII, Line 2c oversight of audit or selection of independent accountant ST. VINCENT FRANKFORT HOSPITAL, INC. is included in the consolidated financial statements of Ascension Health Alliance. The Finance and Audit committee of Ascension Health Alliance's Board assumes responsibility for the consolidated organization as a whole. 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